上海口腔医学最新文献

Purpose: To investigate the pathogenic gene of one Chinese family with autosomal dominant hypocalcified amelogenesis imperfecta and to report multidisciplinary treatment process for two patients from this family, so as to provide guidance for genetic counseling and clinical treatment of hereditary amelogenesis imperfecta.

Methods: The clinical data and peripheral blood of the family members were collected. Whole-exome sequencing was performed, and candidate variants were filtered out by data analysis. The identified variant was confirmed by Sanger sequencing and protein three-dimensional structure prediction.

Results: Affected members of this hereditary family exhibited yellow-brown discoloration of the dental crowns, rough tooth surfaces, and enamel erosion, consistent with hypocalcified amelogenesis imperfecta. A nonsense mutation c.1363C＞T(p.Gln455*) in exon 5 of the FAM83H gene was identified in the proband, her mother, and her sister; this mutation was predicted to cause a truncation of the FAM83H protein. This variant was not found in unaffected family members. After receiving multidisciplinary treatment based on orthodontics, the proband and her sister restored oral function and aesthetics.

Conclusions: The nonsense variant of FAM83H caused hypocalcified amelogenesis imperfecta in this study is detected for the first time in a Chinese family. The results further validate the pathogenic variant involved in FAM83H leading to amelogenesis imperfecta. Patients with amelogenesis imperfecta can restore oral function and aesthetics through various orthodontic and restorative treatments.

Purpose: To investigate the effect of chair side computer aided design/computer aided manufacturing (CAD/CAM) crown restoration technique in the treatment of posterior tooth defects and its influence on chewing ability.

Methods: A total of 98 patients with posterior dental defects treated from June 2023 to May 2024 were selected and divided into control group (traditional silicone rubber impression crown repair) and experimental group (chair side CAD/CAM crown repair) according to different treatment methods. The repair effect, masticatory efficiency and bite force before and after treatment, periodontal index, complication rate and patient satisfaction were compared between the two groups. SPSS 22.0 software package was used for statistical analysis of the data.

Results: One month after treatment, there was no significant difference in comfort, edge fit, color matching and surface texture between the experimental group and the control group(P＞0.05). The experimental group was significantly better than the control group in adjacency contact, secondary caries prevention and gingival status (P＜0.05). After treatment,gingival index and plaque buildup, gingival sulcus bleeding index, the degree of gum health improvement of loose tooth in the experimental group were significantly better than in the control group(P＜0.05). There was no significant difference in the incidence of complications between the two groups after treatment(P＞0.05). Repair satisfaction of the experimental group was 96.15%, which was significantly higher than 86.96% of the control group(P＜0.05).

Conclusions: Chair side CAD/CAM crown restoration technology has good application value in the treatment of patients with posterior dental defects, which can significantly improve the repair effect, improve chewing ability, effectively inhibit gingival inflammation and dental plaque generation, reduce the risk of gingival bleeding and tooth loosening, and significantly improve patients' satisfaction.

Purpose: To investigate the clinical efficacy of full crown and porcelain inlay in the treatment of cracked teeth after root canal treatment and repair and its effect on chewing ability and gingival status.

Methods: A prospective study was conducted to select 106 patients with cracked teeth who underwent root canal treatment from December 2020 to December 2023, divided into experimental group and control group according to the random number table method, with 53 cases in each group. The clinical effects and adverse reactions of the two groups were counted and compared. The pain levels [visual analogue scale (VAS)] of the two groups before treatment,1 st, 3 rd and 7 th day after treatment were compared. The gingival conditions [plaque index (PLI), gingival index (GI), gingival bleeding index (BI) and periodontal pocket depth (PD)] were compared between the two groups before treatment and after 6 months of follow-up. The chewing ability (bite force, chewing efficiency) of the two groups before treatment, 1 month, 3 months and 6 months of follow-up were compared.Statistical analysis was performed with SPSS 25.0 software package.

Results: The good rate of the experimental group was higher than that of the control group, and the total incidence of adverse reactions was lower than that of the control group(P＜0.05). At the 1st, 3rd and 7th day after treatment, VAS scores of the two groups were significantly lower than those before treatment. The experimental group[(4.43±0.68), (3.15±0.63) and (2.04±0.51) points] were significantly lower than the control group[(4.86±0.57), (3.81±0.67) and (2.86±0.52) points], all showed a downward trend (P＜0.05). At 6 months of follow-up, BI and PD in the two groups were higher than those before treatment, GI and PLI were lower than those before treatment. GI, PLI, BI and PD in the experimental group were significantly lower than those in the control group(P＜0.05). After 1, 3 and 6 months of follow up, the masticatory efficiency and bite force of the two groups were higher than those before treatment. The masticatory efficiency of the experimental group was (70.25±5.57)%, (85.36±6.74)% and (92.57±6.35)%, which was significantly higher than that of the control group[(62.35±5.44)%, (73.57±6.32)% and (84.26±6.22)%]. The bite force in the experimental group[(112.52±9.67), (130.52±11.58) and (143.54±13.40) Ibs] were significantly higher than those in the control group[(98.53±9.47) , (113.25±10.54) and (125.36±12.46) Ibs], all of which showed an upward trend (P＜0.05).

Conclusions: The clinical efficacy of porcelain inlays for cracked teeth after root canal treatment and repair is better than that of full crown repair, which can effectively improve the chewing ability and the gingival condition, the incidence of adverse reactions is low.

Purpose: To compare the regeneration and repair effects of GBE50 and mecobalamin on facial nerve crush injury.

Methods: Forty healthy Japan giant ear rabbits were randomly divided into 4 groups,namely GBE50 treatment group, mecobalamin treatment group, normal control group and model control group. Each group contained 10 rabbits. Superior buccal branch of facial nerve cursh injured models were established for 2 treatment groups and model control group, while facial incision was made without crush injuries of facial nerve for normal control group. The treatment group was given GBE50 and mecobalamin respectively, while the control group was only given 1 mL of normal saline, respectively. After 28 days of treatment, rabbits' facial injured beard and orbicularis oris muscle movements were observed, neuroelectrophysiological tests, histomorphological observation, and image analysis were performed, facial nerve regeneration and functional recovery were detected. The data were analyzed by SPSS 22.0 software package.

Results: In the model control group, the beard and orbicularis oris muscle movement recovery of rabbits were the worst, but GBE50 treatment group showed better recovery than mecobalamin treatment group. The action potential latency in GBE50 group was lower than the mecobalamin group, and significantly lower than the control group(P＜0.05). The action potential amplitude of GBE50 group was higher than that of mecobalamin group, and significantly higher than the control group(P＜0.05). Image analysis result of never myelinated axons area and axon counts of GBE50 group was higher than that of mecobalamin group, and significantly higher than control group (P＜0.05).

Conclusions: GBE50 is superior to mecobalamin in efficacy and speed of facial nerve repair, and it is expected to become another therapeutic drug for rapid and effective treatment of facial nerve injury in clinical practice.

Purpose: To analyze the relationship between the changes of saliva flow velocity, total protein and dental plaque before and after orthodontic treatment.

Methods: The clinical data of 80 patients who received orthodontic treatment in Huaibei Miners General Hospital from May 2021 to February 2024 were retrospectively analyzed.Six months after treatment, the patients were divided into low-level group (n=39) and high-level group (n=41) according to the median plaque index. The clinical data of the high-level group and the low-level group were compared to analyze the influencing factors of high dental plaque index in orthodontic patients. The predictive value of △saliva flow velocity(before treatment -after 6 months of treatment), △total protein and their combination on high dental plaque index in orthodontic patients was analyzed.SPSS 25.0 software package was used for statistical analysis of the data.

Results: Six months after treatment, the saliva flow velocity and total protein level of orthodontic patients were significantly lower than before treatment (P＜0.05). The soft scale index, △saliva flow velocity and △total protein level in high-level group were significantly higher than those in low-level group (P＜0.05). Logistic regression analysis showed that △saliva flow velocity(OR=4.604, 95%CI: 2.024-10.474) and △ total protein(OR=3.554, 95%CI: 1.562-8.084) were the influencing factors of high dental plaque index (P＜0.05).The area under the curve (AUC) of △ saliva flow velocity, △total protein and their combination in predicting high dental plaque index in orthodontic patients were 0.803, 0.799 and 0.905 (P＜0.05), respectively, and the AUC value of the combination was higher(P＜0.05).

Conclusions: △Saliva flow velocity and △total protein can be used to predict high dental plaque index after orthodontic treatment, and their combination has higher predictive value.

Purpose: To observe the effect of gingipain extracts on anxiety-like behavior in mice.

Methods: Gingipain extracts were derived from Porphyromonas gingivalis(P. gingivalis) ATCC33277 by sonication and ultra-speed centrifugation and identified by Western blot and enzyme activity assay. Gingipains infection models were established by intraperitoneal injection of gingipain extracts with/without iodoacetamide (IAM). Enzyme activity assays were used to detect the activity of arginine-gingipain (Rgp) and lysine-gingipain (Kgp) in plasma of mice. Open field experiments and elevated zero maze experiments were used to detect anxiety-like behavior in mice. Immunofluorescence staining of brain tissue slices was used to observe changes in astrocytes of the brain. GraphPad Prism software was used for statistical analysis.

Results: The gingipain extracts were collected from P. gingivalis ATCC33277 and they showed Rgp and Kgp activity. The activity of Rgp and Kgp could be detected in mice plasma after intraperitoneal injection of gingipain extracts. Compared with the control group, there were no significant changes in the autonomous activity ability of the gingipain group mice. In the open field experiment, the central area staying time of the gingipain groups was significantly reduced(P＜0.05). In the elevated zero maze experiment, the open area frequency of the gingipain groups was obviously shortened(P＜0.05). Anxiety-like behavior was significantly enhanced. Immunofluorescence staining showed that gingipain extracts could significantly activate astrocytes in the hippocampus of mice. The above results could be significantly alleviated by gingipain inhibitor IAM.

Conclusions: Gingipain extracts could induce anxiety-like behavior in mice, which may be related to neuroinflammation due to activation of astrocytes.

Purpose: To compare the recovery effect of advanced platelet-rich fibrin (A-PRF) and concentrated growth factor (CGF) in the treatment of mandibular impacted third molar(M3) extraction, and the effect on alveolar ridge of the adjacent second molar(M2).

Methods: A total of 150 patients who received mandibular impacted M3 extraction in Jinhua Central Hospital from September 2020 to August 2021 were included. Among them, group A (n=49) received conventional suture, group B (n=51)received conventional suture +A-PRF filling, and group C(n=50) received conventional suture +CGF filling. Postoperative clinical indexes, soft tissue healing, alveolar bone density changes and M2 alveolar ridge height changes were compared among the three groups. Meanwhile, complications and adverse reactions were recorded and compared among the three groups. SPSS 20.0 software package was used for data analysis.

Results: One week after surgery, the pain degree and swelling degree of the three groups were lower than before treatment(P＜0.05), and group B ＜ group C ＜ group A(P＜0.05). Mouth opening degree was higher than before treatment(P＜0.05), group B ＞ group C ＞ group A (P＜0.05), and the soft tissue healing condition of group B was better than that of group C, and than that of group A(P＜0.05). At 6 weeks and 12 weeks after surgery, the alveolar bone mineral density of the three groups was higher than that immediately after surgery(P＜0.05), and group B ＞ group C ＞ group A(P＜0.05). There were significant differences between group B and C at 6 weeks and 12 weeks after surgery (P＜0.05). The M2 alveolar ridge height (ΔH) 12 days after surgery was lower than that immediately after surgery(P＜0.05), and group B and C was lower than that of group A (P＜0.05). The incidence of complications such as bleeding, infection, dry socket, nerve injury and periodontal pus discharge in group B ＜ group C ＜ group A, and the incidence of complications was statistically significant(P＜0.05).

Conclusions: The effects of A-PRF and CGF on M2 alveolar ridge and postoperative adverse reactions are similar, but A-PRF is better than CGF in improving clinical symptoms and promoting postoperative recovery in maxillary impacted M3 patients, with fewer complications, and is worthy of clinical promotion.

Purpose: To construct a finite element model of the mandibular molars distalization with clear aligner, and to explore the characteristics of dentition movement and aligner deformation.

Methods: The models of mandible, teeth, periodontal membrane and clear aligne were constructed using CBCT and oral scan data, and were divided into 8 groups according to the starting position of the second and first molar teeth. Working condition 1-4: the distance between the second molar and the first molar was 0, 1, 2, 3 mm, respectively. Working condition 5-8: the second molar had moved far to the target position of 3.2 mm, and the distance between the first molar and the second premolar was 0, 1, 2 and 3 mm, respectively. "Two-step method" was used to simulate the loading of the clear aligner and set the distance of the step to 0.2 mm, the characteristics of dental displacement and appliance shape change in each working condition were analyzed.

Results: Under each working condition, the molar with pseudo-remote displacement showed tilt movement of the crown to the far, and the other teeth showed reverse tilt movement. As the initial position of the pseudo-distant molar changed to the distal, the distal movement of the pseudo-distant molar increased. In working condition 4, the maximum displacement of the second molar was 0.11 mm, and in working condition 8, the maximum displacement of the first molar was 0.10 mm. The change trend of the Von Mises equivalent stress value of the periodontal membrane of the pretended distalization teeth was similar to that of the displacement.

Conclusions: Clear aligner can complete distal movement of molar teeth, but the amount of movement cannot reach the expected value. As the initial position of the molars changed to the distal, the distance displacement will increase.

Purpose: To evaluate the clinical efficacy of advanced platelet-rich fibrin(A-PRF) and concentrated growth factor(CGF) combined with nano-hydroxyapatite in external maxillary sinus lift implantation.

Methods: A total of 68 patients who underwent external maxillary sinus lift implantation from April 2023 to March 2024 at Taikang Xianlin Gulou Hospital were selected. They were randomly assigned to the control group(n=34, using Bio-Oss large particle bone graft material) and combined group(n=34, using A-PRF and CGF combined with nano-hydroxyapatite). Postoperative symptoms, bone levels, wound healing status, stability coefficient, mucosal healing, and complications were compared between the two groups. SPSS 27.0 software package was used for statistical analysis of the data.

Results: At 1 month and 3 months after operation, the conscious symptom score in combination group was significantly lower than that in the control group (P＜0.05), bone mineral density, bone increment and bone height at 6 months after operation were significantly lower than those in the control group; ISQ value, keratinized gingiva width and thickness were significantly higher than those in the control group (P＜0.05). The primary healing rate I in combination group was higher than that in the control group, and the healing time was lower than that in the control group(P＜0.05). There was no significant difference in the occurrence of adverse events between the combined and control groups(P＞0.05).

Conclusions: The combination of A-PRF and CGF with nano-hydroxyapatite significantly improves bone quality, enhances implant stability, and accelerates postoperative recovery in external maxillary sinus lift implantation.