The Chinese journal of dental research : the official journal of the Scientific Section of the Chinese Stomatological Association (CSA)最新文献

Objective: To establish a risk assessment model for early childhood caries and verify its credibility.

Methods: This 1-year multicentre cohort study comprised cohorts of 3-year-old children with and without caries recruited from kindergartens in Beijing, Shanghai, Sichuan, Hubei and Guangdong. Oral disease-related social and behavioural risk factors were collected from both children and their parents using questionnaires. Clinical examinations were performed according to World Health Organization standards, and the plaque's ability to produce acid, saliva pH value and saliva-buffering capacity were assessed. Logistic regression methods were employed to construct a risk-prediction model for caries incidence. Cross-validation methods were applied for the internal validation of the model, and the area under the curve (AUC) and calibration curves were used to evaluate the predictive performance of the constructed model.

Results: A total of 4,381 children were included in the study and randomly allocated 1:1 to the development and validation sets. Using the new occurrence of decayed, missing and filled surfaces as the dependent variable, the predictive model demonstrated AUCs of 0.83 (95% confidence interval [CI] 0.81 to 0.84) in the development model and 0.80 (95% CI 0.78 to 0.82) in the validation model at 1 year. The training and validation sets exhibited high sensitivity (0.69 to 0.72) and specificity (0.73 to 0.81).

Conclusion: The predictive models demonstrated good discriminability with both the training and validation sets and were suitable for primary oral care clinicians and stomatological hospitals.

Objective: To investigate the molecular mechanism by which bone morphogenetic protein receptor type 2 (BMPR2) regulates the odontogenic differentiation of dental pulp stem cells.

Methods: Human dental pulp stem cells (hDPSCs) with lentiviral vector-mediated BMPR2 overexpression and knockdown were generated. Cell proliferation was assessed using a cell counting kit-8 assay. The odontogenic differentiation potential of hDPSCs was examined using alkaline phosphatase and alizarin red S staining. The expression of odontogenic differentiation markers and critical mediators of bone morphogenetic protein (BMP)-suppressor of mothers against decapentaplegic (SMAD) signalling was analysed using real-time quantitative polymerase chain reaction and western blotting.

Results: BMPR2 overexpression promoted odontogenic differentiation of hDPSCs but suppressed their proliferation, which was contrary to the findings in the BMPR2 knockdown group. Moreover, BMPR2 overexpression activated the BMP-SMAD-Runt-related transcription factor 2 (RUNX2) signalling cascade. RUNX2 overexpression partially recaptured the effects of BMPR2 knockdown on odontogenic differentiation of hDPSCs.

Conclusion: These results indicate that BMPR2 promotes odontogenic differentiation of hDPSCs by activating BMPR2-SMAD1/5/8-RUNX2 signalling, and that targeting this cascade could be a promising strategy for gene therapy in human tooth development.

Objective: To elucidate the genetic aetiology of basal cell nevus syndrome (BCNS) within a Chinese cohort featuring an affected family.

Methods: The patient's and their parents' peripheral venous blood was collected for high-throughput exon sequencing. Tools such as Mutation Taster2 and SIFT were used to predict mutation harmfulness and obtain the most suspected pathogenic mutation. GeneMANIA was employed to construct the protein interaction network between the gene and Hedgehog pathway. SWISS-MODEL was used to simulate the bioinformatics structure changes of the mutant gene and HDOCK was utilised to simulate molecular docking. Finally, the function of this gene mutation was verified by q-PCR.

Results: A novel pathogenic mutation of PTCHD3 was identified. CCDC57 in the Hedgehog pathway was found to interact with PTCHD3 through GeneMANIA. SWISS-MODEL predicted that PTCHD3 mutation would lead to changes in the 3D structure of the protein. HDOCK showed that the binding between PTCHD3 and CCDC57 was significantly reduced. The mutation of PTCHD3 may result in decreased binding ability of PTCHD3 to CCDC57, activate the Hedgehog pathway and lead to the occurrence of the disease. The diagnosis and treatment pathway for clinical discovery of OKC was provided.

Conclusion: A novel pathogenic mutation of PTCHD3 was identified in Chinese BCNS patients. PTCHD3 may play a role in various biological processes mediated by the Hedgehog signalling pathway and is expected to be a new potential therapeutic target.

Objective: To investigate the regulatory role of proenkephalin (PENK) on the osteogenic differentiation process of human bone marrow mesenchymal stem cells (hBMMSCs).

Methods: PENK knockdown and overexpression in hBMMSCs were performed by using lentivirus containing the specific short hairpin RNA or whole coding region for PENK in vitro. The alkaline phosphatase level and mineralised nodule formation were observed by alkaline phosphatase (ALP) and Alizarin Red S (ARS) staining and quantification. Meanwhile, the expression levels of osteogenic-related mRNA and protein were detected by qRT-PCR and Western blot.

Results: Transfection of lentivirus in hBMMSCs was effectively confirmed by the green fluorescent protein-positive cells under fluorescence microscopy, and qRT-PCR and Western blot analyses verified the successful establishment of PENK knockdown and overexpression hBMMSCs. The results showed that knockdown of PENK effectively promoted the osteogenic differentiation of hBMMSCs, with enhanced ALP and ARS staining, and increased expression levels of osteogenic-related genes and proteins. Conversely, the overexpression of PENK inhibited the osteogenic differentiation of hBMMSCs.

Conclusion: This finding identified PENK as a potential therapeutic target for bone regeneration of oral and maxillofacial bone defects.

Accurately recording implant positions and maxillomandibular relationships in completely edentulous patients for the fabrication of fixed implant-supported immediate prostheses presents a challenge. This study aimed to introduce a fully digital workflow incorporating artificial intelligence (AI) technology and a dynamic virtual patient to create a screw-retained, full-arch implant-supported prosthesis for a completely edentulous patient. Virtual surgical planning was conducted using digital software (3Shape dental system, 3Shape, Copenhagen, Denmark) that integrates intraoral mucosal information, anatomical images of bone tissue and the radiographic guide based on radiopaque markers of the radiopaque guide. After this, immediate implant-supported fixed complete-arch dentures (IFCDs) were fabricated based on the alignment of intraoral scans and the extraoral scans of the implant position with the scan bodies and preoperative and postoperative CBCT images. Digital impressions of interim and mucosal contours, CBCT images, facial scans and mandibular motions of the patients were collected to construct a dynamic virtual patient. The craniomaxillofacial complex and mandible were automatedly segmented using 3D Slicer via the deep learning system. Subsequently, a definitive restoration was fabricated, and the patient expressed satisfaction with the functionality, aesthetics and passive fit of the IFCDs. This technical procedure presents a digital registration method using AI technology to accurately capture the aesthetic features and maxillomandibular relationship and ensure a passive fit, potentially improving aesthetics and functionality and maintaining the long-term stability of peri-implant soft and hard tissues.Keywords: digital workflow, implant-supported full-arch prosthesis, virtual patient.

Objective: To provide diagnostic and therapeutic references by analysing clinical features and CT imaging data of diffuse tenosynovial giant cell tumours (D-TSGCT) in the temporomandibular joint (TMJ).

Methods: Patients who were diagnosed with a D-TSGCT in the TMJ through histopathological examination and underwent surgical treatment at Peking University Stomatological Hospital from April 2013 to October 2022 were included in the present study. The study retrospectively analysed and summarised patients' clinical and radiological features, the latter including osseous erosion, invasion of surrounding tissues and imaging characteristics.

Results: This study included 31 patients with a D-TSGCT in the TMJ (16 men, 15 women; median age 46 years). All patients underwent surgical treatment, with 51.6% receiving postoperative supplementary radiotherapy. The recurrence rate was 19.4% over a 3- to 12-year follow-up period. Imaging revealed extra-articular extension in 83.9% of cases, and 93.5% of cases showed bone involvement (condyle 48.4%, glenoid fossa 77.4%). Other features included articular eminence destruction (67.7%), ill-defined masses with calcification (51.6%), marginal enhancement (26.9%) and periosteal reaction (9.7%).

Conclusion: The imaging features showed that D-TSGCT in the TMJ is an aggressive and expansive neoplasm with significant bone invasion. The recurrence patterns further support its intermediate-type biological behaviour. Computed tomography images play a critical role in diagnosis, treatment planning and prognosis assessment.

Objective: To evaluate the cross-sectional correlation between severity of periodontitis and diabetes in a representative sample of the Chinese population.

Methods: Data of dentate subjects (35- to 44-year-old group [n = 4,409], 55- to 64-year-old group [n = 4,568] and 65- to 74-year-old group [n = 4,218]) were analysed. Self-reported diagnosis of diabetes was based on a face-to-face interview. Periodontal status was defined according to the 2018 classification scheme. Periodontal parameters included bleeding on probing (BOP), probing depth (PD) and attachment loss (AL). Distribution of periodontal status and parameters in diabetic and non-diabetic subjects were calculated. Smoothing plots were illustrated to show the correlation between periodontal parameters/status and diabetes.

Results: The frequency of severe periodontitis (Stage III and Stage IV) in diabetic subjects was significantly higher than that in non-diabetic subjects (41.88% vs 30.22%, P 0.001). The percentages of periodontal parameters of diabetic subjects were significantly higher than those of non-diabetic subjects (57.71% vs 53.12% for BOP, 22.11% vs 16.29% for PD ≥ 4 mm and 2.07% vs 1.22% for PD ≥ 6 mm, respectively). Increased risk of diabetes was observed in subjects with severe periodontitis. Positive associations were found between the percentage of affected teeth with PD ≥ 4/6 mm and diabetes.

Conclusion: Severe periodontitis is associated with diabetes in the Chinese population, and highlighted in younger patients.

Objective: To assess the impact of hyperbaric oxygen (HBO) therapy on bone healing in dia-betic patients and explore potential mechanisms in an animal experiment.

Methods: Four non-diabetic patients undergoing maxillary sinus lateral augmentation were assigned to either standard care (control group) or HBO treatment for 5, 6 or 9 weeks. Bone core samples were collected for immunochemistry during the preparation for implant insertion. Additionally, 12 db/db diabetic mice and 12 control mice with tibia defects were subjected to HBO treatment. After 7 days, the bone repair process was assessed using microcomputed tom-ography (microCT), histology, immunohistochemistry and Western blot analyses.

Results: HBO improved bone formation in the implant areas of patients treated for 5, 6 and 9 weeks, increasing local vascular endothelial growth factor, bone morphogenetic protein-2 and osteocalcin expression. Diabetic mice exhibited impaired bone healing, but HBO-treated groups (diabetic or non-diabetic) showed enhanced new bone formation. Increased osteocalcin and runt-related transcription factor 2 and decreased tartrate-resistant acid phosphatase expression were detected. The nuclear factor erythroid-derived 2-related factor 2 (Nrf2) pathway and its downstream proteins catalase and heme oxygenase-1 were upregulated after HBO.

Conclusion: HBO enhances bone healing in both patients and diabetic mice, and is potentially mediated through the Nrf2 pathway.

Objective: To compare the effects on the oral microbiome after rinsing with hydrogen peroxide (H2O2), chlorhexidine and essential oil mouthrinses and identify formulations that suppress pathogenic bacteria while preserving beneficial species and maintaining oral microbial bal-ance.

Methods: Twelve healthy volunteers were randomly assigned to three groups: H2O2, chlorhexi-dine and essential oil mouthrinse. Saliva samples were collected at three time points: before and 5 minutes and 1 hour after rinsing with mouthrinse. Microbiome composition was analysed using 16S rRNA gene sequencing.

Results: Alpha and beta diversity showed no statistically significant differences among time points. The genus-level microbiome composition remained relatively stable in the H2O2 and essential oil groups but changed significantly in the chlorhexidine group. In the H2O2 group, Neisseria decreased significantly, while Actinomyces increased. In the chlorhexidine group, Porphyromonas, Veillonella, Streptococcus, Neisseria and Gemella decreased significantly. In the essential oil group, Leptotrichia decreased, and Haemophilus increased significantly.

Conclusion: Essential oil mouthrinse and chlorhexidine exhibit stronger bacteriostatic effects against oral pathogens than H2O2. However, chlorhexidine may disrupt microbial equilibrium, whereas essential oil mouthrinse more effectively preserves a stable oral microbiome. Thus, es-sential oil mouthrinse could serve as a viable alternative to chlorhexidine for oral microbiome management, though its long-term efficacy requires further investigation.

Objective: To develop an efficient and accurate method for the precise quantification of peri-implant marginal bone loss, aiming to overcome the limitations of conventional assessments that rely heavily on expert subjective judgment and to enhance the monitoring of marginal bone level stability and facilitate the early detection of clinical risk factors.

Methods: This research proposes an efficient automatic quantification method for marginal bone loss based on the YOLOv8-pose model. By detecting and localising keypoints associated with peri-implant bone loss, this method enables automated identification of marginal bone loss characteristics. Model performance is evaluated using the marginal bone loss rate to assess its effectiveness in predicting the severity of resorption on both sides of the implant.

Results: The precision of keypoint detection for marginal bone loss features exceeds 98%, and the mean radial error of six keypoints in most images is less than 10 pixels, with the minimum error reaching only 2.89 pixels. In predicting marginal bone loss severity on both implant sides, the model achieves accuracies of 0.906 and 0.844, respectively, demonstrating robust predictive capability and application potential.

Conclusion: The YOLOv8-pose-based method effectively addresses the inefficiency and subjec-tivity of traditional assessments by enhancing the automation and objectivity of peri-implant marginal bone loss detection. It provides valuable technical support for accurate evaluation and clinical decision making in peri-implant marginal bone loss.