Evidence-based medicine (EBM) has rapidly developed in recent years and is currently a hotspot in international medicine. The guiding principle behind EBM is that any medical decision should be determined based on objective clinical and scientific evidence, doctor’s professional skills and experience, and patient’s needs and desires. This paper introduces the concept and practice of EBM and explains how it can be used to solve the issues in stomatology.

Objective  This study aims to construct a long-term, osteogenesis-targeting HU-308 drug delivery implant by the layer-by-layer electrostatic self-assembly (LBL) technique, and observe the features of its delayed release in vitro. Methods  A heparin (Hep) and chitosan (Chi) multilayer was coated on pure titanium using the LBL technique, and the titanium implants were dipped into the solution to load HU-308. The amount of loaded drug and release rates were measured using a UV-Vis spectrophotometer. The relationships between the loading efficiency, release time, and multilayer films were evaluated. The morphology of all the multilayers was characterized by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Results  The results showed that the Hep/Chi self-assembly multilayer was gradually fabricated on the titanium surface. HU-308 was successfully loaded on the titanium implants. The amount of loaded drug increased with the amount of multilayer films, except in the T20 group. In vitro drug release study showed that drug release was more difficult in the system with thicker films, and large amounts of multilayer films decreased the release speed. Both SEM and AFM measurements showed typical LBL deposition of Hep and Chi. Conclusion  The HU-308 drug delivery implant is successfully fabricated via LBL technology. It could provide sustained release of HU-308 over 30 d. This type of implant may provide a new possibility of promoting implant–bone osseointegration for osteoporotic patients.

Objective To study the effect of excessive fluoride on calcium overload and apoptosis in cultured rat ameloblasts in vitro. Methods Logarithmic-phase ameloblasts (HAT-7) were treated with 0, 0.4, 0.8, 1.6, 3.2, and 6.4 mmol·L^-1 sodium fluoride (NaF) solution. Cell activities were detected by using a Cell Counting Kit 8 (CCK-8) assay after 48 h of treatment. The effect of fluoride on cell apoptosis was analyzed by using flow cytometry. Excessive fluoride-induced calcium concentration and calreticulin expression changes in ameloblasts were detected by using laser scanning confocal microscopy, Western blot analysis, and real-time quantitative polymerase chain reaction. Results NaF inhibited ameloblast activity at 1.6, 3.2, and 6.4 mmol·L⁻¹ (dose-dependent) after 48 h of induction. The Ca²⁺ fluorescence intensity of HAT-7 cells incubated with 1.6 and 3.2 mmol·L⁻¹ NaF was higher than that in the control group. The fluoride-induced early-stage apoptosis of ameloblasts after 48 h of induction and the early-stage apoptosis rate was positively correlated with fluoride concentration. Calreticulin mRNA expression in HAT-7 cells was higher than that in the control group after 48 h of incubation with 0.8, 1.2, and 1.6 mmol·L⁻¹ NaF. Conclusion Excessive fluoride-induced calcium overload in ameloblasts and further caused endoplasmic reticulum stress-mediated apoptosis.

Objective To explore the effect of zoledronate (ZOL) on the osteoclast adhesion and expression of integrin α_vand β₃ in vitro. Methods Mice RAW264.7 cells were used for osteoclast differentiation in vitro, and osteoclastogenesis was examined by tartrate-resistant acid phosphatase (TRAP) staining and dentin resorption lacunae examination. The cells were then divided into 2 groups, the control group and ZOL treatment group (treated with 1×10^-6 mol·L^-1 ZOL for 2 d). The adhesion ability of osteoclasts and mRNA and the protein expressions of integrin α_vand β₃were examined by crystal violet staining, real-time fluorescence quantitative polymerase chain reaction, Western blot analysis, and immunofluorescent chemistry. Results TRAP staining and dentin resorption lacunae examination revealed the formation of multi-nuclear osteoclasts. ZOL treatment significantly decreased the adhesion ability of osteoclasts (P<0.01). In the ZOL-treated group, the mRNA levels of integrin α_vand β₃ were 0.66±0.05 and 0.59±0.08, respectively. In the control group, the mRNA levels of integrin α_v and β₃were 1.01±0.01 and 1.01±0.02, respectively; these values were higher than those in the ZOL-treated group (P<0.01). The protein level of integrin α_vand β₃in the ZOL-treated group (31 934.84±112.91 and 18 812.79±194.13) was downregulated by approximately 39.19% and 40.17%, respectively, compared with those in the control group (52 517.81±211.72 and 31 441.93±456.87) (P<0.01). Immunofluorescent examination showed that the fluorescent intensities of integrinα^v and β³ in the ZOL-treated group (9.491±0.748 and 4.744±0.759) were also significantly decreased compared with those in the control group (15.159±1.143 and 11.418±1.095) (P<0.01). Conclusion ZOL significantly inhibits osteoclast adhesion and downregulates integrin α_vand β₃expression, thus contributing to the ZOL-induced inhibition of osteoclastmediated bone resorption.

Objective We used functional magnetic resonance imaging (fMRI) to explore the effects of noxious coldness and non-noxious warmth on the magnitude of cerebral cortex activation during intraoral stimulation with water. Methods Six male and female subjects were subjected to whole-brain fMRI during the phasic delivery of non-noxious hot (23 ℃) and noxious cold (4 ℃) water intraoral stimulation. A block-design blood oxygenation level-dependent fMRI scan covering the entire brain was also carried out. Results The activated cortical areas were as follows: left pre-/post-central gyrus, insula/operculum, anterior cingulate cortex (ACC), orbital frontal cortex (OFC), midbrain red nucleus, and thalamus. The activated cortical areas under cold condition were as follows: left occipital lobe, premotor cortex/Brodmann area (BA) 6, right motor language area BA44, lingual gyrus, parietal lobule (BA7, 40), and primary somatosensory cortex SⅠ. Comparisons of the regional cerebral blood flow response magnitude were made among stereotactically concordant brain regions that showed significant responses under the two conditions of this study. Compared with non-noxious warmth, more regions were activated in noxious coldness, and the magnitude of activation in areas produced after non-noxious warm stimulation significantly increased. However, ACC only significantly increased the magnitude of activation under noxious coldness stimulation. Conclusion Results suggested that a similar network of regions was activated common to the perception of pain and nopain produced by either non-noxious warmth or noxious coldness stimulation. Non-noxious warmth also activated more brain regions and significantly increased the response magnitude of cerebral-cortex activation compared with noxious coldness. Noxious coldness stimulation further significantly increased the magnitude of activation in ACC areas compared with noxious warmth.

Objective The biological safety of a new developed silicone rubber for inflatable silastic prosthesis (SRISP)was evaluated. Methods Following the GB/T 16886.10-2005 standard, YY/T 0127.13-2009 standard, and GB/T 16886.11-2011 standard, samples were prepared and tested by animal experiments, such as guinea pig maximization test, oral mucousmembrane irritation test, and short-term systemic toxicity test (oral route). Results No obvious erythema and edema in theguinea pig abdominal skin were observed after 24, 48, and 72 h of stimulating touch, thus indicating that SRISP does notcause potential skin sensitivity. No local response to SRISP was found, and the visual observation and pathological findingsof oral mucosa were normal and similar to that of the control group. Therefore, SRISP had no irritation response to oralmucosa. No clinical signs of toxicity were observed in rats, and no significant differences in weight and weight relativegrowth rate between extract group and blank control group (P>0.05) were found. Thus, SRISP had no short-term systemictoxicity. Conclusion These results indicated that SRISP met the requirement of biomedical materials and had good biosecurity.

Objective This study aims to investigate the temporal pattern of expression of vascular endothelial growth factor (VEGF) and new bone formation during midpalatal suture expansion osteogenesis for rapid maxillary expansion. Methods A total of 44 New Zealand white rabbits were randomly assigned to 11 groups, namely, five experimental groups, five control groups, and one control 0 group. A Haas appliance was used for the rapid expansion of the midpalatal suture; rapid expansion was set for 2 weeks and fixed for 4 weeks. The tissue of the maxillary midpalatal suture was harvested on the day of installing rapid expansion (control 0 group), on weeks 1 and 2 for rapid expansion, and on weeks 1, 2, and 4 for fixed (experimental group and control group, respectively). The immunohistochemical method was used to detect distribution and expression of VEGF, and new bone formation was observed with periodic acid-Schiff. Results Higher VEGF expressions are observed after midpalatal suture distraction osteogenesis. Positive staining for VEGF is mainly noted in the vascular endothelial cells, and the active osteoblasts are at the edge of a newborn trabecular bone. A weak VEGF expression is detected among cells in the control group. The VEGF expression of the experimental group is higher than that of the control group in rapid expansion weeks 1 and 2 and in fixed weeks 1 and 2. The expression of VEGF in the experimental group increases significantlycn and peaks at fixed week 1, and then gradually decreases. The amount of newly formed bone in the experimental groups is always higher than that in the control group; moreover, it increases significantly and peaks at fixed week 2, and then gradually decreases. Conclusion The mechanical strain created by rapid maxillary expansion generates a sequence of VEGF cellular events that lead to increased vascularization and subsequent new bone formation.

Objective The aim of this retrospective study is to present the long-term effects of open healing of keratocystic odontogenic tumors (KCOTs) in the mandible. Methods A retrospective case series study was conducted on 41 patients with large KCOTs (the maximum diameter of the tumors exceeded 5 cm) treated at our institution between September 2003 and April 2011. A conservative surgical treatment was applied. The treatment involved enucleation of the primary lesion through narrow unroofing and open packing of the residual osseous defect with iodoform gauze for secondary healing. Bone regeneration and surgical complications were observed. The long-term effects of the treatment were followed up. Results The inferior alveolar nerve was exposed in the KCOT bone cavity in all cases, and some nerves adhered to the tumor tightly. The postoperative follow-up time was 81.5 months on the average (36 to 127 months). The packing gauze was changed every two weeks after enucleation, and the total duration time for packing was 8.9 months on the average (3 to 15 months). Notable bone regeneration and satisfactory secondary healing were observed clinically and radiographically. The KCOT-affected teeth were reserved, and their chewing functions were restored. Two cases presented recurrences after the initial treatment. The recurrence rate was 4.9% (2/41). No serious complications were observed. Conclusion Enucleation associated with subsequent open packing is a reliable treatment for patients with large KCOTs in the mandible.

Objective Frictions of Lock-loose brackets with ligated main wings or all six wings were measured as they slid along archwires in dry and artificial saliva environments. The Lock-loose brackets were then compared with traditional brackets and self-ligating brackets. Methods The surface states of the stainless steel archwires were observed with atomic force microscopy before and after mechanical traction. The Lock-loose brackets, traditional brackets, and self-ligating brackets used in this study were composed of 0.406 4 and 0.457 2 mm stainless steel round archwires and 0.457 2 mm×0.634 9 mm and 0.482 6 mm×0.634 9 mm stainless steel rectangular archwires. Two different ligating methods were applied to the Lockloose brackets, i.e., main wings ligated and all six wings ligated. Frictions were measured by using an electronic universal testing machine. Results No significant differences were found between the roughness of different archwires before and after mechanical traction in different brackets (P>0.05). When the main wings of the Lock-loose brackets were ligated, the frictions of the four different stainless steel archwires were close to zero, and the difference with frictions of traditional brackets was significant (P<0.05). When using 0.457 2 mm×0.634 9 mm rectangular archwires, maximum friction (P<0.05; significantly different from those of other brackets) was reached when all six wings of the Lock-loose brackets were ligated. Frictions in the dry state were higher than those in the wet state (P<0.05). Conclusion The Lock-loose brackets can adjust the friction efficiently with different ligating methods, thus solving the problem of low friction and strengthening anchorage.

Objective This study aims to explore and evaluate internal fixation with double titanium plates in mandibular condylar fracture. Methods Twenty-eight patients with mandibular condylar fracture were treated by rigid internal fixation with double titanium plates. The effects of the treatment on occlusion, mouth opening, and titanium plate rupture were evaluated by pantomograms or 3D CT. Results Good retention was observed in all 28 patients with mandibular condylar fracture. Occlusion and mouth opening returned to normal. None of the patients experienced titanium plate rupture or fracture displacement. Two patients suffered from mild facial nerve injury but recovered within 3 months after neurotrophic drug treatment. Two patients suffered from temporo-mandibular joint disease but improved after plate removal. Conclusion Rigid internal fixation with double titanium plates is an ideal treatment for mandibular condylar fracture.

Objective We aim to explore the central auditory nervous system (CANS) functioning in children with nonsyndromic cleft palates by analyzing the auditory evoked potentials and event-related potentials (ERP). Methods A total of 34 children with nonsyndromic cleft palates were recruited as subjects, and 27 normally developed children were selected as the normal controls. Auditory brainstem response (ABR), middle latency response (MLR), and mismatch negativity (MMN) of ERP were selected as indices to observe the function of CANS in children in both groups. Results Astatistically significant difference between the groups was obtainedin the MMN recording (F=227.69, P<0.01), whereas no significant group differences were obtained in the ABR and MLR results (P>0.05). Children with nonsyndromic cleft palates showed diminished MMN responses compared with the normal controls, whereas ABR and MLR were within the normal range. Conclusion Children with nonsyndromic cleft palates are at risk of central auditory discrimination dysfunction. The significant abnormal eventrelated potentials recorded in children with cleft palates suggest that the dysfunction of CANS maybe located at the cortical level and normal function of CANS was located at the brain stem and sub-cortical level.

Objective This study aims to examine the prevalence and diameter of the bony canal structure of the posterior superior alveolar artery (PSAA), residual alveolar bone height, and distance of its inferior border from the alveolar crest using cone-beam computed tomography (CBCT). Methods CBCT images of maxilla in 116 patients were randomly selected from patients who underwent maxillary sinus augmentation procedure and/or posterior teeth implant therapy from April 2011 to September 2012. The lower border of the bony canal to the alveolar crest, diameter of the bony canal, and residual alveolar bone height below the sinus floor to the ridge crest were measured from CBCT scans. Data were presented using descriptive statistics. Results The prevalence of the bony canal was 75.14%(133/177). The mean diameter of the bony canal was (0.96±0.29) mm. The residual alveolar bone height was (7.14±3.64) mm. The distance of the bony canal’s inferior border from the alveolar crest was (17.92±5.68) mm. No statistically significant differences between the right and left sides were observed (F=0.295，P>0.05). The mean diameter of the bony canal was significantly smaller in females than that in males(F=0.187, P<0.05). The maxillary alveolar dimension was significantly correlated with the residual alveolar bone height. Conclusion The results from this study suggest that CBCT is a valuable tool in evaluating the presence of the bony canal of the PSAA before maxillary sinus surgery.

Objective This study aims to evaluate the reliability and validity of the Chinese version of the chronic oral mucosal disease questionnaire (COMDQ). Methods Using translation, back-translation, quality evaluation, cross-cultural adaptation, and pre-assessment, a Chinese version of the COMDQ was drafted. A 26-item instrument which comprised of four domains: pain and functional limitation, medications and side effects, social and emotional aspects, and patient support was designed and tested. This questionnaire was given to patients who visited our clinic. After the patients accomplished the questionnaires, we analyzed the collected data to evaluate the reliability and validity of the scale. Results A total of 130 patients were enrolled in our study. All the COMDQ questionnaires were completely filled out. The Chinese version of the COMDQ showed the following psychometric properties: Cronbach’s alpha of 0.914, split-half reliability of 0.809, and correlation of 0.697. Factor analysis of construct validity demonstrated that the 26 items were classified into four domains, and the cumulative proportion was 67.62%. Thus, the scale had certain logical relation between the items in the same domains. Conclusion The Chinese version of the COMDQ demonstrate good reliability and validity by rigorous psychometric properties. It can be widely used to test the oral health-related quality of life of patients with oral mucosal diseases.

Objective This study aims to observe and compare the influences of the casting alloy post and cores on magnetic resonance imaging (MRI). Methods Six casting alloy post and cores were fabricated for the experimental groups, and zirconia post and core served as the control. The seven types of post and cores were of the same size and shape. Each post and core was orally fastened to a volunteer and then imaged with sequences of T1-weighted spin echo imaging (SE-T1WI), T2-weighted turbo spin-echo imaging (TSE-T2WI), and diffusion weighted imaging (DWI). Results Cobalt chromium alloy post and core generated severe artifacts, whereas gold palladium alloy post and core generated no obvious artifacts, and no difference was observed between the zirconia and the gold palladium alloy post and cores (P>0.05). The pure titanium alloy post and core produced mild artifacts. The post and cores of the titanium, nickel-cadmium, and gold platinum alloys generated moderate artifacts with no significant differences (P>0.05). Conclusion Different metal post and cores have different influences on MRI. With the exception of that generated by cobalt chromium alloy, the artifact generated by the single-alloy post and core does not influence the image of the normal head and neck.

Objective This study further explores the stromal cell-derived factor-1 (SDF-1)/chemokine receptor 4 (CXCR4) signaling axis mechanism in temporomandibular joint osteoarthritis (OA) by detecting the changes in CXCR4, interleukin (IL)-6, and collagen X expression in the ATDC5 cell line stimulated by the cyclic tensile strain and SDF-1. Methods Insulin-transferrin-transferrin-selenium(ITS) was used to induce ATDC5 cells to differentiate into chondrocyte-like cells. After three weeks, the cells were divided into two groups: those with and without cyclic tensile strain. These groups were further divided into the negative control and SDF-1 groups. Strain force of 20% was applied. After 12 h, the total proteins were extracted from cells of the four groups, and Western blot analysis was used to detect the changes in CXCR4, IL-6, and collagen X expression. Results SDF-1 could enhance CXCR4, IL-6, and collagen X expressions in the chondrocytes, and 20% tensile strain force could further upregulate the three factors. Conclusion Under abnormal tensile force, SDF-1 can upregulate its specific receptor CXCR4, thus increasing its binding efficiency and resulting in the activation of the SDF-1/CXCR4 axis. This condition enhances the expressions of IL-6 and other inflammatory factors and directly damages to cartilage tissue. Such damage directly promotes chondrocyte hypertrophy, which enhances collagen X expression.

Objective This preliminary study aims to investigate the effects of titanium and titanium alloy micro-nanodimensional topography on the biological behavior of osteoblasts in vitro. Methods Electrolytic etching (EE) method was used to produce micro-nano dimensional titanium surfaces. The surfaces were observed to determine their effects on the adhesion, proliferation, cell morphology, and alkaline phosphatase (ALP) activity of osteoblasts. Results The surfaces of the titanium and titanium alloy groups exhibited higher adhesion and proliferation of osteoblasts than those of the mechanical group. The titanium surface was covered with a group of cells, a large number of filopodia, and functional particles. The ALP activity of the titanium group was significantly higher than that of the titanium alloy and mechanical groups. Conclusion EE method in pure titanium and titanium alloy surfaces result in bowl-like nests and nanostructures of different diameters and depths. The diameters of the pure titanium and titanium alloy surfaces range from 30 to 50 μm and 5 to 8 μm, respectively. The former is more conducive to promote the proliferation and differentiation of cells.

Objective This study aims to evaluate the antimicrobial activity of decapeptide, a novel antimicrobial peptide, against several major cariogenic and periodontopathogenic bacteria in vitro. Methods In this study, we investigated the antimicrobial activity of decapeptide against Streptococcus mutans (S. mutans), Streptococcus sobrinus, Lactobacillus acidophilus, Streptococcus sanguis, Streptococcus gordonii, Actinomyces viscosus, Actinomyces naeslundii, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, and Saccharomyces albicans in vitro using the agar diffusion method and broth dilution method. Furthermore, a time–kill kinetic study of decapeptide against S. mutans was performed. Results The results showed that decapeptide exhibited antimicrobial activity against various oral bacteria and fungi. The minimum inhibitory concentration (MIC) of main cariogenic bacteria ranged from 62.5 μg·mL^-1 to 125 μg·mL^-1, and the MIC of periodontopathogenic bacteria tested ranged from 250 μg·mL^-1 to 1 000 μg·mL^-1. Among the bacteria tested, decapeptide had a strong inhibitory effect on cariogenic S. mutans. Results of the time–kill kinetic studies showed that decapeptide reduced the viable counts of S. mutans by more than one order of magnitude after 20 min of incubation, and thoroughly killed S. mutans after 30 min. No viable cells could be detected after 24 h of incubation. Conclusion This study suggest that decapeptide might have potential clinical application in treating dental caries by killing S. mutans within dental plaque.

Objective This study aims to evaluate the shaping capability of Reciproc, WaveOne, Mtwo, and ProTaper instruments in simulated root canals. Methods A total of 40 simulated resin blocks were divided randomly into four groups. Each group was prepared with Reciproc (Group 1), WaveOne (Group 2), Mtwo (Group 3), and ProTaper (Group 4). The preparation time and reduction in working length after preparation were measured. Pre-and post-operative images were obtained with a scanner and superimposed through Photoshop. The changes in canal curvature and material removal from the inner and outer canal walls at 10 points beginning at 1 mm from the end point of the canal were measured with Image J. Centering capability was determined accordingly. Data were analyzed through one-way ANOVA, SNK, and Kruskal–Wallis at a significance level of P<0.05. Results The preparation time of Group 2 was (53.7±6.7) s, whereas those of Groups 1, 3, and 4 were (86.9±8.1) s, (112.2±8.2) s, and (177.9±11.2) s, respectively; the difference was found to be significant (P<0.05). The reductions in working length among the four groups after preparation were not significantly different (P>0.05). The canal curvature for Groups 1 to 4 were 2.671°±0.637°, 2.667°±0.450°, 3.664°±0.870°, and 3.797°±0.601°, respectively. The changes for Groups 1 and 2 were significantly smaller than those for Groups 3 and 4. At the 3 mm point, the transportation of Group 1 was (-0.016±0.094) mm, which was significantly less than that of the other instruments (P<0.05). At the 4 mm and 5 mm points, the transportation values of Group 2 were (-0.080±0.104) mm and (-0.312±0.088) mm, which were significantly less than that of Group 1 [(-0.243±0.099) mm, (-0.404±0.064) mm, P<0.05]. Conclusion Reciproc and WaveOne can complete preparation faster and can maintain the original canal curvature better than Mtwo and ProTaper. Reciproc exhibits superior centering capability in the apical part of the canal, whereas WaveOne exhibits superior centering capability in the middle part of the canal.

Objective We aim to evaluate the cytotoxicity and antibacterial effects of Silagum-Comfort (SLC) siliconebased soft liner varnish containing Ag/TiO₂in vitro. Methods Silicone-based liner circular specimens, with a diameter of 10 mm and a thickness of 2 mm, were created and divided into six groups randomly. Ag/TiO₂was incorporated into the SLC varnish based on the agent/material weight rate of 0, 0.5%, 1.0%, 1.5%, 2.0%, and 2.5%. The mixed varnish was used to polish the SLC specimens. Antibacterial specimens (ATSLC) were created. Methyl thiazolyl diphenyl-tetrazolium bromide assay method was used to evaluate the 3T3 cell cytotoxicity of ATSLC in vitro. Surface roughness (Ra) measurements of ATSLC were obtained. The antibacterial effect of ATSLC on Candida albicans was examined using the pelliclesticking method. Results The cytotoxicity of ATSLC was graded from 0 to 2. The Ra of ATSLC increased when Ag/TiO₂agent concentration increased. However, the differences were not statistically significant compared with the 0 group. With increasing Ag/ TiO₂concentration, the antibacterial agent concentration and the antibacterial rate of ATSLC also increased. When the Ag/ TiO₂ antibacterial agent concentration reached 2.0% and 2.5%, the antibacterial rate increased to 97.5% and 96.5, respectively. Conclusion Varnish containing Ag/TiO₂has excellent antibacterial effect and can significantly improve the antibacterial effect of silicone-based soft liner.

Complex odontoma is a relatively rare dental dysplasia. In particular, a complex odontoma with dentigerous cyst is seldom observed. A case of complex odontoma with dentigerous cyst is reported in this paper.

Lateral thoracic flap is a free flap for the reconstruction of soft tissue defects and has been previously used in oral and maxillofacial surgeries. We reported a case involving a huge soft tissue defect on the parotid region caused by the resection of parotid epithelial myoepithelial carcinoma. We discussed the anatomy and application of the lateral thoracic flap.

Intracanal antisepsis acts as one of the fundamental steps in root canal therapy. Intracanal medication is very common among the multitudinous root canal disinfection methods so far. However, as the most frequently-used intracanal medication, calcium hydroxide exists some problems, such as insufficient antimicrobial power and antibiogram. Thus exploring new root canal disinfectant is necessary. Herbal medicine is gaining favor for its wide varieties, broad efficacy and affordable prices. The current researches revealed that many kinds of herbs or compound herbal preparations possess good ability of antimicrobial and other properties that superior to those of traditional root canal disinfectants. However, herbal medicine itself and the studies have shortcomings. This paper will provide a review of various herbal alternatives that are being studied of late years.

Communities of bacteria wrapped in self-generated extracellular polymeric matrix and attached to a solid surface are known as biofilm. Biofilm formation and development can be divided into three stages: adhesion of cells to a surface, reproduction of the cells, and dispersion of cells. The procedure, which surface-attached biofilm disperses bacterial cells into the environment to colonize new sites, is defined as biofilm dispersal. Biofilm dispersal is an essential stage of biofilm life cycle. It plays an important role in the transmission of bacteria. For many pathogenic bacteria, biofilm dispersal can transform bacteria in biofilm into planktonic state and promote the spread of infection. The formation of biofilm may increase the resistance of bacteria to antimicrobial agent and host defence response compared with planktonic cells. In the oral cavity, oral microorganism can attach to the surface of oral tissue and prosthesis to form biofilm. Dental caries and periodontal disease are oral chronic infections diseases of the oral tissue. The occurrence of them has a close relationship with biofilm. The mechanism of dispersal is a hot topic in recent years. Some agents which promote dispersal might be a therapeutic potential against biofilm infections. The clinical implication of dispersal agents and potential application are promising. This article reviews the dispersal-inducing agents of oral biofilms.