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Experts’ consensus on perioperative management of tooth extractions in patients receiving oral antithrombotic treatment
Pan Jian, Xue Yang, Zhao Jihong, Zhou Qing, Zou Duohong, Chen Songling, Han Bing, Cui Nianhui, Liu Xian, Wang Liao, Hu Kaijin
West China Journal of Stomatology    2022, 40 (3): 255-263.   DOI: 10.7518/hxkq.2022.03.002
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Thromboembolic diseases, which comprise venous thromboembolic diseases and arterial thromboembolic diseases, have become the number one cause of death worldwide. To prevent or treat thrombosis, patients with thromboembolic diseases need to take antithrombotic drugs, which would increase the risk of bleeding during and after surgery. Tooth extraction is the most common operation in oral and maxillofacial surgery clinics. Although patients given oral antithrombotic drugs do not need to undergo drug withdrawal, the perioperative management of such patients remains confusing to most clinicians. Moreover, the potential risk factors for bleeding warrant further study. To improve the clinicians’ knowledge of perioperative management for patients subjected to tooth extractions with oral antithrombotic drugs, experts have drafted this consensus focusing on preoperative bleeding risk assessment, intraoperative operating norms, and postoperative care to summarize the points needing attention.

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Experts’ consensus on space management of mixed dentition
Guo Weihua, Wang Jun, Chen Xu, Wang Xiaojing, Zhao Wei, Song Guangtai, Wu Li’an, Jiang Beizhan, Zhang Qiong, Wang Jun, Li Yu, Zhao Ning, Tan Jiali, Li Huang, Shu Rui, Zhou Chenchen, Fu Lei, Chen Xuepeng, Zou Jing
West China Journal of Stomatology    2022, 40 (3): 264-270.   DOI: 10.7518/hxkq.2022.03.003
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The mixed dentition stage is the period between primary and permanent dentition. The following biological processes are complicated and variable: jaw growth, development of inherited permanent teeth embryo, physiological absorption of primary teeth, restoration of surrounding alveolar bones, and growth and function establishment of soft tissues. For the normal development of the jaw, the establishment of the good occlusion relationship, development, and function of soft tissue is very important, whether or not the primary teeth are normally replaced by the permanent teeth in the mixed dentition stage. The eruption space is linked to the normal replacement of primary and permanent teeth. The presence of a mixed dentition space results in the incidence and progression of malocclusion and impacts the normal growth and development of the occlusion, jaw, and face. Space management in the mixed dentition stage is a crucial means to prevent and reduce malocclusion. The following were discussed and analyzed: the possible space problems, why the size of the space was affected, the content that needs to be assessed, and the methods of space management in the mixed dentition that can be used to unify and standardize the management of mixed dentition. This paper was developed to serve as a guide for regulated space management during the mixed dentition period.

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External apical root resorption in orthodontic tooth movement: the risk factors and clinical suggestions from experts’ consensus
Li Huang, Wu Xiuping, Huang Lan, Xu Xiaomei, Kang Na, Han Xianglong, Li Yu, Zhao Ning, Jiang Lingyong, Xie Xianju, Guo Jie, Li Zhihua, Mo Shuixue, Liu Chufeng, Hu Jiangtian, Shi Jiejun, Cao Meng, Hu Wei, Cao Yang, Song Jinlin, Tang Xuna, Bai Ding
West China Journal of Stomatology    2022, 40 (6): 629-637.   DOI: 10.7518/hxkq.2022.06.002
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External apical root resorption is among the most common risks of orthodontic treatment, and it cannot be completely avoided and predicted. Risk factors causing orthodontic root resorption can generally be divided into patient- and treatment-related factors. Root resorption that occurs during orthodontic treatment is usually detected by radiographical examination. Mild or moderate root absorption usually does no obvious harm, but close attention is required. When severe root resorption occurs, it is generally recommended to suspend the treatment for 3 months for the cementum to be restored. To unify the risk factors of orthodontic root resorption and its clinical suggestions, we summarized the theoretical knowledge and clinical experience of more than 20 authoritative experts in orthodontics and related fields in China. After discussion and summarization, this consensus was made to provide reference for orthodontic clinical practice.

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Vessel anastomosis in free flap reconstruction for oral and maxillofacial defects: techniques and key points
Li Chunjie, Han Bo, Zhu Guiquan.
West China Journal of Stomatology    2022, 40 (3): 271-278.   DOI: 10.7518/hxkq.2022.03.004
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The quality of vessel anastomosis is a key element for the success of free flap reconstruction. When adopting free flaps for oral and maxillofacial defect reconstruction, skills in selecting vessels, determining the clinical manifestations of the recipient vessel, and anastomosis technique are needed. Key points on postoperative flap observation were also required. We are experienced on this subject given that we have accomplished more than 1 000 free flaps for patients with oral and maxillofacial defects in the last 5 years. In this article, we summarize the skills and key points in free flap reconstruction of oral and maxillofacial defects, including vessel anastomosis skills, vessel selection, and vessel crisis diagnosis.

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Expert consensus on clinical management for early childhood caries
Zhang Qiong, Wang Jun, Xia Bin, Zhao Wei, Chen Xu, Jiang Beizhan, Huang Yang, Wu Li’an, Yuan Guohua, Zou Jing
West China Journal of Stomatology    2022, 40 (5): 495-503.   DOI: 10.7518/hxkq.2022.05.001
Abstract1917)   HTML323)    PDF(pc) (951KB)(2013)       Save

Early childhood caries (ECC) is the most prevalent chronic oral disease and one of the worldwide public health problems of great urgency for children. ECC can affect children's teeth, dentition, craniomaxillofacial, and general health and development. Therefore, through dental caries etiologies and caries risk assessment, patient-centered, personalized planning and a combination of prevention and treatment should be implemented in the clinical management for ECC. Periodic and continuous cycle management can only be accomplished with the cooperation of medical staff, children, and their guardians. This expert consensus will expound the clinical management of ECC in the following aspects: caries risk assessment, early clinical prevention, treatment strategies, and postoperative management.

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Core scientific issues of orthodontic tooth movement: position objective, efficiency, and accuracy
Zhao Zhihe, Jin Zuolin, Bai Yuxing, Fang Bing, Bai Ding, Li Weiran, He Hong, Hu Min, Liu Yuehua, Chen Lili, Song Jinlin, Cao Yang, Li Yu, Shu Rui
West China Journal of Stomatology    2022, 40 (4): 371-376.   DOI: 10.7518/hxkq.2022.04.001
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Although the current technical systems of orthodontic tooth movement are practically mature, a noticeable gap still exists between the overall treatment results and the expectations. According to literature review, orthodontic tooth movement involves three core scientific issues, i.e., position objective, efficiency, and accuracy. Research concerning these three issues is the key to further improve orthodontic treatment outcomes and promote progress of the subject orthodontics.

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Experts’ consensus on precaution and treatment for complications of sagittal split ramus osteotomy
Zhu Songsong, Wang Xudong, Yang Xuewen, Wang Xiaoxia, Tian Lei, Liu Shuguang, Zheng Guangsen, Tang Zhenglong, Wu Guomin, Li Zhiyong, Bai Xiaofeng, Huang Xuanping, Huang Li, Xi Weihong, Zhu Yaomin
West China Journal of Stomatology    2022, 40 (3): 247-254.   DOI: 10.7518/hxkq.2022.03.001
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Sagittal split ramus osteotomy (SSRO) is a versatile orthognathic procedure for correcting mandibular deformities. Various complications can possibly occur when performing SSRO, and it can even cause serious adverse consequences because of the complexity of anatomy and operative procedures. The types of complications and their accompanying clinical manifestations are closely related to the choice of diagnosis and treatment strategies and clinical outcomes. To discuss the causes, prevention, and treatment measures of various common complications of SSRO, domestic orthognathic surgery experts prepared this consensus to increase the awareness of SSRO complications, thereby ensuring safe surgical procedure and good results.

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Digital partition bonding for porcelain veneers guided by sequence 3D printing templates
He Jinxiu, Gao Jing, Liu Chunxu, Xie Chenyang, Yu Jiayi, Yu Haiyang.
West China Journal of Stomatology    2022, 40 (3): 365-369.   DOI: 10.7518/hxkq.2022.03.019
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Obtaining optimal enamel bonding is a common recommendation to ensure the retention, edge closure, and clinical service life of porcelain veneers. Bonding surface is determined after tooth preparation. More or less dentin exposure often occurs due to the uneven thickness of the enamel. Identifying the enamel or dentin on the bonding surface and adopting the “selective etching” technique are useful to obtain the maximal bonding strength. Naked eye recognition in “selective etching” has uncertain results and is experience-based, whereas the proposed technique controls the preparation depth through the first target restoration space template to obtain the accurate enamel and dentin subarea. It is mapped to the second bonding template, depending on the treatment carried out on the enamel and dentin surface, to accurately predict the adhesion of porcelain veneers.

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Regulation of reactive oxygen species on the mitophagy of human periodontal ligament cells through the PINK1/Parkin pathway under starvation
Fan Zhibo, Jin Ke, Li Shenghong, Xu Jie, Xu Xiaomei
West China Journal of Stomatology    2022, 40 (6): 645-653.   DOI: 10.7518/hxkq.2022.06.004
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Objective This study aimed to explore the specific mechanism, mediated by the reactive oxygen species (ROS) and PINK1/Parkin pathway, of the mitochondrial autophagy of human periodontal ligament cells (hPDLCs) under starvation conditions. Methods hPDLCs were isolated and cultured from normal periodontal tissues. Earle’s balanced salt solution (EBSS) was used to simulated a starvation environment and thus stimulate hPDLCs mitochondrial autophagy. N-Acetyl-L-cysteine (NAC) was used to inhibit ROS production to explore the role of ROS in hPDLC mitochondrial autophagy. Cyclosporin A was used to inhibit the PINK1/Parkin pathway to study the role of ROS and the PINK1/Parkin pathway in hPDLCs activation under starvation. The mitochondrial membrane potential was detected by flow cytometry with a JC-1 mitochondrial membrane potential detection kit. The morphological structure of mitochondria and the formation of mitochondrial autophagosome were observed by transmission electron microscopy. Mito tracker red cmxros and lyso tracker green staining were used to observe the localization of mitochondria and lysosomes. The formation intensity of ROS was detected with a DCFH-DA ROS fluorescent probe. The expression levels of mitochondrial autophagy genes (Tomm20 and Timm23) and the PINK1/Parkin pathway were detected by real-time quantitative polymerase chain reaction (RT-qPCR). The expression levels of mitochondrial autophagy proteins (Tomm20 and Timm23) and PINK1/Parkin protein were detected by Western blot. Results EBSS starvation for 30 min induced the strongest activation of hPDLCs mitochondrial autophagy, increased the expression of ROS, downregulated the expression of mitochondrial autophagy-related genes (Tomm20 and Timm23) (P<0.001), and upregulated the PINK1/Parkin pathway (P<0.001). After NACinhibited ROS production, mitochondrial autophagy was also inhibited. Meanwhile, the expression of Tomm20 and Timm23 was upregulated (P<0.001 and P<0.05), and the expression of the PINK1/parkin pathway (P<0.001 and P<0.05) was down regulated. When cyclosporin A inhibited the expression of the PINK1/Parkin pathway (P<0.05 and P<0.05), it reversed the mitochondrial autophagy of hPDLCs (P<0.001 and P<0.01) and also upregulated the expression of Tomm20 and Timm23 (P<0.001 and P<0.01). Conclusion ROS enhanced the mitochondrial autophagy of hPDLCs primarily through the PINK1/Parkin pathway under starvation conditions.

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Progress of research on oral mucosal adhesive agents
Zhao Hang.
West China Journal of Stomatology    2023, 41 (1): 1-10.   DOI: 10.7518/hxkq.2023.01.001
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Oral mucosal administration is extensively used to treat systemic diseases and oral mucosal diseases owing to unique oral mucosal structure and convenient administration. However, the special microenvironment of the oral cavity being open, moving, and humid causes oral mucosal drug delivery to face great challenges. To address this dilemma, local adhesive agents have been widely studied for sustained drug delivery and improved bioavailability, showing broad prospects. Recently, the author has performed studies on oral mucosal adhesive agents. In this paper, the progress of research on oral mucosal adhesive materials is reviewed.

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The immune checkpoint inhibitors treatment of head and neck squamous cell carcinoma: an expert consensus
Liu Lei, Xiang Zhongzheng, Li Yi, Guo Wei, Yang Kai, Wang Jun, Sun Zhijun, Ren Guoxin, Zhang Jianguo, Sun Moyi, Ran Wei, Huang Guilin, Tang Zhangui, Li Longjiang
West China Journal of Stomatology    2022, 40 (6): 619-628.   DOI: 10.7518/hxkq.2022.06.001
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Immune checkpoint inhibitors (ICIs) present significant efficacy in the treatment of malignant tumors, and they have been approved as the first-line of treatment for various cancers. Pembrolizumab monotherapy or combined with chemotherapy has been recommended by domestic and foreign guidelines for the first-line treatment of recurrent/metastatic head and neck squamous cell carcinoma. Although ICIs represent a milestone in the treatment of head and neck squamous cell carcinoma, potential problems still need to be addressed, such as the selection of the efficacy predictors for ICIs, the evaluation of the tumor response to ICIs, and the treatment of immune hyperprogression and immune-related adverse events. Therefore, to form a relatively unified understanding of ICIs treatment for head and neck squamous cell carcinoma, we integrated the clinical experience of multi-disciplinary experts of head and neck cancers on the basis of current clinical hot issues and finally developed this consensus.

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Effect evaluation of different methods for removal of root canal filling materials
Yang Wenjun, Han Jiajia, Wang Yichen, Li Fengxiang, Du Qitao
West China Journal of Stomatology    2022, 40 (6): 685-689.   DOI: 10.7518/hxkq.2022.06.009
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Objective This study aimed to evaluate the efficacy of three methods in root canal retreatment to remove the filling material in the root canals. Methods Ninety tooth roots filled by gutta percha or plasticized material (n=45, each) were randomly divided into three groups (n=15). WaveOne (WaveOne group), 1#P drill+WaveOne (1#P+WaveOne group), and ultrasound P5 working end ET25+ProTaper Universal (P5+ProTaper Universal group) were used to remove the root canal filling material and prepare for root canal. The operating time of each canal was recorded and the percentage of residual filling material area was measured on the root canal wall of the mesial and distal dissected root section. The degree of deviation of the root canal after operation was measured for the root samples filled by gutta percha. Results The type of root filling material and the method of root canal retreatment had no significant effect on the percentage of residual area of the filling material (P>0.05). However, the remaining filling material area of apical 1/3 of the root canal was significantly higher than that of cervical 1/3 of the root canal (P<0.05). The average operating times for removing gutta-percha or plasticized material in the W and 1#P+WaveOne groups were significantly less than that in the P5+ProTaper Universal group (P=0.000). The root canal retreatment methods had no significant effect on the curvature of the root canal (P=0.650). Conclusion WaveOne single file's cleaning ability and center positioning ability were similar to those of ProTaper Universal. Moreover, WaveOne can be independently used for most root canals without a pathway when removing the root canal fillings, thereby simplifying the process of root canal retreatment.

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Clinical decision-making of anterior implant abutment
Yu Haiyang, Sun Manlin, Wang Zhongyi.
West China Journal of Stomatology    2022, 40 (5): 504-512.   DOI: 10.7518/hxkq.2022.05.002
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Abutment is an important component serving as a connecting link between the implant and the implant-supported prosthesis. In accordance with mechanical, biological, and other conventional norms, it can compensate the deviation between the implant and the prosthesis, which plays a significant role in maintaining the health of peri-implant tissue and the longevity, stability, and effectivity of prosthesis. However, choosing an anterior implant abutment correctly and conveniently is challenging, given the great variety of anterior abutment in clinical practice. Through virtual implant design, the correct implant site was compared and selected, and the supra-target prosthesis was coordinated before and after the operation. The implant level vertical of height of target restoration space (I) was measured to predict the availability and the retentive method of the implant restoration. After implantation, the primary selection of abutment type was selected according to the implant system (S), screw access position, and retentive method of the prosthesis. The final selection of abutment is accomplished by combining the measured values of peri-implant soft tissue thickness (T), gingival height (GH), and long axis of implant (L). Furthermore, the concepts and the classified applications of custom abutment were discussed in detail in this paper. The plan's main control variables L, I, GH, T, and S compose the words Lights, so this plan can be abbreviated as the anterior abutment decision tree. The decision tree has good decision-making efficiency and high clinical accessibility.

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Evaluation of changes in orbital volume in adult female patients with maxillary transverse deficiency treated with a maxillary skeletal expander
Shi Xiaoyang, Lin Xuefen, Ma Chi, Chen Muhan, Liu Dongxu.
West China Journal of Stomatology    2022, 40 (3): 314-319.   DOI: 10.7518/hxkq.2022.03.011
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Objective

The effects of using a maxillary skeletal expander (MSE) on the orbital volume and width between periorbital bones in the treatment of adult female patients with maxillary transverse deficiency (MTD) were evalua⁃ted.

Methods

A total of 20 adult female patients with MTD with an average age of (22.60±6.29) years were included in the study. The patients were treated with MSE. Cone beam computed tomography was performed before expansion (T0) and no more than 3 weeks after expansion (T1). Orbital volume and periorbital bone width were measured with Mimics 21.0 and analyzed with SPSS 20.0. Paired t-test was performed, and a P value of <0.05 indicated significant difference.

Results

After expansion, the orbital volume increased by (346.80±275.31) mm3 (P<0.05). The width between the right and left zygomaticomaxillary sutures increased by (1.69±0.57) mm (P<0.05), and the width between the right and left infraorbital points increased by (1.71±0.70) mm (P<0.05). However, the width between the right and left frontozygomatic sutures increased by (0.15±0.32) mm (P>0.05). Finally, the width between the right and left supraorbital points increased by (0.23±0.52) mm (P>0.05).

Conclusion

The maxillary skeletal expander slightly expanded the orbital volume in the adult female patients and increased the lateral widths of the periorbital bones.

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Literature review and prospect on oral cognition and disease diagnosis and treatment between Han and Tang dynasties
Gao Qin, Zhu Mengdi, Wang Jiabo, Wang Songling, Zhou Jian, Zhang Jingqiu
West China Journal of Stomatology    2023, 41 (5): 604-612.   DOI: 10.7518/hxkq.2023.2023183
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Chinese medicine entered a significant period from foundation to maturity between Han and Tang dynasties when the Chinese traditional stomatology was a key stage. Sorting and analysis of existing literature and research outcomes have showed that current research on stomatology between Han and Tang dynasties focuses on oral physiology, pathology, diagnosis and treatment, and health care. It also involves stomatology history and explanation of termino-logies related to mouth and teeth recorded in medical books, use of simple methods, and thinking with citation and analysis of literature simply listed and reasoning preliminarily deducted. From the macro perspective, current research has not unveiled the whole picture of stomatology between the two dynasties and left a series of key issues unresolved. Thus, new methods should be developed and employed to carry out medical research on stomatology between Han and Tang dynasties given that is has a prosperous future.

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Application of mixed reality-based surgical navigation system in craniomaxillofacial trauma bone reconstruction
Lin Chengzhong, Zhang Yong, Dong Shao, Wu Jinyang, Zhang Chuxi, Wan Xinjun, Zhang Shilei
West China Journal of Stomatology    2022, 40 (6): 676-684.   DOI: 10.7518/hxkq.2022.06.008
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Objective This study aimed to build a surgical navigation system based on mixed reality (MR) and optical positioning technique and evaluate its clinical applicability in craniomaxillofacial trauma bone reconstruction. Me-thods We first integrated the software and hardware platforms of the MR-based surgical navigation system and explored the system workflow. The systematic error, target registration error, and osteotomy application error of the system were then analyzed via 3D printed skull model experiment. The feasibility of the MR-based surgical navigation system in craniomaxillofacial trauma bone reconstruction was verified via zygomatico-maxillary complex (ZMC) reduction experiment of the skull model and preliminary clinical study. Results The system error of this MR-based surgical navigation system was 1.23 mm±0.52 mm, the target registration error was 2.83 mm±1.18 mm, and the osteotomy application error was 3.13 mm±1.66 mm. Virtual surgical planning and the reduction of the ZMC model were successfully conducted. In addition, with the guidance of the MR-based navigation system, the frontal bone defect was successfully reconstructed, and the clinical outcome was satisfactory. Conclusion The MR-based surgical navigation system has its advantages in virtual reality fusion effect and dynamic navigation stability. It provides a new method for doctor-patient communications, education, preoperative planning, and intraoperative navigation in craniomaxillofacial surgery.

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The infection control of post-and-core crown restoration
Huang Cui, Zhu Jiakang, Wang Qian
West China Journal of Stomatology    2023, 41 (3): 247-253.   DOI: 10.7518/hxkq.2023.2023030
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Post-and-core crown is one of the most common forms of restoration of tooth after root canal therapy (RCT). Infection control is the core objective of RCT, which is usually well realized by endodontists. However, many prosthodontists often neglect the infection control of the tooth and the maintenance of the curative effect of RCT during the process of post-and-core crown, which may lead to the failure of the final restoration. The concept of integrated crown-root treatment advocated recently requires clinicians to consider the RCT and final restoration as a whole, rather than simply divided into two parts—endodontic treatment and restorative treatment. As the core content of integrated crown-root treatment, infection control should be taken seriously by clinicians and implemented throughout the whole treatment process, especially in the restorative treatment that is easily overlooked after RCT. Therefore, this article describes the infection control of post-and-core crown restoration, classifies the tooth requiring post-and-core crown restoration, and puts forward the measures of infection control before and during post-and-core crown restoration, in order to provide reference and guidance for clinical practice.

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Dental implant treatment in vascularized bone flaps after jaw reconstruction
Shan Xiaofeng, Cai Zhigang.
West China Journal of Stomatology    2023, 41 (2): 123-128.   DOI: 10.7518/hxkq.2023.2023005
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Jaw defects caused by various reasons often seriously affect appearance and function. The goal of the treatment of oral and maxillofacial tumors should include the cure of the tumor and the restoration of premorbid function. The development of microsurgery and digital surgery technology has promoted the development of jaw reconstruction with vascularized free bone flap. Good appearance and improved predictability could be obtained with the help of preope-rative visual design. How to rehabilitate occlusal function on the reconstructed jaw and improve the quality of life of patients has become an important research direction. This article discusses the challenge of jaw reconstruction, the selection of vascularized bone flap, the choice of implant timing, the treatment of peri-implant soft tissue, and the influence of radiotherapy on implants after jaw reconstruction.

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Application of gelatin methacryloyl/minocycline-chitosan-nanoparticles composite hydrogel for the treatment of periodontitis
You Ziying, Wu Yanlin, Sun Yimin, Wang Zhenming, Ye Ling.
West China Journal of Stomatology    2023, 41 (1): 11-20.   DOI: 10.7518/hxkq.2023.01.002
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Objective This study aimed to investigate the feasibility of gelatin methacryloyl (GelMA) hydrogel loa-ded with minocycline-chitosan-nanoparticles (MCN) for the treatment of periodontitis in vitro and vivo. Methods MCN were synthesized by ionic gel method. GelMA/MCN composite hydrogels were prepared by compounding MCN with GelMA hydrogel. The materials were characterized by transmission electron microscope, scanning electron microscopy, and Fourier transform infrared spectroscopy. The degradation behavior and drug release rates of hydrogels were evaluated. The antibacterial activity of GelMA/MCN hydrogel against Porphyromonas gingivalis was detected, and the minimum antibacterial concentration was determined. Biocompatibility and osteogenic experiments were conducted under a simulated periodontitis environment. A rat model of periodontitis was constructed to observe the therapeutic effects of GelMA/MCN hydrogel. Results MCN was successfully synthesized with a particle size of about 80 nm, while the structures of GelMA/MCN had no significant differences from GelMA. MCN and GelMA/MCN released minocycline slowly and steadily. Bacterial growth was completely inhibited when the MCN concentration was higher than or equal to 0.2 mg·mL-1. GelMA/MCN hydrogels exhibited good biocompatibility at effective antimicrobial concentrations under the simulated periodontitis environment with the enzyme. The in vivo results showed that GelMA/MCN prevented the progression of periodontitis and promoted the repair of bone defects. Conclusion GelMA/MCN composite hydrogel can release minocycline slowly and steadily and has good antibacterial activity and biocompatibility to promote the repair of periodontitis bone defects.

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Occlusal analysis of patients with chewing side preference and symptoms of temporomandibular disorders
Zhang Qiao, Huang Dongzong, Zhai Xiaoting, Li Hongbo, Hu Min, Liu Hongchen, Jiang Hua
West China Journal of Stomatology    2022, 40 (4): 457-467.   DOI: 10.7518/hxkq.2022.04.014
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Objective In this study, TeeTester digital occlusal analysis system was used to analyse the occlusal characteristics of chewing side preference (CSP) and non-CSP patients with TMD symptoms. Methods According to the questionnaire and oral examination, 80 subjects were screened and divided into four groups: 20 CSP patients with TMD symptoms, 20 CSP patients without TMD symptoms, 20 non-CSP patients with TMD symptoms, 20 non-CSP patients without TMD symptoms. TeeTester digital occlusal system was applied to measure the occlusal characteristics in all four groups, including total contect area (TCA), total occlution force (TOF), distribution of occlusal force (DOF), asymmetric index of occlusal force (AOF), occlusal time (OT), disclusion time (DT) and center of occlusal force(COF). SPSS 25.0 was used to analyze the statistical data. Results At intercuspal position, the data reveals significant differences in the maximum TOF and TCA among the four groups (P<0.05). There was significant difference in the distribution of occlusal force between the preferred side and the other side of CSP patients with or without TMD symptoms (P<0.05). Among the four groups, there were statistically significant difference in the position of the center point of occlusal force, the direction of the center point of occlusal force, and the vertical distance between the center point of occlusal force and the center line (P<0.05). The COF, maximum TOF and TCA of the preferred side of dentition were significantly positive correla⁃ted with CSP (P<0.05), according to Spearman correlation analysis. However, the maximum TOF and TCA of the both side of dentition were significantly negative correlated with TMD symptoms (P<0.05). Conclusion 1) The occlusal characteristics of CSP patients and non-CSP patients with TMD symptoms are different. TeeTester digital occlusal analysis system provides objective parameters for the dynamic evaluation of occlusion. 2) Among all the occlusal cha⁃racteristics, maximum TOF, TCA and COF of the preferred side of dentition were positively correlated with CSP. The abnormal occlusal characteristics (maximum TOF and TCA of the whole dentition) caused by CSP are related to TMD symptoms.

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Vital pulp therapy of permanent teeth with irreversible pulpitis
Wang Jun.
West China Journal of Stomatology    2023, 41 (6): 622-627.   DOI: 10.7518/hxkq.2023.2023193
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Traditionally, vital pulp therapy (VPT) is mainly indicated for young permanent teeth. However, in recent years, VPT has been increasingly applied to mature permanent teeth. VPT was previously thought to be effective only for teeth with normal pulp or reversible pulpitis. However, an increasing body of evidence has demonstrated that VPT can successfully manage permanent teeth with irreversible pulpitis or apical periodontitis. This work discusses which teeth with irreversible pulpitis or apical periodontitis are suitable for VPT, the recommended method to evaluate and select this kind of case, and the clinical procedure involved to operate such a case.

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Synthesis of a novel injectable alginate impression material and impression accuracy evaluation
Liu Xingzi, Wang Xinhui, Wu Jingya, Luo Jingjing, Wang Yun, Li Quanli
West China Journal of Stomatology    2022, 40 (6): 662-667.   DOI: 10.7518/hxkq.2022.06.006
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Objective This work aimed to synthesize a novel injectable alginate impression material and evaluate its accuracy. Methods Certain proportions of sodium alginate, trisodium phosphate dodecahydrate, potassium fluorotitanate, diatomaceous earth, and other ingredients were dissolved in water and mixed evenly with a planetary centrifugal mixer to obtain a certain viscosity base paste. Certain proportions of calcium sulfate hemihydrate, magnesium oxide, glycerin, and polyethylene glycol (PEG) 400 were mixed evenly with a planetary centrifugal mixer to obtain the reactor paste with the same viscosity as the base paste. The base and reactor pastes were poured into a two-cylinder cartridge at a 2∶1 volume ratio. A gun device was used to accomplish mixing by compressing materials into a mixing tip. The samples were divided into three groups: injectable alginate impression materials (IA group) as the experimental group, and Jeltrate alginate impression materials (JA group) and Silagum-putty/light addition silicone rubber impression materials (SI group) as the two control groups. Results Scanning electron microscopy (SEM) showed that the injectable alginate impression materials had a denser structure and fewer bubbles than the commercial alginate impression material. The accuracy of the three kinds of impression materials was evaluated by 3D image superposition. The deviations between the three test group models and the standard model (trueness) were 49.58 μm±1.453 μm (IA group), 54.75 μm±7.264 μm (JA group), and 30.92 μm±1.013 μm (SI group). The deviations of the models within each test group (precision) were 85.79 μm±8.191 μm (IA group), 97.65 μm±11.060 μm (JA group), and 56.51 μm±4.995 μm (SI group). Significant differences in trueness and precision were found among the three kinds of impression materials (P<0.05). Conclusion The accuracy of the new injectable alginate impression material was better than that of the traditional powder-type alginate impression material but worse than that of the addition silicone rubber impression materials. The novel injec-table alginate impression material demonstrated good operation performance and impression accuracy, showing broad application prospect.

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Developments and trends of endoscopic salivary gland resection: from endoscope-assisted to full endoscopic
Zhu Guiquan, Li Chunjie.
West China Journal of Stomatology    2023, 41 (4): 377-384.   DOI: 10.7518/hxkq.2023.2023116
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More than 30 years of rapid development of endoscopic surgery has led to the mainstreaming of this procedure in many surgical departments in China. Since the first report on endoscopy, it has been used in salivary gland resection for more than 20 years. The overall development of endoscopic surgery indicates that its use in oral and maxillofacial surgery is still in the early exploration stage; it has not yet been maturely developed or applied. Owing to the advancement of other disciplines and corresponding widening experiences in those fields, the development of endoscopic technology in oral and maxillofacial surgery will likely achieve a leapfrogging. Learning from the general development pattern of endoscopy, this research explores the application history, current situation, and future direction of the application of endoscopy in salivary gland surgery.

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Surgical treatment of severe medication-related osteonecrosis of the jaw
Feng Zhiqiang, An Jingang, Zhang Yi, He Yang
West China Journal of Stomatology    2023, 41 (1): 43-51.   DOI: 10.7518/hxkq.2023.01.006
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Objective This study aimed to summarize the clinical outcomes of surgical treatment for severe medication-related osteonecrosis of the jaw (MRONJ, stages 2 and 3). Methods A retrospective cohort study was conducted to review the patients with severe MRONJ from July 2013 to May 2021. All patients were treated surgically. The characteristics and clinical variables were recorded and analyzed. Results A total of 104 patients (123 MRONJ lesions) were included, including 42 males and 62 females, aged 64.6±9.1 years. The primary disease was malignant in 91 cases and benign in 13 cases. Forty-three cases (35.0%) were stage 2 lesions, and 80 (65.0%) were stage 3 lesions. Thirty-nine (31.7%) lesions were located in the maxilla, and 84 (68.3%) lesions were located in the mandible. The most commonly used bisphosphonates were zoledronic acid (n=89; 85.6%), followed by alendronate (n=10; 9.6%), and pamidronate (n=10; 9.6%). Antiangiogenic agents were administered in 62 (59.6%) patients. The mean duration of bisphosphonate therapy was 34.7±25.8 months, and the mean duration of drug holiday was 10.1±10.7 months. All operations were performed under general anesthesia. For stage 2 lesions, debridement and saucerization were performed to completely resect the lesions, and the wounds were closed without tension through local mucoperiosteum flaps. For stage 3 lesions, after the lesions were completely resected, the bone defect was covered by reconstruction plate fixation and ipsilateral submandibular gland translocation, iodoform gauze, and buccal fat pad accordingly. The follow-up period ranged from 3 months to 6 years; 81.3% (100/123) of the lesions reached mucosal healing at the last follow-up, whereas wound infection and dehiscence occurred in 18.7% (23/123) of the lesions postoperatively. Conclusion Severe MRONJ lesions could be surgically treated to achieve mucosal healing. Vascularized flap reconstruction could be considered if the patient’s general condition could tolerate it.

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A case of precise prosthesis under the direction of target restoration space analysis after multidisciplinary combination therapy
Yang Leining, Qin Hanglin, Zhang Jing, Han Xiaopeng
West China Journal of Stomatology    2022, 40 (5): 610-617.   DOI: 10.7518/hxkq.2022.05.016
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Quantitative grinding of abutment teeth is needed in crown and bridge restoration. Accurate quantitative preparation of teeth is one of the goals of minimally invasive restoration. In this paper, a case of congenital loss of upper and lower incisors was reported. Guided by the target restoration space (TRS), a personalized digital guide plate for tooth preparation was built to assist precise tooth preparation after the multidisciplinary combination therapy of orthodontic and periodontal teeth. Finally, the fixed bridge was prepared to meet the integrity, beauty, and function of the maxillary for the patient. In this case, the results suggest that the digital guide plate built under the guidance of TRS can be used to improve the accuracy of dental preparation.

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Bonding properties of mild universal adhesives to dentin pretreated with hydroxyapatite-based desensitizing agents
Meng Yuchen, Huang Fan, Wang Silin, Huang Xin, Lu Yi, Pei Dandan
West China Journal of Stomatology    2022, 40 (6): 668-675.   DOI: 10.7518/hxkq.2022.06.007
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Objective The purpose of the study was to evaluate the effect of hydroxyapatite (HA)-based desensiti-zing agents and determine their influence on the bonding performance of mild universal adhesives. Methods Mid-coronal dentin samples were sectioned from human third molars and prepared for a dentin-sensitive model. According to desensitizing applications, they were randomly divided into four groups for the following treatments: no desensitizing treatment (control), Biorepair toothpaste (HA-based desensitizing toothpaste) treatment, Dontodent toothpaste (HA-based desensitizing toothpaste) treatment, and HA paste treatment. Dentin tubular occlusion and occluded area ratios were evaluated by scanning electron microscopy (SEM). Furthermore, All-Bond Universal, Single Bond Universal, and Clearfil Universal Bond were applied to the desensitized dentin in self-etch mode. The wettability and surface free energy (SFE) of desensitized dentin were evaluated by contact angle measurements. Bonded specimens were sectioned into beams and tested for micro-tensile bond strength to analyze the effect of desensitizing treatment on the bond strength to dentin of universal adhesives. Results SEM revealed that the dentin tubule was occluded by HA-based desensitizing agents, and the area ratios for the occluded dentin tubules were in the following order: HA group>Biorepair group>Dontodent group (P<0.05). Contact angle analysis demonstrated that HA-based desensitizing agents had no statistically significant influence on the wettability of the universal adhesives (P>0.05). The SFE of dentin significantly increased after treatment by HA-based desensitizing agents (P<0.05). The micro-tensile bond strength test showed that HA-based desensitizing toothpastes always decreased the μTBS values (P<0.05), whereas the HA paste group presented similar bond strength to the control group (P>0.05), irrespective of universal adhesive types. Conclusion HA-based desensitizing agents can occlude the exposed dentinal tubules on sensitive dentin. When mild and ultra-mild universal adhesives were used for subsequent resin restoration, the bond strength was reduced by HA-based desensitizing toothpastes, whereas the pure HA paste had no adverse effect on bond strength.

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Accuracy of progress assessment with clear aligners
Li Bo, Xu Yimeng, Shi Ruiying, Hu Yirong, Liu Siying, Gu Zexu.
West China Journal of Stomatology    2022, 40 (6): 698-703.   DOI: 10.7518/hxkq.2022.06.011
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Objective This study aimed to investigate the accuracy of model superimposition and automatic analysis for upper and lower dentition widths in iTero Progress Assessment during the clear aligner process. Methods Nineteen cases were included in this retrospective case control study. Pretreatment dental cast (T0) and post treatment dental cast after staged treatment (T1) were available for three-dimensional (3D) model superimposition. The movements of maxillary teeth in the horizontal plane (cross section) after staged treatment and the widths of upper and lower dentitions were measured by 3D model superimposition in real world and iTero Progress Assessment. The data collected from the two methods were compared. Results The movements [Median (upper and lower quartiles)] of maxillary teeth in the horizontal plane after staged treatment were 2.31 (1.59, 3.22) and 1.79 (1.21, 3.03) mm in iTero Progress Assessment and 3D model analysis, respectively. Significant difference was observed between the two groups (P<0.05). In the measurement of upper and lower dentition width, four indicators were measured, including intercanine width upper, intermolar width upper, intercanine width lower, and intermolar width lower. Before treatment, the measurement of iTero Progress Assessment were (35.78±2.49), (56.21±2.51), (27.43±1.38), (52.26±2.91) mm, respectively, and actual measurement were (35.77±2.53), (56.17±2.47), (27.40±1.41), (52.30±2.86) mm, respectively, without significant difference (P>0.05). After stage treatment, the measurement of iTero Progress Assessment were (37.37±2.86), (57.76±2.56), (28.89±2.00), (54.16±2.19) mm, respectively, and actual measurement were (37.29±2.94), (57.71±2.63), (28.88±2.05), (54.01±2.15) mm, respectively, and there was no significant difference (P>0.05). Conclusion The data from iTero Progress Assessment did not coincide with the model superimposition results with palate as reference. The accuracy of model superimposition in iTero Progress Assessment needs further investigation, whereas the arch width analysis is accurate. Therefore, iTero Progress Assessment results should be interpreted with caution by orthodontists in clinical applications.

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Regenerative endodontic treatment of dens in dente in maxillary lateral incisor with immature root: a case report
Yuan Jing, Yu Sijing, You Meng, Zhang Qiong, Ye Ling, Gao Bo
West China Journal of Stomatology    2022, 40 (6): 716-720.   DOI: 10.7518/hxkq.2022.06.014
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Dens invaginatus (DI) is a developmental anomaly as a result of a deepening or invagination of the enamel organ into the dental papilla during tooth development. In addition, DI is a malformation with varying anatomical features, which poses numerous challenges to treatment. Endodontic treatment of dens in dente is one of the most complica-ted cases of DI. Herein, an immature lateral incisor that employed regenerative endodontic treatment was presented. The mentioned tooth was diagnosed with DI, pulp necrosis, and chronic apical periodontitis. Hence, a favorable prognosis has been shown by a 2-year review with cone beam computed tomography. The tooth was functional with normal periodontal parameters and exhibited a normal response to the electric pulp sensibility test. Thus, regenerative endodontic treatment can also be recommended to endodontists for teeth with DI.

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Mandibular advancement with clear aligners and functional appliances in the treatment of skeletal ClassⅡmalocclusion: a systematic review and meta-analysis
Yu Lei, Li Ziwei, Kang Fujia, Wang Songqing, Xie Zunxuan, Zhu Xianchun.
West China Journal of Stomatology    2023, 41 (3): 305-314.   DOI: 10.7518/hxkq.2023.2022453
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Objective This study aimed to conduct a meta-analysis of the efficacy of mandibular advance clear alig-ners with traditional functional appliances as the control group. Methods PubMed, Web of Science, Embase, Cochrane Library, China Biomedical Abstracts Database, China Knowledge Network Database, Wanfang Database, and Weipu Database were used in this study. The two groups of researchers screened the literature and extracted data based on the inclusion and exclusion criteria established by PICOS entries, and used the ROBINS-I scale for quality evaluation. Revman 5.4 and Stata 17.0 software were used for meta-analysis. Results Nine clinical controlled trials were included in this study with a total sample size of 283 cases. No significant difference was found in SNA, SNB, ANB, Go-Pog, U1-SN, Overjet, and other aspects between the invisible group and the traditional group in the treatment of skeletal class Ⅱ ma-locclusion patients; there was a 0.90° difference in mandibular plane angle between the two groups; the growth of the mandibular ramus (Co-Go) in the traditional group was 1.10 mm more than that in the invisible group; the lip inclination of the lower teeth in the invisible group was better controlled, 1.94° less than that in the control group. Conclusion The invisible group can better control the lip inclination of the mandibular anterior teeth when guiding the mandible. Furthermore, the mandibular plane angle (MP-SN) can remain unchanged, but the growth of the mandibular ramus is not as good as the traditional group, and auxiliary measures should be taken to improve it in clinical practice.

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Application of visualization technology of multimode data fusion in occlusal rehabilitation
Sun Xinrong, Feng Yue, Liu Weicai.
West China Journal of Stomatology    2022, 40 (4): 468-475.   DOI: 10.7518/hxkq.2022.04.015
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Objective This study aimed to present a method for multi-modal medical data fusion that could be used for increased vertical dimension of occlusion (VDO) and occlusal rehabilitation in a digital manner, thus facilitating the process of clinical diagnosis and restoration. Methods With the aid of a computer software, a visual and operable four-dimensional virtual dental patient was created by data fusion of intraoral scan, extra-oral face scan, cone-beam computed tomography, and dynamic occlusal movement trace to conduct a systematical review of the occlusion and temporomandibular joint of the virtual patient. This approach could be used for increased VDO on the basis of the aesthetics of anterior teeth and the restoration space of posterior teeth. It allowed jaw reconstruction and occlusal rehabilitation with fixed prosthesis by using computer-aided design and manufacturing (CAD/CAM) devices. Results A visual and operable four-dimensional virtual dental patient was created by integrating the method for multimodal medical data fusion with CAD/CAM devices, thus making the process of occlusal rehabilitation with fixed prosthesis safer and more convenient than before. Conclusion With the method for multimodal medical data fusion, the presented application enables the fusion of different data sources of the patient at the same time and space by creating a virtual patient. It is useful for showing the function and anatomical structure of the patient’s oral and maxillofacial system in a visual and convenient manner, thus providing a powerful tool in the process of clinical diagnosis and restoration.

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Comparing accuracy after guide access and microscope-assisted access for fiber post removal
Cai Pingping, Chen Xi, Jiang Yi, Lu Zhaojie, Lin Jie, Zheng Zhiqiang.
West China Journal of Stomatology    2022, 40 (3): 297-302.   DOI: 10.7518/hxkq.2022.03.008
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Objective

This study compared the accuracy of the guide-supported and the microscope-assisted fiber post removal systems by using the extracted teeth. These new idea and theory can be used by clinicians to remove fiber posts.

Methods

Twenty-eight human extracted premolars were randomly divided into the guide and microscope groups. After root canal treatment and fiber post restoration, the fiber posts were removed by using a digital guide and via microscope-assisted ultrasonic instrument, respectively. Mimics 10.0 was used to measure the deviation, and the accuracy of the two fiber post removal systems were compared.

Results

In the guide group, the apical vertical deviation was 0.99 mm±0.52 mm, the apical horizontal deviation was 0.75 mm±0.19 mm, the angle deviation was 2.32°±0.64°, and the volume loss was 8.09 mm3±1.42 mm3. In the microscope group, the apical vertical deviation was 0.44 mm±0.23 mm, the apical horizontal deviation was 0.23 mm±0.07 mm, the angle deviation was 0.64°±0.31°, and the volume loss was 15.25 mm3±3.94 mm3. No significant difference was found in the apical vertical deviation between the two groups (P>0.05), whereas the apical horizontal deviation, the angle deviation, and the volume loss were significantly different between the two groups (P<0.05).

Conclusion

The removal of fiber post supported by a digital guide helped reduce the volume loss of post-core restoration teeth, but its accuracy was lower than that of removal by using a microscope-assisted ultrasonic instrument.

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Microglia activation and temporal changes in rat model of trigeminal neuralgia
Lu Yanzhu, Zhang Jingqi, Lai Wenli.
West China Journal of Stomatology    2022, 40 (6): 638-644.   DOI: 10.7518/hxkq.2022.06.003
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Objective This study aimed to investigate whether the microglia in the spinal trigeminal nucleus caudal part (Sp5C) were activated in a rat model of trigeminal neuralgia and to explore whether the activation level of microglia is consistent with maxillofacial pain level. Methods Chronic constriction injury of trigeminal nerve (CCI) was induced by partial ligation of infraorbital nerve (IoN) in rats. The behavioral change of rats observed at D1, D5, D10, D15, and D30 days post-surgery and the change of pain threshold were detected with electronic Von Frey filaments served as an evaluation index of maxillofacial pain. Weight change was measured by weighing. Ionized calcium binding adaptor molecule-1 (Iba-1) expression level of Sp5C at each time point was detected, and three microglia morphological categories were analyzed by immunohistochemical staining. Results The changes of behavioral and pain threshold suggested the maxillofacial pain level first increased and then decreased post-surgery in the IoN-CCI group. Both the expressions of Iba-1 and proportion of ameboid morphology in ipsilateral Sp5C increased from D1 and reached their peaks in D10 and D5, respectively. Then, they recovered nearly to the same level with contralateral Sp5C on D30. This trend was consistent with the maxillofacial change. Conclusion The model of trigeminal neuralgia in rats constructed by partial ligation of infraorbital nerve can induce the activation of microglia in Sp5C, and the activation level is consistent with maxillofacial pain, which reached its peak at around D10 post-surgery.

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Clinical decision and related factors influencing implant direction in the esthetic area
Liu Yuting, Yuan Quan.
West China Journal of Stomatology    2023, 41 (5): 512-520.   DOI: 10.7518/hxkq.2023.2023151
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Implant treatment in the esthetic area requires stable osseointegration and successful esthetic outcomes. Achieving this goal requires careful consideration of accurate implant axis and ideal three-dimensional position. Owing to the high esthetics and the special anatomical structure of the maxillary, a successful implant means a synthesized deli-beration of the residual bone dimensions, soft-tissue thickness, and the relationship of the residual alveolar ridge with the planned restoration. This article offers an in-depth analysis of the clinical decisions and key factors affecting the implant direction in the esthetic area.

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Simultaneous implantation and tooth preparation technology guided by 3D-printed guide
Hu Nan, Liu Chunxu, Gao Jing, Xie Chenyang, Yu Jiayi, Jia Luming, Yu Haiyang.
West China Journal of Stomatology    2023, 41 (4): 483-490.   DOI: 10.7518/hxkq.2023.2022027
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Using digital technologies in concurrently performing missing tooth implantation and preparation of remaining teeth is a solution to reduce the number of visits and improve efficiency. This paper proposes a digital process for simultaneously implanting and preparing teeth. It integrates implant surgical guide and 3D-printed tooth preparation guide into a single guide and completes guided implant placement and precise tooth preparation. Based on “repair-oriented” virtual implant planning, the implant surgical guide can improve the efficiency and predictability of implant placement, and its linear accuracy is about 1 mm. The tooth preparation guide precisely guides tooth preparation and restoration space visualization, ensuring the quality of the tooth preparation. The two guides have different design accuracy requirements, and thus their combination improves the overall guiding accuracy requirements. The concurrent application of the two guides minimizes the clinical operation time, number of visits, and economic burden of patients.

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Clinical efficacy of extra-short implant (4 mm) placed in posterior areas: a Meta-analysis
Zhang Qihang, Gong Jiaming, Yu Jiaying, Zhao Ruimin, Gou Ping, Yu Zhanhai
West China Journal of Stomatology    2023, 41 (1): 80-87.   DOI: 10.7518/hxkq.2023.01.011
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Objective This study aimed to systematically evaluate the safety and clinical efficacy of 4 mm-extra-short implant (ESI) placement in severely atrophic posterior areas. Methods Databases of PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang from January 1, 2010, until August 31, 2022, were searched to identify randomized controlled trials or controlled clinical trials related to ESI and standard implants (SI). An additional hand search of the references of included articles was also conducted. Meta-analyses were carried out with RevMan 5.4 software. Results A total of 11 studies were included, involving six randomized controlled trials and five controlled clinical trials. The meta-analyses indicated that when implants were placed in the posterior area, the implant survival rate between ESI and SI did not significantly differ [RR=1.23, 95%CI (0.66, 2.27), P=0.52]. ESI resulted in significantly stable marginal bone level [MD=-0.16, 95%CI (-0.25,-0.07), P=0.000 7] and less biological complications [RR=0.34, 95%CI (0.19, 0.62), P=0.000 4] but more mechanical complications [RR=2.89, 95%CI (1.05, 7.92), P=0.04]. Conclusion Based on the limited evidence, ESI could achieve clinical outcomes similar to those of SI when the height of the posterior alveolar bone is less than 5 mm, with lower technical sensitivity and fewer postoperative clinical complications than SI. Due to insufficient evidence and limited sample size, further clinical trials are needed to verify the long-term efficacy of ESI.

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Treatment of dentofacial deformities secondary to condylar hyperplasia
Luo En.
West China Journal of Stomatology    2023, 41 (4): 369-376.   DOI: 10.7518/hxkq.2023.2023059
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Dentofacial deformities secondary to condylar hyperplasiais a kind of disease presenting facial asymmetry, malocclusion, temporomandibular joint dysfunction, and other symptoms caused by non-neoplastic hyperplasia of the condyle. The etiology is still unknown, and currently, pre- and post-operative orthodontics accompanied by orthognathic surgery, temporomandibular joint surgery and jawbone contouring surgery are the main treatment methods. A personalized treatment plan was developed, considering the active degree of condyle hyperplasia, the severity of the jaw deformity, and the patient’s will, to correct deformity, obtain ideal occlusal relationship, and regain good temporomandibular joint function. Combined with the author’s clinical experience, the etiology, clinical and imageological features, treatment aims, and surgical methods of condylar hyperplasia and secondary dentofacial deformities were discussed in this paper.

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The color stability, water sorption, and solubility of ten composite resins
Luo Wenji, Huang Wenkai, Xu Minghua, Ren Ling, Cheng Yuyao, Zhan Desong, Fu Jiale
West China Journal of Stomatology    2023, 41 (1): 58-66.   DOI: 10.7518/hxkq.2023.01.008
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Objective This study aims to evaluate the color stability and related properties including water sorption and solubility of ten light-cured composite resins in different solutions. Methods A total of 10 composite resins were BeautifilⅡ(B2) and Ceram. X One Universal (CXU), Charisma (CS), Charisma Diamond (CD), Denfil (DF), DX. Universal (DXU), Filtek Z250 (Z250), Filtek Z350 XT (Z350), FS-1 (FS), and Magnafill Putty (MP). Meanwhile, a total of 20 disk-shaped samples were fabricated and randomly divided into four groups (n=5), which were immersed in distilled water (control group), curry, coffee, and red wine for 28 days. The color (CIE L∗a∗b∗) was measured by a spectrophotometer at baseline and 1, 7, 14, 21, and 28 days after immersion, and the color differences were calculated. Water sorption and solubility values were measured ba-sed on ISO 4049: 2019. In addition, three-way ANOVA was used to evaluate the influence of resin materials, solutions, and immersion time on discoloration results, meanwhile, one-way ANOVA was used to compare the water sorption values and solubility values of different materials. Results All samples showed a certain degree of color change with time. Color differences were significantly influenced by materials, solutions, and immersion time (P<0.001). The color changes of the measured materials at any time point: curry>red wine>coffee>distilled water. Thus, all materials showed clinically unacceptable discoloration (ΔE>3.3) after immersing in staining curry, coffee, and red wine for 7 days. Therefore, when immersed in curry for 28 days, CS and DXU had the smallest and the largest color difference. In addition, when immersed in coffee for 28 days, FS showed the smallest color change and DXU showed the largest. Moreover, when immersed in red wine for 28 days, FS showed the smallest color change and Z350 showed the largest. Furthermore, MP and CXU had small color differences in all solutions. Meanwhile, Z350 had the highest water sorption and MP had the lowest. The solubility values of CS and CD were significantly higher than those of other materials. Conclusion The color stability of light-cured composite resin is materials-depended and affected by pigment types and immersion time. Thus, MP and CXU have better color stability. MP has low water sorption.

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Evaluation of root-canal isthmus debridement efficacy of 3 kinds of activated irrigation technique
Cong Xinyu, Xue Ming.
West China Journal of Stomatology    2022, 40 (5): 554-559.   DOI: 10.7518/hxkq.2022.05.008
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Objective This study aimed to compare the capabilities of sonic, ultrasonic, and laser-activated irrigation for debris removal in the root canal isthmus. Methods A total of 32 human maxillary first premolars with root canal isthmus were prepared by Reciproc Blue, and were randomly divided into four groups (n=8, each group). The groups were subsequently subjected to different regimens as follows: the conventional syringe group (control group) was irrigated by No.27 side opening syringe, the sonic group with EDDY connected pneumatic motor, the ultrasonic group with IRRI Safe connected to a ultrasonic P5 handle, and the laser group with Er:YAG laser device connected to a 9 mm fiber tip for 20 s in each root canal. The first and last four samples in each group were irrigated for 80 and 120 s, respectively. All samples were fixed, decalcified, embedded, sectioned, and stained with hematoxylin-eosin. Image J software was used for measurement analysis of the isthmus and canal debridement efficacy, and SPSS 25.0 was utilized for statistical analysis of all data. Results The isthmus debridement efficacy of conventional syringe irrigation, sonic, ultrasonic, and laser groups after 80 s irrigation were 30.91%±3.14%, 52.22%±0.31%, 83.77%±5.64%, and 77.97%±7.97%, respectively. The isthmus debridement efficacy of the three experimental groups were better than the conventional syringe irrigation group (P<0.05). The isthmus debridement efficacies of ultrasonic and laser groups after 80 s were better than that of the sonic group (P<0.01, P<0.05). However, no significant difference was observed between the ultrasonic and laser groups. The isthmus debridement efficacy of conventional syringe irrigation, sonic, ultrasonic, and laser groups after 120 s were 75.72%±2.38%, 85.66%±4.42%, 88.07%±4.09%, and 89.12%±3.63%, respectively. The isthmus debridement efficacies of the three experimental groups were better than that of the conventional syringe irrigation group (P<0.05), but no significant difference was observed among the groups (P>0.05). The root canal debridement efficacy among the four groups also exhibited no significant difference (P>0.05). The debridement efficacies of the root canal and isthmus after 120 s irrigation were better than those after 80 s irrigation (P<0.01, P<0.001). Conclusion Ultrasonic, sonic, and laser-activated irrigation have better results in removing debris from the isthmus than conventional syringe irrigation. The isthmus debridement efficacy of sonic- and laser-activated irrigation are slightly better than that of ultrasonic activated irrigation. The debridement efficacies of 120 s irrigation are better than those of 80 s irrigaion.

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Comparison of surgical effects between the modified West China method and Millard method in repairing unila-teral cleft lip
Liu Xiaolin, Wang Yu, Feng Xiaowei, Liu Wenjing, Li Xiangjun.
West China Journal of Stomatology    2022, 40 (3): 309-313.   DOI: 10.7518/hxkq.2022.03.010
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Objective

The purpose of this study is to compare the surgical effects of the modified West China method and Millard methods for repairing unilateral cleft lip.

Methods

A total of 34 cases of unilateral cleft lip were analyzed, composed of 16 cases in the experimental group subjected to the modified West China method and 18 cases in the control group, which was subjected to the Millard method. Photographs before and after operation were compared, and SPSS 21.0 was used in statistical analysis.

Results

After operation, no significant difference in symmetry between the healthy and affected sides of the nasal alar foot (sba), nasal alar point (al), lip peak point (cph), and mouth angle point (ch) in the experimental group (P>0.05), but no significant difference in symmetry was found between healthy and affected sides of cph and ch in the control group (P>0.05). No significant differences in the symmetry rates of the sba, cph, ch and the nasal columella regression rates were found between the experimental and control groups (P>0.05). The symmetry rates of the al in the experimental group were higher (P<0.05).

Conclusion

For unilateral cleft lip repair, two methods had better effects on lip repair, but the nasal symmetry showed greater improvement when the modified West China me-thod was used than when the Millard method was used.

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Clinical application of double eyelid incision in internal fixation of zygomatic-frontal fracture
Feng Dajun, Xu Peng, Sun Yunfeng.
West China Journal of Stomatology    2022, 40 (4): 436-439.   DOI: 10.7518/hxkq.2022.04.010
Abstract715)   HTML81)    PDF(pc) (1582KB)(505)       Save

Objective This study aimed to investigate the clinical application effect of double eyelid incision in the internal fixation of suturae zygomatico-frontalis fracture. Methods A total of 12 patients with zygomatic complex fracture and evident fracture segment displacement, accompanied by facial collapse or mouth opening limitation and other functional disorders, were selected for open reduction and internal fixation. The suturae zygomatico-frontalis fracture was fixed using a double eyelid approach. Postoperative evaluation was performed on fracture reduction and fixation to evaluate the improvement of function and deformity, postoperative scar, and other conditions. Results All fractures had convenient reduction and fixation, and all patients had satisfactory facial appearance, evident functional improvement, and hidden postoperative scar. Conclusion As a surgical approach to reduce and internally fix zygomatic complex fracture, double eyelid incision can reduce not only the fracture, but also the trauma, thereby indicating its certain clinical value.

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