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Review of clinical effects of disk-up sinus reamer(DSR)-based internal sinus floor elevation with implantation in 10 years ZHANG Kai-yue, HAN Ze-yu, JIANG Shuai, XU Hao, LI Fan, ZHAO Bao-dong Shanghai Journal of Stomatology    2024, 33 (1): 64-70.   DOI: 10.19439/j.sjos.2024.01.011 Abstract （292）      PDF （1101KB）（136）       Knowledge map    PURPOSE: To analyze the bone remodeling around the implant 10 years after disk-up sinus reamer(DSR)-based internal sinus floor elevation with implantation and to investigate the influence of different factors on implant retention. METHODS: The clinical and imaging data of patients undergoing DSR-based sinus floor elevation with simultaneous implantation were collected from the Department of Dental Implantology, Affiliated Hospital of Qingdao University from January 2008 to December 2011. Panoramic film and CBCT were used to measure the changes of bone mass around implant in different periods. Kaplan-Meier and Log-rank tests were used to analyze the effects of different factors on implant retention with SPSS 26.0 software package. RESULTS: The study included 98 patients with a total of 128 implants. During the follow-up of 0-168 months, 7 implants failed, and the remaining formed good osseointegration and functioned, with a 10-year cumulative retention rate of 94.53%. The height of bone formation was (0.29±0.15) mm at the top and (2.74±0.66) mm in the sinus of 75 implant sites with complete imaging data obtained ten years after surgery. Kaplan-Meier and Log-rank tests showed that 8 factors including initial bone height, elevated bone height, mucosal perforation, implant length, implant torsion, diabetes, smoking and periodontitis had significant effects on implant retention. CONCLUSIONS: The DSR-based internal sinus floor elevation with implantation is a reliable and stable bone augmentation operation for vertical bone defect in maxillary posterior region, with a 10-year cumulative retention rate of no less than 94%. Initial bone height, elevated bone height, mucosal perforation, implant length, implant torsion, diabetes, smoking and periodontitis are the important factors affecting the long-term retention rate of implants. Reference | Related Articles | Metrics

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Applied anatomy of the stylomastoid foramina and its relation to the surrounding bone structures QIN Si-jia, LIU Huan-qi, ZHANG Yu-qing, WANG Dan-yang, HUANG Shuo, WANG Feng, LIU Chang-kui Shanghai Journal of Stomatology    2023, 32 (6): 568-571.   DOI: 10.19439/j.sjos.2023.06.002 Abstract （212）      PDF （607KB）（142）       Knowledge map    PURPOSE: To study the relationship between the stylomastoid foramen and surrounding bony structures, enrich anatomical data and provide reference for clinical surgery. METHODS: A total of 62 intact and dry adult skulls were selected. The shape of the stylomastoid foramen was observed, the diameter of the stylomastoid foramen, the distances from the posterolateral point and the anterior medial point to the surrounding bony structures were measured with a vernier caliper. SPSS 25.0 software package was used to analyze the data. RESULTS: There were four shapes of stylomastoid foramen, i.e., circular (61.29%), oval (29.84%), irregular (8.06%) and triangular (0.81%). The circular diameter was (2.80±0.61) mm, the oval long and short diameters were (4.43±0.96) and (2.79±0.60) mm. Distances from the posterolateral and anterior medial points of the stylomastoid foramen to the posterolateral point of the external opening of the carotid canal, the anterior medial point of the jugular foramen, the midline, the most anterior point of the foramen magnum, the posterior point of the great palatine foramen, the posterolateral point of the foramen lacerated, the foramen ovale, the posterolateral point of the foramen spinosum, the anterior point of the styloid process root, the outermost point of the tympanomastoid fissure and the tip of the mastoid process were (16.10±2.81), (24.01±2.65), (44.95±3.24), (45.10±2.71), (61.66±4.14), (35.56±4.35), (32.26±2.85), (29.12±3.40), (10.39±3.25), (9.49±2.24) and (12.01±2.79) mm; (12.80±2.41), (21.56±2.51), (42.96±3.97), (42.91±2.76), (58.97±3.97), (32.98±4.14), (29.20±2.77), (25.80±2.87), (7.37±2.33), (11.42±2.00) and (15.41±2.57) mm, respectively. Statistical analysis showed that there was no significant difference in the apertures and distances between the left and right side(P>0.05). CONCLUSIONS: Most of the stylomastoid foramen are round and oval, understanding the distance between the foramen and surrounding bony structures is helpful for guiding clinical operations and enriching anatomical knowledge. Reference | Related Articles | Metrics

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Clinical comparative study of efficacy of Er:YAG laser for debonding different veneers ZHUANG Jiao-ling, XU Zhi-qiang, JIN Di, WU Qian-ju Shanghai Journal of Stomatology    2023, 32 (6): 578-582.   DOI: 10.19439/j.sjos.2023.06.004 Abstract （204）      PDF （938KB）（136）       Knowledge map    PURPOSE: To compare the debonding time of IPS e.max CAD lithium disilicate glass-ceramic veneers in different thickness and transparency using Er:YAG laser, and evaluate the effect of Er:YAG laser on the surface topography of the veneers and the underlying tooth. METHODS: A total of twelve maxillary first premolar teeth were collected and prepared, then veneers were made by computer aided design and computer aided manufacture(CAD/CAM) system. The veneers were divided into four groups according to different thicknesses and transparency: e.max HT with 0.5 mm and 1.0 mm thickness, e.max LT with 0.5 mm and 1.0 mm thickness. Three veneers of each group were cemented to prepared premolar with resin cement and then stored in normal saline solution at room temperature for 7 days. All veneers were debonded with Er:YAG laser and the debonding time of all-ceramic veneers of all groups was recorded. Scanning electron microscopy(SEM) observation was performed to detect the surface topography of the veneers and the underlying tooth. SPSS 19.0 software package was used for statistical analysis. RESULTS: The debonding time of 1.0 mm-thick groups were longer than 0.5 mm-thick groups. When the veneer thickness was 0.5 mm, the average debonding time of e.max LT group was longer than e.max HT. Consistent with the finding of 0.5 mm, the longer debonding time was found in the e.max LT group of 1.0mm. No cracks and crater structure were found in SEM observation of veneers after Er:YAG laser irradiation. Teeth surface was covered with bonding cement with no signs of ablation or damage of the enamel. CONCLUSIONS: Er:YAG laser can completely debond lithium disilicate glass-ceramic veneers, and the debonding time depends on the transparency and thickness of the veneers. The lower translucent porcelain veneers (e.max LT) and thicker ones (1.0 mm-thick) had a longer debonding time. Moreover, Er:YAG laser does not damage the morphology and topography of the veneer and the teeth surface. Reference | Related Articles | Metrics

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An in vitro experiment on the stability and irritant of hypochlorous acid in oral cavity LIU Zhao-chen, SUN Pei, PAN Ke-qing, WANG Pei-yan, ZHANG Hui, YUAN Chang-qing, DENG Jing Shanghai Journal of Stomatology    2024, 33 (2): 141-147.   DOI: 10.19439/j.sjos.2024.02.006 Abstract （202）      PDF （2020KB）（66）       Knowledge map    PURPOSE: To study the stability of physicochemical properties and sterilizing effect about two commercially available hypochlorous acid (HClO) products under simulated clinical conditions, and to evaluate the compatibility of HClO on soft and hard tissues and cells in oral cavity. METHODS: Samples of HClO solution with different production processes were prepared, to detect the changes of physicochemical indexes of each sample over time under simulated clinical conditions (shielded from light at 20-25 ℃, open the cover for 5 minutes every day), including free available chlorine, oxidation-reduction potential and pH. Through suspension quantitative germicidal test, the antibiosis-concentration curve of HClO solution was made, so as to calibrate the change of antibacterial ability of disinfectant with the decrease of available chlorine content during storage. Pulp, tongue and dentine were immersed in PBS, 100 ppm HClO, 200 ppm HClO and 3% NaClO. The influence on soft and hard tissues was evaluated by weighing method and microhardness test. The toxic effects of HClO, NaClO and their 10-fold diluent on human gingival fibroblasts were determined by CCK-8 cytotoxicity assay. GraphPad PRIS 8.0 software was used to analyze the data. RESULTS: Under simulated conditions, the free available chlorine (FAC) of HClO solution decayed with time, and the attenuation degree was less than 20 ppm within 1 month. The bactericidal effect of each HClO sample was still higher than 5log after concentration decay. There was no obvious dissolution and destruction to soft and hard tissues for HClO(P>0.05). The cell viability of HClO to human gingival fibroblast cells (HGFC) was greater than 80%, which was much higher than 3% NaClO (P<0.001). CONCLUSIONS: The bactericidal effect and stability of HClO solution can meet clinical needs, which has low cytotoxicity and good histocompatibility. It is expected to become a safe and efficient disinfection product in the field of living pulp preservation and dental pulp regeneration. Reference | Related Articles | Metrics

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Single-cell transcriptome characterization of oral mucosal fibroblasts ZHAO Jiong, BAI Guo, YANG Chi Shanghai Journal of Stomatology    2024, 33 (1): 1-5.   DOI: 10.19439/j.sjos.2024.01.001 Abstract （185）      PDF （1308KB）（144）       Knowledge map    PURPOSE: To elucidate the disparities and similarities in the composition and function of fibroblast subtypes between normal oral mucosa and cutaneous tissue, to establish a unified classification of fibroblast subtypes between these two tissue types, comprehend the differences and similarities in their functionalities, and provide a foundational basis for future applications in the fields of tissue repair and regeneration. METHODS: Four single-cell databases from both oral mucosa and cutaneous tissue were integrated and fibroblast subpopulations were extracted. Batch effects were eliminated using Harmony, and fibroblast subpopulations were subsequently classified via UMAP (Uniform Manifold Approximation and Projection) clustering. The functional analysis of these subpopulations was conducted through gene set enrichment results. Statistical analysis was performed with R 4.2.0 software package. RESULTS: Eight distinct functional fibroblast subpopulations were defined, and their functions were found to be associated with the composition of the extracellular matrix, immunity, and contraction. Statistical analysis revealed differences in the composition ratios of these subpopulations between oral mucosa and skin tissue. CONCLUSIONS: To evaluate the role of fibroblasts in tissue homeostasis and wound healing accomplished by integrating and analyzing fibroblasts from normal skin and oral mucosal tissue from various sites, this study identifies the differences in fibroblast subpopulation composition and function between these two tissue types in healthy conditions, and provides an understanding of oral mucosa and skin homeostasis and cellular function at the transcriptomic level. The findings of this study may serve as a basis for future research in this area. Reference | Related Articles | Metrics

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A survey of parents of preschool children on their perception of bad oral habits KANG Ying, DING Qin, WANG Sun Shanghai Journal of Stomatology    2024, 33 (1): 101-105.   DOI: 10.19439/j.sjos.2024.01.018 Abstract （184）      PDF （620KB）（152）       Knowledge map    PURPOSE: Through questionnaire survey, parents' cognition of children's bad oral habits and their related influencing factors were explored, in order to provide a reference for science popularization and education in future work. METHODS: With a self-designed questionnaire, 247 parents of children at first visit were surveyed on basic information and problems related to bad oral habits. Descriptive statistics were used for the counting data. Logistic regression analysis was used for the relevant factors affecting the parents' cognition of children's bad oral habits with SPSS 26.0 software package. RESULTS: Among 247 parents of preschool children, 17.4% of the parents took their children to the hospital for treatment because of bad oral habits. The prevalence of oral unhealthy habits was 44%. Parents' knowledge of bad oral habits was not high, less than half of the parents (46.6%) knew about bad oral habits, of which 82.6% of the parents thought that bad oral habits would affect the development of children's teeth, jaws, face and mental health, including facial contour (62.1%), dentition (34.7%), masticatory function (48.4%), and mental health (21.1%). 78.3% of the parents thought that bad oral habits needed to be corrected; 69.6% of the parents thought that they needed to go to the hospital for treatment, and 30.4% of the parents thought that it was ok as long as their children giving up bad oral habits. 61.7% of the parents would seek medical treatment in time when their children had bad oral habits. The ways for parents to obtain knowledge about bad oral habits were hospital education (61.5%). Parents with different characteristics had different cognition of bad oral habits. Logistic regression analysis showed that parents' education background was a risk factor affecting parents' cognition of bad oral habits(P=0.009). CONCLUSIONS: Parents' awareness of bad oral habits is not high, and parents' educational background is a risk factor for parents' awareness of bad oral habits. It is necessary to improve parents' awareness of oral habits, strengthen health education of bad oral habits, especially for parents with special signs, and improve the attention to oral health care, to achieve early detection, early prevention, early treatment and timely treatment, so as to prevent the occurrence and development of malocclusion. Reference | Related Articles | Metrics

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Experimental study of APB-DOCK8 transgenic tomato vaccine for caries prevention LONG Qian, LIAO Cheng-cheng, XIAO Lin-lin, LIU Jian-guo, GUAN Xiao-yan Shanghai Journal of Stomatology    2023, 32 (6): 561-567.   DOI: 10.19439/j.sjos.2023.06.001 Abstract （182）      PDF （1616KB）（137）       Knowledge map    PURPOSE: To observe the anti-caries effect of transgenic tomato anti-caries vaccine after immunization with SD rats by gavage and to explore its immunity mechanism initially. METHODS: SD rats were used to establish an experimental caries model. The transgenic anti-caries tomatoes expressing the target protein were cultivated and identified. The SIgA and IgG contents of specific anti-PAcA in saliva and blood samples of SD rats were detected by ELISA. Then, the SD rats were sacrificed, the maxillary and mandibular bones were taken for Keyes dental caries score, and spleens were taken for the analysis of RNA-seq. Statistical analysis was performed with SPSS 18.0 software package. RESULTS: The target protein concentration in the transgenic tomato anti-caries vaccine was 36.28μg/mL. After vaccine immunization of SD rats, group D (8 mL/kg) produced the highest levels of specific SIgA and IgG antibodies at week 6 and was significantly different from the other groups(P<0.05), and caries counting score was also significantly different than the other groups (P<0.05). The spleen mRNA of SD rats in group D was extracted and sequenced by RNA-seq, and 40 genes with significant differences in mRNA expression were obtained(P-adjust<0.05 & |Fold Change|≥1.5). 26 genes were significantly upregulated, including IGFBP6 and COL15A1. The upregulated gene GO enrichment was enriched to humoral immune response, B-cell activation, and immunoglobulin receptor binding; KEGG enrichment was enriched to 56 signaling pathways, including PI3K-AKT and NF-κB, and F<0.001. Fourteen genes were significantly downregulated, but the analysis of downregulated gene GO and KEGG enrichment was not statistically significant(F>0.1). CONCLUSIONS: Transgenic tomato anti-caries vaccine may reduce caries occurrence by upregulating the activation of PI3K-AKT signaling pathway mediated by IGFBP6 in SD rats. Reference | Related Articles | Metrics

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Effect of different cleaning methods on bond strength and surface wettability of high translucency zirconia JIAO Ji-lan, YE Xin-yi, DENG Lu, JIANG Hui, LI Xiao-xia, ZENG Li-wei, TAN Jian-guo Shanghai Journal of Stomatology    2024, 33 (1): 36-39.   DOI: 10.19439/j.sjos.2024.01.006 Abstract （177）      PDF （602KB）（132）       Knowledge map    PURPOSE: To study the effect of different cleaning methods on the shear bond strength of self-adhesive resin cement to saliva-contaminated high translucency zirconia and surface wettability. METHODS: Eighty zirconia specimens were randomly divided into 5 groups (n=16), i.e., control group(not contaminated), 75% ethanol group,cleaning paste group,airborne-particle abrasion group, and atmospheric pressure cold plasma group. The contact angles was measured, shear bond strength were examined, and fracture types were determined. SPSS 26.0 software package was used for statistical analysis of the data. RESULTS: The atmospheric pressure cold plasma group produced the lowest contact angle(P<0.05). The shear bond strength of the airborne-particle abrasion group, the cleaning paste group and the atmospheric pressure cold plasma group respectively were similar to the control group without significant difference(P>0.05), while those were significantly higher than 75% ethanol group(P<0.05). The mixed fracture mode of the atmospheric pressure cold plasma group evidently increased. CONCLUSIONS: Airborne-particle abrasion, cleaning paste and atmospheric pressure cold plasma overcome the effects of saliva contamination, producing the shear bond strength to zirconia similar to the control group. The atmospheric pressure cold plasma improves hydrophilicity of high translucency zirconia significantly. Reference | Related Articles | Metrics

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A novel periodontal endoscopy-aided non-incisional periodontal regeneration technique：a case series study SHI Jia-hong, LI Jing-wen, JIANG Li-shan, LEI Lang, LI Hou-xuan Shanghai Journal of Stomatology    2024, 33 (1): 80-84.   DOI: 10.19439/j.sjos.2024.01.014 Abstract （174）      PDF （888KB）（133）       Knowledge map    PURPOSE: To investigate the effect of endoscopy-aided non-incisional periodontal regeneration technique (NIT) in the treatment of alveolar bone angular resorption. METHODS: Thirteen patients with severe periodontitis(13 diseased teeth) were selected. All patients had alveolar bone angular resorption on adjacent surface. The patients received NIT treatment 6 weeks after periodontal primary therapy. The visualization of subgingival environment was acquired by the periodontal endoscopy. Following the removal of the subgingival plaque, calculus and intra-bony granulation tissue, bone grafting materials were placed into the intra-bony defects with the assistance of a delicate gingival protector. No flap was elevated and no sutures were applied. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), as well as radiographic parameters were evaluated at baseline and 2 years after treatment. SPSS 22.0 software package was used for data analysis. RESULTS: At 2-years follow-up, an average CAL gain of (3.65±2.10) mm (P<0.001), PD reduction of (4.42±1.66) mm (P<0.001), and minimal increase in GR of (0.38±0.87) mm (P=0.25) were observed. Alveolar bone was significantly improved at 2-years follow-up on radiographs (P<0.001). CONCLUSIONS: For angular resorption site of alveolar bone, NIT treatment can obtain good periodontal regeneration results without flap inversion. Reference | Related Articles | Metrics

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Biological characteristics and osteogenic differentiation of magnesium-doped nanoporous titanium coating ZHAO Shan, ZHANG Lin, LI Sheng-nan, KANG Nan, MENG Jian, LI Xiao-dong Shanghai Journal of Stomatology    2024, 33 (1): 6-12.   DOI: 10.19439/j.sjos.2024.01.002 Abstract （171）      PDF （2088KB）（133）       Knowledge map    PURPOSE: Bioactive magnesium ions were successfully incorporated into the nanoporous titanium base coating by micro-arc oxidation(MAO), and its physical properties and osteogenic effects were explored. METHODS: Non-magnesium-containing and magnesium-containing titanium porous titanium coatings(MAO, MAO-mg) were prepared by changing the composition of MAO electrolyte and controlling the doping of magnesium in porous titanium coatings. The samples were characterized by scanning electron microscope (SEM), roughness, contact angle and energy dispersive X-ray spectrometer (EDS). Mg2+ release ability of magnesium-doped nanoporous titanium coatings was determined by inductively coupled plasma/optical emission spectrometer(ICP-OES). The structure of the cytoskeleton was determined by live/dead double staining, CCK-8 detection of material proliferation-toxicity, and staining of β-actin using FITC-phalloidin. The effects of the coating on osteogenic differentiation in vitro were determined by alizarin red (ARS), alkaline phosphatase (ALP) staining and real-time polymerase chain reaction (qRT-PCR). SPSS 25.0 software package was used for statistical analysis. RESULTS: The MAO electrolyte with magnesium ions did not change the surface characteristics of the porous titanium coating. Each group prepared by MAO had similar microporous structure(P>0.05). There was no significant difference in surface roughness and contact angle between MAO treatment group (MAO, MAO-mg)(P>0.05), but significantly higher than that of Ti group (P<0.05). With the passage of cell culture time, MAO-mg group promoted cell proliferation (P<0.05). MAO-mg group was significantly higher than other groups in ALP and ARS staining. The expression of Runx2 mRNA (P<0.05), ALP(P<0.05) and osteocalcin OCN(P<0.05) in MAO-mg group was significantly higher than that in Ti and MAO groups. CONCLUSIONS: MAO successfully prepared magnesium-containing nanoporous titanium coating, and showed a significant role in promoting osteogenic differentiation. Reference | Related Articles | Metrics

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Inhibition of connexin 43-mediated hemichannel activity promotes odontoblast differentiation of human dental pulp cells induced by lipopolysaccharide ZHANG An-ni, DING Can-can, HUANG Li-ping, LI Shi-ting Shanghai Journal of Stomatology    2024, 33 (1): 22-29.   DOI: 10.19439/j.sjos.2024.01.004 Abstract （168）      PDF （2155KB）（131）       Knowledge map    PURPOSE: To investigate the role and mechanism of connexin 43（Cx43）in odontoblast differentiation of human dental pulp cells (hDPCs) induced by lipopolysaccharide (LPS). METHODS: The maxillary first molar injury model of SD rats was established. The expression pattern of Cx43 in dental pulp repair after injury was detected by immunofluorescence(IF) staining. hDPCs was respectively stimulated with 0, 1, 10, 100 and 1 000 ng/mL LPS for 6 h to screen the optimal concentration, and then the expression of Cx43 was inhibited and overexpressed in hDPCs. Quantitative real-time PCR(qRT-PCR) and Western blot(WB) were used to detect the expression of Cx43 and dentin sialophosphoprotein (DSPP), dental matrix protein-1 (DMP-1), osterix (Osx) and extracellular signal-regulated kinase (ERK) activity. Furthermore, hDPCs were treated with specific Cx43 channel inhibitors to investigate the effect of Cx43-mediated channel activity in odontoblast differentiation of hDPCs, and to explore the role and mechanism of Cx43 in regulating odontoblast differentiation of hDPCs induced by LPS. Statistical analysis was performed with SPSS 26.0 software package. RESULTS: IF results showed that Cx43 was mainly expressed in the odontoblast layer in healthy dental pulp tissues. At 3-24 h after tooth injury, the expression of Cx43 decreased and then gradually increased to the normal level; from 3 days to 2 weeks after injury, the expression of Cx43 tended to be down-regulated which was in the odontoblast layer and pulp proper. The expression of DSPP mRNA was significantly up-regulated in the hDPCs stimulated with 10 ng/mL LPS for 6 h(P<0.01). Inhibition of Cx43 significantly up-regulated the expression of DSPP, DMP-1 and Osx mRNA induced by LPS in hDPCs(P<0.05), while overexpression of Cx43 obviously inhibited the expression of factors related to LPS-induced odontoblast differentiation(P<0.01) and the fluorescence intensity of DSPP. 10 ng/mL LPS activated ERK signal in hDPCs, and overexpression of Cx43 significantly attenuated the activity of ERK signal induced by LPS(P<0.01). Inhibition of Cx43-mediated hemichannel (HC) promoted mRNA expression of factors related to odontoblast differentiation in hDPCs and the activity of ERK signal induced by LPS(P<0.05), while blocking Cx43-mediated gap junction channel (GJC) inhibited odontoblast differentiation. CONCLUSIONS: Cx43 participates in the regulation of dental pulp repair after injury, and its expression shows a downward trend as a whole. Inhibition of Cx43 or blocking of HC promotes LPS-induced ERK signal activity and odontoblast differentiation of hDPCs. Reference | Related Articles | Metrics

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Characteristics of caries-related oral microorganisms in early childhood caries HUANG Jun, HAN Xuan, MA Qi-zhao, ZOU Jing Shanghai Journal of Stomatology    2024, 33 (1): 59-63.   DOI: 10.19439/j.sjos.2024.01.010 Abstract （166）      PDF （1397KB）（144）       Knowledge map    PURPOSE: To study the structural characteristics of oral microorganisms in children with caries by 16S rRNA high-throughput sequencing technology. METHODS: Thirty healthy children aged 3-5 years were enrolled as subjects. According to the index of dmfs, they were divided into caries-free (CF) group (15) and early childhood caries (ECC) group(15). To compare the differences in bacterial community structure, samples of saliva and dental plaque were collected, and high-throughput sequencing was conducted using the Illumina Miseq sequencing platform. Bioinformatics analysis was used to analyze the difference of microbial community structure and diversity with SPSS 23.0 software package. RESULTS: Microbial diversity in ECC group was significantly lower than CF group. At phylum level, Actinobateria was more abundant in saliva samples of ECC group, while Firmicutes was more abundant in plaque samples of CF group. At genus level, the abundance of Lautropia of CF group was higher in saliva samples while Cardiobacterium, Gemella and Granulicatella were abundant in plaque samples. The abundance of Rothia of ECC group was higher in saliva samples and Corynebacterium was abundant of ECC group in plaque samples. CONCLUSIONS: There are significant differences in the species and composition of microbial community in saliva and plaque of children with or without caries. Specific microorganisms are related to the occurrence of ECC, and screening specific microorganisms is helpful for early prediction and prevention of ECC. Reference | Related Articles | Metrics

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Effects of orthodontic treatment combined with bone level implant in repairing dentition defect GONG Ru-juan, HE Lei Shanghai Journal of Stomatology    2024, 33 (1): 76-79.   DOI: 10.19439/j.sjos.2024.01.013 Abstract （165）      PDF （458KB）（102）       Knowledge map    PURPOSE: To analyze the effect of orthodontic treatment combined with bone level implant in repairing dentition defect. METHODS: The data of 88 patients with single dental implant in mandibular posterior region who were treated for dentition defect from January 2020 to January 2022 were retrospectively analyzed, including 44 patients with bone level implant repair(control group) and 44 patients with orthodontic treatment combined bone level implant repair (experimental group). The success rate of implant implantation, periodontal health status, masticatory function, implant stability, postoperative complications and implant satisfaction were compared between the two groups. Statistical analysis was performed with SPSS 18.0 software package. RESULTS: There was no significant difference in the success rate of implant implantation at 3 months and 6 months between the two groups(P>; 0.05). The success rate of implant implantation at 12 months in the experimental group was significantly higher than that in the control group (P<; 0.05). The gingival sulci bleeding index (SBI) and probing depth (PD) of the experimental group were significantly lower than those of the control group at 12 months after implantation (P<; 0.05), and there was no significant different in bone absorption between the two groups at 12 months after implantation(P>; 0.05). The EMG activities of masseter muscle and temporal muscle in the two groups were significantly higher than those before treatment(P<; 0.05), and those of masseter muscle and temporal muscle in the experimental group were significantly higher than those in the control group (P<; 0.05). The implant stability coefficient values of 6 months and 12 months in 2 groups were significantly higher than those of 3 months (P<; 0.05), the implant stability coefficient values of 12 months in 2 groups were significantly higher than those of 6 months and 12 months in 2 groups (P <; 0.05), and the implant stability coefficient values of 6 months and 12 months in the experimental group were significantly higher than those in the control group(P<; 0.05). There was no significant difference in the total complication rate between the two groups (P>; 0.05). The implant satisfaction of the experimental group was significantly higher than that of the control group (P<; 0.05). CONCLUSIONS: Orthodontic treatment combined with bone level implants can improve the success rate of implantation and masticatory efficiency, enhance the periodontal health of implants, and increase the patients' satisfaction with implants. Reference | Related Articles | Metrics

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BMP9 promotes osteogenic differentiation of periodontal ligament stem cells under inflammatory environment via ERK5/KLF4 signaling pathway LI Li, LIAN Wen-Wei Shanghai Journal of Stomatology    2023, 32 (6): 583-589.   DOI: 10.19439/j.sjos.2023.06.005 Abstract （164）      PDF （1355KB）（113）       Knowledge map    PURPOSE: To explore how bone morphogenetic protein 9(BMP9) promotes the osteogenic differentiation of periodontal ligament stem cells(PDLSCs) via ERK5/KLF4 signaling pathway under an inflammatory environment. METHODS: Recombinant adenovirus to overexpress BMP9 in PDLSCs stimulated with TNF-α was used and the expression level of osteogenic-related genes and proteins in BMP9-treated cells was examined using RT-PCR and Western blot. Then, KLF4 was overexpressed in PDLSCs via transfection and subjected to inflammatory stimulation to observe its effects on osteogenic differentiation and the expression of osteogenic-related genes. overexpression of BMP9 under the condition of KLF4 knockdown was conducted and its effects on osteogenic differentiation and the expression of osteogenic-related genes was analyzed. ERK5 inhibitor BIX02189 was used to explore the role of ERK5 in BMP9-induced osteogenic differentiation. Statistical analysis was performed with SPSS 20.0 software package. RESULTS: BMP9 could promote the osteogenic differentiation of PDLSCs and the expression of KLF4 in an inflammatory environment. Moreover, the overexpression of KLF4 further promoted the osteogenic differentiation of PDLSCs. However, when KLF4 was knocked down, the osteogenic differentiation promotion effect of BMP9 on PDLSCs was weakened. After BMP9 treatment, the phosphorylation level of ERK5 significantly increased. However, after adding ERK5 inhibitor, the promoting effect of BMP9 on osteogenic differentiation was significantly reduced. CONCLUSIONS: BMP9 can promote the osteogenic differentiation of PDLSCs via ERK5/KLF4 signaling pathway in an inflammatory environment. Reference | Related Articles | Metrics

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BRAF V600E expression in ameloblastomas, ameloblastic carcinomas and cysts PEI Jing, ZHANG Lin, JIA Yun-xiang, CHEN Wei-hua Shanghai Journal of Stomatology    2023, 32 (6): 630-634.   DOI: 10.19439/j.sjos.2023.06.012 Abstract （161）      PDF （812KB）（114）       Knowledge map    PURPOSE: To investigate protein and genetic status of BRAF V600E in ameloblastomas, ameloblastic carcinomas and cysts, and to explore if recurrence and malignant transformation of ameloblastomas depends on BRAF status. METHODS: Twenty cysts, 25 primary ameloblastomas, 25 recurrent ameloblastomas and 8 ameloblastic carcinomas were analysed by immunohistochemistry, and 2 cysts, 5 primary ameloblatomas, 5 recurrent ameloblastomas, 3 atypical ameloblastomas and 6 ameloblastic carcinomas were analysed by quantitative real-time PCR(qPCR). SPSS 26.0 software package was used for data analysis. RESULTS: There was no correlation between BRAF V600E expression and recurrence. Cysts and carcinomas had lower frequencies of BRAF V600E mutations than ameloblastomas. There was a concordance between positive staining of BRAF V600E protein and BRAF V600E mutation. CONCLUSIONS: BRAF V600E mutation may be useful in the differential diagnosis of ameloblastomas with cysts and ameloblastic carcinomas. Immunohistochemistry may be a beneficial method to screen for BRAF V600E mutation in ameloblastoma. Reference | Related Articles | Metrics

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Applied anatomical characteristics of vascularized iliac muscle flap and its clinical application in repairing oral and maxillofacial defects ZHANG Yang, ZHU Qing-hai, ZHANG Yong-jie, WANG Chen-xing, YE Jin-hai Shanghai Journal of Stomatology    2023, 32 (6): 603-608.   DOI: 10.19439/j.sjos.2023.06.008 Abstract （160）      PDF （2130KB）（125）       Knowledge map    PURPOSE: To investigate the feasibility and safety of the deep circumflex iliac artery (DCIA) derived chimeric flap through the anatomical study of the blood vessels and perforating branches in the ilioinguinal region, and to provide the basis for selecting different DCIA chimeric flap schemes according to the difficulty of surgery, defect conditions and repair needs. METHODS: Six Chinese adult specimens were dissected by retrograde perfusion of red latex into bilateral femoral arteries. At the same time, the length, diameter and main branch position of DCIA vascular pedicle were measured in 12 lower limb CTAs, and compared with the anatomical data. Six patients with oral tumors accompanied by mandibular defects who were treated in the Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University from July 2020 to November 2021 were repaired and reconstructed with the chimeric iliac myofascial flap. The postoperative appearance and occlusal function of the recipient area were observed. SPSS 19.0 software package was used for data analysis. RESULTS: A total of 19 DCIA perforators with an external diameter of ≥ 0.5 mm were found in 12 specimens of ilioinguinal region. These perforators were distributed in the 5 cm×3 cm area, inside the ilium and 5cm behind the anterior superior iliac spine. The length of DCIA vascular pedicle was (6.73±1.06) cm. The measured value of the external diameter of the starting position of the vascular pedicle was (2.55±0.29) mm. The outer diameter of DCIA skin perforator penetrating deep fascia was (1.12±0.14) mm. In the CTA analysis of 12 lower limbs, it was found that the length of DCIA vascular pedicle was (6.98±0.62) cm. The measured diameter at the original position of vascular pedicle was (2.35±0.20) mm. Six cases of mandibular defects were repaired with iliac internal oblique fascia mosaic flap. Six cases of lliac flap survived successfully after operation. Follow up for 6 to 24 months (average 12 months) showed that the mandibular shape and function recovered well, the intraoral myofascial flap became mucosal, and the implanted iliac bone showed no significant volume change on CT after operation. Walking and weight bearing in donor area were basically normal, and no abdominal hernia occurred. CONCLUSIONS: DCIA and its main branches have a relatively constant course and distribution in the ilioinguinal region. According to the conditions of different defect areas, different tissue types of chimeric flaps based on DCIA can be prepared to meet the repair requirements. The donor site complications can be controlled, and it is an ideal choice to repair mandibular defects. Reference | Related Articles | Metrics

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Evaluation of the 5-year clinical restoration effect of implants retained complete overdentures with Locator attachments in 48 patients ZHOU Tuan-feng, YANG Xue, ZHANG Hua, ZHANG Zhi-yong, CHEN Quan Shanghai Journal of Stomatology    2024, 33 (1): 90-96.   DOI: 10.19439/j.sjos.2024.01.016 Abstract （158）      PDF （998KB）（123）       Knowledge map    PURPOSE: To observe the long-term clinical effect of implants retained complete overdentures with Locator attachments. METHODS: A total of 48 patients with edentulous jaws treated with implants retained complete overdentures with Locator attachments were selected from the Outpatient Department of Peking University School and Hospital of Stomatology from 2016 to 2017. Among them, 21 patients underwent double-maxillary complete overdentures restoration and 27 patients underwent single-maxillary restoration. A total of 230 implants were implanted. The clinical observation indicators included the implant survival rate, peri-implant mucosal bleeding on probing(BOP), the change in the vertical height of alveolar bone absorption around the implants, overdenture base fracture rate, artificial tooth fall off and fracture rate and other complications. The change of the locator attachment retention force of the implant-supported overdentures was evaluated. SPSS 13.0 software package was used for data analysis. RESULTS: During the five-years clinical observation period, 5 implants fell off, 1 narrow dimeter implant in the anterior zone was broken, and 12 implants were lost to follow-up. The implant survival rate was 97.25%. One year after the restoration therapy finished, peri-implant mucosal bleeding on probing (BOP+) was detected in 48 (21.4%) implants. The average BI was 0.21±0.42, which was higher in the anterior zone than that in the posterior zone. The vertical alveolar bone absorption height around the implants was (0.21±0.35) mm, 2 implants-supported complete overdenture bases were broken. After 5 years of restoration, 163(76.89%) implants had peri-implant mucosal bleeding on probing(BOP+). The average BI was 1.00±0.70, and the vertical alveolar bone absorption height around the implants was (0.58±0.85) mm. There was no significant difference between males and females. There was no significant difference in the peri-implant mucosal bleeding index and the alveolar bone vertical absorption height between the anterior zone and the posterior zone(P>0.05). The mean BI of peri-implant mucosa and the vertical absorption height of peri-implant alveolar bone were significantly different between the 1-year observation period and the 5-year observation period respectively(P<0.01). There were 17(26.15%) cases with overdenture bases fracture, and the fracture rate of artificial teeth was 16.92%. Most of them occurred in the midline area of the anterior zone and the location of the overdenture base on the locator attachments. The average first replacement time of the locator attachment nylon retainer washer was 34.2±10.3 months. CONCLUSIONS: Implants retained complete overdentures with Locator attachments are effective in long term clinical observation. Complications are mainly found in peri-implant mucosal bleeding on probing and vertical alveolar bone absorption, and tended to increase gradually over time. The fracture of the implant retains complete overdenture bases and the fall off or fracture of the artificial teeth are the second serious complications. Overdenture base with metal frame at the location of the Locator abutment and the midline of the anterior area should be strengthened, and narrow diameter implants should be avoided as far as possible in the anterior zone. Reference | Related Articles | Metrics

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Changes in tongue position and three-dimensional changes in upper airway before and after treatment with Twin-block combined with maxillary expansion appliance in children with mandibular retrusion WANG Meng, TAO Li-ming, HU Ya-nan Shanghai Journal of Stomatology    2023, 32 (6): 635-639.   DOI: 10.19439/j.sjos.2023.06.013 Abstract （155）      PDF （1329KB）（126）       Knowledge map    PURPOSE: To observe changes of upper airway in three dimensions and tongue position after correction with Twin-block combined with maxillary expansion appliance in children with mandibular retrusion and history of mouth breathing. METHODS: Twenty children with Class Ⅱ malocclusion and mandibular retrusion were selected and treated with Twin-block combined with maxillary expansion appliance. Cone-beam CT(CBCT) data before and after treatment were imported into Mimics 21.0 software to measure the total volume of the upper airway (nasopharyngeal segment + oropharyngeal segment), as well as segmental airway volume of nasopharyngeal, glossopharynx and oropharyngeal space. The cross-sectional area and maximum sagittal diameter at the tip of uvula in glossopharyngeal airway,and maxillary width were measured, too. Anterior-posterior and height changes of tongue position were observed. SPSS 26.0 software package was used to perform paired sample t test and Wilcoxon signed rank test of the data. RESULTS: The total upper airway volume and the airway volume of the nasopharyngeal, oropharyngeal and glossopharyngeal segments increased significantly after correction. The cross-sectional area and maximum sagittal diameter at the tip of uvula in glossopharyngeal segment, and the maxillary width were increased significantly.Tongue position increased and moved forward. All the above data had significant different(P<0.05). CONCLUSIONS: Twin-block combined with maxillary expansion appliance can increase the total volume of the nasopharyngeal segment, oropharyngeal segment, glossopharyngeal segment and upper airway in children with Class Ⅱ malocclusion and mandibular retrusion and expand the anterior-posterior depth of oropharynx airway.In addition,the treatment can increase maxillary width and normalize the tongue position, and contribute to the improvement of airway patency. Reference | Related Articles | Metrics

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Evaluation of the efficacy of combined application of concentrated growth factors in ridge preservation of teeth with severe periodontitis XIA Ting-ting, WANG Yong Shanghai Journal of Stomatology    2023, 32 (6): 650-655.   DOI: 10.19439/j.sjos.2023.06.016 Abstract （155）      PDF （1451KB）（131）       Knowledge map    PURPOSE: To evaluate the efficacy of combination of deproteinized bovine bone matrix and concentrated growth factors in maintaining the three-dimensional contour of alveolar bone in ridge preservation of teeth with severe periodontitis. METHODS: Thirty patients with posterior teeth suffering from severe periodontitis requiring extraction and with the intention of implant restoration were selected and randomly divided into the experimental group and control group, with 15 cases in each group. In the experimental group, DBBM combined with CGF fluid was used as bone graft material and placed in the extraction socket of the patient after minimally invasive tooth extraction and thorough debridement,while DBBM was used in the control group mixed with normal saline as the bone graft material.The extraction wounds of both groups were covered with absorbable biofilm and free gingival tissue. CBCT was performed at the initial diagnosis, immediately after operation, and 6 months after operation, and the CT images were imported into Mimics 20.0 software package to measure the difference after fitting to obtain data, SPSS 26.0 software package was used for statistical analysis of the data. RESULTS: The vertical height of the alveolar bone in the experimental group and the control group was significantly increased 6 months after operation compared with the initial diagnosis (P<0.05), but there was no significant difference between the 2 groups(P>0.05). There was significant difference in the change of the alveolar bone width at 1 mm below the alveolar crest between the two groups at the initial diagnosis and 6 months after operation(P<0.05), and the horizontal width absorption in the experimental group was smaller than that in the control group. The horizontal absorption rate of bone graft material in the two groups at 1 mm below the alveolar crest showed that the experimental group was lower than the control group, and the difference was statistically significant(P<0.05). CONCLUSIONS: Compared with DBBM alone, combined application of DBBM and CGF can better maintain the alveolar bone contour of the extraction socket with severe periodontitis. Reference | Related Articles | Metrics

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Evaluation of a modified maxillary protraction appliance for the treatment of patients with skeletal Class Ⅲ malocclusion associated with crowding LIU Ye, GE Xiao-lei, ZHANG Shi-long, QIN Yuan, HOU Yan, LU Hai-yan, MA Wen-sheng Shanghai Journal of Stomatology    2024, 33 (2): 180-185.   DOI: 10.19439/j.sjos.2024.02.013 Abstract （153）      PDF （1149KB）（67）       Knowledge map    PURPOSE: To investigate the efficacy of a modified maxillary protraction appliance in patients of skeletal Class Ⅲ with crowding. METHODS: Forty patients with skeletal Class Ⅲ malocclusion were divided into two groups, with 20 patients in each group. The experimental group had molar in a neutral or distal relationship and applied a modified maxillary protraction appliance, while the control group had molar mesial relationship and applied a conventional maxillary protraction appliance. Lateral cephalometric radiographs were taken before and after treatment in both groups for comparison. SPSS 22.0 software package was used for data analysis. RESULTS: The angle measurements taken before and after treatment showed a significant increase in SNA, ANB, SN-MP and U4-SN(P<0.01), while SNB decreased(P<0.01) in both groups. SN-OL changes were statistically different before and after treatment in the experimental group(P<0.05). The sagittal measurements before and after treatment in both groups showed significant alterations in all(P<0.05) but the length of the maxillary arch in both groups. For vertical measurements, U1-PP, L1-MP, U4-SN, U6-SN, and ANS-ME all increased (P<0.05), while the changes of U4-PP and U6-PP in the two groups before and after treatment were statistically different(P<0.05). Compared with the control group, the experimental group had a significantly increased maxillary arch length, a more remote location at U6, and a less variable molar relationship after treatment(P<0.01). The two groups showed a variable amount of cephalometric measurements before and after treatment: the experimental group had a significant increase in maxillary arch length, a more remote position at U6, and a smaller change in molar relationship compared to the control group(P<0.01). CONCLUSIONS: The modified maxillary protraction appliance showed good results for maxillary protraction and pushing the molar distally in patients with skeletal Class Ⅲ with crowding at neutral or distal molar relationship. Reference | Related Articles | Metrics