上海口腔医学最新文献

Purpose: To investigate the clinical value of nursing care plans employing 4R crisis management model for prevention of oral mucositis in patients with autologous hematopoietic stem cell transplantation.

Methods: According to different intervention time points, totally 40 transplantation patients from May 2019 to December 2020 were selected as the control group, while 68 transplantation patients from January 2021 to January 2023 were selected as the experimental group. Compared to the control group, patients in the experimental group adopted more comprehensive risk management measures and applied 4R crisis theory. The preventive and therapeutic outcomes were compared in the aspects of oral mucosal inflammation incidence, grade, time to resume orally fed diet and inpatient stay of two groups of patient. SPSS 27.0 software package was used for statistical analysis.

Results: Oral mucositis occurred in 76.5% of patients in the experimental group, which was significantly lower than the control group (100%) (P＜0.05). Severe oral mucositis (grades Ⅲ and Ⅳ) were 11.8% in the experimental group, which was significantly lower than the control group(65.0%). The clinical nursing satisfaction of the experimental group was significantly higher than that of the control group(P＜0.001). There was no significant difference in hospital duration or oral refeeding time between the two groups(P＞0.05).

Conclusions: The application of 4R crisis management strategy can substantially decrease oral mucositis occurrences and severity, thereby enhancing the effectiveness of oral care management for autologous hematopoietic stem cell transplantation patients, reducing patient discomfort, accelerating recovery time and improving quality of life . The strategy has promising clinical potential of application.

Purpose: To explore the differential miRNA expression profiles and predicted target genes of mandibular bone marrow mesenchymal stem cells (MBMSCs) in a postmenopausal osteoporosis (POP) mouse model using bioinformatics methods, providing new targets for diagnosis, treatment, and prevention of POP.

Methods: POP mouse model was established by performing ovariectomy surgery, and MBMSCs were obtained using whole bone marrow adherent culture method. Microarray sequencing was performed to detect the miRNA expression profile of MBMSCs. Subsequently, miRNA identification and prediction analysis were conducted, along with the prediction of target genes. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, and protein-protein interaction (PPI) network analysis were performed on the predicted target genes. Key hub genes were identified using algorithms such as Degree, Betweenness, and Closeness. The data were analyzed by GraphPad Prism 8.0 and R language.

Results: A total of 84 differentially expressed miRNAs were obtained using a threshold of P＜0.05, with 33 upregulated and 51 downregulated miRNAs. GO and KEGG enrichment analyses of the 84 differentially expressed miRNAs revealed their involvement in various biological processes and pathways. Among them, 130 target gene mRNAs were enriched in the "regulation of stem cell pluripotency" signaling pathway. PPI network analysis and hub gene selection were performed for the 130 predicted target gene mRNAs, resulting in the identification of 7 reliable hub genes: Ctnnβ1, Hras, Kras, Akt1, Mapk3, Smad3, and Smad2. Among these hub genes, Ctnnβ1, Akt1, Mapk3, Smad3, and Smad2 were found to be significantly associated with POP.

Conclusions: The differentially expressed miRNAs identified in MBMSCs of POP mice may serve as potential biomarkers and play important roles in the pathogenesis of POP. This study provides new research direction and theoretical basis for the diagnosis and treatment of POP.

The standardized training of oral and maxillofacial surgery specialists is an important part of post-graduation education in oral and maxillofacial surgery, and has been transferred from the initial local pilot to the full implementation stage. Hospital of Stomatology, Wuhan University is the first batch of national oral and maxillofacial surgery training bases in China, with a total of 25 students enrolled since 2018. The author is one of the first batch of oral and maxillofacial surgery trainees and instructors in China. In the practice of standardized training of oral and maxillofacial surgeons, we gradually found some problems, and conducted extensive discussions and in-depth thinking. It is hoped that this article will be helpful to improve the training system of oral and maxillofacial surgery specialists in China.

Purpose: To explore the expression of hub genes, pathways and inhibitory immune checkpoints of CD8+ T cells in metastatic lymph nodes of head and neck squamous cell carcinoma(HNSCC) in C3H/He mice.

Methods: A popliteal lymph node metastasis model of immunocompetent C3H/He mice was constructed with SCC-7 cell line of HNSCC, and the lymph node metastasis status was determined by immunofluorescence. CD8+ T cells in normal and metastatic lymph nodes were sorted by flow cytometry, and transcriptome sequencing analysis was performed to screen out differentially expressed genes. GO functional enrichment analysis and KEGG pathway enrichment analysis were performed sequentially. Flow cytometry and multiplex immunohistochemical were used to detect the expression of four immune checkpoints of CD8+ T cells in metastatic lymph nodes of tumor-bearing mice. SPSS 26.0 software package was used for statistical analysis.

Results: After 4 weeks of foot pad injection of SCC-7 cells, C3H/He mice displayed obvious metastasis in popliteal drainage lymph node. A total of 912 differentially expressed genes were screened out by transcriptome sequencing analysis of CD8+ T cells in normal and metastatic lymph nodes, including three inhibitory immune checkpoint-related genes which were upregulated(Pdcd1, Lag3 and Tigit). Eight tumor-related signaling pathways were screened out by KEGG network analysis, including Toll-like receptor signaling pathway, NF Kappa-B signaling pathway, TNF signaling pathway, MAPK signaling pathway, IL-17 signaling pathway, NOD-like receptor signaling pathway, PD-L1 and PD-1 immune checkpoint pathway in tumors and p53 signaling pathway. Flow cytometry showed high expression level of PD-1 and TIM-3 in CD8+ T cells in mouse metastatic lymph nodes. It was further confirmed by multiplex immunohistochemical that PD-1 was highly expressed in CD8+ T cells in metastatic lymph nodes of patients with HNSCC.

Conclusions: Tumor-related signaling pathway of CD8+ T cells in mouse metastatic lymph nodes is significantly activated. The PD-1 expression level of CD8+ T in metastatic lymph nodes of mice and patients with HNSCC is markedly increased. Immunotherapy targeting CD8+ T cells may become a new strategy for the prevention and cure for lymph node metastasis of HNSCC.

Purpose: To evaluate the value of X-ray and cone-beam CT(CBCT) three-dimensional reconstruction in the diagnosis of impacted teeth in adolescent orthodontic patients.

Methods: From May 2021 to May 2024, totally 86 adolescent orthodontic patients with 126 impacted teeth admitted to the Second Hospital of Baoding City were selected for X-ray examination and CBCT 3D reconstruction. The diagnostic efficiency and accuracy of the two methods were evaluated by comparing their ability to reveal the location and adjacent anatomical structures of the impacted teeth. SPSS 26.0 software package was used for statistical analysis of the data.

Results: Among the 126 impacted teeth, totally 40 cases (52 teeth) were in the maxillary anterior tooth region, 8 in the maxillary posterior region (12 teeth), 12 with maxillary supernumerary teeth (20 teeth), 14 in the mandibular anterior region (22 teeth), 8 in the mandibular posterior region (14 teeth), and 4 with mandibular supernumerary teeth (6 teeth). The results of CBCT 3D reconstruction were close to operation findings. CBCT 3D reconstruction was superior to X-ray films in most indexes, especially in sensitivity and positive predictive value, showing higher diagnostic efficiency.

Conclusions: CBCT three-dimensional reconstruction provides high diagnostic value in the diagnosis of impacted teeth in adolescent orthodontic patients, especially in accurately assessing the position of impacted teeth.

Purpose: To investigate the prevalence characteristics of temporomandibular joint disc displacement in patients with malocclusion and influencing factors of disc displacement, and to provide reference for orthodontic treatment.

Methods: A total of 1 157 consecutive orthodontic cases admitted to the Department of Orthodontics at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2012 to December 2021 were selected retrospectively. Based on temporomandibular joint MRI, the prevalence of disc displacement in orthodontic cases was investigated. The influencical factors of gender, age and skeletal classification on disc displacement was analyzed. SPSS 25.0 software package was used for data analysis.

Results: Among 1 157 orthodontic cases, there were 672 cases(58.08%) of disc displacement, and 334 cases(28.87%) had anterior disc displacement. The prevalence of disc displacement in female was significantly higher than that in male. The prevalence of disc displacement in skeletal Class Ⅱ malocclusion was significantly higher than that in skeletal Class Ⅲ malocclusion. In orthodontic cases aged between 10 and 18, the prevalence of disc displacement increased with age.

Conclusions: There is a high proportion of abnormal articular disc position in patients with malocclusion. Age, gender(female) and skeletal Class Ⅱ malocclusion have higher correlation with temporomandibular joint disc displacement.

Purpose: To explore the influence of different preset drill radius on the drill compensation space of zirconia dioxide restoration and the characteristics of tooth position and anatomical parts of the drill compensation space.

Methods: The digital design data of 12 cases of incisor, premolar and molar were randomly selected, and the radius of the needle was preset to 0.3, 0.4, 0.5 and 0.6 mm. Software analysis was performed to obtain four evaluation index values for each group of drill compensation gaps ,including compensation area, the proportion of the drillcompensation area to the preparation area, compensation volume and the maximum value of the compensation. The compensation frequency of the occlusal/incisal edge, axial surface and edge area of 0.5 mm preset radius group were recorded. Data were analyzed by two-way ANOVA and Chi-square test using SPSS 22.0 software package.

Results: The preset drill radius and tooth position significantly affect the values of the four evaluation indicators(P＜0.05) of the drill compensation space, among which the four evaluation index values were significantly reduced by the preset radius of the drill (P＜0.05). The probability that the maximum drill compensation thickness value of incisor and molar teeth in the 0.5 mm group and all types of teeth in the 0.6 mm group exceeded 300 μm existed, the frequency of 20 μm gap compensation in the incisor/occlusal edge area, the axial surface area, and the edge area of the preparation decreased in turn(P＜0.05).

Conclusions: The preset radius of 0.3-0.4 mm can obtain a reasonable drill compensation gap on the tissue surface of the prosthesis. The occlusal/incisor area of the preparation needs to be carefully prepared to reduce the frequency of gap compensation.

Purpose: To evaluate the soft tissue position changes in the lower 1/3 of face after application of the vestibular shield for correction of mouth dyspnea.

Methods: A total of 32 pediatric patients wearing vestibular shield appliances for mouth breathing correction were reviewed, and the changes of upper and lower lip positions as well as chin position before and after appliance treatment were compared and analysed. GraphPad Prism 6.0 software package was used for data analysis.

Results: The values of lateral protrusion N'-Sn-Pog' (facial convexity), nasolabial angle (Cm-Sn-Ls) lower lip protrusion (LL-EP) and upper lip prominence (UL-EP) were significantly reduced, of which UL-EP changes were the most obviously changed parameter. In addition, the chin morphology associated parameters Si-LiPg' and Sn-Gn'-C were significantly improved after treatment as well. No significant differences were observed within gender.

Conclusions: Vestibular shield treatment for patients with mouth breathing can effectively improve the lip morphology.

Purpose: To explore the application value of invisible orthodontic appliance without brackets in the correction of ClassⅡand ClassⅠmalocclusion in adolescents with mandibular recession.

Methods: A retrospective collection of clinical data was conducted on 114 adolescent patients with ClassⅡand ClassⅠmalocclusion of mandibular retrusion admitted to Hubei Hospital of Traditional Chinese Medicine from February 2020 to October 2022. They were divided into two groups based on different orthodontic methods, with 57 cases in each group. The control group was treated with Twin block appliances, while the experimental group was treated with invisible appliances without brackets. Both groups of patients were corrected for 12 months. The treatment effects of the two groups were evaluated, and the levels of inflammatory factors [alkaline phosphatase (ALP), matrix metalloproteinase-8 (MMP-8), interleukin-1β (IL-1β)] in gingival crevicular fluid before and after treatment, X-ray cephalometric indicators(SNB angle, ANB angle, Go-Gn, Ar-Go), temporomandibular joint parameters (anterior joint space, posterior joint space, superior joint space, fossa height) and upper airway conditions [nasopharyngeal volume (V-nasopharynx), velopharyngeal volume(V-velopharynx), glossopharyngeal volume (V-glossopharynx)], and the subjective perception scores of wearing orthodontic appliance were compared between the two groups. SPSS 28.0 software package was used for data analysis.

Results: There was no significant difference in the orthodontic outcome of the experimental group compared to the control group (P＞0.05). After correction, the levels of IL-1β, MMP-8 and ALP in the gingival crevicular fluid were significantly lower in the experimental group compared to the control group(P＜0.05), but there was no significant difference(P＞0.05) between the two groups in terms of SNB angle, ANB angle, Go Gan, Ar Go, anterior and posterior joint spaces, supraarticular space, and joint socket height. After correction, there was no significant difference(P＞0.05) between the two groups in V-glossopharynx, V-palatopharynx, and V-nasopharynx. The experimental group had significantly higher scores in terms of comfort, compliance, and aesthetics when wearing invisible orthodontic appliances without brackets compared to the control group(P＜0.05).

Conclusions: The treatment effect of Twin-block appliance and non-bracket invisible appliance is comparable for Class Ⅱ division Ⅰ malocclusion in adolescents with mandibular retrognathia. Both can improve the morphology of the mandible and dentition, expand the upper airway, but non-bracket invisible appliance can further reduce inflammation and improve patients' comfort.

Purpose: To investigate the effect and mechanism of let-7c overexpression on the proliferation of human dental pulp stem cells (hDPSCs).

Methods: hDPSCs were isolated and cultured. After transfected with let-7c mimics and inhibitors, transfection efficiency was detected by qRT-PCR, and cell proliferation was detected by cell counting kit-8 (CCK-8). Flow cytometry was applied to determine the cell cycle. The mechanism of let-7c inhibiting cell proliferation was analyzed by Western blot. A cell model targeting insulin-like growth factor 2 mRNA binding protein 2 (IGF2BP2) was constructed by transient transfection of small interfering RNA(siRNA) and analyzed by bioinformatics and dual luciferase reporter. Bioinformatics analysis and dual luciferase reporter gene assay were performed to investigate whether let-7c directly targeted IGF2BP2. The data were statistically analyzed using SPSS 17.0 software package.

Results: Overexpression of let-7c inhibited cell proliferation. Let-7c blocked cell proliferation by regulating the S and G2/M cycles, and directly bound to a group of messenger RNA (mRNA) sequences related to cell cycle regulation, IGF2BP2, and targeting and inhibiting IGF2BP2 expression, with a negative correlation between the two expression levels.

Conclusions: let-7c inhibites the proliferation of hDPSCs by targeting and inhibiting IGF2BP2 expression.