Endo-periodontal lesions (EPLs) involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple cont...Endo-periodontal lesions (EPLs) involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.展开更多
The dental operative microscope has been widely employed in the field of dentistry,particularly in endodontics and operative dentistry,resulting in significant advancements in the effectiveness of root canal therapy,e...The dental operative microscope has been widely employed in the field of dentistry,particularly in endodontics and operative dentistry,resulting in significant advancements in the effectiveness of root canal therapy,endodontic surgery,and dental restoration.However,the improper use of this microscope continues to be common in clinical settings,primarily due to operators’insufficient understanding and proficiency in both the features and established operating procedures of this equipment.In October 2019,Professor Jingping Liang,Vice Chairman of the Society of Cariology and Endodontology,Chinese Stomatological Association,organized a consensus meeting with Chinese experts in endodontics and operative dentistry.The objective of this meeting was to establish a standard operation procedure for the dental operative microscope.Subsequently,a consensus was reached and officially issued.Over the span of about four years,the content of this consensus has been further developed and improved through practical experience.展开更多
Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is ...Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.展开更多
Background:Osteoporosis is a chronic bone disease characterized by bone loss and decreased bone strength.However,current anti-resorptive drugs carry a risk of various complications.The deep learning-based efficacy pre...Background:Osteoporosis is a chronic bone disease characterized by bone loss and decreased bone strength.However,current anti-resorptive drugs carry a risk of various complications.The deep learning-based efficacy prediction system(DLEPS)is a forecasting tool that can effectively compete in drug screening and prediction based on gene expression changes.This study aimed to explore the protective effect and potential mechanisms of cinobufotalin(CB),a traditional Chinese medicine(TCM),on bone loss.Methods:DLEPS was employed for screening anti-osteoporotic agents according to gene profile changes in primary osteoporosis.Micro-CT,histological and morphological analysis were applied for the bone protective detection of CB,and the osteogenic differentiation/function in human bone marrow mesenchymal stem cells(hBMMSCs)were also investigated.The underlying mechanism was verified using qRT-PCR,Western blot(WB),immunofluorescence(IF),etc.Results:A safe concentration(0.25mg/kg in vivo,0.05μM in vitro)of CB could effectively preserve bone mass in estrogen deficiency-induced bone loss and promote osteogenic differentiation/function of hBMMSCs.Both BMPs/SMAD and Wnt/β-catenin signaling pathways participated in CB-induced osteogenic differentiation,further regulating the expression of osteogenesis-associated factors,and ultimately promoting osteogenesis.Conclusion:Our study demonstrated that CB could significantly reverse estrogen deficiency-induced bone loss,further promoting osteogenic differentiation/function of hBMMSCs,with BMPs/SMAD and Wnt/β-catenin signaling pathways involved.展开更多
Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical regi...Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical region has yet to be solved, impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.展开更多
The overall health condition of patients significantly affects the diagnosis, treatment, and prognosis of endodontic diseases. Asystemic consideration of the patient’s overall health along with oral conditions holds ...The overall health condition of patients significantly affects the diagnosis, treatment, and prognosis of endodontic diseases. Asystemic consideration of the patient’s overall health along with oral conditions holds the utmost importance in determining thenecessity and feasibility of endodontic therapy, as well as selecting appropriate therapeutic approaches. This expert consensus is acollaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures, improve patient safety and enhance clinical outcomes of endodontictherapy in patients with compromised overall health.展开更多
Various engine-driven NiTi endodontic files have been indispensable and efficient tools in cleaning and shaping of root canals for practitioners. In this review, we introduce the relative terms and conceptions of NiTi...Various engine-driven NiTi endodontic files have been indispensable and efficient tools in cleaning and shaping of root canals for practitioners. In this review, we introduce the relative terms and conceptions of NiTi file, including crystal phase composition, the design of the cutting part, types of separation. This review also analysis the main improvement and evolution of different generations of engine-driven nickel-titanium instruments in the past 20 years in the geometric design, manufacturing surface treatment such as electropolishing, thermal treatment, metallurgy. And the variety of motion modes of NiTi files to improve resistance to torsional failure were also discussed. Continuous advancements by the designers, provide better balance between shaping efficiency and resistance to of NiTi systems. In clinical practice an appropriate system should be selected based on the anatomy of the root canal, instrument characteristics, and operators’ experience.展开更多
How osteoblast cells are induced is a central question for understanding skeletal formation. Abnormal osteoblast differentiation leads to a broad range of devastating craniofacial diseases. Here we have investigated i...How osteoblast cells are induced is a central question for understanding skeletal formation. Abnormal osteoblast differentiation leads to a broad range of devastating craniofacial diseases. Here we have investigated intramembranous ossification during cranial bone development in mouse models of skeletal genetic diseases that exhibit craniofacial bone defects. The GNAS gene encodes Gαs that transduces GPCR signaling. GNAS activation or loss-of-function mutations in humans cause fibrous dysplasia(FD) or progressive osseous heteroplasia(POH) that shows craniofacial hyperostosis or craniosynostosis, respectively. We find here that, while Hh ligand-dependent Hh signaling is essential for endochondral ossification, it is dispensable for intramembranous ossification, where Gαsregulates Hh signaling in a ligand-independent manner. We further show that Gαscontrols intramembranous ossification by regulating both Hh and Wnt/β-catenin signaling. In addition, Gαsactivation in the developing cranial bone leads to reduced ossification but increased cartilage presence due to reduced cartilage dissolution, not cell fate switch. Small molecule inhibitors of Hh and Wnt signaling can effectively ameliorate cranial bone phenotypes in mice caused by loss or gain of Gnas function mutations, respectively. Our work shows that studies of genetic diseases provide invaluable insights in both pathological bone defects and normal bone development, understanding both leads to better diagnosis and therapeutic treatment of bone diseases.展开更多
Bone remodelling keeps going through the lifespan of human by bone formation and bone resorption.In the craniofacial region,mandibles act as the main force for biting and chewing,and also become susceptible to a commo...Bone remodelling keeps going through the lifespan of human by bone formation and bone resorption.In the craniofacial region,mandibles act as the main force for biting and chewing,and also become susceptible to a common bone-loss disease,namely,apical periodontitis,once infected dental pulp is not treated timely,during which bone resorption occurs from the apical foramen to the apical bone area.Although conventional root canal treatment(RCT)can remove the most of the infection,chronical apical periodontitis due to incomplete removal of dental pulp and subsequent microleakage will become refractory and more challenging,and this process has scarcely been specifically studied as a bone remodelling issue in rat models.Therefore,to study chronical and refractory apical periodontitis owing to incomplete cleaning of infected dental pulp and microleackage in vivo,we establish a modified rat model of gradually progressive apical periodontitis by sealing residual necrotic dental pulp and introducing limited saliva,which simulates gradually progressive apical periodontitis,as observed in the clinical treatment of chronical and refractory apical periodontitis.We show that bone-loss is inevitable and progressive in this case of apical periodontitis,which confirms again that complete and sound root canal treatment is crucial to halt the progression of chronical and refractory apical periodontitis and promote bone formation.Interestingly,bone remodelling was enhanced at the initial stage of apical periodontitis in this model while reduced with a high osteoblast number afterwards,as shown by the time course study of the modified model.Suggesting that the pathological apical microenvironment reserve its hard tissue formation ability to some degree but in a disturbed manner.Hopefully,our findings can provide insights for future bone regenerative treatment for apical periodontitisassociated bone loss.展开更多
Digital guided therapy(DGT)has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades.The concept of DGT for endodontic diseases is categorized into static guided ...Digital guided therapy(DGT)has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades.The concept of DGT for endodontic diseases is categorized into static guided endodontics(SGE),necessitating a meticulously designed template,and dynamic guided endodontics(DGE),which utilizes an optical triangulation tracking system.Based on cone-beam computed tomography(CBCT)images superimposed with or without oral scan(OS)data,a virtual template is crafted through software and subsequently translated into a 3-dimensional(3D)printing for SGE,while the system guides the drilling path with a real-time navigation in DGE.DGT was reported to resolve a series of challenging endodontic cases,including teeth with pulp obliteration,teeth with anatomical abnormalities,teeth requiring retreatment,posterior teeth needing endodontic microsurgery,and tooth autotransplantation.Case reports and basic researches all demonstrate that DGT stand as a precise,time-saving,and minimally invasive approach in contrast to conventional freehand method.This expert consensus mainly introduces the case selection,general workflow,evaluation,and impact factor of DGT,which could provide an alternative working strategy in endodontic treatment.展开更多
Bioactive glasses(BG)have been generally used in bone defects repair for its good osteoinductivity and osteoconductivity.However,the early angiogenesis of BG in the repair of large-sized bone defects may not be suffic...Bioactive glasses(BG)have been generally used in bone defects repair for its good osteoinductivity and osteoconductivity.However,the early angiogenesis of BG in the repair of large-sized bone defects may not be sufficient enough to support new bone formation,resulting in the failure of bone repair.Photobiomodulation(PBM)therapy,which is superior on promoting early angiogenesis,may contribute to the angiogenesis of BG and further enhance the repair of bone defects.Therefore,we applied BG and PBM in combination and preliminarily investigated their additive effects on bone regeneration both in vitro and in vivo.The in vitro results revealed that BG combined with PBM remarkably enhanced human bone marrow mesenchymal stem cells proliferation,osteogenic-related genes expression and mineralization,which was better than applying BG or PBM respectively.For in vivo studies,the histological staining results showed that BG induced new bone formation in the interior of defects and promoted new bone reconstruction at 6 weeks post-operation.The micro-computed tomography results further confirmed that BG combined with PBM accelerated bone formation and maturation,improved the speed and quality of bone regeneration,and promoted bone repair.In conclusion,with the optimum BG and PBM parameters,BG combined with PBM generated additive effects on promoting bone regeneration.展开更多
Developmental defects of enamel are common due to genetic and environmental factors before and after birth.Cdc42,a Rho family small GTPase,regulates prenatal tooth development in mice.However,its role in postnatal too...Developmental defects of enamel are common due to genetic and environmental factors before and after birth.Cdc42,a Rho family small GTPase,regulates prenatal tooth development in mice.However,its role in postnatal tooth development,especially enamel formation,remains elusive.Here,we investigated Cdc42 functions in mouse enamel development and tooth repair after birth.Cdc42 showed highly dynamic temporospatial patterns in the developing incisors,with robust expression in ameloblast and odontoblast layers.Strikingly,epithelium-specific Cdc42 deletion resulted in enamel defects in incisors.Ameloblast differentiation was inhibited,and hypomineralization of enamel was observed upon epithelial Cdc42 deletion.Proteomic analysis showed that abnormal mitochondrial components,phosphotransferase activity,and ion channel regulator activity occurred in the Cdc42 mutant dental epithelium.Reactive oxygen species accumulation was detected in the mutant mice,suggesting that abnormal oxidative stress occurred after Cdc42 depletion.Moreover,Cdc42 mutant mice showed delayed tooth repair and generated less calcified enamel.Mitochondrial dysfunction and abnormal oxygen consumption were evidenced by reduced Apool and Timm8a1 expression,increased Atp5j2 levels,and reactive oxygen species overproduction in the mutant repair epithelium.Epithelium-specific Cdc42 deletion attenuated ERK1/2 signaling in the labial cervical loop.Aberrant Sox2 expression in the mutant labial cervical loop after clipping might lead to delayed tooth repair.These findings suggested that mitochondrial dysfunction,up-regulated oxidative stress,and abnormal ion channel activity may be among multiple factors responsible for the observed enamel defects in Cdc42 mutant incisors.Overall,Cdc42 exerts multidimensional and pivotal roles in enamel development and is particularly required for ameloblast differentiation and enamel matrix formation.展开更多
Background Streptococcus （S.） oligofermentans is a newly identified bacteria with a yet to be defined mechanism of sucrose metabolism that results in acid production. This study aimed to investigate the biochemical ...Background Streptococcus （S.） oligofermentans is a newly identified bacteria with a yet to be defined mechanism of sucrose metabolism that results in acid production. This study aimed to investigate the biochemical mechanisms of S. oligoferm-entans glucose metaolism. Methods The S. oligofermentans LMG21532, Lactobacillus （L.） fermentum 38 and the S. mutans UA140 were used to characterize sucrose metabolism by measuring lactate dehydrogenase （LDH） activity and lactic acid production. Continuous dynamics and high performance capillary electrophoresis were used to determine LDH activity and lactic acid production, respectively, from bacteria collected at 0, 10 and 30 minutes after cultured in 10% sucrose. Results These analyses demonstrated that LDH activity of the three bacterial strains examined remained stable but significantly different throughout the sucrose fermentation process. The S. oligofermentans LDH activity （（0.61±0.05） U/mg） was significantly lower than that of L. fermentum （（52.91±8.97） U/mg）. In addition, the S. oligofermentans total lactate production （（0.048±0.021） mmol/L） was also significantly lower than that of L. fermentum （（0.958±0.201） mmol/L）. Although the S. oligofermentans LDH production was almost double of that produced by S. mutans （（0.32±0.07） U/mg）, lactic acid production was approximately one sixth that of S. mutans （（0.296±0.058） mmol/L）. Additional tests examining pyruvic acid production （the LDH substrate） demonstrated that lactic acid concentrations correlated with pyruvic acid production. That is, pyruvic acid production by S. oligofermentans was undetectable following sucrose incubation, however, （0.074±0.024） and （0.175±0.098） mmol/L pyruvic acid were produced by S. mutans and L. fermentum, respectively. Conclusion S. oligofermentans is incapable of fermenting carbohydrates to produce enough pyruvic acid, which results in reduced lactic acid production.展开更多
Dental Caries is a kind of chronic oral disease that greatly threaten human being’s health.Though dentists and researchers struggled for decades to combat this oral disease,the incidence and prevalence of dental cari...Dental Caries is a kind of chronic oral disease that greatly threaten human being’s health.Though dentists and researchers struggled for decades to combat this oral disease,the incidence and prevalence of dental caries remain quite high.Therefore,improving the disease management is a key issue for the whole population and life cycle management of dental caries.So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification.Dentists should perform oral examination and establish dental records at each visit.When treatment plan is made on the base of caries risk assessment and carious lesion activity,we need to work out patient-centered and personalized treatment planning to regain oral microecological balance,to control caries progression and to restore the structure and function of the carious teeth.And the follow-up visits are made based on personalized caries management.This expert consensus mainly discusses caries risk assessment,caries treatment difficulty assessment and dental caries treatment plan,which are the most important parts of caries management in the whole life cycle.展开更多
Regenerative endodontic procedures(REPs)is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis.The ultimate objective of REPs is to regenerate the pulp-dentin complex,extend t...Regenerative endodontic procedures(REPs)is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis.The ultimate objective of REPs is to regenerate the pulp-dentin complex,extend the tooth longevity and restore the normal function.Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports,case series,cohort studies,and randomized controlled studies.However,variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics.The heterogeneity in protocols may cause confusion among dental practitioners,thus guidelines and considerations of REPs should be explicated.This expert consensus mainly discusses the biological foundation,the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis,as well as the main complications of this treatment,aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies,suggesting REPs may become a more consistently evidence-based option in dental treatment.展开更多
Utilization of the body’s regenerative potential for tissue repair is known as in situ tissue regeneration.However,the use of exogenous growth factors requires delicate control of the dose and delivery strategies and...Utilization of the body’s regenerative potential for tissue repair is known as in situ tissue regeneration.However,the use of exogenous growth factors requires delicate control of the dose and delivery strategies and may be accompanied by safety,efficacy and cost concerns.In this study,we developed,for the first time,a biomaterial-based strategy to activate endogenous transforming growth factor beta 1(TGFβ1)under alkaline conditions for effective in situ tissue regeneration.We demonstrated that alkaline-activated TGFβ1 from blood serum,bone marrow fluids and soaking solutions of meniscus and tooth dentin was capable of increasing cell recruitment and early differentiation,implying its broad practicability.Furthermore,we engineered an injectable hydrogel(MS-Gel)consisting of gelatin microspheres for loading strong alkaline substances and a modified gelatin matrix for hydrogel click crosslinking.In vitro models showed that alkaline MS-Gel controllably and sustainably activated endogenous TGFβ1 from tooth dentin for robust bone marrow stem cell migration.More importantly,infusion of in vivo porcine prepared root canals with alkaline MS-Gel promoted significant pulp-dentin regeneration with neurovascular stroma and mineralized tissue by endogenous proliferative cells.Therefore,this work offers a new bench-to-beside translation strategy using biomaterial-activated endogenous biomolecules to achieve in situ tissue regeneration without the need for cell or protein delivery.展开更多
The object of this study was to evaluate the effect of bioactive glass （BG） size on mineral formation on dentin surfaces. Totally demineralized dentin discs were treated using BG suspensions with different particle ...The object of this study was to evaluate the effect of bioactive glass （BG） size on mineral formation on dentin surfaces. Totally demineralized dentin discs were treated using BG suspensions with different particle sizes： i.e., microscale bioactive glass （m-BG）, submicroscale bioactive glass （sm-BG） and nanoscale bioactive glass （n-BG）. Field-emission scanning electron microscopy and 3D profile measurement laser microscopy were used to observe the surface morphology and roughness. It was found that all BG particles could promoted mineral formation on dentin surfaces, while plug-like depositions were observed on the dentin discs treated by n-BG and they were more acid-resistant. The present results may imply that n-BG has potential clinical application for dentin hypersensitivity treatment.展开更多
基金supported by Jiangsu Province Key Research and Development Program(No.BE2022670)the National Key Research and Development Program of China(No.2023YFC2506300)+1 种基金Jiangsu Provincial Medical Key Discipline Cultivation Unit(No.JSDW202246)Nanjing Medical Science and Technology development Fund(ZKX22054).
文摘Endo-periodontal lesions (EPLs) involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.
文摘The dental operative microscope has been widely employed in the field of dentistry,particularly in endodontics and operative dentistry,resulting in significant advancements in the effectiveness of root canal therapy,endodontic surgery,and dental restoration.However,the improper use of this microscope continues to be common in clinical settings,primarily due to operators’insufficient understanding and proficiency in both the features and established operating procedures of this equipment.In October 2019,Professor Jingping Liang,Vice Chairman of the Society of Cariology and Endodontology,Chinese Stomatological Association,organized a consensus meeting with Chinese experts in endodontics and operative dentistry.The objective of this meeting was to establish a standard operation procedure for the dental operative microscope.Subsequently,a consensus was reached and officially issued.Over the span of about four years,the content of this consensus has been further developed and improved through practical experience.
文摘Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.
基金Beijing Natural Science Foundation,Grant/Award Number:L222145 and L222030Emerging Engineering Interdisciplinary Project and the Fundamental Research Funds for the Central Universities,Grant/Award Number:PKU2022XGK008Peking University Medicine Fund of Fostering Young Scholars’Scientific&Technological Innovation,Grant/Award Number:BMU2022PY010。
文摘Background:Osteoporosis is a chronic bone disease characterized by bone loss and decreased bone strength.However,current anti-resorptive drugs carry a risk of various complications.The deep learning-based efficacy prediction system(DLEPS)is a forecasting tool that can effectively compete in drug screening and prediction based on gene expression changes.This study aimed to explore the protective effect and potential mechanisms of cinobufotalin(CB),a traditional Chinese medicine(TCM),on bone loss.Methods:DLEPS was employed for screening anti-osteoporotic agents according to gene profile changes in primary osteoporosis.Micro-CT,histological and morphological analysis were applied for the bone protective detection of CB,and the osteogenic differentiation/function in human bone marrow mesenchymal stem cells(hBMMSCs)were also investigated.The underlying mechanism was verified using qRT-PCR,Western blot(WB),immunofluorescence(IF),etc.Results:A safe concentration(0.25mg/kg in vivo,0.05μM in vitro)of CB could effectively preserve bone mass in estrogen deficiency-induced bone loss and promote osteogenic differentiation/function of hBMMSCs.Both BMPs/SMAD and Wnt/β-catenin signaling pathways participated in CB-induced osteogenic differentiation,further regulating the expression of osteogenesis-associated factors,and ultimately promoting osteogenesis.Conclusion:Our study demonstrated that CB could significantly reverse estrogen deficiency-induced bone loss,further promoting osteogenic differentiation/function of hBMMSCs,with BMPs/SMAD and Wnt/β-catenin signaling pathways involved.
文摘Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical region has yet to be solved, impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.
基金supported by the National Natural Science Foundation of China(82370947)the Natural Science Foundation of Sichuan Province(2023NSFSC1505)。
文摘The overall health condition of patients significantly affects the diagnosis, treatment, and prognosis of endodontic diseases. Asystemic consideration of the patient’s overall health along with oral conditions holds the utmost importance in determining thenecessity and feasibility of endodontic therapy, as well as selecting appropriate therapeutic approaches. This expert consensus is acollaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures, improve patient safety and enhance clinical outcomes of endodontictherapy in patients with compromised overall health.
文摘Various engine-driven NiTi endodontic files have been indispensable and efficient tools in cleaning and shaping of root canals for practitioners. In this review, we introduce the relative terms and conceptions of NiTi file, including crystal phase composition, the design of the cutting part, types of separation. This review also analysis the main improvement and evolution of different generations of engine-driven nickel-titanium instruments in the past 20 years in the geometric design, manufacturing surface treatment such as electropolishing, thermal treatment, metallurgy. And the variety of motion modes of NiTi files to improve resistance to torsional failure were also discussed. Continuous advancements by the designers, provide better balance between shaping efficiency and resistance to of NiTi systems. In clinical practice an appropriate system should be selected based on the anatomy of the root canal, instrument characteristics, and operators’ experience.
基金supported by the NIH grants R01DE025866 from NIDCRR01AR070877 from NIAMSsupported by the 111 Project, MOE (B14038), China
文摘How osteoblast cells are induced is a central question for understanding skeletal formation. Abnormal osteoblast differentiation leads to a broad range of devastating craniofacial diseases. Here we have investigated intramembranous ossification during cranial bone development in mouse models of skeletal genetic diseases that exhibit craniofacial bone defects. The GNAS gene encodes Gαs that transduces GPCR signaling. GNAS activation or loss-of-function mutations in humans cause fibrous dysplasia(FD) or progressive osseous heteroplasia(POH) that shows craniofacial hyperostosis or craniosynostosis, respectively. We find here that, while Hh ligand-dependent Hh signaling is essential for endochondral ossification, it is dispensable for intramembranous ossification, where Gαsregulates Hh signaling in a ligand-independent manner. We further show that Gαscontrols intramembranous ossification by regulating both Hh and Wnt/β-catenin signaling. In addition, Gαsactivation in the developing cranial bone leads to reduced ossification but increased cartilage presence due to reduced cartilage dissolution, not cell fate switch. Small molecule inhibitors of Hh and Wnt signaling can effectively ameliorate cranial bone phenotypes in mice caused by loss or gain of Gnas function mutations, respectively. Our work shows that studies of genetic diseases provide invaluable insights in both pathological bone defects and normal bone development, understanding both leads to better diagnosis and therapeutic treatment of bone diseases.
基金supported by the National Natural Science Foundation of China(Grant No.81371136)to X.Z.National Natural Science Foundation of China(Grant No.81771033)to L.Z
文摘Bone remodelling keeps going through the lifespan of human by bone formation and bone resorption.In the craniofacial region,mandibles act as the main force for biting and chewing,and also become susceptible to a common bone-loss disease,namely,apical periodontitis,once infected dental pulp is not treated timely,during which bone resorption occurs from the apical foramen to the apical bone area.Although conventional root canal treatment(RCT)can remove the most of the infection,chronical apical periodontitis due to incomplete removal of dental pulp and subsequent microleakage will become refractory and more challenging,and this process has scarcely been specifically studied as a bone remodelling issue in rat models.Therefore,to study chronical and refractory apical periodontitis owing to incomplete cleaning of infected dental pulp and microleackage in vivo,we establish a modified rat model of gradually progressive apical periodontitis by sealing residual necrotic dental pulp and introducing limited saliva,which simulates gradually progressive apical periodontitis,as observed in the clinical treatment of chronical and refractory apical periodontitis.We show that bone-loss is inevitable and progressive in this case of apical periodontitis,which confirms again that complete and sound root canal treatment is crucial to halt the progression of chronical and refractory apical periodontitis and promote bone formation.Interestingly,bone remodelling was enhanced at the initial stage of apical periodontitis in this model while reduced with a high osteoblast number afterwards,as shown by the time course study of the modified model.Suggesting that the pathological apical microenvironment reserve its hard tissue formation ability to some degree but in a disturbed manner.Hopefully,our findings can provide insights for future bone regenerative treatment for apical periodontitisassociated bone loss.
文摘Digital guided therapy(DGT)has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades.The concept of DGT for endodontic diseases is categorized into static guided endodontics(SGE),necessitating a meticulously designed template,and dynamic guided endodontics(DGE),which utilizes an optical triangulation tracking system.Based on cone-beam computed tomography(CBCT)images superimposed with or without oral scan(OS)data,a virtual template is crafted through software and subsequently translated into a 3-dimensional(3D)printing for SGE,while the system guides the drilling path with a real-time navigation in DGE.DGT was reported to resolve a series of challenging endodontic cases,including teeth with pulp obliteration,teeth with anatomical abnormalities,teeth requiring retreatment,posterior teeth needing endodontic microsurgery,and tooth autotransplantation.Case reports and basic researches all demonstrate that DGT stand as a precise,time-saving,and minimally invasive approach in contrast to conventional freehand method.This expert consensus mainly introduces the case selection,general workflow,evaluation,and impact factor of DGT,which could provide an alternative working strategy in endodontic treatment.
基金supported by the National Natural Science Foundation of China[Project 81870753]Peking University School of Stomatology[Project PKUSS20190104]Michigan Medicine-Peking University Health Science Center Joint Institute[BMU2022JI007].
文摘Bioactive glasses(BG)have been generally used in bone defects repair for its good osteoinductivity and osteoconductivity.However,the early angiogenesis of BG in the repair of large-sized bone defects may not be sufficient enough to support new bone formation,resulting in the failure of bone repair.Photobiomodulation(PBM)therapy,which is superior on promoting early angiogenesis,may contribute to the angiogenesis of BG and further enhance the repair of bone defects.Therefore,we applied BG and PBM in combination and preliminarily investigated their additive effects on bone regeneration both in vitro and in vivo.The in vitro results revealed that BG combined with PBM remarkably enhanced human bone marrow mesenchymal stem cells proliferation,osteogenic-related genes expression and mineralization,which was better than applying BG or PBM respectively.For in vivo studies,the histological staining results showed that BG induced new bone formation in the interior of defects and promoted new bone reconstruction at 6 weeks post-operation.The micro-computed tomography results further confirmed that BG combined with PBM accelerated bone formation and maturation,improved the speed and quality of bone regeneration,and promoted bone repair.In conclusion,with the optimum BG and PBM parameters,BG combined with PBM generated additive effects on promoting bone regeneration.
基金the National Natural Science Foundation of China(No.81900958,82170987,82073378,81974146,82101053)the Natural Science Foundation of Guangdong Province,China(No.2020A1515-010059,2021A1515012535)+2 种基金Sun Yat-Sen University Clinical Research 5010 Program(No.2023009)Science and Technology Planning Project of Guangzhou,China(No.2023-A04J2148)Open Funding of Guangdong Provincial Key Laboratory of Stomatology(China)(No.KF2021120104).
文摘Developmental defects of enamel are common due to genetic and environmental factors before and after birth.Cdc42,a Rho family small GTPase,regulates prenatal tooth development in mice.However,its role in postnatal tooth development,especially enamel formation,remains elusive.Here,we investigated Cdc42 functions in mouse enamel development and tooth repair after birth.Cdc42 showed highly dynamic temporospatial patterns in the developing incisors,with robust expression in ameloblast and odontoblast layers.Strikingly,epithelium-specific Cdc42 deletion resulted in enamel defects in incisors.Ameloblast differentiation was inhibited,and hypomineralization of enamel was observed upon epithelial Cdc42 deletion.Proteomic analysis showed that abnormal mitochondrial components,phosphotransferase activity,and ion channel regulator activity occurred in the Cdc42 mutant dental epithelium.Reactive oxygen species accumulation was detected in the mutant mice,suggesting that abnormal oxidative stress occurred after Cdc42 depletion.Moreover,Cdc42 mutant mice showed delayed tooth repair and generated less calcified enamel.Mitochondrial dysfunction and abnormal oxygen consumption were evidenced by reduced Apool and Timm8a1 expression,increased Atp5j2 levels,and reactive oxygen species overproduction in the mutant repair epithelium.Epithelium-specific Cdc42 deletion attenuated ERK1/2 signaling in the labial cervical loop.Aberrant Sox2 expression in the mutant labial cervical loop after clipping might lead to delayed tooth repair.These findings suggested that mitochondrial dysfunction,up-regulated oxidative stress,and abnormal ion channel activity may be among multiple factors responsible for the observed enamel defects in Cdc42 mutant incisors.Overall,Cdc42 exerts multidimensional and pivotal roles in enamel development and is particularly required for ameloblast differentiation and enamel matrix formation.
基金This study was supported by grants from 115-National Key Technologies R＆D Programme, the Ministry of Science and Technology of China （No. 2007BAI18B01）, National Natural Science Foundation of China （No. 8107088）, and Beijing Municipal Natural Science Foundation （No. 7102163）. Conflict of interests： None.
文摘Background Streptococcus （S.） oligofermentans is a newly identified bacteria with a yet to be defined mechanism of sucrose metabolism that results in acid production. This study aimed to investigate the biochemical mechanisms of S. oligoferm-entans glucose metaolism. Methods The S. oligofermentans LMG21532, Lactobacillus （L.） fermentum 38 and the S. mutans UA140 were used to characterize sucrose metabolism by measuring lactate dehydrogenase （LDH） activity and lactic acid production. Continuous dynamics and high performance capillary electrophoresis were used to determine LDH activity and lactic acid production, respectively, from bacteria collected at 0, 10 and 30 minutes after cultured in 10% sucrose. Results These analyses demonstrated that LDH activity of the three bacterial strains examined remained stable but significantly different throughout the sucrose fermentation process. The S. oligofermentans LDH activity （（0.61±0.05） U/mg） was significantly lower than that of L. fermentum （（52.91±8.97） U/mg）. In addition, the S. oligofermentans total lactate production （（0.048±0.021） mmol/L） was also significantly lower than that of L. fermentum （（0.958±0.201） mmol/L）. Although the S. oligofermentans LDH production was almost double of that produced by S. mutans （（0.32±0.07） U/mg）, lactic acid production was approximately one sixth that of S. mutans （（0.296±0.058） mmol/L）. Additional tests examining pyruvic acid production （the LDH substrate） demonstrated that lactic acid concentrations correlated with pyruvic acid production. That is, pyruvic acid production by S. oligofermentans was undetectable following sucrose incubation, however, （0.074±0.024） and （0.175±0.098） mmol/L pyruvic acid were produced by S. mutans and L. fermentum, respectively. Conclusion S. oligofermentans is incapable of fermenting carbohydrates to produce enough pyruvic acid, which results in reduced lactic acid production.
基金supported by National Natural Science Foundation of China[81870759]。
文摘Dental Caries is a kind of chronic oral disease that greatly threaten human being’s health.Though dentists and researchers struggled for decades to combat this oral disease,the incidence and prevalence of dental caries remain quite high.Therefore,improving the disease management is a key issue for the whole population and life cycle management of dental caries.So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification.Dentists should perform oral examination and establish dental records at each visit.When treatment plan is made on the base of caries risk assessment and carious lesion activity,we need to work out patient-centered and personalized treatment planning to regain oral microecological balance,to control caries progression and to restore the structure and function of the carious teeth.And the follow-up visits are made based on personalized caries management.This expert consensus mainly discusses caries risk assessment,caries treatment difficulty assessment and dental caries treatment plan,which are the most important parts of caries management in the whole life cycle.
文摘Regenerative endodontic procedures(REPs)is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis.The ultimate objective of REPs is to regenerate the pulp-dentin complex,extend the tooth longevity and restore the normal function.Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports,case series,cohort studies,and randomized controlled studies.However,variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics.The heterogeneity in protocols may cause confusion among dental practitioners,thus guidelines and considerations of REPs should be explicated.This expert consensus mainly discusses the biological foundation,the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis,as well as the main complications of this treatment,aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies,suggesting REPs may become a more consistently evidence-based option in dental treatment.
文摘Utilization of the body’s regenerative potential for tissue repair is known as in situ tissue regeneration.However,the use of exogenous growth factors requires delicate control of the dose and delivery strategies and may be accompanied by safety,efficacy and cost concerns.In this study,we developed,for the first time,a biomaterial-based strategy to activate endogenous transforming growth factor beta 1(TGFβ1)under alkaline conditions for effective in situ tissue regeneration.We demonstrated that alkaline-activated TGFβ1 from blood serum,bone marrow fluids and soaking solutions of meniscus and tooth dentin was capable of increasing cell recruitment and early differentiation,implying its broad practicability.Furthermore,we engineered an injectable hydrogel(MS-Gel)consisting of gelatin microspheres for loading strong alkaline substances and a modified gelatin matrix for hydrogel click crosslinking.In vitro models showed that alkaline MS-Gel controllably and sustainably activated endogenous TGFβ1 from tooth dentin for robust bone marrow stem cell migration.More importantly,infusion of in vivo porcine prepared root canals with alkaline MS-Gel promoted significant pulp-dentin regeneration with neurovascular stroma and mineralized tissue by endogenous proliferative cells.Therefore,this work offers a new bench-to-beside translation strategy using biomaterial-activated endogenous biomolecules to achieve in situ tissue regeneration without the need for cell or protein delivery.
基金the financial support from the National Natural Science Foundation of China (No. 51372005)
文摘The object of this study was to evaluate the effect of bioactive glass （BG） size on mineral formation on dentin surfaces. Totally demineralized dentin discs were treated using BG suspensions with different particle sizes： i.e., microscale bioactive glass （m-BG）, submicroscale bioactive glass （sm-BG） and nanoscale bioactive glass （n-BG）. Field-emission scanning electron microscopy and 3D profile measurement laser microscopy were used to observe the surface morphology and roughness. It was found that all BG particles could promoted mineral formation on dentin surfaces, while plug-like depositions were observed on the dentin discs treated by n-BG and they were more acid-resistant. The present results may imply that n-BG has potential clinical application for dentin hypersensitivity treatment.
