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Journal: Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology

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Oral microecosystem comprises the different anatomic microniches of the oral cavity, oral microbiome living in them and the bathing fluid, saliva. Dynamic balance of the ecosystem plays an important role in keeping human health whereas disease conditions supervene when the microbial equilibrium is broken. Hence, the researchers have focused more attention on it recently. In this paper, the relationship between oral microecological homeostasis and general health was systematically reviewed from such aspects as the composition of oral microecosystem, the effects of its imbalance on oral and general health, and the methods currently used to modulate the oral microecology.

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Objective: To evaluate the effects of periodontal therapy on the quality of life in chronic obstructive pulmonary disease (COPD) patients with chronic periodontitis (CP). Methods: In a randomized controlled pilot study, 60 COPD patients with CP were randomly assigned into three groups to receive scaling and root planing (SRP) treatment, supragingival scaling treatment and oral hygiene instructions only with no periodontal treatment, respectively. The scores of each patient’s quality of life at baseline, 1 year and 2 years, respectively, were evaluated by using the standardized St George’s respiratory questionnaire (SGRQ). The SGRQ was composed of three dimensions: symptoms, activity, and impact. A score was calculated for each section and a total summary score was also calculated. A high score indicated poor health and a decrease in the score indicates an improvement in quality of life. Results: There were no statistically significant differences among the three groups for age, gender, body mass index, smoking status, lung funtion, periodontal parameters and the SGRQ scores (including total, symptoms, activity and impacts scores) among three groups at baseline (all P>0.05). The SGRQ scores were all significantly correlated with major lung function parameters (r=-0.54 –0.28). The result of ANCOVA analysis adjusted for the influence of baseline measurements showed that the total scores of two periodontal treatment groups were significantly lower (P=0.01) than that of control group at 2-year follow-up (SRP group: 31.1±12.1; scaling group: 28.9±9.8; control group: 46.5±24.9). The symptoms score of SRP group (45.4±19.7) was significantly lower (P=0.03) than that of control group (53.6±25.4) at 2-year follow-up. The impacts scores of two treatment groups were significantly lower (P=0.02) than that of control group at 2-year follow-up (SRP group: 15.2±8.3; scaling group: 14.9±7.7; control group: 34.8±18.8). Conclusions: Our preliminary results from this study suggest that non-surgical periodontal treatment in COPD patients with CP might improve the quality of life of the COPD patient.

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Objective: To investigate periodontal status of patients with pre-diabetes and evaluate the prevalence of periodontal pathogens in oral cavity. Methods: All the subjects were under regular care in urban area of Beijing, including 88 subjects with normal blood glucose (normal blood glucose group), 27 pre-diabetic patients (pre-diabetic group), 58 well-controlled diabetic patients (glucose well controlled group) and 72 poor-controlled diabetic patients (glucose poor controlled group). Whole unstimulated saliva samples were collected before periodontal examination. Periodontal parameters, including plaque index (PLI), probing depth (PD), bleeding index (BI), bleeding on probing (BOP) and clinical attachment loss (CAL), were examined at mesial-buccal and distal-lingual sites of each tooth. Number of missing teeth was recorded. DNA was extracted from the salivary deposition, Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Campylobacter rectus (Cr), and Prevotella nigrescens (Pn) were detected by using PCR method based on 16SrRNA. Periodontal status and prevalence and quantity of the pathogens under various blood glucose states were compared. Results: The PD scores of four groups had no statistical differences. The CAL [(2.29±1.35) mm] and the number of missing teeth[2.0 (7.0)] in pre-diabetic group were significantly lower than that in glucose poor controlled group [(3.07±1.45) mm, P=0.04 and 5.0 (10.0), P=0.04, respectively]. The number of missing teeth in pre-diabetic group [2.0 (7.0)] was significantly lower than that in glucose well controlled group [5.0 (9.0), P=0.02]. The percent of bleeding on probing [BOP(+)%] in pre-diabetic group [(63.89±20.03)%] was significantly higher than that in normal blood glucose group [(54.51±22.29)%, P=0.04] and glucose well controlled group [(53.12±21.77)%, P=0.03]. The prevalence of Pg in pre-diabetic group (81.5%) was significantly higher than that in glucose poor controlled group (54.2%, P=0.02). The prevalence of Tf in pre-diabetic group (96.3%) was significantly higher than that in glucose poor controlled group (76.4%, P=0.01). Meanwhile the quantity of Pg [1.58 (4.75)] and Tf [5.46 (7.77)] in pre-diabetic group were significantly higher than that in glucose poor controlled group [0.60 (1.87), P=0.01 and 1.63 (3.06), P<0.01, respectively]. The quantity of Pn [0.85 (1.68)] in pre-diabetic group was significantly higher than that in normal blood glucose group [0 (1.02), P=0.04]. Conclusions: Pre-diabetic patients showed severe periodontal infection and BOP(+)% than other three groups and had high risk-level of periodontitis.

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Objective: To detect the expression of matrix metalloproteinase-3 (MMP-3) in serum and gingival crevicular fluid in patients with rheumatoid arthritis (RA) and its correlation with chronic periodontitis (CP). Methods: From March 2017 to July 2018, 26 patients with RA and CP [CP+RA group, (54.9±6.5) years old, 4 males and 22 females], 22 patients with RA only [RA group, (49.6±11.7) years old,5 males and 17 females] in the Department of Rheumatology and Immunology, Shengjing Hospital Affiliated to China Medical University, 22 patients with simple CP in the Department of Stomatology, Shengjing Hospital Affiliated to China Medical University [CP group, (51.4±12.5) years old, 8 males and 14 females] and 18 generally healthy controls in Physical Examination Center of Shengjing Hospital Affiliated to China Medical University [group H, (49.4±9.1) years old, 8 males and 10 females] were recruited. There were no significant differences in age and sex ratio amongst 4 groups. Patient’s general status, probing depth (PD) , clinical attachment loss (CAL), sulcus bleeding index (SBI), simplified calculus index (CI-S) and simplified debris index (DI-S) were recorded in 4 groups. Samples of serum and gingival crevicular fluid were collected from patients of each group, and the expression levels of MMP-3 in serum and gingival crevicular fluid samples were detected by using enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate, rheumatoid factor, anti-cyclic citrulline peptide antibody and C-reactive protein were detected in the serum of subjects in RA group and CP+RA group. Correlation analysis was conducted between MMP-3 expression level and periodontal indices amongst 4 groups. The results were statistically analyzed using the SPSS 20.0 software package. Results: The indices of CAL [(4.12±1.13) mm], SBI (2.58±0.64) and DI-S (2.65±0.69) in CP+RA group were significantly higher than indices of CAL [(3.00±0.00) mm], SBI (2.59±1.05) and DI-S, (2.36±0.49) in CP group (P<0.05); The expression levels of MMP-3 in serum samples of CP+RA group [(1 1645.6±6 903.4) μg/L] and CP group [(9 337.0±6 719.0) μg/L] were significantly higher than that of RA group [(2 389.9±1 320.3) μg/L] and H group [(1 493.5±292.1) μg/L] (P<0.05). The expression level of MMP-3 in gingival crevicular fluid samples of CP+RA group [(164.4±45.3) μg/L] was significantly higher than that of CP group [(84.6±92.5) μg/L], RA group [(49.0±18.1) μg/L] and H group [(20.4±6.3) μg/L] (P<0.05), respectively. The erythrocyte sedimentation rate, rheumatoid factor and anti-cyclic cirullinated peptide antibodies levels in the CP+RA group were significantly higher than those in the RA group (P<0.05). The expression level of MMP-3 in serum is positively correlated with PD (r=0.45, P=0.04) and the expression level of MMP-3 in gingival crevicular fluid is positively correlated with CAL (r=0.58, P<0.01). Conclusions: The levels of MMP-3 in serum and gingival crevicular fluid of patients with RA and CP were significantly increased. MMP-3 may be associated with the development of CP and RA.

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Objective: To evaluate water sorption and hygroscopic dimensional changes of five core buildup composite resins, and to provide references for material modification on water sorption. Methods: Five commercial core buildup materials (group A: Smart Dentin Replacement™; group B: NanoFil; group C: ParaCore™; group D: LuxaCore Z; group E: EmbraceCore™ Resin Cement) were fabricated to disk-shaped specimens: (15.0±0.1) mm diameter, (2.0±0.1) mm thickness (n=10). Specimens were thoroughly irradiated with curing lights. The initial mass in air was recorded, and the initial mass in deionized water was recorded. Five specimens of each group were immersed in deionized water for 28 d. They were weighed as a function of different immersion time (1, 2, 3, 4, 5, 6, 7, 14, 28 d). The mass in air was recorded, and the displayed mass in deionized water was recorded. Archimedes' principle was applied to calculate the dimensional changes. The other five specimens of each group were stored in artificial saliva and were tested by the same methods. Results: All specimens gained weight and hygroscopic changes during 28 d immersion. When stored in deionized water, the apparent mass change of group A [(10.6±0.9) μg/mm(3)] and the dimensional change of group A [(0.39±0.10)%] were the lowest, while the mass change of group E [(48.0±0.2) μg/mm(3)] and the dimensional change of group E [(3.16±0.13)%] were the highest (P<0.05). In artificial saliva, the lowest apparent mass change was found in group A [(11.8±1.0) μg/mm(3)] while the highest change was found in group E [(47.4±3.5) μg/mm(3)] (P<0.05). The lowest dimensional change was found in group C [(0.37±0.09)%] and the highest was found in group E [(3.07±0.19)%] in artificial saliva (P<0.05). Conclusions: Water sorption and dimensional changes vary in immersion fluids with different osmotic pressure. Water sorption and dimensional changes of core buildup composite resins are highly correlated with test materials in both of the deionized water and artificial saliva.

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Objective: To investigate the in vitro and in vivo effects of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy against oral squamous cell carcinoma (OSCC) and preliminarily explore the possible mechanisms. Methods: SCC25 cells were divided into the control group (5-ALA of 0 mg/L) and the experimental group (5-ALA of 10, 25, 50, 100 and 150 mg/L). The production of protoporphyrin Ⅸ (PpⅨ) induced by 5-ALA in SCC25 cells was detected using the flow cytometry. SCC25 cells were divided into the control group (5-ALA of 0 mg/L), lazer alone group, 5-ALA alone group (5-ALA of 100 mg/L) and the 5-ALA combined with laser irradiation group (5-ALA of 5, 10, 25, 50 and 100 mg/L), the cytotoxicity of 5-ALA combined with laser irradiation (wave length 635 nm, power density 87 mW/cm(2) and laser dose 10.4 J/cm(2)) was evaluated in SCC25 cells using the methyl thiazolyltetrazolium assay (incubation times of 4, 8 and 12 h in each group) and the induction effect of combination treatment on the cell apoptosis was assessed by the flow cytometry (incubation time of 12 h in each group). The intracellular production of reactive oxygen species (ROS) triggered by 5-ALA combined with laser irradiation was determined using a fluorescence probe method (incubation time of 12 h in each group). A mouse OSCC xenograft model bearing SCC25 tumor was built, and the mice were divided into control group (saline), 5-ALA group (5-ALA of 50 mg/kg) and 5-ALA combined with laser irradiation group (5-ALA of 10, 25 and 50 mg/kg). Antitumor effect of 5-ALA combined with laser irradiation (wave length 635 nm, power density 158 mW/cm(2) and laser dose 94.8 J/cm(2)) was further measured. Results: 5-ALA induced the production of PpⅨ in SCC25 cells in a drug concentration (0-150 mg/L)-and incubation time (0-24 h)-dependent manner. When the 5-ALA concentration was 100 mg/L, the intracellular PpⅨ production was in a relatively stable state. Cell viability and apoptosis rate of 5, 10, 25, 50, 100 mg/L 5-ALA combined with laser irradiation are, respectively, (82.3±5.2)%, (3.13±0.38)%; (74.6±9.3)%, (5.38±0.55)%; (38.3±9.7)%, (17.97±2.72)%; (9.2±3.8)%, (24.47±3.37)%; (7.2±0.8)%, (43.01±5.96)%, which indicated that 5-ALA combined with laser irradiation notably inhibited the growth of SCC25 cells and also induced significant cell apoptosis compared with the control group [(96.3±6.0)%, (0.35±0.13)%, P<0.05]. After combination treatment (5-ALA of 5, 10, 25, 50 and 100 mg/L combined with laser irradiation, the mean fluorescence intensity of dichlorofluorescein is (1.46±0.12)×10(4), (2.16±0.30)×10(4), (3.57±0.34)×10(4), (81.70±13.05)×10(4), (113.00±7.35)×10(4), respectively, a large amount of ROS was produced in SCC25 cells compared with the control group [(0.96±0.15) ×10(4), P<0.05], which was in positive correlation with the intracellular PpⅨ content. 5-ALA (concentration of 10, 25 and 50 mg/kg) combined with laser irradiation greatly suppressed the tumor growth in SCC25 tumor-bearing mice compared to the control group (P<0.05). Conclusions: 5-ALA-mediated photodynamic therapy can trigger the generation of intracellular ROS that has significant cytotoxicity and apoptosis induction effect, and thus inhibit the tumor growth both in vitro and in vivo.

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Objective: To investigate the effects of two nanotopographies of ultraviolet (UV)-treated titanium surface on macrophage biological behaviour and inflammatory cytokines secretion, and to provide basis for clinical application of UV-treatment in dental implant modification. Methods: Titanium disks were allocated into two groups. Samples in one group were acid-etched in hydrofluoric acid (Acid Ti group), and those in the other group were acid-etched and anodized (Anodization group) to form two nanotopographies respectively. The surface morphology was evaluated by field-emission scanning electron microscopy (FE-SEM). The samples were stored in the dark for 8 weeks. Thirteen samples from each group were exposed to UV-irradiation for 48 h (Acid Ti+UV group and Anodization+UV group), UV-untreated samples from Acid Ti and Anodization groups served as control. Hydrophilicity of samples was measured using contact angle measuring device. After 4, 24 and 72 h of incubation, macrophage cell adhesion and proliferation were conducted using cell counting kit-8. Cytokine/chemokine secretions [tumor necrosis factor-α (TNF-α), monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein-1α (MIP-1α)] were measured from cell culture supernatants at 24 and 72 h using magnetic luminex assay. Cell morphology was examined using FE-SEM after 2 h of incubation. Results: Micropitted/nanopillar and micropitted/nanotubular topographies were observed in Acid Ti group and Anodization group respectively. Contact angles in Acid Ti+UV and Anodization+UV groups (20.2°±2.8° and 0.0°±0.0°) were significantly smaller than those in the Acid Ti and Anodization groups (P<0.05). Cell adhesion and proliferation in all groups at 4 and 24 h showed no difference (P>0.05). Cell proliferation in Acid Ti+UV and Anodization+UV groups at 72 h were (0.92±0.13) and (1.10±0.08) respectively, which were significantly higher than those in Acid Ti and Anodization groups. TNF-α concentration in Acid Ti+UV and Anodization+UV groups at 72 h were (1.03±0.11) and (0.87±0.10) ng/L, MCP-1 were (301.7±50.3) and (240.8±18.7) ng/L, MIP-1α were (224.9±30.6) and (233.9±14.9) ng/L respectively, which were significantly lower than those in Acid Ti and Anodization groups (P<0.05). Conclusions: UV treatment can increase hydrophilicity of two titanium surface topographies, especially of Anodization+UV group. UV-treated titanium surfaces can promote macrophage proliferation and reduce the inflammatory response in vitro.

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Objective: To investigate the effects of estrogen and remifemin on the expression of neuronal nitric oxide synthase (nNOS), transient receptor potential vanilloid 1 (TRPV1), muscarinic acetylcholine receptor, member 1 and 3 (M1 and M3 receptor) and acetylcholinesterase (AChE) in the submandibular gland of rats. Methods: Forty SD female adult rats were divided into SHAM group (sham operation), OVX group (ovarian removal), OVX+E group (ovarian removal + estrogen treatment) and OVX+ICR group (ovarian removal + remifemin treatment), 10 per group. The rats were recovered for 2 weeks after operation. The SHAM group and the OVX group were treated with distilled water, the OVX+E group and the OVX+ICR group were treated with β-estradiol and remifemin respectively. After 4 weeks, the location and expression of nNOS, TRPV1, M1 and M3 receptors in the submandibular gland were evaluated by immunohistochemistry. The changes of AChE expression in rat submandibular gland were observed by AChE staining. Results: Compared with SHAM group (0.23±0.02, 0.28±0.01, 0.25±0.03, 0.19±0.03), the expression of nNOS, TRPV1, M1 and M3 receptors in OVX group (0.16±0.01, 0.21±0.01, 0.15±0.02, 0.09±0.02) were significantly lower (P<0.05); there were no significant difference between OVX+E group (0.23±0.01, 0.28±0.02, 0.23±0.03, 0.19±0.01) and SHAM group (P>0.05). But compared with OVX group, the expression of nNOS, TRPV1 and M3 receptors in OVX+ICR group were no significantly changed (P>0.05), and only M1 receptor expression (0.22±0.03) was significantly increased (P<0.05). The expression of AChE in OVX group (0.14±0.01) was significantly higher than that in SHAM group (0.10±0.01) (P<0.05). The expression of AChE in OVX+E group (0.15±0.01) was significantly higher than that in SHAM group (P<0.05). The expression of AChE in OVX+ICR group (0.09±0.01) was not significantly different from that in SHAM group (P>0.05). Conclusions: Estrogen can significantly increase the expression of nNOS and TRPV1 in the submandibular gland of rats, suggesting that estrogen may regulate the salivary secretion function of the submandibular gland through nNOS and TRPV1. The mechanism of remifemin is different from that of estrogen, and remifemin does not play a regulatory role by nNOS and TRPV1.

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Five patients with primary malignancies in the pterygopalatine fossa (PPF) and infra temporal fossa (ITF) were enrolled in this retrospective study between January 2012 and January 2018. After malignancies proven by biopsy and evaluation with CT and MRI scan, all patients received modified maxillary swing (MMS) approach for extirpation of malignant tumors in the PPF and ITF under general anesthesia. En bloc resection with wide surgical margins was successfully performed in all cases. Negative margins were observed in 4 cases and positive margins were found in one patient with adenoid cystic carcinoma who received postoperative radiotherapy. The most common complication was facial numbness. During the follow-up period (range 12 to 57 months), one patient suffered from recurrence while others did not. The advantages of MMS include wide surgical field, full exposure and easy manipulation. The MMS approach is expected to become an standard method for monobloc resection of malignancies in the PPF and ITF.

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Porphyromonas gingivalis (Pg) is a kind of gram-negative obligate anaerobes. It can invade and internalize within host cells. The invasion ability of Pg is very important for the occurrence and development of diseases and has been a hot topic for a long time. Remaining pathogenic characteristics in cell is one of its pathogenesis. In the process of invading host, the specific bacterial adhesin combine with the ligand of host cells, which activate various signal transduction pathways and trigger bacterial internalization. Virulence factors in Pg, such as fimbriae, gingival protease, hemagglutinins and outer membrane vesicles play significant roles in the process. This review summarized the research progress of the virulence factors which relate to Pg’s invasion, which provided a serious of new ideas on exploring Pg’s pathogenesis and the prevention and treatment of related diseases.