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  • Yu Haiyang, Shui Yusen, Jiang Qingsong
    West China Journal of Stomatology. 2024, 42(3): 277-285. https://doi.org/10.7518/hxkq.2024.2023460

    Anterior diastema is a common esthetic defect in China. The general treatment for a patient with diastemata, including orthodontics and direct and indirect restorations, is a multidisciplinary clinical procedure covering the orthodontics, operative dentistry, general dentistry, and prosthodontics department. Given the diversity of departments and the complex etiology of this defect, decision-making regarding the closing methods and time selection is undefined and unintegrated, which makes the long-term stability of closure unpredictable. This article proposed an etiology-based decision tree with actual measurement of diastemata width for diastemata closure. The decisional steps include classifying the etiological factors based on patients' medical history and clinical manifestation to evaluate the stability of diastemata. After maintaining the stability of diastemata, contemporary and multidisciplinary treatment plans were selected in accordance with the measured width of diastemata and patients' cosmetic psychology, economics, and available time. These decision trees focus on the challenges of collaboration among dental departments, propose an objective and efficient ways for connections, and promote efficient and effective diastemata closure.

  • Basic Research
    Li Yue, Xu Chunmei, Xie Xudong, Shi Peilei, Wang Jun, Ding Yi
    West China Journal of Stomatology. 2024, 42(3): 286-295. https://doi.org/10.7518/hxkq.2024.2023336

    Objective This study aimed to investigate the temporal and spatial changes in the expression of periostin during periodontal inflammation in mice. Methods A periodontitis model was constructed using silk thread ligation. Mice were randomly divided into five groups including control group, 4-day ligation group, 7-day ligation group, 14-day ligation group, and self-healing group (thread removal for 14 days after 14-day ligation). Micro-CT and histological staining were performed to characterize the dynamic changes in the mouse periodontal tissue in each group. RNAscope and immunohistochemical staining were used to analyze the pattern of changes in periostin at various stages of periodontitis. The cell experiment was divided into three groups: control group, lipopolysaccharide (LPS) stimulation group (treated with LPS for 12 h), and LPS stimulation removal group (treated with LPS for 3 h followed by incubation with medium for 9 h). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of periostin, transforming growth factor-β1 (TGF-β1), and matrix metalloproteinase 2 (MMP2). Results Significant alveolar bone resorption was observed 7 days after ligation. With increasing duration of ligation, the damage to the mouse periodontal tissue was aggravated, which manifested as increased osteoclasts, widening of the periodontal membrane space, and decreased alveolar bone height. Some degree of periodontal tissue repair was observed in the self-healing group. Periostin expression decreased at 4 and 7 days compared with the control group and increased at 14 days compared with 4 and 7 days. A significant recovery was found in the self-healing group. The qRT-PCR results showed that the expression of periostin and TGF-β1 in the LPS stimulation group decreased compared with that in the control group but significantly recovered in the LPS removal group. Conclusion Periostin expression in the PDL of mice showed a downward and upward trend with inflammation progression. The significant recovery of periostin expression after removing inflammatory stimuli may be related to TGF-β1, which is crucial to maintain the integrity of the PDL.

  • Clinical Research
    Zhu Zhanfeng, Yang Tingting, Chen Qinyi, Qiu Weien, Li Yongshan, Lin Yilan, Ban Yu
    West China Journal of Stomatology. 2024, 42(3): 346-352. https://doi.org/10.7518/hxkq.2024.2023458

    Objective This study aims to evaluate the efficacy of concentrated growth factor (CGF) membrane and collagen as barrier materials in sealing the alveolar socket in alveolar ridge preservation (ARP) in the posterior region during a one-year follow-up. Methods A total of 24 patients who underwent ARP in the posterior region were selected for inclusion and randomly assigned to the CGF group (12 cases) and Collagen group (12 cases). The patients in both groups underwent extraction of posterior teeth. The extraction sockets were filled with a bone substitute to the level of the pre-extraction buccal and lingual or palatal alveolar bone plates. The wounds in the CGF group were closed with a fabricated CGF overlaying the upper edge of the bone substitute material, whereas those in the Collagen group were closed with Bio-Oss Collagen. The implants were placed after 6 months. The evaluation was based on implant retention, re-grafting rate, and vertical and horizontal alveolar ridge bone volume changes measured by cone beam computed tomography (CBCT). Data were statistically analyzed using SPSS 28.0 software. Results No patient withdrew throughout the follow-up period. No implant failure and no severe peri-implant or mucosal soft tissue complications were observed. Six months after the operation, the degree of vertical alveolar ridge height resorption in the CGF group was lower than that in the Collagen group (P<0.05). There were no statistically difference between the groups at 1 year after the operation (P>0.05). The amount of bone reduction in horizontal alveolar ridge width showed no difference between the groups at 6 months and 1 year after surgery (P>0.05). Conclusion CGF membrane and Bio-Oss Collagen as barrier materials for posterior ARP inhibited reduction in alveolar ridge bone mass.

  • Shen Jiefei
    West China Journal of Stomatology. 2024, 42(1): 1-11. https://doi.org/10.7518/hxkq.2024.2023317

    In the field of prosthodontics, the use of virtual patients for biomimetic restoration holds great promise for various applications. Virtual patients consist of digitized data that encompasses details on the morphology, structure, and spatial relationships within the maxillofacial and intraoral regions. Nonetheless, there are several challenges associated with acquiring digital data, achieving accurate alignment, and recording and transferring dynamic jaw movements. This paper aims to concentrate on the process of constructing virtual patients, highlight the key and challenging aspects of virtual patient construction, and advocate for the extensive adoption and utilization of virtual patient technology.

  • He Lanxi, Jurat·Omar , Zhou Zihang, Yu Jian, Wang Zhaoling, Chen Hongyu
    West China Journal of Stomatology. 2024, 42(3): 403-408. https://doi.org/10.7518/hxkq.2024.2023362

    Most of the maxillary impacted third molars are located in the maxillary tuberosity, where the vision and operation space are limited. This paper reports a case of surgical extraction of the left maxillary horizontal superhigh impacted third molar, which is located between the roots of the adjacent teeth and is closely related to the maxillary sinus. The digital simulation technology was used to reconstruct a three-dimensional visual image of the patient’s maxilla, related teeth, and other adjacent anatomical structures to assist in finding the optimal surgical method accurately. Root dislocation before the crown not only protects the roots of the adjacent tooth, but also reduces the risk of maxillary sinus lining damage or perforation during operative procedures, improves the efficiency of the operation, and reduces surgical trauma, which conforms to the concept of minimally invasive surgery and provides a new idea and experience for the clinical extraction of such maxillary impacted third molars.

  • West China Journal of Stomatology. 2025, 43(01): 76-83.
    目的 探讨L形技术联合浓缩生长因子应用于上颌前牙水平型骨缺损的临床效果。方法 选择行单颗上颌前牙种植同期植骨的25例患者的25颗种植体为研究对象,据植骨术式的不同,将患者分为试验组(L形技术引导性骨再生术联合浓缩生长因子,11例)、对照组(传统引导性骨再生术联合浓缩生长因子,14例)。对2组患者术后的早期不适、创口愈合、种植体周骨量、种植体周硬组织吸收量、影像灰度值、种植体稳定性等进行对比。结果 2组术后早期不适、创口愈合及术后6个月的种植体稳定性、影像灰度值间的差异均无统计学意义(P>0.05)。术后6个月,试验组的垂直向种植体周骨量大于对照组,差异具有统计学意义(P<0.05)。术后6个月,试验组的水平向种植体周硬组织吸收量大于对照组,差异具有统计学意义(P<0.05)。结论 L形技术联合浓缩生长因子应用于上颌前牙区种植同期垂直向骨增量效果更优,且在种植体稳定性、早期不适及创口愈合方面均可获得良好的临床效果。
  • West China Journal of Stomatology. 2025, 43(01): 133-139.
    种植体周围炎是发生在种植体周围组织中与牙菌斑相关的病理状况,其特征是种植体周围黏膜组织发生炎症性改变,随后支持骨组织逐渐丧失。本文报道1例基于菌斑控制的种植体周围炎引导骨再生治疗病例。患者35牙种植术后4年因“左下后牙肿胀不适2年余”就诊。X线根尖片显示35牙种植体远中骨密度降低,临床诊断为35牙种植体周围炎。35牙种植体经引导骨再生治疗,并进行定期牙周维护,术后3.5、11、18个月和7年复查显示牙槽骨高度及骨密度稳定,牙周探诊深度变浅,但牙龈轻度退缩。本病例7年的随访结果提示,种植体周围炎经过完善的牙周治疗后,临床牙周指标可以获得明显改善,牙槽骨得到良好的修复再生。
  • Clinical Research
    Wang Zi, Xue Ming
    West China Journal of Stomatology. 2024, 42(1): 75-81. https://doi.org/10.7518/hxkq.2023.2023257

    Objective This study aimed to compare the differences among four kinds of mechanical Ni-Ti files including T-Flex, Reciproc Blue (RB), ProTaper Gold (PTG), and ProTaper Universal (PTU) in dentinal microcrack generation after root canal preparation in vitro by using micro-computed tomography (micro-CT) analysis. Methods A total of 32 freshly extracted double-root-canal premolars with an angle not exceeding 10° were selected and established as root canal preparation models in vitro. Then, the specimens were randomly assigned to four experimental groups (n=8) according to the different Ni-Ti systems used for root canal preparation: group T-Flex, group RB, group PTG, and group PTU. The voxel size of the micro-CT was set at 17.18 μm. Pre- and post-operative cross-sectional images of roots (n=56 940) were scanned and analyzed to identify the presence of dentinal microcracks. The results of each group were expressed by the quantity and percentage of sectional images with microcracks. McNemar test was used to determine whether a significant difference existed in the existence of dentinal microcracks before and after instrumentation. The level of significance was set at P<0.05. Results Overall, 11.04% of the images presented dentinal defects (n=6 288). Dentinal microcracks were observed in 9.82%, 10.79%, 12.27%, and 11.25% of the post-instrumentation images from groups T-Flex, RB, PTG, and PTU, respectively. However, all these dentinal microcracks were already present in the corresponding pre-operative images. No new microcrack of premolars were generated after the root canal preparation utilizing the aforementioned systems. Conclusion Denti-nal microcracks already existed in advance in extracted teeth before root canal preparation. Root canal preparation using the T-Flex, RB, PTG, and PTU systems did not induce the formation of new dentinal microcracks on the straight root canals of premolars.

  • Hou Weiwei, Zheng Xuhong, Chen Xiaoling, Cai Weiliang, Wang Chaoyang, Su Zhiwei, Zhao Juan
    West China Journal of Stomatology. 2024, 42(1): 111-120. https://doi.org/10.7518/hxkq.2023.2023130

    Noncarious lesions, a multifactorial condition encompassing tooth attrition, abrasion, and erosion, have a surge in prevalence and required increased attention in clinical practice. These nonbacterial-associated tooth defects can compromise aesthetics, phonetics, and masticatory functions. When providing full-arch fixed occlusal rehabilitation for such cases, the treatment strategy should extend beyond by restoring dentition morphology and aesthetics. This report details a complex case of erosive dental wear addressed through a fully digital, full-arch fixed occlusal rehabilitation. A 4D virtual patient was created using multiple digital data sources, including intraoral scanning, 3D facial scanning, digital facebow registration, and mandibular movement tracing. With a comprehensive understanding of the masticatory system, various types of microinvasive prostheses were customized for each tooth, including labial veneers, buccal-occlusal veneers, occlusal veneers, overlays, inlays, and full crowns, were customized for each tooth. The reported digital workflow offered a predictable diagnostic and treatment strategy, which was facilitated by virtual visualization and comprehensive quality control throughout the process.

  • Hu Xiaoyan, Zhao Chunhui, Wang Lu, Zhang Zheng, Yang Fan, Zhang Hongyan
    West China Journal of Stomatology. 2024, 42(2): 242-248. https://doi.org/10.7518/hxkq.2024.2023308

    Objective This study aimed to observe the outcomes of iRoot BP Plus full pulpotomy in primary molars with partial irreversible pulpitis retrospectively. Methods Collect 102 cases of primary molars with partial irreversible pulpitis undergoing iRoot BP Plus full pulpotomy from January 2019 to August 2023, with a follow-up period of 24-47 months. Based on the presence of irreversible pulpitis symptoms before surgery, the included cases will be divided into asymptomatic group (n=53) and symptomatic group (n=49). Observe the clinical and imaging success rates of both groups. Results Clinical success rates were 96.2% and 97.9% in asymptomatic and symptomatic groups, and radiographic success rates were 96.2% and 93.9% respectively. Conclusion iRoot BP Plus full pulpotomy can be used for the treatment of primary molars with partial irreversible pulpitis under an enhanced pulpotomy protocol.

  • Clinical Research
    Chen Luona, Zhang Xin, Tian Zhengyu, Wang Jian
    West China Journal of Stomatology. 2024, 42(3): 353-358. https://doi.org/10.7518/hxkq.2024.2023372

    Objective This work aimed to evaluate the effect of artificial aging on the translucency and color difference (ΔE) of ultra-translucent zirconia and provide a reference for clinical application. Methods The discs of ultra-translucent zirconia from six brands (Wieland, 3M ESPE, Amann Girrbach, Kuraray Noritake, Upcera, and Besmile) were cut and sintered according to each manufacturer’s product instructions; the experimental groups were named ZNT, LVP, AG, KAT, UPC, and BSM, respectively. IPS e.max Press was used as the control group (PLT). The specimens (n=6) were prepared with a diameter of 14 mm and a thickness of 1 mm. The specimens were subjected to artificial aging treatment according to the following conditions: in an autoclave at 134 ℃ at 0.2 MPa for 4, 8, and 12 h. According to the CIE1976Lab system, the CIE L*, a*, and b* values of the specimens before and after aging were measured by a co-lorimeter. The translucency parameter (TP) and ΔE were calculated. Results The mean TP values of each group before aging inorder were PLT>KAT>AG>ZNT>BSM>UPC>LVP. We found no significant difference in translucency in all experimental groups after aging for 4 and 8 h compared with those before aging. After 12 h of aging, the TP values of the KAT and ZNT groups were not significantly different from those before aging, but the TP values of the AG, BSM, LVP, and UPC groups were significantly lower than those before aging (P<0.05). The TP value of the control group was significantly higher than that of the other experimental groups at different stages (P<0.05). ΔE=3.3 was considered the visible color difference, and ΔE was less than 3.3 in all groups after 4 h of aging. After aging for 8 h, ΔE of the UPC group was slightly higher than 3.3. ΔE of the BSM and UPC groups was greater than 3.3 after 12 h of aging. Conclusion The TP and ΔE of different brands of ultra-translucent zirconia may change after various aging times. The translucency of some zirconia showed a decreasing trend and the color difference showed an increasing trend with the aging time.

  • West China Journal of Stomatology. 2024, 42(04): 512-520.
    目的 联合使用转录组测序(RNA-seq)和生信分析,探究柚皮素(Nar)对脂多糖(LPS)刺激下的人牙周膜干细胞(hPDLSCs)的抗炎作用及机制。方法 采用细胞计数试剂盒(CCK-8)、实时荧光定量逆转录聚合酶链反应(qRT-PCR)、酶联免疫吸附试验(ELISA)检测Nar对LPS刺激下hPDLSCs增殖及炎性因子表达情况,筛选出Nar的最佳抗炎浓度。采用RNA-seq,以|log2FC|≥1且P≤0.05为标准筛选出显著差异基因(DEGs)。采用火山图分析、京都基因与基因组百科全书(KEGG)通路富集分析、String数据库及Cytoscape的MCODE模块筛选核心基因。ELISA、qRT-PCR和蛋白印迹实验(Western blot)检测对核因子κB (NF-κB)信号通路的影响。结果 适宜浓度的Nar可减轻LPS刺激下hPDLSCs的炎症因子表达,促进其增殖,20μmol/L Nar抗炎效果最佳。RNA-seq提示炎症相关信号通路显著富集。Nar通过抑制NF-κB信号通路产生抗炎作用,Nar与NF-κB抑制剂BAY 11-7802效果相似。结论 Nar可以通过抑制NF-κB信号通路发挥抗炎作用。Nar可能是辅助治疗牙周炎的一种潜在的药效成分。
  • Gong Yanji, Liu Yang, Yin Deqiang
    West China Journal of Stomatology. 2024, 42(2): 268-276. https://doi.org/10.7518/hxkq.2024.2023327

    Objective The aim of this study was to demonstrate a novel jaw position adjustment technique derived from digital twins and evaluate the application effect of digital technology-assisted optimization in the process of adjusting jaw position on patients with temporomandibular disorders (TMD). Methods A total of 74 patients with TMD who attended the Department of Temporomandibular Joint, West China Hospital of Stomatology, Si-chuan University, between June 2022 and May 2023 were selected. The patient’s initial computed tomography (CT) and bilateral temporomandibular joint data obtained by magnetic resonance imaging (MRI) were collected. The 148 joints were divided into the normal disc-condyle relationship (N) group, disc displacement with reduction (DDWR) group, and disc displacement without reduction (DDWoR) group. Assisted by digital technology, the patient’s CT data were reconstructed, and a personalized reference plane was established to adjust the jaw position. A three-point bite guiding splint was designed by the adjusted occlusal space and then fabricated by 3D printing technology. It was worn by the patients and then reviewed by MRI. Before and after the adjustment of jaw position, the amount and direction of condyle and disc displacement and the angle between condyle and disc were measured as the evaluation indexes of the effect of the adjustment. The correlation with condylar displacement was evaluated. Results In the N group, the disc moved backward and downward along the X and Z axes by (-0.60±0.62) and (0.51±0.71) mm, respectively. In the DDWR group, the disc moved backward and upward along the X and Z axes by (-1.33±1.38) and (-0.09±1.31) mm, respectively. In the DDWoR group, the disc moved forward and downward along the X and Z axes by (0.49±1.76) and (1.35±1.76) mm, respectively. The angle between the condyle and the disc decreased after adjustment of the jaw position in all three groups. All patients showed improvement in symptoms after adjustment. Conclusion Digital technology-assisted jaw position adjustment can simplify the process, reduce the sensitivity of the technique, and improve patients’ disc-condyle structure and symptoms. Therefore, its application in the treatment of patients with TMD is of great clinical significance.

  • Chen Hong, Zhang Ronghua, Zhao Yuan
    West China Journal of Stomatology. 2024, 42(3): 409-414. https://doi.org/10.7518/hxkq.2024.2023291

    Dental invagination is an abnormality of the crown or root development induced during tooth germ development when the enamel-forming apparatus or epithelial root sheath overpopulates and folds into the papilla. In severe cases, the invaginated channels are connected to the pulp and periodontal tissues, often causing endodontic and periapical diseases. The complex anatomical pattern of this disease adds difficulty in its preoperative diagnosis and clinical operation. In this paper, we report a case of non-surgical treatment assisted by cone beam CT and microscopy for maxillary lateral incisor double dens invaginatus type Ⅲ (Ⅲa and Ⅲb) with apical periapical infection. After 1-year follow-up, the affected tooth was asymptomatic and the periapical lesion was significantly reduced.

  • Clinical Research
    Zhu Jie, Liu Ya
    West China Journal of Stomatology. 2024, 42(3): 329-333. https://doi.org/10.7518/hxkq.2024.2023348

    Objective This retrospective study explored the incidence of independent distal-lingual root (DLR) in mandibular first molars and the morphologic features of distal furcations through cone beam computed tomography (CBCT) in Beijing population. Methods A total of 401 CBCT images of both mandibular first molars existed were included. The sex of the patients, the incidence of DLR, the distal root trunk length (DRT), the locations of distal furcation entrance (DFE), and the separation angle of distal furcation (ADF) were recorded. Results The incidence rates of DLR were 33.2% on the subject level and 26.8% on the tooth level. The incidence of DLR was not different between genders but was higher on the right sides. The DRT values were 4.15 mm±1.02 mm. The ADF was 65.56°±11.56°. The DFE was located lingually, and 97.2% DFE was located more apically than buccal/lingual furcations. Conclusion A high incidence of DLR was found in the Beijing population. The DRT was longer than buccal and lingual sites. The DFE was located lingually with a wide separation. Understanding the morphological features of distal furcation can help clinicians to make proper treatment plans.

  • Basic Research
    Xin Yu, Fu Ruobing, Xin Xirui, Shang Yaqi, Liu Xinchan, Yu Weixian
    West China Journal of Stomatology. 2024, 42(3): 296-303. https://doi.org/10.7518/hxkq.2024.2023352

    Objective This study aims to investigate the role of gap junction mediated by connexin 43 (Cx43) in renal injury induced by periodontitis in rats. Methods Twelve SPF-grade Wistar male rats were divided into a control group and a periodontitis group by using a completely random number table method, with six rats in each group. The control group rats were not treated, while the periodontitis group rats were subjected to wire ligation of the neck of their bilateral maxillary first molars to construct a periodontitis model. After 8 weeks of modeling, the rats were examined for clinical indicators of the periodontium. micro-CT scanning of the maxilla reconstructed its 3D structure and analyzed the absorption of alveolar bone. Histopathological changes in periodontal and renal tissues were detected. MitoSOX red reagent was used to determine reactive oxygen species (ROS) content in renal tissues. A biochemical reagent kit was used to detect serum oxidative stress biomarkers. Real-time fluorescent quantitative-polymerase chain reaction (qRT-PCR) was employed to determine Cx43, nuclear factor kappa-B (NF-κB) , interleukin (IL)-1β, IL-6, BCL2-Associated X (Bax), B-lymphomatoma-2 gene (Bcl-2), and Caspase-3 mRNA were determined. Western blot analysis was used to detect Cx43, NF-κB, IL-1β, Bax, Bcl-2 and Caspase-3 protein. Results micro-CT 3D reconstruction showed significant bone resorption of the first molar alveolar bone in the periodontitis group rats and decreased height of the alveolar ridge. The distance from the enamel cementum boundary to the top of the alveolar ridge in the periodontitis group was significantly higher than that inthe control group. The histopathological results showed a large number of inflammatory cells that infiltrated the periodontal tissue of the periodontitis group, and the alveolar bone was significantly absorbed. Rats in the periodontitis group also exhibited mild thickening of the glomerular basement membrane, dilation of the Bowman’s capsule, and destruction of the brush-like edge of the renal tubules in the renal tissue. The MitoSOX red staining results showed a significant increase in ROS content in the renal tissue of the periodontitis group. The biochemical test results showed that the levels of superoxide dismutase and glutathione in the serum of rats with periodontitis decreased, while that of malondialdehyde increased. The results of qRT-PCR and Western blot showed that the expression levels of Cx43, IL-1β, IL-6, Bax, Caspase-3 mRNA and Cx43, IL-1β, NF-κB, Bax, Caspase-3 proteins in the periodontitis group significantly increased compared with those in the control group, while the expression levels of Bcl-2 mRNA and protein decreased. Conclusion Periodontitis may activate NF-κB signaling molecules by upregulating the expression of Cx43 in rat kidney tissues, leading to increased levels of inflammation and apoptosis and ultimately inducing kidney injury.

  • Zhu Guiquan, Ma Zhongkai, Cao Chang, He Jialu, Hong Jiawei, Ren Ruiting, Xia Hui, Yan Bing, Wang Xiaoyi, Li Long-jiang, Li Chunjie
    West China Journal of Stomatology. 2024, 42(2): 262-267. https://doi.org/10.7518/hxkq.2024.2023393

    Robotic surgery is known as the “third technological revolution” in the field of surgery, and is an important milestone in the development of modern surgery. However, our country’s innovative surgical robot industry is still in its early stages, and it is only being utilized in certain surgical fields. To explore the effectiveness of the application of domestic surgical robot in oral and maxillofacial surgery, the author successfully completed a case of benign parotid tumor resection with the assistance of a domestic autonomous robot. The operation was successful, facial nerve function was preserved, and postoperative wound healing was good.

  • Li Guoli, Lou Jing, Tan Na, Zheng Hong
    West China Journal of Stomatology. 2024, 42(2): 256-261. https://doi.org/10.7518/hxkq.2024.2023240

    Diffuse large B-cell lymphoma (DLBCL) in the oral gums is very rare and is prone to misdiagnosis and mistreatment. In this paper, 2 cases of oral gingival DLBCL were reported. Their clinicopathological features, diagnosis, and differential diagnosis were discussed based on the literature of 21 cases of gingival DLBCL reported at home and abroad from 2008 to 2023.

  • Clinical Research
    Yang Haoran, Chen Yuxiang, Zhao Anna, Cheng Tingting, Zhou Jianzhong, Li Ziliang
    West China Journal of Stomatology. 2024, 42(2): 214-226. https://doi.org/10.7518/hxkq.2024.2023275

    Objective This study aimed to reveal critical genes regulating peri-implantitis during its development and construct a diagnostic model by using random forest (RF) and artificial neural network (ANN). Methods GSE-33774, GSE106090, and GSE57631 datasets were obtained from the GEO database. The GSE33774 and GSE106090 datasets were analyzed for differential expression and functional enrichment. The protein-protein interaction networks (PPI) and RF screened vital genes. A diagnostic model for peri-implantitis was established using ANN and validated on the GSE33774 and GSE57631 datasets. A transcription factor-gene interaction network and a transcription factor-micro-RNA (miRNA) regulatory network were also established. Results A total of 124 differentially expressed genes (DEGs) involved in the regulation of peri-implantitis were screened. Enrichment analysis showed that DEGs were mainly associated with immune receptor activity and cytokine receptor activity and were mainly involved in processes such as leukocyte and neutrophil migration. The PPI and RF screened six essential genes, namely, CD38, CYBB, FCGR2A, SELL, TLR4, and CXCL8. The receiver operating characteristic curve (ROC) indicated that the ANN model had an excellent diagnostic performance. FOXC1, GATA2, and NF-κB1 may be essential transcription factors in peri-implantitis, and hsa-miR-204 may be a key miRNA. Conclusion The diagnostic model of peri-implantitis constructed by RF and ANN has high confidence, and CD38, CYBB, FCGR2A, SELL, TLR4, and CXCL8 are potential diagnostic markers. FOXC1, GATA2, and NF-κB1 may be essential transcription factors in peri-implantitis, and hsa-miR-204 plays a vital role as a critical miRNA.

  • Basic Research
    Li Kaiyu, Shi Lijuan, Liu Linxin, Wang Jie, Nie Minhai, Liu Xuqian
    West China Journal of Stomatology. 2024, 42(2): 192-206. https://doi.org/10.7518/hxkq.2024.2023280

    Objective This study aimed to explore the expression trends of innate immune cells and immune-checkpoint molecules validated by data calculation in the process of oral mucosal carcinogenesis, as well as to explore methods of suppressing oral mucosal carcinogenesis based on immunotherapy by predicting their interactions. Me-thods 1) The cancer genome atlas (TCGA) database comprehensively scores immune cells and immune-checkpoint molecules in the process of oral mucosal carcinogenesis and screens out intrinsic immune cells and immune-checkpoint molecules that interfere with tumor immune escape. 2) Clinical patient blood routine data were collected for the statistical analysis of peripheral blood immune cells during the progression of oral mucosal carcinogenesis. Immune cells in peripheral blood that may affect the progression of oral mucosal carcinogenesis were screened. 3) Immunohistochemical staining was performed on intrinsic immune cells and immune-checkpoint molecules validated based on data calculation in various stages of oral mucosal carcinogenesis. 4) Special staining was used to identify innate immune cells in various stages of oral mucosal carcinogenesis based on data-calculation verification. 5) Survival analysis was conducted on intrinsic immune cells and immune-checkpoint molecules validated based on data calculation during the process of oral mucosal carcinogenesis. The association of intrinsic immune cells and immune-checkpoint molecules with the prognosis of oral squamous cell carcinoma was verified. Results The expression of monocytes and neutrophils increased during the process of oral mucosal carcinogenesis. The expression of eosinophils showed a single peak trend of up and down. The expression of mast cells decreased. In the process of oral mucosal carcinogenesis, the expression of the immune-checkpoint molecules cytotoxic T-lymphocyte-associated protein 4 (CTLA4) and programmed cell death-ligand (PD-L1) increased. The expression trends of monocytes, neutrophils, and eosinophils were positively correlated with those of CTLA4 and PD-L1 immune-checkpoint molecules. The expression trend of mast cells was negatively correlated with the expression of CTLA4 and PD-L1. Monocytes, neutrophils, and eosinophils may promote tumor immune escape mediated by CTLA4 and/or PD-L1, thereby accelerating the progression of oral mucosal carcinogenesis. Mast cells may inhibit tumor immune escape mediated by CTLA4 and/or PD-L1, delaying the progression of oral mucosal carcinogenesis. Conclusion Therefore, interference with specific immune cells in innate immunity can regulate the expression of CTLA4 and/or PD-L1 to a certain extent, inhibit tumor immune escape, and delay the progression of oral mucosal carcinogenesis.

  • Basic Research
    Sun Yanping, Liao Li
    West China Journal of Stomatology. 2024, 42(2): 172-180. https://doi.org/10.7518/hxkq.2024.2023244

    Objective The effect of TiO2 nanotube morphology on the differentiation potency of senescent periodontal ligament stem cells was investigated. Methods Two types of titanium sheets with TiO2 nanotube morphology (20V-NT and 70V-NT) were prepared via anodic oxidation at 20 and 70 V separately, and their surface morphology was observed. Young periodontal ligament stem cells were cultivated in an osteogenic induction medium, and the most effective surface morphology in promoting osteogenic differentiation was selected. RO3306 and Nutlin-3a were used to induce the aging of young periodontal ligament stem cells, and senescent periodontal ligament stem cells were obtained. The osteogenic differentiation of senescent periodontal ligament stem cells was induced, and the effect of surface morphology on osteogenic differentiation was observed. Results Nanotube morphology was achieved on the surfaces of titanium sheets through anodic oxidation, and the diameters of the nanotubes increased with voltage. A significant difference in the effect of nanotube morphology was found among nanotubes with different diameters in the young periodontal ligament stem cells. The surface nanotube morphology of 20V-NT had a more significant effect that promoted osteogenic differentiation. Compared with a smooth titanium sheet, the surface nanotube morphology of 20V-NT increased the number of alkaline phosphatase-positive senescent periodontal ligament stem cells and promoted calcium deposition and the expression of osteogenic marker genes Runt-related transcription factor 2, osteopontin, and osteocalcin. Conclusion A special nanotube morphology enhances the differentiation ability of senescent periodontal ligament stem cells, provides an effective method for periodontal regeneration, and further improves the performance of implants.

  • Basic Research
    Ma Haonan, Li Qiong, Shang Yaqi, Xin Xirui, Liu Xinchan, Wu Zhou, Yu Weixian
    West China Journal of Stomatology. 2024, 42(2): 163-171. https://doi.org/10.7518/hxkq.2024.2023245

    Objective To investigate the mechanism of circadian clock protein Bmal1 (Bmal1) on renal injury with chronic periodontitis, we established an experimental rat periodontitis model. Methods Twelve male Wistar rats were randomly divided into control and periodontitis groups (n=6, each group). The first maxillary molars on both sides of the upper jaw of rats with periodontitis were ligated by using orthodontic ligature wires, whereas the control group received no intervention measures. After 8 weeks, clinical periodontal parameters, including probing depth, bleeding index, and tooth mobility, were evaluated in both groups. Micro-CT scanning and three-dimensional image reconstruction were performed on the maxillary bones of the rats for the assessment of alveolar bone resorption. Histopatholo-gical observations of periodontal and renal tissues were conducted using hematoxylin-eosin (HE) and periodic acid-Schiff (PAS) staining. Renal function indicators, such as creatinine, albumin, and blood urea nitrogen levels, and oxidative stress markers, including superoxide dismutase, glutathione, and malondialdehyde levels, were measured using biochemical assay kits. MitoSOX red staining was used to detect reactive oxygen species (ROS) content in the kidneys. The gene and protein expression levels of Bmal1, nuclear factor erythroid 2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) in rat renal tissues were assessed using real-time quantitative polymerase chain reaction (RT-qPCR) and immunohistochemical staining. Results Micro-CT and HE staining results showed significant bone resorption and attachment loss in the maxillary first molar region of the periodontitis group. Histological examination through HE and PAS staining revealed substantial histopathological damage to the renal tissues of the rats in the periodontitis group. The findings of the assessment of renal function and oxidative stress markers indicated that the periodontitis group exhibited abnormal levels of oxidative stress, whereas the renal function levels showed abnormalities without statistical significance. MitoSOX Red staining results showed that the content of ROS in the renal tissue of the periodontitis group was significantly higher than that of the control group, and RT-qPCR and immunohistochemistry results showed that the expression levels of Bmal1, Nrf2, and HO-1 in the renal tissues of the rats in the periodontitis group showed a decreasing trend. Conclusion Circadian clock protein Bmal1 plays an important role in the oxidative damage process involved in the renal of rats with periodontitis.

  • Special Review
    Wang Jian, Yang Linxin
    West China Journal of Stomatology. 2024, 42(2): 135-141. https://doi.org/10.7518/hxkq.2024.2023404

    Zirconia crown has been widely used in the field of prosthodontics. Traditional zirconia exhibits excellent mechanical properties but lacks translucency. The introduction of transparent zirconia significantly enhances its aesthetic performance. In clinical applications, factors affecting the aesthetic results of full zirconia crown should be comprehensively considered, and the most suitable restoration should be chosen. Additionally, clinicians need to design appropriate tooth preparation dimensions and methods based on an individual patient’s actual situation. During the clinical bonding process of zirconia, proper surface treatment of the tooth and restoration is essential. The selection of suitable adhesives is crucial for achieving optimal bonding strength and aesthetics.

  • Clinical Research
    Zhou Zheqing, Wang Siyu, Yuan Quan, Yue Li, Yang Shengtao
    West China Journal of Stomatology. 2024, 42(1): 67-74. https://doi.org/10.7518/hxkq.2024.2023242

    Objective This clinical study aimed to evaluate the accuracy of a fully digital technique for measuring sagittal condylar inclination (SCI), as well as validating whether differences existed between the left and right SCI values of the same participant, to provide a reference for clinical practice. Methods Ten participants with good occlusal relationship and normal temporomandibular joint were recruited. Three methods were used to measure the SCI values of the participants, namely, A (mechanical facebow transferring and mechanical articulator-based measuring method with physical protrusive interocclusal registration), B (face scan-based virtual facebow and virtual articulator-based measuring method with digital protrusive interocclusal registration), and C (jaw motion tracking system-based measuring method). With the group subjected to methods A and C as the control, the SCI values obtained by the three methods were statistically analyzed. The left and right SCI values of the same participant were also compared. Results The left and right SCI values measured by method A were 41.70°±7.09° and 42.80°±8.62°, those by method B were 35.09°±12.49° and 37.63°±12.10°, and those by method C were 39.43°±8.72° and 38.45°±6.91°. No significant difference existed among the SCI values measured by the three methods (P>0.05). Meanwhile, no statistical difference existed between the SCI values on the left and right sides of the same participant (P>0.05). Conclusion The accuracy of the virtual facebow and digital protrusive occlusal registration based SCI measuring method was the same as that of mechanical facebow based and jaw motion tracking system-based methods. The SCI values on the left and right sides of the same participant were similar. Clinically, an appropriate SCI measurement and setting strategy can be selected based on the actual situations.

  • Basic Research
    Ding Xiao, Chen Jiawen, Qu Pengyu, Sun Chenyu, Li Hongli, Hu Wenting, Fan Xin
    West China Journal of Stomatology. 2024, 42(1): 46-55. https://doi.org/10.7518/hxkq.2024.2023237

    Objective This study aimed to explore the effect of pituitary tumor-transforming gene 1 (PTT-G1) on the invasion and proliferation of oral squamous cell carcinoma (OSCC) cell lines under the action of miR-362-3p. Methods The bioinformatics online database was used to query the expression of PTTG1 in head and neck squamous cell carcinoma (HNSCC). The expression of PTTG1 in the Cal-27, HN-30, and HOK cell lines was detected by Western blot. A wound-healing assay was used to determine the effect of PTTG1 on the migration ability of the OSCC cells. The Transwell assay was used to examine the changes in cell-invasion ability. 5-ethynyl-2'-deoxyuridine (EdU) cell-proliferation assay was used to detect changes in cell-proliferation ability. Bioinformatics approach predicted the upstream miRNA of PTTG1. The targeting relationship between miR-362-3p and PTTG1 was examined by the dual luciferase assay, and quantitative real-time polymerase chain reaction (qRT-PCR) was used to determine the expression of miRNA in OSCC tissues. Results The ENCORI database showed that PTTG1 expression was up-regulated in OSCC tissues. Western blot confirmed that PTTG1 expression was up-regulated in Cal-27 and HN-30 cells than HOK cells. PTTG1 knockout can inhibit the migration, invasion, and proliferation of Cal-27 and HN-30 cells (P<0.05). Bioinformatics prediction websites predicted that the upstream miRNA of PTTG1 was miR-362-3p, and PTTG1 can bind to miR-362-3p. Results of qRT-PCR showed that miR-362-3p expression was downregulated in OSCC tissues compared with normal tissue (P<0.05). Transwell and EdU experiments confirmed that miR-362-3p knockdown can promote the invasion and proliferation of Cal-27 and HN-30 after PTTG1 knockdown. Conclusion miR-362-3p can inhibit the invasion and proliferation of Cal-27 and HN-30 cells by targeting PTTG1.

  • Basic Research
    Enimubai Daerya, Zhang Di, Awuti Gulinuer
    West China Journal of Stomatology. 2024, 42(1): 28-36. https://doi.org/10.7518/hxkq.2023.2023161

    Objective This study aims to compare the osteogenic effects of implanting demineralized dentin matrix and acellular dentin matrix in bone defect areas. Methods Demineralized dentin matrix and acellular dentin matrix were prepared. Twenty-four male SPF-grade SD rats were randomly divided into four groups: demineralized group (group A), acelluar group (group B), Bio-Oss bone powder group (group C), and blank control group (group D), with six rats in each group. All rats were subjected to general anesthesia to prepare bilateral femoral bone defects. Rats in groups A, B, and C were implanted with demineralized dentin matrix, acellular dentin matrix, and Bio-Oss bone powder at the bone defect area, respectively, while rats in group D were not implanted with any material. At 4 and 8 weeks after surgery, three rats were randomly executed in each group. The healing of the bone defect area was analyzed through gross observation. The concentrations of osteogenic indicators bone morphogenetic protein-2 (BMP-2) and alkaline phosphatase (ALP) were detected by serology. The distribution of high-density gray area (representing bone healing) in the bone defect area was observed by X-ray examination, and the formation of new bone was observed by histomorphology. The rate of new bone formation was calculated. Results At 4 and 8 weeks, the bone formation ability of group A was more active than that of the other groups; the concentrations of BMP-2 and ALP in group A were higher than those in the other groups, and the differences were statistically significant (P<0.05). At 8 weeks, the imaging observation showed that the high-density gray area in the bone defect of group A was evenly distributed. The histomorphological observation showed the regular arrangement of bone matrix in group A. The rate of new bone formation in group A was 28.51%±0.55% at 4 weeks and 32.57%±2.28% at 8 weeks, both of which were significantly higher than those in the other groups (P<0.05). Conclusion Demineralized dentin matrix has better osteogenic potential than acellular dentin matrix.

  • Yu Haiyang, Zhao Junyi, Sun Manlin
    West China Journal of Stomatology. 2024, 42(1): 19-27. https://doi.org/10.7518/hxkq.2024.2023212

    At present, the commonly used clinical protocols of oral comestic restoration are mostly based on the aesthetic indicators proposed by Western developed countries (referred to as Western aesthetics). Mechanically copying the Western aesthetic scheme, ignoring the difference between it and the Chinese oral aesthetic indicators (referred to as Chinese aesthetics), is unable to effectively support personalized cosmetic restoration diagnosis and treatment. In addition, new technologies and new solutions for cosmetic restoration, which are developing rapidly in recent years, are emerging one after another, but many popular concepts are confusing and lack of proper hierarchical diagnosis and treatment norms, and there is indeed an urgent need for discussion and clarity. From the perspective of serving clinical application, this paper discusses the deficiencies of the Chinese translation of the word “aesthetics”, the diffe-rence and connection between aesthetics and cosmetology, and the relationship between cosmetic restoration and fixed restoration. It also discusses the difference between anterior teeth, esthetic zone and exposed zone, the diagnostic and therapeutic value of oral aesthetic analysis, as well as the application methods of desensitization, suggestion, and other therapies in difficult oral cosmetic restoration cases. We further introduce the decision tree and the clinical pathway for restoration and reconstruction of teeth in exposed zone guided by aesthetic analysis, and introduce the clinical process of aesthetic analysis and evaluation, the clinical triclassification of oral cosmetic restoration, and the corresponding clinical classification diagnosis and treatment points.

  • West China Journal of Stomatology. 2025, 43(03): 305-313.
    术后恶心和呕吐(PONV)是正颌手术后常见的并发症,主要发生在术后24 h内。正颌手术PONV发生率居高不下,目前仍然是患者和外科医生较为棘手的问题。恶心和呕吐不仅影响伤口愈合,增加术后出血风险,呕吐物及血液还可能进一步引发恶心和呕吐,形成恶性循环。频繁的恶心和呕吐是一种痛苦的经历,甚至比术后疼痛更为严重,是术后感染、延迟出院、增加住院费用和影响患者满意度的主要原因之一。本文中笔者结合文献回顾和临床经验,总结并分析正颌手术PONV的原因及预防和治疗策略,以供同行参考。
  • West China Journal of Stomatology. 2025, 43(03): 325-335.
    咬合重建也叫(牙合)重建,是指采用修复手段,在正确的颌位关系下重新建立全牙列或多数牙的咬合接触关系的治疗方法,是矫正牙齿严重磨损和牙列缺损等的重要治疗手段。其中,全颌固定咬合重建可有效恢复美观及功能,但其临床技术方案复杂、技术敏感性高,各种并发症高发,一直以来被业界关注。随着数字化技术在(牙合)重建中的应用和发展,数字化(牙合)重建的临床程序相较于传统方案面貌一新。然而,数字化技术种类众多,其效能高低不一,如何构建高效规范的数字化临床技术方案仍然是当前的临床难点。为此,本文首先着墨于高发的有牙颌重建,系统整理了数字化全颌固定咬合重建的临床程序,从(牙合)重建“从大到小”贯穿几何量依次进行空间转移的底层逻辑入手,指出了(牙合)重建时应关注的最小几何量(最小咬合感知厚度)和最大几何量(正中关系),最后提出了有牙颌(牙合)重建的5阶段19步(或加N步)的临床技术方案,简称有牙颌“5-19N”(牙合)重建临床技术方案,该方案对今后采用数字化技术方案处理有牙颌复杂全颌固定咬合重建病例有一定的指导价值。
  • West China Journal of Stomatology. 2025, 43(03): 336-345.
    目的 本研究通过比较经多巴胺或硅烷化修饰的氧化石墨烯钛表面涂层的成骨性能差异,旨在尝试为钛表面氧化石墨烯涂层的修饰提供较为适宜的方案。方法 钛碱热处理后分别进行多巴胺和硅烷化改性,被覆氧化石墨烯涂层,设计对照组:纯钛(Ti)组;实验组:钛经碱热处理(Ti-NaOH)组、钛经碱热处理后硅烷化改性(Ti-APTES)组、钛经碱热处理后多巴胺改性(Ti-DOPA)组、钛经硅烷化改性表面修饰氧化石墨烯(TiAPTES/GO)组、钛经多巴胺改性表面修饰氧化石墨烯(Ti-DOPA/GO)组。利用扫描电子显微镜、接触角测量仪、X射线光电子能谱分析仪及拉曼光谱分析仪对材料表面的理化性能进行分析。通过细胞活性检测、免疫荧光染色后激光共聚焦显微镜观察小鼠胚胎成骨细胞前体细胞MC3T3-E1在材料表面的增殖及黏附形态。通过碱性磷酸酶、茜素红染色及定量、实时荧光定量聚合酶链反应研究对MC3T3-E1细胞成骨分化的影响。结果 氧化石墨烯涂层修饰后扫描电子显微镜观察可见覆盖一层薄膜样结构,实验组亲水性皆有改善,其中Ti-DOPA/GO组亲水性最佳。X射线光电子能谱学和拉曼光谱分析显示氧化石墨烯修饰后的材料均出现典型D峰和G峰,表面出现大量含氧官能团。细胞计数盒检测可见各组材料均无细胞毒性,Ti-APTES/GO组增殖水平高于Ti-DOPA/GO组。激光共聚焦显微镜下可见Ti-DOPA/GO组和Ti-APTES/GO组细胞铺展更为饱满。Ti-DOPA/GO组与Ti-APTES/GO组碱性磷酸酶染色最深,Ti-APTES/GO组茜素红染色矿化结节最多,茜素红染色定量结果最高;在Ti-DOPA/GO组和Ti-APTES/GO组中,早期成骨相关基因RUNX2的表达均达到较高水平,而在晚期成骨相关基因OPN和OCN的表达上,Ti-APTES/GO组的表现优于Ti-DOPA/GO组。结论 Ti-APTES/GO在促进MC3T3-E1细胞的黏附、增殖及体外成骨分化方面,效果显著优于Ti-DOPA/GO。
  • West China Journal of Stomatology. 2025, 43(03): 442-447.
    在口腔种植领域,若出现上颌窦穿孔或上颌窦瘘,对于上颌窦底骨板不连续、口窦黏膜相通且伴有牙槽骨垂直向缺损的病例,该如何行种植修复,目前尚无统一共识与权威指南。本文报道1例上颌窦两次穿孔患者,经简单分次手术成功完成种植修复。经2年临床随访,种植体使用状况良好,患者满意。本文旨在为此类病例,提供一种简单安全、易于推广的新思路。
  • West China Journal of Stomatology. 2025, 43(03): 395-405.
    目的 构建口腔癌患者发生失志综合征的风险预测模型,为帮助口腔癌患者更好地应对失志综合征,并为其制定更加个性化的支持方案提供参考依据。方法 选取2024年3月—7月在四川大学华西口腔医院及中山大学孙逸仙纪念医院共486例口腔癌住院患者作为研究对象。综合分析临床资料和既往研究证据,以确定影响口腔癌患者失志综合征的关键变量。将486例患者按照8∶2的比例分为训练集和验证集,将365例患者的个体数据纳入训练集,基于最小绝对收缩和选择算子(LASSO)回归构建口腔癌失志综合征中重度风险预测模型并构建列线图。采用Bootstrap重采样进行内部验证,通过121例验证组患者的独立数据进行外部验证。结果 口腔癌患者失志综合征总发生率为83.3%(405例)。其中,轻度失志患者占比48.9%(198例),中度失志患者占比43.4%(176例),重度失志患者占比7.7%(31例)。核心模型包括患者文化水平、疾病了解程度和MDASI-HN评分。模型内部验证结果显示C统计量为0.783 6 (95%CI为0.78~0.87),校准斜率为0.843 4,截距为-0.040 6。外部验证集的C统计量为0.80 (95%CI为0.71~0.87),校准斜率为0.80,截距为-0.08。结论 口腔癌患者失志综合征风险预测模型在不同护理环境的验证队列中表现稳健,模型校正良好,具有良好的区分度,可作为入院评估预测项目的参考。
  • West China Journal of Stomatology. 2025, 43(02): 197-203.
    目的 研究0~6岁腭裂患者经Sommerlad-Furlow (SF)法腭裂修复术后上颌牙弓的发育变化影响因素。方法 纳入18月龄前行SF法腭裂一期整复的患者共183例,术后在不同年龄段随访并收集上颌牙弓数字化模型,使用3-matic Research 12.0测量牙弓及腭弓的长度和宽度,探究SF法腭裂修复术后患者0~6岁上颌牙弓的发育变化规律,以及性别、年龄、腭裂类型和松弛切口对上颌牙弓发育的影响。结果 SF法腭裂修复术后,0~2岁与3~6岁上颌牙弓长度及宽度部分指标差异有统计学意义(P<0.05),3~6岁各年龄段指标间差异无统计学意义;男性后牙弓宽度及后腭弓宽度大于女性(P=0.001),男性前牙弓长度及全牙弓长度小于女性(P<0.05);相较于单纯腭裂组,单侧唇裂伴腭裂组牙弓长度更短(P<0.01),而后腭弓更宽(P<0.01);有无硬腭松弛切口组间上颌牙弓的各指标差异无统计学意义。结论 影响0~6岁SF法腭裂修复术后儿童牙弓宽度的主要因素是性别和年龄,而影响牙弓长度的主要因素是年龄和腭裂类型。
  • West China Journal of Stomatology. 2025, 43(02): 151-157.
    早期矫治是近年来口腔正畸、儿童口腔,乃至全科口腔医生的发展热点和关注焦点,但仍存在一些误区,如过早或过度进行干预,适应证把控不严,夸大早期矫治的作用等。本文以国内早期矫治的现状分析为切入点,逐一剖析口腔医生乃至大众关心的9个问题,包括早期矫治是否是新兴概念,早期矫治是否有必要,早期矫治的时机,早期矫治的适应证,早期矫治能否提供一个不拔牙或不手术的机会,早期矫治能否彻底改变面型和下颌生长型,早期矫治能否治疗口呼吸或腺样体面容或阻塞性睡眠呼吸暂停综合征,硅胶类口腔功能训练器在早期矫治中的作用,透明矫治器在早期矫治中是否优于传统矫治器,旨在促进早期矫治的规范化。早期矫治一定要选择好适应证,掌握正畸的基本原理和技术,选择最合适患儿的治疗方式和治疗时机。
  • West China Journal of Stomatology. 2025, 43(02): 269-274.
    目的 分析对温度骤降敏感的颞下颌关节紊乱综合征(TMD)患者的临床症状及影像学表现。方法纳入2022年12月—2023年12月于解放军总医院第一医学中心口腔科就诊的TMD患者119例,其中男性44例,女性75例,平均年龄为32.4±13.7岁。通过调查问卷确定是否对温度骤降敏感,将TMD患者分为温度骤降敏感组和温度骤降不敏感组。观察2组患者的临床症状及影像学表现。采用SPSS 25.0软件进行统计学分析。结果温度骤降敏感组(50例)和温度骤降不敏感组(69例)患者的性别及年龄差异均无统计学意义(P>0.05)。温度骤降敏感组患者关节/咀嚼肌疼痛的比例[86.0%(43/50)]略高于温度骤降不敏感组[68.1%(47/69)],差异有统计学意义(χ2=5.031,P=0.025),两组间关节杂音和下颌运动受限的差异均无统计学意义。检测两组患者共计238侧关节中,温度骤降敏感组出现骨关节病影像改变的比例[82.0%(82/100)]显著高于温度骤降不敏感组[53.6%(74/138)](χ2=20.675,P<0.001)。核磁影像显示温度骤降敏感组患者关节积液的比例[66.0%(33/50)]高于温度骤降不敏感组[42.0%(29/69)],差异有统计学意义(χ2=5.602,P=0.018)。结论 伴有颌面部疼痛症状、关节积液和骨关节结构异常影像学表现的TMD患者更易对温度骤降敏感。
  • West China Journal of Stomatology. 2024, 42(04): 486-493.
    目的 系统评价口腔癌患者生存质量的相关影响因素。方法 系统检索中国知网、万方、维普、中国生物医学文献数据库、Pubmed、Medline、Web of Science、Embase、The Cochrane Library等中英文数据库中关于口腔癌患者生存质量的研究,检索时间限定为建库至2023年5月。纳入的所有研究由2名研究员独立筛选、提取资料并进行质量评级,主要采用定性分析的方法对研究结果进行总结。结果 共纳入24篇文献,包括2 717名患者。结果显示口腔癌患者生存质量的相关因素主要包含年龄、肿瘤TNM分期、是否放化疗和性别等22个因素,可归纳成个人因素、疾病相关因素和手术相关因素三方面。其中年龄、性别、肿瘤TNM分期、病理分期、颈清方式、婚姻状况、是否复发、是否吸烟和文化程度等因素的分析上,有超过5篇以上的文献报道,其结果比较一致。结论 患者术后生存质量的相关影响因素众多。由于目前的临床研究多为横断面研究,且样本量有限,相关因素与生存质量之间的因果关系还需未来开展更多大样本的相关研究予以验证。
  • West China Journal of Stomatology. 2024, 42(04): 444-451.
    目的 基于基因表达综合(GEO)数据库芯片挖掘、网络药理学及分子对接技术探讨芒果苷(MF)治疗口腔黏膜下纤维化(OSF)的核心作用靶标及潜在作用机制。方法 基于GEO芯片挖掘OSF的潜在治疗靶点,利用数据库预测MF潜在作用靶标和收集OSF疾病靶标,使用EVenn平台绘制维恩图,STRING数据库绘制蛋白质互作(PPI)网络,DAVID平台进行基因本体论(GO)和京都基因与基因组百科全书(KEGG)富集分析,Cytoscape 3.10.1软件绘制药物—靶标—通路—疾病网络图,AutoDocktools 1.5.6软件进行分子对接分析及可视化。结果 从多种数据库挖掘得到MF潜在靶标356个,OSF疾病靶标360个,选取PPI网络中排名前15个关键靶蛋白,GO功能及KEGG通路富集分析结果显示,MF治疗OSF主要涉及高级糖基化终末产物-受体(AGERAGE)、表皮生长因子受体(EGFR)等信号通路。分子对接显示,MF与丝氨酸蛋白激酶(AKT1)、肿瘤坏死因子(TNF)等核心靶点有较佳结合活性。结论 MF可能通过多靶点、多途径的方式对OSF发挥治疗作用。
  • West China Journal of Stomatology. 2024, 42(04): 452-461.
    目的 对纯钛表面分别进行碱蚀、碱蚀后硅烷化、碱蚀后多巴胺修饰等不同方式改性后在其表面制备生物胶原蛋白涂层,评价钛表面不同改性处理后胶原修饰的方案对细胞增殖黏附与成骨分化能力的影响。方法胶原蛋白通过交联剂作用附着于纯钛(Ti-C)、碱蚀钛片(Ti-Na-C)、碱蚀后硅烷化修饰钛片(Ti-A-C)及碱蚀后多巴胺修饰钛片表面(Ti-D-C),以纯钛为对照组。采用扫描电子显微镜(SEM)观察材料表面微形貌,X射线光电子能谱仪(XPS)分析材料表面元素组成,表面接触角测量仪评估材料表面亲水性。体外培养MC3T3-E1细胞,通过CCK-8、激光共聚焦显微镜、碱性磷酸酶(ALP)活性检测、茜素红染色及定量检测评价材料表面成骨细胞的增殖黏附与成骨分化能力,实时定量聚合酶链反应(RT-qPCR)检测成骨相关基因ALP、Ⅰ型胶原蛋白(COL-1)、骨钙素(OCN)、骨桥蛋白(OPN)的mRNA表达水平。结果 SEM与XPS结果表明胶原已成功修饰于钛片表面,Ti-Na-C组有较厚的胶原纤维层覆盖。表面接触角测量结果显示,除了Ti-Na-C组与Ti-Na组的接触角差异无统计学意义,其余胶原修饰后的材料表面具有更好的亲水性。CCK-8结果显示各组材料均无明显细胞毒性,胶原修饰后的材料表面成骨细胞增殖高于相应的未经胶原修饰材料;共聚焦显微镜检测结果可见,胶原修饰后材料表面细胞铺展面积更大;ALP染色与茜素红染色结果均提示,Ti-Na-C组体外成骨效果最佳,茜素红定量结果显示Ti-Na-C组吸光度值最高;RT-qPCR检测结果显示Ti-Na-C组的OPN基因表达量最高。结论在碱蚀、碱蚀后硅烷化、碱蚀后多巴胺修饰等对钛表面进行不同改性处理后修饰胶原的方案中,钛表面经过碱蚀处理后直接修饰胶原的方法最有利于MC3T3-E1黏附铺展、增殖与成骨分化,可作为胶原修饰的方案。
  • West China Journal of Stomatology. 2024, 42(04): 531-537.
    第二恒磨牙异位萌出若未得到及时治疗,会导致相邻的第一磨牙牙体组织吸收、牙齿早失、咀嚼效率下降及其他严重的错畸形。及时发现和处理第二恒磨牙异位萌出,对预防青少年错畸形、建立正常咬合关系具有重要的意义。然而,目前针对下颌第二恒磨牙异位萌出的病例报告比较少见,大多治疗方法主要为手术及正畸的方式,且缺乏长期的随访。本文报道1例采用铜丝结扎法治疗下颌第二恒磨牙异位萌出,使恒牙顺利萌出并建立正常咬合。术后观察5年,咬合稳定,牙根发育、牙髓活力及牙周状况正常。本文为近中倾斜度不大且已经部分萌出的阻生年轻下颌第二恒磨牙提供一种治疗周期短、简便及微创的临床思路。
  • West China Journal of Stomatology. 2024, 42(04): 521-530.
    目的 探讨慢性牙周炎(CP)和帕金森病(PD)之间潜在的核心基因、相关通路和转录因子。方法从基因表达综合(GEO)数据库下载CP (GSE16134、GSE23586和GSE10334)和PD (GSE20141和GSE49036)的基因表达谱进行差异表达分析、功能聚类分析,并构建蛋白质相互作用(PPI)网络,通过4种拓扑分析算法和模块划分筛选出核心基因,进行转录因子的预测及功能聚类分析。通过CP和PD的外部数据集对核心基因进行验证,并通过双本孟德尔随机化(MR)进一步评估二者的因果关系。结果 合并数据后,CP数据集共筛选出1 211个差异表达基因(DEG),其中551个上调,660个下调,PD数据集共筛选出2 407个DEG,其中1 438个上调,969个下调;PPI网络包括145个节点和126条边,最终筛选出4个核心基因,分别为FCGR3B、PRF1、IL18和CD33;预测的转录因子包括HSF1、HSF2和HSF4;相关通路主要为自然杀伤细胞(NK)介导的细胞毒性作用;MR结果表明,CP与PD的发病风险可能呈正向因果关系。结论 本研究探索了CP和PD的潜在共同发病机制及可能的因果关系,为进一步的机制研究提供新思路,预测的转录因子为可能的治疗靶点提供新见解。