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With the advent of big data era and improvement of computer performance, the artificial intelligence (AI) technology has rapidly boosted in the field of stomatology. Dental caries is one of the cutting-edge research domains in stomatology. The application of AI in dental caries is expected to promote intelligent, precise and high-efficient diagnosis and treatment of caries. This article focuses on the application of AI in medical-aided diagnosis, treatment and risk prediction of caries and discusses their challenges.

Dental fluorosis is a developmental disturbance of dental enamel caused by excessive fluoride intake during tooth development, leading to the changes in morphology, structure and function of tooth enamel, which can affect the aesthetics and function of teeth. There are many factors which may account for the occurrence of dental fluorosis. However, the pathogenesis mechanism underlying dental fluorosis has not been fully clarified.In recent years, researches in the fields of fluoride-induced stress response pathways, signaling pathways and apoptosis at the molecular and genetic level had provided extensive knowledge of dental fluorosis. This article focuses on the latest research progress in the mechanism of dental fluorosis, which include the effects of fluoride on ameloblasts and enamel matrix proteins, genetic polymorphism and dietary nutrients, in order to provide new references for the targeted prevention and treatment of dental fluorosis.

Dental dysplasia are abnormalities in teeth structure, morphology, number and eruption caused by genetic and environmental factors during dental development. Digital medical techniques, as the current hot spot of medical research, bring great challenges and opportunities to modern stomatology. The applications of digital techniques, such as digital diagnosis method, digital virtual simulated design, three-dimensional printing, static and dynamic guidance and artificial intelligence, can provide a more accurate, efficient, automatic and intelligent modern concepts and patterns for epidemiology, diagnosis, multidisciplinary treatment and outcome assessment of dental developmental anomalies.

Root canal therapy and endodontic surgery are conventional treatments for pulpal and periapical diseases. Compared with naked-eye operations, the application of dental operating microscope has enhanced the procedural accuracy and prognosis efficiently. However, root canals with pulp calcification/obliteration, apical lesions with thick cortical bone or adjacent to important anatomic structures are even challenging for experienced operators to achieve predictable clinical outcomes. Recently, with the advances in the field of digitalized information sciences, the above mentioned complicated endodontic cases can be solved under static and dynamic guidance. Before the treatment begins, virtual path is designed from data collected by cone-beam CT and oral image scanning using guidance software. Afterwards, root canal therapy and endodontic surgery can be performed precisely under the assistance of three-dimensional printed guide or dynamic guidance system. The present review describes the classification, features and clinical applications of the guided endodontics.

Composite resin filling material is the first choice for tooth direct bonding restoration. Its good performance can meet the requirements of clinical tooth repair treatment. It is used to restore the structure, aesthetic and function of defected teeth with a way of minimally invasive intervention. To further improve its clinical efficacy, the fundamental strategy is to ameliorate the limitation of material properties. Based on the summary of current research progress, this article focuses on the property of improved composite resin material, and the progress of developing novel resin material including antibacterial composite resin, bioactive remineralizing resin as well as self-healing resin, so as to provide innovative ideas for the future research of new composite resin filling materials.

Dental fluorosis is the most common and prominent symptom in the early stage of chronic fluorosis, which is caused by excessive fluorine intake during tooth development. In severe cases, it may be accompanied by skeletal fluorosis. There are also systemic damages to the nervous system, cardiovascular system, endocrine system and so on. The pathogenesis of dental fluorosis is not totally clear, which may be a complex pathological process involving both genetic and environmental factors. The prevalence of dental fluorosis has an upward trend arround the world, thus certain public prevention and treatment strategies need to be taken. This article focuses on the prevalence, etiology, diagnosis and scoring system, as well as the public prevention and treatment strategies, of dental fluorosis, so that to provide reference for the research and prevention of the disease.

Coronavirus disease 2019 has become a worldwide pandemic that is seriously jeopardising people's health. The National Health Commission and regional health administrations have issued regulations on the prevention and control of coronavirus disease 2019. Dentistry involves many invasive treatments, which differentiates it from other forms of medical practice. The following guidelines were produced by experts from the Stomatological Healthcare Service branch of the Chinese Stomatological Association to prevent the spread of coronavirus disease 2019 in dental clinics. The guidelines are in accordance with the relevant laws and documents from the health administration and range from technical guidelines to advice on how dental treatment should be conducted. Dental institutions can take these suggestions as a reference, based on the current local epidemic situation. It is anticipated that the guidelines will help dental institutions of different sizes to prevent the spread of the epidemic.

There are several trends in contemporary endodontics such as development of minimally invasive biologically based therapies, preservation of dental pulp in a healthy status with sustained vitality, prevention of apical periodontitis and improvement of long-term survival rates of teeth with pulpal disorders. As for the vital pulp therapy, direct pulp capping is a less invasive approach to keep the exposed dental pulp intact, which may improve the long-term treatment outcome employing a minimally invasive biologically strategy. With the recent progress in pulp biology, improvement of treatment modality and development of bioactive dental cements, great advancements have been achieved in direct pulp capping therapy. This review article focuses on the transition of indications, prognostic factors and future perspectives of direct pulp capping therapy, attempting to provide evidence and practical guidance for minimally invasive biologically based therapies of teeth with injured pulp.

Recently, various levels of success have been achieved in dental pulp and dentin regeneration using latest techniques such as pulp revascularization, stem cell transplantation and cell homing. These cutting-edge technologies utilize stem cell mobilization, homing and directional differentiation, stem cell sub-population isolation, expansion and transplantation, modification and optimization of biomaterials and/or synergetic effects of biological cues. The objective of this review is to identify approaches for clinical translation and improve the success rates of pulp regeneration. We will focus on either basic and clinical research progress of dental pulp revascularization, or translational challenges and strategies of stem cell transplantation and cell homing in dental pulp regeneration.

Objective: To examine the expression of naked cuticle homolog 2 (Nkd2) in the process of root development and osteogenic differentiation of dental follicle cells of rat (rDFC), in order to explore the molecular mechanisms of Nkd2 on the osteoblast differentiation of rDFCs. Methods: Immunohistochemical analysis was used to detect the expression of Nkd2 in the base dental follicle of the mandibular first molar of rat at 1, 3, 5, 7, 9, 11 and 13 days postnatal. Mineralization nodule formation of rDFCs was detected by alizarin red staining and cetylpyridine. The change of Nkd2 during osteogenic differentiation of rDFCs was evaluated by Western blotting and the associations between Nkd2 and osteogenic cytokines of alkaline phosphatase (ALP), Runt-related transcription factor-2 (RUNX2) and osteocalcin (OCN) were examined. The rDFCs were transfected with small interfering RNA (siRNA) to knock down the expression of Nkd2 and Western blotting and quantitative real-time PCR (qPCR) were adopted to explore the effects of Nkd2 on osteogenic differentiation by detecting variations of Nkd2 and osteogenic factors ALP, RUNX2, OCN among silencing group (Si), negative control RNA group (Nc) and mock control group (Mock), respectively. Results: The expression of Nkd2 in the base dental follicle of the mandibular first molar of rat was time dependent. Mineralization nodules of rDFCs and absorbance of cetylpyridine after osteogenic induction increased gradually (the absorbances of cetylpyridine were 0 week: 0.017±0.005, 1 week: 0.702±0.044, 2 weeks: 1.812±0.531, 3 weeks: 2.767±0.253, respectively). Results of Western blotting showed that Nkd2 (1.60±0.23) of mineralization group was significantly higher than that of control group (1) ( P< 0.05) at the early stage of osteogenic differentiation along with the expression of other osteogenic factors. The protein and mRNA of Nkd2 and osteogenic factors were significantly decreased in Si group compared with Nc and Mock groups ( P< 0.05), and no changes between Nc and Mock groups were observed. The changes of protein in Si, Nc and Mock groups were Nkd2: 0.42±0.10, 1.12±0.07, 1, ALP: 0.70±0.15, 1.11±0.14, 1, RUNX2: 0.58±0.08, 0.93±0.08, 1 and OCN: 0.64±0.06, 0.99±0.02, 1, respectively. The mRNA variances in Si, Nc and Mock groups were Nkd2: 0.39±0.05, 0.96±0.10, 1, ALP: 0.15±0.13, 1.01±0.07, 1, RUNX2: 0.39±0.31, 0.97±0.13, 1, OCN: 0.17±0.08, 1.08±0.21, 1, respectively. Conclusions: Nkd2 participates in the root development process in rat and may acts as a positive role in the early stage of osteogenic differentiation of rDFCs in rat.

Sodium hypochlorite is an effective irrigant for chemical debridement of root canals. However, increasing the intracanal pressure during irrigant delivery may result in irrigant extrusion into the bone and soft tissues surrounding the tooth. Because clinicians often encounter teeth with intracanal communications, the objective of the present study was to examine the effects of canal anastomosis on the generation of periapical fluid pressure at different fluid flow rates and insertion depths. Two similar polycarbonate models were used to simulate a single root with double canals, one containing, and the other without communicating channels between the canals. For both models, periapical pressure increased with increasing irrigant flow rates and insertion depths of a 30-gauge side-venting needle. In the presence of communicating channels, the magnitude of pressure build-up decreased by almost 90% irrespective of the fluid flow rate or needle insertion depth. Pressure reduction in anastomoses-containing roots provides an explanation why pressure generation in single roots is considerably higher. Nevertheless, it is still possible in teeth with canal anastomoses for pressure exceeding the intraosseous pressure to be generated when the fluid flow rate is sufficiently high and when the needle tip is close to the apical terminus.

Antimicrobial peptides (AMPs) are short cationic host-defense molecules that provide the early stage of protection against invading microbes. They also have important modulatory roles and act as a bridge between innate and acquired immunity. The types and functions of oral AMPs were reviewed and experimental reports on the use of natural AMPs and their synthetic mimics in caries and pulpal infections were discussed. Natural AMPs in the oral cavity, predominantly defensins, cathelicidins and histatins, possess antimicrobial activities against oral pathogens and biofilms. Incomplete debridement of microorganisms in root canal space may precipitate an exacerbated immune response that results in periradicular bone resorption. Because of their immunomodulatory and wound healing potentials, AMPs stimulate pro-inflammatory cytokine production, recruit host defense cells and regulate immuno-inflammatory responses in the vicinity of the pulp and periapex. Recent rapid advances in the development of synthetic AMP mimics offer exciting opportunities for new therapeutic initiatives in root canal treatment and regenerative endodontics., Statement of Significance: Identification of new therapeutic strategies to combat antibiotic-resistant pathogens and biofilm-associated infections continues to be one of the major challenges in modern medicine. Despite the presence of commercialization hurdles and scientific challenges, interests in using antimicrobial peptides as therapeutic alternatives and adjuvants to combat pathogenic biofilms have never been foreshortened. Not only do these cationic peptides possess rapid killing ability, their multi-modal mechanisms of action render them advantageous in targeting different biofilm sub-populations. These factors, together with adjunctive bioactive functions such as immunomodulation and wound healing enhancement, render AMPs or their synthetic mimics exciting candidates to be considered as adjuncts in the treatment of caries, infected pulps and root canals., (Published by Elsevier Ltd.)

Oral rinses containing chemotherapeutic agents, such as cetylpyridinium chloride (CPC), can alleviate plaque-induced gingival infections, but how oral microbiota respond to these treatments in human population remains poorly understood. Via a double-blinded, randomised controlled trial of 91 subjects, the impact of CPC-containing oral rinses on supragingival plaque was investigated in experimental gingivitis, where the subjects, after a 21-day period of dental prophylaxis to achieve healthy gingivae, received either CPC rinses or water for 21 days. Within-subject temporal dynamics of plaque microbiota and symptoms of gingivitis were profiled via 16S ribosomal DNA gene pyrosequencing and assessment with the Mazza gingival index. Cetylpyridinium chloride conferred gingival benefits, as progression of gingival inflammation resulting from a lack of dental hygiene was significantly slower in the mouth rinse group than in the water group due to inhibition of 17 gingivitis-enriched bacterial genera. Tracking of plaque α and β diversity revealed that CPC treatment prevents acquisition of new taxa that would otherwise accumulate but maintains the original biodiversity of healthy plaques. Furthermore, CPC rinses reduced the size, local connectivity and microbiota-wide connectivity of the bacterial correlation network, particularly for nodes representing gingivitis-enriched taxa. The findings of this study provide mechanistic insights into the impact of oral rinses on the progression and maturation of dental plaque in the natural human population.

Background/purpose: Calcium hydroxide and mineral trioxide aggregate (MTA) are used for inducing a calcific barrier at an open tooth root (apexification). The purpose of this study was to compare the efficacy of calcium hydroxide and MTA for apexification of immature permanent teeth., Methods: Medline, Cochrane, EMBASE, and Google Scholar were searched until November 24, 2015, using the keywords apexification, permanent teeth, MTA, and calcium hydroxide., Results: Of 216 studies identified, four studies were included. There were no differences in the clinical success rate [pooled odds ratio (OR) = 3.03, 95% confidence interval (CI): 0.42-21.72, p = 0.271], radiographic success rate (pooled OR = 4.30, 95% CI: 0.45-41.36, p = 0.206), or apical barrier formation rate (pooled OR = 1.71, 95% CI: 0.59-4.96, p = 0.322) between calcium hydroxide and MTA groups. The time required for apical barrier formation was significantly less in the MTA group (pooled difference in means = -3.58, 95% CI: from -4.91 to -2.25, p < 0.001)., Conclusion: While both materials provide similar success rates, the shorter treatment time with MTA may translate into higher overall success rates because of better patient compliance., (Copyright © 2016. Published by Elsevier B.V.)

In big data era, digital technologies bring great challenges and opportunities to modern stomatology. The applications of digital technologies, such as cone-beam CT(CBCT), computer aided design,(CAD)and computer aided manufacture(CAM), 3D printing and digital approaches for education , provide new concepts and patterns to the treatment and study of endodontic diseases. This review provides an overview of the application and prospect of commonly used digital technologies in the development of endodontics.

Inflammatory myofibroblastic tumors are usually treated by surgical resection. We herein report two cases of intra-abdominal inflammatory myofibroblastic tumors that were unresectable and underwent spontaneous regression without any treatment. Our case report and literature review show that regression is more common in the middle-aged and older male populations. Abdominal discomfort and fever were the most common symptoms, but the majority of patients had no obvious physical signs. There was no specific indicator for diagnosis. The majority of the lesions regressed within 3 mo and nearly all of the masses completely resolved within 1 year. We conclude that the clinical characteristics of inflammatory myofibroblastic tumors are variable and, accordingly, the disease needs to be subdivided and treated on an individual basis. Surgery is always the first-line treatment; however, for those masses assessed as unresectable, conservative therapy with intense follow-up should be considered.

Objective: Halitosis is a common complaint affecting the majority of the population. Mouthrinses containing cetylpyridinium chloride (CPC) have been used as oral hygiene aids to suppress oral malodor. Although the clinical efficacy of these mouthrinses has been well-documented, the mechanism whereby CPC reduces malodor is less-well-understood. We hypothesized that CPC suppresses expression of the genes (mgl and cdl) and enzymes responsible for methyl mercaptan (CH3SH) and hydrogen sulfide (H2S) production by oral anaerobes associated with halitosis. In this study, the mgl and cdl expression of Porphyromonas gingivalis and Fusobacterium nucleatum in the presence of CPC was investigated., Materials and Methods: We used a microdilution method to determine the growth and production of volatile sulfur compounds (VSCs) by P. gingivalis W83 and F. nucleatum ATCC 10953 in respective media containing CPC (0.5 μg/mL to 1.5 μg/mL). For metabolic activity, we used an XTT {2,3-bis(2-methyloxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide} reduction assay. We used real-time RT-PCR and Western blotting to evaluate the effect of CPC at sub-MIC levels on mgl and cdl expression at the transcriptional and enzymatic levels., Results: CPC inhibited the growth of P. gingivalis and F. nucleatum at MICs of 3 μg/mL and 2 μg/mL, and at MBCs of 6 μg/mL and 3 μg/mL, respectively. Compared with untreated controls, CPC at 1.5 μg/mL suppressed CH3SH production of P. gingivalis by 69.84%±2.88% and H2S production of F. nucleatum by 82.55%±8.36% (p<0.05) without affecting metabolic activity. Inhibition of mgl mRNA (81.58%±20.33%) and protein (39.15%±6.65%) expression in P. gingivalis and inhibition of cdl mRNA (61.76%±13.75%) and protein (64.34%±1.62%) expression in F. nucleatum were also noted (p<0.05)., Conclusion: CPC represents an effective agent for halitosis reduction by inhibiting the growth and suppressing the expression of specific genes related to VSC production in anaerobic periodontal pathogens., (Published by Elsevier Ltd.)

Objective: To investigate the expression of wingless-type MMTV integration site family, member 3 (Wnt3) in rat dental follicles and its protein level in dental follicle cells (DFC) undergoing osteogenic induction and to discuss the effects of Wnt3 on the differentiation of DFC., Methods: Rats at postnatal days 1, 3, 5, 7, 9, 11 and 13 were executed, then the mandibles were immediately removed and immunohistochemistry was performed to detect the expression of Wnt3 in dental follicles of postnatal rats. The expression and distribution of Wnt3 in DFC were determined by immunofluorescence. Alizarin red-S staining was performed to assess the mineralization of DFC. Western blotting was used to evaluate Wnt3 and β-catenin protein levels after stimulated by osteogenic medium for 1, 2 and 3 weeks, respectively., Results: Immunohistochemistry revealed that the expression of Wnt3 in rat dental follicles began at day 5 and sustained to day 13. On day 1 and 3, the expression of Wnt3 in dental follicles was negative.Wnt3 was expressed in the cytoplasm of DFC. Alizarin red-S staining indicated that the osteogenic medium stimulated the differentiation of DFC into osteoblastic lineage.Western blotting demonstrated that the Wnt3 protein levels were significantly up-regulated after stimulated with osteogenic medium for 1 weeks compared with the control (2.60 ± 0.04 vs.1.00 ± 0.00, P < 0.05). Then the levels of Wnt3 protein were declined, and at the 3rd week, no significant difference was observed between osteo-induced group and the control (1.00 ± 0.05 vs.1.00 ± 0.00, P > 0.05). The levels of β-catenin were increased in osteo-induced groups compared with the control (1.95 ± 0.05 vs.1.00 ± 0.00, P < 0.05; 9.77 ± 0.65 vs.1.00 ± 0.00, P < 0.05;1.75 ± 0.21 vs.1.00 ± 0.00, P < 0.05). Furthermore, the expression of β-catenin reached to a peak on the 2nd week (9.77 ± 0.65), and then declined., Conclusions: Wnt3 was expressed in the rat dental follicles both in vivo and in vitro and up-regulated during early phase of osteoblast differentiation in DFC.Wnt3 may be involved in early phase of osteoblast differentiation.

Objective: Antimicrobial sensitivity of Streptococcus mutans can be modulated by putative bacteriocin immunity proteins. Bacteria use a quorum sensing (QS) system to regulate physiological activities including bacteriocin production, antimicrobial response, and biofilm formation. QS system of S. mutans is dependent on competence stimulating peptide (CSP), whose precursor is encoded by comC. However, whether bacteriocin immunity proteins play a role in QS system regulated S. mutans antimicrobial sensitivity is still unknown. We hypothesize that bacteriocin immunity proteins encoded by immA and immB play roles in QS regulated antimicrobial sensitivity in S. mutans UA159., Design: In this study, sensitivity of S. mutans UA 159 comC mutant in planktonic and biofilm states to clinically used antimicrobials was investigated by the plate count method and confocal laser scanning microscopy. The effect of immA and immB inactivation on S. mutans antimicrobial sensitivity was studied. The expression of immA and immB in S. mutans comC mutant before and after chlorhexidine (CHX) treatment was also examined., Results: It was found that comC, immA and immB mutation resulted in enhanced antimicrobial sensitivity to sodium fluoride (NaF), CHX and ampicillin (AMP) in planktonic states. After 2% CHX treatment, the live/dead cell ratio in comC mutant and wild strain biofilms decreased 67% and 39% (P<0.05). The expression of immA and immB was up-regulated in wild strain after CHX treatment, while the up-regulation of immB was largely inhibited in comC mutant (P<0.05)., Conclusions: These findings suggest that the effect of S. mutans UA159 comC mutation on antimicrobial sensitivity can be due, in part, to attenuation of the expression of the bacteriocin immunity proteins related genes., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Biofilm detachment is a physiologically regulated process that facilitates the release of cells to colonize new sites and cause infections. Streptococcus mutans is one of the major inhabitants of cariogenic dental plaque biofilm. This study tested the hypothesis that S. mutans biofilm-detached cells exhibit distinct physiological properties compared with their sessile and planktonic counterparts. Biofilm-detached cells showed a longer generation time of 2.85 h compared with planktonic cells (2.06 h), but had higher phosphotransferase activity for sucrose and mannose (P < 0.05). Compared with planktonic cells, they showed higher chlorhexidine (CHX) resistance and fourfold more adherent (P < 0.05). Increased mutacin IV production in biofilm-detached cells was noted by a larger inhibition zone against Streptococcus gordonii (31.07 ± 1.62 mm vs. 25.2 ± 1.74 mm by planktonic cells; P < 0.05). The expressions of genes associated with biofilm formation (gtfC and comDE) and mutacin (nlmA) were higher compared with planktonic cells (P < 0.05). In many properties, biofilm-detached cells shared similarity with sessile cells except for a higher phosphotransferase activity for sucrose, glucose, and mannose, increased resistance to CHX, and elevated expression of gtfC-, comDE-, and acidurity-related gene aptD (P < 0.05). Based on data obtained, the S. mutans biofilm-detached cells are partially distinct in various physiological properties compared with their planktonic and sessile counterparts., (© 2013 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.)

The aim of this study was to investigate the effect of sodium ascorbate (Sa) on degree of conversion (DC) and bond strength (BS) of RealSeal SE to sodium hypochlorite (NaOCl) treated root dentin. Two hundreds simulated canals were prepared and irrigated with Distilled water(DW), 1.3% NaOCl (1.3% N), 5.2% NaOCl (5.2% N), MTAD, 17% EDTA (EDTA), 10% Sa, 1.3% NaOCl/MTAD (N-M), 1.3% NaOCl/Sa/MTAD(N-Sa-M), 5.2% NaOCl/EDTA(N-E), and 5.2% NaOCl/Sa/EDTA (N-Sa-E) respectively. They were subsequently bulk filled with RealSeal SE and analyzed with micro-Raman spectroscopy and universal testing machine for DC and BS respectively. One-way ANOVA and post hoc Tukey's test showed DC of 1.3% N, 5.2% N, N-M and N-E were significantly lower (p<0.01) than other six groups. BS of DW, Sa, N-M were significantly lower than 1.3% N, 5.2% N, MTAD, EDTA, N-Sa-M and N-E (p<0.01), and group N-Sa-E achieved the highest BS among all groups (p<0.01). NaOCl negatively affected DC and BS of RealSeal SE, which could be reversed with 10% Sa.

Purpose: The purpose of this study was to investigate the expression of reprogramming markers including Oct-4, Sox2 and c-Myc in rat dental pulp and periodontal ligament tissues undergoing tissue regeneration after injury., Methods: Lewis rat model with dental pulp and periodontal ligament injury was created. HE staining was applied to investigate the structure of newly formed dentin-pulp complex and periodontium. The distribution of Oct-4, Sox2 and c-Myc was determined by immunofluorescent staining., Results: HE staining showed that newly formed dentin-pulp complex and periodontium was constructed 4 weeks after injury. Immunofluorescent staining revealed Oct-4, Sox2 and c-Myc signal was activated in the newly formed dental pulp and periodontal ligament tissue after injury compared with the normal ones. Oct-4 and Sox2 showed similar expression pattern., Conclusions: Oct-4, Sox2 and c-Myc signaling may play an important modulatory role in the dental tissue regeneration after injury. Oct-4 and Sox2 may have operative interaction whereas c-Myc may play independent role during this process.

Background: Gastric cancer with synchronous liver metastasis remains a clinical treatment challenge. There has been a longstanding debate on the question whether surgical resection could be beneficial to long-term survival. This study is to investigate the effectiveness and prognostic factors of combined curative resection of the stomach and liver lesions in gastric cancer patients with synchronous liver metastases., Methods: A total of 30 patients who underwent simultaneous curative gastric and liver resection from March 2003 to April 2008 were analyzed retrospectively. Univariate and multivariate analyses were performed to select independent factors for survival., Results: The overall 1-, 2-, 3- and 5-year survival rates of 30 patients were 43.3%, 30.0%, 16.7% and 16.7%, respectively, with a median survival of 11.0 months and 5 patients still living by the time of last follow-up. Single liver metastasis (p=0.028) and an absence of peritoneal dissemination (p=0.007) were significantly independent prognostic factors for these gastric cancer patients with synchronous liver metastases. Major adverse events were protracted stomach paralysis in 2 patients and pulmonary infection in another 2 patients, all of whom recovered after conservative treatment., Conclusions: This descriptive study without control group found that patients with solitary liver metastasis and absence of peritoneal dissemination could have better survival benefit from simultaneous curative resection of the gastric cancer and liver metastases.

We examined the effect of three clinically used antimicrobials on Streptococcus mutans UA159 biofilm detachment under flow conditions. Sodium fluoride (NaF) and chlorhexidine at MIC levels promoted biofilm detachment and inhibited detachment when concentrations were higher than the MIC and reduced detached-cell viability only at high concentrations. Ampicillin at all concentrations tested inhibited detachment and reduced the percentage of viable biofilm-detached cells. All the three antimicrobial treatments reduced biofilm live/dead cell ratios.

Aim: To investigate whether the p38α mitogen-activated protein kinases (MAPK) is involved in bone morphogenetic protein (BMP)-2-induced odontoblastic differentiation of human dental pulp cells (HDPCs)., Methodology: Recombinant retrovirus encoding shRNA against p38α MAPK was constructed to investigate the role of p38α MAPK on BMP-2-induced odontoblastic differentiation of HDPCs. HDPCs were transfected with retrovirus expressing sh-p38α. Activation of p38α MAPK was detected by Western blot. The effects of p38α MAPK on BMP-2-induced odontoblastic differentiation of HDPCs were measured by alkaline phosphatase (ALP) activity, and the expression of odontoblastic markers was identified by quantitative real-time polymerase chain reaction analysis. The effect of SD-282, a p38a-specific inhibitor, on BMP-2-induced odontoblastic differentiation was also investigated., Results: BMP-2 dose- and time-dependently upregulated phosphorylation of p38α of HDPCs. Compared with BMP-2-treatment group, gene knock-down of p38α MAPK significantly inhibited ALP activity and the formation of mineralized nodules in HDPCs. Moreover, suppression of p38α MAPK repressed the odontoblastic differentiation in HDPCs. Consistently, inhibition of p38α by SD-282 also decreased odontoblastic differentiation., Conclusions: p38α MAPK is involved in BMP-2-induced odontoblastic differentiation of HDPCs., (© 2011 International Endodontic Journal.)

Fluoride-releasing restorative materials are available for remineralization of enamel and root caries. However, remineralization of dentin is more difficult than remineralization of enamel due to the paucity of apatite seed crystallites along the lesion surface for heterogeneous crystal growth. Extracellular matrix proteins play critical roles in controlling apatite nucleation/growth in collagenous tissues. This study examined the remineralization efficacy of mineral trioxide aggregate (MTA) in phosphate-containing simulated body fluid (SBF) by incorporating polyacrylic acid and sodium tripolyphosphate as biomimetic analogs of matrix proteins for remineralizing caries-like dentin. Artificial caries-like dentin lesions incubated in SBF were remineralized over a 6 week period using MTA alone or MTA containing biomimetic analogs in the absence or presence of dentin adhesive application. Lesion depths and integrated mineral loss were monitored with microcomputed tomography. The ultrastructure of baseline and remineralized lesions was examined by transmission electron microscopy. Dentin remineralization was best achieved using MTA containing biomimetic analogs regardless of whether an adhesive was applied; dentinal tubules within the remineralized dentin were occluded by apatite. It is concluded that the version of MTA employed in this study may be doped with biomimetic analogs for remineralization of unbonded and bonded artificial caries-like lesions in the presence of SBF., (Copyright © 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Nanocomposites created with polycarboxylic acid alone as a stabilization agent for prenucleation clusters-derived amorphous calcium phosphate exhibit non-periodic apatite deposition. In the present study, we report the use of inorganic polyphosphate as a biomimetic analog of matrix phosphoprotein for directing polyacrylic acid-stabilized amorphous nanoprecursor phases to assemble into periodic apatite-collagen nanocomposites. The sorption and desorption characteristics of sodium tripolyphosphate to type I collagen was examined. Periodic nanocomposite assembly with collagen as a template was demonstrated with TEM and SEM using a Portland cement-based resin composite and a phosphate-containing simulated body fluid. Apatite was detected within the collagen at 24 hours and became more distinct at 48 hours, with prenucleation clusters attaching to the collagen fibril surface during the initial infiltration stage. Apatite-collagen nanocomposites at 72 hours were heavily mineralized with periodically-arranged intrafibrillar apatite platelets. Defect-containing nanocomposites caused by desorption of TPP from collagen fibrils were observed in regions lacking the inorganic phase.

Objective: To investigate the expression of macrophage migration-inhibitory factors (MIF) in clinically healthy and inflamed human pulp tissues and the effects of rhMIF on the proliferation of human dental pulp cells (HDPC)., Methods: Immunohistochemistry was used to detect the localization of MIF expression in clinically healthy pulp and inflamed pulp tissues. Quantitative real-time polymerase chain reaction (PCR) was performed to evaluate the mRNA levels of MIF in pulp specimens. In addition, the culture supernatants of HDPC were collected after HDPC was stimulated by lipopolysaccharide (LPS) for 24 h, and then the MIF levels were assayed by quantitative sandwich enzyme-linked immunosorbent assay. Meanwhile, the effects of rhMIF on the proliferation of HDPC at different concentrations for 24 and 48 h were observed by cell counting kit-8 (CCK-8)., Results: MIF was mainly distributed in odontoblasts of healthy pulp tissue, however, in inflamed pulp tissue, it was widely detected in fibroblasts, inflammatory infiltrates and endothelial cells as well as odontoblasts. Quantitative real-time PCR showed that there was no significant difference in MIF mRNA levels between inflamed pulps and healthy pulps (P > 0.05). Additionally, the secretion of MIF was significantly increased by stimulation with LPS at the concentration of 0.1 and 1.0 mg/L [(1772.58 ± 495.05), (1692.58 ± 337.45) ng/L] (P < 0.05), and the concentration was (1048.53 ± 161.81) ng/L in control group. rhMIF stimulated the HDPC's proliferation at the concentration of 10, 30, 60 µg/L for 24 and 48 h., Conclusions: MIF was expressed in pulp tissue and its expression was increased after stimulation by LPS. rhMIF increased the proliferation of HDPC. These results suggest that MIF may be involved in the process of pulpal inflammation.

Objective: To investigate the effects of putative bacteriocin immunity proteins on the growth mode of Streptococcus mutans (Sm). To observe the differences of antimicrobial sensitivity in planktonic Sm wild-type strains and mutant strains caused by the inactivation of bacteriocin immunity proteins and their influence on the biofilm formation., Methods: Sm wild-type strains (WT) and its knockout mutants defective in immA and immB (ΔimmA(-) and ΔimmB(-) mutants) coding putative bacteriocin immunity proteins were cultured in brain heart infusion (BHI) and selected by erythromycin at the concentration of 10 mg/L. Optical density was detected by spectrophotometer every hour and growth curve was drawn. WT, ΔimmA(-) and ΔimmB(-) mutants were treated with ampicillin (0.04, 0.05, 0.06, 0.07, 0.08 mg/L), sodium fluoride (50, 100, 150, 200, 250 mg/L) and sodium hypochlorite (0.078%, 0.156%, 0.313%, 0.625%, 1.250%) for 24 hours. Optical density was detected by multifunctional micro plate reader. WT and the mutants were cultured in MBEC(TM) P&G Assay for 24 hours. The minimum biofilm eradication concentration (MBEC) of chlorhexidine against Sm was determined by serial dilution method. Confocal laser scanning microscopy (CLSM) was used to visualize the biofilm architecture, depth and ratio of live to dead bacteria., Results: Growth curve showed that it took about 3 hours to reach exponential phase and about 7 hours to stationary phase for WT, while 4 hours to exponential phase and 8 hours to stationary phase for mutants. Optical density of mutants were lower than WT in the presence of various antimicrobial agents (P < 0.01). In 0.06 mg/L ampicillin group, optical density value of WT, ΔimmA(-) and ΔimmB(-) mutants were 0.334 ± 0.016, 0.027 ± 0.016 and 0.047 ± 0.018. In 150 mg/L sodium fluoride group, optical density value of WT and mutants were 0.254 ± 0.018, 0.129 ± 0.011 and 0.167 ± 0.010. In 0.313% sodium hypochlorite group, optical density value of WT and mutants were 0.467 ± 0.008, 0.017 ± 0.006 and 0.050 ± 0.006. The MBEC of chlorhexidine against Sm WT, ΔimmA(-) and ΔimmB(-) mutants were 6.25, 1.57, and 3.13 mg/L. The results by CLSM showed a noticeable difference in biofilm architecture. The depth of WT biofilm was higher than the mutants biofilm (P < 0.01). The ratio of live to dead bacteria of WT biofilm was higher than ΔimmA(-) mutants in all layers (P < 0.05) and ΔimmB(-) mutants in the outer and intermedium layer (P < 0.01). There is no significant different between the inner layers of WT and ΔimmB(-) mutants (P = 0.191)., Conclusions: Putative bacteriocin immunity proteins have influence on the growth mode of Sm. The antimicrobial sensitivity of planktonic Sm can be up-regulated by the inactivation of immA or immB. The MBEC of chlorhexidine against ΔimmA(-) and ΔimmB(-) mutants is lower than WT. The inactivation of immA or immB affects the biofilm formation.

The application of adhesive root canal filling materials is the tendency in root canal obturation. The orientation is to develop the adhesive core material and sealer making a whole structure. In this review, we summarized the researches on the resin-dentin adhesion in the root canal obturation.

Immobilization of phosphoproteins on a collagen matrix is important for the induction of intrafibrillar apatite mineralization. Unlike phosphate esters, polyphosphonic acid has no reactive sites for covalent binding to collagen amine groups. Binding of poly(vinyl phosphonic acid) (PVPA), a biomimetic templating analog of matrix phosphoproteins, to collagen was found to be electrostatic in nature. Thus, an alternative retention mechanism was designed for immobilization of PVPA on collagen by cross-linking the latter with carbodiimide (EDC). This mechanism is based on the principle of size exclusion entrapment of PVPA molecules within the internal water compartments of collagen. By cross-linking collagen with EDC, a zero length cross-linking agent, the sieving property of collagen is increased, enabling the PVPA to be immobilized within the collagen. The absence of covalent cross-linking between PVPA and collagen was confirmed by Fourier transform infrared spectroscopy. Based on these results, a concentration range for immobilized PVPA to template intrafibrillar apatite deposition was established and validated using a single layer reconstituted type I collagen mineralization model. In the presence of a polyacrylic acid-containing mineralization medium optimal intrafibrillar mineralization of the EDC-cross-linked collagen was achieved using 500 and 1000 μg ml⁻¹ PVPA. The mineralized fibrils exhibited a hierarchical order of intrafibrillar mineral infiltration, as manifested by the appearance of electron-dense periodicity within unstained fibrils. Understanding the basic processes in intrafibrillar mineralization of reconstituted collagen creates opportunities for the design of tissue engineering materials for hard tissue repair and regeneration., (Copyright © 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Long-range DNA interactions play an important role in gene expression. CCCTC-binding factor (CTCF), a ubiquitously expressed and evolutionarily conserved 11-zinc-finger DNA binding protein, is intimately involved in gene regulation, helping to establish and maintain chromatin architecture and long-range DNA interactions. In order to study the effects of manipulating long range chromatin interactions in the regulation of the neurofibromatosis gene NF1, we targeted Zorro locked nucleic acids (Zorro LNA) to a single CTCF binding site at an NF1 locus in human fibroblast cells. Using chromatin immunoprecipitation, we determined that this Zorro LNA altered CTCF and RNA polymerase II binding at three separate and distinct regions in the NF1 gene. This change in protein binding was associated with changes in long-range DNA interactions at the NF1 locus and downregulation of NF1 gene expression. This study describes an efficient and convenient method to manipulate chromatin structure and alter gene expression that is regulated by long-range DNA interactions without changing the DNA sequence. The use of specific Zorro LNA probes may facilitate our efforts to understand the interactions between chromatin architecture and gene expression., (Published by Elsevier B.V.)

Objectives: Type I collagen alone cannot initiate tissue mineralization. Sodium trimetaphosphate (STMP) is frequently employed as a chemical phosphorylating reagent in the food industry. This study examined the feasibility of using STMP as a functional analog of matrix phosphoproteins for biomimetic remineralization of resin-bonded dentin., Methods: Equilibrium adsorption and desorption studies of STMP were performed using demineralized dentin powder (DDP). Interaction between STMP and DDP was examined using Fourier transform-infrared spectroscopy. Based on those results, a bio-inspired mineralization scheme was developed for chemical phosphorylation of acid-etched dentin with STMP, followed by infiltration of the STMP-treated collagen matrix with two etch-and-rinse adhesives. Resin-dentin interfaces were remineralized in a Portland cement-simulated body fluid system, with or without the use of polyacrylic acid (PAA) as a dual biomimetic analog. Remineralized resin-dentin interfaces were examined unstained using transmission electron microscopy., Results: Analysis of saturation binding curves revealed the presence of irreversible phosphate group binding sites on the surface of the DDP. FT-IR provided additional evidence of chemical interaction between STMP and DDP, with increased in the peak intensities of the PO and P-O-C stretching modes. Those peaks returned to their original intensities after alkaline phosphatase treatment. Evidence of intrafibrillar apatite formation could be seen in incompletely resin-infiltrated, STMP-phosphorylated collagen matrices only when PAA was present in the SBF., Significance: These results reinforce the importance of PAA for sequestration of amorphous calcium phosphate nanoprecursors in the biomimetic remineralization scheme. They also highlight the role of STMP as a templating analog of dentin matrix phosphoproteins for inducing intrafibrillar remineralization of apatite nanocrystals within the collagen matrix of incompletely resin-infiltrated dentin., (Copyright © 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Introduction: Although the presence of the stromal cell-derived factor (SDF)-1alpha-CXCR4 axis has been reported in dental pulp tissue, little has been known about the underlying regulation of this axis in dental pulp stem cells (DPSCs). The purpose of this study was to investigate whether inflammation or hypoxia can regulate this axis in cultured human dental pulp cells (DPCs)., Methods: Primary cultures of DPCs were stimulated by various concentrations of lipopolysaccharide (LPS) for 48 hours, and the production of SDF-1alpha or CXCR4 was assessed through the enzyme-linked immunosorbent assay and Western blotting, respectively. Additionally, DPCs were incubated in a hypoxic condition (1% O(2)) for 24 hours, and the cell proliferation ability was detected by methylthiazol tetrazolum assay. Quantitative reverse-transcription polymerase chain reaction (RT-PCR) was used to observe messenger RNA level changes of hypoxia inducible factor-1alpha(HIF-alpha), SDF-1alpha, and CXCR4. The effects of hypoxia on cell migration ability were further confirmed by transmigration assay., Results: All concentrations of LPS inhibited SDF-1alpha production except that 1 microg/mL LPS increased the expression of CXCR4. Hypoxia promoted the proliferation of DPCs in a 24-hour culture period. Quantitative RT-PCR showed that messenger RNA levels of HIF-alpha and CXCR4 increased, whereas SDF-1alpha decreased in hypoxic DPCs. Transmigration assay indicated that hypoxia increased the migration ability of DPCs., Conclusions: These results suggested that inflammation and hypoxia might play an important role in regulating the SDF-1alpha-CXCR4 axis, which further recruits DPSCs to participate in reparative dentinogenesis., (Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Objective: This study evaluated the effects of different NaOCl concentrations and contact times on removal of the organic phase from mineralized dentin with and without the adjunctive use of EDTA, and the effect of NaOCl concentrations on canal wall erosion after the use of EDTA as the final active irrigant., Methods: Dentin powders were immersed in 5.25% or 1.3% NaOCl for different contact periods and then rinsed with 17% EDTA for 2 min. Before and after the use of 17% EDTA as the final rinse, the NaOCl-treated dentin powders were examined using ATR-FT-IR spectroscopy to analyze the relative loss of organic and inorganic components. Scanning (SEM) and transmission electron microscopy (TEM) were used to examine the erosion of instrumented canal walls irrigated with 5.25% NaOCl/EDTA or 1.3% NaOCl/EDTA., Results: Compared with 1.3% NaOCl, less intact collagen remained within the subsurface of the mineralized dentin powder after the use of 5.25% NaOCl, irrespective of subsequent rinsing with 17% EDTA. Canal wall erosion was apparent only under SEM when root canals were irrigated 5.25% NaOCl followed by 17% EDTA. Under TEM examination, subsurface erosion extended 10-15 microm beneath the sealer-bonded dentin surface after the use of 5.25% NaOCl for 20 min., Conclusion: The superficial destructive effect of NaOCl on mineralized dentin is irreversible and is present irrespective of whether EDTA is subsequently employed as the final active irrigant. The EDTA removes the collagen-depleted apatite phase to expose the underlying cause of destruction that is morphologically perceived as canal wall erosion., (Copyright (c) 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

This study examined changes in elastic modulus, mineral density and ultrastructure of resin-infiltrated dentin after biomimetic remineralization. Sixty demineralized dentin beams were infiltrated with Clearfil Tri-S Bond, One-Step or Prime&Bond NT. They were immersed in simulated body fluid (SBF) for 1 week to maximize water sorption before determining the baseline elastic moduli. For each adhesive (N = 20) half of the beams remained immersed in SBF (control). The rest were immersed in a biomimetic remineralization medium. The elastic moduli were measured weekly for 15 additional weeks. Representative remineralized specimens were evaluated by X-ray microtomography and transmission electron microscopy (TEM). The elastic moduli of control resin-infiltrated dentin remained consistently low, while those immersed in the biomimetic remineralization medium increased by 55-118% after 4 months. X-ray microtomography of the remineralized specimens revealed decreases in mineral density from the beam surface to the beam core that were indicative of external mineral aggregation and internal mineral deposition. Interfibrillar and intrafibrillar remineralization of resin-sparse intertubular dentin were seen under TEM, together with remineralized peritubular dentin. Biomimetic remineralization occurs by diffusion of nanoprecursors and biomimetic analogs in completely demineralized resin-infiltrated dentin and proceeds without the contribution of materials released from a mineralized dentin base., (Copyright 2009 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Introduction: Recently, a methacrylate-based obturation system, Resilon/RealSeal SE, has been developed to replace gutta-percha and traditional sealers. As a resin-based material, degree of conversion (DC) is one of the most important characteristics. The aim of this study was to investigate the time-dependent change of DC of RealSeal SE as well as the influence of canal moisture and root canal depth on it., Methods: DC of RealSeal SE, either self-cured or dual-cured (n = 8 in each group), was calculated according to the Raman spectra obtained at different times after mixing. Thirty extracted teeth with single canal were instrumented and divided randomly into 2 groups in terms of different canal drying methods. In the ethanol group, excess distilled water in root canal was removed with paper points followed by 95% ethanol. In the paper points group, root canals were blot-dried with paper points until the last one appeared dry. DC of RealSeal SE was calculated from serial cross sections (2, 5, and 8 mm from the apex) obtained 1 week after obturation with Resilon/RealSeal SE., Results: Significant increase in DC of RealSeal SE was observed in 1 week (P < .01), with little change afterwards (P > .05). DC of sealer in ethanol group was significantly higher than in paper points group (P < .01). However, DCs of RealSeal SE at different levels of tooth sections were not significantly different (P > .05)., Conclusions: Both self-cured and dual-cured RealSeal SE achieved stable DC after 1 week. Root canal moisture was a critical factor in determining DC of RealSeal SE., (Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This study tested the null hypothesis that there is no difference between the use of 1.3% NaOCl/17% ethylenediaminetetraacetic acid (EDTA) and 5.25% NaOCl/17% EDTA irrigation regimens on the collagen degradation and flexural strength reduction in mineralized dentin., Methods: Dentin powder and mineralized dentin sections were immersed in 1.3% or 5.25% NaOCl for 10-240 minutes and then rinsed with 17% EDTA as the final irrigant for 2 minutes. Untreated mineralized dentin powder/sections served as controls in the respective experiments. Dentin powders were examined by using Fourier transform infrared (FT-IR) spectroscopy to analyze their relative subsurface intact collagen content with the apatite/collagen ratio. Hydrated dentin sections were subjected to 3-point flexure under water for determining their flexural strengths., Results: Collagen degradation was significantly increased and the flexural strength of mineralized dentin was significantly reduced after the use of 5.25% NaOCl as the initial irrigant for more than 1 hour (P < .05). Conversely, changes were insignificant when 1.3% NaOCl was used as the initial irrigant for up to 4 hours (Kruskal-Wallis analysis of variance, n = 10, P < .05)., Conclusions: The null hypothesis was rejected. The deleterious effects attributed to the use of NaOCl on dentin are concentration-dependent and time-dependent and are not associated with the demineralization caused by the use of EDTA as the final active irrigant.

Polyvinylphosphonic acid (PVPA), a biomimetic analog of phosphoproteins, is crucial for recruiting polyacrylic acid (PAA)-stabilized amorphous calcium phosphate nanoprecursors during biomimetic remineralization of dentin collagen matrices. This study tested the null hypothesis that phosphoric acid esters of methacrylates in dentin adhesives cannot replace PVPA during bimimetic remineralization of resin-dentin interfaces. Human dentin specimens were bonded with: (I) XP Bond, an etch-and-rinse adhesive using moist bonding; (II) XP Bond using dry bonding; (III) Adper Prompt L-Pop, a self-etching adhesive. The control medium contained only set Portland cement and a simulated body fluid (SBF) without any biomimetic analog. Two experimental Portland cement/SBF remineralization media were evaluated: the first contained PAA as the sole biomimetic analog, the second contained PAA and PVPA as dual biomimetic analogs. No remineralization of the resin-dentin interfaces could be identified from specimens immersed in the control medium. After 2-4 months in the first experimental medium, specimens exhibited either no remineralization or large crystal formation within hybrid layers. Only specimens immersed in the second remineralization medium produced nanocrystals that accounted for intrafibrillar remineralization within hybrid layers. The null hypothesis could not be rejected; phosphoric acid esters in dentin adhesives cannot replace PVPA during biomimetic remineralization of adhesive-bonded dentin.

Objective: To investigate the expression of matrix extracellular phosphorylated protein (MEPE) in human dental pulp cells (hDPC) undergoing odontogenic induction and explore the role of MEPE in odontoblast-like differentiation., Methods: hDPC were isolated by enzymatic digestion and preceded to odontogenic induction for 7, 14 and 21 days respectively. hDPC before induction served as controls. The expressions of MEPE, dentin sialophosphoprotein (DSPP)/dentin sialoprotein (DSP), bone sialoprotein (BSP) and collagen type I were determined by quantitative real-time RT-PCR and Western blotting., Results: The mRNA levels of MEPE, DSPP, BSP and type I collagen were increased in a time-dependent manner as hDPC were induced along odontoblastic lineage. Statistical differences were detected for MEPE and BSP mRNA expressions in induced hDPC compared with control group (P < 0.001). For DSPP and type I collagen, the mRNA levels in the induced groups were (12 943.33 + or - 3805.73) and (250.55 + or - 31.86) respectively, which were significantly higher than those in control group on days 21 (P < 0.05). Western blotting also revealed the increased expressions of MEPE, DSP, BSP and type I collagen in the induced DPC., Conclusions: hDPC showed analogously temporal expressions of MEPE, DSPP/DSP, BSP and collagen type I while differentiating along odontoblast lineage. MEPE may play an important role in the odontogenic differentiation of hDPC and may be a potential marker of odontoblast-like differentiation.

Objectives: To investigate the occlusal characteristics and the condition of tooth abrasion in patients with cracked tooth and to discuss the etiology of the cracked tooth and the relationships between occlusal disorder, tooth abrasion and cracked tooth., Methods: Twenty-seven patients with cracked tooth were selected. The occlusal courses were recorded by T-ScanIII system in intercuspal position, protrusive movement and lateral movement. Teeth with cracked tooth were regarded as the cracked tooth group, and the healthy adjacent teeth as the control group. The distribution of premature contact, occlusal interference, the center of occlusal force were examined. The abrasive conditions of the two groups were recorded according to the Smith tooth wear index and compared., Results: There were more teeth with occlusal interference in cracked tooth group (20 teeth) than in the control group (6 teeth), which was significantly different (OR = 5.67, chi(2) = 8.45, P = 0.003). In 24 patients with single affected tooth, the center of occlusal force (COF) located in the inside and outside ellipse were 6 teeth (25%) and 18 teeth (75%) respectively, Z test showed that there were statistical differences between the cracked tooth group and normal people. In cracked tooth group, the proportion of the teeth with abrasion was higher in teeth with occlusal interference than those without occlusal interference (chi(2) = 4.79, P = 0.029)., Conclusions: The formation of the cracked tooth was related to the occlusal disorder and associated with the tooth abrasion.

Objective: To examine the expression of heat shock protein 25 (HSP-25) in dental rat follicles in vivo and in vitro in order to investigate the possible effect of HSP-25 on cell proliferation and alkaline phosphatase (ALP) activity., Methods: The expression of HSP-25 in mandibles of postnatal rats from day 1, 3, 5, 7, 9, 11 was examined by immunohistochemistry in vitro, the expression of HSP-25 in the dental follicle cells was detected by the indirect immunofluorescence method. Methyl thiazolyl tetrazolium (MTT) assay, flowcytometry and ALP assay were used to detect the effect of HSP-25 on rat dental follicles., Results: HSP-25 expression was absent or weak in rat dental follicle cells at early postnatal stage and present from day 5 till day 11. HSP-25 was detected in the cytoplasm of cultured dental follicle cells. MTT results showed no effect could be detected on dental follicle cell proliferation after stimulation of different concentrations of HSP-25 on day 1, 2, 3. Flowcytometry results also exhibited no difference in cell cycles after stimulation of HSP-25 at 0 microg/L and 100 microg/L. HSP-25 at a concentration of 50 microg/L and 100 microg/L could up-regulate the ALP activity on day 9., Conclusions: Expression of HSP-25 increases chronologically in the rat dental follicle cells. HSP-25 locates in the cytoplasm of cultured rat dental follicle cells. HSP-25 has no effect on the proliferation of dental follicle cells, however it can up-regulate the ALP activity.

Aim: To detect the expression of HSP25 in rat dental follicles both in vivo and vitro, and explore the underlying mechanism of HSP25 on the proliferation and differentiation of rat dental follicle cells (DFCs)., Methodology: Immunohistochemistry was performed to detect the expression of HSP25 in mandibles of postnatal rats on days 1, 3, 5, 7, 9 and 11 in vivo. In vitro, the expression of HSP25 in DFCs was detected by an indirect immunofluorescence assay. Thiazolyl blue tetrazolium bromide (MTT) assay, flow cytometry and alkaline phosphatase (ALP) assay were used to identify the time-course effect mediated by different concentrations of recombinant murine HSP25 of 0, 1, 10, 50 and 100 ng/mL on rat DFCs., Results: Expression of HSP25 was not detected in dental follicles of the rats until day 5 after birth, but became up-regulated in a time-dependent manner till day 11. HSP25 was detected in the cytoplasm of cultured rat DFCs. No significant difference could be observed in the proliferation of DFCs after stimulation with different concentrations of HSP25 on days 1, 2 and 3 (P > 0.05). HSP25 at concentrations of 50 ng/mL and 100 ng/mL up-regulated the ALP activity of DFCs on day 9 (P < 0.05)., Conclusion: HSP25-immunoreactivity increased chronologically during the development of dental follicles. The protein had no significant effect on cell proliferation but may play a role in cementoblast/osteoblast differentiation of DFCs.

Objective: To obtain regulating proteins during human periodontal ligament cell (hPDLC) osteogenic differentiation and investigate its underlying molecular mechanism., Methods: Two-dimension difference in gel electrophoresis (2D-DIGE) coupled with matrix-assisted laser adsorption ionization-time of flight mass spectrometry (MALDI-TOF-MS) analysis was used to identify regulating proteins during hPDLC osteogenic differentiation., Results: A differently expressed protein profile was obtained 7 days after osteogenic induction, and 61 protein spots with significant differences, 29 protein spots were identified by MALDI-TOF-MS, including cytoskeleton, cell membrane-bounding, nuclear regulation, matrix synthesis, and metabolic enzymes and signal transduction and other proteins. A functional class of cytoskeleton proteins showed co-regulation, these proteins were intimately involved in the reorganization of the cytoskeleton, cytokinesis and migration during PDLC differentiation., Conclusions: A database of differently displayed proteins during hPDLC osteogenic differentiation was established, which may be helpful to understand and further study molecular mechanism of PDLC osteogenic differentiation.

The cellular response to glucocorticoid receptor (GR) activation involves a highly orchestrated series of regulatory actions influenced at multiple levels by a variety of mechanisms including the action of transcription factors and chromatin modifiers. Because the majority of GR binding sites (glucocorticoid-responsive elements (GREs)) are distant from promoters, it is likely that interactions at a distance play an important role in GR action. To determine whether long range chromosomal associations play a role in transcription regulation by GR, we utilized a chromosome conformation capture-based technique (associated chromosome trap) to identify unknown, remote sequences that interact with the GR-induced Lipocalin2 (Lcn2) gene. Our screen revealed that the Lcn2 GRE interacts with the Ciz1 gene, nearly 30 kb upstream. Ciz1 was subsequently found to be a novel GR-responsive gene. The GRE proximal to the Lcn2 promoter apparently functions to regulate both the Lcn2 gene and the distal Ciz1 gene. Using quantitative chromosome conformation capture, we find that a loop structure is organized between these two genes. This structure is hormone-independent and present only in cell types where the genes are active. The strong correlation between gene expression and loop structure in different cell lines suggests that high order interactions play a role in determining tissue-specific gene regulation.

Objective: To evaluate the clinical outcome of periapical endodontic surgery for teeth that can't be treated by nonsurgical endodontic methods., Methods: Sixty-two affected teeth were chosen for surgical endodontic treatment, of which 31 teeth underwent periapical curettage and the others were treated by root-end resection, retrograde preparation and filling. A radiography was taken immediately after surgery and was compared with those taken at 12 and 24 months. The results of two groups were analyzed using the chi2 test., Results: The success rate for retrograde filling was higher (85% after 12 months, 88% after 24 months) compared with that of periapical curettage (52% after 12 months, 45% after 24 months). The difference in success rate between the two groups was statistically significant., Conclusions: Ultrasonic root-end preparation and retrograde filling is a good choice of treatment when the teeth can't be treated appropriately by nonsurgical treatment.