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Table of Content
01 December 2021, Volume 39 Issue 6
  • Expanding the concept of patient-derived xenografts cohorts in head and neck cancer: current and future perspectives
    Zhang Zhiyuan, Sun Shuyang
    West China Journal of Stomatology. 2021, 39(6):  617-623.  doi:10.7518/hxkq.2021.06.001
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    Head and neck cancer is the seventh common cancer in the world, and various existing treatment strategies provide modest benefit for most patients with head and neck cancer. Meanwhile, therapeutic strategies lacking molecular typing significantly hinder the development of individualized treatment for head and neck cancer. In recent years, connected by preclinical models, the novel ideal has gradually reached a consensus in terms of facilitating inter-transformation of clinical problems and basic achievements. As a bridge between basic research and clinical transformation, patient-derived xenografts (PDX) models precisely replicate genetic characteristics and tumor evolution, which are displaying great vitality in elucidating the mechanism of tumorigenesis and progression. Moreover, cohorts composed of several PDX models highlight the unique advantages of mice for drug screening and biomarker analysis for patients. This ideal preclinical model explores potential treatment strategies suited the ethical standards as much as possible for patients.

    Research progress on the application of framework nucleic acid in bone regeneration
    Lin Yunfeng
    West China Journal of Stomatology. 2021, 39(6):  624-632.  doi:10.7518/hxkq.2021.06.002
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    Framework nucleic acid (FNA) is a set of DNA nanostructures characterized by the framework morphology. It can design rational DNA sequences and follow the principle of complementary base pairing to construct FNA. The recent discovery of FNA constructed by DNA nanotechnology has great application potential in the field of bone regene-ration. It plays a positive role in the osteogenic differentiation of stem cells, bone regeneration, vascular regeneration, neuromodulation, immune regulation, and drug delivery. Here, we reviewed the current study findings on FNA in the field of bone regeneration.

    Identification of hub genes and transcription factors involved in periodontitis on the basis of multiple microarray analysis
    Zeng Xiaoli, Li Shengjiao, Shan Zhengnan, Yin Junhao, Jiang Jirui, Zheng Zhanglong, Li Jia
    West China Journal of Stomatology. 2021, 39(6):  633-641.  doi:10.7518/hxkq.2021.06.003
    Abstract ( 641 )   HTML ( 21 )   PDF(pc) (6206KB) ( 1062 )   Save
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    Objective

    To identify the differentially expressed genes (DEGs) during the pathogenesis of periodontitis by bioinformatics analysis.

    Methods

    GEO2R was used to screen DEGs in GSE10334 and GSE16134. Then, the overlapped DEGs were used for further analysis. g:Profiler was used to perform Gene Ontology analysis and pathway analysis for upregulated and downregulated DEGs. The STRING database was used to construct the protein-protein interaction (PPI) network, which was further visua-lized and analyzed by Cytoscape software. Hub genes and key modules were identified by cytoHubba and MCODE plug-ins, respectively. Finally, transcription factors were predicted via iRegulon plug-in.

    Results

    A total of 196 DEGs were identified, including 139 upregulated and 57 downregulated DEGs. Functional enrichment analysis showed that the upregulated DEGs were mainly enriched in immune-related pathways including immune system, viral protein interaction with cytokine and cytokine receptor, cytokine-cytokine receptor interaction, leukocyte transendothelial migration, and chemokine receptors bind chemokines. On the contrary, the downregulated DEGs were mainly related to the formation of the cornified envelope and keratinization. The identified hub genes in the PPI network were CXCL8, CXCL1, CXCR4, SEL, CD19, and IKZF1. The top three modules were involved in chemokine response, B cell receptor signaling pathway, and interleukin response, respectively. iRegulon analysis revealed that IRF4 scored the highest.

    Conclusion

    The pathogenesis of periodontitis was closely associated with the expression levels of the identified hub genes including CXCL8, CXCL1, CXCR4, SELL, CD19, and IKZF1. IRF4, the predicted transcription factor, might serve as a dominant upstream regulator.

    Effect of type 2 diabetes mellitus on mandibular bone regeneration and the expression of T helper cell 17/regulat-ory T cell-related factors in mice
    Wang Yanan, Wu Xuan, Jia Tingting, Feng Yao, Liu Shiyue, Xu Xin, Zhang Dongjiao
    West China Journal of Stomatology. 2021, 39(6):  642-650.  doi:10.7518/hxkq.2021.06.004
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    Objective

    To observe the effect of type 2 diabetes mellitus (T2DM) on mandibular bone regeneration and the expression of factors related to T helper cell 17 (Th17 cell) and regulatory T cell (Treg cell) in mice.

    Methods

    Thirty-six 6-week-old C57BL/6J male mice were randomly divided into normal control (NC) and T2DM groups. Fasting blood glucose levels were detected 0 d, 7 d, 14 d, and 28 d after surgery for mandibular defects. Hematoxylin-eosin (HE) staining was used in observing the bone after 7 d, 14 d, and 28 d of the healing process. Immunohistochemical staining was used in observing the expression of alkaline phosphatase (ALP), Runt-related transcription factor 2 (RUNX2), forkhead box protein P3 (Foxp3), retinoic acid related orphan receptor gamma T (RORγt), and protein tyrosine phosphatase non-receptor type 2 (PTPN2) after 7 d, 14 d, and 28 d of healing.

    Results

    HE staining showed that the area with new bones in the T2DM group was significantly smaller than that in the NC group. Immunohistochemical staining showed that the expression of osteogenesis related proteins ALP and RUNX2 were significantly reduced in the T2DM group. In addition, the number of RORγt positive cells increased, whereas the number of Foxp3 positive cells and the expression PTPN2 decreased significantly in the mandibular bone defect in mice with T2DM.

    Conclusion

    T2DM significantly inhibit mandibular bone regeneration in mice. Decline in PTPN2 expression and the transition of Treg and Th17 may be the underlying molecular mechanisms.

    Effect of 17β-estradiol on the proliferation of condylar chondrocytes
    Zhang Shuai, Wang Jianghong, Tian Lijie, Wang Baoli, Zhang Juan
    West China Journal of Stomatology. 2021, 39(6):  651-657.  doi:10.7518/hxkq.2021.06.005
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    Objective

    To study the effects of 17β-estradiol (E2) on the regulation of the proliferation of condylar chondrocytes and provide a preliminary discussion on the role of phosphorylate-mammalian target of rapamycin (p-mTOR) in this regulatory process.

    Methods

    Condylar chondrocytes were isolated from 6-week-old female rats for primary culture. Drug treatment with different concentrations of E2 and/or rapamycin (RAPA) was carried out on second-generation cells. Cell Counting Kit 8 was used to measure the cell viability of condylar chondrocytes after culture for 24, 48, or 72 h, and reverse transcription-polymerase chain reaction (RT-PCR) was applied to detect the relative gene expression of estrogen receptor alpha (ERα), estrogen receptor beta (ERβ), collagen type Ⅱ (COLⅡ), autophagy-related gene 6 (Beclin-1), and autophagy-related gene 5 (ATG-5). Western blot was employed to determine the relative protein expression of ERα, ERβ, Beclin-1, lipid-modified light chain 3B (LC3-Ⅱ), and p-mTOR.

    Results

    E2 could significantly promote the proliferation of chondrocytes cultured in vitro, and maximum promotion was achieved at a concentration of 10-8 mol·L-1. RAPA could significantly inhibit cell proliferation. E2 at aconcentration of 10-8 mol·L-1 could greatly improve the gene expression levels of ERα and COLⅡ (P<0.01) with the protein levels of ERα and p-mTOR (P<0.05), and decrease the gene expression levels of Beclin-1 and ATG-5 (P<0.05) with the protein levels of Beclin-1 and LC3-Ⅱ (P<0.05). RAPA could also enhance the relative protein expression of Beclin-1 and LC3-Ⅱ (P<0.01), and reduce the expression of p-mTOR (P<0.01). Treatment with the ERα antagonist significantly reduced the expression of p-mTOR in cells (P<0.01).

    Conclusion

    At a concentration of 10-8 mol·L-1, E2 could effectively activate the phosphorylation of mTOR through the ERα-p-mTOR pathway, inhibit cell autophagy, and promote the proliferation of condylar chondrocytes.

    Expression and mechanism of long non-coding RNA HCG22 in oral squamous cell carcinoma
    Gao Yongqiang, Shi Pengwei, Shi Wenkai, Liu Yiming
    West China Journal of Stomatology. 2021, 39(6):  658-666.  doi:10.7518/hxkq.2021.06.006
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    Objective

    To investigate the expression and mechanism of the long non-coding RNA (lncRNA) HCG22 in oral squamous cell carcinoma (OSCC).

    Methods

    HCG22 levels were detected in the OSCC and adjacent tissues, OSCC cells, and normal oral keratinocytes. HCG22 expression in SCC-25 and HSC-3 cells was upregulated by transfection of the overexpressing plasmi dvector. Methyl thiazolyl tetrazolium (MTT) assay, flow cytometry, and Transwell assay were employed to detect changes in cell proliferation, apoptosis, migration, and invasion ability, while Western blotting was used to detect the expression of epithelial-mesenchymal transformation-related proteins. The expression level of miR-650 in the cells was detected by real-time quantitative polymerase chain reaction (RT-qPCR), and dual-luciferase reporter gene assay was applied to assess the targeting relationship between HCG22 and miR-650.

    Results

    Compared with that in adjacent tissues, the expression of HCG22 significantly decreased in OSCC tissues (P<0.05). Moreover, the prognostic survival of patients in the low-HCG22 expression group was significantly lower than that in the high-expression group (P<0.05). Compared with that in HOK cells, the expression of HCG22 was significantly lower in SCC-25, HN13, HSC-3, and CAL-27 cells (P<0.05). Upregulation of HCG22 expression could inhibit the proliferation, migration, invasion, and apoptosis of SCC-25 and HSC-3 cells, upregulatethe expression of E-cadherin, and downregulate the expression of N-cadherin and vimentin (P<0.05). miR-650 mimics could reduce the luciferase activity of HCG22 wild-type plasmid cells (P<0.05), and the expression of miR-650 in SCC-25 and HSC-3 cells decreased after upregulation of HCG22 expression (P<0.05).

    Conclusion

    HCG22 is expressed at low levels in OSCC. Upregulation of the expression of this lncRNA can inhibit the proliferation, migration, invasion, and epithelial-mesenchymal transition of OSCC cells. The mechanism of action of HCG22 may be related to its targeted regulation of miR-650.

    Occluding dentin tubules with monetite paste in vitro
    Tang Hao, Zhu Yawen, Zhu Jiaxiang, Li Quanli
    West China Journal of Stomatology. 2021, 39(6):  667-674.  doi:10.7518/hxkq.2021.06.007
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    Objective

    This study was performed to evaluate the occlusion of monetite paste on dentine tubule and provide a new potential method for treating dentine hypersensitivity.

    Methods

    Calcium oxide, strontium chloride, and polyethylene glycol phosphate were mixed in a certain proportion and ground in a planetary ball mill. The reaction was carried out by adjusting the pH to obtain monetite and hydroxyapatite paste. The morphological characteristics of the paste were observed through scanning electron microscope (SEM). The structure and composition were analyzed through X-ray diffraction (XRD) and Fourier transform infrared spectrometer (FTIR). The extracted third molar was selected to undergo demineralization to establish the in vitro study model of dentin hypersensitivity. The samples were randomly divided into four groups: blank control group (treated with distilled water), casein peptide phosphate-amorphic calcium phosphate (CPP-ACP) group, monetite paste group, and hydroxyapatite paste group. Each group was used to scrub the dentin surface with the corresponding materials for 7 days. The morphological characteristics of the dentin surface and section were observed through SEM, the microhardness of the dentin before and after mineralization was analyzed with a microhardness tester, and the composition of the deposits on the surface of the mineralized samples was examined through XRD.

    Results

    XRD and FTIR showed that the composition of the paste was mainly monetite, and the composition of hydroxyapatite paste was mainly composed of hydroxyapatite. SEM revealed that the size of the crystal particles of the synthesized paste was tens to hundreds of nanometers. Monetite and hydroxyapatite paste could produce a thicker mineralization layer on the dentin surface, and the mineralization of the dentin tubules of monetite was deeper than that of hydroxyapatite paste. The microhardness of the monetite paste group was significantly less than those of the hydroxyapatite paste groups (P<0.05).

    Conclusion

    Monetite paste could effectively block the exposed dentin tubules and be used for treating dentin hypersensitivity.

    Role and mechanism of necrostin-1 in promoting oxidative stress response of macrophages in high glucose condition
    Zhou Ting, Zhou Xue, Song Bin
    West China Journal of Stomatology. 2021, 39(6):  675-681.  doi:10.7518/hxkq.2021.06.008
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    Objective

    To investigate the role and molecular mechanism of necrostatin-1 (Nec-1), a specific programmed cell necrosis inhibitor, in promoting the oxidative stress response of macrophages under high glucose (HG) environment.

    Methods

    Macrophages were cultured in control (5.5 mmol·L-1 glucose) or HG (25 mmol·L-1 glucose) medium for 72 h. The HG+Nec-1 group was given HG and 5 μmol·L-1 Nec-1. Reactive oxygen species (ROS) level, malondialdehyde (MDA) activity, and superoxide dismutase (SOD) activity were measured by 2’-7’dichlorofluorescin diacetate, MDA, and SOD enzyme linked immunosorbent assay kits, respectively. Moreover, receptor interacting protein 1 (RIP1) expression was assessed through real-time quantitative polymerase chain reaction (qRT-PCR) and Western blot (WB). Finally, after the expression of RIP1 in macrophages was silenced, the effect of HG environment on oxidative stress response was evaluated in the gene-deficient cells.

    Results

    The HG group had increased ROS level and MDA activity (P<0.000 1) and decreased SOD activity (P<0.000 1) compared with the control group. The HG+Nec-1 group had higher ROS level and MDA activity (P<0.000 1) and lower SOD activity (P<0.01) than the HG group. The qRT-PCR and WB results showed that RIP1 mRNA level (P<0.001) and protein expression level (P<0.000 1) in the HG group were significantly higher than those in the control group, and RIP1 mRNA and protein expression levels in the HG+Nec-1 group were significantly lower than those in the HG group (P<0.000 1). After RIP1 was silenced effectively (P<0.001) with si-RNA, the ROS level and MDA activity of the HG+si-RIP1 group decreased compared with those of the HG+si-negative control (si-NC) group (P<0.001), and SOD activity in the HG+si-RIP1 group increased than that in the HG+si-NC group (P<0.000 1).

    Conclusion

    HG promotes oxidative stress on macrophages by upregulating RIP1 expression.

    Abnormal static and dynamic brain function in patients with temporomandibular disorders: a resting-state functional magnetic resonance imaging study
    Yin Yuanyuan, Li Fei, He Shushu, Chen Song
    West China Journal of Stomatology. 2021, 39(6):  682-689.  doi:10.7518/hxkq.2021.06.009
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    Objective

    This study was conducted to investigate the brain function of patients with temporomandibular disorders (TMD) by combining the static and dynamic amplitudes of low-frequency fluctuation (ALFF).

    Methods

    Thirty patients with TMD and 20 healthy controls were enrolled. All the participants completed their questionnaires, received clinical examinations, and underwent resting-state functional magnetic resonance imaging scanning. We compared the static and dynamic ALFF between the patients and healthy controls by conducting a two-sample t-test with AlphaSim correction for multiple comparisons. The correlation between the static and dynamic ALFF of the brain regions with significant group differences and clinical measurements was analyzed.

    Results

    The patients with TMD showed increased static and dynamic ALFF in the posterior cingulate cortex compared with that of the controls (whole-brain level, uncorrected P=0.005; region of interest level with AlphaSim correction, voxel level P<0.005, cluster level P<0.05). The dynamic ALFF of the posterior cingulate cortex was negatively correlated with bilateral condylar vertical discrepancies. The dynamic ALFF in the medial orbitofrontal cortex of the patients with TMD was greater than that of the controls (whole-brain level AlphaSim correction, voxel level P<0.005, cluster level P<0.05).

    Conclusion

    Our findings revealed that the resting-state brain function of the posterior cingulate cortex and the medial orbitofrontal cortex of patient with TMD increased. These changes probably indicated the potential central mechanisms underlying the increased self-relevant thoughts, negative emotion, and abnormal emotion regulation in TMD.

    Evaluation of hyperbaric oxygen therapy for the osteoradionecrosis of the jaws: Meta-analysis
    Yin Yin, Zeng Wei, Jing Wei, Tang Wei, Guo Weihua
    West China Journal of Stomatology. 2021, 39(6):  690-697.  doi:10.7518/hxkq.2021.06.010
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    Objective

    This study was performed to investigate the effects of hyperbaric oxygen and other approaches for treating the osteoradionecrosis of the jaws (ORNJ) systematically.

    Methods

    According to the preset inclusion and exclusion criteria, randomized controlled trials and cohort studies on hyperbaric oxygen in the treatment of ORNJ were screened, and foreign language databases such as PubMed, EMBASE, and Cochrane library were searched via a computer; Chinese databases such as CNKI, VIP, Wanfang data, and CBM were searched from the established database to September 2020. Relevant books were searched manually to collect all literatures on the efficacy of hyperbaric oxygen and its related therapies in ORNJ treatment. Two researchers were independent and mutually blind, the papers were selected, data were collected, and the bias risk was evaluated. If any difference was detected, it would be decided by discussion or arbitrated by a third party. The data related to the efficacy of hyperbaric oxygen and its related therapy in the treatment of the ORNJ were extracted, and the Revman5.4 software was used for Meta-analysis. In case of large heterogeneity, sensitivity analysis was performed. A funnel chart was used to evaluate possible publication bias qualitatively.

    Results

    Four randomized controlled trials and seven cohort studies were included in Meta-analyses. In ORNJ treatment, no significant differences between the group subjected to hyperbaric oxygen and both surgery and antibiotics and the group that underwent both surgery and antibiotics (RR=1.16, 95%CI: 0.86~1.58, P>0.05); between the group with hyperbaric oxygen and the group with antibiotics (RR=0.83, 95%CI: 0.63~1.09, P>0.05); between the group with hyperbaric oxygen and the group with antifibrotic drugs (RR=0.07, 95%CI: 0.00~155.86, P>0.05); between the group with single or combined use of HBO and the group with other intervention methods (RR=0.89, 95%CI: 0.67~1.19, P>0.05).

    Conclusion

    Hyperbaric oxygen therapy cannot replace surgery and antibiotic therapy. Hyperbaric oxygen therapy is not superior to antibiotics and antifibrotic drugs, but the benefits of antifibrotic drugs should be further explored.

    Force balance reconstruction of orbicularis oris in correction of unilateral cleft lip deformity
    Chen Yu, Liu Yingmeng, Zhang Bihe, Zheng Qian, Shi Bing, Li Chenghao
    West China Journal of Stomatology. 2021, 39(6):  698-702.  doi:10.7518/hxkq.2021.06.011
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    Objective

    Short-term outcome evaluation for the correction of unilateral cleft lip deformity with a new technique.

    Methods

    Forty-four patients with unilateral cleft lip deformity were included in the study and in which the orbicularis oris muscle was reconstructed to achieve the optimal force balance of reconstructed orbicularis oris. The photometric two-dimensional indexes, including the philtrum oblique angle and asymmetry ratios (lip height, lip width, vertical distance from the white roll to the vermilion bottom at the Cupid’s bow point, and vertical distance from the Cupid ’s bow points to facial midline), were employed to measure and evaluate the outcome.

    Results

    Several indexes showed statistically significant difference, and they included the philtrum oblique angle, asymmetry ratio of the lip height, and asymmetry ratio of the vertical distance from the white roll to the vermilion bottom at Cupid ’ s bow points (P<0.05).

    Conclusion

    The results suggested that the new muscle reconstruction technique can significantly improve the short-term outcome of the correction of unilateral cleft lip deformity.

    Evaluation of therapeutic effect and health economics of general anesthesia and routine outpatient dental treatment in children with severe early child caries
    Liu Yaqi, Zhang Qiong, Wang Yan, Qu Xing, Zou Jing
    West China Journal of Stomatology. 2021, 39(6):  703-708.  doi:10.7518/hxkq.2021.06.012
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    Objective

    To evaluate the efficacy and health economics of the comprehensive therapy for the children with severe early child caries (S-ECC) under dental general anesthesia (DGA) and conventional outpatient treatment to provide references for dentists and parents in the choice of clinical treatment.

    Methods

    A retrospective cohort study was conducted on S-ECC children aged 36-71 months and who received dental treatment under general anesthesia or routine outpatient situation. The filled tooth survival rate, treatment cost, and cost-filled tooth survival time of the two groups were compared, and the curative effect and health economics was evaluated.

    Results

    The filled tooth survival rate of the DGA group was higher than that of the routine outpatient group (P<0.05). The average direct medical cost per filled tooth was significantly higher in the DGA group than in the routine outpatient group (P<0.05). The direct medical cost-filled tooth survival time ratio in the DGA group was higher than that in the routine outpatient group (P<0.05), but no significant difference was observed in the total medical cost-filled tooth survival time ratio (P>0.05).

    Conclusion

    Compared with the conventional outpatient treatment group, the treatment outcomes of S-ECC under general anesthesia were better, and the costs were higher. However, no significant difference was observed in the total medical cost-filled tooth survival time between these two groups, and the conventional outpatient treatment did not have evident economic advantages.

    Effect of the prophylactic use of antibiotics on wound infection after cleft lip surgery
    Wu Min, Zhu Zhibing, Shi Bing, Gong Caixia, Li Yang
    West China Journal of Stomatology. 2021, 39(6):  709-711.  doi:10.7518/hxkq.2021.06.013
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    Objective

    To study the effect of preoperative prophylactic use of antibiotics on wound infection in patients with cleft lip.

    Methods

    Aretrospective study was conducted on the clinical data of 1 361 patients who underwent one-stage cleft lip repair in the Department of Cleft Lip and Palate in West China Hospital of Stomatology, Sichuan University, from January 2015 to November 2018. The patients were divided into two groups according to whether prophylactic antibiotics were used or not. There were 594 patients in the prevention group, including 373 unilateral incomplete cleft lip (UICL) patients, 157 unilateral complete cleft lip (UCCL) patients, 25 bilateral incomplete cleft lip (BICL) patients, 39 bilateral complete cleft lip (BCCL) patients. There were 767 patients in the non-prophylactic group, including 482 UICL patients, 211 UCCL patients, 31 BICL patients, 43 BCCL patients. The relationship between preoperative and postoperative leukocyte count, preoperative and postoperative body temperature, and postoperative wound infection were compared between the two groups.

    Results

    No significant difference was observed in the leukocyte count and body temperature between both groups (P>0.05).

    Conclusion

    The preoperative prophylactic use of antibiotics has no significant effect on the incidence of postoperative infection in patients undergoing cleft lip repair.

    Clinical application of integrated angulated screw channel abutment crown in implant-supported rehabilitation of aesthetic area
    Wang Yanmei, Liu Xin, He Jiacai
    West China Journal of Stomatology. 2021, 39(6):  712-717.  doi:10.7518/hxkq.2021.06.014
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    Objective

    To evaluate the clinical effect of integrated angulated screw channel (ASC) abutment crown in implant-supported rehabilitation of the aesthetic area.

    Methods

    Sixteen patients who received single implant-supported rehabilitation using integrated ASC abutment crown in the aesthetic area were included in the study. After one-year follow-up, the cumulative survival rate, aesthetic effectiveness, bone resorption around implants, and patient satisfaction were analyzed through periapical film, clinical examination, and the visual analog scale (VAS).

    Results

    The implant cumulative survival rate of the integrated ASC abutment crown in the implant-supported rehabilitation of the aesthetic area was 100%. The average pink esthetic index scores reached 9.5, and the white esthetic index scores reached 9.4. The mean marginal bone loss of implants was (0.439±0.123) mm at the mesial side and (0.341±0.118) mm at the distal side. The average VAS satisfaction score was 8.9, which showed that all patients were satisfied with the final restorative effect.

    Conclusion

    Using integrated ASC abutment crown for implant restoration is an ideal implant restoration design in the aesthetic zone and can be applied clinically.

    Effect of Er:YAG laser combined with ethylenediamine tetra acetic acid on three-walled periodontal intrabony defects adjacent to implant sites
    Bolatihan Baligen, Lin Zhihui, Man Yi
    West China Journal of Stomatology. 2021, 39(6):  718-723.  doi:10.7518/hxkq.2021.06.015
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    Objective

    To investigate the clinical effect of Er:YAG laser combined with ethylenediamine tetra acetic acid (EDTA) on three-walled periodontal intrabony defects adjacent to implant sites.

    Methods

    A total of 30 patients with three-walled periodontal intrabony defects adjacent to implant sites were treated with the combination therapy. Patients with three-walled intrabony defects were divided into two groups according to the depth of the intrabony pocket between the implant and natural teeth. Evaluation of wound healing was performed 10 days after the operation, and bone augmentation was evaluated 6 months after the operation.

    Results

    Primary healing in group 1 was 92.31%, primary healing in group 2 was 82.35%. No significant difference was observed between the two groups (P>0.05). Bone augmentation in group 1 and group 2 were (2.85±1.81), (4.92±2.22) mm. There was significant difference between the two groups (P<0.05). New bone growth occurred more slowly in group 1 (0.70 mm±0.32 mm) than in group 2 (1.25 mm±0.47 mm) (P>0.05). Probe depths (PD), clinical attachment levels (CAL), and sulcus bleeding indices (SBI) showed no statistically significant difference between the two groups (P>0.05). The one-year survival rate of natural tooth in group 1 and group 2 were 100%, 94.2%, and the one-year survival rate of implants in both groups was 100%.

    Conclusion

    The effect of bone augmentation with combination therapy was more ideal in group 2 than in group 1. Implant placement with combination therapy may be a viable technique to reconstruct three-walled intrabony defects due to the space maintenance provided by implants and bone grafts and the good root surface biocompatibility provided by the Er:YAG laser and EDTA.

    Experience in the diagnosis and treatment of a drug-induced pemphigus
    Yuan Peiyang, Qiu Min, Wan Zixin, Jiang Lu
    West China Journal of Stomatology. 2021, 39(6):  724-727.  doi:10.7518/hxkq.2021.06.016
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    Drug-induced pemphigus (DIP) is a special type of pemphigus, and its pathogenesis, characteristics of treatment, and prognosis are closely related to the inducing drugs. This article reports the diagnosis and treatment of DIP (pemphigus vulgaris) caused by the administration of rifampin to a patient with tuberculosis. Combined with the literature, we discussed the types, pathogenesis, differential diagnosis, and treatment principles of DIP. We propose that in the oral clinical practice for patients with pemphigus vulgaris, the importance of investigating suspected drugs that induce DIP should be emphasized.

    Peripheral odontogenic keratocysts in buccal soft tissues: two cases report
    Liu Wei, Li Honglin, Xiang Sijie, Miao Cheng, Li Chunjie, Han Bo
    West China Journal of Stomatology. 2021, 39(6):  728-731.  doi:10.7518/hxkq.2021.06.017
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    Peripheral odontogenic keratocysts are rarely observed, and cases of odontogenic keratocysts of buccal soft tissues are even rarer. This study was performed to present two rare cases of odontogenic keratocysts in buccal soft tissues and review related literature.

    Immediate precision of the digital osteotomy template in the digital stackable template: a clinical study
    Lu Jiayi, Yu Jiayi, Xie Chenyang, Gao Jing, Yu Haiyang
    West China Journal of Stomatology. 2021, 39(6):  732-738.  doi:10.7518/hxkq.2021.06.018
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    Objective

    This study aimed to evaluate the immediate accuracy of the digital osteotomy template in the digital stackable template.

    Methods

    From November 2018 to January 2020, 4 patients with dentition loss were selected from the Prosthodontics Department, West China Stomatological Hospital. All patients met the conditions for immediate planting and immediate restoration. Owing to the lack of vertical target-restoration space, the implantation plan included intraoperative osteotomy. According to the preoperative cone beam CT (CBCT) data, combined with aesthetic digital smile design (DSD) analysis, virtual wax design, and so on, the ideal bone plane design was performed. According to the virtual osteotomy plane, the virtual implantation plan was designed, and then the digital stackable template assuming osteotomy template, implantation guide, and temporary restoration were made and 3D printed. Osteotomy was performed under the guidance of digital osteotomy template during the operation. The preoperative CBCT and postoperative CBCT of all patients overlapped, the deviation between the actual osteotomy and the ideal osteotomy was calculated, and the angle deviation between the postoperative bone plane and the ideal bone plane was measured.

    Results

    The ave-rage volume deviation between the postoperative design and the ideal one was 492.94 mm³, accounting for 21.21% of the preset osteotomy volume. The average deviation between the postoperative osteotomy and the ideal osteotomy in four patients was 0.024 8 mm. The average angle between the postoperative bone plane and the ideal bone plane was 6.03°.

    Conclusion

    The displacement deviation of virtual osteotomy design and the actual osteotomy one under the guidance of digital osteotomy template in the digital stackable template are highly consistent with the original design. Thus, this clinical technique is worth popularizing, accurate, and quantifiable.