Since the 1980s, minimally invasive therapy has been proposed and rapidly developed in periodontal non-surgical and surgical therapy with the continuous improvement of minimally invasive instruments and medical image techniques, which has greatly improved treatment effects and patients' experience. The purpose of this review was to clarify the application and development of minimally invasive therapy in periodontal treatment according to the published literature and the authors’ clinical experience.

Abstract: Objective To observe the expression of S100 Calcium Binding Protein A8 (S100A8) on macrophages (m?) in gingival tissue with chronic periodontitis, to analyze the role of CD68-S100A8 double positive m? in the pathogenesis of chronic periodontitis. Methods The gingival tissue specimens of 60 subjects were divided into three groups according to the degree of periodontitis lesions: normal control group (20 cases), mild periodontitis group (20 cases) and severe periodontitis group (20 cases). Tissue specimens were fixed by 4% paraformaldehyde solution, stained with hematoxylin and eosin for histopathology，stained with double-immunofluorescence for identification of CD68-S100A8 double-positive m? in gingival tissues. Results Compared with the normal control group, the expression of CD68-S100A8 double positive m? in gingival tissues with human chronic periodontitis was significantly increased (P<0.05); the number of CD68-S100A8 double positive m? in severe periodontitis group was significantly higher than that in the slight periodontitis group (P < 0.05). Conclusion The results suggest that the CD68-S100A8 double positive m? may play important roles in the initiation, development and pathogenesis of the human chronic periodontitis.

Objective To understand preoperative anxiety and postoperative quality of life in patients with periodontally accelerated osteogenic orthodontics (PAOO) surgery, and provide a theoretical basis for preventing preoperative anxiety and improving postoperative quality of life in PAOO surgery. Methods According to the inclusion and exclusion criteria, 45 patients with PAOO surgery were randomly selected. All patients were asked to answer the following questionnaires which included self-rating anxiety scale (SAS), modified dental anxiety scale (MDAS), pain evaluation (VAS visual pain scale), clinical performance evaluation (swelling, bleeding, nausea, oral odor), and oral function evaluation (chewing, speaking, sleeping, working). Data analysis was performed using SPSS 18.0 software. The quantitative and qualitative statistical description methods were used to evaluate the preoperative anxiety and postoperative quality of life of patients with PAOO surgery. Results The preoperative SAS score of the 45 patients was 44.28±11.15, among whom 10 patients had anxiety accounting for 22.22%. The preoperative MDSA score was 9.29±2.78, among the 45 patients, 8 patients had anxiety accounting for 17.78%. The VAS values 1, 3, 5, 7, and 10 days after surgery were moderate pain (7.13±1.04), mild pain (3.98±1.05), mild pain (1.96±0.85), and painless (0.31±0.51), painless (0.09±0.28). The most common discomforts after PAOO surgery were swelling and bleeding. The degrees of swelling 1, 3, 5, 7, and 10 days after surgery were 100.00%, 100.00%,100.00%, 95.66%, 6.67%. The degrees of bleeding 1, 3, 5, 7, and 10 days after surgery were 97.78%, 17.78%, 8.89%、4.44%, 0.00%. The most common discomforts of oral function after PAOO surgery were the effects on chewing and speech. The degrees of the effects on chewing condition 1, 3, 5, 7, and 10 days after surgery were 100.00%, 97.78%, 73.33%, 11.11%, 4.44%. The degrees of the effects on speech condition 1, 3, 5, 7, and 10 days after surgery were 100.00%, 97.78%, 77.78%,11.11%, 4.44%. Conclusion Approximately 15.38% of the patients have dental anxiety before PAOO surgery. The main clinical symptoms after surgery are moderate to mild pain, varying degrees of swelling, bleeding, disturbance in chewing and speech in 1-7 days after surgery. It is suggested that the clinicians should design the reasonable surgical method and optimize the nursing process to relieve the patients’ anxiety and postoperative discomforts.

The relationship between periodontitis and systemic diseases has become a research hotspot, and the correlation between periodontitis and chronic obstructive pulmonary disease has been paid more and more attention. More epidemiological investigations have confirmed that periodontitis affects the lung function of patients and promotes the aggravation of symptoms of chronic obstructive pulmonary disease. Therefore, periodontal intervention can reduce periodontal symptoms, so as to reduce the symptoms of patients with chronic obstructive pulmonary disease. In this paper, we further reviewed the mechanism of the relationship between them: periodontitis can aggravate lung injury by inducing systemic immune response; local periodontal pathogens alone or cooperatively induce the elevation of the level of pulmonary inflammatory cytokines and the accumulation of immune cells promoting the injury of lung epithelial cells.

Abstract：　Objective The aim of this study is to examined the effect of T3 on the odonto/ostegenic differentiation of SCAPs. Methods After treated with T3, the ALP was measured to select the optimum concentration. The CCK‐8 were taken to distinguish the proliferation ability between the T3-treated group and the control group. To evaluate the odonto/ostegenic differentiation potential of the T3-treated SCAPs, RT-PCR, western blot, Alkaline Phosphatase Staining was performed. The MAPK signal pathway was detected via western blot. Results 10-9 mol/L T3-treated group expressed the highest ALP among all groups (p < 0.01) and it was chosen as the optimal concentration. CCK-8 demonstrated that T3 had no significant effect on the proliferation of SCAPs (p > 0.05). Moreover, results of real-time RT-PCR, western blot, showed that 10-9 mol/L T3 increased odonto/ostegenic differentiation of SCAPs. Besides, ERK signal pathway was activated at 15 min after treated with T3. The odonto/ostegenic related protein was suppressed by U0126. Conclusions 10-9 mol/L T3 promote the osteogenic differentiation of SCAPs and this process may be closely realted to the ERK signal pathway.

Abstract: Objective To investigate the effects of vascular endothelial growth factor (VEGF) on endothelial differentiation of periodontal ligament stem cells (PDLSCs). Methods PDLSCs were isolated and induced by bFGF (10 ng/mL), IGF-1 (2 ng/mL) and VEGF of different concentrations (10, 20, 50 ng/mL) in vitro. After 7 d, 14 d and 21 d of induction, the morphology of PDLSCs were observed by inverted microscope. The lumen forming ability of PDLSCs were measured by the tube formation assay. The expression levels of vWF and VEGFR-2 were detected by immunofluorescence. The expression of ANG2, VEGFR-2, VEGFA, IGF-1 and vimentin were detected by western blotting. Results After induction, the morphology of PDLSCs was obviously changed, tube formation assay showed PDLSCs all connected with each other to form different numbers of lumen like structures. Immunofluorescence results showed positive for vWF and VEGFR-2, western blotting results showed ANG2, VEGFR-2, VEGFA and IGF-1 were positively expressed, while vimentin was negatively expressed, and the high-concentration VEGF group was most obvious at days 14 d and 21 d post-induction. Conclusion?PDLSCs possessed the potential for differentiation into endothelia like cells, and all results suggested that 50 ng/mL VEGF was an optimum induction concentration and the optimum duration of induction were 14 d and 21 d.

Abstract： Objective: The aim of our study is to explore the pathogenic genes or susceptibility genes for maxillary canine agenesis by whole exome sequencing (WES). Method: The study was performed on a Chinese tooth agenesis family which consisted of two maxillary canine agenesis patients and a healthy person. Collecting the peripheral blood of the families and genomic DNA was extracted. Then Whole exome sequencing was performed on the family. Likely pathogenic variants were filtered out by bioinformatic analysis. Then PCR-Sanger sequencing was performed in all of the family members for verification of the candidate variants. The functional of the candidate gene and the conservation of the mutated amino acid were predicted by bioinformatic analysis. Result: ITGAV (c.C2381G) was filtered out in the two maxillary canine agenesis patients but not in the healthy person. This missense mutation made Proline (Pro) change to Arginine (Arg). Then Sanger sequencing identified that the mutation was coseparation in this family. Bioinformatic analysis showed that the ITGAV expressed in the mouse and human tooth germ. Besides that the Proline in mutated site was highly conserved in different species. Conclusion: The study showed that ITGAV may be the pathogenic gene for maxillary canine agenesis.

Objective: To observe the efficacy of ozonated water in the decontamination of dental unit waterlines. Methods: Dental unit waterlines (DUWLs) of 4 dental chair units at the Affiliated Hospital of Stomatology NJMU were flushed and disinfected every morning by 2.0mg/L ozonated water. On the 1st,3rd,5th,8th day of the experiment, water samples were collected from triple syringes and handpieces before disinfection, immediately after disinfection, and at the end of the day. SPSS 22.0 software was used for statistical analysis. Results: The average total viable counts (TVC）tested from the water samples obtained from triple syringes and high-speed handpieces before disinfection reached (49550.00±1117.52) and (63875.00±8842.08) CFU/ml, respectively. After disinfection on the 8th day, TVC of the triple syringes and high-speed handpieces decreased to (83.25±42.99) and (591.50±177.26) CFU/ml, respectively. The average daily sterilizing rates of triple syringes and high-speed handpieces were 97.48% and 95.11%, respectively. During the experiment, the daily bacterial recovery showed a downward trend. Conclusion: DUWLs were polluted seriously. Flushing and disinfecting DUWLs with 2.0mg/L ozonated water can effectively inhibit the flora in the waterlines and improve the water quality.

Objective To explore the influencing factors related to early implant failure based on the retrospective analysis of the implant data of the Stomatological Hospital Affiliated to Zhejiang University School of Medicine in 2018. Methods The data and implant situation of patients who received implant surgeries at the Affiliated Stomatology Hospital of Zhejiang University School of Medicine were collected during January to December in 2018. The factors influencing the early implant failure were analyzed from the patients’ own factors, implant factors, and additional bone incremental surgical factors. Results A total of 3504 patients received 6,178 dental implants in 2018, including 1,626 males and 1,878 females. Up to August 31, 2019, a total of 46 patients (47 implants) of early failures were clearly recorded. The early failure rate was 1.31% (46/3504) at the patient level, and 0.76% (47/6178) at the implant level. The early implant failure rate of male patients was significantly higher than that of female patients, which was statistically significant (P <0.05). The early implant failure rate of the implants with a diameter ≤3.5mm was 1.2% (22/1829), which was significantly higher than that of implants with a diameter of 3.6mm-4.5mm (P <0.05). A total of 419 ZDI implants were placed in 2018, and there were 11 implant failures at the early stage. The early implant failure rate was 2.63%, which was statistically higher than that of other implant systems such as Nobel and Straumann, and the difference was statistically significant (P <0.01). Conclusion Male patients are more likely to have early implant failures, and the implant with a diameter ≤ 3.5mm, mandibular anterior teeth and ZDI implants have higher early failure rates.

ABSTRACT: Objective to study the upper airway change of patients treated with mandibular molars distalization by clear aligner using CBCT and Dolphin software. Methods We select 20 cases treated with mandibular molars distalization by clear aligner, and before the treatment (T0) and the first mandibular molar distalization in place (T1) need shoot CBCT. Then Dolphin was used to rebuild 3D image data. According to anatomical structure, upper airway can be divided into four sections: nasopharynx, velopharyngeal, glossopharynge, laryngopharyngeal. Airway volumes, across-sectional area, the minimum cross-sectional area and height were measured[1]. All the data were analyzed by SPSS24.0. Results The height of nasopharynx, glossopharyngeum and laryngopharyngeal increased slightly, and the other parts showed a decreasing trend. The mean total volume of upper airway decreased 3322.63mm3 (P=0.285). The average cross-sectional area decreases 127.75mm2(P=0.577). The minimum cross-sectional area of oropharyngeal segment decreased 50.21mm2 on average (P=0. 406). The maximum height increase of the glossopharynge was 1.67mm(P=0.237). Velopharyngeal volume and cross-sectional area decreased by 1735.71 mm3 (P = 0. 236), 43.71mm2 (P = 0. 437)at most. The maximum decrease in the minimum cross-sectional area was in the laryngopharyngeal, with an average decrease of 23.75mm2 (P=0. 895). None of the data included in the study was statistically significant. Conclusion there was no significant effect on the volume, cross-sectional area, minimum cross-sectional area and height of the upper airway after mandibular molars distalization by clear aligner .

Objective Distolingual root canal length and curvature in mandibular first molars were measured by CBCT in order to provide theoretical guidance and basis for clinical treatment. Methods The cone-beam computed tomography (CBCT) images of 292 three-rooted mandibular first molars were three-dimensionally reconstructed into the models, and the root canal measurement was used to measure the length and curvature of the distolingual root. Results The mean root canal lengths (from orifice to root apex) of the DL roots were 8.57±1.46mm. The average canal length of DL roots was 6.61±1.38mm for Type I, 8.55±1.34mm for Type II, and 9.02±1.31mm for Type III. These lengths differed significantly by DL root type (p<0.05), and the mean length of the Type I DL roots was the shortest among the 3 types. The degrees of primary canal curvatures of DL roots were measured by the Schneider method. The mean degrees of curvature of DL root canal was 9.71±10.42°in buccolingual view (clinical view, CV), whereas the average curvature of DL root canal was 28.55±11.22°in mesiodistal view (proximal view, PV). Statistical analysis showed that the curvature of DL roots in PV was significantly (p<0.05) greater than that in CV. Conclusion To understand and get familiar with the characteristics of the length and curvature of the distolingual root of the first mandibular molars is helpful to improve the success rate of root canal treatment.

Objective: The purpose of this study was to perform a dental examination of the general population, measuring tooth wear and craniofacial morphological parameters to study the effects of craniofacial structural features on tooth wear distribution. Methods: For the initial data of 103 orthodontic patients collected, the wear area of each tooth was measured on the model, and the cephalometry of the patient was subjected to head ANB, MP-FH (FMA) and FMIA, and analysis of the correlation between cephalometric data and tooth wear. Results: The wear area of the upper and lower anterior teeth was statistically different. The ANB was positively correlated with the total wear area and the average wear area of the anterior and posterior teeth. MP-FH (FMA) was negatively correlated with the ratio of the wear area of the anterior and posterior tooth; FMIA was negatively correlated with the average wear area of the posterior tooth. Conclusion: There is a certain correlation between the wear area of the tooth and the cephalometric measurement in the general population. The too steep occlusal plane can cause the posterior teeth to wear more seriously.

Malignant tumor is one of the major diseases affecting human survival currently. Surgery and chemoradiotherapy are still the most widely used conventional treatment methods at present, but the tumor metastasis and recurrence are still common in decades. Looking for a new effective treatment method is a problem to be solved. Cancer stem cells are a few subsets of cells in tumor with unlimited self-renewal and differentiation potency, and Kruppel-like transcription factors play important roles in maintaining stemness and obtaining invasion ability of cancer stem cells. In recent years, the gradual improvement of cancer stem cell theory and the study of molecular mechanism have provided not only a new direction for the study of the pathogenesis, metastasis and recurrence mechanism of malignant tumors, but also a new entry point for the treatment of malignant tumors. This article reviews the possible relationship between KLFs and cancer stem cells.

Integrins are cell surface receptors involved in the regulation of a variety of cellular behaviors including cell proliferation, migration, survival, tissue invasion and innate immunity.It has been reported that mice lacking integrin β6 gene (ITGB6) show significant periodontal inflammation.The interaction between integrin αvβ6 and transforming growth factor-β1 (TGF-β1) plays an important role in inhibiting inflammation.Therefore, this paper mainly discusses the relationship between integrin αvβ6 and periodontitis.

Bone is composed of cancellous bone and cortical bone. High metabolism and proliferation capacity of cancellous bone are the basis of bone regeneration and remodeling. However, at the histological level, cancellous bone is gradually replaced by fat, cortical bone becomes thinner and the loss of bone is more than regeneration with the aging process; while at the cytological level, the aging of bone is mainly manifested as decreased proliferation ability of mesenchymal stem cells, decreased osteogenesis and increased adipose differentiation. Currently, many miRNAs have been found to be involved in metabolism regulation of aging bone and differentiation regulation of mesenchymal stem cells. This paper reviews the regulation and research progress of miRNA for the aging-related bone.

Cone-beam computed tomography is more widely used in the study of temporomandibular joint morphology.The shape and position of the temporomandibular joint are affected by malocclusion. One of the requirements for orthodontic treatment is to maintain or improve the temporomandibular joint condyle-articular relationship. This paper summarizes the research of cone-beam computed tomography applied to temporomandibular joints in healthy people and patients with malocclusion , relationship between orthodontic treatment and temporomandibular joint disorders.

No-preparation ceramic veneers have become the choice of clinicians and patients under certain circumstances although their indications and material selections are limited. Previous studies indicated that the short-term clinical performance of no-preparation ceramic veneers was similar to that of traditional ceramic veneers, with lower preoperative mental tension and postoperative sensitivity but fair marginal adaption. No-preparation technique preserves the entire enamel thus increases the bonding strength of the restorations and fracture resistance of the tooth. The internal adaptions are not perfect since some minor undercuts are not removed. However, there is no consensus on the occlusion design and clinical protocol of no-preparation veneer of no-preparation veneer. Although no-preparation technique has been proposed, more clinical randomized controlled trials should be performed to obtain consistent results.

Guided Tissue Regeneration (GTR) technique is the major treatment method of the reconstruction and regeneration of periodontium. Bioabsorbable barrier membrane is widely used in GTR technique for its admirable biological characteristics and clinical handling properties. This article aims to review properties of various materials of bioabsorbable membrane, and those research progress in periodontal regeneration.

Abutment is an important restoration structure for connecting implants and upper restorations, the characteristics of the abutment, such as the abutment materials, the manufacturing method, the color, the shape of the gingival profile, and the surface properties of the abutment will have different effects on the gingival aesthetics. More and more patients have higher and higher aesthetic requirements for the anterior region. The gingival margins, the vertices of the gingiva, the gingival papilla, the pink aesthetic score of the gingiva(PES) and gingival contours are important factors affecting the aesthetics of the gingiva in the anterior region. The purpose of this article is to introduce the characteristics of the abutment and the thickness of the gingiva surrounding the implant and perceptual aesthetics, Strive to provide clinicians with appropriate implant abutments in the anterior aesthetic region.