上海口腔医学最新文献

Purpose: To summarize and evaluate the clinical effectiveness of the pedicled buccal fat pad combined with a mucoperiosteal composite flap in preventing and closing oroantral fistula.

Methods: This study included a total of 12 patients who underwent closure of surgical incisions following treatment of posterior maxillary lesions using a pedicled buccal fat pad combined with a mucoperiosteal composite flap. In all cases, the pedicled buccal fat pad was placed beneath the local mucoperiosteum to form a composite flap for incision closure. The retrospective analysis encompassed patients' baseline data, including age, gender, diagnosis, clinical symptoms, imaging characteristics, surgical procedures, and treatment outcomes. Additionally, the analysis included an evaluation of the local functional outcomes in the operative area.

Results: Among the 12 patients, there was an equal distribution of males and females (1∶1 ratio), with an average age of (35.83±20.17) years. Among them, 8 cases had cystic lesions in the maxillary posterior region, 3 cases had oroantral fistula, and 1 case had maxillary comminuted fracture. All patients (100%) underwent surgery involving the maxillary posterior dental region adjacent to the maxillary sinus. Preoperative symptoms included swelling, pain, halitosis, and occlusal disorder. CT imaging revealed that bone destruction in the posterior maxilla frequently affected multiple teeth, often with impacted teeth, and showed a close association with the maxillary sinus. Buccal bone resorption or destruction was the predominant feature in the operative area, and after removal of the diseased teeth, limited buccal bone remained. Wound closure was achieved using a buccal fat pad/mucoperiosteal composite flap technique. During the follow-up period, all 12 patients healed successfully, with no occurrences of oral-nasal fistula. Additionally, no significant changes in buccal morphology or vestibular groove were observed.

Conclusions: The use of a pedicled buccal fat pad combined with a mucoperiosteal composite flap is effective in sealing and preventing oroantral fistula, improving clinical symptoms in cases involving oroantral fistula and maxillary posterior bone resorption during surgery.

Purpose: To compare the biomechanical effects and tissue reparability of photodynamic and laser in the adjuvant treatment of peri-implantitis.

Methods: A total of 112 patients with peri-implantitis who were diagnosed and treated from March 2023 to April 2024 were randomly divided into the control group and the experimental group, with 56 cases in each group. On the basis of conventional symptomatic treatment, the control group received photodynamic therapy and the experimental group received laser therapy. The biomechanical effects [implant mobility(IM), peri-implant bone density(PBD), mesial and distal marginal bone resorption of the implant], tissue reparability[sulcus bleeding index (SBI), plaque index (PLI) and probing depth (PD)], inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and matrix metalloproteinases-8(MMP-8)] and the proportion of Porphyromonas gingivalis(P.g) in the total bacterial count were compared before and 1, 2, and 3 months after treatment between the two groups. SPSS 26.0 software package was used for statistical analysis of the data.

Results: After 1-3 months of treatment, both groups showed significant decrease in IM, mesial and distal marginal bone resorption of the implant, SBI, PLI, PD, IL-6, TNF-α, MMP8, and the proportion of P.g to total bacteria (P＜0.05), and significant increase in PBD (P＜0.05). Compared with the control group, the experimental group showed significant improvements in IM, PBD, mesial and distal marginal bone resorption of the implant, IL-6, TNF-α and MMP8 (P＜0.05). Compared with the experimental group, the control group showed significant improvements in SBI, PLI, PD and the proportion of P.g to total bacteria (P＜0.05).

Conclusions: Both photodynamic and laser therapy can be used in the adjuvant treatment of peri-implantitis. Photodynamic therapy has advantages in tissue repair and reducing the proportion of P.g to total bacteria, while laser therapy has advantages in biomechanical effects and reducing inflammatory factors.

Purpose: To explore the immunoexpression and clinical significance regarding Porphyromonas gingivalis (P.gingivalis) and tumor-associated macrophage (TAM) in the tumor microenvironment of oral squamous cell carcinoma (OSCC).

Methods: A total of 200 OSCC patients admitted to the First Affiliated Hospital of Xinjiang Medical University between June 2008 and June 2020 were divided into P.gingivalis-strong-expression group(n=139) and P. gingivalis-weak-expression group (n=61), based on the immunohistochemical(IHC) staining. The detection of DOK3 and TAM was performed to quantify their expression level in two groups, respectively. The associations between the three mentioned biomarkers and clinicopathologic indicators were compared between the two groups, and the impact on patients' prognosis was also analyzed. R 4.2.2 software was used for data analysis.

Results: Death, late-stage cancer, T3-T4 and N(+) stage, large size (≥3 cm), moderate and poor differentiation, and recurrence exhibited significant associations with strong immunoexpression of P. gingivalis(P＜0.05). Several variables of OSCC patients with strong immunoexpression of P. gingivalis including age, survival status, T and N stage, recurrence exhibited significant associations with strong immunoexpression of DOK3 (P＜0.05); whereas T stage, clinical stage and tumor differentiation exhibited significant associations with strong immunoexpression of TAM (P＜0.05). Additionally, the immunoexpression of P. gingivalis was positively associated with the immunoexpression of DOK3 and TAM(P＜0.01). The prognosis of OSCC patients with strong positive expression of P. gingivalis, DOK3 and TAM was worse than that of patients with weak immunoexpression, respectively(P＜0.05).

Conclusions: P. gingivalis is positively correlated with DOK3 and TAM. In addition, the strong immunoexpression levels of P. gingivalis, DOK3 and tumor-associated macrophage are associated with poor prognosis in patients with OSCC. Collectively, the mentioned three biomarkers can be considered as important indicators for evaluating clinical prognosis.

Purpose: The aim of this study was to evaluate the impact of the nasopalatine canal(NPC) shape and its morphometric characteristics on expected teeth movement by assessing the distance to maxillary central incisors (MCIs) according to NPC type.

Methods: A total of 200 patients with CBCT imaging data meeting the inclusion criteria were selected. The nasopharyngeal canal in the sagittal plane was classified. The following parameters were obtained: incisor foramen diameter, nasopalatine canal length, anterio-posterior diameter of incisor foramen (A-P IF), anterio-posterior diameter of Stenson foramen (A-P NF), nasopalatine tube 1/2 length diameter(M-L IF), and the distance between NPC and MCIs. The data were analyzed with SPSS 26.0 software package.

Results: Diameter of incisor hole（P=0.045）, A-P IF（P=0.001）, M-L IF（P＜0.001）, A-P NF（P＜0.001） had significant difference. In cylindrical-shaped NPC, a significant correlation was observed for NPC length, while in funnel-shaped NPC, a significant correlation was observed for A-P IF and NPC length. In hourglass-shaped NPC, a significant correlation was observed for A-P IF, A-P NF, and NPC length.

Conclusions: Each NPC shape showed specific impacts on the relationship between NPC diameters at different sections and distances to MCIs.

Purpose: To explore the construction process of a standard virtual crown for deciduous canine teeth, provide a foundation for the establishment of a standard crown model for deciduous canine teeth, and reference and basis for the application of CAM/CAM technology in pediatric dentistry.

Methods: A total of 65 children aged 4-5 years old with caries free deciduous canine were selected from the Imaging Department of Nantong Stomatological Hospital, including 34 boys and 31 girls. The obtained DICOM format data was imported into 3DSlicer 5.0.3 software for ray projection rendering and reconstruction. Using the ruler tool in the software, crown data of deciduous teeth were extracted, crown width, thickness and length were measured, and the data were divided into male and female, upper and lower deciduous teeth for Student's t test. The reconstructed model was modified according to the test results, and the mean and median models of crown width, thickness and length of male/female upper/lower deciduous teeth were established. A vernier caliper was used to measure the isolated milk fangs. The results of virtual measurement and specimen measurement were compared by Student's t test. MATLAB R 2016a software was used for statistical analysis.

Results: There were significant differences in the three radial directions between males and females; There was a statistical difference in crown width and thickness between the upper and lower deciduous canines, but there was no significant difference in crown length. The average values of crown width, crown thickness, and crown length of girls' maxillary deciduous canines were 6.20, 3.97, and 5.61 mm, respectively, with a median of 6.15, 3.82 and 5.53 mm. The average values of crown width, crown thickness, and crown length of girls' mandibular deciduous canines were 5.47, 4.25 and 5.66 mm, respectively, with median values of 5.45, 4.22 and 5.68 mm, respectively. The average values of crown width, crown thickness, and crown length of male primary teeth were 6.40, 4.14 and 5.87 mm, respectively, with median values of 6.40, 4.04 and 6.05 mm. The average values of crown width, crown thickness, and crown length of male mandibular deciduous canines were 5.69, 4.53 and 6.00 mm, respectively, with median values of 5.64, 4.65 and 6.06 mm. Based on the above values, virtual crown mean and median models were established for male/female maxillary and mandibular deciduous canines.

Conclusions: The diameter values obtained by ray projection and measurement in 3DSlicer have higher reliability compared to specimen measurements. The measurement results can be used to establish a virtual model of the male/female upper and lower primary canine standard crown, providing a reference for the establishment of the primary canine standard crown model.

PURPOSE： To investigate the clinical application value of making false wall with orthodontic band when a large area of tissue defects of young permanent teeth is subgingival level and vital pulp therapy is required.

Methods: A total of 60 cases of young permanent molars with large tissue defects to subgingival level and requiring vital pulp therapy were selected and randomly divided into experimental group and control group, with 30 cases in each group. Orthodontic band was made in the experimental group, while traditional composite resin was used in the control group, rubber barrier was placed after the fabrication of the false wall. The clinical fabrication time, stability of the false wall after the use of rubber barrier and periodontal health conditions(SBI, GI, SPD) of the affected tooth before and after operation were compared between the two groups.Graph Pad Prism 5.0 software package was used for statistical analysis.

Results: The fabrication time of the experimental group was (6.01±0.34) min, which was shorter than that of the control group (12.02±0.53) min, and the difference was statistically significant(P＜0.05). But the stability of the false wall and the influence on the periodontal health of the affected teeth were not significantly different between the two groups(P＞0.05).

Conclusions: For the cases of young permanent teeth with large area defects to subgingival and requiring vital pulp therapy, orthodontic band can shorten the fabrication time of false wall, provide relatively stable retention, with no significant effect on the periodontal status of the affected teeth in a short time. It can provide a new idea for the fabrication of false wall in pediatric dental clinical work.

Purpose: To construct a brachytherapentic model of patient-derived salivary gland malignant tumor organoids, and evaluate the impact of 125I radioactive seeds intervention on the activity of different organoids, and explore the feasibility of using this model to guide clinical personalized treatment of salivary gland malignant tumors.

Methods: Biopsy specimens from patients with malignant salivary gland tumors including mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma(ACC) and acinic cell carcinoma (AciCC) from Xuzhou Central Hospital were collected, and 3D culture method was used to construct the organoid model. The expression levels of immunohistochemical indicators in salivary gland malignant tumor tissue samples and organoid samples were detected. Brachytherapentic model was constructed and the effect of different doses of 125I seeds on organoid activity were detected using 3D cell viability assay. The activity curves were plotted and the IC50 values were calculated. The data were analyzed by GraphPad Prism 9.0 software.

Results: H-E staining results and immunohistochemical staining results identified homology between organoids and specimen tumors. The mean IC50 values of 125I seeds on 5 cases of salivary gland malignant tumor organoids (1 case of ACC, 2 cases of AciCC and 2 cases of MEC) were 8 508, 6 053, 5 203, 10 379 and 7 743 cGy, respectively. AciCC has a higher sensitivity to 125I seeds, and the sensitivity of 125I seeds varied among individuals of the same type of tumor.

Conclusions: An in vitro tumor organoid culture platform has been established for specimens from patients with salivary gland malignant tumors, and its morphological, histological structure, and molecular marker expression are consistent with the characteristics of tumor cells in the original specimens. Intervention results indicated that the model has significant individualized differences, providing a theoretical basis and methodological reference for the effectiveness of 125I seeds in some patients with local, recurrent, advanced, poorly differentiated, or unresectable tumours. This model has the advantages of low cost, short modeling time, and high throughput detection. It can predict the patient's post-treatment response in vitro, guide risk assessment of malignant tumors in clinical practice, and establish personalized and precise treatment plans.

Purpose: To study the abnormal characteristics of tongue consonants and their correlation with articulatory movement parameters in patients with tongue cancer after operation.

Methods: A total of 119 patients with tongue cancer who received surgical treatment at First Affiliated Hospital of Bengbu Medical University from March 2019 to May 2023 were selected. The patients were divided into tongue margin group(n=38), tongue body group (n=40) and tongue base group(n=41). Twenty-five monosyllabic words in Huang Zhaoming-Han Zhijuan Vocabulary List for evaluating tongue consonants were used as speech assessment tools to evaluate the errors of each tongue consonant. The articulation speech measurement and training instrument were used to extract the second formants (F2) of the /i/ and /u/ vowels of the patients by linear predictive spectrum, and the articulation movement parameters such as tongue distance and F2i/F2u were calculated according to the formula. SPSS 26.0 software package was used for data analysis.

Results: The rate of tongue consonant error in each group was as follows: in tongue margin group, preapical sound (49.5%)＞ apical middle sound (27.8%)＞ apical postapical sound (17.5%)＞lingual facial sound (9.4%)＞ lingual base sound (6.1%). In tongue body group, preapical sound (55.0%)＞ apical middle sound (47.1%) ＞ apical postapical sound (25.4%)＞lingual facial sound (12.1%)＞lingual base sound (3.3%). In tongue base group, preapical sound (60.0%)＞postapical sound (52.0%) ＞apical medium sound (51.9%)＞lingual base sound (44.3%)＞lingual facial sound (34.8%). The error frequency of tongue apex medium sound in tongue body group and tongue base group was significantly higher than that in tongue margin group, and the error frequency of tongue apex posterior sound, tongue surface sound and tongue base sound in tongue base group was significantly higher than that in tongue body group and tongue margin group(P＜0.05). Tongue distance and F2i/F2u in tongue base group were significantly lower than those in tongue margin group and tongue body group, and tongue distance and F2i/F2u in tongue body group were significantly lower than those in tongue margin group(P＜0.05). Tongue distance, F2i/F2u were significantly negatively correlated with the error frequency of apical midpoint, apical postpoint and base sound in all groups(r＜0, P＜0.05).

Conclusions: Most patients with tongue cancer after operation have abnormal tongue tip, and the most serious problem is the pretip. In clinical practice, objective parameters such as tongue distance and F2i/F2u can be used to quantitatively and indirectly evaluate the articulation status and dynamic rehabilitation effect of tongue cancer patients after surgery.

Purpose: To explore the clinical value of 3D computed tomography (CT) reconstruction in the prognostic evaluation of orthodontic treatment for patients with skeletal Class Ⅱ malocclusion.

Methods: A total of 48 patients with skeletal Class Ⅱ malocclusion who received orthodontic treatment at the Department of Stomatology, Baoji People's Hospital from January 2022 to January 2023 were selected. All patients underwent CBCT scans 1 week before treatment (T0), 1 month after treatment(T1) and 6 months after treatment(T2). 3D Slicer software was used for modeling, and Geomagic Qualify software was utilized for fitting alignment and measuring the three-dimensional movement distances of various landmarks on the maxilla and mandible. The coordinates of the landmarks at T1 and T2 were compared and analyzed. Pearson correlation analysis was used to determine the correlation between significant relapse landmarks. SPSS 19.0 software package was used for statistical analysis of the data.

Results: One month and six months post-treatment, changes in the horizontal coordinate of landmark Rgo and changes in the anteroposterior coordinates of landmarks A, RP, B, Pog, Gn, Me, Rgo and Lgo, as well as changes in the vertical coordinate of Gn were statistically significant(P＜0.05). Correlation analysis revealed a positive correlation between the horizontal movement distance of landmark Rgo from T1 to T0 and the relapse distance(r=0.293, P=0.043). There was a positive correlation between the anteroposterior movement distance of landmark A from T1 to T0 and the relapse distance(r=0.418, P=0.003), a positive correlation between the movement distance of RP from T1 to T0 and the relapse distance (r=0.470, P=0.001), a negative correlation between the movement distance of B from T1 to T0 and the relapse distance(r=-0.523, P=0.000), and a negative correlation between the movement distance of Pog from T1 to T0 and the relapse distance(r=-0.391, P=0.006).

Conclusions: Three-dimensional CT reconstruction can provide precise three-dimensional quantitative analysis for the prognostic assessment post-orthognathic surgery in patients with skeletal Class Ⅱ malocclusion. It helps identify landmarks with a high risk of relapse, thus providing more targeted postoperative treatment and monitoring strategies for clinical practice.

Purpose: CBCT was used to measure and analyze the relationship between dental crowding degree and basal bone morphology, dental arch and alveolar arch morphology in adult female maxillary anterior teeth.

Methods: A retrospective analysis was conducted on the medical records of 122 adult female patients with maxillary anterior dental arch crowding who received orthodontic treatment at Qingdao Haici Hospital, Affiliated to Qingdao University, from December 2019 to December 2022. The patients were divided into two groups based on the degree of dental arch crowding: group I(mild crowding,maxillary dentition crowding degree ≤ 4 mm, n=62) and group II(moderate to severe crowding,maxillary dentition crowding degree 4-8 mm, n=60). The lengths and widths of the alveolar bones, dental arches and alveolar arches were compared between the two groups. The correlation between dental arch crowding and alveolar bone morphology, dental arch and alveolar arch morphology was analyzed. SPSS 26.0 software package was used for statistical analysis of the data.

Results: In group I (mild crowding), the maxillary basal bone length, mandibular basal bone length, maxillary basal bone width at the root apex and root bifurcation,mandibular basal bone width at the root apex and root bifurcation were significantly higher than group II(P＜0.05). The maxillary dental arch length, mandibular dental arch length, maxillary dental arch width,mandibular dental arch width on the mesial and distal sides were significantly higher in group I than group II(P＜0.05). The maxillary alveolar arch length and mandibular alveolar arch length in group I were significantly higher than group II (P＜0.05). There was no significant difference in maxillary alveolar arch width and mandibular alveolar arch width between the two groups(P＞0.05). The crowding degree of the dental arch was negatively correlated with the length of the maxillary and mandibular bases, the width of the maxillary and mandibular bases at the root bifurcation,and the width of the proximal maxillary and mandibular arches(P＜0.05). The length of the maxillary base bone(OR=0.283, 95% CI: 0.128-0.625), the width of the maxillary base bone at the root bifurcation (OR=0.182, 95%CI: 0.083-0.402), the width of the proximal maxillary arch (OR=0.347, 95%CI: 0.158-0.766) and the width of the mandibular arch(OR=0.304, 95% CI: 0.137-0.669) were the influencing factors of dental congestion in the aesthetic area of adult female maxillary anterior teeth(P＜0.05).

Conclusions: The reduction of basal bone, dental arch and alveolar arch are associated with crowded dentition in the maxillary anterior aesthetic zone of adult females.