Early childhood caries (ECC) is the most prevalent chronic oral disease and one of the worldwide public health problems of great urgency for children. ECC can affect children's teeth, dentition, craniomaxillofacial, and general health and development. Therefore, through dental caries etiologies and caries risk assessment, patient-centered, personalized planning and a combination of prevention and treatment should be implemented in the clinical management for ECC. Periodic and continuous cycle management can only be accomplished with the cooperation of medical staff, children, and their guardians. This expert consensus will expound the clinical management of ECC in the following aspects: caries risk assessment, early clinical prevention, treatment strategies, and postoperative management.

Abutment is an important component serving as a connecting link between the implant and the implant-supported prosthesis. In accordance with mechanical, biological, and other conventional norms, it can compensate the deviation between the implant and the prosthesis, which plays a significant role in maintaining the health of peri-implant tissue and the longevity, stability, and effectivity of prosthesis. However, choosing an anterior implant abutment correctly and conveniently is challenging, given the great variety of anterior abutment in clinical practice. Through virtual implant design, the correct implant site was compared and selected, and the supra-target prosthesis was coordinated before and after the operation. The implant level vertical of height of target restoration space (I) was measured to predict the availability and the retentive method of the implant restoration. After implantation, the primary selection of abutment type was selected according to the implant system (S), screw access position, and retentive method of the prosthesis. The final selection of abutment is accomplished by combining the measured values of peri-implant soft tissue thickness (T), gingival height (GH), and long axis of implant (L). Furthermore, the concepts and the classified applications of custom abutment were discussed in detail in this paper. The plan's main control variables L, I, GH, T, and S compose the words Lights, so this plan can be abbreviated as the anterior abutment decision tree. The decision tree has good decision-making efficiency and high clinical accessibility.

Objective This study aimed to investigate the feasibility of three different concentrations of silk-fibroin porous scaffolds applied to oral soft-tissue thickening in vivo. Methods Silk-fibroin scaffolds with three different concentrations (1 wt%, 3 wt%, and 5 wt%; denoted as SF1, SF3, and SF5, respectively) were prepared by freeze drying and methanol enhancement. The scaffolds were characterized by scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), and thermogravimetric analysis. Pore size, porosity, and in vitro degradation rate were also evaluated. The three groups of scaffold materials (the experimental sides) and the collagen matrix (the control side) were implanted into the oral mucosa of New Zealand white rabbits. Changed in mucosa thickness before and 3 months after operation were compared. The in vivo metabolism and regeneration effect of each group were observed by histological hematoxylin-eosin (HE) and Masson staining. Results SEM showed that the three groups of scaffolds were all cross-linked porous structures. XRD and FTIR showed that the three scaffolds were dominated by a relatively stable Silk Ⅱ structure, which degraded more slowly in vitro. Among them, SF3 had the largest pore size (133.40 μm±22.85 μm) and moderate porosity (90.05%±6.68%). In vivo results showed that the thickening effect of SF1 was similar to that of the control group because of insufficient space-maintenance property. Meanwhile, the properties of SF3 and SF5 were more stable, and the thickening effect was significantly better than those of the control group. However, unlike SF5 that induced obvious inflammation, SF3 showed better degradation, more fibrosis and angiogenesis, and less inflammatory response in vivo. Conclusion Silk-fibroin scaffolds can be applied to effectively thicken soft tissues, among which SF3 (3 wt%) silk fibroin scaffold exhibited the best physicochemical properties, histocompatibility, and mucosal-thickening effect.

Objective This study aimed to prepare functional composite electrospinning fibrous membranes with the functions of antifibrosis and bacteriostasis, as well as to explore its repair effect on rat jaw defect. Methods Poly-(lactic acid-co-glycolic acid) fibrous membrane loaded with cyclic-arginine-glycine-aspartic acid sequence, ornidazole, and nanohydroxyapatite (n-HA) was prepared by electrospinning as the functional layer (GBRL) for adhering onto defective bone. A barrier layer with the function of supporting and isolating different functional layers was prepared by tape-casting method. Poly(p-dioxanone-co-l-phenylalanine) fiber membrane with the function of inhibiting fibrosis was prepared by electrospinning technology as the antifibrosis layer (AFL). The morphology of the composite membrane was characterized by scanning electron microscopy. The effects of different functional layers on the proliferation of mouse osteoblast precursor cells (MC3T3-E1) and mouse fibroblasts (L929) were studied by cell-proliferation test (CCK-8 method). The inhibitory effect of composite membrane on the proliferation of Porphyromonas gingivalis was studied by bacteriostatic circle test. A rat mandibular-bone defect model was established to study the repair effect of composite fiber membrane on bone-defect tissue. This repair effect was compared with that of collagen oral-repair membrane commonly used in clinics. Results The GBRL layer could support the proliferation of MC3T3-E1 cells, and the AFL layer could inhibit the proliferation of L929 cells. Composite membranes loaded with ornidazole could inhibit the proliferation of Porphyromonas gingivalis. Various composite membranes can induce the reconstruction of rat jaw defects, among which the composite membranes loaded with ornidazole and n-HA had the best repair effect, which was better than that of collagen oral-repair membrane. Conclusion The electrospun membrane loaded with ornidazole and n-HA as the composite fiber membrane of GBRL layer had excellent antibacterial and bone-tissue-regeneration activity. The effect was better than that of the commonly used collagen oral-repair membrane. Therefore, this material has great potential to induce bone regeneration for defects caused by periodontal diseases.

Objective The occurrence and development of periodontitis and nonalcoholic fatty liver disease (NAFLD) are closely related to the accumulation of reactive oxygen species (ROS). ROS are involved in regulating the activation of c-Jun N-terminal kinase (JNK)/nuclear factor kappa-B (NF-κB) signaling molecules. When the signaling molecules are overactivated by ROS, the internal environment of the body can be disturbed. Therefore, this study aimed to explore the mechanism by which ROS/JNK/NF-κB signaling molecules are involved in periodontitis-induced liver injury. Methods Twelve SPF male Wistar rats were randomly divided into control and periodontitis groups. The perio-dontitis model of rats was established by wire ligation in the neck of bilateral maxillary first molars. After 8 weeks, the periodontal clinical indexes of the rats were examined, and the rats were sacrificed. Micro-CT reconstruction of a three-dimensional alveolar bone structure and analysis of alveolar bone absorption were conducted. Pathological changes in the periodontal and liver tissues were analyzed by histopathology. MitoSOX red reagent was used to detect the ROS content in liver tissue. Biochemical kits were used to detect liver function and oxidative stress biomarkers. The mRNA expression levels ofinterleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), NF-κB, BCL2-associated X (Bax), and B-cell lymphoma-2 (Bcl-2) in liver tissue were detected through quantitative real-time polymerase chain reaction (qRT-PCR). The protein expression levels of phosphorylated c-Jun N-terminal kinase (P-JNK), JNK, NF-κB, Caspase-3, Bax, and Bcl-2 in liver tissue were detected by Western blot. Apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. Results Micro-CT results showed that the mice in the periodontitis group had obvious alveolar bone resorption and significantly greater distance from the cemento-enamel junction to the alveolar bone crest than those in the control group. Histopathological results showed that a large number of inflammatory cells were infiltrated in the periodontal tissue of the periodontitis group. In addition, the resorption of alveolar ridge bone was obvious and liver tissue structure was destroyed, with balloon-like changes and red lipid droplets. MitoSOX red staining results showed that the ROS level was significantly higher in the liver tissue of the periodontitis group than in that of the control group. Biochemical test results showed that the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in the serum of the periodontitis group were higher than those in the serum of the control group. The levels of superoxide dismutase (SOD) and glutathione (GSH) in liver tissue decreased, whereas the that of malondialdehyde (MDA) increased. Western blot and qRT-PCR results revealed that the mRNA levels of IL-6, TNF-α, Bax, and NF-κB and the protein levels of P-JNK/JNK, NF-κB, Caspase-3, and Bax were significantly higher in the liver tissue of the perio-dontitis group than in that of the control group. Meanwhile, the mRNA and protein levels of Bcl-2 were lower in the periodontitis group than in the control group. TUNEL staining showed that the number of apoptotic cells was significantly higher in the periodontitis group than in the control group. Conclusion ROS/JNK/NF-κB signaling molecules are involved in periodontitis-induced liver injury by regulating apoptosis.

Objective This investigation aimed to develop a novel hydrophilic and antibacterial silicone rubber impression material for dental application. Methods The basic formula of the new silicone rubber was determined on a preliminary study, and 6% polyether modified silicone oil was added as wetting agent to provide the hydrophilicity. No-vel nano-antibacterial inorganic fillers containing quaternary ammonium salt with long chain alkyl were incorporated into the hydrophilic silicone rubber impression materials at a mass fraction of 0%, 1%, 2%, 3%, 4%, or 5%. A commercial silicone rubber impression material was used as control. The mechanical properties, wettability, detail reproducibility, dimensional stability, and mixing time of silicone rubber materials were measured. Thin-film adhesion method and cell counting kit-8 method were used to detect the antibacterial property and cytotoxicity. Scanning electron microscopy (SEM) was chosen to observe the micromorphology of the novel silicone rubber. Results When the content of antibacterial filler exceeded 4%, the mechanical properties of the new silicone rubber decreased significantly (P<0.05). Compared with those of the control group, the contact angle and linear size change rate of different groups had no significant change at different time nodes, and the detail reproducibility was intact (P>0.05). The addition of antibacterial fillers had no significant effect on the mixing time (P>0.05). Adding 4% antibacterial fillers could result in the antibacterial rate of 95.26%, showing good antibacterial properties. No significant difference was found in the cytotoxicity of all groups (P>0.05). The SEM pictures of the cross section of the silicone rubber sample showed that the fillers had good compatibility with the silicone rubber matrix and distributed in the matrix evenly. Conclusion A novel silicone rubber impression material containing 6% polyether modified silicone oil could obtain promising hydrophilic and antibacterial properties after being added with 4% antibacterial inorganic fillers.

Objective This study aimed to determine the association of periodontitis with cognitive impairment by evaluating periodontal conditions in middle-aged and elderly people of normal cognition and cognitive impairment. Methods Forty patients with cognitive impairment and thirty-five healthy controls were included in this study. Mini-mental state examination (MMSE) was used to evaluate the level of cognitive function in all patients and controls. Periodontal conditions including severity of periodontitis, number of remaining teeth, percentage of bleeding on probing, probing depth (PD), and attachment level (AL) were examined. Periodontal conditions were compared between patients and controls, and the correlation between periodontal conditions and cognitive-function level was analyzed. Statistical analysis was performed with SPSS 26.0. Results The distribution of severity of periodontitis significantly differed between patients and controls (χ²=13.309 and P=0.001). The proportion of severe periodontitis in the cognitive-impairment group was significantly higher than that in the healthy controls (P<0.05). The percentage of sites with PD≥6 mm and AL≥5 mm in the cognitive-impairment group was higher than that in the controls, whereas the percentage of sites with PD=1-3 mm and AL=0-2 mm was higher in the controls (P<0.05). No significant difference in percentage of bleeding on probing was found in the two groups (P>0.05). Patients with cognitive impairment had fewer teeth than the controls (P<0.05). The level of cognitive function, assessed by MMSE, was positively correlated with the number of teeth and the percentage of sites with AL=0-2 mm, and it was negatively correlated with the percentage of sites with AL≥5 mm (P<0.05). Conclusion A correlation existed between periodontitis and cognitive impairment. Further study is essential to explore the specific relationship and related mechanism between periodontitis and cognitive impairment.

Objective This study aimed to compare the capabilities of sonic, ultrasonic, and laser-activated irrigation for debris removal in the root canal isthmus. Methods A total of 32 human maxillary first premolars with root canal isthmus were prepared by Reciproc Blue, and were randomly divided into four groups (n=8, each group). The groups were subsequently subjected to different regimens as follows: the conventional syringe group (control group) was irrigated by No.27 side opening syringe, the sonic group with EDDY connected pneumatic motor, the ultrasonic group with IRRI Safe connected to a ultrasonic P5 handle, and the laser group with Er:YAG laser device connected to a 9 mm fiber tip for 20 s in each root canal. The first and last four samples in each group were irrigated for 80 and 120 s, respectively. All samples were fixed, decalcified, embedded, sectioned, and stained with hematoxylin-eosin. Image J software was used for measurement analysis of the isthmus and canal debridement efficacy, and SPSS 25.0 was utilized for statistical analysis of all data. Results The isthmus debridement efficacy of conventional syringe irrigation, sonic, ultrasonic, and laser groups after 80 s irrigation were 30.91%±3.14%, 52.22%±0.31%, 83.77%±5.64%, and 77.97%±7.97%, respectively. The isthmus debridement efficacy of the three experimental groups were better than the conventional syringe irrigation group (P<0.05). The isthmus debridement efficacies of ultrasonic and laser groups after 80 s were better than that of the sonic group (P<0.01, P<0.05). However, no significant difference was observed between the ultrasonic and laser groups. The isthmus debridement efficacy of conventional syringe irrigation, sonic, ultrasonic, and laser groups after 120 s were 75.72%±2.38%, 85.66%±4.42%, 88.07%±4.09%, and 89.12%±3.63%, respectively. The isthmus debridement efficacies of the three experimental groups were better than that of the conventional syringe irrigation group (P<0.05), but no significant difference was observed among the groups (P>0.05). The root canal debridement efficacy among the four groups also exhibited no significant difference (P>0.05). The debridement efficacies of the root canal and isthmus after 120 s irrigation were better than those after 80 s irrigation (P<0.01, P<0.001). Conclusion Ultrasonic, sonic, and laser-activated irrigation have better results in removing debris from the isthmus than conventional syringe irrigation. The isthmus debridement efficacy of sonic- and laser-activated irrigation are slightly better than that of ultrasonic activated irrigation. The debridement efficacies of 120 s irrigation are better than those of 80 s irrigaion.

Objective To investigate the eruption, caries, and pit and fissure sealing of the first permanent molars in children aged 6-9 years in Henan province. Methods The data of oral health examination in Henan province from 2015 to 2020 were analyzed in the information management system of China Children Oral Disease Comprehensive Intervention Project. Results Among 486 865 children in Henan province, the total eruption rate of the four first permanent molars was 73.44%, The prevalence rate of dental caries was 30.35%, DMFT was 0.67±1.18, the ratio of caries fil-ling was 4.45%, and the rate of pit and fissure sealing was 2.36%. From 2015 to 2020, the total eruption rates of the four first permanent molars in children aged 6, 7, and 8 showed a decreasing trend (χ²_trend was 385.793, 964.142, and 71.964, respectively, all P<0.05). The prevalence rates of dental caries, DMFT caries filling ratio, and pit and fissure sealing rate in children aged 6-9 increased (χ²_trend/F_trend was 1 115.87, 1 270.53, 1 215.02, 763.48, respectively, all P<0.05). The total eruption rates of the four first permanent molars in suburban counties (75.41%) were higher than those in urban areas (71.90%) (χ²=756.44, P<0.05). The prevalence rates of dental caries, DMFT, filling ratio, and pit and fissure sealing rate in urban areas (34.23%, 0.76±1.24, 4.99%, and 3.75%, respectively) were higher than those in suburban areas (25.39%, 0.55±1.09, 3.50%, and 0.58%, respectively) (χ² was 4 435.30, 3 922.56, 390.89, and 5 262.76, respectively, P<0.05). The first permanent molar eruption completely rate maxillary (84.96%) was higher than mandible (82.88%) (χ²=1 565.70, P<0.05), and the dental caries risk of the mandible (26.07%) was higher than that of the upper (13.88%) (χ²=38 112.53, P<0.05). Conclusion The health status of the first permanent molars of children aged 6-9 years in Henan province is not optimistic. The eruption rate decreased, the incidence of caries increased, and the rates of caries filling and pit and fissure sealing were low. We should pay attention to children’s eating habits and oral health, strengthen oral health education, and improve oral health awareness.

Objective This investigation aimed to systematically evaluate the efficacy and safety of applying autogenous dentin (ATD) in alveolar ridge augmentation. Methods The PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang databases were electronically searched from January 1, 2010 to March 19, 2022 to identify clinical trials and cohort studies that employed ATD in alveolar ridge augmentation. The Cochrane Tool and the Newcastle-Ottawa Scale were employed to assess the risk of bias in randomized controlled trials and cohort studies, respectively. Data were analyzed via RevMan 5.4 software. Results A total of 10 studies were included, 5 of which compared ATD with autologous bone and 5 with deproteinized bovine bone matrix (DBBM). Meta-analysis indicated that ATD had preferable performance [MD=2.01, 95% confidence interval (CI) (1.09, 2.93), P<0.000 1] in horizontal ridge augmentation compared with autologous bone but similar effect in vertical ridge augmentation [MD=-0.06, 95%CI (-0.21, 0.08), P=0.39] at 6 months after alveolar ridge augmentation. In terms of material absorption, ATD was significantly less than autologous bone or DBBM [MD=-0.59, 95%CI (-1.03, -0.15), P=0.008; MD=-0.63, 95%CI (-1.18, -0.07), P=0.03], but no significant difference in implant stability quotient and postoperative complications was observed [MD=-0.76, 95%CI (-3.04, 1.52), P=0.51; RR=1.01, 95%CI (0.33, 3.12), P=0.98]. Conclusion ATD, as a bone grafted material for alveolar ridge augmentation, not only achieves similar or better bone incremental performance than autologous bone or DBBM but also has less absorption. However, further evidence from clinical trials with larger samples, higher quality, and longer follow-up period are needed to evaluate its superiority.

Objective This study aims to investigate the diagnostic application of an artificial intelligence (AI) computer-aided diagnostic system based on a convolutional neural network algorithm in detecting chronic apical periodontitis in cone beam computed tomography (CBCT) images. Methods CBCT raw data of 55 single root chronic apical pe-riodontitis taken in 2nd Dental Center of Peking University School and Hospital from 49 patients from January 2017 to December 2021 were collected, and the chronic apical periodontitis areas were identified by experienced clinicians ma-nually and segmented layer by layer in Materialise Mimics Medical Software. Deep learning of lesion characterization was conducted via AI 3D U-Net, and the network segmentation results were compared manually with the test sets in terms of intersection over union (IOU), Dice coefficient, and pixel accuracy (PA). Results In our deep learning algorithm, the IOU for all actual true lesions in test set samples was 92.18%, and the Dice coefficient and the PA index were 95.93% and 99.27%, respectively. Lesion segmentation and volume measurements performed by humans and AI systems showed excellent agreement. Conclusion AI systems based on deep learning methods can be applied for detecting chronic apical periodontitis on CBCT images in clinical applications.

Objective To evaluate the size and shape of sella turcica and cranial base in patients with different degrees of congenital absence of teeth. Methods The subjects comprised 322 patients from the Department of Orthodontics, West China Hospital of Stomatology, Sichuan University from 2020 to 2021. Based on the number of congenital absence of teeth, the patients were divided into three groups: control group (without loss of teeth, n=112), group Ⅰ (loss of 1-2 teeth, n=104), and group Ⅱ (loss of 3 or more teeth, n=106). Uceph cephalometric software was used to measure the linear and angular parameters of cranial base. The length, depth, and diameter of sella turcica were also calculated. The shape of sella turcica was described as normal or with aberrations. Analysis of variance, Kruskal-Wallis H test, chi-square test, and Fisher’s exact test were conducted with SPSS 21.0. Results No statistical differences were observed in the length, depth, and diameter of sella turcica and parameters related to the cranial base among the three groups (P>0.05). The incidence of sella turcica bridge among the three groups was statistically significant (P=0.013). The incidence was higher in the study group compared with the control group (P<0.05), and no significant difference was observed between groups Ⅰ and Ⅱ (P>0.05). Conclusion Although the linear size of sella turcica and parameters related to the cranial base was not statistically different between normal subjects and patients with congenital absence of teeth, the incidence of sella turcica bridge was higher in patients with congenital absence of teeth, suggesting the possibly abnormal anatomical morphology of sella turcica in this population.

Objective This study aimed to investigate the differences in treatment outcomes of upper anterior teeth retraction and intrusion with clear aligners and different types of elastics on mini-implants via the 3D finite element method. Methods Cone-beam computed tomography (CBCT) was conducted to construct a 3D finite element model of maxillary bone, dentition, and clear aligners using Mimics, Geomagic, Solidworks, and Ansys. Four model groups were developed. Group 1 was the control group. Group 2 implanted a mini-implant between the upper second premolar and the upper first molar with a force of 0.98 N applied to the canine cut along the retracting direction for each side. Group 3 was based on Group 2, which implanted an additional mini-implant between the upper central incisors with a force of 0.98 N applied to the upper anterior teeth cuts. Group 4 was also based on Group 2, which implanted 2 additional mini-implants between the upper central and lateral incisors with a force of 0.56 N applied to the upper anterior teeth cuts for both sides. Anterior teeth torque changes, displacement patterns, and stress distributions were analyzed. Results Among all the experimental groups, the anterior teeth demonstrated intrusion and distal inclination, accompanied with varied degrees of torque loss. In Group 3, the maxillary and lateral incisors had the smallest sagittal coronal displacement. In Group 4, the intrusion values of the maxillary and lateral incisors were the largest among all the experimental groups. The maximum stress concentration in Group 2 was the most significant among all the experimental groups. Conclusion Implanting the mini-implant between the central incisors for traction is conducive to torque control. By contrast, implanting the mini-implants between the central incisors and lateral incisors combined with vertical traction is conducive to simple intrusion, avoiding the “bowing effect” to a certain extent.

Growth-hormone deficiency (GHD) is a common growth-related disease in children, and the main reason is the lack of growth hormone. In the oralfacial region, GHD often manifests as severe mandibular retraction, which increases the difficulty of clinical treatment. This article reports a case of severe mandibular retraction with GHD subjected to functional orthopedic treatment combined with differential-force technique, which yielded satisfactory results. This study can serve as a reference for clinical treatments of similar cases.

Salivary low-grade intraductal carcinoma (LGIDC) is a rare tumor that mainly occurs in the parotid. Thus far, LGIDC originating from the accessory parotid gland has been rarely reported in domestic and foreign literature. This study reports a case of LGIDC of the accessory parotid gland and a brief summary of its clinical features, diagnostic points, and treatment by reviewing the literature, with the aim of providing a reference for clinical practice and further research.

Quantitative grinding of abutment teeth is needed in crown and bridge restoration. Accurate quantitative preparation of teeth is one of the goals of minimally invasive restoration. In this paper, a case of congenital loss of upper and lower incisors was reported. Guided by the target restoration space (TRS), a personalized digital guide plate for tooth preparation was built to assist precise tooth preparation after the multidisciplinary combination therapy of orthodontic and periodontal teeth. Finally, the fixed bridge was prepared to meet the integrity, beauty, and function of the maxillary for the patient. In this case, the results suggest that the digital guide plate built under the guidance of TRS can be used to improve the accuracy of dental preparation.