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4 - Vol 25, No 4, 2022
- Chin J Dent Res 2022;25(4):251–259; doi:10.3290/j.cjdr.b3628105
- Status Quo and Advanced Progress in Oral Health Care and Treatment of Children with Autism Spectrum Disorder: A Literature Review
- Lu GAO, Xue Nan LIU
- Autism spectrum disorder (ASD) has become one of the fastest growing diseases in the world, causing a great burden to ASD children’s families and society. Children with ASD face more disadvantages relating to their oral health than those without ASD. There is a positive correlation between prevalence of caries lesions and severity of ASD. Poorer oral hygiene, higher detection rates of dental calculus and far more frequent cases of gingivitis occur in children with ASD. Traumatic injuries and various types of malocclusions are more frequent in children
  with ASD. Poorer oral health care and treatment status are caused by multiple adverse factors. Ways of promoting effective oral health care and treatment include pretreatment counselling; improvement of the individualised treatment environment; routine behaviour guidance techniques (BGTs) including tellshowdo, distraction, role model presentation, voice control, visual education and social stories, encouragement and reinforcement; targeted BGTs including visual education, behaviour modelling, applied behaviour analysis (ABA) and systematic desensitisation; passive BGTs including protective restraint, pharmaceutically administrated sedation and general anaesthesia; oral health education for guardians; and interdisciplinary collaboration and professional dental care/treatment. Dentists, families with children with ASD and schools should cooperate to improve familycentred
  oral health care and treatment for ASD children not only in China, but also the whole world.
  
  Key words: autism spectrum disorder, behaviour management, children, oral health care, promotion
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- Chin J Dent Res 2022;25(4):261–267; doi:10.3290/j.cjdr.b3628117
- Sappanone A Aggrandises Ionising Radiation–induced Damage in Oral Epithelial Cells
- Xue Feng ZHAO, Zhi Yong WANG, Xue Mei QIU, Hang ZHAO, Rui LIU, Qian Ming CHEN
- Objective: To analyse the role played by Sappanone A, a bioactive ingredient isolated from the heartwood of Caesalpinia sappan, in the regulation of oral epithelial cell viability under radiation.
  Methods: Cell viability of human oral keratinocytes (HOKs) and mouse salivary gland cells under ionising radiation was analysed. Expression of Ki67 was measured by immunohistochemical staining. Fragmentation of deoxyribonucleic acid (DNA) was measured by comet assay. Cell death was analysed using trypan blue exclusion assay. Cell viability was measured using a Cell Counting Kit 8 (CCK8; Abcam, Cambridge, UK) assay.
  Results: Sappanone A decreased cell viability of HOK cells and mouse salivary gland cells under ionizing radiation. In addition, Sappanone A enhanced radiation-induced genomic DNA fragmentation, accompanied by impaired homologous recombination and non-homologous end joining DNA repair. Mechanistic evaluation revealed that Sappanone A counteracted radiation-induced inosine monophosphate dehydrogenase 2 (IMPDH2) activation, and that this effect could be abolished by reconstituted expression of a Sappanone A-binding defective IMPDH2 mutant.
  Conclusion: The present study highlights a novel role played by Sappanone A in the modulation of radiosensitivity of oral epithelial cells.
  
  Key words: DNA repair, ionising radiation, oral epithelial cell, Sappanone A
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- Chin J Dent Res 2022;25(4):268; doi:10.3290/j.cjdr.b3628123
- Comments on “Sappanone A Aggrandises Ionising Radiation–induced Damage in Oral Epithelial Cells”
- De Meng CHEN
- Radiation-induced oral mucosal disorders and injuries are major complications for patients undergoing head and neck radiotherapy. They are either reversible or permanent, and include oral mucositis, xerostomia, bacterial or fungal infection, taste dysfunction, sensory disorders and oral mucosal fibrosis. Among these, radiation-induced oral mucositis (RIOM) is the most common complication observed in approximately 80% of patients who undergo head and neck radiotherapy. RIOM is a form of acute inflammation that arises within the first 2 to 3 weeks after radiotherapy and is characterized by hyperaemia and redness of the oral mucosa, which can eventually progress to oral ulcers with a pseudomembrane. Patients may suffer from extreme pain when speaking and swallowing, leading to decreased food intake, significant weight loss and malnutrition, thus influencing their subsequent radiotherapy.
  Traditional Chinese medicine plays an increasingly active role in the prevention and treatment of radiation-induced oral mucosal injuries. Many studies have demonstrated that traditional Chinese medicine can reduce the incidence of oral mucositis effectively and alleviate related symptoms such as xerostomia and pain, thus improving patients’ prognosis. As a widely distributed medicinal material, Caesalpinia sappan (CS) processes anti-inflammatory and antimicrobial properties and shows potential value in the treatment of multiple inflammatory
  disorders.
  In the article “Sappanone A aggrandises ionising radiation–induced damage in oral epithelial cells”, Zhao et al report that Sappanone A, isolated from the heartwood of CS, has destructive effects on the viability of oral epithelial cells, accentuating ionising radiation–induced DNA damage. Sappanone A targets and suppresses inosine monophosphate dehydrogenase 2, a rate-limiting enzyme in nucleotide synthesis, leading to delayed DNA repair under radiation. These discoveries have deepened our understanding of the role of CS in regulating cell radiosensitivity, which will assist future pharmaceutical developments for treating RIOM.
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- Chin J Dent Res 2022;25(4):269–275; doi:10.3290/j.cjdr.b3628171
- MiR-146a-5p Promotes Dental Stem Cells Osteo/odontogenic Differentiation through NF-Kappa B Signaling Pathway by Targeting TRAF6
- Xin YU, Jian Feng LU, Mei Qin GAO, Bin XIONG, Wen Qian XIA
- Objective: To screen miRNAs that could simultaneously regulate osteo/odontogenic differentiation of multiple stem cells, including dental pulp stem cells (DPSCs), stem cells from the apical papilla (SCAPs) and periodontal ligament stem cells (PDLSCs).
  Methods: Differentially expressed miRNAs analysis on three miRNA microarrays data of dental stem cells undergoing osteo/odontogenic differentiation (GSE138180, GSE154466 and GSE159508) was performed, and miR-146a-5p were identified by bioinformatic prediction, dual-luciferase reporter assay and quantitative real-time polymerase chain reaction (PCR). In addition, differentially expressed genes between miR-146a-5p overexpressed group and control group (GSE79341) were applied for KEGG pathways enrichment analysis.
  Results: MiR-146a-5p expression increased in the osteo/odontogenic differentiation of DPSCs, SCAPs and PDLSCs. Tumour necrosis factor receptor (TNFR)-associated factor 6 (TRAF6) was identified as the target gene of miR-146a-5p. Furthermore, miR-146a-5p could influence the NF-Kappa B signalling pathway.
  Conclusion: This study suggests that miR-146a-5p could promote differentiation in multiple dental stem cells through the NF-Kappa B signalling pathway by targeting TRAF6.
  
  Key words: dental stem cells, miR-146a-5p, NF-Kappa B signalling pathway, osteo/odontogenic differentiation, TRAF6
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- Chin J Dent Res 2022;25(4):277–284; doi:10.3290/j.cjdr.b3628177
- Correlation Analysis between Self-perceived Oral Health and Self-perceived General Health among Adults in China
- Yi Zhen YU, Shuo DU, Min DING, Zhi Ying CUI, Yi LIU, Yan SI
- Objective: To analyse the correlation between self-perceived oral health (SPOH) and selfperceived general health (SPGH) and the influencing factors.
  Methods: In this study, we collected sociodemographic information and details about SPOH and SPGH status for Chinese adults (≥ 18 years), and a total of 2233 people were included. The data were analysed using SPSS software (IBM, Armonk, NY, USA) with a chi-square test and binary logistic regression.
  Results: In total, 43.4% of adults' self-perceived oral health was at a "good" level and 57.9% of adults' self-perceived general health was at a "good" level. The SPOH was correlated with SPGH (r = 0.593, P < 0.001). Good SPOH was associated with younger age, no dentures, no smoking, brushing teeth twice or more a day, periodontal health, no malocclusion and decayed, missing and filled teeth (DMFT) ≤ 12. Good SPGH was associated with younger age, higher educational level, no dentures, no smoking, brushing teeth twice or more a day, periodontal health, no malocclusion and DMFT ≤ 12.
  Conclusion: SPOH and SPGH are correlated with each other, and greater attention should be paid to oral health to promote general health.
  
  Key words: adults, China, correlation, general health, oral health
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- Chin J Dent Res 2022;25(4):285–291; doi:10.3290/j.cjdr.b3628195
- Expressions of GLUT-1, PK-M2 and HIF-1α and Mutation Status of BRAF in Odontogenic Keratocysts
- Zhu YOU, Jing DU, Li Li XU, He Yu ZHANG, Xue Fen LI, Zhi Peng SUN, Li Sha SUN
- Objective: To investigate the expressions and clinicopathological features of glucose transporter 1 (GLUT-1), pyruvate kinase M2 (PK-M2) and hypoxia-inducible factor 1α (HIF-1α) in odontogenic keratocysts (OKCs), and to investigate the mutation status of v-raf murine sarcoma viral oncogene homolog B1 (BRAF).
  Methods: Following a retrospective review of the clinicopathological data of 28 OKC cases, the expressions of GLUT-1, PK-M2 and HIF-1α in these tissue samples were detected through immunohistochemistry. The BRAF mutation statuses of all cases were examined using polymerase chain reaction amplification and direct sequencing.
  Results: The expression levels of HIF-1α varied in 96.4% of OKC tissues, and there were higher positive rates of PKM2 (100%) and GLUT-1 (100%) in these tissues. None of the 28 OKC samples carried the BRAF mutation.
  Conclusion: The positive expressions of GLUT-1, PK-M2 and HIF-1α indicate that patients with OKCs undergo anaerobic glycolysis to a certain extent, but these processes appear to be irrelevant to clinicopathological features and to the BRAF mutation.
  
  Key words: BRAF gene, GLUT-1, HIF-1α, odontogenic keratocyst, PK-M2
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- Chin J Dent Res 2022;25(4):293–299; doi:10.3290/j.cjdr.b3628215
- Prefabricating Implant-supported Interim Prosthesis from CBCT Scans: a Case Report of Digital Immediate Implant Restoration
- Hong Ye YANG, Aihemaiti MUHETAER, Ya Ke WANG, Cui HUANG
- This clinical report describes the immediate implant placement and restoration for a 47-yearold woman with a protruded and loose maxillary right central incisor. The treatment included minimally invasive extraction, flapless immediate implant placement using a fully guided surgical template, and immediate implant-supported provisionalisation. The interim anatomical prosthesis was fabricated in advance based on preoperative CBCT scans, and the digital technique made it possible to integrate data precisely from different sources. After 6 months of provisionalisation, satisfactory gingival aesthetic and functional improvements were achieved, followed by a definitive screw-retained zirconia restoration. Thus, application of a complete digital workflow could reduce chairside time and create an optimal emergence profile that matches the residual bone architecture of the extraction sites with minimal interference.
  
  Key words: aesthetic restoration, anterior teeth, digital dentistry, flapless surgery, immediate implant
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- Chin J Dent Res 2022;25(4):301–310; doi:10.3290/j.cjdr.b3628219
- Orthodontic and Orthognathic Treatment Combined with Surgically Assisted Rapid Maxillary Expansion in an Adult Patient with a Hyperdivergent Skeletal Pattern
- Yi Neng HAN, Hao LIU, Zi Li LI, Yi Ping HUANG, Wei Ran LI
- In this case study, we report the successful treatment of a 35-year-old woman with a hyperdivergent skeletal pattern, open bite and severe transverse deficiency, exhibiting a skeletal Class III malocclusion. The treatment plan included 3D correction of these issues with surgically assisted rapid maxillary expansion (SARME) to solve the transverse deficiency, presurgical orthodontic treatment including aligning and levelling of the teeth in both arches, LeFort I osteotomy and bilateral sagittal split ramus osteotomy, and postsurgical correction of malocclusion. Orthodontic treatment was performed with labial brackets, and the patient achieved satisfactory occlusion and a significantly improved facial profile. Retention at the 1-year follow-up showed stable occlusion and arch forms with a harmonious facial profile.
  
  Key words: hyperdivergent skeletal pattern, open bite, orthodontic-surgical treatment, surgically assisted rapid maxillary expansion, transverse deficiency
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- Total: 8