[Comfortable initial periodontal therapy: step by step]

With the transition of the medical model from the traditional biomedical model to the biopsychosocial one, there is a growing trend and requirement for oral operations that prioritize comfort, pain management, minimally invasive techniques, and visualization. Consequently, demands for comfortable dental treatments among individuals are increasing. However, initial periodontal therapy is often accompanied by pain, and patients' reactions to pain range from nervousness to dental fear, such as irritability, hyperventilation, even nausea, vomiting, and refusal to cooperate, which make the implementation of initial periodontal therapy difficult or even impossible. This article will focus on three key steps: firstly, the preparation of the clinic, the acquisition of patients' trust and the implementation of preventive sedation before treatment; secondly, the use of comfort operation and nursing, psychological intervention measures, local anesthesia, and sedation techniques during treatment; thirdly, the health education and follow-up after treatment. By addressing these aspects, we aim to clarify how to perform comfortable initial periodontal therapy step by step.

[Association of urinary cadmium level with body mass index and body circumferences among older adults over 65 years old in 9 longevity areas of China]

Objective: To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China. Methods: Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model. Results: The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI (Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference (Plinear<0.001), hip circumference (Plinear<0.001), and calf circumference (Plinear<0.001). Conclusion: Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.

[Advances in assessment methods of midpalatal suture and its clinical application]

Rapid palatal expansion is commonly uesd to correct maxillary transverse deficiency. The timing and effects of palatal expansion, and the choice of palatal expansion devices are related to the condition of midpalatal suture. Nowadays, there are several methods to assess the condition of midpalatal suture, including physiological age, skeletal age, occlusal film, CT, ultrasonography and so on. This narrative review seeks to review these methods for assessment of midpalatal suture.

[Introduction and interpretation of the European Federation of Periodontology S3 level clinical practice guideline for treatment of periodontitis]

2018 international classification of periodontal and implant diseases relates the classifications with the approaches of prevention and treatment based on the stages and grades of disease. European Federation of Periodontology (EFP) evaluated the available evidences following the methodological guidance of the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE), and published the EFP S3 level clinical practice guideline for the treatment of stage Ⅰ-Ⅲ and Ⅳ periodontitis in 2020 and 2022, respectively. The present manuscript gives introduction and interpretation based on the EFP S3 level clinical practice guideline and Chinese national conditions. On the base of the diagnostic key points of staging and grading, it introduces in detail the step treatment procedures of stageⅠ-Ⅲ periodontitis as well as the multi-disciplinary treatment procedures of stage Ⅳ periodontitis, compares the similarities and differences between the step and phase procedures, and then proposes a strategy for determining the recall interval more suitable for Chinese clinicians. The present manuscript aims to help dentists to learn and grasp the key points more quickly and accurately on the clinical application of the guideline and to assist them in making the optimal treatment plans after judging and evaluating the specific clinical circumstances, so as to maximize the chances of favorable outcome.

[Advance and review: miniscrew-assisted rapid palatal expansion]

Rapid palatal expansion (RPE) is commonly used to correct transverse maxillary deficiencies and recognized as a reliable orthopedic procedure in children and adolescents. For adults, however, conventional RPE has been considered rarely successful and can produce undesirable dental effects. Along with the development of digital techniques and mini-implant anchorage, a novel method called miniscrew-assisted RPE (MARPE) has become available for the treatment of maxillary transverse deficiency in older patients recently. In this article, the biomechanical principles and indications of MARPE, the advances in device design, the clinical effects, the matters needing attention and limitations of this method, and the stability after expansion are discussed.

[Status on sexual partners among men who have sex with men among college students in Qingdao, 2016]

Objective: To investigate the situation of sexual partners and related factors among men who have sex with men (MSM) in college students. Methods: Snowball sampling and Convenience sampling were both used to recruit MSM from colleges in Tsingtao in 2016. Questionnaire-based interviews were conducted to collect data of socio-demographic and situation of sexual partners. Sample Size was estimated based on cross-sectional study, and theoretical 267. SPSS 17.0 software was used for statistical analysis. Results: A total of 300 MSM, average aged 20.7, were analyzed. Both first sex partner and the last same-sex sexual partner were met instantly, with proportions as 58.7% (176/300) and 62.3% (187/300) respectively. Among all the MSM, 88.3% (265/300) preferred selecting men as sex partners and 42.7% (128/300) enjoyed finding sex partners in college, while 86.0% (258/300) preferred finding their sex partners through internet. Conclusions: Internet had been the major way of looking for sex partner among MSM in college students, the male sexual partner were met instantly. We should focus on men who have sex with men and their sexual health among college students to prevent and control HIV/AIDS.