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25 April 2020, Volume 29 Issue 2 Previous Issue    Next Issue

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Special Topic on COVID-19

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Instructions for clinical research of oral diseases under the first level response to public health emergencies HUANG Cheng, SHI Chao-ji, XU Feng, ZHEN Hong, CHEN Ru, LU Hai-xia, ZHANG Zhi-yuan 2020, 29 (2):  113-117.  doi: 10.19439/j.sjos.2020.02.001 Abstract ( 306 )   PDF (3880KB) ( 266 )   Corona virus disease 2019(COVID-19) has swept across our country and local governments have successively initiated first level response to public health emergencies. The outbreak of COVID-19 poses a huge challenge to the implementation of various clinical researches including oral diseases. In view of the specialty of oral diseases, it is particularly necessary to protect the health and rights of the participators and related practitioners, and to standardize the implementation of clinical trials. Based on the normative standards issued by the National Health Commission of China, consensus on clinical trial management formulated by the organization of clinical research, and regulations for the diagnosis and treatment of oral diseases during public health emergencies by Chinese Stomatological Association, we drafted the guideline for clinical research of oral diseases, with a view to provide reference for the clinical studies of oral diseases under the first level response to major public health emergencies. References | Related Articles | Metrics

Special Topic on COVID-20

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Experts recommendation on the diagnosis and treatment of oral mucosal diseases during prevention and control stage of the novel coronavirus infection Society of Oral Medicine Shanghai Stomatological Association, Oral Mucosal Disease Specialist Alliance Organization of Shanghai Ninth People's Hospital Group 2020, 29 (2):  118-122.  doi: 10.19439/j.sjos.2020.02.002 Abstract ( 462 )   PDF (4311KB) ( 216 )   The announcement of National Health Commission on January 20, 2020 (No. 1 of 2020) has included Novel Coronavirus Pneumonia(NCP) into the B class infectious diseases according to the law of the People's Republic of China on the prevention and control of infectious diseases, and has been managed as A class infectious diseases. People's governments at all levels and health administration departments have been paying high attention to it, and medical and health institutions have taken a series of prevention and control measures according to the law to prevent and control the spread of NCP. In the process of combating the outbreak of NCP, how to protect the oral mucosal disease physicians normatively, how to ensure hand and environmental cleaning and disinfection; how to carry out triage of the patients with oral mucosal disease accompanied by fever reasonably; how to carry out oral mucosal disease patients'self-care and self-management during this stage, are the practical problems that all levels of medical institutions and medical workers and patients will meet. For these three problems, we invited the experts from the Society of Oral Medicine, Shanghai Stomatological Association and the Oral Mucosal Disease Specialist Alliance Organization of Shanghai Ninth People's Hospital Group to write the recommendation on the diagnosis and treatment of oral mucosal disease during prevention and control stage of novel coronavirus infection, in order to provide references for oral mucosal disease medical physicians and patients in this special period. This recommendation will be updated according to the situation of epidemic prevention and control in China and the new relevant diagnosis and treatment plans. References | Related Articles | Metrics

Special Topic on COVID-21

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Management and prevention of dental emergency during corona virus disease 2019 (COVID-19) epidemic LIAO Qian, LI Zhong-ren, TAO Jiang, JIANG Long, DU Qin, ZHU Ya-qin 2020, 29 (2):  123-126.  doi: 10.19439/j.sjos.2020.02.003 Abstract ( 808 )   PDF (3149KB) ( 390 )   The outbreak of corona virus disease 2019 (COVID-19) has developed rapidly and the situation of prevention and control is severe. During the epidemic period of COVID-19, due to the particularity of diagnosis and treatment of oral diseases, there is great challenges for how to deal with various types of dental emergency. In order to prevent and control the epidemic situation strictly, and to perform a scientific and orderly clinical diagnosis and treatment of dental emergency, this article provided suggestions on personnel management training, procedures and treatment, protection and disinfection of dental emergency during COVID-19 epidemic, and reference for dental institutions and medical staff. References | Related Articles | Metrics

Special Topic on COVID-22

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The risk and prevention of bio-aerosol transmission in dental clinics YANG Yi-jie, ZHAO Jun-jun, ZHU Ya-qin 2020, 29 (2):  127-132.  doi: 10.19439/j.sjos.2020.02.004 Abstract ( 523 )   PDF (4834KB) ( 346 )   Corona virus disease 2019 (COVID-19) has become a Public Health Emergency of International Concern since its outbreak, and whether COVID-19 can transmit by aerosol remains controversial. The problem of bio-aerosol transmission in the relatively confined dental clinics has aroused wide attention in the field of dentistry. This review provided a most updated summary on the relation between bio-aerosols and dental clinics, which included the microorganisms in bio-aerosols, the bio-aerosol transmission and the sources testing methods, temporal and spatial distribution of dental bio-aerosols and summarized how to reduce the exposure to bio-aerosols in dental clinics. References | Related Articles | Metrics

Original Articles

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Effect of porcelain thickness and substrate on optical properties of porcelain veneers for tetracycline stained teeth QIAN Hui-fen, LIN Jia-ru, LIN Yun-hong, WANG Wei-qi, LI Xing-xing 2020, 29 (2):  133-137.  doi: 10.19439/j.sjos.2020.02.005 Abstract ( 289 )   PDF (4076KB) ( 169 )   PURPOSE: To analyze the effect of porcelain layer thicknesses and substrates on color properties and translucency of IPS e.max LT porcelain laminate veneers used to restore tetracycline stained teeth. METHODS: Porcelain specimens with different core and veneer thickness (veneer/core thickness: 0.25 mm/0.25 mm, 0.50 mm/0.25 mm, 0.25 mm/0.50 mm, 0.50 mm/0.50 mm, and 0.25 mm/0.75 mm) were fabricated by heat-press layering technique. CIE L*a*b* parameters were measured under simulated tetracycline backgrounds and black and white backgrounds by a spectrophotometer, color differences ΔE001 between specimens on simulated tetracycline backgrounds and backgrounds themselves and ΔE002 between specimens on simulated tetracycline backgrounds and white background were calculated. The translucent parameter(TP) was also calculated. The data were submitted to statistical analysis with SPSS 17.0 software package. RESULTS: ΔE001 increased with increase of thickness of the core and veneer layer, but there was no significant difference between 0.25 mm and 0.50 mm core thickness groups with 0.50 mm veneer in thickness (P>0.01). Except for light grey, ΔE002 decreased over other substrates with increase of thickness of the core and veneer layer, but there was no significant difference between 0.50 mm and 0.75 mm core thickness groups with 0.25 mm veneer in thickness (P>0.01). Both ΔE001 and ΔE002 were significantly different over different substrates(P<0.01). TP decreased as the increase of core and veneer thickness and TP was significantly different with different core and veneer thickness(P<0.01). CONCLUSIONS: Both the core/veneer thickness and the substrate have significant influence on color matching and masking ability of IPS e.max LT porcelain laminate veneers used to restore tetracycline stained teeth. As for IPS e.max LT porcelain veneers, the color property was the best when yellowish tetracycline stained teeth were restored, while the light grey was worst. The thickness of core and veneer has significant influence on the translucency of porcelain laminate veneers. References | Related Articles | Metrics

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Effect of disulfiram on epithelial-mesenchymal transformation of oral squamous cell carcinoma cells WANG Xue-mei, JIANG Yong 2020, 29 (2):  138-145.  doi: 10.19439/j.sjos.2020.02.006 Abstract ( 260 )   PDF (5565KB) ( 269 )   PURPOSE: To investigate the effect of disulfiram on epithelial-mesenchymal transformation(EMT) in oral squamous cell carcinoma(OSCC) cells based on Smad4 mutation. METHODS: The cancer tissues and adjacent normal tissues of 46 patients with OSCC who underwent tumor resection in the Affiliated Stomatological Hospital of Anhui Medical University from June 2017 to June 2018 were included in the study. Immunohistochemical staining was used to observe the expression of Smad4 in tissues, Western blot was used to determine the expression of Smad4 in tumor cells. The effects of disulfiram on TGF-β1-induced cell EMT migration, invasion, morphology and expression of p38, JNK and ERK were analyzed. SPSS 20.0 software package was used to analyze the data. RESULTS: The positive expression rate of Smad4 in cancer tissues was significantly lower than that in adjacent normal tissues (P<0.05). The survival rates of human tongue cancer SCC-25 and CAL-27 cells were not significantly different from those of the control group at disulfiram concentrations of 5, 10, and 20 μmol/L(P>0.05). The survival rate of human tongue cancer SCC-25 and CAL-27 cells was significantly lower than that of the control group at disulfiram concentrations ≥30 μmol/L(P<0.05). After treatment with TGF-β1, the morphology of SCC-25 and CAL-27 cells changed from epithelial to mesenchymal. E-cadherin expression was significantly reduced, Vimentin and Snail expression were significantly increased, and migration and invasion were enhanced (P<0.05). After disulfiram + TGF-β1 treatment, as the concentration of disulfiram increased, the morphological changes of SCC-25 and CAL-27 cells gradually decreased, the expression of E-cadherin protein gradually increased, the expression of Vimentin and Snail protein gradually decreased, and migration ability gradually weakened (P<0.05). After 5 minutes of TGF-β1 stimulation, p-ERK levels in SCC-25 and CAL-27 cells gradually increased, reached a maximum at 15 minutes, and then gradually decreased (P<0.05). After 20 μmol/L disulfiram + TGF-β1 treatment, p-ERK levels in SCC-25 and CAL-27 cells gradually decreased with the increase of the treatment time(P<0.05). CONCLUSIONS: Disulfiram can inhibit EMT of Smad4 mutant and Smad4 non-mutated OSCC cells by blocking ERK phosphorylation in the MAPK signaling pathway. References | Related Articles | Metrics

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Evaluation of the effects of TF and S3 nickel-titanium instruments in severely curved molar root canal preparation FENG Er-mei, YANG Jian-zhen, ZHANG Yan-xia 2020, 29 (2):  146-149.  doi: 10.19439/j.sjos.2020.02.007 Abstract ( 371 )   PDF (3055KB) ( 212 )   PURPOSE: To compare the shaping ability and dental cracks of Twisted File and S3 in severely curved molar root canal preparation. METHODS: Sixty extracted mandibular molars with mesiobuccal canals (canal curvature angles beyond 25°) were selected and divided randomly into 2 groups with 30 canals in each group. The canals were scanned by cone-beam CT(CBCT) before and after root canal preparation.The canal transportation was recorded at 3 points (3, 5, 7 mm to root tip). After root canal preparation,all the roots were horizontally sectioned 3,5 and 7mm from the apex. The slices were observed under optical stereomicroscope. SPSS 19.0 software package was used for statistical analysis. RESULTS: Transportations occurred in all groups. No significant difference was found between the two groups of canal transportation at the two points (5 mm and 7 mm to root tip) (P>0.05); at the point of 3 mm to the root tip,the transportation of canals prepared by S3 was obviously lesser than the canals prepared by TF. There was no significant difference in the incidence of dentinal cracks between the two groups (P>0.05). CONCLUSIONS: Under the conditions of severely curved molar root canal in extracted teeth, cracks were found in both groups, S3 was found to be better in maintaining original canal shape than TF system. References | Related Articles | Metrics

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Effect of chlorhexidine on the bonding effect of self-acid adhesive to pre-treatment dentin JING De-bao, WANG Li-qin, HU Yu-feng, ZHU Jing 2020, 29 (2):  150-154.  doi: 10.19439/j.sjos.2020.02.008 Abstract ( 293 )   PDF (4269KB) ( 291 )   PURPOSE: To evaluate the effect of 2% chlorhexidine(CHX) on the self-etching adhesive to dentin. METHODS: Fifty carious free molars were selected to expose the flat dentin surface. The specimens were bonded with composite resin by self-etching adhesive,which were pretreated by 2% CHX for 0, 15, 30, 45 and 60 s. The microtensile bond strength (μTBS) and scanning electron microscope(SEM) were evaluated before and after thermocycling. SPSS 19.0 software package was used for statistical analysis. RESULTS: μTBS of the 45 and 60s-CHX pretreated group had significant difference before thermocycling, significantly higher than the control group(P<0.05). The 60s-CHX pretreated group showed significant greater μTBS than the control group after thermocycling(P<0.05). CONCLUSIONS: 2%CHX pretreatment can improve the bonding strength of the self-etching adhesive, and slow down the aging progress of bonding interface. References | Related Articles | Metrics

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Effect of human bone marrow mesenchymal stem cells on invasion of tongue squamous cell carcinoma cell line Cal-27 XU Zhu-qing, ZHANG Xin-yu, WANG Shao-ru, LI Tao, DONG Gang, LI Feng-mei, ZHENG Jian-jin, WANG Yun-ying, XU Xiao-na 2020, 29 (2):  155-161.  doi: 10.19439/j.sjos.2020.02.009 Abstract ( 234 )   PDF (5343KB) ( 170 )   PURPOSE: To investigate the effect of human bone marrow mesenchymal stem cells (hBM-MSCs) on invasion of tongue squamous cell carcinoma cell line Cal-27 and its mechanism. METHODS: hBM-MSCs and Cal-27 were cultured respectively, and the morphology of the cells was observed under an inverted microscope. The co-cultured Cal-27 cells were obtained by co-culture of hBM-MSCs and Cal-27. The migration area of Cal-27 was observed by scratch test;transwell migration and invasion experiments were performed to observe migration and invasion of Cal-27, and a bar graph was then drawn. Fluorescence quantitative PCR was used to observe the effect of hBM-MSCs on gene expression of the tumor markers E-cadherin, twist, slug, snail, MMP-2 and MMP-9. Western blot was used to observe the effect of hBM-MSCs on protein expression of MMP-2 and MMP-9, related to the invasion of Cal-27. SPSS 19.0 software package was used for statistical analysis of the data. RESULTS: Under the influence of hBM-MSCs, the invasion of Cal-27 was promoted, accompanied by down-regulation of E-cadherin, up-regulation of twist, slug, snail, MMP-2, MMP-9 and up-regulation of MMP-2 and MMP-9 expression. CONCLUSIONS: hBM-MSCs can promote invasion of Cal-27 cells, which may be related to up-regulation of the expression of tumor markers related to invasion of Cal-27 cells. References | Related Articles | Metrics

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Study on the expression level of four kinds of interleukins in mice model with peri-implantitis LENG Chun-tao, LI Ting, GAO Xiao-wei 2020, 29 (2):  162-167.  doi: 10.19439/j.sjos.2020.02.010 Abstract ( 234 )   PDF (4810KB) ( 243 )   PURPOSE: To investigate the gross manifestation and tissue destruction at different inflammatory periods of ligature-induced peri-implantitis in mice model, and to evaluate the changes of interleukins level in the gingival crevicular fluid of implants at different stages. METHODS: Forty 4-week-old male C57BL/6N mice (18-22 g) were used and the maxillary right first molars were extracted, custom-made pure titanium machined screw type implants (1 mm×1.5 mm) were placed immediately, one implant per animal. Four weeks later, the mice were randomly divided into experimental and control group. 5-0 cotton ligatures were applied around implant necks in the experimental group to induce peri-implantitis. Alveolar bone loss and clinical index records of the soft and hard tissue were assessed every 5 days following ligature.According to the measured data, the stages of peri-implantitis were ascertained. The gingival crevicular fluid of implants in the early, middle and late stages in the experimental group was extracted and the expression of IL-1α, IL-1β, IL-6 and IL-17A was detected. SPSS 22.0 software package was used to analyze the data. RESULTS: Alveolar bone absorption of all the mice in the experimental group reached 25% 10 days after ligature. This time point was early stage of peri-implantitis. On day 20, the alveolar bone loss around implant in 95% of mice in the experimental group reached 25%-50%, which was identified as middle stage. The alveolar bone loss of all mice in the experimental group was over 50% 30 days following ligature, which was confirmed as late stage. Compared with the early stage, the expression of IL-1α and IL-6 decreased significantly in the middle stage; while the expression levels of IL-1α, IL-6 and IL-17A decreased significantly in the late stage. CONCLUSIONS: Mice models with peri-implantitis of various stages were successfully established by ligature and the expression of IL-1α, IL-1β, IL-6 and IL-17A in different stages of disease was detected, which provided a basis for further research the relationship between interleukin content and peri-implantitis development. References | Related Articles | Metrics

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Gefitinib/chloroquine-liposome-microbubble complexes as ultrasound-triggered therapeutic particles for head and neck squamous cell carcinoma in vitro ZHOU Lu, GONG Xia, XIONG Ping 2020, 29 (2):  168-173.  doi: 10.19439/j.sjos.2020.02.011 Abstract ( 208 )   PDF (4588KB) ( 169 )   PURPOSE: To explore a kind of therapeutic particle of targeted, fewer side effects, both with value of diagnosis and treatment for head and neck squamous cell carcinoma(HNSCC) in vitro. METHODS: Gefitinib-liposome-microbubble model and chloroquine liposome-microbubble model were prepared separately. HN-30 cells were divided into 5 groups: PBS, GE-Lipo+CQ-Lipo, MB-GE-Lipo, MB-CQ-Lipo, MB-GE-Lipo+ MB-CQ-Lipo. MTS kit was used to detect the inhibitory effect of cell proliferation in each group. SPSS17.0 software package was used to analyze the data. RESULTS: When EPC: Chol=2:1, there was no significant difference in the entrapment efficiency between 2:1 and 8:1 group (P>0.05). Compared with 5:1,10:1,20:1 group, there was significant difference in the entrapment efficiency of 2:1 group (P<0.05). Among group 5:1, 8:1, 10:1, and 20:1, compared with each other, there was no significant difference (P>0.05). For HN-30 cells, there was significant difference(P<0.05) between MB-GE-Lipo+ MB-CQ-Lipo group and PBS group. There was no significant difference between MB-GE-Lipo+ MB-CQ-Lipo group and MB-GE-Lipo group (P>0.05). CONCLUSIONS: When EPC:Chol=5:1, the EE of GE-Lipo was higher, the ratio of cholesterol was appropriate, and the liposome was more stable. The inhibitory effect of gefitinib liposome-microbubbles + chloroquine liposome-microbubbles combined with ultrasound on HN-30 cell proliferation was significant. References | Related Articles | Metrics

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Early childhood caries and its related risk factors in 1 296 children aged 3 to 5 years old in Shanghai WANG Hu-ning, WANG Yan, ZHANG Hao, MAO Yan-min, DONG Hua, HUA Min, JIANG Yi-wei, ZHANG Ying 2020, 29 (2):  174-178.  doi: 10.19439/j.sjos.2020.02.012 Abstract ( 375 )   PDF (3516KB) ( 343 )   PURPOSE: To investigate the prevelence of early childhood caries (ECC) and its related risk factors in children aged 3 to 5 years old in Shanghai. METHODS: According to the requirements of the Fourth National Epidemiological Survey of Oral Health, multistage, stratified, equal capacity and simple random sampling method was performed. A total of 1 296 children aged 3, 4 and 5 years old in 12 kindergartens in Shanghai were selected to calculate the prevalence and the mean dmft(decayed-missing-filled tooth). Their parents were surveyed with questionnaire on oral hygiene habit and consciousness of oral health and related factors. Statistical analysis were performed using SPSS 21.0 software package. RESULTS: The prevalence of ECC were 58.07% in children aged 3 to 5 years old in Shanghai, with dmft index of 2.99 in average. There were significant differences in the mean dmft and the prevalence between male and female and among different age groups(P<0.05). In multivariate logistic regression analysis, more frequent sweet drinks, eating sweets before sleep, less daily tooth brushing, starting tooth brushing after 2 years old and low level of parents' education and oral health knowledge were risk factors for dental caries. CONCLUSIONS: The prevalence of ECC in children aged 3 to 5 years old in Shanghai is severe. There is an urgent need for implementation of a systematic education on diet habit and oral health behavior, and the parental education on oral hygiene needs to be further improved. References | Related Articles | Metrics

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Research on the relationship between ABO blood type and oral and maxillofacial malignancy in Chongqing area WANG Fei, QIU Li-hua, PANG Liang, WAN Shu-liang 2020, 29 (2):  179-182.  doi: 10.19439/j.sjos.2020.02.013 Abstract ( 194 )   PDF (3292KB) ( 188 )   PURPOSE: To explore the relationship between ABO blood type and oral and maxillofacial malignancy in Chongqing area. METHODS: A total of 1054 patients with oral and maxillofacial malignant tumors diagnosed in the Stomatological Hospital of Chongqing Medical University in the past five years were selected as the research subjects, and the blood types of the healthy people were examined as the control group. SPSS 22.0 software package and Chi-square test were used to verify the correlation between the groups. The OR values of oral and maxillofacial malignancy of different blood types were compared among patients of three major cancers (squamous cell carcinoma, adenoid cystic carcinoma, mucoepidermoid carcinoma), so as to judge the relative risk of oral and maxillofacial malignant tumors of each blood type. RESULTS: The distribution of blood type in oral and maxillofacial malignancy patients was as follows: O(4.2%)>A(32.8%)>B(24.6%)>AB(8.4%), there was no significant difference in blood types between the patients and the controls. Patients with blood type O were easier to develop mucoepidermoid carcinoma compared with patients with other blood types (P<0.05, OR=2.09, 95%CI=1.04~4.17). In addition, the distribution of blood type of patients with mucoepidermoid carcinoma was significantly different from the control group. Males with blood type O were different from males with other blood types, which were more susceptible to adenoid cystic carcinoma and mucoepidermoid carcinoma (P<0.05, OR=3.06/3.06, 95%CI=1.31~7.12). CONCLUSIONS: There is certain relationship between the occurrence of oral and maxillofacial malignancy and ABO blood type in Chongqing area. The population of O blood type is easier to develop mucoepidermoid carcinoma while males with O blood type are more likely to develop adenoid cystic carcinoma and mucoepidermoid carcinoma. References | Related Articles | Metrics

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Radiographic study of the age for crown and root length completion stages of permanent teeth in male and female children YANG Lian-yi, LAI Guang-yun, WANG Jun 2020, 29 (2):  183-186.  doi: 10.19439/j.sjos.2020.02.014 Abstract ( 984 )   PDF (2976KB) ( 316 )   PURPOSE: To determine the age medians for crown and root length completion stages of permanent teeth (except for the third molars) and to study gender differences in crown and root length completion stages by radiographic examinations. METHODS: The development of permanent teeth (except for the third molars) was evaluated from 3304 panoramic radiographs of children aged between 3 and 18 years by Haavikko's method. Statistical analysis was performed using SPSS 25.0 software package. Age medians for crown and root length completion stages of permanent teeth were calculated. Gender differences were analyzed by Mann-Whitney U test. RESULTS: There were no significant gender differences in crown completion stages of central incisor and first molar, of which P values were 0.143 (for maxillary central incisor), 0.122 (for maxillary first molar), 0.191 (for mandibular central incisor) and 0.558 (for mandibular first molar), while girls were found to be ahead of boys for crown completion stages of other teeth. In maxilla, girls were found to be ahead of boys for root length completion stages except for lateral incisor, second premolar and second molar, of which P values were 0.057, 0.130 and 0.294; in mandible, except for second premolar and second molar, girls were observed to be ahead of boys for root length completion stages, of which P values were 0.428 and 0.057. CONCLUSIONS: It is concluded that girls are advanced than boys for crown and root length completion stages in most teeth. There is a similarity in gender differences for crown and root length completion stages between maxilla and mandible. References | Related Articles | Metrics

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Relationship between eruption status of mandibular third molars and thickness of the lingual bone HUANG Cheng, ZHOU Chun, XU Min-hua, ZOU De-rong 2020, 29 (2):  187-191.  doi: 10.19439/j.sjos.2020.02.015 Abstract ( 342 )   PDF (3849KB) ( 211 )   PURPOSE: To estimate the relationship between the eruption status of the mandibular third molars and the thickness of the lingual bone. METHODS: Cone-beam CT (CBCT) data of 187 patients who underwent mandibular third molar extraction from Jan 2016 to Dec 2018 were selected. Lingual bone thickness at the levels of mid-root and root-apex of the third molars were measured using GALIEOS Viewer software, and the relationship between the eruption status of the mandibular third molars and the thickness of the lingual bone was estimated. SPSS 22.0 software package was used for Wilcoxon test, univariate and multivariate logistic regression analysis. RESULTS: The mean thickness of the lingual bone at the mid-root of the third molars was significantly less than that at the root apex (P<0.01). There was a significant correlation between the thickness of the lingual bone at the mid root and the mesiodistal angulations of the third molars. The thickness of the lingual bone at the mid root of mesioangularly and horizontally impacted third molars were significantly thinner (P<0.01). There was a significant correlation between the thickness of the lingual bone at the root apex and the impaction depth of the third molars. The thickness of the lingual bone at the root apex of medium and low positioned third molars were significantly thinner (P<0.05). CONCLUSIONS: The thickness of the lingual bone is associated with the eruption status of the mandibular third molars. Mesially angulated and lower positioned third molars are considered as the risk factors for the thinner lingual bone, so that lingual plate fracture should be prevented during tooth extraction. References | Related Articles | Metrics

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Construction of perioperative oral care program for elderly patients with oral cancer based on Delphi method ZHENG Yao-wen, JIANG Li-li, HU Jia-le, YANG Wen-yu, RUAN Hong 2020, 29 (2):  192-201.  doi: 10.19439/j.sjos.2020.02.016 Abstract ( 177 )   PDF (7011KB) ( 86 )   PURPOSE: To construct an oral care program for elderly patients with oral cancer during perioperative period. METHODS: Based on the content analysis of the guidelines and personal in-depth interviews of the doctors, nurses and patients, according to the clinical characteristics of the elderly patients with oral cancer and treatments, combined with PDCA cycle, the first draft of perioperative oral care program for the elderly patients with oral cancer was constructed. Delphi method was used to carry out two rounds of mail inquiry to 16 experts in related fields to determine the scheme. Excel 2016, SPSS 25.0 software package were used for statistical description and analysis. RESULTS: The questionnaire return rate of the two rounds of expert consultation was 100% and the overall expert authority coefficient was 0.84. After two rounds of expert consultation, the variation coefficient of each index was 0-0.240, and the overall coordination coefficient was 0.171. The oral care program was formed in three stages: preoperative, postoperative, and during radiotherapy and chemotherapy. The preoperative stage included 4 dimensions, 12 first-level items, 56 second-level items; the postoperative stage included 4 dimensions, 18 first-level items, 102 second-level items; the radiochemotherapy stage included 4 dimensions, 13 first-level items and 35 second-level items. CONCLUSIONS: The perioperative oral care program of the elderly patients with oral cancer accords with the characteristics of the elderly patients with oral cancer during perioperative period, which meets the oral care needs of this group of patients. The construction of the program is reliable and provides a reference for clinical practice. References | Related Articles | Metrics

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Three-dimensional model analysis of obstructive sleep apnea hyponea syndrome patients with long-term treatment of oral appliances HU Jia-xin, XU Shu-hua, MOU Si-xuan, DU Chang-xin, WANG Xue-chun, ZHU Min 2020, 29 (2):  202-207.  doi: 10.19439/j.sjos.2020.02.017 Abstract ( 248 )   PDF (4631KB) ( 240 )   PURPOSE: The aim of the study was to investigate the dental changes of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) with long-term treatment of oral appliances, via the method of three-dimensional model analysis. METHODS: Using Geomagic Studio 2014 software, we transferred the dental models, which were from 18 OSAHS patients before and after treatment of oral appliances, into three-dimensional models for digital analysis. Datasets obtained from pre- and after treatment were compared for accuracy via paired t test using SPSS 22.0 software package. RESULTS: Eighteen patients using oral appliances for 6.57±1.98 years, showed significant differences in some dentition values between pre-treatment and after-treatment. The total dentition changes indicated intrusion of upper premolars, buccalization of upper posterior teeth and mesialization of lower posterior teeth. Statistical analysis demonstrated decrease in upper dental arch length, increase in upper posterior arch width and decrease in upper arch depth and dramatic reduction of overjet in anterior teeth. In the same time, other values evaluated showed no significant change before and after treatment of oral appliances. CONCLUSIONS: Long-term wearing oral appliances results in changes in several variables of dental occlusion, which should not be ignored for dentists conducting this treatment plan. However, the side effect of dental occlusion changes is little on a whole, leading to high security in this aspect. References | Related Articles | Metrics

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Comparative study of submucosal microbial ecological environment between human peri-implantitis and healthy implants ZHAO Xiang, GE Hua-bing, FENG Jie, DU Yan 2020, 29 (2):  208-212.  doi: 10.19439/j.sjos.2020.02.018 Abstract ( 237 )   PDF (3769KB) ( 251 )   PURPOSE: To investigate the balance of submucosal microbial ecological environment in human peri-implantitis and healthy implants. METHODS: The patients with peri-implantitis and dental implants in Beijing Stomatological Hospital, and followed up for one year from September 2017 to January 2019 were enrolled. Patients were divided into two groups according to the presence or absence of peri-implantitis, i.e. peri-implantitis group (43, 51 implants) and healthy group (59 patients, 63 implants). The probing depth, bone resorption, probing bleeding, mPLI and mSBI were recorded. DNA of the submucosal microflora was extracted using a microbial gene extraction kit and sequenced by Illumina's MiSeq sequencing platform. Logistic regression analysis was used to analyze the correlation between the dominant bacteria and the average maximum probing depth, mPLI grading and MSBI grading in peri-implantitis group. The data were processed by SPSS 23.0 software package. RESULTS: The average maximum probing depth of peri-implantitis group was significantly higher than that in healthy group (P<0.05). The proportion of mPLI grade 2 in peri-implantitis group was significantly higher than that in healthy group [56.86%(29/51) vs 0.00%(0/63), P<0.05]. The proportion of mSBI grade 2 in peri-implantitis group was significantly higher than that in healthy group [60.78%(31/51) vs 0.00%(0/63), P<0.05]. The Simpson index of peri-implantitis group was significantly higher than that of the healthy group, and the Shannon index was significantly lower than the healthy group (P<0.05). In peri-implantitis group, the dominant microflora were Selenomonas (16.35%), Pseudomonas (11.20%), Fusobacterium (10.05%), Streptococcus (7.63%) and Treponema (6.84%). CONCLUSIONS: Compared with healthy implants, submucosal microorganisms of peri-implantitis have high species abundance and low species evenness, Pseudomonas, Selenomonas, Fusobacterium, Streptococcus and Treponema account for high proportions in the dominant bacteria. References | Related Articles | Metrics

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Evaluation of 93 cases of mandibular first molar root bifurcation lesions treated with autologous dentin Granules combined with platelet-rich fibrin membrane WU Zheng-rong, ZUO Yuan-lin, LI Chao-hui 2020, 29 (2):  213-216.  doi: 10.19439/j.sjos.2020.02.019 Abstract ( 228 )   PDF (2963KB) ( 189 )   PURPOSE: To investigate the efficacy of autologous dentin particles combined with platelet-rich fibrin membrane (PRF) in the treatment of root bifurcation lesions of mandibular first molar. METHODS: Ninety-three patients (93 teeth) with mandibular first molar root bifurcation lesions were selected from our department from February 2016 to October 2017. They were randomly divided into 2 groups. Forty-six patients with 46 teeth in the experimental group underwent autologous dentin particles combined with platelet-rich fibrin membrane, while patents in the control group (47 patients with 47 teeth) were treated with Bio-Oss implanted in the bone defect area covered with collagen membrane. The patients were revisted at 1, 3, 6 and 12 months after operation. The success rate of the operation group, the depth of periodontal pocket (PD), the loss of attachment (AL), the depth of penetration of the root bifurcation (HPD), and the bone density of the root bifurcation area before and after treatment. The data were recorded and compared with SPSS25.0 software package. RESULTS: The success rate was 97.83%(45/46) in the experimental group, 85.11%(40/47) in the control group, the difference between the two groups was significant(P<0.05). After treatment, PD, AL and HPD decreased significantly (P<0.05), and MGVs increased gradually. There was no significant difference in MGVs before treatment and 1 month after treatment in the experimental group (P>0.05). MGVs at other time points were significantly higher than those of the control group (P<0.05). PD, AL and HPD of the experimental group were lower significantly than the control group at each time point after treatment (P<0.05), and MGVs value was significantly higher than the control group (P<0.05). There was no significant difference in the incidence of complications(4.35% vs 6.38%, χ2=0.189, P>0.05). CONCLUSIONS: Autologous dentin particles combined with platelet-rich fibrin membrane is effective for the treatment of root bifurcation lesions of mandibular first molar, which is worthy of wide application. References | Related Articles | Metrics

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Effect of oral implant restoration on dentition defect patients and its impact on TNF-α and IL-6 levels in gingival crevicular fluid CHANG Zhong-fu, JIANG Dan-dan, ZHANG Zhi-rong, CAI Jian-ying 2020, 29 (2):  217-220.  doi: 10.19439/j.sjos.2020.02.020 Abstract ( 243 )   PDF (2889KB) ( 212 )   PURPOSE: To investigate the clinical effects of oral implant restoration in patients with dentition defects and the its impact on tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) levels in gingival crevicular fluid. METHODS: Eighty-four patients with dentition defects from May 2017 to August 1919 in People's Hospital of Shanghai Pudong District were enrolled and randomly divided into control group (n=42) and experimental group (n=42). Patients in the control group were repaired by routine methods,while those in the experimental group were treated with oral implant restoration. The effect of restoration was evaluated 6 months after treatment. The levels of TNF-α, IL-6 in the gingival crevicular fluid and dental function were compared between the 2 groups. The data were analyzed using SPSS 18.0 software package. RESULTS: The levels of TNF-α and IL-6 in the experimental group and the control group after treatment were significantly higher than those before treatment (P<0.05). The levels of TNF-α and IL-6 in the experimental group were significantly lower than those in the control group 6 months after treatment (P<0.05). The scores of dental function in the experimental group and the control group were significantly higher than those before treatment (P<0.05). The scores of retention, speech, chewing and aesthetics of the experimental group 6 months after treatment were significantly higher than the control group (P<0.05). The incidence of infection, pricking, post and core loosing and teeth missing in the experimental group was significantly lower than that of the control group (P<0.05). CONCLUSIONS: In the treatment of patients with dentition defects, implant restoration has little effect on the levels of TNF-α and IL-6 in gingival crevicular fluid, which is helpful to improve dental function and reduce the incidence of postoperative complications. Therefore, it is worthwhile to be popularized in clinical application. References | Related Articles | Metrics

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Clinical evaluation of mandibular impacted third molar removed without surgical flaps ZHOU Jun-bo, WU Yan-hui, ZHANG Shun-chu, WANG Ming, HAN Yuan 2020, 29 (2):  221-224.  doi: 10.19439/j.sjos.2020.02.0021 Abstract ( 246 )   PDF (3074KB) ( 254 )   PURPOSE: To evaluate the effect of impacted mandibular third molars extracted without surgical flaps. METHODS: Ninety-eight patients with impacted mandibular third molars were collected. A total of 112 teeth were divided into non-surgical flap group and surgical flap group. In non-surgical flap group, the teeth were removed by transection method or T-shaped truncation method, and triangular flaps were designed in the surgical flap group. Postoperative complications at 1 day, 3 days, and 1 week after operation were recorded, and statistical analysis was performed using SPSS 17.0 software package. RESULTS: Complications such as hemorrhage, swelling, pain, mouth opening limitation and impact on daily life at postoperative 1 day and 3 day in non-surgical flap group were significantly lower than in surgical flap group (P<0.05).There was no significant difference in average operation time between the two groups (P>0.05). CONCLUSIONS: Impacted mandibular third molar can be removed without surgical flaps in selected patients. It helps alleviate patients'postoperative complications and improve their quality of life. References | Related Articles | Metrics