To investigate the clinical effect of periodontal endoscope-assisted scaling and root planing (SRP) in treating advanced periodontitis.

Nineteen cases of grade Ⅲ and Ⅳ periodontitis selected from June 2017 to January 2019 in the Nanjing Stomatological Hospital, Medical School of Nanjing University were divided into the periodontal endoscope and control groups. In the periodontal endoscope group, SRP was performed under a periodontal microscope in one treatment after initial supragingival scaling; in the control group, SRP was performed under regular conditions, and additional SRP was conducted in positive bleeding on probing sites twice every other week as needed. Periodontal status, including probing depth (PD), bleeding on probing (BOP) and attachment loss (AL), was recorded by a Florida probe.

For sites of 4＜PD ≤ 6 mm, there was no significant difference in PD-and BOP-positive rates or AL between the two groups at baseline. The PD-and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. PD in the endoscope group was smaller than that in the control group at 3 months (P ＜ 0.05). There was no significant difference between the two groups at 6 months (P ＞0.05). There was no significant difference in the BOP positive rate or AL change between the two groups at 3 months and 6 months (P ＞ 0.05). For sites with PD ＞ 6 mm, at baseline, the positive rates of PD, BOP and AL in the endoscope group were more serious than those in the control group, and the differences were statistically significant. The PD-and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. However, PD in the endoscope group became shallower than that in the control group (P ＜ 0.05) after 3 and 6 months. There was no significant difference in the BOP positive rate or AL between the two groups (P ＞ 0.05).

When compared to regular SRP, periodontal microscope-assisted SRP achieves better improvement in PD and is more beneficial for reducing the BOP and AL of deeper sites.

To explore the influence of impacted maxillary central incisor on craniofacial structure and its orthodontic treatment.

A total of 63 subjects with impacted upper central incisors were selected and categorized into the mixed (n = 32) and permanent dentition group (n = 31). By using the lateral cephalograms of each subject, 15 angular and 6 linear measurements were made. The cephalometric data were analyzed and compared to data of its corresponding control group with normal occlusion.

Among the etiological factors of all 63 cases with impacted upper incisors, supernumerary teeth, dentigerous cyst or odontoma, mechanical trauma and idiopathic factors comprise of 6.3%, 6. 3%, 12. 4% and 73% respectively. Cephalometric analysis demonstrated a more retruded position of "A" point with decreased SNA and ANB angle in incisor impaction group. Dental compensations followed the decreased ANB angle with more proclined upper incisor and more upright lower incisor. In early stage of root development (stage 7 and 8 of Nolla's method), 12 out of 13 incisors were tracted successfully, whereas in late stage (stage 9 and 10), 7 out of 15 incisors were extracted.

Upper central incisor impaction adversely influences maxillary development. Early orthodontic treatment can improve successful rate and gain a better root morphology.

To explore the clinical efficacy and imaging changes of minimally invasive nonsurgical periodontal therapy (MINST) assisted by endoscopy for deep intrabony defects and to compare its effectiveness with that of traditional scaling and root planning (SRP) to therefore provide a reference for clinical periodontal treatment.

Patients with deep intrabony defects ≥ 4 mm in size were selected and divided into two groups: the MINST (MINST, 20 cases, 81 sites) group and the classic scaling and root planing (SRP, 20 cases, 80 sites) group. Before treatment and 12 and 24 months after treatment, probing depth (PD) and clinical attachment loss (CAL) were examined. Moreover, changes in the depth and angle of the intrabony defects were analyzed. Follow-up examination and maintenance treatment should be conducted every 3 months for 12 months after the initial treatment and every 6 months thereafter until 24 months.

The PD and CAL of patients in both groups continued to decrease (P＜0.001), and imaging examinations revealed a decrease in defect depth and an increase in intrabony defect angle (P＜0.001). The changes in the first 12 months were significantly greater than those in the last 12 months in both groups (P＜0.001). The decreases in PD, CAL, and depth of intrabony defects and increase in angle in the MINST group were significantly greater than those in the SRP group (P＜0.001). At 12 and 24 months after treatment, the PD and CAL in the MINST group were lower than those in the SRP group (P＜0.001). The defect height of the MINST group decreased more than that of the SRP group (P＜0.001), and the defect angle of the MINST group increased more than that of the SRP group (P＜0.001).

Minimally invasive nonsurgical periodontal therapy can significantly promote the healing of deep intrabony defects and the regeneration of alveolar bone. Imaging reflects that alveolar bone healing is rapid at first and then slows. Compared with traditional SRP, endoscopically assisted MINST can yield better clinical indicators and imaging changes in intrabony defects.