Hemangiomas and vascular malformations are common clinical diseases. According to their clinical and imaging characterizations, the International Society for the Study of Vascular Anomalies (ISSVA) has systematically classified infantile hemangioma and vascular malformations, and the classification has been widely recognized and applied. To date, most vascular malformations involve the following important signaling pathways: PI3K/Akt/mTOR and RAS/MAPK/ERK. This discovery has major impacts on the diagnosis and treatment of vascular malformations including the following: the understanding of the biology of vascular malformations has been increased; the understanding of vascular malformations based on genotype has been refined; and the development of targeted drugs for the treatment of vascular malformations has been promoted. Despite facing many challenges, with the development of gene sequencing, molecular biology and imaging technology, the relevance of vascular malformation classification and the accuracy of diagnosis are improving, and this is accompanied by innovations in surgical treatment and sclerotherapy, interventional embolization, and continuous progress in targeted therapy. At present, investigations on vascular malformations are mostly retrospective clinical studies or low-level clinical trials. The purpose of this paper is to review the literature on the treatment of infantile hemangioma, lymphatic malformation, venous malformation and arteriovenous malformation and to review the research progress in evidence-based treatment of infantile hemangioma and vascular malformation.
Objective To prepare a copper-nobium antibacterial coating on a titanium surface by a microarc oxidation-microwave hydrothermal two-step method and to study its surface structure and antibacterial properties. Methods Using titanium coated with a microarc oxidation coating (MAO group) as the substrate, copper and niobium were introduced by a microwave hydrothermal method in low (MHL-Cu group), medium (MHM-Cu group) and high (MHH-Cu group) copper chloride solutions and niobium oxalate (MH-Nb group) solutions, respectively. The component with the highest copper content was determined by energy spectrum analysis, and the copper-niobium composite coating (MH-Cu/Nb group) was prepared by microwave hydrothermal mixing with niobium oxalate. The microstructure, element distribution and phase composition of the specimens were characterized by scanning electron microscopy, energy dispersive spectrometry and X-ray diffraction, and the bacteriostatic effect of the coating onEscherichia coliand Staphylococcus aureus was determined by the film method. Results Energy dispersive spectrometry showed that Cu was introduced onto the surface of the MHL-Cu, MHM-Cu, and MHH-Cu groups, and the atomic ratios of copper in each group were （0.68 ± 0.04）%,（1.17 ± 0.06）%, and （1.64 ± 0.03）%. The difference between groups was statistically significant (P< 0.01). Scanning electron microscopy showed a crater-like porous structure on the surface of the MAO group, and the MHL-Cu, MHM-Cu, MHH-Cu, MH-Nb, MH-Cu/Nb groups maintained micropore morphology. The roughness increased with increasing Cu2+ concentration, in which the MH-Nb and MH-Cu/Nb groups showed gully like structures simultaneously. X-ray diffraction showed that the coating of the MAO group was mainly composed of titanium and anatase phase TiO2, and the coatings of the MHL-Cu, MHM-Cu, MHH-Cu, MH-Nb, MH-Cu/Nb groups were mainly composed of anatase and rutile phase TiO2. Compared with the MAO group, Escherichia coli and Staphylococcus aureus in the MHH-Cu, MH-Nb, MH-Cu/Nb groups decreased to varying degrees, with significant differences (P< 0.001); compared with the MH-Cu/Nb group, the colony number difference had statistical significance (P> 0.05).Conclusion The rough, porous coating containing copper and niobium prepared by the microarc oxidation-microwave hydrothermal two-step method can effectively inhibit the growth ofEscherichia coli and Staphylococcus aureus.
Objective To analyze the effects of different restorations and the thickness of the occlusal space on the stress distribution of endodontically treated molars with endocrowns. Methods The finite element model of the restoration of the first mandibular molar was created, and four different endocrown materials were used including two resin based ceramics (Lava Ultimate, Vita Enamic), one lithium disilicate ceramic (IPS e.max CAD) and one zirconia ceramics (Cercon), and four kinds of surface space thickness were designed: 1 mm, 2 mm, 3 mm and 4 mm. A total of 600 N was loaded to simulate the maximum bite force in the vertical and inclined directions, and the finite element software ANSYS 10.0 was used to analyze the stress distribution.Results The vertical loading analysis showed that the crown stress of the 1 mm-Cercon group was the highest at 211.30 MPa, and that of the 4 mm-Lava Ultimate group was the lowest at 11.56 MPa; the highest dentin stress was 38.84 MPa in the 3 mm-Lava Ultimate group, and the lowest was 11.68 MPa in 1 mm-Cercon group. The stress in the periodontal ligament and alveolar bone had little change. The inclined loading analysis showed that the crown stress of the 1 mm-Cercon group was the highest at 78.73 MPa and that of the 1 mm-Lava Ultimate group was the lowest at 35.51 MPa; the highest dentin stress was 41.63 MPa in the 1 mm-Cercon cervical group, and the lowest was 10.81 MPa in the 4 mm-Cercon coronal group. The stress concentration of cement and cervical dentin under inclined loading was higher than that under vertical loading. Conclusion The results of finite element analysis show that the elastic modulus of the endocrown increases, the stress of the crown restoration shows an upward trend, and the stress in the tooth shows a downward trend. With increasing crown thickness, the stress of the crown prosthesis decreased.
Objective To investigate the changes and significance of human beta-defensin-2 (HBD-2) and LL-37 in the gingival crevicular fluid of patients with periodontitis and type 2 diabetes mellitus (T2DM). Methods This study was conducted among 45- to 85-year-old patients in the Department of Stomatology and Internal Medicine of Shenzhen Center for Chronic Disease Control, including a healthy control group of 22 people, a systemically healthy control group of 19 people with periodontitis, a T2DM periodontal health group of 15 people, and a T2DM group of 21 people with periodontitis. The Florida periodontal probe was used for periodontal examination, and the clinical indexes, including probing depth (PD), clinical attachment level (CAL) and probing on bleeding (BOP), were recorded. The concentrations of HBD-2 and Ll-37 in gingival crevicular fluid were determined by ELISA. The differences in HBD-2, LL-37 and periodontal clinical indexes between the groups were compared, and correlation analysis was conducted.Results The PD values in T2DM with the periodontitis group were higher than those of the systemically healthy controls with periodontitis group (P < 0.05); the levels of HBD-2 and LL-37 in gingival crevicular fluid in systemically healthy controls with periodontitis group were significantly higher than those in the healthy control group (P < 0.05), the level of HBD-2 in gingival crevicular fluid in systemically healthy controls with periodontitis group was significantly higher than that in T2DM with periodontitis group (P < 0.05); and the antimicrobial peptides HBD-2 and LL-37 in gingival crevicular fluid were significantly positively correlated with the PD and CAL in systemically healthy controls with periodontitis group (P < 0.05), and there was no significant correlation between the antimicrobial peptides HBD-2, LL-37 in gingival crevicular fluid and PD, CAL in T2DM with periodontitis group (P > 0.05). Conclusion The levels of antimicrobial peptides HBD-2 and LL-37 in gingival crevicular fluid of middle-aged and elderly patients with T2DM periodontitis were lower, and there was no significant correlation with PD and CAL in periodontal clinical indicators.
Objective This systematic review and meta-analysis was undertaken to evaluate the efficacy of antibacterial photodynamic therapy (aPDT) in the treatment of periodontitis in type-2 diabetes mellitus (T2DM) patients and to provide better treatment for patients with T2DM complicated with periodontitis.Methods The PubMed, Cochrane, Embase, Web of Science, CNKI, CBM, and Wanfang databases were searched for relevant randomized controlled trials (RCTs). RevMan 5.3 was applied for the meta-analysis, and a systematic evaluation was conducted. Results A total of 8 RCTs were included. The results showed that compared to simple subgingival scaling and root planing (SRP), aPDT assisted SRP had a better effect on improving the probing depth (PD) at 3 months after treatment, The difference was statistically significant [WMD=-0.32,95%CI（-0.45, -0.2）, P < 0.05], but 6 months after treatment, there was no significant difference in the two groups [ WMD=-0.15,95%CI（-0.40, 0.10）,P=0.23]. During the 6-month follow-up period, there were no significant differences in the clinical attachment level (CAL), bleeding on probing (BOP) or hemoglobin A1c (HbA1c) between the two groups (P> 0.05).Conclusion aPDT-assisted periodontal nonsurgical treatment in T2DM patients can improve PD in the short term but has no significant effect on the improvement of CAL, BOP and HbA1c.
Objective To investigate the relationship between the thickness of the lateral wall of the maxillary sinus and patient age and sex at different tooth sites to provide a reference for sinus floor elevations. Methods Cone-beam CT（CBCT） imaging data were collected from 222 patients admitted to the Department of Stomatology, the First Hospital of Shanxi Medical University, from March 2020 to October 2020. The thicknesses of the maxillary sinus lateral wall of the first premolar, second premolar, first molar and second molar were observed and measured on the coronal plane of CBCT images, and the relationship between the maxillary sinus lateral wall thickness and patient sex was analyzed. The patients were divided into the following groups according to their age: ①the young group (18~29 years old), ②the middle-aged group (30~59 years old), and ③the elderly group (≥ 60 years old). The difference in the maxillary sinus lateral wall thickness was compared among these three age groups.Results The mean thicknesses of the maxillary sinus lateral wall at the first premolar, second premolar, first molar and second molar were （1.61 ± 0.58） mm, （1.68 ± 0.66） mm, （2.00 ± 0.76） mm and （1.71 ± 0.71） mm, respectively. The maximum thickness of the lateral wall was located at the first molar (P< 0.05). The thickness of the maxillary sinus lateral wall in the young group was significantly thicker than that in the middle-aged group and the elderly group at the first premolar and first molar (P < 0.05). The thickness of the maxillary sinus lateral wall in males was significantly thicker than that in females at the second molar [(1.78 ± 0.80) mm vs. (1.63 ± 0.62) mm, P=0.029].Conclusion The mean thickness of the lateral wall changes at different reference points. The maxillary sinus lateral wall is the thickest at M1. The thickness of the maxillary sinus lateral wall decreased with age, and the thickness of the lateral wall was higher in males than in females.
Objective The purpose of this study was to explore the application value of digital surgery in the reconstruction of mandibular composite defects with a chimeric deep circumflex iliac artery perforator flap (DCIAPF). Methods Six patients with complex defects within half of the mandible underwent reconstruction using DCIAPF from January 2019 to January 2020 in Shenzhen People’s Hospital. Doppler was used to locate the deep iliac circumflex artery, the range of mandibular osteotomy was designed, and DCIAPF was used to repair the mandibular composite under the guidance of the guide plate during the operation. Twelve months postoperatively, the facial shape, jaw height, and occlusal relationship were evaluated.Results DCIAPF was harvested successfully in 6 patients, and the heights of all alveolar ridges and occlusal function of patients were significantly restored, without pain or snapping in the temporomandibular joint area. Conclusion The blood supply of DCIAPF is rich, and soft-bone tissue is sufficient for the reconstruction of mandibular composite defects. Combined with digital surgery, the accuracy and safety are improved.
Oral submucous fibrosis is a chronic, occult and progressive potentially malignant disease that seriously affects the oral function and quality of life of patients. The oral burning sensation and limitation of mouth opening are the main reasons for patients to see a doctor. At present, the main treatment for oral submucosal fibrosis is still drug therapy. To provide ideas and references for the clinical treatment of oral submucosal fibrosis, this article reviews the mechanism, therapeutic effect and characteristics of common Chinese and Western medicine in the treatment of oral submucosal fibrosis. The results of the literature review show that salvia miltiorrhiza, aloe, lycopene, curcumin and other traditional Chinese medicine and Western medicine are effective in the treatment of oral submucosal fibrosis; in addition, Taohong Siwu Decoction combined with Western medicine and other combinations of traditional Chinese and Western medicine are effective and reduce side effects, and clinicians can choose appropriate drugs according to the patient’s main symptoms and general condition. In the future, researchers can study more combinations of traditional Chinese and Western medicine to treat oral submucosal fibrosis.
Oral squamous cell carcinoma (OSCC) is the most common malignant tumor in the oral and maxillofacial regions. Cervical lymph node metastasis is not only an important biological behavior of oral cancer but also an important factor affecting the prognosis of oral cancer patients. As neck dissection is the most commonly used method of neck management, the appropriate choice of surgical procedure is very important. The current view is that radical neck dissection or modified radical neck dissection can be used for patients with clinically node-positive neck (cN+), while selective neck dissection can be used for patients with clinically node-negative neck (cN0). In recent years, selective neck dissection has been increasingly popularized and applied. Its implications are also gradually expanding from cN0 to cN+. However, there is still no consensus on whether selective neck dissection can also be used in patients with cN+ necks. This article reviews the clinical studies on the neck management of cN+ OSCC patients in recent years, analyzes the effects of different neck dissections on the prognosis of cN+ OSCC patients, and summarizes the treatment principles of neck management.
Implant dentures have become the main method for the treatment of dentition defects or complete edentulism. However, due to the lack of periodontal ligament and periodontal ligament proprioceptors, implant dentures have very limited cushioning and sensing capabilities and are prone to occlusal overload. As a risk factor for peri-implantitis, occlusal overload seriously threatens the stability and success rate of implant dentures. This paper reviews the occlusal overload of implant dentures, the causal relationship between occlusal overload and plaque biofilms in peri-implantitis, the mechanism by which occlusal overload promotes peri-implantitis, and the effect of reasonable clinical occlusal adjustment on healing. This review shows that occlusal overload is closely related to the occurrence of peri-implantitis. Occlusal overload can promote the process of peri-implantitis by increasing the release of inflammatory factors and mechanical transduction mechanisms. The intervention of the patients’ bad bite habits and occlusal adjustment can promote the healing of peri-implantitis. At present, there is no uniform standard ideal experimental model for occlusal overload. The phenomenon and mechanism of bone resorption around the implant caused by overload force still need further observation and research, which will help determine the intensity, direction and timing of occlusal loading to guide clinical occlusal adjustment.
Periodontium regeneration and repair is a controversial and difficult point in the treatment of periodontosis. The proliferation, differentiation, migration and adhesion of periodontal ligament cells and the dynamic relationship between periodontal ligament cells and their extracellular matrix proteins are the basis of periodontium morphological reconstruction, functional maintenance and tissue repair. This article reviews the mechanism of estrogen-regulated periodontal membrane fine repair and periodontal tissue reconstruction to provide the basis for follow-up research on the treatment of periodontitis and the promotion of periodontal tissue repair and reconstruction by exogenous estrogen-mediated periodontal membranes. Under the regulation of certain concentrations of estrogen, the proliferation and differentiation ability of periodontal ligament stem cells (PDLSCs) and bone mesenchymal stem cells (BMSCs) to other periodontal ligament cells were enhanced. At the same time, PDLSCs, BMSCs, human periodontal ligament fibroblasts (HPLFSs), osteoblasts and cementoblasts synthesized and secreted collagen I (COLI), osteopontin (OPN), bone sialoprotein (BSP) and osteocalcin (OCN) into the extracellular matrix. They interact with fibronectin (FN) and cementum attachment protein (CAP) in the extracellular matrix to form a variety of chain complexes and regulate each other, thus promoting the growth, migration, adhesion and fibrosis of periodontal ligament cells, repairing the collagen fiber skeleton of the periodontal ligament and adhering the two ends to the new cementum and the inherent alveolar bone.
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