Current Issue
01 October 2021, Volume 39 Issue 5
  • Targeting-YAP/TAZ therapies for head and neck cancer, directly or indirectly?
    Feng Xiaodong.
    West China Journal of Stomatology. 2021, 39(5):  493-500.  doi:10.7518/hxkq.2021.05.001
    Abstract ( 223 )   HTML ( 37 )   PDF(pc) (1571KB) ( 312 )   Save
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    YAP/TAZ are wild over-activated in head and neck squamous cell carcinoma (HNSCC) with high potential as a direct therapy target for HNSCC treatments. However, the efforts on the directly targeting-YAP/TAZ therapies over the past decade, have very limited impacts, mainly caused by: 1. There is still none effective and specific YAP/TAZ inhibitor with clinical potential; 2. YAP/TAZ might not be directly targeted, because of their multiple important biological functions, such as: regulation of cell proliferation and survival, stem cell maintain, regulation of organ development, organ size control, and tissue regeneration. Interestingly, the over-activation of YAP/TAZ in HNSCC mainly be regulated by upstream abnormal molecular or biological events, instead of genes alteration of YAP/TAZ. Therefore, exploring the alternative molecular events regulating YAP/TAZ activation and molecular mechanism in HNSCC might help to uncover novel indirect targets of YAP/TAZ therapies for HNSCC prevention and treatment.

    The investigation of energy metabolism in osteoblasts and osteoclasts
    Shi Yu.
    West China Journal of Stomatology. 2021, 39(5):  501-509.  doi:10.7518/hxkq.2021.05.002
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    The maintenance of bone homeostasis is critical for bone health. It is vulnerable to cause bone loss, even severely osteoporosis when the balance between bone formation and absorption is interrupted. Growing evidence has shown that energy metabolism disorders, such as abnormal glucose metabolism, irregular amino acid metabolism, and aberrant lipid metabolism, can damage bone homeostasis, causing or exacerbating bone mass loss and osteoporosis-related fractures. Here, we summarize the studies of energy metabolism in osteoblasts and osteoclasts and provide a better appreciation of how energy metabolism, especially glucose metabolism maintains bone homeostasis. With this knowledge, new avenues will be unraveled to understand and cue bone-related diseases such as osteoporosis.

    Effect of RhoE expression on the migration and invasion of tongue squamous cell carcinoma
    Zhao Kai, Yuan Wenhong, Li Wenjian, Chi Zengpeng, Wang Shaoru, Chen Zhenggang
    West China Journal of Stomatology. 2021, 39(5):  510-517.  doi:10.7518/hxkq.2021.05.003
    Abstract ( 75 )   HTML ( 6 )   PDF(pc) (4504KB) ( 75 )   Save
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    Objective

    This study aims to investigate the effect of RhoE expression on the migration and invasion of tongue squamous cell carcinoma (TSCC).

    Methods

    Forty-eight TSCC cases were selected from the Maxillofacial Surgery Center of Qingdao Municipal Hospital from 2017 to 2019. The expression of RhoE in the specimens (TSCC and adjacent tissues) was detected by immunohistochemistry, and RhoE mRNA and protein were extracted to further detect the expression of RhoE. SCC-4 and CAL-27 cells were selected for in vitro experiments. Transient transfection was used to overexpress RhoE. Real-time fluorescence quantitative PCR (qRT-PCR) and Western blot analyses were conducted to detect the overexpression efficiency. Scratch test and Transwell cell invasion tests were used to detect the migration and invasion ability of TSCC, respectively. The expression levels of Rho-associated coiled-coil-containing protein kinase 1 (ROCK1), matrix metalloproteinase-2 (MMP-2), and matrix metalloproteinase-9 (MMP-9) were detected by Western blot. Experimental data were analyzed by Graphpad prism 8.2.1 software.

    Results

    The expression level of RhoE in TSCC was significantly lower than that in adjacent tissues (P<0.05). The migration and invasion abilities of TSCC were significantly lower than those in the control group (P<0.05). The Western blot showed significantly lower expression levels of ROCK1, MMP-2, and MMP-9 in the experimental group than in the control group (P<0.05).

    Conclusion

    RhoE expression is low in TSCC. Over expression RhoE in TSCC can significantly decrease its migration and invasion abilities. Hence, RhoE may play an important role in regulating the metastasis and invasion of TSCC and provide a new target for gene therapy.

    Effect of peroxisome proliferator-activated receptor-γ coactivator-1α on liver injury induced by periodontitis in rats
    Xia Boyuan, Li Yan, Ding Xu, Li Xin, Liu Xinchan, Yu Weixian
    West China Journal of Stomatology. 2021, 39(5):  518-523.  doi:10.7518/hxkq.2021.05.004
    Abstract ( 43 )   HTML ( 3 )   PDF(pc) (2698KB) ( 89 )   Save
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    Objective

    To investigate the effect of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) on liver injury induced by periodontitis in rats.

    Methods

    Twenty-four male Wistar rats were randomly divided into two groups: control group and periodontitis group, twelve per group. In periodontitis group, the periodontitis models were established for the maxillary first molars in rats by means of “wire ligation+vaccinationwith Porphyromonas gingivalis”, the control group was inoculated with the equal volume of 2% sodium carboxymethyl cellulose in the same position, for 6 weeks. The probing depth, tooth mobility and sulcus bleeding index were detected. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of liver tissues in rats. The quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) were used to detect the gene and protein expression levels of PGC-1α, nuclear factor erythroid 2-related factor 2 (Nrf2) and mitochondrial transcription factor A (TFAM) in liver tissues of rats.

    Results

    The probing depth, tooth mobility and sulcus bleeding index in periodontitis group were significantly higher than that in control group. HE staining showed in periodontitis group, hepatic cords ranged disorderly and there were vacuoles in cells and inflammatory cells infiltrated in liver tissues of rats, and there was no obvious abnormality in control group. The qRT-PCR results showed that the mRNA expression levels of Pgc-1α, Nrf2 and Tfam in liver tissues of rats in periodontitis group were lower obviously than that in control group. IHC results showed that the protein expression level of PGC-1α in liver tissues of rats in periodontitis group was decreased significantly than that in control group.

    Conclusion

    PGC-1α may be involved in the process of periodontitis-induced liver injury in rats.

    Effects of different irradiators on the establishment of osteoradionecrosis model of rat mandible
    Chen Huawei, Zhang Shengfu, He Haitao.
    West China Journal of Stomatology. 2021, 39(5):  524-530.  doi:10.7518/hxkq.2021.05.005
    Abstract ( 58 )   HTML ( 1 )   PDF(pc) (6363KB) ( 43 )   Save
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    Objective

    To compare the effects of different irradiators on the establishment of osteoradionecrosis of jaw model (ORNJ) to explore an ideal modeling method.

    Methods

    A total of 33 adult SD rats were included and randomly divided into three groups according to the radiation equipment, namely, the blank control (CN, 3 rats), group A (linear accelerator irradiation, 15 rats), and group B (small-animal irradiator irradiation, 15 rats). Groups A and B were irradiated with daily fractions of 7, 8, and 9 Gy for 5 days and further divided into three subgroups as follows: group A35/B35, 35 Gy; group A40/B40, 40 Gy; and group A45/B45, 45 Gy. The left mandibular molars of the rats were extracted 1 week after irradiation. The rats were sacrificed 3 weeks after tooth extraction, and the mandible specimens were obtained for gross observation, micro-CT scanning, and histological detection to evaluate the success rate of modeling.

    Results

    At 3 weeks after dental extractions, complete gingival healing was found in the regions of dental extractions in groups A35 and A40. However, failed gingival healing and bone exposure were found in groups A45 and B. Hematoxylin and eosin staining showed necrotic bone of the irradiated mandible in groups A40, A45,and B, with success modeling rates of 40% in group A and 93.3% in group B.

    Conclusion

    Small-animal irradiator irradiation is an ideal device for establishing ORNJ model.

    Effect of micro/nanoscaled Ti phosphate/Ti oxide hybrid coating on the osseointegration of Ti implants
    Zhang Jie, Zhu Songsong, Jiang Nan.
    West China Journal of Stomatology. 2021, 39(5):  531-539.  doi:10.7518/hxkq.2021.05.006
    Abstract ( 54 )   HTML ( 5 )   PDF(pc) (6605KB) ( 66 )   Save
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    Objective

    This study was performed to fabricate a bionic coating with titanium (Ti) phosphate to promote the osseointegration of Ti substrate implants.

    Methods

    Phosphorylated micro/nanocoating was prepared on the surface of pure titanium (i.e., TiP-Ti) by hydrothermal process under special pressure, and the untreated smooth pure titanium (cp-Ti) was selected as the control. To evaluate the characteristics of the coating surface, scanning electron microscopy, X-ray diffraction, atomic force microscopy, and contact-angle measurement were performed. In addition, the effects of TiP-Ti on the proliferation, adhesion, and differentiation of rat bone marrow mesenchymal stem cells (BMSCs) were investigated by using in vitro cytology. Finally, TiP-Ti implants were implanted into the rat tibia, and the effect of TiP-Ti on the osseointegration in the host was evaluated after 12 weeks.

    Results

    The TiP-Ti surface presented a bionic structure with coexisting nanoscale 3D spatial structure and microscale pores. In vitro experiments showed that the BMSCs had enhanced adhesion, proliferation, and osteogenic differentiation on the TiP-Ti surface. Furthermore, in vivo, TiP-Ti showed considerably stronger osseointegration compared with pure titanium, and the ultimate shear strength and maximum pushing force were significantly improved.

    Conclusion

    A bionic structure with TiP-Ti micro/nanoscale coating was successfully fabricated, indicating a promising method for modifying the surface of implants.

    Effect of acidic culture conditions on the proliferation, apoptosis, and migration ability of human tongue squamous cell carcinoma cells and its related mechanism
    Dai Xiaohua, Wang Guanhua, Lian Xiaoli, Yan Yan, Wang Yue, Zou Huiru, Liu Hao.
    West China Journal of Stomatology. 2021, 39(5):  540-546.  doi:10.7518/hxkq.2021.05.007
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    Objective

    This study aims to explore the effect of acidic culture conditions on the proliferation, apoptosis, and migration ability of human tongue squamous cell carcinoma SCC15 and CAL27 cells and its potential molecular mechanism.

    Methods

    After acidic culture for different periods, methyl thiazolyl tetrazolium (MTT) method was adop-ted to detect the cell proliferation of SCC15 and CAL27. Flow cytometry was employed to detect the apoptosis level of SCC15 and CAL27 cells. The migration ability of SCC15 and CAL27 after acidic culture was detected by scratch hea-ling test. Real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) was used to detect the mRNA expression of cyclooxygenase 2 (COX-2) and survivin in SCC15 and CAL27 cells after acidic culture.

    Results

    After culture for 24 h under acidic microenvironment, SCC15 and CAL27 cells grew rapidly and reached the stationary phase after adjustment for 3 days. The apoptosis levels of SCC15 and CAL27 cells decreased after acidic culture, but the most significant reduction occurred after 6 h of acidic culture. The scratch healing rates of SCC15 and CAL27 cells increased after acidic culture. The results of FQ-PCR showed that the mRNA expression levels of COX-2 and survivin in SCC15 and CAL27 cells increased after acidic culture.

    Conclusion

    Extracellular acidic microenvironment can inhibit the apoptosis of tongue squamous carcinoma cells, promote their migration, and induce more adaptable and malignant tongue squamous carcinoma cells. The mechanism may be related to COX-2 and survivin and their signal pathways.

    Long non-coding RNA potassium voltage-gated channel subfamily Q member 1 overlapping transcript 1 regulates the proliferation and osteogenic differentiation of human periodontal ligament stem cells by targeting miR-24-3p
    Pang Ming, Wei Hongxia, Chen Xi
    West China Journal of Stomatology. 2021, 39(5):  547-554.  doi:10.7518/hxkq.2021.05.008
    Abstract ( 47 )   HTML ( 1 )   PDF(pc) (2160KB) ( 64 )   Save
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    Objective

    This study aims to explore the effect and molecular mechanism of long non-coding RNA (lncRNA) potassium voltage-gated channel subfamily Q member 1 overlapping transcript 1 (KCNQ1OT1) on proliferation and osteogenic differentiation in human periodontal ligament stem cells (hPDLSCs).

    Methods

    The hPDLSCs of normal periodontal tissues were isolated and cultured. The mineralized solution induced the osteoblast differentiation of hPDLSCs. The down-regulation of lncRNA KCNQ1OT1, the overexpression of anti-miR-24-3p on the proliferation and the levels of osteocalcin (OCN), osteopontin (OPN) and alkaline phosphatase (ALP) of hPDLSCs were investigated. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the levels of lncRNA KCNQ1OT1, miR-24-3p, OCN, OPN, and ALP. Methyl thiazolyl tetrazolium (MTT) method was used to detect cell viability and activity. Cell proliferation was evaluated by MTT. Western blot was used to detect protein expression. The targeted relationship between lncRNA KCNQ1OT1 and miR-24-3p was detected by double-luciferase experiment.

    Results

    The expression level of lncRNA KCNQ1OT1 increased, and that of miR-24-3p decreased during the osteogenesis of hPDLSCs (P<0.05). The down-regulation of lncRNA KCNQ1OT1 inhibited cell proliferation and reduced the mRNA and protein expression levels of OCN, OPN, and ALP (P<0.05). LncRNA KCNQ1OT1 targeted and regulated miR-24-3p. The overexpression of miR-24-3p inhibited cell proliferation and reduced the mRNA and protein expression levels of OCN, OPN, and ALP (P<0.05). Inhibition of miR-24-3p reversed the effect of the down-regulation of lncRNA KCNQ1OT1 on cell proliferation and mRNA and protein expression levels of OCN, OPN, and ALP (P<0.05).

    Conclusion

    Down-regulation of lncRNA KCNQ1OT1 inhibited the proliferation and osteogenic differentiation of hPDLSCs by targeting the up-regulated expression of miR-24-3p.

    Clinical analysis on the root fracture of the maxillary first molar
    Yuan Zhiyao, Zou Xihong, Dai Linlin, Ao Huizhi, Li Houxuan.
    West China Journal of Stomatology. 2021, 39(5):  555-559.  doi:10.7518/hxkq.2021.05.009
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    Objective

    This study aimed to investigate the common types and directions of root fractures of the maxillary first molar and the influence of root canal treatment on the prevalent sites of root fractures.

    Methods

    A total of 274 maxillary first molars with root fractures diagnosed via cone beam computed tomography were included. The root fractures of nonendodontically and endodontically treated teeth were identified to be spontaneous and secondary root fractures, respectively. The sites, types, and directions of spontaneous and secondary root fractures were determined.

    Results

    Among the spontaneous root fractures, the proportion of palatal root fractures (56.1%) was higher than those of mesial buccal root fractures (36.1%) and distal buccal root fractures (7.8%). Among the secondary root fractures, the proportion of mesial buccal root fractures (52.7%) was higher than those of palatal root fractures (36.5%) and distal buccal root fractures (10.8%). The distribution of predominant fracture sites was statistically significant (P<0.05), and vertical root fracture was the most common type. Palatal and buccal roots were commonly fractured at the mesiodistal and buccal-palatal directions, respectively.

    Conclusion

    This study provided an epidemiological basis for the clinical features of root fractures of the maxillary first molar. During the dia-gnosis and treatment of the maxillary first molar, the possibility of palatal root fractures should be considered. The occurrence of mesial buccal root fractures may be related to root canal treatment. Therefore, the risk of mesial buccal root fractures caused by iatrogenic factors should be minimized.

    Short-term nasal symmetry repaired by force-balanced muscular reconstruction technique
    Liu Yingmeng, Chen Yu, Zhang Bihe, Shi Bing, Li Chenghao
    West China Journal of Stomatology. 2021, 39(5):  560-565.  doi:10.7518/hxkq.2021.05.010
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    Objective

    This study aimed to compare the postoperative outcome of the new and classical muscular reconstruction technique combined with nasal internal-fixation method for secondary deformity post unilateral cleft lip repair. A rationale is provided for the further surgical improvement of secondary deformities.

    Methods

    Sixty patients aged 4-18 years with secondary unilateral cleft lip-nose deformity were involved in this research. The deformities of 28 patients were repaired using the muscular force balance technique through nasal internal fixation method, and 32 were repaired using classical muscular reconstruction technique. Two-dimensional analysis was used to evaluate the nose-lip morphology of pre- and post-operative patients through standardized photographs seven days after surgery.

    Results

    Compared with preoperative nasal morphology in the muscular force balance technique group, the 7-days postoperative results of this group showed the significantly improved short-term outcomes in the correction of columellar deflection, alar rim angle, nasal shape, and the symmetry of alar base width, nostril width, nostril height, alar rim angle (P<0.05).

    Conclusion

    The new muscular reconstruction technique with nasal internal-fixation method has a significant effect on nasal repair.

    Clinical study on obstructive sleep apnea following pharyngeal flap surgery
    Zhao Ning, Liu Zhenguo, Xu Yaoxiang, Yue Jin, Xue Lingfa, Xiao Wenlin
    West China Journal of Stomatology. 2021, 39(5):  566-569.  doi:10.7518/hxkq.2021.05.011
    Abstract ( 39 )   HTML ( 1 )   PDF(pc) (603KB) ( 41 )   Save
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    Objective

    This study aims to investigate the incidence and severity of obstructive sleep apnea (OSA) in cleft patients with velopharyngeal insufficiency (VPI) after pharyngeal flap surgery (PFS) and explore the influence of operation age.

    Methods

    A retrospective study was conducted in 82 cleft patients after PFS. The patients were divided into two groups according to their age at the time of surgery. The incidence and severity of OSA were assessed at least 1.2 years (mean 6.0 years) postoperatively by polysomnography (PSG).

    Results

    The incidence rates of OSA were 20% in the adult group and 31% in the child group. No significant difference was found between the two groups (P=0.289). Patients with OSA in the adult and child groups were classified into different levels of severity (mild, moderate, severe) according to the apnea hypoventilation index (AHI). No statistically significant difference in the severity of OSA was found between the two groups (P=0.079).

    Conclusion

    Some patients still have OSA average of 6.0 years after PFS, and operation ageis unrelated to the incidence and severity of OSA.

    Retrospective study on the merits of bone grafts and the influence of implant protrusion length after osteotome sinus elevation surgery
    Yang Dawei, Xiao Jingyi, Zhang Peng, Lu Boyao, Liang Xing.
    West China Journal of Stomatology. 2021, 39(5):  570-575.  doi:10.7518/hxkq.2021.05.012
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    Objective

    This study aims to evaluate the endo-sinus bone remodeling of dental implants placed via osteotome sinus floor elevation (OSFE) after 6 months and using different implant protrusion lengths and bone grafts through cone beam computed tomography (CBCT).

    Methods

    Ninety-six patients with 124 implants were included and assigned into four groups. Group 1: implant protrusion length<4 mm with bone graft; group 2: implant protrusion length>4 mm with bone graft; group 3: implant protrusion length<4 mm without bone graft; group 4: implant protrusion length>4 mm without bone graft. Apical bone gain (ABG), cortical bone gain (CBG), bone density gain (BDG), and marginal bone loss (MBL) were observed and analyzed at baseline and 6 months after implant surgery.

    Results

    The CBG in grafted groups 1 and 2 was higher than that in non-grafted groups. The ABG and BDG were higher in non-grafted groups 3 and 4 than in grafted groups, and the levels in group 3 were higher than those in group 4. The CBG in grafted group 2 was higher than that in group 1. No significant difference was observed in MBL analysis.

    Conclusion

    The BDG of IPL<4 mm implants was higher than IPL>4 mm implant when bone grafts were not applied. No relevance was observed between IPL and CBG. Bone grafts can accelerate endo-sinus bone remodeling by increasing CBG and dissipating the influence of IPL on BDG.

    An investigation of the microstructure and mechanical properties of dental zirconia manufactured by digital light processing 3D printing
    Mei Ziyu, Lu Yuqing, Lou Yuxin, Zhang Junjing, Sun Manlin, Yu Haiyang.
    West China Journal of Stomatology. 2021, 39(5):  576-581.  doi:10.7518/hxkq.2021.05.013
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    Objective

    This study was performed to investigate the microstructure and mechanical properties of dental zirconia manufactured by digital light processing (DLP) 3D printing and the clinical application prospects of this material.

    Methods

    The experiment (DLP) group was zirconia manufactured by DLP 3D printing, and the control (MILL) group was milled zirconia. The density, grain size, and phase composition were measured to study the microstructure. Flexural strength was measured by using three-point bending tests, while Vickers hardness was determined through a Vickers hardness tester. Fracture toughness was tested using the single-edge V-notched beam method.

    Results

    Zirconia density of the DLP group was (6.019 8±0.021 3) g·cm-3, and the average grain size was (0.603 0±0.032 6) μm, but without statistical difference with the corresponding values of the MILL group (P>0.05). Tetragonal phase was found in the X-ray diffraction patterns of the DLP and MILL groups. The flexural strength of the DLP group was (1 012.7±125.5) MPa, and Vickers hardness was (1 238.5±10.8) HV1, which was slightly lower than that of the MILL group (P<0.05). The fracture toughness of the DLP group was (7.22±0.81) MPa·m1/2, which was not statistically different from that of the MILL group (P>0.05).

    Conclusion

    Zirconia manufactured by DLP 3D printing had microstructure and mechanical properties similar to those of the milled zirconia. Only the flexural strength and the Vickers hardness of the experimental zirconia were slightly lower than those of the milled zirconia. Therefore, DLP-manufactured zirconia has a promising future for clinical use.

    Study on the application of oral digital design in aesthetic restoration of anterior teeth of cleft lip/palate patients
    Yao Jinfeng, Deng Mengzhao, Xie Tian, Chen Kan, Wang Qiuxu, Liang Zhigang.
    West China Journal of Stomatology. 2021, 39(5):  582-590.  doi:10.7518/hxkq.2021.05.014
    Abstract ( 270 )   HTML ( 53 )   PDF(pc) (4205KB) ( 262 )   Save
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    Objective

    A study was conducted to investigate the clinical effects of oral digital design on the aesthetic restoration of anterior teeth of cleft lip/palate patients.

    Methods

    Nine adult cleft lip/palate patients who need aesthetic restoration of anterior teeth were recruited. Digital information of patients' dental arches, the surrounding soft tissue and face were captured by digital camera and scanner. The aesthetic analysis and design were conducted using keynote and 3shape software and were demonstrated to the patients. The optimized treatment plan was ensured by communicating with the patients. Digital wax-up models were exported and printed into resin diagnostic models, which were then utilized in the treatment process to guide the doctors and the technicians in tooth preparation and in making the final restorations, respectively. The adhesive procedure was completed after satisfactory try-in. Aesthetics assessment was conducted in accordance with the anterior esthetic evaluation form. The scores of patient's satisfaction were recorded on a questionnaire containing six items of aesthetic index and doctor-patient communication. Patients were interviewed and examined after 1, 3, 6, and 12 months, respectively, and the clinical effects of restorations were evaluated.

    Results

    All nine patients had satisfactory clinical results. The aesthetic defects of the patients were effectively addressed. All treatments met the requirements of the preoperative digital designs. The patients' scores were all above 90 on the satisfaction scale. At 12 months after the operation, the clinical effects of restorations of all cases achieved A class in each evaluation indicator.

    Conclusion

    For cleft lip/palate patients with esthetic defect in the anterior teeth, the digital design plays an important role in optimizing the treatment plan and guides the whole treatment process. This design can help clinicians achieve predictable satisfactory aesthetic results.

    Detection of peripheral blood circulating tumor cells in oral squamous cell carcinoma and its clinical significance
    Zhang Shuaiyuan, Qin Shuo, Li Guanghui, Yi Yaqun, Fu Haojie, Gao Yajing, Sun Minglei.
    West China Journal of Stomatology. 2021, 39(5):  591-597.  doi:10.7518/hxkq.2021.05.015
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    Objective

    This study aims to investigate the diagnostic value of peripheral blood circulating tumor cells (CTCs) in oral squamous cell carcinoma (OSCC) and its correlation with the clinicopathological features of OSCC.

    Methods

    Ninety-three patients diagnosed as OSCC in the First Affiliated Hospital of Zhengzhou University from May 2019 to May 2020 were selected as the experimental group, and 20 healthy volunteers were employed as the control group. The CTCs value of peripheral blood of the patients were measured by CTCs detection technology, and its clinical significance was analyzed.

    Results

    The CTCs values in the experimental group were higher than those in the control group, and the difference was statistically significant (P<0.000 1). The CTCs value in the peripheral blood of patients in the experimental group were not correlated with gender, site of onset, and presence or absence of peripheral tissue infiltration (P>0.05), but was correlated with age (P=0.022), tumor T stage (P=0.02), tumor N stage (P=0.007 5), tumor M stage (P=0.013), clinical stage (P=0.029), early or late stage (P=0.022), tumor differentiation degree (P<0.001), and node metastasis (P=0.006 4). The AUC value of CTCs in OSCC diagnosis was 0.925, and the energy efficiency was statistically significant [P=0.000, 95%CI (0.876, 0.974)]. When the CTC value was 8.450 FU/3 mL, the maximum value of the Yoden index was 0.853, and the sensitivity and specificity of OSCC diagnosis were 90.3% and 95.0%, respectively. The AUC value of CTCs in the diagnosis of OSCC metastasis was 0.691, and the energy efficiency was statistically significant [P=0.000, 95%CI (0.580, 0.803)]. When the blood CTC value was 12.250 FU/3 mL, the maximum value of Yoden index was 0.367, the sensitivity was 63.6%, and the specificity was 73.3%. Multivariate regression analysis showed that buccal tumor was negatively correlated with CTCs in patients with OSCC (P=0.001 08), N2 stage (P=0.000 74) and M stage (P=0.026 38). High differentiation (P<0.000 1) and moderate differentiation (P=0.001 5) were negatively correlated with CTCs values in patients with OSCC.

    Conclusion

    Peripheral blood CTCs has important clinical value for early screening, auxiliary diagnosis, evaluation of metastasis, and determination of malignant degree, progression, and pathological grade of OSCC and a relatively reliable tumor detection indicator.

    Distal-triangular flap design for impacted mandibular third molars: a randomized controlled trial
    Liu Jiyuan, Liu Chang, Pan Jian, Qu Tao, Hua Chengge.
    West China Journal of Stomatology. 2021, 39(5):  598-604.  doi:10.7518/hxkq.2021.05.016
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    Objective

    This prospective study was performed to evaluate whether the distal-triangular flap was a practical alternative surgical approach for extracting mandibular third molars.

    Methods

    Sixty participants with impacted mandibular third molars were randomly divided into three groups: group A, distal-triangular flap; group B, Szmyd flap; and group C, envelope flap. The impacted third molars were extracted by the corresponding flapping method. During a three-month follow-up observation after the extraction, the postoperative pain, swelling, mouth opening, and periodontal status were recorded and analyzed by ANOVA and chi-square tests.

    Results

    The 60 participants had successful extraction and 3-month follow-up observation. No participant suffered from postoperative infections, lower lip disorder, or tongue sensory disorders. No statistical differences were found in the postoperative symptoms and signs of the three flap designs, such as postoperative pain, swelling, mouth opening, and periodontal status (P>0.05).

    Conclusion

    The distal-triangular flap was as safe and reliable as the Szmyd and envelope flaps but more advantageous because of its convenient operative field exposure and low requirement for the patient's mouth opening. Thus, the distal-triangular flap is one of the alternative flap options for extracting impacted mandibular third molars.

    Application of platelet-rich fibrin on mandibular third molar extraction: systematic review and Meta-analysis
    Bao Mingzhe, Liu Wei, Yu Shurong, Men Yi, Han Bo, Li Chunjie
    West China Journal of Stomatology. 2021, 39(5):  605-611.  doi:10.7518/hxkq.2021.05.017
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    Objective

    This study aims to analyze the effectiveness of platelet-rich fibrin (PRF) in mandibular third molar extraction and provide suggestions for alleviating postoperative complications.

    Methods

    Pubmed, EMBASE, Web of Science, and SinoMed were searched electronically on February 2020. Randomized controlled trials focusing on PRF usage in mandibular third molar extraction were included. Reviewers assessed the risk of bias in the included literature and extracted data independently using the criteria recommended by the Cochrane Collaboration. Meta-analysis was performed using RevMan 5.3 and STATA 13.0.

    Results

    Twenty-one studies were included, comprising 991 patients who had mandibular third molar extraction. The topical application of PRF effectively reduced pain after extraction [MD=-12.06, 95%CI (-21.42, -2.71), P=0.01], attenuated post-extraction swelling [MD=-1.42, 95%CI (-2.41, -0.44), P=0.005], and promoted soft tissue hea-ling [MD=0.66, 95%CI (0.34, 0.99), P<0.000 1]. PRF significantly reduced trismus and alveolar osteitis (P<0.05). However, data could not prove whether PRF has any significant positive effect on bone healing compared with the control group (P>0.05).

    Conclusion

    Limited clinical evidence indicates that applying PRF after mandibular third molar extraction could reduce pain, swelling, trismus and the occurrence of dry socket and promote soft tissue healing. However, the effect of PRF on bone healing requires further large-scale randomized controlled trials and unified measurement criteria.

    Simultaneous bilateral distinct parotid tumors: a case report
    Zhang Bowen, Han Bo.
    West China Journal of Stomatology. 2021, 39(5):  612-615.  doi:10.7518/hxkq.2021.05.018
    Abstract ( 74 )   HTML ( 11 )   PDF(pc) (2152KB) ( 71 )   Save
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    Parotid gland tumors are usually solitary tumors, and multiple tumors of the parotid gland are extremely rare. We present a highly unusual case of bilateral and simultaneous pleomorphic adenoma and basal cell adenoma of the parotid gland. We review the literature and discuss the clinical manifestations, diagnosis, and treatment of these two rare tumors.

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