[Single-cell transcriptome analysis reveals development atlas of mouse molar pulp cells]

Objective: Single-cell RNA sequencing (scRNA-seq) was used to analyze the developing mouse molars, in order to construct a spatiotemporal development atlas of pulp cells, and further to reveal the developmental process and regulatory mechanism of tooth development. Methods: Ten mandibular first molars from C57BL/6 mice in postnatal day (PN) 0 and 3 were respectively dissected and digested to obtain single-cell suspensions. scRNA-seq was performed on 10× Genomics platform. PN 7 mouse molar scRNA-seq data were obtained from our previous study. PN 0, 3, and 7 scRNA-seq data were integrated for following analysis. The initial quality control, mapping and single cell expression matrix construction were performed by Cell Ranger. Quality control, standardization, dimensional reduction and cluster analysis were performed by using Seurat. Monocle was used to generate the pseudotime trajectory. Scillus was used to perform gene ontology analysis. In order to detect the spatiotemporal change of different population of pulp cells, the marker genes of each cluster were demonstrated by RNAscope in situ hybridization. Results: There were twenty-six cell clusters within mouse molars, which were identified as eight different cell types, including dental pulp cells, dental follicle cells, epithelial cells, immune cells, endothelial cells, perivascular cells, glial cells and erythrocytes. We further re-clustered and analyzed dental pulp cells. Cluster 0 were mature pulp cells, which located at the upper portion of crown. The main functions of cluster 0 were osteogenesis and extracellular structure organization. Cluster 1 were apical papilla cells, which located at the apical part of roots, whose main functions were extracellular structure organization and organ development. Cluster 2 were cycling cells, which were actively proliferated, resided in the lower portion of the crown. Cluster 3 and 4 were preodontoblasts and odontoblasts, respectively. Their functions were closely related to biomineralization. The proportion of mature pulp cells increased with the development process, while the proportion of cycling cells and odontoblast lineage decreased. According to the expression pattern of marker genes of each cluster, we constructed a cell atlas of dental pulp. Pseudotime trajectory analysis found there were two development trajectories within dental pulp. They both started from SPARC related modular calcium binding 2 (Smoc2)+ dental papilla cells, then went through DNA topoisomerase Ⅱ alpha (Top2a)+ cycling cells, and finally divided into coxsackie virus and adenovirus receptor (Cxadr)+ mature pulp cells or dentin sialophosphoprotein (Dspp)+ odontoblasts two lineages. Conclusions: scRNA-seq could fully discover the intercellular heterogeneity of cells on transcriptome level, which provides a powerful tool to study the process and regulatory mechanism of organ development.

[Corrigendum] Comparison of the biological characteristics of human mesenchymal stem cells derived from exfoliated deciduous teeth, bone marrow, gingival tissue, and umbilical cord

Subsequently to the publication of this paper, an interested reader drew to the authors' attention that, in Fig. 3 on p. 4973, the data panels shown for the "Osteogenesis" row of data for the GMSC and BMSC experiments appeared to be overlapping, such the data may have been derived from the same original source. After having examined their original data, the authors have realized that the data panel selected for the GMSC "Osteogenesis" experiment was inadvertently chosen incorrectly. The corrected version of Fig. 3 is shown below. Note that this error did not significantly affect the results or the conclusions reported in this paper, and all the authors agree to this Corrigendum. The authors are grateful to the editor of Molecular Medicine Reports for allowing them the opportunity to publish this corrigendum, and apologize to the readership for any inconvenience caused.[Molecular Medicine Reports 18: 4969‑4977, 2018; DOI: 10.3892/mmr.2018.9501].

Hsa-miRNA-143-3p regulates the odontogenic differentiation of human stem cells from the apical papilla by targeting NFIC

AIM

To evaluate the effects of hsa-miRNA-143-3p on the cytodifferentiation of human stem cells from the apical papilla (hSCAPs) and the post-transcriptional regulation of Nuclear factor I-C (NFIC).

METHODOLOGY

miRNA expression profiles in human immature permanent teeth and during hSCAP differentiation were examined. hSCAPs were treated with miR-143-3p overexpression or silencing viruses, and the proliferation and odontogenic and osteogenic differentiation of these stem cells, and the involvement of the NFIC pathway, were investigated. Luciferase reporter and NFIC mutant plasmids were used to confirm NFIC mRNA as a direct target of miR-143-3p. NFIC expression analysis in the miR-143-3p overexpressing hSCAPs was used to investigate whether miR-143-3p functioned by targeting NFIC. Student's t-test and chi-square tests were used for statistical analysis.

RESULTS

miR-143-3p expression was screened by microarray profiling and was found to be significantly reduced during hSCAP differentiation (p < .05). Overexpression of miR-143-3p inhibited the mineralization of hSCAPs significantly (p < .05) and downregulated the levels of odontogenic differentiation markers (NFIC [p < .05], DSP [p < .01] and KLF4 [p < .01]), whereas silencing of miR-143-3p had the opposite effect. The luciferase reporter gene detection and bioinformatic approaches identified NFIC mRNA as a potential target of miR-143-3p. NFIC overexpression reversed the inhibitory effect of miR-143-3p on the odontogenic differentiation of hSCAPs.

CONCLUSIONS

miR-143-3p maintained the stemness of hSCAPs and modulated their differentiation negatively by directly targeting NFIC. Thus, inhibition of this miRNA represents a potential strategy to promote the regeneration of damaged tooth roots.

[Preliminary study on the relationship between different blood glucose levels and periodontitis in patients with diabetes mellitus type 2]

Objective: To determine the correlation between the diabetes mellitus control and periodontitis. Methods: This study was a cross-sectional survey using stratified system sampling model design. The target population was the patients with diabetes investigated from May to July 2018 in Huangpu District of Shanghai. In the present study, severe periodontitis was defined as at least at two sites in different quadrants with probing depth (PD)≥6 mm and clinical attachment loss (CAL)≥ 5 mm. Edentulous induced by periodontitis were also classified as severe periodontitis and the others were classified as non-severe periodontitis subjects. Diabetes control levels were divided into the following three groups: poorly controlled group [glycated hemoglobin (HbA1c)>7.5% and fasting blood glucose (FPG)>7.0 mmol/L], well controlled group (6.5%≤HbA1c≤7.5％ or 6.1 mmol/L≤FPG≤7.0 mmol/L) and ideally controlled group (HbA1c<6.5% and FPG<6.1 mmol/L). SPSS 25.0 was used for statistical analysis. Chi square test was used for demographic data and frequency distribution, α=0.05, two-sided test. Ordinal regression model was used for PD and diabetes control status to balance confounding factors (including age, gender, education and smoking status). After matching the propensity scores between severe periodontitis group and non-severe periodontitis group, logistic regression analysis was used to analyze the level of diabetes control and periodontitis. Results: A total of 5 220 adults over the age of 18 with a medical history of diabetes participated in the survey, of which 3 064 subjects with diabetes mellitus type 2 (T2DM) who were given both oral and laboratory examinations and were included in this study. Statistics showed that the prevalence of moderate and severe periodontitis was 10.57% (324/3 064). In the severe periodontitis group, 79.01% (256/324) of the subjects were over 65 years old, 55.56% (180/324) were male, 58.33% (189/324) had lower education level than high school level, and 21.91% (71/324) were smokers, which were significantly higher than those in the non-severe periodontitis group (P<0.01). In different T2DM status groups, the percentage of severe periodontitis increased with the aggravation of T2DM status. In severe periodontitis group, the proportion of patients with poor glycemic control was higher. T2DM patients with poor glycemic control accounted for 68.52% (222/324) in severe periodontitis group, which was significantly higher than the proportion of non-severe periodontitis group of 60.99% (1 671/2 740) (P<0.05). The regression coefficient of PD was 0.191, and PD had a significant negative effect on the level of blood glucose (P<0.01). There was a significant positive correlation between diabetes glycemic control and severe periodontitis (OR=2.800, P<0.05). Conclusions: In Huangpu District of Shanghai, among T2DM patients, the age of severe periodontitis group was higher than that of non-severe periodontitis group, most of them were male, with lower education level and higher proportion of smoking. The severity of diabetes was related to periodontitis and the proportion of severe periodontitis was higher in patients with poor glycemic control.

Treatment with Stem Cells from Human Exfoliated Deciduous Teeth and Their Derived Conditioned Medium Improves Retinal Visual Function and Delays the Degeneration of Photoreceptors

Retinitis pigmentosa (RP) is a hereditary disease characterized by degeneration and the loss of photoreceptors. Stem cell-based therapy has emerged as a promising strategy for treating RP. Stem cells from exfoliated deciduous teeth (SHEDs), a type of mesenchymal stem cell from human exfoliated deciduous teeth, have the potential to differentiate into photoreceptor-like cells under specific induction in vitro. It has been confirmed that through paracrine secreta, SHEDs exert neurotrophic, angiogenic, immunoregulatory, and antiapoptotic functions in injured tissues. This study was designed to determine whether retinal-differentiated SHEDs and the conditioned medium derived from SHEDs (SHEDs-CM) have therapeutic effects in a mouse model of RP. The results showed that both SHEDs and SHEDs-CM improved electroretinogram responses, ameliorated photoreceptor degeneration, and maintained the structure of the outer segments of photoreceptors. The therapeutic effects were related to antiapoptotic activity of SHEDs and SHEDs-CM. Thus, SHEDs may be a promising stem cell source for treating retinal degeneration.

Comparison of the biological characteristics of human mesenchymal stem cells derived from exfoliated deciduous teeth, bone marrow, gingival tissue, and umbilical cord

Different sources of mesenchymal stem cells (MSCs) may differ in their biological characteristics, which are important for their clinical application. In the present study, MSCs were isolated from human exfoliated deciduous teeth (SHED), bone marrow, gingival tissue and umbilical cord tissue, and their biological characteristics including surface markers, proliferation capacity, tumorigenicity and immunogenicity were analyzed by flow cytometric analysis, ELISA and co‑culture with human lymphocytes, respectively. The results indicated that all four types of stem cells obtained from different sources expressed MSC surface markers, and they did not show tumorigenicity either in vivo or in vitro. Stem cells from SHED exhibited the strongest proliferation capacity. Umbilical cord‑derived MSCs displayed the strongest immunomodulatory ability, while bone marrow MSCs exhibited the best antigen‑presenting potential in response to interferon‑γ stimulation. These results provide information on MSCs derived from different tissues, which may be helpful in their clinical application.

[Three-dimensional analysis of the early correction of anterior crossbite using eruption guidance appliance]

OBJECTIVE

To investigate the clinical effect of eruption guidance appliance in the treatment of anterior cross bite in mixed-dentition children.

METHODS

In the study,10 mixed-dentition children with anterior cross bite, totally 12 incisors, were selected. Alginate was used to take upper and lower dentition impression and make a hard plaster model,which served as the eruption guidance appliance for treatment. The pre- and post-operative dental casts were digitized with SmartOptics Activity 880 scanner,and the three-dimensional overlapping models were obtained by reverse engineering software,Geomagic Studio 2012,then the three-dimensional movements of the upper and lower incisors were analyzed using Imageware 13.2 software. The overbite and overjet were analyzed using the same methods. Measurement with copper wire was used to analyze the upper and lower arch length. Space analysis was the result by the sum of crown width minus the arch length. The crown width of unerupted permanent teeth was according to X-ray method to predict. The SPSS 17.0 software was used to analyze the pre- and post-operative measurements of the same child. The normality test of the measured data showed that it conformed to the normal distribution. Therefore,the t test and double side test were used,and the significance level was 0.05.

RESULTS

The course of treatment was (5.6±2.7) months. During orthodontic treatment, the upper incisors moved mainly labially (P<0.001) in three-dimensional displacement, and the lower incisors moved mainly the same direction (P=0.025). During the treatment of eruption guidance appliance,the average overbite decreased (1.01±0.9) mm (t=-3.531, P=0.006), and the difference was statistically significant. There was no statistically significant difference between the pre- and post-operative average overjet (t=0.771, P=0.460). The severity of crowding in upper arch decreased (1.9±0.99) mm (t=-6.042, P<0.001),and that in lower arch decreased (1.9±0.74) mm (t=-8.143, P<0.001), both of the differences were statistically significant.

CONCLUSION

The anterior cross bite in mixed dentition could be corrected by eruption guidance appliance, and at the same time, the normal overjet and overbite were established, and the teeth were aligned.

[Comparison of the properties of CD146 positive and CD146 negative subpopulations of stem cells from human exfoliated deciduous teeth]

OBJECTIVE

Stem cells from human exfoliated teeth (SHED) were sorted by magnetically activated cell sorting (MACS) technique to obtain the CD146 positive and negative cell subpopulation. Then the biological characteristics of these subpopulations were compared to explore their specific application potential in tissue engineering.

METHODS

In this study, freshly extracted deciduous teeth without any caries or dental pulp disease were obtained. SHED was isolated using enzyme digestion method and then sorted by MACS, CD146 positive cells and CD146 negative cells were obtained after cell sorting. The biological characteristics of the unsorted mixed cells, CD146 positive subpopulation and CD146 negative subpopulation were compared. The proliferation ability was detected through cell counting kit-8 (CCK-8) and colony-forming unit (CFU). After osteogenic induction, alizarin red staining was performed and the gene expression of osteogenic related markers was detected by quantitative real-time polymerase chain reaction(qPCR). After adipogenic induction, oil-red O staining was performed and the gene expression of adipogenic related markers was detected. After neurogenic differentiation induction, the expression of neural markers was detected by immunofluorescence and the gene expression of neural markers was detected by qPCR.

RESULTS

SHED of the fifth passage was sorted by MACS. And the CD146 positive cell subpopulation and CD146 negative cell subpopulation were obtained. CCK8 assay showed that the proliferative tendency of the three cell groups was consistent, but the proliferation potential of CD146 positive and negative cell subpopulations was significantly lower than that of the unsorted cells. The colony forming rates of the unsorted mixed cell group, CD146 positive and negative populations were 28.6%±3%,17.1%±2.3% and 27.5%±2.5%, respectively. After 21 days of osteogenic induction, alizarin red staining and qPCR showed that the CD146 positive cell population had more mineralized nodule formation and expressed higher level of osteogenic related genes compared with the other two groups. After 21 days of adipogenic induction, oil red O staining and qPCR results showed that the CD146 negative subpopulation produced more lipid droplets and the expression of lipid related genes increased more significantly. After 14 days of neural induction, cell immunofluorescence and qPCR results showed that the unsorted mixed cell group and CD146 positive subpopulation expressed glial cell marker, and the expressions of neural precursor cells and neuronal marker increased significantly in negative subpopulation.

CONCLUSION

The unsorted mixed cells showed better proliferative potential than CD146 positive and negative subpopulations. The CD146 positive subpopulation was most potent in osteogenic differentiation; it was more suitable for bone tissue engineering. The CD146 negative cells had stronger adipogenic differentiation potential than the other two cell groups; different subpopulations differed in neural differentiation.

Treatment of gingival defects with gingival mesenchymal stem cells derived from human fetal gingival tissue in a rat model

Background

The study aimed to evaluate the efficacy and safety of gingival mesenchymal stem cells (GMSCs) from human fetal gingival tissue used for treating gingival defects in a rat model.

Methods

GMSCs were isolated from human fetal gingival tissue and identified by flow cytometry for nestin, Oct4, vimentin, NANOG, CD105, and CD90. The immunogenicity of GMSCs was analyzed by mixed lymphocyte reactions; the tumorigenicity of GMSCs was evaluated by xenotransplanting into nude mice. The gingival defect animal model was established by mechanical resection in rats. GMSCs were transplanted into the defective area, and the regeneration of gingival tissue was observed twice weekly. Four weeks after transplantation, the gingival tissue was surgically cut down, and the graft was analyzed by immunohistochemistry staining for human mitochondrial antigens and rat CD3 and CD20.

Results

GMSCs from human fetal gingival tissue positively expressed nestin, Oct4, vimentin, NANOG, CD105, and CD90. There was no cell aggregation after mixed lymphocyte reactions, and interleukin-2 did not increase. Inoculation of GMSCs into nude mice for 6 months showed no tumor formation. GMSCs were transplanted into the gingiva defects of rats. One week after transplantation, the defect area was reduced, and after 3 weeks the morphology and color of local gingival tissue was similar to normal gingival tissue, and gingival height was the same as the normal control group.

Conclusions

Using GMSCs from human fetal gingival tissue to treat gingival defects is a safe and effective innovative treatment method.

[A 2-year cohort study on the caries risk assessment of 3-year-old caries-free children using Cariostat caries activity test]

Objective: To evaluate the caries status of a cohort of 3-year-old caries-free children from 2 kindergartens in Beijing in a period of 2 years by using Cariostat caries activity test and to assess the sensitivity and specificity of Cariostat score as a caries risk indicator for caries-free children. Methods: Totally 426 3-year-old caries-free children from 2 kindergartens in Beijing were recruited in the present study. Informed consents were obtained from the children's parents. Dental plaque samples of the children were collected and the Cariostat caries activity tests were conducted at baseline and once a year for 2 years. After two years, the caries status of the cohort children were re-evaluated and the caries incidences amongst children with high (2.0, 2.5, 3.0), medium (1.5) and low (1.0, 0.5, 0.0) levels of Cariostat scores were compared and analyzed. Results: Totally 864 3-year-old children from 2 kindergartens were screened before the study startedand 426 (49.3%) children were caries free. After 2-year follow-up, 312 out of 426 (73.2%) remained in the study. The overall caries incident rate was 46.5% (145/312). The caries incident rate of children with high level of Cariostat scores was 88.9% (88/99), while the caries incident rates of children with medium and low levels of Cariostat scores was 38.7% (36/93) and 17.5% (21/120), respectively. The sensitivity and specificity of the Cariostat test in assessing the caries risk of 3-year-old caries-free children in a period of 2 years were 60.7% and 93.4%, respectively. Conclusions: Cariostat caries activity test can be used as an indicator to predict the caries risk of 3-year-old caries-free children. Comprehensive caries management could be conducted for children in kindergartens based on the caries risk assessment results of caries experience and the Cariostat score.

[Recombinant human transforming growth factor β1 promotes dental pulp stem cells proliferation and mineralization]

OBJECTIVE

To explore suitable concentration of recombinant human transforming growth factor β1 (rhTGF-β₁) usage and study the effect of rhTGF-β₁ on differentiation of dental pulp stem cells (DPSCs).

METHODS

DPSCs were isolated from the undiseased third molars of people aged 18-25 years and cultured according to instructions in vitro. Different concentrations (1 , 6 , 10 μg/L) of rhTGF-β₁ were added to the culture medium to examine DPSCs proliferation by CCK-8 (cell counting kit-8) assay.The suitable concentration was then selected. For differentiation, the DPSCs were incubated for 7 or 14 days with rhTGF-β₁ supplemented with osteo/odontoblastic induction medium containing 10 nmol/L dexamethasone, 10 mmol/L b-glycerophosphate, 50 g/L ascorbate phosphate, 10 nmol/L 1,25-dihydroxyvitamin D3 and 10% fetal bovine serum. The cells were then washed 3 times with phosphate-buffered saline and sonicated with 1%Triton X-100 for 30 minutes on ice. Cellular alkaline phosphatase (ALP) activity was assayed with p-nitrophenyl phosphate as the substrate. The enzyme activity was expressed as p-nitrophenyl produced per milligram of protein [bicinchoninic acid (BCA) protein assay kit]. To examine mineral nodule formation, the cultured cells were fixed in 4% paraformaldehyde and washed in water, and the mineralization of the extracellular matrix was assayed by 1% alizarin red S staining and elution of staining was examined as optical density (D) under microplate reader. The mean difference was considered significant at 0.05 and 95% confidence interval.

RESULTS

The DPSCs had typical fibroblast morphology and could form mineral nodules after being cultured with osteo/odontoblstic induction medium for 14 days. 6 μg/L rhTGF-β₁ significantly promoted the DPSCs proliferation on the 3rd and 5th days. After the incubation of osteo/odontoblastic induction medium, the DPSCs with the 6 μg/L rhTGF-β1 increased ALP activities compared with the control; D values in the 6 μg/L rhTGF-β₁ group was 0.31±0.03, while the control group was 0.02±0.01 (P<0.05). The total protein content in the 6 μg/L rhTGF-β₁ group was (2 775.46±83.54) mg/L, and the control group was (1 432.20±110.83) mg/L (P<0.05). To eliminate the cells proliferation influence, relative ALP activities, which was defined as the total ALP divided by the total protein content, the 6μg/L rhTGF-β₁ group was 6 times higher than the control group. Alizarin red S staining showed increased mineral nodule formation in the rhTGF-β₁ group. The elution of staining under microplate reader also showed more optical density in the 6 μg/L rhTGF-β₁-treated cells (0.83±0.02) than that in the control groups (0.55±0.05, P<0.05).

CONCLUSION

6 μg/L rhTGF-β₁ could significantly promote DPSCs proliferation and odontoblastic differentiation in vitro.

[Comparison of long-term dental treatment effects of children treated under general anesthesia and passive restraint]

Objective: To compare the long-term dental treatment effects, oral health habits and oral-health-related qualities of life of children treated under general anesthesia (GA) and passive restraint (PR), respectively. Methods: Twenty seven 2 to 4-year-old children treated under GA and thirty four children treated under PR were recruited in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology. Up to 2 years after the treatment, a follow up assessment was conducted. The data of general information, dental plaque level and the unplanned treatments were recorded and analyzed. The questionnaire of oral health habits and early childhood oral health impact scale (ECOHIS) for each child was also completed and analyzed. The survival rate and median survival time of the deciduous teeth were calculated. Multivariate analysis was performed by using Cox proportional hazard model. Results: Twenty-five children under GA and 32 under PR were finally included, with a total of 1 098 deciduous teeth. The postoperative dental plaque indicesin both GA and PR groups had significantly improved than that of before the treatments (P=0.019, P<0.001). The oral health habits had also improved, and the improvement in PR group was more obvious than that in GA group. Totally 128 teeth (27.0%) appeared unplanned treatments in GA group and 232 teeth (37.2%) in PR group during the follow-ups. The new caries and recurrent caries in PR group were significantly more than that in GA group (P<0.001, P=0.012). No significant differences were found between the two groups in restoration failure, secondary caries and endodontic diseases (P=0.129, P=0.822, P=0.642). However, the time of occurrence of endodontic disease and secondary caries in GA group were significantly longer than that in PR group (P<0.01, P<0.001). The median survival time of teeth in GA group was 1 018 days comparing to 944 days in PR group. The difference was statistically significant (P<0.05). The survival rate was associated with such factors as decayed-missing-filled tooth (dmft), anterior or posterior teeth, feeding frequency, brushing habits and behavior management techniques. Conclusions: The long-term dental treatment effects of children treated under GA was significantly better than that of PR group. Continuous reinforcement of proper dietary and oral hygiene habits might help in maintaining the long-term treatment effect.

[Effects of breast-feeding duration, bottle-feeding duration and oral habits on the occlusal characteristics of primary dentition]

OBJECTIVE

To assess the effects of breast-feeding duration, bottle-feeding duration and oral habits on the occlusal characteristics of primary dentition in 3-6-year-old children in Beijing.

METHODS

This cross sectional study was conducted via an examination of the occlusal characteristics of 734 children combined with a questionnaire completed by their parents/guardians. The examination was performed by a single, previously calibrated examiner and the following variables were evaluated: presence or absence of deep overbite, open bite, anterior cross bite, posterior cross bite, deep overjet, terminal plane relationship of the second primary molar, primary canine relationship, crowding and spacing. Univariate analysis and multiple Logistic regressions were applied to analyze the associations.

RESULTS

It was found that a short duration of breast-feeding (never or ≤6 months) was directly associated with posterior cross bite (OR=3.13, 95%CI=1.11-8.82, P=0.031) and no maxillary space (OR=1.63, 95%CI=1.23-2.98, P=0.038). In children breast-fed for ≤6 months, the probability of developing pacifier-sucking habits was 4 times that for those breast-fed for >6 months (OR=4.21, 95%CI=1.85-9.60, P=0.000 2). The children who were bottle-fed for over 18 months had a 1.45-fold higher risk of nonmesial step occlusion and a 1.43-fold higher risk of class II canine relationship compared with those who were bottle-fed for 6-18 months. Non-nutritive sucking habits were also found to affect occlusion: a prolonged digit-sucking habit increased the probability of an anterior open bite, while a pacifier-sucking habit was associated with excessive overjet and absence of lower arch developmental space. Tongue-thrust habit was associated with anterior open bite (OR=4.21, 95%CI=1.85-9.60, P=0.000 2) and posterior cross bite (OR=7.24, 95%CI=1.30-40.13, P=0.024). Lower lip sucking habit was associated with deep overjet and had a negative association with class III canine relationship. Unilateral chewing was associated with spacing in mandibular (OR=1.57, 95%CI=1.03-2.41, P=0.037). Mouth breathing was associated with chronic rhinitis and adenoidal hypertrophy and had an association with spacing in maxillary. The chi-square test did not indicate a statistically significant association between upper lip sucking habit and any occlusal characteristics.

CONCLUSION

Breast-feeding duration was shown to be associated with the prevalence of posterior crossbite, or no maxillary space in the deciduous dentition and development of a pacifier-sucking habit. Children who had a longer duration of bottle-feeding were more likely to develop class II canine relationship. Children who had an oral habit were more likely to develop abnormal occlusal characteristics.

[Impact of different degree pulpitis on cell proliferation and osteoblastic differentiation of dental pulp stem cell in Beagle immature premolars]

OBJECTIVE

To compare the proliferation and osteoblastic differentiation of dental pulp stem cell (DPSC) isolated from normal and inflamed pulps of different degrees in Beagle immature premolars, and provide evidence for the use of inflammatory DPSC (IDPSC).

METHODS

This study evaluated 14 Beagle's young premolars (21 roots). In the experiment group, irreversible pulpitis was induced by pulp exposure and the inflamed pulps were extracted 2 weeks and 6 weeks after the pulp chamber opening.For the control group, normal pulps were extracted immediately after the exposure. HE staining and real-time PCR were performed to confirm the inflammation. The cells were isolated from the inflamed and normal pulps (IDPSC and DPSC). Cell proliferation and osteoblastic differentiation potentials of the two cells were compared.

RESULTS

Inflammation cells infiltration was observed in the inflamed pulps by HE staining. The expression of inflammatory factor was much higher in the 6 week inflamed pulp. IDPSC had higher potential of cell proliferation and osteoblastic differentiation potentials. Furthermore, the osteoblastic differentiation potentials of IDPSC from 2 week inflamed pulp were higher than those from 6 week inflamed pulp.

CONCLUSION

The potential of cell proliferation and osteoblastic differentiation of DPSC was enhanced at early stage of irreversible pulpitis, and reduced at late stage in Beagle immature premolars.

[Children's intelligence quotient following general anesthesia for dental care: a clinical observation by Chinese Wechsler young children scale of intelligence]

OBJECTIVE

It has been demonstrated that anesthetics exposure may lead to neurocognitive impairment in developing brain of animal models. However, for the limitation that the animal models cannot fully mimic the dose and duration in clinical settings especially for dental general anesthesia, the clinical significance of anesthetics exposure on developing central nervous system remains undetermined. Therefore, we conducted the current study in order to observe the fluctuation of intelligence quotient (IQ) after the administration of dental general anesthesia comparing to that before surgery. We conducted the current study in order to observe the fluctuation of intelligence quotient (IQ) after the administration of dental general anesthesia compared with that before surgery.

METHODS

Thirty two patients, ASA I, who were exposed to dental general anesthesia in Department of Pediatric Dentistry Peking University School and Hospital of Stomatology, aged 4 to 6.5 years, were enrolled in this prospective study. Patients with severe learning difficulties or communication disorders were excluded. Written and informed consent was obtained from each patients' family which was fully explained of the purpose and method of study. Their intelligence quotients were evaluated with the Chinese Wechsler young children scale of intelligence (Urban version) before and 2 weeks after dental anesthesia. They were treated by experienced pediatric dentists and the sevoflurane, propofol and nitrous oxide were used for general anesthesia by anesthetist. Articaine hydrochloride and epinephrine tartrate injections were used for their pulp treatment or extraction. The examiners and scorers for IQ had technical training in the test administration. All the patients were tested by the same examiner and with standardized guide language. Each subtest was scored according to the tool review. Verbal IQ and performance IQ consisted of relevant 5 subtests and full scale IQ. Statistical analyses were performed by SPSS 18.0. All the scores of subtests and 3 types of IQ were expressed as mean±standard deviation. Paired two-tailed t test was applied and P<0.05 was accepted as statistically significant.

RESULTS

The results of intelligent assessment from 28 subjects were collected. The anesthetic time was (163.4±32.6) min and the number of treated teeth was 12.1±2.3, mean age (4.60±0.41) years; age range=4.04 to 5.44 years. Among the patients, there were 13 girls and 15 boys. There was no significant difference in gender distribution. The postoperative full IQ (128.46±10.85) was higher than that before surgery (124.64±11.46, P= 0.017). We found that the elevation of performance IQ, to a large extent, contributed to this change in full IQ (P= 0.007). Correspondingly, there was no statistical difference in the verbal IQ, which was 119.68±11.74 to 120.21±15.61 (P=0.854).

CONCLUSION

Dental general anesthesia has no negative effect on the intelligence of preschool children, who were treated under general anesthesia by sevoflurane, propofol and nitrous oxide for 2 to 4 hours. The full IQ and performance IQ were slightly enhanced after treatment which can be explained by the memory effect.

RUNX2 Mutation Impairs 1α,25-Dihydroxyvitamin D3 mediated Osteoclastogenesis in Dental Follicle Cells

Cleidocranial dysplasia (CCD), a skeletal disorder characterized by delayed permanent tooth eruption and other dental abnormalities, is caused by heterozygous RUNX2 mutations. As an osteoblast-specific transcription factor, RUNX2 plays a role in bone remodeling, tooth formation and tooth eruption. To investigate the crosstalk between RUNX2 and 1α,25-dihydroxyvitamin D3 (1α,25-(OH)₂D₃) in human dental follicle cells (hDFCs) during osteoclast formation, we established a co-culture system of hDFCs from CCD patient and healthy donors with peripheral blood mononuclear cells (PBMCs). Expression of the osteoclast-associated genes and the number of TRAP⁺ cells were reduced in CCD hDFCs, indicating its suppressed osteoclast-inductive ability, which was reflected by the downregulated RANKL/OPG ratio. In addition, 1α,25-(OH)₂D₃-stimulation elevated the expression of osteoclast-related genes, as well as RANKL mRNA levels and RANKL/OPG ratios in control hDFCs. Conversely, RUNX2 mutation abolished this 1α,25-(OH)₂D₃-induced RANKL gene activation and osteoclast formation in CCD hDFCs. Therefore, RUNX2 haploinsufficiency impairs dental follicle-induced osteoclast formation capacity through RANKL/OPG signaling, which may be partially responsible for delayed permanent tooth eruption in CCD patients. Furthermore, this abnormality was not rescued by 1α,25-(OH)₂D₃ application because 1α,25-(OH)₂D₃-induced RANKL activation in hDFCs is mediated principally via the RUNX2-dependent pathway.

Nuclear factor I-C expression pattern in developing teeth and its important role in odontogenic differentiation of human molar stem cells from the apical papilla

Nuclear factor I-C (NFIC) has an important role in the development of murine dental roots, but its role in human root formation is unreported. We thus elucidated the regulatory role of NFIC in the differentiation of human stem cells from the apical papilla (hSCAPs). The first step for this was to determine the expression of NFIC in human teeth, and it was found that NFIC expression was restricted to the odontoblasts and preodontoblasts of the developing molars of humans and mice. NFIC was found to be expressed in odontoblast-like cells after the subcutaneous transplantation of hSCAPs. NFIC expression was concomitant with dentin sialophosphoprotein (DSPP) in the mineralization of hSCAPs. NFIC knockdown in hSCAPs significantly inhibited expression of DSPP and promoted that of dentin matrix protein 1 (DMP1), meanwhile upregulated the expression of TGF-β1 and downregulated SMAD3 and SMAD4. NFIC expression was significantly upregulated after TGF-β1 treatment in hSCAPs. NFIC knockdown prolonged G1 phase of the cell cycle, but had no effect on cell proliferation and migration. These results suggest that NFIC is involved in the development of human root dentin and the regulation of odontoblastic differentiation of hSCAPs. NFIC may participate in the DMP1-DSPP signaling pathway and comprises a complex signaling cycle with TGF-β1.

Predictive role of RRM1 and BRCA1 mRNA expression on the clinical outcome of advanced non-small cell lung cancer

This study aimed to evaluate the association between RRM1 and BRCA1 expressions and the therapeutic efficacy of platinum-based chemotherapy in non-small cell lung cancer patients in terms of their response and prognosis. In total, 377 patients agreed to participate in our study, and all of them received platinum-based combination chemotherapy between January 2008 and January 2009. The relative cDNA quantitation for RRM1 and BRCA1 was conducted using a fluorescence-based, real-time detection method, using β-actin as a reference gene. The average age of the 377 patients was 64.6 years (range: 25.5-86.4 years), including 269 men and 108 women. Patients with high RRM1 expression benefited more from a platinum-containing regimen, and patients with high BRCA1 expression showed a high response rate to a platinum-containing regimen and reduced disease progression. Patients with high RRM1 expression were associated with a longer progression-free survival (PFS) and overall survival (OS) than those with low expression, and the hazard ratios (HRs) (95% confidence interval (CI)) were 0.67 (0.32-0.91) and 0.54 (0.30-0.95), respectively. Patients with high BRCA1 expression showed longer PFS and OS compared to those with low expression, and the HRs (95%CI) were 0.54 (0.30-0.95) and 0.62 (0.32-0.93), respectively. These results could be used in personalized chemotherapy decisions and to increase the response rate and prolonged survival, and could encourage exploration of the predictive value of other genes.

[An experimental study on the penetration abilities of resin infiltration into proximal caries lesions in primary molars]

OBJECTIVE

To compare the penetration abilities of resin infiltration into proximal lesions in primary molars with those of adhesive in vitro.

METHODS

Thirty-two extracted or exfoliated primary molars showing proximal white spot lesions were selected. Roots of the teeth were removed, and the crowns were cut across the white spot lesions perpendicular to the surface. Cut surfaces were examined (by stereo microscopy) and classified with respect to histological lesion extension (C1-C4): lesions confined to the outer half on enamel (C1), lesions confined to the inner half on enamel (C2), lesions confined to the outer half on dentin (C3), lesions extending into the inner half of dentin (C4). Corresponding lesion halves were etched for 120 s with 15% hydrochloric acid gel and were subsequently treated with either adhesive or resin infiltration. Specimens were observed with laser scanning confocal microscope (LSCM) in dual fluorescence mode. In confocal microscopic images, lesion depth and penetration depth of the resin infiltration or the adhesive in corresponding halves were measured, and penetration percentages were calculated respectively. Differences of the data between two groups were analyzed by Wilcoxon signed rank test. Variations of histological caries extensions were detected with Kruskal-Wallis H test.

RESULTS

At the same grading level (C1-C3) in histological caries extension, penetration depths of the resin infiltration group and the adhesive group were 240 (230, 260) µm vs 190 (150, 210) µm, 405 (300, 523) µm vs 180 (160, 200) µm, and 590 (430, 640) µm vs 180 (160, 200) µm respectively. There was significant statistical difference in the data between two groups (P < 0.05). Statistically significant difference in penetration depths of the resin infiltration group (at C1-C3) were found (P < 0.01). At the same grading level (C1-C3) in histological caries extension, percentage penetrations of the resin infiltration group and the adhesive group were [100.0% (96.2%, 100.0%)], [99.1% (95.7%, 100.0%)], [82.0% (81.1%, 92.2%)] and [79.2% (68.4%, 87.5%)], [41.8% (29.1%, 74.5%)], [30.2% (29.2%, 39.6%)], respectively. The difference between the above data was also significant (P < 0.05). Percentage penetrations of the resin infiltration group at C1 and C2 level was higher than those at C3 level (P < 0.05).

CONCLUSIONS

The resin infiltration is capable of penetrating almost completely into proximal lesions in primary molars.

Effect of skimmed pasteurized milk and Hank's balanced salt solution on viability and osteogenic differentiation of human periodontal ligament stem cells

BACKGROUND/AIM

The purpose of this study was to compare the effect of skimmed pasteurized milk and Hank's balanced salt solution on the viability and osteogenic differentiation potential of the human periodontal ligament stem cells at room temperature in vitro.

MATERIAL AND METHODS

Human periodontal ligament stem cells were obtained from extracted healthy third molars and conserved in skimmed pasteurized milk and Hank's balanced salt solution for 1, 2, and 4 h at room temperature to detect the viability of the cells and their osteogenic differentiation potential.

RESULTS

The efficacy of skimmed pasteurized milk on cell viability at 4 h was significantly higher than that of HBSS (P < 0.05), and cells stored in skimmed pasteurized milk showed significantly higher levels of mineralization than those in HBSS at 2 and 4 h (P < 0.05).

CONCLUSIONS

Skimmed pasteurized milk was more effective than Hank's balanced salt solution in maintaining the viability and osteogenic differentiation potential of PDLSCs at room temperature in vitro.

Root resorption of primary molars without successor teeth. An experimental study in the beagle dog

Tooth agenesis is a common craniofacial congenital malformation in humans, but little is known about the mechanisms of root resorption in this condition. The purpose of this study was to investigate the mechanisms of root resorption in primary molars without successors. An animal model without permanent tooth germs was established by surgery in beagles. The times of onset of primary molar root resorption, with and without successors, were compared. The distribution of immune cells, odontoclasts, and their activating factors were determined by histochemistry and immunohistochemistry. Root resorption of primary mandibular molars without successors began later than physiological resorption. In primary molars without permanent germs, odontoclasts and immune cells were present mainly in the apical pulp at the start of root resorption, whereas in control teeth receptor activator of nuclear factor-κB ligand (RANKL)-positive cells were found mainly in the region of the periodontal ligament. CD14(+) and CD3(+) cells were found in both the pulp and the periodontal ligament region. These results suggest that the dental pulp of primary molars, as well as immune cells, may play an important role in root resorption in primary molars without permanent tooth germs.

Right hepatic arterial pseudoaneurysm with hemobilia following minilaparotomy cholecystectomy: a rare complication

Hepatic arterial pseudoaneurysm with hemobilia occurs less frequently as a complication of minilaparotomy cholecystectomy than laparoscopic cholecystectomy; however, given its severe nature, it needs to be managed promptly. This report presents a case of right hepatic artery pseudoaneurysm with hemobilia in a 36-year-old woman who underwent minilaparotomy cholecystectomy 5 weeks earlier. Angiography with embolization was carried out as definitive treatment.

PAX6 polymorphisms in 20 Chinese children with supernumerary teeth in the maxillary incisor area

AIM

To search for variants of PAX6 gene in patients with nonsyndromic supernumerary teeth in the maxillary incisor area (NSST) and compare genotypes and allele frequencies of the detected polymorphisms between the patients and controls.

DESIGN

Twenty children with NSST and 31 controls were included. Genomic DNA was extracted from buccal epithelial cells of each individual. Sequencing analysis of all exons and exon/intron boundaries of PAX6 gene were performed in patients. Genotypes and allele frequencies of the single nucleotide polymorphisms detected in patients were compared between the two groups using chi-square tests.

RESULTS

Of the 20 patients examined, six showed heterozygous for rs667773 and rs3026393 simultaneously. Among them, four possessed two supernumerary teeth and the other two possessed one. Another six patients showed heterozygous for rs3026393, five of which possessed only one supernumerary tooth and the other one possessed two. Of another six patients with homozygous rs3026393, three possessed one supernumerary tooth and the other three possessed two. The distributions of genotypes and alleles frequencies of single nucleotide polymorphisms rs667773 and rs3026393 showed no significant difference between the two groups.

CONCLUSIONS

The present study did not find evidence of PAX6 polymorphisms being associated with supernumerary teeth in the population studied.

Factors associated with dental behaviour management problems in children aged 2-8 years in Beijing, China

AIM

This study determined the prevalence of children's dental behaviour management problems (BMP) in our clinic, investigated the influence of non-dental and dental background variables on BMP, and analysed the predictive power of these variables.

DESIGN

The study group included 209 children aged 2-8 years who received dental treatment. Interviews were conducted with accompanying guardians. Children's dental behaviour was rated by a modified Venham's clinical anxiety scale and a cooperative behaviour rating scale. Regression models were used to analyse behavioural and interview data and to calculate the power of background variables to predict children's dental behaviour.

RESULTS

During the first treatment, 29.7% of children displayed BMP. Four variables were found to predict BMP in 87.9% of cases. The risk factors for BMP were younger age, negative guardian expectations of the child's behaviour during treatment, anxiety or shyness around strangers, and presence of toothache. Children aged 2.5-3.5 years who attended kindergarten showed better dental behaviour than those who did not.

CONCLUSIONS

This study is the first to report BMP prevalence in mainland China. Our results indicate that a simple pre-treatment interview could provide data allowing the dentist to identify children with special dental behavioural needs.

[Establishment of permanent tooth germ missing animal model and study on root resorption of the corresponding deciduous teeth]

OBJECTIVE

To establish the permanent tooth germ missing animal model for future research on the root resorption of deciduous tooth in the absence of permanent tooth germ.

METHODS

The permanent tooth germ missing animal model was established by surgical removal of the permanent tooth buds in a male 11-week-old Beagle dog. Root resorption of the deciduous teeth without permanent successors was observed by taking periapical films periodically,and compared with physiological root resorption. Once the sign of root resorption of the deciduous teeth without permanent successors was detected on radiographic films, the animal was sacrificed and the mandibular bone was collected for histological study.

RESULTS

Root resorption of the deciduous teeth with the presence of permanent tooth germ started at 20 weeks after birth, while root resorption of deciduous teeth without permanent tooth germ started 26-27 weeks which was significantly delayed. Histological studies showed that a large number of multinucleated giant cells were present on the pulpal surface of the root, while only few of them were seen on the outer surface.

CONCLUSION

The permanent tooth germ missing animal model was successfully established in this study which simulated the case of congenital absence of permanent tooth germ in human. Root resorption of deciduous tooth without permanent tooth germ was significantly delayed than the deciduous tooth with permanent tooth germ.

[Clinical analysis of simple hypodontia]

OBJECTIVE

To compare and analyse the distribution and characteristic of born missing teeth.

METHODS

A total of 183 simple hypodontia patients was reviewed and statistically analysed.

RESULTS

There was no significant difference in the number of missing teeth between different sexs (P > 0.05), and there was also no significant difference in the number of missing teeth among different sites (maxilla, mandible or left and right sides) (P > 0.05). The mandibular second premolar was the most frequently missing tooth. The missing molars were more commonly seen in oligodontia patients who had six missing teeth or beyond than hypodontia patients with less than six missing teeth (P < 0.05).

CONCLUSIONS

Each hypodontia patient has his own clinical manifestation, and appropriate treatment should be planed accordingly for these patients.

[Experimental study of compomer sealant with non-rinse conditioner used on permanent molar]

OBJECTIVE

To compare the microleakage of compomer sealant with non-rinse conditioner and resin sealant with phosphoric acid (35%) by dye test and scanning electron microscope (SEM) observation.

METHODS

16 extracted third permanent molars were divided into 4 groups: Group I, non-rinse conditioner (NRC) + Prime & Bond NT + Dyract seal; Group II, phosphoric acid (35%) + Concise sealant; Group III, phosphoric acid (35%) + Dyract seal; Group IV, NRC + Prime & Bond NT + Concise sealant. The teeth were then coated with nail polish, placed in a 50% AgNO3 dye for 18 hours, and sectioned with a diamond saw. SEM observation was performed to evaluate microleakage in the teeth.

RESULTS

Silver nitrate penetration was found in each group. The percentage of microleakage in group I was higher than that in group II, and group IV was higher than that in group II (P < 0.01). The percentage of microleakage of resin sealant with phosphoric acid was lower than that in compomer sealant with NRC (P < 0.01). On SEM observation, resin tags and few gaps were found in groups with phosphoric acid. Some gaps and bubbles were found at the bottom of the fissures, particularly in the narrow fissures because of the failure of sealant penetration.

CONCLUSION

Resin sealant used with phosphoric acid was better than compomer sealant with NRC on microleakage.

[Risk factors of alveolar bone loss of primary teeth]

OBJECTIVE

To study the risk factors of alveolar bone loss (ABL) of primary teeth in Chinese children.

METHODS

Caries, restoration, food impact, pulp pathosis, calculus, and periodontal status were examined in 106 children aged 3-10 years old. Bite-wing radiographs of posterior teeth were scanned into computer. The distance from the cemento-enamel junction to alveolar bone crest was measured from the mesial surface of the first primary molar to the distal surface of the second primary molar using Adobe Photoshop 5.0 image analyzing system. ABL was recorded if the distance was more than 2 mm and the lamina dura was absent. All patients were divided into ABL group and non-ABL group. All data were analyzed by SPSS 10.0.

RESULTS

Alveolar bone loss was found in 31 children (29%). Most of the affected areas were located at the proximal surface of primary molars. The mean of dmft and proximal dmft in ABL group were higher than those in non-ABL group (P < 0.01). Logistic regression also confirmed that proximal caries was high related factor. Inadequate restoration, and pulp pathosis were also related to alveolar bone loss in primary tooth.

CONCLUSION

In children, alveolar bone loss was mainly associated with local factors such as proximal caries, inadequate restoration, and pulp pathosis. Caries and pulp pathosis might be treated in time. Children with bone loss should be re-examined regularly.

[A study on initial colonization of Mutans streptococci on teeth in infants and toddlers]

OBJECTIVE

To investigate the initial colonization of Mutans streptococci (MS) on teeth of children.

METHODS

Dental plaque was collected from 123 children aged from 7 to 42 months. MS was isolated by culturing on selective medium and identified by biochemical tests.

RESULTS

MS was detected in 51 of 123 children. The rate of colonization was 41.5%, and the mean age of colonization was 29 month. The incidence of MS infection increased with age and tooth eruption, and reached peak at 25 - 31 months, which was statistically significant. There was a correlation between infection of MS and dental caries.

CONCLUSION

The results indicate that the susceptive period of MS infection is from 25 to 31 months when the second primary molars erupt. MS infection is associated with dental caries.

[A study of fluoride and dexamethasone affecting the expression of growth factors in osteoblast]

OBJECTIVES

Investigate the expression of growth factors or receptors in osteoblast, to understand the possible mechanism of low dose fluoride and dexamethasone on the development and differentiation of osteoblast.

METHODS

Investigate the expression of platelet derived growth factors (PDGF-A) and insulin-like growth factors (IGF-I-Ralpha) in osteoblast cultured in vitro by immunohistochemistry, furthermore, to deal with the results by image analysis.

RESULTS

There were no significant effects of PDGF-A both of low doses fluoride and dexamethasone treated on the MC3T3-E1 osteoblast during the various stages of the development. Otherwise, the expression of IGF-I-Ralpha might increase treated with them at the early stage of the cell culture, and dexamethasone did more significantly.

CONCLUSION

Low doses of fluoride or dexamethasone may promote the expression of IGF-I-Ralpha in osteoblast precursors, which maybe contribute to the effects of fluoride and dexamethasone on the proliferation and differentiation of osteoblast.

[A study of fluoride and dexamethasone affecting the proliferation in osteoblast]

OBJECTIVE

Investigate the effects of low dose of fluoride and dexamethasone on the proliferation of MC3T3-E1 osteoblast cell line in vitro, which was for determining the possible effects of fluoride and dexamthasone affecting the development and differentiation of osteoblast.

METHODS

Observe the growing shape of MC3T3-E1 osteoblast cultured in vitro, and investigate the effects of low dose of fluoride and dexamethasone on the proliferation of osteoblast by cell count.

RESULTS

MC3T3-E1 osteoblast grew stably. The cells in D group increased obviously in the early stage of the cell culture, however the cells in F group had no tendency of increasing during the whole culture.

CONCLUSION

In vitro low doses of dexamethasone may promote the proloferation of osteoblast precursors,however,low dose of fluoride has no effect on promoting proliferation of MC3T3-E1 osteoblast.

[The characters on histopathological changes in dental fluorosis]

The microradiography SEM and TEM were used ton observe histopathological changes in dental fluorasis with various degrees in this study.The characters of histopathological changes of dental fluorasis are:(1) the lesios appear in exterior layer of enamel,not excess one third enamel.(2)the future of the lesion is enamel-hypoplasia,enamel rods were hypomineralized.the space among enamel rods widen and form some cavities.There are a lot of spaces in intercrystlines.Many micropores and injures exhibit on enamel surface.(3)the clinic severe degree of lesion is similar to the histopathological changes.It could be indicated using the Dean's and the TF index.