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20 February 2021, Volume 29 Issue 2
    

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    Expert Forum
  • WANG Anxun
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 73-80. https://doi.org/10.12016/j.issn.2096-1456.2021.02.001
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    The evaluation of immune function plays an important role in the diagnosis, treatment and prognosis of many diseases. To date, immune function detection includes cellular immunity, humoral immunity, and inflammatory markers. In this paper, the application of immune function detection in the diagnosis, differential diagnosis and treatment monitoring of various diseases was discussed; then, the application value of immune function detection in the diagnosis and treatment of three common oral mucosa-related diseases, including recurrent aphthous ulcer (RAU), oral lichen planus (OLP), and oral squamous cell carcinoma (OSCC), were reviewed combined with the literature and our research. Our research found that RAU patients present abnormal humoral immune function and obvious inflammatory reactions, whereas OLP and OSCC patients present mild inflammatory reactions and more serious abnormal cellular and humoral immune function, so the combined detection of immune function has a certain guiding value for the diagnosis and treatment of these diseases. Moreover, in the future, it is necessary to carry out a study on large sample, multicenter and multiindex joint detection to better clarify the role of immune dysfunction in the pathogenesis of various diseases and its mechanism, to establish the corresponding diagnostic model and prognostic prediction model, to find more effective treatment methods.

  • Basic Study
  • SHI Weiwei,DING Yi,TIAN Weidong,GUO Shujuan
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 81-87. https://doi.org/10.12016/j.issn.2096-1456.2021.02.002
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    Objective The purpose of this study was to investigate the effect of different concentrations of exosomes (Exos) secreted from dental folic cells (DFCs) preconditioned with lipopolysaccharide (LPS) on the osteogenic differentiation ability of periodontal cells in periodontitis (p-PDLCs) in patients to provide a basis for the prevention and treatment of periodontal disease. Method Tissue block and enzyme digestion methods were used to culture DFCs and p-PDLCs. Exosomes were isolated from 250 ng/mL LPS-preconditioned DFCs 24 h later. The characteristics of exosomes were detected by transmission electron microscopy, particle size analysis and Western blotting. The effects of 10 μg/mL and 100 μg/mL exosomes on the osteogenic differentiation of p-PDLCs were detected by RT-PCR and Alizarin red staining. Results LPS-pretreated DFC-derived exosomes (L-Exos) are vesicle-like structures with a size between 30-100 nm that positively express CD63 and Alix. Compared with the control group, exosomes significantly upregulated Periostin, Col Ⅰ, and Col Ⅲ expression at 100 μg/mL (P < 0.05), while TGF- β1 was significantly upregulated at 10 μg/mL (P < 0.01). At 7 days after osteogenic induction, mineralized nodules were significantly more abundant in the exosome group than in the control group (P < 0.01), and the results were better at a concentration of 100 μg/mL (P < 0.01). Conclusion 100 μg/mL L-Exos are better than 10 μg/mL L-Exos in enhancing the osteogenic differentiation ability of p-PDLCs.

  • LUO Yongxi,HUANG Xueying,XIAN Ruoting,YU Wanxin,LIANG Lixin,LIANG Zhaojia,CHEN Ziyun,HOU Dan,YU Ting
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 88-93. https://doi.org/10.12016/j.issn.2096-1456.2021.02.003
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    Objective Establish a murine model for hyperuricemia (HU) and periodontitis to explore whether there is correlation between them and provide a basis for periodontal treatment. Methods Fourteen male KM mice were divided into 2 groups; the HU group (n=7) was fed food supplemented with potassium oxonate and uric acid, the NC group (n=7) was fed standard food, and the induction period was 35 days. On the 25th day, the molars on one side were ligated to induce periodontitis (P side), while the opposite was true for the control (C side). Baseline and terminal serum uric acid (UA) levels were detected, and alveolar bone resorption was analyzed by micro-CT. Results The serum UA level of HU mice was (112.94 ± 26.82 )mol/L, that of the NC group was (72.21 ± 19.95) μmol/L, and the difference in UA level was statistically significant (P < 0.05). The P side bone volume fractions of the HU and NC groups were( 29.01 ± 11.09)% and (29.56 ± 15.27)%, respectively, which were not significantly different (t=-0.072, P=0.944). The P side bone mineral densities of the HU and NC groups were(0.53 ± 0.16) g/cm3 and (0.52 ± 0.14) g/cm3, respectively, which were not significantly different (t=0.038, P=0.970). Additionally, there was no correlation between HU or serum UA and alveolar bone resorption (P > 0.05). Conclusion This research established a murine model for HU and periodontitis, but based on micro-CT analysis of alveolar bone, no relationship between HU or UA levels and periodontitis was found.

  • Clinical Study
  • GUO Zhichen,SAKENDEKE Jumatai,JIA Xinyu,HU Lulu,GONG Zhongcheng
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 94-98. https://doi.org/10.12016/j.issn.2096-1456.2021.02.004
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    Objective A retrospective analysis aimed to identify the clinical features of patients with descending necrotizing mediastinitis (DNM) to improve the effects of treatment and prognosis. Methods The clinical data of 59 patients with DNM who were treated in the Department of Oncology of Oral and Maxillofacial Surgery of the Affiliated Stomatology Hospital of Xinjiang Medical University and transferred to the intensive care unit (ICU) were retrospectively analyzed from March 2010 to March 2020. Statistical analysis was performed to identify the risk factors that were associated with mortality. Results A total of 59 patients were identified: 21 cases of DNM typeⅠ (35.6%), 19 cases of DNM typeⅡA (32.2%), and 19 cases of DNM type ⅡB (32.2%). All patients with DNM received emergency surgery. Patients with typeⅠ and ⅡA underwent anterior mediastinal xiphoid incision and drainage combined with thoracic drainage. The thoracic mediastinum was completely debrided, and postoperative drainage was performed in type ⅡB patients. Pus samples from all 59 DNM patients were cultured for bacteria, and 19 of them were positive. Systemic antiinflammatory therapy was administered. Five patients died (8.5%), and 54 patients survived (91.5%). Compared with the survival group, the mortality group had a higher proportion of patients aged ≥ 65 years, with diabetes, with an interval from admission to ICU ≥ 6 days, with an APACHE Ⅱ score ≥ 20 days, with a duration of ICU treatment ≥ 10 days, and with septic shock, with statistically significant differences (P < 0.05). Conclusions Timely transfer to the intensive care unit for treatment combined with early active surgery and timely treatment of systemic diseases and systemic antimicrobial therapy is the key to reducing DNM mortality.

  • DONG Jingbo,LI Zhenzhen,LIU Chenxi,SHI Peikai
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 99-105. https://doi.org/10.12016/j.issn.2096-1456.2021.02.005
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    Objective To evaluate the effect of platelet-rich fibrin (PRF) on alveolar ridge preservation after tooth extraction. Methods Randomized controlled trials (RCTs) published before August 25, 2020 about the use of PRF after tooth extraction were searched through the PubMed, Embase, Cochrane Library, HowNet, Wanfang, CBM databases and clinical trial registration centers in China and the United States. Outcome indicators included in the studies included dry socket occurrence, alveolar bone resorption in the horizontal and vertical directions, and the percentage of new bone. Meta-analysis was conducted with Review Manager Version 5.3 software. Results A total of 706 studies were retrieved. After screening, 8 studies were analyzed quantitatively. Meta-analysis results showed that PRF could reduce the absorption of alveolar bone after tooth extraction, which reduced the horizontal bone mass (WMD=-0.71, 95% CI=-1.11 to -0.32, P < 0.05) and buccal (WMD=-1.38, 95% CI =-1.87 to -0.88, P < 0.05) and lingual sides (WMD=-0.49, 95% CI=-0.92 to -0.06, P < 0.05) and increased the percentage of new bone (SMD=1.24, 95% CI =0.25 to 2.23, P < 0.05). However, there was no significant difference in preventing the occurrence of dry socket (RD < 0.01, 95% CI=-0.05 to 0.04, P=0.95) and reducing bone absorption in the vertical direction of mesial (WMD=-0.11, 95% CI=-1.17 to 0.95, P=0.84) and distal (WMD=-0.66, 95% CI=-1.93 to 0.60, P=0.30) alveolar ridge after tooth extraction. Conclusion Using PRF alone after tooth extraction can effectively preserve bone mass in the horizontal direction of the alveolar ridge and the vertical direction of the buccal and lingual sides.

  • Prevention and Treatment Practice
  • WU Junwei,ZHENG Junfa,YAN Xin,DING XuXuan
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 106-109. https://doi.org/10.12016/j.issn.2096-1456.2021.02.006
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    Objective To investigate the diagnosis and clinical treatment of maxillofacial connective tissue hyperplastic trichoepithelioma. Methods The clinical data of two cases of maxillofacial connective tissue hyperplastic trichoepithelioma were summarized and analyzed along with the literature. Results Two cases of maxillofacial connective tissue hyperplastic trichoepithelioma were male, aged 21 and 30 years. The clinical manifestations were painless pale brown and pale white plaques in the maxillofacial region. The lesion was tough and clear, with no ulcers in the middle depression. The course was 10-16 months, with 1-3 months before medical treatment, and the tumor had a significant history of enlargement. After surgery, the skin was cut 3 mm along the outer circumference of the tumor, and local tissue defects were repaired by the adjacent flap. The pathological report showed that the tumor cells were located in the dermis, and were striped, trabecular or nested. The tiny sac contained fibrous connective tissue proliferation. The tumor cells were amorphous without obvious nuclear division. Immunohistochemical analysis reported bcl-2(-), CK7(-), CK19(-), CD34(+), P63(+), CK56(+), and Ki67(±). The pathological diagnosis was connective tissue proliferative hair epithelial tumor. The patient was followed up for 24 months. There was no recurrence of the tumor, no obvious scarring, and no deformity or dysfunction of the maxillofacial region. Conclusion Pathological and immunohistochemical examination is the basis for the differential diagnosis of maxillofacial connective tissue hyperplastic trichoepithelioma, and surgical removal of tumors is an effective treatment.

  • Review Articles
  • SHI Shaojie,LIU Xiangdong,SONG Yingliang
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 110-114. https://doi.org/10.12016/j.issn.2096-1456.2021.02.007
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    Patients with type 2 diabetes mellitus (T2DM) have a large demand for dental implants, but the pathologic state of T2DM patients could compromise the efficacy of implant treatment. Glycemic control can improve the success rate of implants in the T2DM population, but the early osseointegration of individuals still needs to be improved. Strengthening early osseointegration in patients with T2DM is one of the urgent problems for clinicians. The pharmacological mechanisms of hypoglycemic drugs on the market for bone metabolism are different and may require different interventions on the bone around the implant, but there is a lack of direct clinical evidence of the protective effect of hypoglycemic drugs. This review integrated the bone metabolic effect of drugs in clinical medical research and dental implant research. The aim was to provide medication guidance for T2DM patients who require implant surgery, and it is recommended to avoid the use of drugs with negative effects on bone as far as possible without violating the clinical medication guidelines, including SGLT-2 inhibitors and thiazolidinediones. Instead, they should choose glucose-lowering drugs that are beneficial to bone metabolism, such as insulin, metformin and GLP-1 receptor agonists. However, the comparative clinical effects of these drugs on periimplant bone need to be further elucidated. The researcher should select appropriate drugs (incretin drugs) to enhance the early osseointegration of implants in patients with T2DM.

  • LIN Xi,LI Shaobing,DING Xianglong,XU Shulan
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 115-118. https://doi.org/10.12016/j.issn.2096-1456.2021.02.008
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    The rapid absorption of labial alveolar bone after tooth extraction not only reduces the aesthetic effect of implant repair but also affects the long-term success rate of implants. The socket shield technique is reported as the latest alveolar preservation technique in the aesthetic zone from both domestic and international case reports and shows a high success rate of short-term osseointegration and excellent aesthetic effects. However, some investigations have shown short- and long-term complications with the socket shield technique, such as failure of osseointegration, loss of crestal bone and buccal bone, inflammation, etc. In this review, the socket shield technique will be reported in detail with its pros and cons. Although the socket shield technique has achieved good clinical effects and short-term success rates in many cases, there are still no conclusions regarding the surgical procedure, such as the thickness, the position of the shield, whether to put the graft material between the shield and implant, etc. Due to the lack of long-term research or a large amount of clinical literature support and technical sensitivity, the socket shield technique should be carefully used in clinical application to reduce unexpected risks.

  • SHI Yangyang,ZHOU Xuedong,CHENG Lei,REN Biao
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 119-123. https://doi.org/10.12016/j.issn.2096-1456.2021.02.009
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    Oral cancer is one of the most common cancers that occur in the head and neck and can seriously affect the life span and living standard of oral cancer patients. Candida albicansC. albicans) is the most common opportunistic pathogenic fungus in the oral cavity, shows pathogenicity and easily causes Candida infection when the host′s immune function is low. Recent studies have shown that C. albicans infection is closely related to oral cancer. This paper reviews the epidemiology of C. albicans infection in oral cancer patients, the influence of C. albicans infection on the occurrence and development of oral cancer and research on its mechanism. Existing studies have shown an increased risk of C. albicans infection in oral cancer patients, while C. albicans infection may promote the occurrence and development of oral cancer through mechanisms such as damaging the oral epithelium; producing carcinogens, including nitrosamine and acetaldehyde; and inducing a chronic inflammatory response and T helper cell 17 immune response. However, these mechanisms are still relatively superficial and lack sufficient direct evidence. In the future, additional in-depth studies are still needed to further clarify the cancer-promoting mechanisms of C. albicans and provide new ideas for the prevention and treatment of oral cancer.

  • JI Ling,WANG Jiahe,WANG Jiantao,Wang Yan
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 124-129. https://doi.org/10.12016/j.issn.2096-1456.2021.02.010
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    Mucositis is a common gastrointestinal complication in cancer patients undergoing chemoradiotherapy, including oral mucositis and gastrointestinal mucositis, with clinical manifestations of oral ulcers, vomiting, diarrhea and pain that seriously reduce the quality of life of patients and even affect anticancer therapy. Toll-like receptor (TLR) are important receptors involved in innate immunity and in the development of chemoradiation-induced mucositis by mediating the effect between microorganisms and the host. A comprehensive understanding of the role of TLR in mucositis is helpful to guide the prevention and treatment of mucositis. This paper reviews the available studies on TLR and mucositis. The results of the literature review indicate that different TLR have different roles in chemoradiation-induced mucositis: TLR2 is an important receptor in the inflammatory cascade of chemoradiation-induced mucositis; TLR4 activation can increase gastrointestinal mucosal inflammation and lead to oral epithelial ulceration; TLR5 agonists can reduce the degree of radiation-induced mucositis damage; and antagonizing or knocking out TLR9 can reduce chemoradiation-induced gastrointestinal mucositis. However, no TLR agonists or inhibitors have yet been applied in clinical practice, and additional studies are needed to explore the role of different TLR in mucositis in the future to provide a reference for the precise prevention and treatment of chemoradiation-induced mucositis.

  • CHEN Shuang,XUE Xin,JIN Xing′ai,LIU Yingqun
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 130-134. https://doi.org/10.12016/j.issn.2096-1456.2021.02.011
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    Resin-modified glass ionomer cement (RMGIC) has good physical, chemical and biological properties and is suitable for the treatment of deciduous caries, aged root surface caries and wedge-shaped defects. Surface treatment is a common method to improve bonding strength, which can improve physical and chemical retention between different components. This paper mainly introduces the current research status of the influence of different dentin surface treatment methods on the bonding strength of RMGIC. At present, the common dentin surface treatment methods are pretreatment, acid etching, laser treatment, etc. The pretreatment agent can improve the bond strength of RMGIC by increasing the surface area and porosity of dentin. The bond strength of RMGIC could be effectively improved after the dentin was treated by an acid-etching bonding system. The dentin was treated with a laser to obtain a higher bonding strength. However, whether the use of resin adhesives will affect the release of fluoride ions in RMGIC into the deep dentin and thus affect the repair effect also needs further research.

  • LU Lidan,XU Hui
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 135-139. https://doi.org/10.12016/j.issn.2096-1456.2021.02.012
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    Autologous fat transplantation in the treatment of velopharyngeal insufficiency has the advantages of good histocompatibility, small local trauma, few complications, reversible operation and simple postoperative nursing, which can effectively increase the velopharyngeal closure area. If the clinical effect is poor, other surgical methods can be used at any time for replacement. Although there are many advantages in the treatment of velopharyngeal insufficiency with autologous fat transplantation, there are still some problems in the selection of indication, donor site, injection dose, recipient site, follow-up evaluation, complications and prevention and treatment. Current research shows that autologous fat transplantation is mainly used in patients with mild or moderate velopharyngeal insufficiency, but with the improvement of fat acquisition and treatment techniques, the indications for autologous fat transplantation continue to expand, and autologous fat transplantation combined with palatoplasty or pharyngoplasty has been proposed for the treatment of severe velopharyngeal insufficiency. However, there are complications, such as fat absorption and obstructive sleep apnea syndrome. In addition, the application of autologous fat transplantation in severe VPI patients and how to improve the long-term stability of autologous fat transplantation need further study.

  • AIPIZIGULI Yakupu,YAERKEN Aji,XU Hui
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(2): 140-144. https://doi.org/10.12016/j.issn.2096-1456.2021.02.013
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    Postoperative fistulae are one of the most significant complications of cleft palate repair. They usually has an adverse effect on patients’ oral hygiene, speech and even mental health. There has been a wide range of rates of fistula occurrence, from 0.8%-60%, with the classification and definition of fistulae differing from one author to the next. In this paper, the definition and classification of palatal fistulae and their reconstruction method are reviewed. At present, there is a lack of a consistent definition of palatal fistulae and a classification that can fully reflect the characteristics of palatal fistula. Adjacent flap is mainly used for repairing small fistulae with an adequate amount of surrounding tissue; anteriorly based dorsal tongue flaps are a safe and reliable method for large fistulae; free flap is beneficial for refractory and complicated palatal fistulae that are difficult to repair by the local and pedicle flap; and different synthetic materials are used in multilayer repair of fistulae; among them, composite polymer membrane is highly biocompatible, promoting cell attachment and proliferation in animal models, but its security in the human body needs further research.