上海口腔医学最新文献

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.