01 November 2022, Volume 49 Issue 6 Previous Issue   
Expert Forum
Combined treatment strategy of oral implantology and endodontics microsurgery: clinical protocol and practical cases (part 2)
Man Yi, Huang Dingming
Int J Stomatol. 2022, 49 (6):  621-632.  DOI: 10.7518/gjkq.2022096
Abstract ( 352 )   HTML ( 71 )   PDF(pc) (7988KB) ( 393 )   Save

When an implant-related surgery is in areas in proximity to a periapical lesion of the adjacent tooth, the chronic apical periodontitis of adjacent teeth could become a potential source of infection to cause the failure of surgery. Unlike traditional treatment procedures, the combined treatment modality of performing implant-related surgery with simultaneous endodontic microsurgery of adjacent teeth was proposed in this study. This novel strategy ensured the early safety of implant-related surgery and increased the long-term predictability of oral treatment. It also seemed to be a more cost-effective treatment strategy. This article presented the clinical procedures and practical cases on the clinical application of the novel combination therapy strategy in different clinical situations.

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Original Articles
Oral beta-carotene in the treatment of non-erosive oral lichen planus: a randomized controlled trial
Zhang Shenyi,Wang Xiangjian,Shi Liran,Shi Jiahong,Wang Yuhong,Zhou Hongmei
Int J Stomatol. 2022, 49 (6):  633-640.  DOI: 10.7518/gjkq.2022099
Abstract ( 75 )   HTML ( 9 )   PDF(pc) (2298KB) ( 23 )   Save

Objective This study aims to illustrate the efficacy and safety of oral beta-carotene in the treatment of non-erosive oral lichen planus (OLP) by designing and conducting a randomized controlled clinical trial. Methods A total of 74 patients with non-erosive OLP and widespread white lesions were randomized into the experimental group (n=38) who received oral beta-carotene soft capsules (6 mg p.o. q.d.) or the control group (n=36) who received oral vitamin E soft capsules (100 mg p.o. q.d.) for 6 months continuously. Then, the white area, keratotic degree, pain level, and adverse effects were recorded at the first visit and after 3 and 6 months of treatment. If the white lesions disappeared, any recurrence du-ring the follow-up period was recorded. Results The final diminution in white lesion areas (both P<0.001) and keratotic degree scores (P=0.018, P=0.001) were significantly greater with beta-carotene than with vitamin E after 3 and 6 months of treatment, respectively. However, the intergroup differences in the reduction of pain level were not significant (P>0.05). No severe adverse reactions were found in both groups. Recurrence rates did not significantly differ between groups (P>0.05). Conclusion Oral beta-carotene is an effective and safe alternative for the treatment of non-erosive OLP.

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Endothelial-cell-specific overexpression of Dickkopf 1 using Cadherin 5 promoter regulates osteogenesis in vivo
Yin Yijia,Yang Jinting,Shen Jianqi,Huang Lingyi,Jing Yan,Guan Qiuyue,Han Xianglong
Int J Stomatol. 2022, 49 (6):  641-647.  DOI: 10.7518/gjkq.2022103
Abstract ( 51 )   HTML ( 7 )   PDF(pc) (4445KB) ( 14 )   Save

Objective This study aimed to the expression of Dickkopf 1 (DKK1) during orthodontic tooth movement is examined. Then, the effects of endothelial-cell-specific overexpression of DKK1 on bone formation were detected. Moreover, the function of DKK1 on bone formation through endothelial cells was explained. Methods A rat orthodontic tooth movement model was constructed to detect the expression of DKK1 on the compressive and tensile side of alveolar bone. Then, R26-DKK1 and Cadherin 5 (Cdh5)-Cre mice were crossbred to produce transgenic mice expressing DKK1 in endothelial cells (Cdh5-Cre; R26-DKK1/R26-DKK1) and to detect the changes of bone morphology and bone volume of the femur and alveolar bone. Results During orthodontic tooth movement, DKK1 was highly expressed in the compressive side. DKK1 transgenic mice widely expressed DKK1 in the femur and alveolar bone, increased in bone density, narrowed in central bone marrow cavity, and increased in Trap+ cells numbers and collagen Ⅳ expression compared with wild type controls. Conclusion DKK1 might regulate orthodontic tooth movement. Endothelial-cell-specific overexpression of DKK1 using Cdh5 promoter is closely related to the differentiation of chondrocytes and the formation of trabecular bone, and causes increased expression level of collagen Ⅳ in periodontal tissue and bone.

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Comparative study of facial soft tissue angle between Mongolian and Han adults in Inner Mongolia
Fan Yongjie,Dong Tingting.
Int J Stomatol. 2022, 49 (6):  648-656.  DOI: 10.7518/gjkq.2022076
Abstract ( 86 )   HTML ( 8 )   PDF(pc) (1302KB) ( 19 )   Save

Objective The purpose of the paper is to obtain the angle measurement data of facial soft tissues of Mongolian nationality and to establish the angle value database of human facial soft tissues of Mongolian and Han adults through studying their facial soft tissues with individual normal teeth occlusion in Inner Mongolia by using three-dimensional (3D) stereo photography technology. Methods A total of 295 normal dental occlusion samples were selected from students in Inner Mongolia, including 60 Han males, 90 Han females, 76 Mongolian females, and 69 Mongolian males. Using Morpheus 3D facial scanner, 14 soft tissue markers were identified, and 17 items were angled. SPSS 22.0 was used for statistical analysis and the comparisons of facial differences. Results Statistically significant differences were observed in facial shape angle (G-Sn-Pg), facial convex angle (N-Sn-Pg), total convex angle (N-Prn-Pg), nasolabial angle (Cm-Sn-Ls), SNPG angle (Pg-N-Ls), INPG angle (Pg-N-Li), Na angle (N-T-Prn), and Mn angle (Ls-T-Pg) between Han and Mongolian males. Statistically significant differences were noted in G-Sn-Pg, N-Sn-Pg, N-Prn-Pg, Pg-N-Ls, Pg-N-Li, mentolabial sulcus angle (Pg-Sm-Li), Mx angle (Ls-T-Pg), Ls-T-Pg, 1/3 of the face angle (Tri-T-N), and 1/3 of the middle face angle (N-T-Sn) between Han and Mongolian females. Statistically significant differences were observed in N-Sn-Pg, nasofrontal angle (G-N-Prn), Cm-Sn-Ls, Pg-N-Ls, Pg-Sm-Li, SNI angle (Ls-N-Li), TV angle (N-T-Pg), Ls-T-Prn, Ls-T-Pg, Tri-T-N, and N-T-Sn between Han females and Han males. In the Mongolian male-female comparison, the female’s N-Prn-Pg, G-N-Prn, nasal tip angle (N-Prn-Sn), and Tri-T-N are all larger than the male’s, whereas the male’s Sn-T-Me is larger than the female’s. Conclusion Some differences exist in the facial profile between Mongolian and Han populations in Inner Mongolia.

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Analgesic effects of local anesthesia after cleft lip and palate repair
Pei Ling,Zeng Ni,Yang Chao,Wang Yan,He Miao,Luo Qiang,Shi Bing
Int J Stomatol. 2022, 49 (6):  657-662.  DOI: 10.7518/gjkq.2022088
Abstract ( 46 )   HTML ( 7 )   PDF(pc) (1335KB) ( 19 )   Save

Objective This study aimed to compare the effect of different local anesthesia during general anesthesia on postoperative pain relief after cleft lip and palate (CLP) surgery. Methods A total of 92 CLP children at the age ran-ging from 2 months to 6 years, who were admitted to the hospital from June 2021 to January 2022, were selected as objects. All patients were divided into three groups as follows: control group, local injection of normal saline preoperative; infiltration group: local infiltration anesthesia preoperative; and block group, bilateral suprazygomatic maxillary nerve block preoperative. All patients received sufentanil for general analgesia and acetaminophen 2 h postoperative. The admi-nistration of sevoflurane and sufentanil during general anesthesia was recorded. Hemodynamic changes in patients 10 min before surgery, 5 min before surgery, at the beginning of surgery, and 30 min after the beginning of surgery were collec-ted. FLACC scores were also recorded from the time of transferring to the post-anesthesia care unit (PACU) to 24 h after surgery. The number of children with mode-rate and severe pain at each observation time was recor-ded. Results No significant difference was found in the dosage of sevoflurane and sufentanil [(0.34±0.09) μg·kg-1] among all groups. No significant difference was also found in blood pressure and heart rate at continuous time points among all groups. A statistical difference in FLACC score was observed between the control group and the infiltration group at 3 h after transferring to PACU. A statistical difference was also found in the number of patients with moderate and severe pain between the block group and the infiltration group at 4 h after transferring to PACU. The FLACC score and the number of patients with moderate and severe pain increased in the infiltration group and the block group 8-16 h after transferring to PACU, whereas the control group showed a continuous downtrend during this period. Conclusion Under the condition of conventional dose of sufentanil [(0.34±0.09) μg·kg-1] combined with oral analgesics, local anesthetics showed no obvious advantage in postoperative analgesia.

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Trentment
Research progress on nickel-titanium instruments for root canal preparation machine
Zhang Qilin,Li Jun,Li Shuhui
Int J Stomatol. 2022, 49 (6):  663-669.  DOI: 10.7518/gjkq.2022097
Abstract ( 441 )   HTML ( 110 )   PDF(pc) (843KB) ( 450 )   Save

The emergence of nickel-titanium instruments for root canal preparation machine is a major milestone in root canal treatment, and the safety and efficiency of root canal preparation have been greatly improved. In recent years, the design of nickel-titanium instruments has undergone a series of changes and improvements to meet the clinical needs, and each design has its own characteristics. Understanding and being familiar with the performance and characteristics of nickel-titanium instruments for choosing appropriate instruments are important. This article focuses on the development of nickel-titanium instruments used in root canal preparation machine and reviews the progress on the changes in crystal structure, external structure improvement, safety, and efficiency to provide a reference for the selection of appropriate instruments for root canal preparation in clinical work.

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Research progress on evaluation of root-end filling in vitro
Dong Xu,Xu Xin.
Int J Stomatol. 2022, 49 (6):  670-677.  DOI: 10.7518/gjkq.2022100
Abstract ( 65 )   HTML ( 12 )   PDF(pc) (815KB) ( 53 )   Save

Root-end filling is an important step in apical surgery. Strict apical sealing is the key to microleakage reduction and successful operation. Numerous methods exist for the in vitro evaluation of apical sealing. They include dye lea-kage, three-dimensional image analysis, bacterial and endotoxin leakage, fluid filtration, and glucose leakage. This work aims to introduce the progress in the research on various evaluation methods and the advantages and disadvantages of these methods to provide a reference for the development of novel materials and techniques for root-end filling.

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Application and progress on targeted endodontic microsurgery techniques
Tang Zhiwei,Gao Ying
Int J Stomatol. 2022, 49 (6):  678-683.  DOI: 10.7518/gjkq.2022090
Abstract ( 96 )   HTML ( 17 )   PDF(pc) (763KB) ( 54 )   Save

The targeted endodontic microsurgery technique is a new technique that combines the digital static navigation system with the bone ring drill on the basis of improving the traditional endodontic microsurgery for precise, minimally invasive operation. For endodontic microsurgery, the precise positioning of the apical region of the affected tooth and minimally invasive debridement are the difficult, critical points of the surgery, and the targeted endodontic microsurgery technique can reduce the operating error and technical sensitivity of the surgery, and improve the safety of the surgery. In this paper, we review the current development of targeted endodontic microsurgery, the factors affecting surgical precision, the advantages, and the shortcomings.

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Prospects for the application of concentrated growth factor in vital pulp therapy
Zhou Can,Zeng Qian,Wei Xi.
Int J Stomatol. 2022, 49 (6):  684-689.  DOI: 10.7518/gjkq.2022092
Abstract ( 67 )   HTML ( 12 )   PDF(pc) (729KB) ( 30 )   Save

Vital pulp therapy (VPT) is a minimally invasive treatment for pulp injury, and the continuous optimization of pulp capping materials plays an important role in its curative effect. Studies have shown that bio ceramic materials loaded with biologically active small molecules for VPT can induce dental pulp-dentin complexes. Concentrated growth factor (CGF) is a third-generation autologous platelet concentrate, rich in white blood cells and a large number of biologically active factors, and has broad application prospects in VPT. This article summarizes the development, preparation methods, and active ingredients of CGF, and reviews the related research on its application in tissue repair and regeneration, which can provide new ideas for the research of CGF in VPT.

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Reviews
Oral diagnosis and treatment strategies for patients with gag reflex sensitivity
Li Zhouchi,Ye Ling,Wang Chenglin.
Int J Stomatol. 2022, 49 (6):  690-698.  DOI: 10.7518/gjkq.2022078
Abstract ( 994 )   HTML ( 241 )   PDF(pc) (1305KB) ( 1219 )   Save

The gag reflex is a normal defense mechanism that protects the pharynx and throat from foreign objects. Its main manifestations are nausea and vomiting after a foreign body stimulates the posterior pharyngeal wall and the root of the tongue. Despite being a normal protective reflex, the gag reflex, when pronounced, can complicate dental care and adversely affect oral health. Moreover, it causes inconvenience to diagnosis and treatment processes. Here, the sensitivity and etiology of the gag reflex, related hazards, gagging severity, gagging prevention index, and management measures were analyzed in patients with sensitive gag reflex. This paper will help dentists develop assessment issues and a variety of management strategies for these patients.

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Clinical related factors influencing the retention rate of pit and fissure sealant and improvement countermeasures
Lin Kaifeng,Wang Xinyue,Zou Jing,Zhang Qiong.
Int J Stomatol. 2022, 49 (6):  699-706.  DOI: 10.7518/gjkq.2022079
Abstract ( 104 )   HTML ( 14 )   PDF(pc) (814KB) ( 48 )   Save

Pit and fissure sealants can substantially reduce the occurrence of dental caries, especially preventing pit and fissure caries. The longevity and retention rate of the sealants determine their effectiveness. Sealant loss can result in the adhesion, accumulation, and fermentation of cariogenic micrograms on the tooth surface. Many studies have enhanced the retention rate of sealant and success rate of pit and fissure sealant technique. This paper summarizes clinical related factors, including tooth cleaning techniques, physical and chemical modification of tooth surface, selection of pit and fissure sealants and precautions for clinical operation, to provide reference and guidance to clinicians.

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com
Application progress on photobiomodulation in the prevention and treatment of oral complications after radiothe-rapy
Chen Xiaoli,Zhang Fan,Liu Chengcheng
Int J Stomatol. 2022, 49 (6):  707-716.  DOI: 10.7518/gjkq.2022098
Abstract ( 66 )   HTML ( 13 )   PDF(pc) (2066KB) ( 24 )   Save

Radiotherapy is one of the effective treatments for head and neck cancer. However, most patients receiving radiotherapy experience a series of oral complications, including radiotherapy-induced oral mucositis, xerostomia, taste change, dysphagia, and osteoradionecrosis of jaw. The existing treatment methods are mainly symptomatic treatment. Since Endre Mester discovered and pioneered photobiomodulation (PBM) in 1967, many clinical and basic research results have shown that PBM has great potential in preventing and treating oral complications after radiotherapy. This paper summarizes the mechanism of PBM and the new progress of its application in the prevention and treatment of radiotherapy-induced oral mucositis, xerostomia, osteoradionecrosis of jaw, dysphagia, and other radiation-related oral diseases, with the aim to provide a new method to treat oral complications after radiotherapy among patients with head and neck cancer.

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Reviews
Research progress on treatments of enamel white spot lesions
Wang Qiqiu,Zhi Qinghui.
Int J Stomatol. 2022, 49 (6):  717-723.  DOI: 10.7518/gjkq.2022101
Abstract ( 83 )   HTML ( 11 )   PDF(pc) (1023KB) ( 55 )   Save

White spot lesions are a common complication of orthodontic treatment. They are named for the enamel demineralization that causes the tooth surface to lose luster and exhibit a chalky color. Usually, separate white spots or multiple white plaques merged into one lesion may be present on the tooth surface. These lesions seriously affect the appearance of teeth, exert psychological pressure on patients, reduce the satisfaction of patients with orthodontics, increase the risk of dental caries, and endanger dental health. The timely treatment of white spot lesions has important clinical significance. The treatment methods for white spot lesions include oral hygiene guidance;remineralization methods, such as the fluoride and casein phosphopeptide-amorphic calcium phosphate method; and aesthetic restoration treatment methods, such as infiltration resin, microabrasion, and invasive dental restoration technologies. This article reviews these treatment methods to provide a reference for the research and development of treatment methods for white spot lesions in the future.

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Research progress on the use of inorganic nanoparticles in the diagnosis and treatment of periodontal disease
Li Weiguang,Wu Yafei,Guo Shujuan.
Int J Stomatol. 2022, 49 (6):  724-730.  DOI: 10.7518/gjkq.2022102
Abstract ( 64 )   HTML ( 12 )   PDF(pc) (759KB) ( 30 )   Save

Inorganic nanoparticles generally refer to new nano multifunctional materials that are composed of non-carbon elements with structural units ranging from 1 nm to 100 nm in size. They have many advantages, such as good biocompatibility, high specific surface areas, stable chemical properties, excellent mechanical strength, and low cost. Inorga-nic nanoparticles have been widely studied in the fields of antibacterial applications, cell labeling, tissue regeneration, and targeted drug transport. Their application value in the diagnosis and treatment of periodontal diseases has also attracted increasing attention. The progress in the use of inorganic nanoparticles in the diagnosis and treatment of periodontal disease, including their application in diagnosis, antibacterial treatment, regulating the local immune microenvironment of perio-dontal tissues, carrying periodontal drugs, and promoting periodontal tissue regeneration, is summarized.

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Application of computer-aided technology in fiber post removal
Cai Pingping,Zhuo Yingying,Lin Jie,Zheng Zhi-qiang.
Int J Stomatol. 2022, 49 (6):  731-736.  DOI: 10.7518/gjkq.2022104
Abstract ( 53 )   HTML ( 7 )   PDF(pc) (957KB) ( 24 )   Save

With the gradual development of “Guided endodontics” in the field of endodontics, dynamic navigation system and digital surgical guide have also been applied to remove the fiber post in clinical. Compared with the current fiber post removal systems, the computer-aided removal methods are accurate, efficient, and minimally invasive. This article reviews the clinical application, advantages and disadvantages of various fiber post removal methods, analyzes the accuracy and error factors of computer-aided technology in fiber post removal, and provides reference for the operations to clinicians.

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Research progress on oral clinical diagnosis and treatment of ectodermal dysplasia syndrome
Zhu Xingrong,Liao Lan
Int J Stomatol. 2022, 49 (6):  737-742.  DOI: 10.7518/gjkq.2022091
Abstract ( 75 )   HTML ( 8 )   PDF(pc) (805KB) ( 31 )   Save

Ectodermal dysplasia syndrome (EDs) is a general term of oral congenital dysplasia, and it is often characte-rized by dysplasia of various tissues developed from the ectodermal lobes, including hair, nails, teeth, and sweat glands. It often seriously affects the growth, development, physical, and mental health of these patients. Therefore, the early diagnosis and timely treatment of these diseases are particularly important. The purpose of this paper was to review the research progress of the clinical diagnosis and treatment of EDs to provide reference for oral clinicians.

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