上海口腔医学最新文献

Purpose: To evaluate the clinical efficacy of tunnel technique combined with connective tissue grafting in the treatment of gingival recession with non-carious cervical lesion(NCCL).

Methods: Fourteen patients with 26 gingival receding sites who were admitted to Hefei Stomatological Hospital from January 2021 to August 2022 due to gingival receding and sensitivity to cold and heat were selected as the research objects. All patients were treated with tunnel technology combined with connective tissue grafting. Clinical indexes such as gingival receding (GR), probing depth (PD), clinical attachment loss(CAL), keratinized gingival width (KTW) and tooth defect depth were measured before surgery, 3 months after surgery and 6 months after surgery, respectively, to evaluate the clinical efficacy.

Results: At 3 and 6 months after surgery, GR and CAL were significantly decreased(P＜0.05), and KTW was significantly increased(P＜0.05). Three months after operation, the complete root coverage rate was 77.00%, and the average root coverage rate was 94.23%. At 6 months after operation, the complete root coverage rate was 73.00%, and the average root coverage rate was 93.27%.

Conclusions: Tunnel technique combined with connective tissue grafting can be used for the treatment of MillerⅠ and Miller Ⅱ gingival receding with NCCL, and the clinical and aesthetic results are significant and stable.

Purpose: To evaluate the effects of bone-level implantation combined with orthodontics on periodontal health and implant stability in patients with dentition defect.

Methods: A total of 92 patients(92 teeth) with dentition defect admitted to the hospital from January 2020 to January 2023 were selected and divided into 2 groups by random number table method, with 46 cases in each group. All patients in the two groups were treated with bone-level implantation, and the experimental group was treated combined with orthodontics before implantation. The implant success rate 6 months post-surgery, along with the periodontal status before and 6 months after implantation [sulcus bleeding index (SBI), probing depth(PD), plaque index (PLI)], chewing function, bone resorption, implant stability quotient and incidence of complications (occlusal elevation, non-occlusal contact, food impaction and occlusal pain) were compared.

Results: The implantation success rate of the experimental group was significantly higher than that of the control group, SBI, PD and PLI after 6 months of implantation were significantly lower than those of the control group, and the surface myoelectric activity of temporal muscle, bilateral masseter muscle and implant stability coefficient at maximum occlusion were significantly higher than those of the control group(P＜0.05). There was no significant difference in bone absorption between the two groups(P＞0.05), and the complication rate of the experimental group was significantly lower than that of the control group(P＜0.05).

Conclusions: Bone-level implantation combined with orthodontics helps improve periodontal health and enhances implant stability in patients with dentition defect.

Purpose: To investigate the therapeutic effect of Xipayi Guyin fluid combined with metronidazole in treating periimplantitis and its impact on the levels of matrix metalloproteinase 8 (MMP-8) and nitric oxide (NO) in gingival crevicular fluid.

Methods: A total of 84 patients with periimplantitis treated in Lishui People's Hospital from January 2021 to January 2024 were selected and divided into experimental group and control group, with 42 patients in each group. The control group was treated with metronidazole alone, while the experimental group was treated with Xipayi Guyin fluid on the basis of metronidazole. The levels of interleukin 6(IL-6), MMP-8, transforming growth factor α(TGF-α), and NO were compared between the two groups before and after treatment, and the number of plaques and degree of bleeding in patients were analyzed based on the plaque index(PLI) and sulcus bleeding index (SBI), and the clinical total effective rate and incidence of adverse reactions after treatment were observed.

Results: The total clinical effective rate of the experimental group was 73.81%, which was significantly higher than that of the control group(52.38%)(P＜0.05). After treatment, the PLI, SBI, NO, IL-6, MMP-8 and TGF-α level of the two groups were obviously reduced compared to pre-treatment, and there was significant difference between the two groups(P＜0.05). The adverse reaction ratio of the experimental group and the control group were 2.38% and 7.14%, respectively, with no significant difference between the two groups (P＞0.05).

Conclusions: The combination of Xipayi Guyin fluid and metronidazole can help inhibit the proliferation of oral pathogenic microorganisms, reduce the levels of inflammatory factors such as MPP-8 and regulate NO level. It also helps to strengthen teeth and gums, with controlling effect on the onset of periimplantitis in patients.

Purpose: By analyzing the national continuing medical education programs in the field of dental medicine declared and implemented in Shanghai in 2023, as well as the situation of the participants, this study aimed to understand the current status of continuing medical education in dental medicine in Shanghai and provide suggestions for the transformation and development of continuing education of dental medicine.

Methods: The study collected and analyzed information on 54 national continuing medical education programs in dental medicine and 5 246 participants declared and implemented in Shanghai in 2023 using the online application and feedback system of the national CME project.

Results: Shanghai had been approved for a national-level continuing medical education program in dentistry, accounting for 11.07% of the total dental medicine programs in the country. The number of students from 12 western provinces accounted for 5.47% of the total, while the number of students at the grassroots level accounted for 2.88% of the total. Junior and lower-level title students tended to participate in purely theoretical projects, while senior students tended to participate in projects that included practical training and surgical demonstrations.

Conclusions: Shanghai's continuing education resources in dentistry are insufficient, and there is a large difference in the level of trainees. Trainees with different professional titles have different preferences for course content, and the contradiction between dental science and engineering is becoming more prominent. Therefore, by actively sinking educational resources, Shanghai's dental medicine can play a demonstrative and leading role. The course content should be classified and planned to meet the differentiated training needs of the trainees. Innovating the credit management method can stimulate trainees' active learning motivation and better promote the development of continuing education in dental medicine.

Purpose: To investigate the effect and underlying mechanism of long non-coding RNA H19 on the osteogenic differentiation of periodontal ligament stem cells(PDLSCs) under inflammatory conditions.

Methods: PDLSCs were subjected to osteogenic and adipogenic induction. Alizarin Red staining and Oil Red O staining were used to observe osteogenic and adipogenic differentiation, respectively. The expression levels of osteogenesis-related genes RUNX-2, ALP, and BSP, as well as LncRNA H19, were measured before and after osteogenic induction. Cells were also cultured in an inflammatory environment to assess the expression of RUNX-2, ALP, BSP, LncRNA H19 and NRF-2/HO-1. Furthermore, LncRNA H19 was upregulated via lentiviral transfection, and subsequent changes in the expression of osteogenic genes (RUNX-2, ALP, BSP) and NRF-2/HO-1 were analyzed.

Results: PDLSCs had stem cell properties and could be induced to undergo osteogenic and adipogenic differentiation. During osteogenic differentiation, the expression of osteogenic genes RUNX-2, ALP, BSP and LncRNA H19 increased. Under inflammatory conditions, the expression of RUNX-2, ALP, BSP and LncRNA H19 was downregulated, along with a decrease in NRF-2/HO-1 expression. Upregulation of LncRNA H19 resulted in increased expression of NRF-2/HO-1 as well as osteogenic genes RUNX-2, ALP and BSP.

Conclusions: The inflammatory microenvironment may suppress osteogenic differentiation of PDLSCs by reducing LncRNA H19 expression, which in turn inhibits the NRF-2/HO-1 signaling pathway.

Purpose: To explore whether RNA-activated protein kinase-like ER resident kinase(PERK) has a regulatory effect on the osteogenic differentiation of human periodontal ligament cells (PDLCs).

Methods: PDLCs were primarily cultured, and siRNA was used to silence the expression of PERK in PDLCs. PDLCs were cultured in osteoblast differentiation-induction medium. Subsequently, the osteogenic differentiation capacity was evaluated using alkaline phosphatase(ALP) staining and alizarin red staining.

Results: After osteogenic induction culture of PDLCs in vitro, ALP and alizarin red staining were enhanced, and the deposition of mineral salts increased. Meanwhile, the expression of phosphorylated PERK(p-PERK) in osteogenic PDLCs was higher than cells in the control group. Transfection of si-PERK significantly downregulated PERK protein expression in PDLCs (P＜0.05). ALP and alizarin red staining showed that the PERK^-/- group had markedly lower ALP staining intensity and calcium salt deposition than the osteogenic induction group, along with decreased activating transcription factor 4(ATF4) protein expression.

Conclusions: PERK regulates the osteogenic differentiation of PDLCs.

Purpose: To explore the effects of minimally invasive jaw surgery combined with orthodontic treatment on the root length of maxillary anterior teeth and alveolar bone thickness after correcting maxillary protrusion, and to provide a reference for the selection of clinical treatment plans.

Methods: A total of 40 female patients with maxillary protrusion who visited Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to February 2024 were selected and divided into two groups according to the treatment plan: the experimental group(n=20) received minimally invasive jaw surgery combined with orthodontic treatment, and the control group(n=20) received orthodontic treatment with simple tooth extraction. The orthodontic treatment course and changes in the root length of maxillary anterior teeth and alveolar bone thickness before and after treatment were compared between the two groups.

Results: The space closure time in the experimental group was (7.2±1.15) months, and the total orthodontic treatment time was (19.6±3.35) months, both significantly shorter than those in the control group [(12.93±1.27) months and (27.0±3.22) months, respectively] (P＜0.001); there was no significant difference in the alignment and leveling time between the two groups(P=0.63). Root resorption of maxillary anterior teeth occurred in both groups after treatment, but there was no significant difference between the two groups(P＞0.05). The thickness of the labial alveolar bone at the root neck and mid-root regions increased in the experimental group after treatment, while it decreased in the control group, and the difference between the two groups was significant (P＜0.01).

Conclusions: Minimally invasive jaw surgery combined with orthodontic treatment for maxillary protrusion can significantly shorten the orthodontic treatment course and increase the thickness of the labial alveolar bone of maxillary anterior teeth to reduce the risk of bone dehiscence and fenestration. However, it cannot reduce orthodontically related root resorption.

Purpose: To investigate the risk factors for lymphoma in patients with primary Sjögren's syndrome (pSS), construct a risk prediction model, and evaluate its predictive efficacy.

Methods: A total of 202 patients diagnosed with pSS at the Department of Stomatology, Affiliated Hospital of Xuzhou Medical University from February 2019 to August 2024 were collected and divided into two groups: lymphoma occurrence group(n=23) and non-occurrence group(n=179). Univariate analysis and multivariate logistic regression were performed to screen risk factors with SPSS 26.0 software package, and a risk prediction nomogram model was established. The model was evaluated by the receiver operator characteristic curve(ROC) and calibration curve(CC). Then, the decision curve analysis(DCA) was plotted.

Results: Univariate analysis showed that lymphadenopathy, swollen glands, neutropenia, thrombocytopenia, lymphocytopenia, high IgG levels, interstitial pneumonia, and renal damages had significant differences between two groups (P＜0.05). Multivariate logistic regression analysis showed that lymphadenopathy, neutropenia, lymphocytopenia, and high IgG levels were independent risk factors. The area under the curve(AUC) was 0.931. The calibration curve indicated that the model had good predictive performance. The decision curve showed that the prediction model had a high net benefit within the threshold probability range of 5%-95%.

Conclusions: Lymphadenopathy, neutropenia, lymphocytopenia, and high IgG levels can be used as predictive factors for lymphoma occurrence in pSS. This risk prediction model is helpful for assessing the risk of lymphoma occurrence in pSS, thereby actively intervening to reduce the occurrence of lymphoma.

Purpose: To analyze the risk factors for the failure of CAD/CAM system-designed all-ceramic onlays in repairing dental defects using the nomogram model.

Methods: Clinical data from 236 patients with dental defects in Yulin First Hospital from January 2019 to January 2021 was conducted. All patients received all-ceramic onlay restorations designed by CAD/CAM system and were followed up for 3 years. According to the follow-up results, they were divided into successful group(n=169) and failed group(n=67). Basic details were collected for each group, including gender, age, smoking history, tooth type, type of tooth defect, dental arch defect status, root canal treatment status, type of ceramic block, measurements of pre-treatment occlusal force, alveolar bone density and periodontal indices [plaque index (PLI), sulcus bleeding index(SBI) and probing depth(PD)]. Logistic regression analysis was used to identify the risk factors for failure after all-ceramic onlay restoration, the prediction model of nomogram was constructed and the fitting effect of the model was evaluated.

Results: Logistic regression analysis indicated that older age, comorbid diabetes, smoking history, molar teeth, use of CEREC Blocs ceramic, multi-surface cavity defects, incomplete dental arch post-restoration, high pre-treatment occlusal force, low alveolar bone density, high values of PLI, SBI and PD were related to an increased likelihood of treatment failure(P＜0.05). The calibration curve for this predictive model approximates the ideal curve.

Conclusions: Age, history of diabetes, smoking history, condition of the defective tooth and periodontal health status are significant factors influencing the failure of CAD/CAM system-designed all-ceramic onlay restorations for dental defects.