中华口腔医学杂志最新文献

The anatomical structure of the gingival papilla around the implant is special, and it is difficult to recover after injury. The reduction of its height will have a negative impact on function and esthetics, and it is one of the many problems in implant treatment at present. This paper analyzes the influencing factors of implant gingival papilla height from three aspects: anatomical factors, implant surgical design and implant restorative design, including the classical influencing factors such as the shape of natural teeth, interproximal distance between the implant and the adjacent tooth, soft tissue grafting, and contour of implant restorations, as well as the hot and controversial influencing factors in recent years such as the thickness of soft tissues around the implant, the implant surgical timing, the flap design, and the surgical incision, in order to provide reference for clinicians in the process of implant treatment for gingival papilla preservation and reconstruction.

Objective: To investigate the bone augmentation effects of domestic decellularized porcine small intestinal submucosa (PSIS) absorbable biomembrane and domestic bovine pericardium tissue (BPT) absorbable biomembrane in guided bone regeneration (GBR) for single-tooth implantation in diabetic patients. Methods: A prospective case-control study was conducted with 48 diabetic patients who received single-tooth implant restoration at the Department of Prosthodontics, School of Stomatology. The Fourth Military Medical University, between January 2023 and January 2024. Patients were randomly assigned to the study group (PSIS group) and the control group (BPT group) using a random number table, with 24 patients in each group. GBR was performed simultaneously with the implant surgery. Cone-beam CT was used to compare the buccal-side horizontal bone gain at 6 months post-operation between the two groups. Wound healing was evaluated at 1 and 4 weeks post-operation using wound healing scores. Results: At 6 months post-operation, the buccal-side horizontal bone gain in the study group [69.1 (55.2, 82.4) mm] and the control group [71.4 (59.8, 77.0) mm] showed no statistically significant difference (Z=-0.25, P=0.805). The wound healing scores at 1 and 4 weeks post-operation in the study group did not differ significantly from those in the control group at the same time points (1 week: Z=-0.49, P=0.627; 4 weeks: Z=-0.61, P=0.539). Conclusions: The use of two types of domestic absorbable collagen membranes for GBR in single-tooth implantation in diabetic patients showed comparable buccal-side horizontal bone gain effects at 6 months post-operation and similar clinical outcomes for wound healing at 1 and 4 weeks post-operation in both groups. The GBR effects of PSIS and BPT are similar.

Exploring the application of minimally invasive techniques in the extraction of impacted mandibular third molar (IMTM), to achieve the treatment goal of "less trauma, short time, fast recovery", remains the focus of dentists. For now, the IMTM are mostly extracted in pieces after removing the crown and root resistance by bone removal and tooth segmentation, using 45°reverse-angle high speed turbine, piezosurgery, chisel or other dynamic system. However, There is a lack of principle-level parsing in different provinces and primary hospitals, while experience is still the main factor in avoiding excessive bone removal in complex IMTM extraction, as well as optimizing the specific position and angle of the parting teeth, finding the fulcrum and designing the best dislocation path when there is root resistance. In this review, the principle of geostatics was introduced into the extraction of IMTM. According to this principle, we analyzed how to design a clever tooth cutting line cleverly to enhance the efficiency of tooth segmentation, and how to optimize the mechanical design of root dislocation and the root dislocation path. Meanwhile, we will also focus on how to minimize trauma to alveolar bone during tooth extraction, so as to reduce the risk of intraoperative and postoperative complications, and provide interpretation and reference for dentists in surgical design and techniques of minimally invasive tooth extraction.

Periodontitis constitutes the primary cause of tooth loss among adults in China. The disease is characterized by the high morbidity, which significantly impairs both oral and systemic health. As the key insights of initial periodontal therapy, subgingival scaling and root planing (SRP) have been considered as simple, effective, and cost-efficient treatment approaches for managing periodontal inflammation. Substantial published evidences indicated that the majority of patients diagnosed with periodontitis could achieve lifelong retention of their natural teeth through standardized initial periodontal therapy, rigorous plaque control, and long-term supportive periodontal treatment. However, the proficiency in periodontal diagnosis and treatment among general dental practitioners in China is heterogeneous, with a notable scarcity of periodontists and a suboptimal level of SRP standardization. Drawing upon over four decades of clinical expertise from Peking University School and Hospital of Stomatology as well as comprehensive literature reviews, this paper meticulously outlines the standardized procedures for SRP, aiming at guiding clinicians to perform standardized SRP step by step, and thereby enhancing clinical efficacy of periodontal treatment, promoting periodontal health, and ultimately improving patients' quality of life.

Dynamic navigation technology can "real-time guide" the implantologist to place the implant in the alveolar bone of the missing tooth area according to the preoperative design of the optimal site and path, making the whole implant surgery process more safe and precise. In order to further promote the standardized application of oral implant dynamic navigation technology, China Association of Gerontology and Geriatrics has convened distinguished experts to engage in deliberations and develop the standard. This standard covers the basic requirements, indications and contraindications, operation procedures, common complications and treatment measures, and accuracy verification. This standard can be used as a reference for the use of dynamic navigation technology in implant surgery.

Insufficient keratinized mucosa is a common clinical problem. Although there is no consistent data on the long-term success of implant restorations relative to the presence or absence of peri-implant keratinized mucosa, it is widely accepted that the presence of keratinized mucosa width<2 mm is associated with increased biofilm accumulation, soft-tissue inflammation, and mucosal recession. Free gingival graft (FGG) is the standard surgical intervention for augmenting the width of keratinized gingiva. However, the clinical application of FGG is technique-sensitive. Therefore, this article describes the significance and efficacy, surgical timing, conventional procedures and techniques, common complications, as well as some modified approaches of the FGG, aiming to provide guidelines for its clinical application.