Shanghai Journal of Stomatology

Study of the effect of different methods on the removal of calcium hydroxide in root canal by micro-computed tomography in vivo

WU Tian-tian, Han Yan-yan, WANG Yi

2024, 33 (3): 225-228. doi: 10.19439/j.sjos.2024.03.001

Abstract ( 150 )

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PURPOSE: To establish molar root canal model with micro-computed tomography (Micro-CT) and evaluate the removal efficiency of calcium hydroxide by different methods. METHODS: Eight molar teeth (24 root canals) extracted from the Department of General Dentistry, Shanghai Ninth People's Hospital from October 2023 to February 2024 were collected. Root canal preparation was instrumented by M3 according to standard root canal treatment procedures, then calcium hydroxide was injected into the root canal. One week later, the samples were randomly divided into 3 groups according to different irrigation methods(n=8): lateral opening syringe group, ultrasonic group and sonic vibration group. Micro-CT was used to reconstruct the root canal system before and after irrigation, and independent root canals were marked with different colors. The root canals were divided into upper root segment, middle root segment and apex segment. The volume of calcium hydroxide in each canal was calculated, and the clearance rate of calcium hydroxide was compared among the groups. SPSS 19.0 software package was used for statistical analysis. RESULTS: None of the three methods could completely remove calcium hydroxide from the root canal. When sodium hypochlorite was used as the flushing solution, the removal effect of ultrasonic group and sonic vibration group was significantly better than that of lateral opening syringe group(P<0.05). The removal efficiency of calcium hydroxide by ultrasonic group and sonic vibration group was similar, and the difference was not statistically significant(P>0.05). The removal rate of calcium hydroxide in apical segment was low. CONCLUSIONS: Micro-CT can reconstruct the molar root canal model efficiently for evaluating the removal effect of calcium hydroxide. The removal efficiency of calcium hydroxide in ultrasonic group and sonic vibration group is similar, and both are better than that in lateral syringe group.

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Inhibitory effect and mechanism of sodium cantharidate on human tongue squamous cell carcinoma CAL27 cells

LI Xin-ran, CHEN Lin, MENG Jian

2024, 33 (3): 229-234. doi: 10.19439/j.sjos.2024.03.002

Abstract ( 110 )

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PURPOSE: To investigate the inhibitory effect of sodium cantharidate (SCA) on human tongue squamous cell carcinoma CAL27 cells and its mechanism. METHODS: CAL27 cells were pretreated with different concentrations of SCA. Cell viability was analyzed by CCK-8 method. The migration and invasion of CAL27 cells were measured by scratch test and Transwell chamber, and the apoptosis rate was measured by flow cytometry. p53 protein and its phosphorylation sites Ser33, Ser37, Ser46, expression of BCL-2, BAX, and cleaved caspase 3 in CAL27 cells were detected by Western blot. Statistical analysis was performed with Graphpad Prism 9.0 software package. RESULTS: Compared with the blank control group, the proliferation, migration and invasion of CAL27 cells in sodium cantharidate group were significantly decreased, and the apoptosis rate was significantly increased(P<0.01) in a dose-dependent manner. The expression of p53 protein and its phosphorylation sites Ser33, Ser37, Ser46 protein was significantly up-regulated(P<0.05 or P<0.01). The expression of BCL-2 protein was down-regulated and the expression of BAX protein was significantly up-regulated(P<0.05 or P<0.01). The ratio of BCL-2/BAX was significantly decreased and the expression of cleaved caspase 3 protein was significantly up-regulated(P<0.05 or P<0.01). CONCLUSIONS: SCA can inhibit the proliferation, migration and invasion of human tongue squamous cell carcinoma CAL27 cells. It also down-regulates the ratio of BCL-2/BAX and up-regulates the expression of cleaved caspase 3 protein by regulating the phosphorylation of p53 protein, which induces apoptosis.

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Study on fatigue resistance of mechanical nickel-titanium files by phase-locked infrared flaw detection method

PU Zhuo-guang, ZHANG Fu-hua

2024, 33 (3): 235-238. doi: 10.19439/j.sjos.2024.03.003

Abstract ( 90 )

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PURPOSE: The fatigue resistance of mechanical nickel-titanium files was tested by phase-locked infrared flaw detection method, in order to timely detect instrument wear, providing reference for clinical safe use and timely abandonment of nickel-titanium files. METHODS: Twenty sets of mechanical nickel-titanium files were selected from Reciproc-Blue(RB), MTWO and S3 respectively, and resin simulated root canals with 60° and 90° bending were prepared, which were divided into 6 subgroups. The fatigue value after use, the number of uses before breaking and the length of fracture of file 25# of each group of files were recorded and compared with SPSS 26.0 software package. RESULTS: With the increase of the times of use, the fatigue value of the three kinds of files increased gradually. Among the two types of curved root canals, the number of uses before fracture in RB group was significantly increased compared with that in MTWO group and S3 group (P<0.05). The number of uses of the three kinds of files in the 90° curved root canal were significantly less than in the corresponding groups in the 60° curved root canal(P<0.05). There was no significant difference in the length of fracture among the three kinds of files(P>0.05). CONCLUSIONS: Phase-locked infrared flaw detection method can be used for non-destructive testing and quantitative analysis of the fatigue degree of nickel-titanium files.

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Study on movement trend of posterior teeth and distribution of periodontal membrane stress during adduction

OU Xiao-li, FANG Zhi-xin, LONG Zhi-ling, LUO Hai-ou, TANG Qian

2024, 33 (3): 239-244. doi: 10.19439/j.sjos.2024.03.004

Abstract ( 101 )

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PURPOSE: The movement trend of the posterior teeth and the distribution of the periodontal membrane stress were studied by using three-dimensional digital technology. METHODS: CBCT data of 88 patients admitted to our hospital from June 2017 to June 2022 were selected, and input into Mimics20.0 software for preliminary extraction of all parts and stored with STL files; then the data were repaired and optimized through Geomagic Studio 2014 software. With the help of normal phase extension, the invisible appliance and periodontal membrane were constructed. Finally, the six FEM models were simulated and observed by the current teeth in different groups. Statistical analysis was performed with SPSS 21.0 software package. RESULTS: The effect force of the largest periodontal membrane was distributed in the neck of the tooth, followed by the apical area, with the maximum effect force value in the NA group. In all accessory groups, the periodontal membrane maximum paradigm isoeffect force values of all patients in the accessory vertical rectangular group were significantly smaller than the values obtained in the horizontal rectangular group. CONCLUSIONS: The design of orthodontic tooth accessories has a strong inhibition effect on the position movement of anterior teeth during recovery, which improves the accuracy of tooth three-dimensional movement to a certain extent. Meanwhile, the normal equivalent stress of the periodontal membrane of patients in the initial application of the invisible appliance without brackets is large.

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The effect of erbium laser pretreatment on bond strength between dentin and enamel and microleakage at the edge of CAD/CAM glass ionomer cement restorations for repairing tooth defects

YANG Hua-xuan, CHEN Ren-sheng, HUANG Jia-hui, KONG Hai-ying, ZHANG Lin-lin

2024, 33 (3): 245-249. doi: 10.19439/j.sjos.2024.03.005

Abstract ( 109 )

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PURPOSE: To investigate the effects of erbium laser pretreatment on the bond strength of dentin and enamel,as well as microleakage at the edge of tooth defects repaired with computer-aided design (CAD) and computer-assisted manufacturing (CAM) glass-ceramic restorations for repairing dental defects. METHODS: A total of 62 fresh, nondecayed, nondiscoloration and noncracked wisdom teeth were collected from the Oral Surgery Clinic between January 2020 and January 2023. According to different pretreatment methods, they were randomly divided into two groups, erbium laser group and phosphoric acid group, with 31 teeth in each group. Each group was further divided into two subsets for bond strength testing (16 teeth) and microleakage testing (15 teeth).The shear bond strength between enamel and dentin of both groups was compared, as well as the degree and distribution of microleakage.Statistical analysis was performed with SPSS 17.0 software package. RESULTS: The shear bond strength between enamel and dentin of the erbium laser group was significantly higher than that of the phosphoric acid group (P<0.05); the degree and distribution of microleakage at the lateral walls and gumline of the erbium laser group were significantly lower than those of the phosphoric acid group (P<0.05). The scores of microleakage at the lateral walls of the erbium laser group mainly concentrated in grade 1 and 2, whereas those of the phosphoric acid group mainly concentrated in grade 2. There was significant difference in the distribution of lateral wall microleakage scores between the two groups (P<0.05). The scores of microleakage at the gumline of the erbium laser group mainly concentrated in grade 1 and 2, whereas those of the phosphoric acid group mainly concentrated in grade 2 and 3. There was significant difference in the distribution of gumline microleakage scores between the two groups (P<0.05). CONCLUSIONS: Erbium laser pretreatment can improve bonding strength between glass ionomer cement and dentin and enamel, reduce microleakage at the edge of CAD/CAM glass ionomer cement restorations, and enhance marginal fit.

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Impact of GuttaFlow Bioseal sealer on the vertical fracture resistance of oval-shaped canals

DILINAER Kurexi, YANG Ya, HE Hong

2024, 33 (3): 250-254. doi: 10.19439/j.sjos.2024.03.006

Abstract ( 108 )

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PURPOSE: To investigate the effect of GuttaFlow Bioseal root canal sealer on the vertical root fracture resistance of oval-shaped root canals. METHODS: Sixty orthodontically subtracted maxillary and mandibular single-rooted premolar teeth were scanned with CBCT. Oval canals were eligible when the buccolingual diameter of the canal was greater than or equal to two times the mesiodistal diameter at a distance of 5 mm from the root apex. Thirty single-rooted premolars with oval-shaped root canals were prepared to F2 using the Protaper system and then randomly divided into the GuttaFlow Bioseal filling group and iRoot SP filling group. Each group was further divided for root canal filling using warm vertical compression, cold lateral condensation and single cone techniques. Five single-rooted premolars was chosen as a negative control group. After 30 days of storage in a constant thermotank at 37 ℃ and 100% humidity, the filled roots were vertically placed into a cylindrical model of self-polymerizing acrylic resin. Subsequently, the samples were fixed on the lower plate of a universal testing machine, and a ball of 4 mm in diameter was applied vertically with a downward pressure at a speed of 1 mm/min until fracture occurred. The load values were recorded in Newtons. The data were analyzed using SPSS 29.0 software package. Fracture patterns were examined under microscope. RESULTS: T test results showed no significant difference between the GuttaFlow Bioseal-filled and iRoot SP-filled groups (P=0.321). One-way ANOVA showed a significant difference in vertical fracture resistance between the groups(P<0.05), and LSD analysis showed that the GuttaFlow Bioseal-filled sample teeth were significantly more resistant to vertical fracture than the iRoot SP when using the thermal vertical compression filling method and the single-tip method(P<0.05). In contrast, the GuttaFlow BIoseal-filled group was significantly less resistant to vertical fracture than the iRoot SP group when using the cold lateral compression filling method(P<0.05). CONCLUISIONS: GuttaFlow Bioseal has the potential to improve root resistance to vertical fracture when filling root canals using the thermal vertical pressurization method and the single-tip method, but more clinical trials are needed to validate this result and its long-term prognosis.

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Effects of Sophora japonica extract on alveolar bone mass in ovariectomized osteoporosis mice

LIN Hui, GAO Yun-fei, WEI Chao, WANG Meng-lei, MA Xu-hui

2024, 33 (3): 255-259. doi: 10.19439/j.sjos.2024.03.007

Abstract ( 106 )

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PURPOSE: To investigate the effect of Sophora japonica extract on alveolar bone mass in ovariectomized osteoporosis mice. METHODS: Six-week-old female non-pregnant wild-type C57BL/6J mice were randomly divided into sham operation group, ovariectomy(OVX) group and OVX+Sophora japonica extract group. Ovaries of the mice in the OVX group and the OVX+Sophora japonica extract group were removed, and the mice in the OVX+Sophora japonica extract group were treated by Sophora japonica extract at a dose of 150 mg/kg, three times a week for 4 weeks; while mice of the other two groups were given an equal volume of normal saline at the same time. Body weight was measured 3 times a week, and the micro-parameters of alveolar bone were detected by Micro-CT after 4 weeks. The data were analyzed by GraphPad Prism 9 software. RESULTS: Compared with the sham-operated group, the trabecular bone parameters of the alveolar bone in the OVX group were significantly decreased 1 month after operation (P<0.05). One month after intervention with Sophora japonica extract, alveolar bone mineral density (BMD), trabecular number (Tb.N) and trabecular separation(Tb.Sp) in OVX mice was significantly rescued, with no significant difference compared to the sham surgery group(P>0.05); but bone volume fraction(BV/TV) and trabecular thickness (Tb.Th) had not completely recovered to the levels of the sham-operated group(P<0.05). CONCLUSIONS: Sophora japonica extract can effectively increase the alveolar bone mass reduced by estrogen deficiency and may be used as one of the potential drugs for the treatment of menopausal alveolar bone osteoporosis.

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Comparison of the effects of using iRoot BP plus and MTA apical barrier surgery in young permanent teeth with chronic apical periodontitis

SUN Yan-ni, ZHAO Lei, LIU Wei, YIN Xiao-ping

2024, 33 (3): 260-264. doi: 10.19439/j.sjos.2024.03.008

Abstract ( 123 )

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PURPOSE: To explore the effect of using iRoot BP plus and MTA apical barrier surgery in young permanent teeth with chronic apical periodontitis. METHODS: A total of 122 patients with chronic periapical periodontitis with open root tips of permanent teeth were randomly divided into experimental group (n=61, 61 teeth) and a control group (n=61, 61 teeth). Patients in the experimental group received iRoot BP plus plus apical barrier surgery, while those in the control group received MTA apical barrier surgery. The old periapical index (O-PAI), apical transmission area, efficacy, treatment times, and inflammatory factor levels of the two groups of patients were compared at 3, 6, 9, and 12 months after surgery. SPSS 19.0 software package was used for statistical analysis. RESULTS: At 12 months after surgery, the O-PAI ratings of the experimental group and the control group were (1.48±0.36) and (1.71±0.42), respectively, and the apical transmission area was (0.51± 0.14) and (1.09±0.31). There was a significant difference in the O-PAI ratings and apical transmission area between the two groups(P<0.05). At 3 months, 6 months, and 12 months after surgery, the O-PAI scores of patients in both groups gradually decreased (P<0.05). After 12 months of treatment, the success rates of the experimental group and the control group were 98.36% and 88.52%, respectively, with significant difference between the two groups (P<0.05). The treatment frequency of patients in the experimental group and the control group was (3.64±0.58) times and (4.72±0.61) times, respectively, with a significant difference between the two groups(P<0.05). After 3 months of treatment, the serum hs-CRP levels in the experimental group and the control group were (6.89±1.13) mg/L and (7.25±1.40) mg/L, respectively, with a significant difference compared to pre-treatment(P<0.05). After 3 months of treatment, the serum IL-6 levels in the experimental group and the control group were (82.04±19.62) mg/L and (87.52±20.85) mg/L, respectively, with significant differences compared to pre-treatment (P<0.05). There was no significant difference in serum IL-6 and hs-CRP levels between the two groups before and after treatment(P>0.05). CONCLUSIONS: iRoot BP plus apical barrier surgery for the treatment of chronic apical periodontitis with open permanent teeth can reduce the O-PAI index, decrease the number of postoperative visits, and have a higher postoperative success rate.

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Clinical effect of MB-PDT assisted initial therapy on alveolar angle absorption of lower anterior teeth

BU Xiao-shuang, WANG Xiao, PAN Tiao-hua, ZHU Li-lei, Guo Jin-cai

2024, 33 (3): 265-268. doi: 10.19439/j.sjos.2024.03.009

Abstract ( 109 )

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PURPOSE: To evaluate the effect of MB-PDT assisted essential therapy on angle resorption of lower anterior alveolar bone in patients with periodontitis. METHODS: Forty patients who were diagnosed with periodontitis stage III-IV or C, lower anterior teeth alveolar bone angle resorption, and periodontal pocket depth greater than 4 mm were selected from April 2018 to October 2020 in the Department of Periodontology and Oral Mucosal Diseases, Changsha Stomatological Hospital. The patients were randomly divided into control group and experimental group with 20 cases in each group. Compared with the control group which was only managed with essential treatment, the experimental group was treated with MB-PDT on the basis of the control group. The plaque index (PLI) and gingival bleeding index (GBI) scores of the two groups were recorded before surgery and 1 and 2 weeks after surgery. Probing depth (PD) and clinical attachment level (CAL) were detected before and 6 months after surgery. Statistical analysis of the data was performed using Graphpad Prism 5 software package. RESULTS: The PLI and GBI of the experimental group were significantly lower than those of the control group at 1 and 2 weeks after operation(P<0.05). Six months after surgery, PD and CAL levels in the experimental group were significantly lower than those in the control group (P<0.05). CONCLUSIONS: MB-PDT adjuvant therapy has the advantages of simple operation, efficient sterilization, promotion of healing, and high safety performance. It may be a new non-surgical adjuvant treatment strategy for effective treatment of lower anterior alveolar angular resorption.

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Clinical anatomy of the free latissimus dorsi myocutaneous flap and its application in the restoration of giant defects of the head and neck

QIAN Ye-mei, WANG Wei-hong, ZHU Jin, HE Yong-jing, XU Biao, ZOU Zhi-rong, SHI Yan-an, LUO Lei, LI Jing-yi

2024, 33 (3): 269-272. doi: 10.19439/j.sjos.2024.03.010

Abstract ( 97 )

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PURPOSE: To investigate the feasibility and effect of free latissimus dorsi myocutaneous flap in the reconstruction of giant head and neck defects. METHODS: Free latissimus dorsi myocutaneous flap on the cadaver was simulated dissected, and measured by Image-Pro Plus 6.0 to assess the feasibility of repairing giant head and neck defects. Between May 2011 and September 2022, seven patients with giant head and neck defects of different causes repaired with the latissimus dorsi myocutaneous flap were retrospectively analyzed. RESULTS: The diameter of the initiating thoracodorsal artery was (4.03±0.56) mm, and the mean lengths of the arteriolar and venous pedicles of the latissimus dorsi myocutaneous flaps obtained from human specimens were (85.5±10.5) mm and (104±4.2) mm, respectively. Among 7 patients, 5 cases had scalp defects, the remaining 2 cases had neck defects. There were no substantial postoperative problems in the donor site, and all seven latissimus dorsi myocutaneous flaps were successfully transplanted. CONCLUSIONS: For the treatment of considerable head and neck deformities, the latissimus dorsi myocutaneous flap is an optimal muscle flap due to its abundance of tissue, enough length of vascular pedicles, and sufficient venous drainage.

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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

2024, 33 (3): 273-278. doi: 10.19439/j.sjos.2024.03.011

Abstract ( 102 )

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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.

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Application of small intestinal submucosa absorbable biofilm in the repair of alveolar bone defects

ZHANG Min-zhen, KUANG Hui-fang, YANG Li-yan, LUO Wen

2024, 33 (3): 279-284. doi: 10.19439/j.sjos.2024.03.012

Abstract ( 97 )

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PURPOSE: To study the clinical efficacy of small intestinal submucosa (SIS) absorbable biological membrane in alveolar bone defect repair. METHODS: A total of 102 patients with alveolar bone defect who received guided bone regeneration (GBR) in our hospital from January 2020 to January 2022 were selected and divided into Bio-Gide group (51 cases using Bio-Gide absorbable biofilm) and SIS group (51 cases using SIS absorbable biofilm) by computer random number generator. The perioperative related indicators, blood calcium, blood phosphorus, biocompatibility, periodontal attachment loss (PAL) length, pulp sensitivity, tooth mobility, alveolar bone volume and adverse events of the two groups were compared. Statistical analysis was performed with SPSS 24.0 software package. RESULTS: There was no significant difference in operation time, intraoperative blood loss, visual analogue scale (VAS) score of pain on the first day after operation, VAS score on the fifth day after operation, wound healing time, blood calcium and phosphorus levels before operation, 1 d and 12 d after operation, PAL length before operation, 3 months, 6 months and 12 months after operation, pulp sensitivity and tooth looseness grade 1 and 2 percentage at 3, 6 and 12 months after operation, bone width increase, bone height increase at 12 months after operation and adverse event rate between the two groups (P>0.05). Compared with Bio-Gide group, the wound healing time and biofilm absorption time were shortened in SIS group(P<0.05), and the incidence of rejection was decreased 12 d after operation (P<0.05). CONCLUSIONS: SIS absorbable biofilm and Bio-Gide absorbable biofilm have similar efficacy and safety in repairing GBR for alveolar bone defects, but the former is more biocompatible and the latter can provide longer barrier function.

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Comparison of the repair effects of Haiao oral biofilm alone or in combination with allogeneic bone graft in bone defects after jaw bone cyst surgery

WEI Zi-cheng, ZHOU Chen, JI Lian, HOU De-qiang, DONG Yu

2024, 33 (3): 285-289. doi: 10.19439/j.sjos.2024.03.013

Abstract ( 107 )

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PURPOSE: To compare the repair effects of Haiao oral biofilm alone or in combination with allogeneic bone graft on bone defects after jaw bone cyst surgery. METHODS: A prospective study was conducted on 105 patients with bone defects after jaw bone cyst surgery who were admitted to Affiliated Hospital of Jiangnan University from November 2020 to July 2022. According to the random number table methods, the patients were divided into three groups: Haiao membrane group, allogeneic bone graft group and combination group. Among them, Haiao membrane group(35 patients) were repaired using Haiao oral biofilm; allogeneic bone group(35 patients) using allogeneic bone, while combined group (35 patients) using a combination of Haiao oral biofilm and allogeneic bone graft. The clinical basic data of three groups of patients were compared, including the healing effect at the incision, bone density at the bone defect, bone resorption and attachment loss. Statistical analysis was performed with SPSS 22.0 software package. RESULTS: There was no significant difference in general clinical data among the three groups (P>0.05). The postoperative restoration effect of gingival soft tissue morphology in combined group was significantly better than that in Haiao membrane group and allogeneic bone graft group (P<0.05). There was no significant difference in bone density at the bone defect site among the three groups before treatment(P>0.05); 6 and 12 months after treatment, the bone density of the three groups was significantly improved (P<0.05), and combined group was significantly higher than the other groups(P<0.05). There was no significant difference in the vertical and lingual bone resorption levels among the three groups before treatment(P>0.05); 6 and 12 months after treatment, the vertical and lingual bone resorption levels of the three groups were significantly reduced (P<0.05), and combined group were significantly lower than the other groups (P<0.05). There was no significant difference in attachment loss among the three groups before treatment(P>0.05); 6 and 12 months after treatment, the attachment loss of the three groups decreased(P<0.05), and combined group was significantly lower than the other groups(P<0.05). CONCLUSIONS: The combination of Haiao oral biofilm and allogeneic bone graft has good repair effect in the treatment of bone defects after jaw bone cyst surgery, which is beneficial for the recovery of gingival soft tissue, improvement of bone density, reduction of bone resorption and attachment loss.

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Influence of gingival biotype width on the health of peri-implant bone and soft tissues and the aesthetic outcome of the gingival papilla for single maxillary posterior implants

YANG Cheng-dong, XIANG Xu-dong

2024, 33 (3): 290-294. doi: 10.19439/j.sjos.2024.03.014

Abstract ( 90 )

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PURPOSE: To explore the influence of gingival biotype and width of keratinized gingiva on peri-implant bone tissue, soft tissue health, and esthetic outcome of the papilla surrounding single posterior maxillary implants. METHODS: Seventy-eight patients who underwent single posterior maxillary implant surgery from May 2019 to September 2022 were selected, involving the placement of 78 implants. Based on periodontal probing outcomes one month post-restoration, the patients were divided into thin gingival biotype group(n=32) and thick gingival biotype group(n=46). Comparisons were made six months after implant restoration regarding buccal keratinized mucosa width(KMW), peri-implant bone tissue [implant bone loss(IBL)], soft tissue health [modified plaque index (mPLI), modified bleeding index for implants (mBLI), probing pocket depth (PPD)], and esthetic effect of the papilla [papilla index score (PIS), food impaction, gingival margin color satisfaction index (GMCS)]. Statistical analysis was performed with SPSS 27.0 software package. RESULTS: The thick gingival biotype group showed significantly greater keratinized gingival width compared to the thin gingival biotype group (P<0.05). Spearman correlation analysis revealed a positive correlation between gingival biotype and keratinized gingival width(r=-0.416, P=0.000). For peri-implant bone tissue, bone loss in the thin gingival biotype group was significantly higher than that in the thick gingival biotype group. In soft tissue health, the probing pocket depth for implants in the thin gingival biotype group was significantly less than that in the thick gingival biotype group. In terms of esthetic effect of the papilla, PES score in the thin gingival biotype group was significantly lower than in the thick gingival biotype group(P<0.05). Pearson correlation analysis showed a negative correlation between gingival biotype and papilla index score, GMCS, bleeding on probing, and PPD, but a positive correlation with food impaction, bone loss and mPLI(P<0.05). The width of keratinized gingiva was positively correlated with papilla index score, GMCS, bleeding on probing and PPD, but negatively correlated with food impaction, bone loss and mPLI(P<0.05). There was significantly difference between thin and thick gingival biotype groups for KMW >2 mm(P<0.05). A significant difference was showed in thick gingival biotype group when KMW ≤2 mm and >2 mm(P<0.05). CONCLUSIONS: Gingival biotype and keratinized mucosa width significantly influence peri-implant bone and soft tissue health as well as esthetic outcome of the papilla around single posterior maxillary implants, offering guidance for predicting the long-term success and esthetic outcomes of implants.

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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

2024, 33 (3): 295-300. doi: 10.19439/j.sjos.2024.03.015

Abstract ( 106 )

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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.

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Comparison of the application of micro-implant screw support and flat guide plate in the treatment of excessive deep overbite of lower anterior teeth

WANG Jing, SUN Yi-fan, LU Qian, PANG Shu-ting

2024, 33 (3): 301-305. doi: 10.19439/j.sjos.2024.03.016

Abstract ( 96 )

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PURPOSE: To compare and analyze the orthodontic effects of micro-implant screw support and flat guide plate on excessive deep overbite of lower anterior teeth. METHODS: Eighty-two patients with excessive deep overbite of the lower anterior teeth who were treated from January to December 2022 were selected and randomly divided into two groups (41 in each group) by random number table method. Both groups were treated with straight wire arch orthodontic technology, and the anterior teeth were supported by micro-implant screws (micro-implant screw group) and flat guide plates (flat guide plate group), respectively. The effect of upper anterior tooth compression, changes in occlusal plane, and apical absorption were compared between the two groups. SPSS 25.0 software package was used for statistical analysis. RESULTS: There were no significant changes in SNA angle, SNB angle, ANB angle, U1-PP, U6-PP, and L6-MP before and after treatment between the two groups (P>0.05). L1-MP significantly increased in both groups after treatment than before treatment(P<0.05). There was no significant difference in bite opening, Spee curve depth, U1 depression, L1 depression, U6 elongation, L6 elongation and occlusal opening time between the two groups before and after treatment(P>0.05). The root apex absorption of the mandibular central incisors and lateral incisors in the micro-implant screw group was significantly lower than that in the flat guide plate group(P<0.05), while there was no significant difference in root apex absorption between the two groups of canines(P>0.05). CONCLUSIONS: Both micro-implant screw support and flat guide plate can effectively lower the mandibular anterior teeth in the treatment of deep overbite in adults, with good orthodontic effects. However, the latter can lead to increased root resorption.

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Study of the mucosal morphological difference of distal-extension of mandibular dentition defect impressions taken by intra-oral digital scanning and selective pressure impression technique

GONG Zhi-cheng, PENG Yan, ZHONG Qun, WU Xue-ying, FANG Shuo-bo

2024, 33 (3): 306-311. doi: 10.19439/j.sjos.2024.03.017

Abstract ( 97 )

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PURPOSE: To compare the mucosal morphological difference in distal-extension area of mandibular dentition defect taken by intra-oral digital scanning and selective pressure impression techniques. METHODS: Seventeen patients with Kennedy Class I and Class II dentition defect in lower jaw were included, including twenty-two distal-extensions. Intraoral digital scanning and functional impression technique were taken in each patients, respectively. Laboratory cast scanner was used to scan the plaster casts made from the selective pressure impression to obtain the three-dimensional data. All the data were stored in STL format. The 3D data collecting from intra-oral digital scanning and selective pressure impression from the same patient were compared by Geomagic Control 2014 software. Root mean square of 2.5mm diameter area was calculated in 5,10,15 mm from terminal tooth. Pearson's correlation test was used to analyze the correlation of the distance and morphological difference with SPSS 20.0 software package. RESULTS: Mean mucosal morphological difference of jaw distal-extension edentulous area taken by intra-oral digital scanning and selective pressure impression techniques was (0.37±0.12) mm. There was positive correlation between distance from terminal tooth and mucosal morphological difference(P<0.05). Morphological differences in 5, 10, 15 mm from terminal tooth were (0.14±0.11) mm, (0.22±0.13) mm and (0.39±0.16) mm, respectively. CONCLUSIONS: In this study, there was positive correlation between the length of distal-extension edentulous area and mucosal morphological difference, while the kind of ridge defect and mucosal thickness may also affect the morphological difference quantity.

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Transverse characteristics of normodivergent patients in different sagittal skeletal patterns

YU Zi-hang, DUAN Yi-ge, CUI Yu-tong, TIAN Yu-lou

2024, 33 (3): 312-317. doi: 10.19439/j.sjos.2024.03.018

Abstract ( 104 )

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PURPOSE: This study aimed to measure and analyze the transverse indicators of normodivergent patients with different sagittal skeletal malocclusions, to explore the transverse characteristics of different sagittal skeletal malocclusions. METHODS: Lateral cephalograms and CBCT of 90 normodivergent patients with skeletal Class Ⅰ, Ⅱ and Ⅲ in their permanent dentition were collected. Dolphin software was applied to measure the widths of the basal bone, alveolar bone, dental arch and buccolingual inclination angle of the corresponding teeth in the maxillary and mandibular canine, premolar and molar areas. SPSS 22.0 software package was applied for statistical analysis of the data. RESULTS: The widths of the mandibular basal bone in canine, premolar and molar areas of skeletal Class Ⅲ were (27.15±2.74), (39.30±2.82) and (59.97±2.93) mm, respectively. The widths of the mandibular alveolar bone of skeletal Class Ⅲ were (25.38±1.78), (34.51±2.28) and (47.72±2.73) mm, respectively. The dental arch widths of the maxillary premolar and mandibular canine areas of skeletal Class Ⅲ were (48.70±2.35) and (30.69±2.31)mm, respectively. The above data of skeletal Class Ⅲ were significantly larger than those of skeletal Class Ⅰ and Ⅱ(P<0.01). The dental arch widths of the maxillary canine, maxillary molar and mandibular molar areas of skeletal Class Ⅲ were (38.88±1.90), (59.51±3.40) and (56.01±2.86)mm, respectively, which were significantly larger than those of skeletal Class Ⅱ(P<0.05). The maxillomandibular width difference of basal bone in the canine, premolar and molar areas of skeletal Class Ⅲ were (4.69±2.84), (2.31±2.39) and (3.27±2.05) mm, respectively, which were significantly less than that of skeletal Class Ⅰ and Ⅱ(P<0.01). Compared with skeletal Class Ⅰ, the maxillary canines and first molars of skeletal Class Ⅱ had larger lingual inclination level, while the maxillary first premolars and first molars of skeletal Class Ⅲ had larger buccal inclination level, the mandibular canines and the mandibular first premolars of skeletal Class Ⅲ had larger lingual inclination level(P<0.01). CONCLUSIONS: For normodivergent patients, the width of the mandibular base bone, alveolar bone, and maxillary and mandibular dental arch in skeletal Class Ⅲ is the widest, which is more likely to have width discrepancy in basal bone. In skeletal Class Ⅲ, the maxillary teeth are buccally inclined, and the mandibular teeth are ingually inclined. In skeletal Class Ⅱ, the maxillary teeth are lingually inclined, and the mandibular teeth are compensatory upright.

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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

2024, 33 (3): 318-323. doi: 10.19439/j.sjos.2024.03.019

Abstract ( 122 )

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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.

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Clincopathological analysis of 171 patients with osteochondroma and malignant transformation in maxillofacial bone

LIU Li-min, SUN Jing-jing, QIAN Jia-jun, ZHANG Chun-ye, HU Yu-hua, LI Jiang

2024, 33 (3): 324-327. doi: 10.19439/j.sjos.2024.03.020

Abstract ( 98 )

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PURPOSE: To investigate the clinical and pathological features of osteochondroma in maxillofacial region, and to summarize the clinicopathological features of rare osteochondroma malignant transformation in order to provide clinical guidance. METHODS: From January 2018 to September 2023, a total of 171 patients with osteochondroma were retrospectively collected in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Their preoperative CT and clinicopathological features were analyzed. RESULTS: Of the 171 patients with osteochondroma in maxillofacial bone, 66%（113/171） were females and 34% were male. Their age ranged from 11-76 with an average age was 44 years old. Of the 171 cases, 95.3%（163/171）in mandible condyle, 4%(7/171) in mandible processus coronoideus, and 0.5%（1/171） in zygomatic arch. The imaging findings showed that the thickness of cartilaginous cap was less than 1 cm in 98%（159/161） cases with condyle lesions. Only 2 cases(2/171, 1.1%) had malignant transformation. One was diagnosed with secondary chondrosarcoma, another developed low-grade osteosarcoma. CONCLUSIONS: Osteochondroma in maxillofacial region mostly occurs in females, and most commonly located in condylar process, with a malignant change rate of 1.1%, which is similar to that of other parts of the body. Imaging findings have important guiding significance for the diagnosis of osteochondroma malignant change.

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Ultrasonographic features of Castleman disease in the head and neck: a report of 7 cases

ZHOU Hui-hong, CHEN Qian-qian, YUAN Fang, SUN Jing-jing, TIAN Zhen, XIONG Ping

2024, 33 (3): 328-331. doi: 10.19439/j.sjos.2024.03.021

Abstract ( 109 )

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PURPOSE: To summarize the ultrasonographic features of head and neck Castleman disease (CD), and to clarify its diagnostic key points. METHODS: Seven patients with head and neck CD confirmed by histopathology were collected from Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The clinical features and ultrasound findings of the patients were evaluated. RESULTS: Of the 7 patients (1 male and 6 females), the mean age at diagnosis was 31.4 years (7-60 years). All the cases were hyaline vascular type. On ultrasound, 3 lesions (42.9%) were located in the parotid gland, 4 lesions(57.1%) in the neck. All the lesions presented as a solitary, well-defined and solid mass without calcification. The echogenicity was markedly hypoechoic in 1 case(14.3%) and hypoechoic in 6 cases (85.7%). Of the 7 CD cases, 4 cases (57.1%) were heterogeneous masses with linear echogenic septa. All lesions had mixed pattern in vascularity on color Doppler sonography. CONCLUSIONS: Most CDs in the head and neck represent as a markedly hypoechoic or hypoechoic lesion with mixed pattern in vascularity. The neoplasm may be characterized by the presence of linear echogenic septa within the mass.

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Evaluation of the role of standardized periodontal probing training on the teaching of undergraduates using the Florida probe system

XU Mu-xin, SUN Qing

2024, 33 (3): 332-336. doi: 10.19439/j.sjos.2024.03.022

Abstract ( 99 )

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PURPOSE: To evaluate the effect of standardized periodontal probing training on the teaching of periodontal clinical probing for undergraduates by using Florida probe system. METHODS: Twenty undergraduates who practiced in the Department of Periodontology of Changzhou Stomatological Hospital from May 2022 to November 2022 were selected as the study objects and randomly divided into two groups with 10 students in each group. The experimental group received standardized periodontal probing training, while the control group did not receive training. Two groups of students used the traditional probe and the Florida probe to probe the left and right half-mouth teeth of one patient. In addition, a periodontal specialist used Florida probe to conduct full oral examination of the same patient, and the results were compared with those of the two groups of students. SPSS 26.0 software package was used for statistical analysis of the obtained data. RESULTS: There was no significant difference of probing depth(PD) between undergraduates and periodontal specialist in the experimental group (P>0.05), while there was significant difference in the control group (P<0.05). In the control group, PD values in the anterior area were not statistically different from those of periodontal specialist (P>0.05), while PD values in the posterior area were statistically different (P<0.05). Both groups of patients reported that the Florida probe system was more comfortable. CONCLUSIONS: Standardized periodontal probing training is helpful to improve the clinical probing ability of undergraduates. The use of Florida probe system can not only evaluate the teaching effect, but also improve the comfort level of patients, which is worthy of further application in the teaching course of periodontal probing for undergraduates.

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