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The chance and challenge of creating virtual patients in prosthodontics
Shen Jiefei
West China Journal of Stomatology    2024, 42 (1): 1-11.   DOI: 10.7518/hxkq.2024.2023317
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In the field of prosthodontics, the use of virtual patients for biomimetic restoration holds great promise for various applications. Virtual patients consist of digitized data that encompasses details on the morphology, structure, and spatial relationships within the maxillofacial and intraoral regions. Nonetheless, there are several challenges associated with acquiring digital data, achieving accurate alignment, and recording and transferring dynamic jaw movements. This paper aims to concentrate on the process of constructing virtual patients, highlight the key and challenging aspects of virtual patient construction, and advocate for the extensive adoption and utilization of virtual patient technology.

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Research status and prospects of biodegradable magnesium-based metal-guided bone regeneration membranes
Chen Liangwei, Han Jianmin, Guo Chuanbin
West China Journal of Stomatology    2024, 42 (4): 415-425.   DOI: 10.7518/hxkq.2024.2024140
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Biodegradable magnesium-based metal-guided bone regeneration (GBR) membranes possess excellent mechanical properties, biodegradability, and osteopromotive capabilities, making them ideal implants for the treatment of maxillofacial bone defects. This review summarizes the current status and future research trends related to magnesium-based GBR membranes. First, the research history and application fields of magnesium-based metals are introduced, and the advantages of the use of magnesium-based materials for GBR membranes, including their mechanical properties, biocompatibility, osteopromotive performance, and underlying mechanisms are discussed. Finally, this review addresses the current limitations of magnesium-based GBR membranes and their applications and prospects in the field of dentistry. In conclusion, considerable advancements have been in fundamental and translational research on magnesium-based GBR membranes, which lays a crucial foundation for the treatment of maxillofacial bone defects.

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Facial nerve function training in patients with peripheral facial paralysis: an expert consensus
Chen Yunmei, Liu Yan, Huang Qiuyu, Luo Jiang, Wu Hongmei, Wang Yehua, Wu Ling, Li Xiu’e, Bi Xiaoqin
West China Journal of Stomatology    2023, 41 (6): 613-621.   DOI: 10.7518/hxkq.2023.2023200
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Facial nerve training can prevent facial expression muscle atrophy and promote the recovery of facial para-lysis in patients with peripheral facial paralysis. However, there is still a lack of specific and unified technical standards for facial nerve training, which results in a variety of clinical training methods and uneven levels. In order to standardize the application of facial nerve function training technology for nursing staff, the study convened relevant domestic experts, based on evidence-based combination with the disease characteristics of peripheral facial paralysis and expert clinical experience, conducted in-depth interviews with experts, expert correspondence and expert meetings, and finally formulated the expert consensus on facial nerve function training in patients with peripheral facial paralysis. Overall, suggestions for standardizing the timing, training methods, evaluation methods, health education and other aspects were provided for clinical reference.

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Expert consensus on classification and diagnosis of congenital orofacial cleft
Li Chenghao, An Yang, Duan Xiaohong, Guo Yingkun, Liu Shanling, Luo Hong, Ma Duan, Ren Yunyun, Wang Xudong, Wu Xiaoshan, Xie Hongning, Zhu Hongping, Zhu Jun, Shi Bing
West China Journal of Stomatology    2025, 43 (1): 1-14.   DOI: 10.7518/hxkq.2025.2024306
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Congenital orofacial cleft, the most common birth defect in the maxillofacial region, exhibits a wide range of prognosis depending on the severity of deformity and underlying etiology. Non-syndromic congenital orofacial clefts typically present with milder deformities and more favorable treatment outcomes, whereas syndromic congenital orofacial clefts often manifest with concomitant organ abnormalities, which pose greater challenges for treatment and result in poorer prognosis. This consensus provides an elaborate classification system for varying degrees of orofacial clefts along with corresponding diagnostic and therapeutic guidelines. Results serve as a crucial resource for families to navigate prenatal screening results or make informed decisions regarding treatment options while also contributing significantly to preventing serious birth defects within the development of population.

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Orthodontic program design based on aesthetic
Ma Yanning, Jin Zuolin.
West China Journal of Stomatology    2023, 41 (6): 628-634.   DOI: 10.7518/hxkq.2023.2023231
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Orthodontics is a discipline that is based on aesthetics. It coordinates the relationship among nose, lip, and chin through the movement of teeth and the adjustment of jaw relationship. Orthodontists need to fully analyze the patient’s soft tissue profile before treatment. They also need to analyze the existing problems and those that may be solved or caused during orthodontics to guide the design of orthodontic treatment and effectively improve the clinical effect of orthodontics. This article reviews the aesthetic preconditions that guide the design of orthodontic treatment from the perspective of orthodontists.

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

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Correlation between differences in intraoperative jumping gaps and soft tissue changes around immediate implant placement and provisionalization in the maxillary anterior region
Zhang Sui, Sun Yi, Huang Changbo, He Dongning
West China Journal of Stomatology    2023, 41 (6): 678-685.   DOI: 10.7518/hxkq.2023.2023153
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Objective This study aims to evaluate the correlation between differences in intraoperative jumping gaps and soft tissue changes around immediate implant placement and provisionalization (IIPP) in the maxillary anterior region. Results will provide a basis for clinical evaluation of the change trend and long-term stability of the labial soft tissue contours of patients with different jumping gaps. Methods Thirty-two patients with single tooth loss in the maxillary aesthetic area were enrolled, and they all received immediate implant placement and restoration. All patients were divided into three groups: A, B, and C according to the size of the jumping gap, group A: horizontal defect dimension (HDD) ≤2 mm; group B: 2 mm<HDD≤3 mm; group C: HDD>3 mm. Geomagic studio 2013 was used to quantitatively analyze the contour volume of the soft tissue around the implant and the level of the labial gingival margin. The pink esthetic score (PSE) was used for the final aesthetic evaluation. Results All implants had osseointegration within 6 months after the surgery. The average thickness of soft tissue contour volume changed by 0.62 mm±0.15 mm, and the average PES was 11.09±0.99. The changes in the gingival mucosa levels in the three groups at 6 months after operation were 0.45 mm±0.11 mm, 0.40 mm±0.12 mm, and 0.35 mm± 0.11 mm, respectively. The changes in the average thickness of the soft tissue contour volume in the three groups at 6 months after the operation were 0.77 mm±0.16 mm, 0.63 mm±0.17 mm, and 0.54 mm±0.11 mm. A moderate negative correlation was found between the jumping gap size and the gingival mucosa level, and the average thickness changed. No significant correlation was found between size of jumping gap and PES. Conclusion Although the contour volume of the labial soft tissue continuously decreased within 6 months after IIPP in the maxillary anterior region, the surgical procedure can achieve a satisfactory aesthetic effect, and the level of soft tissue around the implant can be well maintained.

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Postextraction infections, prevention, and treatment
Cao Yubin, Ye Li, Pan Jian
West China Journal of Stomatology    2024, 42 (4): 426-434.   DOI: 10.7518/hxkq.2024.2023427
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Postoperative infection is one of the most common complications of tooth extraction. It may manifest as localized infection or develop to systemic infection. Clinically, oral surgeons can prevent postoperative infections by urging patients to strengthen oral hygiene, applying antibiotics in a rational and compliant manner, and choosing appropriate surgical methods for tooth extraction. For the treatment of infection, the oral surgeon should formulate a response strategy on the basis of different diagnoses. For local infections such as dry socket, delayed alveolar osteitis, gap infection, and marginal osteomyelitis of the jaws, the infection can be controlled by local debridement, therapeutic use of antibiotics, and incise and drain if necessary. For patients suspected of necrotizing fasciitis, timely extensive debridement should be made to reduce the area of tissue necrosis. For those who have received radiotherapy or anti-resorptive drugs, tooth extraction should follow the recommendations of the relevant clinical guidelines or expert consensus to minimize the risk of osteonecrosis of the jaws. For patients with poor systemic health or dysfunction of the immune system, attention should be paid to identifying infective endocarditis and intracranial infection to ensure the life safety of patients. In this study, the author intends to combine literature review and clinical experience to tackle postextraction infection and its prevention to provide a reference for colleagues on oral and maxillofacial surgery.

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Mechanism of mangiferin in the treatment of oral submucous fibrosis based on Gene Expression Omnibus database chip mining combined with network pharmacology and molecular docking
Song Ziyi, Yang Chao, Zhang Yunlong, Zhang Zhujiang, Ren Tianjiao, Zhang Xinyue, Li Xue
West China Journal of Stomatology    2024, 42 (4): 444-451.   DOI: 10.7518/hxkq.2024.2024050
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Objective This study aims to investigate the primary target and potential mechanism of mangiferin (MF) in treating oral submucous fibrosis (OSF) through Gene Expression Omnibus (GEO) database chip mining, network pharmacology, and molecular docking techniques. Methods Potential therapeutic targets for OSF were identified using GEO chip data. The potential targets of MF were predicted, and disease-related targets for OSF were collected from databases. A Venn diagram was created using the EVenn platform to identify overlapping targets. The protein-protein interaction (PPI) network was constructed using the STRING database. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using the DAVID platform. Cytoscape 3.10.1 software was used to visualize a drug-target-pathway-disease network, while AutoDocktools 1.5.6 software was employed for molecular docking analysis. Results A total of 356 potential targets for MF and 360 disease-related targets for OSF were obtained from multiple databases. The top 15 key target proteins in the PPI network were selected as significant candidates. GO function and KEGG pathway enrichment analyses revealed that MF treatment primarily involved advanced glycation end products-receptor (AGE-RAGE), epidermal growth factor receptor (EGFR), and other signaling pathways associated with OSF pathogenesis. Molecular docking analysis demonstrated that MF exhibited a strong binding activity toward AKT serine kinase 1 (AKT1), tumor necrosis factor (TNF), and other core targets. Conclusion These findings suggest that MF may exert its therapeutic effects on OSF through a multitarget approach involving various signaling pathways.

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

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Role of fatty acid metabolism-related genes in periodontitis based on machine learning and bioinformatics analysis
Chen Yuxiang, Zhao Anna, Yang Haoran, Yang Xia, Cheng Tingting, Rao Xianqi, Li Ziliang
West China Journal of Stomatology    2024, 42 (6): 735-747.   DOI: 10.7518/hxkq.2024.2024214
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Objective This study aims to investigate the role of genes related to fatty acid metabolism in periodontitis through machine learning and bioinformatics methods. Methods Periodontitis datasets GSE10334 and GSE-16134 were downloaded from the GEO database, and the fatty acid metabolism-related gene sets were obtained from the GeneCards database. Differentially expressed fatty acid metabolism-related genes (DEFAMRGs) in periodontitis were screened using the “limma” R package. Functional enrichment and pathway analyses were conducted. Recursive Feature Elimination, Least Absolute Shrinkage and Selection Operator, and Boruta algorithm were used to determine hub DEFAMRGs and construct diagnostic models with internal and external validation. Subtypes of periodontitis related to hub DEFAMRGs were constructed using consistency clustering analysis. CIBERSORT was used to analyze immune cell infiltration in gingival tissues and explore the correlation between hub DEFAMRGs and immune cells. Results A total of 113 periodontitis DEFAMRGs were screened out as a result. The enrichment analysis results indicate that DEFAMRGs are mainly associated with immune inflammatory responses and immune cell chemotaxis.Finally, 8 hub DEFAMRGs (BTG2, CXCL12, FABP4, CLDN10, PPBP, RGS1, LGALSL, and RIF1) were identified and a diagnostic model (AUC=0.967) was constructed, based on which periodontitis was divided into two subtypes. In addition, there is a significant correlation between hub DEFAMRGs and different immune cell populations, with mast cells and dendritic cells showing higher correlation. Conclusion This study provides new insights and ideas for the occurrence and development mechanism of periodontitis and proposes a diagnostic model based on hub DEFAMRGs to provide new directions for diagnosis and treatment.

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Clinical decision of centric relation
Yu Haiyang, Yan Zhebin, Xie Chenyang, Wu Qin
West China Journal of Stomatology    2024, 42 (5): 558-565.   DOI: 10.7518/hxkq.2024.2024147
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Centric relation (CR) was used in the complete dentures for edentulous jaws firstly. Then, CR was gradually applied in the clinical diagnosis and treatment of dentate jaws. Regarding the application of CR in dentate jaws, there are many doubts about its rationality. For instance, should CR be the core of diagnosis and treatment of temporomandibular disorders? Should CR be used as the jaw position of establishing occlusion in occlusal reconstruction? Should CR serve as the target jaw position in orthodontic treatment? Meanwhile, varieties of CR clinical applications are objective. According to the existing evidence, this paper summarizes the applicable conditions of several main clinical situations with little controversy. We preliminarily put forward the decision tree for the clinical application of CR, which can be used as a reference in clinical practice.

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

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Treatment strategies for periodontitis patients with systemic disease
Lin Li, Li Zhaorong, Jin Yining, Yin Shou-cheng.
West China Journal of Stomatology    2023, 41 (5): 502-511.   DOI: 10.7518/hxkq.2023.2023181
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Periodontitis is a chronic inflammatory disease that destroys the integrity of tooth-supporting tissue. Periodontitis is listed as a major oral disease by the World Health Organization and is a public-health problem affecting global oral and systemic health. The fourth national oral health epidemiological survey has revealed that periodontitis is one of the most common oral problems in China. With the development of science and medicine, increased attention is being paid to the importance of oral health and its influence on general health. Accordingly, stomatologists are required to master more relevant information on clinical diagnosis and treatment, as well as to pay more attention to the diagnosis and treatment methods of patients with different systemic diseases. This article expounds the diagnosis and treatment strategy of patients with systemic disease periodontitis. We aimed to help stomatologists make more reasonable diagnosis and treatment decisions.

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Clinical considerations of emergent oral manifestations during pregnancy
Zhang Xuefeng, Liu Xian, Liu Chang, Hua Chengge
West China Journal of Stomatology    2024, 42 (2): 142-153.   DOI: 10.7518/hxkq.2024.2023367
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Pregnancy is a special period for developing and treating oral diseases. Oral emergencies during pregnancy need to be handled appropriately. Changes in the physiological environments and personal habits of pregnant women increase susceptibility to some oral diseases. However, clinical treatment strategies are limited due to the need to ensure the safety of pregnant women and fetuses. Pregnant women should obtain oral health knowledge and enhance their awareness. Dentists should adhere to the principle of “prevention before pregnancy, controlling symptoms during pregnancy, and treating diseases after pregnancy” for different pregnancy periods. They should also formulate appropriate treatment plans to control emergencies, prevent disease progression, and avoid harmful effects on pregnant women by using the safest, simplest, and most effective strategies that avoid adverse effects on fetuses. Pregnant women and dentists should combine prevention and treatment while collaborating in maintaining oral health during pregnancy. This article focuses on the principles of treatment during pregnancy, and the treatment timing, clinical management, and treatment strategies of different diseases causing oral emergencies during pregnancy are reviewed.

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Three-dimensional finite element study of mandibular first molar distalization with clear aligner
Kang Fujia, Yu Lei, Zhang Qi, Li Xinpeng, Hu Zhiqiang, Zhu Xianchun.
West China Journal of Stomatology    2023, 41 (4): 405-413.   DOI: 10.7518/hxkq.2023.2023021
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Objective This study aimed to construct the finite element model of the mandibular first molar with the invisible appliance and explore the dentition movement characteristics of the mandibular first molar when using micro-implant anchorage and different initial positions of the first molar. Methods Models of the mandible, tooth, periodontal membrane, and invisible appliance were constructed using cone beam computed tomography (CBCT) data. The two groups were divided into the non-anchorage group and the micro-implant group (between the roots of the first molar and the second molar) based on whether the elastic traction of the micro-implant was assisted or not. The two groups were divided into the following conditions based on the starting position of the first molar: Working condition 1: the distance between the first molar and the second premolar was 0 mm; working condition 2: the distance between the first molar and the second premolar was 1 mm; working condition 3: the distance between the first molar and the second premolar was 2 mm; working condition 4: the distance between the first molar and the second premolar was 3 mm. The data characte-ristics of total displacement and displacement in each direction of dentition were analyzed. Results In the non-ancho-rage group, all the other teeth showed reverse movement except for the first molar which was moved distally. Meanwhile, in the micro-implant group, except for a small amount of mesial movement of the second molar in wor-king condition 1, the whole dentition in other working conditions presented distal movement and anterior teeth showed lingual movement, among which the distal displacement of the first molar in working condition 4 was the largest. With the change of the initial position of the first molar to the distal, the movement of the first molar to the distal, the premolar to the mesial, and the anterior to the lip increased, while the movement of the second molar to the mesial decreased. Conclusion The micro-implant can effectively protect the anterior anchorage, increase the expression rate of molar distancing, and avoid the round-trip movement of the second molar. The initial position of the first molar movement is related to the amount of distancing and the remaining tooth movement.

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Case of precise full-mouth occlusal reconstruction guided by digital occlusal function analysis
Guo Yanling, Li Jiaxin, Liu Xinran, Yue Yuan, Wei Na, Wang Min, Hao Liang
West China Journal of Stomatology    2024, 42 (3): 394-402.   DOI: 10.7518/hxkq.2024.2023448
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The clinical demand for occlusal reconstruction increases rapidly with increasing number of patients who have lost their normal occlusion because of tooth wear and dentition defects. Occlusal reconstruction is a special type of restoration defined as a comprehensive restoration of the function of the stomatognathic system by reestablishing a uniform and stable occlusal relationship between the upper and lower dentitions. Occlusal function analysis is an important part of occlusal reconstruction to achieve accurate restoration design and adjustment. Digital occlusal function analysis was conducted to monitor the movement of the mandible and obtain related data for the parameter design of occlusal reconstruction. Preoperative design, intraoperative adjustment, and postoperative verification were achieved, thereby improving the efficiency and accuracy of occlusal reconstruction.

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Effect of the application of digital technology-assisted optimization in the process of adjusting jaw position
Gong Yanji, Liu Yang, Yin Deqiang
West China Journal of Stomatology    2024, 42 (2): 268-276.   DOI: 10.7518/hxkq.2024.2023327
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Objective The aim of this study was to demonstrate a novel jaw position adjustment technique derived from digital twins and evaluate the application effect of digital technology-assisted optimization in the process of adjusting jaw position on patients with temporomandibular disorders (TMD). Methods A total of 74 patients with TMD who attended the Department of Temporomandibular Joint, West China Hospital of Stomatology, Si-chuan University, between June 2022 and May 2023 were selected. The patient’s initial computed tomography (CT) and bilateral temporomandibular joint data obtained by magnetic resonance imaging (MRI) were collected. The 148 joints were divided into the normal disc-condyle relationship (N) group, disc displacement with reduction (DDWR) group, and disc displacement without reduction (DDWoR) group. Assisted by digital technology, the patient’s CT data were reconstructed, and a personalized reference plane was established to adjust the jaw position. A three-point bite guiding splint was designed by the adjusted occlusal space and then fabricated by 3D printing technology. It was worn by the patients and then reviewed by MRI. Before and after the adjustment of jaw position, the amount and direction of condyle and disc displacement and the angle between condyle and disc were measured as the evaluation indexes of the effect of the adjustment. The correlation with condylar displacement was evaluated. Results In the N group, the disc moved backward and downward along the X and Z axes by (-0.60±0.62) and (0.51±0.71) mm, respectively. In the DDWR group, the disc moved backward and upward along the X and Z axes by (-1.33±1.38) and (-0.09±1.31) mm, respectively. In the DDWoR group, the disc moved forward and downward along the X and Z axes by (0.49±1.76) and (1.35±1.76) mm, respectively. The angle between the condyle and the disc decreased after adjustment of the jaw position in all three groups. All patients showed improvement in symptoms after adjustment. Conclusion Digital technology-assisted jaw position adjustment can simplify the process, reduce the sensitivity of the technique, and improve patients’ disc-condyle structure and symptoms. Therefore, its application in the treatment of patients with TMD is of great clinical significance.

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

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Meta-analysis of prevalence and filling rate of dental caries in preschool children in China
Zhang Jing, Wang Yan.
West China Journal of Stomatology    2023, 41 (5): 573-581.   DOI: 10.7518/hxkq.2023.2023071
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Objective This study aims to understand the prevalence and treatment status of dental caries in preschool children aged 3-5 years in China among the past five years. Methods Databases including CNKI, WanFang data, VIP, MEDLINE, EMBASE were systematically searched for the epidemiological literature of dental caries in preschool children in China from 2017 to 2022 for Meta-analysis. Subgroup analysis was carried out by sex, age, geographical region, ethnology, and residence. Results The Meta-analysis enrolled 27 literatures, including 72 788 preschool children; of which, 38 344 children had dental caries. The merged prevalence of dental caries in preschool children was 59.3% (95%CI: 54.6%-63.9%), and the merged filling rate of caries was 5.7% (95%CI: 2.5%-8.8%). In the subgroup analysis, the merged prevalence rates of caries in children aged 3, 4, and 5 years were 46.9% (95%CI: 42.5%-51.4%), 59.0% (95%CI: 55.1%-62.8%), and 67.3% (95%CI: 62.5%-72.2%), respectively, and the difference was significant. In addition, significant differences were found among different regions. The merged prevalence of dental caries in preschool children was the highest in northwest China (68.6%, 95%CI: 55.5%-81.8%) and the lowest in central China (49.1%, 95%CI: 47.3%-51.0%). The merged prevalence of dental caries was not significantly different among preschool children of different genders, ethnicities, and residence. Conclusion The prevalence of dental caries in preschool children aged 3-5 years in China is high and continuously increases. The oral health of preschool children should be comprehensively strengthened, and a three-level strategy should be implemented to prevent diseases.

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Mechanism of Cnidii Fructus in the treatment of periodontitis with osteoporosis based on network pharmacology, molecular docking, and molecular dynamics simulation
Feng Miaomiao, Xu Xiaoran, Li Ningli, Yang Mingzhen, Zhai Yuankun
West China Journal of Stomatology    2025, 43 (2): 249-261.   DOI: 10.7518/hxkq.2025.2024275
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Objective This study aimed to explore the active components, potential targets, and mechanism of Cnidii Fructus in the treatment of periodontitis with osteoprosis through network pharmacology, molecular docking, and molecular dynamics simulation technology. Methods The main chemical constituents and targets of Cnidii Fructus were screened using the TCMSP and SwissTargetPrediction databases, as well as literature reports. Targets of periodontitis and osteoporosis were predicted using different databases. The intersection targets of Cnidii Fructus, periodontitis, and osteoporosis were obtained using Venny 2.1. The protein-protein interaction network was formed on the STRING platform. Cytoscape 3.9.1 was used to construct the active component-intersection target interaction network, perform the topological analysis, and screen key targets and core active components. Furthermore, the Metascape database was used to perform gene ontology (GO) function and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis on the intersection targets. The top five key targets and core active components were selected as receptor proteins and ligand small molecules. Discovery Studio 2019 was used to dock ligands and receptors and visualize the docking results. Molecular dynamics simulation was conducted using Gromacs2022.3 to assess the stability of the interactions between the core active components and the main targets. Results A total of 20 potential active ingredients of Cnidii Fructus were screened, and 116 targets of Cnidii Fructus were obtained for treating periodontitis and osteoporosis. GO and KEGG analysis of the 116 targets showed that Cnidii Fructus may play a therapeutic role through the phosphoinositide 3-kinase-protein kinase B (PI3K-Akt) and advanced glycation end products-receptor for advanced glycation end products (AGE-RAGE) signaling pathways. Molecular docking showed that the core constituents were well bound to the main targets. Molecular dynamics simulations confirmed the stability of the Diosmetin-AKT1 complex system. Conclusion The preliminary discovery of the potential molecular pharmacological mechanism of Cnidii Fructus extract in the targeted treatment of periodontitis with osteoporosis through a multi-component, multitarget, and multi-pathway approach can serve as a theoretical foundation for future drug-development research and clinical application.

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Reflections on the current state of early orthodontic treatment
Li Huang
West China Journal of Stomatology    2025, 43 (2): 151-157.   DOI: 10.7518/hxkq.2025.2024323
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Early orthodontic treatment has been a hot spot and focus of development in recent years in the field of orthodontics, pediatric dentistry, and general practice dentistry. However, there are still some misconceptions, such as excessive or premature intervention, strict control of indications, exaggeration of the role of early orthodontic treatment. This article starts from the analysis of the current status of early orthodontic treatment in China and combines the latest literature and reviews at home and abroad to analyze the nine issues that dentists and the public are concerned about one by one, including whether early orthodontic treatment is a new concept, whether it is necessary, the timing of early orthodontic treatment, the indications for early orthodontic treatment, whether it can provide a non-tooth extraction or non-surgical opportunity, whether it can completely change the facial profile such as retrognathia and growth pattern of the mandible, whether it can treat habitual mouth breathing or adenoid face or obstructive sleep apnea, the role of myofunctional therapy with prefabricated appliances in early orthodontic treatment, whether transparent aligners are superior to traditional aligners in early orthodontic treatment, with the aim of promoting the standardization of early orthodontic treatment. Early orthodontic treatment must choose the right indications, master the basic principles and techniques of orthodontics, and choose the most suitable treatment method and timing for the child.

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

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Effect of glycosaminoglycans with different degrees of sulfation on chondrogenesis
Zheng Wen, Cai Ming-xiang, Peng Huizhen, Liu Minyi, Liu Xiangning
West China Journal of Stomatology    2023, 41 (4): 395-404.   DOI: 10.7518/hxkq.2023.2023055
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Objective This study aims to investigate the effects and mechanisms of chondroitin sulfate (CS), dermatan sulfate (DS), and heparin (HEP) on chondrogenesis of murine chondrogenic cell line (ATDC5) cells and the maintenance of murine articular cartilage in vitro. Methods ATDC5 and articular cartilage tissue explant were cultured in the medium containing different sulfated glycosaminoglycans. Cell proliferation, differentiation, cartilage formation, and mechanism were observed using cell proliferation assay, Alcian blue staining, real-time quantitative polymerase chain reaction (RT-qPCR), and Western blot, respectively. Results Results showed that HEP and DS primarily activated the bone morphogenetic protein (BMP) signal pathway, while CS primarily activated the protein kinase B (AKT) signal pathway, further promoted ATDC5 cell proliferation and matrix production, and increased Sox9, Col2a1, and Aggrecan expression. Conclusion This study investigated the differences and mechanisms of different sulfated glycosaminoglycans in chondrogenesis and cartilage homeostasis maintenance. HEP promotes cartilage formation and maintains the normal state of cartilage tissue in vitro, while CS plays a more effective role in the regeneration of damaged cartilage tissue.

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Clinical application principles and new developments of zirconia crown
Wang Jian, Yang Linxin
West China Journal of Stomatology    2024, 42 (2): 135-141.   DOI: 10.7518/hxkq.2024.2023404
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Zirconia crown has been widely used in the field of prosthodontics. Traditional zirconia exhibits excellent mechanical properties but lacks translucency. The introduction of transparent zirconia significantly enhances its aesthetic performance. In clinical applications, factors affecting the aesthetic results of full zirconia crown should be comprehensively considered, and the most suitable restoration should be chosen. Additionally, clinicians need to design appropriate tooth preparation dimensions and methods based on an individual patient’s actual situation. During the clinical bonding process of zirconia, proper surface treatment of the tooth and restoration is essential. The selection of suitable adhesives is crucial for achieving optimal bonding strength and aesthetics.

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Liver macrophages show an immunotolerance phenotype in nonalcoholic fatty liver combined with Porphyromonas gingivalis-lipopolysaccharide infection
Guo Lijia, Liu Yitong, Chen Yingyi, Xu Junji, Liu Yi
West China Journal of Stomatology    2023, 41 (4): 385-394.   DOI: 10.7518/hxkq.2023.2023111
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Objective This study aimed to explore the functions and potential regulatory targets of local macrophages in nonalcoholic fatty liver combined with Porphyromonas gingivalis (P. gingivalis)infection. Methods Single-cell RNA sequencing was used to analyze the phenotypes and functional changes in various cells in the liver tissue of nonalcoholic steatohepatitis (NASH) mice fed with P. gingivalis. Real-time polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay, and immunofluorescence staining were applied to observe the inflammation and expression levels of macrophage antigen presenting functional markers in the NASH liver. Oil red staining was performed to observe the accumulation of local adipose tissue in the NASH liver. Results were verified through RT-PCRand RNA sequencing using P. gingivalis-lipopolysaccharide treated mouse peritoneal macrophages. Results In comparison with healthy livers with Kupffer cells, the NASH liver combined with P. gingivalis infection-related macrophages showed significant heterogeneity. C1qb, C1qc, Mafb, Apoe, and Cd14 were highly expressed, but Cd209a, H2-Aa, H2-Ab1, and H2-DMb1, which are related to the antigen presentation function, were weakly expressed. Further in vivo and in vitro investigations indicated that the activation and infiltration of these macrophages may be due to local P. gingivalis-lipopolysaccharide accumulation. Conclusion P. gingivalis-lipopolysaccharide induces a local macrophage immunotolerance phenotype in nonalcoholic fatty liver, which may be the key mechanism of periodontitis pathogen infection that promotes NASH inflammation and pathogenesis. This study further clarifies the dysfunction and regulatory mechanisms of macrophages in the pathogenesis of P. gingivalis-infected NASH, thereby providing potential therapeutic targets for its clinical treatment.

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Application of intentional replantation in advanced periodontitis involving teeth preservation
Ye Changchang, Yang He, Huang Ping
West China Journal of Stomatology    2024, 42 (1): 12-18.   DOI: 10.7518/hxkq.2024.2023206
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With the development of periodontal regenerative technology, an increasing number of scholars reported that advanced periodontitis involving teeth can be preserved through intentional replantation. Intentional replantation has become the last possible method to preserve natural teeth for advance periodontitis with signs of tooth extraction. However, the indications of intentional replantation are strict, and the success of the operation is closely related to the condition of cases and the operation skills of doctors. In this article, the operation steps and criteria of intentional replantation were summarized by introducing three success cases of advanced periodontitis involving teeth preserved by intentional replantation. The relevant factors that affect the prognosis of intentional replantation in advanced periodontitis involving teeth preservation were analyzed to help clinicians preserve natural teeth.

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Personal understanding of the extraction or rescue on severe periodontitis teeth
Wang Qintao, Ma Zhiwei, Wang Jinjin.
West China Journal of Stomatology    2023, 41 (6): 635-640.   DOI: 10.7518/hxkq.2023.2023274
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To keep or extract severe periodontitis damaged teeth is one of the controversial topics in the dentistry from ancient times to present. From different perspectives, professions, technologies, time, and economics, there may be different choices with unidentified consensus. Based on the author’s own understanding, experience, literature review, and other aspects, this article proposes some exchange views on influencing factors, abandoning consideration, preserving possibility, and how to detect and prevent the development of lesions. The aim is to stimulate more thinking and accumulate clinical evidence-based data among peers, in order to facilitate cooperation and promote oral health.

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Multidisciplinary clinical decision-making of anterior diastema closure
Yu Haiyang, Shui Yusen, Jiang Qingsong
West China Journal of Stomatology    2024, 42 (3): 277-285.   DOI: 10.7518/hxkq.2024.2023460
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Anterior diastema is a common esthetic defect in China. The general treatment for a patient with diastemata, including orthodontics and direct and indirect restorations, is a multidisciplinary clinical procedure covering the orthodontics, operative dentistry, general dentistry, and prosthodontics department. Given the diversity of departments and the complex etiology of this defect, decision-making regarding the closing methods and time selection is undefined and unintegrated, which makes the long-term stability of closure unpredictable. This article proposed an etiology-based decision tree with actual measurement of diastemata width for diastemata closure. The decisional steps include classifying the etiological factors based on patients' medical history and clinical manifestation to evaluate the stability of diastemata. After maintaining the stability of diastemata, contemporary and multidisciplinary treatment plans were selected in accordance with the measured width of diastemata and patients' cosmetic psychology, economics, and available time. These decision trees focus on the challenges of collaboration among dental departments, propose an objective and efficient ways for connections, and promote efficient and effective diastemata closure.

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Comparison of the efficacy and long-term stability of tunnel technique and coronally advanced flap in the treatment of gingival recession: a Meta-analysis
Cheng Xiaoming, Tang Rui, Ge Zili
West China Journal of Stomatology    2023, 41 (4): 450-462.   DOI: 10.7518/hxkq.2023.2023045
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Objective This study aimed to evaluate the efficacy and long-term stability of tunnel technique (TUN) and coronally advanced flap (CAF) combined with connective tissue graft (CTG) in treating gingival recession. Methods Databases including PubMed, Web of Science, Embase, and CNKI were electronically searched to collect randomized controlled trial (RCT) of CAF+CTG compared to TUN+CTG in the treatment of Miller class Ⅰ or Ⅱ gingival recession on September 1, 2022. Results There were 8 RCTs with 305 patients (454 recession sites) participating. The results of the Meta-analysis revealed that, in terms of mean root coverage (MRC) of main indicators, no significant difference was found between the CAF group and the TUN group in both short- and long-term results, which were [MD: 1.45%, 95%CI (-2.93%, 5.82%), P=0.52] and [MD: -0.70%, 95%CI (-6.41%, 5.00%), P=0.81]. However, the CAF group outperformed the TUN group in the long term [MD: 5.69%, 95%CI (0.87%, 10.50%), P=0.02], and the results of complete root coverage (CRC) analysis were similar to those of MRC. In the short term, the TUN group grew keratinized gingiva significantly faster than the CAF group [MD: -0.38 mm, 95%CI (-0.67 mm, -0.10 mm), P=0.008]. Long-term findings revealed no significant difference between the two groups [MD: -0.26 mm, 95%CI (-0.94 mm, 0.43 mm), P=0.46]. The TUN group’s secondary index root coverage esthetic score (RES) was statistically significantly higher than the CAF group’s [MD: 0.62, 95%CI (0.28, 0.96), P=0.000 3]. Given that there were few results included in the literature and the heterogeneity was too great, no significant difference was observed in the postoperative VAS pain index score [MD: 0.53, 95%CI (-1.96, 3.03), P=0.68]. Conclusion This study discovered that both CAF+CTG and TUN+CTG can achieve good root coverage in treating gingival recession, with CAF outperforming TUN and both groups achie-ving good long-term stability. After the operation, the TUN group had a higher RES than the CAF group. Given the limitations of this study, more high-quality studies are needed in the future to demonstrate the efficacy of TUN in gingival retraction surgery.

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

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

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Heterogeneity of Wnt1-Cre-marked and Pax2-Cre-marked first branchial arch cranial neural crest cells in mice
Xu Jue, Liu Shuang, Fu Honggao, Shao Meiying, Chen Meiling, Huang Zhen
West China Journal of Stomatology    2024, 42 (4): 435-443.   DOI: 10.7518/hxkq.2024.2023374
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Objective This study aimed to explore the heterogeneity and gene ontology of Wnt1-Cre-marked and Pax2-Cre-marked first branchial arch cranial neural crest cells (CNCs) in mice. Methods The embryos of Wnt1-Cre;R26RmTmG and Pax2-Cre;R26RmTmG at embryonic day (E)8.0-E9.25 were collected for histological observation. We performed immunostaining to compare green fluorescent protein (GFP)-positive CNCs in Pax2-Cre;R26RAi9 and Wnt1-Cre;R26RAi9 mice at E15.5. Single-cell RNA sequencing (scRNA-seq) was used to analyze the first branchial arch GFP-positive CNCs from Wnt1-Cre;R26RmTmG and Pax2-cre;R26RmTmGmice at E10.5. Real time fluorescence quantitative polymerase chain reaction (q-PCR) was performed to validate the differential genes. Results Wnt1-Cre-marked and Pax2-Cre-marked CNCs migrated from the neural plateto first and second branchial arches and to the first branchial arch, respectively, at E8.0. Although Wnt1-Cre-marked and Pax2-Cre-marked CNCs were found mostly in cranial-facial tissues, the former had higher expression in palate and tongue. The results of scRNA-seq showed that Pax2-Cre-marked CNCs specifically contributed to osteoblast differentiation and ossification, while Wnt1-Cre-marked CNCs participated in limb development, cell migration, and ossification. The q-PCR data also confirmed the results of gene ontology analysis. Conclusion Pax2-Cre mice are perfect experimental animal models for research on first branchial arch CNCs and derivatives in osteoblast differentiation and ossification.

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

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From “Empirical Surgery” to “Precision Surgery”: establishment and clinical application of precision orthognathic surgery system
Wang Xudong, Wei Hongpu, Li Biao.
West China Journal of Stomatology    2023, 41 (5): 491-501.   DOI: 10.7518/hxkq.2023.2023152
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Orthognathic surgery, which involve osteotomy and repositioning of the maxillomandibular complex, has recently emerged as a crucial method of correcting dentofacial deformities. The optimal placement of the maxillomandibular complex holds utmost significance during orthognathic surgery because it directly affects the surgical outcome. To accurately achieve the ideal position of the maxillomandibular complex, with the rapid advancements in digital surgery and 3D-printing technology, orthognathic surgery has entered an era of “Precision Surgery” from the pervious “Empirical Surgery.” This article provides comprehensive insights into our extensive research and exploration of the treatment modality known as “precision orthognathic surgery” over the years. We also present the technical system and application in“Ortho+X” treatment modality to offer valuable references and assistance to our colleagues in the field.

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Intentional replantation for the retreatment of mandibular second molar: a case report
Cai Meijuan, Xiang Shaowen, Xie Chengjie, Ouyang Chuhong, Tong Fangli
West China Journal of Stomatology    2023, 41 (4): 471-477.   DOI: 10.7518/hxkq.2023.2022487
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When the use of root canal retreatment and apical surgery experiences difficulty in treating endodontic diseases, intentional replantation is an optional clinical technique used to retain the tooth. A 28-year-old female complained of chewing discomfort at the mandibular second molar after undergoing root canal treatment 3 month ago. History record and radiographic examination revealed that a C-shaped root canal system was filled with gutta-percha in the mandibular second molar. A radiolucency area existed at the root furcal area with a thin canal wall in the distal and mesial roots. Intentional replantation was used to treat this tooth. The clinical and radiographic results showed that intentional replantation and nano-biomaterial application facilitated infection control, tooth retention, and periodontal tissue regeneration.

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Effects of sitagliptin activation of the stromal cell-derived factor-1/CXC chemokine receptor 4 signaling pathway on the proliferation, apoptosis, inflammation, and osteogenic differentiation of human periodontal ligament stem cells induced by lipopolysaccharide
Tang Xiaoxue, Zhou Zheng, Li Qiqi, Jiang Dandan
West China Journal of Stomatology    2024, 42 (1): 37-45.   DOI: 10.7518/hxkq.2024.2023213
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Objective This study aimed to investigate the effects of sitagliptin on the proliferation, apoptosis, inflammation, and osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs) in lipopolysaccharide (LPS)-induced inflammatory microenvironment and its molecular mechanism. Methods hPDLSCs were cultured in vitro and treated with different concentrations of sitagliptin to detect cell viability and subsequently determine the experimental concentration of sitagliptin. An hPDLSCs inflammation model was established after 24 h of stimulation with 1 µg/mL LPS and divided into blank, control, low-concentration sitagliptin (0.5 µmol/L), medium-concentration sitagliptin (1 µmol/L), and high-concentration sitagliptin (2 µmol/L), high-concentrationsitagliptin+stromal cell derived factor-1 (SDF-1)/CXC chemokine receptor 4 (CXCR4) pathway inhibitor (AMD3100) (2 µmol/L+10 µg/mL) groups. A cell-counting kit-8 was used to detect the proliferation activity of hPDLSCs after 24, 48, and 72 h culture. The apoptosis of hPDLSCs cultured for 72 h was detected by flow cytometry. After inducing osteogenic differentiation for 21 days, alizarin red staining was used to detect the osteogenic differentiation ability of hPDLSCs. The alkaline phosphatase (ALP) activity in hPDLSCs was determined using a kit. The levels of inflammatory factors [tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6] in the supernatant of hPDLSCs culture were detected by enzyme-linked immunosorbent assay. The mRNA expressions of osteogenic differentiation genes [Runt-associated transcription factor 2 (RUNX2), osteocalcin (OCN), osteopontin (OPN)], SDF-1 and CXCR4 in hPDLSCs were detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR). Western blot analysis was used to determine SDF-1 and CXCR4 protein expression in hPDLSCs. Results Compared with the blank group, the proliferative activity, number of mineralized nodules, staining intensity, ALP activity, and RUNX2, OCN, OPN mRNA, SDF-1, and CXCR4 mRNA and protein expression levels of hPDLSCs in the control group significantly decreased. The apoptosis rate and levels of TNF-α, IL-1β, and IL-6 significantly increased (P<0.05). Compared with the control group, the proliferative activity, number of mineralized nodule, staining intensity, ALP activity, and RUNX2, OCN, OPN mRNA, SDF-1, and CXCR4 mRNA and protein expression levels of hPDLSCs in low-, medium-, and high-concentration sitagliptin groups increased. The apoptosis rate and levels of TNF-α, IL-1β, and IL-6 decreased (P<0.05). AMD3100 partially reversed the effect of high-concentration sitagliptin on LPS-induced hPDLSCs (P<0.05). Conclusion Sitagliptin may promote the proliferation and osteogenic differentiation of hPDLSCs in LPS-induced inflammatory microenvironment by activating the SDF-1/CXCR4 signaling pathway. Furthermore, it inhibited the apoptosis and inflammatory response of hPDLSCs.

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Case of clear-cell oncocytoma of parotid gland and literature review
Zhu Wencui, Zhang Yinglin, Li Fangfang, Li Guiyun, Zhang Peng, Fang Hui, Bian Li
West China Journal of Stomatology    2024, 42 (1): 126-134.   DOI: 10.7518/hxkq.2024.2023185
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Oncocytoma is a benign tumor of the salivary gland. Its incidence is very low and very seldom documen-ted in literature. Clear-cell dominant oncocytoma is even less common. The tumor’s clinical symptoms and imaging results are nonspecific, so distinguishing other salivary gland tumors (such as oncocytic carcinoma) from clear-cell renal carcinoma is difficult, possibly leading to misdiagnosis and maltreatment. Here, a case of clear-cell dominant oncocytoma was presented, and the relevant literature was evaluated to investigate the diagnosis and management of clear-cell dominant oncocytoma.

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Evaluation of the accuracy of a fully digital method of measuring sagittal condylar inclination
Zhou Zheqing, Wang Siyu, Yuan Quan, Yue Li, Yang Shengtao
West China Journal of Stomatology    2024, 42 (1): 67-74.   DOI: 10.7518/hxkq.2024.2023242
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Objective This clinical study aimed to evaluate the accuracy of a fully digital technique for measuring sagittal condylar inclination (SCI), as well as validating whether differences existed between the left and right SCI values of the same participant, to provide a reference for clinical practice. Methods Ten participants with good occlusal relationship and normal temporomandibular joint were recruited. Three methods were used to measure the SCI values of the participants, namely, A (mechanical facebow transferring and mechanical articulator-based measuring method with physical protrusive interocclusal registration), B (face scan-based virtual facebow and virtual articulator-based measuring method with digital protrusive interocclusal registration), and C (jaw motion tracking system-based measuring method). With the group subjected to methods A and C as the control, the SCI values obtained by the three methods were statistically analyzed. The left and right SCI values of the same participant were also compared. Results The left and right SCI values measured by method A were 41.70°±7.09° and 42.80°±8.62°, those by method B were 35.09°±12.49° and 37.63°±12.10°, and those by method C were 39.43°±8.72° and 38.45°±6.91°. No significant difference existed among the SCI values measured by the three methods (P>0.05). Meanwhile, no statistical difference existed between the SCI values on the left and right sides of the same participant (P>0.05). Conclusion The accuracy of the virtual facebow and digital protrusive occlusal registration based SCI measuring method was the same as that of mechanical facebow based and jaw motion tracking system-based methods. The SCI values on the left and right sides of the same participant were similar. Clinically, an appropriate SCI measurement and setting strategy can be selected based on the actual situations.

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Analysis of clinical changes and magnetic resonance imaging features of 37 patients with temporomandibular joint disc condylar complex with anterior disc displacement without reduction
Yan Sen, Qiao Yongming, Duan Liangwei
West China Journal of Stomatology    2024, 42 (1): 82-88.   DOI: 10.7518/hxkq.2024.2023219
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Objective This study aims to investigate clinical outcomes, imaging changes, and age differences with regard to temporomandibular joint disc condylar complex with anterior disc displacement without reduction (ADDWoR). Methods A total of 37 patients (45 lateral joints) with ADDWoR who were admitted to The First Affiliated Hospital of Zheng Zhou University from January 2016 to June 2023 were selected. The patients were composed of 4 males and 33 females and had an average age of 23.5 years. The average course of the disease was 14.4 months. Clinical and magnetic resonance imaging (MRI) data were collected at the end of initial diagnosis and follow-up, and the length and thickness of the articular disc, the angle of the disc condyle, and the height of the condyle were measured. The statistical significance of the changes was assessed using SPSS 25.0 software package. Results At the end of follow-up, disc displacement in three patients (three lateral joints) was healed. Approximately 48.4% of the patients felt that limitation of mandibular movement was not alleviated; 58.3% of patients reported that pain during mouth opening was not reduced; 54.5% reported pain while chewing; 33.3% of the patients showed facial deviation, and only one showed remission. The mean disk-condyle angle increased from 61.63° to 67.81°. The average length of articular disc shortened from 8.20 mm to 7.27 mm, and the height of the condyle significantly decreased from 23.17 mm to 22.76 mm (P<0.05). The absorption ratio of the condyle increased, and no significant differences in the changes of joint soft and hard tissues between the adolescent and adult groups (P>0.05). Conclusion In different age groups of patients with ADDWoR, clinical symptoms cannot be completely relieved. The disc is anteriorly displaced and shortens, condylar height decreases, and secondary facial asymmetry and mandibular retraction occur.

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