IgG4-related sialadenitis (IgG4-RS) is a type of autoimmune disease that has been recognized in recent years, and the pathogenesis remains unclear. IgG4-RS mainly affects the submandibular gland and parotid gland and is characterized by diffuse painless swelling of the bilateral salivary glands and/or lacrimal glands, usually lasting more than 3 months. Some patients have accompanying hearing loss or hearing impairment, sinusitis, lymphadenopathy and other symptoms; nearly half of patients have different degrees of salivary gland secretion disorders. Most patients have elevated serum IgG4 levels, but they cannot be used as the only marker for diagnosis. Histopathology remains the “gold standard” for diagnosis. Presently, submandibular gland biopsy is often used for diagnosis. Histopathology showed lymphoplasmacytic infiltration, occlusive phlebitis, striated fibrosis; immunohistochemistry showed IgG4+/IgG+ plasma cells >40%, and IgG4+ plasma cell/high-power field vision > 10. Glucocorticoids are regarded as first-line drugs for the treatment of this disease. Clinically, glucocorticoids are often combined with immunosuppressive agents such as cyclophosphamide, but no standard drug regimen exists. Most patients have a significant short-term treatment effect, and the long-term prognosis requires further study. Patients with a recurrence tendency should adjust the hormone dose over time. In the future, further research is needed regarding the pathogenesis and treatment of the disease to improve the clinical diagnosis rate and therapeutic effect.
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Open Access
Review Article
Issue
Open Access
Basic Study
Issue
To investigate the effects of platelet-rich fibrin (PRF) and acellular dermal matrix (ADM) on the repair of oral mucosal defects and to provide the basis for soft tissue growth in oral implant operations.
Thirty-six healthy male Japanese big ear rabbits were randomly divided into the PRF group, ADM group, Autograft group (autologous connective tissue transplantation group) and Control group (blank control group); each group contained nine rabbits. Between the midline and the hard palate maxillary incisors, in an 8-mm location preparation and a 10-mm standard mucosa defect, the ADM group, PRF and Autograft group were implanted with ADM, autologous PRF and autologous cornification mucosa, respectively, whereas the control group had wound gauze compression processing at 7, 14, and 21 days to determine the wound healing rate in the area selected by HE staining. The inflammatory grade and average epithelial thickness were observed, and the results were statistically analyzed.
Compared with the control group, the PRF, ADM and Autograft groups had significantly advanced wound healing (P < 0.05). The wound healing degree in the PRF group was similar to that of the ADM group at all time points (P > 0.05). The wound healing degree in the PRF and ADM groups was lower than that of the Autograft group at each time point (P < 0.05). HE staining results showed that compared with the control group, the levels of inflammation in the PRF group, ADM group and Autograft group were reduced, and the difference was statistically significant (P < 0.05). Nevertheless, there was no significant difference between the PRF, ADM and Autograft groups (P > 0.05). The epithelial thickness in the ADM group was similar to that in the Autograft group (P > 0.05). The epithelial thickness in the ADM group was higher than that in the PRF group at 7 d and 14 d (P < 0.05), but there was no significant difference at 21 d (P > 0.05).
PRF and ADM have similar healing effects in repairing oral mucosa defects, and they can be used as soft tissue augmentation materials instead of connective tissue transplantation.
Open Access
Clinical Study
Issue
To study the morphological characteristics of the posterior canal of mandibular molars in the Shanxi population, provide theoretical guidance for the surgical safety of the retromolar region and mandibular ramus.
A total of 400 patients in the Department of Stomatology of the First Hospital of Shanxi Medical University were randomly selected to screen the images that met the inclusion criteria. Cone beam computed tomography and digital software were used to measure the relevant data. Divide the classification of the retromolar canal, and establish a three-dimensional model of the retromolar canal. The number, distribution and course of the retromolar canals were observed and counted, and the relevant data were measured.
A total of 368 samples were included in the study, and the retromolar canal was present in 84 samples, with an incidence of 22.83%. There were 47 men and 37 women; there were 55 on the left side and 52 on the right side, with no significant difference between the gender. In this study, the mandibular angle was bounded by the posterior margin of the retromolar region, and the initial position of the retromolar canal was divided into two regions: A (mandibular ramus area) and B (retromolar area). The retromolar canal can be divided into types A1 to A5 and B1 to B4 according to its shape and course, with type A3, which starts from the mandibular ramus area and bends upward along the medial side of the mandible, being the most common, followed by type B3, and type A4 being the least common. The mean length of the retromolar canal was (10.95 ± 2.76) mm, the mean diameter of the starting position was (1.22 ± 0.50) mm, the mean diameter of the retromolar foramen was (1.05 ± 0.39) mm, and the mean distance from the retromolar foramen to the distal enamel cementum boundary of the third molar was (9.50 ± 3.66) mm.
The incidence of retromolar canals is high in the population of Shanxi Province. It is necessary to note the presence of these canals in order to avoid intraoperative and postoperative complications when performing surgery on the retromolar region and mandibular ramus.
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