Objective: To compare the clinical parameters and levels of salivary immunoglobulin A (IgA), Interleukin-1β (IL-1β) and matrix metalloproteinase-8 (MMP-8) in patients with moderate to severe chronic periodontitis and in individuals with healthy gingiva. Methods: Levels of clinical parameters plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BOP) along with salivary biomarkers salivary IgA, IL-1β and MMP-8 were recorded among 50 adults (30 test subjects with moderate to severe generalised chronic periodontitis, constituting group A, and 20 periodontally healthy controls – group B). Clinical evaluation was done before oral prophylaxis, and 6 weeks and 12 weeks after oral prophylaxis, and saliva samples were obtained before and 12 weeks after oral prophylaxis. Salivary IgA, IL-1β and MMP-8 levels in saliva were assessed using enzyme-linked immunosorbent assay. Results: In group A, there were highly significant differences in terms of PI, GI, PD, CAL and BOP before oral prophylaxis, and 6 weeks and 12 weeks after oral prophylaxis when compared at these intervals. Differences in their levels in group B were non-significant at such intervals except PI. Mean levels of salivary IgA, IL-1β and MMP-8 in chronic periodontitis patients at baseline were significantly higher than in the periodontally healthy group. Their levels in group A decreased significantly 12 weeks after oral prophylaxis, but remained static in group B. Conclusion: The levels of salivary IgA, IL-1β and MMP-8 showed significant reduction after oral prophylaxis, suggesting that these biomarkers could facilitate the screening, early diagnosis, and management of periodontal disease.
Chin J Dent Res 2017;20(2):97–104;
doi:10.3290/j.cjdr.a38274
Risk Factors associated with Early Childhood Caries
Hui Bin SUN, Wei ZHANG, Xiao Bin ZHOU
Objective: To analyse factors associated with the susceptibility of early childhood caries (ECC), populations with a high risk of ECC were screened and guidance for ECC prevention was proposed. Methods: A total of 392 children aged 24 to 71 months were selected for oral examination in Qingdao. Parents or guardians of the participants completed the questionnaires and decayed missing filled surface (dmfs) were recorded. Differences in caries condition and oral health behaviour in different families were compared. Risk factors related to ECC were screened. The subjects were finally grouped based on the obtained dmfs into three groups: caries-free, ECC and S-ECC (severe ECC). Association of risk factors with the caries status was analysed using the Kruskal-Wallis test, the chi-square test and logistic regression analysis. Results: There were significant differences among the caries-free, ECC and S-ECC groups in three parameters: eating too many sweets each day, brushing before and after sleeping, and whether parents helped to brush (P < 0.01). Combined factors such as the parents’ level of education, oral health knowledge, attitudes, the family’s annual income, the age of children when they start to brush and not brushing regularly were also significantly related to ECC (P < 0.05). No significant differences were observed among the three groups for these factors, including birth condition and nursing state, physical condition of the mother during pregnancy, feeding situation, if a pacifier was used during sleep, duration of brushing, frequency of mouth rinsing after meals each day and brushing with fluoride toothpaste (P > 0.05). Conclusion: Eating a lot of sweets, an incorrect brushing method, starting brushing at a later stage and not brushing regularly are susceptible factors for ECC. Emphasising oral health knowledge to parents and guardians, conducting proper brushing methods, limiting the frequency of sweets being eaten and avoiding an inappropriate habit of eating sweets are very important factors in the prevention of ECC.
Chin J Dent Res 2018;21(1):9–19;
doi:10.3290/j.cjdr.a39914
Understanding of Burning Mouth Syndrome Based on Psychological Aspects
Moon-Jong KIM, Hong-Seop KHO
Burning mouth syndrome (BMS) is a chronic pain condition characterised by a persistent burning sensation in clinically normal oral mucosa. BMS most commonly occurs in middleaged and elderly women. Various local and systemic factors can cause oral burning symptoms.When all possible local and systemic factors are excluded, burning mouth symptoms can be diagnosed as BMS. Psychophysical tests and histopathological data suggest the involvement of peripheral and central neuropathic mechanisms in BMS etiopathogenesis. Psychological problems are frequently observed in BMS patients. Several mechanisms, including increased parafunctional habits, steroid dysregulation, central disinhibition due to taste dysfunction, and low dopamine levels in the brain, have been proposed as an explanation for the role of psychological factors in BMS pathophysiology. However, the causal relationship between BMS and psychological problems remains controversial. Given the neuropathic nature of BMS, treatment for it is similar to other neuropathic pain conditions. Although various treatment modalities, including pharmacological intervention, behavioural therapy and psychotherapy, have been proposed, there is no definitive treatment always effective for the majority of BMS patients. In conclusion, for better understanding of the relationship between BMS and psychological factors, well-designed prospective studies are needed. In addition, the evaluation and treatment of psychological problems are essential for successful management of BMS patients.
Chin J Dent Res 2018;21(3):167–179;
doi:10.3290/j.cjdr.a41076
Dental Caries Status and its Associated Factors among 3- to 5-year-old Children in China: A National Survey
Min Quan DU, Zhen LI, Han JIANG, Xing WANG, Xi Ping FENG, De Yu HU, Huan Cai LIN, Bo WANG, Yan SI, Chun Xiao WANG, Shu Guo ZHENG, Xue Nan LIU, Wen Sheng RONG, Wei Jian WANG, Bao Jun TAI
Objective: To investigate the prevalence and severity of dental caries among pre-school children in China as part of the 4th National Oral Health Survey. Methods: The sampling process was conducted with a multistage stratified cluster method. A total of 40,360 children aged between 3 and 5 years were recruited for this study. Each participant was clinically assessed according to the 5th edition of the oral health survey’s basic methods recommended by the World Health Organization (WHO) and their parents or grandparents completed a questionnaire at a face-to-face interview. The status of dental caries was shown in the form of the mean dmft and the prevalence of dental caries. The logistic regression analysis was performed to study the relationships between the prevalence of dental caries and the selected variables. Results: The prevalence of dental caries was 50.8%, 63.6% and 71.9% for 3-, 4- and 5-yearolds, respectively. The mean dmft was 2.28, 3.40 and 4.24, respectively. Logistic regression analysis showed that children who were mixed-fed had a higher chance of staying free of dental caries; children who had dessert before going to bed were associated with a higher probability of caries. Conclusion: The status of dental caries among preschool children in China is on the increase. The preschoolers’ dental caries status related to their breastfeeding conditions within the first 6 months of life and their snacking habits.
Key words: China, dental caries, preschool children, epidemiology, the 4th National Oral Health Survey
Chin J Dent Res 2018;21(3):161–165;
doi:10.3290/j.cjdr.a41079
The 4th National Oral Health Survey in the Mainland of China: Background and Methodology
Hai Xia LU, Dan Ying TAO, Edward Chin Man LO, Rui LI, Xing WANG, Bao Jun TAI, De Yu HU, Huan Cai LIN, Bo WANG, Yan SI, Chun Xiao WANG, Shu Guo ZHENG, Xue Nan LIU, Wen Sheng RONG, Wei Jian WANG, Xi Ping FENG
Oral disease patterns change over time and it is important to conduct epidemiological surveillance population surveys regularly to monitor the situation. The overall objectives of the present survey were: (1) to describe the oral health status of Chinese children and adults in the 2015–2016 4th National Oral Health Survey; (2) to investigate the oral health knowledge, attitudes, and behaviours among children and adults; (3) to explore the association among sociodemographic characteristics, oral health behaviours, and the oral health status of Chinese children and adults. A national oral health survey was conducted among a representative sample of Chinese children and adults. Local residents from the five age groups – 3 to 5 years, 12 to 15 years, 35 to 44 years, 55 to 64 years, and 65 to 74 years – were selected. A multi-stage cluster sampling method was adopted for the identification of participants. All 31 provinces, autonomous regions and municipalities of the mainland of China were included. All participants were clinically examined and information on their oral health status, including oral mucosal lesions, dental caries experience, periodontal health status, dental fluorosis, and dental prosthesis status, was collected according to the procedures and criteria recommended by the World Health Organization (WHO). A calibration training programme and quality control procedures were conducted to ensure the reliability of the findings. Information on sociodemographic background, oral health behaviours, knowledge and attitude was also collected from all five age groups through a questionnaire survey.
Key words: China, epidemiology, methodology, the 4th National Oral Health Survey
Chin J Dent Res 2018;21(3):181–193;
doi:10.3290/j.cjdr.a41080
Permanent Teeth Caries Status of 12- to 15-year-olds in China: Findings from the 4th National Oral Health Survey
Jun Kang QUAN, Xiao Zhe WANG, Xiang Yu SUN, Chao YUAN, Xue Nan LIU, Xing WANG, Xi Ping FENG, Bao Jun TAI, De Yu HU, Huan Cai LIN, Bo WANG, Yan SI, Chun Xiao WANG, Wei Jian WANG, Wen Sheng RONG, Shu Guo ZHENG
Objective: To investigate the dental caries status of teenagers in China by means of analyzing national data from the 4th National Oral Health Survey of China. Methods: Data for 12- to 15-year-olds participated in the 4th National Oral Health Survey of China were used for statistical analysis. Children who were recruited in the survey completed a dental examination and filled in a questionnaire. Social demographic factors, oral hygiene behaviours, sugar consumption habits, status of dental service utilisation, and pit-and-fissure sealant history were compared between adolescents with caries experiences and those without. For decayed, missing and filled permanent teeth (DMFT) and each of its components, mean values were statistically tested to see if significance existed between or among different categories of all involved variables. Results: In total, data from 27,821, 30,961, 30,691 and 29,128 Chinese 12-, 13-, 14-, and 15-year-olds respectively, were analysed. Social demographic factors, sugar consumption and dental service utilisation showed statistical significance when compared between those with and without dental caries experience in the 12- and 15-year-old groups. Certain categories of these factors above also had important influence on the mean value of the number of decayed teeth (DT), filled teeth (FT) and DMFT, and they might be potential determinants of dental caries experience of permanent teeth for teenagers. Conclusion: Dental caries in 12- and 15-year-old Chinese adolescents was impacted by certain social demographic and dental behavioural factors, which could provide some implications for policy makers and dental public health professionals when attempting to enhance oral health status for those teenagers in the early stages of permanent dentition.
Key words: adolescents, dental caries, dental behaviour, social demographic factor, the 4th National Oral Health Survey
Chin J Dent Res 2019;22(1):21–28;
doi:10.3290/j.cjdr.a41771
Clinical Efficiency and Patient Preference of Immediate Digital Impression after Implant Placement for Single Implant-Supported Crown
Dan Ni GUO, Yu Shu LIU, Shao Xia PAN, Peng Fei WANG, Bing WANG, Jian Zhang LIU, Wen Hui GAO, Yong Sheng ZHOU
Objective: To evaluate the time efficiency and patient preference of three impression techniques by comparing immediate digital impression performed directly after implantation with regular digital impression and conventional implant impression performed 3 months after implantation. Methods: Twenty consecutive patients with a missing single molar or premolar who received implant treatment were recruited into this prospective self-controlled clinical trial. Three different impression techniques were performed after implant surgery on all the participants: An intraoral scanning (IOS) impression performed immediately after implant placement (immediate digital impression) was compared with a regular digital impression and a classic polyether impression (conventional implant impression) performed 3 months after implant surgery. The operating time of each impression technique was recorded. Patients were asked to complete a visual analogue scale (VAS) questionnaire on their perception of the three techniques to describe their satisfaction and preference. Statistical analyses were performed with the Wilcoxon signed rank test. Results: The clinical time of the immediate digital impression (10.97 ± 2.1 min) was significantly shorter than that of the conventional implant impression (14.45 ± 3.0 min) (P < 0.05).The mean time of the immediate digital impression (10.97 ± 2.1 min) was statistically the same as that of the regular digital impression (10.23 ± 2.7 min) (P > 0.05). Participants’ subjective evaluation indicated higher satisfaction with the immediate digital impression than with the regular digital impression and the conventional implant impression. Conclusion: The immediate digital impression was more efficient than the conventional implant impression and had the same efficiency as the regular digital impression. Among the three impression techniques, the participants showed higher satisfaction with the immediate digital impression.
Chin J Dent Res 2019;22(2):93–104;
doi:10.3290/j.cjdr.a42513
Applications of Bioactive Ions in Bone Regeneration
Si Han LIN, Wen Jie ZHANG, Xin Quan JIANG
The repair of large bone defects remains a huge challenge for bone regenerative medicine. To meet this challenge, a number of bone substitutes have been developed over recent years to overcome the drawbacks of traditional autograft and allograft therapies. Thus, the improvement of the osteoinductive ability of these substitutes has become a major focus for research in the field of bone tissue engineering. It has been reported that some metallic ions play an important role in bone metabolism in the human body, and that bone repair could be enhanced by incorporating these ions into bone substitutes. Moreover, it is well documented that ions released from these substitutes such as magnesium, zinc, and strontium can increase the osteogenic and angiogenic properties of bone repair scaffolds. However, the mechanisms of action of these ions on cellular bioactivity are currently unclear. Therefore, in the present article, we highlight the recent use of bioactive ions in bone tissue engineering and discuss the effects of these ions on osteogenesis and neovascularisation.
Key words: bioactive ions, bone regeneration, tissue engineering, osteogenesis, angiogenesis
Chin J Dent Res 2020;23(1):57–62;
doi:10.3290/j.cjdr.a44339
Experience of Diagnosing and Managing Patients in Oral Maxillofacial Surgery during the Prevention and Control Period of the New Coronavirus Pneumonia
Yue YANG, Hui Yuh SOH, Zhi Gang CAI, Xin PENG, Yi ZHANG, Chuan Bin GUO
The newly emerged coronavirus disease (COVID-19) is a respiratory disease caused by a novel coronavirus (2019-nCoV) which was first identified in China in December 2019. It is a highly contagious infection that can spread from person to person through close contact and respiratory droplets. The healthcare personnel of the Department of Oral and Maxillofacial Surgery are especially vulnerable to the infection due to their extensive and close exposure to patients’ oral and nasal cavities and secretions. As one of the busiest specialised hospitals in the world, the Department of Oral and Maxillofacial Surgery of Peking University School and Hospital of Stomatology summarised the experience with disease prevention and control and clinical recommendations on the examination, diagnosis and treatment processes, clinical management, healthcare personnel protection and disinfection amid the continued spread of the pandemic.
Key words: diagnosis and treatment process, new coronavirus, oral and maxillofacial surgery, protection
Chin J Dent Res 2020;23(2):105–107;
doi:10.3290/j.cjdr.a44746
Ventilation in the Dental Clinic: An Effective Measure to Control Droplets and Aerosols during the Coronavirus Pandemic and Beyond
Lin YUE
Clinical and epidemiological studies suggest that human-to-human transmission of coronavirus disease 2019 (COVID-19) most frequently occurs through virus-laden respiratory droplets discharged from infected individuals while coughing and sneezing. Aerosols can act as another potential transmission route. The World Health Organisation (WHO) has advised medical personnel to consider taking ‘airborne precautions’. It is important to protect dentists and patients and reduce the amount of spatter produced during dental procedures. In order to prevent airborne transmission, dental offices should be sufficiently ventilated, with great emphasis placed upon removing bioaerosols.
Key words: aerosol, airborne transmission, disease prevention during dental care, SARSCoV-2, ventilation