Oral squamous cell carcinoma (OSCC) is the most common malignant tumor of the head and neck, accounting for 90% of all oral cancers. The disease is prone to recurrence, invasion, and metastasis, leading to a poor prognosis with a five-year survival rate of approximately 50%–60%. The invasive front of OSCC is a critical region for tumor recurrence and metastasis, characterized by high heterogeneity and aggressiveness. Metabolic reprogramming in this area drives malignant progression and offers potential targets for the development of imaging biomarkers. This review summarizes the metabolic features of the invasive front and their underlying molecular mechanisms, with a focus on how aberrant activation of pathways such as glucose metabolism, lipid metabolism, and amino acid metabolism promotes tumor cell migration, invasion, and immune evasion. Additionally, it discusses the translational applications of metabolic traits at the OSCC invasive front as imaging biomarkers, including the application value of spatial metabolomics, Raman spectroscopy, and positron emission tomography/computed tomography (PET-CT) in predicting tumor boundaries and visualizing metabolic profiles of the invasive front. In the future, integrating multi-omics data with imaging analysis may facilitate the development of clinical translation pathways based on metabolic markers of the invasive front, thereby providing new strategies for precise diagnosis, surgical navigation, and prognosis evaluation of OSCC, and advancing precision diagnosis and treatment for OSCC at the level of small-molecule metabolites.
In recent years, the rapid advancement of artificial intelligence (AI) technology has brought about transformative technological advancements in the field of dental defect restoration. AI has significantly enhanced the accuracy and efficiency of personalized restoration, driving the transition of dental rehabilitation from traditional methods toward digital and intelligent solutions. However, certain technical challenges remain that limit its effective translation into clinical practice. This review summarizes the current applications and unresolved issues of AI in the field of dental prosthodontics, aiming to provide insights for clinical reference.
Dental implantation has revolutionized the traditional prosthetic approach to tooth loss and is regarded as the optimal solution for replacing missing teeth and restoring oral function and aesthetics. With the swift development of artificial intelligence (AI) technology and its profound integration with oral implantology, a growing number of studies have begun to explore the application of AI in the field of oral implantology, covering multiple aspects such as auxiliary diagnosis, treatment planning and surgical robotics. This review systematically introduces the multi-dimensional progress of AI in the digital and intelligent transformation of oral implantology in recent years and provides an outlook on its potential and research value.
Objective: To screen and identify key genes associated with prognosis in head and neck squamous cell carcinoma (HNSCC). Methods: The clinical data and RNA sequencing (RNA-Seq) data of HNSCC patients from the Cancer Genome Atlas (TCGA) database were randomly divided into training set (cohortⅠ, n=228) and validation set (cohortⅡ, n=98). The prognostic seed genes were determined using random survival forest (RSF) models and Cox proportional hazards models, and the key genes related to prognosis were further screened using a forward selection modes. The survival risk scoring system was constructed using the selected key genes, and these genes were subsequently validated and subjected to bioinformatics analysis. The expression of the key genes was detected by real-time quantitative polymerase chain reaction (RT-qPCR) in the human oral epithelial keratinocytes (HOK cell line) and the human tongue squamous carcinoma cell (CAL27 cell line). Results: Twelve prognosis-related key genes were identified. Patients in the high-risk group had a significantly poorer prognosis than those in the low-risk group, with a hazard ratio (HR) of 4.19 in CohortⅡ (P<0.05). There was a significant difference in the expression level of the key genes between the HOK cell line and the CAL27 cell line (P<0.05). Conclusion: Twelve key genes affecting the prognosis of HNSCC patients were identified through a machine learning model and may serve as prognostic biomarkers for HNSCC.
Objective: To investigate the effects of cathepsin K (Ctsk) on the proliferation, migration, and differentiation of jaw bone marrow-derived mesenchymal stem cells (JBMMSCs) in mice. Methods: Mouse JBMMSCs were cultured and identified in vitro. Third-passage (P3) cells were subjected to osteogenic, chondrogenic, and adipogenic tri-lineage induction. The expression of Ctsk was detected using real-time quantitative polymerase chain reaction (RT-qPCR). Small interfering RNA (siRNA) transfection was used to knockdown Ctsk expression in JBMMSCs, with knockdown efficiency verified by RT-qPCR and Western blotting. Cell proliferation was assessed using the CCK8 assay, and cell migration was evaluated via scratch wound healing assay. The expression of key genes during tri-lineage differentiation was detected by RT-qPCR. Alkaline phosphatase (ALP) staining was used to assess osteogenic mineralization, Alcian blue staining was applied to evaluate cartilage matrix secretion, and oil red O staining was employed to examine lipid droplet formation. Results: Ctsk expression increased after osteogenic and chondrogenic induction, but decreased after adipogenic induction. Following Ctsk knockdown, cellular migration, osteogenesis, and chondrogenesis were attenuated, but proliferation and adipogenic ability were enhanced. Conclusion: Ctsk promotes the migration, osteogenesis, and chondrogenesis in mouse JBMMSCs, but inhibits their proliferation and adipogenic differentiation.
Objective: To evaluate the differences in nerve fiber density and the percentage of Piezo-positive nerve fibers between peri-implant and periodontal tissues. Methods: Primary trigeminal ganglion neurons were isolated from male Sprague-Dawley (SD) rats, and the expression of Piezo ion channels in these neurons was confirmed by immunofluorescence staining, real-time quantitative polymerase chain reaction (RT-qPCR) and gel electrophoresis. Subsequently, a dental implant model was established in the maxillary first molar region of male SD rats. One month after osseointegration, the rats were euthanized, and the maxillae were collected. Hematoxylin-eosin (HE) staining and immunofluorescence staining were employed to analyze and compare the differences in nerve fiber density and the percentage of Piezo-positive nerve fibers across four regions between the peri-implant tissues and the periodontal tissues. Results: Immunofluorescence staining, RT-qPCR and gel electrophoresis results demonstrated that both Piezo 1 and Piezo 2 ion channels were expressed in trigeminal ganglion neurons. In both peri-implant tissues and periodontal tissues, the gingival and apical regions exhibited a higher density of nerve fibers, with similar nerve fiber density observed in the gingival region between the two tissue types. In the middle region, the density of nerve fibers in the periodontal ligament was significantly higher than that in the bone surrounding the implant, while no significant differences were found in the gingival, apical and coronal regions. In the gingival region, there were no notable differences in the percentage of Piezo 1- and Piezo 2-positive nerve fibers among the groups. In the coronal and middle root regions, the percentage of Piezo 1- and Piezo 2-positive nerve fibers in the periodontal ligament was significantly higher than that in the alveolar bone directly adjacent to the implant. Conclusion: In the coronal and middle root regions, the percentage of Piezo-positive nerve fibers in the periodontal ligament was significantly higher than that in the alveolar bone directly adjacent to the implant.
Objective: To develop and validate a nomogram prediction model based on gingival carcinoma patient data from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute in the United States, and evaluate its effectiveness. Methods: The basic information, clinical information, and follow-up data of patients diagnosed with gingival carcinoma between 2004 and 2018 was downloaded from the SEER database, and the patients were randomly divided into a modeling group (70%) and a validation group (30%). Through univariate and multivariate Cox regression analysis, variables were screened to determine independent prognostic risk factors for gingival carcinoma patients, and a nomogram was constructed. The prediction model was evaluated from three perspectives: Discrimination, calibration, and clinical applicability. X-Tile software was used for risk stratification of the gingival carcinoma patients. Results: This study included 3 334 patients with gingival carcinoma, with 3-year, 5-year, and 10-year survival rates of 59.03%, 48.89%, and 30.09%, respectively. The concordance index (C-index) of the modeling group and validation group was 0.716 and 0.715, respectively; the receiver operating characteristic (ROC) curve results showed that the area under the curve (AUC) for predicting the 3-year, 5-year, and 10-year overall survival rates of gingival carcinoma patients in the modeling group was 0.758, 0.759, and 0.769, respectively. In the validation group, they were 0.746, 0.764, and 0.788, respectively. The C-index and AUC of the nomogram were higher than those of the traditional TNM staging system (P<0.001). The calibration curve results indicate that the nomogram model has good predictive accuracy. The decision curve analysis (DCA) results show that the nomogram has good clinical application value and is superior to the traditional TNM staging system.Patients were divided into low-risk group (<118.4 points), medium-risk group (118.4-213.6 points), and high-risk group (>213.6 points) based on the cutoff value of the total score in the nomogram. There was a statistically significant difference in survival rate among the three groups (P<0.001). Conclusion: Age, marital status, histological grading, T stage, N stage, surgical status, and radiotherapy status are factors affecting the survival of patients with gingival carcinoma. The nomogram prediction model constructed in this study can provide reference for predicting the prognosis of gingival carcinoma patients.
Objective: To explore the clinical efficacy of a concealed pre-tragal incision combined with a trans-cartilaginous approach in the treatment of sagittal fracture of the mandibular condyle. Methods: A retrospective analysis was performed on the clinical data of 40 patients with mandibular condylar fracture admitted to Tangshan Second Hospital from January 2021 to June 2023. All patients underwent rigid internal fixation via the concealed pre-tragal incision combined with a trans-cartilaginous approach. They were systematically followed up for 6 months postoperatively. Evaluation indicators included mandibular movement function (occlusal relationship, maximum mouth opening, mouth opening pattern), facial nerve function, imaging findings, postoperative complications (abnormal pain, infection, salivary fistula, Frey syndrome, great auricular nerve paresthesia), and patient satisfaction with the appearance of the incision. Results: All patients achieved good recovery of occlusal relationship. At 6 months after surgery, the maximum mouth opening reached (38.50±1.65) mm, which was significantly increased compared with that before surgery (P<0.001), and the mouth opening pattern showed no deviation. Postoperatively, only 1 case (2.5%) exhibited transient forehead wrinkle shallowing, which recovered after drug treatment, and no permanent facial nerve injury occurred. Imaging examination showed that all patients achieved anatomical reduction, the internal fixation was in good position, and the fracture healed satisfactorily. No complications occurred in any patient during the follow-up period. The patient satisfaction score with the appearance of the incision was 10 points (full score), with a satisfaction rate of 100%. Conclusion: The concealed pre-tragal incision combined with the trans-cartilaginous approach for the treatment of sagittal fracture of the mandibular condyle offers the advantages of minimal trauma, few complications, and excellent aesthetic outcomes, making it a safe and effective surgical option.
Objective: To investigate the possible risk factors leading to adverse outcomes in patients with oral and maxillofacial space infection (OMSI) and to provide references for clinical prevention and treatment. Methods: The clinical data of 320 patients with OMSI who were admitted from January 2012 to October 2022 were collected. The χ2 test was used to analyze the effects of patient sex, age, time from infection onset to medical consultation, affected anatomical spaces, infection etiology, number of involved spaces, bacterial culture results, whether diabetes mellitus (DM) was present, whether incision and drainage was performed, C-reactive protein (CRP), neutrophil percentage (NEUT%), white blood cell count (WBC) on patient hospitalization outcomes. Multivariate logistic regression analysis was further performed to identify risk factors for adverse outcomes in OMSI patients. Results: This study included a total of 320 patients, 49 (15.3%) had adverse outcomes, which included 24 cases of severe complications, 32 cases of hospitalization exceeding 15 days, and 1 death. The χ2 test indicated that age, number of involved spaces, whether DM was present, whether incision and drainage was performed, WBC, NEUT% and CRP were risk factors for adverse outcomes in OMSI patients. Multivariate logistic regression analysis revealed that comorbid DM, no performance of incision and drainage, and NEUT exceeding 90% were independent risk factors for adverse outcomes in OMSI patients. Conclusion: The likelihood of adverse outcomes is relatively high in OMSI patients. Comorbid DM, absence of incision and drainage, and NEUT exceeding 90% were significant risk factors for adverse outcomes in these patients.
Calcium phosphate, due to its excellent biocompatibility and bioactivity, can be used as the implant coating to improve osseointegration. However, the calcium phosphate coating still faces problems such as exfoliating and insufficient adhesion strength to the metal substrate in practical applications. This article aims to systematically review the relevant factors that affect the adhesion strength between the calcium phosphate coatings and the implant surfaces.
Titanium and titanium alloy are the predominant materials for dental implants. However, in long-term applications, they are associated with issues such as the release of titanium particles, potential induction of immune responses, and aesthetic drawbacks. Zirconia implants, by contrast, present a promising alternative due to their tooth-like color, excellent mechanical properties, and high biocompatibility, and have gradually been applied in clinical practice. Currently, most zirconia implants adopt a one-piece design. With the advancements in processing and material science, newly developed two-piece zirconia implants offer greater restorative flexibility and a broader range of indications compared to one-piece zirconia implants. This paper reviews relevant domestic and international literature and summarizes the current research on the mechanical properties, biological properties, and clinical outcomes of two-piece zirconia implants, aiming to provide a reference for clinicians.
Following tooth loss, alveolar bone resorption often necessitates bone augmentation procedures, either prior to or during implant placement, to establish adequate foundation for implantation. However, common postoperative complications include wound dehiscence and membrane exposure, alongside significant patient discomfort such as swelling and pain. The implementation of a split-thickness soft tissue flap design facilitates tension-free closure while obviating the need for horizontal periosteal releasing incisions. This approach effectively preserves the blood supply to the surgical site and mitigates postoperative adverse reactions. This article systematically reviews the classification of split-thickness flap techniques and their respective indications, aiming to provide clinical guidance for incision design and soft tissue management in bone augmentation for dental implants.
Salivary duct carcinoma (SDC) is a rare and highly malignant tumor of the parotid gland. Various methods can be used for reconstructing the postoperative defect. This article reports a case of defect repair following parotid duct carcinoma surgery using a free anterolateral thigh flap, along with a discussion based on relevant literature.
