上海口腔医学最新文献

Purpose: To retrospectively evaluate the clinical outcomes of implant-supported prosthesis in alveolar cleft patients.

Methods: A total of 14 patients with alveolar cleft underwent implant restoration in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2015 to January 2023 were collected. Among them, 9 were male and 5 were female. The age ranged from 18 to 52 years, with a mean of (26.1±10.6) years. The sequence treatment history of patients with cleft lip and palate and the effect of implant repair were retrospectively analyzed.

Results: Bone grafting in the fissured area failed repeatedly in 1 patient and no implant was implanted. A total of 21 implants were implanted in the remaining 13 patients with alveolar cleft, all of which achieved good osseointegration. In 10 cases, one implant was implanted in each fissure area for single crown or single end bridge repair. In 3 cases, 11 implants were implanted in the non-fissure area for fixed bridge repair. Seven patients with single implant were followed up for 6 to 96 months, with an average of (39.4±29.2) months. During their visits, patients underwent various examinations, including pink aesthetic score (PES) averaging 10.16±0.98, white aesthetic score(WES) averaging 8.50±1.23, and probing depth(PD) with a mean of (2.68±0.61) mm. Additionally, gingival index(GI) was recorded with a mean of 1.33±1.10, and marginal bone loss(MBL) was measured with a mean of (0.17±0.35) mm. The width of the mid-labial keratinized mucosa was observed to be (5.14±2.10) mm.

Conclusions: Implant-supported prosthesis in the alveolar cleft area after well-established multidisciplinary sequential treatments have predictable middle-term success rate, satisfactory aesthetic outcomes and stable peri-implant soft and hard tissue conditions.

Purpose: To investigate the predictive value of microRNA-146a-5p (miR-146a-5p), phosphatidylinositol 3 kinase (PI3K) and protein kinase B (Akt) in gingival crevicular fluid for the severity of chronic periodontitis (CP).

Methods: A total of 121 CP patients admitted to Qinhuangdao Hospital of Peking University Third Hospital from March 2021 to March 2024 were selected. According to the severity of the disease, the patients were divided into mild-to-moderate group(n=85) and severe group(n=36). The levels of miR-146a-5p, PI3K and Akt in gingival crevicular fluid were detected, and probing depth(PD), clinical attachment loss(CAL), sulcus bleeding index(SBI) were collected to analyze the factors affecting the severity of CP. Area under the curve (AUC) of receiver operating characteristic (ROC) was used to analyze the predictive value of miR-146a-5p, PI3K and Akt in CP severity.

Results: The miR-146a-5p, PI3K, Akt, probing depth(PD), the level of clinical attachment loss (CAL), the ratio of combined diabetes and the smoking history in the severe group were significantly higher than those in the mild-moderate group(P＜0.05). Logistic regression analysis showed that diabetes mellitus(OR=3.252, 95%CI: 1.312-8.059), miR-146a-5p level(OR=5.273, 95%CI: 2.469-11.258), PI3K level (OR=4.877, 95%CI: 1.812-13.123) and Akt level (OR=4.421, 95%CI: 1.669-11.710) were independent risk factors affecting the severity of the disease(P＜0.05). ROC results showed that the AUC of miR-146a-5p, PI3K, Akt and their combined prediction of CP severity were 0.801, 0.789, 0.772 and 0.898, respectively(P＜0.05).

Conclusions: The levels of miR-146a-5p, PI3K and Akt in gingival crevicular fluid are independent risk factors for CP severity, and combined detection of the three parameters can better predict the severity of patients' disease.

Purpose: To study the stress effect and distribution pattern of the first and second primary molars on temporomandibular joint in the restoration of upper and lower teeth with stainless steel precrown using three-dimensional finite element method, in order to provide theoretical basis for clinical diagnosis and treatment.

Methods: CBCT data from one male and one female aged 3, 6, and 8 years old were collected, and the first and second maxillary molar teeth, upper and lower mandible, dentition and temporomandibular joint(TMJ) data were obtained respectively. Three-dimensional finite element method was used to create the finite element models of the first and second maxillary molar teeth, upper and lower mandible, dentition and TMJ, respectively. The stress distribution of the TMJ with the stainless steel prefabricated crown raised at different heights was analyzed by applying the load force.

Result: After stainless steel crown repair, different loads were applied to the TMJ, and the maximum stress values generated by the condyle were analyzed and compared. The stress difference analysis results of the condyle in children aged 3, 6, and 8 under different genders, ages, and load angles were statistically significant(P＜0.01), while the stress difference analysis results of different groups were not statistically significant(P＞0.05).

Conclusions: After restoring primary molars with stainless steel preformed crowns, applying three angle loads results in a more uniform distribution of stress in the TMJ at normal occlusal height. Therefore, using stainless steel crowns to restore normal occlusal height in clinical restorative treatment is beneficial for reducing stress concentration in TMJ and improving the efficacy and long-term prognosis of primary molars restoration.

Purpose: To investigate the effect and underlying mechanism of astaxanthin electrospun patches in treating oral ulcers in rats.

Methods: An oral ulcer model of rats was established by mechanical trauma, then the rats were randomly divided into astaxanthin electrospun patch group, chitosan patch group, metronidazole patch group and blank control group. The ulcer healing time and the area healing rate of each group were observed. The pathological changes of ulcer tissues in each group were observed and scored by H-E staining 2, 4 and 6 days after drug administration. Meanwhile, the toxic effects of the drugs on the rat organs were detected. The changes in the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in ulcer tissues were detected by WST-1 and TBA methods. Tumor necrosis factor-α (TNF-α) and Interleukin 6 (IL-6) were analyzed through immunohistochemistry experiments.

Results: Compared with the other groups, the astaxanthin electrospun patch could significantly accelerate the reduction of the ulcer area, promote its pathological healing, reduce the expression levels of TNF-α and IL-6, and significantly decrease the content of MDA in the ulcer tissue while increasing the activity of SOD. Six days after administration, there were significant differences in the levels of SOD and MDA compared with the blank control group and the metronidazole patch group(P＜0.05), while there was no significant difference compared with the chitosan patch group(P＞0.05).

Conclusions: The astaxanthin electrospun patches have better performance in promoting ulcer healing, which may be related to their strong antioxidant and anti-inflammatory properties. It is expected to provide a natural marine preparation with better efficacy for the treatment of oral ulcers.

Purpose: To investigate the effects of oral occlusion exercises on occlusal performance of oral cancer patients who underwent segmental mandibular resection without simultaneous reconstruction.

Methods: From October 2022 to May 2023, a total of 63 oral cancer patients who underwent segmental mandibular resection without reconstruction at the Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were selected. They were randomly divided into control group (30 patients) and experimental group (33 patients). The control group received conventional care, while the experimental group underwent oral occlusion exercises except conventional care. After three months, the maximum total occlusal force(TOF), asymmetry index of occlusal force(AOF), center of occlusal force(COF), and mastication efficiency of both groups were compared. Statistical analysis was conducted using SPSS 26.0 software package.

Results: Compared with the control group, TOF in the experimental group was increased, AOF and COF were decreased, and the differences were statistically significant(P＜0.01). The masticatory efficiency of the experimental group was significantly better than that of the control group(P＜0.01).

Conclusions: Oral occlusal exercises can improve occlusal performance in patients with mandibular resection without reconstruction, but larger sample size and rigorous design are needed to further verify its clinical effect and mechanism.

Purpose: Comparative analysis of MORSE, formic acid and Plank-Rychlo decalcification solution for the treatment of combined tooth-mandibular-periodontal tissues to explore their application value.

Methods: Specimens including normal teeth, jaws and periodontal tissues discarded from Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were collected and randomly divided into 3 groups to analyse the differences in decalcification time, staining effect and nucleic acid integrity of 3 different decalcification solutions. SPSS 23.0 software package was used for statistical analysis.

Results: The mean decalcification time was 4.5, 3.5 and 3.6 days in the MORSE, formic acid and Plank-Rychlo group, respectively. H-E staining scores were in descending order in the MORSE, formic acid and Plank-Rychlo group. Immunohistochemical staining showed that AE1/AE3, p63 and Ki67 scores in MORSE group were better than those in the formic acid group and the Plank-Rychlo group, and Vimentin staining indices showed no significant difference between the 3 groups. In the fluorescence in situ hybridisation results, normal fluorescence signals were detected in 15 cases in MORSE group, 1 case in formic acid group and 4 cases in Plank-Rychlo group. The mean DNA concentration was 1.987, 1.963 and 1.115 ng/μL in MORSE, formic acid and Plank-Rychlo group, respectively; and the mean RNA concentration was 13.03, 11.08 and 1.66 ng/μL, respectively. There was no significant difference in DNA concentration and RNA concentration between MORSE and formic acid group(P＞0.05), and both DNA and RNA concentrations were higher in the 2 groups than those in Plank-Rychlo group(P＜0.001).

Conclusions: MORSE decalcification solution has comprehensive advantages in the treatment of combined tooth-mandibular-periodontal tissues and is of value in the clinical, teaching and research aspects of pathology.

Purpose: To analyze the etiology and related influencing factors of burning mouth syndrome (BMS).

Methods: A total of 109 patients with BMS who visited the Department of Stomatology of Shengjing Hospital of China Medical University from November 2022 to October 2023 were selected, and 84 healthy volunteers who participated in the survey during the same period were selected as the control group. The basic information of the research subjects was recorded, and oral health status, periodontal health status and psychological status of the research subjects were evaluated. Student's t test, Chi-square test and binary logistic regression analysis were used to analyze the factors affecting the incidence of BMS with SPSS 27.0 software package.

Results: Mono-factor analysis showed that residual crown, residual root, periodontitis, anxiety status, depressive status, sleep disorders, menopause, diabetes, digestive system diseases and lacunar infarction were related to the incidence of BMS (P＜0.05). The variables with P＜0.1 in mono-factor analysis were selected for multivariate logistic regression analysis. The results showed that periodontitis, COVID-19, anxiety status, depressive status, sleep disorders, lacunar infarction, and digestive system diseases were factors affecting the incidence of BMS (P＜0.05 and OR＞1).

Conclusions: The diagnosis and treatment of BMS require multidisciplinary cooperation of specialists such as psychiatry, neurology and gastroenterology, and active treatment of systemic or related diseases. In addition to strengthening oral hygiene and periodontal health management for patients, clinical practitioners should also pay attention to the aggravation of BMS patients' pain intensity, sleep quality and anxiety caused by COVID-19 pandemic, and provide timely psychological counseling to better control the development of BMS.

Purpose: To find the clinical characteristics of permanent teeth trauma among young and adult people in Shanghai Ninth People's Hospital, and provide reference for the treatment and prevention of dental trauma among them.

Methods: The data of 956 patients who visited the Dental Trauma Clinic of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from September 2021 to March 2023 were collected and analyzed according to age, gender, occupation, causes of trauma, types of tooth injuries, number and position of affected teeth, time to seek treatment after injury, and whether the patients had been exposed to popular science knowledge related to tooth trauma.

Results: The male to female ratio of dental trauma patients was 0.93∶1. The tooth position with the highest incidence of dental trauma was the maxillary central incisor, followed by the maxillary lateral incisor. Subluxation and uncomplicated crown fractures were the subcategories with the highest incidence of dental trauma. For the post-traumatic treatment time, 55.54% of patients sought medical consultation within 1-4 hours. Survey of the occupation of patients with dental trauma found that high-risk exposure accounted for only 7%. Among them, the highest risk occupation were builders and men for takeaway. Falls and traffic accidents were the main causes of dental trauma. Only 8% of the patients received scientific knowledge related to dental trauma.

Conclusions: Tooth injuries are more common in the upper incisors, and the types of injuries are more common in crown fractures and subluxations. The main causes are falls and traffic accidents. Dentists should strengthen the popularization of knowledge about dental trauma, and the public should pay attention to strengthening the rational use of mobile phones, raising road safety awareness, and learning emergency treatment methods for dental trauma.

Purpose: To evaluate the effect of sliding vermilion flap in angulus oris defect after buccal mucosal cancer ablation.

Methods: A total of 33 patients with buccal mucosal cancer who underwent buccal mucosal cancer radical surgery and resection of angulus oris, and reconstructed with free anterolateral thigh flap transfer and sliding vermilion flap were collected from January 2015 to April 2021 in Department of Oral and Maxillofacial Surgery at Second Xiangya Hospital. Thirty-three patients with buccal mucosal cancer admitted to Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University from January 2015 to April 2021 were selected. All patients underwent combined buccal-mandibulectomy and neck radical operation and resection of oral angle, and underwent anterolateral femoral free flap and lip red elastic flap reconstruction. The angulus oris outcome, aesthetics outcome, masticatory efficacy, swallowing and speech function were assessed by FACT-HN (The Functional Assessment of Cancer Therapy-Head and Neck). The mouth opening was measured and recorded. SPSS 19.0 software package was used for statistical analysis of the data.

Results: The success rate of free flap transplantation was 100% in 33 patients. Although the aesthetics outcome was decreased at postoperative 1 year compared with that of preoperative duration (P＜0.001), there was no significant difference of angulus oris outcome at postoperative 1 year compared with that of preoperative duration (P＞0.05). Moreover, the masticatory function was significantly improved at postoperative 1 year compared with that of preoperative duration(P=0.004). However, there was no significant difference of speech and swallowing function at postoperative 1 year compared with that of preoperative duration (P＞0.05). The mouth opening was significantly improved at postoperative 1 year compared with that of preoperative duration(P＜0.05), and the satisfaction of mouth opening in these patients was 75.7%.

Conclusions: The use of sliding vermilion flap can ideally repair the angulus oris, and offer a novel method to reconstruct defect of angulus oris.

Purpose: To compare the effect of glass fiber post core porcelain crown and cobalt alloy post core porcelain crown in repairing residual root and crown of the anterior teeth.

Methods: The data of 121 patients with residual root and crown of anterior teeth admitted to the hospital from January 2020 to December 2023 were reviewed, of which 61 patients were treated with glass fiber post-core porcelain crown restoration (experimental group) and 60 patients with cogger alloy post core all porcelain crown repair (control group). The repair outcomes of the two groups were recorded after 12 months of follow-up. The final results, aesthetic effect, periodontal health index, gingival crevicular fluid inflammatory factors and complications were compared between the two groups. SPSS 18.0 software package was used for statistical analysis of the data.

Results: The success rate of the experimental group was significantly higher than that of the control group (P＜0.05). There was no significant difference in pink esthetic scores (PES) and white aesthetic scores (WES) between the two groups before and after treatment (P＜0.05). The sulcus bleeding index (SBI), gingival index (GI) and plaque index (PLI) after treatment were significantly lower in both groups than before treatment (P＜0.05), and the experimental group after treatment was more lower(P＜0.05). TNF-α, IL-6 and IL-8 levels after treatment were significantly lower in both groups than before treatment (P＜0.05), and TNF-α and IL-6 levels in the experimental group after treatment were more lower (P＜0.05). There was no significant difference in the total complication rate between the two groups (P＞0.05).

Conclusions: Compared to cobalt alloy post-core all-porcelain crown, glass fiber post-core all-porcelain crown can enhance the repair effect, improve periodontal health, inhibit the damage of gingival crevicular fluid inflammation.