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Table of Content

    01 May 2022, Volume 49 Issue 3 Previous Issue   
    Expert Forum
    Clinical diagnosis and strategies for early orthodontic treatment of Class Ⅲ malocclusion with tonsillar hypertrophy in children
    He Hong.
    Int J Stomatol. 2022, 49 (3):  249-254.  DOI: 10.7518/gjkq.2022056
    Abstract ( 1233 )   HTML ( 304 )   PDF(pc) (1109KB) ( 1128 )   Save

    Adenotonsillar hypertrophy is the most frequent cause of upper airway obstruction and related dentofacial abnormalities in children. Its clinical symptoms, including sleep snoring, mouth breathing, and restless sleep, have been increasingly noticed by the children’s parents. Adenotonsillar hypertrophy does not only cause prognathism or retrognathism malocclusion in children but also pediatric obstructive sleep apnea (OSA), the clinical diagnosis and treatment of which often requires multidisciplinary collaboration. To our knowledge, most of the existing studies have paid more attention to Class Ⅱ malocclusion caused by adenoid hypertrophy in children, and only a few have investigated Class Ⅲ malocclusion associated with tonsillar hypertrophy. With the aim of providing reference for orthodontic treatment, this paper examines the clinical diagnosis and treatment strategies of Class Ⅲ malocclusion with tonsillar hypertrophy in children based on a literature review and actual clinical experience.

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    Stem Cells and Regenerative Medicine
    Research progress on dental stem cells in the treatment of nervous system diseases
    Cai Yunzhu,Zhu Shu,Liu Yao,Chen Xu.
    Int J Stomatol. 2022, 49 (3):  255-262.  DOI: 10.7518/gjkq.2022043
    Abstract ( 245 )   HTML ( 29 )   PDF(pc) (831KB) ( 71 )   Save

    Nervous system diseases include central and peripheral nervous system diseases, such as spinal cord injury, Alzheimer’s disease, stroke, chronic cerebral ischemia, and sciatic nerve injury. No effective treatment method is available for these diseases. Mesenchymal stem cells (MSCs) have the potential for self-renewal and multi-lineage differentiation and have gradually become a new strategy for the treatment of neurological diseases. Dental stem cells are derived from the embryonic neural crest and are homologous to nervous tissues. Compared with MSCs from other tissues, dental stem cells are easier to obtain and have less damages to the donor and less susceptibility to immune rejection. This article reviews the research advances of application of dental stem cells in tissue repair and regeneration of nervous system diseases.

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    Advances in research on noncoding RNA during the osteogenic differentiation of dental follicle stem cells
    Hong Yaya,Chen Xuepeng,Si Misi
    Int J Stomatol. 2022, 49 (3):  263-271.  DOI: 10.7518/gjkq.2022029
    Abstract ( 205 )   HTML ( 30 )   PDF(pc) (803KB) ( 50 )   Save

    Alveolar bone-defect regeneration has long been a challenge in the field of dentistry. The rising technology of periodontal tissue engineering provides a new strategy to solve it, and ideal seed cells are key elements of this technology. Dental follicle stem cells (DFSCs), as promising seed cells, have the potential of osteogenic differentiation, which are also easily accessible for cell culture and preservation. The osteogenic differentiation of DFSCs involves complex gene regulation. Noncoding RNA (ncRNA), as a functional RNA that is transcribed from DNA but does not encode protein, can reportedly regulate the osteogenic differentiation of stem cells at the epigenetic, transcription, and post-transcription le-vels. Exploring the role and mechanism of ncRNA in the regulatory network of DFSCs’ osteogenic differentiation can provide novel therapeutic strategies for tissue regeneration. This review summarizes the advances in research on ncRNA during the osteogenic differentiation of DFSCs, including microRNA, long noncoding RNA, and circular RNA.

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    Strategies of vascularization in dental pulp regeneration
    Qin Siwen,Liao Li.
    Int J Stomatol. 2022, 49 (3):  272-282.  DOI: 10.7518/gjkq.2022024
    Abstract ( 460 )   HTML ( 74 )   PDF(pc) (873KB) ( 476 )   Save

    Pulpitis has one of the highest incidences of oral diseases, and restoring the structure and function of dental pulp is difficult by the commonly adopted treatment methods. Therefore, the strategy of dental pulp regeneration through regenerative medicine has been widely explored. However, the reconstruction of a pulp vascular network is a difficult problem in pulp tissue regeneration because of the special morphological characteristics of root canal and pulp cavity. Studies on pulp angiogenesis strategies have mainly focused on two aspects: orthotopic angiogenesis strategies and graft pre-angiogenesis techniques. In this work, the basic principles of orthotopic angiogenesis in vivo were mainly discussed by systematically analyzing the results of research on angiogenesis in dental pulp regeneration based on dental pulp stem cells (DPSCs): 1) signaling molecules, physical and chemical factors, and regulation of extracellular vesicles during angiogenesis and 2) cell source, vascular network construction conditions, gel scaffold selection, and microenvironment configuration of the pre-angiogenesis system. Studies and trials on the strategies of the vascularization of dental pulp in clinics were also summarized. The application prospect of pre-angiogenesis in the reconstruction of a vascular network in pulp regeneration was also discussed and prospected.

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    Microbiology
    Research status of the use of root canal and periapical microflora in refractory periapical periodontitis
    Zhu Jiani,Su Qin
    Int J Stomatol. 2022, 49 (3):  283-289.  DOI: 10.7518/gjkq.2022047
    Abstract ( 960 )   HTML ( 212 )   PDF(pc) (816KB) ( 843 )   Save

    The pathogenic factors of refractory apical periodontitis include persistent intraradicular infection and extraradicular infection, both connectedly and differentially. With the development of modern molecular technology, it is found that the use of single sampling method and traditional bacterial detection methods makes it difficult to offer clear insight into all the bacterial species in the root canal. However, the combination of multiple sampling and detection methods can better improve the detection of species and populations of detected bacteria. Based on the review of literature on the intraradicular and extraradicular bacterial communities of refractory apical periodontitis in the last 10 years, this paper discus-ses the comparison of predominant microbial flora in and outside of the root canal of refractory apical periodontitis obtained by different sampling methods and detection techniques as well as the sources of infection microorganisms in refractory apical periodontitis.

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    Research progress on the interactions between Enterococcus faecalis and other oral microorganisms
    Liu Qianxi,Wu Jiayi,Ren Biao,Huang Ruijie
    Int J Stomatol. 2022, 49 (3):  290-295.  DOI: 10.7518/gjkq.2022034
    Abstract ( 282 )   HTML ( 22 )   PDF(pc) (765KB) ( 46 )   Save

    Interactions among different oral microbes play an important role in the occurrence and development of oral diseases. Enterococcus faecalis contributes to various inflammatory diseases by forming biofilm and secreting harmful substances, including gelatinase and cytolysin. It becomes an opportunistic pathogen in case of low immunity. Enterococcus faecalis can be detected together and interact with other pathogenic microbes, such as Candida albicans, Staphylococcus aureus, Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Streptococcus mutans from a series of oral lesions, including pulpitis, periapical periodontitis and periodontitis. This review summarised the research progress on studies about the interactions between Enterococcus faecalis and other oral pathogens and focuses on their combination effects in oral diseases to provide a new version for clinical prevention and treatment.

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    Original Articles
    Effect of 3D printing orthognathic surgical splints with different dental model offsets on occlusal precision
    Ma Jianbin,Xue Chaoran,Wang Peiqi,Li Bin,Bai Ding.
    Int J Stomatol. 2022, 49 (3):  296-304.  DOI: 10.7518/gjkq.2022061
    Abstract ( 294 )   HTML ( 44 )   PDF(pc) (3982KB) ( 154 )   Save
    Objective

    This study aimed to assess the precision of 3D-printed orthognathic surgical splints (OSS) with different dental model offsets and explore the optimal offsets of OSS.

    Methods

    Ten resin models that met the standard of normal occlusion were selected, and the digital models were obtained by using an optical scanner. The research models were made by using a 3D photosensitive resin printer, and then the original digital models were obtained. Digital OSS with different offsets (0.00, 0.05, 0.10, 0.15, 0.20, and 0.25 mm groups) was designed for each model, and physical OSS was fabricated by 3D printing. The upper and lower dentition of each resin model was reoccluded in OSS with different offsets, and the deviation of the actual occlusion from the original occlusion in six dimensions of horizontal, sagittal, vertical, pitch, roll, and yaw was evaluated.

    Results

    1) The actual occlusion obtained by OSS without offsets (0.00 mm group) had deviation in six dimensions, and the deviation in vertical (1.044±0.181 mm) and pitch (1.738°±0.772°) dimensions was the largest. 2) In sagittal, vertical, pitch, and roll dimensions, the mean value of actual occlusal deviation gradually decreases with the increase of offsets. In the vertical and pitch dimensions, the actual occlusal deviation of the 0.15 mm group was significantly less than that of the 0.00, 0.05, and 0.10 mm groups (P<0.01), but no significant difference was found between the 0.20 mm and 0.25 mm groups (P>0.05). In addition, no significant difference in sagittal and roll dimensions was found among the groups (P>0.05). 3) In the horizontal and yaw dimensions, within the range of 0.00-0.20 mm, the mean value of actual occlusal deviation gradually decreased with the increase of offsets (P>0.05). However, the actual occlusal deviation of the 0.25 mm group was larger than that of the 0.20 mm group (P>0.05).

    Conclusion

    3D printed OSS with offsets can reduce the deviation of the actual occlusion. Among the parameters, 0.15 mm is the suitable option for generating OSS.

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    Photodynamic therapy as an adjunct to periodontitis: a meta-analysis
    Ma Yu,Zuo Yu,Zhang Xin
    Int J Stomatol. 2022, 49 (3):  305-316.  DOI: 10.7518/gjkq.2022054
    Abstract ( 276 )   HTML ( 79 )   PDF(pc) (5355KB) ( 185 )   Save
    Objective

    This study aimed to evaluate the clinical efficacy of photodynamic therapy (PDT) adjunctive to scaling and root planning (SRP) in patients with chronic periodontitis.

    Methods

    Published literature on PubMed, Embase, Web of Science/SCI, Wanfang, CNKI, and VIP was searched by Boolean algorithm combined with medical subject words and free words. The time was also searched from their inception until December 2020, and the language type was Chinese or English. Then, a manual search was performed to obtain a randomized controlled trial of PDT adjunctive to SRP in the treatment of periodontitis. Literature was screened out on the basis of the inclusion and exclusion criteria. The Cochrane bias risk assessment tool was used to evaluate literature quality. Revman 5.3 software was used for meta-analysis. Outcome indicators included clinical attachment loss, probing depth, plaque index, and bleeding on probing.

    Results

    A total of 21 articles were included. Meta-analysis showed that at 1 month after SRP+PDT treatment, PD and BOP diffe-rences were statistically significant (PD: SMD=-0.81, 95%CI was -1.40 to -0.21, P=0.008; BOP: SMD=-0.61, 95%CI was -1.05 to -0.16, P=0.008). At 3 months after treatment, only PD difference was statistically significant (SMD=-0.57, 95%CI was -0.91 to -0.23, P=0.001). At 6 months after treatment, CAL and PD differences were statistically significant (CAL: SMD=-0.46, 95%CI was -0.88 to -0.03, P=0.04; PD: SMD=-0.57, 95%CI was -1.04 to -0.11, P=0.02). The experimental group was lower than the control group.

    Conclusion

    PDT adjunctive to SRP improved CAL and reduced PD in the short term (6 months), but no evidence that PDT adjunctive to SRP was superior to pure SRP in improving PI and BOP was found.

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    Investigation of the mechanism of 2,3,7,8-tetrachlorodiphenyl dioxin-induced cleft palate mice model
    Luo Xiao,Cai Shengqing,Shi Bing,Li Chenghao.
    Int J Stomatol. 2022, 49 (3):  317-323.  DOI: 10.7518/gjkq.2022048
    Abstract ( 188 )   HTML ( 28 )   PDF(pc) (4174KB) ( 96 )   Save
    Objective

    This study aims to investigate the mechanism in which 2,3,7,8-tetrachlorodiphenyl dioxin (TCDD) induces palatal cleft in C57BL mice by affecting palatal ridge epithelial cells.

    Methods

    C57BL mice were divided into the control and experimental group. The pregnant mice in the experimental group were treated with TCDD at embryonic day 12.5 (E12.5), while the mice in the control group were treated with an equivalent volume of castor oil. Haematoxylin and eosin (HE) staining, real-time quantitative polymerase chain reaction, Western blot and immunohistochemistry were employed to determine the expression level of protease-activated receptor/atypical protein kinase C (PAR/aPKC) complex and β-catenin in foetal mouse palatal processes in the phase of the control and experimental group.

    Results

    Cleft palate was induced in all foetal mice in TCDD group at E18.5 but not in the control group. The reverse transcription-polymerase chain reaction (RT-PCR) quantitative results show that the expression of PAR/aPKC complex mRNA was the strongest at E13.5 but weakened at E14.5 and E15.5. The expression level of β-catenin was the highest at E14.5, followed by E13.5, and the lowest at E15.5. The expression of β-catenin in TCDD group at E13.5 and E14.5 was significantly lower than that of the control group but higher at E15.5 (P<0.01). Western blot analysis revealed that the expression of PAR/aPKC complex decreased with palatal development. Strong positive expression of β-catenin in the palatal ridge epithelial cells was observed at E13.5 and E14.5 in the control group by immunohistochemical staining.

    Conclusion

    TCDD may induce failure of palatal epithelial fusion in mice by interfering with the expression of PAR/aPKC complex and β-catenin, resulting in cleft palate.

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    Exploration on cleaning and disinfection mode of dental instruments based on multi-enzyme detergent control
    Lin Jie,Liu Fan
    Int J Stomatol. 2022, 49 (3):  324-327.  DOI: 10.7518/gjkq.2022052
    Abstract ( 201 )   HTML ( 25 )   PDF(pc) (940KB) ( 24 )   Save
    Objective

    To obtain the optimal temperature, the operating life after the configuration of the detergents, and the best reuse times of the detergents corresponding to the two kinds of multi-enzyme detergents, which were commonly used in the cleaning and disinfection of dental instruments.

    Methods

    In this study, the multi-enzyme detergents currently in commercial use were taken as the research objects, according to the best working temperature, configuration time and frequency of fluid change, explore the optimal conditions for the use of multi-enzyme cleaning agents.

    Results

    The optimal temperature of group one treatment is around 55 ℃, while the optimal temperature of group two is around 50 ℃. Too long detergent configuration time or repeated use of multiple enzyme detergent in batches may result in reduced disinfection effect. Reasonable control of the number of instruments, use within an effective time period, and timely replacement of multi-enzyme detergents are important methods to ensure the disinfection effect.

    Conclusion

    Controlling the working temperature at about 50-55 ℃, using the multi-enzyme detergents of the configuration time, and the cleaning times of not more than three times can help to clean the dental instruments efficiently.

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    Case Report
    Pleomorphic adenoma with extensive keratin cysts: a case report
    Zhai Xiaojing,Cao Shi,Xin Wenlong,Cao Shan,Zhang Hao
    Int J Stomatol. 2022, 49 (3):  328-331.  DOI: 10.7518/gjkq.2022046
    Abstract ( 207 )   HTML ( 30 )   PDF(pc) (1932KB) ( 34 )   Save

    Pleomorphic adenoma, which has a diverse histology, is the most common benign tumor in the salivary glands. About 25% of pleomorphic adenoma is associated with squamous metaplasia, while cases with extensive squamous metaplasia and keratin cysts are unusual. Thus, there is a need to differentiate this from other cystic lesions, squamous cell carcinoma, mucoepidermoid carcinoma. In this work, we reported a case characterized by extensive keratin cyst formations. Squamous metaplasia and keratin cyst components account for about 40% of pleomorphic adenomas. Finally, through a literature review, we summarized the clinicopathological features, imaging examinations, differential diagnoses, treatments, and prognosis of pleomorphic adenoma with extensive keratin cysts.

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    Reviews
    Classification and treatment of dentin dysplasia type
    Lei Bin,Chen Ke
    Int J Stomatol. 2022, 49 (3):  332-336.  DOI: 10.7518/gjkq.2022030
    Abstract ( 702 )   HTML ( 146 )   PDF(pc) (913KB) ( 571 )   Save

    Dentin dysplasia type Ⅰ (DD-Ⅰ) is a rare genetic disorder of dentine formation that affects all deciduous and permanent teeth. In this disease, the tooth crown’s appearance, color, and lustre are normal; tooth loosening is obvious; and spontaneous tooth alveolar abscess or cyst may be present. Imaging examinations show that the pulp cavity disappeared or the residual pulp has a “crescent shape” and the root is short and blunt or the root is absent. The pathogenesis of DD-Ⅰ has been studied by most scholars, and its clinical treatment is often challenging. In this paper, the clinical classification and manifestations, pathogenic genes, histological characteristics, and treatment of DD-Ⅰ in recent years are reviewed to provide guidance for the clinical diagnosis and treatment of this disease.

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    Research progress on cervical vertebra maturation in evaluating bone age of mandible
    Li Jingwen,Zhou Li.
    Int J Stomatol. 2022, 49 (3):  337-342.  DOI: 10.7518/gjkq.2022058
    Abstract ( 1135 )   HTML ( 180 )   PDF(pc) (880KB) ( 909 )   Save

    Early functional correction and orthopedic treatment are important means to improve the difference in mandibular development. Therefore, the peak growth period of the mandible by bone age must be evaluated to determine the start time of correction. The cervical vertebra maturation (CVM) method can predict the growth and development period of the mandible based on the regular changes in the shape and size of cervical vertebra at different growth and development stages. The assessment of bone age is convenient and practical. Compared with the wrist bone method, bone age assessment is widely used in clinical practice and does not require patients to receive additional radiation. However, this method is controversial because of its high subjectivity and low repeatability. In response to these problems, a variety of improved methods, including incorporation of objective indicators to describe cervical-spine morphology, improvement of experimental design and data analysis methods, the use of cone-beam computed tomography images to analyze cervical spine morphology, and the use of computer-aided positioning, have been proposed. This article reviews the supporting evidence, related controversies, and improved methods for the clinical application of CVM method.

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    Research progress on adenosine monophosphate-activated protein kinase in periodontal disease
    Li Guiping,Qin Xu,Zhu Guangxun.
    Int J Stomatol. 2022, 49 (3):  343-348.  DOI: 10.7518/gjkq.2022059
    Abstract ( 159 )   HTML ( 29 )   PDF(pc) (704KB) ( 28 )   Save

    Periodontal disease is characterized by the pathological resorption of periodontal support tissue caused by the interaction of specific pathogenic bacteria and destructive immune response. As a key regulator of cellular energy, adenosine monophosphate-activated protein kinase (AMPK) participates in the regulation of the metabolism of fatty acids and glucose in important tissues and organs to maintain body homeostasis, and it has been studied extensively in metabolic diseases. Previous studies showed that AMPK can also participate in regulating periodontal bone metabolism, immune response, matrix metalloproteinase secretion, and cellular autophagy to regulate the occurrence and development of periodontal diseases, revealing the potential role of AMPK in the pathogenesis of periodontal disease and providing a new therapeutic target for its treatment. This review provides an overview of the research progress of AMPK in periodontal diseases.

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    Differential expression of microRNA in gingival crevicular fluid of periodontitis and its regulatory mechanism on periodontitis
    Qian Suting,Ding Lingmin,Ji Yaning,Lin Jun.
    Int J Stomatol. 2022, 49 (3):  349-355.  DOI: 10.7518/gjkq.2022051
    Abstract ( 206 )   HTML ( 30 )   PDF(pc) (877KB) ( 37 )   Save

    Periodontitis is an inflammatory disease characterised by the formation of periodontal pocket and the resorption of alveolar bone. It is the main cause of tooth loss in adults over 40 years old. The gingival crevicular fluid produced by the periodontal tissue can reflect the state of periodontal inflammation to a certain extent, and the expression level of microRNA (miRNA) in it changes according to the progression of periodontal inflammation, which can be used as an indicator of periodontal diagnosis. The expression levels of miR-146a and miR-223 can be altered significantly during perio-dontitis progression. They are currently the most potential biomarkers periodontitis diagnosis by using miRNA in gingival crevicular fluid. Different miRNAs can play different roles by regulating the different stages of the periodontitis signalling pathway, such as the binding of bacterial lipopolysaccharide and Toll-like receptor, nuclear factor-κB ligand signalling pathway, and the release of inflammatory factors. This review elaborates the expression differences and modulation mechanisms of miRNA in periodontitis gingival crevicular fluid with a view to offer novel insights and strategies for the accurate diagnosis of periodontitis by miRNA in gingival crevicular fluid.

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    Research progress on the analysis of tongue-movement patterns during articulation by ultrasound imaging
    Zhu Mengxian,Jiang Chenghui,Zhou Guangchao,Wang Binbing,Li Sheng,Shi Xinghui
    Int J Stomatol. 2022, 49 (3):  356-361.  DOI: 10.7518/gjkq.2022049
    Abstract ( 181 )   HTML ( 21 )   PDF(pc) (1286KB) ( 21 )   Save

    The tongue is an important flexible articulation organ. Changes in the position, shape, and movement of the tongue in the oral cavity could induce changes in the resonance and airflow, consequently affecting the quality of speech. Ultrasound is extensively used in clinical practice because of its advantage in real-time imaging, convenience, and safety without radiation. This paper reviews the progress of research on the principle, application, and methodology of ultrasound-imaging technology in the study of tongue patterns during articulation.

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    Research progress on measuring methods of tooth movement under functional load
    Zhao Zhe,Wang Fu,Zheng Xiuli,An Na,Chen Jihua.
    Int J Stomatol. 2022, 49 (3):  362-366.  DOI: 10.7518/gjkq.2022037
    Abstract ( 159 )   HTML ( 25 )   PDF(pc) (774KB) ( 49 )   Save

    Tooth movement under functional load is a basic physiological phenomenon in the process of mastication, which plays an important role in maintaining the force balance of dental arch and avoiding food impaction and tooth fracture. In recent years, with the continuous progress of research and the continuous application of new technologies and methods, the research on tooth movement under functional load is deepening, and its measurement method is moving closer to the direction of high precision and digitalisation. This paper reviews the related literature in recent years on the physiological basis, influencing factors, measurement methods and clinical significance of tooth movement under functional load to provide reference for an objective and comprehensive description of tooth movement under mastication.

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    Effect of residual calcium hydroxide in root canal on root canal treatment
    Wang Luxuan,Hou Benxiang.
    Int J Stomatol. 2022, 49 (3):  367-372.  DOI: 10.7518/gjkq.2022018
    Abstract ( 2326 )   HTML ( 628 )   PDF(pc) (748KB) ( 2667 )   Save

    Root canal treatment mainly aims to eliminate microorganisms from the contaminated root canal system. Calcium hydroxide have anti-bacterial properties, can dissolve necrotic tissue, inhibit root resorption and induce hard tissue formation and has little side effect. Thus, calcium hydroxide as an intracanal medicament is commonly used to control root canal infection in clinical practice. However, considering the complex anatomy of the root canal system and the influence of calcium hydroxide vehicles and irrigation equipment, the complete removal of calcium hydroxide in root canal is hard. The residual calcium hydroxide influences the sealing of root canal filling and reduces the fracture resistance of teeth. Therefore, the success rate of root canal treatment is influenced. This paper reviews factors leading to the residual of calcium hydroxide and the influence of residual calcium hydroxide on root canal treatment.

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