As one of the most common chronic diseases of the oral cavity, caries gradually accumulate over the lifetime and affect approximately 80% of the world population. The epidemiological characteristics of the disease are specific in terms of regional distribution, temporal distribution and population distribution. Caries prevalence and mean decayed, missing and filled permanent teeth (mean DMFT) scores are the most commonly used indexes in oral epidemiology. Caries prevalence is used to describe the frequency of caries over a certain period of time. In addition, DMFT scores reflect the severity of caries in the population. The caries prevalence and the severity of caries are assessed as part of a dynamic process. In developing countries, caries prevalence is higher among urban populations than among rural populations. Currently, the epidemic characteristics of caries in urban and rural areas are changing, and the caries prevalence of urban residents is lower than that of rural residents. This article is a chronological review of the Oral Health Epidemiological Surveys of China from 1983 to 2015, the Preventive Dentistry study and other related studies. It is concluded that the epidemic characteristics of caries in urban and rural areas in China have changed from a higher caries prevalence in urban areas compared to that in rural areas to a lower caries prevalence in urban areas compared to that in rural areas. Several factors, such as the dynamic development of differences in dietary habits, economic levels and access to oral medical resources of urban and rural residents might have led to changes in caries prevalence in urban and rural areas. The caries prevalence of rural residents has increased greatly, which indicates that the caries prevention efforts of the relevant departments should be focused more on rural areas in the future.
Clinical trials are the key step in verifying the effectiveness, safety and usability of novel oral medical devices. With improvements in invention capability, the number of clinical trials of medical devices has steadily increased domestically, indicating the need for new requirements for quality management. Here, on the basis of summarizing the characteristics of clinical trials for oral medical devices in China, we proposed a whole-process quality-control model for good clinical practice (WQGCP). This model clarified the management specifications for oral medical device clinical trials in the new era. It indicates that the clinical trial design is the breakthrough point, while whole-process risk control is the key point. This suggests the need for the establishment of a quality management cooperation system, evaluation and postevaluation systems and the training of high-level personnel who conduct clinical trials. It also provides suggestions to promote the participation of oral clinicians in high-quality research and invention of novel clinical medical devices with the aim of accelerating the development of oral medical devices in China.
Objective To investigate the effects of different doses of aspirin on the early osteointegration of titanium alloy implants in the femurs of rats to provide a reference for dental implantation in patients who take aspirin.Methods Forty-eight 8-week-old SD male rats were randomly divided into four groups, namely, the control, A, B, and C groups. Forty-eight Ti-6Al-4 V implants with a diameter of 1.4 mm and a length of 6 mm were implanted at the distal end of the right femur. In the A, B, and C groups, dosages of aspirin of 8.93 mg/kg/d, 17.86 mg/kg/d, and 26.79 mg/kg/d were administered by gavage starting on the day of surgery, and the control group was given similar doses of 0.9% saline. HE, Masson, BMP-2 immunohistochemical and TRAP staining evaluations were performed in the 2nd and 4th weeks after surgery.Results Compared with the results in the control group, the HE staining results showed that the amount of new bone formation was reduced, the trabeculae were more sparse, and the bone marrow cavity was enlarged around the implants in the B and C groups, with the C group showing the most obvious effects. The Masson staining results showed that, compared with that in the control group, the red-stained area in the new bone tissue around the implant was reduced in groups B and C, and the reduction in group C was more significant. However, there was no significant difference between group A and the control group. The BMP-2 staining results indicated that the expression of BMP-2 was not significantly different between the control group and the A group (P > 0.05), and the expression in group C was lower than that in the other groups (P < 0.05). The TRAP staining results demonstrated that the number of positive cells per unit area was decreased sequentially in the control, A, B, and C groups, and the difference was statistically significant (P < 0.05).Conclusion Aspirin may reduce the formation of bone tissue by inhibiting the activity of osteoblasts and expression in osteoclasts. This effect on osteogenesis was aspirin dose-dependent, and large doses of aspirin can inhibit osteogenesis more significantly.
Objective To investigate the effects of srtA on the oxidation tolerance of the Streptococcus mutans UA159 strain and to explore the potential mechanism. Methods The oxidation tolerance in the planktonic state and biofilm state were compared among UA159, the srtA-deleted strain and the complementary strain through oxidative tolerance experiments. The RNA-sequencing data from both the exponential and stationary phases of UA159 and the srtA-deleted strain were obtained by using the Illumina HiSeq 4 000 sequencing platform to determine the impact of srtA knockout on S. mutans genomic transcription. We compared the differences in the transcriptional expression of oxidative tolerance-related genes between the UA159 strain and the srtA gene deletion strain and further explored the intrinsic relationship between the changes in oxidative tolerance and the genetic transcriptome. qPCR was used to verify the changes in the expression level of oxidation tolerance-related genes. Results The oxidation tolerance of the srtA-deleted strain decreased significantly in both the planktonic state and the biofilm state compared to that of UA159 (P < 0.05). A total of 33 oxidation tolerance-related genes were differentially expressed according to transcriptome sequencing. There was no significant change in the expression of peroxide synthesis- and metabolic-related enzyme genes, but in the stationary phase samples, the two-component signal transcription systems lrgA, lrgB, and lytT were significantly downregulated (2.2- to 2.4-fold) in the srtA-deleted strain. qPCR further confirmed that in both the exponential and stationary phases, lrgB and lytT expression in the planktonic state was reduced 11.01-53.51-fold, while the expression of the other two-component system-encoding gene vicK was reduced by 6.57-10.88-fold (P < 0.001). Conclusion SrtA gene deletion did not change the expression level of peroxide synthesis-related and metabolic enzyme-encoding genes but downregulated the expression of the associated transcription regulation factors to reduce the oxidation tolerance of S. mutans.
Objective To investigate the clinical characteristics of salivary gland tumors and their pathological types.Methods Data from 2 456 patients with salivary gland tumors diagnosed between January 1973 and December 2018 at Sun Yat-sen Memorial Hospital of Sun Yat-sen University were collected, and their gender, age and tumor pathological type, location, and benign and malignant composition ratios were retrospectively analyzed.Results Over the 46-year study period, 2 456 patients with salivary gland tumors were treated; 41.9% were female, and 58.1% were male. The peak incidence was found among the 40 to 60 years of age group, in which 593 (24.1%) patients had malignant tumors and 1 863 (75.9%) had benign tumors. The ratio of benign and malignant tumors was 3.1∶1. The top two most common benign tumors were pleomorphic adenoma (58.7%) and Warthin tumors (33.6%). The top two most common malignant tumors were mucoepidermoid carcinoma (27.7%) and adenoid cystic carcinoma (26.1%). The most common sites of benign pleomorphic adenomas were the parotid glands, palate, and submandibular glands. Mucinous epidermoid carcinomas in malignant tumors were common in the parotid glands and small salivary glands. The incidence of salivary gland tumors in this group has increased each year, and this group accounted for 53.3% of the total cases over the past 10 years.Conclusion The number of patients with salivary gland tumors is increasing each year. The total incidence of salivary gland tumors is higher in men than in women. Large salivary gland tumors are mainly benign tumors, and small salivary gland tumors are more common. Polymorphic adenomas, Warthin tumors, and mucoepidermoid carcinomas are the most common tumor types; patients 40~60 years old are most likely to have benign salivary glands and have a high incidence of malignant tumors.
Objective To compare the analgesic effect and safety of bilateral inferior alveolar nerve block combined with parecoxib sodium analgesia and simple intravenous analgesia pump in analgesia after orthognathic surgery.Methods Forty patients with simple ascending sagittal split osteotomy and ankle plasty were randomly divided into the experimental group and the control group, with 20 patients in each group. The experimental group received 2 mL 1% ropivacaine by inferior alveolar nerve block anesthesia on both sides. Immediately after surgery, parecoxib sodium 40 mg was intravenously administered. The control group was given an intravenous analgesia pump for analgesia. Pain intensity (VAS pain score) and Ramsay sedation score were recorded at 2 h, 4 h, 8 h, 24 h, 48 h after operation, and the incidence of postoperative adverse reactions was observed.Results There was no significant difference in pain intensity and Ramsay sedation score between the two groups at each time point (P>0.05). During the analgesic treatment, the incidence of nausea and vomiting in the experimental group was significantly lower than that in the control group (P<0.05).Conclusion Bilateral inferior alveolar nerve block combined with parecoxib sodium analgesia and simple intravenous analgesia pump are effective for analgesia after mandibular orthognathic surgery, but the former has a lower incidence of adverse reactions, more suitable for analgesia after mandibular orthognathic surgery.
Objective The purpose of this study was to investigate the relevant social and environmental factors affecting the occurrence of periodontal diseases during pregnancy in pregnant women and to analyze the influence of the periodontal status of women in the second trimester of pregnancy on small for gestational age (SGA) delivery.Methods A total of 215 pregnant women were enrolled in this study in the Department of Periodontology of the West China Hospital of Stomatology of Sichuan University from May 2015 to May 2018. Periodontal parameters, such as bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL), were recorded at 16-24 weeks of gestational age. Subjects were divided into the periodontitis (n=32) group, gingivitis (n=171) group and periodontally healthy (n=12) group according to their periodontal conditions. With the patient′s informed consent, the patient decided whether to receive periodontal treatment. Basic and socioeconomic information was collected through questionnaires. After delivery, subjects were divided into the SGA group and non-SGA group according to their birth results. The periodontal clinical indicators, questionnaire results and delivery results were compared among the groups.Results The mean PD (P=0.005, r=-0.192) and BOP% (P=0.003, r=-0.199) were negatively correlated with economic income. The family income in the periodontitis group was significantly lower than that in the healthy group and the gingivitis group (P < 0.05). The flossing use rate was significantly higher in the healthy group than that in the gingivitis group (P < 0.05). A total of 106 pregnant women received scaling and root planing, while 109 patients only received oral hygiene instruction. After delivery, SGA occurred in 23 cases (10.7%), and there were no significant difference in SGA incidence among the three groups (P > 0.05). PD ≥ 5 mm% and PD ≥ 4 mm% (P < 0.05) were significantly higher in the SGA group than in the non-SGA group. There was no significant difference in SGA incidence between the treated group and the untreated group (P > 0.05).Conclusion Family income and dental flossing use have an impact on the incidence of periodontal diseases during pregnancy. The severity of periodontitis in pregnant women is correlated with the incidence of SGA.
Objective To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease.Methods A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss.Results The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05).Conclusion The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.
Primary cilia are organelles present on most mammalian cells that sense environmental changes and transduce signaling, and they are the key coordinators of various signaling pathways during tissue development. This article reviews the progress of research on the distribution of primary cilia in tooth development and the related signaling pathways. A literature review shows that in odontogenesis, primary cilia play an important role in the mutual induction of the epithelium and mesenchyme; during the continuous proliferation and differentiation of cells, the distribution of primary cilia is temporally and spatially dependent. Although the reason for this distribution is still unclear, some experimental evidence indicates that this phenomenon is compatible with the function of cells and tissues in which primary cilia are distributed. Primary cilia are involved in the regulation of two important signaling pathways, Hedgehog and Wnt, in odontogenesis. Genes encoding cilia (such as Kif3a, Evc/Evc2 and Ift) can affect the development of teeth by regulating these two signaling pathways, and there is an interaction between the two signaling pathways. Deletion of related genes (such as Ofd1 and Bbs) can damage the transmission of upstream and downstream signals by damaging the structure or function of cilia, thereby causing various types of dental dysplasia, including small teeth, enamel hypoplasia, missing teeth, or craniofacial deformities.
Inflammation of the oral mucosa induced by radiotherapy and/or chemotherapy may cause pain, difficulty speaking and swallowing, an increased risk of local and systemic infections, and even interrupt cancer treatment, which can seriously affect a patient′s quality of life. The pathogenesis of oral mucositis is complicated. There is still a lack of prevention and treatment modalities for oral mucositis in the clinic. Animal models play a vital role in exploring the pathogenesis of oral mucositis and developing better prevention and treatment methods. This article reviews the current research progress on the establishment and assessment of animal models of oral mucositis. The literature review results showed that animal models of oral mucositis have been established, such as mouse, rat, and gold hamster models. In the replication of animal models, radiotherapy-induced oral mucositis is generally induced by local single-dose or fractionated irradiation using X-ray equipment, either alone or in combination with the chemotherapy drugs 5-fluorouracil or cisplatin; cesium can also be used used as a radioactive source for local irradiation. Oral mucositis induced by the chemotherapy drug 5-fluorouracil alone is generally mild, so 5-fluorouracil was combined with mechanical trauma or acetic acid. The main methods for assessing oral mucositis are gross observation as well as histopathological observation.
There are many kinds of medical facial protective equipment with different functions. However, due to the lack of recognition of the hazards of facial occupational exposure, an incomplete understanding of the functions and effects of protective equipment and a lack of awareness, the proportion of staff that wear protective equipment in the Department of Stomatology is low. In this paper, the harmful and protective effects of face occupational exposure of dental staff were reviewed. A literature review showed that with the increasing prevalence of infection with AIDS, hepatitis B, hepatitis C and multidrug resistant bacteria in recent years, the occupational infection rate of medical staff in the Department of Stomatology has increased. The noise generated during oral treatment and the light from photosensitive curing lamps and treatment or surgical lasers can also cause occupational damage to hearing and vision. Face protection measures lack comprehensive functioning, and there is a lack of products that can be easily worn, indicating that the functions of face protection products need to be improved and strengthened. To minimize occupational infection and injury, we should not only improve the existing protective equipment but also improve personal protection awareness through advertising and education and comprehensively explore effective measures to improve occupational safety to ultimately achieve safe and high-quality medical services.
The method of placing an implant immediately into the fresh extraction socket at the same time as tooth extraction has the advantages of reducing the number of operations and the overall treatment time, making full use of the existing bone mass, and resulting in ideal aesthetic effects. However, immediate implant placement also has its own inherent shortcomings. Due to the existence of the extraction socket, it is difficult to close the wound; because the size of the implant does not match the size of the extraction socket, it is difficult to achieve good initial stability, and there is a risk of soft tissue recession. This article reviews the success rate, indications and expansion of immediate implant placement, surgical requirements, complications and the prevention and treatment of anterior teeth in the aesthetic area. A literature review showed that the 5-year success rate of immediate implant placement was over 95%. The indications included intact socket walls, a facial bone wall at least 1 mm in thickness, the presence of thick, soft tissue, the absence of acute infection at the site, and the availability of bone apically and lingually to the socket to provide primary stability. In addition, in recent years, with the improvement of surgical implantation technology and the improvement of bone substitute material performance, immediate implant placement can be used as one of the conventional methods for oral implantation treatment, and its indications have shown a trend toward expansion. Immediate implant placement also has complications, including poor placement of implants and gingival receding that results in poor aesthetic outcomes. In addition, immediate restoration and conventional loading protocols after immediate implant appear to have similar outcomes and result in better aesthetic effects. However, the long-term stability and patient satisfaction after immediate implant placement in terms of soft tissue aesthetics require more research.
Early tongue cancer is more prone to occult lymphatic metastasis than other oral cancers. Therefore, the decision of whether to perform neck dissection in the early stage of tongue cancer has been a controversial issue among many scholars. To accurately evaluate the neck condition of patients and determine whether neck dissection should be performed, this article reviews evaluation factors such as sex, age, tumor site, preoperative auxiliary examination results, depth of invasion, pathological grade, and nerve, lymphatic and vascular invasion. A literature review showed that the cervical lymphatics of early tongue cancer mainly migrated to regionsⅠ,Ⅱ and Ⅲ, and distant metastasis was rare. The cervical lymphatics of early tongue cancer were mainly affected by the depth of invasion, pathological grade, and nerve, lymphatic and vascular invasion. To achieve a high survival rate for patients with early tongue cancer, patients with preoperative ultrasound or MRI showing a tumor invasion depth of more than 5 mm, a tumor with a higher pathological grade, and clinical symptoms such as numbness or pain who are in stage T1 and T2 and who have already have nerve and vascular lymphatic infiltration according to the frozen sectioning results should be considered for primary simultaneous cervical lymphatic dissection.
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