TNM（tumor node metastasis）classification is a common way to evaluate the prognosis of patients with oral cancer; however, many years of application have proven this method to be confined merely in clinical and pathological data and it cannot be adapted to the development of modern medicine. Deep learning (DL) has been widely used in various aspects of human life, has advantages for conducting efficient and intelligent searches and can explore and analyze substantial medical information well. Additionally, the application of DL to medical practice is quickly increasing. In the field of oral cancer prognosis, DL can efficiently process and analyze the pathological, radiographic and molecular data of oral cancer patients represented by lymphocytes, gray level cooccurrence matrix (GLCM) and gene maps and make accurate prognostic judgments accordingly. By assisting physicians in optimizing treatment plans, DL can effectively improve patients’ survival. Although DL lacks sufficient data and practical clinical application in prognostic studies, it has shown good clinical application prospects.
Objective To explore effect on the remineralization of demineralized enamel surfaces with glycine-guided carboxymethyl chitosan (CMC)/amorphous calcium phosphate (ACP). Methods Remineralized solultion at different stages were prepared: ①reactive CMC/ACP (CMC/ACP nanoparticles treated with NaClO), ②reactive CMC/ACP+glycine; transmission electron microscopy was used to detect the morphology of the remineralized solution particles. Twenty teeth were randomly divided into two groups: group A and group B. Reactive CMC/ACP was applied to the enamel surface of group A and group B was treated with reactive CMC/ACP remineralization solution containing glycine. Scanning electron microscopy was used to detect the enamel surface morphology before and after remineralization, and nanoindentation was used to detect the mechanical strength (including nanoindentation depth, hardness and elastic modulus) of the enamel surface. Results Under a transmission electron microscope, the particles in the reactive CMC/ACP remineralization solution were smooth, and the increase in particle size was approximately 100-300 nm. After the addition of glycine, the particles in the reactive CMC/ACP remineralization solution particles showed a linear ordered arrangement, and microcrystals were formed in the solution 15 min later, with a crystal length of approximately 5-15 μm. Remineralization in group A was granular and heterogeneous. In group B, the crystal morphology of the demineralized enamel was homogeneous and ordered, similar to that of natural enamel. The nanoindentation depth of group B after remineralization was smaller than that of group A, and it was closest to that of natural enamel, there was no significant difference between group B and natural enamel in terms of the hardness and elastic modulus of the enamel surface after remineralization. Conclusion CMC/ACP nanoparticles treated with NaClO can rapidly and specifically form directional and ordered remineralization on the enamel surface of a model of glycine-guided rapid remineralization of enamel caries. The surface structure of remineralized enamel is similar to that of natural enamel in terms of nanoindentation depth, hardness and elastic modulus.
Objective To investigate the effect of silencing histone deacetylase 9 (HDAC9) expression on the proliferation and osteogenic differentiation of periodontal ligament stem cells (PDLSCs). Methods PDLSCs were isolated, cultured and identified in vitro. An siRNA construct specific for HDAC9 was transfected into PDLSCs (siHDAC9 group), and a nontargeting siRNA was used as a control (siNC group). The interference effect was determined by qRT-PCR. The cell cycle progression of PDLSCs was detected using flow cytometry. The proliferation activity of PDLSCs was detected via CCK-8 assay. Western blotting was used to detect the protein expression of proliferating cell nuclear antigen (PCNA). The mRNA expression of runt-related transcription factor 2 (RUNX2) and alkaline phosphatase (ALP) was investigated by qRT-PCR. The protein expression of RUNX2 was detected by western blotting. In addition, the formation of mineralized nodules was assessed by alizarin red staining. Results Compared with that in the siNC group, the mRNA expression of HDAC9 in the siHDAC9 group was lower (P < 0.01). Moreover, compared with those in the siNC group, the proliferation index (P<0.01), proliferation activity (P<0.05) and protein expression of PCNA (P<0.01) in the siHDAC9 group were all increased. Compared with the siNC group, the siHDAC9 group exhibited higher mRNA expression of RUNX2 and ALP (P < 0.05), and the protein expression of RUNX2 showed the same results (P < 0.01). The results of alizarin red staining showed that compared to the siNC group, the siHDAC9 group formed more mineralized nodules. Conclusion Silencing HDAC9 expression can promote the proliferation and osteogenic differentiation of PDLSCs.
Objective To investigate the relationship between serum miR-199a-5p and miR-378a-3p levels and the recurrence of infants with proliferative facial hemangioma relapsed after propranolol withdrawal in infants. Methods Ninety-three infants with proliferative facial hemangioma were selected, all of whom received propranolol treatment. The recurrence of the hemangioma after treatment was followed up, and the children were divided into a recurrence group (23 patients) and a nonrecurrence group (70 patients). Venous blood was collected before and after treatment, and the serum levels of miR-199a-5p and miR-378a-3p were detected by qRT-PCR, and the relationship between the serum levels of miR-199a-5p and miR-378a-3p and the recurrence of proliferative facial hemangioma relapsed after propranolol withdrawal in infants was analyzed. Results The serum expressions levels of miR-199a-5p and miR-378a-3p in non-relapsed group were increased after treatment compared with before treatment (P < 0.05), and there was no significant difference in the levels of miR-199a-5p and miR-378a-3p in the serum of the recurrence group after treatment compared with before treatment (P > 0.05). After treatment, the levels of miR-199a-5p and miR-378a-3p in the serum of the recurrence group were lower than those of the nonrecurrence group (P < 0.05). After treatment, the serum levels of miR-199a-5p and miR-378a-3p in patients with Ⅲ ~Ⅳ Norm grade hemangioma were higher than those in patients with Ⅰ~Ⅱ Norm grade hemangioma (P < 0.05). Logistic regression analysis showed that the low expression of miR-199a-5p, low expression of miR-378a-3p and tumor grade Ⅰ~Ⅱ after treatment were risk factors for the recurrence of proliferative facial hemangioma after propranolol withdrawal in infants (P < 0.05). Conclusion Low serum levels of miR-199a-5p and miR-378a-3p are associated with the recurrence of proliferative facial hemangioma after propranolol withdrawal in infants.
Objective To investigate the effect of treatment dentures on changes in denture space in edentulous patients and to evaluate its clinical effect. Methods Twenty patients with treatment dentures were investigated with a questionnaire and Oral Health Impact Profile (OHIP-14) before and after treatment. The denture space, denture tissue surface, occlusal points, Gothic arch images, mucosal condition, lateral occlusal condition, bite force, retention and stability, patient mastication ability, denture satisfaction, and OHIP-14 score were collected for statistical analysis. Results After wearing treatment dentures, the denture space significantly improved, the tissue conditioners on the treatment denture gradually began to be distributed, and the occlusal points gradually became symmetrical. The gothic arch images showed that the joints, nerves, and muscles gradually stabilized. The mucosal condition changed to a healthy state. The lateral occlusal conditions were improved. There were also significant differences in the bite force, retention and stability, subjective and objective chewing ability, satisfaction with the denture and OHIP-14 score before and after treatment (P < 0.05). The objective chewing ability was positively correlated with the retention stability of the denture, the subjective chewing ability and the satisfaction of the denture, and it was negatively correlated with OHIP-14. Conclusion Treatment dentures could help to restore denture space to an ideal condition and improve the oral health of patients. This treatment could also improve the retention and stability of the denture and the chewing ability to improve patient satisfaction. This treatment has clinical application value and promotion potential.
Objective To investigate the correlation between vitamin D levels and the risk of early childhood caries (ECC), and to provide a reference for the primary prevention of ECC in children. Methods A total of 389 children aged 6 months to 48 months were enrolled in this study. Data of feeding patterns and oral health behaviors were collected, and decayed-missing-filled teeth (dmft) were recorded. The children were divided into an ECC group (dmft > 0, n= 146) and a caries-free group (dmft=0, n=243). Peripheral blood of fingertips was collected to detect the active form of vitamin D--25(OH)D in vivo, and the cariogenic activity of dental plaque was analyzed with the Cariostat test. Logistic regression analysis was carried out to analyze the correlation among caries related factors such as 25(OH)D levels and caries risk in patients with ECC. Results There was no significant difference in the prevalence of dental caries among 25(OH)D deficiency, insufficiency and normal children (χ2=2.320, P=0.313). There was no correlation between dmft and 25(OH)D levels (dmft=1-3, r < 0.001, P > 0.05; dmft > 3, r= 0.009, P > 0.05). The risk factors for ECC were age (OR=1.082, 95% CI: 1.045-1.121, P < 0.001), breastfeeding within 6 months after birth (OR=2.789, 95% CI: 1.581-4.921, P < 0.001), nighttime milk consumption or sleeping with a nipple (OR=4.187, 95% CI: 1.938-9.048, P < 0.001), and a high Cariostat value of 1.5-3.0 (OR=4.173, 95% CI: 2.014-8.646, P < 0.001). Conclusion There was no correlation between 25(OH)D level and caries in children aged 6-48 months. The risk factors for ECC are age, breastfeeding before 6 months old, nighttime milk consumption or sleeping with a nipple and high cariogenic activity (Cariostat value of 1.5-3.0). It is necessary to establish good feeding habits and oral hygiene habits for children while promoting breastfeeding.
Objective To study the effect of fluoride varnish, glass ionomer and resin sealant on the prevention of pit and fissure caries in young children, and to identify an a method to reduce the sensitivity of operation technique to prevent pit and fissure caries in young children with limited moisture isolation. Methods A self-control design was used to select 370 young children aged 3 to 5. Eight molars in the mouth were distributed in four quadrants, and each quadrant was randomly allocated to the blank group, fluoride varnish Duraphat group, glass ionomer GC FujiⅦ group, and resin ClinproTM Sealant group. The retention rate of pit and fissure sealant and the incidence of primary molar caries were observed in the 6th, 12th, 24th and 36th months respectively. Results In the 6th month, 12th month and 24th month, there were no significant differences in the material retention rate between the GC Fuji Ⅶ group and ClinproTM Sealant group. In the 36th month, the retention rate of the ClinproTM sealant group was better than that of the GC Fuji Ⅶ group (P < 0.05). In the 6th month, the caries incidence in the Duraphat group, GC Fuji Ⅶ group and ClinproTM sealant group was significantly lower than that in the blank group (P < 0.001). There was no significant difference between the Duraphat group, GC Fuji Ⅶ group and ClinproTM sealant group. In the 12th month, 24th month and 36th month, the incidence of caries in the GC Fuji Ⅶ group and ClinproTM sealant group was lower than that in the Duraphat group and blank group (P < 0.001), but there was no significant difference between the blank group and Duraphat group, and there was no significant difference in caries incidence between the GC Fuji Ⅶ group and ClinproTM sealant group. Conclusion The GC Fuji Ⅶ and ClinproTM sealant treatments continuously and effectively prevented pit and fissure caries compared with simple fluoride application. However, in cases of limited cooperation and poor moisture isolation in young children, the preventive measures of glass ionomer pits and fissure sealants (GC Fuji Ⅶ) are simpler and more feasible.
Objective To investigate the clinical efficacy of Nd: YAG laser combined with 3% acyclovir cream in the treatment of herpes labialis. Methods A total of 72 patients with herpes labialis were enrolled. According to the random number table method, the patients were divided into an observation group and a control group with 36 patients in the observation group and 36 patients in the control group. The Nd: YAG laser combined with 3% acyclovir cream was administered to the observation group, while 3% acyclovir cream was administered to the control group. The total effective rate, scab, scab removal, analgesic time, and quality of life were compared between the two groups. Results 7 days after treatment, the total effective rate of clinical treatment in the control group was 27 patients (75%), and that in the observation group was 34 patients (94.4%); the contrast difference was statistically significant (P < 0.05). Compared with those in the control group, the crusting, prolapse and analgesic time of the observation group were shorter, and the differences were statistically significant (P < 0.05). Compared with the control group, the observation group had higher quality of life scores, and there was a statistical significance (P < 0.05). Conclusion For patients with herpes labialis, using Nd: YAG laser combined with 3% acyclovir cream treatment can significantly improve the quality of life of patients and accelerate the speed of patient rehabilitation.
Optical illusion refers to the phenomenon in which the scene observed by the human eye is not completely consistent with the objectively presented scene. Optical illusions in stomatology, as well as their clinical application, are demonstrated in this paper in terms of shade, shape and aesthetic design. Shade is not only affected by the optical illusions with which it is associated, such as color metamerism, color constancy and the Chevreul illusion, but also influenced by the surroundings. It is suggested that the surrounding lighting during veneering should be the same as that during color matching in the clinic. As indicated by the Poggendorf illusion and the Leaning Tower illusion, the practice should be conducted and checked from multiple perspectives to compensate for the limitation of human eyes, such as intraoral scanning. Other digital technologies, including digital facial scanning and cephalometric measurement, could be used to reduce the subjective influence of observation. In terms of esthetic design, the interaction of the part and the whole, suggested by Ebbinghaus illusion, should be considered: an individual harmony smile should be designed considering the characteristics of the personality and the features of the face, lips, teeth and gingiva of the patient. Furthermore, personal information, such as gender and age, should be taken into consideration in beautification presentation. Further research should be focused on the influence of optical illusions in stomatology in more details. More communication among doctors, technicians and patients is needed. Clinicians should be aware of the impact of optical illusions to reduce subjective bias in clinical standardized operations and further take advantage of optical illusions to create beautification presentations of dental restorations and smiles.
The endocrown, a modified overlay or crown, is considered to have the advantages of adhesive retention and mechanical retention. Marginal adaptation and mechanical strength are common criteria for evaluating endocrowns. This review studied these aspects of endocrowns to guide further clinical application. Results from previous academic studies indicate that endocrowns made of different materials, such as glass-based ceramics, zirconia-based ceramics and resin-based ceramics, exhibit clinically acceptable marginal adaptation. Zirconia is a common dental material, but when used in endocrowns, it tends to present a risk of irreparable tooth root fractures. Compared with products manufactured with zirconia, endocrowns manufactured with resin-based ceramics and glass-based ceramics, such as lithium disilicate ceramics, do not tend to cause irreparable results, such as tooth root fracture, but their mechanical strengths are not as good as those of zirconia. At the same time, the tooth prepration design such as the types of endocrowns, the pulp chamber extension depth and angles, the endocrown thickness can influence the mechanical strength of endocrowns as well. Compared with traditional zirconia, self-glazed zirconia, a new type of material used to restore defective teeth, has the similar elasticity modulus（210 GPa）and better aesthetic advantages, and is suitable for short crown patients with insufficient occlusal space. Further study is warranted to improve the performance of endocrowns made from ceramic materials to prevent root fracture.
Endodontic microsurgery is one effective method for preserving teeth affected by periapical disease, and is also an essential technique for treating difficult cases. However, due to the restricted operating space at the posterior site and the proximity of the root apex to the maxillary sinus, endodontic surgery in the posterior maxillary area represents great challenges. This article summarizes the anatomical relationship between the maxillary sinus and the maxillary posterior teeth, the influence on endodontic microsurgery, and the application of assistive techniques on maxillary posterior teeth, such as 3D-printed surgical guides and ultrasonic osteotomes. Literature review results show that the spatial relationship between the apex of maxillary posterior teeth and the maxillary sinus is usually divided into three categories: the apex enters the maxillary sinus; the apex contacts the bottom of the maxillary sinus; and there is a distance between the apex and the bottom of the maxillary sinus. CBCT should be performed before the operation, and the periapical state of the tooth and the maxillary sinus and the distance between the lesions and the sinus floor should be considered to evaluate the difficulty of the operation. Meanwhile, during surgery, equipment such as surgical guides, endoscopes and ultrasonic osteotomes should be used to ensure that the operation is safer, reliable, precise and less invasive, but the clinical popularity of ultrasonic osteotomes still needs further promotion. Moreover, high-quality clinical studies on the long-term effects of micro-apical surgery in the posterior maxillary area are still lacking.
Obstructive sleep apnea hypopnea syndrome (OSAHS), which is a common childhood disease, is a trending topic in clinical multidisciplinary research due to its detriment to the growth and development of children. Due to the wide variety and specificity of pathogenesis and clinical manifestations, the clinical diagnosis of OSAHS is sophisticated and difficult and remains controversial in the field. This review summarizes the common diagnostic methods in OSAHS for children, including polysomnography,which is known as the current “gold standard”, pulse oximetry, fiberoptic nasopharyngoscopy, nasopharyngeal lateral X-ray, CT, and magnetic resonance imaging (MRI). Furthermore, it emphasizes the new diagnostic critical value from Chinese guidelines for the diagnosis and treatment of obstructive sleep apnea in children (2020) for children with OSAHS released by China in 2020: the obstructive apnea hypopnea index (OAHI) is ≥ 1 time/h; it also emphasizes the importance of history and physical examination to contribute to clinical diagnosis and treatment for children with OSAHS.
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