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Research progress on association between periodontitis and inflammatory bowel disease

Journal of Prevention and Treatment for Stomatological Diseases.2024;32(9):715-721. doi: 10.12016/j.issn.2096-1456.202330546

Inflammatory bowel disease (IBD) is a group of chronic, non-specific inflammatory diseases of the gastrointestinal tract including primarily Crohn’s disease and ulcerative colitis, which are affected by multiple factors. Periodontitis is a type of disease characterized by plaque biofilm as the initiating factor and chronic destruction of alveolar bone via resorption. An increasing number of studies have reported a correlation between periodontitis and IBD, but the relationship between the two remains unclear. In this study, we explore the internal relationships between the two diseases from three dimensions, including epidemiological, biological, and associated treatment evidence. Based on epidemiological evidence, periodontitis was found to be associated with an increased risk of IBD, which also affects periodontal health, although the bidirectional correlation needs to be further studied by expanding the number of data sources. From the biological evidence, both clinical studies and animal experiments show that IBD and periodontitis are interconnected. Based on evidence from association therapy, drugs that are beneficial for the treatment of IBD are also effective in the prevention and treatment of periodontitis. In addition, drugs that are good for improving periodontitis can also significantly alleviate IBD. The interaction mechanism between IBD and periodontitis includes the microbial pathway and the immunization route. The microbial pathway refers to the increase in the probability of intestinal tract ectopic colonization by oral bacteria transmitted through the mouth-gut axis or blood, resulting from the increase in the proportion of opportunistic pathogens in the oral cavity of patients with periodontitis and the influence of IBD on the secretion of gastric juice and the balance of intestinal flora. These microorganisms further aggravate IBD inflammation by releasing virulence factors, destroying the intestinal mucosal barrier, and triggering inflammatory responses. In periodontitis, adaptive immunity is activated in the mouth, leading to the production of a large number of immune cells, including Th17 containing the intestinal homing marker α4β7 integrin on their surface. Increased ligand expression of α4β7 integrin in the intestinal mucosa of patients with IBD accelerates oral Th17 cell transfer to the intestine, thereby worsening intestinal inflammation. In parallel, the abnormal expression of cytokines, such as TNF-α, IL-1β, IL-10, IL-6, IL-21, soluble CD40 ligand (sCD40L), IL-23, and INF-γ, in the oral cavity of patients with IBD was observed, suggesting that IBD may affect periodontitis through immunity. These cytokines represent targets for the treatment of both diseases and provide a research direction for their prevention and treatment in the future.

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Research progress on the correlation between plaque biofilm and peri-implantitis

WEN Yan ; WANG Yulan

Journal of Prevention and Treatment for Stomatological Diseases.2024;32(9):730-736. doi: 10.12016/j.issn.2096-1456.202330512

Bacterial overproliferation and virulence factors in plaque biofilms can cause inflammation of soft and hard tissues around the implant, resulting in peri-implantitis. If not well controlled, severe peri-implantitis can lead to failure of implant osseointegration and implant loosening and loss. Currently, peri-implantitis can be treated by surgical and non-surgical treatment such as mechanical debridement and chemotherapy, but there remain problems related to the unpredictable therapeutic effect and high recurrence rate. Therefore, gaining a comprehensive understanding of the relationship between plaque biofilm formation and peri-implantitis is crucial for the prevention and treatment of peri-implantitis. In this article, we comprehensively review current research on the specific composition and formation process of biofilms and the influence of implant material characteristics on biofilm formation. The results of the research review indicated that peri-implantitis biofilms are composed of extracellular matrix, with a predominant population of anaerobic Gram-negative bacteria embedded within. The formation process includes the acquisition of an acquired membrane, microbial adhesion, and biofilm detachment and dispersion. Biofilm formation is primarily influenced by the implant surface roughness, surface free energy (SFE), and material properties. Current strategies for biofilm removal around implants mainly involve implant surface coating techniques, mechanical debridement, chemical agents, laser therapy, and photodynamic therapy; however, the therapeutic outcomes remain uncertain. The future research direction will be based on the characteristics of the plaque biofilm around the implant, combined with cutting-edge methods, such as nanotechnology, immunotherapy, and gene therapy, to continuously prevent the formation of plaque biofilm on the surface of the implant to prevent and treat peri-implantitis.

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Clinical observation on the influence of apical dense bone islands on orthodontic tooth movement

LIANG Ye ; SHEN Longduo ; CAO Fang ; DAI Jingtao

Journal of Prevention and Treatment for Stomatological Diseases.2024;32(10):780-788. doi: 10.12016/j.issn.2096-1456.202440207

Objective : To explore the influence of apical dense bone islands on tooth movement during orthodontic treatment and its complications, and to provide a reference for orthodontic clinical treatment. Methods : This study obtained approval from the hospital ethics committee. A retrospective analysis was conducted on 33 patients with apical dense bone islands who received full-mouth fixed orthodontic treatment in the Orthodontics Department of Huizhou Stomatological Hospital from 2018 to 2022. Cone-beam CT (CBCT) was used to determine the location, distribution, and wrapping severity of the apical dense bone islands before treatment. The number of loose teeth located in the apical dense bone islands and the degree of external apical root resorption in the apical area of teeth were analyzed before treatment, immediately after treatment, and 12 months after treatment. Results: There were 33 orthodontic patients (aged 11 to 42 years, with an average age of 16.7 years and a median age of 15 years) included in this study, including 12 males (36.4%) and 21 females (63.6%). All apical dense bone islands involved a single tooth located in the mandible, mainly in the premolar-molar area. No gender differences were present in the location of the dense bone islands (P>0.05). The apical dense bone islands were mildly wrapped in 23 cases (69.7%), moderately wrapped in 10 cases (30.3%), and severely wrapped in no cases. No difficulty in tooth movement or incomplete closure of extraction space was found in the apical dense bone islands with different degrees of wrapping during orthodontic treatment. For teeth located in apical dense bone islands, 1 patient (3.0%) had loose teeth before treatment, 6 patients (18.2%) had loose teeth after treatment, and 2 patients (6.1%) had loose teeth 12 months after treatment. The number of patients with grade I loose teeth increased after treatment and 12 months after treatment. There was a statistically significant difference in the number of loose teeth before and after treatment (P<0.05), no statistically significant difference in the number of loose teeth before treatment and 12 months after treatment (P>0.05), and no statistically significant difference in the number of loose teeth after treatment and 12 months after treatment (P>0.05). After treatment, apical dense bone islands showed mild resorption in 26 cases (78.8%), moderate resorption in 7 cases (21.2%), and severe resorption in no cases. The apical dense bone islands showed mild resorption in 25 cases (75.8%), moderate resorption in 8 cases (24.2%), and severe resorption in no cases 12 months after treatment. For the severity of root resorption, there was a statistically significant difference between before and after treatment (P<0.05) as well as between before treatment and 12 months after treatment (P<0.05). However, no statistically significant difference was observed between after treatment and 12 months after treatment (P>0.05). Conclusion Apical dense bone islands were not found to affect tooth movement during orthodontic treatment. After orthodontic treatment, the number of loose teeth increased and mild-to-moderate tooth external apical root resorption occurred, which may be a potential risk of external apical root resorption. Thus, it is recommended to pay close attention during the orthodontic process.

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Research on deep learning assisted diagnosis technology of jaw lesions using panoramic radiographs

GAO Ge ; LIU Chang ; ZENG Mengyu ; PENG Junjie ; GUO Jixiang ; TANG Wei

Journal of Prevention and Treatment for Stomatological Diseases.2024;32(10):789-796. doi: 10.12016/j.issn.2096-1456.202440248

Objective : To study the effect of deep learning applied to the assisted diagnosis of radiolucent lesions and radiopaque lesions of the jaws in panoramic radiography and to reduce the missed diagnosis, with early screening to assist doctors to improve the diagnostic accuracy. Methods: This study was approved by the Ethics Committee of the West China Stomatological Hospital of Sichuan University. The YOLO v8m-p2 neural network model was constructed with 443 panoramic images as a subject to read. The labeled images were divided into 354 training sets, 45 verification sets, and 44 test sets, which were used for model training, verification, and testing. Accuracy, recall, F-1 score, G score, and mAP50 were used to evaluate the detection performance of the model. Results: 443 panoramic images covered the common benign lesions of the jaw, the number of radiolucent lesions of the jaw was 318, containing dentigerous cyst, odontogenic keratocyst, and ameloblastoma. The number of radiopaque lesions was 145, containing idiopathic osteosclerosis, odontoma, cementoma, and cemento-osseous dysplasia; the samples are well representative. The accuracy of the YOLO v8m-p2 neural network model in identifying jaw lesions was 0.887, and the recall, F-1 score, G score, and mAP50 were 0.860, 0.873, 0.873, and 0.863, respectively. The recall rates of dentigerous cyst, odontogenic keratocyst, and ameloblastoma were 0.833, 0.941, and 0.875, respectively. Conclusion YOLO v8m-p2 neural network model has good diagnostic performance in preliminary detection of radiolucent and radiopaque lesions of the jaws in panoramic radiography and multi-classification monitoring of radiolucent lesions of jaws, which can assist doctors to screen jaw diseases in panoramic radiography.

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Advances in the differentiation of human induced pluripotent stem cells into osteoblasts

LIAO Lingzi ; SONG Yameng ; LIU Meixuan ; LI Siyi ; ZHOU Ping

Journal of Prevention and Treatment for Stomatological Diseases.2024;32(10):805-813. doi: 10.12016/j.issn.2096-1456.202440158

Bone diseases, such as osteoporosis and osteoarthritis, have emerged as pressing public health concerns requiring immediate attention and resolution. Cellular therapy and tissue engineering techniques are among the most promising therapeutic approaches for such conditions. Human induced pluripotent stem cells (hiPSCs) possess remarkable capacity for indefinite self-renewal in vitro and the ability to differentiate into all somatic cell types originating from the three germ layers, thereby making them a promising source of osteoblasts. Consequently, it is crucial to establish a well-delineated system for osteogenic differentiation of hiPSCs in vitro, with the aim to generate osteoblast-like cells that conform to clinical application standards. Numerous research teams have achieved substantial advancements in both the direct osteogenic differentiation of hiPSCs and the indirect pathway via mesenchymal stem cells. In this article, we provide a comprehensive review of these two osteogenic differentiation pathways and their current applications, with the aim of serving as a valuable reference for bone regeneration technologies. Current research efforts have relied on embryoid body formation and monolayer induction methods utilizing biomaterials to develop a system that facilitates in vitro culture and osteogenic differentiation of hiPSCs. However, the existing research is primarily constrained by unclear system components and low efficiency. Therefore, the development of a stepwise and three-dimensional induction system based on stringent regulation by specific compounds is a primary research direction for the future.

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Clinical effect of a guided resin cementation technique in the treatment of vertical food impaction

HUO Jingyi ; ZHAN Weisheng ; HAO Liang ; REN Jie ; WANG Min ; LUO Yun

Journal of Prevention and Treatment for Stomatological Diseases.2021;29(9):624-628. doi:10.12016/j.issn.2096-1456.2021.09.008

Objective: To explore the clinical effect of a guided resin cementation technique on vertical food impaction symptoms and to provide a new method for the treatment of vertical food impaction. Methods : Treatment of 76 patients with vertical food impaction with guided resin cementation was performed. A specially fabricated contact shaping wire was used to aid the shaping of the contact. Cementation was applied under a rubber dam with the total-etch technique with flowable composite resin. Patient subjective perception was recorded after treatment (i.e., “totally relieved”=3, “significantly improved”=2, “slightly improved”=1 and “no change”=0). Follow-up visits lasted for one year. Scores of 1 to 3 were recorded as effective. The efficiency rates at different times were calculated. Results: Patient subjective perceptions scored 2.47, 2.21, 1.79, 1.30 and 0.97 on the day immediately after and 1, 3, 6, and 12 months after treatment, respectively. There were significant differences among scores at each time point (P<0.01). The Efficacy rate reached 91.78% immediately after treatment and was sustained above 50% within half a year. Management of resin debonding or fracture successfully relieved the symptoms again. Conclusion The guided resin cementation technique relieves vertical food impaction symptoms immediately, and the effect of the guided resin cementation technique is maintained for a short period of time. Management of resin debonding or fracture helps consolidate treatment outcomes.

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Research progress on tetrabutylammonium dihydrogen trifluoride as a substitute for hydrofluoric acid used for porcelain surface treatment

CHEN Jing ; CHEN Wenchuan

Journal of Prevention and Treatment for Stomatological Diseases.2021;29(9):629-633. doi:10.12016/j.issn.2096-1456.2021.09.009

Hydrofluoric acid is a common surface treatment agent for glass ceramic restorations before bonding. However, the use of hydrofluoric acid has a high safety risk, so the search for hydrofluoric acid substitutes has been a research hotspot. Tetrabutylammonium dihydrogen trifluoride is a kind of fluoride, whose chemical activity is lower than that of hydrofluoric acid, so it’s safer, and the surface morphology changes on glass ceramics caused by it are smaller and more superficial. At present, the vast majority of laboratory studies and clinical case reports indicate that the mechanical strength and bonding strength of glass ceramics treated with tetrabutylammonium dihydrogen trifluoride can meet the clinical requirements. In the future, according to the research results, the performance of porcelain surface treatment agents containing tetrabutylammonium dihydrogen trifluoride can be further improved, and more hydrofluoric acid substitutes may be developed. In this review, the research progress of tetrabutylammonium dihydrogen trifluoride as a substitute for hydrofluoric acid is reviewed in terms of the influence of the surface morphology, mechanical strength, and bonding strength of glass ceramics.

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Research progress on nano-calcium phosphate modified dental materials for the prevention and treatment of dental pulp diseases

HUANG Yannan ; CHENG Lei

Journal of Prevention and Treatment for Stomatological Diseases.2021;29(9):634-637. doi: 10.12016/j.issn.2096-1456.2021.09.010

Nanomaterials usually refer to tiny particles with a diameter of 1-100 nm, which often have unique physicochemical properties and are one of the main areas of research interest for development of dental biomaterials. Nano-calcium phosphate modified dental materials have been widely used in pit and fissure sealing, dental resin restoration, tooth adhesion, and root canal sealing. The current research shows that the dental material modified by nano-calcium phosphate has stronger mechanical properties and shows long-term calcium and phosphorus ion release and excellent ion recharging ability, which can promote the remineralization of tooth hard tissue and has good prospects for application. However, it is difficult to accurately simulate the complex environment of the oral cavity. Therefore, the biocompatibility, cytotoxicity and effect of clinical application of nano-calcium phosphate modified dental materials still needs further study. This review summarizes and discusses the recent research progress regarding nano-calcium phosphate modified dental materials in the prevention and treatment of dental pulp diseases.

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Research progress on the antibacterial properties of dental resin materials

ZHOU Zeying ; ZHANG Jingyue ; NIU Ju ; LIU Dandan ; ZHAO Wendi ; LIU Xiaoqiu

Journal of Prevention and Treatment for Stomatological Diseases.2021;29(9):638-643. doi: 10.12016/j.issn.2096-1456.2021.09.011

Dental resin materials have been widely used in the treatment of dental defects. However, the polymerization shrinkage of the resin materials tends to cause microleakage and accumulation of bacterial plaque, which leads to secondary dental caries. Endowing dental resin with antibacterial properties is an important way to solve this problem. Adding antibacterial agents to dental resin is the main method to give it antibacterial properties. Antimicrobial agents are mainly divided into three types: release type, non-release type and mixed type. In terms of antibacterial effects, the selection and addition of antibacterial agents will affect the antibacterial and mechanical properties of dental resin materials; and the long-term antibacterial effect of antimicrobial agents in the oral cavity remains to be verified; as antimicrobial agents or other environmental factors can lead to drug resistance and even dormant persistent bacteria. In recent years, researchers have been committed to improving the antibacterial effect by modifying antibacterial agents. The sustained release of antimicrobial agents via carriers is also the main research direction. This paper reviews the research progress on the antibacterial properties of dental resin materials.

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The impact of masticatory dysfunction caused by occlusal disharmony on cognitive function

OU Yanzhen ; LI Baosheng ; CAI Qing ; JIANG Jiayang ; Jiayang Zhuohua ; MENG Weiyan

Journal of Prevention and Treatment for Stomatological Diseases.2021;29(9):644-648. doi:10.12016/j.issn.2096-1456.2021.09.012

As the world’s population ages, age-related cognitive decline and dementia are becoming important challenges for geriatric care. Despite the ongoing search for solutions to address cognitive decline, effective interventions have not yet been established. There is increasing evidence from clinical, epidemiological, and animal studies that masticatory dysfunction due to occlusal disharmony is a risk factor for cognitive decline and an increased incidence of dementia. The mechanisms may involve altered nutritional intake, decreased cerebral blood flow, chronic stress, and hippocampal morphological function. These findings suggest that maintaining and adequately restoring the entire masticatory system has a positive impact for the prevention of cognitive decline.

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