Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health, function, and aesthetics, ensuring both patient satisfaction and long-term stability. Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues, especially in severe cases. Therefore, close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment, along with diligent patient compliance throughout the entire process, is crucial for achieving favorable treatment outcomes. Moreover, long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success. This expert consensus, informed by the latest clinical research and practical experience, addresses clinical considerations for orthodontic treatment of periodontal patients, delineating indications, objectives, procedures, and principles with the aim of providing clear and practical guidance for clinical practitioners.
Humans ; Consensus ; Orthodontics, Corrective/standards* ; Periodontal Diseases/complications* ; Tooth Movement Techniques/methods* ; Practice Guidelines as Topic

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective:To explore the effect of family involvement, optimistic attitude, coping effectiveness, uncertainty reduction and symptom management (FOCUS) couple intervention on depression and psychological resilience of young and middle-aged stroke patients and their spouses.Methods:From June 2018 to January 2020, convenience sampling was used to select 76 young and middle-aged stroke patients and their spouses in a Class Ⅲ Grade A hospital in Zhengzhou as the research object. According to the order of hospitalization, patients were randomly divided into control group and experimental group, with 38 cases in each group. Control group implemented routine post-stroke nursing, and experimental group conducted the FOCUS couple intervention on the basis of control group. Depression and psychological resilience of patients and their spouses were evaluated with the Hamilton Depression Scale and Connor-Davidson Resilience Scale before and after intervention.Results:Finally, 37 cases in experimental group and 38 cases in control group completed the study. After intervention, the depression scores of patients and their spouses in experimental group were lower than those in control group, and the psychological resilience score and all dimension scores of patients and their spouses in experimental group were higher than those in control group, and the differences were statistically significant ( P<0.05) . Conclusions:The FOCUS couple intervention can reduce the degree of depression of stroke patients and their spouses, and improve the patients' psychological resilience, which has strong clinical significance.

OBJECTIVETo explore the clinical efficacy and partial mechanism of medicinal-cake-separated moxibustion for senile osteoporosis.

METHODSSixty cases of senile osteoporosis were randomly divided into an observation group and a control group according to the random digits table, 30 cases in each one. The two groups were both treated with basic treatment of western medicine. The acupoints included four groups:① Dazhui (GV 14), Dazhu (BL 11) and Ganshu (BL 18); ② Zhongwan (CV 12), Danzhong (CV 17) and Zusanli (ST 36); ③ Pishu (BL 20), Shenshu (BL 23) and Mingmen (GV 4); ④ Shenque (CV 8) and Guanyuan (CV 4). Each group of acupoints was selected for one treatment. The observation group was treated with medicinal-cake-separated moxibustion, and the medicinal cake was consisted of fructus psoraleae (30 g), prepared rehmannia root (30 g), atractylodes (30 g), codonopsis pilosula (30 g), epimedium herb (20 g), rhizoma curculiginis (20 g), syzygium aromaticum (5 g) and cinnamon (5 g). The control group was treated with wheat-flour-cake moxibustion. Each acupoint was treated with 5 moxa cones in the two groups. The treatment was given once every other day for six months. The symptom score, lumbar and hip bone mineral density (BMD), serum type Ⅰ procollagen amino-terminal propeptide (PINP) and serum β-type Ⅰ collagen carboxy-terminal peptide (β-CTX) were observed before and after treatment.

RESULTSAfter treatment, the symptom score and serum β-CTX were significantly lowered (all<0.05), while the lumbar and hip BMD and serum PINP were significantly increased (all<0.05) of the two groups. After treatment, the symptom score and serum β-CTX in the observation group were significantly lower than those in the control group (both<0.05), while the lumbar and hip BMD and serum PINP in the observation group were significantly higher than those in the control group (all<0.05).

CONCLUSIONSThe medicinal-cake-separated moxibustion has significant efficacy for senile osteoporosis, which is superior to wheat-cake-se-parated moxibustion.

Objective To evaluate the clinical outcomes of minimally invasive internal fixation for femoral intertrochanteric fracture in osteoporotic elderly patients. Methods A retrospective study was conducted in 112 patients using interan nail (IN) or trochanteric antegrade nail (TAN) for the management of intertrochanteric femoral fracture from January 2009 to September 2015 in our hospital. According to AO classification, there were 34 cases of type 31-A.1, and 61 cases of type 31-A.2, 17 cases of type 31-A.3. Clinical and radiological follow-up were available. Surgical and fluoroscopic time, length of hospital stay, blood loss, complications and hip functions were compared between two groups. Results A total of 78 patients meeting the criteria were evaluated at a mean follow-up of 15 months (range, 3-27 months). The IN was used in 41 patients and the TAN in 37 patients. Operative time, fluoroscopy time and blood loss showed significant difference between the IN group and TAN group (respectively, 58.9±6.9 vs. 75.6±5.9min; 2.70±0.47 vs. 4.40±0.47min; 107.6±6.7 vs. 127.8±6.8ml, P<0.05), suggesting that patients treated with the IN experienced shorter operative and fluoroscopy times, less blood loss and better hip function (73%) than those with TAN (65%, P<0.05). Rate of postoperative complications was lower in the IN group (4.9%) than in the TAN group (10.8%, P<0.05). There was no difference in hospital stay and fracture healing time between the two groups (P>0.05). Conclusions For minimally invasive treatment of unstable femoral intertrochanteric fractures, use of either the IN or TAN is clinically effective. However, IN presents more advantages (e.g., easy operation, reliable fixation, less bleeding, better clinical outcomes, and less complications). The use of IN is a suitable option for the treatment of unstable intertrochanteric fractures in osteoporotic elderly patients.

Objective To evaluate the clinical curative effect and safety of application of Jiegu pill in the conservative treatment of patients with middle clavicle fracture.Methods Fifty-four cases of patients with middle clavicle fracture were randomly divided into the control group and treatment group,27 cases in each group.Two groups of patients were treated with conservative treatment,the control group was given Jiegu Qili Pian1.5g,bid,oral; the experimental group was treated with Jiegu pill 3.0g,bid,oral.Before and after treatment,compared between the two groups of patients with serum Osteocalcin(BGP),total type I collagen amino terminal peptide(TPINP),alkaline phosphatase(ALP)levels,efficiency of treatment and incidence of adverse reactions.Results After treatment,compared with the control group,the serum levels of BGP、TPINP and ALP were higher in the experimental group(P<0.05).The treatment efficiency of the experimental group(96.29％)was significantly higher than that of the control group(77.78％)(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The Jiegu pill can significantly improve the serum levels of BGP、TPINP and ALP in patients with middle clavicle fracture,promote fracture healing,the clinical efficacy and safety were high.

BACKGROUND:Previous studies have found that human platelet-derived growth factor-B (PDGF-B)-transfected gingival fibroblasts are capable of rapid proliferationin vitro, which can secrete platelet-derived growth factor BB proteins. OBJECTIVE:To explore the ability of PDGF-B-modified gingival fibroblasts in the acelular dermal matrixin vivo to form periodontal tissue engineering compound. METHODS: Gingival fibroblasts from Beagle dogs transfected with or without PDGF-B gene were implanted into the acelular dermal matrix. Cel growth on the acelular dermal matrix was observed. PDGF-B gene-transfected gingival fibroblasts/acelular dermal matrix composite (experimental group), gingival fibrobalsts/acelular dermal matrix composite (control group) and acelular dermal matrix (blank group) were implanted subcutaneously into the nude mice, respectively. At 2, 4, 8 weeks after implantation, skin tissues were taken and observed histologicaly. RESULTS AND CONCLUSION: PDGF-B gene-modified gingival fibroblasts and non-transfected gingival fibroblasts both grew and proliferated wel in the acelular dermal matrix. At 8 weeks after implantation, in the blank group, the surrounding cels largely entered into the acelular dermal matrix, but produce less new colagen fibers, and the cels only grew on the original colagen scaffold; in the control group, a great amount of colagen fibers formed, the original colagen fibers in the acelular dermal matrix were replaced by newly formed colagens, but the original colagen structure was reserved; in the experimental group, a large scale of permineralization formed, and mineralized nodes were arranged along the original colagen scaffold. These findings indicate that PDGF-B gene modified gingival fibroblasts can acquire osteoplastic abilities in the acelular dermal matrix in vivo.

Objective To analyze the reason of post-operative infection of tibial plateau fracture, the therapeutic effect of using pedicle musculocutaneous flaps of proximal leg was researched and summarized. Methods There were 52 patients of tibial plateau fracture after internal fixation complicated by disunion of infected wound and soft tissue defects, traumatic osteomyelitis from January 2005 to May 2009. After pre-operative physical examination, laboratory examination, X-ray, CT scan and bacterial culture of the secretion,the operation, such as debridement, dead bone moving, medullary cavity cleaning, transferring to the external fixation when the internal fixation lost efficacy and bacterial culture of granulation tissue of different levels. The cavity was filled with RBK combined with vancomycin or tobramycin. If the cavity was rather large, autografts from the iliac bone were combined. The tissue defects were covered with pedicle musculocutaneous flaps of proximal leg, and the wound had effective drainage. The antibiotic was used for 3-4 weeks, and the X-rays were given at fixed period until the fracture was cured. Results The soft tissue defects of all 52 patients were repaired well. They were followed from 1 year to 5 years, and the time of bone union ranged from 4 months to 1 year. Two patients of osteomyelitis had a relapse after 3,4 months, then they were cured by the second operation. Three patients had unhealed fracture after 6 months, then they were cured by bone grafting again after 4-6 months. Conclusion Patients of tibial plateau fracture after internal fixation complicated by disunion of infected wound and soft tissue defects, traumatic osteomyelitis should be cured by comprehensive treatments, one of the crucial treatment for success is using pedicle musculocutaneous flaps of proximal leg to fill in lacuna, close wound, improve the local blood supply and promote bone union.

BACKGROUND: Studies have demonstrated that exogenous basic fibroblast growth factor (bFGF) has intensive effects to promote proliferation of gingival fibroblasts (GFs) cultured in vitro and the heeling of gingival wounds. OBJECTIVE: To investigate the effects of bFGF gene transfection on the biological performance of Beagle canine GFs. DESIGN, TIME AND SETTING: An observation and comparison in vitro experiment regarding cells was accomplished in Centre of Cell Biology and Development of Fujian Medical University and Department of Comparative Medicine in Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from April to September of 2008. MATERIALS: Four beagle dogs, male, 12 months old, weighing 10-13 kg were used in this experiment, plRES2-EGFP-bFGF plasmid containing full-length human bFGF gene cDNA was constructed and conserved by our institution. METHODS: Free gingiva of the 2nd, 3rd and 4th premolars were excised from left upper jaw of Beagle dogs, dnsed with aseptic phosphate buffer four times, then cut into pieces and digested with 2.5 g/L pancreetin for 2 hours at 37 ℃. After the cantrifugation and supernatant removal, DMEM containing 10% fetal bovine serum was added to incubate on 6-well plate with coverlips in 5% CO2 incubator at 37 ℃. Logadthrnically growing cells were digested and passaged. GFs were transfected with pIRES2-EGFP-bFGF plasmid using liposome mediated method, while vacant plasmid transfection and un-transfection group served as controls.MAIN OUTCOME MEASURES: Proliferation and apoptosis feature of the GFs were evaluated by M'rE and AOEB, respectively. The activity of alkaline phosphatase was assayed by chemical coledmetry. RESULTS: All of three groups cells entered log phrase on three days after transfection. MTT results showed that the proliferation of GFs transfected with bFGF was greater than cells transfected with vacant vector and untransfected cells (P < 0.05). AO/EB dyeing showed the apoptosis rate of GFs transfected with bFGF was reduced compared with other two groups (P < 0.05). After bGFG gene transfection, the ALP activity remained unchanged and there was no significant difference compared with untransfected cells.CONCLUSION: The transfection of bFGF gene to GFs can promote the proliferation of GFs and depress the apoptosis. No promotion is present with regard to the GFs differentiation.

Objective:To evaluate the influence of platelet-rich plasma(PRP) on periodontal healing of replanted teeth in 6 Beagle dogs.Methods:The second incisors were pulled out and re-implanted after 60 min dry storage.In group A,PRP were applied before replantation,and 7days later the teeth received root canal treatment.In group B,PRP were applied before replantation either,but without root canal treatment.In group C,PRP were not applied and 7 days later,the teeth received root canal treatment.In group D,no PRP were applied and no root canal treatment.All the dogs were sacrificed after 12 weeks and the histological parameters were observed.Results:There were no significant differences between group A and C.Group B showed a lower incidence of ankylosis,and higher incidence of healed PDL compared with group D.Conclusion:Under the definite condition,PRP can help to decrease the incidence of ankylosis and increase the incidence of healed PDL in groups that the pulps were not removed.