上海口腔医学最新文献

Purpose: To evaluate the effect of sliding vermilion flap in angulus oris defect after buccal mucosal cancer ablation.

Methods: A total of 33 patients with buccal mucosal cancer who underwent buccal mucosal cancer radical surgery and resection of angulus oris, and reconstructed with free anterolateral thigh flap transfer and sliding vermilion flap were collected from January 2015 to April 2021 in Department of Oral and Maxillofacial Surgery at Second Xiangya Hospital. Thirty-three patients with buccal mucosal cancer admitted to Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University from January 2015 to April 2021 were selected. All patients underwent combined buccal-mandibulectomy and neck radical operation and resection of oral angle, and underwent anterolateral femoral free flap and lip red elastic flap reconstruction. The angulus oris outcome, aesthetics outcome, masticatory efficacy, swallowing and speech function were assessed by FACT-HN (The Functional Assessment of Cancer Therapy-Head and Neck). The mouth opening was measured and recorded. SPSS 19.0 software package was used for statistical analysis of the data.

Results: The success rate of free flap transplantation was 100% in 33 patients. Although the aesthetics outcome was decreased at postoperative 1 year compared with that of preoperative duration (P＜0.001), there was no significant difference of angulus oris outcome at postoperative 1 year compared with that of preoperative duration (P＞0.05). Moreover, the masticatory function was significantly improved at postoperative 1 year compared with that of preoperative duration(P=0.004). However, there was no significant difference of speech and swallowing function at postoperative 1 year compared with that of preoperative duration (P＞0.05). The mouth opening was significantly improved at postoperative 1 year compared with that of preoperative duration(P＜0.05), and the satisfaction of mouth opening in these patients was 75.7%.

Conclusions: The use of sliding vermilion flap can ideally repair the angulus oris, and offer a novel method to reconstruct defect of angulus oris.

Purpose: To compare the effect of glass fiber post core porcelain crown and cobalt alloy post core porcelain crown in repairing residual root and crown of the anterior teeth.

Methods: The data of 121 patients with residual root and crown of anterior teeth admitted to the hospital from January 2020 to December 2023 were reviewed, of which 61 patients were treated with glass fiber post-core porcelain crown restoration (experimental group) and 60 patients with cogger alloy post core all porcelain crown repair (control group). The repair outcomes of the two groups were recorded after 12 months of follow-up. The final results, aesthetic effect, periodontal health index, gingival crevicular fluid inflammatory factors and complications were compared between the two groups. SPSS 18.0 software package was used for statistical analysis of the data.

Results: The success rate of the experimental group was significantly higher than that of the control group (P＜0.05). There was no significant difference in pink esthetic scores (PES) and white aesthetic scores (WES) between the two groups before and after treatment (P＜0.05). The sulcus bleeding index (SBI), gingival index (GI) and plaque index (PLI) after treatment were significantly lower in both groups than before treatment (P＜0.05), and the experimental group after treatment was more lower(P＜0.05). TNF-α, IL-6 and IL-8 levels after treatment were significantly lower in both groups than before treatment (P＜0.05), and TNF-α and IL-6 levels in the experimental group after treatment were more lower (P＜0.05). There was no significant difference in the total complication rate between the two groups (P＞0.05).

Conclusions: Compared to cobalt alloy post-core all-porcelain crown, glass fiber post-core all-porcelain crown can enhance the repair effect, improve periodontal health, inhibit the damage of gingival crevicular fluid inflammation.

Purpose: To train the U-net of convolutional neural network to establish a method for detecting and segmenting the mandibular canal and its bifurcation, and validate its accuracy based on the ground truth labeled by experts.

Methods: A total of 290 CBCT scans were collected from Shanghai Stomatological Hospital from Jan. 2022 to Dec. 2022, which were divided into training set of 200 scans and test set of 90 scans. Model training included two steps. In the first step, bilateral mandibular canals and its bifurcation of 50 CBCT scans were labeled in 3D Slicer image computing platform by investigators. Three dimensional U-net segmentation model were trained initially with data enhancement. A morphological post-processing method was applied to the predicted results. In the second step, pseudo label method was employed to help annotating the mandibular canal and corresponding bifurcations on remaining 150 CBCTs, which would be included in training set after revision. Three dimensional U-net model was trained based on these 200 data. During test phase, totally 90 scans were labeled by two doctors and U-net model respectively. Consistency check was conducted to evaluate the labels between two doctors. Dice similarity coefficient and Hausdorff distance were calculated to evaluate the labels between doctors and the model. The detection rate of bifurcation was calculated. SPSS 20.0 software package was used for data analysis.

Results: In 90 CBCT test set, the Kappa value between two dentists' annotations was 0.667. The average Dice and Hausdorff distance between predictions and labels of doctors were (0.739±0.068) and (0.988±1.14) mm. In bifurcation detection, the detection rate was 91.30% on scans with clear bifurcations.

Conclsions: The dentification and segmentation U-net model of mandibular canal on dental CBCT can be reliable and practical for its high segmentation precision and predicting speed.

Purpose: To explore the effectiveness of improved Twin block appliances combined with micro-implant anchorage in correction of Class Ⅱ division 1 malocclusion.

Methods: A retrospective analysis of medical records of 96 patients with Class Ⅱ division 1 malocclusion treated at Rugao Hospital of Traditional Chinese Medicine from January 2018 to January 2022 was conducted. The patients were divided into experimental group (n=52) and control group (n=44) based on the treatment methods. The control group was treated with modified Twin-block appliance, while the experimental group was treated with modified Twin-block appliance combined with micro-implant anchorage. Comparison was made between the two groups regarding treatment duration, time to achieve bite opening, alignment time, ANB angle, SNB angle, SNA angle, U1-NA angle, U1-NB angle, U1-SN angle, L1-MP angle, upper lip protrusion(ULP), lower lip protrusion (LLP), Z angle, plaque index (PLI), gingival index (GI) and sulcus bleeding index (SBI). Complications and patient satisfaction were recorded. SPSS 24.0 software package was used for statistical analysis of the data.

Results: The treatment duration, time to achieve bite opening and alignment time in the experimental group were significantly shorter than those in the control group (P＜0.05). After treatment, ANB, U1-NA and U1-SN of the two groups were lower than before treatment, and the experimental group was significantly lower than the control group (P＜0.05). U1-NB and L1-MP were higher than those before treatment, and the experimental group was significantly higher than the control group (P＜0.05). There was no significant difference between SNB and SNA (P＞0.05). After treatment, ULP and LLP of the two groups were lower than before treatment, and the experimental group was significantly lower than the control group(P＜0.05). Z-angle of the experimental group was significantly higher than that of the control group(P＜0.05). PLI in the experimental group was significantly lower than that in the control group (P＜0.05). There was no significant difference between GI and SBI (P＞0.05), and there was no significant difference in satisfaction between the two groups(P＞0.05).

Conclusions: The modified Twin-block appliance combined with micro-implant anchorage can help to shorten the treatment time, improve the jaw and facial soft tissue contour, and promote the recovery of dental aesthetics.

Purpose: To investigate the effect of nonsurgical periodontal therapy on blood glucose control in patients with type 2 diabetes mellitus (T2DM) and chronic periodontitis, as well as the sensitive population.

Methods: A total of 120 patients with T2DM and chronic periodontitis who were admitted to the Department of Endocrinology at Lishui City People's Hospital from March 2022 to March 2023 were randomly divided into experimental group and control group, with 60 patients in each group. All patients received oral health education, and their general information, community periodontal index (CPI), attachment loss (AL), fasting plasma glucose (FPG), and haemoglobin A1c (HbA1c) were collected. The experimental group received periodontal scaling and root planing. Three months later, CPI, AL, FPG, and HbA1c were measured. Stata 15.0 software was used for statistical analysis.

Results: After periodontal scaling and root planing, the CPI, FPG, and HbA1c in the experimental group were significantly lower than those before treatment(P＜0.01) and those in the control group(P＜0.05). AL in the experimental group was also significantly lower than before treatment(P＜0.05) and the control group (P＜0.05). The change of FPG after treatment was positively correlated with the duration of diabetes (P＜0.01) and the baseline CPI(P＜0.05), but negatively correlated with whether suffering from hypertension(P＜0.05). It was also negatively correlated with the FPG level before treatment (P＜0.01). The change of HbA1c after treatment was positively correlated with the duration of diabetes(P＜0.05) and negatively correlated with the HbA1c level before treatment(P＜0.01).

Conclusions: Nonsurgical periodontal therapy is helpful to blood sugar control of type 2 diabetes patients with periodontitis. Patients with higher baseline CPI levels and longer disease durations show greater improvement in glycemic control after treatment.

Puepose: To examine the expression difference of LINC 00478 in oral squamous cell carcinoma (OSCC) and analyze its relationship with the prognosis of OSCC patients. To investigate the effects of LINC 00478 on proliferation, migration, and invasion of OSCC cells, with the goal of offering a new potential approach for molecular detection and clinical diagnosis of OSCC.

Methods: Transcriptome data samples from OSCC were obtained from TCGA, and R software was utilized to assess the expression variance of LINC 00478 in OSCC tumor and normal tissues. Tissue samples from 26 OSCC patients, including cancer and adjacent tissues, were collected for RT-PCR analysis to determine the differential expression of LINC 00478 in OSCC tissues. In vitro experiments were conducted to explore the impact of LINC 00478 on proliferation, invasion, and migration of CAL27 cells. CCK-8 assay was used to observe the proliferation capability of LINC 00478 in CAL27 cells, while Transwell experiment was employed to assess its effects on cell migration and invasion. GraphPad Prism 8.0.2 software was used for statistical analysis of the data.

Results: Analysis of the TCGA database revealed that LINC 00478 was weakly expressed in OSCC tissues compared to adjacent normal tissues (P＜0.001), with high-expression LINC 00478 correlating with improved patient prognosis(P＜0.05). Furthermore, LINC 00478 was significantly under-expressed in 26 OSCC tissues (P＜0.001). Experimental data from CCK-8 assays indicated that upregulation of LINC 00478 suppressed CAL27 proliferation (P＜0.05). Additionally, Transwell experiments demonstrated that high-expression LINC 00478 significantly inhibited CAL27 migration and invasion (P＜0.05).

Conclusions: LINC 00478 is significantly under-expressed in OSCC, and its high expression is positively correlated with a better prognosis. Over-expression of the LINC 00478 gene has been shown to inhibit the proliferation, migration, and invasion of CAL27 cells, suggesting a potential role in inhibiting cancer progression in OSCC.

Purpose: To explore the effect of Lava Ultimate veneer combined with cast porcelain inlays in the treatment of mild-moderate dentition wear in the elderly.

Methods: A total of 60 elderly patients with mild-moderate dentition wear due to physical factors who underwent treatment from July 2019 to July 2023 were selected and randomly divided into control group(n=30) and experimental group(n=30). The control group received traditional all-ceramic crown restoration treatment, while the experimental group received Lava Ultimate veneers for anterior teeth and porcelain inlays for posterior teeth. The chewing efficiency, prosthesis effectiveness, periodontal index [gingival index(GI), plaque index (PI)], clinical efficacy, aesthetic satisfaction and comfort were compared between the two groups before and after treatment.SPSS 19.0 software package was used for statistical analysis of the data.

Results: Before treatment, there was no significant difference in chewing efficiency and absorbance between the two groups(P＞0.05). After treatment, masticatory efficiency and absorbance of the experimental group were significantly higher than those of the control group(P＜0.05). One week and 6 months after treatment, there was no significant difference in prosthesis margin fit, wear degree, retention, gingival condition, color, shape, secondary caries, restoration fracture, GI and PI between the two groups(P＞0.05). At 12 months after treatment,the prosthesis margin fit, retention, gingival condition, GI and PI of the experimental group were significantly better than those of the control group(P＜0.05). The total effective rate, satisfaction and comfort of the experimental group were significantly higher than those of the control group(P＜0.05).

Conclusions: After treatment with Lava Ultimate veneers for anterior teeth and porcelain inlays for posterior teeth, the masticatory efficiency of the elderly patients with mild-moderate dentition wear is improved, and the prosthesis effect, periodontal index, satisfaction and comfort are significantly improved.

Purpose: To explore the bleeding tendency and related risk factors of patients with or without oral antithrombotic drugs after tooth extraction, in order to provide theoretical reference for perioperative management of tooth extraction.

Methods: A cohort study was conducted among patients who attended the Cardiovascular Tooth Extraction Specialist Clinic of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from March 2023 to June 2023. The patients were divided into experimental group (medication group) and control group (no medication group) according to whether they took antithrombotic drugs for a long time. Teeth extraction was performed under ECG monitoring and postoperative bleeding was followed up to analyze the incidence of bleeding and related risk factors. SPSS 22.0 software package was used for data analysis.

Results: A total of 645 patients were included, including 305 patients in the medication group and 340 patients in the non-medication group. Bleeding events occurred in 17 cases (5.6%, 17/305) in the medication group and 1 (0.3%, 1/340) in the non-medication group, with significant difference between the two groups (P＜0.01). Binary logistic regression analysis showed that old age (OR: 4.089, 95%CI: 1.351-12.374, P=0.013) had a significant positive effect on postoperative bleeding.

Conclusions: Oral antithrombotic drugs and advanced age are the risk factors for postoperative bleeding in patients with cardiovascular diseases undergoing tooth extractions.

Purpose: To measure and analyze the thickness of the maxillary sinus mucosa under different relationships between the maxillary posterior teeth apex and the maxillary sinus floor on cone beam CT (CBCT).

Methods: A total of 987 patients requiring implant surgery due to dentition defect or loss were selected from Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2020 to December 2022. The maxillary posterior teeth most closely related to the maxillary sinus were observed on CBCT, the tooth position and root apex were recorded, and the vertical distance between the apex of the posterior tooth and the base of the maxillary sinus was measured. According to the distance between the root apex and the maxillary sinus floor, the posterior teeth were divided into three categories: Class Ⅰ: the distance between the root apex and the maxillary sinus floor (d ＞0 mm); Class Ⅱ : the root apex was attached to the maxillary sinus floor and the cortical bone of the maxillary sinus floor was continuous (d=0 mm); Class Ⅲ : apical protrusion into the maxillary sinus floor(d＜0 mm). The thickness of the thickest part of the maxillary sinus floor mucosa was measured. The distance between the root and the maxillary sinus floor and the thickness of the maxillary sinus mucosa were compared under different root-sinus floor relationship, and the correlation analysis was performed. SPSS 26.0 software package was used to analyze the data.

Results: Among the 1974 maxillary sinuses of 987 patients, there were 450 maxillary sinuses with Class I relationship between the posterior root apex and the maxillary sinus floor, while 126 (28%) of the maxillary second molar proximal root and the maxillary sinus floor were the most closely related. In ClassⅠrelationship, the average distance from root to the maxillary sinus floor was (2.9±2.7) mm, and the average thickness of the maxillary sinus mucosa was (2.9±4.0) mm. There was no correlation between the distance from root to the maxillary sinus floor and the thickness of the maxillary sinus mucosa. There were 808 maxillary sinuses with ClassⅡ relationship between the posterior root apex and the maxillary sinus floor, among which 132 (16.3%) maxillary first molars had the closest relationship with the maxillary sinus floor. In Class Ⅱ relationship, the average thickness of the maxillary sinus mucosa was (3.0±4.6) mm. There were 249 maxillary sinuses with Class Ⅲ relationship between the posterior tooth root apex and the maxillary sinus floor, among which 87 (34.9%) palatal roots of the maxillary first molar were the most closely related to the maxillary sinus floor. The average distance from the root to the maxillary sinus floor was (-1.9±-1.4) mm, and the average thickness of maxillary sinus mucosa was (2.4±4.9) mm. There was a positive correlation between them (r=0.18, P=0.004).

Conclusions: The most common relationship

Purpose: To evaluate the pulp capping effect of iRoot BP Plus combined with Nd: YAG laser irradiation in the treatment of caries induced exposed pulp and its impact on pulp vitality and occlusal function recovery.

Methods: From January 2022 to January 2023, a total of 196 patients with dental caries and exposed pulp, including 268 permanent teeth, were selected and randomly divided into the experimental group of 98 patients (136 teeth) and control group of 98 patients (132 teeth) using computer randomization. Both groups were treated with Nd:YAG laser after cleaning the caries. The experimental group was filled with iRoot BP Plus and the control group was filled with mineral trioxide polymer (MTA). The treatment efficacy, pulp vitality and occlusal function were compared between the two groups. SPSS 24.0 software package was used for statistical analysis of the data.

Results: There was no significant difference in the success rate of treatment between the two groups at 3, 6 and 12 months after surgery(P＞0.05). At 12 months after treatment, the bite force and chewing efficiency of the experimental group were significantly higher than those of the control group(P＜0.05). At 3, 6 and 12 months after treatment, the pulp vitality and pulp blood flow in both groups significantly decreased compared to preoperative levels (P＜0.05); the pulp vitality and pulp blood flow of the experimental group were significantly higher than those of the control group(P＜0.05).

Conclusions: iRoot BP Plus combined with Nd: YAG laser in the treatment of cariogenic exposed pulp is helpful to preserve pulp vitality and improve occlusal function.