Abstract：　Objective To evaluate the marginal microleakage of class-Ⅱrestorations separately with SonicFillTM composite and 3M FiltekTMZ350composite under self-etch and selective enamel etch conditions. Methods　Class-II cavities were prepared in 48 molars and randomly divided into 4 groups according to different composite and etch ways (n=12): Group A: Self-etch with 3M single bond Universal adhesive + 3M FiltekTM Z350; Group B: Selective enamel etch + 3M single bond Universal adhesive+3M FiltekTM Z350; Group C: Self-etch with Kerr Optibond Versa adhesive + SonicFillTM composite; Group D: Selective enamel etch + Kerr Optibond Versa adhesive + SonicFillTM composite. After thermocycling, the specimens were submitted to Methylene blue for 24 hours. Then each sample was sectioned into 4 pieces in mesio-distal direction. Dye penetrations were examined under stereomicroscope. Results　The differences which were statistically significant in the microleakage of gingival wall were that Group B less than Group A, Group D less than Group C, Group C less than Group A and Group D less than Group B. And the differences which were statistically significant in the microleakage of side wall were that Group B less than Group A, Group D less than Group C, Group C less than Group A and Group D less than Group B. Conclusions　 Less microleakage of class-Ⅱ restorations in posterior teeth has been found in SonicFillTM composite than 3M FiltekTMZ350composite. And it is suggested to use selective enamel etching to reduce the marginal microleakage while filling posterior teeth with big cavities.

Abstract： Objective To provide the basis for the application of electronic colorimeter into shade selection in composite resin adhesive restorations. Methods Three light-curing resin composites, a total of 23 shades, were investigated. Trapezoidal specimens of 1mm, 2mm and 3mm in thickness of each shade of resin composites were prepared, 5 for each kind of thickness. Color was measured by CrystalEye spectrophotometric colorimeter against white and black backgrounds. CIE L* , a*, b* values relative to CIE source were obtained, and color difference was analyzed under the Vita classical built shade guide. The system gavethe most recommended shade and color difference ΔE was obtained. With Vita classical shade guides as a built-in, the factors of brand, background and the thickness of the resins affecting the match rate of the results of shade matching were analyzed. Results Background influenced the match rates of the results of shade matching to Tetric and Majesty, while not to Ceram X（p>0.05）. The match rate of the results of shade matching over a black background was much higher than that over a white background（p<0.001）.Thickness of the resins influenced the match rates of the results of shade matching to Tetric and Majesty（p<0.05）, while not to Ceram X（p>0.05）. As the thickness increased, the match rates of the results of shade matching showed a tendency to increase.

Objective: To analyze the changes and characteristics of jaw growth in adolescent patients with temporomandibular joint disc displacement. Methods: 32 adolescent patients with unilateral temporomandibular joint disc displacement were involved in this study. CT scan were performed and the data was input in to Surgicase5.0 software for three-dimensional measurement. The upper/lower mandible markers and reference planes were set up to measure horizontal, vertical and sagittal growth, and to compare the difference between two sides of jaws. Statistical analysis was made by SPSS 16.0. Results: The development of the mandible in the side with TMJ disc displacement was smaller in all directions than those in the contralateral side. All of the patients showed mandibular deviation to affected side. Distance of point Gn to SAG plane ranged from 0.72 to 12.37mm, the average was 4.72 +/- 3.41mm; the ipsilateral mandibular body length was shortened compared to the normal side (P<0.05); the discrete distance of points Go and Co to SAG plane were shorter than those of the contralateral side (P<0.001); mandibular incisor point (Li) deviated to the side with disc displacement at a range of 3.44 +/- 2.72mm, overtook maxillary incisor point (Ui), with a date of 1.19 +/-0.63mm(P<0.001); transverse diameter of condyle was smaller in the side with disc displacement (P<0.001). Conclusion: Temporomandibular joint disc displacement in adolescence was closely related to the occurrence of asymmetric maxillofacial deformity and presented a consistent characteristic. Key words: three dimensional changes, adolescent , temporomandibular joint, disc displacement

Abstract： Objective To evaluate the clinical effects of VITA resin inlay in restoration of the badly broken-down first permanent molars for children and adolescents. Methods 178 badly broken-down first permanent molars aged from 6 to 16 years old were selected and randomly assigned into 2 groups. VITA resin inlay restorations were used in the test group, composite resin direct fillings were used in the control group. Clinical assessment was made after treatment one year later. All data were statistically analyzed by SPSS 16.0. Results The restoration success rate of test group was 97.78%, significantly higher than that of control group 84.09% (P＜0.01). There was no significant difference between maxillary and mandible teeth in test group and control group(P＞0.05). There was no significant difference in effective rate between male and female in the test group(P＞0.05), but the restoration success rate of male was significantly lower than that of female in the control group (P＜0.01). Conclusions The clinical effects of VITA resin inlay in restoration of the badly broken-down molar are superior to composite resin direct filling. The clinical requirement can be satisfied.

Objective：To evaluate the influence of surgery first orthodontic treatment for temporomandibular disorder(TMD) Methods: 43 patients who had undergone surgery first orthognathic treatment at Affiliated Stomatological Hospital of Nanjing Medical University between 2013 and 2015 were studied. The symptoms of TMD were assessed subjectively and objectively in three different periods: one or two weeks before surgery (T1),two or three weeks after surgery(T2), after postoperativeorthodontics(T3).Statistical analysis were performed to verify the association of the variables(P<.05). Results: When compared to males females had a higher prevalence of TMD(P=0.014). There was a decrease in TMD between T1 and T3. Patients with occlusal plane deviation over 2mm also had a higher prevalence of TMD(P=0.009). Maximum mouth opening(MMO) with TMD decreased from T1 to T2(P<.001), improved from T1 to T3(P<.001) and no different between T1 and T3. The same situation occurred in MMO without TMD.There was no statistical significant different between mandible surgery and combined jaws surgery. Conclusions: The signs and symptoms of patients with TMDs can be relived under treatment of surgery first orthodontic.

[Abstract] Objective ：To observe the clinical effects of Physiologic Anchorage Control technique in the treatment of maxillary lip-opposite low canine and severely crowding . Methods: 20 patients with maxillary lip-opposite low canine and severely crowed teeth were included, their average years were 14.5. They were extracted 4 first premolars and treated with PASS appliance .Analysis was carried out before and after treatment．Results: After treatment，normal overbite ,overjet and good occlusal relationship were achieved. The upper first molar showed mesial displacement of 1.56±1.1mm, no significant change was found after treatment． Conclusions ：Physiclogic Anchorage Control technique could be effectively and conveniently used in the treatment of patients with severely crowed malocclusion

Abstract： Objective To investigate cranial base morphology of patients with Angle Class Ⅱ and Ⅲ malocclusion in the permanent dentition using tomographic cone beam (CBCT). Methods Forty patients aged from 19 to 26 years old were divided into Class Ⅱ and Class Ⅲ group according molar relationship. Linear and angular measurements were obtained in the mid-sagittal plane from the images of CBCT, and analyzed for all subjects. The mean differences between both groups were tested using Student’s t-test for independent samples. Pearson’s product-moment correlations were calculated between the parameters of the sagittal jaw relationship and cranial base. Results The cranial base angle deceased significantly in patients with Class Ⅲ malocclusion compared with Class Ⅱ malocclusion. Positive correlation was detected between SNA and S-N，S-Ba，N-Ba. The value of SNB was found significant negative correlation with NSBa，and positive correlation with S-N，S-Ba，N-Ba. There was also negative correlation between ANB angle NSBa . Conclusions There is association between malocclusion in sagittal jaw relationship and cranial base morphology in adult，and cranial base angle has more effects on maxillofacial morphology.

Objective　 The purposes of this study were to evaluate facial asymmetry 3 dimensionally using cone beam computed tomography (CBCT) . Methods　 The CBCT datas of 30 malocclusion pattern with asymmetry (soft tissue menton deviation more than 4 mm distance from the facial midline),(mean age, 19.5years) and 30 pattern without asymmetry (soft tissue menton deviation less than 2 mm distance from the facial midline) (mean age, 19.9 years) were exported to the MIMICS software program (version 17.0). Linear distance, angular, volumetric, and surface area measurements were performed 3 dimensionally to assess and compare intragroup and intergroup differences. Results　 Z-Ag,ZA-Goinf,J-FML,J-N,Golat-Me,Co-Goinf,Gopost-FML,Golat-FML,Gopost-Me,Co-Me,P-N, MOP, MBP and the Golat-Me have significant differences between the deviated side and the undeviated side for the asymmetry pattern（P＜ 0.05) . J-FML、J-N 、Golat-FML have significant differences for the control. The volume and surface of mandibular have significant differences in asymmetry . Conclusions　 Asymmetry mainly be found in mandibular, especially in the gonial region. Facial hard and soft tissue asymmetries can be precisely quantified using CBCT,which is important for diagnosis and treatment.

Abstract：Objective By using two different methods of unilateral cleft lip repair，and 6 months after surgery，respectively，were compared in order to compare the recovery of the affected side lip height there are no significant differences. Methods Fifty children with unilateral cleft lip in were selected，25 patients in each group. The first group was treated with ShiBing’s method，the second group was treated with a new improved Millard individual operative design . Two groups of patients，after surgery，respectively，in 6 months，were measured lip height and the difference calculated，and then compare the two groups，the data for statistical analysis. Results In the second group immediate total figures of the health and trouble side lip height standard deviation difference was big；in the first group immediate total figures of the health and trouble side lip height standard deviation difference was minimum. Thus it can be seen that the surgery method first group of surpassed surgery method second group of obviously. Conclusion At the beginning of the unilateral cleft lip repair surgery, ShiBing individual improvement MillardII operation,have wider application range, can improve lip height restoration;Another new modified Millard method can avoid the nasal floor transverse scar, but can not improve lip height restoration.

Objective Using digital design (referred to as DSD) according to oral and maxillofacial aesthetics principles, through computer simulation analysis and design software, the tooth shape and arrangement can be expressed artistically in a virtual state. The medical team and patients can predict and communicate the treatment outcome well before the treatment, and the unified treatment plan designed by both doctors and patients can guide the whole treatment process. Methods From October 2014 to October 2016, 50 patients with anterior teeth discoloration, tooth defect and uneven dentition were treated under DSD design guidance. The treatment effect was analyzed. Results Aesthetics evaluation was conducted in accordance with Howard B.Kay’s Classification of Altered Dental Esthetics, and all treatments met the requirements of the earlier DSD design. At the same time, the treatment results were satisfactory, and all the patients were satisfied with the shape of the front teeth. There were 3 patients who wanted brighter colors and reworked their bleached white color. Functional occlusion basically mimicked the shape of a temporary restoration, with only a small amount of adjustment needed. Conclusion DSD plays an important role in the esthetic restoration of the anterior teeth. It guides the whole process of the treatment and improves the satisfaction of the patients.

Abstract Objective The purpose of this study is to assess the quality of life and measure oral health and function of cleft lip and/or palate population and to determine if there is a difference in these prospects between younger and older age groups and to support the evidence for making policy to improve the cleft patients’ quality of life. Methods 40 individuals with repaired cleft lip and palate from two age groups of 19-28 years old （G1） and 10-18 years old（G2）identified from Nanjing Medical University Affiliated Stomatology Hospital and Children’s Hospital Affiliated to Nanjing Medical University were selected as experimental groups, and 20 normal adults and 20 normal teenagers were selected as control groups （G3 and G4）. Four groups were investigated by Oral health-related quality of life （OHRQOL） questionnaires. Statistical tool （t-tests） will be used to compare relevant data obtained from the four groups in this study with SPSS 19.0 software package. Results 1） G1 has significant difference with the G3 in terms of the scores of OHIP14, Aesthetic，and no significant difference in terms of the scores of Function, Masticatory Ability, Treatment Satisfaction and Perceived Treatment Need. 2）G1 has significant difference with the G2 in terms of the scores of OHIP14 and Aesthetic. No significant difference with the G2 was observed in terms of the scores of Function, Masticatory Ability, Treatment Satisfaction and Perceived Treatment Need. Conclusion quality of life and oral health status of adults with repaired CLP is relatively low.

Abstract: Objective To investigate the first permanent molar status of primary-school students in Zhoushan City, as a reference for dental caries prevention and treatment. Methods The eruption out, nest ditch, and caries status of first permanent molars of 1035 second-grade students were inspected, recorded, classified and analyzed. Results Among the 1035 students inspected, 3345 first permanent molars had erupted, but 89 had no erupted first permanent molar with calculated eruption rate 91.4%. And 495 students were found to have one molar or several molars caries with calculated caries rate 47.8%. Conclusion The first-permanent-molar caries rate of Zhoushan City is significantly higher than the national average level, which is probably connected with geographical remoteness, traffic inconvenience, and local economical/cultural development level. In order to reduce the dental caries incidence and the effect of dental caries on children’s oral and mental health, it is very important to popularize oral health knowledge to local residents and improve their awareness of oral health.

Abstract:To probe further into the medicine treatment of major recurrent aphthous ulceration.Clinical data:A 46-year-old male had been treated with prednisone acetate for one year due to major recurrent aphthous ulceration and presented complaining of severral large painful ulcer on the right tougne persisting for one weeks. Biopsy, serologies and cultures were performed to rule out infectious etiology .Local medicine treatment was used. Result: Local treatment of Triamcinolone Acetonide Injection as well as Amlexanox was prescribed and the ulcer spontaneously resolved in two weeks. Conclusion: Major recurrent aphthous ulceration can be effectively cured by local medication . Key words: major recurrent aphthous ulceration, medicine treatment

Multiple myeloma (MM) is a monoclonal malignant proliferation disease of plasma cells. The disease is more frequently in men and affects individuals aged from 60 to 70 years old. The initial manifestation of MM is various and depends on the sites and extent of involvement. Its occurrence in the maxilla and/or mandible is very common, however oral lesions rarely appear as the first manifestation of the disease. This paper reported a case of a 55 years old female who had a chief complaint of a mass in the right maxilla and the chin numbness. Contrast-enhanced CT and PET/CT scanning showed middle cranial fossa and maxilla and mandible bone diffuse destructive lesions. The biopsy results, imaging and physical examination led to the diagnosis of MM. The findings of the case report suggest that MM should be included in the differential diagnosis and related radiographic and laboratory evaluation should be administered when considering a patient whose complaint is an unusual maxillary and/or mandibular mass.

In order to discuss the occlusion relationship in both teeth open bite cases and skeletal open bite cases which could design the treatment plan and implement in clinic , we choose 1 open bite case in skeletal type Ⅲ as the clinical treatment; and in skeletal type Ⅲ cases without jaw surgery ,we used the orthodontic technology combined with porcelain cover repair technology ,which treated patients have teeth lingual defect with severs open bite causes by bad habits with noninvasive treatment in how to keep a stable occlusal and treatment effect.

Tooth eruption is a complicated and tightly regulated process involved by a variety of factors including the histologic change of alveolar bone and tooth germ, the cytological change of dental follicle cells, osteoblast and osteoclast etc., and various cytokines. Recently, animal model researches have been used to illustrate the dynamic process of tooth eruption, and this paper will give an overview of animal model research on tooth eruption.

Patients with diabetes have increased incidence, severity of periodontal disease ,which is regarded as a serious complication of diabetes mellitus. Advanced glycation end of products (AGEs) is formed by irreversible reaction of reductase with protein. It plays an important role in the pathogenesis of diabetic chronic complication. In autophagy, damaged organelles and proteins are transported to lysosomes for degradation and recycling, aiming to maintain a homeostatic environment. This process is a highly defensive mechanism among eukaryotic cells. The study of autophagy in mammalian systems is advancing rapidly and has revealed that it is involved in the pathogenesis of various metabolic and age-related diseases. However, the mechanism of autophagy and periodontal destruction in relation to diabetesis unclear. This review focuses on the potential relations between autophagy and periodontitis associated with diabetes mellitus.

Cytotoxic T-lymphocyte-associated protein-4 (CTLA-4) has been identified functioning as an immune checkpoint, downregulates the immune system. Susceptibility to the periodontitis is influenced by gene polymorphisms related to the immune response. This parper reviewed the CTLA-4 inflammatory immune response and evaluated the association of CTLA-4 polymorphisms with periodontitis.

It’s a common practice for orthodontists to extract first premolar and move canine distally to relieve crowding for patients with dental crowding. The biggest resistance for distal movement of canine is the interdental septum distal to canine after extraction of first premolar. Periodontal ligament distraction osteogenesis(PLDO) can decrease the resistance effectively and achieve the goal of rapid distal movement of canine. The histological changes of tooth movement after PLDO are similar to those of traditional tooth movement. The main difference lies in the remodeling speed. It has been confirmed that PLDO can move canine rapidly without complications in a short period.

The signaling pathway exists in all types of life activities of cells. It has been discovered that many signaling pathways are closely associated with the occurrence, development and prognosis of the temporomandibular disorders. In recent years, great progress has been made in the study of signaling pathways and their relationship with TMD, which provides a new way for the precision medicine of TMD.

Cone-beam computed tomography（CBCT）is an emerging oral imaging technology. It is widely used in dental practice due to its low radiation dose，non-distorted image and high spatial resolution. Compared with traditional imaging technology, CBCT has a greater advantage in observation of complex and periapical lesions, diagnosis of omissive root canal, root fractures，root canal perforation，assisting dredging calcified root canal and judging the efficacy of root canal therapy. It is of great help to clinical diagnosis and treatment if CBCT can be made full use in endodontics.