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 screen the habitat processing technology of Isatis tinctoria slices, and provide basis for its quality.METHODS: Appearance score, the contents of moisture, ash, extract and main component (R, S) -goitrin in I. tinctoria slices prepared by 4 kinds of dried degree [A. 60 ℃ drying after cutting; B. cutting after natural drying; C. cutting after natural drying (13-15 d), drying at 60 ℃ again; D. cutting after natural drying (30-50 d), drying at 60 ℃ again]from fresh harvested sample. RESULTS: Appearance score was in descending order with C>D>A>B; the content of moisture was in descending order with B>A>D>C. There was little difference in the content of ash among different methods. The contents of extract and (R, S)-goitrin were in descending order with C>A>B>D. CONCLUSIONS: The quality of I. tinctoria slices prepared by 4 processing technologies are different, and the quality of I. tinctoria slices prepared by cutting after natural drying (about 15 d)and drying at 60 ℃ again is relatively best.

Objectives: To establish SD rat model with type 2 diabetes mellitus (DM) and concomitant chronic periodontitis (CP) and to evaluate the influence of periodontitis on the vascular lesions of type 2 diabetes rats. Methods: Totally 241 clean level SD rats were randomly divided into four groups, group A (normal control, NC, n=27), group B (DM, n=34), group C (CP, n=90) and group D (DM+CP, n=90). The rats of DM group were fed with high-fat and high-sugar diet for 8 to 10 weeks, and then were multiply injected with small dose streptozotocin under the condition of ice bath. Blood sugar levels after the injection were dynamically monitored at 72 h, 1 week, 2 weeks and 4 weeks, respectively. The CP model was established by means of ligation. Bilateral maxillary first and second molars were selected and ligated using 0.2 mm orthodontic wires binding with 4-0 surgical suture soaked with Porphyromonas gingivalis (Pg) suspension. After a period of 14 weeks, all the rats were put to death. Maxillary samples were subjected to methylene blue staining to observe alveolar bone loss. Bilateral carotid artery specimens were collected. The left carotid artery specimens were used to detect the prevalence of Pg using quantitative real-time PCR. The right carotid artery specimens were used to observe pathological changes. Results: Blood sugar levels of rats in group B and D increased and changed sharply after Streptozotocin injection with in 1 week. Symptoms of 'more drink, more food and body weight loss’ appeared. The fasting blood glucose (FBG) was more than 7.8 mmol/L and (or) the random blood glucose (RBG) was more than 17.8 mmol/L. Both FBG and RBG became stable after 2 to 3 weeks. Levels of HbA1C in group B and D ([7.32±0.45]%, [9.41±0.45]%) were significantly higher than that of group A ([4.02±0.45]%) (P<0.01). Rats of group D were observed the most severe bone loss showing wider interdental space and furcation involvement. Pathological results of carotid artery tissues of group D showed the worst lesions including thinning and calcification of vessel walls, and breaking down or disappearance of elastic fibers. The prevalences of DNA of Pg in groups of A, B, C and D were 3/7, 3/7, 6/7 and 7/7, respectively. The bacteria numbers detected by quantitative real-time PCR in groups C and D were significantly higher than that of groups A and B (P<0.01). Conclusions Rat model of type 2 DM with periodontitis was successfully established in the present study. Carotid artery specimens from DM+CP model rats showed typical vascular lesions such as calcification and fiber disorders. Pg was found in all carotid specimens and the highest bacteria numbers were detected in the composite model rats. The Pg might play a role in the progress of diabetes vascular lesions.

Objective To investigate the effect of tooth extraction with antibiotics on atherosclerosis, and to examine the expression of serum interleukin 6(IL-6) and the pathological changes of the carotid artery in chronic periodontitis(CP) rats with or without atherosclerosis(As).Methods A total of 44 SD rats were randomly divided into four groups, group A(normal control), group B(As), group C(CP),group D(CP+As).After model establishment, group C and group D were randomly divided into group C1/D1 (tooth extraction) and group C2/D2(tooth extraction with antibiotics) according to random number table and received the corresponding oral intervention treatment respectively.Serum IL-6 levels were determined by enzyme linked immunosorbent assay(ELISA) respectively one week before the intervention, one week after the first intervention, one, three, five weeks after the second intervention.The pathological changes of the carotid artery were accessed under light microscope.Results At all sampling time points, the levels of serum IL-6 in group B, C, D were higher than that of group A, with group D 1 being increased most obviously,significantly higher than that of group A(P＜ 0.001).One week after the second intervention, the content of IL-6 in group C and group D peaked[C1(127.0±29.9) ng/L, C2: (120.6±23.1) ng/L, D1: (175.1±50.8) ng/L,D2: (160.5±37.7) ng/L], and was significantly higher than that of group B[B: (43.4±7.5) ng/L, P＜0.001].Then they all had varying degrees of decline, 5 weeks after the second intervention, group C1 and D1 were still higher than that of group B, but group C2 and D2 were lower than that of group B.At all sampling time points, the levels of serum IL-6 in group C2/D2 were lower than those in group C1/D1, 5 weeks after the second intervention the difference was most obvious and statistically significant(P＜0.001).Pathology showed that the carotid artery wall in group A was normal.The carotid artery wall was thickened in group B,inflammatory cells and foam cells could be seen, and elastic fibers disordered.The carotid artery wall in group C 1 was uneven, foam cells and a small amount of inflammatory cells were visible, and elastic fiber disordered.Obvious thickening was not seen in the carotid artery wall of group C2, a small amount of foam cells and inflammatory cells were found, and elastic fiber mildly disordered.The carotid artery wall in group D1 was obviously uneven, calcium salt deposits were visible in the artery wall, a large amount of inflammatory cells and foam cells could be found, and elastic fiber disordered.Obvious thickening was not seen in the carotid artery wall of group D2, a small amount of inflammatory cells and a large amount of foam cells could be seen, and elastic fiber disordered.Conclusions Periodontitis and hyperlipidemia could increase the level of serum IL-6 and the risk of the As.In chronic periodontitis rats with or without atherosclerosis, when periodontal inflammation was not controlled, tooth extraction may increase the risk of the As.At the time of tooth extraction, giving the anti-inflammatory treatment can reduce the risk to a certain extent.

OBJECTIVE:To establish a preparative separation method for euphol reference substance in Euphorbia pekinensis. METHODS:Parts of petroleum ether extraction from E. pekinensis ethanol extract were separated by silica gel column chromatogra-phy with petroleum ether-ethyl acetate(95∶5-70∶30,V/V)by gradient elution. The enriched fractions of euphol were collected. With the methanol repeated recrystallization,nuclear magnetic resonance spectroscopy(NMR)method,mass spectrometry(MS)meth-od and other spectroscopic methods were used to identify the chemical structures,and thin layer chromatography (TLC),UV, HPLC-UV,HPLC-MS were combined to detect the mass fraction. RESULTS:The mass fraction of euphol reference substance sepa-rated from E. pekinensis was>99%. CONCLUSIONS:The reference substance of euphol acquired by this method meet the relative requirements of the chemical reference substance in the content dertermination of TCM new drug quality standard. It provides chemi-cal reference substance for the quality control of E. pekinensis and prescription preparations containing E. pekinensis and the basic research of effective substances.

Objective To explore the relationship between the change of serum β-HCG and the effect of　conservative treatment in tubal ectopic pregnancy.Methods 95 patients with tubal ectopic pregnancy were treated with single dose methotrexate injection.Among them,87 patients were successfully cured,16 patients were treated with the 2nd dose and Chinese herbal medicine orally:8 patients failed.The change of serum β-HCG levels after the first and 2nd course of treatment were measured.Results It showed that after the first or 2nd course of treatment,the cases which serum β-HCG level reducing less than 15%in patients who had successful treatment were signiflcantly lower than that in patients who failed(P＜0.05).Conclusion Detecting the change of serum β-HCG concentration can evaluate the therapeutic effect in tubal ectopic pregnancy with conservative treatment,and according that surgical operation should be chosen if serum β-HCG reduce less than 15%after two courses of treatment.

Objective To evaluate the potential value of IgG antibodies against recombinant PPE65 protein (rPPE65) of Mycobacterium tuberculosis in serodiagnosis of tuberculosis.Methods The gene encoding PPE65 protein of M.tuberculosis was cloned into the PET-28a vector and then expressed in Escherichia coli.The rPPE65 was purified with Ni-NTA affinity and ion exchange chromatography.After dialysis renaturation, the concentration of rPPE65 was determined using Lowry assay.ELISA was used to detect the levels of specific IgG against rPPE65 and recombinant PstS1 protein (rPstS1) in sera from 144 patients with pulmonary tuberculosis (PTB patients), 144 health controls, and 56 patients with non-tuberculosis pulmonary diseases.ROC curves were used to determine cut-off values with the results of IgG antibodies against rPPE65 and rPstS1 for 144 PTB patients and 97 controls with negative PPD skin test.The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of rPPE65 and the combination of rPPE65 and rPstS1 were counted.Results The PPE65 protein of M.tuberculosis was successfully expressed in E.coli. The purity and concentration of rPPE65 were 95% and 0.5 mg/ml, respectively.ROC analysis showed that the cut-off of ELISA using rPPE65 was 0.64.The sensitivity, specificity, PPV, NPV, and accuracy of rPPE65 were 34.7%(50/144), 93.5%(187/200), 79.4%(50/63), 66.5%(187/287), and 68.9%(237/344), respectively.The sensitivity, specificity, PPV, NPV, and accuracy of the combination of rPPE65 and rPstS1 were 59.0%, 91.0%, 82.5%, 75.5%, 77.6%, respectively.Conclusions The rPPE65 of M.tuberculosis appears to be a candidate antigen for serodiagnosis of tuberculosis.Detection of IgG antibodies against the combination of rPPE65 and rPstS1 can increase the sensitivity of serological test for tuberculosis.

OBJECTIVETo compare the crystal form with the toxicity intensitity of raphides in four poisonous herbs of Araceae family.

METHODThe four kinds of raphides were extracted and isolated from Pinellia ternate, P. pedatisecta, Arisaema amurense and Typhonium giganteum. These raphides were observed with scanning electron microscopy (SEM), and the elements were analyzed with X-ray photoelectron spectroscopy. Infrared spectrum was used for detecting the functional groups. Toxic intensities of the four kinds of raphides were detected by mice acute toxicity experiment, and the value of LD0 were from caculated by Bliss rule.

RESULTThe raphides in the four plants have the similar crystal form. Observation with SEM showed a pointed and blunt end, and a long groove and barbs on a raphide. The raphides in P. ternate and P. pedatisecta were sharper than that in other two, respectively. The results of X-ray diffraction, photoelectric spectra showed that the major component of raphides was calcium oxalate monohydrate, and also showed the elements of N and S existing. Infrared spectra showed the raphides contained functional groups of -COOH and -NH2. These results illustrated that the calcium oxalate monohydrate was not the only component of the raphide. The raphides could produce severe toxic reactions. LD50 values of P. ternate, P. pedatisecta, A. amurense and T. giganteum were 14.78, 14.11, 16.02 and 18.90 mg x kg(-1) (ip), respectively. The corresponding LD50 values of crude drugs were all above 3000 mg x kg(-1) (ip). The toxicity of raphides was 200 times of crude drugs'.

CONCLUSIONThe raphides in P. ternate and P. pedatisecta, A. amurense and T. giganteum were their common poisonous factor.

Animals ; Araceae ; chemistry ; Calcium Oxalate ; chemistry ; toxicity ; Crystallization ; Mice ; Mice, Inbred ICR ; Plant Extracts ; chemistry ; toxicity