Melnick-Needles syndrome associated molecule,Filamin-A regulates dental epithelial cell migration and root formation

BackgroundFilamin-A (FLNA) is one of the adaptor proteins binding to both integrin beta chain and actin filament. Several kind of mutation in human FLNA gene were observed in Melnick-Needles syndrome (MNS). However, the role of FLNA in tooth formation is still unknown.Matrials and methodsWe analyzed the tissue expression of FLNA during tooth development using immunostaining. The role of FLNA in cell migration was analyzed using a scratch assay. In addition, we analyzed the phenotype of teeth in patients with Mernick-Needles syndrome caused by FLNA gene abnormalities.ResultsFLNA expressed in inner and outer enamel epithelium in mouse tooth germ and also expressed in cervical region of dental epithelium. In postnatal stage, FLNA expressed in ameloblast and odontoblast layers. In rat dental epithelium cell line SF2, FLNA is localized at the boundary between cells and co-localized with the terminal region of F-actin filament. shRNA-FLNA transfected cells showed delayed cell migration and scratch closure compared with control cells. Analysis of actin fiber movement by time-lapse confocal microscopy showed slower fiber movement in shRNA-FLNA over expressing SF2 cells. Novel mutation in FLNA gene was observed in MNS with tooth anormaly. This patient showed tooth agenesis and short root in both primary and permanent dentition with thin enamel.ConclusionTaken together, these results suggest that filamin-A is play a key role for dental epithelium migration and root formation.     

不同根管冲洗液和冲洗方法对粪肠球菌清除作用的体外研究

目的 比较不同冲洗液和冲洗方法对根管内粪肠球菌的清除效果。方法 建立120颗人完整单根管前磨牙粪肠球菌感染根管模型,随机分组,分别采用不同冲洗液(0.9% NaCl,0.5% NaClO,3% NaClO)及冲洗方法(注射针头冲洗,超声荡洗,RinsEndo系统处理,超声荡洗协同RinsEndo系统联用)进行根管清理。无菌吸潮纸尖取样,平板菌落计数法计算CFU值,计算细菌清除率,运用SPSS 22.0软件进行统计分析,P<0.05时差异具有统计学意义。结果 使用0.9% NaCl及0.5% NaClO冲洗液时,注射针头冲洗组细菌清除率明显低于超声荡洗及RinsEndo系统处理组(P<0.001);使用3% NaClO冲洗液的各组不同的冲洗方法,细菌清除率的差异无统计学意义(P=0.556)。而无论采用哪种冲洗方法,3% NaClO溶液的细菌清除效果均优于0.5% NaClO溶液和0.9% NaCl溶液(P<0.001)。结论 不同根管冲洗液在一定程度上会影响根管冲洗方法对根管内粪肠球菌的清除效果。     

含氟涂漆与CPP-ACP或生物活性玻璃对根龋的作用评价

目的：体外研究含氟涂漆与酪蛋白磷酸肽-非结晶型磷酸钙(casein phosphopeptide-amorphous calcium phosphate,CPP-ACP)或生物玻璃对根龋的作用。方法：选择2017年4月—2018年10月北京大学人民医院口腔科收集的84颗活动性根龋牙,随机分为A、B、C、D组,每组均21颗牙,4组均给予含氟牙膏刷牙,B组增加含5%氟化钠的涂漆,C组增加含5%氟化钠+CPP-ACP的涂漆,D组增加含5%氟化钠+生物活性玻璃的涂漆。观察涂漆前、后各组根龋严重程度、表面粗糙度、矿物质浓度。采用SPSS 23.0软件包分析根龋严重程度与表面粗糙度的相关性。结果：B、C、D组涂漆50 d后硬度显著高于涂漆前及A组（P<0.05）;C、D组涂漆50 d后硬度显著高于B组（P<0.05）;D组涂漆50 d后硬度显著高于C组（P<0.05）。涂漆7 d后,B、C组表面粗糙度评分均显著高于A、D组（P<0.05）;涂漆14 d后,B组表面粗糙度评分均显著高于A、C、D组（P<0.05）;涂漆50 d后,D组表面粗糙度评分显著高于B、C组（P<0.05）。A组根龋严重程度评分与表面粗糙度呈负相关（P<0.05）。各组涂漆50 d后矿物质浓度均显著高于涂漆前（P<0.05）。结论：含氟化物+CPP-ACP或生物活性玻璃涂漆均具有显著阻止根龋的作用,生物活性玻璃较CPP-ACP更稳定,提高牙表面矿物质浓度效果更好。     

Current perspectives on dental adhesion: (3) Adhesion to intraradicular dentin: Concepts and applications

Adhesion science is one of the greatest contributions to restorative dentistry. Adhesion not only established the current principles of tissue preservation, but also allowed for the production of more hermetic and long-lasting restorations. Although adhesive strategies are routinely used in most clinical situations, adhesion to root dentin is still a major challenge. The presence of humidity together with less intertubular dentin are factors that limit the adhesive potential of root dentin. This situation is more unfavorable in endodontically treated teeth prepared for prefabricated or custom-made intraradicular posts; these procedures may alter the mechanical properties of teeth by modifying the viable dentin surface for adhesion. Also, contaminants deposited on the dentin surface are difficult to remove through conventional techniques. Moreover, root canal morphology has a very unfavorable C-factor, bringing undesirable effects resulting from polymerization contraction of resin-based materials. However, the differences between coronal and root dentin are not a barrier for dentin adhesion. Standardization of procedures and care during clinical steps are fundamental to the success of adhesion to coronal or intraradicular dentin. Thus, it is essential to know the anatomy of the root structure, the factors that interfere with intraradicular adhesion, as well as the current adhesive materials and techniques.     

根本原因分析法在住院患者非计划拔管中的运用

目的探讨根本原因分析法在住院患者非计划拔管中的应用效果。方法成立根本原因分析法小组,对2017年发生的35例非计划拔管事件进行分析,收集患者非计划拔管的相关资料,采用鱼骨图找出非计划拔管事件的近端原因,确定根本原因,并拟定改进计划。实施1年后,比较应用根本原因分析法前后患者非计划拔管的情况。结果应用根本原因分析法后,住院患者非计划拔管发生率由应用前的1.28%下降至0.46%(P<0.05)。结论运用根本原因分析法能有效降低住院患者非计划拔管发生率。     

三种机用镍钛器械对推出根尖孔碎屑和冲洗液影响的比较

背景:根管预备过程中所产生的牙本质碎屑及冲洗液有可能被带到牙根尖周围,造成严重的术后疼痛并延缓根尖组织愈合过程。研究表明,采用机用镍钛器械主进行根管预备时的根尖碎屑产生量明显低于手用器械。目的:比较临床上常用的3种机动镍钛旋转式器械ProT aper、Pro File及K3和手动不锈钢器械K-file在根管预备时,推出根尖孔的牙本质碎屑量和冲洗液渗出量。方法:选取40颗单根管人离体牙,随机均分成4组,分别用镍钛旋转器械ProT aper、ProF ile、K3及手动不锈钢器械K-file进行根管预备,预备后每颗样本牙用等量的冲洗液冲洗根管,收集预备过程中从根尖孔推出的碎屑和液体,电子秤测得推出根尖孔的液体和碎屑的质量。结果与结论:K-file组所产生的根尖推出碎屑量及冲洗液渗出量最多,多于镍钛旋转器械3组(P<0.05);K3组根尖推出碎屑量最少,但3种机动镍钛器械根尖推出碎屑量组间比较差异无显著性意义(P>0.05);K3组冲洗液渗出量明显少于ProT aper及Pro File组(P<0.05),后两组间差异无显著性意义(P>0.05)。K-file组所产生的冲洗液渗出量与根尖推出碎屑量呈正相关(P<0.05),机用镍钛器械3组中冲洗液与根尖推出碎屑量无明显相关性。说明在临床上进行根管预备时尽量选用机用镍钛器械。     

不同相主牙胶尖对根尖区三维封闭的Micro CT观察

目的 观察α相与β相主牙胶尖在热垂直加压充填法中对根尖区的三维封闭作用.方法 实验筛选出根尖区4mm具有侧支根管或根尖分歧的下颌第一前磨牙20颗,以镍钛根管锉ProtaPer冠向下法预备至F3,将20例样本随机分为2组,分别采用α相牙胶与β相牙胶,以热垂直加压根管充填技术进行根管充填.充填完成前、后采用微计算机断层扫描技术对根尖区4mm容积进行扫描及三维重建,计算根尖区4mm充填程度即充填后容积与充填前容积之比,观察2种不同相的主牙胶尖对根尖区的封闭效果.结果 2种牙胶的根尖区充填程度均在81％以上,α相牙胶组在根尖区的充填程度与β相牙胶组差异无统计学意义.结论 α相牙胶组与β相牙胶组均对根尖区有良好的三维封闭效果,二者无显著性差异.     

Incidence of postoperative pain after use of calcium hydroxide mixed with normal saline or 0.2% chlorhexidine digluconate as intracanal medicament in the treatment of apical periodontitis

Objective

To compare the incidence of postoperative pain after the use of calcium hydroxide powder mixed with normal saline or 0.2% chlorhexidine digluconate as intracanal medicament.

Participants

Fifty-five subjects aged 17–60 years with teeth diagnosed to have apical periodontitis.

Intervention

Two-visit conventional root canal treatment of seventy teeth. The teeth were divided by randomization (balloting) into two groups: control group and experimental group, each with thirty-five teeth treated with calcium hydroxide mixed with normal saline or with 0.2% chlorhexidine digluconate as intracanal medicament respectively. Incidence of postoperative pain was assessed using the universal pain assessment tool and whether or not analgesic was taken.

Main outcome measured

Incidence of post-operative pain.

Result

Postoperative pain occurred only at 1-day and 1-week reviews. In the control group, the overall incidence of pain was the same at both review periods (5.7%), while the experimental group showed a slight decrease in incidence between 1-day (17.2%) and 1-week (11.4%) reviews. Incidence of flare-ups was more in the experimental group (11.4%) than in the control group (5.7%). No significant statistical differences between the two groups were observed (p > 0.05).

Conclusion

The incidence of postoperative pain was lower in the normal saline treatment group, but the difference was not statistically significant.     

Rare case of external dental fistula of the submental region misdiagnosed as inverted follicular keratosis and thyroglossal duct cyst

IntroductionOdontogenic cutaneous sinus tract is a relatively rare occurrence that can be complicated to diagnose. The presence of a cutaneous lesion is often not even partly associated with a dental etiology because of the less frequency of occurrence in the case of dental symptoms. Consequently, the underlying dental cause is often missed leading to inappropriate diagnosis and treatment.Case presentationHere, we report the case of a 45-year-old man who presented with a persistent lesion of the cervical region. At the time of presentation, the lesion had been present for approximately one year with a gradual increase in size but no specific symptoms. The patient had previously undergone punch resection under local anesthesia, which resulted in a histopathological diagnosis of inverted follicular keratosis. A diagnosis was made of an odontogenic cutaneous sinus tract secondary to chronic apical periodontitis of the left mandibular second molar.DiscussionCutaneous sinus tract in the face and neck is most likely to develop intraorally. Root canal treatment or surgical extractions are the common treatment choices. A previously reported review of 137 cases found that 106 (77%) were treated by extraction and 27 (20%) were treated by surgical or conservative nonsurgical endodontic therapy.ConclusionEarly diagnosis of cutaneous sinus tract using proper aid is responsible for shortening the treatment duration and avoiding unnecessary treatment.     

盐酸米诺环素软膏在感染渗出性根管封药中的应用

目的 评价盐酸米诺环素软膏作为根管消毒剂治疗感染渗出型慢性根尖周炎的临床疗效.方法 随机单盲对照研究,选择54例(患牙54颗)诊断为慢性根尖周炎合并根管渗液的患者,随机分为两组各27例.A组用盐酸米诺环素软膏作根管封药,B组常规用氢氧化钙甘油糊剂作根管封药;比较两组患者约诊间疼痛程度和复诊时根管渗液的变化,并对根管治疗术(RCT)半年后的临床疗效进行评价.结果 A组约诊间疼痛发生率约为7.4%,低于B组的33.3%(P<0.05);A组根管渗液减少程度优于B组(P<0.05);根管充填术后半年,A、B组间患者的治疗有效率分别为96.3%和88.89%,两组间比较差异无统计学意义(P>0.05).结论 盐酸米诺环素软膏在感染渗出性根管封药中应用短期疗效优于氢氧化钙甘油糊剂.