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20 June 2021, Volume 29 Issue 6
    

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    Expert Forum
  • WANG Anxun
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 361-367. https://doi.org/10.12016/j.issn.2096-1456.2021.06.001
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    Benign condylar hyperplasia is one of the causes of mandibular lateral deformity, it is easily to be misdiagnosed clinically and leads to the treatment failure. This article will elaborate the etiology and clinical features of benign condylar hyperplasia, as well as the diagnostic points and treatment progress, based on the literature and the clinical experience of our research group, to provide evidence-based medical evidence for the standardized clinical treatment of benign condylar hyperplasia. The etiology of benign condylar hypertrophy includes neurotrophic disorders, local circulatory disorders, traumatic injuries (especially condylar injuries that occur in childhood), unilateral mastication, temporomandibular arthritis, endocrine disorders, condylar osteoma, and heredity. Benign condylar hypertrophy is insidious, and occurs most frequently in individuals 10-30 years old, and the course of disease can last for many years. Its clinical characteristics are slow progressive facial asymmetry. Radionuclide bone scans have become the basis for the diagnosis and differential diagnosis of and treatment planning for benign condylar hypertrophy. Different treatment plans for active and inactive periods need to be developed, including close observation, proportional condylar resection and orthognathic surgery.

  • Basic Study
  • WANG Yanfeng,ZENG Jiajun,YUAN Qiao,LUAN Qingxian
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 368-376. https://doi.org/10.12016/j.issn.2096-1456.2021.06.002
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    Objective To investigate the influence of mechanical debridement on the subgingival microbiome in chronic periodontitis by 16S rRNA high-throughput sequencing. Methods Patients with generalized moderate to severe chronic periodontitis were recruited into this study and received oral hygiene instruction and supragingival scaling. One week later, they received ultrasonic and manual subgingival scaling and root planning. Clinical parameters were recorded and subgingival plaques were sampled at baseline and 3 months and 6 months after treatment. The comprehensive profiles of the subgingival microbiome were analyzed by sequencing the V3-4 region of 16S rRNA with the Illumina MiSeq platform. Results Alpha diversity analysis showed that the richness and diversity of the subgingival community were consistent before and after treatment, but a significant difference in community structure was detected only between baseline and month 3 by principal coordinates analysis (PCoA). After 3 months, the clinical parameter as probing depth (PD) decreased significantly and the relative abundances of the genera related to periodontitis such as Porphyromonas, Treponema, Tannerella, and Filifactor decreased significantly. Meanwhile, the relative abundances of the genera associated with periodontal health increased, such as Capnocytophaga, Kingella. Six months later, however, less genera related to periodontitis decreased significantly from the baseline level, such as Filifactor. PD decreased significantly compared with baseline, but increased significantly compared with 3 months after treatment. Conclusion Mechanical debridement alone could relieve periodontal inflammation and balance microbial dysbiosis and the greater efficacy occurred 3 months after treatment.

  • XING Xiaoyu,LI Yanping,ZHANG Lin,HE Lina,LIU Huimei,NIU Yumei
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 377-382. https://doi.org/10.12016/j.issn.2096-1456.2021.06.003
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    Objective To study the computational fluid dynamics (CFD) characteristics of ultrasonic root canal irrigation when the file was placed at a certain depth in the root canal, to provide a reference for clinical application. Methods First, scanning laser vibrometry (SLV) was utilized to analyze the characteristics of vibrational ultrasonic files under specific power. Then ICEM CFD 18.0 software was used to establish the root canal ultrasonic irrigation model. The insertion position of the ultrasonic working tip was set 1 mm away from the physiological apical foramen, and cloud images of the results were obtained by FLUENT 18.0 software. Volume fraction, flow velocity and pressure in the root canal were evaluated after setting the computing conditions. Results The vibration of the ultrasonic working tip was mainly transverse vibration with slight longitudinal vibration. The amplitude of transverse vibration of each part of the working tip was different. Maximum values were observed at the apical end area of the file, and the closer to the base of the file, the smaller the amplitude. The area where the cavitation volume fraction of the rinsing fluid was greater than 0 was concentrated around the working point. The flow rate of the irrigating fluid was up to 2 m/s, within the area 0.2 mm in front of the working tip, the velocity of the irrigating fluid was greater than 0.1 m/s, while within the area 0.8 mm from the root tip, the velocity of the irrigating fluid was small or even zero. The apical pressure value was non-positive when the tip of the file was 1 mm away from the apical foramen in this model. Conclusion Based on the experimental results, it appears that when the ultrasonic working tip was placed 1 mm short of the working length, the ultrasonic irrigating flow did not overflow the root apical foramen and the irrigation process was relatively safe; the irrigation fluid had a strong irrigation effect within approximately 0.2 mm in front of the working tip.

  • WANG Qianqian,DING Dandan,DING Xiang,HAN Rui,HAN Yingying,ZHOU Meiyun,XU Jincheng
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 383-387. https://doi.org/10.12016/j.issn.2096-1456.2021.06.004
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    Objective To investigate the expression of brain expressed X-linked gene 1(Bex1) and nuclear factor-kBp65 (NF-kBp65) in tongue squamous cell carcinoma, and its significance. Methods Immunohistochemistry was used to detect the expression of Bex1 and NF-kBp65 in 60 tongue squamous cell carcinoma (TSCC) tissues and adjacent normal tissues, and the relationships between Bex1, NF-kBp65 and the clinicopathological features and prognosis of patients were analyzed. Results The positive expression rate of Bex1 in TSCC was 48.3% (29/60), which was significantly lower than that in adjacent normal tissues 88.3% (53/60) (x2=22.18, P < 0.01). The positive rate of Bex1 was negatively correlated with TNM stage, and the difference was statistically significant (P < 0.05). The positive rate of 63.3% (38/60) in TSCC was significantly higher than 20% (12/60) in adjacent normal tissues (x2=23.18, P < 0.01), the positive rate of NF-kBp65 was positively correlated with TNM stage, and the difference was statistically significant (P < 0.05). According to the Pearson correlation analysis results, the expression of Bex1 and NF-kBp65 in TSCC tissues was negatively correlated (r=-0.302, P=0.019). Kaplan-Meier survival curves showed that the survival rate of Bex1 positive patients was significantly higher than that of Bex1 negative patients. Conclusion In TSCC tissues, the low positive expression rate of Bex1 and the high positive expression rate of NF-kBp65 may promote tumor invasion and metastasis, and the negative expression of Bex1 may be related to the poor prognosis of patients.

  • Clinical Study
  • LIU Liu,WANG Xiang,DUAN Ning,ZHAO Maomao,XU Kaiyuan,WU Kaihui,HUANG Fan,WANG Wenmei
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 388-394. https://doi.org/10.12016/j.issn.2096-1456.2021.06.005
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    Objective To investigate the pathogenic factors and clinical manifestations of contact stomatitis, and to provide references for its clinical diagnosis and prevention. Methods The data of 55 subjects with contact stomatitis were analyzed retrospectively, including age, gender, pathogenic factors, type of lesions and site of occurrence. Results Among the 55 patients, contact stomatitis occurred at all ages, 19 were male, 36 were female, and the ratio of males to females was 1∶1.89. Among 55 patients, 78.18% (43/55) were caused by oral mucosal contact with dental materials: amalgam fillings accounted for 52.73% (29/55), metal crowns accounted for 9.09% (5/55), removable denture plastic bases accounted for 9.09% (5/55), resin fillings accounted for 5.45% (3/55), and alginate impression materials accounted for 1.82% (1/55); 21.82% (12/55) were caused by oral mucosal contact with food and daily necessities. The clinical manifestations of contact stomatitis include lichenoid reaction, erythema and erosion. The most common site of contact stomatitis was the cheek, followed by the tongue, and the lips, and the gingival and palatal areas were relatively rare. In the buccal mucosa, the incidence of lichenoid reaction was 55% (22/40), which was higher than that of erosion (20%) and erythema (25%), and the difference was statistically significant (P < 0.05). For tongue, lip, gingiva and palate, there was no significant difference in the incidence of the three lesion types(P > 0.05). Conclusion Contact stomatitis occurred at all ages, and there are more female patients than males with contact stomatitis. Dental materials, especially metal and acrylic materials (such as the plastic base of removable dentures, resin fillings, adhesives, and self-setting plastics), are the main pathogenic factors. In buccal mucosa, the incidence of lichenoid reaction is higher.

  • YAN Xingquan,NAN Xinrong,ZHANG Zejun,ZHANG Qi
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 395-399. https://doi.org/10.12016/j.issn.2096-1456.2021.06.006
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    Objective To examine the outcome of surgical treatment in patients with stages Ⅱ-Ⅲ bisphosphonate-related osteonecrosis of the jaw. Methods Twenty-nine patients with bisphosphonate-related osteonecrosis of the jaw were examined. The patients were followed up for more than 6 months, and the treatment outcome was reviewed. Results After curettage of local lesions, 19 out of the 21 patients were cured, and 2 were relieved of symptoms. Six patients underwent subtotal resection of the maxilla, and the symptoms disappeared completely after the surgery. Two patients underwent partial resection of the mandible and recovered. Conclusion Surgical debridement is an effective measure for the treatment of patients with bisphosphonate-related osteonecrosis of the jaw in stages Ⅱ-Ⅲ. In most cases, curettage of local lesions via the intraoral approach can completely remove sequestrum and inflammatory granulomatous tissue. Subtotal maxillary resection or partial mandible resection is performed when the bone death reaches the level of the maxillary sinus floor or continues to the mandible. By timely surgical intervention, the bone lesion is removed to maintain the sterile, active bone microenvironment locally.

  • ZHANG Shuguang,YIN Xiteng,XU Wenguang,HAN Wei,LIU Zhe
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 400-405. https://doi.org/10.12016/j.issn.2096-1456.2021.06.007
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    Objective To investigate the diagnosis, treatment and prognosis of lymphoepithelial carcinoma of the parotid gland. Methods Data from 22 patients with parotid lymphoepithelial carcinoma from 2012 to 2019 were collected, and their clinical manifestations, imaging examinations, treatment methods and follow-up results were retrospectively analyzed. Results Among the 22 patients, 8 were males and 14 were females. The patients ranged from 26 to 61 years old, with a complaint duration ranging from 3 days to 18 years. One patient had multiple unilateral lumps in the parotid gland, and the other 21 patients had single unilateral lumps in the parotid gland. All patients underwent preoperative spiral CT examination. CT showed a soft tissue lump in the parotid tissue, the internal density shadow was not uniform, the CT value ranged from 26 to 81 Hu, and 15 patients presented elliptical lesions with clear boundaries. Seven patients presented nodular lesions, and the boundary was not clear. The diagnosis of all cases was ultimately based on pathological examination. Hematoxylin-eosin (HE) staining images showed active epithelial cell growth with atypia, mitotic figures could be seen, and abundant lymphocyte and plasma cell infiltration could be seen in the tumor stroma. All 22 patients received surgical treatment; 9 patients did not undergo cervical lymph node dissection. Twenty patients received adjuvant radiotherapy after surgery, and 10 of them received adjuvant chemotherapy at the same time. One patient only received chemotherapy after surgery, and one patient did not receive any other adjuvant therapy after surgery. All patients received follow-up visits. One patient died of liver metastasis 16 months after the operation, and the remaining patients survived without tumors for periods of 13 months to 8 years until the present. Conclusion Parotid lymphoepithelial carcinoma is a rare malignant tumor clinically. Pathology is still the gold standard for the diagnosis of lymphoepithelial carcinoma of the parotid gland. Radical resection of the tumor is the first choice of treatment. Selective neck lymph node dissection and postoperative adjuvant radiotherapy and chemotherapy can obtain better therapeutic effects according to clinical examination, imaging examination and neck conditions.

  • Prevention and Treatment Practice
  • LIU Ying,XIA Dahong
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 406-410. https://doi.org/10.12016/j.issn.2096-1456.2021.06.008
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    Objective To explore the effect of a community family doctor model on caries management for children aged 1 to 3 years in Wuhan, and to provide basis for community prevention and control of children’s caries. Methods Using stratified randomization and paired sampling, 1 000 children aged 1 to 3 years were selected from the core community of the Wuhan Donghu High-tech Zone. The trial group was followed up 4 times a year at home or in the clinic, and the control group was followed up only at the baseline and the endpoint (2 years later). Caries and caries status were examined at baseline and 2 years later, and brushing behavior was investigated by questionnaire. Results The prevalence/dmft in the test group and control group after two years were 15.8%/1.41 and 46.6%/3.25, respectively, and the difference was statistically significant. The frequency with which parents helped their children to brush in the test group improved significantly compared to that of the control group. Conclusion For children aged 1 to 3 years, the dental family doctor model of caries prevention is economical and effective, and its application and promotion are recommended.

  • Review Articles
  • SHU Chang,CAI Qin,Erpan Alkam,ZHOU Yuan
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 411-416. https://doi.org/10.12016/j.issn.2096-1456.2021.06.009
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    The oral microbiota has been proven to play an essential role in local and systemic health. Hence, it is essential to understand how the oral microbiota and further microbial ecosystems are established and the associated development process to understand the physiologic and pathologic events related to the oral microbiota and management of the whole lifecycle oral and systemic health. The present review summarizes recent studies of the establishment and development of oral microbial communities in early life with related factors and briefly describes their prospects. By investigating the characteristics and development of the oral microbiota, current studies have shown that health status during pregnancy, mode of delivery, diet, environment, antibiotics and genetic factors are related to oral microbiota development, which is helpful in clinical practice. Nevertheless, current studies are mostly cross-sectional. Prospective cohort studies with larger sample sizes using metagenomics or metatranscriptomics and studies on molecular mechanisms are needed to further elucidate the influences and mechanisms of the related factors on the establishment and development of microbiota in early life and their impact on local or systemic health.

  • HUANG Jinxia,SHI Haitao,PAN Jian
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 417-421. https://doi.org/10.12016/j.issn.2096-1456.2021.06.010
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    Tooth extraction in patients receiving anticoagulation/antiplatelet therapy is often considered contraindicated by many oral and maxillofacial surgeons because of a higher risk of postoperative bleeding. Multiple factors contribute to postoperative bleeding, but there is no consensus. Based on recent literature, this article reviews factors related to bleeding after tooth extraction in patients receiving anticoagulation/antiplatelet therapy. The literature review indicates that patients taking antiplatelet drugs have a lower postoperative bleeding risk than patients taking anticoagulant drugs. Prescription of anticoagulants together with non-steroidal anti-inflammatory drugs, selective serotonin inhibitors or serotonin-norepinephrine inhibitors increases the risk of bleeding, so does preoperative antibiotic use increase. In addition, systemic diseases such as diabetes, history of infection at the extraction site, and greater surgical trauma are associated with a higher risk of postoperative bleeding. At present, it is generally believed that it is safe and feasible to use different hemostatic measures after tooth extraction and to rationally apply different hemostatic measures after surgery. More prospective controlled trials are needed in the future to establish an assessment system for patients undergoing anticoagulation/antiplatelet therapy under different conditions during tooth extraction.

  • WANG Jue,WANG Qian,WU Jia,LI Lingfeng,SUI Xin,LI Meihui,ZHANG Xiao,GAO Ying,YANG Liuqing,LIU Zhihui
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 422-427. https://doi.org/10.12016/j.issn.2096-1456.2021.06.011
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    Dental hard tissues lack the ability to self-heal. In dentin and cementum, hydroxyapatite (HA) can exist outside and/or inside collagen fibers. It is difficult to repair or regenerate HA with a highly ordered orientation in the presence of collagen fibers. At present, the biomimetic mineralization of dentin and cementum, mainly carried out by imitating its biological formation process and its physiological structure, can be divided into those originating from the fiber mineralization mechanism and those with HA as the main component. The materials used include natural materials such as demineralized dentin matrix (DDM) and calcined bovine hydroxyapatite (BHA), and synthetic materials such as polymer-induced liquid precursor (PILP) and synthetic HA. In the future, natural materials and synthetic materials should be combined for the restoration and regeneration of dentin and cementum by means of biomimetic mineralization of calcium phosphate released by remineralization solution-HA.

  • ZHOU Meixi,ZHU Linhong
    Journal of Prevention and Treatment for Stomatological Diseases. 2021, 29(6): 428-432. https://doi.org/10.12016/j.issn.2096-1456.2021.06.012
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    The application of tooth whitening technology in oral clinical diagnosis and treatment is becoming increasing widespread. Non-invasive tooth whitening based on bleaching technology has become the choice of many patients with tooth discoloration because of its unique advantage of not destroying the hard tissue of the tooth. The whitening effects differ according to the causes and degrees of tooth discoloration The effect of bleaching on tetracycline teeth is not as good as that of fluorosis teeth. The bleaching effect of hydrogen peroxide bleaching agents is similar to that of urea peroxide bleaching agents with the same concentration of hydrogen peroxide. The addition of non-peroxide agents such as bromelain to peroxide bleaching agents can improve the whitening effect on teeth. The whitening effect of a high-concentration bleaching agent can be achieved by using a low-concentration bleaching agent for a prolonged the working time. The effect of pH on tooth whitening is still controversial; the combination of lasers and traditional peroxide bleaching agents can effectively improve the whitening effect of teeth. The combination of enamel micro-grinding and peroxide tooth bleaching agents can improve the whitening effect in cases of dental fluorosis. This review analyzes the causes of tooth staining, the properties of bleaching agents, the application of laser microgrinding and the changes in tooth tissue after bleaching to discuss the influencing factors of the non-invasive tooth whitening effect mainly based on bleaching techniques.