This article focuses on the clinical prevention and management of medication-related osteonecrosis of the jaw (MRONJ) in patients treated with bone-modifying agents (BMAs) [bisphosphonates (BPs) and denosumab]. Integrating domestic and international consensus guidelines with clinical practice, it proposes a comprehensive, risk-stratified prevention and management strategy. The article systematically analyzes the three major high-risk factors for MRONJ (medication-related, systemic, and local oral factors), emphasizing the difference in MRONJ risk associated with different drug regimens (low-dose vs. high-dose), and constructs a four-tier (R0–R3) risk stratification system accordingly. For each risk level, the paper elaborates on corresponding key focuses for oral screening, preventive interventions, indications for invasive procedures (such as tooth extraction), and perioperative management protocols. Specific guidance is provided for high-risk (R3) patients regarding drug holidays, radiographic evaluation, minimally invasive surgery, and wound management strategies. The aim of this article is to promote a shift in the clinical approach to MRONJ from a reactive treatment model to a proactive prevention model, providing systematic reference for dentists to effectively reduce the incidence of MRONJ while ensuring the treatment of patients' underlying systemic diseases.

Distraction osteogenesis (DO) is a surgical technique that promotes new bone formation by gradually pulling apart bone segments using a specialized distraction device. Initially developed for orthopedic surgery, DO was introduced into craniofacial surgery in the 1990s and has since been widely applied in the treatment of mandibular hypoplasia and jaw defect reconstruction. This paper reviews the fundamental principles, technical aspects, indications, advantages, and disadvantages of mandibular distraction osteogenesis, and discusses different distraction modes, including unifocal, bifocal, and trifocal distraction. The advantages of DO include the avoidance of bone grafting, minimal surgical trauma, and simultaneous soft tissue expansion. However, its long treatment duration and associated complications remain challenges for broader clinical application. In the future, the integration of imaging navigation and artificial intelligence is expected to enhance surgical precision and treatment stability.

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 evaluate the efficacy of kangfuxin liquid combined with metronidazole in patients with impacted mandibular third molar (IMTM) extraction. Methods: A total of 100 patients who underwent IMTM extraction surgery at our hospital from January 2022 to May 2023 were enrolled. They were divided into 3 groups according to different wound treatment regimens: Group A (packing with gelatin sponge) with 34 cases; Group B (kangfuxin liquid + gelatin sponge) with 30 cases; Group C (kangfuxin liquid + metronidazole + gelatin sponge) with 36 cases. The clinical data of the patients were collected. The chi-square test was used to compare granulation tissue coverage rates, dry socket syndrome and the incidence of complications 7 days after surgery. The Kruskal-Wallis test was used to compare the number of patients with limited opening 24 hours after surgery. One-way analysis of variance was used to compare the visual analogue scale (VAS) scores at 24 hours after surgery, degree of facial swelling 24 hours after surgery, healing time of alveolar socket, height of alveolar bone, gray value of bone mineral density, width of alveolar bone, generic quality of life inventory-74 (GQOLI-74) scores. Results: Compared with group A, the VAS scores, the degree of facial swelling, the number of patients with grade Ⅲ limited opening 24 hours after the operation in Group B, and the healing time of the alveolar socket, the complete coverage rate of granulation tissue in the alveolar socket 7 days after the operation were significantly improved (P<0.05). Group C was superior to Group A and Group B in all the above indicators (P<0.05). The incidence of dry socket and other complications in Group B were lower than those in group A (P<0.05), while those in Group C were lower than those in both Group A and Group B (P<0.05). Three months after the operation, the alveolar bone heights in all three groups were lower than those before the operation (P<0.05), but those in Group B and Group C were higher than those in Group A (P<0.05). The gray values of bone mineral density were all higher than those before the operation (P<0.05), among which Group B was higher than Group A, and Group C was higher than both Group A and Group B (P<0.05). Seven days after the operation, the GQOLI-74 scores of all three groups were higher than those before the operation (P<0.05). The GQOLI-74 score of Group B was higher than that of Group A, and that of Group C was higher than that of Group A and Group B (P<0.05). Conclusion: Kangfuxin liquid combined with metronidazole can effectively promote the recovery of patients after IMTM extraction, prevent the occurrence of complications such as dry socket, and reduce the alveolar bone absorption to some extent.

Parapharyngeal space (PPS) is a deep anatomical compartment in the head and neck region, containing critical structures such as the internal carotid artery and cranial nerves. Primary tumors in this area are relatively rare. Surgical resection remains the primary treatment for tumors in this region, and selecting an appropriate surgical approach is crucial for ensuring safe tumor removal and minimizing postoperative complications. Based on recent literatures and the clinical experiences of our team, this article systematically reviews and discusses the main surgical approaches based on the three-dimensional compartmentalization of the PPS, aiming to provide a reference for selecting appropriate clinical surgical strategies.

Objective: To investigate the clinical efficacy of decompression combined with secondary curettage for the treatment of large jaw cysts, and analyze the impact of this technique on patients' perioperative outcomes and recurrence rates. Methods: A retrospective study was conducted, collecting clinical data from 80 patients with large jaw cysts admitted to our hospital between May 2021 and September 2023. Based on the surgical approach, patients were divided into two groups: 38 patients treated with conventional curettage were assigned to the conventional curettage group, while 42 patients treated with decompression combined with secondary curettage were assigned to the study group. The two groups were compared regarding treatment effectiveness, postoperative inflammatory markers, complication rates, bone recovery status (bone formation thickness, bone density, reduction rate of the cystic cavity), and cyst recurrence rate. Quality of life was assessed using the 36-Item Short Form Health Survey (SF-36). Results: The treatment effectiveness rate in the study group (92.86%) was higher than that in the conventional curettage group (76.32%) (P<0.05). On postoperative day 3, the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) in the study group were all lower than those in the conventional curettage group (P<0.05). The postoperative complication rate in the study group (4.76%) was significantly lower than that in the conventional curettage group (21.05%) (P<0.05). At 6 months postoperatively, the bone formation thickness, bone density, and reduction rate of the cystic cavity in the study group were significantly higher than those in the conventional curettage group (P<0.001). All domain scores of the SF-36 in the study group were significantly higher than those in the conventional curettage group (P<0.05). Furthermore, the recurrence rate in the study group (2.38%) was significantly lower than that in the conventional curettage group (18.42%) (P<0.01). Conclusion: Decompression combined with secondary curettage is an effective treatment for large jaw cysts. It can effectively reduce postoperative inflammatory response, promote bone repair, improve patients' quality of life, and significantly lower the incidence of complications and recurrence.

Objective: To evaluate the clinical effect of the modified socket-shield technique (MSST) in the immediate implant placement of single teeth in the anterior esthetic zone, and to discuss the related technical points. Methods: Five cases of immediate implant placement using MSST in the anterior esthetic zone from December 2022 to December 2023 were reviewed. The alveolar bone remodeling around implants was evaluated by imaging analysis. The esthetic effect of peri-implant soft tissue was evaluated by pink esthetic score (PES). The visual analogue scale (VAS) was used to assess the patients' subjective evaluation of the postoperative reaction (pain, swelling, etc.), the final repair effect and the whole treatment process. Results: Radiographic analysis showed that all implant sites achieved good osseointegration. The average vertical change of the labial alveolar bone of the implant at 6 months postoperatively was (0.18±0.15) mm. The average horizontal changes of labial alveolar bone at 2, 4, and 6 mm apical to the implant shoulder were (0.39±0.17), (0.18±0.23), (0.22±0.18) mm, respectively. The average change of alveolar bone width at implant shoulder level was (0.10±0.10) mm. The average PES score was (12.40±1.34) points, and satisfactory esthetic results were obtained in all implant sites. The VAS score showed that the subjective satisfaction of patients was high. Conclusion: The application of MSST in immediate implant placement in the anterior aesthetic area can effectively maintain the bone volume and soft tissue contour around the implant, and is a feasible technical solution for aesthetic area implant restoration.

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.

Periodontitis often leads to irreversible damage, and guided tissue regeneration (GTR) remains the primary therapeutic strategy for reconstructing lost hard tissue and periodontal attachment. However, current GTR membranes still face multiple limitations in complex clinical applications, highlighting the urgent need for the development of advanced GTR membranes with improved performance. This review systematically summarizes recent progress in GTR membranes from four key aspects, aiming to provide insights and perspectives for the future improvement and innovation of GTR membrane design.

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.

Objective: To investigate the effect of N-acetyltransferase 10 (NAT10) gene on the polarization of mouse macrophages in vitro and in vivo. Methods: Mouse monocyte line RAW264.7 cells were cultured in vitro and induced by polarization, and the expression level of NAT10 was observed using real-time quantitative polymerase chain reaction (RT-qPCR). The NAT10 inhibitor Remodelin hydrobromide was used to inhibit the expression of NAT10, and its effect on the polarization of RAW264.7 cells was observed. A model of periodontitis was established using silk thread ligation, while Remodelin hydrobromide was injected simultaneously. The mice were randomly divided into control group, periodontitis group, control medication group and periodontitis medication group. After 7 days, their mandibles were taken for RT-qPCR, micro-CT analysis and histological staining. Results: NAT10 was highly expressed in mouse M2 macrophages. Compared with the control group, the periodontitis group showed decreased NAT10 expression in alveolar bone tissue, along with reduced proportions of NAT10-positive cells in the furcation area and lower percentages of NAT10/F4/80 double-positive cells. The concentration gradient experiment showed that 10 μmol/L Remodelin hydrobromide had the best inhibition efficiency. After adding Remodelin hydrobromide, the expression of M1 macrophage-associated genes increased and M2 macrophage-associated genes decreased in RAW264.7 cells. Inhibition of NAT10 expression enhanced alveolar bone destruction in a mouse model of periodontitis; the proportion of CD86-positive cells at the root bifurcation increased; the proportion of CD163-positive cells decreased. Conclusion: The expression of NAT10 significantly increased in RAW264.7 cells after M2 polarization, and significantly decreased in the mouse periodontitis alveolar bone. Inhibiting the expression of NAT10 can promote M1 polarization of macrophages, inhibit M2 polarization, and notably exacerbate alveolar bone destruction in mice with periodontitis.

From January 2017 to May 2023, our institution treated 46 patients with zygomatic-arch fractures using a periorbital mini-incision approach. Titanium plate systems were employed for rigid internal fixation in all cases. Postoperative evaluations confirmed anatomical reduction in all 46 patients. Follow-up results demonstrated that all patients achieved satisfactory facial contour recovery with no significant scar formation and excellent incision healing. This study summarizes and analyzes our clinical experience in treating these cases.

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.

Numerous epidemiological studies have confirmed an correlation between periodontitis and hypertension. Moderate to severe periodontitis is not only associated with an increased risk of hypertension and elevated blood pressure levels, but the hypertensive state itself may also exacerbate the degree of inflammation in periodontal tissues. This article will review the research progress on the association between periodontitis and hypertension from two aspects: The relationship between hypertension and periodontitis, and the role of periodontitis in vascular endothelial dysfunction.

Objective: To investigate the application and efficacy of a temporary screw and steel wire traction technique during reduction surgery for mandibular condylar neck fractures. Methods: A total of eight patients with condylar neck fractures who underwent open reduction and internal fixation in our department between June 2023 and May 2024 were selected for this study. The operative time for condylar fracture reduction was recorded, and postoperative follow-up was conducted for six months to assess the recovery of mouth opening and occlusal relationships. Results: All patients successfully underwent surgery, with an average reduction and fixation time of 50 minutes. At the six-month follow-up, significant improvements in mouth opening and occlusal relationships were observed. Conclusion: The temporary screw and steel wire traction technique effectively facilitates the reduction of mandibular condylar neck fractures, and its operation is less restricted by the surgical approach for condylar fractures.

Objective: To investigate the effects of resveratrol (Res) combined with NVP-BEZ235 (BEZ235) on the proliferation, invasion, and migration of the oral mucosal malignant melanoma (OMM) cell line Mm9h-1, and to explore the underlying mechanisms. Methods: Cell viability after drug treatment was detected using the CCK8 assay to determine drug concentrations and group assignments. The following groups were established for 48-hour treatment: Control group, 100 μmol/L Res group, 1.0 μmol/L BEZ235 group, and combination group (C1 group: 100 μmol/L Res+1.0 μmol/L BEZ235). The scratch wound healing assay and Transwell assay were used to evaluate cell migration and invasion abilities, respectively. Hoechst staining was applied to observe cell death morphology, and Western blotting was performed to detect the expression levels of apoptosis-related proteins. Results: Both Res and BEZ235 alone inhibited multiple biological behaviors of Mm9h-1 cells. Compared with the Control, 100 μmol/L Res, and 1.0 μmol/L BEZ235 groups, the C1 group showed significantly reduced cell viability, invasion, and migration capabilities, along with significantly upregulated expression of apoptosis-related proteins. Conclusion: The combination of Res and BEZ235 inhibits Mm9h-1 cell survival, invasion, and migration more effectively than either agent alone, and more potently induces apoptosis.

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 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.

Dental calculus is a significant contributor to periodontal disease, making its accurate identification crucial for effective prevention and treatment. Traditional methods for identifying dental calculus have the problems of strong subjectivity and low accuracy, especially when it comes to detecting calculus in the concealed subgingival areas, which cannot meet the demands of modern clinical practice. Recently, optical detection technology has attracted widespread attention due to its non-invasive and high-sensitivity characteristics. A variety of optical techniques have provided new ideas for the identification of dental calculus, such as polarization detection, optical coherence tomography (OCT), differential reflectometry, hyperspectral imaging (HSI), and fluorescence spectroscopy systems. Furthermore, artificial intelligence (AI) technology, particularly the combination of machine learning and deep learning with optical techniques, has significantly enhanced the level of automation and intelligence in the identification of dental calculus. This review provides the current mainstream methods for identifying dental calculus, compares and analyzes the advantages and disadvantages of each technology, and looks forward to the future development direction. This work aims to guide research and clinical application of dental calculus detection technologies.

Langerhans cell histiocytosis (LCH) is a rare disease with an unknown etiology. It can involve multiple organs/systems. This is a clinical report presenting surgical treatment and reconstruction with a vascularized fibular musculocutaneous flap in an adult patient with mandibular LCH. The patient was diagnosed with diabetes insipidus (DI) after surgery. Based on relevant literature, the pathogenesis, clinical characteristics, diagnosis and treatment strategies of LCH are systematically discussed in this article.

Objective: To investigate whether long intergenic non-coding RNA-EPS (lincRNA-EPS) affects microglial inflammatory response induced by Porphyromonas gingivalis lipopolysaccharides (P.g-LPS). Methods: Mouse microglia cell lines (BV-2 cells) were stimulated with P.g-LPS in vitro and the expression changes of lincRNA-EPS were detected by real‐time quantitative polymerase chain reaction (RT‐qPCR). BV-2 cells were transfected with plasmids to construct lincRNA-EPS overexpressed BV-2 cells. The effects of lincRNA-EPS overexpression on P.g-LPS-induced migration ability of BV-2 cells were observed by cell scratch assay, and the expression changes of inflammation-related genes interleukin 1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α), inducible nitric oxide synthase (iNOS), arginase-1 (Arg1), nuclear factor kappa B protein family member p65 (NF-κB p65) and phosphorylated p65 (pp65) were detected by RT‐ qPCR, enzyme-linked immunosorbent assay (ELISA) and Western blotting. The subcellular localization of p65 in BV-2 cells was detected by immunofluorescence staining. Results: The expression of lincRNA-EPS was down-regulated after in vitro P.g-LPS induction of BV-2 cells (P<0.05). Overexpression of lincRNA-EPS significantly inhibited the P.g-LPS-induced migration of BV-2 cells and the expressions of IL-1β, IL-6, TNF-α, and iNOS (P<0.05). In contrast, the expression of Arg1 was up-regulated at resting state (P<0.05). After overexpression of lincRNA-EPS, the expression of total p65 in BV-2 cells was not significantly changed, while the p65 in the nucleus and pp65 expression were decreased (P<0.05). Conclusion: This study demonstrated that lincRNA-EPS can attenuate the inflammatory response of BV-2 cells stimulated by P.g-LPS in vitro by inhibiting the phosphorylation and nuclear translocation of p65.

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.

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.

Cervical necrotizing fasciitis (CNF) is a highly dangerous infectious disease characterized by acute onset, rapid progression, and life-threatening severity. This article reports a case of CNF with acidosis in a diabetic patient caused by pericoronitis. Based on relevant research data, we thoroughly investigate the critical role of early diagnosis of CNF in the treatment process.

Objective: To investigate the effect of lactate dehydrogenase A (LDHA) on alveolar bone remodeling after mandibular ramus osteotomy. Methods: The rat model of unilateral mandibular ramus osteotomy was established in vivo , and the rats were divided into the surgical group and the sham surgical group. Mouse RAW264.7 cells were induced to differentiate into osteoclasts and divided into normoxia group, hypoxia group, hypoxia + knockout (KO) group, hypoxia + siNC group, hypoxia + siLDHA group. The number of osteoclasts and LDHA expression levels in the local alveolar bone were detected using tartrate resistant acid phosphatase (TRAP) staining and immunofluorescence staining. The effects of hypoxia-inducible factor 1α (HIF-1α) on LDHA expression in osteoclasts under hypoxic conditions were assessed using real-time quantitative polymerase chain reaction (RT-qPCR), Western blotting, and TRAP staining. The impact of LDHA expression levels on the expression of osteoclast-specific genes was evaluated using immunofluorescence staining. Results: The osteoclasts in alveolar bone were active after mandibular ramus osteotomy, and the level of LDHA in alveolar osteoclasts increased after operation. Under hypoxic conditions in vitro, LDHA expression in osteoclasts was significantly increased compared to the normoxia group, and osteoclast differentiation capacity was also enhanced. Compared to the hypoxia group, the expression of osteoclast-specific genes was suppressed in the hypoxia + siLDHA group. Conclusion: LDHA after mandibular ramus osteotomy can accelerate alveolar bone remodeling by promoting osteoclast formation.

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.

Objective: To investigate the clinical outcomes of the partially deepithelialized forearm flap for reconstructing defects following resection of cheek malignancies. Methods: A total of 12 patients who underwent reconstruction with a partially deepithelialized forearm flap for post-resection defects of cheek malignancies in our department between June 2021 and June 2023 were selected. Postoperative follow-up ranged from 6 to 24 months. Evaluations included facial contour, mouth opening and closing function, as well as flap survival, color, and texture. Results: All 12 flaps survived completely. Facial symmetry was satisfactory, and mouth opening and closing function was unimpaired. The flaps exhibited good color match with the surrounding tissues and a soft texture. No tumor recurrence or distant metastasis was observed during the follow-up period. Conclusion: The application of the partially deepithelialized forearm flap for reconstructing defects after cheek malignancy resection achieves favorable clinical outcomes.

The diagnosis of medication-related osteonecrosis of the jaw (MRONJ) currently lacks a globally unified "gold standard", with discrepancies existing among the consensus statements or guidelines of various academic societies. This diagnostic challenge is particularly pronounced for MRONJ cases without clinically evident bone exposure. According to the 2022 position paper of the American Association of Oral and Maxillofacial Surgeons (AAOMS), the diagnosis of MRONJ includes "intraoral or extraoral fistula that probes to bone" as a clinical manifestation in the absence of overt bone exposure. However, in clinical practice, MRONJ presenting with periapical fistula closely resembles periapical periodontitis, making differentiation difficult. Moreover, some MRONJ cases without bone exposure exhibit concealed drainage pathways located in periodontal pockets or the maxillary sinus, without typical fistula formation, increasing the risk of misdiagnosis or underdiagnosis. To address these issues, this article defines "non-exposed" MRONJ as a subtype of MRONJ characterized by the absence of overt bone exposure but the presence of fistulae that probe to bone or other concealed purulent drainage pathways, with non-specific symptoms and characteristic imaging changes. This article systematically analyzes the diagnostic challenges of this variant, synthesizes key differentiating features from medical history, clinical manifestations, and imaging findings to differentiate from odontogenic infections, and discusses the role of diagnostic treatment. Finally, a clinical pathway is proposed to facilitate the early identification of "non-exposed" MRONJ. It should be emphasized that "non-exposed" MRONJ is distinct from the AAOMS-defined stage 0 disease and does not represent an early phase of MRONJ. Clarifying the concept of "non-exposed" MRONJ may improve the overall diagnostic rate of MRONJ and reduce medicolegal disputes arising from misdiagnosis and inappropriate treatment.

Objective: To evaluate the accuracy of deep learning (DL) in detecting periodontal radiographic bone loss (RBL). Methods: A systematic search of the literature was conducted in PubMed, Scopus, Google Scholar, and Web of Science for relevant studies, the search covered the period from the inception of each database until March 2024, with language restrictions set to English. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included studies. Results: A total of 19 articles meeting the criteria were included for full-text screening, with 8 of them being incorporated into the Meta-analysis. The Meta-analysis results showed that the DL models achieved a sensitivity of 0.84 [95% confidence interval (CI)=0.79 to 0.90] and a specificity of 0.83 (95% CI=0.75 to 0.91) in the classification of periodontitis. The summary receiver operating characteristic-area under the curve (SROC-AUC) was 0.92 (95% CI=0.89 to 0.94). Conclusion: DL models demonstrate good accuracy and sensitivity in detecting periodontal RBL.

Objective: To develop a deep learning (DL)-based three-dimensional (3D) point cloud reconstruction network that utilizes the morphological features of the ipsilateral maxillary lateral incisor, canine, and premolars to predict and reconstruct the anatomical morphology of the maxillary central incisor, providing insights for personalized anterior tooth aesthetic restoration. Methods: A total of 192 intraoral scan models were collected. Exocad software was used to segment crowns of teeth #11-14. After standardizing coordinate systems in MATLAB, 182 cases were randomly selected as the training set and 10 were the test set. A dual-network architecture (morphology and pose estimation) was trained to reconstruct maxillary central incisor point clouds. Reconstructed outputs were meshed, aligned with original crowns for evaluation, and applied to incisal third defect models of tooth #11 to compare restoration outcomes among the proposed algorithm, mirroring technique, and standard database method. Results: The test set achieved a chamfer distance (CD) of 0.405, earth mover's distance (EMD) of 0.152, and a root mean square error (RMSE) of (0.128±0.030) mm. For incisal defect restoration, the proposed algorithm [RMSE：(0.128±0.030) mm] demonstrated comparable accuracy to mirroring technique [RMSE: (0.130±0.021) mm], but significantly outperformed the database method [RMSE: (0.233±0.038) mm, P<0.001]. Conclusion: The proposed 3D point cloud reconstruction network enables high-precision maxillary central incisor restoration based on adjacent tooth morphology, offering a reliable technical solution for personalized anterior dental rehabilitation.

Objective: To analyze the radiological factors influencing maxillary sinus floor elevation in patients from alpine region, including maxillary sinus septa, alveolar antral artery (AAA), cysts, and cyst-like lesions, and to provide a reference for surgical planning. Methods: A total of 132 patients who underwent cone beam CT (CBCT) in our department from May 2023 to March 2024 were included, with 264 maxillary sinuses evaluated. Data on gender, posterior maxillary tooth status, maxillary sinus mucoperiosteal condition, AAA, and sinus septa were collected. Chi-square tests and logistic regression were used to identify risk factors of pathological sinus conditions. Results: Among the 264 maxillary sinuses imaging data sets from 132 patients, 140 (53.0%) showed no abnormalities in the maxillary posterior teeth region (e.g., missing teeth, dental implants, impacted teeth, or periapical lesions). A total of 131 sinuses (49.6%) exhibited normal imaging findings, while 133 (50.4%) showed abnormalities, with mucous retention cyst (MRC) being the most common (26.5%, 70 sinuses). Maxillary sinus septa were detected in 87 sinuses (33.0%), and AAA was visible in 215 (81.4%). Chi-square and logistic regression analyses revealed that gender and posterior maxillary tooth status significantly influenced mucoperiosteal pathology (P<0.05). Missing teeth, periapical diseases, and mixed factors increased the risk of sinus pathology (P<0.05), whereas dental implants and impacted teeth did not. Conclusion: Clinically, it is recommended that, the maxillary sinus mucoperiosteal condition should be prioritized for evaluation in male patients with missing teeth and periapical lesions before sinus floor elevation.

Objective: To investigate the impact of extracting mandibular third molar (M3M) tooth germs via the vestibular sulcus approach on the periodontal tissue of adjacent teeth and on patient postoperative recovery, providing a reference for the clinical application of this technique. Methods: This self-controlled study included 27 patients who required bilateral M3M germ extraction and presented to the Department of Oral and Maxillofacial Surgery, Qujing Central Hospital of Yunnan Province between May 2023 and July 2024. For each patient, one side was randomly assigned (by drawing lots) to the vestibular sulcus approach (vestibular approach group), while the contralateral side was assigned to the classic angular incision approach (angular incision group). Operative time was compared between the two groups. On postoperative days 1, 3, and 7, facial swelling, degree of mouth opening limitation, and pain visual analog scale (VAS) scores were assessed. The occurrence of complications (hemorrhage, nerve injury, dry socket, adjacent tooth injury, and wound dehiscence) was recorded. Probing depth (PD) and gingival index of the adjacent teeth were compared between the two groups preoperatively, and at 1 and 3 months postoperatively. At 6 months postoperatively, cone beam CT (CBCT) was used to compare the distobuccal osseous defect depth (ODD) of the adjacent teeth between the two groups. Results: A total of 24 patients (48 tooth germs) completed all follow-ups. On postoperative day 7, there were no statistically significant differences (P>0.05) between the two groups in facial swelling, pain VAS scores, or degree of mouth opening limitation. No postoperative complications occurred in any patient. There were no statistically significant differences (P>0.05) in operative time or the adjacent teeth gingival index at 1 and 3 months postoperatively between the two groups. At 1 month postoperatively, the distobuccal PD of adjacent teeth in the vestibular approach group was essentially unchanged from the preoperative level and was significantly smaller than that in the angular incision group (P<0.01) ; by 3 months postoperatively, the difference in this indicator between the two groups was not statistically significant (P>0.05). At 6 months postoperatively, CBCT results showed that the distobuccal ODD of adjacent teeth in the vestibular approach group was significantly smaller than that in the angular incision group (P<0.001). Conclusion: The vestibular sulcus approach for extracting M3M tooth germs is more beneficial for preserving the periodontal tissues on the distal aspect of the adjacent teeth, while showing no significant difference in postoperative recovery compared to the angular incision approach.

This article focuses on the clinical prevention and management of medication-related osteonecrosis of the jaw (MRONJ) in patients treated with bone-modifying agents (BMAs) [bisphosphonates (BPs) and denosumab]. Integrating domestic 
and international consensus guidelines with clinical practice, it proposes a comprehensive, risk-stratified prevention and 
management strategy. The article systematically analyzes the three major high-risk factors for MRONJ (medication-related, systemic, and local oral factors), emphasizing the difference in MRONJ risk associated with different drug regimens (low-dose vs. high-dose), and constructs a four-tier (R0‒R3) risk stratification system accordingly. For each risk level, the paper elaborates on corresponding key focuses for oral screening, preventive interventions, indications for invasive procedures (such as tooth extraction), and perioperative management protocols. Specific guidance is provided for high-risk (R3) patients regarding drug holidays, radiographic evaluation, minimally invasive surgery, and wound management strategies. The aim of this article is to promote a shift in the clinical approach to MRONJ from a reactive treatment model to a proactive prevention model, providing systematic reference for dentists to effectively reduce the incidence of MRONJ while ensuring the treatment of patients' underlying systemic diseases.

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.

Periodontitis is a chronic inflammatory disease affecting periodontal supporting tissues, which is closely associated with various systemic diseases. In recent years, a number of epidemiological investigations have revealed the possible independent association between periodontitis and myocardial infarction to some extent, and certain research results suggest that periodontal pathogens may be one of the important factors mediating this association. Based on the current research data, the link between the two diseases has yet to be established. This article reviews the research progress on the association between periodontitis and myocardial infarction, with the aim of evaluating the existing epidemiological evidence, elucidating potential pathological mechanisms, and providing a theoretical basis for interdisciplinary prevention and treatment strategies.

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 investigate the effects of aging on the bone regeneration capacity of mouse jaw and the osteogenic differentiation ability of mouse embryo osteoblast precursor cells (MC3T3-E1 cells). Methods: A maxillary bone defect model was established using senescence-accelerated mice (SAMP8 mice). Micro-CT was used to analyze the bone microstructural parameters of new bone in the maxillary bone defect area of young (2-month-old) and aged (8-month-old) mice. In vitro, hydrogen peroxide (H₂O₂) was used to induce senescence in MC3T3-E1 cells. The expression of senescence-related genes was detected by real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting. Senescence-associated β-galactosidase (SA-β-Gal) staining was used to compare the positive area; flow cytometry was employed to analyze cell cycle distribution; alkaline phosphatase (ALP) staining and alizarin red S (ARS) staining were used to evaluate osteogenic differentiation ability; and Western blotting was applied to detect the expression levels of osteogenesis-related proteins. Results: On the 14th day after bone defect surgery, the amount of new bone in the aged group was lower than that in the young group. In vitro experiments showed that after H₂O₂ treatment, the expression levels of senescence-related genes and proteins in MC3T3-E1 cells were significantly increased, and the SA-β-Gal staining positive area was significantly enlarged. Cell cycle analysis revealed a significant decrease in the proportion of cells in the S and G2 phases. Meanwhile ALP and ARS staining indicated weakened osteogenic differentiation, and the expression levels of osteogenesis-related proteins, bone morphogenetic protein-2 (BMP-2) and Runt-related transcription factor 2 (Runx2) were also significantly decreased. Conclusion: Aging can inhibit bone regeneration in the mouse jaw, partly due to the decreased differentiation capacity of osteoblast precursor cells under aging conditions.

Objective:To investigate the clinical efficacy of minimally invasive ultrasonic bone surgery for extracting maxillary anterior supernumerary teeth in children.Methods:A total of 128 children with maxillary anterior supernumerary teeth treated in our hospital between July 2021 and July 2023 were included. Based on the surgical methods, the patients were divided into 2 groups: The conventional group (n=64) underwent the conventional extraction, and the ultrasonic bone surgery group (n=64) underwent the minimally invasive ultrasonic bone surgery. Perioperative parameters were compared, including success rate (χ ² test), operation time (independent-samplet-test), postoperative pain (Mann‑WhitneyUtest), and changes in gingival crevicular fluid levels of inflammatory mediators [myeloperoxidase (MPO), prostaglandin E₂ (PGE₂), pentraxin‑3 (PTX3)] and stress mediators [peroxisome proliferator‑activated receptor γ (PPARγ), glutathione peroxidase (GPX)] (independent-samplet-test).Results:The success rate did not differ significantly between the two groups (P>0.05). However, the ultrasonic bone surgery group had a significantly shorter operation time than the conventional group (P<0.001). Postoperative pain scores were significantly lower in the ultrasonic bone surgery group on day 1 and day 3 than in the conventional group (P<0.05). On postoperative day 3, levels of MPO, PGE₂, PTX3, and PPARγ increased in both groups compared with preoperative levels, but were significantly lower in the ultrasonic bone surgery group than in the conventional group. GPX levels decreased in both groups, but were significantly higher in the ultrasonic bone surgery group than in the conventional group (allP<0.01).Conclusion:Minimally invasive ultrasonic bone surgery for extraction of maxillary anterior supernumerary teeth in children demonstrated favorable outcomes, significantly shortening operation time, reducing surgical trauma, alleviating postoperative pain, and effectively mitigating local inflammation and stress responses.