Improper diagnosis and design, misusing orthodontic technique, relapse after orthodontic treatment, and poor patient compliance may lead to treatment failure, requiring orthodontic retreatment. While in such cases, patients usually have already had their teeth extracted, or are with periodontal, joint, and other dental problems, which often require multidisciplinary treatment. The retreatment of orthodontic patients is difficult, and the treatment options are limited. The characteristics of clear aligner treatment, such as comfortable and beautiful appearance, high degree of digital precision, and personalized tooth arrangement to simulate the final outcome, make it popular in the orthodontic retreatment. This article discusses and summarizes the details of orthodontic design, case monitoring, and the application of clear aligner in orthodontic retreatment of failed cases. Before starting treatment, the difficulty assessment tool (clear aligner treatment complexity assessment tool) can be used to evaluate the difficulty of clear aligner treatment. Orthodontists are recommended to treat orthodontic patients with clear aligners within their ability to avoid treatment failure. The key to the success of the extraction case treatment with clear aligner is to make the correct diagnosis and select the right cases. In the treatment planning, attention should be paid to the restoration of anterior tooth torque, making good use of molar distalization to obtain the space, vertical control, and improving posterior tooth relationship. Proper selection of cases and reasonable design in clear aligner treatment are expected to obtain tooth alignment, good intercuspation, normal overbite and overjet, periodontal health, parallel roots, and to achieve the goal of aesthetic, functional, stable, and healthy orthodontic treatment.

Preeclampsia is a serious threat to maternal and fetal health and safety, and is an important cause of maternal death. At present, there is no effective treatment except termination of pregnancy. It is an important measure to identify high-risk groups for standardized management and early prevention to reduce the incidence of preeclampsia and maternal and fetal mortality. Chronic patients are at high risk of preeclampsia, and their morbidity and mortality have increased significantly. It is of great significance for chronic patients to regulate preconception guidance and formulate preconception management strategies to reduce the incidence of preeclampsia and improve maternal and infant outcomes.

Objective : To investigate the clinical efficacy of clear aligner therapy combined with orthognathic surgery in the treatment of skeletal Class Ⅲ mandible deviation. Methods : A case of mandibular lateral deviation treated by combined orthodontic and orthognathic surgery was reported and analyzed in combination with the related literature. Clear aligner therapy was chosen for orthodontic treatment, and bilateral sagittal split ramus osteotomy and genioplasty were adopted to address the skeletal deformity. Results: Eight intermaxillary fixation screws were inserted during surgery to fix the splint, and settling elastics were run to achieve better occlusion postsurgery. With good compliance of the patient, treatment was completed by the first set of aligners, Class I canine and molar relationships were obtained, normal overbite and overjet were achieved, and mandibular deviation was addressed. The stability was good 1 year after treatment. The results of the literature review showed that clear aligner therapy in conjunction with orthognathic surgery has been widely used, but there are still some challenges in front. Compared with traditional orthodontics, the digital features of clear aligner therapy makes it fit more closely with computer-aided surgery, and there is more space for exploration. Conclusion For patients with good compliance, clear aligner therapy combined with orthognathic surgery can effectively complete the treatment of simple cases. The advantage of digital design equips clear aligner therapy with good prospects for development.

OBJECTIVES: This study aimed to investigate whether the microglia in the spinal trigeminal nucleus caudal part (Sp5C) were activated in a rat model of trigeminal neuralgia and to explore whether the activation level of microglia is consistent with maxillofacial pain level. METHODS: Chronic constriction injury of trigeminal nerve (CCI) was induced by partial ligation of infraorbital nerve (IoN) in rats. The behavioral change of rats observed at D1, D5, D10, D15, and D30 days post-surgery and the change of pain threshold were detected with electronic Von Frey filaments served as an evaluation index of maxillofacial pain. Weight change was measured by weighing. Ionized calcium binding adaptor molecule-1 (Iba-1) expression level of Sp5C at each time point was detected, and three microglia morphological categories were analyzed by immunohistochemical staining. RESULTS: The changes of behavioral and pain threshold suggested the maxillofacial pain level first increased and then decreased post-surgery in the IoN-CCI group. Both the expressions of Iba-1 and proportion of ameboid morphology in ipsilateral Sp5C increased from D1 and reached their peaks in D10 and D5, respectively. Then, they recovered nearly to the same level with contralateral Sp5C on D30. This trend was consistent with the maxillofacial change. CONCLUSIONS The model of trigeminal neuralgia in rats constructed by partial ligation of infraorbital nerve can induce the activation of microglia in Sp5C, and the activation level is consistent with maxillofacial pain, which reached its peak at around D10 post-surgery.
Rats ; Animals ; Trigeminal Neuralgia ; Rats, Sprague-Dawley ; Microglia ; Pain Threshold/physiology* ; Pain

Orthodontic tooth movement elicits alveolar bone remodeling and orofacial pain that is manifested by tooth mechanical hyperalgesia. Nerve growth factor (NGF) is upregulated in periodontium and may modulate tooth mechanical hyperalgesia. The objectives were to examine the role of NGF in tooth mechanical hyperalgesia and to elucidate the underlying mechanisms. Tooth mechanical hyperalgesia was induced by ligating closed coil springs between incisors and molars in Sprague-Dawley rats. Retrograde labeling was performed by periodontal administration of fluor-conjugated NGF and the detection of fluorescence in trigeminal ganglia (TG). Lentivirus vectors carrying NGF shRNA were employed to knockdown the expression of NGF in TG. The administration of agonists, antagonists, and virus vectors into TG and periodontium was conducted. Tooth mechanical hyperalgesia was examined through the threshold of biting withdrawal. Our results revealed that tooth movement elicited tooth mechanical hyperalgesia that could be alleviated by NGF neutralizing antibody and that NGF was upregulated in periodontium (mainly in periodontal fibroblasts) and TG. Retrograde labeling revealed that periodontal NGF was retrogradely transported to TG after day 1. Acid-sensing ion channel 3 (ASIC3) and NGF were co-expressed in trigeminal neurons and the percentage of co-expression was significantly higher following tooth movement. The administration of NGF and NGF neutralizing antibody into TG could upregulate and downregulate the expression of ASIC3 in TG, respectively. NGF aggravated tooth mechanical hyperalgesia that could be alleviated by ASIC3 antagonist (APETx2). Moreover, NGF neutralizing antibody mitigated tooth mechanical hyperalgesia that could be recapitulated by ASIC3 agonist (GMQ). NGF-based gene therapy abolished tooth mechanical hyperalgesia and downregulated ASIC3 expression. Taken together, in response to force stimuli, periodontal fibroblasts upregulated the expressions of NGF that was retrogradely transported to TG, where NGF elicited tooth mechanical hyperalgesia through upregulating ASIC3. NGF-based gene therapy is a viable method in alleviating tooth-movement-induced mechanical hyperalgesia.

To evaluate the efficacy and safety of left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) over 75 years. A total of 82 patients with AF who underwent LAAO successfully in Beijing Anzhen Hospital from March 2014 to March 2019 were divided into two groups according to age: the elderly group (aged>75 years) and the young group (aged ≤75 years). Risk of perioperative complications and incidence of ischemic stroke and major bleeding during follow-up were retrospectively analyzed. The results showed that there were no significant differences in procedure-related ischemic stroke(0 vs.1.6%, P=0.768) and major bleeding (0 vs.1.6%, P=0.768) during perioperative period between the two groups. No complications as death or pericardial tamponade occurred in the two group. During a (25.9±15.9) months period of followed up, ischemic stroke event rate was 3.6/100 person-years in the elderly group and 4.9/100 person-years in the young group, respectively. Major bleeding event rate was 2.5/100 person-years in the elderly group and 0/100 person-years in the young group, respectively. Compared with the expected ones, the relative risk reduction (RRR) of stroke in the elderly group was more profound than that in the young group (32.0% vs. 25.0%), while the risk of major bleeding in the young group was significantly lower than that in the elderly group (RRR 100% vs. 56.9%). Therefore, LAAO might be suitable for stroke prevention in the elderly AF patients.

Objective: To provide empirical evidence on the effectiveness of comprehensive sexuality education (CSE) on sexual knowledge and sexual attitudes improvement among college students. Methods: Sexual knowledge and attitudes questionnaire survey was implemented among college students in Beijing, who later received the CSE for a full semester. Sexual knowledge and attitude were evaluated after intervention and were compared with control students. Results: The average score of sexual knowledge was low among college students in Beijing. Most students held neutral attitudes towards "AIDS community" and "masturbation behavior" and positive attitudes towards "LGBT"(58.85%, 68.75%, 61.98%). Compared with the control group, after one semester of CSE curriculum intervention, the average scores of the five dimensions on sexual knowledge in the intervention group was significantly improved(11.79±1.16, 9.36±1.23, 4.84±0.88, 4.91±1.00, 5.35±1.03)(t=11.25, 15.74, 10.37, 5.59, 8.17, P<0.01), and the attitudes towards "sexual minorities", "AIDS communities" and "masturbation behavior" were also significantly improved(30.59±3.91, 17.70±3.41, 10.12±2.17)(t=5.16, 5.83, 2.97, P<0.01). Conclusion College students’ knowledge of sexuality is not optimistic. The attention to proper sexual attitudes is in great need. Systematic and comprehensive sexuality education curriculum could improve college students’ sexual knowledge and attitudes.

Orthodontic pain that is induced by tooth movement is an important sequela of orthodontic treatment and has a significant effect on patient quality of life. Studies have shown that the high expression of transient receptor potential vanilloid 1 (TRPV1) in trigeminal ganglions plays a vital role in the transmission and modulation of orofacial pain. However, little is known about the role of TRPV1 in orthodontic pain. In this study, male Sprague-Dawley rats were randomly assigned to six groups to study the role of TRPV1 in the modulation of tooth-movement pain. The expression levels of TRPV1 mRNA and protein were determined by real-time PCR and western blot, respectively. Moreover, pain levels were assessed using the rat grimace scale (RGS). The role of TRPV1 in modulating tooth-movement pain was examined by injecting a TRPV1 antagonist into the trigeminal ganglia of rats. A lentivirus containing a TRPV1 shRNA sequence was constructed and transduced into the rats' trigeminal ganglia. The results showed that the expression levels of TRPV1 protein and mRNA were elevated following tooth-movement pain. Pain levels increased rapidly on the 1 day, peaked on the 3 day and returned to baseline on the 14 day. The TRPV1 antagonist significantly reduced tooth-movement pain. The lentivirus containing a TRPV1 shRNA sequence was able to inhibit the expression of TRPV1 and relieved tooth-movement pain. In conclusion, TRPV1-based gene therapy may be a treatment strategy for the relief of orthodontic pain.
Animals ; Calcitonin Gene-Related Peptide ; Genetic Therapy ; Male ; Molar ; Pain ; Quality of Life ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; TRPV Cation Channels ; Tooth Movement Techniques ; Trigeminal Ganglion

Orthodontic pain that is induced by tooth movement is an important sequela of orthodontic treatment and has a significant effect on patient quality of life.Studies have shown that the high expression of transient receptor potential vanilloid 1 (TRPV1) in trigeminal ganglions plays a vital role in the transmission and modulation of orofacial pain.However,little is known about the role of TRPV1 in orthodontic pain.in this study,male Sprague-Dawley rats were randomly assigned to six groups to study the role of TRPV1 in the modulation of tooth-movement pain.The expression levels of TRPV1 mRNA and protein were determined by real-time PCR and western blot,respectively.Moreover,pain levels were assessed using the rat grimace scale (RGS).The role of TRPV1 in modulating tooth-movement pain was examined by injecting a TRPV1 antagonist into the trigeminal ganglia of rats.A lentivirus containing a TRPV1 shRNA sequence was constructed and transduced into the rats' trigeminal ganglia.The results showed that the expression levels of TRPV1 protein and mRNA were elevated following tooth-movement pain.Pain levels increased rapidly on the 1st day,peaked on the 3rd day and returned to baseline on the 14th day.The TRPV1 antagonist significantly reduced tooth-movement pain.The lentivirus containing a TRPV1 shRNA sequence was able to inhibit the expression of TRPV1 and relieved tooth-movement pain.In conclusion,TRPV1-based gene therapy may be a treatment strategy for the relief of orthodontic pain.