Early loss of primary molar and permanent tooth germ caused by the use of devitalizer during primary molar root canal therapy: Two cases report / 北京大学学报(医学版)

Devitalization has been widely used in the root canal therapy of primary and permanent teeth in China more than ten years ago. With the development of local anesthetic drugs and injection technologies, this treatment method with high potential risks has been gradually abandoned. However, a questionnaire survey targeted all the participants at the 2018 China Pediatric Dentistry Conference showed that the devitalizer utilization proportion was still as high as 38.1% (383/1 005), even though the ratio was much lower than 75.5% (105/139) in 2003. These doctors had pay more attention to tissue burn caused by devitalizer marginal leakage or direct leakage, and know how to identify and handle with devitalizer burn. Devitalizers were usually made of arsenic trioxide, metal arsenic or paraformaldehyde, which have cytotoxicity, allergenicity, mutagenicity, carcinogenicity, and teratogenic effects on animals. Marginal leakage of devitalizers have high risks of causing soft and hard tissue necrosis. Most of the dentists have an understanding of the potential damages of arsenic containing devitalizers, so they will choose parafor maldehyde with relatively less toxicity. Paraformaldehyde has a certain self limitation, and there are few cases reported, so some dentists lack of vigilance. Paraformaldehyde can also causes tissue necrosis if leakage happens, and the treatment methods are similar to that of arsenic containing devitalizers. When handling with devitalizers burn, the necrosed soft and hard tissue, for example gingiva, alveolar bone or teeth that cannot keep, must be completely removed until fresh blood appears, then rinse with large amount of saline and seal with iodoform gauze. This paper described two cases of devitalizer burn during the root canal treatment of primary molars, both of the doctors failed to identify the devitalizer burn symptoms in the early stage, thus didn't do proper treatments immediately after burning. Resulting in the necrosis of large area of gingiva and alveolar bone, loss of primary molars and permanent tooth germs 1-2 months after devitalizer burn. This paper reported these two cases in detail in order to warn dentists the high risks of using any kind of devitalizers, help them learn how to identify and treat devitalizer burn, and remind them to stop using devitalizers as soon as possible.

Effects of three self-etch adhesives and mild salivary contamination on the bonding durability of deciduous teeth / 北京大学学报(医学版)

OBJECTIVE@#To compare the bonding durability of three different self-etch adhesives to primary enamel and dentin, and to investigate the effect of mild salivary contamination followed by air drying on the bonding durability.@*METHODS@#Two hundred and forty enamel specimens were divided randomly into 16 groups (n=15/group)according to the adhesive system [self-etch adhesives: Clearfil SE Bond(SE), AdperTM Easy One (EO), Scotchbond Universal (SBU); total-etch adhesive: AdperTM Single Bond Plus(SL)], contamination status (non-contaminated vs. salivary-contaminated) and storage condition (stored in distilled water for 24 h vs. aging mode 5 000 thermal cycles in 5 ℃ and 55 ℃). Two hundred and forty dentin specimens were assigned in the same way. Shear bond strength for 12 specimens in each group were measured. The adhesive interface for the residual specimens in each group was observed by scanning electron microscopy(SEM). Data were analyzed by three-way analysis of variance and Tukey test(P < 0.05).@*RESULTS@#For primary enamel, total-etch adhesive showed higher initial shear bond strength values (28.92±1.83) MPa and shear bond strength values (27.27±3.03) MPa after thermal cycles compared with the other groups, and the difference between the groups was statistically significant (P < 0.01). Shear bond strength values of EO decreased significantly in salivary-treated groups, regardless of storage conditions, and the difference was statistically significant (P < 0.01). For primary dentin, shear bond strength values of EO decreased significantly in salivary-treated groups after 24 h (P < 0.01). After 5 000 thermal cycles, total-etch adhesive showed significantly lower shear bond strength values (14.31±1.97) MPa compared with the other groups, and the difference between the groups was statistically significant (P < 0.01), and shear bond strength values of EO were significantly lower than those in SE and SBU groups (P < 0.01), regardless of contamination status.@*CONCLUSION@#Total-etch adhesive SL has better bonding durability to primary enamel. SE and SBU have better bonding durability to primary dentin and have a certain resistance to salivary contamination, while the bonding performance of EO is compromised greatly by mild salivary contamination followed by air drying.

Level of circulating Alarin in obese children and its association with insulin resistance / 中国当代儿科杂志

OBJECTIVE@#To study the level of circulating Alarin in obese children and its association with various metabolic parameters.@*METHODS@#A total of 86 obese children with a body mass index (BMI) above the 95th percentile were enrolled as the obesity group, and 82 healthy children, matched for age and sex, with a BMI below the 85th percentile were enrolled as the healthy control group. According to the presence or absence of insulin resistance (IR), the obesity group was further divided into an IR group with 27 children and a non-IR group with 59 children. Related anthropometric parameters, including body height, body weight, systolic blood pressure (SBP), and diastolic blood pressure (DBP), were measured, and BMI was calculated. Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), uric acid (UA), fasting insulin (FINS), and fasting blood glucose (FBG) were measured. The area under the receiver operating characteristic curve (AUC) for glucose and insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and whole-body insulin sensitivity index (WBISI) were calculated. ELISA was used to measure the level of circulating Alarin.@*RESULTS@#The obesity group had a significantly higher level of circulating Alarin than the healthy control group (P<0.01). The IR group had a significantly higher level of circulating Alarin than the non-IR group (P<0.01). Circulating Alarin was positively correlated with BMI, TG, FBG, AUC-glucose, AUC-FINS, and HOMA-IR (P<0.05) and was negatively correlated with WBISI (P<0.05). The circulating Alarin level had a linear regression relationship with BMI, FBG, and HOMA-IR, among which HOMA-IR had the greatest influence on the circulating Alarin level (P<0.05).@*CONCLUSIONS@#There is a significant increase in the circulating Alarin level in obese children, which may be associated with the development of obesity and IR.

Nearinfrared light transillumination for detection of incipient proximal caries in primary molars / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the practical value of nearinfrared light transillumination (NILT, DIAGNOcam) on detection of incipient proximal caries in primary molars.@*METHODS@#In this study, 4-9-year-old children with suspicious proximal lesions in primary molars were recruited. The target teeth were examined with clinical examination, bitewing radiograph and DIAGNOcam. And the caries indexes were rated as 0 (no caries), 1 (caries reaching outer 1/2 enamel), 2 (caries reaching inner 1/2 enamel), and 3 (dentine caries). Those primary molars with at least one of the adjacent molars according with the criteria of invasive treatment, i.e. the teeth were diagnosed as caries reaching inner 1/2 enamel or dentine with at least two detection methods, were included. The target teeth with caries index ≥2 accepted the invasive treatment. And the caries status of the adjacent teeth was observed under direct vision and those teeth of caries index ≥2 would also accept the invasive treatment. The relationship of lesions to enamel-dentine junction (EDJ) were recorded and used as reference standard to compare the sensitivity, specificity and accuracy of those three methods in detecting the incipient proximal caries in primary molars.@*RESULTS@#In this study, 36 children with 104 suspicious proximal lesions in primary molars were recruited, of which 5 were diagnosed as no caries, 20 were diagnosed as superficial enamel caries, and 79 accepted invasive treatment, of which 22 were diagnosed as EDJ caries, and 57 as dentine caries. The sensitivity of clinical examination, bitewing radiograph, and DIAGNOcam were 68.69%, 81.82%, 78.79%, respectively. The specificity were 100.00%, 100.00%, 80.00%, and the accuracy were 75.96%, 85.65%, 78.85%, respectively. As for superficial enamel caries, the sensitivity of clinical examination was lowest, only 10%, while DIAGNOcam was 60%, higher than 40% of bitewing radiograph. As for EDJ caries, the sensitivity of bitewing radiograph was highest as 86.36%, followed by DIAGNOcam 72.73% and clinical examination 68.18%. As for dentine caries, the sensitivity of the three detection methods were higher than 85%, of which bitewing radiograph was the highest as 94.74%.@*CONCLUSION@#The accuracy of DIAGNOcam in detecting incipient proximal caries in primary molars was comparable to that of bitewing radiograph. It was safe, and convenient with no exposure to radiation, which was applicable to be used in pediatric dentistry.

Expression and function of miR-194 in thymic epithelial cell with aging / 中国免疫学杂志

Objective:To study the expression and interaction between miR-194 and PTPN12 in the process of age-related atrophy of thymus for clarifying the regulatory mechanism in the process of this disease.Methods:C57BL/6 mouse were divided into 4 groups as 1 month,6 months,10 months and 19 months old and each group has 6 cases.Thymus tissue was removed and thymic stromal cells were isolated.And thymus epithelial cells were washed out by CD45 antibody and LS column after anesthesia.Fluorescence quantitative real-time PCR and Western blot were used to detect the changes of miR-194 and PTPN12 gene expression in thymus epithelial cells with aging.miR-194 and PTPN12 luciferase reporter vectors were transfected into HEK293 cells,and the auto fluorescence values were detected at 24 h and 48 h,respectively in vitro.Results:The expression level of miR-194 decreased (P<0.05),while the expression level of PTPN12 mRNA increased (P<0.05) as the age increased.And the correlation between miR-194 and PTPN12 mRNA expression was found to be negative(P<0.05).In vitro,luciferase reporter gene results show that miR-194 has a direct effect on the 3'UTR region of PTPN12 gene and had the highest binding efficiency in 48 h.Conclusion:PTPN12 is one of the target genes of miR-194,which is involved in the aging process of thymus and is an important factor regulating the function of thymic ep-ithelial cells.

Interleukin-1β and C-reactive protein level in plasma and gingival crevicular fluid in adolescents with diabetes mellitus / 北京大学学报(医学版)

OBJECTIVE@#Cytokines produced by various cells are strong local mediators of inflammation. Interleukin-1beta (IL-1β) and C-reactive protein (CRP) play essential roles in the development and progression of diabetes mellitus (DM). Thus periodontal diseases could be related to DM via the same mediators of inflammation. To evaluate plasma and gingival crevicular fluid (GCF) levels of IL-1β and CRP in adolescents with DM to further investigate whether DM has an impact on the levels of inflammation factors at an early stage, and to analyze the risk of developing periodontal diseases in adolescents with DM.@*METHODS@#A total of 121 adolescents aged from ten to sixteen years were enrolled, 41 adolescents diagnosed with diabetes mellitus were collected in the DM group, and 80 nondiabetic adolescents as the control group. The periodontal indices of each individual were recorded, including plaque index (PLI), modified bleeding index (mBI), probing depth (PD) and attachment loss (AL). GCF and intravenous blood samples were collected, and CRP and IL-1β levels were detected by enzyme-linked immunosorbent assay (ELISA).@*RESULTS@#(1) PLI of DM group and control group were 1.23±0.05 and 0.95±0.04 separately, with significant difference (P=0.001). DM group and control group had mBI of 0.80±0.08 and 0.51±0.06 separately, with significant difference (P=0.003). Attachment loss was found in none of the subjects. PDs of DM group and control group were (2.37±0.51) mm and (2.31±0.05) mm separately, and there was no significant difference. (2) CRP in GCF was only detectable in partial of the individuals, with a detectable rate of 22.9% (11/48) in total. The detectable rate of CRP in GCF was significantly higher in DM group (38.5%) than that in control group (4.5%, P=0.006). The plasma level of CRP in DM group [0.23 (0.15, 1.89) mg/L] was higher than that in control group [0.19 (0.12, 4.18) mg/L], but without significance (P=0.776). (3) The plasma levels of IL-1β in DM group and control group were (14.11±0.57) ng/L and (14.71±0.50) ng/L separately, but there was no significance (P=0.456). GCF levels of IL-1β in DM group and control group were (12.91±1.95) μg/L and (17.68±3.07) μg/L, without significant difference (P=0.185).@*CONCLUSION@#Periodontitis was not observed in adolescents with DM at an early stage. However, the rising levels of periodontal indices and CRP in GCF, might indicate that adolescents with DM have a higher risk of developing periodontal diseases in the future.

A preliminary study of saliva matrix metalloproteinases (MMP-2 and MMP-9) in children with caries / 北京大学学报(医学版)

OBJECTIVE@#To investigate the correlation between matrix metalloproteinase (MMP)-2/MMP-9 levels and childhood caries, and the saliva levels of MMP-2/MMP-9 among healthy children and those with different degrees of dental caries, both before and after treatment.@*METHODS@#In the study, 368 children aged 3 to 5 years were separated into three groups: severe caries group (112 children), mild caries group (98 children) and caries free group (158 children). The children with severe caries were included in treatment group (83 children) after accepting a comprehensive treatment of caries. MMP-2 and MMP-9 levels were determined by enzyme-linked immunosorbent assay (ELISA) and the data were analyzed by the Statistics Package for Social Science (SPSS 13.0). The differences among severe caries group, mild caries group and caries free group were analyzed by SNK-q (Student Newman Keuls). The severe caries group and treatment group were compared by paired t test. The differences between each group were statistically analyzed.@*RESULTS@#There was no significant difference of the age and gender composition among severe caries group, mild caries group, caries free group and treatment group. The MMP-2 level of severe caries group [(141.3±32.5) μg/L] was higher than those of mild caries group [(107.5±21.3) μg/L] and caries free group [(102.8±18.5) μg/L] (P<0.05). There was no significant difference between mild caries and caries free group (P>0.05). After analysis of 83 children in the treatment group, the level of MMP-2 [(120.1±24.8) μg/L] was lower than before [(144.6±30.3) μg/L] (P<0.05), but was higher than that of caries free group (P<0.05). The MMP-9 levels of severe caries group [(445.8±68.1) μg/L] and mild caries group [(428.6±59.2) μg/L] were higher than that of caries free group [(385.4±60.6) μg/L] (P<0.05), but the difference between severe caries group and mild caries group was not significant (P>0.05). After analysis of 83 children in the treatment group, the alteration of MMP-9 [(432.2±64.7) μg/L] was not significant either (P>0.05).@*CONCLUSION@#The saliva levels of MMP-2 and MMP-9 in children with severe caries were higher than those in caries free children, even if the treatment was implemented, which suggests that the MMP-2 and MMP-9 in saliva might be related to the caries in children.

Blood Enriching Effect and Mechanism of Jiuwei Ejiao Ointment on Mouse Model of Blood Deficiency Syndrome / 中国药学杂志

OBJECTIVE: To study the blood enriching effect and mechanism of Jiuweiejiao ointment on mouse model of blood deficiency syndrome.METHODS: Blood deficiency syndrome model was established with cyclophosphamide(CTX) and acetylphenylhydrazine(APH). Total of 60 ICR mice were divided into normal group, model group, Siwu granule group, Jiuweiejiao ointment high-dose, medium-dose and low-dose group (15.6, 7.8, 3.9 g•kg-1). Each group mouse were treated with the respective drug through intragastrical administration once a day for consecutive 14 d. The levels of red blood cells (RBC), leukocytes (WBC), hemoglobin (HGB) level in blood of mice were detected by blood analyzer; the histopathological changes of bone marrow were determined by HE staining; the levels of erythropoietin (EPO), interleukin-3 (IL-3), tumor necrosis factor-α (TNF-α), granulocyte colony stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating factor (GM-CSF) in serum were measured by enzyme linked immunosorbent assay (ELISA) method; the expression level of EPO protein in kidney tissue, G-CSF and GM-CSF protein in bone marrow tissue were detected by Western-blot method.RESULTS: Compared with model group, Jiuweiejiao ointment could significantly increase the levels of RBC, WBC and HGB in blood of mice, markedly improve bone marrow hyperplasia, reduce the non-hematopoietic tissue and adipocytes, obviously repaire the hematopoietic tissue structure; significantly decrease the level of TNF-α and increase the level of EPO, IL-3, G-CSF and GM-CSF in serum. In addition, Jiuweiejiao ointment could also obviously increase the expression of EPO protein in kidney tissue and G-CSF, GM-CSF protein in bone marrow tissue compared with that in model group.CONCLUSION: Jiuweiejiao ointment has obvious blood enriching effects, which may be related with promoting the secretion of hematopoietic growth factors and reducing the inhibition of hematopoietic function by negative hematopoietic factor.

Chemical Constituents from Pericarpium Citri Reticulatae / 中草药·英文版

Objective To study the chemical constituents from Pericarpium Citri Reticulatae (Citrus reticulata). Methods The chemical constituents were isolated and purified by silica gel column, Sephadex LH-20, and ODS column chromatography. The structures were identified by spectral data. Results Nineteen compounds were isolated and identified as 4′,5,6,7-tetramethoxyflavone (1), 3,3′,4′,5,6,7,8-heptmethoxyflavone (2), sinensetin (3), 5-O-demethylnobiletin (4), tangeretin (5), nobiletin (6), apigenin (7), 5-O-desmethyltangeretin (8), 5,7-dihydroxy-3,3′,4′,6-tetramethoxyflavone (9), pachypodol (10), 4′,5,6,7-tetramethoxyflavanone (11), 3′,4′,5,7,8-pentamethoxyflavanone (12), agestricin C (13), scoparone (14), isoscopoletin (15), hesperidin (16), didymin (17), methylhesperidine (18), and naringin (19). Conclusion Compounds 9-15 are obtained from this plant for the first time.

Retrospective analysis of pulp revascularization in immature permanent teeth with diffuse pulpitis / 中华口腔医学杂志

Objective@#To evaluate the treatment effectiveness of revascularization in immature permanent teeth with diffuse pulpitis and to provide an alternative approach for the treatment of these teeth.@*Methods@#Clinical and radiographic data were collected from 17 immature permanent teeth which were diagnosed as diffuse pulpitis and with their pulp extirpated at Emergency Department of Peking University School and Hospital of Stomatology. All these teeth were treated using pulp revascularization at Department of Pediatric Dentistry. Clinical success rate was then evaluated based on the clinical and radiographic findings. The increase of root length and dentin wall thickness of the revascularized teeth and the contralateral control teeth were measured and compared according to the preoperative and recall periapical radiographs.@*Results@#The average follow-uptime is (25.8±9.9) months (12-46 months). Totally 13 out of the 17 teeth showed normal clinical and radiographic manifestation and achieved the increasein root length and dentin wall thickness. They met criteria for success treatment. The rest 4 out of the 17 teeth also showed root length and dentin wall thickness increaseand apical foramen closure. However, periapical inflammations were observed during 12 to 36 monthfollow-ups. These cases were recognized as failed. In all the17 teeth, the increase of root length and dentin wall thickness was not significantly different between the revascularized teeth and the contralateral control teeth (P>0.05).@*Conclusions@#Pulp revascularization in young permanent teeth with diffuse pulpitis resulted in similar clinical outcomes in root development and root canal wall formation compared with the contralateral control teeth. However, reinfection might occur during long-term follow-up.

Chemical Constituents from Roots of Millettia speciosa / 中草药·英文版

Objective To study the chemical constituents from the roots of Millettia speciosa. Methods The chemical constituents were isolated and purified by silica gel, Sephadex LH-20, and ODS column chromatography. The structures were identified by means of spectral data. Results Fifteen compounds were isolated and identified as naringenin (1), liquiritigenin (2), garbanzol (3), 7-hydroxy-6,4′- dimethoxyisoflavone (4), calycosin (5), 2′,5′,7-trihydroxy-4′-methoxyisoflavone (6), 2′-hydroxybiochanin A (7), 6-methoxycalopogonium isoflavone A (8), demethylmedicarpin (9), 4,4′-dihydroxy-2′-methoxychalcone (10), 2′,4′-dihydroxy-4-methoxychalcone (11), rhododendrol (12), secoisolariciresinol (13), bisdihydrosiringenin (14), and polystachyol (15). Conclusion All compounds are obtained from this plant for the first time.

Retrospective study about periodontal ligament healing of replanted permanent teeth in children / 北京大学学报(医学版)

Objective:To analyze the prognosis about periodontal ligament healing of replanted perma-nent teeth in children and to examine the associated factors.Methods: The sample consisted of 49 children with 61 avulsed permanent teeth, whose injuries had been managed in the period from 2000 to 2012.The clinical data of replanted teeth were collected, and the follow-up period was no less than 12 months .The factors were analyzed in relation to postoperative outcomes, classified as functional periodon-tal healing ( FH ) , infection-related ( inflammatory ) resorption ( IRR ) and replacement resorption ( RR) .Results:The functional healing rate was 23.0%, while replacement resorption rate was 72.1%. The replacement resorption ( ankylosis ) was usually observed earlier by clinical examination than by radiographic examination.86.0% (40/47) resorptive processes were diagnosed within the first year. Physiological storages, such as milk, saline and saliva were significantly better to periodontal ligament healing than nonphysiological storages, such as tap water and sterilizing solutions ( chloramine and alco-hol) .Functional healing was found significantly more frequent in canines and premolars.Conclusion:The factor significantly affecting periodontal ligament healing is storage medium.Replacement resorption is the most common type of root resorption.The replacement resorption diagnosis must combine the radio-graphic examination with the clinical examination.It is better to follow up more than 1 year after tooth re-plantation.

A retrospective study on pulpal tissue prognosis of avulsed permanent teeth in children / 北京大学学报(医学版)

Objective:To analyze the pulpal prognosis of replanted permanent teeth in children and to examine the associated factors .Methods:The samples consisted of 67 children with 81 avulsed perma-nent teeth treated in Peking University Hospital of Stomatology from 2000 to 2012 .Their clinical data of the replanted teeth were collected , and the follow-up period was no less than 12 months.The pulpal prognosis was classified as pulp necrosis and pulp non-necrosis .Results: The replantation within 30 minutes after avulsion led to the most significant increase in pulpal healing (P<0.05).The dental pulp of 80% ( 4/5 ) young permanent teeth replanted within 30 minutes remained vital , while all the teeth replanted after 30 minutes developed pulp necrosis within 60 days after replantation .Conclusion: The extra-alveolar period significantly affects the prognosis of pulp in immature permanent teeth after replanta-tion.When the extra-alveolar period is more than 30 minutes, the chance of pulp revascularization after replantation is very low , therefore pulp extirpation should be performed .

Masticatory performance and assessment of life quality of children with ectodermal dysplasia after prosthetic rehabilitation / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate masticatory performance and life quality of children with ectodermal dysplasia (ED) after prosthetic rehabilitation.</p><p><b>METHODS</b>Six children with ED received denture restoration and 18 healthy children were involved in this study. The surface electromyography (EMG) of masseter (MM) and anterior temporalis (TA) during clenching and chewing movement were recorded. The EMG amplitude, area, asymmetry index of total and activity index of MM/TA were compared at each stage. The masticatory efficiency was measured with spectrophotometer. The life quality was assessed using visual analogue scale questionnaire.</p><p><b>RESULTS</b>The EMG amplitude of MM and TA during chewing in ED Group were 41.7% and 45.6% of the control group respectively, the area were 35.9% and 36.0% respectively. Significant difference in asymmetry index of total during clenching was observed between the two groups (P < 0.05) but not during chewing (P > 0.05). The differences of activity index of MM/TA during clenching and chewing between the two groups were not detected (P > 0.05). The masticatory efficiency of ED group was 67.2% of the control group. The score of chewing function in children with ED after prosthetic rehabilitation was three times higher than before, and no difference was present between the two groups (P > 0.05).</p><p><b>CONCLUSIONS</b>Early prosthetic rehabilitation can significantly improve the masticatory performance and life quality of children with ED.</p>

Effects of mineral trioxide aggregate on the proliferation and differentiation of human pulp cells from primary and permanent teeth / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aims to investigate the effects of mineral trioxide aggregate (MTA) and calcium hydroxide on proliferation and differentiation of human pulp cells from primary and permanent teeth.</p><p><b>METHODS</b>Cell proliferation was detected by methyl thiazolyl tetrazolium (MTT) assay. The mRNA expression levels of dentinogenesis-related factors, including alkaline phosphatase (ALP) and dentin sialophosphoprotein (DSPP), and odontoclastogenesis-related factors, such as osteo- protegerin (OPG) and receptor activator of NF-κB ligand (RANKL), were determined by real time polymerase chain reac- tion (PCR).</p><p><b>RESULTS</b>Primary and permanent pulp cells treated with calcium hydroxide exhibited significantly lower proli- feration rates than the control cells (P<0.01). By contrast, the MTA-treated group showed significantly higher proliferation rates than the control group (P<0.01). Real time PCR results showed that calcium hydroxide-treated primary pulp cells exhi- bited significantly decreased ALP, DSPP, and OPG expression compared with the control group (P<0.01). Conversely, the MTA-treated group displayed significantly increased ALP, DSPP, and OPG expression (P<0.01). Calcium hydroxide-treated primary pulp cells also exhibited significantly upregulated RANKL expression (P < 0.01); by contrast, MTA-treated cells did not show any change in RANKL expression (P>0.05). Likewise, MTA-treated permanent pulp cells showed significantly upregulated ALP and DSPP expression (P < 0.01). However, the calcium hydroxide-treated group remained almost the same as the control group (P > 0.05). Neither MTA nor calcium hydroxide affected OPG and RANKL expression in per- manent pulp cells (P > 0.05).</p><p><b>CONCLUSION</b>MTA is more suitable as a pulp-capping agent, particularly in primary teeth, than calcium hydroxide.</p>

Mineral trioxide aggragate pulpotomy for the treatment of immature permanent teeth with irreversible pulpitis: a preliminary clinical study / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the preliminary clinical effect of mineral trioxide aggragate (MTA) pulpotomy on immature permanent teeth with irreversible pulpitis.</p><p><b>METHODS</b>Twenty-six immature permanent teeth with irreversible pulpitis were recuited from Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology. These teeth were treated with partial or full pulpotomy according to the condition of pulp bleeding. MTA was used as pulp capping material. Patients were recalled periodically after the treatment. Clinical and radiographic effects were evaluated.</p><p><b>RESULTS</b>At one year follow-up, 20 teeth were evaluated as healed or healing, 2 teeth were evaluated as failure and 4 teeth were dropped out. The success rate was considered 91% (20/22). A dentinal bridge was radiographcally observed underneath the pulpotomy site in 13 teeth(65%, 13/20).</p><p><b>CONCLUSIONS</b>MTA pulpotomy is an effective method for the treatment of immature permanent teeth with irreversible pulpitis. But further research with longer follow up period is required.</p>

Application of anterior middle superior alveolar block anesthesia with computer-controlled local anesthesia de-livery system in children / 实用口腔医学杂志

133 teeth in 34 children aged 4 to 8 year-old were recruited for the treatment of bilateral maxillary primary canines or primary molars with deep caries,chronic pulpitis or chronic periapical periodontitis under local anesthesia.Buccal infiltration(BI)with conventional syringe(CS)was used for one quadrant,anterior middle superior alveolar anesthesia(AMSA)with computer-controlled local anesthesia de-livery system(C-CLADS)on the contralateral side.The injection duration(s)of CS and C-CLADS was 63.6 ±22.6 and 136.6 ±12.4 re-spectively(P =0.000).The pain perception of C-CLADS injection was significantly lower than that of CS(P 0.05).55.9% children preferred C-CLADS anesthesia.

Analysis of caries susceptibility factors during transition from caries-free to caries in three-year-old children / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the changes of caries susceptibility factors during the transition from caries-free to caries in three-year-old children.</p><p><b>METHODS</b>The study included 144 caries-free children aged 34-38 months. All participants underwent clinical examination and full-mouth supragingival plaque collection.Survey of children's oral health behaviors involving feeding habits and oral health care was also taken from children's parents of all participants. The children were reexamined 6 and 12 months later. According to the potential changes of caries status in twelve months follow up, all the participants were divided into three groups: caries-free group (caries free children in twelve months follow up), caries at 6-month group (children who were found with caries or cavities fillings at six months review) and caries at 12-month group (children who were caries free at six months but found with caries or cavities fillings at twelve months). Streptococcus mutans (Sm)and Streptococcus sobrinus (Ss) loads were compared among the three groups by real time fluorescence quantitative polymerase chain reaction (FQ-PCR).</p><p><b>RESULTS</b>One hundred and thirty children completed twelve months review, the dropout rate was 9.7% (14/144). At the end of twelve months follow up, the number of children in caries-free group, caries at 6-month group and caries at 12-month group was 58, 44 and 28 respectively. The changes of oral behavioral habits in caries-free group, caries at 6-month group and caries at 12-month group during twelve months follow up were not significantly different (P > 0.05). At baseline, the frequency of sweets consumption and eating sweets before sleeping in caries-free group was significantly lower than that in caries at 6-month group and caries at 12-month group (P < 0.001). At baseline, the quantity of Sm and Ss in caries at 6-month group[copy number of Sm: (6.33 ± 2.21)×10(3), copy number of Ss: (1.99 ± 0.45)×10(3)] was significantly higher than that in the caries-free group[copy number of Sm: (5.81 ± 2.43)×10(3), copy number of Ss: (1.34 ± 0.53)×10(3)] (P < 0.05). There was no significant difference in the quantity of Sm and Ss in the caries-free group and caries at 12-month group(P > 0.05). At six months, the quantity of Sm and Ss in caries at 12-month group was significantly higher than that in the caries-free group although both groups of children were caries-free at six months (P < 0.05).</p><p><b>CONCLUSIONS</b>The quantity of Sm and Ss increased six months before the caries onset in three-year-old children.High frequency sweets consumption and eating sweets before sleeping were important susceptibility factors for caries onset in the future.</p>

The salivary factors related to caries and periodontal disease in children and adolescents with diabetes mellitus / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To detect the salivary factors related to caries and periodontal disease and to analyze the risk of caries and periodontal disease in children and adolescents with diabetes mellitus.</p><p><b>METHODS</b>The study comprised 30 children with diabetic mellitus, aged 7-15 years old, and 60 healthy age-and gender-matched children. Caries and periodontal indexes were recorded and saliva related factors were analyzed.</p><p><b>RESULTS</b>Caries indexes of diabetes children [permanent teeth: decay missing filling tooth (DMFT) M (Q1,Q3) = 0(0, 4), deciduous teeth: decay missing filling tooth (dmft) M (Q1,Q3) = 0(0, 1)] were not significantly different with those of healthy children [DMFT M (Q1,Q3) = 1(0, 3), dmft M (Q1,Q3) = 0(0, 4)], but plaque index (PLI) (1.25 ± 0.33) and bleeding index (BI) (0.74 ± 0.45) of diabetes children were significantly higher than those of healthy children (PLI was 0.93 ± 0.31,BI was 0.34 ± 0.22) (P < 0.001). Salivary pH of diabetes children (7.68 ± 0.36) was significantly higher than that of healthy children (7.30 ± 0.32) (P < 0.05), and salivary acid buffering capacity had no significant difference between the two groups (P > 0.05). Salivary glucose, immunoglobulin sIgA and sIgG were not significantly different between the two groups (P > 0.05).Salivary lysozyme of diabetes children was significantly higher than that of healthy children (P < 0.05). Total protein was significantly lower in diabetes children than in healthy children (P < 0.05). Salivary lactate dehydrogenase had no significant difference between the two groups (P > 0.05).</p><p><b>CONCLUSIONS</b>Diabetes mellitus can lead to the changes of some salivary factors related to gingivitis in diabetes children. Children and adolescents with diabetes mellitus may have a higher risk of periodontal disease.</p>

Pulp revascularization of immature teeth with apical periodontitis: a clinical study / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effect of pulp revascularization procedure for immature teeth with apical periodontitis.</p><p><b>METHODS</b>Nine immature permanent teeth diagnosed with chronic or acute apical periodontitis were recruited. According to a standard pulp revascularization procedure, the canal was disinfected with copious irrigation and a combination of three antibiotics, followed by a blood clot created in the canal. Patients were recalled periodically after the treatment. Clinical and radiographic evidence of healing was evaluated.</p><p><b>RESULTS</b>Eighteen to 24 months after treatment, 6 teeth showed complete resolution of the radiolucency and closure of the apex and thickening of the dentinal walls. One tooth showed healing of periodontal lesion, but the root mature was not observed. Two teeth had recurrent apical periodontitis and no evidence of healing. Apexification was performed later.</p><p><b>CONCLUSIONS</b>Pulp revascularization could be an effective treatment for immature permanent teeth with apical periodontitis, and root elongation and narrowing canal space were observed in appropriate cases. If the treatment failed, traditional apexification could be started instead.</p>