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Metabolomics study on the difference of tongue coating metabolites between patients with intra-oral halitosis and healthy individual LIMAN Aviella-nathania, ZHU Hong-lai, YANG Wen-jie, YE Wei Shanghai Journal of Stomatology    2023, 32 (5): 525-531.   DOI: 10.19439/j.sjos.2023.05.014 Abstract （376）      PDF （1306KB）（753）       Knowledge map    PURPOSE: To analyze the difference of metabolites of tongue coating between patients with intra-oral halitosis and healthy individuals by untargeted metabolomics, and to explore significant differences in metabolites of intra-oral halitosis as biomarkers. METHODS: The untargeted metabolomics of tongue coating samples from 12 patients with intra-oral halitosis and 12 healthy individuals were studied by liquid chromatography and mass spectrometry combined with principal component analysis and orthogonal partial least squares discriminant analysis. The value of variable importance in projection >1 and P<0.05 of Student's t test in the orthogonal partial least squares-discriminant analysis model were used as the criteria to screen and determine the differential metabolites. RESULTS: There were differences in the metabolites of tongue coating between patients with intra-oral halitosis and healthy individuals, and 11 different metabolites were identified. They were valyl-arginine, glycine-phenylalanine, tryptophyl-proline, deoxyadenosine, 4,5-dihydroniveusin A, N-acetyl-DL-tryptophan, paramethasone acetate, cyclopentanol, [(2-hexylcyclopentylidene) amino]thiourea, L-pipecolic acid and taurine. In the intra-oral halitosis group, the expressions of Glycine-phenylalanine and N-acetyl-DL-tryptophan were significantly up-regulated, while the expressions of taurine were significantly down-regulated. CONCLUSIONS: There are differences in the metabolites of tongue coating between patients with intra-oral halitosis and healthy individuals. The differential metabolites with diagnostic value may be used as diagnostic markers of intra-oral halitosis. Reference | Related Articles | Metrics

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Analysis of hub genes, pathways and immune checkpoints of CD8+ T cells in metastatic lymph nodes of head and neck squamous cell carcinoma in C3H/He mice ZHOU Di, HAN Nan-nan, LI Hua-sheng, YAN Ming, RUAN Min Shanghai Journal of Stomatology    2024, 33 (6): 586-593.   DOI: 10.19439/j.sjos.2024.06.004 Abstract （290）      PDF （2332KB）（698）       Knowledge map    PURPOSE: To explore the expression of hub genes, pathways and inhibitory immune checkpoints of CD8+ T cells in metastatic lymph nodes of head and neck squamous cell carcinoma(HNSCC) in C3H/He mice. METHODS: A popliteal lymph node metastasis model of immunocompetent C3H/He mice was constructed with SCC-7 cell line of HNSCC, and the lymph node metastasis status was determined by immunofluorescence. CD8+ T cells in normal and metastatic lymph nodes were sorted by flow cytometry, and transcriptome sequencing analysis was performed to screen out differentially expressed genes. GO functional enrichment analysis and KEGG pathway enrichment analysis were performed sequentially. Flow cytometry and multiplex immunohistochemical were used to detect the expression of four immune checkpoints of CD8+ T cells in metastatic lymph nodes of tumor-bearing mice. SPSS 26.0 software package was used for statistical analysis. RESULTS: After 4 weeks of foot pad injection of SCC-7 cells, C3H/He mice displayed obvious metastasis in popliteal drainage lymph node. A total of 912 differentially expressed genes were screened out by transcriptome sequencing analysis of CD8+ T cells in normal and metastatic lymph nodes, including three inhibitory immune checkpoint-related genes which were upregulated(Pdcd1, Lag3 and Tigit). Eight tumor-related signaling pathways were screened out by KEGG network analysis, including Toll-like receptor signaling pathway, NF Kappa-B signaling pathway, TNF signaling pathway, MAPK signaling pathway, IL-17 signaling pathway, NOD-like receptor signaling pathway, PD-L1 and PD-1 immune checkpoint pathway in tumors and p53 signaling pathway. Flow cytometry showed high expression level of PD-1 and TIM-3 in CD8+ T cells in mouse metastatic lymph nodes. It was further confirmed by multiplex immunohistochemical that PD-1 was highly expressed in CD8+ T cells in metastatic lymph nodes of patients with HNSCC. CONCLUSIONS: Tumor-related signaling pathway of CD8+ T cells in mouse metastatic lymph nodes is significantly activated. The PD-1 expression level of CD8+ T in metastatic lymph nodes of mice and patients with HNSCC is markedly increased. Immunotherapy targeting CD8+ T cells may become a new strategy for the prevention and cure for lymph node metastasis of HNSCC. Reference | Related Articles | Metrics

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A reflectional insight into orthodontic theoretical renovation and technological innovation SHEN Gang Shanghai Journal of Stomatology    2023, 32 (2): 113-119.   DOI: 10.19439/j.sjos.2023.02.001 Abstract （650）      PDF （867KB）（579）       Knowledge map    Orthodontics, among other specialties in dentistry, remains most dynamic and vigorous in upgrading and reforming its fundamental doctrines and clinical technologies. Orthodontic specialty in China has played a leading role in recent years in reshaping fundamental theories and in creating cutting-edge therapeutic modalities. The newly developed diagnostic classification system, a complementary addition to that of Angle's, not only defines the natures, but also identifies the developmental mechanisms of malocclusions. Orthopedic therapy aiming to relocate the mandible before correcting the dentition is emerging as an indispensable treatment mode to malocclusions concurring with mandibular deviation. Whilst correlations exist between malocclusion and TMD susceptibility and incidence, the specifically designed orthopedic and orthodontic approaches have proven effective in managing cases inflicted by TMD conditions. Innovative efforts that create the GS products, have redefined the clear appliances much more beyond merely clear aligners, thus further pushing the boundaries of both the indications and clinical use for clear appliances. Reference | Related Articles | Metrics

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Application of sliding vermilion flap in angulus oris defect after buccal mucosa cancer ablation Wu Kun, Wu Hanjiang Shanghai Journal of Stomatology    2025, 34 (2): 157-161.   DOI: 10.19439/j.sjos.2025.02.008 Abstract （135）      PDF （1469KB）（556）       Knowledge map    PURPOSE: To evaluate the effect of sliding vermilion flap in angulus oris defect after buccal mucosal cancer ablation. METHODS: A total of 33 patients with buccal mucosal cancer who underwent buccal mucosal cancer radical surgery and resection of angulus oris, and reconstructed with free anterolateral thigh flap transfer and sliding vermilion flap were collected from January 2015 to April 2021 in Department of Oral and Maxillofacial Surgery at Second Xiangya Hospital. Thirty-three patients with buccal mucosal cancer admitted to Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University from January 2015 to April 2021 were selected. All patients underwent combined buccal-mandibulectomy and neck radical operation and resection of oral angle, and underwent anterolateral femoral free flap and lip red elastic flap reconstruction. The angulus oris outcome, aesthetics outcome, masticatory efficacy, swallowing and speech function were assessed by FACT-HN (The Functional Assessment of Cancer Therapy-Head and Neck). The mouth opening was measured and recorded. SPSS 19.0 software package was used for statistical analysis of the data. RESULTS: The success rate of free flap transplantation was 100% in 33 patients. Although the aesthetics outcome was decreased at postoperative 1 year compared with that of preoperative duration (P<0.001), there was no significant difference of angulus oris outcome at postoperative 1 year compared with that of preoperative duration (P>0.05). Moreover, the masticatory function was significantly improved at postoperative 1 year compared with that of preoperative duration(P=0.004). However, there was no significant difference of speech and swallowing function at postoperative 1 year compared with that of preoperative duration (P>0.05). The mouth opening was significantly improved at postoperative 1 year compared with that of preoperative duration(P<0.05), and the satisfaction of mouth opening in these patients was 75.7%. CONCLUSIONS: The use of sliding vermilion flap can ideally repair the angulus oris, and offer a novel method to reconstruct defect of angulus oris. Reference | Related Articles | Metrics

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Application of 3D printing modified tooth-supported cyst plug in decompression of mandibular cystic lesions KOU Peng, LI Ying-mei, LI Zhi-ping, MENG Jian Shanghai Journal of Stomatology    2023, 32 (2): 203-208.   DOI: 10.19439/j.sjos.2023.02.017 Abstract （538）      PDF （1849KB）（546）       Knowledge map    PURPOSE: To evaluate the application value of 3D printing modified dental support cyst plug in fenestration of large jaw cystic lesions. METHODS: Forty patients with mandibular cystic disease in Xuzhou Central Hospital from October 2019 to April 2021 were selected. They were randomly divided into experimental group(3D printing group) and control group (traditional plug group), with 20 cases in each group. All enrolled patients underwent preoperative digital modeling of cystic lesions of the jaw, obtained the cystic cavity volume data of preoperative lesions, designed the windowing site according to the plan and performed decompression for jaw cysts. Three days after surgery, the patient's postoperative CBCT and Oral-scan data in the experimental group was obtained, and a digitally modified tooth-supported cyst plug with porous column channel was designed, and titanium alloy material for 3D printing was selected. In the control group, the plug was manually molded by experienced physicians. The visual analogue scale(VAS) score of pain, retention, mechanical properties of the plug and its effect on the adjacent teeth were compared between the two groups during the process of model preparation, and the changes of the cyst volume 1, 3 and 6 months after operation were compared between the two groups. SPSS 25.0 software package was used for data analysis. RESULTS: Compared with the control group, the patients in the experimental group who made titanium alloy as printing material by digital impression complained more comfortable, and the mechanical strength and stability of the cyst plug were better than those in the control group(P< 0.05). There was no significant difference in retention between the two groups(P>0.05). The reduction rate of cyst volume in the experimental group was significantly higher than that in the traditional plug group 3 and 6 months after operation(P<0.05). CONCLUSIONS: The modified tooth-supported titanium alloy cyst plug with digital 3D printing has good mechanical properties and stability. It has little damage to the abutment and no lateral force, and has the advantages of precision, individualization and comfort. The improved irrigation and injection channel can fully flush the cavity and speed up the narrowing of the cyst and reduce the waiting time before the second operation, which is worth promoting in clinical practice. Reference | Related Articles | Metrics

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Feasibility of precise digital techniques combined with bone puncture techniques to guide the extent of jaw resection LIU Chang, WU Qiong, CHEN Shao-hua, XU Tao, LIU Liang, ZHANG Kai Shanghai Journal of Stomatology    2023, 32 (5): 519-524.   DOI: 10.19439/j.sjos.2023.05.013 Abstract （329）      PDF （1534KB）（544）       Knowledge map    PURPOSE: To evaluate the feasibility of Mimics software combined with 3D printing and bone biopsy to guide the resection scope of mandibular malignant tumors. METHODS: Fifteen patients admitted to the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Bengbu Medical College from January 2019 to April 2021 for oral malignancies and requiring mandibular osteotomy were selected. Preoperatively, CT data of the mandibles were taken to design and print the puncture guide using Mimics software and 3D printing technology, and the length of the osteotomy and the number of teeth lost were also measured. The resected mandible was then combined with the puncture guide and a percutaneous puncture needle to perform bone puncture at the appropriate site and sent for pathology. The mandibular gross specimen was decalcified and when decalcified, the mandibular gross was taken from the same loci, thus testing the accuracy of the bone puncture pathology relative to the gross decalcification pathology, comparing the actual osteotomy length with the simulated osteotomy length and comparing the actual number of missing teeth with the simulated number of missing teeth. SPSS 17.0 software package was used for data analysis. RESULTS: Bone puncture pathology using 3D guides possessed consistent accuracy with gross decalcification pathology. Simulated osteotomy length was significantly less than actual osteotomy length(P<0.001). Simulated number of missing teeth was significantly less than actual number of missing teeth (P<0.01). CONCLUSIONS: The use of Mimics software combined with bone puncture biopsy techniques to guide the extent of resection of malignant tumors in the mandible allows for more accurate mandibular osteotomy, thereby preserving more healthy bone and teeth. Reference | Related Articles | Metrics

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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 Abstract （439）      PDF （873KB）（542）       Knowledge map    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. 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 （337）      PDF （2088KB）（482）       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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Comparison of clear aligners and customized lingual appliance for bimaxillary dentoalveolar protrusion: a retrospective study LI Zhen-xia, YUAN Ling-jun, ZHENG Xiao-wen, LIU Lu, LIU Chao, FANG Bing Shanghai Journal of Stomatology    2023, 32 (5): 480-484.   DOI: 10.19439/j.sjos.2023.05.006 Abstract （334）      PDF （629KB）（467）       Knowledge map    PURPOSE: To compare the treatment effects of clear aligners and customized lingual appliance on treating bimaxillary dentoalveolar protrusion patients with first premolar extractions. METHODS: Fifty-four patients with bimaxillary dentoalveolar protrusion treated in Shanghai Ninth People Hospital were involved in the retrospective study. Twenty-five cases used clear aligners and 29 cases used customized lingual appliance. All of them were treated by extracting 4 first premolars and retracting anterior teeth with strong anchorage. The changes of anterior tooth and soft tissue adduction before and after treatment were compared by lateral cephalometric measurements. SPSS 26.0 software package was used for data analysis. RESULTS: The total course of treatment in the clear aligners group (46.32±7.37 months) was about 10.8 months longer than that in the customized lingual appliance group (35.55±5.90 months) (P<0.05). There was no significant difference in upper incisor retraction, lower incisor inclination and overjet reduction between the two groups(P>0.05). There were significant differences in upper lip retraction, lower lip retraction, upper incisor torque reduction, and overbite reduction between the two groups(P<0.05). Customized lingual appliance group showed a significant improvement of lips retraction and overbite reduction in orthodontic treatment. For the correction of overjet, there was no significant difference between the two groups (P=0.337). The data of U1-OP (the distance between edge of the upper central incisor and the functional occlusal plane) was not in normal distribution, and there was no significant difference between the two groups(P=0.184). CONCLUSIONS: The two techniques can both retract the anterior teeth and lips to improve the profile. However, the customized lingual appliance was more effective in improving the soft tissue profile of patients with bimaxillary dentoalveolar protrusion, with shorter treatment course. Reference | Related Articles | Metrics

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Application of mind mapping-assisted flipped classroom in clinical endodontics teaching SUN Rui-nan, LI Xu-yan, FU Yu-jie, JIANG Zi-han, ZHANG Xue-han, ZHANG Qi Shanghai Journal of Stomatology    2024, 33 (5): 548-554.   DOI: 10.19439/j.sjos.2024.05.019 Abstract （210）      PDF （1322KB）（464）       Knowledge map    PURPOSE: To explore the application effect of mind mapping-assisted flipped classroom in clinical endodontics teaching. METHODS: A total of 41 fifth-year undergraduates majoring in stomatology from School of Stomatology, Tongji University, finishing their clinical internship at Departments of Endodontics from October 2023 to March 2024, were randomly divided into control group (traditional teaching group, n=21) and experimental group (flipped classroom teaching group, n=20). Theoretical assessments were conducted on the day of entering the department and at the end of eight weeks in the department. Mini-CEX assessments were conducted in the third week and at the end of the eighth week (including indicators such as medical interviews, clinical examinations, humanistic care, clinical judgment, health education, clinical operations, and overall clinical capabilities). The scores of these two assessment indicators were used to evaluate the mastery extent of basic knowledge and clinical abilities of the two groups of students, and teaching satisfaction questionnaire survey was conducted. SPSS 22.0 software package was used for data analysis. RESULTS: In terms of theoretical assessment results, there was no significant difference between the two groups in the average scores of the first assessment. The average scores of both groups were better than those of the first assessment, and the average scores of the experimental group were significantly higher than those of the control group. In terms of mini-CEX assessment results, at the first assessment, the experimental group was better than the control group in two dimensions of clinical examination and clinical judgment, but there was no significant difference between the two groups in the other five dimensions. In the second assessment, the results of the two groups in 7 dimensions were higher than those of the first assessment, and the scores of the experimental group in 5 dimensions of medical interview, clinical examination, clinical judgment, clinical operation and overall clinical ability were significantly higher than those of the control group. CONCLUSIONS: Mind mapping-assisted flipped classroom teaching can significantly improve the subjective initiative of undergraduate students during clinical internships, enhancing their mastery extent of theoretical knowledge and overall clinical capabilities, and significantly improve the teaching effect. Reference | Related Articles | Metrics

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The impact of oral occlusal exercises on occlusal performance of oral cancer patients following segmental mandibulectomy without simultaneous reconstruction Yang Ling, Zhou Tian, Zhao Ning, Qu Xingzhou, Chen Weihong, Zhao Yan, Hou Lili Shanghai Journal of Stomatology    2025, 34 (2): 184-190.   DOI: 10.19439/j.sjos.2025.02.013 Abstract （140）      PDF （1111KB）（453）       Knowledge map    PURPOSE: To investigate the effects of oral occlusion exercises on occlusal performance of oral cancer patients who underwent segmental mandibular resection without simultaneous reconstruction. METHODS: From October 2022 to May 2023, a total of 63 oral cancer patients who underwent segmental mandibular resection without reconstruction at the Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were selected. They were randomly divided into control group (30 patients) and experimental group (33 patients). The control group received conventional care, while the experimental group underwent oral occlusion exercises except conventional care. After three months, the maximum total occlusal force(TOF), asymmetry index of occlusal force(AOF), center of occlusal force(COF), and mastication efficiency of both groups were compared. Statistical analysis was conducted using SPSS 26.0 software package. RESULTS: Compared with the control group, TOF in the experimental group was increased, AOF and COF were decreased, and the differences were statistically significant(P<0.01). The masticatory efficiency of the experimental group was significantly better than that of the control group(P<0.01). CONCLUSIONS: Oral occlusal exercises can improve occlusal performance in patients with mandibular resection without reconstruction, but larger sample size and rigorous design are needed to further verify its clinical effect and mechanism. Reference | Related Articles | Metrics

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Analysis of potential pathogenic factors of trigeminal neuralgia in rats LIU Yue-min, CHAI Ying, WEI Wen-bin, LIU Zhi-yang, HAN Zi-xiang, CHEN Min-jie Shanghai Journal of Stomatology    2023, 32 (1): 33-39.   DOI: 10.19439/j.sjos.2023.01.007 Abstract （330）      PDF （1559KB）（434）       Knowledge map    PURPOSES: Transcriptomics-based analysis of key transcriptional molecules in the pathogenesis of trigeminal neuropathic pain was conducted to screen key molecules in the pathogenesis of trigeminal neuralgia. METHODS: Rat trigeminal nerve pathological pain model, namely chronic constriction injury of distal infraorbital nerve (IoN-CCI), was constructed and animal behaviors postsurgery were observed and analyzed. Trigeminal ganglia were collected for RNA-seq transcriptomics analysis. StringTie was used to annotate and quantify genome expression. DESeq2 was applied to compare between groups with P value less than 0.05 and fold change greater than 2 times and less than 0.5 times to screen differential genes, and display them with volcano graphs and cluster graphs. ClusterProfiler software was used to perform GO function enrichment analysis of differential genes. RESULTS: On the fifth postoperative day (POD5), the rat's face-grooming behavior increased to a peak; on the seventh postoperative day (POD7), the von-frey value dropped to the lowest value, indicating that the mechanical pain threshold of rats was significantly decreased. RNA-seq analysis of IoN-CCI rat ganglia found that the significantly up-regulated signaling pathways included B cell receptor signaling pathway, cell adhesion, complement and coagulation cascade pathways; significantly down-regulated pathways were related to systemic lupus erythematosus. Multiple genes among Cacna1s, Cox8b, My1, Ckm, Mylpf, Myoz1, Tnnc2 were involved in mediating the occurrence of trigeminal neuralgia. CONCLUSIONS: B cell receptor signaling pathway, cell adhesion, complement and coagulation cascade pathways, neuroimmune pathways are closely related to the occurrence of trigeminal neuralgia. The interaction of multiple genes among Cacna1s, Cox8b, My11, Ckm, Mylpf, Myoz1, Tnnc2 leads to the occurrence of trigeminal neuralgia. Reference | Related Articles | Metrics

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Segmentation and validation of mandibular canal and its bifurcation on cone beam CT based on deep learning Ye Ye, Fang Shuobo, Lu Huitong, Liu Mingqian, Wu Xueying Shanghai Journal of Stomatology    2025, 34 (2): 119-125.   DOI: 10.19439/j.sjos.2025.02.002 Abstract （247）      PDF （1649KB）（433）       Knowledge map    PURPOSE: To train the U-net of convolutional neural network to establish a method for detecting and segmenting the mandibular canal and its bifurcation, and validate its accuracy based on the ground truth labeled by experts. METHODS: A total of 290 CBCT scans were collected from Shanghai Stomatological Hospital from Jan. 2022 to Dec. 2022, which were divided into training set of 200 scans and test set of 90 scans. Model training included two steps. In the first step, bilateral mandibular canals and its bifurcation of 50 CBCT scans were labeled in 3D Slicer image computing platform by investigators. Three dimensional U-net segmentation model were trained initially with data enhancement. A morphological post-processing method was applied to the predicted results. In the second step, pseudo label method was employed to help annotating the mandibular canal and corresponding bifurcations on remaining 150 CBCTs, which would be included in training set after revision. Three dimensional U-net model was trained based on these 200 data. During test phase, totally 90 scans were labeled by two doctors and U-net model respectively. Consistency check was conducted to evaluate the labels between two doctors. Dice similarity coefficient and Hausdorff distance were calculated to evaluate the labels between doctors and the model. The detection rate of bifurcation was calculated. SPSS 20.0 software package was used for data analysis. RESULTS: In 90 CBCT test set, the Kappa value between two dentists' annotations was 0.667. The average Dice and Hausdorff distance between predictions and labels of doctors were (0.739±0.068) and (0.988±1.14) mm. In bifurcation detection, the detection rate was 91.30% on scans with clear bifurcations. CONCLSIONS: The dentification and segmentation U-net model of mandibular canal on dental CBCT can be reliable and practical for its high segmentation precision and predicting speed. Reference | Related Articles | Metrics

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A correlation study between the occlusal cant and temporomandibular joint space in patients with mandibular lateral deviation LI Shuang, XIAO Rong-rong, WANG Ming-feng Shanghai Journal of Stomatology    2024, 33 (3): 318-323.   DOI: 10.19439/j.sjos.2024.03.019 Abstract （298）      PDF （1159KB）（431）       Knowledge map    PURPOSE: To investigate the correlation between the occlusal canting and the bilateral temporomandibular joint (TMJ) space in adult and juvenile mandibular deviation patients and study the mutual influence between the occlusal canting and mandibular position, in order to provide references for clinical treatment. METHODS: CBCT data of mandibular deviation patients（20 adults,20 juveniles）were selected. Inivo5 Dental Anatomage software was used to reconstruct the structures. The occlusal cant and vertical height of the bilateral maxillary from canines to first molars were measured, and the vertical heights difference between the same teeth on both sides was calculated. The anterior, superior and posterior space of temporomandibular joint were measured respectively in both groups. Pearson correlation analysis between the occlusal canting and bilateral condylar space was carried out by using SPSS 17.0 software package. RESULTS: In the juvenile group, negative correlations were found between the occlusal cant and the superior TMJ space on the deviated side (P<0.05). Negative correlation was found between the vertical height difference of bilateral canines and the anterior TMJ space on the deviated side in the juvenile group(P<0.05). In the adult group, no significant correlation was observed among those correlated examination (P>0.05). CONCLUSONS: The occlusal canting is moderately correlated with mandibular position in the early stage of mandibular deviation patients. Early treatment of mandibular deviation is of great importance in preventing its progression into severe skeletal malocclusion, and more attention should be paid on the correction of the canted frontal occlusion plane. Reference | Related Articles | Metrics

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Clinical study of cervical lymph node metastasis in oral tongue squamous carcinoma by a machine learning model based on contrast-enhanced CT radiomics SUN Heng-xiang, ZHU Qing-hai, LI Huai-qi, WANG Chen-xing, YE Jin-hai Shanghai Journal of Stomatology    2024, 33 (6): 608-616.   DOI: 10.19439/j.sjos.2024.06.007 Abstract （297）      PDF （1996KB）（426）       Knowledge map    PURPOSE: To investigate the value of machine learning model based on enhanced CT imaging features and clinical parameters in predicting cervical lymph node metastasis in patients with tongue squamous cell carcinoma (TSCC). METHODS: A total of 75 patients with TSCC who were treated in the Affiliated Stomatology Hospital of Nanjing Medical University from January 2015 to July 2022 were collected. All patients had complete clinical data, enhanced CT image data and postoperative cervical lymph node pathological examination results. All cases were randomly assigned to the training group (n=60) and the validation group (n=15) in a ratio of 8∶2. A total of 1 833 radiomics features were extracted from the venous phase image data of enhanced CT. Correlation coefficient selection and LASSO method were used for feature selection and dimensionality reduction to select the optimal combination of radiomics features. Multiple machine learning algorithm models(LR, KNN, Random Forest, Extra Trees, XGBoost and LightGBM) were used to predict cervical lymph node metastasis on the selected radiomics and clinical features. The performance of the model was evaluated by receiver operating characteristic(ROC) curve and decision curve analysis(DCA). SPSS 21.0 software package was used for data analysis. RESULTS: After screening and dimensionality reduction, totally 14 optimal feature combinations were obtained, and a variety of prediction models were established based on them. Among them, the KNN model showed a more balanced fitting effect in the training group and the test group, with AUC values of 0.869 and 0.861, respectively. To further improve the efficiency of the model, we integrated imaging features with patient clinical features, and the AUC value of this comprehensive model was increased to 0.893 and 0.880 in the training group and the test group, respectively. The DCA decision curve showed that compared with the simple radiomic model, the image-clinical model with the integration of clinical features showed a higher predictive effect and clinical application value. CONCLUSIONS: The prediction model based on enhanced CT image omics features combined with clinical parameters can effectively estimate cervical lymph node metastasis in patients with TSCC. This approach facilitates risk stratification of patients with TSCC and optimizes clinical decisions to improve treatment strategies and patient outcomes. Reference | Related Articles | Metrics

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Three-dimensional gingival morphology in the aesthetic zone of maxillary anterior teeth: a cone-beam CT analysis WANG Wen-li, FU Ya-ting, LIU Hua, MA Xiao Shanghai Journal of Stomatology    2023, 32 (2): 177-182.   DOI: 10.19439/j.sjos.2023.02.012 Abstract （345）      PDF （822KB）（425）       Knowledge map    PURPOSE: To measure and investigate the relationship of three-dimensional gingival morphology on the labial side of the maxillary anterior teeth by using cone-beam CT(CBCT) in conjunction with a novel radiocontrast agent. METHODS: Thirty periodontal healthy subjects were enrolled. The composition of light-cured gingival barrier resin and iohexol injection was applied to the measurement area, then a positioning wire was set up, and CBCT was used to assess supracrestal gingiva tissue (SGT), gingiva thickness (GT) and width of keratinized gingiva (KGW). The differences in each parameter between different gingival biotypes were compared. SPSS 25.0 software package was used for data analysis. RESULTS: The mean distance of SGT was greater for central incisors than canines (P<0.05). The central incisors had the thickest GT in the maxillary anterior region, while the canines had the thinnest(P<0.01). The GT of male central and lateral incisors was significantly thicker than that of females(P<0.05), and the KGW was significantly wider than that of canines (P<0.05). GT- SGT, KGW- SGT and GT- KGW all had a positive correlation (r=0.315, 0.287,0.406, P<0.01). The thick gingival type was greater than the thin gingival type in the KGW of lateral incisors and canines and the SGT height of canines (P<0.05). CONCLUSIONS: There were significant differences in the measuring results of GT, KGW, and SGT in the maxillary anterior region under different gingival biotypes, and individualized treatment strategies can be formulated based on gingival biotypes. Reference | Related Articles | Metrics

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Effects of Fusobacterium nucleus derived outer membrane vesicles on claudin-4 expression in oral epithelial cells YANG Cheng-long, YANG Meng, WANG Yu-feng, SONG Chen-cheng, DU Guan-huan, TANG Guo-yao Shanghai Journal of Stomatology    2023, 32 (2): 126-131.   DOI: 10.19439/j.sjos.2023.02.003 Abstract （434）      PDF （1295KB）（420）       Knowledge map    PURPOSE: To investigate the effect of outer membrane vesicles (OMVs) secreted by Fusobacterium nucleatum (F.n) on Claudin-4 of human oral keratinocytes (HOK) and oral epithelial barrier function. METHODS: Fusobacterium nucleatum was cultured under anaerobic conditions. The OMVs were extracted by dialysis and characterized by nanosight and transmission electron microscopy (TEM). HOK were stimulated with OMVs at different mass concentrations(0-100 μg/mL) for 12 h, and stimulated with 100 μg/mL OMVs for 6 h and 12 h respectively. The expression of Claudin-4 at gene and protein level was analyzed by RT-qPCR and Western blotting. Inverted fluorescence microscope was used to observe co-localization of HOK and OMVs and localization and distribution of Claudin-4 protein. Human oral epithelial barrier was constructed by Transwell apical chamber. Transepithelial electrical resistance(TER) of barrier was measured with a transmembrane resistance measuring instrument(EVOM2), and the permeability of the barrier was evaluated by transmittance of fluorescein isothiocyanate-dextran(FD-4). Statistical analysis was performed with GraphPad Prism 8.0 software package. RESULTS: Compared with the control group, the expression of Claudin-4 at protein and gene level in the HOK of OMVs stimulated group was significantly reduced (P<0.05), and immunofluorescence showed that the continuity of Claudin-4 fluorescence among cells was destroyed. OMVs stimulation decreased TER value of oral epithelial barrier(P<0.05) and increased the transmittance of FD-4(P<0.05). CONCLUSIONS: OMVs derived from Fusobacterium nucleatum may damage oral mucosal epithelial barrier function through inhibiting the expression of Claudin-4. Reference | Related Articles | Metrics

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Effects of laser combined with periodontal basic treatment on periodontal indices, subgingival microflora, adiponectin, MMP-13 and IL-1β in gingival crevicular fluid in patients with periodontitis ZHANG Zhong-yue, CHEN Li, YAN Na, ZHANG Shu-hua Shanghai Journal of Stomatology    2024, 33 (3): 295-300.   DOI: 10.19439/j.sjos.2024.03.015 Abstract （277）      PDF （785KB）（413）       Knowledge map    PURPOSE: To investigate the effects of laser combined with periodontal basic treatment on periodontal indices, subgingival flora, adiponectin, matrix metalloproteinase-13 (MMP-13) and interleukin-1β (IL-1β) in patients with periodontitis. METHODS: A retrospective analysis was performed on 100 patients with periodontitis diagnosed and treated in Hengshui People's Hospital from December 2022 to July 2023. According to treatment methods, the patients were divided into control group (n=51) and experimental group (n=49). The control group received periodontal basic treatment, and the experimental group received laser treatment on the basis of the control group. The periodontal indexes, subgingival microflora, adiponectin, MMP-13, IL-1β and bone metabolic factors of gingival crevicular fluid before and after treatment were compared between the two groups, as well as the clinical therapeutic effect. Statistical analysis was performed with SPSS 22.0 software package. RESULTS: After treatment, probing depth(PD), bleeding on probing(BOP), gingival index(GI) and plaque index (PLI) in the experimental group were lower than before treatment (P<0.05), PD, BOP and PLI in the control group were lower than before treatment (P<0.05), and PD, BOP, GI and PLI in the experimental group were significantly lower than those in control group (P<0.05). After treatment, Lactobacillus, Clostridium and Bacteroides in both groups were significantly lower than before treatment (P<0.05), and the experimental group was significantly lower than the control group(P<0.05). After treatment, adiponectin in gingival crevicular fluid increased in both groups compared with before treatment(P<0.05), and MMP-13 and IL-1β in gingival crevicular fluid decreased in both groups compared with before treatment (P<0.05), and adiponectin in gingival crevicular fluid in the experimental group was significantly higher than that in the control group (P<0.05), MMP-13 and IL-1β in the experimental group were significantly higher than that in the control group (P<0.05). After treatment, procollagenⅠtype N-terminal peptide (PINP), cross linked C-telopeptide of type Ⅰ collagen(CXT) and bone glaprotein (BGP) were significantly higher than those before treatment (P<0.05), and the experimental group was significantly higher than the control group (P<0.05). The total effective rate of the experimental group was significantly higher than that of the control group (P<0.05). CONCLUSIONS: Laser combined with periodontal basic treatment can effectively improve periodontal indexes, reduce subgingival flora, increase the levels of adiponectin and bone metabolic factor in gingival crevicular fluid, reduce the levels of MMP-13 and IL-1β in gingival crevicular fluid, and improve the clinical therapeutic effect in patients with periodontitis. Reference | Related Articles | Metrics

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Oral health and hygiene behavior in chronic renal failure patients XIE Tian, DENG Meng-zhao, KANG Jian, CHEN Kan, YAO Jin-feng, ZHENG Cang-shang Shanghai Journal of Stomatology    2023, 32 (5): 541-544.   DOI: 10.19439/j.sjos.2023.05.017 Abstract （303）      PDF （484KB）（404）       Knowledge map    PURPOSE: To investigate the oral health and hygiene behavior of chronic renal failure(CRF) patients in Shenzhen, so as to provide basis for formulating education for them. METHODS: The history of renal failure, oral health status and oral health care behavior of 336 patients with chronic renal failure(CRF) in the hemodialysis center of Shenzhen Second People's Hospital were investigated by questionnaire and oral examinations. RESULTS: At an average, dialysis was required for 3.2 years. The main cause of renal failure was glomerulonephritis in 49.11% of patients, hypertensive kidney lesion in 19.35% and diabetic nephropathy in 15.77% of patients; 77.8% of them kept brushing teeth two or more than two times every day; 72.9% patients suffered from oral problems such as toothache in recent 12 months. The rate of visiting a dentist when having complaints was 21.7%. CONCLUSIONS: The state of oral health of CRF is worse than the general population of comparable age in China, while their hygiene behavior is better than the corresponding reference general population. However, their consciousness of dental treatment is poor. Therefore, health education for CRF patients should include knowledge about oral diseases complicated with CRF and correct medical philosophy. Reference | Related Articles | Metrics

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Evaluation of efficacy of denture occlusal plate combined with comprehensive physical therapy for temporomandibular joint disc displacement without reduction LI Su-na, SONG Wen-shang, LIU Zi-lue, DU Yue-ru, CAI Shi-xin Shanghai Journal of Stomatology    2024, 33 (3): 273-278.   DOI: 10.19439/j.sjos.2024.03.011 Abstract （307）      PDF （767KB）（398）       Knowledge map    PURPOSE: To explore the efficacy of denture occlusal plate combined with comprehensive physical therapy for temporomandibular joint disc displacement without reduction(ADDwoR). METHODS: Sixty patients of ADDwoR and dentition defect or severely worn teeth who visited the Department of Orthodontics and Prosthodontics of Hengshui People's Hospital from January 2019 to December 2020 were selected and randomly divided into denture occlusal plate group (group A) and denture occlusal plate + comprehensive physical therapy group (group B) according to the treatment methods. Maximum mouth opening (MMO) and visual analog pain score(VAS) among all patients were recorded before treatment and every three weeks during three months of treatment. Cone-beam CT(CBCT) was taken before and 3 months after treatment. The changes in clinical efficacy indicators before and after treatment and CBCT data between the two groups were analyzed. Statistical analysis was performed with SPSS 26.0 software package. RESULTS: The differences of VAS of group A and B were statistically significant from before treatment to three weeks after treatment(P<0.05), and group B decreases more. From 3 weeks after treatment, there was a significant difference of group B for MMO and VAS before treatment (P<0.05). From 9 weeks after treatment, there was a significant difference of group A for MMO before treatment (P<0.05), but there was no significant difference in MMO and VAS between group A and B(P>0.05). CBCT showed narrowed anterior joint space, widened posterior joint space, enlarged superior joint space, decreased horizontal angle of the condyle and increased slope of joint nodules (P<0.05). The difference between joint depth, anteroposterior diameter of the condyle, internal and external diameter was not significant (P>0.05). There was significant differences in anterior, superior, and posterior joint space, condylar level angle, and slope of joint nodules of group B compared with group A(P<0.05). CONCLUSIONS: Denture occlusal plate can effectively improve symptoms of ADDwoR, and denture occlusal plate combined with comprehensive physical therapy can quickly improve mouth opening and reduce pain in the joint area. Reference | Related Articles | Metrics