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12 April 2013, Volume 22 Issue 6 Previous Issue    Next Issue

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Basic Scientific Study

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Spatiotemporal expression of ADAM10 during cranial base suture development FU Run-qing, TAN Yu, YANG Zhi, FANG Bing 2013, 22 (6):  601-606.  Abstract ( 198 )   PDF (2232KB) ( 217 )   PURPOSE: To explore the expression of a disintegrin and metalloproteinase 10 (ADAM10) during mouse’s development of cranial base synchondrosis. METHODS: Histological and biochemical method including alcian blue-alizarin red staining, IHC, ICC and Western blot were applied to observe and analyze the expression of ADAM10 in mouse cranial base. RESULTS: The spheno-occipital synchondrosis and spheno-ethmoid synchondrosis were of similar histological structure, including resting zone, proliferative zone and hypertrophic zone. ADAM10 was expressed widely in synchondrosis,especially in the hypertrophic zone. During development of cranial base, ADAM10 was highly expressed from embryo period to infantile period, while there was a huge decrease when it came to adulthood. As an excellent cell line to mimic chondrogenesis, ATDC5 expressed ADAM10 in cytoplasm, particularly around the nucleus. CONCLUSIONS: The expression of ADAM10 during mouse’s development of cranial base synchondrosis is spatiotemprally different. References | Related Articles | Metrics

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Finite element analysis of first maxillary molars restored with different post and core materials ZHAO Li, LI Li-jun, ZHAO Ke*, DENG Xu-liang* 2013, 22 (6):  607-612.  Abstract ( 305 )   PDF (1507KB) ( 248 )   PURPOSE: To analyze the stress magnitude and distribution of residual dentin in maxillary first molar restored with post and crown using three-dimension finite element methods. METHODS: An intact maxillary first molar was scanned using a 3DX multi-image micro-CT. Three-dimensional finite element models simulated an endodontically treated first maxillary molar restored with post and crown, which were varied in different number and material of post. A load of 480 N, simulating intercuspal occlusion, was applied vertically to the occlusal surface；and a load of 240 N simulating mastication was applied to the occlusal surface with a 45° angle to the long axis of the tooth. Von Mises stresses were calculated by MSC.Marc software. RESULTS: The maximum stresses among the post in the radicular portion increased as elastic modulus of the material increased. The stress values of remaining dentin observed in two-post group were lower than those in one post group and three-post group for cast metal post systems. In the test simulating mastication, the peak value of Von Mises stress was higher on remaining dentin among the post in the radicular portion and lower on the outer surface of residual tooth tissue than that in the test simulating intercuspal occlusion. CONCLUSIONS: The number, material of post and occlusal loading have influence on magnitude and distributionn of stress. References | Related Articles | Metrics

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Detection of the exogenous gene copy number of the transgenic tomato anti-caries vaccine BAI Guo-hui, LIU Jian-guo, TIAN Yuan, CHEN Zhu, BAI Peng-yuan, HAN Qi, GU Yu, GUAN Xiao-yan, WANG Hai-hui 2013, 22 (6):  613-617.  Abstract ( 190 )   PDF (1350KB) ( 292 )   PURPOSE: To detect the exogenous gene copy number of the transgenic tomato anti-caries vaccine by using the SYBR Green real-time PCR. METHODS: Recombinant plasmid pEAC10 and pEPC10 were used as standard to detect genome samples of exogenous gene pacA-ctxB and pacP-ctxB by SYBR green fluorescent quantitation, then the average value was calculated as gene copy number. RESULTS: The copy number of the transgenic tomato carrying pacA-ctxB was 1.3 and the pacP-ctxB was 3.2. CONCLUSIONS: The transgenic tomato plants which have high stability are low-copy transgenic plants. References | Related Articles | Metrics

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Specific markers and ultrastructure of lymphatic vessel in healthy human dental pulp LAN Wei-dong, DONG Ying-chun, LIU Rui 2013, 22 (6):  618-622.  Abstract ( 227 )   PDF (982KB) ( 234 )   PURPOSE: To explore the existence of lymphatic vessels in healthy human dental pulp. METHODS: Thirty healthy human dental pulps were obtained from non-carious premolars removed for orthodontic reasons. Immunohistochemistry was performed using the antibodies specific for lymphatic endothelium such as D2-40 and LYVE-1, and for vascular endothelial cell such as CD31 and CD34. The expression of D2-40 was detected by Western blotting and ultrastructure was examined by transmission electron microscopy. RESULTS: In healthy human dental pulps, we failed to detect any reactivity for the lymphatic markers D2-40 and LYVE-1 in the observed vessels. These vessels were positive stained by blood endothelial markers CD34 and CD31. Odontoblasts were weakly stained with D2-40. Western blotting performed on collagenase-treated human dental pulps did not show a band at 40 kDa, corresponding to the molecular weight of the lymphatic marker D2-40. Transmission electron microscopy indicated that vessels in dental pulp consisted of endothelial monolayer surrounded by pericytes and complete basement membrane, which were typical ultrastructural characteristics of blood vessels rather than lymphatic vessel. CONCLUSIONS: Human dental pulp does not contain true lymphatic vessels under healthy conditions. Whether lymphatic system is involved in dental pulp interstitial fluid circulation during inflammation deserved further study. References | Related Articles | Metrics

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Construction of recombinant for generation of Porphyromonas gingivalis minor accessory proteins FimCDE deficient strain LI Jing-jing , GAO Xin , LI Kuan-yu , WANG Wen-mei 2013, 22 (6):  623-627.  Abstract ( 287 )   PDF (668KB) ( 242 )   PURPOSE: To construct a recombinant plasmid containing the upstream of fimC and downstream of fimE of Porphyromonas gingivalis, designated as pPHU281-C-Spec-E, which may be further used to knock out fimCDE gene to determine the role of FimCDE in the infection by P. gingivalis. METHODS: DNA fragments were generated by PCR with the genomic DNA of P. gingivalis strain ATCC 33277 as the template. The upstream fragment of fimC (fragment C) and downstream fragment of fimE (fragment E) were cloned into the suicide plasmid pPHU281 to generate plasmid pPHU281-C-E. The spectinomycin resistance gene was inserted between fragment C and E to construct plasmid Pphu281-C-Spec-E. The recombinant plasmid was verified by restriction enzyme digestion and DNA sequencing. RESULTS: The recombinant plasmid pPHU281-C-Spec-E was successfully constructed, which was ready for generation of FimCDE-knockout mutant of P. gingivalis. CONCLUSIONS: The recombinant plasmid pPHU281-C-Spec-E is a tool for construction of FimCDE deficient mutant of P. gingivalis. References | Related Articles | Metrics

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A comparative study of the cytotoxicity of five dental bonding agents to human periodontal ligament cells LI Jun-liang, WANG Wen-mei, GE Jiu-yu, JI Jun, WANG Tian-cong 2013, 22 (6):  628-633.  Abstract ( 456 )   PDF (1232KB) ( 493 )   PURPOSE: To compare the cytotoxicity of 5 different dental bonding agents to human periodontal ligament cells(HPDLCs). METHODS: Primary cultured HPDLCs were exposed to different concentrations(100%，50% and 25%)of Super Bond, Clearfil SE Bond, G-Bond, Single Bond2, and Adper Easy One for different times (24 h, 48 h and 72 h). Cytotoxicity of 5 different agents to HPDLCs were observed by MTT method. The data was analyzed using SPSS 19.0 software package. RESULTS: Cytotoxicity of 5 dentin bonding agents to HPDLCs were Super BondP<0.05)but no significant difference was found between 48h and 72h(P>0.05). CONCLUSIONS: Cytotoxicity of 5 dentin bonding agents are different. Cytotoxicity of Super-bond C&B，G-Bond and Clearfil SE Bond are weak, while cytotoxicity of Single Bond2 is the strongest among the 5 agents. References | Related Articles | Metrics

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Recombinant hFOXA2 and hPDX1 lentivirus induced dental pulp stem cells from deciduous teeth reprogramming for insulin-producing cells SHI Jian-feng, ZHU Chun-hui, LIU Jin, SUN Jun-yi, RAO Guo-zhou, LI Ang 2013, 22 (6):  634-642.  Abstract ( 215 )   PDF (1904KB) ( 264 )   PURPOSE: The purpose of this study was to culture and identify dental pulp stem cells(DPSCs) from deciduous teeth in vitro and construct the recombinant hFOXA2 and hPDX1 lentivirus vectors and transfect the DPSCs to induce insulin-producing cells (IPCs). METHODS: DPSCs were separated and cultured by enzyme digest method, and purified by limited dilution method. Flow cytometry was used to determine the surface marker expression of the DPSCs, and the ability of multiple differentiations was determined by specific staining. hFOXA2 and hPDX1 genes were amplified by PCR, and the recombinant hFOXA2 and hPDX1 lentivirus vectors were reconstructed and transfected into 293T cells by lipofectamine2000 for virus packaging. The viral infection efficiency and titer were determined through fluorescence cell count. The recombinant virus was used to infect the DPSCs cells via multiplicity of infection(MOI)and induce the DPSCs reprogramming for IPCs. Immunofluorescence staining was used to measure the expression of proinsulin, FOXA2 and PDX1. ELISA method was used to detect the insulin secretion. The data was analyzed Using SPSS13.0 software package. RESULTS: DPSCs were isolated and cultured successfully. Cell surface highly expressed STRO-1 (98.01%), CDl46 (98.51%), CD34 (99.54%) and CD45 (24.08%). The multi-lineage differentiation capacity into osteoblasts, chondrocytes, and adipose was achieved. The recombinant hFOXA2 and hPDX1 lentivirus vectors were successfully constructed. Double enzyme digestion and sequencing appraisal showed that the sequence was fully consistent with GenBank retrieval. Virus packing efficiency was (96.15±0.17) % and (95.49±0.21) % respectively, and the infection titer was about 1.80×108 GTU/mL. The best MOI of the virus was 20. After inducing the cells to express proinsulin, FOXA2 and PDX1, insulin secretion volume was about 1.92 μmol/L. Compared with the uninduced group and control group, insulin secretion increased significantly (P<0.01). CONCLUSIONS: The recombinant transcription factor virus can activate cell reprogramming mechanism, form insulin-producing cells, and can be used for gene therapy of diabetes seed cells. References | Related Articles | Metrics

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Study of the effect of chitosan and its composites on proliferation and differentiation of mouse osteoblasts SONG Xue-lian, CHEN Qing, BI Xin-xin, YU Jing-tao 2013, 22 (6):  643-648.  Abstract ( 346 )   PDF (1182KB) ( 221 )   PURPOSE: A mouse osteoblast cell line, MC3T3-E1, was cultivated in the medium that contained chitosan, type Ⅰcollagen and recombinant human bone morphogenetic protein-2 in vitro to evaluate the effect of chitosan and its composites on proliferation and differentiation of mouse osteoblasts. METHODS: This study was categorized into 4 groups based on the medium used. Group A: α-MEM medium; group B: CS, type Ⅰcollagen and α-MEM medium; group C: CS, type Ⅰcollagen, rhBMP-2 and α-MEM medium. α-MEM medium containing 1%FBS was used in the control group. Cells of each group were cultivated for 1,3,5 and 7 days. The optical density (OD) value at each time point was evaluated with MTT assay and growth curve was drawn to observe the proliferation of osteoblasts. Differentiation of osteoblasts was determined with alkaline phosphatase (ALP) activity assay, alkaline phosphatase staining and alizarin red staining. Alkaline phosphatase activity of each group was measured at day 1, 3, 5 and 7 days. After 7 days of culture, the cells were stained with alkaline phosphatase, and at day 14, the mineralized nodules were stained with alizarin red. Statistical analysis was performed using SPSS13.0 software package. RESULTS: The MTT assay results showed that the OD value was maximal when osteoblasts were cultured in group C. The difference were statistically significant between group C and others (P<0.05). The ALP activity showed that the result of group C was significantly higher than other groups. The increase of ALP activity was significant between group C and control group (P<0.05). However, no significant difference was found between group C and group B (P>0.05). Compared with the control group, group C had more calcium nodules and blue particles than others. CONCLUSIONS: The incorporation of type Ⅰ collagen and bone morphogenetic protein-2 into chitosan can promote MC3T3-E1 cell proliferation and differentiation better. References | Related Articles | Metrics

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Effect of overexpressed VEGF165 and TGFβ1 on the regeneration of dentin-like tissue in rat YANG Lin, YANG Hai-bing, TIAN Cheng, WANG Yan 2013, 22 (6):  649-654.  Abstract ( 228 )   PDF (921KB) ( 211 )   PURPOSE: To transfect recombinant vectors pcDNA3.1hisA-VEGF165 and pcDNA3.1hisA-TGFβ1 in Chinese hamster ovary cell (CHO) and investigate the effect of released VEGF165 and TGFβ1 proteins by CHO on the regeneration of dentin-like tissues. METHODS: The recombinant plasmids pcDNA3.1hisA-VEGF165 and pcDNA3.1hisA-TGFβ1 were transfected in CHO via liposome. After screen culture by G418，stable transfected CHO cell line was established. The levels of VEGF165 and TGFβ1 were evaluated by RT - PCR and ELISA. Then the cells were seeded on collagen membranes. The bilateral maxillary first molars of 24 Wistar rats were selected as experimental teeth and the collagen membranes were separately planted over the holes of artificial dental pulp exposure. The cavities were filled with ChemFlex finally. After 8 weeks, specimens from 24 rats were collected and dyed with toluidine blue. Statistical analysis was performed with SPSS 17.0 software package. RESULTS: The results of RT-PCR and ELISA showed that CHO stably expressed VEGF165 and TGFβ1 mRNAs and proteins after transfection and selection. The result of toluidine blue staining showed that in the group of CHO transfected with pcDNA3.1hisA-VEGF165, the blood capillaries were congestive and inflammatory cells infiltrated obviously under the mechanically exposed pulpal site, but no hard tissue regenerated. In the group of CHO transfected with pcDNA3.1hisA-TGFβ1, a spot of colored mineralization pellets under the mechanically exposed pulpal site surrounded with hyperplastic fibroblast were observed, no tubular dentin and sporadic inflammatory cells were detected. In the group of CHO transfected with pcDNA3.1hisA-VEGF165 and pcDNA3.1hisA-TGFβ1, generous colored mineralization pellets almost closed the mechanically exposed pulpal site and columnar odontoblast were arranged orderly, no regular dentin bridge was detected. The hard tissue was not detected in the control group. CONCLUSIONS: TGFβ1 could promote the formation of mineralization pellets in vivo, and VEGF165 and TGFβ1 could promote the formation of mineralization pellets better. References | Related Articles | Metrics

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The experimental study of subcutaneous ectopic ossification with different proportional mixtures of human autologous bone and hydroxyapatite in nude mice ZHANG Da-yong, DU Ning, LIU Yue-e, ZHANG Xiao-lu, WANG Si-jia 2013, 22 (6):  655-658.  Abstract ( 223 )   PDF (1202KB) ( 217 )   PURPOSE: To observe the effect of subcutaneous ectopic osteogenesis using different proportional mixtures of hydroxyapatite (HAP) and human mandible in nude mice. METHODS: After obtaining external oblique ridge of mandible, autologous bone was mixed with HAP according to certain proportion. The mixtures were divided into 5 groups (group A: autologous bone/HAP=2/1; Group B: autologous bone/HAP=1/1; Group C: autologous bone/HAP=1/2; Group D: autologous bone/HAP=a quarter; Group E: HAP). The 5 groups of mixtures were respectively implanted into nude mice subcutaneously. After 8 weeks, the specimens were obtained and hard tissue sections were completed. The new bone formation was measured after trinitrophenol staining. The data was analyzed with SPSS 13.0 software package. RESULTS: The hard tissue section showed that new ectopic bone formation area was 9.1% (Group A), 16.1% (Group B), 6.1% (Group C), 3.8% (Group D), and 1.3% (Group E), respectively. New bone formation was the most in group B, while it was the least in group E. Significant differences were found between group B and other groups(P<0.05). However, there was no significant difference between group E and group C or D (P>0.05). The retention rate of HAP was the most in group E (30.3%) and the least (16.3%) in group A. CONCLUSIONS: During 8 weeks, human autologous bone mixed with HAP helps new bone formation in nude mice. The best ratio autologous bone and HAP was 1:1. This study provides certain reference basis for dentist to make lifting surgery outside the maxillary sinus using artificial bone graft. References | Related Articles | Metrics

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Effect of bonding strength of dentin adhesive agent under 2 kinds of storage temperatures ZHANG Xiao, WANG Qing, XUE Miao-miao, LIU Yi-fan 2013, 22 (6):  659-661.  Abstract ( 189 )   PDF (434KB) ( 217 )   PURPOSE: To measure the changes of bonding strength of dentin adhesive agent at different storage temperatures. METHODS: One hundred extracted bicuspids were randomly divided into 10 sets, 10 teeth in each set. Each set was further divided randomly into Group A and Group B, each with 5 teeth. During a 10-week test period, Groups A and B were applied with adhesives labeled A and B. Group A was refrigerated under 4℃ and B was stored at room-temperature from the second week on. The first set was stored at the same situation. The shear force of samples were tested by universal material tester at the speed of 1 mm/min. The results were evaluated using one-way ANOVA and LSD t test using SPSS 18.0 software package. RESULTS: According to one-way ANOVA, the shear bond strength of the 2 groups differed significantly(P<0.05). Comparing the sets by LSD t test, the results showed that during the first 5 weeks, there was no significant difference between Group A and B. However, there were measurable differences in performance after 6 weeks. CONCLUSIONS: With time goes on, the bonding strength of both refrigerated and room-temperature adhesives tend to diminish. After 6 weeks, the bonding performance of the 2 groups begins to differ significantly, and the refrigerated adhesives are superior to room-temperature adhesives. References | Related Articles | Metrics

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Effect of different surface managements on micro-tensile bond strength of non-carious sclerotic dentin to resin WANG Xue, QIU Li-hong, LI Zi-mu, SUN Hai-yan 2013, 22 (6):  662-666.  Abstract ( 210 )   PDF (817KB) ( 284 )   PURPOSE: To evaluate the micro-tensile bond strength of 3 different surface managements to non-carious sclerotic dentin. MOTHODS: Fifteen periodontal patients’ occlusal wearing molars which were above 3rd degree were selected. The teeth were equally cut into two pieces along the buccolingual direction, and each piece was randomly divided into 3 groups. Group 1 was processed with polishing, group 2 was processed with EX-26 diamond bur and group 3 was processed with 5# round bur. All teeth were subjected to Optibond treatment, and then filled with composite resin (Premisa) and saved in normal artificial saliva (37℃) for 24 hours. At last, fatigue test pieces were made, the micro-tensile bond strength was evaluated and every specimen was examined under stero-microscope. The micro-tensile bond strength was analyzed with one-way analysis of variance using SPSS17.0 software package. RESULTS: The micro-tensile bond strength of the 3 groups were (10.48±1.29) MPa, (21.52±0.97) MPa and(16.30±1.02) MPa, respectively. The bond strength of EX-26 diamond bur group was significantly greater than that of the other 2 groups(P<0.05). The bond strength of 5# round bur group was significantly greater than that of polishing group (P<0.05). The breakage mostly happened in adhesive dentine surface. CONCLUSIONS: Non-carious sclerotic dentin which is processed with diamond bur has better micro-tensile bonding strength. References | Related Articles | Metrics

Clinical Study

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Effect of pituitary tumour transforming gene on invasion and metastasis of salivary adenoid cystic carcinoma QI Zhong-zheng, LIU Jie, LIU Fa-yu, SUN Chang-fu 2013, 22 (6):  667-670.  Abstract ( 278 )   PDF (1035KB) ( 331 )   PURPOSE: To study the effect of pituitary tumour transforming gene (PTTG) on invasion and metastasis of salivary adenoid cystic carcinoma. METHODS: The expression of PTTG and bFGF was investigated in 40 salivary adenoid cystic carcinoma tissues and 20 normal salivary tissues by immunohistochemistry. Pearson’s Chi-square test and Spearman correlation analysis were used to analyze the data using SPSS 11.5 software package. RESULTS: The expression of PTTG and bFGF were significantly higher in salivary adenoid cystic carcinoma tissues than in normal salivary gland tissues(P<0.01)and their expression levels were positively correlated(P<0.01). CONCLUSIONS: PTTG and bFGF are highly expressed in salivary adenoid cystic carcinoma. The invasion and metastasis of salivary adenoid cystic carcinoma are correlated with the expression of PTTG. References | Related Articles | Metrics

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Assessment of mental health status in oral squamous cell carcinoma patients and its correlation with catecholamines level LI Bo, LI Li, GUO Dai-mo, PAN Wei-yi, DUAN Ze-xi, HUANG Yi-bing, ZOU Xiao-li, ZHU Cai-rong, XIE Hui-xu, 2013, 22 (6):  671-675.  Abstract ( 243 )   PDF (989KB) ( 314 )   PURPOSE: To investigate the relationship between mental health status and catecholamines level in oral squamous cell carcinoma patients. METHODS: Forty patients with oral squamous carcinoma (OSCC) who were diagnosed in West China School of Stomatology between Dec. 2011 and Aug. 2012, were assessed with symptom checklist-90 (the 5-grade scoring of 0 to 4 points was used) independently according to their actual conditions. Blood sample was taken on the second admission day and fresh tumor tissue with the weight of 0.5 g was obtained. A method was developed for determination of catecholamine and glucocorticoid in serum using liquid chromatography-tandem mass spectrometry (HPLC-MS-MS). SPSS19.0 software package was used for statistical analysis. RESULTS: Forty patients were included in the study. Compared with the scores of SCL-90 in national norms, the scores were all higher in oral squamous carcinoma patients except the interpersonal relationship. Epinephrine(E) and norepinephrine(NE) in serum was (70.27±34.50) pg/mL and (316.73±109.22) pg/mL, respectively. E and NE in tumor tissues was (6.66±3.58) pg/mg and (12.67±5.27) pg/mg respectively. As the concentrations of NE and E from circulating serum increasing, the stage and grade of oral squamous carcinoma were promoted. CONCLUSIONS: Psychiatric factors have an important impact on OSCC patients. The increased level of catecholamines is closely related to clinical stage and grade of OSCC. References | Related Articles | Metrics

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Clinical study on base bonding CAD/CAM customized zirconium abutment ZHU Gui-lian, WANG Ren-fei, CHEN He-liang 2013, 22 (6):  676-679.  Abstract ( 290 )   PDF (921KB) ( 215 )   PURPOSE: To evaluate the clinical application of base bonding customized zirconium abutment. METHODS: A total of 141 base bonding customized zirconium abutments used in 114 implant-supported cases during 2010.6-2012.11 in Hangzhou Stomatology Hospital were involved in the study. To evaluate the efficacy, they were followed up for 3 months to 2 years. RESULTS: Among 141 abutments, 140 were successfully applied to implant prosthesis at first time. During the observation period, partial zirconia exfoliation from bases occurred in 1 abutment. All the patients and dentists were satisfied with the final esthetic outcomes. CONCLUSIONS: The clinical effect of base bonding customized zirconium abutment is acceptable. References | Related Articles | Metrics

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Abnormal expression of CytC in the labial gland of patients with primary Sj?gren’s syndrome KANG Yuan-yuan, ZHANG Ying 2013, 22 (6):  680-683.  Abstract ( 260 )   PDF (1560KB) ( 251 )   PURPOSE: To explore the expression of CytC in the labial glands of patients with primary Sj?gren’s syndrome(pSS). METHODS: Thirty-five cases with pSS and 15 controls were collected. Immunohistochemistry and RT-PCR were used to examine CytC protein and mRNA in labial glands of 2 groups. The integral optical density were measured and the data was analyzed by Mann-Whitney test with SPSS14.0 software package. The correlation between the clinical manifestations and the expression of CytC were calculated by Spearman’s analysis. RESULTS: The expression of CytC protein and mRNA in pSS were positively correlated with the disease course and significantly higher than those in control group (P<0.05). There was a positive correlation between the lymphocyte focus score and the expression of CytC, but no correlation with the other clinical parameters. CONCLUSIONS: The expression of CytC in pSS is increased,which is related to the disease course and the lymphocyte focus score. References | Related Articles | Metrics

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Evaluation of upper airway and surrounding structures in patients with obstructive sleep apnea using cephalometry combined with Müller’s maneuver ZHAO Yan-hui, ZHU Min, LU Xiao-feng, SUN Hong-xia, NIE Ping, XU Xiao-long, TAO Li 2013, 22 (6):  684-689.  Abstract ( 284 )   PDF (1007KB) ( 225 )   PURPOSE: To evaluate the upper airway and surrounding structures under intraluminal pressure using cephalometry combined with Müller’s maneuver in obstructive sleep apnea and hypopnea syndrome (OSAHS) patients with different severity. METHODS: Thirty-nine male patients were enrolled in our department during June 2011 to February 2012. Polysomnography (PSG) and anthropometric measurements data were recorded prior to the study. The lateral cephalograms of each patient were obtained during both the end-expiration phase and Müller’s maneuver phase. The patients enrolled were classified into 3 groups according to the results of apnea-hypopnea index (AHI), including mild group (n=11), moderate group (n=14), and severe group (n=14). Craniofacial and upper airway structures were measured in lateral cephalometry by application of Cassos 2001 computed aided measurement software before and after the patients practicing Müller’s maneuver. The data was analysed using SAS 9.13 software package. RESULTS: [Müller’s] maneuver had a great influence on the upper airway and surrounding tissue, including increased thickness of the uvula, reduction in the anteroposterior dimension of retropalatal and increased vertical distance of the hyoid bone to the mandible in all groups (P<0.05). In addition, Müller’s maneuver also had an impact on the length of the upper airway, which was more significant in severe cases. CONCLUSIONS: Cephalometry combined with [Müller’s] maneuver can display how the intraluminal pressure function on the upper airway and surrounding tissues, and they also can distinguish some minor differences of the upper airway in patients with different security. References | Related Articles | Metrics

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Perforator vascular anatomy and clinical application of the anteromedial thigh flap for head and neck reconstruction XU Zhong-fei, ZHANG En-jiao, DUAN Wei-yi, DAI Wei, LIU Fa-yu, QI Zhong-zheng, TAN Xue-xin, HUANG Shao-hui, SUN Chang-fu 2013, 22 (6):  690-694.  Abstract ( 383 )   PDF (1055KB) ( 204 )   PURPOSE: A clinical study was undertaken to define the vascular anatomy of anteromedial thigh perforator flap (AMT) and evaluate the outcomes of the flap in head and neck reconstruction. METHODS: The sizable perforators of AMT flaps and their origins were prospectively explored in 54 patients. For each patient, we recorded the sizable perforators’ location, diameter, source vessel, numbers and anatomical types. Among them, 14 cases underwent head and neck reconstruction with AMT flaps. The complications and functions of donor and recipient sites were recorded and the operative techniques of AMT were described. Statistical analysis was performed with SPSS 13.0 software package. RESULTS: Eight of fifty-four thighs had no sizable AMT perforators. AMT flap was based on the medial branch of descending branch of lateral circumflex femoral artery (d-LCFA) and shared the same vascular pedicle with anterolateral thigh flap (ALT). The total sizable perforators were 56. Among them, 40.9%(25/61) were direct septocutaneous perforators, the remaining perforators were all musculocutaneous. Most of the sizable perforators (58/61, 95.1%) were located in the middle one-third of the thigh, with an average of (3.9±0.72) cm medial to a line connecting the anterior superior iliac spine and the superolateral patella and an average of (22.5±2.38) cm to anterior superior iliac spine. There was an negtive relationship between the number of sizable perforators of AMT and ALT flaps(P<0.01). 14 flaps survived completely. No complications were observed in recipient and donor site. CONCLUSIONS: The pedicle of AMT flap is the medial branch of d-LCFA. The AMT flap may be useful if ALT flap is without sizable perforators. AMT flap may be as a primary or an alternative choice of anterolateral thigh flap for head and neck reconstruction. References | Related Articles | Metrics

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Survey and analysis of dental anxiety in adult outpatients TANG Yu, ZHU Ya-qin 2013, 22 (6):  695-697.  Abstract ( 242 )   PDF (395KB) ( 386 )   PURPOSE： To analyze the prevalence of dental anxiety in outpatients and to discuss the possible correlative factors. METHODS: A questionaire survey was conducted among a total of 1266 adult outpatients in our department from Jan. 2010 to Jun. 2012. All patients were asked to complete the Modified Dental Anxiety Scale to evaluate the level of dental anxiety and the related factors. The data was analyzed by SPSS 13.0 software package. RESULTS： The prevalence rate of dental anxiety in outpatients was 61.37%；Dental anxiety was more likely to occur in female patients, patients of lower education level, and patients who re-visit or visit for oral surgery (P<0.05). CONCLUSIONS: The prevalence rate of dental anxiety of adult outpatients is high. Dental anxiety is positively correlated with gender, education level, main complaints, first visit or re-visit. References | Related Articles | Metrics

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Effect of dexmedetomidine on emergence agitation after oral and maxillofacial surgery CHEN Zhi-feng, CHEN Yuan-kun, GUO Yong, JIANG Hong 2013, 22 (6):  698-701.  Abstract ( 239 )   PDF (461KB) ( 185 )   PURPOSE: To evaluate the effect of dexmedetomidine on emergence agitation after oral and maxillofacial surgery. METHODS: Fifty five patients who went into recovery room after oral and maxillofacial surgery were randomly divided into 2 groups: dexmedetomidine group (n=28) and control group (n=27). Patients in dexmedetomidine group were assigned to receive intravenous dexmedetomidine at a dose of 0.3 μg/kg when they came into recovery room. Patients in control group were assigned to receive intravenous normal saline. Emergence agitation was assessed and extubation time after operation was recorded. Mean arterial pressure, heart rate, arterial oxygen saturation, Ramsay scale were recorded at the time point of entering the recovery room instantly(T0) and 5 minutes(T1), 15 minutes(T2), 30 minutes(T3), 60 minutes(T4), 120 minutes(T5) after the patient came into recovery room. Statistical analysis was performed using SAS 9.1 software package. RESULTS: The incidence of emergence agitation was significantly lower in the dexmedetomidine group (18%) than in the control group (70%) (P<0.05). The Ramsay scale was significantly higher in dexmedetomidine group than in the control group at the time point of T1, T2, T3, T4 (P<0.05). The heart rate was significantly lower in dexmedetomidine group than in the control group at the time point of T1, T2, T3, T4, T5 (P<0.05). Mean arterial pressure was significantly lower in dexmedetomidine group than in the control group at the time point of T2, T3 (P<0.05). There was no significant difference on extubation time between 2 groups. There was no postoperative respiratory depression in 2 groups. CONCLUSIONS: Intravenous dexmedetomidine at a dose of 0.3 μg/kg can reduce emergence agitation after oral and maxillofacial surgery with safety and efficacy. References | Related Articles | Metrics

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Clinical trail on the effect of nitrous oxide/ oxygen inhalation sedation on the treatment of acute pulpitis ZHOU Xin-wen, WANG Li-xin, LIU Xi-yun 2013, 22 (6):  702-704.  Abstract ( 504 )   PDF (444KB) ( 252 )   PURPOSE: To evaluate the effectiveness and safety of nitrous oxide/ oxygen inhalation sedation in the treatment of acute pulpitis. METHODS: The study population comprised 72 patients of acute pulpitis treated from September 2012 to March 2013. They were randomly divided into 2 groups, which included experimental group (37 cases) and control group (35 cases). Venham clinical anxiety, cooperative behavior level and WHO clinical pain level evaluation were conducted for the patients. Wilcoxon and Chi-square test were used respectively for statistical analysis with SPSS 14.0 software package. RESULTS: In the experimental group, 86.5% cases behaved comfortable, while in the control group the rate was only 42.9%. 94.6% of the patients in the experimental group felt painless after therapy. The proportion of that in the control group was 68.6%. There was significant difference between the 2 groups (P<0.01). CONCLUSIONS: The technique of nitrous oxide/oxygen inhalation sedation provides a safe and effective way to release pain and anxiety during treatment of acute pulpitis, while the long-term clinical result still needs further investigation. References | Related Articles | Metrics

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Efficacy of E-max porcelain laminate veneer on esthetic restoration for anterior teeth over 2 years ZHANG Ning, TAO Lin-shuai, ZHANG Xiao-dong 2013, 22 (6):  705-707.  Abstract ( 191 )   PDF (435KB) ( 256 )   PURPOSE: To evaluate the clinical effect of E-max porcelain laminate veneer on esthetic restoration for anterior teeth over 2 years. METHODS: E-max porcelain laminate veneer was used in 45 patients with 120 defective anterior teeth. Improved Ryge veneer reexamination standards including the integrity of ceramic veneer, marginal adaptation, gingival health and color match were adopted to evaluate the of clinical effect during 2 years of follow-up. RESULTS: The average satisfaction rate instantly after treatment， 1 year after treatment and 2 years after treatment was 93%, 95% and 94%, respectively. CONCLUSIONS: E-max porcelain laminate veneer has fewer side effects, better aesthetics and biological characteristics. The treatment is cost-efficient, safe and long-lasting. References | Related Articles | Metrics

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A randomized single-blind controlled clinical trial of tacrolimus mouth rinse on erosive oral lichen planus ZUO Wen-xin, LI Xiao-yu, CAI Gan-ying, CHEN Yan-qing 2013, 22 (6):  708-710.  Abstract ( 553 )   PDF (424KB) ( 471 )   PURPOSE: To evaluate the efficacy and safety of tacrolimus mouth rinse on the treatment of erosive and ulcerative oral lichen planus (OLP). METHODS: A randomized single-blind open trial of tacrolimus mouth rinse with dexamethasone as control was designed. The VAS and REU scoring system was utilized to compare the signs and symptoms. The scores and therapeutic effects were analyzed with SPSS 17.0 software package. RESULTS: There was no significant difference in effective rate between the treatment group and control group(χ2=0.295、0.413, P>0.01)at 4-week and 12-week after treatment. There was significant difference in REU scores between the 2 groups (P<0.01) 4 weeks after treatment. CONCLUSIONS: Tacrolimus mouth rinse effects quickly and is worthy of application in the treatment of erosive and ulcerative OLP. References | Related Articles | Metrics

Dental Education

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Application of case-based learning in clinical internship teaching of conservative dentistry and endodontics LIU Sheng-bo, PENG Bin, SONG Ya-ling, XU Qing-an 2013, 22 (6):  711-714.  Abstract ( 393 )   PDF (551KB) ( 426 )   PURPOSE: To investigate the education effect of case-based learning (CBL) pattern on clinical internship of conservative dentistry and endodontics. METHODS: Forty-one undergraduates were randomly assigned into CBL group and traditional teaching group. After clinical internship in the department of conservative dentistry and endodontics for 11 weeks, each student in the 2 groups underwent comprehensive examinations including medical record writing, case analysis, academic knowledge, professional skills and the ability of winning the trust of the patients. The scores were compared between the 2 groups using SPSS 13.0 software package. RESULTS: There was no significant difference between the 2 groups with regard to the scores of academic knowledge and profession skills (P>0.05). However, the results of medical record writing, case analysis and the ability of winning the trust of the patients showed significant difference between the 2 groups(P<0.05). CONCLUSIONS: Proper application of CBL in clinical internship of conservative dentistry and endodontics contributes to improve students’ ability of clinical thinking, synthetical analysis and adaptability to different patients. References | Related Articles | Metrics

Clinical Reports

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The reasons why 13 MK1 attachment were re-fabricated and some methods for improvement WU Zhi-hong, ZHANG Xue-jun, ZHAO Jun 2013, 22 (6):  715-717.  Abstract ( 636 )   PDF (394KB) ( 279 )   PURPOSE: To investigate the reasons why 13 MK1 attachment were re-fabricated and to suggest some improvement methods. METHODS: Mechanics and denture production technology were reviewed in 13 cases with MK1 attachment denture to determine the causes of failure. RESULTS: In some cases, MK1 attachments were poorly designed, while in other cases problems were found during denture design and production process due to limited experiences at the initial stage. MK1 attachments were re-done based on the specific cause and the outcome was good after 1~1.5 years of follow-up. CONCLUSIONS: When using MK1 attachment, prosthodontists should be familiar with the characteristics and indications of MK1 attachment. Meanwhile, we should strengthen doctor-patient communication and follow up patients timely to improve the success rate of MK1 attached denture repair. References | Related Articles | Metrics

Case Reports

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Use of cone-beam computed tomography to detect atypical vertical root fracture occurring at first left mandibular incisor:report of one case ZHANG Ge-chang, YUE Jin, XIAO Wen-lin 2013, 22 (6):  718-720.  Abstract ( 269 )   PDF (745KB) ( 246 )   The use of cone-beam computed tomography (CBCT) in stomatology was a hot spot in recent years, both to CT researchers and dentists. Vertical root fracture was the fracture occurring in root which didn't spread to the crown. This paper showed how to use CBCT to diagnose a vertical root fracture occurring in incisor correctly. Compared with conventional periapical film, CBCT was more accurate in diagnosing root fracture and had higher clinical application value. References | Related Articles | Metrics