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Kamal NM, Hamouda MA, Abdelgawad N. Expression of TGF-β and MMP-2 in hereditary gingival fibromatosis epithelial cells. A possible contribution of the epithelium to its pathogenesis. J Oral Biol Craniofac Res 2022; 12:617-622. [PMID: 35989975 DOI: 10.1016/j.jobcr.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 06/15/2022] [Accepted: 08/10/2022] [Indexed: 10/15/2022] Open
Abstract
Background Although the molecular mechanisms that cause the development of hereditary gingival fibromatosis are not fully understood, multiple theories have been suggested to clarify its pathogenesis. However, the overlying keratinocytes' function is poorly comprehended. This work aimed to investigate the expression of TGF-β and MMP-2 in hereditary gingival fibromatosis epithelial cells compared to the normal gingival epithelium to give an insight into the mechanism of the development of this condition. Methods Biopsies were obtained from 20 hereditary gingival fibromatosis patients and 20 healthy controls. Biopsies were stained immunohistochemically and statistically analyzed for MMP-2 and TGF-β expression. Results Regarding MMP-2, The hereditary gingival fibromatosis group recorded a higher mean value compared to the normal gingiva, with a mean difference of 3.29 ± 0.34. This difference was statistically significant (p = 0.00). Regarding TGF-β, a higher mean value was recorded in the HGF group compared to the normal gingiva, with a mean difference of 15.88 ± 1.05 The difference was statistically significant (p = 0.00). A strong positive correlation was detected between MMP-2 and TGF-β (R = 0.534, p = 0.015). Conclusions In hereditary gingival fibromatosis, the epithelium expresses higher levels of TGF-β and MMP-2 than normal gingival tissue. There was an evident positive correlation between MMP-2 and TGF-β. Our data suggest that the expression of TGF-β and MMP2 by epithelial cells of HGF may play a role in the epithelial-mesenchymal transition pathogenic pathway.
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Affiliation(s)
- Naglaa M Kamal
- Department of Oral Pathology, Faculty of Oral and Dental Medicine, Ahram Canadian University, 6th of October, Egypt
| | - Mai A Hamouda
- Department of Oral Pathology, Faculty of Oral and Dental Medicine, Ahram Canadian University, 6th of October, Egypt
| | - Nora Abdelgawad
- Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
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Saxena S, Bhatia G, Krishna KM, Mehrotra S. Gingival fibromatosis with congenital hypertrichosis. J Indian Soc Periodontol 2020; 24:80-82. [PMID: 31983850 PMCID: PMC6961445 DOI: 10.4103/jisp.jisp_26_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/27/2019] [Accepted: 07/29/2019] [Indexed: 11/04/2022] Open
Abstract
Idiopathic gingival fibromatosis is a slowly progressive proliferative fibrous lesion of the gingival tissue, leading to functional, esthetic, and psychological difficulties. This entity is mainly associated with hypertrichosis and epilepsy either as an isolated disorder or as part of a syndrome. We present a case report of a female with severe generalized gingival fibromatosis and hypertrichosis which was treated by conventional gingivectomies under local anesthesia. Postoperative healing was uneventful with a marked improvement in patient's appearance and oral hygiene.
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Affiliation(s)
- Sameer Saxena
- Department of Periodontology, Mansarovar Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Gouri Bhatia
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Karthik Munagala Krishna
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Shalabh Mehrotra
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
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Yussif NM, Abdul Aziz MA. Towards the targeted management of hereditary gingival fibromatosis. Med Hypotheses 2018; 121:188-190. [PMID: 30396478 DOI: 10.1016/j.mehy.2018.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 09/09/2018] [Indexed: 11/15/2022]
Abstract
Although hereditary gingival fibromatosis is a rare condition, it leaves unrestroable psychological, esthetical as well as functional problems to the affected patients. The purpose of the current research is to find a non-surgical pharmacological mechanism that could provide a control of the active phase of such disease helping individual to continue their lives.
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Affiliation(s)
- Nermin M Yussif
- Oral Diagnosis, Medicine & Periodontology Dept., Fcaulty of dentistry-october university of modern science and arts (MSA), Giza, Egypt.
| | - Manar A Abdul Aziz
- Oral and Maxillofacial Pathology Department, Faculty of dentistry, Cairo University, Giza, Egypt.
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Pêgo SPB, de Faria PR, Santos LAN, Coletta RD, de Aquino SN, Martelli-Júnior H. Ultrastructural evaluation of gingival connective tissue in hereditary gingival fibromatosis. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:81-88.e2. [PMID: 27260277 DOI: 10.1016/j.oooo.2016.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 04/02/2016] [Accepted: 04/05/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To describe the ultrastructural features of hereditary gingival fibromatosis (HGF) in affected family members and compare microscopic findings with normal gingival (NG) tissue. STUDY DESIGN Gingival tissue samples from nine patients with HGF from five unrelated families were evaluated by transmission electron microscopy. Nine NG tissue samples were used for comparison. RESULTS Areas containing collagen fibrils forming loops and folds were observed in both groups, whereas oxytalan fibers were frequently identified in the HGF group. The diameter of collagen fibrils and the interfibrillar space among them were more uniform in the NG group than in the HGF group. Fibroblasts were the most common cells found in both the HGF and NG groups and exhibited enlarged, rough endoplasmic reticulum, mitochondria with well-preserved crests, conspicuous nucleoli, and euchromatic chromatin. Other cells, such as mast cells, plasma cells, and macrophages, were also observed. CONCLUSIONS HGF tissues had ultrastructural characteristics that were very similar to those of NG tissues. Oxytalan fibers were observed more frequently in the HGF samples than in the NG samples. Other studies of HGF in patients from different families should be performed to better understand the pathogenesis of this hereditary condition.
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Affiliation(s)
- Sabina Pena B Pêgo
- Full Professor, Dental School, State University of Montes Claros, Av Rui Braga - Vila Mauriceia - Campus Darcy Ribeiro - CEP 39401-089, Montes Claros, Minas Gerais, Brazil.
| | - Paulo Rogério de Faria
- Adjunct Professor, Institute of Biomedical Science, Department of Morphology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Luis Antônio N Santos
- Full Professor, Dental School, State University of Montes Claros, Av Rui Braga - Vila Mauriceia - Campus Darcy Ribeiro - CEP 39401-089, Montes Claros, Minas Gerais, Brazil
| | - Ricardo D Coletta
- Associate Professor, Department of Oral Diagnosis, School of Dentistry, State University of Campinas, São Paulo, Brazil
| | - Sibele Nascimento de Aquino
- Professor, Department of Oral Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Hercílio Martelli-Júnior
- Full Professor, Dental School, State University of Montes Claros, Av Rui Braga - Vila Mauriceia - Campus Darcy Ribeiro - CEP 39401-089, Montes Claros, Minas Gerais, Brazil
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Pol DG, Lobo TM, Pol SD. Idiopathic gingival fibromatosis with asymmetrical presentation and electrosurgical management. J Indian Soc Periodontol 2016; 20:98-102. [PMID: 27041849 PMCID: PMC4795147 DOI: 10.4103/0972-124x.170831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Idiopathic gingival fibromatosis is a rare genetically heterogeneous condition characterized by recurrent gingival enlargement without any identifiable cause. We report a case of 14-year-old female patient affected with sporadic, nonsyndromic, progressive gingival enlargement. It manifested more severely on the right side of the mouth with history of recurrence after prior conventional surgical excision. Electrosurgical resection of the enlargement was done, and overall patient management had a successful outcome along with achieving preservation of teeth with poor prognosis in the 2 years follow-up.
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Affiliation(s)
- Dilip Ganpat Pol
- Department of Periodontology, Government Dental College and Hospital (Affiliated to Maharashtra University of Health Sciences, Nashik), Navi Mumbai, Maharashtra, India
| | - Tanya Marguerite Lobo
- Department of Periodontology, Government Dental College and Hospital (Affiliated to Maharashtra University of Health Sciences, Nashik), Navi Mumbai, Maharashtra, India
| | - Samruddhi Dilip Pol
- Department of Periodontology, Padmashree Dr. D.Y. Patil Dental College and Hospital (Affiliated to Padmashree Dr. D.Y. Patil University, Nerul), Navi Mumbai, Maharashtra, India
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Abstract
Idiopathic gingival fibromatosis (IGF) is a rare hereditary condition characterized by slowly progressive, nonhemorrhagic, fibrous enlargement of maxillary and mandibular keratinized gingiva caused by increase in submucosal connective tissue elements, mostly associated with some syndrome. This case report describes a case of nonsyndromic generalized IGF in an 18-year-old male patient who presented with generalized gingival enlargement. The enlarged tissue was surgically removed by internal bevel gingivectomy and ledge and wedge procedure. The patient was regularly monitored clinically for improvement in his periodontal condition as well as for any recurrence of gingival overgrowth.
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Affiliation(s)
- Nitin Hemchandra Dani
- Department of Periodntics, M.G.V's K.B.H Dental Hospital, Panchavati, Nashik, Maharashtra, India
| | - Dinkar Parveen Khanna
- Department of Periodntics, M.G.V's K.B.H Dental Hospital, Panchavati, Nashik, Maharashtra, India
| | - Vaibhavi Hitesh Bhatt
- Department of Periodntics, M.G.V's K.B.H Dental Hospital, Panchavati, Nashik, Maharashtra, India
| | - Chaitanya Pradeep Joshi
- Department of Periodntics, M.G.V's K.B.H Dental Hospital, Panchavati, Nashik, Maharashtra, India
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Di CP, Sun Y, Zhao L, Li L, Ding C, Xu Y, Fan Y. Effect of nifedipine on the expression of keratinocyte growth factor and its receptor in cocultured/monocultured fibroblasts and keratinocytes. J Periodontal Res 2013; 48:740-7. [PMID: 23528007 DOI: 10.1111/jre.12064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Keratinocyte growth factor (KGF) and its receptor (KGFR) are involved in hyperplastic diseases. This study explored the effect of intercellular communication on KGF and KGFR in cocultured/monocultured gingival fibroblasts and keratinocytes following treatment with nifedipine. MATERIAL AND METHODS Human gingival fibroblasts and keratinocytes were monocultured and cocultured, respectively. MTT was used to investigate the effects of nifedipine on the proliferation of gingival fibroblasts and keratinocytes. Monoculture and coculture systems were treated with different concentrations (0, 0.2 or 20 μg/mL) of nifedipine, and the expression of KGF and KGFR mRNAs was examined by RT-PCR, whilst the secretion of KGF and the expression of KGFR on the membrane were analyzed using ELISA and flow cytometry, respectively. RESULTS Nifedipine (0, 0.2 and 20 μg/mL) had no influence on cell proliferation within 3 d. KGF and KGFR mRNAs were up-regulated, but only in the cocultures. In coculture, the secretion of KGF was significantly increased by nifedipine, while it was only significantly up-regulated by 20 μg/mL of nifedipine in monoculture. Moreover, the level of KGFR protein in the membrane was significantly increased by 20 μg/mL of nifedipine in monocultures, while it was significantly down-regulated by 20 μg/mL of nifedipine in cocultures. CONCLUSION The expression of KGF and KGFR are influenced by the interplay of gingival keratinocytes and fibroblasts. Epithelial keratinocytes and mesenchymal fibroblasts may interplay to dynamically regulate gene expression, which may have an effect on the gingival condition following treatment with nifedipine.
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Affiliation(s)
- C-P Di
- Institute of Stomatology, Nanjing Medical University, Nanjing, China; Department of Periodontology, College of Stomatology, Nanjing Medical University, Nanjing, China
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Poulopoulos A, Kittas D, Sarigelou A. Current concepts on gingival fibromatosis-related syndromes. ACTA ACUST UNITED AC 2011; 2:156-61. [PMID: 25426785 DOI: 10.1111/j.2041-1626.2011.00054.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Gingival fibromatosis is a rare, benign, slowly-growing fibrous overgrowth of the gingiva, with great genetic and clinical heterogeneity. Gingival fibromatosis/overgrowth can be inherited as an isolated trait (hereditary gingival fibromatosis) and/or as a component of a syndrome, or it can be drug induced. As a clinical manifestation of a syndrome, gingival fibromatosis is usually associated with generalized hypertrichosis, mental retardation, or epilepsy. Gingival fibromatosis and its related syndromes are mainly inherited in an autosomal-dominant manner, but autosomal-recessive inheritance has also been reported. Clinical syndromic presentation includes Zimmermann-Laband syndrome, Ramon syndrome, Rutherford syndrome, Cowden syndrome, Cross syndrome, Göhlich-Ratmann syndrome, Avani syndrome, and I-cell disease. However, a phenotypic overlap has been suggested, as many combinations of their systemic manifestations have been reported. Treatment of choice is usually gingivectomy with gingivoplasty. Before any therapy, clinical practitioners must take into consideration the clinical course of a particular syndrome and every possible functional and esthetic disorder.
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Affiliation(s)
- Athanasios Poulopoulos
- Department of Oral Medicine and Oral Pathology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Anand Nayak P, Nayak UA, Khandelwal V, Ninave N. Idiopathic Gingival Fibromatosis. Int J Clin Pediatr Dent 2011; 4:77-81. [PMID: 27616864 PMCID: PMC4999643 DOI: 10.5005/jp-journals-10005-1086] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 08/28/2010] [Indexed: 11/23/2022] Open
Abstract
Idiopathic gingival fibromatosis is a rare heriditary condition characterized by slowly progressive, nonhemorrhagic, fibrous enlargement of maxillary and mandibular keratinized gingiva caused by increase in submucosal connective tissue elements. This case report gives an overview of gingival fibromatosis in a 11-year-old female patient who presented with generalized gingival enlargement. Based on the history and clinical examination, the diagnosis was made and the enlarged tissue was surgically removed. The patient was being regularly monitored clinically for improvement in her periodontal condition as well as for any recurrence of gingival overgrowth.
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Affiliation(s)
- Prathibha Anand Nayak
- Reader, Department of Periodontics, Modern Dental College and Research Center, Airport Road, Gandhi Nagar Indore, Madhya Pradesh, India
| | - Ullal Anand Nayak
- Professor, Department of Pedodontics and Preventive Dentistry, Modern Dental College and Research Center, Airport Road Gandhi Nagar, Indore, Madhya Pradesh, India
| | - Vishal Khandelwal
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Modern Dental College and Research Center Gandhi Nagar, Indore, Madhya Pradesh, India
| | - Nupur Ninave
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, USPM Dental College and Research Center Nagpur, Maharashtra, India
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Shi J, Lin W, Li X, Zhang F, Hong X. Hereditary gingival fibromatosis: a three-generation case and pathogenic mechanism research on progress of the disease. J Periodontol 2010; 82:1089-95. [PMID: 21142979 DOI: 10.1902/jop.2010.100599] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Hereditary gingival fibromatosis (HGF) is a rare benign disorder characterized by progressive overgrowth of gingiva. Although the clinical and histopathologic characteristics of HGF are explicit, the pathogenic mechanism remains unclear. The goal of this article is to describe a three-generation HGF case and discuss the diagnosis, treatment, and inheritance of the disease. The known cellular and molecular features of HGF are also emphasized. METHODS Family and medical histories of the patients were recorded, and a series of preliminary examinations, including clinical, histologic, radiographic, and gene examination, were performed to make a diagnosis and learn about the genetic characteristics. An all-quadrant flap surgery was performed to remove excess gingiva, and orthodontic treatment was undertaken to help tooth eruption. Recent advances were reviewed for further knowledge of genetic, cellular, and molecular features of HGF. RESULTS The patient's manifestations and examinations showed a typical HGF characteristic. There was no recurrence after surgery, and the premolars and molars erupted to bite plane. Genetic studies have found several gene mutations involved in HGF. Only the son-of-sevenless-1 gene is identified. Multiple molecular factors, such as transforming growth factor-β and matrix metalloproteinases, participate in HGF, regulating the extracellular matrix. CONCLUSIONS Surgical intervention is the usual treatment of HGF, but patients still have to deal with the risk of recurrence. Once the correlations between gene mutations, molecular changes, histology, and clinical situation are clear, they can be applied to clinical application, providing novel methods for disease prognosis and diagnosis and targets for disease prevention and treatment.
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Affiliation(s)
- Jiejun Shi
- Department of Orthodontics, Affiliated Stomatological Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Lin YH, Lin JH, Peng SF, Yeh CL, Chen WC, Chang TL, Liu MJ, Lai CH. Multifunctional gentamicin supplementation of poly(γ-glutamic acid)-based hydrogels for wound dressing application. J Appl Polym Sci 2010. [DOI: 10.1002/app.33249] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ye X, Shi L, Yin W, Meng L, Wang QK, Bian Z. Further evidence of genetic heterogeneity segregating with hereditary gingival fibromatosis. J Clin Periodontol 2009; 36:627-33. [DOI: 10.1111/j.1600-051x.2009.01438.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Zhou J, Meng LY, Ye XQ, Von den Hoff JW, Bian Z. Increased expression of integrin alpha2 and abnormal response to TGF-beta1 in hereditary gingival fibromatosis. Oral Dis 2009; 15:414-21. [PMID: 19422573 DOI: 10.1111/j.1601-0825.2009.01567.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate the possible correlation between integrin alpha1, alpha2, and beta1 expression and excessive collagen synthesis in fibroblasts from 3 unrelated Chinese families with hereditary gingival fibromatosis (HGF). DESIGN Gingival fibroblasts from three Chinese HGF patients and three healthy subjects were included. The expression of alpha1, alpha2, and beta1 integrin subunits was examined by immunohistochemistry, quantitative PCR, and flow cytometry. We also investigated the effects of transforming growth factor-beta1 (TGF-beta1) on the expression of these integrin subunits. RESULTS Our results demonstrate that the expression of alpha2 was significantly higher in HGF fibroblasts compared with control fibroblasts (P < 0.01). No significant differences in the expression of alpha1 and beta1 were detected. Furthermore, TGF-beta1 promoted the expression of alpha1 and alpha2 in fibroblasts from both HGF patients and controls. However, it had a larger effect on the expression of alpha2 in HGF fibroblasts than in control cells. In contrast, alpha1 expression was stimulated more in control fibroblasts. CONCLUSION The increased expression of integrin alpha2 and the increased response to TGF-beta1 of HGF fibroblasts may be related to the excessive collagen deposition in HGF patients.
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Affiliation(s)
- J Zhou
- Key Laboratory for Oral Biomedical Engineering Ministry of Education, School and Hospital of Stomatology, Wuhan University, Hubei, China
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