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20 August 2022, Volume 30 Issue 8
    

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    Basic Study
  • LI Yujiao, CHENG Xiaogang, QIAN Fei, PAN Yating, CHEN Liyuan, TIAN Yu
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 533-541. https://doi.org/10.12016/j.issn.2096-1456.2022.08.001
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    Objective Metagenomic sequencing was used to explore the species composition and internal functional metabolic pathway of saliva and supragingival plaque microbial communities in healthy adults to provide a theoretical reference for the biological prevention and treatment of oral diseases. Methods Saliva and supragingival plaque samples were collected from healthy adults, total DNA was extracted, and a metagenomic library was constructed. The qualified library was sequenced via metagenomics, and the sequencing data were analyzed using bioinformatics and statistics. Results The main bacterial phyla in healthy oral samples were Proteobacteria (32.51%), Bacteroidetes (30.81%), and Actinobacteria (16.23%), and the main bacterial species were Corynebacterium matruchotii (3.84%), Haemophilus parainfluenzae (2.91%), and Prevotella melaninogenica (2.76%). The alpha diversity of the supragingival plaque group was higher than that of the saliva group, and there was a significant difference in the composition of the microbial community between the two groups (P<0.05). At the species level, Prevotella melaninogenica, Fusobacterium periodonticum, and Prevotella intermedia were more abundant in saliva samples than in supragingival plaque samples, while Corynebacterium matruchotii, Propionibacterium acidifaciens, and Rothia dentocariosa were more abundant in supragingival plaque samples than in saliva samples (P<0.05). High-quality gene sets of saliva and supragingival plaque in healthy adults were constructed based on metagenomic sequencing. The results of KEGG pathway functional metabolic differences showed that starch and sucrose metabolism, leucine and isoleucine degradation, and arginine biosynthesis in salivary microorganisms were more abundant than in supragingival plaque, while glycolysis/gluconeogenesis and carbon metabolism in supragingival plaque were more abundant than in saliva. Conclusion There are significant differences in the species composition and functional gene metabolic pathways of saliva and supragingival plaque microecology in healthy adults. The sensitivity of dominant species in different microecological regions to the identification of oral diseases may be different. In the microbiological study of oral diseases, appropriate samples should be selected according to different diseases.

  • ZENG Huaqian, MAO Ling, JIN Yaheng, LI Shiting, XU Ai
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 542-548. https://doi.org/10.12016/j.issn.2096-1456.2022.08.002
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    Objective To investigate the inhibitory effect of honeysuckle on Streptococcus mutans UA159 in vitro. Methods We used a double-dilution method to measure the minimum inhibitory concentration (MIC) of honeysuckle against Streptococcus mutans UA159. Lonicerae lonicerae powder was dissolved in the solvent DMSO, different concentrations of liquid medicine were prepared, and bacterial liquid was added. The solution control group and bacterial liquid control group were set at the same time. The growth and acid production of UA159 were determined using antibacterial experiments. A growth curve and acid production curves were drawn, and the adhesion rate and adhesion inhibition rate were calculated. The effect of honeysuckle on the formation of Streptococcus mutans UA159 was determined by crystal violet quantification, and a microscope and a scanning electron microscope were used to observe biofilm formation and structural changes. Results The MIC of honeysuckle against Streptococcus mutans UA159 was 12.5 mg/mL. The bacteriostatic experiments showed a difference in the growth, acid production and adhesion of UA159 after honeysuckle treatment (P<0.05) compared with the controls, and the inhibitory effect increased as the drug liquid concentration increased. Crystal violet quantification showed a significant difference in biofilm formation between the pharmaceutical liquid group and the control group (P<0.05). Meanwhile, the forward microscope showed a significant decrease in biofilm formation. Under SEM, the number of bacteria decreased significantly at 0, 6 and 12 h after honeysuckle addition. Conclusion Honeysuckle inhibits the growth and acid production of UA159 and inhibits adhesion and the formation of biofilms.

  • HU Dandan, LUO Xiaoping, REN Canxia
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 549-555. https://doi.org/10.12016/j.issn.2096-1456.2022.08.003
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    Objective To evaluate the effect of heat treatment on the bonding strength of pure titanium formed by selective laser melting (SLM) and porcelain. Methods Ninety-six pure titanium specimens were laser machined to meet ISO 9693 standards. The specimens were divided into a heat treated group (A) and a nonheat treated group (B). According to the porcelain type, the specimens in groups A and B were divided into Super Ti22 (a), Titankeramik (b), and Triceram (c) groups. Then, according to sandblasting pressures of 0.25 MPa (1) and 0.45 MPa (2), they were further divided into Aa1, Aa2, Ab1, Ab2, Ac1, Ac2, Ba1, Ba2, Bb1, Bb2, Bc1, and Bc2 groups. The surface morphology and roughness of the sandblasted specimens were assessed using a laser scanning confocal microscope. After the porcelain was fused, the three-point bending titanium-porcelain bonding strength was tested. A stereomicroscope was used to characterize the titanium-porcelain interfaces and determine the mode of failure. Results The Vickers hardness of group A specimens (188.21 ± 11.94) was significantly lower than that of group B specimens (204.48 ± 6.32) HV (P<0.05). The roughness value in group A1 (2.90 ± 0.32) μm was significantly lower than that in group A2 (3.43 ± 0.43) μm (P<0.05). Specimens in group B1 (2.62 ± 0.08) μm were significantly smaller than those in group B2 (3.01 ± 0.06) μm (P<0.05). The bonding strength in group Aa1 was (33.75 ± 2.31) MPa, group Aa2 was (36.32 ± 1.44) MPa, group Ab1 was (39.82 ± 2.28) MPa, group Ab2 was (33.74 ± 1.53) MPa and group Ac2 was (38.63 ± 1.36) MPa, which was significantly higher than that in the corresponding groups Ba1 (29.65 ± 1.10) MPa, Ba2 (27.17 ± 2.24) MPa, Bb1 (27.29 ± 1.61) MPa, Bb2 (23.85 ± 0.97) MPa, and Bc2 (35.75 ± 1.93) MPa (P<0.05). With increasing sandblasting pressure, the bonding strength of the titanium ceramic in group Aa2 was significantly higher than in group Aa1, while that in group Ab2 was significantly lower than that in group Ab1 (P<0.05). In groups A, Bc1 and Bc2, the fracture model showed mixed failure, while in groups Ba1, Ba2, Bb1, and Bb2, the model showed interfacial failure. Conclusion The Vickers hardness of SLM titanium can be significantly reduced by heat treatment. SLM pure titanium after heat treatment is beneficial to combination of the three porcelain types and titanium. The titanium-porcelain bonding strength may be affected by sandblasting pressure.

  • Clinical Study
  • LI Shiqi, SU Zhenya, MO Anchun
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 556-563. https://doi.org/10.12016/j.issn.2096-1456.2022.08.004
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    Objective To study the postoperative soft and hard tissue changes and aesthetic effect of immediate implantation and provisionalization (IIPP) combined with guided bone regeneration (GBR) for a single anterior maxillary tooth with a thin facial bone phenotype. Methods A total of 34 patients with thin facial bone (<1 mm) were categorized into two groups: a flapped GBR group and a flapless group. Tooth extraction and IIPP were conducted at the sites in both groups. Implant survival rates, dimensional changes in soft and hard tissues during the six- and twelve-month follow-ups, the pink esthetic score (PES) and patient satisfaction scores at the twelve-month follow-up were measured. Results The implant survival rates were 100% in both groups, and no complications occurred during the 12 months after surgery. The facial bone thickness remained over 2 mm on all measured sides, and the height of the facial bone crest remained at 1.39 mm at the 12-month follow-up in the flapped GBR group, while the facial bone thickness remained less than 2 mm on all measured sides, and the height of the facial bone crest remained at 1.03 mm at the 12-month follow-up in the flapless group. The absorption of facial bone at all measured sides in the flapped GBR group was greater than that in the flapless group (P<0.05). There was no significant difference between the two groups in the dimensional changes of labial soft tissues during the six- and twelve-month follow-ups (P>0.05). The mean PES scores were 10.29 ± 2.34 for the flap GBR group and 10.12±1.78 for the flapless group (P = 0.807). The mean patient satisfaction scores were 8.65 ± 1.27 in the flapped GBR group and 8.76 ± 1.25 in the flapless group, and the patients in both of the groups were satisfied with the esthetic outcomes (P = 0.787). Conclusion IIPP combined with GBR might be a prospective treatment strategy for a single anterior maxillary tooth with a thin facial bone phenotype, but the esthetic risks should never be ignored.

  • ZHU Huixuan, HE Xingfang, HUANG Qiuyu, LIU Manfeng, LIN Yantong
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 564-570. https://doi.org/10.12016/j.issn.2096-1456.2022.08.005
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    Objective To understand the incidence and influencing factors of postoperative constipation in patients with malignant tumors who undergo oral and maxillofacial surgery and construct a constipation risk prediction model to provide a reference for the prevention and treatment of postoperative constipation. Methods The data of 191 patients who underwent oral and maxillofacial malignant tumor surgery at the Affiliated Stomatological Hospital of Sun Yat sen University from June 2019 to June 2020 were analyzed retrospectively. The independent influencing factors were selected via univariate analysis and logistic multivariate regression analysis, a risk prediction nomogram was established, and the prediction model was evaluated by the area under the ROC curve. Both internal and external use the C index to verify the accuracy of the model. Results Among 191 patients, 52 (27.23%) had postoperative constipation. Univariate analysis showed that a preoperative secret history of defecation, total energy intake, tracheotomy, smoking, drinking, operation duration, bleeding volume, bed time, eating homogenate diet, sex, surgical repair method, use of probiotics, T-stage of cancer and food intake may be the influencing factors of postoperative constipation in patients with oral and maxillofacial malignant tumors (P<0.05). Multivariate analysis showed that repair method, bed time and sex were independent risk factors for postoperative constipation in patients with oral and maxillofacial malignant tumors (P<0.05). The repair method was a fibular myocutaneous flap with a long bed time, and male patients were prone to constipation after surgery. The c-index values in the training group and the verification group were 0.882 and 0.953, respectively. The area under the ROC curve of the training group was 0.909 (95%CI: 0.850-0.968), and the area under the ROC curve of the verification group was 0.893 (95%CI: 0.787-0.999). The nomogram showed good discrimination ability. Conclusion The repair method, bed time and sex are independent risk factors for postoperative constipation in patients with oral and maxillofacial malignant tumors. The risk prediction model has good discrimination ability.

  • HU Mingjing, WANG Zhiyong
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 571-577. https://doi.org/10.12016/j.issn.2096-1456.2022.08.006
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    Objective To improve the dentist's understanding of desmoplastic fibroma of the jaw, we investigated the clinical manifestations, pathological features, treatment and prognosis of this disease. Methods The clinical data of 8 patients with desmoplastic fibroma of the jaw who were admitted to Nanjing Stomatological Hospital from 2011 to 2021 were retrospectively reviewed. Results The male-female ratio in this group was 3:1, the age of first onset was 32.13±15.00, and the lesions were mainly in the mandible. Histologically, the lesions was composed of mildly atypical fibroblasts and a large number of collagen fibers. The positive rates of Vimentin, α-SMA and β-catenin in the cytoplasm were 100%, 62.5% and 62.5%, respectively. The Ki-67 level in the initial patients was lower than 5%, and the S-100 protein level was 100% negative. The imaging manifestations were single-room or multichamber light-transmitting lesions with clear or irregular boundaries, with or without peripheral sclerosis. Five patients were treated with curettage for the first time; among them, two patients relapsed with poor prognosis. Three patients underwent extended resection, and all had no recurrence. Conclusions The clinical and imaging features of desmoplastic fibroma of the jaw are not specific. We mainly rely on histopathology to diagnose the disease. It has a high recurrence rate after surgery. At present, the best treatment is to extend surgical resection. Local curettage is easy to relapse and has a poor prognosis.

  • Prevention and Treatment Practice
  • ZHOU Yuwei, WANG Yan, WANG Yuepeng, ZENG Mimi, CHEN Yongju, HUANG Zhiquan, HUANG Zixian
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 578-581. https://doi.org/10.12016/j.issn.2096-1456.2022.08.007
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    Objective To investigate the feasibility of using a carbon dioxide(CO2) laser in the treatment of facial papilloma in children and to evaluate its curative effect and prognosis. Methods A case of pediatric facial papilloma treated with a CO2 laser was reported, and the effects of this disease and CO2 laser treatment were reviewed and analyzed in combination with the literature. Results Under general anesthesia, the lesion tissue of the left lip was excised for pathological biopsy, and the diagnosis was maxillofacial papilloma. The lesions were surgically ablated in stages with a CO2 laser, and erythromycin ointment was applied to the surgical incision after surgery. A total of three rounds of CO2 laser treatment were performed for 3 treatment courses. The child had no complications during or after the operation, the facial appearance was significantly improved, and there was no sign of recurrence during the 6-month follow-up. A literature review showed that CO2 lasers have been widely used in the excision of various surface lesions. In clinical practice, continuous CO2 laser with power of 10-50 W and wavelength of 10.6 μm is used to treat superficial tissue lesions, which can achieve accurate vaporization resection of diseased tissue, less bleeding and a good prognosis. Conclusion CO2 laser was accurate and minimally invasive for the removal of facial papilloma in children.

  • WU Lin, KONG Fanzhi, QIAN Liangyu, QIU Chenguang, SUN Hongtao, SHE Peng
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 582-587. https://doi.org/10.12016/j.issn.2096-1456.2022.08.008
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    Objective To discuss and summarize the preventive measures and treatment methods for aspiration/ingestion during dental procedures. Methods One case of aspiration during an implant operation was reported, and the literature on aspiration/ingestion during oral procedures was reviewed. Results An implant screwdriver accidentally slipped into the mouth of the patient during implant surgery. The patient experienced no obvious discomfort except a few coughs. The surgeon and assistant paused the procedure immediately to search for the screwdriver, but it was not found. The patient declared that there was no special abnormality, such as breathing disorder or chest distress, so we considered that the foreign body was ingestion. After the implant surgery was completed, no foreign body was found in the stomach via gastroscopy. Chest X-ray and CT showed a dense metal shadow in the lower lobe of the left lung. Under local anesthesia, bronchoscopy and biopsy forceps were used by respiratory physicians to clip out the foreign body. After removal of the foreign body, the patient had no obvious discomfort but a slight cough. Cephalexin and metronidazole were given for three days to prevent infection. Three days later, the patient had no complaints of respiratory discomfort. After reviewing the literature, we found that the operation should be paused immediately after aspiration/ingestion occurs during dental procedures and that the dental chair should be laid down to prevent the foreign body from descending deeper, which may increase the difficulty of removal and cause gastrointestinal and respiratory tract injury. The position of the foreign body should be determined by imaging examination, and the corresponding means to remove the foreign body should be performed. Conclusion Patients may have no obvious symptoms after aspiration/ingestion during dental procedures, and the foreign body can be removed after imaging examination.

  • Review Articles
  • ZHOU Ziyi, REN Biao, ZHOU Xuedong
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 588-593. https://doi.org/10.12016/j.issn.2096-1456.2022.08.009
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    Curcumin is a natural medicine with a wide range of sources and low toxicity. It has antibacterial, antifungal, anti-inflammatory and other pharmacological effects. In recent years, curcumin has attracted much attention in the field of prevention and treatment of oral infectious diseases. Single curcumin is easily degraded during application and has poor water solubility and low bioavailability, but it can be used as a natural photosensitizer to mediate photodynamic treatment of oral infections. Photodynamic therapy has high antibacterial efficiency and can better protect the appearance and function of the affected area. This article reviews the research on curcumin-mediated photodynamic therapy for oral infectious diseases. As a natural photosensitizer, curcumin mediates photodynamic therapy and has shown good therapeutic effects against dental caries, endodontics, periodontitis, oral candidiasis and other oral infectious diseases by enhancing antibacterial ability, increasing the production of reactive oxygen species, and inhibiting the formation of biofilms. In-depth exploration of the mechanism of action of curcumin-mediated photodynamic therapy in different oral infectious diseases can provide new strategies for the prevention and treatment of oral infectious diseases.

  • ZHANG Yaoyue, LIN Xiaoping
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 594-599. https://doi.org/10.12016/j.issn.2096-1456.2022.08.010
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    Periodontitis is a chronic infectious disease in which periodontal tissue loss is caused by dental plaque biofilm. Atherosclerosis is a chronic inflammatory disease that occurs in the walls of arteries and is characterized by lipid accumulation. Recently, many studies have suggested that there is a certain relationship between periodontitis and atherosclerosis. From an epidemiological perspective, a previous literature review indicated that patients with periodontitis have a higher incidence of atherosclerosis. IL-17 secreted by Th17 cells may aggravate the progression of the two diseases by elevating the levels of matrix metalloproteinases, which may damage the connective tissue. Treg cells reduce the activation of T cells and limit the development of inflammation by secreting anti-inflammatory factors and expressing coinhibitory molecules. Periodontal intervention may contribute to the treatment of atherosclerosis by reducing inflammatory markers in atherosclerosis. Many studies have shown that periodontitis and atherosclerosis may interact with each other, but further studies are needed to explore the concrete mechanism of the interaction between periodontitis and atherosclerosis.

  • ZHAO Xiwen, OUQI Yazhi, MAN Yi
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 600-603. https://doi.org/10.12016/j.issn.2096-1456.2022.08.011
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    Chronic periodontitis is a prevalent disease; if left untreated, it is a main indication for tooth extraction and can lead to tooth loss. The reactive soft tissue, formed as a result of the immune response to chronic inflammation, is left in the compromised socket. The major concern is how to deal with the residual reactive soft tissue. Conservative thought states that the reactive soft tissue should be completely debrided. In addition, novel practices concerning the reactive soft tissue were proposed in recent trials, which demonstrated that there might be merits for soft and hard tissue regeneration with preservation of the reactive soft tissue. Studies have shown that mesenchymal stem cells exist in inflammatory reactive soft tissue, stressing their potential in tissue regeneration. Although the therapeutic value is highly promising, the specific components of the reactive soft tissue and the standard on whether it should be preserved need further investigation.

  • YU Fan, RAO Nanquan, LV Changhai, LIU Bo
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(8): 604-608. https://doi.org/10.12016/j.issn.2096-1456.2022.08.012
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    The properties of adhesives and light-cured resin composites are closely related to the repair of dental defects. Therefore, improving the properties of adhesives and resins composite to increase the success rate of filling has been the focus of research in the field of prosthodontics in recent years. Current studies have confirmed that temperature can change the properties of adhesives and light-cured resin composites, affecting their repair effect. A proper storage temperature ensures the good performance of materials: the self-etching adhesive system should be refrigerated, and the light-cured resin composite should be refrigerated or stored at room temperature according to its composition, proportion and other properties; however, the appropriate storage temperature for the etch-and-rinse adhesive system is not clear. The appropriate application temperature could improve the fluidity, monomer conversion, bonding strength, compressive strength and other properties of the materials to improve the quality of filling restoration. However, there is a wide variety of adhesives and resin composites, and the effect of temperature on each material is different. Thus, it is still necessary to explore the temperature range for material storage, precooling and preheating. Few studies have been performed in vivo, and the clinical restorative effects of adhesives and resin composites stored and used at different temperatures need to be further studied.