A Sampling Survey of the Oral Health Status and Awareness among Primary School Students in Lhasa / 中国医学科学院学报

Objective To investigate the oral health status and awareness of urban children in Lhasa,aiming to provide a data basis for the prevention and treatment of children's caries and the promotion of oral health education. Methods A total of 504 Tibetan students were selected by cluster sampling from 2 primary schools in Chengguan District of Lhasa.All the participants were required to take oral health examination and complete a questionnaire about oral health awareness and behavior. Results The caries prevalence rate and mean decayed-missing-filled tooth(DMFT)of permanent teeth were 75.00% and 2.18±1.91,respectively.The rates of pit and fissure sealant and filling of permanent teeth were 3.77% and 6.81%,respectively.The caries prevalence rate of first permanent molars was 47.62%.The mean DMFT of permanent teeth and caries prevalence rate of first permanent molar were significantly higher in female group(

Medical Emergencies in Dental Clinics: A Survey of 2013 Dentists in China / 中国医学科学杂志(英文版)

Objective To investigate the feature and frequency of medical emergencies in dental clinics in China and the associated factors for Chinese dentists experiencing medical emergencies.Methods A survey study was conducted among 2408 dentists who attended continuing educational courses held by Society of Sedation and Analgesia of Chinese Stomatological Association in 18 cities from December 2015 to December 2018. Demographic information of the dentists and the characteristics of medical emergencies they encountered were collected and analyzed. The associated demographic features for dentist experiencing medical emergencies were analyzed by logistic regression model.Results A total of 2013 dentists provided valid responses and reported 2923 events of medical emergencies in dental clinics. Among them, 85.0% reported that they had encountered medical emergencies, and 35.5% had encountered at least twice. Syncope (35.9%) and hypoglycemia (30.3%) were the most common reported medical emergencies. Medical emergencies were most likely to occur during local anesthesia (49.9%), out-patient oral surgery (25.9%), and root canal treatment (11.3%). There were 6 patients (0.2%) died in emergencies. 84.0% dentists reported that they had never received training courses about medical emergency management in dentistry other than Basic Life Support. Longer practicing time (10-15 years) (

Advance in Functional Restoration of Injured Nerve with Low Level Laser and its Utilization in the Dental and Maxillofacial Region / 中国医学科学杂志(英文版)

The inferior alveolar nerve and facial nerve are the two most important nerves in the dental and maxillofacial region. The injury to them is one of the major postoperative complications after alveolar surgery and orthognathic surgery. However, recovering the nerve function after injury takes a long time and the recovery effect tends to be unsatisfactory. In recent years, an intensively investigated technique, low level laser which has been applying in assisting the recovery of nerve function, has been gradually proved to be effective in clinically treating postoperative nerve injury. In this article we review in terms of the mechanisms involved in low level laser-assisted functional restoration of nerve injury and its clinical application in the recovery of nerve function in the dental and maxillofacial area as well.

Types of Organ Involvement in Patients with Immunoglobulin G4-related Disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic disease that can involve multiple organs and various clinical phenotypes. The purpose of this study was to analyze different types of organ involvement in IgG4-RD patients in China.</p><p><b>METHODS</b>We conducted a prospective cohort study on IgG4-RD patients to analyze the clinical manifestations and rare features of IgG4-RD. Patients were grouped into different types according to organ involvement regarding organ number and organ site. The constituent ratio in different types was also analyzed.</p><p><b>RESULTS</b>A total of 200 IgG4-RD patients, with a male:female ratio of 2.08:1, were grouped into different types. Cases having involvement of two or three organs were the most common whereas the fewest number of patients had multi-organ (≥4) involvement. Serum IgG4 and IgE levels, IgG4/IgG ratio, and percentage of eosinophils increased as the number of involved organs increased. In addition, constituent ratio analysis revealed that patients with salivary gland/lacrimal gland swelling, who also constituted the largest number of IgG4-RD patients, had higher serum IgG4 concentrations and IgG4/IgG values, had higher percentage of Eos, and were more likely to have had a history of allergies relative to patients with internal organ involvement.</p><p><b>CONCLUSIONS</b>The characteristic feature of IgG4-RD is multiple organ involvement with various clinical manifestations and different types. Although serum IgG4 levels increased with the number of involved organs, serum IgG4 levels were higher for those patients with salivary gland/lacrimal gland swelling compared with those with internal organ involvement. Thus, valuable clues to the differential diagnosis of IgG4-RD could be obtained by examining the clinical patterns of organ involvement.</p>

Efficacy of Topical Tacrolimus for Erosive Oral Lichen Planus: A Meta-analysis / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the efficacy and safety of topical tacrolimus for erosive oral lichen planus (EOLP).</p><p><b>METHODS</b>Literatures published up to December 2013 were searched from PubMed, Embase, CENTRAL, Chinese BioMedical Literature Database (CBM), and System for Information on Grey Literature in Europe (SIGLE). All randomized controlled trials (RCTs) of topical tacrolimus for EOLP which compared with other interventions or a placebo were considered in this Meta-analysis. Two researchers collected data independently. The assessment of methodological quality was based on Cochrane Handbook and the materials were analyzed with the software Revman 5.2.5. The primary outcome measures were the symptoms (e.g. pain, discomfort) complained by patients. The secondary outcome measures included the improvement rate of clinical signs assessed by the investigators and the incidence of adverse effects (e.g. clinical candidiasis).</p><p><b>RESULTS</b>A total of 9 RCTs involving 476 patients were finally included. The pooled odds ratio (OR) of clinical improvement for topical tacrolimus vs. topical corticosteroids was 1.19 [95% confidence interval (CI): 0.64-2.22, I2: 44%]. Regarding to 0.1% tacrolimus and 0.03% tacrolimus, the pooled OR were 1.87 (95% CI: 0.60-5.82) and 1.47 (95% CI: 0.14-16.04) respectively in subgroup analysis. No serious adverse events were reported in topical tacrolimus group.</p><p><b>CONCLUSIONS</b>There was no evidence to support that topical tacrolimus for EOLP was more effective and safer than topical corticosteroids in this Meta-analysis. Clinical assessment criteria should be established and accepted by clinicians and researchers before further RCTs are undertaken.</p>

Advances in Oral Venous Lakes / 中国医学科学院学报

New advances have been pioneered in the pathogenesis,clinicopathological features,and treatment of oral venous lakes. It is concluded that oral venous lakes can be classified as a venous malformation,and multidisciplinary approaches (in particular the involvement of department of dermatology and department of ear,nose and throat) may be adopted to achieve better management of this disease.

Applications of lasers in dental implantology / 中国医学科学院学报

With the constant progress of laser physics, medical laser technology has been widely applied in clinical practices and basic researches. In this article, we reviewed the relevant articles on the laser applications in dental implantology and concluded that lasers provides promising solutions in the treatment technology of dental implants and in the treatment of soft and hard tissue conditions.

The application of free tissue flap in simultaneous reconstruction of defects after tongue cancer / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the feasibility of using free tissue flap for simultaneous tongue reconstruction after tongue cancer resection.</p><p><b>METHOD</b>Radial forearm flaps and anterolateral thigh flaps were used for simultaneous reconstruction of different defects after tongue cancer resection in 47 cases. The functional evaluation was assessed during the follow-up period of 3 months to 9 years.</p><p><b>RESULTS</b>Only one flap failed,giving a success rate of 97.7%. The 36 patient available for postoperative follow-up were all able to communicate in basic languages and eat normally. Among them, normal speech was found in 34, while slurred speech was found in two. 31 patients could eat normal diet ,while eight could eat soft diet and two could eat liquid diet.</p><p><b>CONCLUSIONS</b>Simultaneous tongue reconstruction with free tissue flap is a reliable method with high successful rate. Flaps selection based on different tongue defects is the key point to achieve good functional and cosmetic results for the reconstruction tongue.</p>

Multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate whether multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin.</p><p><b>METHODS</b>Twelve caries-free human primary molars were randomly divided into 2 groups. In group 1, each tooth was hemisected into 2 halves. One half was assigned to the control subgroup 1, which was bonded with a commercially available one-step self-etching adhesive according to the manufacturer's instructions; the other half was assigned to experimental subgroup 1, in which the adhesive was applied three times before light curing. In group 2, one split half tooth was bonded with a commercially available one-step self-etching adhesive according to the manufacturer's instructions; for the other half, three layers of adhesive were applied with each successive layer of light curing. Specimens were stored in 0.9% NaCl containing 0.02% sodium azide at 37℃ for 18 months and then were subjected to microtensile bond strength test and the fracture mode analysis.</p><p><b>RESULTS</b>When the adhesive was applied three times before light curing, the bond strength of the experimental subgroup 1 was significantly higher than that of the control subgroup 1 (47.46∓13.91 vs. 38.12∓11.21 MPa, P<0.05). When using the technique of applying multiple layers of adhesive with each successive layer of light curing, no difference was observed in bond strength between the control subgroup and the experimental subgroup (39.40±8.87 vs. 40.87±9.33 MPa, P>0.05).</p><p><b>CONCLUSION</b>Multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin when using the technique of light-curing after applying 3 layers of adhesive.</p>

Expression of MICA/B protein in esophageal cancer and its clinical significance / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the expression of MICA/B in human esophageal cancer, and to analyze its correlation with clinicopathological features.</p><p><b>METHODS</b>The expression of MICA/B in 40 cases of esophagus carcinoma and corresponding normal esophageal mucosa tissues were examined by immunohistochemistry.</p><p><b>RESULTS</b>The positive rate of expression of MICA/B protein in the esophageal carcinoma was 75.0% (30/40), and that in the corresponding normal esophageal mucosa was 0 (0/40). Up-regulation of MICA/B expression was found in the esophageal carcinomas. The expression of MICA/B was related with histological grade of the esophageal carcinoma (P = 0.012).</p><p><b>CONCLUSION</b>MICA/B protein plays an important role in the esophageal carcinogenesis, and my become a useful molecular marker for the diagnosis of esophageal carcinoma.</p>

Effect of Yunnan Baiyao capsules on the socket healing of impacted mandibular third molar extraction / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of the traditional Chinese medicine Yunan Baiyao on the socket healing of impacted mandibular third molar extraction.</p><p><b>METHODS</b>A total of 200 patients requiring extractions of impacted mandibular wisdom teeth were randomized into the treatment group and the control group in a double-blinded manner, and Yunan Baiyao capsules or placebo capsules (2 g/d) were orally administered for 28 days after the operation. Dental quantitative CT scan was performed, and the volume and density of new bone at the extraction site were measured two month after operation.</p><p><b>RESULTS</b>A total of 188 patients completed the study. No adverse events related to the medication occurred. The volume of new bone was (477.39 ± 166.47) mm(3) in the treatment group and (442.65 ± 143.58) mm(3) in the control group, which was not significantly different between the two groups. The density of new bone was (296.90 ± 37.94) mg/cm(3) in the treatment group and (298.54 ± 40.21) mg/cm(3) in the control group, which was not significantly different between the two groups. The number of the teeth root, the impacted conditions, whether or not retainning the alveolar septum, suturing soft tissues of the extraction site and blood clot formation within 1 week after operation were significantly correlated with the volume of new bone.</p><p><b>CONCLUSIONS</b>Yunnan Baiyao capsules has no effect on the volume and density of new bone at the extraction site two months after operation following extractions of impacted mandibular third molars.</p>

Effect of multiple coatings of one-step self-etching adhesive on microtensile bond strength to primary dentin / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effect of multiple coatings of the one-step self-etching adhesive on immediate microtensile bond strength to primary dentin.</p><p><b>METHODS</b>Twelve caries-free human primary molars were randomly divided into 2 groups with 6 teeth each. In group 1, each tooth was hemisected into two halves. One half was assigned to control subgroup 1, which was bonded with a single-step self-etching adhesive according to the manufacturer's instructions; the other half was assigned to experimental subgroup 1 in which the adhesive was applied three times before light curing. In group 2, the teeth were also hemisected into two halves. One half was assigned to control subgroup 2, which was bonded with the single-step self-etching adhesive according to the manufacturer's instructions; the other half was assigned to experimental subgroup 2 in which three layers of adhesive were applied with light curing each successive layer. Microtensile bond strength was immediately tested after specimen preparation.</p><p><b>RESULTS</b>When the adhesive was applied three times before light curing, the bond strength of the experimental subgroup 1 (n=33, 57.49 +/-11.61 MPa) was higher than that of the control subgroup 1 (n=31, 49.71 +/-11.43 MPa, P<0.05). When using the technique of applying multiple layers of adhesive with light curing each successive layer, no difference of immediate bond strength was observed between the control subgroup 2 and the experimental subgroup 2 (P>0.05).</p><p><b>CONCLUSION</b>strength to primary dentin when using the technique of light-curing after applying three layers of adhesive.</p>

Effect of combination of pulsed CO2 laser irradiation and diammine silver fluoride treatment on ultrastructure of dentine / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the effect of combination of pulsed CO2 laser irradiation and diammine silver fluoride treatment on the ultrastructure of dentine.</p><p><b>METHODS</b>Each extracted molars was made into four identical dentinal specimens, which were randomly divided into 4 groups according to the treatment methods: A, control group; B, pulsed CO2 laser irradiation; C, coated with 38%Ag(NH3)2F; and D, laser irradiation plus fluoride. Scanning electron microscope (SEM) analysis was performed.</p><p><b>RESULTS</b>As shown by SEM, group A showed clear dentinal tubuli, group B showed melted surface without dentinal tubule openings, group C showed thicker melted layer without dentinal tubule openings, and group D showed the thickest melted and recrystallized layer on dentine surface.</p><p><b>CONCLUSIONS</b>Both pulsed CO2 laser irradiation and 38%Ag(NH3)2F treatment can seal dentinal tubule. The combination of these two techniques can form a synergistic effect.</p>

Mutation and expression of tumor suppressor gene phosphatase and tensin homolog deleted in chromosome 10 in oral squamous cell carcinoma / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the role of mutation and mRNA expression of tumor suppressor gene phosphatase and tensin homolog deleted in chromosome 10 (PTEN) in tumorigenesis and progression of oral squamous cell carcinoma (OSCC).</p><p><b>METHODS</b>The mutation of exon 3, 5, 6 and exon 8 of PTEN gene in 42 oral squamous cell carcinoma tissue and paired normal tissue were detected by polymerase chain reaction (PCR) and DNA sequencing methods. The levels of PTEN mRNA expression in these tissues were assayed using semi-quantitative RT-PCR. Data was analyzed with SPSS 14.0 software package.</p><p><b>RESULTS</b>Mutated exon 5 of PTEN gene was found in 2 cases of advanced OSCC. The expression of PTEN mRNA was detected in all OSCC and paired normal tissue. The level of PTEN mRNA in OSCC tissue (0.36 +/- 0.12) was significantly lower than that of paired normal tissue (0.64 +/- 0.09, P < 0.01).</p><p><b>CONCLUSIONS</b>The decreased expression of PTEN mRNA contributes to tumorigenesis of OSCC.</p>

Reconstruction of large through-and-through palate defects with folded free forearm flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the reconstruction method of large through-and-through palate defects.</p><p><b>METHODS</b>From 2003 to 2006, 7 cases of large through-and-through palate defects were reconstructed with vascularized folded free forearm flap. 8 flaps were used, including 7 free forearm flaps and 1 pectoralis major myocutaneous flap.</p><p><b>RESULTS</b>All the tissue flaps survived well except one flap necrosis because of arterial thrombosis. The appearance of reconstructed palate was acceptable, and the functions of swallowing and speech were normal or almost normal.</p><p><b>CONCLUSIONS</b>It is feasible and effective to repair large through-and-through palate defects with folded free forearm flap.</p>

Blood pressure changes of elderly hypertensive patients during dental extraction under sedation with continuous intravenous infusion of midazolam / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the changes in blood pressure (BP) of elderly hypertensive patients having dental extraction under sedation with continuous intravenous infusion of midazolam.</p><p><b>METHODS</b>One hundred elderly hypertensive patients undergoing dental extraction were recruited for this single-blind, randomized, controlled study. Patients in intervention group (n = 50) were given midazolam dissolved in glucose solution and patients in control group (n = 50) were given glucose solution only with communication technique. Systolic BP (SBP) and diastolic BP (DBP) were recorded in five time points.</p><p><b>RESULTS</b>Under basal conditions, intervention group did not show significant difference in BP compared with control group. Before sedation, mean values of SBP and DBP (especially SBP) significantly increased compared with basal conditions in both groups (P < 0.05). During dental extraction sessions, mean values of BP in intervention group significantly decreased than control group (P < 0.05), but coefficient of variation did show significant difference in both groups.</p><p><b>CONCLUSION</b>Continuous intravenous infusion of midazolam has been proved to be very successful in controlling BP of elderly patients having dental extraction.</p>

Continuous intravenous infusion of midazolam: a clinical study of conscious sedation for dental phobia / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the sedative effect of continuous intravenous infusion of midazolam in treating severe dental phobia.</p><p><b>METHODS</b>31 patients with severe dental phobia were enrolled and all of them had good communication with dentists. Two teeth in each patient were assigned to control group and experiment group seperately. The control group received root canal therapy. The experiment group were sedated by intravenous midazolam and received root canal therapy. The treat dependence and behavior therapy efficacy were evaluated. The vital signs and side effects during treatment were noted.</p><p><b>RESULTS</b>Continuous intravenous infusion of midazolam showed a significant good sedative effect on patients with severe dental phobia. There were statistical difference in the Houpt score and the Frankl score between experiment group and control group (z = -4.846, P = 0.000; z = -4.907, P = 0.000). The total dose of midazolam was (9.58 +/- 3.76) mg, and mean infusion rate was (0.28 +/- 0.06) mg x kg(-1) x h(-1). The blood pressure, heart rate and respiration of experiment group were depressed. But these changes didn't interfere with the completion of the whole treatment. No severe side effects were detected.</p><p><b>CONCLUSION</b>The single use of midazolam as an intravenous sedation agent has satisfactory effect on patients with severe dental phobia.</p>

Evaluation of midazolam intravenous sedated patient's comfort degree in mandibular third molar surgery / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of continuous low-flow intravenous infusion of midazolam sedation in mandibular third molar surgery.</p><p><b>METHODS</b>Fifty healthy patients with symmetrically placed impacted bilateral mandibular third molars were included in this self controlled, randomized clinical study. Degree of comfort (their actual current anxiety level) was assessed using a visual analogue scale (VAS) of pain and anxiety. Patients' satisfaction and degree of amnesia were also evaluated. Vital signs and oxygen saturation were recorded.</p><p><b>RESULTS</b>Low dose midazolam sedation obviously increased the degree of patients' comfort and satisfaction. Vital signs and oxygen saturation levels did not differ significantly between the two groups.</p><p><b>CONCLUSIONS</b>Midazolam as an intravenous sedation agent in mandibular third molar surgery showed satisfactory effect on patients with mild dental fear.</p>

Evaluation of oral midazolam as conscious sedation for pediatric patients in oral restoration / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the effect of midazolam alone on sedation in young children for dental restorative care.</p><p><b>METHODS</b>Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twenty-one patients were assigned to intervention group received 0. 5 mg/kg of oral midazolam 20 minutes prior to the beginning of dental treatment, and 19 patients in control group received placebo liquid 20 minutes before treatment All patients received painless local anesthetic injection and were restrained with children's board and bands. Blood pressure (BP), heart rate (HR), oxygen saturation, treatment compliance scores of the Ramsay scale, the Briekopf and Buttner scale, Frankl scale, and the Houpt scale were recorded. Each procedure was taped and all the data were evaluated every 5 minutes by an anesthetist or experienced dentist who was unaware of the drug given to the child.</p><p><b>RESULTS</b>HR in intervention group (82.5 +/- 5.1 bpm) was much lower than that in control group (95.2 +/- 8.9 bpm; F = 31.20, P < 0.001). Intervention group had a significantly lower systolic BP level (94.8 +/- 5.6 mm Hg) than control group (98.5 +/- 5.5 mm Hg; F = 4.34, P = 0.04), but the diastolic BP (63.0 +/- 3.5 mm Hg) was not significantly lower than control group (65.5 +/- 4.8 mm Hg; F = 3.31, P = 0.07). Children in intervention group showed more compliance. The patients' scores of the Ramsay scale, Briekopf and Buttner scale, Frankl scale, and Houpt scale in intervention group (1.37 +/- 0.96, 1.37 +/- 0.83, 1.32 +/- 0.67, and 2.32 +/- 1.49, respectively) were significantly lower than those in control group (3.71 +/- 1.23, 2.71 +/- 0.96, 2.71 +/- 0.90, and 4.71 +/- 1.19; F = 44.66, 22.36, 30.39, and 31.88, respectively, all P < 0.001).</p><p><b>CONCLUSIONS</b>Oral midazolam alone is safe and produces effective sedation for the dental treatment of young children. Oral midazolam application should be generally preferred because it is more easily accepted by pediatric patients.</p>

Application of CTA and CAD\CAM techniques in mandible reconstruction with free fibula flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the application of computed tomographic angiography (CTA) and computer aided design\manufacture (CAD\CAM) techniques in mandible reconstruction with free fibula flap.</p><p><b>METHODS</b>7 cases of complex mandible defect were reconstructed with free fibula flap. Patients' lower extremity vasculature was evaluated by preoperative CTA examination; mandible tumor resection and reconstruction were simulated by CAD technique, the surgical template was manufactured with CAM technique preoperatively; and fibula flap was shaped according to surgical template during mandible reconstruction operation.</p><p><b>RESULTS</b>Preoperative CTA examination performed without complication, the desired anatomy was adequately demonstrated in all patients. All of flaps survived, patients' facial contour are symmetry approximately.</p><p><b>CONCLUSIONS</b>CTA and CAD\CAM techniques have important value for complex mandible reconstruction in selection of donor site, planning of operation and shaping of fibula flap.</p>