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Table of Content
01 August 2017, Volume 35 Issue 4
  • Orginal Article
    Vital pulp therapy of damaged dental pulp
    Xuedong Zhou, Dingming Huang, Jianguo Liu, Zhengwei Huang, Xin Wei, Deqin Yang, Jin Zhao, Liming Chen, Lin Zhu, Yanhong Li, Jiyao Li
    West China Journal of Stomatology. 2017, 35(4):  339-347.  doi:10.7518/hxkq.2017.04.001
    Abstract ( 1623 )   HTML ( 94 )   PDF(pc) (764KB) ( 2177 )   Save
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    The development of an expert consensus on vital pulp therapy can provide practical guidance for the improve-ment of pulp damage care in China. Dental pulp disease is a major type of illness that adversely affects human oral health. Pulp capping and pulpotomy are currently the main methods for vital pulp therapy. Along with the development of minimal invasion cosmetic dentistry, using different treatment tech-nologies and materials reasonably, preserving healthy tooth tissue, and extending tooth save time have become urgent problems that call for immediate solution in dental clinics. This paper summarizes the experiences and knowledge of endo-dontic experts. We develop a clinical path of vital pulp therapy for clinical work by utilizing the nature, approach, and degree of pulp damage as references, defense and self-repairing ability of pulp as guidance, and modern technologies of diagnosis and treatment as means.

    Criterion of dental treatment for the disabled
    Huchun Wan, Zheng Yang, Hongkun Wu, Jianguo Liu, Jin Zhao, Xiaoping Ji, Lin Zhu, Deqin Yang, Xuedong Zhou
    West China Journal of Stomatology. 2017, 35(4):  348-354.  doi:10.7518/hxkq.2017.04.002
    Abstract ( 617 )   HTML ( 12 )   PDF(pc) (715KB) ( 565 )   Save
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    The number of disabled persons increases in the course of human life and in the aging population. The high prevalence, low treatment rate, long therapy period, and sophisticated procedures prevent most of disabled individuals from availing dental services. Moreover, special dental institutions for the disabled are insufficient, and a certain treatment standard is commonly not complied. This study performed analysis and evaluation, including treatment features, pretreatment proce-dures, patient communication, treatment factors, and treatment standards to provide a targeted solution for the special require-ments of the oral therapy for disabled patients.

    Clinical application and material selection of provisional restorations
    Ke Zhao, Yitong Yao, Xiaodong Wang, Li Dao
    West China Journal of Stomatology. 2017, 35(4):  355-361.  doi:10.7518/hxkq.2017.04.003
    Abstract ( 840 )   HTML ( 12 )   PDF(pc) (1853KB) ( 792 )   Save
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    Provisional restorations are beneficial to final restorations. However, the importance of provisional restorations is often overlooked because they are designed to function for a limited period. This article summarizes the clinical values and two common materials of provisional restorations.

    Effect of different oxygen tension on the cytoskeleton remodeling of goat temporomandibular joint disc cells
    Xiao-lan He, Guangjie Bao, Linglu Sun, Xue Zhang, Shanying Bao, Hong Kang
    West China Journal of Stomatology. 2017, 35(4):  362-367.  doi:10.7518/hxkq.2017.04.004
    Abstract ( 650 )   HTML ( 2 )   PDF(pc) (1092KB) ( 388 )   Save
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    Objective The effect of different oxygen tensions on the cytoskeleton remodeling of goat temporomandibular joint (TMJ) disc cells were investigated. Methods Goat TMJ disc cells were cultured under normoxia (21% O2) and hypoxia (2%, 4%, and 8% O2). Toluidine blue, picrosirius red, and type Ⅰ collagen immunocytochemical staining were performed to observe the changes in cell phenotype under different oxygen levels. Immunofluorescent staining and real-time reverse trans-cription-polymerase chain reaction analysis were then performed to identify actin, tubulin, and vimentin in the cultured disc cells. Results TMJ disc cells still displayed fibroblast characteristics under different oxygen levels and their cytoskeletons had regular arrangement. The fluorescence intensities of actin and vimentin were lowest at 4% O2 (P<0.05), whereas that of tubulin was highest at 2% O2 (P<0.05). No significant difference among the other groups was observed (P>0.05). Actin mRNA levels were considerably decreased at 2% O2 and 4% O2 in hypoxic conditions, while actin mRNA expression was highest in 21% O2. Tubulin mRNA levels considerably increased at 2% O2, while tubulin mRNA expression was lowest in 8% O2 (P<0.05). Vimentin mRNA expression was lowest at 4% O2 and highest at 21% O2, and significant differences were observed between vimentin mRNA expression levels among these oxygen levels (P<0.05). Conclusion Cytoskeletons were recon-structed in different oxygen tensions, and 2% O2 may be the optimal oxygen level required to proliferate TMJ disc cells.

    The effect of Toll-like receptor 4 in nicotine suppressing the osteogenic potential of periodontal ligament stem cells
    Luan Yan, Deqin Yang
    West China Journal of Stomatology. 2017, 35(4):  368-372.  doi:10.7518/hxkq.2017.04.005
    Abstract ( 698 )   HTML ( 11 )   PDF(pc) (1019KB) ( 474 )   Save
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    Objective To explore the impact of nicotine on proliferation and osteogenic capability of periodontal ligament stem cells (PDLSCs), and the role of Toll-like receptor 4 (TLR4) in nicotine, suppressing the osteogenic capability of PDLSCs. Methods PDLSCs were cultured in vitro, and the flow cytometer was used to identify the surface antigen markers of PDLSCs. WST-1 was used to detect the proliferation ability of PDLSCs, which were stimulated by different concentrations of nicotine. Alizarin red staining was used to observe the formation of mineralized nodules after PDLSCs stimulation with different con-centrations of nicotine. Real-time polymerase chain reaction (RT-PCR) and Western blot were used to detect the change in osteogenic potential of PDLSCs stimulated by nicotine, after TAK-242, and with the inhibitor of TLR4. Results PDLSCs expressed mesenchymal stem cell-associated mar-kers CD90 and CD105. When the concentration of nicotine was 10-4mol·L-1, the PDLSC proliferation could be suppressed after 3 d compared with the control group (P<0.05). The amount of mineralized nodules reduced after osteogenic differentiation at 21 d by alizarin red staining. RT-PCR and Western blot showed the expression levels of alkaline phosphatase (ALP), and osteocalcin (OCN), and the Runt-related transcription factor-2 (Runx-2) were lower than in the control group when nicotine suppressed the PDLSCs (P<0.05). This effect was atte-nuated after TAK-242 was added. Conclusion Nicotine suppresses the proliferation and osteogenic capability of PDLSCs, which may be regulated by TLR4.

    Effects of geranylgeranyltransferaseⅠsilencing on the proliferation of tongue squamous cancer cells
    Ying Wang, Qimin Wang, Jinghua Li, Jinhong Han, Lili Wang, Chen Chao, Jianhua Zhou, Lei Tong, Xufei Lu, Yuan Zhou, Yixiang Liao, Zongxuan He, Ning Li, Lei Cao, Wenjun Liu, Zhenggang Chen
    West China Journal of Stomatology. 2017, 35(4):  373-378.  doi:10.7518/hxkq.2017.04.006
    Abstract ( 692 )   HTML ( 2 )   PDF(pc) (958KB) ( 501 )   Save
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    Objective This study aims to investigate the effect of geranylgeranyltransferaseⅠ (GGTase-Ⅰ) on the proliferation and growth of tongue squamous cancer cells. Methods Three small interfering RNAs (siRNAs) were designed on the basis of the GGTase-Ⅰ sequence in GeneBank. These siRNAs were then transfected into tongue squamous cancer cells Cal-27. The mRNA and protein expression of GGTase-Ⅰ and RhoA were examined by real-time quantitative polymerase chain reaction and Western blotting, respectively. The expression of Cyclin D1 and p21 were examined by Western blotting. The proliferation and growth ability were analyzed by cell counting kit-8 assay and flow cytometry. Results The mRNA and protein expression of GGTase-Ⅰ in Cal-27 was reduced significantly after the GGTase-Ⅰ siRNAs were transfected (P<0.05). No significant difference in RhoA mRNA and protein expression was detected (P>0.05). Cyclin D1 expression decreased, whereas p21 expression increased significantly. The cell cycle was altered, and the growth-proliferative activity was inhibited (P<0.05). Conclusion GGTase-Ⅰ siRNA can inhibit the expression of GGTase-Ⅰ and the proliferative activity of tongue squamous cancer cells. GGTase-Ⅰ may be a potential target for gene therapy in tongue squamous cell cancer.

    Brushing abrasion of the enamel surface after erosion
    Lipei Chen, Xiangke Ci, Xiaoyan Ou
    West China Journal of Stomatology. 2017, 35(4):  379-383.  doi:10.7518/hxkq.2017.04.007
    Abstract ( 897 )   HTML ( 22 )   PDF(pc) (843KB) ( 1032 )   Save
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    Objective A study was conducted to compare the effect of different enamel remineralization periods after ero-sion on the depth of brushing abrasion. Methods Ten volunteers were selected for a 4-day experiment. A total of 60 enamels were randomly assigned into six groups (A-F) and placed in intraoral palatal devices. On the first day, the palatal devices were placed in oral cavity (24 h) . On the following three days, brushing experiments were performed extraorally, two times per day. The specific experimental method of brushing follows these next steps. First, the group F specimens were covered with a film of wax, and then acid etched for 2 min. Subsequently, the film of wax was detached. The groups from A to D were brushed after remineralization at the following time intervals: group A, 0 min; group B, 20 min; group C, 40 min; group D, 60 min. Erosion and remineralization were performed on group E, but without brushing. Remineralization was performed on group F, but without acid etching and brushing. The depth of enamel abrasion was determined by a mechanical profilometer. The surface morphology of the enamel blocks was observed using a scanning electron microscope. Results 1) The depth of abrasion was different in varied enamel remineralization time after acid etching. The statistical significant differences between groups were as follows. 2) When the time of enamel remineralization after acid etching was short, the surface depression in the electron microscope was deep, and the surface morphology was rough. Conclusion Brushing immediately after acid etching would cause much serious abrasion to the enamel surface. Brushing after 60 min can effectively reduce the abrasion of acid etching enamel.

    Clinical application of cone beam computed tomography combined with micro-ultrasound technique in treating three mesial canals in mandibular first molars
    Lili Yang, Yan Zhang, Shijun Zhao, Shuai Zhang, Na Wang, Jie Xu, Shue Hu, Zhiyuan Xu
    West China Journal of Stomatology. 2017, 35(4):  384-388.  doi:10.7518/hxkq.2017.04.008
    Abstract ( 715 )   HTML ( 3 )   PDF(pc) (2217KB) ( 551 )   Save
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    Objective The aim of this study is to investigate the influence of cone beam computed tomography (CBCT) and micro-ultrasound technique for the treatment of three mesial canals in mandibular first molars. The three mesial canals according to Pomeranz’s classification were characterized. Methods A total of 75 permanent mandibular first molars for root canal treatment were randomly selected from patients belonging to the age group of 14-60 years. After preparing the access cavity and locating the main canals, the middle mesial canal orifices in all teeth were determined with an endodontic explorer under direct vision (StageⅠ), under magnification with the aid of micro-ultrasound (Stage Ⅱ), and with the combined use of CBCT and micro-ultrasound to remove the dentin wall and calcifications (Stage Ⅲ). Results Middle mesial canals were detected in 4.0%, 18.7%, and 22.7% of the teeth in StagesⅠ-Ⅲ, respectively. Statistical analysis showed significant differences (P<0.05) between StagesⅠand Ⅱ with regard to middle mesial canal detection. The number of Stage Ⅲ was more than that of Stage Ⅱ. The difference between the two stages was no significant. Among the 17 middle mesial canals, “confluent”, “fin” and “independent” anatomies were 52.9%, 35.3%, and 11.8%. Conclusion When used with adjunctive aids, including CBCT, micro-ultrasound facilitates dental clinicians in the location and treatment of middle mesial canals.

    Effect of repeated sintering and variations in thickness on the color and microstructure of dental lithium disilicate-based glass ceramic veneers
    Cui Huang, Jia Yu, Shaofeng Meng, Biyun Gao
    West China Journal of Stomatology. 2017, 35(4):  389-394.  doi:10.7518/hxkq.2017.04.009
    Abstract ( 793 )   HTML ( 18 )   PDF(pc) (824KB) ( 561 )   Save
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    Objective The aim of this study is to evaluate the effect of repeated sintering and variation in thickness on the color and microstructure of dental lithium disilicate-based glass ceramic veneers. Methods A total of 24 computer aided design and computer aided manufacturing (CAD/CAM) veneers was fabricated using the IPS e.max-CAD LS2 and then randomly divided into four groups (S0, S1, S2, S3; n=6). Each group was sintered 0, 1, 2, 3 times individually according to the manufacturer’s recommendation. The color parameters (L, C, H, a, b values) of all the specimens were measured by a Vita easyshade dental colorimeter. The results were statistically analyzed using the SAS 9.1.3 software for MANOVA and LSD. Subsequently, the microstructures of the intersecting surfaces of the specimens were observed by scanning electron microscopy (SEM). Results After repeated sintering, the L value significantly decreased (P<0.05). For the C and b values, statistical differences were observed among the groups except between S2 and S3. SEM results showed that the interlocking microstructures of rod-shaped Li2Si2O5 crystals became more compact when the number of sintering times was increased. Conclusion Repeated sintering exhibited significant influence on the color of the IPS e.max-CAD LS2 veneers.

    Measurements of mechanical properties and morphology of root canal in maxillary primary anterior teeth
    Jia Hu, He Liu, Qing Cai, Xuliang Deng
    West China Journal of Stomatology. 2017, 35(4):  394-398.  doi:10.7518/hxkq.2017.04.010
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    Objective This study aimed to measure the taper and diameter of root canal, as well as the elastic modulus and hardness in the root dentin of maxillary primary anterior teeth. Methods Patients under general anesthesia who needed root canal therapy in the maxillary primary anterior teeth were selected. Silicone impression material was used to take impressions. The impressions were scanned, and the taper and diameter of root canal were measured. Maxillary primary anterior teeth were collected in vitro. The elastic modulus and hardness of root dentin was tested. Results A total of 74 silicone impressions were obtained. The mean tapers of primary incisor teeth, primary lateral incisor teeth, and primary canine teeth were 0.106, 0.185, and 0.098, respectively. The mean diameters of the root canal 5 mm below the cementum-enamel junction (CEJ) were 1.267, 0.860, and 1.429 mm, respectively. The elastic modulus and hardness of root dentin were measured in 10 primary anterior teeth in vitro. The range of elastic modulus was 19.919-25.017 GPa. The range of hardness was 0.867-1.082 GPa. Conclusion The root canal post used in primary anterior teeth can be produced by the following data: taper of primary incisor teeth and primary canine teeth, 0.1; diameters of their tips, 1.2 mm and 1.4 mm, respectively; taper of primary lateral incisor teeth, 0.2; diameter of their tips, 0.8 mm; range of elastic modulus, 20-25 GPa; and range of hardness, 0.87-1.08 GPa.

    Application of single-retainer all-ceramic resin-bonded fixed partial denture in replacing single anterior tooth
    Lili Yang, Debiao Du, Ruoyu Ning, Deying Chen, Junling Wu
    West China Journal of Stomatology. 2017, 35(4):  399-402.  doi:10.7518/hxkq.2017.04.011
    Abstract ( 1093 )   HTML ( 43 )   PDF(pc) (736KB) ( 874 )   Save
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    Objective In this study, we aimed to evaluate the clinical effect of single-retainer all-ceramic resin-bonded fixed partial denture (RBFPD) on the single anterior tooth loss patients. Methods A total of 20 single-retainer all-ceramic RBFPD were fabricated and evaluated in a two-year follow-up observation. The restorations were examined on the basis of the Ame-rican Public Health Association (APHA) criteria. Results A total of 20 single-retainer all-ceramic RBFPD achieved class A evaluation after a six-month follow-up observation. One single-retainer all-ceramic RBFPD was classified as class B for secondary caries after a one-year follow-up observation. After a two-year follow-up observation, one single-retainer all-ceramic RBFPD was classified as class B because of secondary caries, and one single-retainer all-ceramic RBFPD was classified as class B because of fracture. Conclusion Single-retainer all-ceramic RBFPD is a promising and optional method in replacing single anterior tooth.

    Characteristics of mandible and mandibular dentition in patients with near-normal occlusion and different vertical facial skeletal types
    Jingqiu Tu, Jiaqian Fan, Yonghua Lei
    West China Journal of Stomatology. 2017, 35(4):  403-407.  doi:10.7518/hxkq.2017.04.012
    Abstract ( 1152 )   HTML ( 13 )   PDF(pc) (824KB) ( 484 )   Save
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    Objective The aim of our work is to characterize individual normal occlusions to establish appropriate treat-ment standards for different vertical facial types. Methods A total of 30 patients with near-normal occlusion were grouped into high-angle group (eight cases), medium-angle group (12 cases), and low-angle group (10 cases) according to vertical facial skeletal type. Invivo5 software was used and digital imaging and communications in medicine data were rebuilt to measure the ∠L1/MP, ∠L6/MP, axis corner of L6, cant of occlusion plane, Balkwill angle, and Bonwill triangle of each group. Results Among the groups, the low-angle group had the smallest ∠L6/MP (P<0.05) and largest cant of occlusion. No significant difference was observed among the three groups with regard to the other parameters (P>0.05). Conclusion Patients with low-angle vertical facial skeletal type requires a modified treatment standard. In this group, the treatment standard must ensure that the cant of occlusion plane is more parallel to the Frankfurt horizontal plane compared with those of the other groups, and the axis of L6 is tilted distally relative to the mandibular plane.

    Comparison between propofol and propofol-remifentanil sedation under target-controlled infusion for impacted super-numerary teeth extraction surgery for children
    Hao Zhang, Yali Hou, Xiangjun Li, Fusheng Dong, Ruihua Lin
    West China Journal of Stomatology. 2017, 35(4):  408-412.  doi:10.7518/hxkq.2017.04.013
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    Objective The aim of this study is to compare sedation titrated under target-controlled infusion of propofol and propofol-remifentanil for impacted supernumerary teeth extraction surgery for children. Methods A total of 60 children with anterior maxillary region impacted supernumerary teeth extraction surgery were divided randomly into two groups, namely, propofol group (group P, n=30) and propofol-remifentanil group (group PR, n=30). In group P, a titrated infusion of propofol was started until the modified observer’s assessment of alertness/sedation (OAA/S) scale reached level 3 before the actual surgery. In group PR, a remifentanil infusion with a target plasma concentration of 1 ng·mL-1 was started until the operation was finished. A titrated infusion of propofol was also started until the modified OAA/S score reached level 3 before the actual surgery. The Houpt behavior scale was adopted to evaluate the cooperation of each patient in both groups. The heart rate, blood pressure, respiratory rate, oxyhemoglobin saturation, and Narcotrend index, complications, adverse reactions and propofol infusion of all patients were recorded during the operation. Results The Houpt behavior scales in group PR were better than those in group P (P<0.05). The oxyhemoglobin saturation and respiratory rate in group PR were lower than that in group P (P<0.05). The heart rate, blood pressure and NI in two groups were no significant difference (P>0.05). The incidence of respiratory depression and anterograde amnesia in group PR were higher than that in group P (P<0.05). Conclusion Sedation titrated under the target-controlled infusion of propofol and that titrated under propofol-remifentanil for impacted super-numerary teeth extraction surgery for children are safe. The sedation titrated under target-controlled infusion of propofol-remifentanil is better than sedation by propofol when inhaling oxygen.

    Single-photon emission computed tomography for the diagnosis of mandibular invasion caused by oral cancers: a systematic review and Meta-analysis
    Xiaonian Wang, Fenjuan Luo, Xianghe Qiao, Wenbin Yang, Jie Lin, Chunjie Li
    West China Journal of Stomatology. 2017, 35(4):  413-418.  doi:10.7518/hxkq.2017.04.014
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    Objective This review aimed at assessing the diagnostic efficacy of contrast-enhanced single-photon emission computed tomography (SPECT) in the diagnosis of mandibular invasion by oral cancers. Methods Five databases were searched electronically on August 5, 2016. The reference lists of included studies were hand searched. Quality assessment was performed by two reviewers in duplicate with tools suggested by Cochrane’s handbook. Furthermore, the data extraction of included studies was delivered. Meta-analysis was performed using STATA 11.0. Results Ten studies with 460 participants were included. One study had a low risk of bias, and two studies had a high risk of bias. The remaining seven studies had an unclear risk of bias. Meta-analysis results showed that SPECT had a pooled sensitivity of 0.99 [95% confidence interval=0.87-1.00]. Sensitivity was 0.99 on Q* point. The specificity of 0.61 and the area under summary receiver operating characteristic curve (SROC) were 0.93 [95% confidence interval=0.90-0.95]. The pooled positive likelihood ratio was 2.555. The negative likelihood ratio was 0.015. The diagnostic odd ratio was 5.115. Conclusion SPECT had high sensitivity, which became suitable for excluding bone invasion by oral cancers. However, its specificity was relatively low, indicating its limited capability in confirming diagnosis. Therefore, sur-geons should perform this method under certain conditions.

    Association between chronic periodontitis and hyperlipidemia: a Meta-analysis based on observational studies
    Lianhui Yang, Meifei Lian, Zhongyue Hu, Yunzhi Feng
    West China Journal of Stomatology. 2017, 35(4):  419-426.  doi:10.7518/hxkq.2017.04.015
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    Objective The aim of this study is to evaluate the relationship between periodontitis and hyperlipidemia risks through Meta-analysis. Methods Two researchers conducted an electronic search on PubMed, Cochrane Library, Embase, CBM, CNKI, Wanfang and VIP databases established until July 2016 for observational studies on the association between periodontitis and hyperlipidemia. The language used was limited to Chinese and English. After data extraction and quality evaluation of included trials, Meta-analysis was conducted using the RevMan 5.3 software. The GRADE 3.6 software was used to evaluate the quality level of the evidence.Results Six case-control studies and one cohort study were included. The results of Meta-analysis showed that serum triglyceride (TG) in patients with periodontitis was significantly higher than that of the periodontal health group (MD=50.50, 95% confidence interval=39.57-61.42, P<0.000 01), as well as serum total cho-lesterol (TC) (MD=17.54, 95% confidence interval=10.91-24.18, P<0.000 01). Furthermore, the risks of TG and TC in the serum of patients with chronic periodontitis were 4.73 times (OR=4.73, 95% confidence interval=2.74-8.17, P<0.000 01) and 3.62 times (OR=3.62, 95% confidence interval=2.18-6.03, P<0.000 01) of that of periodontal healthy patients. No significant difference was observed between the group with high-density lipoprotein cholesterol (HDL-C) and that with low density lipo-protein cholesterol (LDL-C). Conclusion Current evidence indicates that a correlation exists between chronic periodontitis and hyperlipidemia, and chronic periodontitis is an independent risk factor for hyperlipidemia, especially for TC and TG in serum.

    Advances in macrophage function and its anti-inflammatory and proresolving activity and role in periodontitis deve-lopment
    Lin Bai, Yuejiao Xin, Dingyu Duan, Yi Xu
    West China Journal of Stomatology. 2017, 35(4):  427-432.  doi:10.7518/hxkq.2017.04.016
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    Macrophage plays an important role in human innate immune system. It has powerful functions, such as recog-nition, phagocytosis, and bacteria and foreign body removal. Periodontitis, which is a chronic infectious disease characterized by gum inflammation and bone loss, is a major cause of tooth loss in adults. Several studies demonstrated that periodontal tissue destruction is caused by the host immune response defending against infections. As an important part of host immune response, macrophage is also involved in periodontitis pathogenesis. Recently, anti-inflammatory and proresolving activities of macrophage was discovered. Thus, the complex function of macrophage in the occurrence, development, and resolution of inflammation and its potential role in periodontitis were reviewed.

    Current therapy of atrophic edentulous mandibular fractures among elderly people
    Mingzhe Li, Xiaofeng Xu, Bing Xu
    West China Journal of Stomatology. 2017, 35(4):  433-436.  doi:10.7518/hxkq.2017.04.017
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    The cases of mandible fractures among elderly people, especially those with atrophic mandibles, are increasing. Atrophic mandibular fractures among elderly people require specific treatment because of the differences between the anato-micophysiologies of elderly people and those of normal adults. This paper serves as a literature review on the characteristics, selection of the treatment method, and complication of atrophic edentulous mandibular fractures among elderly people.

    Effect of maternal health and prenatal environmental exposure factors on tooth development
    Mian Wan, Xue-dong Zhou, Liwei Zheng
    West China Journal of Stomatology. 2017, 35(4):  437-441.  doi:10.7518/hxkq.2017.04.018
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    Odontogenesis is a consequence of a complex series of reciprocal signal interactions between odontogenic epi-thelium and neural crest-derived odontotgenic mesenchyme. These interactions result from a complex interplay of genetic and environmental factors. Given that a fetus develops in the mother, maternal health and environmental exposures have a great influence on tooth development. In this review, we focused on the key issues in the developmental defects of teeth induced by various types of maternal environmental factors, including environmental endocrine disruptors, joint action of two or more chemical exposures, and maternal health status. This review also discussed the adverse effects of maternal environmental factors on tooth development. These effects include enamel developmental defects, molar incisor hypomineralization, dental fluorosis, hyperdontia and hypodontia. Overall, this review provides a theoretical basis for the prevention of tooth defects in early life, assessment of risks from developmental tooth defects, and advancement of pediatric oral health management.

    Clinical application of mandibular overdenture supported by a two-implant and interforaminal bar in an edentulous atrophic mandible
    Li Dao, Xue Xiao, Xiaodong Wang, Ke Zhao
    West China Journal of Stomatology. 2017, 35(4):  442-447.  doi:10.7518/hxkq.2017.04.019
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    Implant-overdenture supported by an interforaminal bar provides stability and is effective in an edentulous atro-phic mandible. However, using this attachment requires precise planning from the restorative and surgical aspects to ensure a satisfying outcome. Consdering the feature and space requirements for bar attachment, this article establishes a clinical pro-tocol for a two-implant-retained overdenture on the mandible. In this study, a case of mandibular edentulism was considered to illustrate this protocol and provide a reference for clinical practice.

    Intentional replantation for the treatment of palatal radicular groove with endo-periodontal lesion in the maxillary lateral incisor: a case report
    Xuelian Tan, Lan Zhang, Dingming Huang
    West China Journal of Stomatology. 2017, 35(4):  448-452.  doi:10.7518/hxkq.2017.04.020
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    Palatal radicular groove leads to severe endo-periodontal lesion in lateral incisors. The groove occurs on the labial and lingual root surfaces, while the localized periodontal pocket develops along the lingual groove length. The compli-cated root canal system, extensively destroyed bone lamella, and persistent fistula pose a challenge for root canal therapy, tooth retention, and thorough infection control inside and outside of the root canal. Combining microscopic root canal therapy with intentional replantation and nano-biomaterial application facilitates infection control, tooth retention, and formation of newly periodontal attachment.