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20 September 2022, Volume 30 Issue 9
    

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    Expert Forum
  • YE Qingsong, PENG Youjian, LUO Yu
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 609-619. https://doi.org/10.12016/j.issn.2096-1456.2022.09.001
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    Exosomes are phospholipid bilayer vesicles secreted by living cells that can carry a variety of signaling molecules, such as RNA, DNA, protein, and lipids. Exosomes play a role in the transmission of signaling molecules between cells, thus regulating many physiological and pathological processes. The methods of extracting exosomes include differential centrifugation, density gradient centrifugation, exclusion chromatography, ultrafiltration, coprecipitation, polymer immune affinity, microfluidic separation technology, etc. Each of these extraction technologies has advantages and disadvantages; however, there is no unified international standard. In addition, the expression of specific proteins and genetic material of exosomes from different cell sources are different; thus, their expression characteristics and functions are also distinctive. Based on this situation, research on exosomes is limited to preclinical studies, and difficulties and challenges still exist in clinical application. This paper summarizes the progress of research in the field of exosomes, to understand the characteristics, modification and application of exosomes from different cell sources, and to summarize their advantages and disadvantages as well as challenges, which can help researchers better understand and master the performance of exosomes. Furthermore, improvement of standard procedures in the extraction and manufacturing of exosomes is important, as it will provide a reference for researchers to carry out exosome-related translational clinical research.

  • Basic Study
  • GUO Yiting, HAN Wenhao, XU Pan, SHAO Ruru, HE Yuan
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 620-629. https://doi.org/10.12016/j.issn.2096-1456.2022.09.002
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    Objective To investigate the transcriptomic changes in primary human oral keratinocytes (pHOKs) after coculture with Prevotella melaninogenica (P.m) and to verify the changes in human oral keratinocyte (HOK) cell lines. Methods pHOK was isolated and cocultured with P.m for 0, 4 and 24 h. Total RNA was extracted, a gene library was constructed, transcriptional sequencing was performed, differentially expressed genes (DEGs) were analyzed, gene ontology (GO) pathway analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed, and the validation of DEGs was performed by qRT-PCR and Western Blot in the HOK and P.m coculture cell model. Results 1 788 DEGs were detected between the 4 h group and control group, including upregulated DEGs such as lymphocyte cytosolic protein 1(LCP1), keratin 7 (KRT7) and Cilia and flagella associated protein 251(CFAP251) and downregulated DEGs such as FERM, ARH/RhoGEF and Pleckstrin domain protein 1 (FARP1), WW domain containing transcription regulator 1(WWTR1) and Discoidin, CUB and LCCL domain-containing protein 2 (DCBLD2). 1 832 DEGs were detected between the 24 h group and control group, including upregulated DEGs such as LCP1, complement C1s(C1S), kynureninase (KYNU) and downregulated DEGs such as phosphoserine aminotransferase 1 (PSAT1), FARP1 and FKBP prolyl isomerase 10 (FKBP10). There were 1 090 common differentially expressed genes (cDEGs) in the 4 h and 24 h groups, including LCP1, KYNU and long intergenic nonprotein coding RNA 958 (LINC00958). The GO pathways were mainly enriched in response to lipopolysaccharide and the molecules of bacterial origin and apical part of the cell. KEGG pathway analysis revealed enrichment in the interleukin-17 (IL-17) signaling pathway, tumor necrosis factor (TNF) signaling pathway, Toll-like receptor (TLR) pathway, etc. We verified the expression of a cDEG, Myosin1B (MYO1B), and qRT-PCR and Western Blot analysis showed that MYO1B expression was significantly upregulated between the control group and the P.m cocultured group (P<0.001), and its expression followed a time-dependent and concentration-dependent manner. Conclusion P.m played an important role in the transcriptome of oral keratinocytes.

  • ZHENG Jiawen, ZHAO Qing
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 630-637. https://doi.org/10.12016/j.issn.2096-1456.2022.09.003
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    Objective To investigate the effect of brain and muscle arant-like-1 (Bmal1) and miRNA-155-5p on the proliferation ability and aging of bone marrow mesenchymal stem cells (BMMSCs) to provide an experimental basis for elucidating the mechanism of bone senescence. Methods BMMSCs were extracted from the femur medullary cavity of 1-month-old mice, purified and cultured via the whole bone marrow mesenchymal adherent method and passed to P3. The characteristics of BMMSCs were detected by flow cytometry. BMMSCs were transfected with lentivirus to construct stable miR-155-5p and Bmal1 overexpression/interference BMMSCs. shRNA-transfected BMMSCs were identified by qRT-PCR. The proliferation activities of miR-155-5p and Bmal1 overexpression/interference BMMSCs were detected via CCK-8 assay. The apoptosis rates were measured by flow cytometry. The aging status of BMMSCs was identified with the senescence-associated β-galactosidase (SA-β-Gal) test. The expression of senescence-related genes P16 and P53 was detected by qRT-PCR. Results The shRNA-transfected BMMSCs were successfully generated. The proliferation ability decreased, and the apoptosis rates, the activity of SA-β-Gal and the relative expression levels of P53 and P16 increased when miRNA-155-5p was overexpressed. The proliferation ability increased, and the apoptosis rates, the activity of SA-β-Gal and the relative expression levels of P53 and P16 decreased when miRNA-155-5p was inhibited. The effect of Bmal1 is opposite to that of miRNA-155-5p. Conclusions The expression of Bmal1 promotes the proliferation and antiaging ability of BMMSCs, while miRNA-155-5p inhibits the proliferation and accelerates the aging of BMMSCs.

  • YANG Guofeng, CHEN Weiting
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 638-643. https://doi.org/10.12016/j.issn.2096-1456.2022.09.004
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    Objective To investigate the clearance effect of photodynamic therapy (PDT) with an oxygen-releasing photosensitizer methylene blue (MB) formula on Enterococcus faecalis in the root canal. Methods Groups were divided into the MB group and oxygen release MB group. Samples in the MB group were mixed with 50 μmol/L MB solution, and samples in the oxygen release MB group were mixed with 50 μmol/L MB in oxygen release emulsion. N-acetyl-L-tryptophan amide (NATA) and 1,3-diphenylisobenzofuran (DPBF) were used to detect the oxidative activity and singlet oxygen generation of different formulas of MB (MB group, oxygen-releasing MB group), and the oxygen-releasing capacity of the oxygen-releasing photosensitizer formula was analyzed. The single root canal anterior teeth were collected, and the Enterococcus faecalis root canal infection model of isolated teeth was constructed. The distribution of Enterococcus faecalis in the root canal was observed by scanning electron microscopy. The isolated teeth with Enterococcus faecalis root canal infection were divided into three groups: the conventional root canal therapy group, MB-PDT therapy group, and oxygen-releasing MB-PDT therapy group, with 10 teeth in each group. Bacterial samples in the root canals of each group were obtained, the number of colonies was analyzed(CFU/mL) after 24 h of in vitro culture, and the clearance rate of Enterococcus faecalis in the root canal by photodynamic therapy was evaluated. The remaining isolated teeth with Enterococcus faecalis root canal infection were divided into 3 groups, with 5 samples in each group. Bacterial samples at a depth of 1 000 μm in the dentin tubules of the upper root, middle root and lower root segment were obtained and cultured in vitro for 24 h for calculations. The number of colonies (CFU/mL) was analyzed, and the clearance rate of Enterococcus faecalis in the dentin tubules of different segments of the root canals in each group was analyzed. Results The oxidation activity and singlet oxygen generation capacity in the oxygen-releasing MB group were stronger than those in the MB group. Scanning electron microscope detection showed that Enterococcus faecalis was distributed in dentinal tubules, indicating that the model of root canal infection in vitro was successfully constructed. The clearance rate of Enterococcus faecalis in the oxygen-releasing MB-PDT therapy group was higher than that in the conventional therapy group and the MB-PDT therapy group (P<0.05). Oxygen-releasing PDT significantly improved the bactericidal effect in the lower dentinal tubules, and the clearance rate of Enterococcus faecalis was better than in the other two groups (P<0.05). Conclusion Photodynamic therapy with the oxygen-releasing photosensitizer MB can achieve a better root canal bactericidal effect and can significantly improve the clearance effect of Enterococcus faecalis in the deep dentin of the lower root segment.

  • Clinical Study
  • GUO Li, WU Guofeng, SHI Anyuan, GU Chunning, JIANG Xiaowei, QIN Haiyan
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 644-650. https://doi.org/10.12016/j.issn.2096-1456.2022.09.005
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    Objective To explore the early failure of narrow-diameter implants (NDIs) and to provide a reference for clinical implant restoration. Methods From April 2017 to April 2020, data from a total of 725 patients (with 1 001 NDIs) who accepted implant restoration due to dentition defects were collected from the department of dental implantology in a stomatological hospital; 353 males and 372 females were included. The early failure rate of 1 001 NDIs was retrospectively analyzed. Univariate generalized estimated equation (GEE) and multivariate GEE were used to explore risk factors, including age, sex, implant location, materials, surface modification, length, bone augmentation and healing procedure, associated with early failure of NDIs. Results There were 34 cases of early failure among 725 patients, including 38 NDIs. The early failure rate of NDIs was 4.69% at the patient level and 3.80% at the implant level. There was no significant difference in the early failure rate of NDIs among different age groups, sexes, implant materials, surface modifications, lengths, and healing procedures (P>0.05). Univariate analysis showed that there was a significant difference between the early failure rate of NDIs in the anterior maxilla group (2.16%) and the anterior mandible group (8.64%) at the implant level (P<0.001). However, there was no significant difference in the early failure rate between the anterior maxilla group and the posterior group (3.35%) (P>0.05). In addition, in the anterior region, the early failure rate of NDIs in the group with simultaneous bone augmentation was significantly lower than that of the group without bone augmentation (P<0.05). However, multivariate GEE analysis showed that the early failure rate of NDIs was only significantly positively correlated with implants in the mandibular anterior region (P<0.01). Conclusion The overall early survival rate of Straumann 3.3 mm NDIs is greater than 95%. The early failure of NDIs in the anterior mandible region is much higher than that in the anterior maxilla region and posterior region.

  • ZHENG Ying, BI Xiaoqin
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 651-657. https://doi.org/10.12016/j.issn.2096-1456.2022.09.006
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    Objective To investigate the influencing factors of vascular crisis after oral and maxillofacial tumor free tissue flap transplantation. Methods A retrospective analysis was performed on all patients who underwent free tissue flap transplantation and developed vascular crisis in the surgical ward of head and neck cancer in a grade A specialized hospital. Forty-six possible influencing factors were collected using 1:1 matching according to surgeons, operation time, sex and age of patients from patients without vascular crisis from 2015-2020 in this ward during the same period. SPSS 26.0 statistical software was used for univariate and multivariate logistic regression analyses of the data. Results A total of 158 patients were enrolled, including 79 in the crisis group and 79 in the pairing group. Univariate analysis was performed for each variable. Paired logistic regression analysis showed that only postoperative blood potassium (P = 0.048, OR = 3.118, 95% CI: 1.008-9.641) and preoperative and postoperative red blood cell count differences (P = 0.004, OR = 4.53, 95% CI: 1.609-12.750) were statistically significant. Conclusion High blood potassium levels and red blood cell count differences before and after surgery were risk factors for vascular crisis.

  • LIU Yingkun, LI Jia, TAO Boqiang, MIN Fenghe, LIU Weiwei
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 658-662. https://doi.org/10.12016/j.issn.2096-1456.2022.09.007
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    Objective To investigate the clinical effect of buccal fat pad flaps on the restoration of maxillary defects. Methods Nineteen cases with oral-nasal communications and maxillary soft and hard tissue defects ranging from 3.0 cm×2.0 cm-5.0 cm×4.0 cm after resection of the primary tumor foci were repaired with a pedicled buccal fat pad flap, and the maxillary sinus cavity and oral-nasal communication were closed. The survival, healing and complications of the flap were observed during the 3-month follow-up. Results The buccal fat pad flaps of 19 patients all survived. Five days after the operation, the buccal fat pad flap was dark red with slight edema, and the maxillary defect area collapsed. Ten days after the operation, most of the buccal fat pad flap turned pink, and the collapse was alleviated. One month after the operation, the buccal fat pad flap had no obvious collapse, and its surface was epithelialized, with a shape and color close to those of the normal mucosa. The opening was slightly limited. Three months after the operation, the buccal fat pad flap was completely epithelialized, with no difference from the surrounding tissue, and the opening was approximately 3 transverse fingers. No complications, such as swelling and necrosis of the buccal fat pad flap, limitation of mouth opening, maxillary sinus fistulas, oral-nasal communications and facial changes occurred in 19 patients within 3 months after the operation. Conclusion The application of a buccal fat pad flap has a good effect to repair maxillary tissue defects and close oral maxillary sinus communication with diameters less than 5 cm, so it can be widely used in the clinic.

  • Review Articles
  • NI Guangcheng, DAN Hongxia, ZHAO hang, CHEN Qianming
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 663-669. https://doi.org/10.12016/j.issn.2096-1456.2022.09.008
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    Oral mucosal disease is a general term for a type of disease that mainly affects the oral mucosa and surrounding soft tissues. In the treatment of oral mucosal diseases, due to the particularity of the anatomical location, the use of topical administration is relatively simple and convenient; drugs can easily accumulate in the lesions, and at the same time, they can also avoid adverse reactions caused by systemic drug delivery. Topical administration has become an important and even preferred option for the treatment of oral mucosal diseases. There are various types of topically used drugs for oral mucosal diseases, such as glucocorticoids (triamcinolone acetonide), immunomodulatory drugs (tacrolimus), antiseptic drugs (chlorhexidine), pain relievers (lidocaine) and proprietary Chinese medicines (aloe vera gel). Among these drugs, although the most widely used liquid formulations such as gargles and sprays are easy to use, they are not conducive to local retention of drugs due to the particularity of the oral environment and function. Based on this, researchers have continuously improved the dosage form of the drug, and developed a series of semi-solid pharmaceutical preparations such as gels and ointments, some of which have exerted good curative effects in clinical work. In addition, although films, patches and other solid oral mucosal topical pharmaceutical preparations have few clinical applications, they have also been widely researched and described and are expected to become the mainstream dosage form in the future. In general, with the improvement of dosage forms, topical administration is playing an increasingly important role in the treatment of oral mucosal diseases. Therefore, combined with basic research and clinical reports, this article reviews the application of topical drug delivery in the treatment of oral mucosal diseases.

  • ZHANG Ning, WANG Xiangyu, HOU Ruxia, LIU Junyu, LIU Jiajia
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 670-674. https://doi.org/10.12016/j.issn.2096-1456.2022.09.009
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    Early childhood caries (ECC) is not only harmful to children's oral cavity and even the whole body, the government and relevant health departments pay more and more attention to the prevention and treatment of early childhood caries. However, at present, the primary treatment for ECC is the traditional filling therapy. The chronic disease management model can conduct regular testing of chronic non-communicable diseases and their risk factors, and provide long-term and effective professional management to patients by supervision and advice by doctors, nurses and pharmacists. This model has a good effect on slowing down the development of the disease, improving the quality of life of patients and saving public health resources. As a common chronic non-communicable disease, ECC is very suitable for prevention and treatment through chronic disease management. In recent years, chronic disease management models have also been increasingly used in the management of caries. The current common chronic disease management models include the chronic care model, innovative care for chronic condition, and British chronic disease management system models. And above models have certain applications in the management of ECC. How to establish the caries risk assessment system suitable for the diagnosis and treatment model of our country, and how to screen the children with high risk of caries by step-by-step prevention and control network for personalized prevention needed to be further studied in the future.

  • FANG Na, LI Xiangwei
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 675-679. https://doi.org/10.12016/j.issn.2096-1456.2022.09.010
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    Tissue engineering provides a new possibility for pulp regeneration. As one of the three elements of tissue engineering, scaffolds have attracted increasing attention. Because the root canal system is limited by the unique anatomical structure of the long and narrow lumen, the preformed scaffold cannot be completely covered with the whole root canal space, although it is convenient to apply, so the injectable scaffold may be an ideal choice for pulp tissue engineering. Hydrogels are hydrophilic polymer networks with physical properties similar to soft tissues. They can provide a porous hydrophilic microenvironment, which facilitates the diffusion of oxygen and nutrients. In recent years, researchers have used injectable hydrogels with different mechanical properties and/or loaded biologically active ingredients as scaffolds to promote revascularization and the regeneration of pulp. The results show that natural polymer hydrogels, synthetic polymer hydrogels, and composite hydrogels combining natural and synthetic polymers all have excellent biocompatibility. The types and mechanical properties of hydrogels and the addition of bioactive ingredients can influence the behavior of stem cells, and gelatin-based hydrogels and fibrin-based hydrogels can also achieve rapid vascularization, which creates the conditions for the formation of pulp-like tissues. Among them, photocrosslinked methacrylated gelatin/hyaluronic acid hydrogels, two/multicomponent hydrogels combined with chitosan with antibacterial and temperature-sensitive properties and new self-assembled peptides have become major research topics in recent years due to their excellent properties. To develop suitable hydrogel scaffolds and promote their application in pulp regeneration, this article reviews the research progress in the types, preparation, and application of injectable hydrogels used for dental pulp regeneration.

  • ZHANG Shunhao, WANG Yuxuan, LI Mingli
    Journal of Prevention and Treatment for Stomatological Diseases. 2022, 30(9): 680-684. https://doi.org/10.12016/j.issn.2096-1456.2022.09.011
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    Dental anxiety refers to the unique tension, worry and even fear of dental treatment, which may lead to patients refusing to receive treatment and missing the best time for treatment. With the development of bio-psycho-social medical models, psychotherapy has gradually become the optimal treatment for dental anxiety. This article reviewed the etiology, evaluation and psychotherapy of dental anxiety. Research has shown that uncomfortable dental treatment experience is the main cause of dental anxiety, which is commonly assessed using questionnaires in clinical practice. Psychotherapy for dental anxiety is a noninvasive, widely applicable treatment without side effects, mainly including improving the treatment environment and service attitude, behavior therapy, and cognitive therapy, which has been shown to effectively alleviate dental anxiety in patients. However, psychotherapy for dental anxiety is highly demanding for dentists, which hinders its promotion and application. At the same time, the psychotherapeutic mechanism of dental anxiety is not clear and remains to be further elucidated by large-scale and high-quality randomized controlled studies.