Journal of Oral Science Research

The S3 Level Clinical Diagnosis and Practice Guideline of Stage Ⅳ Severe Periodontitis Based on 2018 EFP/AAP Classification

CAO Zhengguo, GAO Ya, ZENG Yu

2023, 39(11): 943-951. DOI: 10.13701/j.cnki.kqyxyj.2023.11.001

Abstract ( 221 )

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The early symptoms of periodontitis are not obvious, while it always accompanied by severe alveolar ridge defects, tooth drifting, flaring, and even tooth loss in advanced stage. It leads to a heavy burden on the country, society, and patients themselves with high prevalence. In 2018, consensus reports on the Classification of Periodontal and Peri-implant Diseases and Conditions were published by the American Academy of Periodontology (AAP) and European Federation of Periodontology (EFP), which divided periodontitis into four stages and three grades. Subsequently, the EFP has published S3-level clinical guidelines for the treatment of stage Ⅰ-Ⅲ and stage Ⅳ periodontitis. This article will discuss the clinical diagnosis and treatment practice of severe periodontitis based on the 2018 Classification with a case of periodontitis (stage Ⅳ, grade C).

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Research Progress of Glycolic Acid for Enamel and Dentin Etching

LIN Lingkang, ZHU Song

2023, 39(11): 952-955. DOI: 10.13701/j.cnki.kqyxyj.2023.11.002

Abstract ( 128 )

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In the process of resin-bonded restoration, the surface treatment of enamel and dentin is a key step. At present, phosphoric acid commonly used in the clinic is a strong acid, which has an aggressive pattern of demineralization of dentin, and affects the long-term stability of the resin-dentin adhesive interface. In recent years, glycolic acid has been used as an alternative etch agent. This paper introduces the application background and the principle of glycolic acid etching, focuses on the effect of glycolic acid etching on enamel and dentin and the comparison between glycolic acid and traditional phosphoric acid, in order to provide reference for further research.

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Research Progress of Nerve Compression Related to Orthodontic Tooth Movement

PAN Yihua, LIU Jun

2023, 39(11): 956-959. DOI: 10.13701/j.cnki.kqyxyj.2023.11.003

Abstract ( 110 )

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Orthodontic tooth movement is to move the tooth to a desired position in the upper and lower jaw by orthodontic force. In this process, the tooth root may be in close contact with some neural canal structures in the jaw, such as the Mandibular canal and the incisive canal, which may lead to the risk of nerve injury. In addition, because the nerve is located in the nerve canal, the tooth root first contacts the bone cortex, which may also lead to the risk of tooth root absorption. This article reviews the relevant research at home and abroad, and discusses the nerve compression related to orthodontic tooth movement. At the same time, orthodontists need to be aware of the potential risk of neural canal compression and take necessary preventive measures to reduce the risk for related high-risk cases.

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Research and Application of Convolutional Neural Network in Endodontic Imaging Diagnosis

QI Shuai, ZHANG Qi

2023, 39(11): 960-964. DOI: 10.13701/j.cnki.kqyxyj.2023.11.004

Abstract ( 167 )

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With the progress of computer technology, the research and application of artificial intelligence (AI) in dental imaging diagnosis has developed rapidly. As the most common dental disease, endodontics becomes one of the earliest AI-related research fields in dentistry. In recent years, deep learning technology represented by convolutional neural network (CNN) has shown great prospects in endodontic imaging diagnosis, and is expected to provide clinicians with intelligent support in the future. At present, the development of CNN in endodontic imaging diagnosis is still in the preliminary stage. This article will focus on the research and application of CNN in endodontic imaging diagnosis based on the working principle of CNN, and briefly analyze its development prospect.

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A Modification of Surgical Incision in Extraction of Maxillary Impacted Teeth

WANG Tao, CHEN Lingling, LIN Shiqi, WU Ye

2023, 39(11): 965-968. DOI: 10.13701/j.cnki.kqyxyj.2023.11.005

Abstract ( 136 )

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Objective: To investigate the effects of modified incision in the extraction of maxillary middle or low position completely impacted teeth. Methods: Fifty patients with maxillary completely impacted teeth were selected in the Department of Oral and Maxillofacial Surgery of Stomatological Hospital of Fujian Medical University from March 2020 to March 2022. According to random number table method, they were divided into experimental group and control group. The experimental group was treated with modified incision flap, while the control group was treated with traditional angular flap. The incision suture time, swelling, wound healing, opening degree, and suture removal time were compared between two groups, and the pain difference was evaluated between 2 groups using the simplified McGill pain questionnaire. Results: The suture time and suture removal time in the experimental group were significantly shorter than those in the control group (P<0.05). Two days after surgery, the pain in the experimental group was significantly less than that in the control group (P<0.05). There were no significant differences in the swelling, wound healing, and opening degree between experimental group and control group (P>0.05). Conclusion: The modified incision flap can shorten the suture time and suture removal time significantly. Besides, it can reduce postoperative pain, which improves patient comfort and is worthy of clinical promotion.

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Effects of Pre-emptive Analgesia with Celecoxib on Postoperative Pain in Patients after Orthognathic Surgery

YANG Chen, PENG Xin, YI Biao

2023, 39(11): 969-972. DOI: 10.13701/j.cnki.kqyxyj.2023.11.006

Abstract ( 108 )

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Objective: To investigate the analgesic effect and safety of preemptive use of celecoxib in orthognathic surgery. Methods: Seventy-one patients undergoing bimaxillary orthognathic surgery were randomly divided into the experimental group and the placebo group. Patients in the experimental group received 400 mg celecoxib oral 2 hours before surgery, followed by 200 mg celecoxib twice daily for 4 days postoperatively. The placebo group received a placebo at the same time point as the experimental. All patients underwent the same orthognathic surgery, with identical anesthesia methods and postoperative treatments. Pain scale after surgery was assessed using the Wong-Baker Faces Pain Rating Scale from the time of awakening until the fourth postoperative day. Blood loss and additional analgesic requirements and adverse reactions were recorded. Results: The postoperative pain in the experimental group were significantly lower than those in the placebo group (P＜0.05). The incidence of pain complaints and the use of additional analgesics were significantly reduced in the experimental group. However, there was no statistically significant difference in pain scores between two groups from awakening to the first postoperative day in patients undergoing segmental Le FortⅠ maxillary osteotomy. The incidence of postoperative nausea and vomiting showed no statistical difference between two groups. No other medication-related adverse reactions were observed, and there was no statistically significant difference in intraoperative blood loss between two groups. Conclusion: Preemptive analgesia with celecoxib significantly reduces postoperative pain in patients after orthognathic surgery, but its effect is not significant in patients undergoing segmental Le FortⅠ maxillary osteotomy. Furthermore, it does not increase intraoperative blood loss or other adverse reactions.

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Comparative Study on Remimazolam Mesylate and Propofol for Radiofrequency Thermocoagulation of Trigeminal Neuralgia under Deep Sedation

LI Jinjie, ZHANG Tiejun

2023, 39(11): 973-977. DOI: 10.13701/j.cnki.kqyxyj.2023.11.007

Abstract ( 77 )

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Objective: To compare the efficacy and safety of remimazolam mesylate and propofol for radiofrequency thermocoagulation of trigeminal neuralgia under deep sedation. Methods: A total of 78 patients who underwent elective radiofrequency thermocoagulation of the trigeminal nerve under deep sedation were enrolled and randomly divided into group R and B (n=39). Patients in group B were anesthetized with propofol combined with remifentanil, while those in group R were anesthetized with remimazolam combined with remifentanil. The mean arterial pressures, heart rates, and pulse oxygen saturations of both groups were compared at five time points: 5 minutes before anesthesia (T1), the time of modified alertness/sedation score (MOAA/S) ≤3 (T2), the time of beginning of radiofrequency thermocoagulation (T3), the time of the end of radiofrequency thermocoagulation (T4), and the time of awakening (T5). Furthermore, both groups were compared for the adverse reaction (respiratory inhibition, circulatory inhibition, body movements during administration to MOAA/S≤3 and operation, and injection pain), and for the modes of assisted breathing (mask oxygenation, oxygenation by mandibular lift and face mask, and oxygenation by mandibular lift and face mask under pressure). Results: Compared with those at T1, both MAP and SpO₂ decreased at T2 and SpO₂ decreased at T3 and T4 in group B (P<0.05), while only SpO₂ reduced at T3 in group R (P<0.05). Compared with group B, the incidence of breathing inhibition, injection pain and oxygen administration with mandibular lift and face mask under pressure were reduced in group R (P<0.05), while SpO₂ was increased at T2 and T4, and the incidence of body movement during administration to MOAA/S≤3 and the incidence of oxygen administration using a mask were increased (P<0.05). Other indicators were not significantly different between two groups (P>0.05). Conclusion: Compared with propofol, remimazolam mesylate has a low incidence of respiratory and circulatory inhibition, no injection pain, and a simple mode of assisted breathing, which can be used more safely and effectively for radiofrequency thermocoagulation of trigeminal neuralgia under deep sedation.

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Clinical and CT Imaging Analysis of Primary Non-Hodgkin Lymphoma of Jaw

FENG Yongjing, WEN Shanhui, WANG Tiemei, TENG Yuehui, XIA Shu

2023, 39(11): 978-981. DOI: 10.13701/j.cnki.kqyxyj.2023.11.008

Abstract ( 97 )

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Objective: To analyze the clinical and CT imaging features of primary bone non-Hodgkin lymphoma (PB-NHL) of jaw retrospectively. Methods: The clinical and CT imaging features of 24 patients with PB-NHL of jaw confirmed by pathology were retrospectively analyzed. Results: Of the 24 patients with PB-NHL of the jaw, 17 were male and 7 were female; 16 underwent anti-inflammatory therapy before diagnosis, 6 underwent tooth extraction, and 2 underwent incision and drainage. In the imaging classification of bone changes, osteolytic type accounted for 17/24, mixed type accounted for 5/24, and alveolar bone resorption accounted for 2/24. In the classification of the edge of bone destruction, moth-eaten destruction margin accounted for 8/24, infiltration destruction margin accounted for 13/24, and geographic type accounted for 3/24. There was significant statistical difference between different parts of mandible and mandible in the classification of bone destruction margin (P=0.003). Moth-eaten was the main type of mandibular edge damage, and infiltration was the main type of maxillary edge damage. Osteolytic type was the most common bone change in posterior mandible. Conclusion: PB-NHL of the jaw has certain clinical and imaging characteristics, which is helpful for the clinical and imaging recognition of the disease.

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Feasibility Study on Intraoperative Lugol's Iodine Enhanced Micro-CT Imaging Accelerated by Ultrasound for Specimen of Oral Squamous Cell Carcinoma

NIU Yanhong, XIA Chengwan, ZHANG Qian, MA Guanyu, WANG Yuxin, HU Qingang, PU Yumei

2023, 39(11): 982-987. DOI: 10.13701/j.cnki.kqyxyj.2023.11.009

Abstract ( 80 )

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Objective: To evaluate the feasibility of Lugol's iodine enhanced micro-CT imaging accelerated by ultrasound for the oral squamous cell carcinoma (OSCC) samples. Methods: Firstly, ultrasound (3W) was applied to accelerate Lugol's iodine (1%, 3%, and 5%) staining of Cal-27 cell line for 5, 10, and 15 min, respectively. The average optical density (AOD) was used to evaluate the staining difference. Then, thirty-six BALB/C nude mice [8 weeks old, (25±2) g] were randomly divided into ultrasound group and non-ultrasound group, which were stained by 1%, 3%, and 5% Lugol's iodine respectively. Micro-CT imaging and CT quantitative analysis were performed at 0.5 h and 1 h after staining. Finally, four male OSCC patients with buccal mucosa squamous-cell carcinoma were selected and randomly divided into ultrasound group and non-ultrasound group. Micro-CT images were obtained at 0.5 h, 1 h, 2 h, and 4 h after staining with 3% Lugol's iodine, and CNR was used to quantitative analyze the image clarity between tumor and normal tissue. Results: When Cal-27 was exposed to ultrasound for 5 min and 10 min, the AOD of 1% and 3% Lugol's iodine was higher than that of the control group (P<0.05). The value of micro-CT imaging of mouse tongue under ultrasound was higher than that of control group (P<0.05). The OSCC specimen results showed that the tumor and normal tissue boundaries were visible on micro-CT imaging with 3% Lugol's iodine staining for 2 h, while the dividing line was visible on HE sections. Conclusion: Ultrasound-assisted Lugol's iodine accelerates the infiltration of Cal-27, while ultrasound-assisted Lugol's iodine-enhanced micro-CT imaging provides some clinical guidance for intraoperative margin assessment of OSCC specimens.

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3D Finite Element Non-linear Stress Analysis of Minimal Invasive Prosthesis for Short Coronal Molars

LIAO Ying, HUANG Yi

2023, 39(11): 988-994. DOI: 10.13701/j.cnki.kqyxyj.2023.11.010

Abstract ( 83 )

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Objective: To study von Mises stress distribution of endocrown and occlusal veneer applied to tooth defect of short coronal molars using three dimensional finite element non-linear stress analysis methods. Methods: A healthy and complete right mandibular first molar was selected and established three-dimensional finite element model. The crown was squeezed to 4 mm, then simulated with root canal therapy (master apical file was 25/06) and restored with endocrown or occlusal veneer. Under the set mechanical parameters, mastication motion was simulated, the value and distribution of equivalent stress in the whole and each part of the model were recorded. Results: The maximum residual dentine mesial root equivalent stress was: the control group (105.30 MPa) > endocrown group (88.95 MPa) > occlusal veneer group (75.47 MPa). Conclusion: From the perspective of protecting the remaining tooth tissue, the occlusal veneer can distribute stress more evenly at the root of the tooth and lower the peak stress in the remaining tooth tissue.

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Accuracy of 3D Printed Maxillary Resin Model with Four Structural Designs of Model Bases

ZHAO Yanfang, XIN Haitao, ZHANG Zhiyuan, LI Kai, LUO Huiwen, WU Yulu

2023, 39(11): 995-999. DOI: 10.13701/j.cnki.kqyxyj.2023.11.011

Abstract ( 83 )

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Objective: To investigate the impact of different model designs on the accuracy of 3D printed maxillary resin models. Methods: A model scanner was used to scan the standard gypsum dentition model of the upper jaw, and four sets of printed models with different structural types were designed, including complete solid model of the upper palate, complete hollow model of the upper palate, horseshoe shaped solid model, and horseshoe shaped hollow model. A 3D printer was used to print five resin models per group. The printing time of the resin models was recorded and all models were weighted. On the first and seventh day after printing, a model scanner was used to scan them. The printed models were performed deviation analysis with the corresponding model design files in Geomagic software. Results: The accuracy range of four printing models on the first day was (31.40±4.26) μm to (57.38±7.56) μm. The accuracy range on the seventh day was (34.26±5.06) μm to (86.40±26.93) μm. There were statistical differences in the accuracy of 3D printed maxillary resin models with different designs. The horseshoe shaped hollow model had the largest deformation, while the horseshoe solid model had the smallest deformation. The accuracy of the complete solid palate group and the complete hollow palate group were between the above two groups. The mass range of four types of models was (15.82±0.04) g to (42.08±0.31) g. Conclusion: The accuracy of printing models with four structural designs is within the clinical acceptance range. Considering printing accuracy and material utilization, it is recommended to use a maxillary printing model with horseshoe solid design.

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Effect of Poly-urethane Oligomer on Properties of Light-cured Dental Resin

FENG Dan, YANG Zhengyuan, WEN Yaqing, LIN Qi

2023, 39(11): 1000-1004. DOI: 10.13701/j.cnki.kqyxyj.2023.11.012

Abstract ( 71 )

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Objective: To improve the comprehensive performance of dental resin matrix through a new polyurethane-dimethacrylate oligomer (PU-MA). Methods: BPA, IPDI, and HEMA were used to synthesize the PU-MA, and the new dental resin matrix was prepared by combining the PU-MA with Bis-GMA/TEGDMA resin matrix reinforced by 5 wt% POSS-MA. The mechanical-physical properties and in vitro cytotoxicity were tested. Results: The flexible strength of PU-MA-20 was up to (124.51±6.00) MPa, which was higher than the minimum standard of ISO 4049(≥90 MPa); the water absorption and solubility were (25.93±1.47) μg/mm³ and (0.50±0.08) μg/mm³, which were lower than the maximum standard of ISO 4049(water absorption≤40 μg/mm³, water solubility≤7.5 μg/mm³). The relative growth rate of PU-MA-20 was more than 90% and the L929 cell morphology performs well. Conclusion: For methacrylate based resin, PU-MA is conducive to improve the mechanical strength of traditional dental resin and decrease its water sorption and solubility, which indicates that it may have a good application potential in improving the aging resistance of composite resin.

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Effect of Porphyromonas Gingivalis on Blood Glucose and Intestinal Flora in Diabetic Mice: A Mechanistic Exploration

CHEN Wenwen, YAN Fuhua, MO Chaolun, HUANG Mingkun, LI Xiaowen, ZHANG Junmei

2023, 39(11): 1005-1011. DOI: 10.13701/j.cnki.kqyxyj.2023.11.013

Abstract ( 106 )

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Objective: To investigate the impact of Porphyromonas gingivalis (P.g) on blood glucose levels in diabetic mice and identify the bacteria in the intestinal flora closely associated with blood glucose regulation; and to explore the underlying mechanisms of this intervention. Methods: Thirty-two C57BL/6J mice were randomly divided into four groups (n=8 per group) using a randomized control repeated blind method. The groups were as follows: healthy mice fed with phosphate-buffered saline (PBS) (WT group); healthy mice fed with P.g (WT P.g group); diabetic mice injected with streptozotocin and fed with PBS (STZ group); and diabetic mice injected with streptozotocin and fed with P.g (STZ P.g group).The blood glucose levels, body weight, and mental state of the mice were observed weekly. 16S rDNA analysis was performed to assess the composition changes of intestinal flora in colon feces. Immunofluorescence and enzyme-linked immunosorbent assay (ELISA) techniques were used to measure the expression of glucagon-like peptide-1 (GLP-1). Additionally, quantitative polymerase chain reaction (qPCR) was employed to examine the expression of prohormone converting enzyme-1 (PC1/3) and proglucagon mRNA in colon tissue. Results: No significant difference in fasting blood glucose (FBG) levels was observed between the WT group and the WT P.g group. However, at the sixth week after oral administration, a significant difference was observed between the STZ group and the STZ P.g group, with the latter showing higher blood glucose levels. The richness and diversity of the intestinal flora were significantly decreased in the STZ P.g group. qPCR analysis revealed abnormal expression of PC1/3 and proglucagon mRNA, as well as significantly decreased expression of GLP-1. The 16S rDNA analysis indicated a significant increase in the richness of Aeromonas, Rothia, Paraprevotella, and Clostridium in the STZ P.g group, while the richness of Ligilactobacillus, Desulfovibrio, Akkermansia, Bacteroides, and Lachnospiraceae was significantly reduced. FBG levels showed a negative correlation with the richness of Lachnospiraceae_NK4A136_group, Enterorhabdus, and Candidatus_Saccharimonas, but a positive correlation with Desulfovibrio, Akkermansia, and Bacteroides. Conclusion: The results suggest that P.g may interfere with intestinal endocrine function through modulating the intestinal flora, potentially influencing blood glucose regulation throughout the body.

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Osteogenic Properties of Polyetheretherketone Biocomposited by Biphasic Calcium Phosphate

GU Teng, LUO Guisheng, XU Xianzhi, LI Junjun, WANG Xuran, YUAN Changyong, WANG Penglai

2023, 39(11): 1012-1017. DOI: 10.13701/j.cnki.kqyxyj.2023.11.014

Abstract ( 80 )

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Objective: To investigate the osteogenic properties of polyetheretherketone modified by the biphasic calcium phosphate. Methods: The biphasic calcium phosphate/polyetheretherketone composites processed by the composite process were used as the experimental group and polyetheretherketone as the control group. Scanning electron microscopy, X-ray photoelectron spectroscopy, and contact angle measurement were used to examine the surface morphology, chemical elemental composition, and hydrophilicity of the samples. Rat bone marrow mesenchymal stem cells were co-cultured with the samples, and the proliferation performance of the cells was detected by CCK-8 assay; the expression of osteogenic genes OCN, ALP, BMP-2, RUNX2, and SP7 were detected by real-time fluorescence quantitative PCR. In addition, two groups of implants were implanted into the distal femur of rats by establishing a rat femoral implant model, and the osseointegration of the implants was analyzed by Micro-CT. Results: Although the surface morphology of the polyetheretherketone material modified by biphasic calcium phosphate did not change significantly, calcium and phosphorus, which were essential for bone growth, were successfully introduced and the surface hydrophilicity of the samples was improved (P<0.01). The modified polyetheretherketone significantly promoted cell proliferation activity (P<0.01) and showed good biosafety; and it also improved the expression of the osteogenic genes ALP, BMP-2, OCN, RUNX2, and SP7 (P<0.05). In vivo experiments in rats, the surface of the biphasic calcium phosphate/polyetheretherketone implants possessed more and denser new bone formation (P<0.01). Conclusion: Polyetheretherketone modified with biphasic calcium phosphate significantly improved the bioactivity of the polyetheretherketone surface, enhanced hydrophilic properties, and was able to promote osteoblast differentiation and proliferation and enhance the osseointegration properties of the implants.

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Maxillary Molar Distalization using Digitally Designed Nickel-titanium Wire: A Case Report

XU Xiaolin, SUN Dong, LIN Baojun, SUN Peng

2023, 39(11): 1018-1021. DOI: 10.13701/j.cnki.kqyxyj.2023.11.015

Abstract ( 91 )

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Molar distalization is frequently used to increase arch length in orthodontic treatment. This article aims to introduce a simple device that uses digitally designed superelastic nickel-titanium (Ni-Ti) wire to achieve maxillary molar distalization. When the NiTi wire is bonded to the tooth surface, its deformation will produce orthodontic force, which makes the molar move. The device is easy to operate and clean. Besides, it requires low patient compliance and it can produce marked effects.

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Twice Dental Traumas in Upper Anterior Region within Six Months: a Case Report

LIU Yanqing, XU Qiang

2023, 39(11): 1022-1024. DOI: 10.13701/j.cnki.kqyxyj.2023.11.016

Abstract ( 100 )

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Dental trauma usually occurs in the anterior tooth area, especially in the upper anterior tooth area. For permanent teeth, the probability of twice traumas at the same site is very low, not to say the second trauma happened within a short time. This paper reports a case of twice tooth traumas in the upper anterior region within 6 months. After treatment, the alveolar bone was well reconstructed, and the function and aesthetics of the upper anterior teeth were well restored, providing clinical experience for the diagnosis and treatment of patients with twice dental traumas in the same area within a short period.

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A Case of Complete Denture with the Aid of Digital Technology

ZHONG Heli, YAN Ming, HAO Yuetao, WANG Jiawei

2023, 39(11): 1025-1028. DOI: 10.13701/j.cnki.kqyxyj.2023.11.017

Abstract ( 123 )

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With the progress of an aging society, the number of people with edentulous jaw is gradually increasing, and traditional complete dentures are still the main way to repair edentulous jaws. However, the production process of traditional complete denture is cumbersome, requires frequent patient visits, and relies heavily on the experience of clinicians and technicians. Complete dentures produced with the assistance of digital technology have obvious advantages in reducing the number of medical visits, standardizing and facilitating clinical operations, and storing and copying denture data. This article demonsrates the clinical procedure of a case of complete denture assisted by digital technology, with aim to provide ideas for doctors to rationally use digital technology in the production of complete dentures in clinical decision-making.

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