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20 March 2022, Volume 30 Issue 3
    

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    Expert Forum
  • ZHANG Yufeng, WANG Yulan
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 153-159. https://doi.org/10.12016/j.issn.2096-1456.2022.03.001
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    Tooth loss is accompanied by alveolar bone absorption or defect, resulting in insufficient bone and soft tissue. In addition to restoring the masticatory function of missing teeth, implant treatment should also needs to restore the contour and shape of the dental arch. Guided bone regeneration is a common means of bone increase. Xenogeneic granular bone substitute materials are widely used in the field of clinical bone augmentation due to their advantages of long degradation time and low immunogenicity, but other problems, such as inconvenient operation and low osteogenic activity, remain. Plasmatrix can effectively improve the effect of oral tissue regeneration and reduce the occurrence of postoperative complications, and its application in oral tissue regeneration is gradually increasing. This article first introduces the main application forms of plasmatrix in horizontal bone augmentation (mainly solid plasmatrix membrane and plasmatrix bone block), and reclassifies horizontal bone defects according to commonly used decision-making schemes in clinical bone augmentation, in other words, whether the implant can be placed in the ideal position and whether there is bone dehiscence after implantation. Type Ⅰ defects refers to the situation where the bone at the implant site can allow the insertion of an implant with ideal size, and there is no bone dehiscence around the implant, but the alveolar bone contour is not ideal; type Ⅱ defects refers to the situation that when an ideal size implant is placed at the implant site determined by the future prosthesis position, there will be bones on three sides of the implant, but there is bone dehiscence in the buccal bone wall (the length of bone dehiscence is less than 50% of the implant length); type Ⅲ defects refers to the situation where the bone volume at the implant site is not enough to for the placement of the ideal size implant at the ideal position, and bone grafting is required to restore the bone volume before the implant placement. The application of plasmatrix in different types of bone defects is then described. In type Ⅰ bone defects, the solid plasmatrix membrane is used instead of the collagen membrane; in type Ⅱ bone defects, the bone defect around the implant is filled by plasmatrix bone block and then covered with collagen membrane and solid plasmatrix membrane; and in type Ⅲ bone defects, plasmatrix bone block is used to replace autogenous bone block to fill the defect area, and titanium screws are used for fixation. The defect is then covered with a collagen membrane and a solid plasmatrix membrane. This article aims to provide oral clinicians with a comprehensive understanding of plasmatrix and simplify the guidelines for bone regeneration operations.

  • Basic Study
  • WEI Yuan, ZHU Yanan, YANG Weidong
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 160-168. https://doi.org/10.12016/j.issn.2096-1456.2022.03.002
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    Objective The goal of this study was to investigate the effect of the Toll-like receptor-4 (TLR-4) inhibitor TAK-242 on bone resorption in severe periodontitis in rats in order to provide an experimental basis for finding new adjuvant treatments for severe periodontitis.Methods Eighteen three-week-old male Wistar rats were randomly divided into three groups (n=6). One group was the control group, and the other two groups were modelled with severe periodontitis in bilateral maxillary molars ligated with 5-0 silk thread containing P. gingivalis ATCC33277 (periodontitis and TAK-242 groups, respectively). The TAK-242 group was injected with TAK-242 (2 mg/kg) in DMSO every other day through the tail vein from the first day of silk ligation, and the other two groups were injected with DMSO solvent at the same proportion of body weight for 8 consecutive weeks. At the end of the 8th week, rats in the 3 groups were sacrificed, and maxillary specimens were taken. Three-dimensional reconstruction was achieved after micro-CT scanning to measure the distance between the enamel cementum boundary and alveolar crest at specific sites to assess the amount of bone loss. The parameters related to alveolar bone and bone microstructure were analyzed, and the pathological changes of periodontal tissue were observed by hematoxylin-eosin (HE) staining. Alveolar bone resorption was observed by Methyl Green staining, and the distribution of osteoclasts was observed by anti-tartrate acid phosphatase double staining (TRAP).Results Micro-CT quantitative analysis showed that alveolar bone resorption in the periodontitis group and TAK-242 group was significantly higher than that in the control group. Compared with the periodontitis group, bone loss of the mesial and distal root resorption sites of maxillary first molars was significantly reduced in the TAK-242 group (P < 0.001), the bone mineral density (P < 0.05) and bone volume/total volume fraction (P < 0.01) were significantly increased, and the number of trabeculae and the trabeculae thickness (P < 0.01) were relatively increased. The trabecular separation (P < 0.01) and trabecular structure model index were significantly decreased. In the periodontitis group, the bone exhibited a sparse and porous honeycomb structure, with deterioration of the trabecular structure and a shift towards a rod-strength structure. In the TAK-242 group, the bone microstructure was improved, the bone volume was enriched, the distribution of trabeculae was relatively denser and the trabecular structure shared more similarities with the control group. HE staining displayed that the attachment loss and bone absorption were significantly higher in the periodontitis group and TAK-242 group than in the control group. Compared with the periodontitis group, MG staining displayed significantly alleviated bone absorption in the TAK-242 group. TRAP staining showed that osteoclast infiltration decreased in the TAK-242 group compared with the periodontitis group (P < 0.001).Conclusions The TLR-4 inhibitor TAK-242 can alleviate bone resorption in severe periodontitis and improve the porous, sparse and disorganized inflammatory bone trabecular structure in rats.

  • XU Wantian, DONG Wenrui, ZHU Wenyin
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 169-177. https://doi.org/10.12016/j.issn.2096-1456.2022.03.003
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    Objective To study the regulatory effect of coiled-coil domain containing 134 (CCDC134) on the osteogenic differentiation of human dental pulp stem cells (hDPSCs).Methods HDPSCs were isolated and cultured from dental pulp tissue and transfected with NC-CCDC134, shCCDC134 and CCDC134 lentiviruses. They were divided into the control group, negative control group, CCDC134 downregulation (shCCDC134) group and CCDC134 overexpression (CCDC134) group. Surface markers of hDPSCs (Stro-1, CD105, CD34, CD45) were detected by flow cytometry; colony formation was analyzed by toluidine blue staining; ALP expression was estimated by ALP staining; mineralized nodule formation was evaluated by alizarin red staining; lipid droplet formation was examined by oil red staining; and gene and protein expression of CCDC134, Runt-related transcription factor 2 (RUNX2), osteocalcin (OCN), bone morphogenetic protein-2 (BMP-2), and mothers against decapentaplegic homolog 1 (SMAD1) was detected by qPCR and western blot, respectively. Further, a BMP-2 activator (BMP-2) and inhibitor (Dorsomorphin) were used to down-regulate and up-regulate CCDC134, respectively (shCCDC134, shCCDC134+BMP-2, CCDC134, CCDC134+Dorsomorphin), in hDPSCs. The hDPSC aggregates were subcutaneously transplanted into nude mice for 2 months, and new bone formation was detected by H&E staining. The BMP-2/SMAD1 signaling in each group was detected by qPCR.Results hDPSCs showed high expression of mesenchymal markers and low expression of hematopoietic markers. Compared with the control group, the expression of CCDC134 was increased in the osteogenic-induced hDPSCs (P < 0.05). Compared with the negative control group, the expression of CCDC134 was decreased in the shCCDC134 group, whereas it was increased in the CCDC134 group (P < 0.05). The mineralized nodules, osteogenic genes and proteins in the shCCDC134 group were decreased (P < 0.05), while they were increased in the CCDC134 group (P < 0.05). The expression of BMP-2/SMAD1 signaling decreased in the shCCDC134 group, while it increased in the CCDC134 group (P < 0.05). Compared to the shCCDC134 group, osteogenic genes and proteins increased in the shCCDC134+BMP-2 group, and subcutaneous new bone formation increased in nude mice (P < 0.05). The indexes of the CCDC134+Dorsomorphin group decreased compared with the CCDC134 group (P < 0.05).Conclusion CCDC134 promotes the osteogenic differentiation of hDPSCs by regulating the BMP-2/SMAD1 signaling pathway.

  • DENG Wenzhen, TIAN XU Tengyue, LI Xuewei, DONG Wei, LIANG Yongqiang
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 178-184. https://doi.org/10.12016/j.issn.2096-1456.2022.03.004
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    Objective The antibacterial properties and bonding strength of 3M orthodontic adhesive resin modified by chlorhexidine acetate (CHA) composite mesoporous silica were investigated.Methods CHA with different mass fractions was encapsulated in mesoporous silica nanoparticles (MSNs) (denoted CHA@MSNs). Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM) were used to characterize the samples. The 3M Z350XT flow resin was divided into 4 groups: group A: 3M+CHA@MSNs (0%); group B: 3M+CHA@MSNs (3%); group C: 3M+CHA@MSNs (5%); and group D: 3M+CHA@MSNs (6.4%), with mass scores of 0%, 3%, 5%, and 6.4%, respectively. The shear strength of the modified adhesive was tested by a universal electronic material testing machine, the adhesive residue was observed by a 10 × magnifying glass, and the adhesive Remnant index (ARI) was calculated. The four groups of modified adhesives were cultured with Streptococcus mutans. The OD540 value of the bacterial solution was measured by a spectrophotometer, and the amount of plaque attachment was observed by scanning electron microscopy to evaluate the antibacterial performance of the adhesives.Results Infrared spectroscopic analysis of CHA@MSNs showed that CHA was successfully loaded onto MSNs. Under scanning electron microscopy, it could be seen that, after Cha was combined with MSNs, the structure of MSNs changed, as the boundary was fuzzy and aggregated into a layered structure. A comparison of shear strength revealed a statistically significant difference between the groups containing CHA@MSNs and the groups without CHA@MSNs (P<0.05). The value of the shear strength in group D decreased the most, while there was no statistically significant difference between group B and group C (P > 0.05). There was no statistical significance across all groups (P > 0.05), suggesting that the addition of CHA@MSNs had little effect on the bracket shedding. The OD540 value of bacterial fluid indicated that the difference among groups A, B and C was statistically significant (P < 0.05), and the antibacterial effect of group C was the best; there was no statistically significant difference between group C and group D (P > 0.05).Conclusions Therefore, adding 5% CHA@MSN antibacterial agent significantly improved the antibacterial effect and did not affect the bond strength.

  • Clinical Study
  • SONG Yuefeng, WANG Wenmei, XU Dongmei, WANG Xiang, LI Bing, ZHAO Maomao, DUAN Ning
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 185-190. https://doi.org/10.12016/j.issn.2096-1456.2022.03.005
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    Objective To investigate the classification of atrophic glossitis and to study the correlation between the classification and changes of VitB12, folic acid (FOL) and blood cell parameters.Methods A total of 70 patients with atrophic glossitis (AG) were divided into complex type and simple type according to whether they had ulcer or erosion on the tongue mucosa or not. Another 65 healthy subjects during the same period were collected as the control group. The levels of vitamin B12, FOL and blood cell parameters were statistically analyzed using SPSS 25.0 software package.Results The levels of vitamin B12, red blood cell count (RBC) (3.52 ± 0.69) × 1012·L-1, hemoglobin (HGB)(11.97 ± 1.70) g·dL-1, white blood cell count (WBC) (4.85 ± 1.16) × 109·L-1, neutrophil count (NEUT) (2.76 ± 0.99) × 109·L-1, lymphocyte count (LYMPH) (1.48 ± 0.44) × 109·L-1 in complex type AG group were lower than those in simple type AG group (P<0.05). The levels of mean red blood cell volume (MCV) (104.90 ± 11.13) fL, mean corpuscular hemoglobin (MCH) (34.83 ± 4.56) pg, mean corpuscular hemoglobin concentration (MCHC) (331.09 ± 13.60) g·L-1 were higher than those in the simple type AG group (P<0.05). There was no significant difference in FOL content between these two groups (P>0.05). The levels of VitB12, MCV, MCH, MCHC, WBC, lymph and neut were correlated with the classification of atrophic glossitis (P < 0.05). Conclusion VitB12 deficiency was more apparent in complex AG, especially in large cell anemia, which correlated with the levels of WBC, NEUT, and LYMPH.

  • ZHANG Wen, ZOU Bo, LIU Jianlin, YUAN Daoying
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 191-199. https://doi.org/10.12016/j.issn.2096-1456.2022.03.006
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    Objective To clarify the prognostic value of the neutrophil to lymphocyte ratio (NLR) in oral squamous cell carcinoma (OSCC) patients.Methods The literature on the correlation between NLR and the prognosis and clinicopathological features of OSCC was searched in PubMed, Web of Science, Cochrane and Embase. The outcome indicators, including overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), tumor size, cervical lymph node metastasis, tumor stage, extracapsular lymph node invasion and peripheral nerve invasion, were analyzed by RevMan5.3 software.Results In total, 6 180 patients were included in 23 studies. The analysis showed that NLR was significantly negatively correlated with OS [HR=1.62, 95%CI(1.38, 1.91), P < 0.001], DFS [HR=1.48, 95%CI(1.24, 1.77), P < 0.001] and DSS [HR=1.87, 95%CI(1.60, 2.20), P < 0.001]. In addition, higher NLR values were positively correlated with tumor size [OR=2.68, 95%CI (1.84, 3.90), P < 0.001], cervical lymph node metastasis [OR=1.59, 95%CI (1.35, 1.88), P < 0.001], tumor stage [OR=2.85, 95%CI (2.35, 3.47), P < 0.001], extralymphatic invasion [OR=1.72, 95%CI (1.23, 2.40), P=0.001], and peripheral nerve invasion [OR=1.70, 95%CI (1.29, 2.24), P < 0.001]. However, there was no significant correlation with age [OR=0.96, 95%CI (0.71, 1.29), P=0.77], sex [OR=1.08, 95%CI (0.88, 1.33), P=0.55], or degree of differentiation [OR=1.15, 95%CI (0.92, 1.43), P=0.22].Conclusion Elevated NLR was significantly associated with the prognosis and clinicopathological features of OSCC and might be an independent prognostic factor.

  • DING Qianchuan, FENG Hongchao, WEI Jing, YE Bin, WANG Zhaohui
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 200-206. https://doi.org/10.12016/j.issn.2096-1456.2022.03.007
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    Objective To explore the imaging characteristics of the mandibular nerve canal in adults to provide a reference for clinical mandibular surgery.Methods One thousand adult patients in Guiyang Stomatological Hospital from January 2018 to January 2021 were randomly selected. Cone beam CT (CBCT) was used to observe the anterior mandibular canal and other branches, and the incidence of anterior canal in the mandibular ramus area, posterior molar area and molar area and the distance to each point of the mandible were measured.Results Of the 901 patients (1 802 sides) included in the study, 386 patients (42.84%) found branches of the mandibular canal, and 182 patients (97 males and 85 females) found the Anterograde Canal 20.20% (182/901). In total, 225 mandibles were found to have anterior canals. There were 101 cases of left mandible and 124 cases of right mandible. The forward canal mainly occurred in the molar area, the molar posterior area and the ascending branch area, and the ascending branch area was the best starting point of the forward canal and the molar stopping point (P < 0.05). The average length of the forward canal (L1) was (10.364 ± 3.833) mm, the average height of the forward canal to the main trunk of the mandibular nerve (L2-RRB) was (3.623 ± 2.035) mm, and the average height of the forward canal to the crest of the alveolar ridL3 (l3) was (9.280 ± 3.240) mm.Conclusion Mandibular nerve canal branches are common, and there were no differences in male, female and lateral distribution. In this study, the incidence of mandibular anterior canal was the highest, and it often occurred in the molar area.

  • LIU Qing, LIU Qinghui, ZHOU Jing, DENG Xuehua
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 207-211. https://doi.org/10.12016/j.issn.2096-1456.2022.03.008
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    Objective To explore the design and manufacture of anatomical healing abutment for mandibular first molar implant in order to provide more choices for clinical healing abutment.Methods The buccal lingual diameter and mesial distal diameter of the tooth neck, as well as the slope data of the four axial surfaces of the natural isolated teeth, were obtained by scanning the isolated mandibular first molar with a shining scanner. After statistical analysis of the data, the anatomical healing abutment of the mandibular first molar was designed and constructed using computer aided design/computer aided manufacturing (CAD/CAM).Results The mean buccal and lingual diameters of the mesial and distal diameters of the isolated mandibular first molars were (8.54 ± 0.78) mm and (7.87 ± 0.86) mm, and the tooth neck slopes of each axial surface of the isolated mandibular first molars were 17.53 °(buccal), 14.41 °(lingal), 13.40 °(mesial) and 13.43 °(distal), respectively. Three anatomical healing abutments with different peripheral diameters and heights of 5 mm were obtained according to a certain proportion of reduction of the natural teeth of the mandibular first molars.Conclusion The anatomical healing abutment of the mandibular first molar can be quickly obtained by Shining scanning and CAD/CAM technology.

  • Review Articles
  • TANG Xiaoyi, ZHANG Pan, WANG Kaiyan, NIU Lina, JIAO Kai, XIAO Yuhong
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 212-216. https://doi.org/10.12016/j.issn.2096-1456.2022.03.009
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    Oral squamous cell carcinoma (OSCC) is a common malignant tumor of the head and neck. In recent years, the incidence rate has been increasing. Mitochondria are dynamic organelles involved in various cell behaviors in eukaryotic cells. Mitochondrial dysfunction is closely related to tumor development. As a switch that determines cancer cell death, targeting mitochondria has become the focus of OSCC treatment. This article reviews the relationship between mitochondria and tumorigenesis and development, OSCC treatment, and cisplatin resistant OSCC. Current studies have found that mitochondrial dysfunction promotes cell carcinogenesis, and the mitochondrial morphology and function of cancer cells are significantly changed. The increase of mitochondrial fission improves the invasiveness of cancer cells, and mitophagy dysfunction can induce cancer cell apoptosis. The emergence of drugs and the development of nanotechnology in targeted drug delivery systems have opened up new methods for targeting mitochondria to treat OSCC, reducing the side effects of systemic medication. The cisplatin resistance of OSCC is generated through the mitochondrial pathway, and the mitochondrial function and mutation mechanism of mitochondrial DNA are clarified in order to provide new ideas for targeting mitochondria to treat cisplatin resistant OSCC.

  • ZHONG Yongjin, TANG Quan, HUANG Ruijie
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 217-220. https://doi.org/10.12016/j.issn.2096-1456.2022.03.010
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    Berberine is a natural isoquinoline alkaloid extracted from Rhizoma Coptidis and other Chinese herbal medicines. Since berberine has a variety of biological effects, such as bacteriostasis, anti-inflammatory, anti-bone resorption and blood sugar-lowering effects, and is associated with few side effects, studies are increasingly discovering its potential application in the prevention and treatment of periodontitis. This review summarizes the relevant research progress of berberine in the prevention and treatment of periodontitis in recent years, aiming to provide a new strategy for the clinical prevention and treatment of periodontitis. The results of the literature review showed that berberine could prevent the occurrence and development of periodontitis by inhibiting periodontal pathogens, reducing periodontal tissue inflammation and inhibiting alveolar bone resorption. However, the mechanism of periodontitis is complicated, and current research remains limited. In the future, more in vivo and in vitro studies are needed to further explore the mechanism of berberine in inhibiting the occurrence and development of periodontitis, and more large-sample prospective clinical studies should be conducted to confirm the effect of berberine on the prevention and treatment of periodontitis.

  • WANG Suping, CAI Yingchun
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 221-224. https://doi.org/10.12016/j.issn.2096-1456.2022.03.011
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    Metformin is currently the first-line drug for the treatment of diabetes. In addition to its hypoglycemic effect, it has also been found to have other potential effects, such as anti-inflammatory, odontogenic differentiation-promoting, osteogenic differentiation-promoting, and antitumor effects. Previous studies have shown that metformin can promote the healing of periapical lesions, and its mechanism may be related to the promotion of osteogenic differentiation and the induction of dental pulp cell differentiation by activation of adenylate-activated protein kinase by dimethyldiphosphate. Clinical indexes, such as the probing depth, attachment loss level and probing bleeding index, were significantly improved in patients with periodontitis treated with metformin, which may play a role in the prevention and treatment of periodontal disease by promoting the proliferation, migration and osteogenic differentiation of periodontal ligament stem cells. Metformin has been proven to inhibit the growth and proliferation of tumor cells and plays an important role in the prevention and treatment of oral tumors such as oral squamous cell carcinoma. At present, research remains in the in vitro and animal experimental stage, and the related mechanism needs to be further explored. Clinical trials remain in the evaluation of clinical indicators, so large-scale, long-term, multicenter, randomized controlled clinical trials need to be further developed.

  • ZHENG Jiji, LUO Guangyun, WU Jiayuan
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(3): 225-228. https://doi.org/10.12016/j.issn.2096-1456.2022.03.012
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    Conservative endodontic access cavity (CEC) is the first step of minimally invasive endodontics. After that operation, teeth retain the dental hard tissue, such as crest and peri-cervical dentin, to a large extent. It is of great significance to reduce the tissue excision and achieve a favorable prognosis. There are a variety of approaches and corresponding cavities in CEC. The methods to determine the medullary approach include X-ray localization, micro CT/cone beam CT localization and digital guide plate localization. Among them, X-ray film and micro CT/cone beam CT are simple and commonly used in the clinic. For more complex root canal systems, the use of a digital guide plate can establish a more accurate pulp opening pathway and reduce the unnecessary loss of tooth hard tissue. However, the positioning price of a digital guide plate is high, and it has not been widely used in the clinic. The hole types of CEC include minimally invasive medullary hole type, super conservative minimally invasive medullary hole type, "Truss" hole type and cutting end hole type. The stress analysis of CEC and traditional endodontic access (TEC) cavity are mainly based on the loading of teeth by a universal mechanical testing machine in vitro, finite element analysis and clinical observation. Most scholars’ studies have shown that minimally invasive endodontics can improve the fracture resistance of teeth, but the differential capacities of CEC and TEC remain controversial. How does on balance the purpose of pulp treatment and the maximum retention of tooth tissue? Further exploration is still needed.