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20 September 2020, Volume 28 Issue 9
    

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    Expert Forum
  • XU Shulan,GUO Zehong,NING Yingyuan,GAO Yan
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 545-550. https://doi.org/10.12016/j.issn.2096-1456.2020.09.001
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    The crown-root ratio (C/R) theory of natural teeth has been widely recognized in the field of stomatology,and has important clinical significance in predicting and assessing the prognosis?of natural teeth as well as for abutment selection during denture restoration. In the past few decades, scholars have advocated for the implantation of implants as long in length as possible to improve the success rate according to the theory of crown-root ratio of natural teeth. However, with the application of short implants, our philosophy of implantation has changed, and the relationship between the crown-implant (C/I) ratio and complications has become one of the current research hotspots. In this paper, the concept of the crown-implant ratio, the research progress of the C/I ratio, the implant survival rate and clinical complications of implant?restoration were reviewed and summarized, and the following suggestions were put forward: although most studies have shown no significant correlation between the C/I ratio and implant survival or marginal bone loss, this relationship may increase the risk of mechanical complications. A C/I < 3 and a crown length < 15 mm are recommended in implant restoration; when ultra-short implants are applied, the implant system can increase the bone-to-implant contact area, and splint prostheses such as crown or bridge are recommended.

  • RONG Mingdeng,ZHOU Tengfei
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 551-561. https://doi.org/10.12016/j.issn.2096-1456.2020.09.002
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    Maxillary sinus membrane lesions have been broadly detected before implant surgery in the posterior maxilla region, resulting in uncertainty regarding maxillary sinus floor elevation surgery. In this context, we composed this commentary article based on the current literature and the clinical experience of our department. We discuss the common lesion types shown by CBCT including membrane pathological thickening, polyps/cystic lesions and air-liquid level in the sinus. Maxillary sinus floor elevation surgery can be conducted in patients with membrane thickening of 2-5 mm or with polyps/cysts of less than half of the sinus height (because the above symptoms have little influence on the outcome of surgery). Membrane thickening of more than 5 mm with ostium obstruction, antrochoanalpolyps, mucoceles and cysts of more than half of the sinus height should be carefully treated. Different treatments can be performed such as conducting elevation surgery while retaining the cyst, removing the cyst before surgery or removing the cyst during surgery based on the cyst type and size, inflammation, patency of the ostium, etc. Antibiotics-anti-inflammatory-aspiration, surgical debridement and oral lesions eliminations are generally used for treating post-operative sinusitis. Presurgical radiographic evaluation is the key to diagnosing and treating these membrane lesions. We highly advocate collaboration between our dentists and otolaryngologists on this issue.

  • Basic Study
  • YANG Jin,WU Feifei,GAO Qinghong,LI Xiaoyu,MANABU Kato,CHENG Ran,ZHOU Hongmei
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 562-568. https://doi.org/10.12016/j.issn.2096-1456.2020.09.003
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    Objective To observe the effect of transforming growth factor-β1 (TGF-β1) on the migration of oral carcinoma associated fibroblasts (CAFs) with two-dimensional culture model and three-dimensional model.Methods Under two-dimensional culture conditions, CAFs stimulated by TGF-β1 with the addition of 10 ng/mL medium were used as the experimental group, and untreated CAFs were used as the control group. The migration of CAFs with the stimulation of TGF-β1 was measured by cell scratch assay and transwell assay. CAFs positive for green fluorescent protein (GFP) were cultured by retrovirus transfection. Human tongue squamous cell carcinoma cells SCC25, GFP(+) CAFs and CAFs with three-dimensional cell co-culture models were established. The three-dimensional model cultured under the stimulation of TGF-β1 with 10 ng/mL medium was used as the experimental group, and the three-dimensional model without TGF-β1 was used as the control group. The migration of CAFs with the stimulation of TGF-β1 was also measured by the three-dimensional models.Results It was verified that 10 ng/mL TGF-β1 promoted the migration of CAFs in the two-dimensional culture model. The three-dimensional co-culture models of SCC25, GFP(+) CAFs and CAFs were successfully established. The migration of SCC25 and CAFs was detected in the three-dimensional model. However, 10 ng/mL TGF-β1 had little effect on their migration.Conclusion The effect of TGF-β1 in vitro on the migration of oral CAFs was associated with different culture models in two and three dimensions.

  • MA Lingzhi,SHI Jiaozhuang,GE Wenbin,ZHANG Kun,YU Bing,LIU Yali
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 569-574. https://doi.org/10.12016/j.issn.2096-1456.2020.09.004
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    Objective To explore the effect of miR-21 on human periodontal ligament stem cells (PDLSCs) proliferation and osteogenesis and to provide a theoretical basis for the stem cell treatment of periodontitis.Methods hPDLSCs were isolated and cultured with the enzymatic tissue block method, and surface molecules (CD34, CD45, CD90 and CD105) were detected by flow cytometry. An miR-21 mimics (pre-miR-21) and inhibitor (anti-miR-21) were transfected into hPDLSCs by Lipofectamine 2000. The experiment groups: mimics-NC group, mimics group, inhibitor group, and inhibitor-NC group. The transfection efficiency of miR-21 was determined by qRT-PCR. Proliferation was detected by CCK-8 and flow cytometry. The osteogenic differentiation ability of hPDLSCs was determined by alizarin red staining. Western blot was used to detect the protein expression of osteogenic related genes: Runx2.Results The mRNA expression of miR-21in the mimics group was significantly higher than that in the mimics-NC group; additionally, the expression in the inhibitor group was significantly weaker than that in the inhibitor-NC group (P < 0.05). hPDLSCs proliferation and the S phase cell ratio in the mimics group were stronger than those in the mimics-NC group(P < 0.05); those in the inhibitor group were weaker than those in the inhibitor-NC group (P < 0.05). After alizarin red staining, the mimics group was found to have more mineralized modules than mimics-NC group, and the inhibitor group had fewer than that in the inhibitor-NC group. Runx2 protein expression in the mimics group was higher than that in the mimics-NC group (P <0.05), and expression was lower in the inhibitor group than in the inhibitor-NC group (P < 0.05).Conclusion miR-21can promote the proliferation and osteogenesic differentiation of hPDLSCs.

  • Cinical Study
  • SUN Zhongyi,CHEN Yiming,WANG Yi,JI Tong
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 575-580. https://doi.org/10.12016/j.issn.2096-1456.2020.09.005
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    Objective To analyze the characteristics of perioperative mortality (POM) in oral maxillofacial head and neck cancer patients.Methods A retrospective study was adapted for head and neck cancer patients who were treated and had POM in the department of oral maxillofacial & head and neck oncology in Shanghai Ninth People′s Hospital from Jan 1999 to Dec 2019. Demographic information, disease characteristic and clinical records were collected. The factors of POM were classified into surgical complication, medical complication, mixed complication (surgical and medical) and personal complication. SPSS 17.0 software was used to analyze the cause composition for POM under different condition.Results 55 patients were included: 39 were male, and 16 were female. A total of 12 patients had a smoking history. Furthermore, 28 patients had general comorbidities. 20 underwent preoperative radiotherapy and 9 received preoperative chemotherapy. Squamous cell carcinoma was the most frequent pathological diagnosis in 37 patients. A total of 9 patients had tumors in the maxilla and skull base. In addtition, 4 patients had POM preoperatively, 1 patient had POM within the operation, and 50 patients had POM postoperatively. The leading causes of death were as follows: rupture of the carotid artery was the most frequent (8), and the surgical complication of pulmonary infection was the main medical complication (6). Pulmonary infection and hemorrhage were regarded as the main mixed complication (4). Two patients had POM due to personal complications. The higher the American Society of Anesthesiologists (ASA) score, the higher the proportion of medical factors in POM (P=0.039).Conclusion The composition of POM in oral maxillofacial- head and neck cancer (OMHNC) patients was complicated. Carotid artery rupture was the most common and fatal surgical complication, especially for those who underwent preoperative radiotherapy. Pulmonary infection was the most frequent medical complication, and those who had a higher ASA grade tended to have more complication.

  • WANG Ke,PENG Guoguang,HE Shanzhi,TAN Yulian,YI Lilei
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 581-585. https://doi.org/10.12016/j.issn.2096-1456.2020.09.006
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    Objective To explore the effect of negative pressure sealing drainage on the treatment of maxillofacial-neck-mediastinal infection in multiple spaces.Methods Vacuum sealing drainage (VSD) was applied in five patients with maxillofacial-neck-mediastinal infection caused by odontogenic infection accompanied by diabetes or renal failure and other systemic diseases. After extensive debridement, a negative pressure drainage sponge was placed in the pus cavity and then the wound was closed. Continuous negative pressure drainage was continued after the operation. At the same time, multidisciplinary consultation was applied to control basic diseases and, strengthen anti-inflammatory responses, and nutrition and other systemic treatments were applied.Results Four patients underwent continuous negative pressure drainage and successful removal of the negative pressure sponge after inflammatory symptoms subsided. One patient′s inflammatory symptoms became more serious after the operation, and we performed another operation to change the placement of the negative pressure sponge. All 5 patients underwent VSD with negative pressure sponge replacement ranging from 1 to 3 times during treatment. After multidisciplinary consultation, they were all cured and discharged from the hospital.Conclusion For infection of the mediastinum, maxillofacial region and neck, local treatment and systemic treatment are emphasized, as well as the treatment of infected lesions and basic diseases. Negative pressure closure and drainage technology promotes the alleviation of inflammation, and multidisciplinary combined treatment is beneficial for the control of basic diseases.

  • Prevention and Treatment Practice
  • ZHANG Qianyu,YANG Peixin,CHEN Boshen,WANG lin,HUANG Zhiquan
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 586-589. https://doi.org/10.12016/j.issn.2096-1456.2020.09.007
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    Objective To investigate the diagnosis and treatment of synchronous double primary malignant tumours of the tongue and lung.Methods A case of adenoid cystic carcinoma(ACC) and lung adenocarcinoma with double primary malignancy was retrospectively analyzed.Results The tumor of patient′s tongue base gradually grew. MRI showed multiple enlarged lymph nodes on both sides of neck. CT of the chest showed obvious lesions in the anterior basal segment of the right lower lobe. The pathological biopsy of the tongue mass identified ACC, and pathological biopsy of the lung mass identified lung adenocarcinoma. The tongue and lung tumors were both surgically resected, and the tongue defect was repaired at the same time. No residue was found after surgery, and no recurrence was found during the follow-up period. The aesthetic and functional restoration of the lingual region was good.Conclusion There are few cases of adenoid cystic carcinoma and lung adenocarcinoma with double primary malignancies, and the related diagnosis and treatment are very difficult; the simultaneous removal of double primary malignant tumors may achieve good prognosis.

  • LU Jie,WANG Yingju,ZHANG Lijuan,LI Fan,LI Shanshan,TAN Kaixuan,ZHANG Ying,YANG Fang
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 590-593. https://doi.org/10.12016/j.issn.2096-1456.2020.09.008
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    Objective To investigate the etiology, diagnosis and treatment principles of inherited permanent tooth embryo necrosis caused by alveolar bone resorption due to severe periapical periodontitis of deciduous teeth, in order to provide a reference for clinical diagnosis and treatment.Methods The clinical data and related literature of a rare case of permanent tooth embryo necrosis were analyzed retrospectively.Results This case was a 5-year-old girl. Physical examination and X-ray examination revealed chronic periapical inflammation in 75. X-ray showed that the periodontal bone of tooth 75 was extensively destroyed; additionally, the permanent tooth germ of tooth 35 was incomplete and the development was delayed compared to that of tooth 45 because of severe periapical periodontitis in the primary teeth. The initial diagnosis was that-- the embryo of tooth 35 stopped developing due to inflammation and was necrotic after tooth 75 was extracted. The postoperative pathological examination report showed that most bone around the embryos of tooth 35 was sequestrated. Through literature review and analysis, it was found that the degree of periapical lesions in the primary teeth and the developmental stage of the tooth embryo have a great impact on the formation of permanent tooth embryos. Conservative methods such as root canal therapy are usually adopted as treatment. Permanent tooth embryo necrosis caused by periapical periodontitis of deciduous teeth is rare in the clinic, so it is necessary to judge the degree of inflammatory infiltration and of tooth embryo damage as soon as possible according to the clinical symptoms and imaging manifestations; and to make a correct treatment plan.Conclusion There are no objective and clear diagnostic and treatment criteria for the clinical diagnosis of the pathological state of permanent tooth embryo, thus, methods such as etiology elimination and follow-up observation are usually adopted for abnormal permanent tooth embryo development. Future research should focus on prevention and finding addtional effective methods for diagnosis and treatment.

  • Review Articles
  • XIE Lin,FENG Xiaoli,DENG Zi,MA Rui,HU Chen,SHAO Longquan
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 594-598. https://doi.org/]10.12016/j.issn.2096-1456.2020.09.009
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    Recently, the dental application of nano materials has made progress in clinical treatment, such as implant surface modification as well as antibacterial, and controlled release. However, the active physical and chemical properties of nanomaterials may pose a potential safety risk in humans. Dental nanomaterials used for oral application can be released into the blood through a variety of mechanisms, and they can penetrate the blood-brain barrier and enter the central nervous system. Moreover, nanomaterials can also directly affect the central nervous system through the olfactory nerve and via sensory nerve terminal transport, causing organic and functional damage to central nerves, and even causing neurotoxicity during embryo development. Nanomaterials can interact with biomolecules such as cells, genes, and proteins in the body, and can produce neurotoxicity through the mechanisms of inducing oxidative stress, inflammatory responses, cell autophagy, apoptosis, genotoxicity, etc. Factors affecting the toxicity of nanomaterials include particle size, concentration, and solubility. Dental nanomaterials and their pathways into the central nervous system, as well as the mechanisms that may cause neurotoxicity, will be discussed on this review.

  • XU Hongwei,HAN Bing
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 600-606. https://doi.org/10.12016/j.issn.2096-1456.2020.09.010
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    Bone tissue engineering, as an emerging method for the treatment of jaw defects caused by oral and maxillofacial trauma, inflammation, tumors and other diseases, has been a research hotspot due to its advantages of wide sources of materials, low risk of immune rejection and personalized treatment. However, due to functional activities such as chewing and expression in the oral and maxillofacial regions, the mechanical strength of scaffolds is highly required. A single component of scaffolds can not fully meet the requirements of oral and maxillofacial bone defect repair. In this paper, the methods of strengthening the mechanical strength of jaw bone tissue engineering scaffolds are summarized by summarizing the research on strengthening the mechanical strength of scaffolds in recent years. A review of the literature showed that, composite modification, crosslinking, coating, bionic scaffolding and other new processing methods have been used to enhance the mechanical strength of scaffolds. Among these studies, research on compound modification occurred the earliest. Although this process is simple, other substances have been introduced to increase the number of degradation products, and the compounding ratio needs to be adjusted. The crosslinking method has the risk of cytotoxicity due to the use of crosslinking agents; the coating method does not change the original structure and only changes the surface modification; however, it can be better utilized if the problem of stress concentration between interfaces is solved. Biomimetic scaffolds and microregulatory scaffolds are emerging technologies in recent years that can improve the internal molecular arrangement of materials, thus enhancing mechanical strength. Therefore, on the basis of perfecting the traditional method, future research will focus on new nanoscale materials, bionic scaffolds and new methods for the precise control of scaffold microstructure.

  • ZHOU Min,XU Laijun
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(9): 607-612. https://doi.org/10.12016/j.issn.2096-1456.2020.09.011
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    Enterococcus faecalis has been confirmed to be closely related to dental pulp and periapical disease in recent years. Enterococcus faecalis is one of the important bacteria causing persistent or secondary root canal infection and root canal treatment failure. Traditional root canal disinfection drugs such as sodium hypochlorite, chlorhexidine and calcium hydroxide can not completely remove Enterococcus faecalis in the root canal because of the concentration limitation of the drug and the complexity of the root canal system. Therefore, how to effectively resist the Enterococcus faecalis infection in the root canal has become one of the important research directions in the treatment of periodontal pulp periapical disease. In recent years, some new antimicrobial agents and disinfection methods have emerged due to the drug resistance and pathogenicity of Enterococcus faecalis, such as laser, photodynamic, ultrasonic irrigation and ozone therapy. Their combination with traditional root canal irrigation drugs can significantly enhance the ability of traditional drugs to remove Enterococcus faecalis in the root canal. In addition, the emergence of new disinfection methods such as chlorine dioxide, nano-magnesia, superoxidized water and N-acetylcysteine have been shown to have a unique killing effect on Enterococcus faecalis in root canals. At present, most of the new disinfection methods described above are in the in vitro experimental stage, and their stimulation and damage to normal tissue still lack relevant clinical data support; thus, these outcomes need to be further studied.