上海口腔医学最新文献

Purpose: To explore the effect of fluoride iontophoresis in preventing dental caries in children, characteristics of saliva fluoride metabolism and influencing factors.

Methods: A total of 500 children who underwent oral examinations from April 2022 to October 2023 were selected and divided into experimental group and control group according to the random number table method, with 250 children in each group. The control group received routine prevention, while the experimental group received fluoride iontophoresis prevention. The caries prevention effects, salivary fluoride concentrations and caries prevalence after 12 months of intervention were compared between the two groups before intervention and 12 months after intervention, according to whether they had caries or not, they were divided into caries group (n=258) and non-caries group (n=242). The general data of the two groups were compared, and the influencing factors of caries in children were analyzed by multivariate logistic regression.

Results: Twelve months after intervention, the decayed, missing and filled teeth (DMFT) index and significant caries index (SiC) in the experimental group were significantly lower than those in the control group (P＜0.05). At 30 minutes, 2 hours, 4 hours, 6 hours, and 2 days after intervention, the salivary fluoride concentration in the experimental group was significantly higher than that in the control group (P＜0.05). Twelve months after intervention, the caries incidence rate in the experimental group was significantly lower than that in the control group (P＜0.05). The results of univariate analysis showed that age, weaning age, frequency of sweet food consumption, frequency of night eating, age of starting to brush teeth, brushing frequency, toothpaste with or without fluoride, regular check-ups and the concentration of free fluoride after intervention were the influencing factors of dental caries in children (P＜0.05). The results of multivariate logistic regression analysis showed that older age and older weaning age were independent risk factors for dental caries in children (P＜0.05), while the frequency of sweet food consumption＜3 times per week, the frequency of nocturnal eating＜5 times per week, fluoride content in toothpaste and regular oral examinations were independent protective factors for dental caries in children (P＜0.05).

Conclusions: Fluoride iontophoresis can significantly reduce the incidence of dental caries in children, increasing the fluoride concentration in saliva, affected by multiple factors.

Purpose: To investigate the effect of dental-derived mesenchymal stem cells on the biological characteristics of cementoblasts.

Methods: Periodontal ligament stem cells (PDLSCs) and dental pulp stem cell (DPSCs) were isolated, flow cytometry was used to detect cell surface markers. Cementoblasts OCCM-30 were coculture with PDLSCs and DPSCs for 12 h and 24 h. Cell proliferation was examined using the CCK-8 method. ALP staining was used to evaluate the osteogenic differentiation of cementoblasts in different treatment groups. Wound healing migration assays and Transwell migration assays were performed to compare the migration of cementoblasts. The expression of MMP9 and MMP13 was assessed using enzyme-linked immunosorbent assay(ELISA).

Results: The expression rates of CD90 and CD34 of PDLSCs were 99.44% and 0.23%. The expression rates of CD90 and CD34 of DPSCs were 99.93% and 3.47%. Their multipotency were illustrated based on differentiation to abiogenic, osteogenic lineages. Human mesenchymal stem cells promoted the proliferation of cementoblasts(P＜0.05). The osteogenic differentiation of cementoblasts was increased after stem cells treatment. The migration of cementoblasts was increased after stem cells treatment (P＜0.05), and the expression of MMP9 and MMP13 were enhanced.

Conclusions: Dental-derived stem cells can promote the proliferation, osteogenic differentiation and migration of cementoblasts, playing an active role in cementum restoration and providing a scientific basis for promoting the repair process in root resorption.

Purpose: To evaluate the effects of anxiety and depression on the risk of periodontitis using Mendelian randomization (MR) method, and to analyze the prevalence and influencing factors of anxiety and depression symptoms in patients with periodontitis, so as to provide evidence for clinical prevention and treatment.

Methods: The data of 70 patients with periodontitis and 35 healthy controls who were treated in the Fourth Hospital of Changsha from August 2022 to August 2024 were collected.Hamilton Anxiety Rating Scale (HAMA) was used to assess the anxiety of the subjects. Hamilton Depression Rating Scale (HAMD) was used to assess symptoms of depression of the subjects, and potential risk factors were analyzed by logistic regression. Single nucleotide polymorphisms (SNP) were screened from the Genome-Wide Association Study (GWAS) database as instrumental variables. The independent SNP were screened according to the P-value threshold (P=5e-05) and the linkage unbalanced clustering method (window size 10 000 kb, r² threshold 0.001), and the data were coordinated. Five MR methods, including inverse variance weighted (IVW), were used to analyze the causal relationship between anxiety and depression on acute and chronic periodontitis.

Results: In the clinical case-control study, HAMA and HAMD scores of the periodontitis group were significantly higher than those of the control group (HAMA: P=0.006; HAMD: P=0.007). The incidence of anxiety in the periodontitis group was significantly higher than that in the control group (P=0.008), and the incidence of depression was also significantly higher (P=0.006). Logistic regression analysis revealed that anxiety, depression, and age ≥ 60 years were independent risk factors for periodontitis (P＜0.05). MR analysis showed that anxiety was significantly positively correlated with acute periodontitis (IVW method, P =0.037), and depression was significantly positively correlated with acute periodontitis (IVW method, P=0.043), but neither was significantly associated with chronic periodontitis (P＞0.05). The tests for pleiotropy and heterogeneity indicated that the analysis results were reliable (IVW method and MR Egger method, P＞0.05 for both).

Conclusions: There is significant correlation between anxiety and depression symptoms and periodontitis. It is recommended to consider the influence of psychological factors in clinical treatment of periodontitis.

Purpose: This study constructed a model of OSAA (oral survival analysis with attention) for survival analysis of competitive events in oral cancer based on attention mechanism, and explored its application value in oral auxiliary diagnosis and treatment of oral cancer.

Methods: Eligible data of oral cancer patient from Surveillance, Epidemiology, and End Results Program(SEER) database were selected as research subjects. Cox proportional hazards models, deep learning-based survival analysis models (such as DeepSurv, DeepHit), and OSAA models were established and trained for prediction. The predictive performance of each model was tested through concordance index (C-index) and integrated Brier score (IBS) test. The model's discriminative ability was evaluated using the Kaplan-Meier survival curve and the time-dependent receiver operating characteristic (ROC) curve.

Results: OSAA demonstrated ahigher C-index and a lower IBS on different datasets, with more distinct survival and ROC curves compared to other models.

Conclusions: The OSAA model exhibits superior predictive performance compared to other models, with better robustness and generalization ability under different datasets and tasks. It has a certain value for establishing auxiliary diagnosis and treatment models for oral diseases represented by oral cancer.

Purpose: To evaluate the expression efficiency of personalized labial appliances in patients with mild dental crowding.

Methods: Thirty-two Class Ⅰor Class Ⅱ malocclusion patients with mild crowding of anterior teeth were selected. All patients were treated with the Insignia personalized labial correction system without tooth extraction. The three-dimensional digital dental models before treatment, at the target position and after treatment were collected. Then, the widths and torques of the maxillary and mandibular dental arches were measured, and the expansion efficiency was calculated.

Results: After orthodontic treatment, the widths of the maxillary and mandibular dental arches were significantly increased compared with those before treatment (P＜0.05), but there was no significant difference compared with the widths of the target dental arches (P＞0.05). Among the maxillary teeth positions, except for the first premolar, the actual expansion amounts of the other teeth positions were significantly less than the target expansion amounts (P＜0.05); among the mandibular teeth positions, except for the first molar, there was no significant difference between the actual expansion amounts and the target expansion amounts of the other teeth positions (P＞0.05). In the maxilla, the expansion efficiency was the highest for the first premolars and the lowest for the first molars; while in the mandible, it was the highest for the second premolars and the lowest for the first molars. Except for the mandibular first molars, there were statistically significant differences in the torques between pre-treatment and the target torques as well as between pre-treatment and post-treatment at most tooth positions in the maxilla and mandible (P＜0.05). Except for the maxillary second premolars, there was no significant difference in the torques between pre-treatment and the target torques at the other tooth positions (P＞0.05).

Conclusions: The application of Insignia personalized labial aligners in the treatment of mild anterior tooth crowding cases with relatively good lateral profile can effectively widen the dental arch and achieve a correction result close to the target position. However, the long-term effect still needs further research.

Purpose: To analyze the clinical efficacy of 3D-printing individualized titanium mesh (3D-PITM) technology in the treatment of complex alveolar bone defects.

Methods: A total of 22 patients with complex alveolar bone defects were selected for treatment with 3D-PITM. Mimics 21.0 software was used to reconstruct the CBCT data before surgery, immediately after surgery, and 6 months after surgery. Alveolar bone width and bone height increase were measured and postoperative complications were recorded. Buccal keratinized gingival width was measured before and after bone grafting, and the correlation between the change of keratinized gingival width and the amount of bone grafting immediately after surgery was analyzed.

Results: Six months post-grafting, there was significant increase in horizontal bone gain (4.21±1.03) mm and vertical bone gain (4.24±1.12) mm (P＜0.001). One patient experienced postoperative infection, with no other complications reported. Six months after grafting, the width of the keratinized gingiva on the buccal side was significantly reduced by (1.19±0.20) mm compared to pre-graft measurements (P＜0.001). The reduction in keratinized gingival width was positively correlated with the immediate postoperative bone volume (r=0.80, P＜0.001).

Conclusions: 3D-PITM can effectively complete complex bone augmentation with low incidence of complications, but there is a reduction in the buccal keratinized gingivitis after bone augmentation, and the reduction is positively correlated with the amount of bone grafting immediately after surgery.

Purpose: To explore the factors influencing aesthetic perception changes among non-orthodontic professionals with higher education in Shanghai regarding the maxillofacial appearance of women before and after orthodontic treatment with extractions.

Methods: A total of 18 non-orthodontic professionals (9 men and 9 women) who had received or were receiving higher education in Shanghai were recruited. Using Q-sort technique, the study compared pre- and post-treatment facial soft tissue changes in 48 adult females who underwent orthodontic treatment with extractions.

Results: Non-orthodontic professionals with higher education in Shanghai showed significant sensitivity to changes in the lower third of the face, overall facial contour, mouth corners, and chin of women before and after orthodontic treatment (P＜0.05). However, changes in the nasolabial fold and upper and lower lips, which were often the focus of orthodontic professionals,didn't show significant differences in aesthetic perception. Female reviewers were more sensitive than male reviewers to aesthetic changes in the chin and lower third of the face, but there was no significant difference in overall facial evaluation. Reviewers born in the 2000s and 1990s demonstrated higher aesthetic sensitivity, while those born in the 1970s and 1980s showed more stable aesthetic evaluations.

Conclusions: Non-orthodontic professionals with higher education experience in Shanghai are more sensitive to the aesthetic changes in the lower 1/3 of the face, chin and other areas after orthodontic treatment with tooth extraction, and the perceived differences are affected by gender and age, which can provide a reference for the design of endpoint goal schemes in clinical orthodontic treatment.

Purpose: To analyze and summarize the clinical characteristics of patients with two supernumerary teeth in the upper incisor area, in order to provide reference for clinical diagnosis and treatment.

Methods: A total of 309 patients with two supernumerary teeth in the upper incisor area who were admitted to Hospital of Stomatology, Hebei Medical University from January 2017 to December 2021 were collected, their age, gender, reasons for medical treatment, and related information on supernumerary teeth were statistically analyzed. The growth direction, eruption status, morphology, and development of supernumerary teeth in different genders and age groups were grouped and analyzed. SPSS 21.0 software package was used for data analysis.

Results: Among 309 patients, the average age was (8.21±3.89) years old, and the male to female ratio was 3.83∶1. The 6-12 years old group had the highest number of visits, with 205 cases (66.34%); 204 cases (66.02%) had 2 supernumerary teeth with inconsistent growth directions, 223 cases (72.17%) had 2 supernumerary teeth with inconsistent morphology, 194 cases (62.78%) had 2 supernumerary teeth with fully developed roots, 174 cases (56.31%) had 2 supernumerary teeth in an unexpired state. There was no significant difference(P＞0.05) in the growth direction, eruption status, development, treatment reasons, and impact on adjacent tissues between the two supernumerary teeth of different genders, but there was significant difference(P＜0.05) in morphology. There was significant difference in the growth direction of two supernumerary teeth in different age groups(P＞0.05), but there were significant differences in eruption status, morphology, development, medical reasons, and impact on adjacent tissues(P＜0.05).

Conclusions: Patients with two supernumerary teeth in the upper incisor area are mostly seen in the mixed dentition period. The incidence rate of males is significantly higher than that of females. Gender has certain impact on the morphology of supernumerary teeth, and age has certain impact on the eruption, morphology, and development of supernumerary teeth.

Purpose: To explore the influence of alveolar process expansion, guided bone regeneration (GBR) and bone grafting for simultaneous dental implantation therapy on bone resorption volume, retention and masticatory function in patients with severe deficiency of alveolar bone horizontal width.

Methods: Eighty patients with severely insufficient alveolar bone width who received dental implantation therapy in Hangzhou Stomatology Hospital were selected from January 2021 to January 2023. Totally 40 patients (55 teeth) who received alveolar process expansion combined with GBR bone grafting were included in the experimental group, while 40 patients (51 teeth) with traditional alveolar bone splitting were enrolled as the control group. Both groups were treated with dental implantation at the same time. The repair effect [bone healing time, diameter and implant stability quotient (ISQ)], occurrence of complications and subjective feeling scores (retention, pain and tooth aesthetics) 1 year after surgery, alveolar bone resorption volume (mesial and distal), periodontal related indicators [gingival sulcus depth (SPD), gingival sulcus bleeding index (SBI) and gingival index(GI)] and masticatory function (masticatory efficiency, occlusal force) before surgery and 1 year after surgery were compared between both groups.

Results: The bone healing time in the experimental group was significantly less than that in the control group(P＜0.05). The total incidence rate of complications was significantly lower in the experimental group than that in the control group(P＜0.05). At 1 year after surgery, the alveolar bone resorption volume, SPD, SBI and GI in both groups were significantly reduced than those before surgery, and the indicators in the experimental group were much lower(P＜0.05). The masticatory efficiency and occlusal force in the experimental group were significantly enhanced compared to before surgery(P＜0.05), and the two indicators were significantly higher than those in the control group(P＜0.05). At 1 year after surgery, the retention function and pink esthetic score(PES) in the experimental group were significantly higher (P＜0.05) while the visual analogue scale(VAS) score was significantly lower than the control group (P＜0.05).

Conclusions: Simultaneous dental implantation with alveolar process expansion combined with GBR bone grafting has good repair effect and safety for patients with severe bone width deficiency. It can help to reduce bone resorption volume, enhance retention stability after bone grafting, relieve pain and improve tooth aesthetics.

Purpose: To investigate the anatomic features of nasolabial flap pedicled with a facial artery and its application in repairing the defect after surgery of stage T1-T2 carcinoma of the floor of mouth.

Methods: Dissections of the maxillofacial region were performed on 8 specimens of national adults fixed with 10% formaldehyde, and the anatomical pictures were analyzed using Image-Pro Plus 6.0 software. Nine patients were retrospectively reviewed from August 2015 to January 2024 for the repair of postoperative defects of stage T1-T2 carcinoma of the floor of mouth using nasolabial fold flaps with a facial artery perforator branch as vascular pedicle.

Results: The external diameter of the facial artery at the lower border of the mandible was (2.05±0.98) mm. The main trunk of the facial artery traveled along the line from the beginning of the facial artery to the nasal blade and had a length of (90.89±3.79) mm. The main facial vein run along the line from the beginning of the facial artery to the medial canthus, and its length is (118.10±2.57) mm. The longest distance between the facial artery and the facial vein was (25.92±1.96) mm. Nine patients had a favourable postoperative outcomes without obvious complications.

Conclusions: Repair of postoperative defects in middle-aged and elderly patients with T1-T2 stage carcinoma of the floor of mouth using a nasolabial fold flap can achieve satisfactory clinical outcomes.