上海口腔医学最新文献

Purpose: To investigate the functional and structural characteristics of temporomandibular joint(TMJ) in introverted deep overbite patients with severe wear, to analyze the correlation between the vertical distance of the lower 1/3 of the face and TMJ space, and to compare the clinical efficacy of multidisciplinary treatment with orthodontics and prosthodontics on TMJ function.

Methods: Eighty patients with deep overbite and severe abrasion and forty subjects with normal occlusion admitted to our hospital from January 2019 to June 2023 were enrolled in this study. The clinical data were collected and the functional and structural characteristics of TMJ were collected. Eighty patients with deep overbite and severe abrasion were randomly divided into control group and experimental group, with 40 cases in each group. The control group was treated with restoration, and the experimental group was treated with orthodontic combined with restoration. The efficacy and CBCT imaging indexes were evaluated during the treatment. SPSS 26.0 software package was used for statistical analysis.

Results: The mean Helkimo index of patients with deep overbite and severe abrasion was significantly higher than that of patients with normal occlusion(P＜0.05). CBCT scan showed that anterior space of TMJ in patients with deep overbite and severe abrasion significantly increased than those with normal occlusion(P＜0.05), while superior and posterior space were significantly decreased than those with normal occlusion(P＜0.05). Lateral cephalometric analysis showed that the vertical distance of submaxillofacial 1/3 in patients with deep overbite and severe abrasion significantly decreased than normal occlusion(P＜0.05). The Helkimo index of the two groups after treatment was significantly reduced (P＜0.05), and the Helkimo index of the experimental group was significantly lower than that of the control group (P＜0.05). The anterior TMJ spaces of the two groups significantly decreased after treatment, and the superior and posterior TMJ spaces were significantly increased(P＜0.05), but there was no significant difference in TMJ space between the experimental group and the control group(P＞0.05). The vertical distance of submaxillofacial 1/3 in patients in both groups significantly increased after treatment(P＜0.05). There were correlations between the vertical distance of lower one-third of face and the anterior, superior and posterior TMJ spaces(P＜0.05).

Conclusions: The clinical effect of dual disciplinary treatment of orthodontics and prosthodontics on TMJ function was significantly better than that of prosthodontics alone, and the effect on TMJ structure correction is similar to that of prosthodontics.

Purpose: To investigate the expression of ubiquitin specific protease 20 (USP20) in oral squamous cell carcinoma (OSCC) and its correlation with clinicopathological parameters.

Methods: OSCC samples and paired paracancerous samples were screened from the TCGA database for differential expression analysis and paired differential analysis. Immunohistochemical staining was used to detect the expression level of USP20 in OSCC tissue, paracancerous tissues and normal tissues. The correlation between USP20 expression level and clinicopathological parameters of tissue microarray was analyzed. GraphPad Prism 9.5.0 software was used for statistical analysis of the data.

Results: TCGA data showed that the expression of USP20 in OSCC was significantly higher than that in paracancerous tissue(P＜0.001). Immunohistochemical staining score showed that the expression of USP20 in OSCC was significantly higher than that in paracancerous tissues and normal tissues(P＜0.01). The analysis of clinicopathological indicators of tissue microarray showed that the staining scores of USP20 were significantly different in tumor differentiation (P＜0.05) and primary tumor size (P＜0.01). Kaplan-Meier survival analysis indicated no significant difference in overall survival time and 5-year survival rate between high expression group and low expression group (P＞0.05).

Conclusions: USP20 is highly expressed in OSCC compared with paracancerous tissues and normal oral tissues. The expression of USP20 is associated with differentiation and the size of primary tumor in OSCC，and can accelerate its growth.

Purpose: To evaluate the clinical effect of self-made oral science video on guiding parents to promote oral health of pre-school children, and to explore a more effective new technology in oral hygiene education.

Methods: One hundred and four 3-6 years old children with early childhood caries from Shanghai Xuhui District Dental Center were randomly recruited and divided into intervention group(n=52) and control group (n=52) during July to September 2022. At recruitment and 1 month after recruitment, the control group received routine oral health education, while the intervention group parents watched self-made oral health video and received routine oral health education. Plaque index (PLI), decayed missing filled tooth surface (dmfs) as well as oral health knowledge, attitude, practice(KAP) score of parents were compared between the two groups 1 and 6 months after recruitment.SPSS 26.0 software package was used for statistical analysis of the data.

Results: At 1 and 6 months after recruitment, the KAP score of intervention group （86.445±7.156, 85.694±5.880）was significantly higher than that of the control group [82.571(77.286, 88.142)，81.853±7.482]（P＜0.05）. The PLI of intervention group [2.014±0.403, 1.895(1.250, 2.100)] was significantly lower than that of the control group（P＜0.05）. There was no significant difference of dmfs between the intervention group and control group(P＞0.05).

Conclusions: As a new oral hygiene education technology, self-made oral science video is effective on improving oral health condition of pre-school children and the KAP condition of their parents.

Purpose: To investigate the changes of root development before and after orthodontic traction of maxillary inverted impacted central incisors using CBCT and Mimics software.

Methods: Ten patients, who had a maxillary inverted impacted central incisor, were treated using a modified movable retractor combined with surgical eruption. Cone-beam computed tomography(CBCT) was taken before and after treatment. Mimics 21.0 software was used to reconstruct the impacted central incisors (the impacted teeth group) and the contralateral namesake teeth (the contralateral group) before and after treatment, and the tooth volume and surface area were calculated by the software. SPSS 26.0 software package was used for paired t test, to evaluate the root development before and after treatment.

Results: All 10 patients were successfully treated,and the mean duration was (16.10±4.46) months. After treatment, the volume and surface area of teeth in the impacted teeth group were significantly increased compared with those before treatment(P＜0.01). The volume and surface area of the teeth before and after traction were significantly lower than those of the contralateral group(P＜0.01). However, during the treatment, there were no significant differences in the increase of tooth volume and surface area between the two groups(P＞0.05).

Conclusions: Modified movable retractor combined with surgical eruption can promote root development of maxillary inverted impacted tooth, which is a safe and reliable treatment method.

Purpose: To analyze the safety of closed traction appliance in the treatment of impacted anterior teeth and its effect on pulp blood flow and masticatory function.

Methods: A total of 80 patients with impacted anterior teeth who received treatment from January 2017 to December 2022 were selected, and randomly divided into experimental group and control group with 40 cases in each group. The two groups of patients were treated with occlusion adjustment and orthodontic traction. Closed traction was used in the experimental group, while open traction was used in the control group. The clinical efficacy, treatment duration, chewing ability, root length, periroot bone density, dental aesthetic score, pulp blood flow at different time points and the occurrence of adverse events were compared between the two groups. Statistical analysis was performed with SPSS 22.0 software package.

Results: The total effective rate was 95.00% in the experimental group and 90.00% in the control group, with no significant difference(P＞0.05). There was significant difference in traction eruption time and orthodontic time between the two groups(P＜0.05). There were significant differences in masticatory efficiency, bite force and masticatory pain score between the two groups before and after treatment(P＜0.05). There was no significant difference in root length and periroot bone density between the two groups before and after treatment(P＞0.05). There was no significant difference in white aesthetic score between the two groups before and after treatment(P＞ 0.05), but there was significant difference in red aesthetic score between the two groups before and after treatment(P＜0.05). There was no significant difference in pulp blood flow between the two groups at each time point(P＞0.05). At T1, the pulp blood flow reached its peak higher than T0; at T2, it rapidly decreased below T1 but higher than T0; at T3, it gradually decreased below T1 and T2 but higher than T0(P＜0.05). The incidence of adverse events in the experimental group was 10.00% compared with 27.50% in the control group, and the difference was statistically significant(P＜0.05).

Conclusions: Both closed traction and open traction correction can effectively treat the impacted anterior teeth, and the two methods have no significant effects on root length, surrounding bone density and pulp blood flow. Although the treatment time of closed traction is slightly longer, it is more beneficial to improve patients' masticatory ability, and has high aesthetics and safety, which is worthy of clinical promotion.

Purpose: To explore a more effective comprehensive prevention and treatment model for children's oral health by constructing a health network platform that integrates medical information evaluation, interaction, monitoring, and prevention with oral health management as the core.

Methods: The database of Shaoxing Children's Oral Health Management Network Platform was established. The oral health survey and information entry of 7 042 second-grade children in primary school in Yuecheng District from 2021 to 2022 were conducted. An open randomized controlled clinical trial was designed, with 3 472 of 7 042 children randomly assigned to the platform management group and 3 570 to the control group. One year later, oral examinations were conducted again on two groups of children, and the correlation between oral examination indicators between the two groups was statistically analyzed using SPSS 25.0 software package.

Results: There was significant difference between the two groups in the mean number of newly added deciduous caries decayed- missing-filled teeth(dmft), deciduous caries decayed teeth (dt), deciduous caries missing teeth(mt), and deciduous caries filled teeth(ft) after one year(P＜0.05). The newly added rates of caries, gingival bleeding, calculus detection, and malocclusion between the two groups were lower in the platform group than in the control group, with a significant difference(P＜0.05).

Conclusions: To the prevention and treatment of oral diseases, intelligence has become more and more indispensable and important. Building a network platform for oral health is an effective way to promote oral health level.

Purpose: To evaluate the efficacy of micro-computed tomography(Micro-CT) in removing calcium hydroxide from posterior curved root canals.

Methods: Twenty molar teeth (48 root canals) extracted at the Department of General Dentistry, Shanghai Ninth People's Hospital between December 2023 and February 2024 were collected. After preparing by Ni-TI instruments M3 according to standard root canal treatment procedures, calcium hydroxide was injected into the root canals. One week later, the samples were randomly divided into 6 groups(n=8) based on different irrigation methods: sodium hypochlorite group, 17% EDTA group and 70% ethanol group. Each group was further divided into 2 subgroups with or without sonic vibration. Micro-CT was used to reconstruct the root canal system before and after irrigation, with independent root canals marked using different colors. The root canals were categorized as upper segment, middle segment, and apical segment. The volume of calcium hydroxide in each segment was calculated, and the clearance rate of calcium hydroxide in each segment was compared. SPSS 19.0 software package was used for statistical analysis.

Results: Calcium hydroxide could not be completely removed from any of the 6 groups tested. The removal efficiency of calcium hydroxide by ethanol in the apical region was higher than that achieved by other two groups(P＜0.05). In the ethanol subgroup, there was no significant difference in removal efficiency between sonic vibration and syringe techniques(P＞0.05).

Conclusions: Using 70% ethanol enhances the removal efficiency of calcium hydroxide in curved root canal.

Purpose: To compare the clinical efficacy of autologous bone block graft and guided bone regeneration (GBR) in horizontal bone augmentation.

Methods: A total of 42 patients were included and divided into two groups. Group A included 20 patients, in whom autologous bone block graft was performed. Group B included 22 patients, in whom GBR was conducted. The incidence of complications, pain degree, secondary bone graft rate, bone width increment, bone resorption rate, marginal bone resorption and implant success rate after 1 year of restoration were recorded and evaluated. SPSS 26.0 soft ware package was used for data analysis.

Results: There was no significant difference in implant success rate, incidence of complications and the rate of secondary bone grafting between the two groups. The pain degree in group A was significantly higher than that in group B(P＜0.05). The increment of bone width at 2 mm below the crest in group A was more than that in group B(P＜0.05). There was no significant difference in increment of bone width between 6 mm and 10 mm below the crest. The absorption rate of group A was significantly lower than that of group B at 2 mm below the crest(P＜0.05), while the difference was not statistically significant at 6 mm and 10 mm below the crest. There was no significant difference in marginal bone resorption between the two groups 1 year after restoration.

Conclusions: For horizontal bone defects, autologous bone block graft has a better bone contour at the crest than GBR. The amount of marginal bone resorption in two groups is similar after 1 year of restoration.

Purpose: To investigate the application value of periodontal microsurgery in accelerated osteogenic orthodontics (PAOO).

Methods: A total of 100 patients with the need of PAOO surgery before orthodontic treatment due to the lack of alveolar bone in the mandibular anterior area were selected and randomly divided into microsurgery group and control group with 50 cases in each group. Preoperative CBCT was used to measure the thickness and height of the alveolar bone as well as the gingival thickness. The gingival recession height was measured using periodontal probe. The pain level of the patients was evaluated immediately, 3, 7 and 14 days after surgery while the wound healing was recorded 14 days after surgery. The aforementioned indexes were recorded again 6 months after surgery. GraphPad Prism 5.0 software package was used for data analysis.

Results: The pain level of the microsurgery group were significantly lower than those of the control group at different time points after surgery. All the patients in the microsurgery group achieved healing by first intention 14 days after surgery. In addition, 6 months after surgery, the increase in alveolar bone thickness and the improvement of gingival recession in the microsurgery group were significantly better than those in the control group, thus achieving higher patient satisfaction.

Conclusions: Periodontal microsurgery can facilitate the improvement of the surgical effect of PAOO, which has a promising value in the clinical application.