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Table of Content

    01 July 2021, Volume 48 Issue 4 Previous Issue    Next Issue
    Expert Forum
    Novel concepts of dental local anesthesia
    Zhao Jihong
    Int J Stomatol. 2021, 48 (4):  373-379.  DOI: 10.7518/gjkq.2021080
    Abstract ( 3574 )   HTML ( 746 )   PDF(pc) (2070KB) ( 4864 )   Save

    This article introduces some new concepts and techniques of local anesthesia for dental treatment. The signi-ficant measures that ensure local anesthesia’s safety are to evaluate the dental patients’ physical and mental state before local anesthesia, rationally use drugs depending on the results of physical state evaluation, and conduct necessary psychological counseling sedation for nervous and fearful patients. Articaine is highly prevalent in clinical practices because of its relative safety, good anesthetic efficacy, and diversity of applicable methods. The new painless syringes will make patients comfortable with local anesthesia and improve the safety of local anesthesia. The application of proper local anesthetics and painless needles will bring about several changes in local anesthesia methods and techniques. Local infiltration anesthesia has become the first choice of local anesthesia for dental treatment. Periodontal membrane anesthesia has become routine anesthesia, and customized and distinctive nerve block anesthesia has emerged. The safety, comfort, and efficacy of local anesthesia depend on the standardized operation. Under this circumstance, an imperative formulation of “Ope-rational Standard of Oral Local Anesthesia” has been established in the Chinese Stomatological Association.

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    Periodontitis
    Research progress on the relationship between hypothyroidism and periodontitis
    Zhu Xuanzhi,Zhao Lei
    Int J Stomatol. 2021, 48 (4):  380-384.  DOI: 10.7518/gjkq.2021081
    Abstract ( 1125 )   HTML ( 26 )   PDF(pc) (1292KB) ( 317 )   Save

    The thyroid gland regulates various physiological activities by secreting thyroid hormones, and its abnormal function can lead to bone metabolism disorders and osteoporosis. Periodontitis is a chronic inflammatory disease caused by plaque biofilm, and alveolar bone resorption is one of its primary features. Clinical trials and animal experiments indicated that hypothyroidism is positively related to periodontal disease. Hypothyroidism may affect bone metabolism and the expression of immune factors by regulating the activation of downstream hormone receptors, thereby inhibiting alveolar bone osteogenesis and promoting bone resorption. In addition, low-turnover osteoporosis caused by hypothyroidism may be a systemic condition that aggravates the progression of periodontitis. This article reviews the relevance and possible mechanisms of the above two diseases.

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    Research progress on the relationship among oxidative stress, mitochondrial quality control, and periodontitis
    Ding Xu,Li Xin,Li Yan,Xia Boyuan,Yu Weixian
    Int J Stomatol. 2021, 48 (4):  385-390.  DOI: 10.7518/gjkq.2021079
    Abstract ( 1029 )   HTML ( 27 )   PDF(pc) (1293KB) ( 467 )   Save

    Periodontitis is a chronic inflammation of the periodontal supporting tissue caused by plaque microorga-nisms. In recent years, scholars have paid close attention to the relationship between mitochondrial quality control and periodontitis. Mitochondrial quality control includes mitochondrial biogenesis, kinetics, and autophagy. Any part of the disorder will lead to mitochondrial dysfunction and then induce the occurrence of related diseases. Some scholars have pointed out that oxidative stress can lead to an imbalance in mitochondrial quality control, which plays a key role in the development of periodontitis. This article reviews the research progress of mitochondrial dysfunction caused by oxidative stress, peroxisome-proliferator-activated receptor-gamma co-activator 1α, nuclear respiratory factor 1/2, mitofusin 1/2, dynamin related protein 1, PTEN-induced putative kinase 1 and other proteins in periodontitis. It aims to provide new ideas for the prevention and treatment of periodontitis.

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    Research progress on periodontal functional gradient membrane for guided tissue/bone regeneration
    Zhao Wenjun,Chen Yu
    Int J Stomatol. 2021, 48 (4):  391-397.  DOI: 10.7518/gjkq.2021072
    Abstract ( 714 )   HTML ( 26 )   PDF(pc) (1558KB) ( 633 )   Save

    The application of biological barrier membrane (BBM) is the key role in guided tissue/bone regeneration (GTR/GBR) technology. Its main function is to isolate the periodontal defect area from gingival tissue, and prevent the gingival epithelial tissue from growing rapidly into the defect area, so as to create a relatively closed and profitable environment for periodontal tissue regeneration. The ideal BBM should have enough mechanical strength, promoting osteogenesis and anti-inflammatory properties. However, the effect of the current commercially GTR/GBR membranes cannot meet the above ideal requirements, and have different degrees of defects. Therefore, scholars have widely carried out the development and research on the new generation of bioabsorbable GBR/GTR membranes. Of the deeply and extensively researched BBM, FGM has great potential to possess the properties of ideal BBM. It has a broad prospect to enhance the clinical effect of GBR/GTR. In this paper, the research progress of functional gradient GBR/GTR membrane is reviewed, in order to provide reference for its further research and development.

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    Radiologics
    Research progress of reference coordinate system for three-dimensional cephalometric based on cone beam computed tomography
    Shi Danni,Yang Xin,Wu Jianyong
    Int J Stomatol. 2021, 48 (4):  398-404.  DOI: 10.7518/gjkq.2021068
    Abstract ( 583 )   HTML ( 21 )   PDF(pc) (1379KB) ( 529 )   Save

    Compared with two-dimensional (2D) cephalometry, three-dimensional (3D) cephalometry provides more accurate and complete information, but a complete standard of a 3D cephalometric analysis system has not been formula-ted yet. In this article, to establish a perfect 3D cephalometric analysis system, literature concerning the reference coordinate system for 3D cephalometric measurement on the basis of cone-beam computed tomography was reviewed. The establishment, characteristics and application of the reference coordinate system were explored according to the whole cra-nial-face reference coordinate system and the local reference coordinate system for different facial units. Thus, a theoretical basis for the standardisation and unification of a 3D reference coordinate system was provided.

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    Research progress on the use of radiography to predict maxillary canine impaction
    Shao Bingting,Cao Dan,Yan Bin
    Int J Stomatol. 2021, 48 (4):  405-410.  DOI: 10.7518/gjkq.2021073
    Abstract ( 1515 )   HTML ( 202 )   PDF(pc) (9872KB) ( 1364 )   Save

    Maxillary canine impaction is a common dental problem. Predicting the potential of maxillary canines to become impacted at an early stage often reduces the severity of impaction and even allows the canines to erupt normally. Maxillary canine impaction can be predicted early by radiography. Radiographic tools include not only traditional two-dimensional radiographs, such as panoramic films, but also three-dimensional images obtained via cone-beam computed tomography, which was developed only recently. In this review, we summarized current progress in the early prediction of maxillary impacted canines via radiological examinations to guide the clinical prediction of maxillary canine impaction and the assessment of optimal treatment timing.

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    Original Articles
    Application of autologous fat transplantation combined with lip tissue flap in repairing lip atrophy deformity defect
    Yang Qi,Guo Lijuan
    Int J Stomatol. 2021, 48 (4):  411-416.  DOI: 10.7518/gjkq.2021074
    Abstract ( 729 )   HTML ( 6 )   PDF(pc) (25554KB) ( 74 )   Save

    Objective This study aimed to explore the repair effect of autologous fat transplantation combined with mucosal tissue flap on different degrees of lip atrophy. Methods Fourteen patients with lip atrophy were selected as the research objects. On the basis of the degree of atrophy, they were divided into three types: mild, moderate, and severe atrophy. Different surgical methods were used to restore the lip shape. Fat transplantation was conducted for patients with mild atrophy. Patients with moderate atrophy were treated with fat transplantation combined with lip mucosal extrapolation. For patients with severe lip atrophy, fat transplantation combined with lip mucosal extrapolation was used in the first stage, and the adjacent mucosal tissue flap transplantation was used in the second stage. Results The appearance and function of the lip of 14 patients recovered well after the operation. Three of them received fat grafting again due to the higher requirements of the patients. All of them were satisfied with the effect after the operation. Conclusion Depending on the different degrees of lip atrophy, autologous fat transplantation or combined with mucosal tissue flap to repair lip atrophy deformity could not only achieve a better postoperative effect but also low trauma, low influence on adjacent tissues, good surgical effect, and high patient satisfaction.

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    Experimental study on behavior changes of condylar chondrocytes in early stage of temporomandibular joint degeneration
    Fang Lingli,Tan Xi,Ye Yusi,Huang Lan,He Yao
    Int J Stomatol. 2021, 48 (4):  417-425.  DOI: 10.7518/gjkq.2021070
    Abstract ( 673 )   HTML ( 11 )   PDF(pc) (36331KB) ( 82 )   Save

    Objective To explore the biological behavioural changes in the proliferation, apoptosis and autophagy of condylar chondrocytes and changes in the related signal pathway in the early stage of cartilage degeneration under stress.Methods The forced mouth opening model was used, and samples were taken after 0 d (control group) and 10 d (experiment group) of inducing overloading force. After the laser confocal scanning of the condylar cartilage, 5-ethynyl-2’-deoxyuridine (EdU) staining was performed to detect cell proliferation. The expression of proliferation, apoptosis, autophagy and key proteins of the phosphatidylinositol 3-kinase/ protein kinase B (PI3K/Akt) pathway was detected by haematoxylin/eosin, toluidine blue and immunohistochemical stainings with paraffin sections of the intact temporomandibular joint. Results The thickness of the condylar cartilage increased, but the cell density and cartilage matrix secretion decreased in the experimental group. In addition, the number of proliferation and apoptosis positive cells and the expression of autophagy markers increased. At the same time, the PI3K/Akt pathway was also active. Conclusion The prolife-ration, apoptosis and autophagy activity of chondrocytes were activated to some extent in the early stage of cartilage degeneration induced by stress, with the activation of the PI3K/Akt pathway.

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    Alveolar bone morphology of anterior teeth areas in patients with high-angle skeletal Class Ⅱ open bite
    Wu Chunlan,Tang Hua,Chen Jun
    Int J Stomatol. 2021, 48 (4):  426-432.  DOI: 10.7518/gjkq.2021063
    Abstract ( 886 )   HTML ( 26 )   PDF(pc) (5936KB) ( 320 )   Save

    Objective This study aimed to explore the differences in alveolar bone morphology of anterior teeth areas among patients with high-angle skeletal ClassⅡopen bite patients and high-angle skeletal ClassⅡnormal overbite by u-sing cone-beam computed tomography. Methods Fifty-eight untreated patients (29 anterior open bite patients and 29 normal overbite patients) with high-angle skeletal ClassⅡmalocclusion were selected. The vertical bone level and the width of the alveolar bone were measured in the midsagittal plane of the teeth by Dolphin software. The differences in alveolar bone morphology were compared between the two groups, and the correlation between the alveolar bone morphology and overbite was explored. Results Differences in alveolar bone morphology between patients with open bite and those with normal overbite were identified, and such differences primarily affected the lingual/palatal sides of the vertical bone level and the width of the alveolar bone. The vertical bone level on the lingual/palatal sides of most incisors in the open bite group was statistically lower than those in the control group, and the width of the alveolar bone on the lingual/palatal sides and the apical level was statistically thin. In the correlation analysis, a different degree of positive correlation was observed between the overbite and alveolar bone thickness at different sites of different teeth, whereas overbite was negatively related to the vertical bone level of maxillary incisors and mandibular central incisors. Conclusion The vertical bone level and thickness of the alveolar bone on the lingual/palatal sides were significantly low and thin in the high-angle skeletal ClassⅡopen bite patients, and caution should be taken in the treatment of these patients, particularly the torque of incisors and the backward movement of anterior teeth, to avoid root resorption, alveolar bone dehiscence, and fenestration in the upper and lower incisors.

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    Reviews
    The minimally invasive concept and research progress on access cavity design
    Peng Weiqi,Gao Yuan,Xu Xin
    Int J Stomatol. 2021, 48 (4):  433-438.  DOI: 10.7518/gjkq.2021076
    Abstract ( 1902 )   HTML ( 301 )   PDF(pc) (1339KB) ( 1859 )   Save

    Pulp and periapical diseases are common clinical oral diseases, and root canal therapy is the most effective option for these diseases. Access cavity preparation is the first step of root canal therapy. A well-designed access cavity is crucial to the success of root canal therapy. In recent years, with the concept of minimally invasive endodontics proposed, a minimally invasive improvement of traditional endodontic cavities is recommended, which emphasizes the purposeful preservation of part of the chamber roof and peri-cervical dentin to preserve the healthy tooth tissue as much as possible. Although minimal access cavity designs can reduce the stress concentration in the cervical regions, evidence on its improvement of the fracture resistance of the endodontically treated teeth is lacking. Moreover, minimally invasive access may complicate treatment and increase the difficulty of root canal therapy, which may affect the effect of root canal therapy and increase the prevalence of iatrogenic complications during endodontic procedures. This article reviews the minimally invasive concept of access cavity design and its research progress in the effect of root canal therapy and fracture resistance of teeth.

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    Research status on congenital syphilitic teeth
    Meng Shuhuai,Luo Feng,Pei Xibo,Wan Qianbing
    Int J Stomatol. 2021, 48 (4):  439-443.  DOI: 10.7518/gjkq.2021078
    Abstract ( 1802 )   HTML ( 26 )   PDF(pc) (4331KB) ( 301 )   Save

    Congenital syphilitic teeth (CST) refers to the invasion of tooth germs by Treponema pallidum from 1 month before birth to 1 year after birth. CST invades the enamel organ and causes enamel development disorder, resulting in the formation of enamel hypoplasia, mainly in permanent incisors, and abnormal enamel structure of the first permanent molar. Given its characteristic clinical manifestations, enamel hypoplasia can easily be confused with other diseases in clinical practice, delaying the oral and systemic treatment of patients. This article systematically introduces the clinical manifestations, pathological changes, and differential diagnosis of CST to guide the early diagnosis and treatment of congenital syphilis and CST.

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    Treatment of patients with negative cervical lymph nodes in maxillary squamous cell carcinoma
    Li Shan,Chen Linlin
    Int J Stomatol. 2021, 48 (4):  444-449.  DOI: 10.7518/gjkq.2021077
    Abstract ( 788 )   HTML ( 12 )   PDF(pc) (1287KB) ( 131 )   Save

    Maxillary squamous cell carcinoma (MSCC) with primary maxillary gingiva and hard palate is a relatively rare head and neck tumor. Considering the low incidence and the difficulty of case collection, only few studies focused on the clinical cervical lymph node-negative patients of MSCC. The related clinical treatment strategies are controversial, and a unified treatment guidance strategy remains lacking worldwide. The total rate of cervical lymph node metastasis in patients with MSCC is 21%-46.1%. The main influencing factors are tumor stage, degree of differentiation, location, neurovascular invasion, and bone infiltration. The 5-year survival rate of MSCC is 32%-70.8%. The main influencing factors are cervical lymph node metastasis, location, selective cervical lymph node dissection, and so on. MSCC has the risk of contralateral and bilateral metastases, the neck recurrence rate can reach 33%, and the success rate of salvage surgery is low. Selective neck dissection is recommended for patients with negative cervical lymph nodes in the T3/4 stage. A prospective, large-scale study is necessary to enhance the reliability of the results and provide powerful references for clinical treatment.

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    Unique biological behavior and treatment of the human papilloma virus 16-related oropharyngeal squamous cell carcinoma
    Wang Yue,Ji Yiming,Wang Xiaoyi,Zhang Lingnan,Sun Legang
    Int J Stomatol. 2021, 48 (4):  450-458.  DOI: 10.7518/gjkq.2021065
    Abstract ( 823 )   HTML ( 9 )   PDF(pc) (2347KB) ( 151 )   Save

    Human papilloma virus (HPV) infection is the third-largest independent etiological factor causing orophar-yngeal squamous cell carcinoma (OPSCC) apart from smoking and drinking. High-risk HPV16 plays an important role in the occurrence and development of OPSCC. Considering its unique clinicopathologic features, the prognosis and treatment methods for HPV16-related OPSCC are significantly different from those for traditional OPSCC. Based on the original treatment methods, transoral endoscopic surgery, radiochemotherapy, immunotherapy, and vaccine treatment are extended. This paper focuses on the unique clinicopathologic features and treatment methods of HPV16-related OPSCC.

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    Diagnosis and treatment of salivary duct carcinoma
    Ma Pingchuan,Li Chunjie,Li Longjiang
    Int J Stomatol. 2021, 48 (4):  459-467.  DOI: 10.7518/gjkq.2021061
    Abstract ( 1637 )   HTML ( 29 )   PDF(pc) (1354KB) ( 327 )   Save

    Salivary duct carcinoma (SDC) is a rare and aggressive epithelial malignant tumor that occurs in human salivary glands, of which the parotid gland accounts for the largest proportion. The imaging examination of SDC includes ultrasound, CT, and magnetic resonance imaging. Positron emission tomography-computed tomography can also be used to determine tumor location and distant metastases. In addition, fine-needle aspiration cytology can be used in diagnosis. For the treatment of SDC, the most common method is surgery with postoperative adjuvant radiotherapy and chemotherapy. Moreover, most patients undergo neck dissection. However, the effects of postoperative adjuvant chemoradiotherapy remain unclear. At present, targeted therapies for SDC are considered as research hotspots, including androgen deprivation therapy targeting androgen receptor and Trastuzumab-based treatment targeting human epidermal growth factor receptor-2. Meanwhile, SDC has a poor prognosis. However, the determination of the adverse prognostic factors of the disease remains controversial. This article will review the research advances in the diagnosis, treatment, and prognosis of SDC to improve understanding of the diagnosis and treatment of this disease.

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    Assessment and management of maxillary sinus diseases for sinus lift
    Ye Guanchen,Yu Xiaowen,Zhao Feiya,Yu Mengfei,Wang Baixiang,Wang Huiming
    Int J Stomatol. 2021, 48 (4):  468-474.  DOI: 10.7518/gjkq.2021060
    Abstract ( 1434 )   HTML ( 230 )   PDF(pc) (1296KB) ( 1401 )   Save

    Sinus floor elevation is often performed to increase the vertical bone height of the maxillary posterior area. However, given the maxillary sinus diseases present in some patients, the application of sinus floor lift is restricted. The presence of these diseases may increase the difficulty of surgery and the risk of postoperative complications. Therefore, medical history inquiry and imaging examination should be conducted before maxillary sinus elevation. Preoperative screening should be performed by nasal endoscopy to detect potential maxillary sinus lesions. Given the side effect that sinus floor elevation may have on maxillary sinus, this article discusses the assessment of the maxillary sinus diseases prior to sinus elevation and focuses on the treatment method, particularly surgery approach, thereby providing insights for clinical practice.

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    Application of artificial intelligence in oral diagnosis and treatment
    Tian Erkang,Xiang Qianrong,Zhao Xinran,Peng Jiahan,Shu Rui
    Int J Stomatol. 2021, 48 (4):  475-484.  DOI: 10.7518/gjkq.2021046
    Abstract ( 2022 )   HTML ( 62 )   PDF(pc) (1609KB) ( 724 )   Save

    Artificial intelligence is a subject that makes computer simulate some thinking process and intelligent behavior of human, such as learning, reasoning, thinking, planning, etc.. Since its birth, artificial intelligence has developed rapidly and has been widely used in fields including biomedicine, financial trade and so on, while “artificial intelligence + medical treatment” undertakes the important task of promoting medical progress and changing the status quo of medical treatment. As an important part of medicine, stomatology is characterized by complex diseases and precise operation. Traditional diagnosis and treatment methods have some problems that need to be solved urgently. The application of artificial intelligence in stomatology is committed to solving these problems. This paper reviews the application of artificial intelligence in stomatology and gives a prospect.

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    Research progress on new technology for improving adhesion properties of zirconia ceramics
    Li Min,Hua Chengge,Jiang Li
    Int J Stomatol. 2021, 48 (4):  485-490.  DOI: 10.7518/gjkq.2021066
    Abstract ( 1226 )   HTML ( 226 )   PDF(pc) (1250KB) ( 1339 )   Save

    With the wide application of zirconia ceramics, the bonding of zirconia ceramics has always been a research hotspot. In this paper, several technologies to improve the bonding properties of zirconia ceramics studied in recent years are reviewed from three aspects, the surface morphology of zirconia changed by physical treatment, the surface performance of zirconia improved by chemical coating, and saliva and other pollution removed by surface cleaning. On the basis of traditional treatment methods, several popular surface treatment methods are summarized and illustrated from the aspects of technical principle and clinical application, so as to provide a theoretical basis for improving the bonding properties of zirconia ceramics.

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    Application of digital technology in indirect bonding of straight wire brackets
    Niu Ye,Zeng Yunting,Zeng Yuexiang,Zhang Zeyu,Xiao Liwei
    Int J Stomatol. 2021, 48 (4):  491-496.  DOI: 10.7518/gjkq.2021067
    Abstract ( 929 )   HTML ( 98 )   PDF(pc) (1319KB) ( 616 )   Save

    Indirect bonding of brackets is characterised by more accurate positioning and shorter chair time compared with direct bonding. The straight wire technique reduces the archwire bending and emphasises the accuracy of bonding positions of brackets. Thus, indirect bonding is favoured in straight wire technique. However, the laboratory operation of the conventional indirect bonding method is very complex. In recent years, with the advance digital technology, indirect bonding of straight wire brackets has become more accurate, personalised and simplified. This, some remarkable changes have been obtained. This article reviews the application and development of digital technology, such as three-dimensional(3D) dental cast reconstruction and 3D printing, in the indirect bonding of labial straight wire brackets.

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