01 July 2024, Volume 51 Issue 4 Previous Issue   
Expert Forum
Clinical applications of natural tooth-related maxillary sinus floor elevation
Xuelian Tan,Yi Man,Dingming Huang
Int J Stomatol. 2024, 51 (4):  381-391.  DOI: 10.7518/gjkq.2024071
Abstract ( 66 )   HTML ( 8 )   PDF(pc) (2682KB) ( 92 )   Save

The posterior maxillary teeth are common sites of endodontic periapical diseases and are connected to the maxillary sinus, facilitating the spread of infection and leading to odontogenic maxillary sinusitis. The maxillary tooth-bone-sinus complex exhibits a close anatomical relationship, necessitating procedures for refractory cases. For surgical access, microscopic apical surgery is often combined with maxillary sinus floor elevation, termed “natural tooth-related maxillary sinus floor elevation”, to ensure therapeutic efficacy and reduce complications. This paper provides a comprehensive discussion on the application scenarios, advantages, indications and contraindications, treatment planning, and selection of surgical procedures for tooth preservation-related maxillary sinus floor elevation. Drawing from a combination of literature review and clinical experience, this work explores the clinical applications of this technique and provide preliminary theoretical guidance on its clinical application and a solid foundation for further standardization of the clinical operation path and multidisciplinary joint management strategy.

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Periodontitis
Therapeutic effect of cannabidiol combined with minocycline on periodontitis
Meiyao Qi,Xingying Qi,Xinyi Zhou,Zhen Tan,Quan Yuan
Int J Stomatol. 2024, 51 (4):  392-400.  DOI: 10.7518/gjkq.2024078
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Objective The therapeutic effect of cannabidiol combined with minocycline on experimental periodontitis in mice was studied in vitro and in vivo. Methods The mouse periodontitis model was established by thread ligation. The oral area was treated with cannabidiol, minocycline, and both. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the changes in inflammatory factors in peripheral blood of mice with periodontitis. Micro CT, western blot (WB), and hematoxylin-eosin (HE) staining were used to analyze the improvement in local inflammation. Porphyromonas gingivalis (P. gingivalis) bacteriostatic assay was used to detect the antibacterial properties of the combined drugs in vitro. Inflammation of macrophages and gingival fibroblasts was induced in vitro, and mRNA expression related to inflammation was detected by qRT-PCR. The effect of drugs on cell migration was explored by wound-healing assay, and the effect of drugs on collagen production was explored by enzyme-linked immunosorbent assay. Results After combined administration of cannabidiol and minocycline, the systemic inflammation index of mice decreased, the local attachment loss was alleviated, the tissue inflammation level was reduced, and the destruction of periodontal soft and hard tissues improved compared with single administration. The results of the antibacterial experiment in vitro showed that the combined drugs had good antibacterial properties. In vitro cell experiments proved that the combination of drugs reduced the expression levels of various inflammatory factors in macrophages, promoted the proliferation and migration of human gingival fibroblasts in inflammatory states, and improved the collagen formation function. Conclusion Compared with the single medication method, the local application of cannabidiol combined with minocycline has a significant effect on experimental periodontitis in mice.

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The effect of supportive periodontal therapy on blood cell indicators in patients with periodontitis: a retrospective study
Mengjie Chen, Xiaole Liu, Lilei Zhu
Int J Stomatol. 2024, 51 (4):  401-405.  DOI: 10.7518/gjkq.2024052
Abstract ( 46 )   HTML ( 3 )   PDF(pc) (1257KB) ( 28 )   Save

Objective This study aimed to investigate the effect of supportive periodontal therapy (SPT) on blood cell indicators in patients with periodontitis. Methods In accordance with the inclusion and exclusion criteria, patients who were diagnosed with periodontitis at Changsha Stomatological Hospital from January 2014 to March 2022 were included. On the basis of whether SPT was performed on patients or not, patients were divided into maintenance group (74 patients) and nonmaintenance group (76 patients) to compare the differences in blood cell indicators between the two groups. Results After treatment, the neutrophil count (N), white blood cell count (WBC), platelet count (PLT), and systemic immune-inflammation index (SII) of the maintenance group decreased (P<0.05); the mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV), and mean platelet volume (MPV) increased (P<0.05); the hemoglobin (HGB) showed no significant change (P>0.05). The SII of the nonmaintenance group decreased, whereas the MPV and MCV increased (P<0.05). By comparing the changes in blood cell indicators, we found significant differences in WBC, N, PLT, SII, MCV, MCHC, and MPV between the two groups (P<0.05). During the 5-year follow-up period, a decreasing trend in WBC, N, PLT, and SII and an increasing trend in MCHC, MPV, and MCV in the maintenance group were observed. Conclusion Active SPT could improve the hematological parameters of patients, alleviate the immune and inflammatory imbalance, and benefit the maintenance and improvement of the treatment effect.

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Meta-analysis of the efficacy of antimicrobial photodynamic therapy and systemic antimicrobial drug as an adjunct treatment for periodontitis
Yu Ma, Yu Zuo, Jianhua Liu
Int J Stomatol. 2024, 51 (4):  406-415.  DOI: 10.7518/gjkq.2024074
Abstract ( 74 )   HTML ( 35 )   PDF(pc) (1878KB) ( 103 )   Save

Objective This study aimed to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) and systemic antimicrobial drug as an adjunct treatment for periodontitis. Methods  Seven databases, namely, Embase, PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP, were searched from inception until November 2023. The language of the searched literature is Chinese or English. Studies were screened out according to inclusion and exclusion criteria, and their quality was evaluated using the Cochrane tool. Meta-analysis and publication bias detection of the included studies were performed using RevMan 5.4 and Stata 14.0 software. Results Eight studies were included. Meta-analysis showed that 3 months after treatment using methylene blue (MB) as the photosensitizer (PS), the improvement effect of scaling and root planning (SRP)+aPDT on probing depth (PD) was better than that of SRP+systemic antimicrobial drug. When phenothiazine chloride was the PS, the improvement effect of SRP+systemic antimicrobial drug on PD was better than that of SRP+aPDT (P<0.05). No significant difference was observed in the improvement effect of SRP+aPDT/SRP+systemic antimicrobial drug on clinical attachment level (CAL) and probing bleeding (BOP) at 3 months after treatment (P>0.05) and the improvement effect of SRP+aPDT/SRP+systemic antimicrobial drug on PD, CAL, and BOP at 6 months after treatment (P>0.05). Compared with those at baseline, SRP+aPDT improved PD, CAL, and BOP by (0.80±0.19) mm, (0.94±0.29) mm, and 19.74%±1.91%, respectively, at 3 months after treatment (P<0.05). In addition, SRP+systemic antimicrobial drug improved PD, CAL, and BOP by (1.02±0.27) mm, (0.95±0.25) mm, and 19.39%±11.83%, respectively (P<0.05). At 6 months after treatment, SRP+aPDT improved PD, CAL, and BOP by (1.37±0.47) mm, (1.29±0.52) mm, and 28.97%±2.43%, respectively (P<0.05). In addition, SRP+systemic antimicrobial drug improved PD, CAL, and BOP by (1.55±0.53) mm, (1.34±0.49) mm, and 29.34%±10.47%, respectively (P<0.05). Conclusion For PD, the improvement effect is in the order of SRP+MB-aPDT>SRP+systemic antimicrobial drug> SRP+phenothiazine chloride-aPDT. MB-aPDT may be an alternative to systemic antimicrobial drug as an adjunct treatment for periodontitis. The type of periodontitis, type 2 diabetes mellitus, smoking, number of aPDT, type of systemic antimicrobial drug, and treatment time of systemic antimicrobial drug have a similar influence on the treatment effect of SRP+aPDT/SRP+systemic antimicrobial drug.

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Research progress on chitosan in periodontal disease treatment
Xingyue Wen, Junyu Zhao, Chongjun Zhao, Guixin Wang, Ruijie Huang
Int J Stomatol. 2024, 51 (4):  416-424.  DOI: 10.7518/gjkq.2024037
Abstract ( 37 )   HTML ( 2 )   PDF(pc) (1250KB) ( 39 )   Save

Chitosan is the only naturally occurring cationic polysaccharide and has gradually become a focus of attention in tissue engineering due to its good biocompatibility; biodegradability; antibacterial, anti-inflammatory, anticancer, and tissue repair activity; and great drug delivery capacity. Periodontal disease, as an inflammatory and destructive di-sease, has a high prevalence and significant impact on oral health and even systemic health. In this review, we summarize the role of chitosan in periodontal therapy, including its regenerative scaffolding; drug delivery; and antibacterial, anti-inflammatory, and angiogenesis-promoting effects. We then analyze current issues and point out possible future directions for its development, aiming to provide solutions to problems encountered in periodontal disease treatment.

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Progress of research on the correlation between periodontitis and heart failure
Shili Liu, Lei Zhao
Int J Stomatol. 2024, 51 (4):  425-432.  DOI: 10.7518/gjkq.2024059
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Heart failure (HF) is a serious manifestation or terminal stage of various heart diseases, seriously affecting the physical and mental health of patients. Its etiology is explored through many aspects, among which the influence of inflammation on the HF process is a scholarly research hotspot. Periodontitis is a destructive disease of periodontal soft and hard tissues caused by plaque biofilm and is one of the two major oral diseases. Periodontitis is reportedly associated significantly with cardiovascular disease (CVD). The relationship between periodontitis and HF and its mechanism remain in the initial stage of research. Periodontal pathogens and their toxic products can reportedly affect myocardial function directly and indirectly, thereby affecting HF progression. This work provides a review of the progress of research on perio-dontitis and HF to provide some research ideas for the joint prevention and treatment of periodontitis and CVD.

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Progress of research on sticky bone in oral implant and periodontology
Jing Zhang, Siying Zhou, Xinduo Zhang, Yuxia Feng, Jianxue Li
Int J Stomatol. 2024, 51 (4):  433-440.  DOI: 10.7518/gjkq.2024053
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Sticky bone comprises autogenous platelet concentrates and bone-particle grafts. It exhibits favorable plasti-city and stability for fitting various bone defects and maintaining bone-regeneration space. Angiogenesis and tissue healing are promoted by the release of leukocytes and various growth factors from autogenous platelet concentrates. Sticky bone is currently being gradually applied in oral implantology and periodontology, and positive results have been obtained. This review briefly describes the composition, preparation protocol, and mechanism of sticky bone. Its applications in alveolar bone augmentation, immediate implant placement, alveolar ridge preservation, maxillary sinus floor elevation, and periodontal surgery are also outlined. This work can serve as a reference for further research on sticky bone and its clinical application.

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Materials
Research progress on the application of machinable polymer-infiltrated ceramic network in prosthodontics
Cheng Wu,Yichen Xu,Qianbing Wan
Int J Stomatol. 2024, 51 (4):  441-449.  DOI: 10.7518/gjkq.2024056
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Polymer-infiltrated ceramic network (PICN) has emerged as a novel dental restoration material, attracting widespread attention due to its unique ceramic–resin dual interpenetrating network structure. This material blends the superior features of ceramics and resins, effectively resisting crack propagation, protecting abutment and opposing teeth, and exhibiting excellent adhesive properties. It has shown promising application potential and clinical outcomes in pros-thodontic treatments of single crowns, inlays, partial crowns, and veneers. This review elaborates on the composition, structure, mechanical properties, adhesive performance, wear resistance, optical characteristics, and clinical manifestations of PICN materials. Furthermore, it anticipates future development trends and application prospects.

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Factors influencing the bonding effect of oral translucent zirconia ceramics
Xuemin Yao,Hua Wang,Lu Wang,Bin Zhao
Int J Stomatol. 2024, 51 (4):  450-455.  DOI: 10.7518/gjkq.2024060
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As a new generation of zirconia all-ceramic materials, translucent zirconia ceramics are often used to restore the anterior tooth aesthetic zone because of their good mechanical and optical properties. To achieve a good long-term repair effect, the key is to improve the bonding strength of the material as much as possible. Therefore, clinicians need to clarify the factors influencing the bonding properties of translucent zirconia ceramic materials. In practical applications, the bonding properties of translucent zirconia are affected by many factors. This paper primarily reviews the progress of research on the composition and structure, surface-treatment methods, surface-modification methods, adhesive monomers, and primer of translucent zirconia ceramics. The results can serve as a reference for clinical application.

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Original Articles
Correlation between morphological characteristics of the temporomandibular joint and three-dimensional mandi-bular growth in adolescents
Jingwen Han,Lei Wang,Shiqi Ren,Hongyu Wang,Yingyi Huang,Jiamin Li,Yan Zheng
Int J Stomatol. 2024, 51 (4):  456-466.  DOI: 10.7518/gjkq.2024058
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Objective The aim of the study was to explore the correlation between temporomandibular joint (TMJ) morphological characteristics and mandibular growth potential by measuring the three-dimensional growth of the mandible before and after the growth spurt in adolescents with different TMJ morphological characteristics. Methods A transverse sample of 226 adolescents with normal growth and without orthodontic treatment was selected, and the cone beam computed tomography (CBCT) image of each patient was collected. All the samples were divided into pre-growth groups and post-growth groups based on the stages of spheno-occipital synchondrosis fusion. The condylar position, condylar height-neck ratio, condylar angle, and condylar head vertical angle were measured and calculated. According to the measurement results, all the samples were divided into groups with different TMJ morphological characteristics, and each group’s mandibular three-dimensional growth was measured and analyzed. Results Regardless where the condyle was located in the joint fossa, a significant increase in mandibular length and height was observed during the growth spurt. When the condyle was not in the median position, the growth of mandibular width was statistically significant. The growth of mandibles with short and thick condyles was significant in all directions, whereas the growth of those with long and thin condyles was statistically significant in length and height but not in width. The growth of mandibles with relatively large condyle angle was statistically significant in all three-dimensional directions, whereas those with relatively small condyle angle showed statistical significance in length and height but not in width. Mandibles with relatively large condylar head vertical angle showed significant growth in the length and height but not in width, whereas mandibles with relatively small condylar head vertical angle had statistically significant length and width growth, with no statistical significance in height. Conclusion  The morphological characteristics of the TMJ can be used as a reference index to predict the growth potential of the mandible. The growth volume of mandibles with different TMJ characteristics changes in various directions.

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Reviews
Effects and mechanism of exosomes derived from dental mesenchymal stem cells on dental pulp regeneration
Hui Lu,Yexin Zheng,Wei Zhao
Int J Stomatol. 2024, 51 (4):  467-474.  DOI: 10.7518/gjkq.2024064
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Pulp regeneration is a new strategy for pulp necrosis treatment based on tissue engineering. Seed cells combined with scaffolds and growth factors are used to regenerate dentin, blood vessels, and nerves. As extracellular vesicles with a diameter of approximately 30~150 nm, exosomes play an important role in the transmission of regulatory information between cells. In recent years, exosomes derived from dental mesenchymal stem cells have attracted attention because of their great potential in pulp regeneration. In this article, the species and culture environment of exosomes derived from dental mesenchymal stem cells were introduced. The effect and mechanism of exosomes derived from dental mesenchymal stem cells in regulating odontogenic differentiation, angiogenesis, nerve regeneration, and osteoblastic differentiation were also reviewed.

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Research progress on the removal of calcium silicate-based root canal sealers during retreatment process
Bo Zhang,Xia Li,Mengqi Yang
Int J Stomatol. 2024, 51 (4):  475-482.  DOI: 10.7518/gjkq.2024047
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In recent years, Calcium Silicate-based Root Canal Sealers have been widely used in root canal therapy because of its excellent adhesive sealing and biocompatibility. Its superior adhesive sealing improves the effect of root canal therapy, but when the root canal therapy fails and needs to be retreated, the current conventional root canal retreatment methods, as well as the technical improvement of mechanical preparation and chemical irrigation, are difficult to effectively remove the Calcium Silicate-based Root Canal Sealers, and the power of root canal retreatment is also challenged. Therefore, this paper focuses on the dissolution of the irrigating agents on the Calcium Silicate-based Root Canal Sealers, and summarizes the ability of the irrigating agent components to remove the Calcium Silicate-based Root Canal Sealers from both physical dissolution and chemical dissolution, with a view to providing a new idea for the clinical selection of root canal irrigating agent that can effectively remove the Calcium Silicate-based Root Canal Sealers, as well as the exploration of appropriate root canal irrigation strategies.

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Application progress of convolution neural network in endodontics
Xinyue Chen,Xiaoyu Pan,Yan Yang,Yuanyuan Jia,Liang Chen
Int J Stomatol. 2024, 51 (4):  483-488.  DOI: 10.7518/gjkq.2024063
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In the information age with the rapid development of computer algorithms, the application of deep learning has received extensive attention in various fields. As one of the most typical network structures in deep learning, a convolutional neural network has outstanding learning ability and great adaptability and plays an important role especially in image recognition and processing. Meanwhile, in the development of endodontics, the application of convolutional neural networks has become increasingly common, such as in assisting doctors in the analysis, diagnosis, treatment, and prognosis evaluation of caries and periapical diseases. Such networks have contributed to alleviating the shortage of medical resources and promoting the development of endodontics. This paper mainly summarizes the application of convolutional neural networks in endodontics and looks forward to its future.

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Research progress on diagnosis and management of post-exodontic lingual nerve dysfunction
Lichao Gao,Chang Liu,Yuntong Liu,Yuxue Luo,Yubin Cao,Chengge Hua
Int J Stomatol. 2024, 51 (4):  489-497.  DOI: 10.7518/gjkq.2024072
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Lingual nerve dysfunction (LND) belongs to the complications resulting from tooth extraction surgery. This condition is mainly characterized by abnormal sensations, such as numbness and tingling of the ipsilateral lingual nerve innervation area, with or without decreased/loss of taste. The symptoms of LND can be evoked or improved through frequent movements of the tongue and excessive local stimulation. LND poses negative effects, which are usually intolerable, on the quality of life and psychology of patients. Such condition prompts patients to seek medical assistance to alle-viate or eliminate their discomfort. LND is caused by complex conditions and involves diverse clinical manifestations. Despite the progress of nerve reconstruction techniques, the mechanism underlying the functional recovery of lingual nerve remains incompletely understood, and the treatment effect is still unpredictable. Therefore, the risk prediction, syndrome assessment, treatment, and prognosis of LND still present a challenge to dentists and clinicians. This article reviews the research progress on LND, including its etiology, manifestations, clinical evaluation, treatment methods (including nonsurgical and surgical treatment methods), and prognosis.

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Research progress on early fixed orthodontic treatment of traumatic teeth
Jiaojiao Li,Jun Liu
Int J Stomatol. 2024, 51 (4):  498-504.  DOI: 10.7518/gjkq.2024065
Abstract ( 53 )   HTML ( 5 )   PDF(pc) (784KB) ( 41 )   Save

The orthodontic movement of traumatic teeth is a common problem in orthodontic treatment. Although the orthodontic treatment of traumatic teeth has been studied, no consensus has been reached regarding the best method and timing of treatment for different types and severity of dental trauma. Many researchers agreed that starting orthodontic treatment early could increase the success rate of treatment and avoid tooth ankylosis. However, some studies showed that the orthodontic treatment of traumatic teeth might increase the risk of root resorption, pulp necrosis, and canal obliteration. Therefore, recording the history of dental trauma and comprehensively evaluating the risk for patients with dental trauma are crucial before orthodontic treatment. In this work, studies on the early orthodontic treatment of traumatic teeth were reviewed to provide a reference for related clinical practice.

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Role of the small integrin-binding ligand N-linked glycoprotein family in regulating hard tissue development
Siwei Xu,Hui Li,Lei Liu
Int J Stomatol. 2024, 51 (4):  505-512.  DOI: 10.7518/gjkq.2024057
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The development of hard tissue is a crucial aspect of organismic development. The small integrin-binding ligand N-linked glycoprotein family plays a pivotal role in regulating hard tissue development, including promoting the differentiation of stem cells into odontoblasts or osteoblasts and regulating the gene expression of these cells. Research showed that mutations in the genes encoding this protein family can lead to abnormal mineralization of hard tissue, resul-ting in diseases such as hypophosphatemic rickets and dentinogenesis imperfecta. In recent years, scholars have conducted in-depth research on this protein family involved in hard tissue development. These studies have revealed the main mole-cular regulatory mechanism of the protein family and deepened our understanding of its role and mechanism. This review summarizes the role and the associated molecular regulatory mechanisms of the small integrin-binding ligand N-linked glycoprotein family in regulating hard tissue development.

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