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    Evaluation of the effect of digital crown extension guide in aesthetic restoration of anterior teeth
    WANG Xue-chun, WANG Yong, XU Xiao-bo, HAO Xin-he
    Shanghai Journal of Stomatology    2022, 31 (3): 260-264.   DOI: 10.19439/j.sjos.2022.03.007
    Abstract375)      PDF (749KB)(448)      
    PURPOSE: To evaluate the clinical effect of three-dimensional digital smile design (3D-DSD) combined with double positioning crown extension guide in aesthetic restoration of anterior teeth. METHODS: Twenty patients who needed aesthetic crown lengthening and full crown restoration of upper anterior teeth were selected and randomly divided into the experimental group and control group, with 10 cases in each group. The experimental group carried out 3D-DSD, after confirming the plan, 3D printed double positioning crown extension guides were used to guide aesthetic crown lengthening, and full crown was completed 3 months after operation. The control group used traditional aesthetic crown lengthening and full crown restoration. PES/WES evaluation was performed before operation, three months and six months after operation. Visual analogue scales(VAS) were used to evaluate patient satisfaction 6 and 7 months after surgery, and the repeatability evaluation of VAS was conducted. The correlation between PES/WES score and overall satisfaction was analyzed 6 months after operation. SPSS 23.0 software package was used for statistical analysis. RESULTS: The PES/WES scores of the two groups of patients at 3 months and 6 months after operation were higher than those before operation(P<0.05). The two groups showed that the scores of the experimental group were significantly higher than those of the control group for PES 3 months after operation, PES and WES 6 months after operation(P<0.05).Satisfaction survey results showed that the intra-group correlation coefficient of the two VAS results was 0.956(P<0.05),and crown length-to-width ratio, smile curve, personality characteristics, patient participation and overall satisfaction in the experimental group were better than those of the control group(P<0.05).The results of Speraman correlation analysis showed that PES and WES scores at 6 months after operation were positively correlated with overall satisfaction (rs1=0.905, P<0.001; rs2=0.460, P=0.041). CONCLUSIONS: 3D digital smile design combined with double positioning crown extension guide guides the anterior aesthetic crown lengthening and restoration treatment, which can improve the effect of pink and white aesthetics after treatment and patient satisfaction.
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    Clinical efficacy of the combination of miniscrew with clear aligner in controlling the roller coaster effect
    MA Xiao-qing, XIANG Fei, FAN Ming-yue, SONG Yi, WANG Xiao-hui, ZHANG Ling, QIAN Wen-hao
    Shanghai Journal of Stomatology    2022, 31 (2): 193-197.   DOI: 10.19439/j.sjos.2022.02.015
    Abstract563)      PDF (1173KB)(383)      
    PURPOSE: To investigate the clinical efficacy of miniscrew in controlling the roller coaster effect in long-distance space closure with clear aligner. METHODS: Sixteen adult patients with bimaxillary protrusion were selected. All cases were treated with clear aligner and their four first premolars were extracted. G6 was designed in all cases. In the experimental group, four miniscrews were inserted at the beginning of treatment to control the teeth in three dimensions; while in the control group, the miniscrews were not applied until obvious roller coaster effect appeared. Paired t test was used to analyze the data with Graphpad Prism 6.0 software package. RESULTS: All the extraction space was closed successfully and the lateral profile was improved significantly. The torque of the upper incisor was under well control and no roller coaster effect happened in the experimental group; while in the control group, the lingual inclination of the upper incisors and open bite of the posterior teeth developed(P<0.05). After the miniscrews intrusion of the upper anterior teeth, the occlusion relationship improved significantly. CONCLUSIONS: Miniscrews effectively prevents and eliminates the roller coaster effect in the process of long-distance space closure with clear aligner.
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    Short-term comparison of the clinical efficacy of angulated screw-retained implant crowns and cemented implant crowns in esthetics region
    LYU Xiao-lei, SHI Jun-yu, QIAN Shu-jiao, LAI Hong-chang
    Shanghai Journal of Stomatology    2022, 31 (4): 423-428.   DOI: 10.19439/j.sjos.2022.04.017
    Abstract339)      PDF (865KB)(338)      
    PURPOSE: To compare the clinical efficacy of angulated screw channel abutments and prefabricated titanium abutments on the restoration of single implant crowns in esthetics region. METHODS: The study was a prospective, single center, randomized controlled trial. Patients with the need of restoration of single tooth in esthetics region were included from June 2018 to June 2019. Forty patients were randomly assigned into two groups: screw-retained crowns with angulated screw channel abutments(angulated group, AG) and cemented crowns with prefabricated Ti abutments (cemented group, CG). Clinical and radiological evaluations were performed on the day of final crowns delivery and 6 months later. Implant survival rate, marginal bone loss (MBL), mechanical complications, peri-implant conditions (Probing depth, PD; bleeding on probing, BOP%), pink esthetics score/white esthetics score(PES/WES) and patients' satisfaction were assessed. The data was analyzed with SPSS 19.0 software package. RESULTS: Thirty-six patients (AG: 19, CG: 17) attended the 6-month clinical trial. Implant survival rates were both 100% in two groups. The MBL was (0.21±0.18) mm for AG and (0.38±0.40) mm for CG (P>0.05). The BOP% was significantly higher in AG than that in CG (P=0.04). No significant difference of mechanical complications, PD, PES/WES and patients’ satisfaction was found between the two groups(P>0.05). CONCLUSIONS: Based on the present results, both treatment options show acceptable clinical outcomes in the short term. Angulated screw-retained crowns may benefit the peri-implant soft tissue; however, studies with long-term follow-up are needed to verify the results.
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    Evaluation of the effect of Insignia system in customized orthodontic treatment
    LIU Fan, LIU Lin, WANG Yan-hong
    Shanghai Journal of Stomatology    2022, 31 (1): 96-99.   DOI: 10.19439/j.sjos.2022.01.020
    Abstract417)      PDF (484KB)(330)      
    PORPOSE: To investigate the effect of Insignia system in customized orthodontic treatment. METHODS: A total of 71 patients with malocclusion undergoing orthodontic treatment in Dalian Stomatological Hospital from March 2018 to August 2019 were enrolled, and divided into two groups according to random number table methods. Patients in non-customized group received Damon Q self-locking brackets, while patients in customized group received individualized brackets combined with Insignia appliance. The patients were revisited every 8 weeks in initial phase and thereafter every 6 weeks. The clinical efficacy, number of visits, time required for treatment planning and treatment duration were compared between the two groups. The severity of malocclusion, changes after treatment and improvement before and after treatment were evaluated by peer assessment rating (PAR). The complications and loose brackets during treatment were observed. SPSS 20.0 software package was used to analyze the data. RESULTS: The total effective rate of customized group was significantly higher than that of non-customized group (P<0.05). No significant difference was found in treatment duration between the two groups(P>0.05). The number of visits and time required for treatment planning of customized group were significantly longer than those of non-customized group(P<0.05). After treatment, the midline, tooth dislocation, molar buccal occlusion, overbite, overjet and weighted PAR total scores increased in both groups, and the increase was more significant in customized group(P<0.05). The gingival bleeding rate showed no significant difference between the two groups(P>0.05), while the rate of loose brackets was significantly higher in customized group than in non-customized group (P<0.05). CONCLUSIONS: Compared with non-customized system, insignia customized system has more visits, longer treatment planning time and higher bracket loosening rate, but its effect is better. In general, it has little effect on the treatment duration and does not increase the bracket shedding rate.
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    Evaluation of the effect of Er:YAG laser combined with guided bone regeneration in the treatment of peri-implantitis with osseous defects
    TU Hui-juan, LI Ling-yu, LI Yi-dan, LUO Zhen-lan, YU Ming
    Shanghai Journal of Stomatology    2022, 31 (4): 418-422.   DOI: 10.19439/j.sjos.2022.04.016
    Abstract334)      PDF (1217KB)(308)      
    PURPOSE: To evaluate the clinical benefits of Er:YAG laser combined with guided bone regeneration (GBR) in the treatment of peri-implantitis-assocaited osseous defects. METHODS: Twenty-six patients (34 implants in total) who underwent implant restoration in Dental Disease Prevention and Treatment Institute, Jiading District, from 2017 to 2019 and were diagnosed with peri-implantitis with osseous defects, and randomly divided into the experimental group and control group. The two groups of patients received open flap surgery, debridement and GBR treatment. The only difference in the experimental group was the use of Er: YAG laser to modulate and remove inflammatory tissue as well as to decontaminate the implant surface, instead of traditional mechanical treatment in the control group. The probing depth (PD), bleeding on probing (BOP), and plaque index (PI), the height of the bone defect around the implant (reduce of marginal bone level, RBL) were recorded and compared. SPSS 20.0 software package was used to analyze the data. RESULTS: The PD, BOP, PI and RBL of the two groups of patients were significantly improved after treatment with different methods. There was no significant difference in the improvement of PD, BOP and PI between the two groups 6, 12 and 24 months after treatment, while the improvement of RBL in the experimental group was significantly better than that of the control group 12 and 24 months after treatment. CONCLUSIONS: In the treatment of GBR with peri-implantitis and osseous defects, Er: YAG laser therapy is more effective than traditional mechanical methods, and is more conducive to the regeneration of new bone.
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    Imaging characteristic of Stafne bone cavity:a retrospective study based on cone-beam CT
    HUANG Jin-cheng, ZHAO Hua-qiang, LI Guo-ju
    Shanghai Journal of Stomatology    2022, 31 (4): 439-444.   DOI: 10.19439/j.sjos.2022.04.020
    Abstract660)      PDF (1500KB)(298)      
    PURPOSE: To guide clinical decision-making more efficiently via collecting and analyzing the imaging data of patients with Stafne bone cavity(SBC). METHODS: Six patients with SBC were retrospectively reviewed in Stomatological Hospital of Shandong University. By assessing cone-beam CT (CBCT) data, age, sex, complaint, cavity location, diameter at three dimension, maximal cross-sectional area of multi-planar reconstruction planes, content gray scale, morphological classification and its relationship with mandibular canal were recorded respectively. RESULTS: A total of 6 cases were inadvertently found on CBCT, with no symptoms. The locations of SBC were between mandibular molar region and mandibular angle, inferior border of mandible and mandibular canal, mostly at lingual side. Three were on the left and three were on the right. The bone cavity was elliptic and its long axis was consistent with the long axis of the mandible, with an average long axis diameter of (16.43±4.54) mm, horizontal axis diameter of (6.91±1.48) mm, vertical axis diameter of (10.24±2.10) mm. According to the multi-planar reconstruction planes readings, the maximal cross-sectional area of the bone cavity was (91.93±25.52) mm2, the maximal coronal area was (57.26±23.23) mm2, and the maximal sagittal area was (127.80±51.22) mm2. In view of the classification in the relationship between SBC marginal line and buccal cortical bone, there were 2 cases of type I cavity, 3 cases of type II cavity and 1 case of type III cavity. The connection between the bone cavity and the surrounding anatomical structure was classified into 3 conditions: covering penetration, adjacency and separation on the basis of the relative position between the cavity boundary with the mandibular inferior margin and the mandibular canal in sagittal plane. In addition, the content type could be primarily identified depending on estimation of corrected grey scale in the center of bone cavity. CONCLUSIONS: CBCT can make an intuitive and clear diagnosis of Stafne bone cavity, which brings great significance into the early clinical decision-making, thus not only avoiding unnecessary surgery, reducing the waste of additional medical resources, but also decreasing the physical and mental trauma of patients.
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    Segmentation, accuracy validation of mandibular molar, pulp cavity on cone-beam CT images by U-net neural network
    LIN Xiang, FU Yu-jie, REN Gen-qiang, WEN Jia-huan, CHEN Yu-fei, ZHANG Qi
    Shanghai Journal of Stomatology    2022, 31 (5): 454-459.   DOI: 10.19439/j.sjos.2022.05.002
    Abstract343)      PDF (912KB)(298)      
    PURPOSE: To realize the automatic segmentation of mandibular molar and pulp cavity on cone-beam CT (CBCT) images by U-net convolutional neural network, and to use the 3D models reconstructed by Micro-CT data as the ground truth to validate its accuracy. METHODS: Twenty groups of small field of view(FOV) CBCT data containing complete mandibular molars were collected from the Department of Radiology, Affiliated Stomatology Hospital of Tongji University. After preprocessing, an endodontic specialist labeled teeth and pulp cavities by MITK Workbench software. These data were used as the training set for training U-net neural network. In addition, five mandibular molars and corresponding small FOV CBCT data were collected. These five CBCT were processed in the same way and used as the testing set. Then, teeth and pulp cavities on CBCT images of the testing set were segmented and reconstructed by U-net neural network and the same specialist. The isolated teeth were scanned by a Micro-CT machine after preprocessing and the results were reconstructed to 3D models, which were used as the ground truth. Then the 3D models reconstructed by the specialist’s labeling, U-net network segmentation results, and the ground truth in the testing set were compared. Dice similarity coefficient(DSC), average symmetric surface distance (ASSD), Hausdorff distance (HD), and morphological analysis were used to evaluate the results. SPSS 20.0 software package was used for statistical analysis. RESULTS: Compared with the ground truth, the segmentation accuracy of the U-net neural network measured by DSC, ASSD, and AHD was (95.30±1.01)%, (0.11±0.02) mm, and (1.05±0.31) mm in teeth and (81.21±2.27)%, (0.15±0.05) mm, and (3.29±1.85) mm in the pulp cavity, respectively. Morphological analysis results showed that the U-net network segmentation results were similar to the ground truth in tooth and pulp chamber. As for the segmentation results of root canals, only thick root canals could be segmented rather than the thin root canals, such as the canals in the apical third and lateral root canals. CONCLUSIONS: Under the experimental conditions, the U-net neural network trained by the specialist’s labeling realized the automatic and accurate segmentation of mandibular molar and their pulp chamber on CBCT images. For the segmentation of root canals, the results need to be further improved.
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    Effect of keratinized gingival width on periodontal regenerative surgery for the treatment of intrabony defects: a retrospective study
    LIU Hao-hao, HU Yi, ZHANG Chen, CHEN Mei-hua
    Shanghai Journal of Stomatology    2022, 31 (5): 507-511.   DOI: 10.19439/j.sjos.2022.05.011
    Abstract277)      PDF (1199KB)(295)      
    PURPOSE: To evaluate the effect of keratinized tissue width (KTW) on periodontal regenerative surgery for the treatment of intrabony defects. METHODS: The clinical data of 14 patients (44 intrabony defect sites) treated with periodontal regenerative surgery were retrospectively analyzed at baseline and 2-year of follow-up. Forty four sites were divided into KTW2 mm group and KTW≤2 mm group according to KTW at baseline. Periodontal clinical indicators of the 2 groups were analyzed by SPSS 25.0 software package. RESULTS: At 2-year post-treatment, probing depth (PD) and clinical attachment loss (CAL) in the 2 groups were decreased significantly compared with those at baseline(P<0.05). There was no significant difference in ΔPD, but △CAL in KTW2 mm group was significantly greater than that in KTW≤2 mm group. CONCLUSIONS: Periodontal regenerative surgery for the treatment of intrabony defects can effectively reduce periodontal pocket inflammation, decrease periodontal pocket depth and increase the level of attachment. When the width of the keratinized gingiva is insufficient(KTW≤2 mm), the regeneration of the attachment level obtained by surgery is limited, and the efficacy of regenerative surgery is poor.
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    Curcumin targeting miR-155-5p/TP53INP1axis induced oxidative stress to regulate salivary gland tumor cell proliferation, apoptosis
    DU Hong-liang, HE Deng-qi, WANG Jia-Li, CHE Yin-fu, YAN Qing-han
    Shanghai Journal of Stomatology    2022, 31 (5): 483-490.   DOI: 10.19439/j.sjos.2022.05.007
    Abstract241)      PDF (1709KB)(294)      
    PURPOSE: To investigate the mechanism of curcumin targeting miR-155-5p/TP53INP1 axis to induce oxidative stress to regulate salivary gland tumor cell proliferation and apoptosis. METHODS: A253 cells were cultured by adding curcumin and transfected with miR-155-5p mimic and/or pcDNA3.1-TP53INP1. Cell proliferation was detected by CCK-8 assay cell apoptosis was detected by flow cytometry, cell migration ability was detected by scratch test. The targeting relationship between miR-155-5p and TP53INP1 was verified by dual luciferase reporter assay. miR-155-5p, TP53INP1 mRNA expression was detected by qRT-PCR. Western blot was performed to detect expression of TP53INP1, Caspase8, Caspase3, Bcl-2, Bax protein; and ELISA was used to determine SOD, Gpx, and MDA content. Statistical analysis was performed using SPSS 22.0 software package. RESULTS: Dual luciferase reporter assay confirmed that TP53INP1 was a downstream target regulatory molecule of miR-155-5p. Compared with DMSO group, cell apoptosis, Caspase8, Caspase3, Bax protein expression and TP53INP1 expression were significantly increased in curcumin group, while Bcl-2 protein expression, miR-155-5p mRNA and number of cell migration were significantly decreased(P<0.05). Compared with curcumin + miR-155-5p mimic group, cell apoptosis, Caspase8, Caspase3, Bax protein expression was significantly increased in curcumin + pcDNA3.1-TP53INP1 group and curcumin + miR-155-5p mimic + pcDNA3.1-TP53INP1 group; Bcl-2 protein expression was significantly increased(P<0.05), SOD, GSH-PX activities and number of cell migration were significantly decreased and MDA content was significantly increased in curcumin+pcDNA3.1-TP53INP1 group (P<0.05). CONCLUSIONS: Curcumin inhibited A253 cell proliferation and promoted A253 cell apoptosis. The mechanism may be related to targeting miR-155-5p/TP53INP1 axis to induce oxidative stress regulation.
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    Comparative analysis of the effect of autologous dentin particles, implantation of Bio-Oss on guided bone regeneration in the treatment of periodontal bone defects
    MAO Xin-xia, LIN Xiao-wei, WEI Xuan, LI Qin
    Shanghai Journal of Stomatology    2022, 31 (5): 530-534.   DOI: 10.19439/j.sjos.2022.05.015
    Abstract307)      PDF (597KB)(284)      
    PURPOSE: To analyze the effect of autologous dentin particles and Bio-Oss bone powder implantation on guided bone regeneration in the treatment of periodontal bone defects. METHODS: Eighty-two patients with periodontal bone defect treated in Zhangye People's Hospital from May 2018 to May 2020 who underwent guided bone regeneration treatment were selected and divided into experimental group and control group according to random number table method, with 41 cases in each group. The control group was implanted with Bio-Oss during the operation, and the experimental group was implanted with autologous dentin particles during operation. Periodontal pocket depth and attachment loss, buccal soft tissue profile, buccal soft tissue thickness, red aesthetic score, success rate, and complications were compared between the two groups of patients. SPSS 22.0 software package was used for statistical analysis. RESULTS: Comparison within the group showed that 1 month and 1 year after operation, the periodontal pocket depth and attachment loss of the two groups were significantly reduced(P<0.05); and 1 year after operation, the periodontal pocket depth and attachment loss of the two groups were significantly lower than 1 month after surgery(P<0.05). Comparison between groups showed that 1 month and 1 year after operation, the periodontal pocket depth and attachment loss of the experimental group were significantly lower than those of the control group (P<0.05). Comparison within groups showed that 1 month and 1 year after operation, the buccal soft tissue profile of the two groups were significantly higher than that before operation (P<0.05); and 1 year after operation, the buccal soft tissue profile of the two groups were significantly lower than 1 month after operation. Comparison between groups showed that 1 year after operation, the buccal soft tissue profile of the experimental group was significantly higher than that of the control group (P<0.05). Comparison within groups showed that 1 month and 1 year after surgery, the thickness of the buccal soft tissue of the two groups were significantly higher than that before surgery. Comparison between groups showed that there was no significant difference in the thickness of the buccal soft tissue at each time point between the two groups(P>0.05). Comparison within groups showed that 1 month and 1 year after operation, the red aesthetic scores of patients in the two groups were significantly higher than those before operation (P<0.05); in addition, the red aesthetic scores of the two groups 1 year after surgery were significantly higher than those 1 month after surgery (P<0.05). Comparison between groups showed that 1 month and 1 year after surgery, the red aesthetic scores of the experimental group were significantly higher than those of the control group (P<0.05). One year after operation, the success rate of the experimental group and the control group were 90.24% (37/41) and 85.37% (35/41), respectively, and there was no significant difference between the two groups(P>0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05). CONCLUSIONS: Autologous dentin particles can be used to guide bone regeneration to treat patients with periodontal bone defects, which can reduce the depth of periodontal pockets and loss of attachment, improve the buccal soft tissue profile and red aesthetic score, and the success rate is equivalent to implantation of Bio-Oss. Therefore, it is a safe and reliable treatment method.
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    Study on the influence of passive ultrasonic irrigation on debris cleaning ability and root canal shape
    PRIYA Vishnu, SHAO Jiao-jiao, FENG Fei, ZHANG Qi
    Shanghai Journal of Stomatology    2022, 31 (1): 6-11.   DOI: 10.19439/j.sjos.2022.01.002
    Abstract304)      PDF (978KB)(283)      
    PURPOSE: To evaluate the safety and effectiveness of passive ultrasonic irrigation(PUI) in curved root canals, and debris cleaning ability and the amount of root canal transportation of passive ultrasonic irrigation(PUI) in curved root canals. METHODS: A total of 36 mesially curved root canals of mandibular molars with a curvature above 25° were selected. The root canals were prepared with XP-endo Shaper root canal file. The samples were divided into A1 group (curved length>3 mm, syringe irrigation), B1 group(curved length>3 mm, PUI+K file), C1 group(curved length>3 mm, PUI+irrisafe), A2 group (curved length<3 mm, syringe irrigation), B2 group (curved length<3 mm, PUI+K file), and C2 group (curved length<3 mm, PUI+ irrisafe) (n=6). Micro-CT scans were performed on all samples before and after irrigation, and the volume increase in the root canal after irrigation and the transportation of the root canal were calculated. SPSS 22.0 software package was used to analyze the data. RESULTS: In the apical area of the root canal with a curved length greater than 3 mm, the root canal volume increase in the PUI+irrisafe group was significantly greater than that of the PUI+K file and syringe irrigation (P<0.05), and at 5 mm section, the transportation of the root canal formed by PUI+irrisafe was significantly lower than that of the PUI+K file (P<0.05), but there was no significant difference from syringe irrigation (P>0.05); in root canals with a curved length less than 3 mm, root canal volume increment of the file group was significantly greater than that of syringe irrigation (P<0.05), but there was no significant difference between the root canal transportation and syringe irrigation(P<0.05). CONCLUSIONS: In root canals with larger curved length, passive ultrasonic irrigation combined with a pre-curved file can obtain a better cleaning effect, while in root canals with smaller curved length, both K file and pre-curved file with passive ultrasonic irrigation are safe and effective.
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    Application of sulfylated calcium alginate composite hydrogel loaded with zinc-based zeolite imidazole for the treatment of periodontitis
    OUYANG Ming, WANG Guo-hua
    Shanghai Journal of Stomatology    2022, 31 (4): 379-383.   DOI: 10.19439/j.sjos.2022.04.008
    Abstract254)      PDF (1637KB)(282)      
    PURPOSE: To explore the feasibility of adhesive thiomer calcium alginate composite hydrogel (ZIF-8@CHA-SH) containing metal-organic framework for the treatment of periodontitis in rats. METHODS: Preparation and characterization of ZIF-8@CHA-SH were performed, and the morphology and chemical composition were observed. The antibacterial properties were detected by plate coating method and scanning electron microscope. CCK-8 and live/dead cell fluorescence staining were used to evaluate the toxicity of ZIF-8@CHA-SH on gingival fibroblasts. The anti-inflammatory and tissue repair promoting effects of ZIF-8@CHA-SH were verified by animal experiments. GraphPad Prism 7.0 software was used for statistical analysis. RESULTS: The successful synthesis of ZIF-8@CHA-SH was proved by scanning electron microscopy, energy spectrum analysis, Fourier transform infrared spectroscopy and X-ray diffraction. ZIF-8@CHA-SH had excellent antibacterial ability, and the antibacterial rates against Escherichia coli, Staphylococcus aureus and Streptococcus mutans were (99.88±0.12)%, (99.81±0.32)% and (95.53±3.08)%, respectively(P<0.001). The cell viability rate of ZIF-8@CHA-SH was (91.64±3.66)% after 5 days of co-culture with human gingival fibroblasts (P=0.6). In vivo experiments showed that ZIF-8@CHA-SH could reduce the infiltration of inflammatory cells and the expression of pro-inflammatory factor IL-6 in rats with periodontitis. CONCLUSIONS: ZIF-8@CHA-SH has excellent biological performance, which can effectively treat periodontitis caused by bacteria, and provids a new strategy for the treatment of periodontal diseases in the future.
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    Effect evaluation on different treatment methods of the gap of immediate implantation in canine posterior mandible
    ZHANG Yi-wen, ZOU Duo-hong, ZHANG Zhi-yuan
    Shanghai Journal of Stomatology    2022, 31 (4): 337-342.   DOI: 10.19439/j.sjos.2022.04.001
    Abstract366)      PDF (2212KB)(272)      
    PURPOSE: This study was aimed to explore the formation of new bone after different methods of filling the gap between the extraction socket and the implant in immediate implantation of the canine mandibular molar area. METHODS: Six Labrador dogs aged 1.5-2.0 years were used as the experimental subjects. The fourth premolar and the first molar were extracted from the mandible of each dog, and then 4 dental implants (Astra Tech®, 4.0 mm × 10 mm) were implanted respectively. The mesial and distal gaps between dental implants and the walls of extraction socket were treated in three methods: blank group (group NN), gelatin sponge with colloidal silver (Gelatamp) group (group EN), Gelatamp + absorbable collagen membrane (CM) group (group EG). At 12 weeks, the dogs were euthanized, and specimens were collected for micro-CT scanning and histological analysis. SPSS 25.0 software package was used for statistical analysis. RESULTS: The survival rate at 12 weeks after implantation was 100%. Micro-CT scan results showed no significant differences in new bone height, bone mineral density (BMD), bone volume fraction (BV/TV), bone surface area bone volume ratio (BS/TV), bone trabecular thickness (Tb.Th), bone trabecular number (Tb.N) and bone trabecular separation (Tb.Sp) among different groups. Histological analysis showed no significant differences in the area of new bone formation and bone-implant contact (BIC). CONCLUSIONS: After different treatments are performed on the gap between implants and extraction sockets, Gelatamp alone or in combination with CM has no significant effect on new bone formation, BIC, BMD, BV/TV, BS/TV, Tb.Th, Tb.N and Tb.Sp around implant.
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    Practice and thinking of promoting ideological and political education in system integrated curriculum of stomatology
    YU Song, ZHANG Wen-hui
    Shanghai Journal of Stomatology    2022, 31 (4): 445-448.   DOI: 10.19439/j.sjos.2022.04.021
    Abstract290)      PDF (613KB)(269)      
    System integrated curricula are based on organs and systems. They closely combine basic medicine theory with clinical practice, aiming to stimulate students' subjective initiative and improve their ability to analyze and solve problems. In order to implement moral education concept in the teaching process of professional courses for dental students, dental teaching teams of Shanghai Jiao Tong University School of Medicine has carried out teaching reforms including constructing a stronger team of teachers, making ideological and political achievement goals of curriculum, finding out and writing ideological and political materials. Taking advantages of the various teaching forms of integrated curricula, the curriculum ideological and political education is run through the whole process of professional teaching, in order to cultivate dental talents with both ideological and humanistic ability.
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    Enhanced mechanical properties, cytocompatibility of GelMA hydrogels by incorporating graphene oxide
    BAO Jing, QIN Wei, ZHU Qing, QIAN Wen-hao
    Shanghai Journal of Stomatology    2022, 31 (5): 491-496.   DOI: 10.19439/j.sjos.2022.05.008
    Abstract234)      PDF (1321KB)(269)      
    PURPOSE: To construct graphene oxide/methacrylated gelatin(GO/GelMA) hydrogel and to investigate its mechanical property and biocompatibility. METHODS: 50, 100, 200 μg/mL GO was added to GelMA and mixed thoroughly. The micromorphology of hydrogels was observed under scanning electron microscope(SEM). Compression text was used to assess lastic modulus, CCK-8 and live/dead cell staining was conducted to assess the viability of rat bone marrow-derived mesenchymal stem cells (rBMSCs). The data were analyzed using SPSS 23.0 software package. RESULTS: SEM showed a highly porous structure of the hydrogel. After adding GO, the elastic modulous increased (100, 200 μg/mL), swelling ratio increased(100 μg/mL) and expansion ratio decreased(200 μg/mL). The viability increased in 50 μg/mL GO and decreased in 100 and 200 μg/mL GO. CONCLUSIONS: Proper concentration of GO can increase the mechanical property and biocompatibility. 50 μg/mL GO/GelMA was suggested in bone tissue engineering given priority to biocompatibility.
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    Treatment of maxillary ameloblastoma with different modalities: a retrospective analysis of 92 cases
    LUO Hao, YUAN Zhuang, WU Kai-liu, HE Jie, MENG Jian
    Shanghai Journal of Stomatology    2022, 31 (1): 71-74.   DOI: 10.19439/j.sjos.2022.01.015
    Abstract873)      PDF (860KB)(269)      
    PURPOSE: To explore the appropriate surgical approach for each type of maxillary ameloblastoma. METHODS: The clinical data of 92 patients with maxillary ameloblastoma were retrospectively analyzed. All patients were pathologically diagnosed, followed up for 3-8 years after surgery, maxillofacial CT and panoramic images were taken regularly to observe the surgical outcomes. SPSS 22.0 software package was used for data analysis. RESULTS: The proportion of maxillary ameloblastoma in male and female patients was 3 to 1,with more male patients and the mean age was 45.77 years old. The total recurrence rate of 92 patients was 21.74%, among which unicystic ameloblastoma had no recurrence after different surgical procedures. Among 38 patients with typical maxillary ameloblastoma, 14 underwent curettage, 3 underwent decompression,16 underwent extended resection, 3 underwent subtotal maxillary resection, 1 underwent iliac bone transplantation after subtotal maxillary resection, and 1 underwent reconstruction with anterolateral thigh flap after subtotal maxillary resection. Among them, 18 had recurrence and 5 had canceration. Three patients with extrasseous/peripheral type underwent expanded resection and two underwent curettage,none of them had recurrence. One patient with metastasizing ameloblastoma recurred after extended resection. CONCLUSIONS: Maxillary ameloblastoma with unicystic type should be completely removed with minimal trauma. The recurrence rate of maxillary ameloblastoma via simple curettage or extended resection is still relatively high, which may be due to the large tumor involvement scope of these patients and the failure of complete tumor removal by curettage. For external/peripheral ameloblastoma and metastatic ameloblastoma, the involved jaw bone should be removed as much as possible to prevent recurrence. For malignant transformation of ameloblastoma, the tumor and jaw bone should be dissected during the operation to reduce recurrence rate. The primary site, cervical lymph nodes and lungs should be closely followed after operation to detect early metastasis.
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    Evaluation of red and white aesthetic effects of porcelain veneers in the restoration of developmental anterior dental gaps
    DENG Xiao-lin, YUAN Shuang, ZHU Dan-ting, SHI Le
    Shanghai Journal of Stomatology    2023, 32 (3): 276-279.   DOI: 10.19439/j.sjos.2023.03.011
    Abstract226)      PDF (873KB)(266)      
    PURPOSE: To evaluate the red and white aesthetic effect of porcelain veneer in the restoration of developmental anterior interdental spaces. METHODS: A total of 152 anterior teeth in 64 patients with developmental anterior dental gaps were restored using porcelain veneers, the aesthetic effects before and after restoration were evaluated by pink aesthetic index (PES) and white aesthetic index(WES), the aesthetic effect of gingival papilla filling and reconstruction was evaluated by interdental gingival papilla index (PIS), and visual analogue score (VAS) was used to compare the satisfaction of patients before and after restoration. SPSS 203.0 software package was used for statistical analysis. RESULTS: The overall mean scores of PES before and after restoration of 152 developmental anterior interdental teeth were 9.63±2.23 and 13.64±0.88, respectively. The average scores of WES before and after restoration were 6.85±1.87 and 9.81±0.58, respectively. There were significant differences of PES and WES scores before and after restoration(P<0.01). According to the requirements of "near" perfect restoration(PES≥13 points, WES≥9 points), the red and white aesthetic effect after restoration was near the standard. The scores of PIS before and after restoration were 1.86±0.67 and 2.97±0.18, the interdental gingival papilla was completely filled with space, and the shape was ideal, there were significant statistical differences before and after restoration(P<0.01). Patients were more satisfied with the smile curve and morphology of the restored anterior teeth than other parameters. CONCLUSIONS: The aesthetic effect of using porcelain veneers to repair developmental anterior interdental gaps is ideal, among which the filling of the papillae between the teeth can meet the expectations of patients, and the aesthetic effect evaluation of PIS and PES/WES applied to porcelain veneers to repair developmental anterior interdental spaces has practical guiding significance in clinical practice.
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    Short-term efficacy of three root canal filling methods in endodontic treatment of chronic periapical inflammation
    GUO Jing-jing, TANG Yi-qun, HE Hong, XU Zhen
    Shanghai Journal of Stomatology    2022, 31 (5): 544-549.   DOI: 10.19439/j.sjos.2022.05.018
    Abstract363)      PDF (684KB)(262)      
    PURPOSE: To provide a reference basis for clinical selection of a reasonable and effective root canal treatment by comparing the short-term clinical efficacy of three root canal filling methods in the treatment of chronic periapical inflammation. METHODS: One hundred and twenty patients with chronic periapical inflammation who received root canal filling between October 2019 and October 2020 were randomly divided into 3 groups, with 40 patients in each group. All patients received root canal filling, group A was filled with iRoot SP paste by matched-taper single cone obturation technique, group B was filled with AH-plus paste by warm vertical condensation, and group C filled with AH-plus paste by cold lateral condensation. Root canal filling time in the three groups was calculated, pain score 24 h after treatment was determined using visual analogue scale/score(VAS), and periapical index(PAI) was used to evaluate radiographs. SPSS 22.0 statistical software was applied for data analysis. RESULTS: Root canal filling times in the three groups were (75.50±7.44) s in group A, (85.38±3.46) s in group B and (102.33±3.32) s in group C, the differences were statistically significant (P<0.05); the incidence of postoperative pain in the three groups was 25% in group A, 25% in group B and 32.5% in group C, the difference was not statistically significant(P>0.05). There was no significant difference between group A and group B, but significant difference existed between group A, group B and group C. The results of comparison of PAI scores showed a time effect was F=498.93, P<0.001, suggesting significant difference in total PAI scores at different time points; a group effect was F=0.91, P=0.406, suggesting no significant difference in total PAI scores of the 3 groups; an interaction effect of time and group was F=0.44, P=0.777, suggesting that there was no significant difference in total PAI scores of the 3 groups at the time points. The total effective rate at 3 and 12 months was 97.5%, 97.3% in group A, 97.5%, 97.2% in group B and 90%, 91.9% in group C, the difference was not statistically significant(P>0.05). CONCLUSIONS: Compared with the other 2 root canal filling methods, the iROOT SP paste matched-taper single cone obturation technique is clinically effective in terms of time saving and increasing the comfort of the patients' visit.
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    Comparative study on the effect of microscopic revascularization and apexification in the treatment of pulp necrosis of permanent teeth
    LIN Xiao-ming, SU Jiang-ling, PU Cui-ping
    Shanghai Journal of Stomatology    2022, 31 (3): 318-321.   DOI: 10.19439/j.sjos.2022.03.019
    Abstract529)      PDF (564KB)(260)      
    PURPOSE: To compare the curative effect of microscopic revascularization and apexification in the treatment of pulp necrosis of permanent teeth. METHODS: Seventy-five cases of pulp necrosis in young permanent teeth were divided into two groups according to different treatment methods. Group A (n=30) underwent revascularization under microscope, while group B (n=45) underwent apexification. The treatment effect and pain improvement of the two groups were compared. The changes of the wall thickness and root canal length of the affected teeth before and after treatment were observed, and the bone-like deposition rate after treatment was recorded. SPSS 23.0 software package was used for statistical analysis. RESULTS: There was no significant difference in the length of root canal between the two groups before treatment (P>0.05); there was no significant difference in the length of root canal in group B before and after treatment (P>0.05); the length of root canal in group A was significantly longer than that in group B 6 months after treatment(P<0.05). There was no significant change in the thickness of root canal wall in group B before and after treatment (P>0.05). The thickness of root canal in group A was significantly higher than that in group A 6 months after treatment (P<0.05). Bone-like deposition rate of group A was significantly higher than that of group B 1 month and 6 months after treatment (P<0.05). The total effective rate of group A and B was 90.00% and 84.44%, the difference was not statistically significant (P>0.05). The cure rate of group A was 70.00%, which was significantly higher than that of group B (48.89%, P<0.05). COCLUSIONS: Microscopic revascularization for pulp necrosis of young permanent teeth can effectively promote root development, lengthen root canal and increase the thickness of canal wall, which is better than apexification.
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    Efficiency of clear aligners in extrusion of posterior teeth evaluated by3-dimensional model superimposition
    ZHAO Jia-yuan, HU Cheng-si, JIN Yu, ZHANG Ling-ling, YI Fang, CHEN Jun-jie, ZHOU Ping, LU Yan-qin, LI Cheng-ri
    Shanghai Journal of Stomatology    2022, 31 (5): 556-560.   DOI: 10.19439/j.sjos.2022.05.020
    Abstract249)      PDF (1209KB)(257)      
    PURPOSE: To explore the efficiency of posterior teeth extrusion with clear aligners by 3-dimensional model superimposition, which provides a reference for the design of clinical programs. METHODS: We selected 24 patients with clear aligners whose posterior teeth were designed to extend more than 0.5 mm, and a total of 126 teeth were included. Digital models were obtained before and after treatment by intraoral scanning with iTero, named as "actual initial" and "achieved" digital models. Initial and final models from the ClinCheck, labeled as "virtual initial" and "predicted" models respectively. Initial, predicted, and achieved digital dental models were exported as stereolithography files and subsequently imported into Geomagic Studio. Extrusive measurements were made from the superimposition of the initial and predicted models (predicted movement) and from the superimposed initial and achieved models (achieved movement). Statistical analysis was performed with SPSS 23.0 and GraphPad Prism 5.0 software package. The extrusion efficiency of the posterior teeth was calculated, at the meanwhile the influencing factors were analyzed. RESULTS: The mean extrusion efficiency of posterior teeth during clear aligners treatment was 30.2%. The actual extrusion was linearly related to the expected(P<0.05), and the linear regression equation was y=0.305x-0.010. The difference between the actual and the predicted extrusion was positively correlated with the number of appliances(P<0.05), and also positively correlated with the predicted extrusion value(P<0.001). This difference was larger in low-angle patients than in patients with average angle (P<0.05). CONCLUSIONS: The extrusion rate of posterior teeth is relatively low during clear aligners treatment, and the average efficiency is 30.2%. Vertical growth pattern affects the extrusion efficiency. So more overcorrections can be designed for average angle patients.
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