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Advanced research on root canal therapy for primary teeth
Yu Yi, Zhou Xin, Zheng Liwei
West China Journal of Stomatology    2020, 38 (2): 205-210.   DOI: 10.7518/hxkq.2020.02.016
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Primary tooth root canal therapy is a treatment performed on primary teeth diagnosed with pulpitis or periapical periodontitis. This procedure requires perfect instrumentation, disinfection, and filling of root canals to eliminate infection, control inflammation, relieve pain, prevent pathological effects on inherited permanent tooth, and prolong primary tooth preservation. This paper reviews the research history on primary tooth root canal treatment and summarizes the progress on primary tooth root canal treatment, including anatomical morphology, root canal preparation, root canal disinfection, root canal filling, and application of antibiotics.

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Clinical pathway and preparation method of high-precision tooth shoulder platform
Luo Tian, Li Junying, Yu Haiyang
West China Journal of Stomatology    2020, 38 (6): 712-717.   DOI: 10.7518/hxkq.2020.06.019
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A clear shoulder platform that can be easily identified by doctors and technicians or machines (mouth scan and warehouse scan) is important to obtaining a good long-term and stable fixed prosthesis treatment effect. At present, the preparation of the shoulder platform is usually based on free hands, and the practical operation is mainly guided by experience. Moreover, no comprehensive and objective preoperative design, intraoperative verification, and final test are available. Thus, the accuracy of shoulder platform preparation needs to be improved. In this study, the clinical pathway of “three determination, three selection, and three steps” with high accuracy of preparation and the precise shoulder preparation method of “bur-tip guidance” are proposed in detail.

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Several important issues concerning occlusal reconstruction
Liu Yang
West China Journal of Stomatology    2020, 38 (4): 357-363.   DOI: 10.7518/hxkq.2020.04.001
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Occlusal reconstruction aims to restore the compromised dentition and rehabilitate its function; which is demanding and challenging, even to the well experienced prosthodontists. Analyzing the sophisticate clinical information gives fundamental validity to the subsequent treatment planning. In the whole process, the applied workflow should ensure the transmission of diagnostic information without compromise or error. Certain procedures predetermine the clinical outcome, and they should be given due attention. In this review, the key considerations, including analyzing the pathogenesis for the worn dentition, were briefly addressed to better understand the occlusal reconstruction.

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Diagnosis and treatment of ankyloglossia in newborns and infants
Ji Yuezhi, Ruan Wenhua
West China Journal of Stomatology    2020, 38 (4): 443-448.   DOI: 10.7518/hxkq.2020.04.016
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Ankyloglossia is a congenital condition characterized by a short lingual frenulum, which may result in the restriction of tongue movement and function. Considerable controversy regarding the diagnosis, clinical significance, and management of the condition remains, and great variations in practice have been recorded. Indeed, attitudes toward ankyloglossia differ among professional groups, and opinions may vary remarkably even among those within the same specialty. This article reviews the embryology, genetics, diagnosis, clinical presentation, and treatment of ankyloglossia to help physicians better understand and treat the condition.

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China experts' consensus on preventive and interceptive orthodontic treatments of malocclusions of children
Li Xiaobing, Ye Quanfu, He Hong, Lu Haiping, Zhu Min, Jiang Ruoping, Zou Shujuan, Han Xianglong, Zhou Li, Chen Ke, Yuan Xiao, Zhang Junmei, Tan Lijun, Yin Chang, He Zhou, Li Ang, Cheng Bin, Ruan Wenhua, Huang Fang, Liu Juan, Ma Lan, Zou Rui, Yang Fang, Zhang Weibing, Tian Yulou, Jiang Beizhan, Shao Linqin, Huang Yang, Tang Liqin, Gao Li, Zhou Chenchen
West China Journal of Stomatology    2021, 39 (4): 369-376.   DOI: 10.7518/hxkq.2021.04.001
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Malocclusion is one of the three most common oral diseases reported by World Health Organization(WHO). In China, its incidence rate is rising. Malocclusion seriously affects the dental and maxillofacial function, facial appearance and growth development of nearly 260 million children in China, and what is more, it affects their physical and mental health development. Malocclusion occurrence is related to genetic and environmental factors. Early treatment of malocclusion can create a good dental and maxillofacial development environment, correct abnormal growth and control the adverse effects of abnormal genetic factors. It can effectively reduce the prevalence of children's malocclusion and enhance their physical and mental health. This is an urgent need from the economic perspective of our society, so it has great practical and social significance. Experts from the project group “standard diagnose and treatment protocols for early orthodontic intervention of malocclusions of children” which initiated by China National Health Institute of Hospital Administration wrote the “China Experts' Consensus on Preventive and Interceptive Orthodontic Treatments of Malocclusions of Children”, which aims to guide and popularize the clinical practice, improve the clinical theory and practice level, and accelerate the disciplinary development of early treatment of children's malocclusion in China. The consensus elaborates the harmfulness of malocclusion and the necessity of early treatment, and brings up the principles and fundamental contents. Based on the law of dental and maxillofacial development, this paper puts forward the guiding suggestions of preventive and interceptive treatments in different stages of dental development ranging from fetus to early permanent dentition. It is a systematic project to promote and standardize the early treatment of malocclusion. Through scientific and comprehensive stratified clinical practice and professional training, the clinical system of early treatment of malocclusion in China will eventually be perfected, so as to comprehensively care for children's dental and maxillofacial health, and improve their oral and physical health in China.

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Treatment strategy for pregnancy epulis
Cheng Guoping, Ye Changchang, Tang Jing, Meng Shu, Wu Yafei, Ding Yi
West China Journal of Stomatology    2020, 38 (6): 718-725.   DOI: 10.7518/hxkq.2020.06.020
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Pregnancy epulis is a tumor-like lesion with high prevalence in China. The local lesion, the general condition of the pregnant patient, and the complications during treatment should be taken into consideration when making a treatment plan for pregnancy epulis. In this study, three representative pregnancy epulis cases were presented, and related studies at home and aboard were reviewed to summarize the etiology, differential diagnosis, treatment, and prevention of pregnancy epulis and share the clinical experience in the treatment of pregnancy epulis.

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

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

Methods

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

Results

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

Conclusion

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

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Factors influencing clinical application of bulk-fill composite resin
Xue Jing
West China Journal of Stomatology    2020, 38 (3): 233-239.   DOI: 10.7518/hxkq.2020.03.001
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Bulk-fill composite resin are simple to operate, and they reduce polymerization shrinkage and microleakage compare to traditional resin-based composites. However, their clinical application could be affected by numerous factors, such as the material itself, light curing, placement techniques, storage condition, and preheating. This review aimed to summarize the definitions, classifications, indications, clinical properties, and influencing factors of the clinical application of bulk-fill resin-based composites and discuss the ways to improve their clinical effectiveness.

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Consensus on the preparation margin and restoration margin in ceramic esthetic rehabilitation
Yu Haiyang, Yue Li, Liu Weicai, Liu Feng, Niu Lina, Shao Longquan, Liao Hongbing, Luo Xiaoping, Li Hongbo, Jiang Qingsong, Yu Hao, Zhao Bin, Wu Zhe, Li Changyi, Wu Guofeng, Wang Yan, Mou Yandong, Liu Yunsong, Zhang Haiyang, Chen Jihua, Liu Hongchen
West China Journal of Stomatology    2022, 40 (2): 123-133.   DOI: 10.7518/hxkq.2022.02.001
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In esthetic rehabilitation, methods used to enhance the margin quality have always been the focus and difficulty of improving the level of diagnosis and treatment, prevention and treatment of complications, and collaboration between clinicians and technicians. However, it is impeded by the ambiguous definition and classification of margin, unstandardized tooth preparation, manufacturing process of restoration, and lack of reliable means of checking the quantitative requirements of preparation or restoration. The digital technologies that are increasingly applied, such as intra-oral scanner, impression scanner, and computerized numerical control cutting machine, have strict requirements about margin quality. Failure of recognizing margins by these scanners will hinder the digital process of diagnosis and treatment. Even if these sharp and narrow margins are successfully scanned, they cannot be milled accurately. To overcome these problems, this article demonstrated the clear and complete definition of preparation margin and restoration margin, as well as their subclassifications, by analyzing the target restoration space from a geometric perspective. Practical approaches to measuring the margin width and inspecting the margin quality were proposed. The new and full understanding and proposal about preparation margin and restoration margin characterized by measurements will effectively support the thoroughly digitalized process of esthetic rehabilitation using porcelain in fixed prosthodontics, which is based on the guidance of values.

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Impacted molar upright with self-made helical spring
Xu Yanzhe, Li Zhihua
West China Journal of Stomatology    2021, 39 (3): 362-367.   DOI: 10.7518/hxkq.2021.03.018
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With a case of mesial impaction of maxillary first and second molar, the mechanical analysis and clinical applications of a self-made helical spring for the uprighting treatment of mesial impacted molars was introduced.

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

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Insights into peri-implantitis and its prevention
Song Yingliang, Zhang Sijia
West China Journal of Stomatology    2020, 38 (5): 479-483.   DOI: 10.7518/hxkq.2020.05.001
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Peri-implantitis is one of the most common complications in dental implant treatment. Peri-implantitis is a crucial implication of implant failure, which is characterized by high morbidity and intractability. Thus, how to understand peri-implantitis correctly and deeply, and how to prevent its occurrence, are important problems that every dental implant surgeon has to face.

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Mechanism, prevention, and treatment for medication-related osteonecrosis of the jaws
Pan Jian, Liu Jiyuan
West China Journal of Stomatology    2021, 39 (3): 245-254.   DOI: 10.7518/hxkq.2021.03.001
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The morbidity rate of medication-related osteonecrosis of the jaws (MRONJ) increased rapidly in recent years. Thusfar, the mechanism of MRONJ has no consensus. The possible mechanisms may include bone remodeling inhibition theory, angiogenesis inhibition theory, oral microorganism infection theory, immunosuppression theory, cytotoxicity-targeted oral epithelial cells, microcrack formation of maxillary or mandibular bone, and single nucleotide polymorphism. However, the efficacy of prevention and treatment based on a single mechanism is not ideal. Routine oral examination before MRONJ-related drug treatment, treatment of related dental diseases, and regular oral follow-up during drug treatment are of great significance for the prevention of MRONJ. During the treatment of MRONJ, the stage of MRONJ must be determined accurately, treatment must be standardized in accordance with the guidelines, and personalized adjustments must be made considering the specific conditions of patients. This review aimed to combine the latest research and guidelines for MRONJ and the experiences on the treatment of MRONJ in the Maxillofacial Surgery Department of West China Hospital of Stomatology, Sichuan University, and discuss the strategies to improve the clinical process.

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Bisphosphonate-related osteonecrosis of the jaw caused by implant: a case report
Wu Pingfan, Li Yu, Lei Zhenge, Chen Linlin
West China Journal of Stomatology    2020, 38 (4): 460-463.   DOI: 10.7518/hxkq.2020.04.019
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Osteonecrosis of the jaw could occur after intake of bisphosphonate drugs, which are widely used to treat osteoporosis and bone metastasis of malignant tumors. This effect has aroused concern among dentists. In this paper, a case of bisphosphonate-related osteonecrosis caused by implant is reported, and the pathogenesis, diagnosis, prevention, and treatment of bisphosphonate drug-induced osteonecrosis are described through a literature review. The effects of bisphosphonate drug treatment on dental implants are also discussed.

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Effect of preheating on the properties of resin composite
Xue Jing, Yang Bina
West China Journal of Stomatology    2019, 37 (6): 571-576.   DOI: 10.7518/hxkq.2019.06.001
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Resin composite, which is commonly used as a dental filling material, has some problems, such as poor wear resistance, polymerization shrinkage, and poor dentin marginal adaptability. Preheating of resin composite improves its properties. This paper reviewed the effects of resin composite preheating on its monomer conversion, marginal microleakage, mechanical properties, and irritation on dental pulp.

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Inhibitory effect and underlying mechanism of total saponins from Paris polyphylla var. yunnanensis on the prolifera-tion of salivary adenoid cystic carcinoma ACC-83 cells
Qiumin He, Biao Xu, Weihong Wang, Chongyun Bao, Shao-wei Hu
West China Journal of Stomatology    2017, 35 (3): 317-321.   DOI: 10.7518/hxkq.2017.03.016
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Objective To investigate the inhibitory effect and underlying mechanism of total saponins from Paris polyphylla var. yunnanensis on the proliferation of salivary adenoid cystic carcinoma ACC-83 cells. Methods In vitro cell culture was performed. The proliferation of ACC-83 cells treated with different concentrations (5, 10, 20, 40, 60, 80, 100 μg·mL-1) of total saponins from Paris polyphylla var. yunnanensis was observed using CCK-8 assay. Meanwhile, the apoptosis of ACC-83 cells treated with different concentrations (25, 50, 100 μg·mL-1) of the total saponins was observed using flow cytometry. The expression levels of macrophage migration inhibitory factor (MIF) and CD74 were measured using Western blot and reverse transcription-polymerase chain reaction. Results The total saponins from Paris polyphylla var. yunnanensis induced apoptosis and expressed dose-effect relationship. ACC-83 cells expressed MIF and CD74, and the total saponins suppressed MIF and CD74 expression in ACC-83 cells. Conclusion The total saponins from Paris polyphylla var. yunnanensis can significantly inhibit the proliferation, suppress MIF and CD74 expression, and promote apoptosis in ACC-83 cells. This study provides a theoretical basis for the treatment of salivary adenoid cystic carcinoma using Paris polyphylla var. yunnanensis.

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New diagnostic classification of cheilitis and its clinical diagnostic pathway
Qiu Xuemei, Jiang Lu
West China Journal of Stomatology    2021, 39 (2): 238-244.   DOI: 10.7518/hxkq.2021.02.019
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Cheilitis is a general term for various types of inflammatory diseases that occur on the lips. The etiology differs and the clinical manifestations and pathological features overlap, leading to difficulties in clinical diagnosis. Reasonable classification is conducive to the diagnosis of cheilitis. However, its classification is difficult because of its cha-racteristics. At present, scholars have proposed two different classification schemes, but a unified classification standard has not yet been established. We classified cheilitis based on its etiology, clinical manifestations, pathological characteristics, and relationship with systemic and special diseases on the basis of special medical reports and by combining clinical practice experience and summarizing previous cheilitis diagnosis and treatment literature. In accordance with this classification method, we proposed suggestions for the clinical diagnosis of cheilitis to provide a reference for the clinical diagnosis and treatment of complex cheilitis.

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

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Current dental implant design and its clinical importance
Ye. Lin
West China Journal of Stomatology    2017, 35 (1): 18-28.   DOI: 10.7518/hxkq.2017.01.003
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The development of clinical implant dentistry was intensively affected by dental implant design improvement and innovation, which brought about new concept, even milestone-like changes of clinical protocol. The current improve-ments of dental implant design and their clinical importance could be highlighted as followings: 1) The implant apical design influences the implant preliminary stability in immediate implant. The apical 3-5 mm design of implant makes implant stable in immediate implant, because this part would be screwed into alveolar bone through fresh socket, the other part of implant could not be tightly screwed in the socket because of smaller implant diameter. Implant apical form, screw design, self-taping of apical part would be essential for immediate implant. 2) The enough preliminary stability of implant makes immediate prosthesis possible. When osseointegration does not occur, the implant stability comes from a mechanical anchorage, which depends on implant form, screw thread and self-taping design. 3) Implant neck design may have influence for soft tissue recession in esthetic zone. The implant with large shoulder would not be selected for the esthetic area. The platform design may be more favorable in the area. 4) The connection design between implant and abutment is thought a very impor-tant structure in implant long-term stability. Moose taper and “tube in tube” were well documented structure design in 20-year clinical practice in Peking University. 5) In last 15 years, the plenty studies showed the platform design of implant had positive influence in implant marginal bone level. Whatever in single implant restoration or multi-implant prosthesis. 6) The digital technology makes clinical work more precise and high-tech. This would be a trend in implant dentistry. New generation of chair-side digital computer-aided design/computer-aided manufacturing makes immediate prosthesis without conventional impression possible. 7) New abutment design have changed clinical protocol greatly. The All-on-four concept and Weldone concept benefit both from the abutment innovation, which were large angulated abutment and special welding abutment materials.

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Cited: Baidu(4)
Effect of decompression combined with curettage and autogenous bone cement implantation on large cysts of the jaw
Liu Yixiu, Qu Yang, Li Zhenhua, Wang Hongpeng
West China Journal of Stomatology    2020, 38 (4): 464-469.   DOI: 10.7518/hxkq.2020.04.020
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Decompression and curettage can result are effective as treatments for large jaw cysts, which are common diseases in the clinic. Based on a treatment used in a previous study, this paper proposes a “three-step method” to treat large jaw cyst and repair the bone defect by decompression, curettage, and autologous dental bone powder implantation. This paper introduces the processes and key points of the operation involved in the abovementioned method.

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Clinical application and research progress of digital complete denture
Zhou Yongsheng, Sun Yuchun, Wang Yong
West China Journal of Stomatology    2021, 39 (1): 1-8.   DOI: 10.7518/hxkq.2021.01.001
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Digital technologies use high-precision three-dimensional scanning, intelligence-aided design software, and multi-axis numerical control milling or 3D printing, which can produce restorations with reliable precision and suitable function. However, the development of digital technologies in the field of complete denture restoration has been slow due to the complexity of prosthesis. This review article introduces the current research status and clinical applications of digital complete dentures in prosthodontic clinics and dental laboratories to provide beneficial references to prosthodontists and dental technicians.

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Difficulties and misunderstandings of root canal filling
Chen. Zhang
West China Journal of Stomatology    2017, 35 (3): 232-238.   DOI: 10.7518/hxkq.2017.03.002
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Root canal filling is performed as the final and most important procedure of root canal treatment. The superior 3D filling is the key determinant of endodontic success. However, such procedure remains a challenge because of the comple-xity of the root canal system and the limitation of root canal filling materials and methods. This paper provides an overview of current principles and practices in root canal filling, focusing on advantages, disadvantages and indications. The process errors and countermeasures in various root canal filling methods are also discussed. This review provides guidance and help for clinical and practice to achieve a satisfactory root canal filling and improve root canal treatment outcome.

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Cited: Baidu(1)
External apical root resorption in orthodontic tooth movement: the risk factors and clinical suggestions from experts’ consensus
Li Huang, Wu Xiuping, Huang Lan, Xu Xiaomei, Kang Na, Han Xianglong, Li Yu, Zhao Ning, Jiang Lingyong, Xie Xianju, Guo Jie, Li Zhihua, Mo Shuixue, Liu Chufeng, Hu Jiangtian, Shi Jiejun, Cao Meng, Hu Wei, Cao Yang, Song Jinlin, Tang Xuna, Bai Ding
West China Journal of Stomatology    2022, 40 (6): 629-637.   DOI: 10.7518/hxkq.2022.06.002
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External apical root resorption is among the most common risks of orthodontic treatment, and it cannot be completely avoided and predicted. Risk factors causing orthodontic root resorption can generally be divided into patient- and treatment-related factors. Root resorption that occurs during orthodontic treatment is usually detected by radiographical examination. Mild or moderate root absorption usually does no obvious harm, but close attention is required. When severe root resorption occurs, it is generally recommended to suspend the treatment for 3 months for the cementum to be restored. To unify the risk factors of orthodontic root resorption and its clinical suggestions, we summarized the theoretical knowledge and clinical experience of more than 20 authoritative experts in orthodontics and related fields in China. After discussion and summarization, this consensus was made to provide reference for orthodontic clinical practice.

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Digital workflow of orthodontic and prosthetic treatment for subgingival residual root preservation guided by target restoration space
Guo Jia, Min Jie, Li Juan, Yu Haiyang
West China Journal of Stomatology    2020, 38 (5): 598-601.   DOI: 10.7518/hxkq.2020.05.022
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The use of orthodontic traction to preserve healthy subgingival residual root is a classical method combining the treatment of restoration and orthodontics. Based on the target restoration space (TRS), by establishing a TRS digital model, the final traction position of the subgingival residual root can be preset. After evaluating the key parameters such as crown-to-root ratio and minimum crown height, clinicians can estimate the treatment time and exclude cases with bad preset position. The time of traction treatment can be effectively reduced, and the efficiency and efficacy of the entire treatment can also be improved.

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Relationship of orthodontic treatment and periodontal soft tissue health
Lei Zhao,Xiaoyu Wang,Yi Xu,Shu Meng
West China Journal of Stomatology    2018, 36 (6): 595-601.   DOI: 10.7518/hxkq.2018.06.003
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With the increasing number of the orthodontic patients, the relationship between periodontal and orthodontic becomes increasingly close. Orthodontic treatment can improve periodontal status, but the adverse clinical problems of perio-dontal tissue during orthodontic treatment are relatively common. In this paper, we discuss the problems of soft tissue, including causes, prevention, and treatment of gingivitis, gingival enlargement, gingival recession, and gingival invagination in ortho-dontic treatment.

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

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

Methods

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

Results

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

Conclusion

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

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Questions about the numerical value and quantitative data transfer of tooth preparation—from experience guidance to digital guidance
Yu Haiyang
West China Journal of Stomatology    2021, 39 (1): 9-19.   DOI: 10.7518/hxkq.2021.01.002
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Tooth preparation is a common operation in dental clinical practice. This procedure is irreversible and invasive from the point of view of tooth preservation. Conditions of the abutment tooth, treatment methods, and restoration materials for target restoration affect tooth preparation. To achieve the goals of tooth tissue preservation, dental pulp protection, and periodontal health, dentistry professionals agreed on the importance of minimizing the amount of tooth reduction. The foundations for realizing this consensus are as follows. First, the available restoration materials with improved comprehensive performance need less target restoration space. Next, teeth can be prepared under a digital guide, and the real-time measurement of restoration space can be verified due to the invention of digital technologies for the analysis of the quantity and shape of the prepared tooth and tooth measurement. Moreover, guiding methods for preparation have been developed from freehand operation under the naked eye based on accumulated personal experience to digital-guidance jointing microscope. These innovations indicate the creation of a prototype of guided prosthodontics that is precise and applies real-time measurement throughout the process of tooth preparation. From the perspective of the evolution of digital, guided, and micro prosthodontics, this article raised seven questions about the numerical value and quantitative data transfer of tooth preparation and evaluated the authenticity of existing numerical requirements from the perspective of the four elements of measurement. Identifying unified measuring methods and developing measuring tools with a precision of hundred or ten microns will be the key to solving the problem about the authenticity of numerical measurement. Furthermore, this paper summarizes the methods of how to control tooth reduction and explains in depth why the currently dominant tooth preparation technology, which is based on empiricism, cannot effectively achieve the goals in digital prosthodontics. Therefore, we strongly call for rebuilding the digital foundation of prosthodontic treatment immediately.

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Decision-making of restorations for endodontically treated teeth
Chen Zhi, Chen Binwen.
West China Journal of Stomatology    DOI: 10.7518/hxkq.2015.02.002
Advances in titanium dental implant surface modification
Bangcheng Yang,Xuedong Zhou,Haiyang Yu,Yao Wu,Chongyun Bao,Yi Man,Lei Cheng,Yao Sun
West China Journal of Stomatology    2019, 37 (2): 124-129.   DOI: 10.7518/hxkq.2019.02.002
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Titanium dental implants have wide clinical application due to their many advantages, including comfort, aesthetics, lack of damage to adjacent teeth, and significant clinical effects. However, the failure of osseointegration, bone resorption, and peri-implantitis limits their application. Physical-chemical and bioactive coatings on the surface of titanium implants could improve the successful rate of dental implants and meet the clinical application requirements. This paper reviews the characteristics of surface modification of titanium implants from the aspects of physics, chemistry, and biology. Results provide information for research and clinical application of dental implant materials.

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Confusion and solution for root canal working length determination
Huang Dingming, Tan Xuelian, Zhang Lan, Zhou Xuedong.
West China Journal of Stomatology    DOI: 10.7518/hxkq.2016.02.001
Confusing anchorage
Xu Tianmin
West China Journal of Stomatology    DOI: 10.3969/j.issn.1000-1182.2012.03.001
Confusion and solution for vital pulp therapy
Dingming Huang, Qian Lu, Qian Liao, Ling Ye, Xuedong. Zhou
West China Journal of Stomatology    2017, 35 (3): 227-231.   DOI: 10.7518/hxkq.2017.03.001
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Dental pulp tissue plays a role in forming dentin, providing nutrition, conducting pain, and generating protective responses to environmental stimuli. Bacterial infection is the main cause of pulp disease, where histopathological changes are the histological basis for determining the choice of treatment and the evaluation of therapeutic effect. Thus, particular attention should be given to eliminate infection, as well as preserve and maintain pulpal health in teeth that show reversible or limited pulpal injuries. Vital pulp therapy, especially its indications and prognostic factors, has been a research hotspot that often causes confusion among clinicians. In this paper, we briefly introduce the confusion and solution for vital pulp therapy in terms of indications, pulp condition assessment, infection elimination, and capping material selection. In addition, we develop a clinical pathway and an operation normalization of vital pulp therapy to better perform the therapy.

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Functional clear aligner treatment of class Ⅱ malocclusion in teenagers
Li Zhou,Yanmin Wang,Lan Zhang,Jie Yao
West China Journal of Stomatology    2019, 37 (3): 236-241.   DOI: 10.7518/hxkq.2019.03.002
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Class Ⅱ malocclusion is a common orofacial deformity that could harm the facial esthetics and oral function. Two-stage treatment strategy always applies to functional and skeletal (mild and moderate) class Ⅱ malocclusion with mandibular retrognathism in teenagers. Traditional functional orthopedic appliances are less comfortable and inconvenient to correct the dental arches, making the treatment duration long. With the rapid progress of digital technology and material science, functional clear aligners that offer comfort have emerged. Functional clear aligners can combine orthopedic and orthodontic treatments to correct the jaw relationship and align the dental arch, thereby shortening the treatment duration. This paper emphasizes the treatment key points, and clinical experience of using functional clear aligners.

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Difficulty influence factors of dental caries clinical treatment
Xuedong Zhou, Junqi Ling, Jingping Liang, Jiyao Li, Lei Cheng, Qing Yu, Yumei Niu, Bin Guo, Hui Chen
West China Journal of Stomatology    2017, 35 (1): 1-7.   DOI: 10.7518/hxkq.2017.01.001
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Dental caries is a major disease that threaten human’s oral healthy severely with the characteristics of high incidence, low rate of treatment and high rate of retreatment. At present, restorative treatment remains the main method for caries treatment. With the development of the Minimally Invasive Cosmetic Dentistry (MICD), reasonable application of various treatment technologies, maximum preservation of tooth tissues and realizing the maximization of treatment effects become problems that call for immediate solution in dental clinics. In addition, there still exist a large number of old restora-tions that need standard retreatments. Here, some difficulty influence factors of dental caries clinical treatment such as systemic and oral factors, individual caries susceptibility, treatment technologies and materials, retreatment methods of old restorations and technique sensitivity are analyzed, and corresponding processing strategies are also put forward.

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Cited: Baidu(1)
Oral implant treatment for elderly patients
Yuan Quan
West China Journal of Stomatology    2020, 38 (6): 616-621.   DOI: 10.7518/hxkq.2020.06.002
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With the advance of materials and technologies, modern oral implantology developed rapidly. Dental implant has become the first choice to restore the missing teeth. Although it achieves a high success rate among healthy adults, for elderly patients, with the decline of physical function and other systemic diseases, the risks of implant treatment increase accordingly. Doctors should pay more attention to the factors that may affect the implant treatment of the elderly and ways of preventing possible risks and complications. Here we discuss the specificity, success rate, effect of systemic diseases and drug considerations of implant treatments in elderly patients.

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Dental alveolar bone and dental arch remodeling in children: orthodontic diagnosis and treatments based on individual child arch development
Li Xiaobing
West China Journal of Stomatology    2016, 34 (6): 556-563.   DOI: 10.7518/hxkq.2016.06.002
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The etiology of malocclusions basically involves both congenital and environmental factors. Malocclusion is the result of the abnormal development of the orofacial complex (including tooth, dental alveolar bone, upper and lower jaws). Early orthodontic interceptive treatments involve the elimination of all congenital and environmental factors that contribute to the malformation of the orofacial complex, as well as interrupt the deviated development of the orofacial complex and the occlusion. Early orthodontic interceptive treatments mainly aim to use children’s growth potential to correct abnormal developments of occlusions and orthodontically treat malocclusions more efficiently. The early orthodontic interceptive treatments include correcting the child’s bad oral habits, training the abnormal functioned para-oral muscles, maintaining the normal eruptions of succeeding permanent teeth, applying interceptive treatments to the mal-developed teeth, and employing functional orthopedic treatments for abnormal growths of the upper and lower jaws. In orthodontics, correcting mal-positioned teeth is called orthodontic treatment, while rectifying the abnormal relationships of the upper and lower jaws is called functional orthopedic treatment. However, no clear definition is available as regards to the early orthodontic interceptive treatment of malocclusions caused by the deviated development of the dental alveolar bone. This new theory of “early dental alveolar bone and dental arch remodeling technique” was proposed by Professor Li Xiaobing of the Department of Pediatric Dentistry, Faculty of Pediatric Dentistry and Orthodontics in West China Hospital of Stomatology through his clinical analyses and investigation of his early orthodontic interceptive treatments. He defined the early orthodontic corrections of abnormal growth of dental alveolar bone as “remodel”. The “early dental alveolar bone and dental arch remodeling theory and technique” is proved useful in malocclusion diagnosis and treatment planning during early orthodontic interceptive treatment with malformed dental arch. With the development of the theory and technique, the author intended to prevent and intercept the malocclusion development more effectively and efficiently. This review presents the development and clinical usages of the theory which to provide a new vision in the analysis of malocclusions on the basis of the developmental mechanism of the alveolar bone and dental arch. With clinical case illustration, the author demonstrateshis successful orthodontic clinical practices with this theory, which may contribute to the development of contemporary orthodontic theories and techniques.
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Imaging classification diagnosis and maxillary sinus floor augmentation of maxillary sinus cystic lesions
Wang Hu, Tan Zhen, You Meng, Liu Wenjia
West China Journal of Stomatology    2019, 37 (5): 457-462.   DOI: 10.7518/hxkq.2019.05.001
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Maxillary sinus cystic lesions can often be found in cone-beam computed tomography (CBCT) images. However, whether this change affects the implementation of maxillary sinus floor augmentation remains unclear. Combining the common cystic change performance of CBCT, image classification diagnosis of maxillary sinus cystic change was introduced, and the indications and surgical methods of maxillary sinus floor augmentation and postoperative radiographic changes of mucous were analyzed. This procedure may help clinicians evaluate the feasibility and methods of maxillary sinus augmentation in maxillary sinus cystic changes.

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Research advances in the use of digital surgical guides in implantology
Wang Xiaohua,Liu Aipeng,Deng Wenzheng
West China Journal of Stomatology    2020, 38 (1): 95-100.   DOI: 10.7518/hxkq.2020.01.017
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Dental implants have become the main choice for patients to fill in their missing teeth. A precise placement is the basis for a functional and aesthetic restoration. A digital surgical guide is a carrier that transfers the preoperative plan of dental implants to the actual surgery. This paper provides some references that can help clinicians improve the accuracy of implant surgery by stating the development, classification, advantages and disadvantages, and factors that affect the accuracy of digital guides.

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Endodontic infection management in root canal preparation: question and solution
Yuan Gao,Yu Zhang,Xue-dong Zhou,Dingming Huang
West China Journal of Stomatology    2018, 36 (6): 590-594.   DOI: 10.7518/hxkq.2018.06.002
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The essence of pulp and periapical disease is bacterial infection. Thus, satisfactory infection control is the premise and foundation of healing, in which root canal preparation is a critical procedure. Root canal system anatomy, infection degree, physical cutting during root canal preparation, and certain cleaning measures affect the quality of infection control. Appropriate evaluation of the grades of infected root canals before treatment is necessary because different grades of root canal infection demand various disinfection schedules to facilitate tissue healing and guarantee the long-term success rate of endodontic treatment.

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