1.Evidence-based medicine research for the treatment of oral submucous fibrosis
Journal of Prevention and Treatment for Stomatological Diseases 2024;32(12):907-915
Oral submucous fibrosis (OSF) is an oral potentially malignant disorader that may be closely related to betel chewing and other factors. The pathogenic mechanism of OSF is still unclear, and there is no cure for OSF. Currently, there are many clinical treatments for OSF, such as medications, including steroids, pentoxifylline, lycopene, turmeric, salvia miltiorrhiza, and aloe vera, lasers, and surgery. In order to evaluate the safety and efficacy of these methods to improve the maximum mouth opening, alleviate the burning sensation, increase tongue flexibility, and other symptoms that accompany OSF, researchers have completed some evidence-based studies in recent years. We searched PubMed, Embase, Web of Science, The Cochrane Library, CNKI, Wanfang, and VIP databases for systematic reviews or meta-analyses of OSF research and treatment published over the last 10 years (July 2014-July 2024). Current evidence-based studies have shown that pentoxifylline, hyaluronidase combined with steroids, lycopene, curcumin, salvia miltiorrhiza combined with steroids, and aloe vera are effective in improving maximum mouth opening and alleviating the burning sensation in patients with OSF. The evidence levels of hyaluronidase combined with steroids, lycopene, curcumin, salvia miltiorrhiza combined with steroids, and aloe vera were all A, and pentoxifylline was B. Lycopene was more effective than other positive drugs in improving maximum mouth opening in patients, and aloe vera was more effective than positive drugs in improving the burning sensation in the early stage of treatment. In addition, antioxidants are good for improving OSF symptoms and have promising application. Lasers can improve maximum mouth opening and alleviate pain and other OSF symptoms, but laser treatment is costly and the level of evidence is C. Surgery is effective in improving maximum mouth opening, but it is traumatic and the level of evidence is C. However, the current evidence-based data are not of high quality, and additional well-designed multi-center, large-sample, randomized controlled clinical trials with long follow-up periods and standardized outcome indicators are needed in the future.
2.Restoration of a dental defect in a patient with ectodermal dysplasia: a case report and literature review
LV Hong ; LIU Qinghui ; LI Jiafu ; CAI Hui ; BU Honghu ; PU Yiming ; GUO Jincai
Journal of Prevention and Treatment for Stomatological Diseases 2024;32(4):287-295
Objective:
To explore the treatment options for congenitally missing teeth in patients with ectodermal dysplasia and provide a clinical reference.
Methods:
A patient with ectodermal dysplasia with a concave midface, anterior protrusion of the chin, and underdevelopment of the lower third of the face presented with congenital loss of multiple maxillary teeth, malocclusion of the remaining teeth, congenital loss of mandibular dentition, small dental arches, and upper and lower alveolar bone hypoplasia. The patient was treated by means of a removable partial maxillary prosthesis, implants in the anterior region of the lower mandible designed with the assistance of digital guides, and bar-clamped implant-overlay prostheses. A literature review of the protocol for the treatment of this condition was also conducted.
Results:
In addition to good retention and stability after denture wear, an excellent occlusal relationship, improvement of the patient's facial appearance, including upper and lower lip fullness, more equal balancing of the lower and middle 1/3 of the face, and improved masticatory function were achieved. The results of the literature review showed that patients with ectodermal dysplasia who are congenitally edentulous usually have a complex intraoral situation that makes restoration difficult, and common restorative modalities for these patients include fixed bridges, removable partial dentures, complete dentures, overdentures, and implant prostheses, which need to be selected according to the actual intraoral situation of each patient. Currently, there is no consensus on the treatment of congenitally missing teeth in patients with ectodermal dysplasia, and some scholars have suggested that fixed restorations be recommended for patients with fewer missing teeth, while the option of removable or implant-covered denture restorations should be given to patients with more missing teeth, with removeable prostheses for underage patients that are replaced with permanent fixed prostheses when the jaws have stabilized.
Conclusion
In patients with ectodermal dysplasia with congenital tooth loss, all factors should be taken into account, and an individualized restorative plan should be developed.
3.Characteristics analysis of clinical trial registration for endodontic diseases based on the ClinicalTrials.gov and ChiCTR databases
Journal of Prevention and Treatment for Stomatological Diseases 2024;32(8):598-605
Objective To summarize the clinical registration data of endodontic diseases registered in ClinicalTri-als.gov in the United States and Chinese Clinical Trial Registry(ChiCTR),and analyze the registration characteristics at home and abroad.Methods We searched the clinical studies related to endodontic disease registered in the two data-bases from January 1,2000,to August 20,2023.We extracted and analyzed the information from clinical studies relat-ed to endodontic diseases.The extracted content included information on the registration region,registration year,trial title,research direction,sample size,trial progress,study type,trial design,blinding method,clinical trial phase,and participating institutions.Results The two databases contained a total of 536 191 registered items,of which 634 were endodontic diseases.Clinical trials in the registry of endodontic diseases involved 43 countries,of which the top three were Egypt(188 items),China(130 items),and the America(46 items).In addition,the number of registrations of clini-cal trials on endodontic diseases has significantly increased since 2015.The research directions were mainly pulposis(434 items),caries(106 items),and periapical diseases(77 items),which mostly involved etiology,drug intervention,surgical intervention,new technology,and new materials.Moreover,there were 430 clinical trials(67.82%)with a sam-ple size<100 and 185(29.18%)with a sample size of 100-999.The progress status at the time of registration showed the largest number of completed trials,accounting for 286 items(45.11%),followed by unknown(125 items),recruiting(110 items),and not yet recruiting(81 items).The main research types were intervention studies(546 items,86.12%),and the main design model was randomized parallel controlled trials(473 items,74.61%).Additionally,423 items(66.72%)were marked using the blind method,mainly double-blind trials(195 items),followed by other/unmarked(123 items,19.40%)and open study(88 items,13.88%).Furthermore,the largest number of items in the study phase were marked other/unlabeled(388 items),followed by phaseⅡ study(69 items)and preliminary study(62 items).Addi-tionally,611 items(96.37%)were clinical trials with a number of participating institutions<3,and 23 items(3.63%)had a number of participating institutions≥3.Conclusion The number of clinical trials registered for endodontic dis-eases is generally on the rise,but it is still relatively small.The quality of the study design needs to be enhanced,and the registration information in the study phase needs to be improved.Moreover,the number of multicenter trials is small.In the future,we should fully mobilize the talent advantages of well-known stomatology majors in China,take the lead in conducting high-quality,multi-center clinical research,and realize the transformation of results.
4.Research progress on induced autophagy for the treatment of oral cancer
CHEN Weimin ; GUO Jincai ; XIE Hui
Journal of Prevention and Treatment for Stomatological Diseases 2023;31(8):598-602
Oral cancer has a high degree of malignancy, easily recurs, readily metastasizes and poor progonsis. Autophagy is a catabolic process induced in cells under stressful conditions. In recent years, studies have found that the activation of autophagy in epithelial cells can inhibit carcinogenesis and activate pathways such as mTOR and MAPK to activate autophagy in oral cancer cells and inhibit their survival. Inducing autophagy can degrade eukaryotic initiation factor 4E protein and inhibit oral cancer metastasis. Inducing autophagy in oral cancer cells can inhibit their proliferation and promote their apoptosis. Adding autophagy inducers to the treatment can help improve its efficacy and patient survival compared with chemoradiotherapy alone. In addition, the induction of autophagy in oral cancer cells can improve the body's immune function and enhance the efficacy of oral cancer immunotherapy. This article summarizes the relationship between autophagy and oral cancer and the role of induced autophagy in the treatment of oral cancer with the combined application of chemoradiotherapy and immunotherapy. The goal is to provide new ideas for inducing autophagy during the treatment of oral cancer, improving the therapeutic effect of oral cancer and the survival rate of patients. At present, the mechanism of action of induced autophagy in the treatment of oral cancer is not clear. Future research should study its mechanism of action, improve its therapeutic effect on oral cancer and develop autophagy inducers to accurately regulate and induce autophagy during the treatment of oral cancer.
5.The application of expanded flaps in post-burn head, face and neck reconstruction
Chinese Journal of Plastic Surgery 2023;39(10):1153-1157
Skin and soft tissue expansion is an important treatment in the field of plastic surgery. It can not only enables patients to harvest a large number of new soft tissues with matching color, texture and thickness to that surrounding the defective area, but also repair different parts of the body through a variety of preoperative design and transfer method. In the case of shortage of donor sites and higher appearance requirement in head, face and neck, skin and soft tissue expansion is indispensable for the reconstruction of post-burn scar. This article reviews the related literature of skin and soft tissue expansion in the treatment of post-burn scar in head, face and neck, in order to be helpful to the above clinical work.
6.The application of expanded flaps in post-burn head, face and neck reconstruction
Chinese Journal of Plastic Surgery 2023;39(10):1153-1157
Skin and soft tissue expansion is an important treatment in the field of plastic surgery. It can not only enables patients to harvest a large number of new soft tissues with matching color, texture and thickness to that surrounding the defective area, but also repair different parts of the body through a variety of preoperative design and transfer method. In the case of shortage of donor sites and higher appearance requirement in head, face and neck, skin and soft tissue expansion is indispensable for the reconstruction of post-burn scar. This article reviews the related literature of skin and soft tissue expansion in the treatment of post-burn scar in head, face and neck, in order to be helpful to the above clinical work.
7.Relationship between defense style and family environment among male prisoners of different terms of imprisonment
Yonghang LI ; Jinying QIN ; Wenxuan LI ; Jincai ZHU ; Huagui GUO ; Xuan GU ; Wei HUANG ; Xuesong LI
Sichuan Mental Health 2022;35(3):272-276
ObjectiveTo explore the psychological defense styles and family environment among male prisoners of different terms of imprisonment, and to analyse the relationship between their psychological defense styles and family environment. MethodsA total of 200 male prisoners in a prison in Guangdong were randomly selected from April to June 2015, and they were classified into less than 5 years of imprisonment group (n=108) and 5 years or more imprisonment group (n=92). Their defense style and family environment were evaluated by Defense Style Questionnaire (DSQ) and Family Environment Scale-Chinese Version (FES-CV). Pearson correlation analysis was used to test the correlation between each scale score. ResultsThe factor scores of immature defense mechanism and intermediate defense mechanism of DSQ in the group with less than 5 years of imprisonment were lower than those in the group with 5 years or more imprisonment, with statistically significant differences (t=4.198, 1.137, P<0.01). The scores of FES-CV family intimacy, emotional expression and organizational factors in less than 5 years of imprisonment group were higher than those in 5 years or more imprisonment group (t=3.122, 2.993, 2.203, P<0.01), and the scores of contradiction factors were lower than those in 5 years or more imprisonment group (t=-3.682, P<0.01). The scores of DSQ immature, intermediate defense mechanism and concealment factor of male prisoners were negatively correlated with the scores of FES-CV family intimacy and emotional expression factor (r=-0.428~-0.172, P<0.05 or 0.01), and the scores of 4 factors in DSQ were all positively correlated with the scores of contradiction factor in FES-CV (r=0.175~0.384, P<0.05 or 0.01). ConclusionCompared with male prisoners with less than 5 years of imprisonment, those with 5 years or more are prone to adopt immature and intermediate defense mechanisms, and their family environments are characterized by apparent contradiction and a lack of family intimacy, emotional expression and organization. Furthermore, the defects of psychological defense mechanism of prisoners are related to their family environment.
8.Advances in the application of expanded flaps in post-burn head, face and neck reconstruction
Chinese Journal of Plastic Surgery 2022;38(9):1082-1086
Skin soft tissue expansion is of great importance to plastic surgery. Skin and soft tissue expansion is an important treatment in the field of plastic surgery. It can not only enables patients to harvest a large number of new soft tissues with matching color, texture and thickness, but also repair different parts of the body through a variety of preoperative design and transfer method . In the case of shortage of donor sites and higher appearance requirement in head, face and neck, skin and soft tissue expansion is indispensable for the reconstruction of post-burn scar. This article reviews the related literature of skin and soft tissue expansion in the treatment of post-burn scar in head, face and neck, in order to be helpful to the above clinical work.
9.Advances in the application of expanded flaps in post-burn head, face and neck reconstruction
Chinese Journal of Plastic Surgery 2022;38(9):1082-1086
Skin soft tissue expansion is of great importance to plastic surgery. Skin and soft tissue expansion is an important treatment in the field of plastic surgery. It can not only enables patients to harvest a large number of new soft tissues with matching color, texture and thickness, but also repair different parts of the body through a variety of preoperative design and transfer method . In the case of shortage of donor sites and higher appearance requirement in head, face and neck, skin and soft tissue expansion is indispensable for the reconstruction of post-burn scar. This article reviews the related literature of skin and soft tissue expansion in the treatment of post-burn scar in head, face and neck, in order to be helpful to the above clinical work.
10.Protocol of diagnosis and treatment for scalp avulsion injury
Xiao FENG ; Sheng YAN ; Yi SUN ; Jincai GUO ; Hangyan SHI ; Lei PAN ; Ye ZHAO ; Sufan WU
Chinese Journal of Medical Aesthetics and Cosmetology 2018;24(3):192-195
Objective To search for a treatment approach for scalp avulsion injury based on the clinical experiences and review of literature.Methods Twenty-six consecutive scalp avulsion cases were involved in the study:15 cases were complete scalp avulsion (5 including forehead skin) and 11 cases were partial scalp avulsion.Cranial bones exposure occurred in 16 cases,11 of which had a size over 4 × 4 cm2.The treatment methods were various:11 cases with microsurgical replantation,9 cases with skin grafting,4 cases with secondary skin grafting followed by multiple drilling of the calvarium,1 case with local flap,and 1 case with free flap.According to the clinical cases and literature reviews,authors tried to search for an optimal protocol.Results Patients with microsurgical replantation achieved the best recovery including hair growth.In case of not qualified or fail to microsurgical replantation,skin graft could be considered as an alterative step,whereas the result of it was no hair growth and usually scar healing.In summary,14 different clinical conditions followed with 10 surgical techniques were concluded in a route chart.Conclusions To achieve the optimal outcomes of scalp avulsion injury,proper techniques should be chosen according to the treatment protocols.


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