中华口腔医学杂志最新文献

More and more attention has been paid to the early treatment of malocclusion, especially the early treatment of class Ⅲ malocclusion. Class Ⅲ malocclusion not only affects maxillofacial growth and development, occlusal function and facial beauty, but also leads to serious physical and mental problems. Focusing on class Ⅲ malocclusion, the definition, classification, etiological mechanism, craniofacial growth and development rule, and the influence of early treatment on craniofacial growth and development were reviewed. In class Ⅲ patients, the craniofacial growth and development should be evaluated and analyzed when the early intervention carried out. The purpose of treatment of class Ⅲ malocclusion is achieved by using the appliance to affect the craniomaxillofacial growth.

Caries is an infectious disease in which the invasion of pathogens and their metabolites can activate the recognition and defense system of the pulpodentinal complex. In-depth understanding of the immune responses mediated by the pulpodentinal complex will help to estimate the real state of the dental pulp during the progression of caries and to take reasonable clinical treatment strategies, which can be more targeted and less invasive. Based on the physiology of the pulpodentinal complex, the present article introduce its immunocompetence and mechanism, reactive changes, clinical intervention and its significance during the caries progression, as to improve diagnostics as well as treatment strategies for caries.

Objective: To explore the operational accuracy and operative time of oral surgery robot-assisted endodontic microsurgery on a head-simulator for clinical reference. Methods: Three pairs of surgical simulation models were set up on head-simulator. Each model included 10 positions anteriorly and posteriorly, 20 teeth for each technique, for a total of 60 teeth. An attending physician with more than 3 years clinical experience in endodontic microsurgery completed fixed-point osteotomy and apicoectomy in three groups of endodontic microsurgery under freehand (FH), static navigation (SN), and surgery robot (SR). The duration of each operation was recorded. Cone-beam CT was taken before the operation and the surgical path was planned in the software; after surgery, a plug gauge (precision gauge for measuring hole dimensions) was inserted into the surgical path for intraoral scanning. Surgical accuracy (starting point, end point, and angular deviation) was assessed in all 3 groups, and surgery time was compared. Results: The deviation at the starting point and the end point, and angular deviation was (0.37±0.11), (0.37±0.10) mm, and 0.71°±0.17°in the SR group. The deviations in the SR group were significantly lower than those in the SN group [(0.59±0.14), (0.65±0.18) mm, and 2.64°±0.75°] (P<0.05), and both groups were significantly lower than the FH group [(1.37±0.31), (1.10±0.21) mm, and 9.84°±3.15°] (P<0.05). The operative time in the SN group [(1.20±0.03) min] was significantly less than that in the SR group [(2.18±0.03) min] (P<0.05), and both groups were significantly less than that in the FH group [(8.70±3.15) min] (P<0.05). Starting point deviation, end point deviation, and angular deviation [(1.09±0.10), (0.90±0.07) mm, 7.22°±1.13°] in anterior teeth using the FH was significantly lower than the starting deviation, endpoint deviation, and angular deviation [(1.65±0.14), (1.30±0.06) mm, 12.46°±2.10°] in the posterior teeth using FH (P<0.05), and the operative time in the anterior teeth using the FH [(5.75±0.57) min] was significantly less than that in the posterior teeth using [(11.65±1.14) min] (P<0.05). The difference in accuracy and operative time between using SN and SR on anterior and posterior teeth was not statistically significant (P>0.05). Conclusions: Oral surgery robot-assisted endodontic microsurgery helps improving the accuracy of clinicians' operations and shorten the operation time.

The impaction rate of wisdom teeth is increasingly high, leading to more and more serious clinical problems. For a long time, the primary approach to managing wisdom teeth has been direct extraction, with a notable lack of systematic and diversified treatment methods. This article introduces, for the first time, the concept of whole life-cycle health management for wisdom teeth and suggests that the window for wisdom teeth life-cycle health management should be moved forward to the tooth germ stage. For tooth germs of wisdom teeth with severe risks, timely and necessary intervention should be administered. For normally erupting wisdom teeth, efforts should be made to maintain their health so they can function over the long term. For impacted wisdom teeth that have not caused related clinical symptoms, careful observation and cautious extraction should be considered. If necessary, techniques such as orthodontics and autotransplantation can be used to functionalize them. For impacted wisdom teeth that have caused clinical symptoms, functional oral surgical principles should be applied to reduce surgical trauma and prevent intraoperative and postoperative complications using advanced clinical techniques.

Objective: To investigatethe effect of extraction of mandibular third molar (M3) tooth germon the development of the mandible in orthodontic patients, with a view to providing a reference for clinical M3 tooth germ extraction. Methods: One hundred and twenty-nine Angel class Ⅰ patients aged 10-16 years who attended the Department of Orthodontics Division 1, School & Hospital of Stomatology, Wuhan University from 1 January 2013 to 30 December 2021 and fulfilled the criteria for nativity were included. Those who had their M3 extracted in the Department of Oral and Maxillofacial Surgery were included in the study group, with a total of 66 cases; and those who did not have their M3 extracted were included in the control group, with a total of 63 cases. The average annual growth was calculated by tracing point measurements on cephalometric films before and after orthodontic treatment according to the Jarabak and McNamara methods, with measurements of the mandibular ramus height (Ar-Go'), mandibular body length (Go'-Me), and overall mandibular length (Co-Gn) values, respectively. The average annual growth of Ar-Go', Go'-Me, and Co-Gn were compared between the two groups for the overall sample of patients, patients of the same sex (male/female), patients of the same age group (A, B, and C), and patients of the same cervical vertebral maturation stage (stages Ⅱ, Ⅲ, and Ⅳ), respectively, to see if there was any difference in the average annual growth of Ar-Go', Go'-Me, and Co-Gn. Results: There was no statistically significant difference in the average annual growth of Ar-Go', Go'-Me, and Co-Gn between the study group [0.88 (0.40, 1.80), 0.67 (0.15, 1.18), and 0.86 (0.40, 1.90) mm, respectively] and the control group [1.08 (0.45, 1.60), 0.53 (0.25, 1.13), and 1.20 (0.46, 2.28) mm, respectively] (P>0.05). In addition, there was no significant difference in the average annual growth in the Ar-Go', Go'-Me, and Co-Gn between the groups for patients of the same sex group (male/female), patients of the same age group (A, B, and C), and patients of the same cervical vertebral maturation stage group (stages Ⅱ, Ⅲ, and Ⅳ) (P>0.05). Conclusions: Extraction of the mandibular third molar tooth germ has no significant effect on the development of the mandible in Angle class Ⅰ orthodontic patients.

Objective: To investigate the expression of histone demethylase, Jumonji domain-containing protein 3 (JMJD3), in inflammatory periodontal tissues and its potential mechanism for the regulation of periodontitis. Methods: The results of single-cell sequencing of periodontal tissues published in the Gene Expression Omnibus (GEO) database in 2022 were analyzed. Nine gingival samples each from healthy and inflamed periodontal patients were collected during periodontal surgery or tooth extractions for immunohistochemical staining and real-time fluorescence quantitative PCR (RT-qPCR). Mice periodontitis models were constructed, and the experimental groups were: healthy control+saline group, silk ligation+saline group, silk ligation+GSK-J4(inhibitor of JMJD3) group. Lipopolysaccharide (LPS) derived from Porphyromonas gingivalis (Pg) (Pg-LPS) was used to mimic the periodontal inflammatory microenvironment. The macrophages were treated with small interfering RNA (siRNA) targeting Jmjd3 and the JMJD3 inhibitor GSK-J4. siRNA transfection experiments were grouped into the following: the NC group (negative control sequence transfection group), the siRNA-Jmjd3 group, the NC+LPS group, siRNA-Jmjd3+LPS group. Inhibitor experiments were grouped as dimethyl sulfoxide (DMSO) group, GSK-J4 group, DMSO+LPS group, GSK-J4+LPS group. Western blotting and immunofluorescence staining were used to explore the effects of JMJD3 on macrophage polarization and periodontal inflammation in the in vivo and in vitro settings. Results: RT-qPCR results showed that JMJD3 expression in gingival tissues of periodontitis patients (1.97±0.91) was significantly higher than that in healthy gingival tissues (1.00±0.33) (t=2.45, P=0.048). RT-qPCR results of in vitro experiments showed that either siRNA knockdown of JMJD3 or inhibition of JMJD3 using GSK-J4 promoted M1 polarization and inhibited M2 polarization in macrophages under inflammatory environment: the expression of arginase I (Arg 1) in the NC+LPS group (0.90±0.06) was significantly higher than that in the siRNA-Jmjd3+LPS group (0.61±0.11) (P<0.01); the expression of interleukin (Il)-6, Il-1β, and tumor necrosis factor alpha (Tnf-α) in the NC+LPS group (8.50±0.16, 5.56±0.20, 3.44±0.16) were significantly lower than those in the siRNA-Jmjd3+LPS group (14.63±0.48, 8.55±0.10, 11.72±0.16) (P<0.01). The expression of Arg-1, Ym1, Il-10 in the DMSO+LPS group (0.82±0.01, 0.35±0.16, 1.47±0.11) were significantly higher (P<0.01) than the GSK-J4+LPS group (0.55±0.03, 0.22±0.21, 0.51±0.11); the expression of Il-6, Il-1β, and Tnf-α in the DMSO+LPS group (2.03±0.13, 3.63±0.14, 4.06±0.03) were significantly lower than the GSK-J4+LPS group (2.69±0.16, 15.04±1.15, 4.36±0.10) (P<0.01). The results of the in vivo experiments revealed that inhibition of JMJD3 exacerbated bone loss in experimental periodontitis mice, increased macrophage M1 polarization, and decreased M2 polarization in

Proliferative verrucous leukoplakia (PVL) is a special oral leukoplakia, which has the characteristics of high recurrence and canceration rate. In 2021, the American Society of Oral and Maxillofacial Pathology and the North American Association of head and neck Pathologists published "Proliferative verrucous leukoplakia: an expert consensus guideline for standardized assessment and reporting", and divided PVL into four categories: ①Corrugated ortho(para)hyperkeratotic lesion, not reactive; ②Bulky hyperkeratotic epithelial proliferation, not reactive; ③Squamous cell carcinoma, or suspicious for squamous cell carcinoma; and ④Does not fit any above category. This paper intends to interpret the new classifications of PVL in the guidelines in order to provide guidance for clinical diagnosis and treatment.