Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology最新文献

Odontoma is a hamartoma or developmental malformation of dental tissues and often causes delayed or impacted permanent teeth. This paper reports a case of surgical removal of an odontoma that is closely attached to the labial bone plait and examines the extraction of accompanying high-impacted maxillary canine beside the nose and maxillary sinus. Digital technology was used in reconstructing a part of a patient's maxilla, odontoma, related teeth, and other adjacent anatomical structures, accurately determine the lesion boundary, and design an optimal surgical plan. The minimally invasive extraction of lesions and embedded teeth with a double-fenestration technique through the upper and lower paths not only preserved the continuity of the labial alveolar bone plate in the operative area and prevented postoperative bone collapse but also reduced the risk of maxillary sinus mucosal injury and perforation, improved surgical efficiency, and reduced the surgical trauma. These features were in line with the concept of minimally invasive alveolar surgery.

Objectives: This study aimed to investigate the effects of silencing Ras homolog family member C (RhoC) on the proliferation, apoptosis, invasion, migration, and epithelial-mesenchymal transition (EMT) of salivary adenoid cystic carcinoma (SACC) and its molecular mechanisms.

Methods: A total of 27 SACC lesions and normal salivary gland tissues that were surgically resected at Qingdao Municipal Hospital from January 1, 2019 to March 1, 2024 were selected, and the expression levels of RhoC were detected by Western blot and immunohistochemistry. Three small interfering RNA (siRNAs) were designed to target the RhoC gene sequence, transfected into SACC-LM and SACC-83 cell lines, and evaluated for transfection efficiency. The protein expression levels of RhoC, Rho-associated protein kinase-1 (ROCK1), p38 mitogen-activated protein kinase (p38MAPK), phosphorylated-p38MAPK (p-p38MAPK), twist family bHLH transcription factor 1 (TWIST1), E-cadherin, N-cadherin, and Vimentin were compared using Western blot. CCK-8 assay, flow cytometry, transwell invasion assay, and wound healing assay were conducted to assess the differences in cell proliferation, apoptosis, invasion, and migration abilities among the groups. Bioinformatics methods were also used to predict possible upstream micro RNAs (miRNAs) of RhoC and their expression levels in SACC. Moreover, dual-luciferase reporter gene experiments were performed to verify the binding sites of miR-138-5p and RhoC.

Results: RhoC was highly expressed in SACC (P<0.05). After silencing RhoC, the test group showed a significant decrease in the expression level of ROCK1, p-p38MAPK, TWIST1, N-cadherin, and Vimentin, as well as a significant increase in the expression level of E-cadherin (P<0.05). No significant difference in the expression level of p38MAPK was observed (P>0.05). The cell proliferation, invasion, and migration ability decreased in the test group, whereas the apoptosis rates significantly increased (P<0.05). miR-138-5p was lowly expressed in SACC, and miR-138-5p mimic can significantly downregulated the luciferase activity of 293T cells after transfection with a RhoC wild-type plasmid (P<0.05).

Conclusions: RhoC is highly expressed in SACC, and RhoC silencing may target the downstream ROCK1/p38MAPK/TWIST1 signaling pathway, thereby inhibiting the proliferation, invasion, migration, and EMT of SACC while promoting its apoptosis. On the contrary, miR-138-5p is lowly expressed in SACC and is a potential upstream gene of RhoC, and there may be binding sites between the two genes.

Objectives: To explore and analyze the feasibility of using indocyanine green (ICG) near-infrared fluorescence (NIF) imaging technology for the early diagnosis of oral potential malignant disorders and oral squamous cell carcinoma.

Methods: 7,12-Dimethylbenz[a]anthracene in acetone solution was used to induce various pathological models of buccal mucosal lesions (mild/moderate dysplasia, severe dysplasia, squamous cell carcinoma) in golden hamster. ICG-NIF was conducted for the quantitative analysis of the fluorescence signal of lesion tissue, and evaluation of the diagnostic and discriminative capabilities of the ICG-NIF technology for mucosal lesions in various pathological states. Immunohistochemical staining was perform to examine the microvessel density (MVD) and microlymphatic vessel density (MLVD) of mucosa in various pathological states and explore the histological reasons underlying the differences in fluorescence signals.

Results: The results of ICG-NIF fluorescence quantitative analysis reveal the higher fluorescence intensity of mucosal lesions in the experimental group compared with that of the normal mucosa on the control side, with statistical differences (P<0.05). Moreover, the more severe the malignancy of mucosal lesions in the experimental group, the higher the fluorescence intensity. According to histopathological analysis, the malignant progression of mucosal lesions in golden hamsters was accompanied with an increase in MVD (P<0.05) and a decrease in MLVD (P<0.05).

Conclusions: The abnormal proliferation of mucosal lesions in golden hamsters exhibits a difference in ICG-NIF fluorescence signal compared with normal mucosal tissue. Fluorescence quantitative analysis methods can provide assistance in differentiation and show potential for clinical applications.

Malignant hyperthermia is a rare life-threatening hyperthermic reaction that occurs during general anesthesia and is difficult to diagnose preoperatively. In most reported cases, final diagnoses of malignant hyperthermia were eventually confirmed by genetic testing after the episodes of hyperthermia. Dantrolene is the only specific medicine with improved treatment outcomes for malignant hyperthermia. In this work, we reported a case of malignant hyperthermia that occurred during orthognathic surgery. Malignant hyperthermia was successfully reversed because of the prompt recognition and specific treatment of dantrolene, and only slight increases in myoglobin and creatine kinase were observed postoperatively.

Oral wounds caused by injuries, surgeries, diseases, and chemical irritations bring pain to the patient and increase the risk of infection. Effective wound protection and repair are crucial for improving patients' quality of life and maintaining oral health. Wound dressings provide ideal healing conditions by isolating the wound from the oral environment. However, in the highly moist, microbiologically rich environment of the oral cavity, maintaining the stability of wound dressings remains a considerable challenge. Hydrogels show promising prospects for oral applications and are gradually becoming a research hotspot for addressing the challenges of oral wound protection and repair due to their excellent biocompatibility and versatile performance. In this paper, the current design strategies of hydrogel wound dressings that overcome the unique oral environment, achieve sustained adhesion and fulfill their functions are reviewed to provide new insights for the design of ideal oral wound barrier materials.

Objectives: This paper aims to investigate the application of intraoral scanning and cone beam computed tomography (CBCT) registration implant robot in dental implant surgery.

Methods: The data of 40 cases with dental defect of robot-assisted implantation from November 2023 to May 2024 were retrospectively analyzed. Before the operation, the intraoral scan data and CBCT data of the positioning markers were automatically fused with the initial CBCT images, and the registration error was calculated. The average registration error of positioning markers was determined during the operation, and the implantation accuracy was analyzed after the operation.

Results: The intraoral scan data and CBCT data of 40 patients with dental defect wearing positioning markers were successfully registered with the initial CBCT image, and the registration errors were (0.157±0.026) mm and (0.154±0.033) mm, respectively. Statistical analysis showed no statistical significance between them. The registration errors of the marker was (0.037 3±0.003 6) mm. A total of 55 implants were performed, and the total deviations of the implant point and the apical point were (0.78±0.41) and (0.89±0.28) mm, respectively. The transverse deviations of the implant point and the apical point were (0.44±0.36) and (0.58±0.25) mm, respectively. The depth deviations of the implant point and the apical point were (0.51±0.32) and (0.54±0.36) mm, respectively. The deviation of the implant angle was 1.24°±0.67°.

Conclusions: The fusion technology based on intraoral scanning and CBCT registration can meet the accuracy requirements of preoperative registration of oral implant robots. The technology increases the choice of registration methods before robot-assisted dental implant surgery and reduces the multiple radiation exposuresof the patient.

Objectives: Flap division is the primary method for treating postoperative airway obstruction following pharyngeal flap surgery. However, a discussion on the treatment effectiveness and prognosis of this surgery is lacking. Therefore, this study aims to explore the effectiveness of flap division in improving airway obstruction and hyponasality after pharyngoplasty and to analyze the risk factors for postoperative complications.

Methods: A retrospective review was conducted on the data of all patients who underwent flap division following pharyngeal flap for airway obstruction at our institution. Pre- and post-operative assessments of ventilation, speech, and related factors were performed using the nasal obstruction symptom evaluation scale, speech evaluation scale, nasopharyngeal fiberscope, and lateral cephalometric radiographs. A nasopharyngeal fiberscope was utilized to observe the airway port of the patients, velopharyngeal closure, and the mobility of the lateral pharyngeal walls. Lateral cephalometric radiographs were employed to evaluate the patient's maxillomandibular relationship and adenoid dimensions. A logistic regression model incorporating univariate analysis and multivariate analyses was established to identify the prognostic factors influencing the occurrence of persistent postoperative airway obstruction and hypernasality.

Results: Among the 63 patients, 56 patients (88.9%) experienced a reduction in the severity of airway obstruction postoperatively but 20 patients (31.7%) still presented with moderate-to-severe airway obstruction. Age at surgery (P=0.023) and adenoid hypertrophy (P=0.003) were significantly associated with persistent postoperative airway obstruction. All 39 individuals exhibiting preoperative hyponasality demonstrated effective resolution after flap division, and 11 patients (17.5%) experienced mild hypernasality postoperatively. Unilateral port obstruction (P=0.004) and BMI (P=0.027) were identified as potential independent factors influencing the development of postoperative hypernasality.

Conclusions: Flap division is an effective measure for improving postoperative airway obstruction and hyponasality following pharyngeal flap, although some patients may continue to experience persistent airway obstruction and develop hypernasality after division. Age at surgery and adenoid hypertrophy are prognostic factors for persistent airway obstruction following flap division. Unilateral/bilateral nasal airway obstruction and BMI are related factors for post-operative hypernasality.

Objectives: This study aims to evaluate the mid- and long-term clinical efficacies of simple taper retentive implants for immediate placement in chronic apical infected teeth in the posterior region.

Methods: A total of 36 patients with 41 simple taper retentive implants were included in the study conducted. These patients underwent immediate implant treatment for teeth with chronic apical infection in the posterior region. The soft and hard tissues surrounding the implants were assessed and documented over a period of 5 years following the completion of crown restoration.

Results: During the 5 years follow-up period, one implant failed with mobility, and the implant survival rate was 97.6%. The mean marginal bone resorption was (-0.74±1.03) mm from the immediate post-implant placement to the immediate post-crown restoration, and the difference in marginal bone heights between the two time points was statistically significant (P<0.05). The mean marginal bone resorption was (-0.21±0.70) mm from the immediate post-crown restoration to the 5-year post-crown restoration, and the difference in marginal bone height between the two time points was not statistically significant (P>0.05). No significant difference (P>0.05) was observed in bone resorption between mesial and distal, maxillary and mandibular, different tooth positions, and different implant lengths. The soft tissue surrounding the implants remained healthy at the 5 years follow-up period, one implant exhibited peri-implantitis, and no mechanical complications were observed. The overall satisfaction of patients was good.

Conclusions: Immediate placement of simple taper retentive implants after thorough debridement of chronic infected alveolar socket in the posterior region can achieve good mid- and long-term clinical outcomes after 5 years of loading. The soft and hard tissues were maintained in a steady state, which expanded the indications for immediate implantation.

Root canal therapy is the primary treatment method for pulpal and periapical diseases. Various advanced endodontic instruments for mechanical preparation have been marketed. The emergence of nickel-titanium rotary instruments has greatly improved the efficiency of root canal preparation. New demands have been put forward for nickel-titanium rotary instruments as a result of the deepening of clinicians' awareness of root canal anatomy system as well as the purpose and prognosis of root canal treatment. These clinical-oriented demands accelerate instrument reform and innovation. This work presents new marketed nickel-titanium systems and discusses the advantages and limitations of these systems and how they perform in terms of the efficiency and outcome of root canal preparation.

Objectives: This study aimed to identifyPAX9variants in non-syndromic tooth agenesis families of China, as well as to analyze the genotype⁃phenotype of non-syndromic tooth agenesis caused by PAX9variants, which can provide a basis for the genetic diagnosis of tooth agenesis.

Methods: We collected the data of 44 patients with non-syndromic oligodontia who underwent treatment at Stomatological Hospital of Hebei Medical University between 2018 and 2023. Whole-exome sequencing was performed on the peripheral blood of the proband and its core family members, and the variants were verified by Sanger sequencing. Pathogenicity analysis and function prediction of the variants were performed using bioinformatics tools. The correlation between the genotype of PAX9 variant and its corresponding phenotype was examined by reviewing 55 publications retrieved from PubMed. The studies involved 232 tooth agenesis patients with PAX9 variants.

Results: A novel PAX9 c.447delG (p.Pro150Argfs*62) and a reported PAX9 c.406C>T (p.Gln136*) were identified in two Chinese families. Through bioinformatics analysis and three-dimensional structural modeling, we postulated that the frameshift variant was pathogenic. The outcome was the premature cessation of PAX9 protein, which caused severe structural and functional deficiencies. Summarizing the PAX9 genotype-phenotype relationship revealed that patients carrying the PAX9 variant commonly led to loss of the second molars.

Conclusions: We identified the novel PAX9 c.447delG (p.Pro150Argfs*62) in a Chinese family of non-syndromic oligodontia, expanding the known variant spectrum of PAX9. The most susceptible tooth position for PAX9 variants of tooth agenesis was the second molars and the deciduous molars during the deciduous dentition.