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20 December 2020, Volume 28 Issue 12
    

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    Expert Forum
  • GU Xinhua
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 749-758. https://doi.org/10.12016/j.issn.2096-1456.2020.12.001
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    Rehabilitation and reconstruction of atrophic edentulous predicament represents significant challenges for implant dentists due to the anatomical conditions of the edentulous jaw. Implant-supported fixed complete dental prostheses represent a scientifically and clinically validated treatment for recovering patients, masticatory function and esthetic effect. However, the highly demanding implant surgical techniques and complex rehabilitation procedures for immediate functional reconstruction make it difficult to achieve the desired treatment outcomes. The application of digital and CAD/CAM technology in various stages of the treatment process is logical for patients and dentists. This article summarizes the workflow of digital-assisted implantation with immediate functional reconstruction of atrophic edentulous combined with a clinical case. Digital-assisted diagnosis, design, implantation, immediate reconstruction and final rehabilitation can optimize the implant surgery and immediate rehabilitation workflow, improve the accuracy of implant-supported immediate functional reconstruction, reduce the demand for a large amount of bone graft, and achieve higher patient satisfaction. The “prosthetic-oriented, begin with the end in mind” concept of edentulous jaw implant prosthetics can accurately and efficiently restore the patient,s beauty and chewing function in a minimally invasive manner, and is worthy of clinical promotion.

  • Basic Study
  • LIAO Dan,GE Song
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 759-767. https://doi.org/10.12016/j.issn.2096-1456.2020.12.002
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    Objective To observe the effects of icariin (ICA) and Bu-Shen-Gu-Chi-Wan on the alveolar bone absorption of chronic periodontitis in rats, and to explore the effect and possible mechanism of ICA in the treatment of chronic periodontitis. Methods After the establishment of the periodontitis model, the rats were divided into the periodontitis group (group P), ICA high dose group (group H), ICA low dose group (group L) and Bu-Shen-Gu-Chi-Wan treatment group (group B). Each group received treatment for one month and two months, separately, and the serum osteocalcin (OCN) level was measured. Three-dimensional reconstruction was performed after micro computed tomography (micro CT) scanning to measure the bone parameters of specific points, and the distance between the enamel cementum boundary and alveolar crest (CEJ-ABC) was recorded as alveolar bone resorption value. Tissue sections were generated to evaluate the effect of ICA on alveolar bone repair and reconstruction in rats with experimental periodontitis. Results Compared with the periodontitis group (group P), OCN levels in the serum in treatment groups (groups H, L and B) were decreased significantly (P < 0.05); the values of bone volume/tissue volume (BV/TV) and trabecular number (Tb.N) in treatment groups (groups H, L and B) were significantly higher than that in group P (P < 0.05). Compared with group P, trabecular thickness (Tb.Th) values of groups H and B significantly increased, and trabecular separation (Tb.Sp) of groups H and B significantly decreased (P < 0.05). The changing trend of parameters in group L was the same as that in group H but only after two months of administration. The difference between Tb.Sp values in groups L and P was statistically significant (P < 0.05). Compared with group P, the CEJ-ABC distance significantly reduced in group L (1 month and 2 months after administration), group H (1 month and 2 months after administration), and group B (only 2 months after administration) (P < 0.05). Conclusion ICA and Bu-Shen-Gu-Chi-Wan improve the alveolar bone resorption in an experimental model of chronic periodontitis in rats, and the mechanism may be related to the regulation of osteocalcin serum levels.

  • GUO Ying,WANG Hong,CHE Shuangjiang,MI Nu,YANG Xiaoyu
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 768-775. https://doi.org/10.12016/j.issn.2096-1456.2020.12.003
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    Objective To investigate the expression and distribution of sclerostin in the alveolar bone of rat in the absence of estrogen, and to provide evidence for the analysis of the histological correlation between sclerostin and alveolar bone remodeling in rats. Methods The experimental subjects of this study were 32 8-week-old female Wistar rats. Among them, 16 rats were ovariectomized (OVX), and 16 rats were subjected to a sham operation (Sham). These rats were sacrificed 1, 2, 3, and 4 weeks after the operation, and the mandibles were removed and embedded. The mesial and distal sections of the rat,s mandibular first molars were selected and stained with anti-tartrate phosphatase (TRAP), sclerostin immunostaining, multiple immunostainings, RANKL and TRAP double staining, and silver-plated multiple staining. Results As the postoperative time in rats increased, the TRAP-positive osteoclasts counts in the OVX group in the interalveolar septum of mandibular first molar increased significantly, and statistical difference was noted between the groups (P < 0.05). The OVX 2w, 3w, and 4w groups exhibited more TRAP-positive osteoclasts compared with the Sham group at the corresponding time point, and the results were statistically different (P < 0.05). Sclerostin immunostaining revealed that the proportion of positive bone cells in the mesial side of the periodontal ligament area of mandibular first molar in the OVX group gradually decreased. Statistical differences were noted between the OVX 3w group and the OVX 4w group as well as the OVX 1w group and, the OVX 2w group (P < 0.05). In the comparison between the area near the periodontal ligament and the central area of the alveolar bone septum of the mandibular first molar in the same group, the positive expression ratio of sclerostin in the OVX 3w and OVX 4w groups in the area near the periodontal ligament was reduced compared with that in the central area of the alveolar bone septum. The results were statistically significant (P < 0.05). A larger number of osteoblasts was noted around the osteoclasts in the OVX 4w group compared with the Sham 4w group based on ALP/ TRAP /sclerostin multiple staining, whereas less sclerostin-positive osteoblasts were noted in the OVX 4w group. Sclerostin/TRAP/silver plating staining showed that the bone tubules around the sclerostin positive bone cells mostly exhibited a parallel and neat arrangement, and the bone tubules around sclerostin negative bone cells were more irregular and disorderly arranged in the OVX 4w group. Conclusion Sclerostin protein is involved in alveolar bone remodeling in estrogen-deficient rats.

  • MIAO Qian,PENG Peng,DONG Xiaoxi,MA Yao,ZHANG Xizhong
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 776-780. https://doi.org/10.12016/j.issn.2096-1456.2020.12.004
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    Objective To investigate the effect of low level laser on osteoclast and collagen fiber remodeling during the process of tooth retention after tooth movement in rats and to provide the experimental basis for clinical application. Methods In total, 20 eight-week-old Wistar rats were selected to establish a mesial movement model of the maxillary first molar and then randomly divided into four groups after the appliance was removed. In total, 5 rats were included in each group, including baseline group (without force as blank control), control group (without any intervention after removing the force appliance), retention group (teeth were wrapped with orthodontic ligature wires that were screwed into hemp flower as fixed retention to maintain the space between the first molar and incisor after appliances were removed) and retention and low energy laser irradiation group (teeth were wrapped with the orthodontic ligature wires that were screwed into hemp flower as fixed retention and low energy laser irradiation was applied on days 0, 3, 6, 9 and 12 after appliance removal). Two weeks later, all the rats were sacrificed and the first molar tissue blocks of each group were collected. The distribution of osteoclasts and collagen fiber were studied by HE staining, TRAP staining and Masson staining to illustrate the process of alveolar bone and collagen fiber remodeling. Results Two weeks after appliances were removed, collagen fibers were deposited on both sides of the root in the baseline group, but no osteoclasts were observed in the distal side of the root. In the control group, collagen fibers on the two sides of the root were not obvious and osteoclasts were active on the distal side. In the retention group, collagen fibers were obvious on the two sides of the root and the osteoclasts on the distal side were less active than the control group. Regarding the retention and low energy laser irradiation group, collagen fibers were significantly obvious and osteoclasts were not seen. The difference was statistically significant between the retention and low energy laser irradiation group and the other three groups (P<0.05). Conclusion These results suggest that fixed retention with simultaneous low level laser can effectively promote the synthesis of collagen fibers and inhibit the activity of osteoclasts during the process of tooth retention after movement, thus reducing the possibility of molar recurrence.

  • Clinical Study
  • WU Pingfan,CHEN Linlin,CHEN Fen,GUO Lingyan,LI Yu,LEI Zhenge,KE Xing,TAN Weibing
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 781-784. https://doi.org/10.12016/j.issn.2096-1456.2020.12.005
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    Objective To assess the safety and feasibility of incision in the retroauricular sulcus for removal of benign tumors in the lower pole of the parotid gland and to provide some ideas for aesthetic consideration of parotidectomy. Methods In total, 18 cases with benign tumors of the lower pole regions of the parotid gland were included in this study, including 9 pleomorphic adenomas, 2 myoepitheliomas, 5 Warthin tumors, 1 basal cell adenoma and 1 oncocytoma. Three months after the operation, facial paralysis and salivary fistula were assessed. A visual analog scale was used to score the cosmetic satisfaction of the surgical incision. Tumor recurrence was followed up 6 ~ 12 months after operation. Results In 18 patients with benign tumors the lower pole regions of the parotid gland, the tumor diameter ranges from 1.0 to 3.1 cm, with an average value of 2.5 cm. All patients experienced successful complete removal of the parotid mass with the minimally invasive retroauricular approach, and all wounds healed in one stage after operation. No serious complications, such as permanent facial paralysis and tumor recurrence, occurred 3 months after the operation. The patients were satisfied with the appearance of the surgical incision (aesthetic score 9.3 ± 0.4), achieving the expected aesthetic effect. Conclusion This approach is feasible and safe for most small benign parotid tumors located in the lower pole region of the parotid gland and in the posterior region of the jaw. The scar is located in the retroauricular sulcus, which significantly meets the aesthetic needs of the concealed incision for patients.

  • HU Congjiao,MAO Feifei,WU Ying,FENG Yanhuizhi,ZHOU Min,LUO Lijun
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 785-790. https://doi.org/10.12016/j.issn.2096-1456.2020.12.006
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    Objective To study patient-related information and factors altering their decision making in periodontal treatment and treatment behavior via big data analysis of the electronic medical records and to guide better dental care service and improve periodontal treatment. Methods A retrospective study was performed in patients with periodontitis who visited the Affiliated Stomatological Hospital of Tongji University from 2014 to 2016. Based on the periodontal sequence treatment procedure, the treatment types were divided into six groups and were analyzed using multivariable regression analysis. Chi-square test was performed according to gender and age. Results Age, payment method, disease severity, exhibited statistically significant differences regarding their effects on patients’ treatment behavior (P < 0.05). Men were more likely to have severe periodontitis than women (male 41.04%; female 31.85%), and use medical insurance more often as payment method (male 86.14%; female 83.74%) (P < 0.05). Compared with the population under 35 years old, moderate and severe periodontitis accounted for a larger proportion (84.58%) in the population over 35 years old. The compliance of the population over 35 years old was poor. Less follow-up reviews were conducted (17.10%) and medical insurance was less often used (49.65%) in this population. The differences were statistically significant (P < 0.05). Conclusion Moderate and severe periodontitis accounted for a larger proportion in the population over 35 years old. Patients over 35 years old tend to choose simpler treatments with lower compliance and frequency of revisits. This situation may be related to the lower proportion of medicare use in this population. The awareness and compliance of periodontal treatment protocols in people over 35 years old needs to be improved.

  • HUANG Qiuyu,DENG Yijun,WU Weiqin,HE Xingfang
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 791-795. https://doi.org/10.12016/j.issn.2096-1456.2020.12.007
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    Objective To explore the characteristics of perioperative venous therapy in patients undergoing simultaneous repair and reconstruction of oral cancer after radical resection, and prevention of femoral vein catheterization complications, to provide clinical evidence for venous therapy. Methods A retrospective analysis was perfomed to assess the choice of venous access and its effects in 95 patients undergoing simultaneous reconstruction due to oral cancer during the perioperative period. Results In total, 95 patients underwent successful indwelling femoral vein catheterization with double lumens, and a midline catheter and peripheral intravenous indwelling needles were used to complete the intravenous therapy after surgery. Among the femoral vein complications, 1 case was complicated with lower extremity venous thrombosis (incidence was 1.1%), and 17 cases were complicated with puncture point bleeding (incidence was17.9%). Two cases of puncture site bleeding were noted among 28 cases using a midline catheter. Local phlebitis and infiltration were the most common complications of peripheral venous catheters. The difference in catheter-related complications among different types of catheters was statistically significant (P < 0.05). The complication rate of the midline catheter was lower than that noted with femoral vein catheterization and peripheral intravenous indwelling needles. Conclusion Based on the treatment characteristics of patients, proper venous catheters should be established during the perioperative period. The application of a femoral vein catheter during the operation combined with the use of a midline catheter and peripheral venous indwelling needles after the operation can satisfy intravenous therapy needs in patients undergoing simultaneous repair and reconstruction for oral cancer, and the midline catheter can effectively reduce venous catheter-related complications.

  • Review Articles
  • ZHANG Zheng,WANG Zuomin
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 796-800. https://doi.org/10.12016/j.issn.2096-1456.2020.12.008
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    B cell activating factor (BAFF) is the key regulator of B cells and is considered as a potential therapeutic target for immune inflammatory diseases. Periodontitis can promote local and systemic BAFF factor expression, whereas BAFF aggravates B cell immune responses and tissue destruction in periodontitis. In addition, BAFF also stimulates CD4+T cell response and inhibits regulatory T cell and M2 macrophage responses, thus changing the pathogenesis of a variety of immune inflammatory diseases. However, whether the biological effect mentioned above is an important mechanism by which BAFF aggravates periodontitis still lacks direct evidence and should be confirmed in future research. To provide a theoretical basis for the study of the pathogenic mechanism of BAFF, the expression and role of BAFF in periodontitis is reviewed in this article.

  • ZHU Xuanzhi,MA Rui,XIE Xudong,WANG Jun
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 801-805. https://doi.org/10.12016/j.issn.2096-1456.2020.12.009
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    Osteocytes, which develop from osteoblasts, are recognized as the main cells embedded in mature bone tissue. The traditional notion is that osteocytes exclusively play a structural role, however, with the development of related research in recent years, the role of osteocytes in bone metabolism has been explored. Periodontitis is a chronic inflammatory disease initiated by plaque biofilm, and is the main cause of adult tooth loss. Clinically, periodontitis primarily manifests as attachment loss, bleeding on probing and other symptoms. Alveolar bone resorption is the most characteristic pathological change. Current research demonstrated that osteocytes sense mechanical stress, participate in bone remodeling, regulate mineral balance, and participate in endocrine function. Thus, these cells play an important role in bone homeostasis and systemic metabolic balance. Osteocytes are actively involved in the development of periodontitis through the high expression of receptor activator of nuclear factor kappa B ligand (RANKL), secretion of sclerostin, and effect on apoptosis, senescence and autophagy. In the future, the detection of bone cell metabolism-related products will have certain application prospects for the clinical evaluation of periodontitis prevention and treatment. Therefore, this paper reviewed the role of osteocytes in bone homeostasis and the relationship between osteocytes and periodontitis, to provide new ideas for the prevention and treatment of periodontitis.

  • TONG Ting,CHENG Lei,REN Biao
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 806-810. https://doi.org/10.12016/j.issn.2096-1456.2020.12.010
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    Oral potentially malignant disorders (OPMDs) refer to all epithelial lesions and conditions with an increased risk for malignant transformation, including oral leukoplakia, oral submucous fibrosis, oral lichen planus, erythroplakia, etc. Additionaly, oral infection of Candida albicans is considered to be closely related to the development of OPMDs. It was demonstrated in previous studies that the detection rate of Candida albicans was higher in the oral mucosa with OPMDs; in addition, Candida albicans showed high virulence by adhering to and destroying the epithelium. Moreover, Candida albicans was able to induce the immune response and cause chronic inflammation in the epithelium, producing carcinogenic products such as acetaldehyde. The factors mentioned above play a key role in the occurrence and development of OPMDs. Furthermore, the oral mucosa is highly susceptible to Candida albicans. The present review provides an introduction to the relationship between Candida albicans and OPMDs.

  • ZHAO Yongqiang,JIANG Lian
    Journal of Prevention and Treatment for Stomatological Diseases. 2020, 28(12): 811-816. https://doi.org/10.12016/j.issn.2096-1456.2020.12.011
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    Tent bone augmentation technology, including the tenting screw technique, autogenous cortical bone tenting technique and implant tent-pole technique, has recently been considered as a type of bone augmentation method to solve serious alveolar bone deficiency. The tenting screw technique is simple to perform and widely used in clinical practice; it can effectively increase bone in both horizontal and vertical directions in local bone defect areas with fewer complications than other techniques. The autogenous cortical bone tenting technique is mainly used for bone augmentation in large bone defect areas. The operation is relatively simple, but it needs to be combined with partial autogenous bone grafting, with high technical sensitivity and complications. The implant tent-pole technique is the most complex method and is mainly used for bone augmentation in severe alveolar ridge absorption areas of the mandible. The maximum vertical bone augmentation height can be obtained by combining this method with autogenous bone grafting, and the number of postoperative complications is relatively high. This article reviews recent research on the application of this technique to repair various alveolar bone defects in order to provide reference for clinical implant treatment.