上海口腔医学最新文献

Purpose: To evaluate the clinical effect of autologous fat grafting for treating cervical skin fibrosis in patients with oral cancer after neck dissection with or without radiotherapy.

Methods: A total of 20 patients who underwent oral cancer resection and neck dissection in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from October 2022 to July 2023 were enrolled, 7 patients were treated with radiotherapy after neck dissection and 13 patients were treated with neck dissection. According to the degree of face-neck depression, the range of fibrosis and the function of neck and shoulder, corresponding volume of autologous fat was used to fill the depression. Three months after treatment, the improvement of cervical skin fibrosis was evaluated in terms of scar improvement, shoulder and neck function, and quality of life. SPSS 26.0 software package was used for statistical analysis of the data.

Results: The interval between the treatment of oral cancer and fat filling was 11-72 months, and the dose of fat grafting was 15-45 mL. There were no complications such as local induration, infection and necrosis in all patients. Three months after treatment, the results of Constant-Murley Score(CMS), neck fibrosis symptom(VAS), patient observer scar assessment scale(PSAS, OSAS) and FACE-Q quality of life score were better than those before treatment, and the differences were statistically significant(P＜0.05).

Conclusions: Autologous fat grafting can significantly improve the fibrosis of the neck skin after neck dissection with or without radiotherapy, and improve shoulder and neck dysfunction caused by surgery and radiotherapy. This method is worthy of clinical used because of the low rate of complication.

Purpose: To screen the stress-sensitive genes in myoblasts and reveal the potential target genes and their regulatory mechanisms of facial muscle remodeling induced by functional orthopaedic force.

Methods: The procedure involved the use of gene microarray technology to identify the differentially expressed genes(DEGs) in myoblasts. DEGs were then categorized by Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses. Furthermore, real-time quantitative PCR(qRT-PCR) was used to verify the DEGs. Western blot, transmission electron microscopy(TEM), and confocal laser scanning microscope(CLSM) were employed to detect the effect of stress on autophagy in myoblasts. The data were analyzed by SPSS 17.0 software package.

Results: A total of 1 410 DEGs were identified in stretched myoblasts, with 788 up-regulated and 622 down-regulated genes. GO enrichment analysis indicated that DEGs were primarily involved in signal transduction, biopolymer metabolic process, and protein metabolic process. KEGG analysis revealed that DEGs were primarily associated with ECM-receptor interaction, pathway in cancer, MAPK signaling pathway, focal adhesion and lysosome. Both TEM and CLSM showed that stress could promote the formation of autophagosomes, and Western blot demonstrated that stress could promote the expression of autophagy-related molecules Beclin-1 and LC3-II. Rapamycin could enhance all the above processes, while 3-MA could inhibit them.

Conclusions: Autophagy may play an important role in the regulation of myoblast fate induced by cyclic tensile stress.

Purpose: To study the CBCT imaging features of occlusal plane inclination, molar inclination, and molar height in adolescent patients with Class Ⅱ subdivision malocclusion, in order to provide reference for clinical diagnosis and treatment.

Methods: A total of 80 adolescent patients with malocclusion admitted to Suzhou Stomatological Hospital from January 2019 to December 2022 were selected, including 40 cases of Class Ⅱ subdivision malocclusion as the experimental group and 40 cases of Class Ⅰ malocclusion as the control group. The angles of the anterior, posterior and maxillary occlusal planes, as well as the inclination of the upper and lower molars in the mesial and distal direction, the inclination of the buccal and lingual direction, and the height of the molars were analyzed based on CBCT data. SPSS 23.0 software package was used for data analysis.

Results: There were significant differences in the angles of the neutral and distal anterior, posterior and maxillary occlusal planes, as well as the height of the upper and lower molars between the experimental group of patients with Class Ⅱ subdivision malocclusion(P＜0.05); There was no significant difference in the inclination of the upper and lower molars in the mesial and distal direction, as well as in the inclination of the buccal and lingual directions(P＞0.05). There was no significant difference in the comparison of left and right measurements in the control group(P＞0.05). The angles of the anterior, posterior and maxillary occlusal planes in the experimental group were significantly negatively correlated with the inclination of the maxillary molars in the mesiodistal and buccal lingual direction(P＜0.01), and negatively correlated with the height of the molars(P＜0.05).

Conclusions: Patients with Class Ⅱ subdivision malocclusion may have differences in the angles of the posterior, anterior, and maxillary occlusal planes, as well as the height of the upper and lower molars, compared to Class Ⅰ malocclusion patients. In clinical orthodontic treatment, it is necessary to be vigilant for such patients, trying to choose appropriate treatment opportunities, and reasonable treatment plans to prevent malocclusion from developing towards a more severe direction.

Purpose: To analyze the research progress and technological development of oral surgery robots, reveal the future development trend of oral surgery robots and put forward policy suggestions.

Methods: Focusing on the topic of oral surgery robots, literature review and patent data retrieval methods were used to analyze data from 2011 to 2023 from the perspectives of quantity, source, and technical field.

Results: The number of academic papers and patent applications in the field of oral surgery robots had explosive growth since 2015. The literature mainly focused on topics such as oral implantation and digitalization, with Chinese scholars publishing the most papers. The patents focused on tools such as models and instruments dedicated to oral surgery, as well as technical fields such as implant visual navigation and positioning systems.

Conclusions: Oral surgery robots should be developed towards miniaturization and specialization in the future, and domestic breakthroughs in core technologies such as special instruments need to be accelerated.

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 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 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 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 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 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.