01 September 2021, Volume 48 Issue 5 Previous Issue   
Expert Forum
Research progress and clinical application of inlays and onlays
Wang Jian
Int J Stomatol. 2021, 48 (5):  497-505.  DOI: 10.7518/gjkq.2021097
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A full crown is one of the most widely used restorations for defects in molars. However, the strength of the prepared tooth is compromised because of the large extent of tooth cutting during crown preparation. With the development of bonding technology and mini-invasive restoration, inlays and onlays have become the most popular restorations for defect in molars because the extent of tooth cutting is less than that of crown. This article reviews the mate-rials, indications, advantages, preparation key points, and bonding techniques to provide recommendations for clinical practice.

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Cleft Lip and Palate
Research advances on the characterization of the clinical features and genetics of palatocardiofacial syndrome
Zhou Yulan,Shi Bing,Jia Zhonglin
Int J Stomatol. 2021, 48 (5):  506-511.  DOI: 10.7518/gjkq.2021085
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Velo cardio facial syndrome (VCFS), with 22q11.2 deletion, is one of the most common multiple abnormal syndromes. VCFS is the most common hereditary disease in paediatric otolaryngology. Patients exhibit complex developmental malformations of the palate, heart, craniofacial, immune system and other organs. This review aimed to summarize recent advances in the characterization of the clinical manifestations and genetic characteristics of VCFS.

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Application of twin model in etiology of cleft lip with or without cleft palate
Ma Xiaofang,Huang Yongqing,Shi Bing,Ma Jian
Int J Stomatol. 2021, 48 (5):  512-519.  DOI: 10.7518/gjkq.2021090
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Cleft lip with or without cleft palate (CL/P) is one of the most common congenital cranio/maxillofacial deformities. The cause of the disease is complicated, which is considered to be a genetic disease mainly due to genetic and environmental factors. Twins, who share similar genetic information and environmental factors, are considered ideal models for studying the aetiology of inherited diseases. By reviewing the literature, this paper reviews the classification and identification of twins, the advantages and uses of the twin model and the application and progress of the twin model in the screening of susceptibility genes of CL/P to provide a new idea for further exploration of the causes of CL/P.

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Original Articles
Effects of platelet-rich plasma and concentrated growth factor on the proliferation and osteogenic differentiation of human periodontal cells
Liu Juan,Chen Bin,Yan Fuhua
Int J Stomatol. 2021, 48 (5):  520-527.  DOI: 10.7518/gjkq.2021075
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Objective The study aimed to analyze the effects of platelet-rich plasma (PRP) and concentrated growth factor (CGF) on the proliferation and osteogenic differentiation of human periodontal membrane cells (hPDLCs). Metho-ds The hPDLCs were cultured and isolated from periodontal ligament tissue. PRP and CGF were prepared in accordance with the standard protocols, and platelet count was performed separately. The hPDLCs were cultured to three groups: whole blood (control group), PRP (PRP group), and CGF (CGF group) at various time points. Cell proliferation was detected by the CCK-8 method, and cell migration was detected by the cell scratch assay. The hPDLCs were treated with 1%, 5%, and 10% of PRP and CGF for 24, 48, and 72 h, respectively, for osteogenic induction. Expression levels of osteogenic transcription factors Runx2, Osx, Dlx5, and Msx2 were detected by Western blot. Results Both PRP and CGF could promote the proliferation and migration of the hPDLCs (P<0.05). The expression levels of osteogenic factors Runx2, Osx, and Dlx5 increased significantly; the expression of Msx2, which inhibited osteogenesis, decreased significantly (P<0.05). Conclusion PRP and CGF could promote the proliferation and migration of hPDLCs and induce the expression of osteogenic differentiation-related transcription factors.

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Effects of non-surgical periodontal treatment on risk factors of chronic kidney disease and systematic inflammatory levels in patients with chronic kidney disease and periodontal disease: a Meta-analysis
Zhou Wanhang,Li Yanfei,Xu Ricong,Wan Qijun
Int J Stomatol. 2021, 48 (5):  528-535.  DOI: 10.7518/gjkq.2021102
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Objective The aim of this study was to evaluate the effects of non-surgical periodontal treatment on risk factors of chronic kidney disease (CKD) and systemic inflammatory levels in patients with CKD and periodontal disease so as to provide a theoretical reference for co-management. Methods Eligible studies as of July 2020 were searched systematically in PubMed, Embase, Cochrane Library, S-cience Direct, Scopus, Web of Scienc, CNKI, Wanfang, and VIP. Two independent reviewers screened the literature, evaluated the quality of the studies, extracted the data, and evaluated the risk of bias of the included stu-dies in duplicate. Meta-analysis was then conducted with RevMan 5.3. Results Six randomized controlled trials involving 432 participants were included. Meta-analysis showed that compared with the control group, the patients who received non-surgical periodontal treatment had lower 24-hour urinary protein quantity [MD=-0.32, 95% CI (-0.50, -0.14), P=0.000 4], serum C-reactive protein (CRP) in patients under 45 years old [MD=-1.25, 95% CI (-1.38, -1.12), P<0.000 01], serum interleukin-6 (IL-6) after 3 and 6 months of treatment [MD=-0.82, 95% CI (-1.64, 0.00), P=0.05; MD=-1.17, 95% CI (-2.05, -0.30), P=0.009], and higher serum albumin (Alb) [MD=0.19, 95% CI (0.11, 0.27), P<0.000 01]. Meanwhile, the changes in serum CRP in patients over 45 years old [MD=-0.06, 95% CI (-0.48, 0.36), P=0.77] and serum IL-6 after 6 weeks of treatment [MD=-0.24, 95% CI (-1.14, 0.67), P=0.61] had no statistically significant difference between the two groups. Conclusion Non-surgical periodontal treatment has favorable effects on controlling 24-hour urinary protein quantity and serum Alb and reducing systemic inflammatory (CRP and IL-6) levels in patients under 45 years old.

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Association between ponticulus posticus and maxillary palatally impacted canine: a cone-beam computed tomography study
Tian Haonan,Lin Min,Xie Congman,Ren Aishu
Int J Stomatol. 2021, 48 (5):  536-540.  DOI: 10.7518/gjkq.2021071
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Objective This study was performed to investigate the association and prevalence of ponticulus posticus in patients with maxillary palatally impacted canine by using cone-beam computed tomography (CBCT). Methods We selected 117 patients with maxillary palatally impacted canine as the experimental group and 147 with normally erupted canine as the control group. CBCT images and Mimics 20.0 software were used to record the morphology of the ponticulus posticus. Statistical analysis was performed using SPSS 21.0. Results The prevalence rates of ponticulus posticus were 35.04% in the experimental group and 21.09% in the control group. The prevalence between the two groups was statistically significant (P<0.05). No significant difference was found between the prevalence of unilateral and bilateral ponticulus posticus in the two groups (P>0.05). The prevalence of ponticulus posticus in males was significantly higher than that in females in the experimental group (P<0.05). By contrast, the gender difference in the control group was not statistically significant (P>0.05). The prevalence of ponticulus posticus type 1+2 was higher in the experimental group than that in the control group (P<0.05). Conclusion The prevalence of ponticulus posticus in patients with maxillary palatally impacted canine was significantly higher than that in patients with normally erupted canine, with higher prevalence rate in males.

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Clinical effect of surgical extrusion in the treatment of complicated crown-root fracture of anterior teeth
Liao Wenxiao,Ma Xindi,Hong Zhiwei,Wu Xinyu,Xing Yundi,Liu Jingwei,Chen Lei
Int J Stomatol. 2021, 48 (5):  541-548.  DOI: 10.7518/gjkq.2021089
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Objective This study aimed to evaluate the clinical effect of surgical extrusion in the treatment of complicated anterior teeth crown-root fractures. Methods From January 2017 to January 2019, a total of 10 anterior teeth with complicated crown-root fracture were included and surgically extruded in the General Consulting and Oral Emergency Department of Stomatological Hospital, Southern Medical University. Clinical and radiographic parameters including survival rate, periodontal healing, marginal bone loss, and periapical lesion were evaluated. Follow-up period was 1 year. Results All 10 teeth with complicated crown-root fractures survived during follow-up. Radiographic results showed nine cases of healing with normal periodontal ligament and one case of healing with root-surface resorption. The complication of marginal bone loss occurred in two cases. No periapical lesions, inflammatory root resorption, or ankylosis-related replacement resorption was found. Conclusion Surgical extrusion is a safe and feasible method of treating complicated crown-root fractures in anterior permanent teeth.

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Research progress on parathyroid hormone-related protein modulating mandibular condylar cartilage
Xu Lin,Wang Ruyi,Gou Xinrui,Wang Xiaoli,Li Yu
Int J Stomatol. 2021, 48 (5):  549-555.  DOI: 10.7518/gjkq.2021084
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Mandibular condylar cartilage (MCC), different from other articular cartilages of the body, belongs to secondary fibrocartilage and is an important component of the temporomandibular joint. MCC constantly experiences reconstruction, responds to mechanical stimulation, and may degenerate with age due to the particularity of the mastication function of mandible with teeth. Parathyroid hormone-related protein (PTHrP), first discovered in malignant humoral hypercalcemia, regulates bone metabolism by paracrine or autocrine in many tissues. PTHrP plays a role in the development, remolding, and degeneration of MCC. This study reviews the research progress of PTHrP on MCC, which can provide new ideas for the research of PTHrP on the orthodontic functional treatment and repair and regeneration of the temporomandibular joint.

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The role of follistatin in oral and maxillofacial development and its therapeutic application prospect
Liu Jiacheng,Meng Zhaosong,Li Hongjie,Sui Lei
Int J Stomatol. 2021, 48 (5):  556-562.  DOI: 10.7518/gjkq.2021099
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Follistatin (FST) is a single-chain glycoprotein synthesized and secreted by pituitary, liver, bone, and other tissues. It has extensive tissue distribution and a variety of physiological and pathological functions proven to have therapeutic value in inflammation, bone injury, and muscle atrophy by in vivo and in vitro experiments. Recent studies have demonstrated that FST plays a key role in maintaining the homeostasis of oral and maxillofacial tissues. FST has potential value in the treatment of oral inflammation, bone injury, and other diseases and is particularly important for the development of soft and hard tissues, such as teeth, lip, palate, and jaw. FST expresses in oral and maxillofacial epithelium and mesenchyme, where it antagonizes the transforming growth factor-β signaling pathway through binding to activin and bone morphogenetic proteins. Therefore, it participates in the regulation of oral and maxillofacial development as well as the occurrence and development of related diseases. This paper focuses on the role, mechanism, and application prospect of FST in oral and maxillofacial development and diseases in order to lay a foundation for its further research and clinical application in the field of stomatology.

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Research progress on multiphasic scaffold in periodontal regeneration
Gong Jinglei,Huang Yanmei,Wang Jun
Int J Stomatol. 2021, 48 (5):  563-569.  DOI: 10.7518/gjkq.2021101
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Periodontal tissue damage caused by periodontitis can lead to the mobility and loss of tooth, thereby endangering oral health and even general health. The temporal and spatial relationship of periodontal tissues and their functional reconstruction have become a research frontier, which sets higher demands on traditional therapeutic techniques. As a new type of tissue-engineered materials, multiphasic scaffolds show unique advantages in rebuilding the physiological characteristics and functional relationships of soft and hard tissues, which are keys to periodontal regeneration and functional integration. This article reviews the research progress on multiphase scaffolds in the field of periodontal structure and functional regeneration. It focuses on the frontier of the combination of these scaffolds with growth factor delivery, stem cell technology, existing periodontal treatment strategies, and emerging material technologies. This study serves as a guide for the future integration of tissue engineering and stomatology.

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Diagnosis and treatment of ameloblastoma from molecular biology perspective
Qian Ying,Gong Jiaxing,Yu Mengfei,Liu Yu,Wei Dong,Zhu Ziyu,Lu Kejie,Wang Huiming
Int J Stomatol. 2021, 48 (5):  570-578.  DOI: 10.7518/gjkq.2021064
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Ameloblastoma is the most common odontogenic tumor. It is prone to relapse and malignant transformation, and it should be a borderline tumor. To date, several special markers for ameloblastoma have been found. Although the tissue source and pathogenesis of ameloblastoma are not entirely clear, numerous signal transduction pathways have been found closely associated with its occurrence, such as the mitogen-activated protein kinase signaling pathway, Sonic Hedgehog signaling pathway, and canonical WNT/β-catenin signaling pathway. Recently, multiple mutant genes have been found in ameloblastoma, including V-raf murine sarcoma viral oncogene homolog B1 (BRAF) mutations, rat sarcoma viral oncogene homolog (RAS) mutations, and smoothened (SMO) mutations. Different mutant ameloblastomas have different clinical characte-ristics and biological behavior. The histological characteristics of ameloblastomas can guide typing, and they have distinguished significance for treatment and prognosis. This review will focus on classification, molecular level markers, pathogenesis, targeted therapy, and prognosis of ameloblastoma to explore clinically relevant genotype-phenotype correlations and assist future diagnosis and treatment.

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Clinical evaluation and treatment strategies for post-treatment endodontic disease
Xing Guiqi,Guo Linxi,Su Qin
Int J Stomatol. 2021, 48 (5):  579-584.  DOI: 10.7518/gjkq.2021100
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Root canal therapy is the most effective method to solve pulpal and periapical diseases, but some clinical cases still require retreatment because of treatment failure or new symptoms. Disease complexity, diagnostic uncertainty, and technical equipment limitations have caused difficulties in the diagnosis and treatment of such diseases. This article aims to propose corresponding clinical treatment strategies from the perspective of the affected tooth itself and the risks/benefits to provide a reference for clinicians in choosing a retreatment plan.

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Factors influencing the survival rates of resin-bonded fixed partial dentures and improvement measures
Liu Yuchen,Tian Min,Niu Lina,Fang Ming
Int J Stomatol. 2021, 48 (5):  585-591.  DOI: 10.7518/gjkq.2021086
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With continuous advancement of bonding technology and restorative materials, resin-bonded fixed partial dentures have attracted more and more attention, due to their minimally-invasiveness. However, the high technical sensitivity limits their application and popularization to a certain extent. In order to improve the long-term successful rates of the resin-bonded fixed partial dentures, this paper summarized the related factors influencing their survival rates and countermeasures, which may provide reference and guidance for clinicians.

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Volatile sulfur compounds and its role in the management of intra-oral halitosis
Huang Peiqing,Peng Xian,Xu Xin
Int J Stomatol. 2021, 48 (5):  592-599.  DOI: 10.7518/gjkq.2021069
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Intra-oral halitosis is one of the most frequent complaints of patients seeking oral treatment, which is mainly produced due to the breakdown of certain amino acids by anaerobic bacterium, followed by the release of volatile sulfur compounds (VSCs). It is generally considered that VSCs are closely related with tongue coating and periodontitis. This review summarizes the source of VSCs and the progress on the treatments of intra-oral halitosis, which are aimed at controlling dental plaque or reacting directly with VSCs. Research advancement in this field provides not only evidence for halitosis therapy, but new ideas and methods of halitosis treatment.

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Strategies for preventing alveolar-bone dehiscence and fenestration during orthodontic treatment
Zhou Mengqi,Chen Xuepeng,Fu Baiping
Int J Stomatol. 2021, 48 (5):  600-608.  DOI: 10.7518/gjkq.2021082
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Alveolar bone dehiscence and fenestration have high incidence in natural dentition, and their distribution and frequency are related to the malocclusion type. Cone beam computed tomography has a certain value in the diagnosis of dehiscence and fenestration. Dehiscence and fenestration can be caused by orthodontic treatment, which is related to the anatomy of patient’s alveolar bone, dental position, and treatment style. Clinical orthodontists should focus on the boun-dary of orthodontic treatment and select the appropriate orthodontic method, which can help prevent the occurrence of dehiscence and fenestration in orthodontic treatment. The application of periodontally accelerated osteogenic orthodontics can also prevent and treat alveolar bone dehiscence and fenestration. At present, guided bone regeneration also exerts a certain curative effect, whereas autogenous-tooth bone-graft material and tissue-engineering technology are expected to be applied to the treatment of dehiscence and fenestration in the future. This article reviews the strategies for preventing alveolar-bone dehiscence and fenestration during orthodontic treatment.

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Smoking affects the oral microenvironment and its role in the progression of dental caries
Fan Yu,Cheng Lei
Int J Stomatol. 2021, 48 (5):  609-613.  DOI: 10.7518/gjkq.2021087
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Numerous epidemiological studies report a close relationship between smoking and the occurrence of dental caries. Modern caries etiology shows that changes in the oral microenvironment including saliva flow rate, buffer capacity, composition, and oral microbial composition causes acid-forming and acid-fast bacteria to dominate. Consequently, the balance of demineralization and remineralization is broken, leading to the occurrence of caries. Other caries-related factors such as socioeconomic status and oral-health awareness also affect the occurrence and development of caries. Studies show that smoking exerts direct and indirect effects on the oral microenvironment, thereby promoting the occurrence of caries. The aim of our review is to summarize the effect of smoking on dental caries from this aspect.

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Development of robotic surgery in otorhinolaryngology head and neck surgery
Zhang Gaowei,Li Chunjie
Int J Stomatol. 2021, 48 (5):  614-620.  DOI: 10.7518/gjkq.2021098
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Surgical robots have superior operability, so they can provide surgeons with excellent vision, thereby enabling a precise and minimally invasive surgery in narrow anatomical spaces. Their application is widely described in otorhinolaryngology head and neck surgery. In contrast to traditional methods, robotic surgery avoids more invasive procedures, consequently reducing the effects on esthetics and function. As a result, the postoperative life quality of patients improves. This article summarizes the application of robotic surgery in otorhinolaryngology head and neck surgery in recent years, presents the shortcomings of surgical robots in exploration and practice, and proposes potential development directions.

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