Chronic obstructive diseases of the parotid gland are common clinically, with repeated swelling and a prolonged course and poor treatment outcomes. Based on the summarization of clinical practice and related literature, from the viewpoint of etiology, parotid obstructive diseases can be classified as mechanical obstructions, specific obstructions and non-specific obstructions. The principles of fluid mechanics are introduced to explain the formation of parotid obstructions. According to the different causes, the methods of changing the flow pattern of saliva in the parotid to reduce the resistance and relieve the obstruction, are proposed, such as mechanical factors removals, application of drugs that promote saliva secretion and lower saliva viscosity, ductal expansion under endoscopy and stent placement, and embolization of collateral ducts. These managements can effectively increase the salivary flow rate, reduce the occurrence of the saliva stranded and parotid gland obstructions.
Objective To investigate the effect of casein kinase 2 interacting protein-1 (CKIP-1) on craniofacial soft tissues and hard tissues, to provide the basis for the study and treatment of craniomaxillofacial related diseases. Methods 6-month- old male CKIP-1 knockout (KO) mice were selected as the experimental group, and wild-type (WT) mice were selected as the control group. The craniomaxillofacial hard tissues (parietal bone, nasal bone, incisors and molars) were analyzed through micro- CT, and the morphological changes of maxillofacial soft tissues (nasal cartilage, lip mucosa and tongue) were analyzed through HE staining and toluidine blue staining. Results CKIP-1 negatively regulated bone mass of cancellous bone of cranial and maxillofacial bones and dentin mineralization. Compared with the WT mice, the thickness of the parietal baffle layer increased by 93% in KO mice, while cortical bone showed no significant difference between the two groups. The nasal cancellous bone thickness increased by 160% in KO-mice, while cortical bone showed no significant difference between the two groups; the enamel thickness was normal, but the pulp cavity became smaller and the dentin thickness increased by 48%. Compared with the WT mice, the HE staining and toluidine blue staining analyses of the soft tissues revealed that the thickness of the alar cartilage plate of KO mice increased by 57%, and local ossification was found within the cartilage plate. The thickness of the keratinized layer of the labial mucosa increased by 170% in KO mice and the muscle fiber diameter of the lingual muscle increased by 45%. Conclusion CKIP-1 genes have different effects on the growth and development of various soft and hard tissues in the maxillofacial region of mice.
Objective To explore the effects of two hemostatic agents on the bonding strength of different bonding systems in primary tooth dentin. Methods Seventy-two retained deciduous teeth were randomly selected. Forty-eight teeth were used to construct the microleakage model, the other 24 teeth were cut along the mesial and distal directions and 48 samples were obtained to construct the shear bond strength model. The two experiments were divided into 2 groups. Group A was the total-etch group: A1 (ViscoStat + Spectrum Bond NT); A2 (ViscoStat Clear + Spectrum Bond NT); and A3 (Non + Spectrum Bond NT); Group B was the self-etch group: B1 (ViscoStat + Single bond Universal Adhesive); B2 (ViscoStat Clear + Single bond Universal Adhesive); and B3 (Non + Single bond Universal Adhesive). Microleakage experiments and shear bond strength experiments were carried out respectively and the morphology of the fracture surface was observed by scanning electron microscopy. Results There was no significant difference in microleakage among groups A1, A2, and A3 (P > 0.05). There was no significant difference in microleakage among groups B1, B2, and B3 (P > 0.05). There was no significant difference in the shear bond strength among groups A1, A2 and A3 (P > 0.05). The shear bond strength of groups B1 and B2 was significantly lower than that of group B3 (P < 0.05). There was no significant difference between groups B1 and B2 (P > 0.05). Conclusion ViscoStat and ViscoStat Clear had no effect on the marginal integrity of deciduous tooth dentin under the different bonding systems. The two hemostatic agents reduced the shear bonding strength of deciduous tooth dentin under the self-etch adhesive system, but had no effect on the shear bonding strength of deciduous tooth dentin under the total-etch adhesive system.
Objective To analyze the effect of different cavosurface angles on the stress distribution of ClassⅠ cavity composite resin filling of molars through the three-dimensional finite element method and to provide references for the preparation of ClassⅠ cavities. Methods Three-dimensional finite element models of ClassⅠ composite resin filling of mandibular first molars with three different cavosurface angles (group A: 90°, group B: 120°, group C: 135°) were established. Polymerization shrinkage of composites was simulated with a thermal expansion approach. The mechanical behavior of the restored models in terms of stress and displacement distributions under the combined effects of polymerization shrinkage and occlusal load (600 N) was analyzed. Results For ClassⅠ cavities with the same cavity size, the total stress of the restoration model and the maximum stress of the enamel in group A were less than those in groups B and C after cavity composite resin restoration with three cavity cavosurface angles (in which the width of the enamel bevel was 1 mm in groups B and C). The maximum stress of the dentin and adhesive was similar in the three groups, the maximum stress of the composite in group C was the largest, and the maximum stress of the composite in group B was the smallest. In terms of stress distribution, the maximum stress in each restoration model was mainly concentrated in the enamel at the cavosurface, near the enamel-dentin interface and at the edge of the restoration material. Conclusion From the point of reducing the stress of residual tooth tissue, the preparation of 90° angle without enamel bevel is an ideal method for cavity preparation when composite resin is used to fill ClassⅠ cavities of molars.
Objective To compare the clinical effect of the Yu flap and the Karapandzic flap in repairing greater than 2/3 defects of the lower lip and to provide a reference for clinical application. Methods Ten patients with greater than 2/3 lower lip defects after surgical resection of lower lip tumors and vascular malformations were enrolled: 5 patients were repaired with the Yu flap (Yu flap group) and 5 patients were repaired with the Karapandzic flap (Karapandzic flap group). Follow-up for at least 1 year was conducted to evaluate the morphology (symmetry, stoma, exposure of vermilion) and function (sensory function, motor function) of the reconstructed lower lip. Results All the flaps survived, and all wounds showed primary healing. The lower lips reconstructed with the Yu flap or the Karapandzic flap obtained similar satisfactory oral function. The sensory function was essentially restored. There were no obvious obstacles in speech and expression, and no saliva leakage occurred. In the Yu flap group, only 1 patient had slight microstomia. In the Karapandzic flap group, 2 patients had slight microstomia and 3 patients had moderate microstomia. 90% (9/10) of the patients were very satisfied with the postoperative outcome, and 1 patient in the Karapandzic flap group was basically satisfied. Conclusion Both the Yu flap and the Karapandzic flap can be used to repair greater than 2/3 lower lip defects and reliable outcomes can be achieved. These two methods can achieve similar oral functions, but the effect of the Karapandzic flap is inferior to that of the Yu flap in terms of aesthetic appearance, and microstomia often occurs, while the Yu flap can generally maintain the original size of the mouth cleft.
Objective To investigate the clinical effect of polidocanol sclerotherapy in the treatment of giant venular malformations of the lips and cheeks in adults. Methods From September 2019 to September 2020, 5 patients with huge venular malformations of the lips and cheeks (4 males, 1 female) admitted to Xuzhou Central Hospital were included in the study. All the patients were treated with local injection of polidocanol foam scleroagent, and all patients were followed up with a 3-week treatment course. If the clinical symptoms were not alleviated and the MRI examination showed that > 25% of the lesion remained, or it relapsed again after symptoms are stable, the patient needed to be treated again. The endpoints of treatment were: ①subsidence of clinical symptoms and MRI showing residual lesions < 25% in size; ②continuous treatment for 4 times without relief or aggravation of symptoms; ③a discontinuation of treatment. Results All 5 patients successfully completed the treatment and were injected 2 to 4 times during treatment. The curative effect was evaluated according to the Achauer standard, including grade Ⅰcurative effects in 1 patient, grade Ⅱ in 2 patients, grade Ⅲ in 2 patients. Among them, one patient suffered from erosion and bleeding in the lesion before the operation, and the symptoms were significantly improved postoperatively. No serious side effects were found except skin pigmentation in 1 case. Conclusion Local injection of polidocanol foam scleroagent is a safe and effective treatment method for adult giant venular malformations of the lips and cheeks, and it has a hemostatic effect on spontaneous bleeding invenular malformations.
Objective To analyze the correlation between skeletal vertical patterns and mandibular dental arch width, basal arch width and the dental buccolingual inclination of patients with skeletal ClassⅠ. Methods The CBCT data of 62 skeletal ClassⅠ malocclusion patients were collected and divided into a high-angle group with 19 cases, a mean-angle group with 22 cases, and a low-angle group with 21 cases according to the GoGn-SN angle. Mandible 3D reconstruction of the three groups was performed using Dolphin software, and dental arch widths, basal arch widths and buccolingual inclination of canines, first premolars and first molars, were measured and statistically analyzed respectively. Redults Mandibular dental arch width showed no significant difference among the three groups (P>0.05). The basal arch widths of mandibular canines and first premolars in low-angle group were larger than those in the other groups (P<0.05). The buccolingual inclinations of mandibular canines and first premolars in high-angle group were larger than those in the other groups (P<0.05). The buccolingual inclination and basal arch width of the first molars among the three groups showed no significant differences (P>0.05). Pearson correlation tests showed that the basal arch widths of mandibular canines and first premolars were negatively correlated with GoGn-SN angle. Excluding the influence of dental arch width and basal arch width, there was still a significant positive correlation between the buccolingual inclination of mandibular canines and first premolars and the GoGn-SN angle (P<0.05). Conclusion The width of the basal bone arch between different skeletal vertical patterns mainly differs in the canine segment and the premolar segment, and the difference in the buccolingual inclination of the teeth is mainly to compensate for the difference in the GoGn-SN angle. In clinical practice, individualized therapy should be adopted according to the differences to achieve the long-term efficacy of correction.
Objective To explore the clinical effect of a guided resin cementation technique on vertical food impaction symptoms and to provide a new method for the treatment of vertical food impaction. Methods Treatment of 76 patients with vertical food impaction with guided resin cementation was performed. A specially fabricated contact shaping wire was used to aid the shaping of the contact. Cementation was applied under a rubber dam with the total-etch technique with flowable composite resin. Patient subjective perception was recorded after treatment (i.e., “totally relieved”=3, “significantly improved”=2, “slightly improved”=1 and “no change”=0). Follow-up visits lasted for one year. Scores of 1 to 3 were recorded as effective. The efficiency rates at different times were calculated. Results Patient subjective perceptions scored 2.47, 2.21, 1.79, 1.30 and 0.97 on the day immediately after and 1, 3, 6, and 12 months after treatment, respectively. There were significant differences among scores at each time point (P<0.01). The Efficacy rate reached 91.78% immediately after treatment and was sustained above 50% within half a year. Management of resin debonding or fracture successfully relieved the symptoms again. Conclusion The guided resin cementation technique relieves vertical food impaction symptoms immediately, and the effect of the guided resin cementation technique is maintained for a short period of time. Management of resin debonding or fracture helps consolidate treatment outcomes.
Hydrofluoric acid is a common surface treatment agent for glass ceramic restorations before bonding. However, the use of hydrofluoric acid has a high safety risk, so the search for hydrofluoric acid substitutes has been a research hotspot. Tetrabutylammonium dihydrogen trifluoride is a kind of fluoride, whose chemical activity is lower than that of hydrofluoric acid, so it’s safer, and the surface morphology changes on glass ceramics caused by it are smaller and more superficial. At present, the vast majority of laboratory studies and clinical case reports indicate that the mechanical strength and bonding strength of glass ceramics treated with tetrabutylammonium dihydrogen trifluoride can meet the clinical requirements. In the future, according to the research results, the performance of porcelain surface treatment agents containing tetrabutylammonium dihydrogen trifluoride can be further improved, and more hydrofluoric acid substitutes may be developed. In this review, the research progress of tetrabutylammonium dihydrogen trifluoride as a substitute for hydrofluoric acid is reviewed in terms of the influence of the surface morphology, mechanical strength, and bonding strength of glass ceramics.
Nanomaterials usually refer to tiny particles with a diameter of 1-100 nm, which often have unique physicochemical properties and are one of the main areas of research interest for development of dental biomaterials. Nano-calcium phosphate modified dental materials have been widely used in pit and fissure sealing, dental resin restoration, tooth adhesion, and root canal sealing. The current research shows that the dental material modified by nano-calcium phosphate has stronger mechanical properties and shows long-term calcium and phosphorus ion release and excellent ion recharging ability, which can promote the remineralization of tooth hard tissue and has good prospects for application. However, it is difficult to accurately simulate the complex environment of the oral cavity. Therefore, the biocompatibility, cytotoxicity and effect of clinical application of nano-calcium phosphate modified dental materials still needs further study. This review summarizes and discusses the recent research progress regarding nano-calcium phosphate modified dental materials in the prevention and treatment of dental pulp diseases.
Dental resin materials have been widely used in the treatment of dental defects. However, the polymerization shrinkage of the resin materials tends to cause microleakage and accumulation of bacterial plaque, which leads to secondary dental caries. Endowing dental resin with antibacterial properties is an important way to solve this problem. Adding antibacterial agents to dental resin is the main method to give it antibacterial properties. Antimicrobial agents are mainly divided into three types: release type, non-release type and mixed type. In terms of antibacterial effects, the selection and addition of antibacterial agents will affect the antibacterial and mechanical properties of dental resin materials; and the long-term antibacterial effect of antimicrobial agents in the oral cavity remains to be verified; as antimicrobial agents or other environmental factors can lead to drug resistance and even dormant persistent bacteria. In recent years, researchers have been committed to improving the antibacterial effect by modifying antibacterial agents. The sustained release of antimicrobial agents via carriers is also the main research direction. This paper reviews the research progress on the antibacterial properties of dental resin materials.
As the world’s population ages, age-related cognitive decline and dementia are becoming important challenges for geriatric care. Despite the ongoing search for solutions to address cognitive decline, effective interventions have not yet been established. There is increasing evidence from clinical, epidemiological, and animal studies that masticatory dysfunction due to occlusal disharmony is a risk factor for cognitive decline and an increased incidence of dementia. The mechanisms may involve altered nutritional intake, decreased cerebral blood flow, chronic stress, and hippocampal morphological function. These findings suggest that maintaining and adequately restoring the entire masticatory system has a positive impact for the prevention of cognitive decline.