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Conventional treatments for chronic periodontitis are less effective in controlling inflammation and often relapse. Therefore, it is necessary to explore an immunomodulatory medication as an adjuvant. Ginsenoside Rb3 (Rb3), one of the most abundant active components of ginseng, has been found to possess anti-inflammatory and immunomodulatory properties. Here, we detected the anti-inflammatory effect of Rb3 on Porphyromonas gingivalis LPS-stimulated human periodontal ligament cells and experimental periodontitis rats for the first time. We found that the expression of pro-inflammatory mediators, including IL-1β, IL-6 and IL-8, upregulated by lipopolysaccharide (LPS) stimulation was remarkably downregulated by Rb3 treatment in a dose-dependent manner at both transcriptional and translational levels. Network pharmacological analysis of Rb3 showed that the mitogen-activated protein kinase (MAPK) signaling pathway had the highest richness and that p38, JNK, and ERK molecules were potential targets of Rb3 in humans. Western blot analysis revealed that Rb3 significantly suppressed the phosphorylation of p38 MAPK and p65 NF-κB, as well as decreased the expression of total AKT. In experimental periodontitis rat models, reductions in alveolar bone resorption and osteoclast generation were observed in the Rb3 treatment group. Thus, we can conclude that Rb3 ameliorated Porphyromonas gingivalis LPS-induced inflammation by inhibiting the MAPK/AKT/NF-κB signaling pathways and attenuated alveolar bone resorption in experimental periodontitis rats.

ObjectiveThe purpose of this study was to assess periodontal health conditions among 55- to 74-year-old Chinese people and to analyze the factors associated with periodontal diseases.Materials and methodsIn total, 9054 subjects aged 55–74 years were enrolled from all 31 provinces using a stratified multistage probability sampling method, autonomous regions and municipalities of the Chinese mainland, the response rate was 86.9%. All subjects underwent clinical examinations on the severest site for every tooth and completed a questionnaire that collected information on their sociodemographic characteristics and oral habits. T tests, chi-square tests and binary logistic regression analysis were performed to analyze the data.ResultsThe percentage of people without bleeding on probing, probing depth ≥ 4 mm and attachment loss > 3 mm was 5.0 and 9.3% in the 55- to 64-year-old and the 65- to 74-year-old age group. The prevalence of bleeding on probing was 88.4% among 55 to 64 years old and 82.6% among 65 to 74 years old. Mean number of teeth with bleeding on probing were 13.87 among 55 to 64 years old and 11.25 among 65 to 74 years old. The prevalence of probing depth ≥ 4 mm and attachment loss > 3 mm were 69.3 and 69.9% in people aged 55–64 years and were 64.6 and 74.2% in people aged 65–74 years. Mean number of teeth with probing depth = 4–5 mm and probing depth ≥ 6 mm were 4.48 and 0.36 in 55–64 age group and 3.70 and 0.33 in 65–74 age group. And mean number of teeth with attachment loss > 3 mm were 5.17 among 55 to 64 years old and 5.63 among 65 to 74 years old. Besides, attachment loss > 3 mm was associated with age, gender, smoking, toothbrushing frequency and toothpick use.ConclusionsPeriodontitis was not highly prevalent among 55- to 74-year-old Chinese adults. Age, gender, smoking, toothbrushing frequency and toothpick use could be risk factors.Clinical relevanceScientific rationale for the study: The periodontal conditions among 55 to 64 and 65 to 74 years old Chinese population were not highly serious, but prevalence of bleeding on probing, periodontal pockets and attachment loss should be drawn enough attention by relevant public health administrations.Principal findings: The prevalence of periodontal diseases was evaluated in 55- to 64-year-old and 65- to 74-year-old subjects in a nationally representative Chinese sample population. The prevalence of probing depth ≥ 4 mm and AL > 3 mm were high; these values were 69.3% and 69.9%, respectively, in the 55–64 age group and 64.6% and 74.2%, respectively, in the 65–74 age group. In addition, case percentage of AL = 4–5 mm combined with PD < 6 mm were 23.1 and 19.4% among 55- to 64-year-old and 65- to 74-year-old people. And case percentage of AL> 5 mm combined with PD ≥ 6 mm were 11.1% and 12.1% among 55- to 64-year-old and 65- to 74-year-old people, respectively.Practical implications: The present study provides a reference for the epidemiological analysis of periodontal diseases. To reduce widespread inadequate treatment of periodontal diseases, clinical management should be performed in dental practices. Furthermore, oral health recommendations should be made at multiple levels.

Background To verify the validity of diagnosing initial caries on occlusal surface of permanent posterior teeth by laser fluorescence instrument DIAGNOdent pen. Methods Patients from School of Stomatology in Wuhan University were selected and their posterior teeth were examined using DIAGNOdent pen and the International Caries Detection and Assessment System (ICDAS II) by an experienced dentist. After teeth extraction, histological criteria were used to determine the severity of the lesions. The sensitivity, specificity, accuracy, the area under the curve (AUC), and correlation of DIAGNOdent pen and ICDAS II were analyzed compared with histological criteria. Examiners’ agreement was measured. Results The sensitivity range was 0.440-1 while that of specificity was 0.750–0.994. The accuracy and AUC were above 80% and 0.7 respectively. Consistency of examiners’ kappa values of ICDAS II, DIAGNOdent pen, and histological criteria were ranged from 0.629 to 0.840. Conclusions ICDAS II and DIAGNOdent pen can be effectively used in tandem or independently for the assessment of initial caries.

Periodontitis is a worldwide oral disease induced by the interaction of subgingival bacteria and host response and is characterized by local inflammation, bone resorption, and tooth loss. Ginsenoside Rd (Rd) is a biologically active component derived from Panax ginseng and has been demonstrated to exert antibacterial and anti-inflammatory activities. This study aims to investigate the inhibitory efficiency of Rd towards Porphyromonas gingivalis ( P. gingivalis ), periodontal inflammatory response, and osteoclastogenesis in vitro and to further validate the results in a mouse periodontitis model, thus, evaluate the potential effects of Rd on the control and prevention of periodontitis. According to the results, Rd exerted excellent antibacterial activities against planktonic P. gingivalis , along with attenuating P. gingivalis virulence and inhibiting its biofilms. Meanwhile, the inflammatory cytokine production and osteoclastogenesis were remarkably inhibited by Rd both in vitro and in vivo . Furthermore, Rd efficiently ameliorated the subgingival P. gingivalis abundance and suppressed the alveolar bone resorption in vivo as well. In conclusion, Rd has the potential to be developed as a promising medication in the control and prevention of periodontitis.

Numerous epidemiological studies have focused on the prevalence and related indicators of tooth wear. However, no sufficient studies have been conducted with Chinese adults. The purpose of this study was to assess the prevalence of tooth wear and identify related indicators among adults aged 36 to 74 years in Wuhan City, P.R. China. A cross-sectional and analytic study was conducted with 720 participants, aged 35-49 yrs and 50-74 yrs, in 2014. Each age group included 360 participants, of which 50% were males and 50% were females. All participants completed a questionnaire before examination. Tooth wear was assessed using the modified Basic Erosive Wear Examination (BEWE) index. The data were analyzed using the chi-square test and binary logistic regression analysis. The prevalence of tooth wear was 67.5% and 100% in the 35-49 and 50-74 age groups, respectively. The prevalence of dentin exposure was 64.7% and 98.3%, respectively. A significantly higher prevalence of tooth wear and dentin exposure was found in the 50-74 yr group than in the 35-49 yr group (p < 0.05). Critical indicators of tooth wear and dentin exposure included high frequency of acidic drinks and foods consumption, low socio-economic status, and unilateral chewing. The frequency of changing toothbrushes and the habit of drinking water during meals were associated with tooth wear. In addition, the usage of hard-bristle toothbrushes and consuming vitamin C and aspirin were found to be linked with dentin exposure. In conclusion, the prevalence of tooth wear and dentin exposure observed in Chinese adults was high, and the results revealed an association between tooth wear and socio-behavioral risk indicators.

Knowledge of the polymicrobial etiology of root caries is limited. To conduct a comprehensive research study on root caries, we utilized 454-pyrosequencing of 16S rRNA gene libraries and quantitative PCR to compare supra-gingival bacterial communities from healthy sites and carious sites of 21 patients with root caries (Patient-controls and Patient-cases) and the sites of 21 healthy individuals (Healthy-controls) from two nursing homes. Healthy-controls and Patient-cases showed no significant differences in terms of biomass, species richness, and species diversity. However, as for beta diversity based on either community membership metric (unweighted UniFrac) or community structure metric (weighted UniFrac), Healthy-controls and Patient-cases were clearly distinguished from each other, appearing more variable in the community membership and structure in root caries microbiome but relatively conserved in the health microbiome. The Patient-controls group was at an intermediate stage between Healthy-controls and Patient-cases, but was more inclined to the former. Demonstrated in both relative abundance and prevalence of species in health and root caries, Propionibacterium acidifaciens, Streptococcus mutans, Olsenella profusa, Prevotella multisaccharivorax, and Lactobacillus crispatus were found to be most associated with root caries, whereas Delftia acidovorans, Bacteroidetes[G-2] sp., Lachnospiraceae[G-3] sp., and Prevotella intermedia are most associated with health. Our study provides a basis for further elucidating the microbial etiology of root caries in the elderly.

Background The ex vivo study is to compare the root canal preparation outcomes achieved by five nickel–titanium single-file instrumentation systems (M3-L, Reciproc Blue, V-Taper 2H, WaveOne Gold, XP-endo Shaper) in severely curved molar root canals. Methods A total of 60 root canals were selected from extracted human molar teeth with curvatures ranging from 25° to 50° and divided into five groups based on the instrumentation system employed (n = 12). Before and after root canal preparation, a Micro-CT scan was taken, and pre- and post-operative data were analyzed to evaluate the following parameters: volume increment of root canals (VI), untouched root canal areas (UTA), and canal transportation (CT). Apically extruded debris (AD) was collected during preparation. After that, all samples were separated into two parts and examined respectively by scanning electron microscope (SEM) to assess cleaning ability. Data were statistically analyzed with ANOVA (UTA, AD, VI) or Kruskal–Wallis test (CT, SEM-score), the level of significance was set at α = 0.05. Results There were no significant differences between the five systems regarding the AD, VI, and UTA parameters ( P  > 0.05). In terms of CT, no significant difference was noted at the straight section of canal and apical levels, while XP-endo Shaper showed less canal transportation than M3-L at the level of curved vertex ( P  < 0.05), and the centering ability of V-Taper 2H was significantly better than WaveOne Gold at the initial point of bending ( P  < 0.05). Debris and smear layers were present on the canal walls of all specimens, the apical thirds of the canal presented higher SEM scores than the coronal thirds in all groups ( P  < 0.05). Reciproc Blue and XP-endo Shaper showed fewer smear scores than WaveOne Gold in the apical thirds ( P  < 0.01 and P  < 0.05, respectively), and no statistical difference was found between other groups in the middle and coronal thirds. Conclusion The five single-file systems evaluated performed equally in apically debris extrusion, dentin removal, and untouched root canal areas, while XP-endo Shaper and V-Taper 2H resulted in less canal transportation compared to M3-L and WaveOne Gold. Regarding cleaning ability, Reciproc Blue and XP-endo Shaper were associated with less smear layer than WaveOne Gold in the apical thirds.

Background Streptococcus , Bifidobacteria , Lactobacillus and Actinomyces are acidogenic aciduria that may be associated with root caries (RC). The aim of the study was to analyze Streptococcus mutans ( S. mutans ), Streptococcus sobrinus ( S. sobrinus ), Bifidobacterium spp., Lactobacillus spp. and Actinomyces naeslundii ( A. naeslundii ) in the saliva of nursing home elderly, to assess the correlation between bacterial composition and RC for five putative catiogenic organisms. Methods In this study, we collected 43 saliva samples and divided into two groups: the root caries group (RCG, n = 21) and the caries-free group (CFG, n = 22). Bacterial DNA was extracted from the saliva samples. The presence and abundance of the five microorganisms were detected by Quantitative real-time PCR (qPCR). Spearman correlation test was performed to evaluate the relationship between the numbers of root decayed filled surfaces (RDFS) and root caries index (RCI) and salivary levels of the bacteria. Results The salivary levels of S. mutans , S. sobrinus , Bifidobacterium spp. and Lactobacillus spp. were significantly higher in RCG than in CFG (p < 0.05). RDFS and RCI (RDFS/RCI) were positively associated with salivary levels of S. mutans , S. sobrinus and Bifidobacterium spp. (r = 0.658/0.635, r = 0.465/0.420 and r = 0.407/0.406, respectively). No significant differences in presence and amounts of A. naeslundii was observed between the two groups (p > 0.05). Conclusion S. mutans , S. sobrinus and Bifidobacterium spp. in saliva appear to be associated with RC in the elderly. Taken together, the findings indicate that specific salivary bacteria may be involved in the progression of RC.

To investigate the usage of a water jet for enamel drilling ex vivo , 210 individual extracted molars without lesions or fillings were collected. Then, the specimens were drilled by a water jet or a high-speed dental drill. The cavities of 50 teeth were reconstructed digitally by micro-computed tomography (micro-CT) to measure the height and width. The cavities of 10 teeth were longitudinally incised and their surfaces were observed by scanning electronic microscopy (SEM). After the cavities were filled, 50 fillings were vertically incised. The bonding interface between tooth and filling was observed by SEM. 50 teeth with fillings were stained in 0.1% rhodamine B solution, and then the dye penetration between tooth and filling was observed under the stereomicroscope and confocal laser scanning microscopy (CLSM). The bonding strength between enamel and filling of 50 teeth was simulated and predicted with finite element analysis (FEA). At 140–150 MPa and for 2–3 s, cavities were made with a depth of approximately 764 μm in each tooth. SEM showed the cavity surface in the water jet group had a more irregular concave and convex structure than that in the high-speed dental drill group. There was a trend that the microleakage and bonding width was smaller in the water jet group than in the high-speed dental drill group. FEA indicated that the stress on the resin surface was greater than on the enamel surface in the water jet group. Compared with the tooth drilled by a high-speed dental drill, the tooth drilled by a water jet gained better retention of the filling material and suffered less bonding strength on the enamel surface. Water jet drilling is effective for enamel drilling.

Background The sudden outbreak of coronavirus disease (COVID-19) epidemic influenced people’s daily life. During lockdown of Wuhan city, the oral health and its associated issues of preschool children were investigated and guidance for dental clinics when the epidemic were controlled in the future were also provided. Methods A national online survey was conducted among preschool children and completed by their caregivers. The questionnaire related to children’s oral health status and care behaviour, caregivers' attitudes. The information was statistically analyzed between Wuhan residents and others residents. Results 4495 valid questionnaires were collected. In oral health status, during Wuhan lockdown, 60.8%, 35.5% and 18.3% children had self-reported dental caries, toothache and halitosis respectively. In oral health attitudes, respondents who would increase attention to oral health was more than that would decrease. In oral hygiene behaviour, compared to non-Wuhan children, the children in Wuhan became more active in brushing their teeth. In utilization of dental services in the future, less Wuhan residents would choose to have dental visit directly, 28.5% Wuhan residents and 34.7% non-Wuhan residents agreed all of procedures could be done if proper protected. Conclusions Oral health status and associated issues of preschool children in Wuhan were significantly different from that of others during lockdown of Wuhan city and in the future. Effective measures should be taken as early as possible to protect children's oral health.