上海口腔医学最新文献

Purpose: To evaluate the ability of magnetic resonance imaging(MRI) in diagnosis of degenerative joint disease (DJD).

Methods: A total of 152 patients with temporomandibular joint disorder(TMD) from June 2019 to June 2021 were included. A total of 304 temporomandibular joints(TMJs) were examined both by cone-beam CT (CBCT) and MRI. The sensitivity, specificity and accuracy of MRI for nine types of TMJ abnormalities were calculated with CBCT as gold standard.

Results: The sensitivity of MRI for condylar surface erosion, condylar osteophyte formation, condylar osteosclerosis, subcortical cystic degeneration, condylar flattening, fossa bone erosion or sclerosis, fossa bone absorption or proliferation, joint space reduction or fusion, and joint space increase, was 95.9%, 81.0%, 49.2%, 81.3%, 98.1%, 76.7%, 84.4%, 52.8%, and 29.4% respectively. The specificity was 49.4%, 80.8%, 83.7%, 85.3%, 52.5%, 77.5%, 78.1%, 88.4% and 98.3%, respectively. The accuracy was 83.2%, 80.9%, 69.4%, 84.9%, 92.1%, 77.3%, 82.2%, 76.0% and 94.4% respectively.

Conclusions: MRI has high accuracy in the diagnosis of nine types of TMJ bone abnormalities. MRI is suitable for imaging screening and diagnosis of DJD.

Purpose: To detect the mechanical conditions of short root teeth during stepwise and overall retraction in extraction cases of Class I malocclusion patients, and help clinicians better understand the force distribution of short root teeth under different retraction methods.

Methods: CBCT was used to scan the maxillofacial and oral condition of the volunteers. The obtained CBCT data were imported into Mimics 20.0 software for processing. Modelings were conducted using Geomagic Studio 2014 reverse engineering software and NX1911 software. The three-dimensional finite element software Ansys Workbench 2019 was employed to simulate stepwise and overall retraction using an invisible correction model for extraction cases. The displacement trends, stress magnitudes, and stress distribution in the periodontal ligament of maxillary short root teeth were investigated.

Results: During the retraction of short root teeth, the stress in the roots appeared on the labial surface. When the canine was first distally moved into position, and then 2-2 retraction by 0.2 mm (condition 2), equal effect force value of the central incisor was the largest. The maximum values of the minimum principal stress and hydrostatic pressure in the periodontal ligament of the central incisor appeared on the labial surface of the cervical root. Among them, the force value was the smallest under the condition of 3-3 overall retraction by 0.2 mm (condition 1). In terms of displacement, the short root teeth exhibited elongation during retraction, with the maximum movement distance in the Y direction observed under condition 1.

Conclusions: The forces on the root and periodontal ligament of the short root teeth are the lightest, and there is a slight root resorption under condition 1. Short root teeth are easy to tipping movements and elongation, with a greater amount of tipping and elongation observed under condition 1.

Purpose: To analyze the literatures related to machine learning in periodontal diseases to understand its applications and research hotspots.

Methods: Literatures related to machine learning in periodontal disease researches included in the Web of Science Core Collection from January 1, 2001 to December 31, 2023 were visualized and analyzed using Bibliometrix 4.4.1, CiteSpace 6.3.R1, and VOSviewer 1.16.18.

Results: A total of 127 papers that met the inclusion and exclusion criteria were included, and the number of publications and citation frequency of each year after 2018 showed a rapid upward trend. The high-frequency keywords of related literatures suggested: periodontitis, machine learning, deep learning, and so on. The hotspot of machine learning in periodontal clinical research in the past 2 years was segmentation and feature extraction based on images. The clinical research of machine learning in periodontics focused on combining images to assist in the diagnosis of periodontal disease and peri-implantitis; the basic research of machine learning in periodontics focused on screening biomarkers between periodontal diseases and systemic diseases.

Conclusions: The literature visualization analysis shows the application and hotspots of machine learning in periodontal disease research, which can provide a reference for future research direction.

Purpose: To investigate the effect of surgical navigation combined with CBCT in removing supernumerary teeth with complete bone impaction in maxillary anterior region.

Methods: A total of 82 children (82 teeth) with complete bone impaction in the anterior maxillary region were removed from January 2023 to June 2024, and were divided into 2 groups by random number table method, with 41 patients and 41 teeth in each group. CBCT was taken before operation in 2 groups,the control group underwent surgical extraction and the experimental group underwent dental extraction assisted by surgical navigation system. The exposure time of the impacted teeth, surgery duration and incision length were recorded. Postoperative pain at 1, 6, 12 and 24 hours was assessed using the face, legs, activity, cry, consolability (FLACC) scale. Inflammatory marker levels and complications were compared between the two groups preoperatively and 24 hours postoperatively.

Results: The exposure time, operation time and incision length of the experimental group were significantly lower than those of the control group, and the FLACC score and inflammatory factor level at 1, 6 and 12 h after surgery in the experimental group were significantly lower than those in the control group, and the postoperative complications were also significantly decreased (P＜0.05).

Conclusions: Surgical navigation combined with CBCT can shorten the operation time, reduce postoperative pain and the risk of postoperative complications.

Purpose: To explore the effects of head and neck posture training on the electrical activity of the temporalis and masseter muscles in patients with myogenic temporomandibular disorder(TMD) under different head and neck postures.

Methods: Fourteen patients with TMD who attended Hainan West Central Hospital from July 2022 to February 2023 with presence of head forward posture were selected for the study. All patients received head and neck posture training for 4 weeks, 2-3 times per week for 30 min each time. Changes in the electrical activity of bilateral temporalis and masseter muscles were compared between pre- and post-intervention patients in the natural relaxed position, the teeth lightly touching position, and the neutral head and neck position. Mandibular function, pain intensity, and maximal pain-free mouth opening were assessed for pre- and post-comparisons.

Results: In TMD patients, the electromyographic amplitude of the anterior fasciculus of the left temporalis muscle and the right masseter muscle was higher in the natural relaxed position than in the neutral head and neck position (3.4±1.4 vs. 2.5±1.0, 2.4±1.6 vs. 1.8±1.1, P＜0.05). After head and neck posture training, the patients had lower basal EMG amplitudes of bilateral temporalis and left masseter muscles in the natural relaxed position and the neutral head and neck position compared with the pre-treatment position, and the mandibular function scores and pain were significantly improved(P＜0.05).

Conclusions: Different head and neck postures can affect the basal electromyographic amplitude of the masticatory muscles in patients with myogenic TMD, and postural training can effectively relax the temporalis and masseter muscles in patients with TMD, resulting in pain reduction and promoting functional recovery.

Purpose: To explore the influencing factors of peri-implantitis in patients with dentition defects after oral implant surgery, and to construct and validate a personalized prediction model.

Methods: Patients who underwent oral implant surgery in the Affiliated Suzhou Hospital of Nanjing University Medical School from September 2021 to March 2025 were included retrospectively. Through 1∶1 propensity score matching, 100 cases in the infected group (diagnosed with peri-implantitis) and 100 cases in the non-infected group were finally included. The baseline data of patients and serum interleukin-17A (IL-17A) levels were collected. Binary logistic regression was used to analyze the influencing factors. A nomogram prediction model was constructed based on the screening results, and the prediction performance was evaluated by Bootstrap validation, receiver operating characteristic(ROC) curve and decision tree model.

Results: The proportions of diabetes, smoking history, chronic periodontitis history, poor alveolar bone around implants, and IL-17A levels in the infected group were significantly higher than those in the non-infected group(P＜0.05). Logistic regression showed that diabetes, smoking history, chronic periodontitis history, poor alveolar bone around implants, and elevated IL-17A were independent risk factors for peri-implantitis(OR＞1, P＜0.05). The C-index of the nomogram model was 0.905, the area under the ROC curve(AUC) was 0.905 (95%CI: 0.865-0.946, P＜0.001), and the optimal cut-off value was 48.80 points (specificity was 0.880, sensitivity was 0.820, Youden index was 0.700). The decision tree model showed that IL-17A was the primary predictor; when IL-17A ＞ 14.380 ng/L, the incidence of peri-implantitis reached 87.50%.

Conclusions: Diabetes, smoking history, chronic periodontitis history, alveolar bone condition around implants and IL-17A level are key influencing factors of peri-implantitis. The constructed nomogram model has excellent prediction performance and can be used for preoperative individualized risk assessment.

Purpose: To evaluate the efficacy of Er:YAG laser combined with infiltration resin in the treatment of dental fluorosis of deciduous teeth.

Methods: Eighty-six children treated for deciduous fluorosis teeth at Hebei Medical University Dental Hospital from January 2019 to January 2024 were selected and randomly divided into the control group (n=43, 92 teeth) and experimental group(n=43, 116 teeth). The control group was treated with Opalustre micro-abrasion paste combined with infiltration resin, while the experimental group was treated with Er: YGA laser combined with infiltration resin. Clinical data of both groups were collected, changes in tooth shade, whitening effects and the rate of discoloration removal at baseline, 1 week and 3 months post-treatment were compared. Treatment satisfaction and the incidence of tooth sensitivity were also compared between the two groups.

Results: One week and three months post-treatment, the tooth shade scores in the experimental group were 3.42±0.51 and 3.86±0.62, respectively, significantly lower than those in the control group (5.82±0.75 and 7.23±1.02, P＜0.05). The total effective whitening rate in the experimental group was 100.00% at both one week and three months post-treatment, significantly higher than that in the control group(94.57% and 84.78%, P＜0.05). The rate of discoloration removal in the experimental group was 95.73%, significantly higher than that in the control group (88.13%, P＜0.05). The VAS scores for post-operative pain at 2, 12 hours and 1 day in the experimental group were significantly lower than those in the control group(P＜0.05). The treatment satisfaction rate in the experimental group was 96.55%, significantly higher than that in the control group (64.13%, P＜0.05). The incidence rates of post-operative tooth sensitivity at 2 hours, 1 week and 3 months in the experimental group were 3.45%, 5.17% and 6.03%, respectively, significantly lower than those in the control group(15.22%, 22.83% and 28.26%, P＜0.05).

Conclusions: Er:YGA laser combined with infiltration resin demonstrats superior treatment efficacy for deciduous fluorosis teeth compared to the traditional combination of micro-abrasion paste and infiltration resin. It not only effectively improves dental aesthetics, but also reduces dental sensitivity after treatment, and improves patient satisfaction.

Purpose: The modified Demirjian method was used to evaluate the development of mandibular permanent teeth in children aged 4 to 11 years old, which provided a reference for determining the clinical treatment time and formulating policies for the prevention and treatment of oral chronic diseases.

Methods: A total of 320 panoramic films from 4 to 11 years old, with 160 males and 160 females, met the inclusion criteria. The modified Demirjian scoring method was used to judge the development of 7 permanent teeth or permanent germ on the left side of the jaw, and formed the developmental score line chart and trend chart. Differences in tooth position and gender were analyzed using SPSS 25.0 software package.

Results: There was a certain linear relationship between the development trend of each mandibular permanent tooth and the age. The second molar had the largest slope y=0.6619x-0.8843(R²=0.99) and the first molar had the smallest slope y=0.3783x+3.8626(R²=0.9224). Mandibular tooth development had distinct differences in tooth position. The first molars developed earlier than the central incisors, but lagged behind the central incisors during the apical foramen closure stage. Canine developed earlier than the first and second premolars, and second premolars developed later than the first premolars. Female mandibular teeth developed earlier than in men, mainly in the early stages of tooth development and the whole process of canine development.

Conclusions: The development of mandibular permanent teeth in children aged 4 to 11 years old has differences in tooth position and gender, so the modified Demirjian method is suitable for evaluating the development of mandibular permanent teeth in children.

Purpose: To investigate the clinical efficacy of 3% polidocanol in the treatment of low-flow venous malformations of the oral mucosa.

Methods: A total of 62 patients with low-flow venous malformations of the oral mucosa admitted to the Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of China Medical University from January to December 2024 were selected. All patients were treated with 3% polidocanol foam sclerotherapy and followed up for 1 to 12 months. The therapeutic effects were evaluated through grade assessment, subjective evaluation by patients, and comparison of photos before and after treatment.

Results: Among the 62 patients, 52 were cured (83.87%), 8 showed remarkbally improved, and 2 were improved, with a total effective rate of 100%. The number of treatments ranged from 1 to 3 times, with an average of 1.4 times. Visual analogue scale(VAS) of pain showed that immediate postoperative pain score was 3-8 points, which decreased to 0-1 points after 1 month. Adverse reactions occurred in 8 patients postoperatively, all of them returned to normal after 1 month.

Conclusions: 3% polidocanol is a safe, effective, and low-side-effect treatment for venous malformations of the oral mucosa.

Purpose: To evaluate the effect of digital guide plate assistance in anterior tooth implant restoration.

Methods: A total of 98 patients who underwent anterior tooth implant restoration from January 2022 to January 2024 were selected and divided into the control group and experimental group by the random number table method, with 49 cases in each group. The control group received conventional implant restoration, while the experimental group was assisted by digital guide plates. The deviation between the actual and designed positions of the implants was compared between the two groups. At the 3rd and 6th months postoperatively, the restorative outcomes were evaluated using the modified United States Public Health Service(USPHS) criteria. At the 6th month postoperatively, the patients' periodontal health status was assessed by measuring probing depth (PD), gingival index (GI), sulcus bleeding index (SBI) and plaque index(PLI). Additionally, the pink esthetic score(PES), as well as occlusal and masticatory functions were evaluated.

Results: The deviation between the actual position of the implant in the experimental group and the designed position was significantly less than that in the control group. At the 3rd and 6th months postoperatively, the USPHS score, PD, GI, SBI and PLI in the experimental group were significantly lower than those in the control group, while PES, occlusal and masticatory functions were significantly higher than those in the control group(P＜0.05).

Conclusions: Digital guide plate assistance can reduce the positional deviation of anterior tooth implants, improve aesthetics and masticatory function, and reduce periodontal inflammation, providing a reliable clinical treatment plan for precise implant restoration in the anterior tooth.