上海口腔医学最新文献

Purpose: To investigate the oral health and hygiene behavior of chronic renal failure(CRF) patients in Shenzhen, so as to provide basis for formulating education for them.

Methods: The history of renal failure, oral health status and oral health care behavior of 336 patients with chronic renal failure(CRF) in the hemodialysis center of Shenzhen Second People's Hospital were investigated by questionnaire and oral examinations.

Results: At an average, dialysis was required for 3.2 years. The main cause of renal failure was glomerulonephritis in 49.11% of patients, hypertensive kidney lesion in 19.35% and diabetic nephropathy in 15.77% of patients; 77.8% of them kept brushing teeth two or more than two times every day; 72.9% patients suffered from oral problems such as toothache in recent 12 months. The rate of visiting a dentist when having complaints was 21.7%.

Conclusions: The state of oral health of CRF is worse than the general population of comparable age in China, while their hygiene behavior is better than the corresponding reference general population. However, their consciousness of dental treatment is poor. Therefore, health education for CRF patients should include knowledge about oral diseases complicated with CRF and correct medical philosophy.

Purpose: To observe the effect of eicosapentaenoc acid (EPA) on the expression of inflammatory factors in human periodontal ligament fibroblasts (hPDLCs) induced by using lipopolysaccharides (LPS) of Porphyromonas gingivalis (P. gingivalis).

Methods: hPDLCs were cultured by using tissue block method, and the effects of different concentrations of EPA on the activity of hPDLCs cells were observed by MTT method. According to MTT results, the appropriate concentration of EPA was selected, and the expression of interleukin-6(IL-6), IL-8 and IL-1β in hPDLCs induced by P.gingivalis LPS was detected by real time PCR and ELISA. The data were evaluated by SPSS 10.0 software package.

Results: 25-100 μmol/L EPA had no effect on the activity of hPDLCs cells, but could inhibit the expression of IL-6, IL-8 and IL-1β induced by P. gingivalis LPS in a dose-dependent manner.

Conclusions: EPA can inhibit the expression of inflammatory factors induced by P. gingivalis LPS without affecting cell activity, indicating that EPA has the possibility of anti-inflammatory treatment of periodontitis.

Purpose: To analyze the morphological changes of the upper airway and related influencing factors in patients with skeletal Class Ⅲ malocclusion after bimaxillary surgery.

Methods: Twenty skeletal Class Ⅲ patients who underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy(BSSRO) for maxillary advancement and mandibular setback were selected. The patients received CT scans before(T0) and 3-6 months after surgery, and the images were reconstructed three-dimensionally with Dolphin Imaging 11.9 software. Changes in the volume, cross-sectional area, and landmarks of each soft and hard tissue of the airway were measured. Statistical analysis of the data was performed using SPSS 25.0 software package.

Results: The volume of nasopharyngeal airway increased after operation (P＜0.05), and the volume of oropharyngeal airway decreased significantly(P＜0.01). The cross-sectional area of the airway at the plane of the second cervical vertebra was significantly decreased (P＜0.01), and the coronal and sagittal diameters were decreased(P＜0.05). The change of nasopharyngeal airway volume was moderately positively correlated with the sagittal change of the posterior nasal spine (r=0.460, P＜0.05), and the change of oropharynx and laryngopharyngeal airway volume was positively correlated with the vertical change of the midpoint of the soft palate(r=0.496, 0.696, P＜0.05). The airway cross-sectional area in the second and third cervical vertebra planes and the sagittal diameter of the airway in the third cervical vertebra plane were positively correlated with the vertical changes of the midpoint of the soft palate(r=0.474, 0.629, 0.547, P＜0.05). The change of airway cross-sectional area at the third cervical vertebra plane was moderately negatively correlated with the change of mandibular plane angle(r=-0.536, P＜0.05).

Conclusions: The volume and cross-sectional area of oropharyngeal airway in skeletal Class Ⅲ patients after bimaxillary surgery will decrease. However, the total upper airway volume doesn't change significantly. The changes in the upper airway are correlated with the changes in some soft and hard tissue landmarks.

This article reviewed two-stage orthodontic treatment of a patient with skeletal ClassⅡmalocclusion with mandibular retrusion and maxillary dental arch stenosis. The patient was also accompanied by premature loss of bilateral mandibular deciduous canines and mesialization of mandibular posterior teeth. The first-stage treatment mainly corrected the maxillary dental arch stenosis, maxillary anterior teeth protrusion, mandibular retrusion and skeletal ClassⅡmalocclusion, while the second-stage treatment mainly corrected the mesialization of mandibular posterior teeth and alignment of maxillary and mandibular dentition. The two-stage orthodontic treatment finally enabled the patient to achieve good dental arch shape, tooth alignment, skeletal face pattern and soft tissue profile.

Purpose: To investigate the efficacy and prognostic factors of oral robot-assisted retropharyngeal lymph node (RPLN) dissection in the treatment of head and neck malignancies.

Methods: Sixty-eight patients with head and neck malignant tumors who were treated in our hospital from January 2017 to December 2019 and followed up until December 2022 were treated by oral robot-assisted RPLN dissection. The clinical remission rate, clinical control rate, operation time, intraoperative blood loss, length of hospital stay, and the survival rate and survival time at 1, 2 and 3 years of follow-up were compared. SPSS 22.0 software package was used for statistical analysis of the data.

Results: All 68 patients with head and neck tumors were successfully treated by oral robot-assisted RPLN resection, and no complications such as postpharyngeal incision massive bleeding, Horner syndrome, aspiration pneumonia were found in all patients. The follow-up was 3 years, the survival time was(31.15±4.93) months, the survival rate was 91.18%(62/68) at the first year, 85.29%(58/68) at the second year and 70.59% (48/68) at the third year. There was no significant difference in 3-year survival rate among different genders, ages, disease types, primary lesions, exocapsular lymph node invasion and peripheral nerve invasion (P＞0.05). There were significant differences in the 3-year survival rate of different T stages, N stages, TNM stages, maximum diameter of invaded lymph nodes and vascular cancer thrombus(P＜0.05). Cox proportional risk regression model analysis showed that stage T3 to 4, stage N2b to 3, stage Ⅳb TNM, maximum diameter of invaded lymph node ＞6 cm and vascular cancer thrombi were independent risk factors affecting the 3-year survival rate of head and neck cancer patients after surgery(P＜0.05).

Conclusions: Oral robotic assisted RPLN dissection has certain efficacy in the treatment of head and neck malignant tumors, but the survival rate of patients is affected by T stage, N stage, TNM stage, maximum diameter of invaded lymph nodes, vascular cancer thrombolus and other factors, which should be paid more attention in clinic.

Purpose: To explore the value of metronidazole combined with minocycline in reducing infection after dental implant in patients with localized periodontitis.

Methods: A total of 120 patients with localized periodontitis who underwent dental implantation in the Department of Stomatological, Shanghai Pudong New Area People's Hospital from August 2021 to September 2022 were selected. According to the way of postoperative infection prevention, the patients were divided into control group and experimental group, with 60 patients in each group. The control group was orally given roxithromycin capsules, and the experimental group was locally coated with minocycline hydrochloride ointment and metronidazole gel. The incidence of postoperative infection and complications was compared between the two groups. The modified gingival creval bleeding index (mSBI), periodontal probing depth (PD) and modified plaque index (mPLI) of the patients were examined by periodontal probe. Serum C-reactive protein (CRP) level was determined by immunoturbidimetry and tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) level was determined by ELISA. SPSS 25.0 software package was used for statistical analysis of the data.

Results: Good healing rate of the experimental group was 91.67% higher than that of the control group 73.33%, postoperative infection rate was 8.33% and complication rate was 6.67% in the experimental group, significantly lower than that of the control group (26.67% and 20.00%), respectively (P＜0.05). After treatment, the level of CRP, TNF-α and IL-6 in the experimental group were significantly lower than those in the control group (P＜0.05). At 3 and 6 months after treatment, mSBI, mPLI and PD in the experimental group were significantly lower than those in the control group(P＜0.05).

Conclusions: The administration of minocycline hydrochloride and metronidazole in patients with localized periodontitis undergoing implantation can reduce oral inflammatory response, reduce postoperative infection and other complications, and improve periodontal health.

Purpose: To study the effect of slow maxillary expansion(SME) appliance on the development of premolar tooth germ, primary molar and alveolar crest in the central segment of maxilla in the mixed dentition.

Methods: According to the inclusion and exclusion criteria, 17 children (average age 7.41±0.80 years old ) with maxillary transverse deficiency were selected for SME. Before and after treatment, based on cone-beam CT(CBCT) and Dolphin Imaging software, the position of maxillary premolar tooth germ, the position of maxillary primary molar, the shape of maxillary alveolar crest in the central segment were analyzed. SPSS 21.0 software package was used for data analysis.

Results: There was no significant change in the buccal-lingual movement and inclination of the tooth germs of the maxillary first and second premolars relative to the maxillary alveolar bone cortex after expansion(P＞0.05).After expansion, the maxillary alveolar crest in the central segment had an obvious expansion effect(P＜0.05). There was an arch expansion effect in the alveolar crest bottom of the maxillary second primary molar(P＜0.05), but there was no significant difference in the alveolar crest bottom of the maxillary first primary molar before and after treatment. Buccal cusp width of maxillary first and second primary molars increased after arch expansion (P＜0.05) without inclination of alveolar crest(P＞0.05).

Conclusions: SME in the mixed dentition did not affect the position of premolar tooth germ in alveolar bone. SME can expand and buccally tilt central alveolar crest and dental arch, and buccal inclination is greater than that of skeletal expansion and buccal inclination. The closer tooth site is to the first molar, the greater the skeletal effect of arch expansion is at this site. SME is an effective treatment for early maxillary expansion in the clinic.

Purpose: To observe the regulatory effect of lithium-doped hydroxyapatite nanowires on bone metabolism in osteoporotic zebrafish induced by dexamethasone.

Methods: Pure hydroxyapatite nanowires(nHA) and hydroxyapatite nanowires doped with 10% lithium ions (Li-nHA) were prepared by using hydrothermal method, and then material characterization was performed. The juvenile zebrafish cultured for 3 days(3dpf) were selected and co-cultured with nHA and Li-nHA extracts up to 7dpf. A negative(0.1% DMSO) control group was set up and transgenic zebrafish Tg(ola.sp7:nlsGFP) was used to select the best concentration for promoting bone formation. The osteoporotic zebrafish were induced by dexamethasone and incubated with nHA and Li-nHA extracts. The wild-type zebrafish was stained with alizarin red and the osteogenic differentiation was observed in transgenic zebrafish. Real-time quantitative PCR was adopted to detect osteogenic maker genes, such as zinc finger transcription factor (SP7), alkaline phosphatase (ALP), osteoprotegerin (OPG), Runt related transcription factor 2(Runx2) and osteocalcin (OCN). Statistical analysis was performed with GraphPad Prism 9.3 software.

Results: nHA and Li-nHA promoted bone formation and up-regulated expression levels of ALP, OCN, Runx2, SP7 and OPG of osteoporotic zebrafish. Compared with nHA, Li-nHA significantly increased the mineralization specific staining area and cumulative optical density of zebrafish bone, and the expression of osteogenic maker genes was also significantly increased.

Conclusions: Doping lithium ions in nano hydroxyapatite can enhance its osteoinductive properties, and Li-nHA can effectively improve bone formation of osteoporotic zebrafish.

Purpose: To study the effect and possible mechanism of let-7a on proliferation, differentiation and apoptosis of human dental pulp stem cell (hDPSCs).

Methods: The cells were divided into four groups: overexpression control (let-7a control/let-7a agomir control), overexpression let-7a (let-7a mimics/let-7a agomir), knockdown let-7a control (let-7a inhibitor control) and knockdown let-7a (let-7a inhibitor). Cell counting kit-8 assay(CCK-8) was used to detect the proliferation of cells at 24 hours, 48 hours and 72 hours after transfection. Calcified nodules were detected by Alizarin red staining. The protein expression of alkaline phosphatase (ALP), osteopontin (OPN), 4E-binding protein 1 (4EBP1), p-4EBP1, mammalian target of rapamycin (mTOR) and p-mTOR were detected by Western blot. Annexin V-APC/7-AAD cell apoptosis detection kit was used to detect the level of apoptosis after transfection. Statistical analysis was performed using GraphPad Prism 5.0 software.

Results: Let-7a inhibited proliferation of hDPSCs and promoted odontoblast differentiation and apoptosis. Let-7a down-regulated the expression of 4EBP1, p-4EBP1, mTOR and p-mTOR.

Conclusions: Let-7a may inhibit proliferation of hDPSCs and promote their differentiation and apoptosis by inhibiting mTOR-4EBP1 molecular pathway.

Purpose: To analyze the difference of metabolites of tongue coating between patients with intra-oral halitosis and healthy individuals by untargeted metabolomics, and to explore significant differences in metabolites of intra-oral halitosis as biomarkers.

Methods: The untargeted metabolomics of tongue coating samples from 12 patients with intra-oral halitosis and 12 healthy individuals were studied by liquid chromatography and mass spectrometry combined with principal component analysis and orthogonal partial least squares discriminant analysis. The value of variable importance in projection ＞1 and P＜0.05 of Student's t test in the orthogonal partial least squares-discriminant analysis model were used as the criteria to screen and determine the differential metabolites.

Results: There were differences in the metabolites of tongue coating between patients with intra-oral halitosis and healthy individuals, and 11 different metabolites were identified. They were valyl-arginine, glycine-phenylalanine, tryptophyl-proline, deoxyadenosine, 4,5-dihydroniveusin A, N-acetyl-DL-tryptophan, paramethasone acetate, cyclopentanol, [(2-hexylcyclopentylidene) amino]thiourea, L-pipecolic acid and taurine. In the intra-oral halitosis group, the expressions of Glycine-phenylalanine and N-acetyl-DL-tryptophan were significantly up-regulated, while the expressions of taurine were significantly down-regulated.

Conclusions: There are differences in the metabolites of tongue coating between patients with intra-oral halitosis and healthy individuals. The differential metabolites with diagnostic value may be used as diagnostic markers of intra-oral halitosis.