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28 February 2024, Volume 40 Issue 2 Previous Issue    Next Issue

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Clinical Research Status of Attached Gingival Widening JING Xueqin, MIAO Hui 2024, 40(2): 97-102.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.001 Abstract ( 231 )   PDF (845KB) ( 361 )   Attached gingiva and free gingiva are continuous, both of which are keratinized epithelium, and they are collectively called keratinized gingiva. Attached gingival is tightly attached to alveolar bone, tough texture, strong resistance, and has important significance for periodontal health. Clinically, insufficient or missing attached gingival may cause a series of problems. For example, during chewing, the gingival margin is separated from the dental surface after being rubbed or pulled by muscles, which leads to food residues entering the gingival sulci and causing periodontal destruction. In addition, the edge of the prosthesis and implant will cause pain during mastication. For removable partial denture, it will also affect denture design and patient wearing, and affect the quality of patients life. It can be seen that the deficiency or absence of attached gingival has become a common problem faced by periodontal, prosthesis, implant and other disciplines. For its treatment, there are two main types of methods: autologous soft tissue transplantation and biological replacement materials. The purpose of this review is to explore the characteristics of various therapeutic modalities, provide theoretical basis for clinical work, and provide reference for further research. References | Related Articles | Metrics

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Progress in Pain Management after Extraction of Impacted Mandibular Third Molars ZHOU Shizheng, ZOU Haixiao 2024, 40(2): 103-107.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.002 Abstract ( 192 )   PDF (806KB) ( 636 )   In order to relieve the postoperative pain and improve the quality of life, relevant experts recommend systematic management of tooth extraction pain, so as to improve the prognosis of patients. This review aimed to introduce the mechanism and types of pain and the intervention of pain after mandibular third molars extraction, with a view to provide guidance for the clinical management of pain in mandibular impacted third molars extraction. References | Related Articles | Metrics

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Research Progress on Root Canal Biofilm Models In Vitro BAO Pingping, DENG Jiayin 2024, 40(2): 108-112.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.003 Abstract ( 126 )   PDF (813KB) ( 119 )   Bacterial biofilm is the main cause of pulpal/periapical diseases and endodontic treatment failures. The establishment of in vitro root canal biofilm models is an important part of root canal infection control studies. Whether the selection, design, and construction of the models are scientific and rigorous directly affects the results and significance of the studies. This paper reviews the endodontic biofilm models commonly used in latest in vitro studies, and discusses the various constitutive factors, such as the microbial composition, the selection and pre-treatment of substrates, and the inoculation and growth conditions, hoping to provide a reference for the selection and design of more scientific and sound models and the development of more stable and reproducible standardized models that can better mimic the in vivo conditions for future research. References | Related Articles | Metrics

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Retrospective Study of the Effect of Different Gingival Phenotypes on Clinical Efficacy of Periodontal Tissue Regeneration Surgery FU Junbo, DA Haiqin, ZHOU Zhanhao, TAO Shanyue, CHEN Ying 2024, 40(2): 113-117.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.004 Abstract ( 115 )   PDF (2954KB) ( 129 )   Objective: To evaluate the effect of gingival phenotype on clinical efficacy after periodontal tissue regeneration surgery by analyzing relevant clinical indexes. Methods: Thirty patients who need periodontal tissue regeneration surgery were selected, with a total of 40 affected teeth, including 20 thin gingival type and 20 thick gingival type each. The probing depth (PD), gingival recession depth (GRD), clinical attachment loss (CAL), and keratinized tissue width (KTW) of the affected teeth were recorded and compared before and 6 months after surgery. Results: In the thick gingival type group, there were statistically significant differences in the PD, CAL, and KTW at 6 months after surgery in contrast to before surgery (P<0.05). In the thin gingival type group, there were statistically significant differences in the PD, GRD, and CAL at 6 months after surgery in contrast to before surgery (P<0.05). There was statistically significant difference in the changes of ΔCAL, ΔGRD, and ΔKTW before and 6 months after surgery between thin gingival type and thick gingival type groups (P<0.05). Correlation analysis showed that gingiva thickness (GT) was negatively correlated with ΔGRD, and positively correlated with ΔKTW and ΔCAL. Conclusion: Gingival phenotype is an important factor affecting the clinical efficacy of periodontal tissue regeneration surgery. The improvement of CAL, the increase of KTW, and the prognosis of GRD in patients with thick gingival type were better than those with thin gingival type. References | Related Articles | Metrics

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Expression of Hypoxia Inducible Factor-1α in Periodontal Tissues of Diabetic Patients with Periodontitis and Its Relationship with Gingival Microcirculation Disorder FENG Jiafei, XIE Bing 2024, 40(2): 118-124.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.005 Abstract ( 111 )   PDF (1071KB) ( 76 )   Objective: To investigate the expression characteristics of hypoxia inducible factor-1α (HIF-1α) in periodontal tissues of diabetic patients with periodontitis and the relationship between HIF-1α and gingival microcirculation parameters. Methods: A total of 237 patients with type 2 diabetes who were treated in our hospital from March 2019 to March 2022 were selected as the study objects. According to whether the patients had periodontitis or not, they were divided into the group with periodontitis (105 cases) and the group without periodontitis (132 cases). Logistic regression model was used to analyze the relationship between the expression level of HIF-1α and the risk of periodontitis in diabetic patients. The dose-response relationship between HIF-1α and periodontitis was analyzed by restricted cubic spline model. Multivariate logistic regression analysis was used to analyze the factors affecting the occurrence of periodontitis in diabetic patients. The interaction of HIF-1α and gingival microcirculation parameters was analyzed by Cox regression. The structural equation prediction model was established and verified. Results: After adjusting for confounding factors, HIF-1α was positively correlated with periodontitis in diabetic patients. The expression level of HIF-1α was not nonlinear dose-response related to diabetic patients with periodontitis, and was not related to gender. HIF-1α and gingival microcirculation parameters were important factors affecting the occurrence of periodontitis. The interaction of HIF-1α and gingival microcirculation parameters might increase the risk of periodontitis in diabetic patients. The interaction effect of HIF-1α combined with gingival blood flow was the highest. The overall adaptation of structural equation model was better, which could reflect the relationship between the influencing factors and the occurrence of periodontitis. The prediction model had good differentiation and independence. Conclusion: HIF-1α is a risk factor for periodontitis in diabetic patients. The interaction of HIF-1α and gingival microcirculation parameters may increase the risk of periodontitis in diabetic patients. References | Related Articles | Metrics

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Effects of Diode Laser on Periodontal Initial Treatment of Class Ⅱ Furcation Involvement with Enamel Projection GUO Xiaobin, WEN Chang, LI Sihong, WANG Shuining, YANG Dong 2024, 40(2): 125-129.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.006 Abstract ( 93 )   PDF (2937KB) ( 76 )   Objective: To study the clinical effect of deglazing combined with diode laser on the treatment of class Ⅱ root furcation involvement. Methods: Forty-eight teeth with grade Ⅱ enamel projections which had root furcation involvement were randomly divided into SRP group, deglazing combined SRP group (D+SRP group), and deglazing combined SRP and diode laser group (D+SRP+L group). The periodontal probing depth (PD), gingival bleeding index (BI), gingival recession (GR), and clinical attachment loss (CAL) in three groups at baseline and four weeks and three months after treatment were compared. At the same time, thirty-six isolated teeth with grade Ⅱ cervical enamel projections were collected and randomly divided into three groups, which were given the same treatment mentioned above. Root slices were prepared. The surface morphology and surface roughness (Ra) were observed under atomic force microscope. Immunofluorescent cells scratch was used to observe the migration of periodontal membrane fibroblasts (hPDLFs). Dental colony morphology was observed by porphyromonas gingivalis culture. Results: Four weeks and three months after treatment, the most significant improvement was found in the D+SRP+L group, followed by D+SRP group and the worst was in the SRP group (P<0.01). Atomic force microscope showed that the largest Ra value was found in D+SRP+L group, followed by the D+SRP group, and the smallest in SRP group (P<0.01). Cell migration ratio of hPDLFs showed the highest migration ability was in the D+SRP+L group, followed by D+SRP group, and the lowest was in the SRP group. The difference between groups was statistically significant (P<0.01). For VPM (peak material volume) value under AFM, there was significant difference between D+SRP+L group and SRP group. But there was no significant difference between D+SRP group and SRP group. There was no significant difference in the germ layer thickness among three groups (P>0.05). Conclusion: Deglazing combined with diode laser can improve the effect of initial treatment of root furcation involvement. References | Related Articles | Metrics

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Clinical Observation and Risk Factors Analysis of Crown Lengthening of Mandibular Second Molar JIA Yan, YU Huan, ZHANG Yan, SHI Xue, WANG Zhitao, ZHANG Zheng 2024, 40(2): 130-135.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.007 Abstract ( 101 )   PDF (2168KB) ( 106 )   Objective: To observe the treatment outcome of crown lengthening on mandibular second molars, determine the distribution of risk factors, and explore the influence of the number of risk factors on the effect of crown lengthening. Methods: A total of 314 mandibular second molars were included from the patients visited our hospital from 2019 to 2021. At 6-week follow-up, the patients were divided into successful group and failed group. The risk factors that affected the curative effect of two groups were screened, and the correlation between the number of them and the curative effect was analyzed. Results: Of the 314 teeth, 88.54% had good results and 11.46% had poor results. The distance between gingival margin and the broken end (P<0.01), the distance between gingival margin and crest (P=0.032), and the shape of root (P=0.006) were the risk factors influencing the postoperative outcome. As the number of risk factors increased, the rate of surgical failure increased linearly, and when the number of risk factors reached 3, the risk of failure increased significantly (P<0.01). There was a positive correlation between them (P<0.01). Conclusion: The distance between gingival margin and broken ends, the distance between preoperative broken ends and crest, and the shape of root are the risk factors that influence the effect of crown lengthening. There was a positive correlation between the number of risk factors and the rate of surgical failure (P<0.01). When the number of risk factors reached 3, the risk of surgical failure increased significantly, and the indication should be chosen carefully. References | Related Articles | Metrics

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Effect of Teriparatide on Root Resorption during Orthodontic Tooth Movement in Ovariectomized Rats by Micro-CT SU Chenxi, ZHANG Cheng, HE Shushu, ZOU Shujuan 2024, 40(2): 136-141.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.008 Abstract ( 104 )   PDF (8667KB) ( 63 )   Objective: To investigate the effect of teriparatide on root resorption during orthodontic tooth movement in osteoporotic rats using micro-CT. Methods: Seventy-two female Wistar rats (8-week-old) were randomly divided into 3 groups as follows: ovariectomized group, teriparatide group (ovariectomized rats treated by teriparatide), and the control group (sham-operated). After twelve weeks, 50g of force was placed to move the first molar on the left side by using a closed-coil spring. The teriparatide group was given subcutaneous injection of teriparatide daily, while the ovariectomized group and control group were given equal amounts of PBS solution. Rats were sacrificed on days 0, 7, 14, and 21, and samples were collected and subjected to micro-CT scanning. Results: The root resorption lacunae can be observed in all groups from day 7, and the volume of the lacunae increased gradually with time. The root resorption of rats in ovariectomized group was more serious than that in control group. Teriparatide treatment could significantly reduce the root resorption of ovariectomized rats on day 21. Conclusion: Osteoporosis can aggravate root resorption during tooth movement in rats, and intermittent teriparatide administration can reduce orthodontically induced root resorption in osteoporotic rats. References | Related Articles | Metrics

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Morphological Stability of Three-dimensional Printed Photosensitive Resin Dental Models WU Junqing, WU Bin, LIU Jingjing, SHI Xueming, BAO Han, CAO Dan, YAN Bin 2024, 40(2): 142-146.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.009 Abstract ( 78 )   PDF (2151KB) ( 52 )   Objective: To study the morphological stability of photosensitive resin dental models made from different three-dimensional printing materials. Methods: Resin dental models made from two types of 3D-printed materials were printed, namely FHD1400 group (10 sets) and E-Model-Light group (10 sets). All models were scanned by an optical model scanner instantly after printed and after 1, 3, 7, 14, 28, and 60 days of storage. The heat map was generated by superimposing models at different time points. The average deviation and deformation percentage were calculated, meanwhile, changes of four linear indexes (the anterior, middle, and posterior width and length of the dental arch) of the model were measured. The data were statistically analyzed and the differences were compared among the models. Results: The resin dental model shrunk more with the extension of storage time. The average deviation, deformation percentage, and contraction of arch length and width increased rapidly within 14 days. The width contraction between molars of all models exceeded 0.2 mm after 14 days of storage. Conclusion: The resin dental models printed from two commonly used clinical materials have poor morphological stability and should not be used longer than 14 days after printing. The morphological stability of E-Model-Light group was better than that of FHD1400 group. References | Related Articles | Metrics

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Changes in the Detection Rate and Etiological Analysis of Second Permanent Molar Eruption Disturbances LIU Shiying, ZHAI Junhui, JIANG Hongtao, WANG Mingfeng, LIU Lin, LIU Xiaolin 2024, 40(2): 147-151.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.010 Abstract ( 88 )   PDF (1457KB) ( 76 )   Objective: To investigate the detection rate of second permanent molar eruption disturbances in recent years compared with more than 20 years ago, and to analyze the etiology. Methods: Medical records of patients who were treated in the orthodontic department of the author's hospital were used as the research materials. The patients were divided into the 20-year group and the recent-years group based on the time of their first visit. The detection rate of second molar eruption disturbances between two groups was compared, and the main causes and the relationship with malocclusion classification were analyzed. Results: The detection rate and number of teeth involved in the recent-years group were significantly higher than those in the 20-year group (P<0.01). Significantly more second permanent molars with eruption disturbances were caused by abnormal eruption direction and/or insufficient space than any other reasons (P<0.05). The second molar eruption disturbances were more common in the mandible and had no significant relationship with the presence or absence of the third molar. In cases of second molar eruption disturbances, skeletal type Ⅰ and average angle were the most common, skeletal type Ⅱ cases were more common than skeletal type Ⅲ cases, and high angle cases were more common than low angle cases. Conclusion: The detection rate of second molar eruption disturbances and the number of teeth involved increased significantly when compared with those of 20 years ago. The main causes are abnormal eruption direction and/or insufficient space. The second molar eruption disturbances seem to be more common in cases with skeletal class Ⅱ and high angle. References | Related Articles | Metrics

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Comparison of Incidence of Post-orthodontic White Spot Lesion between Clear Aligners and Fixed Appliances ZHANG Jingqi, YANG Yi, GAO Yanzi, LIN Donger, JIAN Fan, LONG Hu, LAI Wenli 2024, 40(2): 152-155.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.011 Abstract ( 107 )   PDF (954KB) ( 55 )   Objective: To compare the incidence of white spot lesions (WSLs) between fixed appliances (FA) and clear aligner (CA) through retrospective study. Methods: The intraoral photographs of patients who completed orthodontic treatment in the West China Hospital of Stomatology were taken using a digital camera before and after treatment. The photographs were placed side by side on a computer monitor to diagnose orthodontic-related WSLs. Non-existent white spot lesions before treatment and faint white opacities after treatment were identified as orthodontic-related WSLs. Results: The incidence of WSLs in the CA group was 4.63%, which was significantly lower than that in the FA group (17.27%, P=0.003). Teeth of male patients were more likely to develop WSLs than those of female patients in the CA group (P=0.021). The incidence of WSLs in the adolescents was significantly higher than that in the adults (P<0.001). More than 25 months of treatment duration were more likely to develop WSLs (P<0.001). Conclusion: The incidence of post-orthodontic WSLs was lower in the patients with clear aligners than in the patients with fixed appliance. Besides, adolescent, male, poor oral hygiene, and longer treatment duration were risk factors for post-orthodontic WSLs. References | Related Articles | Metrics

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Influence of LIF on Dentin Development in Mice CONG Yaqi, GUO Donghua, ZHU Yuxi, HUANG Jing, ZHANG Yu, ZHOU Yi, ZHANG Jiali 2024, 40(2): 156-160.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.012 Abstract ( 85 )   PDF (6420KB) ( 62 )   Objective: To investigate the effect of LIF during dentin formation. Methods: Immunohistochemistry (IHC) was employed to detect the expression pattern of LIF during odontoblast differentiation in PN2 incisors. About 2mm from the tip of the erupted part of the left incisor of each mouse was removed to compare different growth speed between Lif-/- group and the control group. The mandibles were scanned by a micro-computed tomography (Micro-CT) instrument. Mimics was used to analyze the mineral density of dentin in both groups. Microhardness measurement was carried out to measure the dentin surface hardness. Electron probe X-ray microanalyser (EPMA) was performed for surface elements analysis of mandibular incisors. Immunofluorescence (IF) was employed to detect the expression of Col1α1 and DMP1 in odontoblasts. Results: LIF was present in polarizing odontoblasts, and gradually increased with the mature of odontoblasts. The growth speed of Lif-/- incisors were slower than that of control group. The mineral density and Vickers hardness of dentin in Lif-/- incisors were lower than that in wild-type mice. The element atomic percent of the Ca/P ratio was reduced in Lif-/- mice. Knockdown of Lif decreased the ALP activity and the formation of mineralized matrix nodules and these could be rescued by adding LIF. The expressions of Col1α1 and DMP1 were decreased in odontoblasts of Lif-/- group. Conclusion: Deficiency of LIF restrains the formation and mineralization of incisor dentin in mice. References | Related Articles | Metrics

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Adenoid Cystic Carcinoma with High-grade Transformation in Head and Neck: An Exploration of Its Molecular Genetic Alterations Based on Next-generation Sequencing LIU Shengnan, GU Ting, ZHANG Ying, QIAN Jiajun, XUE Junqing, WANG Yu 2024, 40(2): 161-165.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.013 Abstract ( 91 )   PDF (5998KB) ( 56 )   Objective: To identify the genetic alterations of ACC-HGT in the head and neck. Methods: Clinical and pathological information were gathered from five patients with ACC-HGT who were diagnosed in the Department of Oral Pathology at the Shanghai Ninth People's Hospital during the period from January 2020 to December 2022. The high-grade transformed components microdissected from the 5 cases were detected by next generation sequencing. The effect of gene mutations on protein expression was further verified by immunohistochemistry. Results: These patients were all male, whose average age was 48 years. During the period after surgery ranging from 4 to 30 months, the outcomes of 5 patients was tracked. Of these, 3 survived while 2 deceased. Three patients experienced local recurrence, with 2 also developing distant metastases to lungs and brain. Of the 5 tumors, NOTCH1 mutations were detected in 3 cases and another one case harbored NOTCH1 rearrangement. p53 mutation was detected in 1 case. PIK3CA mutation was detected in 2 cases. PIK3R1 mutation was detected in 1 case. PPP2R2A mutation was detected in 1 case. These gene mutations could cause the overexpression of downstream related proteins NICD, p53 and pAKTSer473. Conclusion: Adenoid cystic carcinoma with high-grade transformation has a poor prognosis, and are enriched for alterations in the key NOTCH, PI3K and P53 signaling pathways. References | Related Articles | Metrics

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Effect of Soluble Epoxide Hydrolase Inhibitor on Migration and Odontogenic Differentiation of Human Dental Pulp Stem Cells Exposed to HEMA LUO Jiaxin, HUANG Jing, WANG Yuling, FENG Yan, DANG Haixia 2024, 40(2): 166-171.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.014 Abstract ( 90 )   PDF (3465KB) ( 52 )   Objective: To investigate the effect of soluble epoxide hydrolase inhibitor (TPPU) on the migration and odontogenic differentiation of human dental pulp stem cells (hDPSCs) exposed to 2-hydroxyethyl methacrylate (HEMA). Methods: hDPSCs were isolated and extracted, and then identified by alizarin red staining and flow cytometry. hDPSCs without drug culture were used as the control group, and HEMA and HEMA+TPPU were used as the experimental group. hDPSCs activity was detected by CCK-8. hDPSCs migration was detected by Scratch test. ALP activity was detected and be quantified by alkaline phosphatase staining and quantitative test kit. Real-time quantitative fluorescent PCR (RT-qPCR) was used to detect the relative expression of Runx2, DMP-1, and DSPP related to odontogenic differentiation. Alizarin red staining was used to detect the formation of mineralized nodules. Results: The cell activity of HEMA group was lower than that of control group (P<0.05), and the cell activity of HEMA+TPPU group was higher than that of HEMA group (P<0.05). The cell mobility of HEMA group was significantly decreased compared with that of control group (P<0.05), and the cell mobility of HEMA+TPPU group was significantly increased compared with that of HEMA group (P<0.05). After the cells were treated with 2 mmol/L HEMA in the process of odontogenic differentiation, alkaline phosphatase activity was decreased when compared with control group (P<0.05), and the expression of odontogenic differentiation related genes was significantly decreased (P<0.05). The activity of alkaline phosphatase in the HEMA+TPPU group was significantly higher than that in HEMA group (P<0.05), and the expressions of Runx2, DMP-1, and DSPP were also significantly increased (P<0.05). In addition, alizarin red staining showed that the relative calcium contents of HEMA+TPPU group and control group were significantly higher than that of HEMA group (P<0.05). Conclusion: HEMA can inhibit the cell migration and odontogenic differentiation of hDPSCs to some extent, and TPPU can partially reverse the inhibitory effect of HEMA on the cell migration and odontogenic differentiation of hDPSCs. References | Related Articles | Metrics

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Periodontal Systematic Therapy Combined with Intentional Replantation in Treatment of Severe Periodontitis: A Case Report HUANG Yongling, LIN Minkui 2024, 40(2): 172-174.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.015 Abstract ( 96 )   PDF (2368KB) ( 105 )   This paper reports a clinical case of periodontal systematic therapy combined with intentional replantation in the treatment of severe periodontitis. After periodontal system treatment, the hopeless tooth 32 of a 65-year-old female patient was treated with intentional replantation. The 2-year follow-up result shows that the natural tooth is maintained and has achieved good therapeutic effect. References | Related Articles | Metrics

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GBR for Upper Anterior Bone Fenestration with Soft Tissue Deficiency: A Case Report LIU Shuo, ZHOU Meilu, XU Wenhua, PAN Taohua, LEI Rongchang 2024, 40(2): 175-177.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.016 Abstract ( 83 )   PDF (3159KB) ( 60 )   After tooth loss, soft and hard tissues are often insufficient and gums collapse due to pathological bone loss or physiological modification, which affects aesthetics. In this paper, a patient with insufficient soft and hard tissue and residual anterior bone fenestration after the loss of upper middle incisors was subjected to guided bone regeneration. The incremental reconstruction of soft and hard tissues was obtained. References | Related Articles | Metrics

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Tent-pole Technique Combine with CGF for Reconstruction of Serious Bone Defects: A Case Report SUN Lili, ZHANG Yu, CHEN Wenfang, HU Jian 2024, 40(2): 178-180.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.017 Abstract ( 98 )   PDF (3535KB) ( 70 )   This article illustrates a successful case for reconstructing severely resorbed maxilla. Tent-pole technique in combination with concentrate growth factor were selected as a modification to general guided bone regeneration procedure. Delayed implant placement was performed in order to avoid the fearing of autogenous bone grafting and the risk factors in lateral window for sinus floor elevation. One-year follow-up visit showed that all implants were stable and prosthesis were satisfactory. It is expected that this case will provide new ideas to the bone regeneration protocol for severe alveolar ridge defects. References | Related Articles | Metrics

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Necrotizing Sialometaplasia on the Palate:A Case Report LIU Zeyu, TONG Wenjin, ZHOU Gang, ZHANG Jiali, LU Rui 2024, 40(2): 181-184.  DOI: 10.13701/j.cnki.kqyxyj.2024.02.018 Abstract ( 109 )   PDF (2293KB) ( 65 )   Necrotizing sialometaplasia (NS) is a rare, self-limiting disease affecting area containing salivary gland tissue. As necrotizing sialometaplasia may resembles other diseases such as malignant tumors in both clinicopathological manifestations, learning the issue of NS is critical for appropriate diagnosis and treatment, avoiding unnecessary radical surgery. Here we reported a case of necrotizing sialometaplasia presented as a massive ulcer on the palate, aiming to provide reference for clinical management of the disease. References | Related Articles | Metrics