上海口腔医学最新文献

Purpose: To identify potential biomarkers of salivary gland adenoid cystic carcinoma to further understand the potential pathogenesis of adenoid cystic carcinoma.

Methods: Two microarray datasets (GSE59701, GSE88804) were downloaded from NCBI GEO database. LIMMA software package was used to screen SACC differentially expressed genes. WGCNAs were used to find the important module genes that were most associated with SACC. Two machine learning methods(LASSO and SVM-RFE) were used to identify Hub genes. Subsequently, ROC curve used to predict SACC was developed to determine the diagnostic effect. R4.2.1 software was used for statistical analysis.

Results: Three hub genes(GABBR1, EN1 and LINC01296) were identified, and a ROC curve with high predictive performance (AUC, 1.000-1.000) was established.

Conclusions: Three hub genes(GABBR1, EN1 and LINC01296) were obtained by WGCNA, LASSO, SVM-RFE as potential biomarkers of SACC, and the findings of this study provide a foothold for future research on potential key genes of SACC, and a target basis for the early diagnosis and treatment of SACC.

Purpose: To investigate the periodontal health status and influencing factors of the elderly aged 65-74 years in Jiading District of Shanghai, and to provide data support for periodontal prevention and health care for the elderly in Jiading District.

Methods: A total of 961 elderly people aged 65-74 years old in Jiading District were selected by multi-stage, stratified, equal size and random sampling method, and oral examination and questionnaire survey were conducted. SPSS 22.0 software package was used for descriptive statistics and multivariate logistic regression analysis.

Results: Among 961 elderly people, the detection rate of periodontal pockets, bleeding on gingival probing, dental calculus and debris were 58.9%, 85.3%, 90.5% and 88%, respectively. The mean number of missing teeth was 6.25±5.94. The average number of gingival index, calculus index and debris index were 1.82±0.706, 1.26±0.632, 1.17±0.620, respectively. The results of univariate analysis showed that gender, education level, smoking, diabetes, cardiovascular disease, oral hygiene habits (frequency of brushing teeth and frequency of cleaning teeth) were risk factors for periodontitis in the elderly in Jiading District. Multivariate logistic regression analysis showed that smoking, diabetes and oral hygiene habits (tooth cleaning frequency) were independent risk factors for periodontitis in the elderly in Jiading District.

Conclusions: The periodontal health status of the elderly aged 65-74 years in Jiading District is poor, and comprehensive prevention and treatment from various aspects and links should be carried out.

Purpose: To evaluate the impact of impacted lower third molar(ILTM) extraction by root dislocation first method on bone formation in the distal middle of the second molar(M2M), pulp status and external root resorption (ERR).

Methods: A total of 64 patients who underwent ILTM extraction in the First Affiliated Hospital of Xinjiang Medical University from January 2023 to October 2023 were selected. Among them, 32 patients underwent root first removal of ILTM (experimental group), and 32 patients underwent crown first removal of ILTM (control group). Preoperative and postoperative M2M mobility, pulp status, ERR situation, and postoperative visual analog scale for pain were recorded. Cone-beam CT was performed at 3 and 6 months after operation to measure bone defect depth of M2M, bone height of M2M, percentage of bone height, and bone ash degree. SPSS 26.0 software package was used for data analysis.

Results: The VAS pain score of the experimental group on the third postoperative day was significantly lower than that of the control group (P＜0.05), while there was no significant difference in surgical time, M2M pulp vitality, and mobility between the two groups(P＞0.05); the amount of bone resection in the experimental group was significantly less than that in the control group (P＜0.05). The immediate postoperative near-midfacial and distal tongue-side probing depth (PD) in the experimental group was significantly lower than that in the control group(P＜0.05). At 3 and 6 months postoperatively, the experimental group exhibited significantly lower bone defect depth, bone height, bone height percentage, and bone gray level compared to the control group across different degrees of external root resorption (ERR) (P＜0.05). There were statistically significant differences in bone defect depth, bone height, bone height percentage, and bone gray level between the two groups with different types of impaction(P＜0.05), while no statistically significant difference was found in impaction depth and ERR severity comparison (P＞0.05). None of the patients experienced complications such as infection or nerve injury postoperatively.

Conclusions: The root dislocation method for ILTM extraction has certain guiding effects on the distal bone formation of M2M, and it has an effect on the improvement of periodontal health and postoperative reaction of M2M.

Purpose: To investigate the value of machine learning model based on enhanced CT imaging features and clinical parameters in predicting cervical lymph node metastasis in patients with tongue squamous cell carcinoma (TSCC).

Methods: A total of 75 patients with TSCC who were treated in the Affiliated Stomatology Hospital of Nanjing Medical University from January 2015 to July 2022 were collected. All patients had complete clinical data, enhanced CT image data and postoperative cervical lymph node pathological examination results. All cases were randomly assigned to the training group (n=60) and the validation group (n=15) in a ratio of 8∶2. A total of 1 833 radiomics features were extracted from the venous phase image data of enhanced CT. Correlation coefficient selection and LASSO method were used for feature selection and dimensionality reduction to select the optimal combination of radiomics features. Multiple machine learning algorithm models(LR, KNN, Random Forest, Extra Trees, XGBoost and LightGBM) were used to predict cervical lymph node metastasis on the selected radiomics and clinical features. The performance of the model was evaluated by receiver operating characteristic(ROC) curve and decision curve analysis(DCA). SPSS 21.0 software package was used for data analysis.

Results: After screening and dimensionality reduction, totally 14 optimal feature combinations were obtained, and a variety of prediction models were established based on them. Among them, the KNN model showed a more balanced fitting effect in the training group and the test group, with AUC values of 0.869 and 0.861, respectively. To further improve the efficiency of the model, we integrated imaging features with patient clinical features, and the AUC value of this comprehensive model was increased to 0.893 and 0.880 in the training group and the test group, respectively. The DCA decision curve showed that compared with the simple radiomic model, the image-clinical model with the integration of clinical features showed a higher predictive effect and clinical application value.

Conclusions: The prediction model based on enhanced CT image omics features combined with clinical parameters can effectively estimate cervical lymph node metastasis in patients with TSCC. This approach facilitates risk stratification of patients with TSCC and optimizes clinical decisions to improve treatment strategies and patient outcomes.

Purpose: To compare the aesthetic effects of resin restoration and CAD/CAM all-porcelain veneer restoration on anterior tooth space.

Methods: The medical records of 185 patients (333 teeth) with anterior space restoration from February 2023 to January 2024 were retrospectively analyzed. The patients were divided into control group(n=92, 170 teeth) and experimental group(n=93, 163 teeth) according the restoration methods. The control group was repaired with resin,while the experimental group was repaired with CAD/CAM all-porcelain veneer. The clinical effect, masticatory function, periodontal health status, aesthetic effect and complications were compared between the two groups. SPSS 25.0 software package was used for statistical analysis of the data.

Results: The total effective rate of the experimental group was significantly higher than that of the control group (P＜0.05). After 1 month of treatment, the masticatory function scores of 2 groups were significantly increased (P＜0.05), and the experimental group was higher than the control group (P＜0.05). The gingival index (GI) score and plaque index (PI) score of the experimental group were significantly lower than those of the control group (P＜0.05), but there was no significant difference in probing depth (PD) between the two groups (P＞0.05). The abutment sensitivity and pulp status, the color matching degree with neighboring teeth, the edge color of prosthesis and the grade distribution of prosthesis integrity in the experimental group were significantly better than these of the control group (P＜0.05). There was no significant difference in the total incidence of complications between the two groups (P＞0.05).

Conclusions: Compared with resin repair, CAD/CAM porcelain veneer has better effect on anterior tooth space repair, which can improve patients' chewing function and periodontal health, enhance aesthetic effect, and reduce the risk of complications.

Purpose: To explore the effects of improved shield technique in the aesthetic zone for single tooth implantation in the maxillary anterior region.

Methods: Eighty-four patients(84 teeth) who underwent single tooth implantation in the maxillary anterior region from January 2020 to January 2023 were selected,randomly divided into the control group and experimental group using digital table method, each with 42 patients(42 teeth). The success rate of implant in 2 groups was recorded, and periodontal index, pink esthetic score (PES), bone absorption and implant stability quotient (ISQ) preoperatively and 6 months after surgery were compared. The incidence of adverse reactions (redness, bleeding, pain and site infection) was recorded. SPSS 26.0 software package was used for statistical analysis of the data.

Results: The success rate of implantation in both groups was 100%. Six postoperative pericrescent indexes of the experimental group were significantly lower than that of the control group, PES and ISQ scores of the experimental group were significantly higher than that of the control group one year after surgery, bone absorption volume was significantly lower than that of the control group and the incidence of adverse reactions was significantly decreased(P＜0.05).

Conclusions: The improved shield technique in the aesthetic zone can enhance the esthetic index and implant stability in the anterior region, and reduce bone resorption volume.

Purpose: To investigate the effect and safety of removing dental resin adhesive with ultrafast laser.

Methods: Resin adhesive layers were prepared on the surface of extracted teeth and processed with ultrafast laser scanning. Morphology was observed under optical microscope and scanning electron microscope. Component change was tested with Raman Spectrometer and dental tissue damage was observed through sample sections.

Results: After laser processing, resin adhesive showed significant change in colour and volume expansion along with laser parameters. Dislodgement happened without any external force. Carbonization was presented in Raman spectroscopy result. No obvious damage was observed in enamel underneath.

Conclusions: Ultrafast laser can be used to remove dental resin adhesives on the enamel.

Purpose: To explore the differences in adverse oral behavior between patients with anterior disc displacement without reduction(ADDWoR) and healthy individuals without temporomandibular disorders(TMD).

Methods: From January to October 2023, a total of 170 patients with clinically confirmed ADDWoR were recruited from the Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, and 165 healthy subjects were recruited as controls during the same period. All subjects completed baseline data survey and Oral Behavior Checklist(OBC). The scores of each item and the total score of OBC were compared between the two groups. Logistic regression was used to analyze the relationship between oral behavior and ADDWoR. SPSS 23.0 software package was used for data analysis.

Results: The oral behavior scores of 16 items, sleeping oral behavior scores, waking oral behavior scores, and total OBC scores of the ADDWoR group were significantly higher than those of the healthy group(P＜0.05). Logistics regression analysis showed that the three behaviors of chin compression during sleep, teeth clenching and chin leaning forward or to one side when awake were risk factors for ADDWoR(P＜0.05).

Conclusions: Compared with non-TMD healthy individuals, ADDWoR patients have a higher frequency of multiple adverse oral behaviors, among which, the occurrence of 3 behaviors (compression of the chin during sleep, gnashing of the teeth and leaning of the chin forward or to one side when awake) can increase the risk of ADDWoR.

Purpose: To evaluate the clinical effect of 3D printing double positioning crown extension guide combined with 3D printing temporary crown in red aesthetic restoration of anterior teeth.

Methods: Twenty patients (70 teeth in total) who needed aesthetic restoration were randomly divided into 3D printing group (9 cases, 36 teeth) and traditional restoration group (11 cases, 34 teeth). The 3D printing team performed digital design, 3D printing double positioning crown lengthening guide to help crown lengthening operation, and 3D printed temporary crown was used after operation. The traditional group underwent diagnostic wax design, traditional film compression to make crown extension guide, 3D printed temporary crown after crown extension, and scored at 1 month, 3 months and 6 months after wearing the temporary crown. The clinical effect was evaluated from papilla index score(PIS), pink esthetic score(PES), white esthetic score(WES) and patient satisfaction. SPSS 28.0 software package was used for statistical analysis of the data.

Results: The PIS score of the 3D printing group at 6 months was significantly better than that of the traditional restoration group(P＜0.05). The PES scores of 3D printing group at 1, 3 and 6 months were significantly higher than those of traditional restoration group(P＜0.05). WES scores at 1 month and 6 months in the 3D printing group were significantly higher than those in the traditional restoration group(P＜0.05). The overall satisfaction score of patients in the 3D printing group was higher than that in the traditional restoration group.

Conclusions: The application of digital design, 3D printing double positioning crown extension guide and temporary crown to guide aesthetic crown lengthening and restoration of anterior teeth can improve the effect of aesthetic restoration and make patients have better aesthetic restoration experience.

Purpose: To compare the changes of sleep-breathing parameters and sleep quality before and after treatment of Class Ⅱ malocclusion in adolescents.

Methods: Forty-eight adolescent patients were selected for functional orthodontic treatment. Portable sleep breathing monitor and Pittsburgh sleep quality index(PSQI) were used before treatment, 1 month and 10 months after treatment, in order to compare the results of apnea and hypopnea index(AHI), obstructive apnea index(OAI), central apnea index(CAI), number of hypoventilation (HI), oxygen reduction index (ODI), minimum oxygen index(LSpO₂) and sleep quality index. SPSS 16.0 software package was used for data analysis.

Results: After 1 month of functional appliance use, AHI, HI and ODI were significantly decreased than those before treatment, while LSpO₂ was significantly increased (P＜0.01), but there was no significant difference in OAI and CAI (P＞0.05). AHI, OAI, CAI, HI, ODI and LSpO₂ 10 months after treatment were significantly different from those before and 1 month after treatment(P＜0.01). The sleep duration, quality, efficiency, and sleep disturbance and daytime dysfunction were not different from one month than before treatment (P＞0.05), and related sleep quality scores were different from ten months after treatment compared with pre-treatment and one month after treatment(P＜0.01). AHI, OAI, HI, ODI and LSpO₂ were positively correlated with sleep quality in patients(P＜0.01).

Conclusions: Functional treatment of Class Ⅱ adolescents can improve sleep breathing situation and sleep quality of patients.