上海口腔医学最新文献

Purpose: To compare the aesthetic effects of immediate implant restoration and delayed implant restoration of single maxillary anterior tooth.

Methods: A total of 163 patients who underwent single anterior tooth implantation in the maxilla at Taikang Xianlin Drum Tower Hospital from January 2020 to May 2023 were selected. They were divided into immediate implant restoration group(n=75) and delayed implant restoration group(n=88). In the immediate implant restoration group, a temporary implant was installed and implanted immediately after extraction, while in the delayed implant restoration group, the implant was implanted 3-6 months after extraction and repaired after the implant was stabilized. The outcomes, including implant success rate, soft tissue aesthetics, implant stability, aesthetic outcomes, periodontal health, pink esthetic score (PES), white esthetic score (WES), bone resorption after 12 months and subjective satisfaction were compared between the two groups.

Results: After exclusion, totally 62 patients in the immediate implant restoration group and 64 patients in the delayed implant restoration group were included in the analysis. Both groups had a 100% implant success rate with no significant difference between the two groups(P＞0.05). The immediate implant restoration group was significantly better in terms of soft tissue aesthetics and implant stability compared to the delayed implant restoration group(P＜0.05). Aesthetic effect scores for the immediate implant restoration group were significantly higher than those of the delayed group at 1, 3, 6 and 12 months postoperatively(P＜0.05). The periodontal tissue health of the immediate implant restoration group was significantly better than that of the delayed group at various time points(P＜0.05). PES and WES scores of immediate implant restoration group were significantly better than those of the delayed group(P＜0.05). At 12 months after surgery, bone resorption in the immediate implant restoration group was significantly lower than that in the delayed group, subjective satisfaction score was significantly higher than that in the delayed group(P＜0.05), and there was no significant difference in color satisfaction between the two groups(P＞0.05).

Conclusions: Immediate implant restoration of maxillary single anterior teeth is superior to delayed implant restoration in soft tissue aesthetic effect, implant stability and patient satisfaction, which is suitable for patients with high aesthetic requirements.

Purpose: To investigate the application effect of an informatized management platform for high-value dental implant consumables developed based on the hospital resource planning system in optimizing consumable management processes.

Methods: A pre-post comparative study was conducted. The conventional management mode for high-value dental implant consumables from May 2023 to January 2024 in the Department of Stomatology, Zhongshan Hospital Fudan University served as the control group (n=5 872), while the informatized management mode from February 2024 to October 2024 was set as the experimental group (n=5 932). The two groups were compared in terms of consumable inventory in-out time, postoperative registration time, inventory time, total process time for single bone grafting surgery, billing accuracy rate, and satisfaction of medical staff.

Results: In the experimental group, the consumable inventory in-out time, postoperative registration time, inventory time, and total surgical process time were significantly shorter than those in the control group (P＜0.001). The billing accuracy rate increased from 97.2% to 100% (P=0.004). The satisfaction rate among doctors reached 94.64%, and that among nurses reached 93.75%.

Conclusions: The informatized platform achieves full-process supervision and quality control of high-value consumables, significantly improves management efficiency and billing accuracy, optimizes surgical processes, and enhances job satisfaction of medical staff, providing an innovative approach for refined management of dental implants.

Purpose: To evaluate the efficacy of rapid maxillary expansion and maxillary alternate rapid expansion combined with maxillary protraction in the treatment of Class III bony malformations.

Methods: A total of 82 patients with skeletal Class III malocclusion admitted to Jiaozhou Central Hospital of Qingdao from May 2021 to April 2024 were selected and divided into two groups according to admission time. The control group (n=40) was treated with simple maxillary rapid arch expansion combined with maxillary protraction. The experimental group (n=42) was treated with maxillary alternate rapid expansion and contraction combined with maxillary protraction, the therapeutic effect of the two groups was compared.

Results: Three months after treatment, the Z-angle, H-angle and upper lip angle of the experimental group were significantly higher than those of the control group, and the lower lip inclination was significantly lower than that of the control group(P＜0.05). SNA, U1-NA, ANB indexes, maximum occlusal contact area and maximum biting force in the experimental group were significantly higher than those in the control group, while U1-L1 and SNB indexes were significantly lower than those in control group (P＜0.05). The masticatory efficiency and oral health impact scale (OHIP-14) scores of the experimental group were significantly higher than those of the control group(P＜0.05).

Conclusions: Rapid maxillary expansion combined with maxillary protraction can improve the occlusal function and masticatory efficiency of patients with skeletal Class III malocclusion, and improve the soft and hard tissue indexes of the patients.

Purpose: To study the effect of electrospinning polycaprolactone (PCL) /gelatin (GE) composite material as a guided bone regeneration membrane on osteogenic properties of mouse embryonic osteoblast precursor cells MC3T3-E1.

Methods: The electrospinning technology was used to fabricate different ratios of PCL/GE nanofiber membranes on tinfoil, and the GE ratios of 0%, 30% and 50% were grouped as PCL, P7G3 and P5G5, with pure PCL as the control group. The morphology, composition, and hydrophilicity were characterized using scanning electron microscopy (SEM), contact angle measurement, Fourier-transform infrared spectroscopy (FTIR), and X-ray photoelectron spectroscopy (XPS). CCK-8 was used to detect the proliferation of MC3T3-E1 on the material. The cell adhesion morphology was observed by SEM, confocal laser scanning microscopy (CLSM). Alkaline phosphatase (ALP) activity and alizarin red staining (ARS) were used to study osteogenic differentiation. The expression levels of osteogenic differentiation related genes were detected by quantitative real-time PCR (qRT-PCR). The data were analyzed using GraphPad Prism 8 software.

Results: SEM showed that the electrospun membranes exhibited a fibrous structure, contact angle measuring instrument showed increasing hydrophilicity of electrospun membranes mixed with gelatin. The successful addition of gelatin was displayed by FTIR and XPS. The results of cell proliferation indicated that all groups of materials had good cell activity, and group P7G3 had the best cell proliferation, and the difference was statistically significant. ALP, ARS showed that group PCL/GE had a promoting effect on cell osteogenic differentiation. qRT-PCR indicated that the expression level of osteogenic differentiation related genes were elevated in PCL/GE, with the best in the group of P5G5.

Conclusions: The PCL/GE electrospun membranes has good biocompatibility and the potential to promote cell proliferation, adhesion, and osteogenic differentiation. Among them, the group P7G3 has the best proliferative ability, while the group P5G5 has a better effect in promoting bone formation.

Purpose: To analyze the correlation of serum Semaphorin3A(Sema3A), fibroblast growth factor 23(FGF-23) levels with periodontal indices and disease severity in patients with chronic periodontitis.

Methods: A total of 115 CP patients admitted to Cangzhou Central Hospital from June 2022 to June 2023 were selected and divided into severe group (34 cases), moderate group (39 cases) and mild group (42 cases) according to the severity of the disease; meanwhile, another 115 healthy individuals with periodontitis who underwent physical examination were selected as the control group. Serum Sema3A and FGF-23 levels of all subjects were detected by enzyme-linked immunosorbent assay (ELISA), and serum inflammatory markers [tumor necrosis factor-α(TNF-α) and interleukin 6 (IL-6), IL-17] and the levels of periodontal indices [gingival index(GI), bleeding index (BI), plaque index (PLI), loss of attachment (AL) and probing depth (PD)] in CP group were detected. Pearson correlation analysis was employed to explore the correlations between the levels of Sema3A and FGF-23 and periodontal parameters and inflammatory markers. Multivariate logistic regression was used to analyze the factors affecting the severity of CP patients. ROC curve was used to evaluate the severity of CP patients with SPSS 25.0 software package.

Results: The serum Sema3A level in the CP group was significantly lower than that in the control group, while the FGF-23 level was significantly higher than that in the control group (P＜0.05). The serum Sema3A level in mild, moderate, and severe CP group decreased sequentially, while FGF-23 level increased sequentially(P＜0.05). The levels of GI, AL, BI, PLI, PD, TNF-α, IL-17 and IL-6 in the mild, moderate, and severe CP groups increased sequentially (P＜0.05). The serum Sema3A level was negatively correlated with GI, AL, BI, PLI, PD, TNF-α, IL-17, and IL-6, while the FGF-23 level was positively correlated with the above indicators (P＜0.05). Sema3A was a protective factor for exacerbation in CP patients, while FGF-23, GI, AL, BI, PLI, PD, TNF-α, IL-17, and IL-6 were risk factors (P＜0.05). The AUC of combined evaluation of serum Sema3A and FGF-23 of the severity of CP patients was 0.919 (95%CI: 0.854-0.962), which was obviously better than a single indicator (P＜0.05).

Conclusions: Serum Sema3A is decreased and FGF-23 is increased in CP patients, which is closely related to periodontal parameters and disease severity, and combination evaluation has a high value in estimating the severity of CP patients.

Purpose: To investigate the differentially expressed proteins in dental pulp serum of pulpitis at different stages.

Methods: Dental pulp serum was collected from 9 pulpitis patients and categorized into three groups: initial pulpitis (IP), mild to moderate pulpitis (MP) and severe pulpitis (SP). Proteomics technology was utilized to screen for differentially expressed proteins. Functional annotation and enrichment analysis were then conducted using the Metascape database, while protein-protein interaction analysis was performed with the STRING database.

Results: Compared with the IP group, the MP group had 20 upregulated proteins and 23 downregulated proteins, while the SP group had one upregulated protein and 44 downregulated proteins. Compared to the MP group, the SP group had 9 upregulated proteins and 15 downregulated proteins. The differential proteins were mainly involved in key biological processes such as cellular response to stress, adaptive immune response, and the Parkin-ubiquitin proteasomal system. Protein-protein interaction network analysis identified several key functional nodes, including CCT6A.

Conclusions: This study analyzed the differential expression of proteins in dental pulp serum between early, mild to moderate, and severe pulpitis, providing a theoretical basis for accurate diagnosis and clinical decision-making of pulpitis.

Purpose: To evaluate the effect of digital smile design combined with minimally invasive laser crown lengthening and the effect on Liébart smile line.

Methods: From January 2021 to May 2023, a total 108 patients receiving crown restoration treatment were selected and assigned to control group (n=54, receiving laser minimally invasive crown lengthening alone) and experimental group (n=54, receiving digital smile design in addition to the control group's treatment) using a random number table. Periodontal health indicators, restoration margin-related distance indicators, tooth mobility, Liébart smile line classification and aesthetic standard scores were compared between the two groups.

Results: Six months after treatment, the plaque index (PLI), probing depth (PD) and bleeding index (BI) of the experimental group were significantly lower than those of the control group. Additionally, the restoration margin to bone crest distance(RM-BC) and restoration margin to gingival margin distance (RM-GM) were significantly higher in the experimental group(P＜0.05). Fourteen days after treatment, tooth mobility of the experimental group was significantly less than the control group (P＜0.05). Six months after treatment, the Liébart smile line classification was superior in the experimental group (P＜0.05);the pink esthetic score (PES) and white esthetic score (WES) of the experimental group were significantly higher than those of the control group(P＜0.05). After one year of follow-up, there was no significant difference in the incidence of adverse events between the two groups(P＞0.05).

Conclusions: Digital smile design combined with minimally invasive laser crown lengthening can significantly improve the clinical efficacy and aesthetic effect of smile line in patients with crown restoration.

Purpose: To evaluate the tool of automatic measuring CBCT, developed based on deep learning technology, and to compare its accuracy with manual measurement and to verify its effectiveness and feasibility.

Methods: Twenty-nine adult patients (11 males, 18 females) with mean age of (31.31±13.77) years old were enrolled, CBCT of enrolled patients were collected, and 427 transverse sections of alveolar teeth were extracted(5-5 position). A novel Segment Anything Model(SAM) -based interactive segmentation and measurement tool was developed and applied to the assessment of alveolar socket dimensions in CBCT. Manual and automatic measurements of bone mass in the buccal and lingual transverse section of the alveolar socket were performed by establishing the test set and the validation set, respectively, and the data were compared.

Results: There was significant correlation and consistency between CBCT automatic measurement method and manual measurement. The coefficient of determination(R²) of regression analysis in test set was 0.942, the measurement error in validation set was mainly varing between -0.43～0.47 mm, Pearson correlation coefficient was 0.9746 (P＜0.001).

Conclusions: This study developed an automatic CBCT measurement tool based on SAM through deep learning, with high accuracy and significantly improved the efficiency of alveolar socket measurement.

Purpose: To evaluate the value of biologically oriented preparation technique and conventional dental preparation in total crown restoration.

Methods: A total of 93 patients who underwent total crown restoration from January 2020 to November 2022 were selected, and were divided into experimental group and control group according to different dental preparation techniques. The control group was treated with conventional dental preparation (46 cases, 74 teeth), while the experimental group was treated with BOPT (47 cases, 75 teeth). Periodontal health indicators [plaque index (PI), gingival index (gingival index), probing depth (PD) and gingival thickness (GT)] were evaluated at 3 months, 6 months, 1 year and 2 years after treatment. The incidence of complications and patients' satisfaction were compared.

Results: In the control group, PI increased with time, reaching the highest value (2.20±0.57) at 1 year and decreasing to (1.70±0.66) at 2 years. PI of the experimental group reached the highest value (2.61±0.52) at the 3rd month, decreased at the 6th month, decreased to close to before treatment at the 1st year, and was significantly lower than before treatment at the 2nd year(P＜0.001). The GI of the two groups decreased with the extension of time, and the GI of the experimental group at 6 months, 1 year and 2 years after treatment was significantly lower than that of the control group (P＜0.001). The PD of the two groups decreased with the extension of time, and the PD of the control group increased at 6 months after treatment, and the PD of the experimental group was significantly lower than that of the control group at 6 months, 1 year and 2 years after treatment (P＜0.001). Buccal GT of the two groups decreased with the extension of time, and the GT of the experimental group at 6 months, 1 year and 2 years after treatment was significantly lower than that of the control group (P＜0.05). The incidence of biological complications in the experimental group (2.67%) was significantly lower than that in the control group (10.81%)(P＜0.05). There was no significant difference in the incidence of mechanical complications between the two groups (P＞0.05). The total complication rate of the experimental group (4.00%) was significantly lower than that of the control group (14.86%)(P＜0.05). The scores and total scores of satisfaction of the experimental group were significantly higher than those of the control group (P＜0.05).

Conclusions: BOPT for total crown repair can reduce PI, GI and PD, increase GT, reduce complications and improve patients' satisfaction.