Objective ClC-3 chloride channels express in osteogenic lineage cells and regulate osteoblast differentiation.This study is designed to observe the effect of TGF-β1 receptor (TβR) on the expression of ClC-3 chloride channels in osteoblasts, and to explore the role of TβR in the ClC-3 chloride channels regulating osteogenic differentiation. Methods CCK-8 kit method and Real-Time PCR method were used to screen the optimal inhibition mode of TβR expression in MC3T3-E1 cells. Then inhibiting TβRI and TβRII expression to observed ClC-3 chloride channels，and down-regulated ClC-3 chloride channels expression to detected the impact on TβRI and TβRII by the siRNA transfection technology. Finally, exploring the effect of TβR on expression of Alp and Runx2 via Real-Time PCR. Results It was found that with the concentration of 2μM and the experimental time of 24h was the optimal TβR inhibition mode, and under this circumstances, the cytotoxicity of TβR inhibitors was within safe levels. Inhibiting TβR expression can promote ClC-3 expression. On the contrary, knocking down ClC-3 chloride channels can promote the expression of TβRI and TβRII. TβR inhibitor can promote the expression of osteogenesis-related genes. Conclusions TβR can inhibit the expression of ClC-3 chloride channel in osteoblasts, and TRβII is more sensitive to the expression of ClC-3 chloride channel.

Objective　 To observe the effect of PCL-GT/PCL-simvastatin membrane on repairing defect of rabbit skull. Methods: PCL-GT/PCL-simvastatin membrane was prepared, and the surface morphology was observed by scanning electron microscopy. The sustained release of simvastatin was detected. Eighteen male New Zealand white rabbits were randomly divided into 3 groups with 6 rabbits in each group to prepare skull defect model. The defect area of blank group was not implanted with membrane; the defect area of negative control group was implanted with PCL-GT/PCL membrane; the defect area of experimental group was implanted with PCL-GT/PCL-simvastatin membrane. Animals in each group were sacrificed at 4 and 12 weeks after operation, respectively. MicroCT and HE staining were performed. Results: Results of scanning electron microscopy showed that the obtained PCL-GT/PCL-simvastatin membrane was porous with different pore sizes in different tissue surfaces. Simvastatin could be released stably and slowly for up to 28 days. MicroCT and HE staining results showed that the new bone formation and bone defect healing in the experimental group were significantly better than those in the negative control group and the blank group (P< 0.05). Conclusion: The experiment shows that PCL-GT/PCL-simvastatin membrane can significantly promote osteogenesis, accelerate the repair of bone defects, and improve repair quality.

Abstract：　Objective　To investigate that necroptosis has effects on distance and receptor activator of nuclear factor-κB ligand(RANKL), osteoprotegerin(OPG) expression changes in periodontal tissues during tooth movement in rats. Methods　The orthodontic model of maxillary tooth movement was established in rats, and according to the use of necroptosis inhibitor Necrostatin-1 (Nec-1), the rats were randomly divided into control group (group A), inhibitor group (group B), activation group (group C) and activation + inhibitor group (group D). The forward movement distance of the maxillary left first molar was measured with the vernier caliper, the hyalinization was observed by HE staining on the pressure side, the expression of RANKL and OPG in the periodontal tissue of the pressure side was detected by immunohistochemistry on the 1st, 3rd, 7th, 10th and 14th day. Results　In the group A and group B, the distances of teeth movement and the area of hyalinization did not change appeared, the expression of RANKL and OPG was less. In the group C and group D, the distances of tooth movement change appeared, there was significant difference between the two groups on the 3rd, 7th, 10th and 14th day(P<0.05); Moreover, the expression of RANKL reached the peak at 7 days, the large areas of hyalinization change appeared at the same time, and the expression of OPG reached the peak at 10 days in group C; The expression trend of RANKL and OPG in the group D was the same as that in the group C, but the expression level in group D was less than that in the group C on the 7th and 10th day, and the range of hyalinization change appeared on the 10th day. Conclusion　Necroptosis can promote tooth movement during orthodontic tooth movement. Nec-1 reduced the expression of RANKL and OPG, inhibited the differentiation and maturation of osteoclasts and hindered tooth movement.

Objective To evaluate the effect of arginine(Arg) combined with Bioglass(BAG) on the remineralization of early caries lesions in deciduous enamel . Methods Caries-like enamel lesions of were assigned to 5 experimental groups : (1) 6%BAG, (2) 6%BAG+1%Arg, (3) 6%BAG+2%Arg, (4) 6%BAG+4%Arg, (5) deionized water and transported to a 14 day's pH-cycline. Vickers hardness test evaluated the mechanical properties through enamel microhardness recovery ratio (% REMH). Surface morphologies along with Ca (Wt%)、P (Wt%),、and Ca/P atomic ratio were observed using scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy. Results % REMH processed by each group were (54.49±2.44), (65.95±4.11), (67.00±2.03), (63.73±1.64b), (8.46±2.63c); a newly formed layer was found in all groups, among which the 2% and 4% arginine combined groups showed the flattest; the Ca(wt%)、P (wt%) and Ca/P ratio were significantly higher in combination groups than bioglass group, and 2% and 4% arginine combination groups showed the similar Ca/P to the normal enamel. Conclusion Arginine and bioactive glass have a synergistic effect on the remineralization of deciduous teeth, and the 2% arginine combined with 6% bioglass showed the best comprehensive ability.

Abstract: Objective To evaluate bone thickness of the infrazygomatic crest (IC) to analyze the risks for mini-screws insertion in adults with different vertical skeletal patterns. Methods The sample collecting CBCT of 67 adult patients with different vertical skeletal patterns who visited Affiliated Stomatological Hospital of Nanjing Medical University from 2016 to 2020. The bone thickness of the IC was evaluated at 70° and 65° angulations on the coronal slice in the mesial buccal root (MB) and distal buccal root (DB) of the maxillary left first molar and the region between the first and second molars (PR) on the left side. Results Bone thickness of the IC decreased from the mesial buccal root of the maxillary first molar to the region between the first and second molars. There were no statistics difference of bone thickness in IC between different skeletal patterns in the three selected measurement planes. Conclusion CBCT may be necessary to install mini-screws in the IC correctly. The best site to install mini-screws is buccal to the first molar mesial buccal root and at 70° angulation which will reduce the risk of invade the maxillary sinus.

Objective　 To verify the feasibility and reliability of digital wafers in bimaxillary surgery for skeletal Class III malocclusion patients and compare the accuracy of digital wafers with traditional wafers. Method Forty patients with skeletal Class III malocclusion who performed bimaxillary surgery were divided into traditional wafer group and digital wafer group, 20 in each group. In ProPlan CMF 3.0 software, the linear distance from 14 hard tissue measurement points to three reference planes was measured and the angles between the three selected measurement planes and the three reference planes were measured. Simulative and real difference between traditional wafer group and digital wafer group was compared. Result The difference between simulative and real linear measurement indexes of digital wafer group was less than 2 mm, and the difference of angle measurement indexes was less than 4°. L1-Y, GoL-X, GoL-Y, GoR-X, GoR-Y, CoL-Y and CoR-Y in digital wafer group had statistical differences between simulation and reality (P≤0.042). There were statistical differences between the traditional wafer group and the digital wafer group in L6L-X, GoR-X, LOP-X, MP-X, GoL-Y and MP-Z (P≤0.046). Conclusion The application of digital wafers in bilateral surgery is safe and reliable, and is more accurate and effective than traditional wafers.

Objective　 Sausage technique was applied in patients with knife-edge ridge to evaluate the effect of horizontal bone increment and provide clinical reference. Methods Twelve patients with residual alveolar bone width less than 5mm in the edentulous area at the Department of Implant, Hangzhou stomatological hospital were included, containing 18 horizontal bone increment sites. Planting sites’ CBCT data were collected, including preoperative data, data immediately after operation and 9 months of postoperative. It was fitted by 6D Dental Planning software. The width of alveolar bone was measured at vertical distance 1 mm, 3 mm, 5 mm and 7 mm from the midpoint of alveolar crest. SPSS25.0 software was used for statistical analysis. Result At 1mm, 3mm, 5mm and 7mm sections, the average increase of bone mass at 9 months postoperative compared with preoperative respectively was 2.26mm, 3.13mm, 3.17mm and 2.81 mm. Bone mass at 9 months of postoperative was compared with preoperative bone mass by One-way analysis of variance (Bonferroni). The bone mass of 1mm, 3mm, 5mm and 7mm sections at 9 months of postoperative was significantly increased compared with preoperative, and there was statistical significance (F=36.83；P<0.05)；(F=76.13；P<0.05)；(F=57.29；P<0.05)；(F=24.10；P<0.05). Conclusion Sausage technique can effectively improve horizontal bone defect of the knife-edge ridge.

[ABSTRACT] Objective: To study the remodeling of the temporomandibular joint after treatment with fixed magnetic functional appliance. Methods: Fifteen patients diagnosed with functional and bony Class III malocclusion by X-ray cephalometric analysis before treatment were treated with Class III fixed magnetic function appliance.Result: After orthopedic treatment: 1.The anterior space of the joint increases, the posterior space of it decreases, the joint space index decreases, and the position of the condyle process in the articular fossa is shifted backward; 2.The disc condyle angle and the anterior band disc condylar angle increase, the joint disc moves backward within the physiological range, and the change of the position of the anterior band of the joint disc is consistent with that of the position of its posterior band; 3.The angle of the condylar process head is increased, and the condyle process is flexed forwards; 4.There is no significant difference between the angle of the articular fossa posterior bevel and the angle of the articular fossa. Conclusion: Fixed magnetic functional appliance treatment can induce adaptive changes within the physiological range in TMJ in patients with type-Ⅲ malocclusion during the growing period. After correction using fixed magnetic functional appliance the posterior condylar process is displaced backwards, the articular disc is displaced forwards, and the thickness of the bilaminar area is reduced. The condylar process head is flexed forward.

Abstract： Objective to evaluate the treatment effects of improved segmental arch wire combined with mini-implant anchorage on patients with moderate and severe dentition crowding and anterior labial inclination. Methods: 12 patients with moderate and severe dentition crowding and anterior labial inclination were selected. The fixed orthodontic appliance combined with improved segmental arch wire and mini-implant anchorage technology were used to align the dentition, close the space and reduce anterior proclination. The changes of before and after treatment were analyzed through the cephalometric and model measurement, and the therapeutic effect was evaluated. Results: After correction, the crowding of dentition and labial inclination of anterior teeth were reduced significantly, the overjet and overbite of anterior teeth was normal, and the occlusion of posterior teeth was stable. Conclusion: the improved segmental arch wire combined with mini-implant anchorage technology can avoid the alternate motion of anterior teeth in the process of correction, shorten the treatment time and obtain ideal correction effect.

Objective: To study the efficacy of decompression combined with secondary surgery, curettage and resection in the treatment of jaw ameloblastoma (AM), and to provide reference for the selection of clinical treatment. Methods: A retrospective analysis of 92 patients with AM in the jaw was performed, and measured by image j software, using paired t-test and chi-square test to analyze the effective rate of decompression combined with secondary surgery, jaw recovery and inferior alveolar nerve injury rate. The recurrence rate of patients with AM in the jaw was evaluated using chi-square test, cox multifactor regression model and Kaplan-Meier method to investigate the effect of age, site of onset, different surgical methods, gender and histopathological typing on the recurrence rate. The effective rate of fenestration, the amount of jaw recovery and the injury rate of inferior alveolar nerve were analyzed by image j software. Results: The age distribution of 92 patients ranged from 8 to 76 years, of which 16 were 0-20 years old; 42 were 20-40 years old, and 34 were over 40 years old. Gender distribution was 54 males and 38 females. According to clinical classification, 33 cases were divided into single cyst type and 59 cases were classic type. According to histopathology, they were divided into single cyst type: 33 cases; follicular type: 28 cases; plexiform type: 24 cases; basal cell type: 5 cases; acanthoma type: 1 case; granular cell type: 1 case. 42 cases underwent curettage alone; 25 underwent resection alone; 25 underwent decompression combined with secondary surgery. The effective rate of measurable patients was 77.8% and the average reduction ratio of the lesion was 52.7% in patients who used decompression treatment (P <0.05). In 14 patients with measurable AM of jaw, the thickness of the thinnest jaw near the tumor cavity was less than 5mm before decompression and recovered to more than 5mm after decompression (P < 0.05). The lower lip numbness rate of patients who used decompression combined with secondary curettage for AM of the mandible was 31.6%, and the numbness of the lower lip after treatment with simple curettage was 36.1% (P > 0.05). The recurrence rate of decompression combined with secondary curettage (21.05%) was lower than that of curettage alone (54.76%) (P < 0.05). The recurrence rate of simple resection (24%) was lower than that of simple curettage (54.76%). Gender, age, pathological classification, pathogenesis, multi-factor Cox regression inspection of the surgical method, showed that these factors have no statistically significant impact on the recurrence of jaw AM (P> 0.05). The 3-year cumulative recurrence rates of curettage, decompression combined with secondary curettage and resection were 24.39%, 16% and 4%, respectively. Conclusions: Decompression can reduce the tumor cavity area of jaw ameloblastoma and increase bone thickness, which is beneficial to the preservation of jaws of patients with ameloblastoma. Decompression does not increase the risk of recurrence of Second stage operation. Decompression can reduce the lumen area of AM and increase bone thickness, which is beneficial for jaw bone preservation in patients with AM. Also, decompression combined with secondary curettage and direct resection compared with simple curettage could reduce the recurrence rate of AM.

[Abstract] Objective To investigate the application of digital analog pressure model in the fabrication of free end removable partial dentures. Methods Two different methods were used to make dentures for 21 subjects . In the experimental group, the soft and hard oral tissue morphology and occlusal relationship of the patients were scanned with 3SHAPE oral digital impression instrument, and the digital model was generated, which was imported into the denture design software together with the CBCT data of the patients. CBCT images and digital model images were fitted and aligned according to the position of remaining teeth to obtain the information of bone morphology and corresponding mucosal thickness. Virtual grinding or buffering operation was carried out on the digital model to generate the analog pressure digital model on which the dental prosthesis framework was designed.the framework was 3D printed and the prosthesis was completed through tooth arrangement and glue filling. In the control group, pressure impression model was obtained by model replacement technique to complete the denture fabrication. The clinical effect of two groups of dentures was compared by testing. The morphological differences of mucosa at 63 sites on the free end of the working model obtained by the two methods were measured and analyzed. Results Among 21 subjects, the proportion of mucosal tenderness in the experimental group was 4.76% significantly lower than that in the control group, 23.81%. The mucosal differences of 63 sites between the simulated pressure digital model and the pressure impression model were analyzed. There was no significant difference between the experimental group and the control group in soft tissue deformation of alveolar crest near abutment（P=0.11）; The soft tissue deformation of distal abutment teeth in the experimental group was significantly greater than that in the control group(P＜0.05)；In the mandibular protuberance area, the experimental group had more buffer space than the control group, and there was a significant difference in morphology(P＜0.05). Conclusion The digital impression was fitted with CBCT data for personalized digital model modification, which can selectively adjust the mucosal pressure distribution and effectively relieve the uneven subsidence and tenderness of the free end of the removable partial denture. The clinical effect was satisfactory.

Objective To analyze the effect of Non-surgical Root canal therapy for large Periapical cyst-like lesions. Methods From January 2015 to December 2020, 60 cases of periapical cystic lesions with the maximum diameter of more than 10mm were treated in the Affiliated Stomatological Hospital of Nanjing Medical University, in which，there are 32 cases only treated with none-surgical root canal treatment in group A , and the other 28 cases in group B with apical surgery after root canal therapy. Then regular follow-up observation was carried out after treatment. Results After 3-18 months of follow-up, 12 of the 32 patients in group A healed, 16 improved, 4 did not see significant changes in the root lesion, the effective rate was 87.5%. Of the 28 patients in group B, 16 were cured and 12 were improved, with an effective rate of 100%. Statistically, there was no significant difference between the two groups (P>0.05). Conclusion Non-surgical treatment has a high success rate for large periapical cyst-like lesions, which can be used as the preferred method for large apical cystic lesions without acute symptoms.

Periodontitis is closely related to general health and many systemic diseases.In recent years, a number of studies have found that there is a correlation between periodontitis and cancer. Periodontitis promotes the occurrence and development of cancer, and patients with periodontitis have an increased risk of cancer, but the specific mechanism between the two remains unclear. This article reviews the relationship between periodontitis and head and neck cancer, gastrointestinal cancer, lung cancer, liver cancer and breast cancer and the mechanisms.

Successful restorations must have functional and durability. The improving of hydrolysis resistance and enzymatic degradation of resin-dentin bonding interface are essential for improving the durability of restoration. Adhesive interface re-mineralization helps to solve this problem. This article reviews the mechanism, common product and characterization of biominetic analogs induced resin-dentin bonding interface remineralization.

Jaw movement recording is an important clinical technique that can help physicians understand the process and principles of jaw movement, diagnose diseases and evaluate the effectiveness of interventions. Zebris Jaw Movement Analysis System（JMA）, as a mandibular motion recording system that has been gradually popularized in recent years, has its special advantages. This article introduces the working principle and method of Zebris Jaw Movement Analysis System (JMA)and summarizes its application.

The plastic aligner is favored by many doctors and patients due to its advantages of aesthetics and comfort. Due to the particularity of correction force loading, its clinical indications are relatively narrow. How to solve the problem of overall tooth movement is the most important task to broaden the indications. However, there is a lack of systematic research on the root control movement at present. This paper will summarize relevant studies on the basis of overall biomechanics of movement, the types of root control attachment and the optimization measures, so as to provide a reference for the plastic aligner in clinical practice.

A normal articular disc-condyle relationship is important to the health of temporomandibular joint. The change of articular disc-condyle is of great clinical significance. Magnetic resonance imaging (MRI) is considered as the gold standard of temporomandibular joint disc-condyle relationship disorder and soft tissue morphology imaging, and is widely used in the evaluation of temporomandibular joint characteristics, diagnosis assistance and treatment choice. At present, most studies show that the early stage of temporomandibular joint disorder（TMD） may be characterized by anterolateral displacement of the joint disc and changes in the shape of biconcave. Changes in the shape and position of the articular disc further lead to changes in the length, height and rotation angle of condyle, which makes the disease develop to a more serious stage. The position and shape changes of joint disc and the anatomical changes of condyle in TMD patients are related to the displacement of joint disc, which is considered to be the most common cause of TMD.

Peri-implantitis is a kind of plaque related inflammatory disease around dental implant, which is clinically characterized by mucositis, bone absorption and other soft and hard tissue damages, and is an important complication leading to the failure of dental implant. In recent years, a great number of studies have reported that immune response plays an important role in the pathogenesis and progression of peri-implantitis. Immunomodulation of local microenvironment can affect the development and prevention and treatment of peri-implantitis. This article reviewed the related research progress of immune response, mechanism and influencing factors of peri-implantitis.

Absence of maxillary central incisor is often accompanied by the absorption of labial bone wall, resulting in the reduction of the width of labial-palatal alveolar ridge. Considering the aesthetic restoration of anterior teeth, implants are usually more palatally inclined. The nasopalatine canal (NPC) is anatomically adjacent to the implant site of the maxillary central incisor, which leads to the possibility of implants entering into NPC during operation. The implants that enter into NPC may result in palatal paresthesia, non-osseointegration, and implants loss. NPC perforation, as one of the complications of maxillary central incisor implantation, not only reduces the success rate of implantation, but also causes negative emotions in patients. Therefore, this paper reviews the incidence, influencing factors of NPC perforation, clinical diagnosis, preventive measures and clinical treatment of NPC perforation in maxillary aesthetic area, in order to provide theoretical reference for avoiding NPC perforation.