上海口腔医学最新文献

Purpose: To compare the mucosal morphological difference in distal-extension area of mandibular dentition defect taken by intra-oral digital scanning and selective pressure impression techniques.

Methods: Seventeen patients with Kennedy Class I and Class II dentition defect in lower jaw were included, including twenty-two distal-extensions. Intraoral digital scanning and functional impression technique were taken in each patients, respectively. Laboratory cast scanner was used to scan the plaster casts made from the selective pressure impression to obtain the three-dimensional data. All the data were stored in STL format. The 3D data collecting from intra-oral digital scanning and selective pressure impression from the same patient were compared by Geomagic Control 2014 software. Root mean square of 2.5mm diameter area was calculated in 5,10,15 mm from terminal tooth. Pearson's correlation test was used to analyze the correlation of the distance and morphological difference with SPSS 20.0 software package.

Results: Mean mucosal morphological difference of jaw distal-extension edentulous area taken by intra-oral digital scanning and selective pressure impression techniques was (0.37±0.12) mm. There was positive correlation between distance from terminal tooth and mucosal morphological difference(P＜0.05). Morphological differences in 5, 10, 15 mm from terminal tooth were (0.14±0.11) mm, (0.22±0.13) mm and (0.39±0.16) mm, respectively.

Conclusions: In this study, there was positive correlation between the length of distal-extension edentulous area and mucosal morphological difference, while the kind of ridge defect and mucosal thickness may also affect the morphological difference quantity.

Purpose: To investigate the effects of erbium laser pretreatment on the bond strength of dentin and enamel,as well as microleakage at the edge of tooth defects repaired with computer-aided design (CAD) and computer-assisted manufacturing (CAM) glass-ceramic restorations for repairing dental defects.

Methods: A total of 62 fresh, nondecayed, nondiscoloration and noncracked wisdom teeth were collected from the Oral Surgery Clinic between January 2020 and January 2023. According to different pretreatment methods, they were randomly divided into two groups, erbium laser group and phosphoric acid group, with 31 teeth in each group. Each group was further divided into two subsets for bond strength testing (16 teeth) and microleakage testing (15 teeth).The shear bond strength between enamel and dentin of both groups was compared, as well as the degree and distribution of microleakage.Statistical analysis was performed with SPSS 17.0 software package.

Results: The shear bond strength between enamel and dentin of the erbium laser group was significantly higher than that of the phosphoric acid group (P＜0.05); the degree and distribution of microleakage at the lateral walls and gumline of the erbium laser group were significantly lower than those of the phosphoric acid group (P＜0.05). The scores of microleakage at the lateral walls of the erbium laser group mainly concentrated in grade 1 and 2, whereas those of the phosphoric acid group mainly concentrated in grade 2. There was significant difference in the distribution of lateral wall microleakage scores between the two groups (P＜0.05). The scores of microleakage at the gumline of the erbium laser group mainly concentrated in grade 1 and 2, whereas those of the phosphoric acid group mainly concentrated in grade 2 and 3. There was significant difference in the distribution of gumline microleakage scores between the two groups (P＜0.05).

Conclusions: Erbium laser pretreatment can improve bonding strength between glass ionomer cement and dentin and enamel, reduce microleakage at the edge of CAD/CAM glass ionomer cement restorations, and enhance marginal fit.

PURPOSE： To investigate the clinical features of children who received treatment under dental general anesthesia (DGA). METHODS: The clinical records of dental patients below 18 years old who were treated under DGA at the Department of Pediatric Dentistry, Affiliated Dental Hospital of Kunming Medical University during June 2017 to November 2019 were obtained, including the baseline information, causes for DGA, anesthesia methods, intubation methods, treatment items, treatment time and follow-up visits. SPSS 26.0 software package was used to analyze the data. RESULTS: A total of 120 patients were included, 58.3% were males, and children aged 3 to 6 years showed the highest demand for DGA (85.0%). Fear of dental treatment, ineffective non-drug behavior management was the main causes for DGA in young children, while the most common causes for children over 6 years old to choose DGA were mental retardation (38.9%) and patients' needs(38.9%). The average number of teeth treated was (15.16±3.42) for each child, and the average time for treating one tooth was 12.26 min. Restoration, root canal treatment and primary teeth pre-forming crown(including anterior preformed resin transparent crown and posterior preformed metal crown) were the main treatment items. At 1-week follow-up visits, 98.3% of children had no discomfort. During 2017 to 2019, there was an increasing tendency in the number of patients who chose DGA in the authors' institute. CONCLUSIONS： The dental issues of children with fear of dental treatment, ineffectiveor non-drug behavior management or mental retardation can be treated under DGA conveniently, safely and efficiently. The acceptance rate of DGA among pediatric patients is on the rise. DGA training programs and related support projects are needed to meet the treatment demands among patients in less developed areas.

Purpose: To analyse the types of chairside CAD/CAM all-ceramic restorations and the color range of all-ceramic materials used so as to provide reference for the application of clinical chairside all-ceramic restoration and the color selection of all-ceramic materials.

Methods: IPS e.max CAD prostheses and related data were collected from January 2021 to December 2021 from the Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The number and type of restorations and the color of materials were investigated and analyzed by descriptive statistics.

Results: A total of 1 374 restorations were included, of which 624 were crown restorations, accounting for 45.41% of the total restorations. 516 cases were veneer, accounting for 37.55%; 219 were inlays, accounting for 15.94%; fixed bridges were all adhesive bridges, with the least number with only 15 cases, accounting for 1.09%. In terms of the selection of restoration materials, the use rate of low-transparent(LT) ceramic blocks was significantly higher than that of other transparent ceramic blocks. A was the most frequently used ceramic color. The most frequently used porcelain blocks for veneers were LTA2 and LTA1; for inlay were LTA3; for crowns were LTA2 and LTA3. The blocks used in the fixed bridges were all LT, and A3 color was the majority.

Conclusions: Chairside CAD/CAM all-ceramic prostheses made of IPS e.max CAD materials have been widely used in clinical practice. The types of prostheses include veneer, inset, crown and fixed bridge. The most commonly used IPS e.max CAD blocks are LTA2, LTA3 and LTA1. These findings have certain guiding significance for the clinical restoration decision and the reserve of porcelain blocks in primary hospitals.

Purpose: To investigate the efficacy of a modified maxillary protraction appliance in patients of skeletal Class Ⅲ with crowding.

Methods: Forty patients with skeletal Class Ⅲ malocclusion were divided into two groups, with 20 patients in each group. The experimental group had molar in a neutral or distal relationship and applied a modified maxillary protraction appliance, while the control group had molar mesial relationship and applied a conventional maxillary protraction appliance. Lateral cephalometric radiographs were taken before and after treatment in both groups for comparison. SPSS 22.0 software package was used for data analysis.

Results: The angle measurements taken before and after treatment showed a significant increase in SNA, ANB, SN-MP and U4-SN(P＜0.01), while SNB decreased(P＜0.01) in both groups. SN-OL changes were statistically different before and after treatment in the experimental group(P＜0.05). The sagittal measurements before and after treatment in both groups showed significant alterations in all(P＜0.05) but the length of the maxillary arch in both groups. For vertical measurements, U1-PP, L1-MP, U4-SN, U6-SN, and ANS-ME all increased (P＜0.05), while the changes of U4-PP and U6-PP in the two groups before and after treatment were statistically different(P＜0.05). Compared with the control group, the experimental group had a significantly increased maxillary arch length, a more remote location at U6, and a less variable molar relationship after treatment(P＜0.01). The two groups showed a variable amount of cephalometric measurements before and after treatment: the experimental group had a significant increase in maxillary arch length, a more remote position at U6, and a smaller change in molar relationship compared to the control group(P＜0.01).

Conclusions: The modified maxillary protraction appliance showed good results for maxillary protraction and pushing the molar distally in patients with skeletal Class Ⅲ with crowding at neutral or distal molar relationship.

Purpose: To explore the efficacy of iRoot BP plus in the treatment of adult carious pulp exposure and its impact on pulp blood flow.

Methods: A total of 126 cases of 156 permanent teeth from adult patients with carious pulp exposure who were treated from January 2020 to January 2022 were selected, the patients were divided into experimental group(63 cases with 79 permanent teeth) and control group(63 cases with 77 permanent teeth) by the envelope method. The experimental group was treated with iRoot BP plus, while the control group was treated with mineral trioxide polymer. The differences in treatment effectiveness, operation time, and tooth discoloration between the two groups were observed. Statistical analysis was performed with SPSS 22.0 software package.

Results: There was no significant difference in treatment success rates between the experimental group and the control group at 3, 6, and 12 months after surgery(P＞0.05). The operating time for each capsule in the experimental group was (2.53±0.41) min, which was significantly shorter than that in the control group(P＜0.05). The incidence of tooth discoloration in the experimental group at 12 months after surgery was 3.80%, which was significantly lower than that in the control group (P＜0.05). The bite force quotient and masticatory efficiency of the experimental group 12 months after operation were (16.65±1.14) Ibs and (94.45±5.65)%, which were significantly higher than those of the control group(P＜0.05).

Conclusions: IRoot BP plus has good efficacy in the treatment of adult carious pulp exposure, with advantages such as convenient operation, less tooth discoloration, less inflammatory reactions and stable pulp blood flow after decline.

Purpose: To investigate the effect of Morinda officinalis polysaccharides(MOP) on the expression of fibronectin(FN) and fibronectin containing extra domain A(FN-EDA) in inflammatory periodontal ligament fibroblasts.

Methods: Thirty six rats were randomly divided into a control group(n=12) and a model group (n=24). The model group used orthodontic wire ligation to establish periodontitis. After three weeks, 6 rats from each group were selected and confirmed by Micro-CT to complete the modeling. The remaining rats in the model group were randomly divided into periodontitis group, normal saline(NS) group, and MOP group. In the MOP group, MOP (200 mg/kg for 3 d, 50 μL for 4 weeks) was injected into the palatal side of the left maxillary first molar of the rats. In the NS group, same volume of NS was injected, and no treatment was performed in the periodontitis group. The left maxillary tissue of rats were taken and the pathological changes of periodontal tissue were observed by H-E staining. The expression of FN and FN-EDA was detected by immunohistochemistry. Periodontal ligament fibroblasts were cultured in vitro, the effect of MOP on cell activity detected by CCK-8. The fourth generation cells were divided into control group, inflammation group (10 mg/mL lipopolysaccharide), and experimental group (12.5 μg/mL MOP, 12.5 μg/mL MOP+10 mg/mL lipopolysaccharide). The expression of FN and FN-EDA was detected by qRT-PCR and Western blot. The data were statistically analyzed using Prism 8.0 software package.

Results: In vivo experiments, the expression of FN-EDA in the MOP group was significantly lower than that in the periodontitis group and NS group(P＜0.05), and the infiltration of inflammatory cells was reduced. However, there was no significant difference in the expression of FN in each group. In vitro experiments, compared with the control group, the expression of FN-EDA mRNA and protein in the inflammation group was significantly increased(P＜0.000 1). MOP significantly reduced the expression of FN-EDA in inflammatory cells, but had no significant effect on FN expression.

Conclusions: With increased expression of FN-EDA in inflammatory periodontal ligament tissues and cells, MOP may play a role in inhibiting inflammation by down-regulating FN-EDA.

Purpose: To summarize the ultrasound, CT and MRI manifestations of Warthin-like mucoepidermoid carcinoma (WT-MEC), and to explore its imaging characteristics, so as to provide reference for clinical and preoperative diagnosis.

Methods: The clinical information and imaging data of ultrasound, CT and MRI of 12 patients with WT-MEC diagnosed by pathology in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2017 to December 2021 were collected, and their specific characteristics were retrospectively summarized.

Results: Among the 12 WT-MEC patients, there were 7 males and 5 females, with an average age of (42.7±16) years. Seven cases underwent ultrasound examination, 6 cases underwent CT examination, and 2 cases underwent MRI examination. Radiologically, all the lesions presented as a solitary mass. 11/12 lesions(91.7%) were identified as well-defined margins, and 10/12(83.3%) as solid-cystic masses. All solid-cystic lesions contained multiple cystic areas with variable sizes. On US images, most lesions showed mixed-echoic echogenicity(5/7, 71.4%), poor vascularization (6/7, 85.7%) and acoustic enhancement (6/7, 85.7%). CT revealed all the lesions (6/6, 100%) as a soft-tissue mass with heterogeneous enhancement (5/6, 83.3%). MRI imaging demonstrated the neoplasm with low or iso-signal intensity on plain T1WI and hyperintensity on T2WI. The heterogeneous enhancement was shown on contrast-enhanced T1WI.

Conclusions: Most WT-MECs represent as a solitary, well-defined, solid-cystic mass in the parotid gland. The neoplasm may be characterized by the multiple and variable-sized cystic components within the tumor.

Purpose: To investigate the effect of TNF-α on osteogenic differentiation of stem cells from human exfoliated deciduous teeth (SHED), and to analyze the changes of ERK1/2-Runx2 signaling pathway in the regulation process.

Methods: SHED cells were isolated and cultured from normal deciduous permanent teeth of healthy children aged 6-8 years old, and the third passage of SHED cells were taken and divided into control group (osteogenic inducer culture), observation group (osteogenic inducer and TNF-α co-culture) and agonist group (osteogenic inducer, TNF-α and ERK pathway agonist co-culture). The osteogenic differentiation was determined by alizarin red staining. The protein expression levels of Osterix, OPN, ERK1/2, pERK1/2 and Runx2 in SHED cells were determined by Western blot. The expressions of Osterix, OPN, ERK1/2, pERK1/2 and Runx2 mRNA were detected by qRT-PCR. Statistical analysis was performed with SPSS 26.0 software package.

Results: Comparison of osteogenic differentiation ability of the three groups of cells showed that red-brown mineralized nodules were observed in the three groups of cells. Compared among the three groups, the control group had the most mineralized nodules, followed by the activation group, and the observation group had the least mineralized nodules. Compared with the control group, the expression levels of Osterix and OPN protein and mRNA in the observation group and the agonist group were significantly decreased, while the expression levels of Osterix and OPN protein and mRNA in the agonist group were significantly higher than those in the observation group. There was no significant difference in the expression levels of ERK1/2 protein and mRNA among the three groups, while the expression levels of pERK1/2 and Runx2 protein and mRNA in the observation group and the agonist group were significantly higher than those in the control group, and the expression levels of pERK1/2 and Runx2 protein and mRNA in the agonist group were significantly higher than those in the observation group.

Conclusions: TNF-α can inhibit osteogenic differentiation of SHED cells, which may be related to the inhibition of ERK1/2-Runx2 signaling pathway.

Purpose: To study the stability of physicochemical properties and sterilizing effect about two commercially available hypochlorous acid (HClO) products under simulated clinical conditions, and to evaluate the compatibility of HClO on soft and hard tissues and cells in oral cavity.

Methods: Samples of HClO solution with different production processes were prepared, to detect the changes of physicochemical indexes of each sample over time under simulated clinical conditions (shielded from light at 20-25 ℃, open the cover for 5 minutes every day), including free available chlorine, oxidation-reduction potential and pH. Through suspension quantitative germicidal test, the antibiosis-concentration curve of HClO solution was made, so as to calibrate the change of antibacterial ability of disinfectant with the decrease of available chlorine content during storage. Pulp, tongue and dentine were immersed in PBS, 100 ppm HClO, 200 ppm HClO and 3% NaClO. The influence on soft and hard tissues was evaluated by weighing method and microhardness test. The toxic effects of HClO, NaClO and their 10-fold diluent on human gingival fibroblasts were determined by CCK-8 cytotoxicity assay. GraphPad PRIS 8.0 software was used to analyze the data.

Results: Under simulated conditions, the free available chlorine (FAC) of HClO solution decayed with time, and the attenuation degree was less than 20 ppm within 1 month. The bactericidal effect of each HClO sample was still higher than 5log after concentration decay. There was no obvious dissolution and destruction to soft and hard tissues for HClO(P＞0.05). The cell viability of HClO to human gingival fibroblast cells (HGFC) was greater than 80%, which was much higher than 3% NaClO (P＜0.001).

Conclusions: The bactericidal effect and stability of HClO solution can meet clinical needs, which has low cytotoxicity and good histocompatibility. It is expected to become a safe and efficient disinfection product in the field of living pulp preservation and dental pulp regeneration.