上海口腔医学最新文献

Purpose: To investigate the effects of prefabricated fiber post and pure titanium post on aesthetic effect, periodontal index and oral function after anterior tooth defect repair.

Methods: A total of 108 patients with anterior tooth defect treated from March 2019 to March 2023 were selected and randomly divided into the control group (n=54, treated with pure titanium metal posts) and the experimental group (n=54, treated with prefabricated fiber posts) using a random number table. The restoration outcomes, oral function, periodontal health indices, inflammatory cytokine levels and aesthetic outcomes were compared between the two groups.

Results: At 1 year post-treatment, the restoration success rate in the experimental group was significantly higher than that in the control group (P＜0.05). At 6 months post-treatment; the plaque index (PLI), bleeding index (BI), probing depth (PD) in the experimental group were significantly lower than those in the control group (P＜0.05). The levels of interleukin-17 (IL-17), interleukin-23 (IL-23) and interleukin-6 (IL-6) levels in the experimental group were significantly lower than those in the control group(P＜0.05). At 1 year post-treatment, the scores for color matching, marginal staining and marginal adaptation in the experimental group were significantly lower than those in the control group(P＜0.05), the satisfaction rate in the experimental group was 96.3%(52/54), significantly higher than that in the control group (85.18%, 46/54) (P＜0.05).

Conclusions: The use of prefabricated fiber posts for the repair of anterior tooth defect can significantly improve the aesthetic effect, periodontal health and oral function, and achieves high patients' satisfaction.

Purpose: To investigate the impact and underlying mechanisms of digital cobalt-chromium alloy porcelain crowns and zirconia all-ceramic crowns restoration on periodontal health in patients with tooth defects.

Methods: A total of 26 patients with tooth defects who were treated in the Second People's Hospital of Kashi Region from March to June 2024 were selected and randomly divided into cobalt-chromium alloy ceramic crown group (n=13) and zirconia all-ceramic crown group (n=13). After 6 months of restoration, the periodontal health status of the two groups was evaluated, including gingival index, gingival bleeding index, plaque index, caries loss index and loss of clinical attachment. In addition, clinical plaque samples from patients were collected for 16S rRNA sequencing and data analysis to compare the characteristics of different flora in the two groups of samples. The samples of gingival crevicular fluid were collected and proteomic analysis was used to screen the differentially expressed proteins, and the biological process and functional pathway of their enrichment were discussed.

Results: After 6 months of restoration, the gingival index, plaque index, and caries loss and repair index in the zirconia all-ceramic crown group were significantly lower than those in the cobalt-chromium porcelain crown group (P＜0.05). Although there was no significant difference in the α-diversity indexes of the plaque samples between the two groups, significant differences were observed in the microbial composition: Scardovia, Granulicatella, and Eikenella were significantly enriched in the zirconia all-ceramic crown group, while Peptococcus and Treponema were enriched in the cobalt-chromium porcelain crown group. In addition, a total of 105 differentially expressed proteins were identified by proteomic analysis, and these differentially expressed proteins were significantly enriched in metabolic related biological processes and functional pathways such as fatty acid metabolism and amino acid metabolism.

Conclusions: Zirconia all-ceramic crowns are superior to cobalt-chromium alloy porcelain crowns in terms of periodontal health for patients with dental defects, with less detrimental impact on oral microbiome, suggesting that zirconia crowns have a high clinical application value. The discovery of differential bacteria and differential expressed proteins provides potential biomarkers for early prediction of periodontal diseases and the development of personalized treatment plans.

Purpose: To investigate the effects of unilateral anterior disk displacement without reduction and sleep bruxism on bone structure of the temporomandibular joint (TMJ).

Methods: From January 2015 to February 2022, a total of 17 cases of unilateral anterior disk displacement without reduction admitted to the First Affiliated Hospital of Xinjiang Medical University were selected as the joint disk displacement group, while 15 cases of sleep bruxism as the sleep bruxism group, and 19 healthy adults were selected as the control group. The CBCT data obtained were imported into Mimics Research 21.0 for morphological measurement of TMJ bone structure and analysis of bone mineral density (BMD).

Results: Compared with the control group, the internal and external diameter of condyle, the posterior slope of condyle and the top BMD in the unilateral anterior disk displacement without reduction group were lower than those in the control group, and the difference was significant(P＜0.05); the inclination of joint eminence was larger than that of control group, and the difference was statistically significant(P＜0.05). The depth of right articular fossa of sleep bruxism was shallower than that of the control group, and the BMD of anterior inclined surface of condyle was lower, the differences were statistically significant(P＜0.05). The BMD of the left anterior condylar slope in the sleep bruxism group was lower than that in the control group, and the difference was statistically significant(P＜0.05).

Conclusions: The condyle of TMJ in the unilateral anterior disk displacement without reduction group became smaller and the slope of the joint emminance increased during the reconstruction. The BMD of the posterior slope and the top of the condyle decreased significantly compared with the control group. However, the BMD of the anterior bevel of the condyle may be decreased due to the asymmetric stress distribution in the sleep bruxism group, and appropriate diagnosis and management of sleep bruxism are necessary.

Purpose: To summarize and analyze the clinicopathological features of chronic nonbacterial osteomyelitis (CNO) in adolescents, and to provide opinions for better diagnosis and treatment of the disease.

Methods: A retrospective study was conducted on adolescent patients diagnosed with CNO in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from September 2013 to December 2023. The demographic data, laboratory examination, imaging examination, pathological manifestations and treatment results of the patients were summarized. Clinical symptom evaluations, laboratory tests and imaging examinations were used to evaluate the effect of clinical treatment.

Results: Thirty-five patients were included, including 14 males and 21 females, with a male to female ratio of 1∶1.5. 45.7% patients had multiple lesions. Diagnoses prior to diagnosis of CNO included fibrous dysplasia, parotitis, infectious osteomyelitis and idiopathic arthritis. Abnormal increases in laboratory test indicators included white blood cells (20%), erythrocyte sedimentation rate (60%), C-reactive protein (40%), interleukin-6 (22.9%) and so on. CT findings showed osteolytic, sclerosing and hyperostosis. Bone scans showed multiple lesions in 5 patients. In drug therapy, the effective rate of NSAIDs and DMARDs exceeded 50%.

Conclusions: Interleukin-6 is elevated in some CNO patients, and its relationship with pathogenesis needs to be further studied. The recurrence rate of decortication is high, and drug therapy may be more effective than surgical treatment.

Purpose: To introduce a digital registration method to compare the design effect and the actual effect of the clear aligner aided expansion in treating mild crowding, and to evaluate its clinical effectiveness.

Methods: A total of 30 patients with mild crowding who were treated by clear aligner aided expansion in Jiading District Dental Disease Prevention and Treatment Institute from January 2019 to December 2023 were selected. The anhydrite models of patients during treatment were scanned by using a D-station 3D-RI optical scanner，and the STL format data of plaster group were obtained. The STL format data of the design group were also obtained from Clincheck. The STL format data of the two groups were imported into Geomagic Studio 2012 software. The change value of arch widths and expansion rate were measured for first premolars and first molars at buccal cusps. The digital registration method was used to measure positive and negative deviation of the arch width.

Results: The average expansion rate of maxillary first premolar, first molar, mandibular first premolar and first molar was 87.26%, 86.57%, 90.5% and 89.88% respectively. There was significant difference between the design group and the plaster group (P＜0.01). The average deviation values of maxillary buccal direction in the design group and plaster group were 0.40 mm and 0.59 mm, respectively, and those of the mandible were 0.41 mm and 0.53 mm, with significant differences between the two groups (P＜0.01). The average deviation values of the maxilla and mandible were -0.36 mm and -0.39 mm, -0.36 mm and -0.11 mm, respectively, and there was no significant difference between the two groups(P＞0.05). The buccal-lingual bias variable could be considered as a criterion for the efficacy of orthodontic treatment.

Conclusions: Digital registration method can be used to evaluate the effect of the clear aligner. Clear aligner aided expansion in treating mild crowding is effective. After expansion, buccal movement is difficult to control and exacerbates buccal tipping. The buccal-lingual bias variable can be considered as a criterion for the efficacy of orthodontic treatment.

Purpose: To investigate the effect of different low temperature plasma treatment time on bonding durability of zirconia.

Methods: Twenty-four pieces of Class Ⅰ(10 mm×10 mm×2 mm) and 80 pieces of Class Ⅱ (3 mm×3 mm×2 mm) zirconia ceramic blocks were produced. The samples were divided into 4 groups, and dealt with separately according to the following groups: blank control group (group A), sandblasting group (group B), plasma treatment group 60 s (group C) and plasma treatment group 120 s (group D). The finished Class Ⅱ zirconia samples were further divided into thermocycling group and non-thermocycling group. Scanning electron microscope (scanning electron microscope, SEM), X-ray photoelectron spectrometer (X-ray photoelectron spectroscopy, XPS), atomic force microscopy (atomic force microscope, AFM) and water contact angle tester were used to detect zirconia surface and calculate shear bond strength.

Results: The surface morphology of group C and D had no significant change, the roughness was not significantly different from that of group A (P＞0.05), and the surface hydrophilicity was significantly increased compared with group A (P＜0.05). The surface roughness of group B was significantly increased compared with group A (P＜0.05), and the hydrophilicity was significantly increased compared with group A (P＜0.05). For the non-thermocycling group, the shear bond strength of group B, C and D was significantly higher than that of group A (P＜0.05). For the thermocycling group, the shear bond strength of group B was the highest, followed by group D, and then group C, and group A was the lowest (P＜0.05).

Conclusions: Increasing the duration of nonthermal plasma treatment can improve the bond strength of zirconia.

Purpose: To investigate the effect of a combination of Kangfuxin liquid, Sipaiya gingival liquid, and chlorhexidine mouthwash on the levels of serum biomarkers and inflammatory factors in patients with erosive oral lichen planus (EOLP).

Methods: A total of 100 EOLP patients admitted to the Fourth Hospital of Changsha from January 2022 to June 2024 were selected and divided into control group and experimental group according to treatment methods, with 50 cases in each group. The control group used Sipaiya gingival liquid, while the experimental group used a combination of Kangfuxin liquid, Sipaiya gingival liquid, and chlorhexidine mouthwash. The changes of wound area, pain VAS score, healing time, serum biomarkers (AT-III, IgM, ZAG) and inflammatory factors (IL-12, IL-17) before and after treatment were compared between the two groups.

Results: The wound healing time of the experimental group was shorter than that of the control group, with significant difference (P＜0.05). After treatment, the experimental group showed significantly better wound area, VAS score, serum biomarkers (AT-III, IgM, ZAG), and levels of inflammatory factors (IL-12, IL-17) compared to the control group (P＜0.05). The total effective rate of the experimental group was 96%, which was significantly higher than that of the control group (84%) (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).

Conclusions: The combination of Kangfuxin liquid, Sipaiya gingival liquid and chlorhexidine mouthwash can effectively accelerate wound healing, reduce pain, suppress inflammatory responses, and improve treatment outcomes in EOLP patients, demonstrating high clinical application value.

Giant complex odontoma of the mandible is a relatively rare odontogenic tumor. This article reported the clinical diagnosis and treatment process of a 42-year-old male patient with a giant complex odontoma in the left mandible accompanied by infection, along with a discussion based on relevant literature. Complex odontomas typically were asymptomatic and grew slowly, but giant odontomas (diameter ＞3 cm) may cause tooth displacement, mandibular swelling, or even infection. The uniqueness of this case lies in the odontoma penetrating the oral mucosa, leading to localized infection, which increased the complexity of clinical management. Surgical excision was the primary treatment for giant odontomas, and cautions must be taken to avoid intraoperative damage to the inferior alveolar nerve and blood vessels, as well as postoperative mandibular fractures. The eruption mechanism of complex odontomas may be related to bone resorption or the pushing force of impacted teeth, though the exact mechanism requires further investigation. This case highlights that early diagnosis and precise surgical intervention for giant mandibular complex odontomas can effectively prevent infection and pathological fractures, thereby improving prognosis.

Purpose: To three-dimensionally evaluate the effects of sagittal-guidance Twin-block (SGTB) appliance on mandibular growth in adolescents with skeletal Class Ⅱmalocclusion.

Methods: Forty-three adolescents with skeletal Class Ⅱ malocclusion were divided into SGTB treatment group [n=22, treatment duration (13.26±1.71) months] and untreated control group [n=21, observation period (12.72±0.59) months]. CBCT scans were obtained pre- and post-intervention for 3D cephalometric analysis.

Results: The treatment group showed significantly greater vertical ramus growth (left (3.16±1.63) mm vs. (1.49±1.13) mm; right (3.18±1.23) mm vs. (1.15±0.76) mm, P＜0.001) with no intergroup difference in mandibular body length (P＞0.05). ANB angle decreased by 1.87°±1.06° in SGTB group, significantly greater than 0.41°±0.20° in controls (P＜0.001). In the treatment group, the maxillary incisors were lingually inclined by 6.12°, and the mandibular incisors were labially inclined by 2.48°, no significant changes were observed in the control group. Three-dimensional measurements showed that the mandible exhibits a combined growth pattern of forward and downward direction.

Conclusions: SGTB effectively enhances vertical ramus development and improves sagittal jaw relationship through combined skeletal adaptation and dentoalveolar compensation.

Purpose: To evaluate the curative effect of pulpotomy combined with prefabricated transparent crown for traumatic anterior primary tooth.

Methods: A total of 82 children with traumatic crown fractures and pulp exposure of anterior primary teeth treated at Xi'an Jiaotong University Stomatology Hospital from March 2022 to February 2023 were selected and randomly divided into experimental group and control group, with 41 cases in each group.Both groups were treated with pulpotomy,the experimental group was treated with prefabricated transparent crown and the control group was treated with composite resin.One month after treatment, gingival index (GI) and plaque index (PLI) were compared between the two groups. At 6, 12 and 18 months after treatment, the success rate of restoration was compared between the two groups.

Results: One month after treatment, GI and PLI of the experimental group were significantly lower than those of the control group(P＜0.05). There was no significant difference in the success rate of restoration between the two groups at 6 and 12 months after treatment (P＞0.05), and the success rate of restoration in the experimental group was significantly higher than that in the control group at 18 months after treatment(P＜0.05).

Conclusions: Pulpotomy combined with prefabricated transparent crown restoration not only significantly improves the success rate of restoration for traumatic anterior primary tooth,but also effectively enhances gingival health, reduces plaque accumulation and maintains long-term tooth stability,with good aesthetic effects and functionality.