Horizontal alveolar bone resorption is common following tooth loss in the posterior mandible. Selecting an appropriate bone augmentation strategy is key to ensuring the long-term success of implant restoration. This article innovatively proposes a defect morphology-based classification system, categorizing bone defects into potential, favorable, partially favorable, and unfavorable types by analyzing the spatial relationship between the implant position and the outer alveolar ridge contour of adjacent teeth. This classification helps assess the spatial maintenance capacity of the defect site. Based on this classification, the article systematically outlines the corresponding implant timing and augmentation technique selection for different defect categories, establishing a clear clinical decision-making pathway to provide a reference for the implant restoration workflow in the posterior mandible.
To investigate the effect of the PIEZO1-specific agonist Yoda1 on osteogenic differentiation of mesenchymal cells derived from human Schneiderian membrane (hSM).
hSM-derived cells were isolated and cultured by enzymatic digestion. Cell surface markers were identified by flow cytometry, and the expression of keratin 14 (KRT14) and cathepsin K (CTSK) was detected by immunofluorescence staining. PIEZO1 protein expression was evaluated by Western blotting, and a calciumion fluorescent probe was used to detect activation of the PIEZO1 channels by Yoda1. The effects of different concentrations of Yoda1 on the proliferation and migration abilities of hSM-derived mesenchymal cells were evaluated using CCK-8 and wound healing assays, respectively. Following osteogenic induction, the expression levels of alkaline phosphatase (ALP) gene ALPL and Runt-related transcription factor 2 (RUNX2) were analyzed by real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting. ALP staining and alizarin red S staining were performed to evaluate the osteogenic differentiation ability of the cells.
hSM-derived cells expressed mesenchymal cell surface markers and co-expressed KRT14 and CTSK proteins. PIEZO1 protein was detected in these cells, and Yoda1 effectively activated the PIEZO1 channels. Low concentrations of Yoda1 had no significant effect on cell proliferation, whereas a high concentration (10.0 μmol/L) significantly inhibited proliferation (P<0.05). No significant effect on cell migration was observed. During osteogenic induction, low-concentration Yoda1 (0.1 μmol/L) upregulated ALPL expression and enhanced ALP activity, while no significant change was observed in RUNX2 expression. Western blotting results were consistent with mRNA expression trends. ALP staining and alizarin red S staining indicated that low-concentration Yoda1 exerted a modest promoting effect on osteogenic differentiation.
Yoda1 exhibits a limited promoting effect on osteogenic differentiation of hSM-derived mesenchymal cells, and low concentrations may promote its early osteogenic differentiation.
To investigate the effects of reduced masseter muscle strength on the structure and cellular biological behavior of the mandibular condyle in mice and to preliminarily analyze the underlying mechanism.
Ten 8-week-old male C57BL/6J mice were randomly assigned to a botulinum toxin type A (BTX-A) injection group and a saline control group (n=5 per group). BTX-A or an equal volume of saline was injected bilaterally into the masseter muscles on days 1 and 14, and all animals were sacrificed 4 weeks after the first injection, and tissues were harvested. Masseter muscle morphology was observed under a stereomicroscope, and muscle weight was measured. Micro-CT was used to analyze bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular connectivity density (Conn.D), and trabecular separation (Tb.Sp) in the condylar subchondral bone. Histological changes in the condyle were examined using hematoxylin-eosin (HE), Alcian blue, tartrate-resistant acid phosphatase (TRAP), and alkaline phosphatase (ALP) staining; immunohistochemistry and immunofluorescence were performed to detect chondrocyte apoptosis and the expression of chondrogenic and osteogenic markers. In vitro, C2C12 myoblasts were subjected to cyclic tensile stretch (CTS) at different magnitudes (12%, 6%, and 0%) using a Flexcell mechanical loading system. Conditioned media were collected and co-cultured with RAW264.7 pre-osteoclast cells. Osteoclast migration and differentiation were evaluated by Transwell assay, immunofluorescence staining, and real-time quantitative polymerase chain reaction (RT-qPCR). The direct toxicity of BTX-A was assessed both in vivo and in vitro.
Compared with the control group, the masseter muscle volume and weight were significantly reduced in the BTX-A group, indicating successful establishment of the masseter weakness model. Micro-CT analysis demonstrated significantly decreased BV/TV, Tb.Th, and Conn.D, along with significantly increased Tb.Sp in the condylar subchondral bone of the BTX-A group (all P<0.05), indicating bone loss. Histological analyses revealed increased chondrocyte apoptosis and decreased expression of collagen typeⅡ (COL2) and SRY-box transcription factor 9 (SOX9) in the condylar cartilage of the BTX-A group; the number of TRAP-positive osteoclasts in the subchondral bone was significantly increased, whereas the expression of ALP and osteocalcin (OCN) showed no significant changes. In vitro experiments showed that conditioned media from C2C12 cells under low-level mechanical stretch (0% CTS) significantly promoted RAW264.7 cell migration and osteoclast differentiation and upregulated the mRNA expression of Mmp9, Nfatc1, and Trap. BTX-A showed no obvious direct toxicity to osteoclast differentiation or visceral tissues of mice.
Reduced masseter muscle strength can lead to bone loss and degenerative changes in the mandibular condyle by activating osteoclasts in the condylar subchondral bone.
To construct an Edaravone-loaded reactive oxygen species (ROS)-responsive hydrogel and to evaluate its physicochemical properties, osteogenic effects and antibacterial properties.
The composite hydrogel was prepared using the freeze-thaw cycle method. The working concentration of Edaravone was screened using the CCK-8 assay. The composition ratios were then optimized through porosity, mechanical property, swelling rate and degradation rate tests to identify the optimal composite hydrogel, and the drug release behavior and ROS scavenging ability were evaluated. The hydrogel was co-cultured with Staphylococcus aureus, and its antibacterial activity was assessed by the colony counting method. After co-culturing the hydrogel with mouse embryo osteoblast precursor cells (MC3T3-E1 cells), alkaline phosphatase (ALP) staining, alizarin red S (ARS) staining and real-time quantitative polymerase chain reaction (RT-qPCR) were used to evaluate the effects of the hydrogel on the proliferation, mineralization and osteogenesis-related gene expression of MC3T3-E1 cells.
A composite hydrogel (P3ATE) with a three-dimensional porous network structure was successfully prepared. It exhibited favorable mechanical, swelling and degradation properties, and provided sustained release of Edaravone. It demonstrated strong ROS scavenging ability (P<0.05) and good antibacterial activity, significantly inhibiting the growth of Staphylococcus aureus (P<0.05). Compared with the control group, the P3ATE hydrogel significantly promoted the proliferation and mineralization of MC3T3-E1 cells, enhanced ALP activity, and upregulated the expression of Bmp2, Spp1, Runx2 and Col1a1 (P<0.05).
The constructed Edaravone-loaded ROS-responsive composite hydrogel exhibits favorable osteogenic, antioxidant and antibacterial properties, suggesting potential application value in the repair of jaw defects.
To explore the construction model of a biobank for oral and maxillofacial malignant tumors and its application value in clinical prognosis research, and to analyze the risk factors influencing patient prognosis.
The establishment and operation of the biobank for oral and maxillofacial malignant tumors at Nanjing Stomatological Hospital were summarized. Based on this biobank, clinical data of 1 138 patients with oral and maxillofacial malignant tumors who underwent surgical treatment at the hospital from January 2013 to December 2018 were retrospectively analyzed. A clinicopathological database was established and follow-up was conducted. Overall survival rate was calculated using the Kaplan-Meier method, univariate analysis was performed using the Log-rank test, and multivariate analysis was performed using the Cox proportional hazards regression model.
A standardized biobank for oral and maxillofacial malignant tumors integrating sample collection, processing, storage, quality control, and clinical follow-up was established at our center. As of December 2023, the biobank had enrolled a total of 2 594 patients. A total of 1 138 patients were included in this study, with a mean follow-up time of 45.37±21.16 months. The overall 1-, 3-, and 5-year survival rates were 89.67%, 80.02%, and 76.04%, respectively. Multivariate analysis showed that age ≥60 years [hazard ratio (HR)=1.439, 95% confidence interval (CI): 1.108–1.868], tumor recurrence (HR=2.679, 95%CI: 1.962–3.657), and lymph node metastasis (HR=3.312, 95%CI: 2.409–4.554) were independent risk factors for overall survival (P<0.01).
The standardized biobank for oral and maxillofacial malignant tumors established at our center provides important platform support for relevant clinical and translational research. Clinical prognostic analysis based on this biobank shows that age ≥60 years, tumor recurrence, and lymph node metastasis are independent risk factors for patient prognosis, which has significant guiding value for risk stratification and individualized treatment.
To construct and validate a Nomogram model for predicting postoperative recurrence of tongue squamous cell carcinoma (TSCC) based on clinical characteristics and tumor markers.
A total of 297 patients with TSCC who underwent surgical treatment at the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2021 were enrolled in this study. Clinical data were collected, and serum levels of vascular endothelial growth factor (VEGF), prolactin (PRL), and tissue polypeptide specific antigen (TPS) were measured. All patients were followed up until January 2024, and 288 completed follow-up. According to recurrence status, patients were divided into a recurrence group (n=71) and a non-recurrence group (n=217). Multivariate Cox regression analysis was performed to identify independent risk factors for postoperative recurrence. A Nomogram model was constructed using R software based on these factors, and its predictive performance and calibration were evaluated using receiver operating characteristic (ROC) and calibration curves.
The median follow-up time of the 288 patients was 48 (41, 53) months, and the postoperative recurrence rate was 24.65% (71/288). Multivariate Cox regression analysis showed that smoking history [hazard ratio (HR)=1.685, 95% confidence interval (CI): 1.164–2.441], TNM stageⅢ (HR=1.848, 95% CI: 1.319–2.589), infiltrative growth pattern (HR=1.935, 95% CI: 1.247–3.001), undifferentiated and poorly differentiated status (HR=1.725, 95% CI: 1.163–2.557), VEGF (HR=1.870, 95% CI: 1.345–2.599), PRL (HR=1.664, 95% CI: 1.228–2.254), and TPS (HR=1.480, 95% CI: 1.127–1.943) were independent risk factors for postoperative recurrence (all P<0.01). The area under the ROC curve (AUC) of the nomogram model was 0.938 (95% CI: 0.904–0.963), with a sensitivity of 87.32% and a specificity of 89.86%. The Hosmer-Lemeshow goodness-of-fit test indicated good model fit (P>0.05), and the calibration curve demonstrated good agreement between predicted and observed outcomes. The Nomogram model showed a significantly higher AUC than the 8th edition of American Joint Committee on Cancer （AJCC） TNM staging system (AUC=0.757, 95% CI: 0.703–0.805, P<0.05).
Smoking history, TNM stageⅢ, infiltrative growth pattern, undifferentiated/poorly differentiated status, and VEGF, PRL, and TPS are independent risk factors for postoperative recurrence of TSCC. The Nomogram model based on these clinical characteristics and tumor markers demonstrated good predictive performance and may provide a reference for individualized assessment of postoperative recurrence risk in patients with TSCC.
To investigate the sedative efficacy, safety, and clinical application value of remimazolam in comfortable dental treatment.
A total of 90 patients who received treatment at the dental outpatient department of Hebei PetroChina Central Hospital from May 2023 to April 2024 were enrolled, and they were randomly divided into Group A, Group B, and Group C using the random number table method, with 30 patients in each group. Group A received local infiltration anesthesia combined with intravenous 0.9% sodium chloride solution, Group B received local infiltration anesthesia combined with remimazolam intravenous sedation, while Group C received local infiltration anesthesia combined with propofol intravenous sedation. The operative time, physiological parameters [mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO2), respiratory rate (RR), bispectral index (BIS)] at different time points [after intravenous administration (T0), during local infiltration anesthesia (T1), during treatment (T2), at the end of treatment (T3), and 2 hours after the end of treatment (T4)], Ramsay sedation scores, dental anxiety scale (DAS) scores, numerical rating scale (NRS) scores, mini-mental state examination (MMSE) scores, Kolcaba general comfort questionnaire (GCQ) scores, and the incidence of adverse reactions were compared among the three groups.
MAP, HR, RR, and BIS showed statistically significant differences in the group main effects, time main effects, and group-by-time interactions (P<0.05), while SpO2 showed no statistically significant difference (P>0.05). From T1 to T3, the MAP, HR, RR, and BIS in Groups B and C were lower than those in Group A (P<0.05), and the MAP in Group C was lower than that in Group B at T2 and T3 (P<0.05). From T1 to T3, the Ramsay sedation scores in Groups B and C were higher than those in Group A (P<0.01). From T1 to T4, the DAS scores in Groups B and C were lower than those in Group A (P<0.01), and the DAS scores in Group C at T3 and T4 were higher than those in Group B (P<0.01). At T1, the NRS scores in Groups B and C were lower than those in Group A (P<0.01). There was no significant difference in MMSE scores among the three groups before treatment or 2 hours after treatment (P>0.05). At 2 hours after treatment, the GCQ scores in Groups B and C were higher than those in Group A (P<0.01). There was a statistically significant difference in the total incidence of adverse reactions among the three groups (P<0.05) , but no significant pairwise difference was found after Bonferroni correction (P>0.05).
The sedative efficacy of remimazolam in comfortable dental treatment is comparable to that of propofol; it helps alleviate patient anxiety and pain and improve treatment comfort, with more stable hemodynamics and no significant increase in adverse reactions, demonstrating favorable clinical application value.
To compare the clinical manifestations and CT imaging features of intraosseous arteriovenous malformations (AVMs) and intraosseous venous malformations (VMs) in the jaws.
A retrospective analysis was conducted on 10 patients with intraosseous VMs of the jaws diagnosed in our hospital from May 2015 to November 2023, including 4 cases of jaw AVMs confirmed by digital subtraction angiography (DSA) or contrast-enhanced CT and 6 cases of jaw VMs confirmed by postoperative histopathology. Clinical data, including age, sex, lesion location, history of bleeding, and pain, were collected. CT imaging features, including lesion margin, internal structure, cortical bone integrity, tooth root resorption, and abnormalities of the mandibular canal, were analyzed. Fisher's exact test was used to compare imaging features between the two groups, and the diagnostic performance of different imaging features for identifying jaw AVMs was evaluated.
All 4 cases of jaw AVMs occurred in the mandible, and 2 patients had a history of bleeding. CT images showed ill-defined hypodense lesions with internal fibrous septa, and all mandibular canals on the affected side were enlarged. Among the 6 cases of jaw VMs, 5 occurred in the mandible, and none had a history of bleeding. CT images mainly showed round or oval hypodense lesions with either well-defined or ill-defined margins, and displacement of the mandibular canal was observed in 2 cases. Significant differences were found between the two groups in abnormalities of the mandibular canal and cortical bone integrity (P<0.05). Abnormalities of the mandibular canal demonstrated relatively high sensitivity and specificity for the diagnosis of jaw AVMs.
CT imaging features differ between jaw AVMs and VMs, warranting careful clinical differentiation.
To investigate the clinical efficacy of computer-aided design (CAD) fibular myocutaneous flap combined with an anterolateral thigh flap in the reconstruction of extensive mandibular osteoradionecrosis accompanied by maxillofacial soft tissue defects.
A retrospective analysis was performed on the clinical data of patients who developed bilateral mandibular osteoradionecrosis with maxillofacial soft tissue defects after comprehensive treatment for oral cancer from January 2019 to October 2024 at Zhuzhou Hospital, Affiliated to Xiangya School of Medicine, Central South University. Five males and one female were included, all with confirmed absence of tumor recurrence. CAD combined with free fibular myocutaneous and anterolateral thigh flaps was used for defect reconstruction. Flap survival, wound healing, mandibular contour restoration, and donor- and recipient-site complications were evaluated.
During a postoperative follow-up period of 6 to 12 months, all six anterolateral thigh flaps survived completely, five fibular myocutaneous flaps survived completely, and one fibular myocutaneous flap showed partial marginal necrosis of the skin island, which healed after treatment. No serious complications were observed. All patients achieved good healing of the mandible and facial soft tissues, with satisfactory postoperative facial contour restoration and essentially symmetric bilateral facial appearance.
For extensive mandibular osteoradionecrosis with maxillofacial soft tissue defects, the use of CAD combined with free fibular myocutaneous and anterolateral thigh flaps is a safe and effective reconstructive method.
To observe the clinical effect of digital three-dimensional (3D) printing combined with cone beam CT (CBCT) in assisting autogenous tooth transplantation.
A total of 40 patients who underwent autogenous tooth transplantation at Dongyang People's Hospital from January 2022 to February 2024 were selected. They were divided into a control group (20 cases, 26 teeth) and an experimental group (20 cases, 27 teeth) using a random number table method. The control group received CBCT combined with 3D digital modeling‑assisted autogenous tooth transplantation, while the experimental group received digital 3D printing combined with CBCT‑assisted autogenous tooth transplantation. The operative time, number of 3D model trials, and survival rate of transplanted teeth were compared between the two groups. Tooth mobility, probing depth, and root resorption of the transplanted teeth were followed up and compared at 1, 3, and 6 months postoperatively.
The operative time and the number of 3D model trials in the experimental group were lower than those in the control group, and the survival rate of transplanted teeth was higher than that in the control group, with statistically significant differences (P<0.05). At 1, 3, and 6 months postoperatively, tooth mobility in the experimental group was lower than that in the control group (P<0.05). The Wald test in the generalized estimating equations (GEE) showed a statistically significant time effect (P<0.001), whereas neither the between‑group effect nor the interaction effect was statistically significant (P>0.05). There was no statistically significant difference in probing depth between the two groups before surgery or at 1 month postoperatively (P>0.05); at 3 and 6 months postoperatively, the probing depth in the experimental group was lower than that in the control group (P<0.01). Repeated‑measures analysis of variance (ANOVA) indicated that both the between‑group effect and the time effect were statistically significant (P<0.05). At 6 months postoperatively, root resorption in the experimental group was better than that in the control group, with a statistically significant difference (P<0.05).
Digital 3D printing combined with CBCT‑assisted autogenous tooth transplantation can shorten operative time, reduce the number of intraoperative model trials, improve the survival rate of transplanted teeth, enhance the stability of transplanted teeth, and reduce the risk of postoperative root resorption, demonstrating good clinical application value.
Patients with periodontitis are confronted with elevated risks during implant therapy, mainly manifested as a lower implant survival rate, as well as a higher incidence and faster progression of peri-implantitis. Meanwhile, patients with periodontitis frequently present with varying degrees of soft and hard tissue defects, which further increase the complexity of implant therapy. Chronic inflammation status and oral microbiota dysbiosis are recognized as critical factors affecting the prognosis of implant therapy. Therefore, prior to implant placement, periodontitis and associated systemic diseases should be adequately controlled, and appropriate implant types as well as optimal surgical timing should be selected. Good postoperative oral hygiene management, regular follow-up and supportive periodontal therapy are of great significance for reducing the risk of peri-implant diseases and improving the long-term success rate of implants. Although patients with periodontitis face considerable challenges when undergoing implant therapy, favorable clinical outcomes can still be achieved through comprehensive treatment and meticulous management.
Cell membrane-coated nanoparticles (CMCNPs) are a class of nanoscale carriers enveloped by natural cell membranes, which efficiently preserve the abundant functional proteins and receptors on the surface of cell membranes, thereby integrating the biological properties of natural cell membranes and demonstrating good biocompatibility and targeting ability in the field of biomedicine. In treating various oral diseases such as oral cancer and periodontitis, CMCNPs have shown good potential and provided new research directions for overcoming related challenges in oral medicine, emerging as one of the forefront topics in current biomedical research. This paper focuses on CMCNPs and explores in depth the relevant mechanisms, application achievements, and existing challenges, aiming to provide a reference for the academic research and clinical translation of oral diseases such as oral cancer, periodontitis, and oral mucosal diseases.
Suppurative infection, trauma, and tumors in the maxillofacial region may cause segmental mandibular defects, resulting in loss of mandibular continuity and functional imbalance of the stomatognathic system. This report describes a case of a patient with a mandibular segmental defect who required removal of the original fixation titanium plate because of repeated postoperative infections. Based on preoperative intraoral scan data, a digitally designed and fabricated guiding flange prosthesis was used to maintain the postoperative mandibular position and occlusal relationship, providing favorable conditions for subsequent mandibular reconstruction.
Sticky bone is a composite bone graft material with adhesiveness and plasticity, prepared by mixing autologous fibrin glue (AFG) with bone powder. It has been increasingly adopted in the repair of alveolar bone defects. This paper reports the diagnosis and treatment of one case of distal bone defect of the mandibular second molar repaired by sticky bone made of autogenous tooth bone powder combined with Bio-Oss bone powder. Combined with literature review, the key application points of this technique were discussed, so as to provide a reference for clinical management of similar bone defects.
