上海口腔医学最新文献

Purpose: To compare the clinical effects of pure titanium-milled metal rings and cast gold alloy milled rods in the prosthetic rehabilitation of zygomatic implant-supported prostheses.

Methods: A total of 11 patients were selected from January 2017 to October 2024 in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The patients were repaired by zygomatic implant-supported prostheses with different types of ring connectors due to bilateral maxillary defects after tumor surgery. Among them, 6 cases used pure titanium-milled metal rings to connect the prosthetics, and the other 5 cases used cast gold alloy milled rods. The difference of repair effect was evaluated from 4 aspects: prosthesis retention, prosthesis wear, connection screw fractures and overall satisfaction.

Results: Compared to pure titanium-milled metal rings, the cast gold alloy milled rod connection scored significantly lower in prosthesis retention, connection screw fractures, and overall scores(P＜0.05). No significant differences were observed in prosthesis wear or overall satisfaction(P＞0.05).

Conclusions: Pure titanium-milled metal rings are a more suitable connection method for prosthetic rehabilitation of bilateral maxillary defects using zygomatic implants.

Purpose: To investigate the expression and clinical significance of silent information regulator 1 (SIRT1) and suppressor of cytokine signaling 6(SOCS6) in gingival tissue of patients with severe chronic periodontitis (CP).

Methods: A total of 213 CP patients treated in Jiaxing Second Hospital from April 2022 to April 2024 were selected and divided into mild group (n=35), moderate group (n=91) and severe group (n=87) according to the severity of the disease. Another 95 patients with healthy periodontium who underwent crown lengthening were selected as control group. qRT-PCR was used to detect SIRT1 and SOCS6 mRNA expression levels in gingival tissues. Multivariate logistic regression was used to analyze the related factors affecting the occurrence of severe CP. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficacy of SIRT1 and SOCS6 expression levels in gingival tissues for severe CP.

Results: The levels of interleukin-10 (IL-10), C-reactive protein (CRP), and interleukin-17(IL-17) in the severe group were significantly higher than those in the moderate to mild group(P＜0.05). The expression levels of SIRT1 and SOCS6 in the gingival tissue of the severe group were significantly lower than those of the moderate to mild group and the control group, the expression levels of SIRT1 and SOCS6 in the gingival tissue of the moderate to mild group were significantly lower than those of the control group (P＜0.05). SIRT1, SOCS6, IL-10, and IL-17 in gingival tissue were related factors affecting the occurrence of severe CP (P＜0.05). The area under the curve (AUC) of SIRT1, SOCS6, and their combination in the diagnosis of severe CP was 0.833, 0.825, and 0.896, respectively, which was superior to single indicator for diagnosis(P＜0.05). The sensitivity and specificity of the combined diagnosis were 91.95% and 78.57%, respectively.

Conclusions: The expression levels of SIRT1 and SOCS6 in gingival tissue of patients with severe CP are greatly reduced, which are related factors for severe CP. Detection of SIRT1 and SOCS6 has high diagnostic efficacy for severe CP.

Purpose: Bioinformatics was used to analyze the possible mechanism of RNA binding protein Lin28 regulating proliferation of human dental pulp stem cells (hDPSCs).

Methods: Lentivirus-mediated stable transfection of Lin28 gene into hDPSCs was performed, and RNA binding protein immunoprecipitation was used to detect the concentration and total amount of mRNA enriched with overexpression of Lin28. The changes of Lin28-enriched mRNA and related pathways were detected by RIP sequencing. The RIP-seq sequencing results were verified by RIP-PCR. The miRNA expression levels of Lin28 and let-7 family members were detected by real-time PCR. TargetScan (http://www.targetscan.org/vert_71/) was used to predict the let-7a relevant target gene mRNA and specific binding sites. Western blot was used to detect the expression levels of let-7a related target genes IGF1R, IRS2, and IGF2BPs family proteins.

Results: RNA binding protein Lin28, as an important mRNA regulatory factor, played a key role in cell growth and development, tissue metabolism, etc. After Lin28 enrichment expression, pri-let-7a/b/c/d/e/f/i/98 and pre-let-7a/b/c/d/e/f/i/98 decreased to different extents. Overexpression of Lin28 could up-regulate the expression levels of let-7-related target genes IGF2BP1 and IGF2BP2 proteins.

Conclusions: Lin28 blocks the processing and maturation of let-7 family through specific complementary binding of pri-let-7 and pre-let-7 in multiple pathways. Lin28 has an indirect regulatory effect on the mRNA of let-7 target genes, and the enriched mRNAs mainly play a role in the growth process, signaling, protein processing, and the translation of the expression of genetic information, which is closely associated with cell growth and proliferation.

Oral and maxillofacial region is the most common site for the onset of vascular anomalies. Some vascular anomalies can lead to bleeding, which may be the first noticeable symptom. Due to the rich blood supply and the proximity to the respiratory tract, bleeding in this area is particularly challenging to manage. If not treated promptly or if inappropriate methods are used, they may result in serious complications. To address this issue, we invited a group of domestic experts with extensive experience in diagnosing and treating vascular anomalies in oral and maxillofacial region to formulate this consensus. The goal is to provide guidance and recommendations for medical professionals on the management of bleeding associated with these vascular lesions.

Purpose: To evaluate and compare the clinical efficacy and biocompatibility of gelatin sponge and hydroxyapatite bioceramic in the repair of bone defects in apicectomy.

Methods: A total of 187 patients with periapical cysts treated from January 2020 to January 2024 were selected and randomly divided into two groups using a random number table method: gelatin sponge group(n=93) and hydroxyapatite ceramic (HA) group(n=94). Apicectomy was performed in both groups, gelatin sponge group was filled with gelatin sponge, HA group was repaired with hydroxyapatite bioceramics.Preoperative and two-week postoperative laboratory indicators were statistically analyzed and compared between the two groups. Additionally, the bone graft height, thickness and bone growth outcomes were compared six months after treatment. The postoperative healing and occurrence of adverse reactions were also compared between the two groups.

Results: The bone graft height, bone graft thickness and new bone density in HA group were significantly higher than those of the gelatin sponge group(P＜0.05). The levels of white blood cell count (WBC), neutrophil ratio (NEU), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and serum creatinine (SCR) in HA group were significantly lower than those of the gelatin sponge group(P＜0.05). The levels of alanine aminotransferase (ALT) and aspartate aminotransferase(AST) in HA group were significantly higher than those in the gelatin sponge group(P＜0.05). The effective rate of HA group was 100.00%, which was significantly higher than that of the gelatin sponge group (95.70%, P＜0.05). The incidence of adverse reactions in HA group was 4.26%, which was significantly lower than 12.90% in the gelatin sponge group (P＜0.05).

Conclusions: Hydroxyapatite bioceramics shows better repairing effect and biocompatibility than gelatin sponges in bone defect repair after apicectomy. Hydroxyapatite bioceramics may be a more effective bone repair material, especially in promoting new bone formation and reducing postoperative complications.

Purpose: To simulate the mineralizing fluid with lithium chloride (LiCl) as a dentinogenic environment and investigate its potential to induce stem cells from human exfoliated deciduous teeth (SHEDs) into dentinogenesis.

Methods: Primary SHEDs were isolated, cultured, and identified, and P3-6 SHEDs were used for subsequent experiments. Osteogenic medium(OM) containing 0, 1.0, 2.5, 5.0, 10 mmol/L LiCl were prepared. Cell proliferation was assessed using CCK-8 assay at 1, 3, 5, and 7 days. Alkaline phosphatase(ALP) activity was examined by staining at 4, 7, and 10 days. Gene expression levels of DSPP, Runx2 and COL-1 were detected by RT-PCR, and protein levels of DSPP and Runx2 were analyzed by Western blot at 10 days. Alizarin red staining and semi-quantitative analysis were conducted at 14 days to evaluate mineralization capacity and select the optimal LiCl concentration.

Results: CCK-8 assay showed that low concentrations(≤2.5 mmol/L) of LiCl had minimal effect on cell proliferation from 1 to 7 days, while high concentrations (＞2.5 mmol/L) inhibited cell proliferation. ALP activity was enhanced by low concentrations of LiCl at 4, 7, and 10 days, with the 2.5 mmol/L LiCl group showing the most significant effect, while high concentrations suppressed ALP activity. Western blot results revealed that low concentrations of LiCl promoted the protein expression of DSPP and Runx2 in SHEDs. RT-PCR demonstrated that low concentrations of LiCl upregulated the gene expression of DSPP and COL-1 in SHEDs. Qualitative and quantitative Alizarin red staining indicated that 1.0, 2.5, 5.0 mmol/L LiCl improved SHEDs mineralization capacity, while 10 mmol/L LiCl showed no significant difference in mineralized nodule formation compared to the control group.

Conclusions: Low concentrations of lithium compounds can promote the dentinogenesis of SHEDs.

Purpose: To investigate the clinical effect of endoscopy-assisted curettage of mandibular bone cyst.

Methods: A total of 80 patients with mandibular bone cyst treated in the First Affiliated Hospital of Bengbu Medical University from September 2021 to July 2023 were selected and divided into experimental group (n=43) and control group (n=37) according to treatment methods. The observation group was treated with endoscopy-assisted cyst curettage and secondary examination, while the control group was treated with traditional cyst curettage. The operation time, postoperative reaction, pathological fracture, nerve injury and recurrence were recorded in the two groups.

Results: The operation time of the experimental group was (50.11±4.65) min, which was significantly longer than (44.89±4.38) min of the control group (P＜0.05). The degree of swelling and VAS pain scores in the experimental group were significantly lower than those in the control group on the 2nd and 7th days after operation (P＜0.05). There was no pathological fracture in the two groups. There was 1 case of nerve injury in the experimental group, which recovered 3 months after operation, and no recurrence was found in the 1-year follow-up. There were 3 cases of nerve injury in the control group, and all of them recovered within 3 to 6 months after operation. Two patients had recurrence during revisit.

Conclusions: Endoscopy-assisted curettage of mandibular bone cysts has the advantages of good surgical field, reducing injury and recurrence, and can improve the accuracy and safety of surgery, which is worthy of clinical application.

Purpose: By constructing a three-dimensional model of anterior teeth with different crown-to-root ratios, the stress distribution and fatigue state of the implant denture model were analyzed under different occlusion conditions.

Methods: SolidWorks modeling software was used to establish a platform switching amount of 0.4 mm and the corresponding crown-root ratio of 1∶1, 1.5∶1, 2∶1 were constructed, and a total of 3 groups of incisor implant restoration models were constructed. In the Ansys Workbench analysis software, the central incisors were designed to have three kinds of occlusion modes, edge to edge occlusion, shallow overbite, deep overbite, and the loading force was 100 N at 45° with the long axis of the teeth. The peak value and distribution of von-Mises stress of implant and implant-bone interface in each group were analyzed.

Results: The peak von-Mises stress was edge to edge occlusion ＞ shallow overbite ＞ deep overbite. The peak values of equivalent stress of abutment, abutment screw and cortical bone increased with the increase of crown-root ratio when edge to edge occlusion and shallow overbite were chosen. There was no significant change in the stress value of the abutment, the abutment screw and the cortical bone during deep overbite. The stress concentration parts of the mode, when the posterior teeth were subjected to lateral force and the anterior teeth were edge to edge occlusion and shallow overbite, the stress concentration occurred at the abutment neck, the middle of the abutment screw and the implant-bone edge.

Conclusions: With the increase of crown to root ratio, the lateral stress of the planting model increases; when the crown-to-root ratio ≥1.5∶1, the peak von-Mises stress on the abutment and the abutment screw exceeds the yield strength of pure titanium. When the model is subjected to lateral force, the neck of the abutment and the middle of the screw are prone to experience fatigue. The lateral force of the implant denture should be reduced during repair.

Purpose: To investigate the therapeutic effect of sodium carboxymethyl cellulose (CMC-Na) oral film combined with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel on radiation-induced oral mucositis (RIOM) in patients with head and neck cancer(HNC).

Methods: A total of 31 HNC patients with RIOM after radiotherapy in Lishui People's Hospital from June 2022 to January 2024 were randomly divided into three groups: group A (n=11), group B (n=11), and group C (n=9). Group A received CMC-Na oral film + rb-bFGF gel, group B received rb-bFGF gel alone, and group C received cetylpyridinium chloride mouthwash (control). On days 0, 5, 10 and 15, the OM grade and pain scores of each patient were evaluated using oral mucositis (OM) grading scale and numeric rating scale (NRS). The quality of life of patients before and after treatment was evaluated by using Oropharyngeal Mucositis Quality of Life (OMQoL) scale.

Results: After treatment in both group A and B, the pain scores and OM grades were significantly lower than those before treatment (P＜0.05), while there was no significant difference in group C before and after treatment (P＞0.05). Comparative analysis across time points revealed that pain scores in group A were significantly lower than those in group B on day 5 and 10 (P＜0.05), with no significant difference on day 15(P＞0.05). OM grades in group A were significantly lower than those in group B only on day 10 (P＜0.05). Quality of life improved significantly in groups A and B(P＜0.05), with greater improvement in group A, while no significant improvement was observed in group C(P＞0.05).

Conclusions: CMC-Na oral film combined with rb-bFGF gel demonstrates superior efficacy in treating RIOM in HNC patients compared to rb-bFGF gel alone, while cetylpyridinium chloride mouthwash shows no significant therapeutic effect.

Purpose: To compare the differences in formation of abfraction lesions using three different types of toothbrushes, i.e. mechanical electric toothbrush, sonic electric toothbrush, and ordinary manual toothbrush.

Methods: Seventy-one subjects were recruited publicly and randomly divided into three groups with 24 subjects in the mechanical electric toothbrush group (experimental group 1 ), another 24 subjects in the sonic electric toothbrush group (experimental group 2), and 23 subjects in the ordinary manual toothbrush group (control group). The observation period was 12-15 months. During the beginning and the end of the experiment, oral digital impressions were obtained by using 3Shape TRIOS 3 intraoral scanning device (Denmark). The two 3D Object (.stl) files obtained were compared and overlapped by using EXO CAD software，and the numerical values of the cervical changes of all canines, first premolars, and second premolars on the labial and buccal sides of the gingival margin after comparison and overlap were measured using 3Shape 3D ViewerTM software.

Results: The cervical defect values of the mechanical electric toothbrush group were significantly higher than those of the sonic electric toothbrush group and the ordinary manual toothbrush group (P＜0.001), and the cervical defect values of the sonic electric toothbrush group were significantly higher than those of the ordinary manual toothbrush group (P＜0.001). There was no significant difference in gender within each group between the mechanical electric toothbrush group and the sonic electric toothbrush group (P＞0.05), while the cervical defect values of the male subjects in the ordinary manual toothbrush group were significantly higher than those of the female subjects (P＜0.001). The cervical defect value of the mechanical electric toothbrush group was significantly higher than that of the conventional manual toothbrush group at 14, 25, 35, 43, 44 and 45 tooth positions among the three groups (P＜0.05). Meanwhile, the cervical defect value of the mechanical electric toothbrush group was significantly higher than that of the sonic electric toothbrush group at 44 tooth position (P＜0.05). There was no significant difference in the defect value among all groups (P＞0.05).

Conclusions: Compared with ordinary manual toothbrushes, mechanical electric toothbrushes and sonic electric toothbrushes are more effective in promoting the formation of abfraction lesions. The teeth in the lower right mandible are more susceptible to abfraction lesions caused by mechanical electric toothbrushes.