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    25 December 2020, Volume 29 Issue 6 Previous Issue    Next Issue
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    Original Articles
    Simultaneous innervation revitalizes bone marrow mesenchymal stem cells from postoperative iliac grafts
    WANG Xu-dong, ZHANG Cheng-yao, ZHANG Shi-jian, SHI Jing-cun, WANG Lei
    2020, 29 (6):  561-566.  doi: 10.19439/j.sjos.2020.06.001
    Abstract ( 317 )   PDF (4859KB) ( 159 )  
    PURPOSE: To compare the osteogenic potential of bone marrow mesenchymal stem cells (BMMSCs) from innervated iliac graft bone flap and traditional one for reconstructing mandibular defects. METHODS: Graft bone marrow samples were harvested 1 year after free vascularized iliac reconstruction of mandibular defects, with or without innervation through simultaneous nerve anastomosis. BMMSCs were isolated and cultured in vitro. Colony forming units-fibrosis observation, Brdu incorporation assay, population doubling, Alizarin red staining for in vitro calcified nodule formation and in vivo assay of subcutaneous osteogenesis in nude mice were used to detect BMMSCs proliferation, self-renewal and osteogenic differentiation capabilities, respectively. SPSS 24.0 software package was used for statistical analysis. RESULTS: Colony formation, proliferation, population doubling and osteogenic differentiation abilities of BMMSCs from innervated group were significantly higher than those from non-innervated group(P<0.05). CONCLUSIONS: Simultaneous innervation of free vascularized iliac during reconstruction of mandibular defects may maintain self-renewal and osteogenic differentiation potentials of BMMSCs in graft bones, thereby maintaining bone homeostasis and reducing postoperative graft bone resorption.
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    Diagnostic accuracy of MALDI-TOF mass spectrum in identification of oral Candidiasis isolates
    WEI Pan, FU Jing-ya, ZAHNG Yi-fei, LYU Xin, GUAN Xiao-bing, YAN Zhi-min, CHEN Feng, HUA Hong
    2020, 29 (6):  567-572.  doi: 10.19439/j.sjos.2020.06.002
    Abstract ( 269 )   PDF (4604KB) ( 172 )  
    PURPOSE: To investigate the diagnostic accuracy of matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) in the identification of clinical oral Candida isolates. METHODS: In the first experiment, 170 suspected oral candidiasis patients were included. Unstimulated saliva was collected and cultured on solid plate (Sabouraud’s agar) for 48 hours. Clinical isolates were analyzed by both PCR, which was used as golden standard, and MALDI-TOF MS. The diagnostic accuracy of MALDI-TOF MS for both C.albicans and non-C.albicans were investigated. In the second experiment, we tried to identify Candida isolates directly from positive liquid culture in a new cohort of 42 patients. MALDI-TOF MS identification of candida isolates were performed on positive liquid medium cultures directly. The data were analyzed using SPSS 18.0 software package. RESULTS: Totally, 230 clinical Candida isolates were isolated from 212 oral candidiasis patients enrolled. Out of the 230 analyzed clinical isolates, C. albicans (65.65%, 151/230) was the most frequently isolated species, followed by C. glabrata (11.74%, 27/230), and other candida species. The sensitivity and specificity of MALDI-TOF in identification of C. albicans were 93.33% and 92.73% respectively, and those for non-C. albicans were 83.64% and 89.2% respectively. Oral rinse followed by culturing in Sabouraud’s liquid medium for 24 hours yield the diagnostic accuracy of 78.42% in MALDI-TOF MS identification. CONCLUSIONS: C. albicans is the most frequent Candida spp. in oral candidiasis. MALDI-TOF MS is an effective and rapid method for identification of Candida spp. The on-plate based method generate much higher diagnostic accuracy than liquid culture based one.
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    Human dental pulp stem cells conditioned medium protects genioglossus myoblast from cobalt chloride-induced hypoxia injury through AMPK/PGC-1α pathway
    ZHANG Wei-hua, YU Li-ming, HAN Xin-xin, PAN Jie, DENG Jia-jia, ZHU Lu-ying, LIU Yue-hua
    2020, 29 (6):  573-579.  doi: 10.19439/j.sjos.2020.06.003
    Abstract ( 315 )   PDF (5971KB) ( 209 )  
    PURPOSE: To study the effect of hypoxia induced by cobalt chloride (CoCl2) on viability and oxidative stress of genioglossus myoblast, and to explore the mechanism of the protective effect of conditioned medium (CM) on human dental pulp stem cells (hDPSCs). METHODS: The hDPSCs were isolated and cultured, and the conditioned medium was prepared by ultrafiltration concentration. Mouse genioglossus myoblasts were isolated and divided into control group, CM group, CoCl2 group and CoCl2+CM group. The cell viability of genioglossus myoblasts was detected by CCK-8. The intracellular and mitochondrial ROS levels were evaluated by DCFH-DA and MitoSOX, respectively. The expression level of mitochondria-related genes in NRF-1 and NRF-2 were analyzed by real-time PCR. The expression of PGC-1α, p-AMPK and total AMPK protein was detected by Western blot. Statistical analysis was performed using SPSS 22.0 software package. RESULTS: The proliferation of genioglossus myoblasts was significantly decreased after 200 μmol/L CoCl2 treatment for 24 h (P<0.05), and the levels of reactive oxygen species (ROS) were significantly increased in intracellular and mitochondria (P<0.05). Compared with CoCl2 group, the proliferation ability of hDPSCs-CM was dramatically raised (P<0.05), and the intracellular and mitochondrial ROS content was remarkably decreased(P<0.05). hDPSCs-CM up-regulated the protein expression levels of pAMPK and PGC-1α in genioglossus myoblasts and mitochondrial downstream effectors of PGC-1α, including mRNA expression levels of NRF-1, NRF-2 (P<0.05). CONCLUSIONS: Human dental pulp stem cells conditioned medium can alleviate hypoxia injury induced by CoCl2 in genioglossus myoblasts, and its mechanism may be related to AMPK/PGC-1α signaling pathway.
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    Synthetic PTHrP1-36 and its role in promoting alveolar bone formation
    LI Qin, LYU Chun-hua, CHEN Lin, LIU Xian, WANG Hua, SUN Wen
    2020, 29 (6):  580-585.  doi: 10.19439/j.sjos.2020.06.004
    Abstract ( 273 )   PDF (4683KB) ( 221 )  
    PURPOSE: To synthetise mouse parathyroid hormone related protein 1-36 (PTHrP1-36) and to study its role in promoting alveolar bone formation. METHODS: pGEX-2TK/ PTHrP1-36 was constructed and PTHrP1-36 was expressed. The role of PTHrP1-36 in promoting alveolar bone formation was observed by treating bone marrow cells in vitro and ovariectomy-induced maxillofacial osteoporosis in vivo. Statistical analysis was performed using SPSS 10.0 software package. RESULTS: The results of PCR analysis showed that pGEX-2TK/ PTHrP1-36 plasmid was correct templates for expressing PTHrP1-36. The molecular weights obtained by SDS-PAGE were the same as the theoretical value after IPTG induction. Scale up production was carried out by 3-hour-induction with 1mM IPTG which was the optimal induction factors. Bone marrow cell culture revealed that synthetic PTHrP1-36 increased the number of total fibroblastic colony forming units (CFU-f), ALP positive CFU-f and calcific nodules. After PTHrP1-36 was subcutaneously administered to ovariectomy mice, density and volume of alveolar bone were improved, as showed by X-ray and histochemistry staining of collagen-l and H-E staining. CONCLUSIONS: Synthetic PTHrP1-36 can promote bone marrow cell osteogenic differentiation and increase alveolar bone formation.
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    Effect of repeated firings on fatigue behaviors of posterior occlusal veneers made of glass ceramic
    GU Li-ling, GUO Yong-jin, CHENG Hui, LI Xiu-rong, ZHANG Bei-jie
    2020, 29 (6):  586-590.  doi: 10.19439/j.sjos.2020.06.005
    Abstract ( 303 )   PDF (3954KB) ( 247 )  
    PURPOSE: To investigate the effect of firing times on the fatigue properties and failure modes of posterior occlusal veneers made of lithium disilicate glass ceramics. METHODS: According to the number of times of firing (1, 3, 5, 7 times), IPS e.max CAD(IC) and IPS e.max Press(IP) occlusal veneer restorations with a thickness of 1.2mm were prepared, and then cemented to the maxillary molar composite resin dies. Each group was subjected to thermo-mechanical fatigue(TMFT) test (5-55 ℃, 5000 cycles, 30-300 N, 10 Hz, sinusoidal wave, 500 000 cycles) and compressive loading. The maximum force at fracture was recorded. Stereomicroscope and scanning electron microscope(SEM), energy dispersive X-ray spectroscopy(EDX) and X-ray diffraction(XRD) were adopted to analyze the failure modes and microstructural features. Statistical analysis was performed with SPSS 20.0 software package. RESULTS: The highest average loads (N) at fracture for IC groups were (1546.73±192.85) N after one firing time; in IP group, the highest average loads were (1504.46±138.56) N after three firing times. There was no significant difference in the fracture load with different firing times for IC/IP(P>0.05). EDX and XRD analysis showed no significant difference in the composition of two materials. SEM showed that the size of crystal was shorter and the porosity increased after multiple firing. CONCLUSIONS: After repeated firing, the fatigue loading of lithium disilicate glass ceramics has a decreasing trend of fracture load value without any significant difference, and it meets clinical requirements.
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    Application of different surface treatment methods in teeth restoration with nano composite resin
    LI Yuan-hui, XING Kong-cai, WANG Yi-ting, TAO Wei, YANG Chao
    2020, 29 (6):  591-595.  doi: 10.19439/j.sjos.2020.06.006
    Abstract ( 263 )   PDF (3687KB) ( 301 )  
    PURPOSE: To investigate the effects of different surface treatments and adhesive self-etch functional monomers on the immediate repair bond strength and integrity of the repaired resin composite interface. METHODS: Ninety-eight resin composite blocks made of a nanohybrid resin composite were randomly divided into seven groups, each with 14 blocks, including positive control group: non-conditioned surface, Group A1: Gluma Comfort Bond, Group A2: Gluma Comfort Bond and sandblasting, Group B1: Tokuyama Bond Force IITM adhesive system, Group B2: Tokuyama Bond Force IITM adhesive system and sandblasting, Group C: polishing, and Group D: sandblasting. Resin composite identical to the substrate was applied and the repaired specimens were subjected to shear bond strength (SBS) testing. Representative samples from all groups received scanning electron microscopy and surface profilometry to determine their mode of failure. The data were processed with SPSS 20.0 software package. RESULTS: SBS of Group D was significantly higher than that of positive control group (P<0.05). SBS of Group A1, A2, B1 and B2 was significantly higher than that of Group C and D (P<0.05). Comparison of SBS among Group B1, D and A1 showed no significant difference(P>0.05). SBS between Group B2 and positive control group had no significant difference(P>0.05). Except specimens with sandblasting and the use of TBF II system, SBS of positive control group was significantly higher than that of Group A1 and C(P<0.05). The polished specimens had significantly more adhesive failures than those with sandblasted surfaces (P<0.05). Specimens treated with polishing and Gluma Comfort Bond showed significantly more adhesive failures than those treated with polishing and TBF II system (P<0.05). The sandblasted surfaces conditioned with TBF II showed significantly more cohesive failures than those treated with polishing and TBF II (P<0.05). The sandblasted specimens provided significantly more irregular and rougher surface finish than the polishing technique (P<0.05). CONCLUSIONS: Sandblasting of the composite substrate and the use of TBF II adhesive system shows the highest repair bond strength, higher adhesive interfacial failures and fewer cohesive failures; however, it is noteworthy that the composite substrate types yield statistically higher food residue rate, which results in poor oral hygiene maintenance. Therefore, the application of this repair protocol should match up with correct oral health behaviors.
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    Study on the accuracy of Co-Cr-Mo alloy removable partial denture framework fabricated by selective laser melting
    XU Hong-zhen, GONG Zhi-cheng, ZHONG Qun
    2020, 29 (6):  596-600.  doi: 10.19439/j.sjos.2020.06.007
    Abstract ( 488 )   PDF (3612KB) ( 310 )  
    PURPOSE: To evaluate the accuracy of Co-Cr-Mo alloy removable partial denture (RPD) frameworks, which were fabricated by selective laser melting(SLM) technology. METHODS: 3Shape 3D optical scanner was used to scan a plaster model of maxillary Kennedy I dentition defect, and the obtained 3D topographical data were reconstructed into a digital model. Computer-aided design (CAD) of RPD framework was performed using 3shape design software. Five Co-Cr-Mo RPD frameworks were fabricated by SLM technology, then each framework was scanned to obtain 3D data and compared with the original CAD data, respectively, to evaluate the match accuracy. RESULTS: The Co-Cr-Mo scaffolds were in good position on the plaster model, and the tissue surface was adhered to the plaster model without warping. The overall 3D deviation from the original model was (0.088±0.021) mm. CONCLUSIONS: The Co-Cr-Mo framework fabricated by SLM technology in this experiment has less deviation and higher accuracy.
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    The role of Bmal1 in regulating the aging of mesenchymal stem cells via Wnt/β-catenin signaling pathway
    YE Cui, WU Hai-miao
    2020, 29 (6):  601-605.  doi: 10.19439/j.sjos.2020.06.008
    Abstract ( 276 )   PDF (3582KB) ( 184 )  
    PURPOSE: To investigate whether Bmal1 and Wnt/β-catenin signaling pathway has synergistic or antagonistic effects on the aging of mouse bone marrow-derived mesenchymal stem cells (BMSCs). METHODS: The cells were divided into two groups. The expression of β - catenin and TCF1 in the transfected group and the blank group were detected by real-time fluorescent quantitative PCR and Western blot. The data were statistically analyzed using SPSS 19.0 software package. RESULTS: Recombinant Bmal1 lentiviral vector was successfully constructed. The expression of β-catenin was enhanced after Bmal1 was transfected(P<0.05), which was different from that of TCF1. There was no significant difference in TCF1. CONCLUSSIONS: Bmal1 has a synergistic effect on the aging changes of MSCs in mice directly or indirectly regulated by Wnt/β-catenin signaling pathway.
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    Effect of EDTA and hyaluronic acid on the activity of periodontal ligament fibroblasts and the expression of cytokines
    ZHENG Jing, LI Tian-ke, ZHANG Su-xin, Qiu Yong-le
    2020, 29 (6):  606-610.  doi: 10.19439/j.sjos.2020.06.009
    Abstract ( 200 )   PDF (3561KB) ( 171 )  
    PURPOSE: To investigate the effect of ethylenediaminetetraacetic acid (EDTA) and hyaluronic acid (HA) on the activity of periodontal ligament fibroblasts (PDLFs) and the expression of cytokines. METHODS: Twelve wisdom teeth extracted due to orthodontics treatment were selected and prepared into 5 mm×4 mm root pieces, then divided into EDTA group, HA group, EDTA+HA group and untreated group according to different treatment methods. They were placed in the well plate and PDLFs inoculated on the root piece. After 24 and 48 h of inoculation, the cell proliferation of each group was detected by MTT assay. The adhesion of PDLFs was observed under microscope. The inflammatory cytokines (IL-6, IL-8 and IL-1β and TNF-α) levels produced by PDLFs were determined by ELLISA and Western Blot. SPSS 22.0 software package was used for statistical analysis. RESULTS: After 24 h and 48 h inoculation, all the treatments promoted cell proliferation and adhesion of PDLFs compared with the untreated group, and the combined treatment promoted cell proliferation and adhesion significantly better than single treatment (P<0.05). The cell proliferation and adhesion effect of EDTA group and HA group increased with the inoculation time, without significant difference between the groups (P>0.05). The results of ELLISA and Western blot showed that compared with the untreated group, the treatment groups inhibited the expression of inflammatory factors IL-6, IL-1β and TNF-α, and promoted the expression of IL-8, and the effect of EDTA+HA group was much more significant(P<0.05). CONCLUSIONS: EDTA+HA can significantly promote the growth of periodontal ligament fibroblasts and inhibit the expression of inflammatory cytokines, which may be related to its ability to enhance the adhesion of fibroblasts and then improve their viability.
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    Influence of canine vertical position on smile esthetic perceptions by using 3D digital facial reconstruction
    CAO Rong-kai, CHEN Bei-bei, LI Qiong, LIU Wei-cai
    2020, 29 (6):  611-616.  doi: 10.19439/j.sjos.2020.06.010
    Abstract ( 378 )   PDF (4390KB) ( 176 )  
    PURPOSE: To verify the impact of alterations in the vertical position of maxillary canine on smile esthetic perceptions, in order to find an optimal canine position. METHODS: A volunteer’s dentition and facial images were scanned by intra-oral scanning and three-dimensional facial scanning, which were then calibrated. In virtue of dental computer-aided design software, the canine vertical positions were symmetrically modified in a variable of 0.5 mm, creating 4 new 3D virtual digital smile faces varying from 1.0 mm of intrusion to 1.0 mm of extrusion. A total of 5 3D virtual digital smile faces were evaluated from the front and 45°to the right sides by 60 dentists and 60 laypersons on a visual analog scale. The data were input into SPSS 20.0 software package, ANOVA of repeated measurement was used to compare the differences in the assessment scores between two groups and rank sum test was used to analyze the differences from different evaluation angles. RESULTS: Alterations in the vertical position of maxillary canine had significant influence on the esthetic evaluation of the smile(P<0.05); there was significant difference between the dentists’ and laypersons' esthetic evaluations after the canine vertical position being modified(P<0.05), there was no significant difference on the evaluations of smile esthetics from different evaluation perspectives(P>0.05). CONCLUSIONS: The most attractive smile was the one with canine cusp 0.5 mm vertically higher than the incisal edge of the lateral incisor. The smile is not attractive when the cusp of canine is vertically lower than the incisal edge of lateral incisor. These results can be used as references in the esthetic treatment planning for anterior maxillary teeth.
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    Analysis of clinical aesthetic effect of buccal alveolar ridge preservation and connective tissue transplantation with single implant
    WU Shi-qing, LU Hai-bin, WEN Zhi-xin, ZHANG Xue-yang, CHEN Guo-dong
    2020, 29 (6):  617-622.  doi: 10.19439/j.sjos.2020.06.011
    Abstract ( 318 )   PDF (4641KB) ( 245 )  
    PURPOSE: To evaluate the clinical aesthetic effect of buccal alveolar ridge preservation (ARP) and connective tissue transplantation (CTG) in patients who received a single implant. METHODS: Forty-three patients with tooth loss admitted to the Department of Stomatology of Shunde Hospital of Southern Medical University from May 2014 to May 2016 were included in the study. Tooth extraction, ARP, implant implantation, CTG and permanent repair were performed respectively. The incidence of bleeding, depth of probing, marginal bone resorption, and red-white aesthetic effect of implants were evaluated 1 year and 3 years after surgery. The buccal mucosa thickness of implants before, immediately after CTG, 1 year and 3 years after surgery were measured. The patient satisfaction was evaluated by visual analogue scale (VAS) from masticatory function, overall aesthetics, attachment height, and color, respectively. The implant conditions at the third year after surgery were observed, and complications during follow-up were recorded. SPSS 20.0 software package was used for statistical analysis of the data. RESULTS: The follow-up rate in the first year after surgery was 100%, and that in the third year after surgery was 90.70%. One year and 3 years after operation, the aesthetic effect of the implant was satisfactory. At the 3rd year after operation, the scores of the near middle gingival papillary were significantly higher than that at the 1st year after operation (P<0.05). The buccal mucosal thickness of the implant immediately after CTG and 1 year and 3 years after surgery increased significantly compared with that before CTG (P<0.05). The buccal mucosal thickness of the implant increased 1.02 mm (relative stability: 90.12%) 1 year after operation and 1.01 mm (relative stability: 84.31%) 3 years after operation, respectively. The satisfaction scores of the patients on chewing function, overall aesthetics, attachment height and color of the implant immediately after CTG, one year after surgery and 3 years after surgery were all > 8. The 3-year survival rate of the implants was 100%, and the 3-year success rate of the implants was 97.44%. During the follow-up, two patients developed peri-implant mucositis, which was relieved after tooth cleaning, but no complications such as tissue flap necrosis, limited opening and tongue movement disorder occurred. CONCLUSIONS: ARP and CTG have good clinical and aesthetic effects on patients with tooth loss. In three years, the buccal mucosal thickness of the implant can be increased and relatively stable, which is worthy of clinical promotion and application.
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    Differences of bone augmentation in patients with different bone defects by extraction site preservation
    XIONG Ji-wen, ZHOU Wei
    2020, 29 (6):  623-627.  doi: 10.19439/j.sjos.2020.06.012
    Abstract ( 356 )   PDF (4205KB) ( 264 )  
    PURPOSE: To explore the difference of bone augmentation in patients with different bone defects by extraction site preservation. METHODS: From January 2017 to June 2019, 85 patients with dental implants treated in Hefei Second People's Hospital were enrolled and divided into the experimental group (43 cases) and the control group (42 cases) according to random number table method. Patients in the experimental group received extraction site preservation, while patients in the control group underwent routine tooth extraction. The two groups were further divided into one-wall group (remaining one wall of the alveolar socket after surgery), two-wall group (remaining two walls), three-wall group (remaining three wall), and four-wall group (remaining four walls). Postoperative pain, wound healing, and infection were recorded. Cone-beam CT (CBCT) was performed immediately and 6 months after surgery to detect alveolar bone height, bone width, bone width recovery rate, etc. SPSS 22.0 software package was used for statistical analysis. RESULTS: There was no significant difference in pain between the two groups after 24 hours (P>0.05). All implants healed well after 7 days, and no wound infection or bone infection occurred 6 months after operation. There was no significant difference in buccal bone volume of alveolar ridge (BV) and lingual volume (LV) before surgery between the two groups (P>0.05). BV and LV in the experimental group increased after treatment, and the increase in one- and two-wall subgroups was significantly higher than that in three- and four-wall subgroups. BV and LV in the control group decreased, the differences between the subgroups were statistically significant (P<0.05). BV and LV increased in both groups after operation, but significantly higher in the experimental group than in the control group. The increase in bone height in one- and two-wall subgroups was significantly higher than that in three- and four-wall groups (P<0.05). Bone width of all subgroups in the experimental group increased, but decreased in the control group. The increase of bone width in the experimental group was significantly different from the control group(P<0.05). In the experimental group, the increase in bone width in one- and two-wall groups was significantly higher than that in three-wall group, and the decrease in bone width in one- and two-wall group in the control group was significantly less than that in three- and four-wall group(P<0.05). The average recovery rate of bone width in the experimental group was significantly higher than that in the control group. The average recovery rate of bone width in one- and two-wall group in the experimental group was significantly higher than that in the control group(P<0.05), while there was no significant difference in the recovery rate from the control group(P>0.05). The change of bone width at 70% of root length in the same group was significantly smaller than that at 50% and 30% of root length (P<0.05). CONCLUSIONS: Extraction site preservation after tooth extraction can relieve alveolar bone resorption and maintain bone mass in contrast to conventional tooth extraction. The smaller the bone defect, the better the bone mass recovery effect.
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    Effect of pulp revascularization on CCL21, IFN-γ-inducible protein 10 in chronic periapical periodontitis
    YU Mei, YU Jin-xian, WANG Wei
    2020, 29 (6):  628-631.  doi: 10.19439/j.sjos.2020.06.013
    Abstract ( 282 )   PDF (2807KB) ( 164 )  
    PURPOSE: To investigate the effect of pulp revascularization on the levels of CCL21 and IFN-γ-inducible protein 10(IP-10)in chronic periapical periodontitis. METHODS: One hundred patients with chronic periapical periodontitis treated from September 2018 to May 2019 were selected as the research subjects. They were divided into two groups by using random number table method. The patients in both groups were taken cone-beam CT(CBCT) film for filing before operation. Patients in the experimental group were treated by pulp revascularization, while patients in the control group were treated by apexification. The level of CCL21 and IP-10 was measured within 4 weeks. The results of operation, the ratio of crown to root and the thickness of root canal wall were analyzed. Statistical analysis of the data was conducted with SPSS 25.0 software package. RESULTS: CCL21 and IP-10 levels of the two groups increased in the course of 1-3 weeks, but decreased after 4 weeks. CCL21 levels were significantly different at 2 weeks, 3 weeks and 4 weeks(P<0.05), but there was no significant difference at one week(P<0.05). There was no significant difference in IP-10 level between the two groups at 1, 2 and 3 weeks of treatment(P<0.05), but there was significant difference at 4 weeks of treatment (P<0.05). The success rate of the experimental group was 90% and that of the control group was 50%,there was a significant difference between the two groups(P<0.05). There was no significant difference in the ratio of crown to root and the thickness of root canal wall between the two groups(P<0.05). CONCLUSIONS: For chronic periapical diseases, pulp revascularization, apical induction can promote the secretion of chemokines CCL21 and IP-10 in the early stage of treatment, the level of CCL21 changes greatly in the early stage of treatment, while changes of IP-10 can be seen in the later stage.
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    Relationships among tongue volume, hyoid position, airway volume and maxillofacial form in paediatric patients with Class Ⅰ, Class Ⅱ and Class Ⅲ malocclusions
    ZOU Yin, FU Qiao-mei, XU Xian-yin
    2020, 29 (6):  632-637.  doi: 10.19439/j.sjos.2020.06.014
    Abstract ( 545 )   PDF (4270KB) ( 244 )  
    PURPOSE: To investigate the relationships among tongue volume, hyoid position, airway volume and maxillofacial form in paediatric patients with Class Ⅰ, Class Ⅱ and Class Ⅲ malocclusion. METHODS: Data of 112 children with malocclusion in the Department of Stomatology, Wuxi Children's Hospital from December 2015 to December 2018 were collected. The children were divided into three groups according to Angle's classification: Class Ⅰ (n=42), Class Ⅱ (n=38) and Class Ⅲ (n=32). Tongue volume was evaluated by oral B-ultrasound, the hyoid position was obtained by lateral cephalogram, then the airway volume and maxillofacial form were evaluated by cone-beam CT (CBCT). Relationship among tongue volume, hyoid position, airway volume and maxillofacial form were analyzed. The data were processed by SPSS 20.0 software package. RESULTS: The tongue volume of Class III was significantly larger than that of Class I and Class II (P<0.05); H-FH and H-MP of Class II were significantly larger than those of Class I and Class III, and H-VL was significantly smaller than that of Class I and Class III (P<0.05). H-FH and H-MP of Class III were significantly smaller than those of Class I, and H-S was significantly larger than that of Class I (P<0.05); V throat of three types was the largest in Class Ⅲ, followed by Class I and Class Ⅱ, with significant difference (P<0.05). V nose of three types was the largest in Class Ⅱ, followed by Class I and Class Ⅲ, with significant difference (P<0.05). SNB angle of three types was the largest in Class Ⅲ, followed by Class Ⅰ and Class Ⅱ, with significant difference (P<0.05). ANB angle was the largest in Class I, followed by Class Ⅱ and Class Ⅲ, with significant difference (P<0.05). Tongue volume was positively correlated with V throat, V nose, and SNB, and negatively correlated with H-FH and ANB (P<0.05). H-FH and H-MP were negatively correlated with SNB angle and positively correlated with H-MP and ANB angle (P<0.05). CONCLUSIONS: Children with Class Ⅲ malocclusion have larger tongue volume, upward displacement of hyoid, and smaller nasopharyngeal volume. Children with Class II malocclusion have small tongue volume, downward displacement of hyoid, and small oropharyngeal volume. Tongue volume, hyoid position, airway volume and maxillofacial form are significantly correlated in paediatric patients with malocclusions, the influence of mandibular recession on the shape of upper airway should be considered during orthodontic treatment, in order to achieve the best aesthetic and therapeutic effects.
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    Clinical analysis of 500 cases of hematological diseases with oral presentation as the first manifestation
    DOU Hong-ju, ZHU Hong
    2020, 29 (6):  638-641.  doi: 10.19439/j.sjos.2020.06.015
    Abstract ( 287 )   PDF (3247KB) ( 345 )  
    PURPOSE: To explore the clinical characteristics of hematological diseases with oral presentation as the first manifestation, and to provide basis for early diagnosis of hematological diseases and prevention of missed diagnosis and misdiagnosis. METHODS: The clinical data of 500 patients with hematological diseases who were first diagnosed in department of stomatology in our hospital during the past five years were reviewed, and the diversity and distribution of oral manifestations of patients with hematological diseases were analyzed. RESULTS: Oral manifestations of 500 patients with hematological diseases were mainly oral mucosa and gingival bleeding, gingival hyperplasia, oral mucosal ulcer, oral mucosal infection, oral and maxillofacial mass. Among them, the number of hematological diseases patients first diagnosed in the department of stomatology with the symptoms of oral and maxillofacial mass was the largest, accounting for 19.8%. Blood routine, coagulation mechanism and oral pathological biopsy were very important for preliminary screening and diagnosis of hematological diseases. CONCLUSIONS: Oral manifestations of various hematological diseases may occur at the early stage of the disease. Correct understanding of oral manifestations of the diversity of hematological diseases, combined with blood routine and coagulation mechanism examination, can preliminarily screen hematological diseases. Pathological examination of tumors in patients with oral and maxillofacial masses can be carried out. Diagnosis and differential diagnosis of hematological diseases can be made earlier in clinic, so as to avoid misdiagnosis and missed diagnosis. For patients with hematological diseases first diagnosed in the department of stomatology, the treatment of oral characterization mainly focuses on hematological diseases, supplemented by local symptomatic treatment of oral cavity.
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    Expression levels of MMP-14, ING4 and HIF-1α in 60 patients with oral squamous cell carcinoma and their clinical significance
    FU Zong-yun, TAO Feng
    2020, 29 (6):  642-646.  doi: 10.19439/j.sjos.2020.06.016
    Abstract ( 365 )   PDF (3577KB) ( 216 )  
    PURPOSE: To investigate the expression of metalloproteinase-14 (MMP-14), growth inhibitory factor 4 (ING4) and hypoxia-inducible factor-1α (HIF-1α) in human oral squamous cell carcinoma (OSCC) and their clinical significance, to provide references for clinical diagnosis and treatment of OSCC. METHODS: Sixty patients with OSCC admitted to our hospital from July 2014 to July 2019 were enrolled in this study. The tissue specimen of 60 patients were prepared into paraffin sections as the experimental group, while 20 cases of normal oral mucosal tissue were paraffin-embedded as the control group. Immunohistochemical S-P method was used to analyze the positive expression levels of MMP-14, ING4 and HIF-1α in oral mucosa of the two groups. The relationship between the 3 indicators and the different clinicopathological features of OSCC patients was analyzed, the correlation of the expression level between 3 protein was also calculated. SPSS 23.0 software package was used for statistical analysis of the data. RESULTS: The positive expression rate of ING4 in OSCC patients was 41.7% (25/60), which was significantly lower than 70.0% (14/20) in the control group (P<0.05). The positive expression rates of MMP-14 and HIF-1α were 68.3% (41/60), 71.7% (43/60), respectively, significantly higher than 20.0% (4/20) and 15.0% (3/20) of the control group. The difference between the 2 groups was statistically significant (P<0.01). The positive expression rate of the 3 proteins was significantly correlated with TNM stage, differentiation and cervical lymph node metastasis (P<0.05). In OSCC tissues, there was a significant negative correlation between ING4 and HIF-1α or MMP-14 expression (r=-0.39, -0.51, P<0.01), while HIF-1α and MMP-14 expression was significantly positively correlated with the clinical features (r= 0.45, P<0.01). CONCLUSIONS: MMP-14, ING4 and HIF-1α are closely related to the progression of OSCC. Down-regulation of ING4 can promote up-regulation of MMP-14 and HIF-1α, and ultimately promote formation, growth, invasion and metastasis of OSCC. The expression levels of the 3 proteins can be used as important indicators for judging the clinical features and prognosis of patients with OSCC.
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    Comparison of digital model and dental plaster model in evaluation of bilateral cleft lip and palate
    CHEN Qi, YOU Qing-ling, PAN Guo-yan
    2020, 29 (6):  647-650.  doi: 10.19439/j.sjos.2020.06.017
    Abstract ( 297 )   PDF (2854KB) ( 201 )  
    PURPOSE: To compare the reliability of digital model and plaster model on evaluation of bilateral cleft lip and palate. METHODS: Nineteen pairs of digital and plaster model obtained from bilateral cleft lip and palate patients were measured, including nine measurements, such as maxillary alveolar length, width, cleft width, the deviation of maxillary middle line. One-way ANOVA was conducted for statistical analysis with SPSS 24.0 software package. RESULTS: There was no significant difference between the repeated measurements of the two types of models, there was no significant difference in the measurements between two types of models used in clinic. CONCLUSIONS: Both methods are suitable for evaluation of bilateral cleft lip and palate patients. Compared with conventional plaster model, digital model provides a safer and convenient way to obtain useful information both for research and clinical need.
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    Effect of different orthodontic techniques on alveolar bone changes in the upper incisor area of patients with periodontitis
    LI Qin, ZHAO Xu-chun, WANG Ming-lang, LI Yuan-yuan, PENG Yi
    2020, 29 (6):  651-655.  doi: 10.19439/j.sjos.2020.06.018
    Abstract ( 384 )   PDF (3728KB) ( 229 )  
    PURPOSE: To explore the effects of different orthodontic techniques on the changes of alveolar bone density, height and gingival crevicular fluid (GCF) bleeding in upper incisor in patients with periodontitis. METHODS: Twenty-three patients with moderate periodontitis who underwent orthodontic treatment from January 2016 to December 2019 in the Department of Stomatology of Jiangxi Pingxiang People’s Hospital were divided into experimentalexperimental group(n=12) and control group(n=11). Patients in the experimental group were treated with bracket-less invisible appliance, while patients in the control group were treated with conventional lip-side fixed appliance. Changes of gingival crevicular hemorrhage index, probing depth, alveolar bone height and bone density in the incisor area were compared between the two groups before and after treatment. Statistical analysis was performed on data using SPSS 22.0 software package. RESULTS: After treatment, the bone mineral density of the upper incisor alveolar crest (L1) of the two groups decreased, and the rate of decrease in the experimental group was significantly less than that in the control group (P<0.05). The bone density at the apical point of the anatomical root of the control group at 1 mm (L3) was also significantly reduced, but there was no significant change in the experimental group. There was no significant change in the alveolar bone height of the upper incisor area between the two groups before and after treatment (P>0.05). Root resorption of the upper incisors in the experimental group was significantly lower than that in the control group(P<0.05). After treatment, the probing depth and GCF bleeding index of the two groups decreased, and the change in the experimental group was significantly greater than that in the control group(P<0.05). CONCLUSIONS: Bracket-free invisible appliance for periodontitis is more conducive to the restoration of alveolar bone mineral density in the upper incisor than the conventional lip-side fixed appliance, and both of which have the same effect on bone height and are safe and effective orthodontic treatment.
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    Evaluations of the morphology and position of condyle and fossa of adolescent temporomandibular joint with Class Ⅱsubdivision malocclusions
    DING Yuan-feng, SONG Li-juan
    2020, 29 (6):  656-660.  doi: 10.19439/j.sjos.2020.06.019
    Abstract ( 509 )   PDF (3726KB) ( 291 )  
    PURPOSE: To evaluate the morphology and position of condyle and fossa and joint space of adolescent temporomandibular joint with Class Ⅱ subdivision malocclusion, in order to provide a reference for diagnosis before treatment. METHODS: The study sample consisted of 30 adolescent patients with Class Ⅱ subdivision malocclusions(9 males, 21 females, mean age 12.5 years) as the experimental group and 30 adolescent patients with Class Ⅰ malocclusions (11 males, 19 females, mean age 12 years) as the control group treated from June 2018 to December 2019 in Suzhou Stomatological Hospital. The long axis of condyle, short axis of condyle, the distance from the outer pole of condyle to sagittal midline, horizontal angle of condyle, Joint space(medial, inner, outer, anterior, superior, posterior), vertical height of condyle, width of joint fossa, depth of joint fossa, angle of posterior wall of the articular tubercle and vertical distance of bilateral condyle to horizontal line were measured on cone-beam CT(CBCT) images and analyzed with Dolphin Imaging 11.95. SPSS 23.0 software package was used for statistical analysis of the data. RESULTS: In Angle Class Ⅱ subdivision malocclusion patients, there were significant differences in posterior joint space, horizontal angle of condyle, vertical height of condyle, width of joint fossa, depth of joint fossa and angle of posterior wall of the articular tubercle between neutral side and distal side(P<0.01). In Angle Class Ⅰ malocclusion patients, there was no significant difference in joint fossa morphology, condyle morphology and condyle position between right side and left side (P>0.05). CONCLUSIONS: There may be differences in condyle position, condyle shape and joint fossa shape between patients with Class Ⅱ subdivision malocclusions and Class Ⅰ malocclusion patients. More attention should be paid to the temporomandibular joint in initial clinical examination and clinical orthodontic treatment.
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    Systemic Review
    Association between periodontitis and Alzheimer disease: a meta analysis
    QIU Che, ZHOU Wei, SHI Wen-tao, SONG Zhong-chen
    2020, 29 (6):  661-668.  doi: 10.19439/j.sjos.2020.06.020
    Abstract ( 416 )   PDF (6091KB) ( 323 )  
    PURPOSE: To evaluate the association between periodontitis and Alzheimer's disease. METHODS: Databases of PubMed, Embase, CNKI, VIP and WanFang databases were searched for the relevant observational studies focusing on the association between periodontitis and Alzheimer's disease. The deadline was January 2019. Data quality evaluation and extraction were independently conducted by two authors. Meta analysis was performed using RevMan 5.2 software. RESULTS: Four case-control, five cross-sectional and two cohort studies were included. One cohort study and four case-control studies treated periodontitis as the exposure factor, all five cross-sectional studies and the other cohort study treated Alzheimer's disease as the exposure factor. The results of meta analysis showed that patients with periodontitis had a higher risk of Alzheimer's disease (RR=1.22, 95%CI: 1.13-1.33, P<0.00001), and the risk was more higher in patients with severe periodontitis(RR=1.54, 95%CI:1.05-2.26, P=0.03<0.05); but there was no significant difference in the risk of Alzheimer's disease in patients with moderate periodontitis (RR=1.19, 95%CI: 0.98-1.44, P=0.07>0.05). The results of meta-analysis also showed that probing depth in patients with Alzheimer's disease was significantly higher than that of the control group (MD=2.58, 95%CI: 0.17-4.99, P=0.04<0.05), as well as clinical attachment loss (MD=1.27, 95%CI: 0.43-2.10, P=0.003<0.05), plaque index (MD=1.14, 95%CI: 0.85-1.44, P<0.00001) and the percentage of bleeding on probing (MD=21.11%, 95%CI: 18.23%-23.99%, P<0.00001). Furthermore, the number of present teeth in patients with Alzheimer's disease was significantly less than that of the control group (MD=-3.77, 95% CI: -6.89- -0.65, P=0.02<0.05). CONCLUSIONS: The current evidence indicates that periodontitis is associated with Alzheimer's disease and patients with periodontitis (especially severe periodontitis) probably have a higher risk of developing Alzheimer's disease, and patients with Alzheimer's disease tend to have poorer periodontal health. However, the number of existing studies is limited and more clinical evidences are needed to support the correlation between these two diseases.
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    Dental Education
    Practice and exploration of orbital anatomy and orbital imaging courses in dental students
    XU Wei, SUN Jing, BI Xiao-ping, ZHOU Hui-fang, XING Yue, LI Jin
    2020, 29 (6):  669-672.  doi: 10.19439/j.sjos.2020.06.021
    Abstract ( 325 )   PDF (2918KB) ( 189 )  
    PURPOSE: To improve the teaching effect of orbital anatomy course for students majoring in stomatology. METHODS: Based on a retrospective analysis of average score of orbital anatomy course for previous dental and medical students, and the problems existing in teaching effect, orbital anatomy and orbital imaging course were designed and carried out in dental students. The course combined imaging with orbital anatomy, and included clinical examples. Medical students were set as control. Examination was carried out after the end of the whole course, and the professional knowledge of orbital anatomy of two groups was compared. A self-designed questionnaire was designed to evaluate the teaching effect of orbital anatomy and orbital imaging courses for dental students and residents over 1 year after graduation. SPSS 22 software package was used for Statistical analysis. RESULTS: The previous average score of dental students was 7.50, and the average score of medical students was 8.67. There was significant difference between the two groups (P=0.004). The average score of dental students after offering the course of orbital anatomy and orbital imaging was 9.67, and the average score of medical students was 9.00. No significant difference was noticed between the two groups(P=0.184). Questionnaire survey showed that the after-class review time of dental students was 20 min, and that of medical students was 30 min. 74.7% of the dental students and 80% of the dental residents did not study orbital anatomy and imaging courses before. 87.4% of the dental students and 100% of dental residents considered that the orbital imaging course was helpful to master the anatomical characteristics of the orbit. 89.7% of the dental students and 100% of dental residents believed that orbital imaging course was helpful to their clinical work. CONCLUSIONS: Orbital anatomy and orbital imaging course were designed for dental students as supplementary teaching programme. It successfully inspired students' interest in learning, cultivated the students' overall and comprehensive thinking, narrowed students to master the knowledge of orbital anatomy, closed the gap of teaching effect between dental and clinical medicine, and laid the foundation to develop dental professional work in the future.
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