Oral mucosal administration is extensively used to treat systemic diseases and oral mucosal diseases owing to unique oral mucosal structure and convenient administration. However, the special microenvironment of the oral cavity being open, moving, and humid causes oral mucosal drug delivery to face great challenges. To address this dilemma, local adhesive agents have been widely studied for sustained drug delivery and improved bioavailability, showing broad prospects. Recently, the author has performed studies on oral mucosal adhesive agents. In this paper, the progress of research on oral mucosal adhesive materials is reviewed.

Objective This study aimed to investigate the feasibility of gelatin methacryloyl (GelMA) hydrogel loa-ded with minocycline-chitosan-nanoparticles (MCN) for the treatment of periodontitis in vitro and vivo. Methods MCN were synthesized by ionic gel method. GelMA/MCN composite hydrogels were prepared by compounding MCN with GelMA hydrogel. The materials were characterized by transmission electron microscope, scanning electron microscopy, and Fourier transform infrared spectroscopy. The degradation behavior and drug release rates of hydrogels were evaluated. The antibacterial activity of GelMA/MCN hydrogel against Porphyromonas gingivalis was detected, and the minimum antibacterial concentration was determined. Biocompatibility and osteogenic experiments were conducted under a simulated periodontitis environment. A rat model of periodontitis was constructed to observe the therapeutic effects of GelMA/MCN hydrogel. Results MCN was successfully synthesized with a particle size of about 80 nm, while the structures of GelMA/MCN had no significant differences from GelMA. MCN and GelMA/MCN released minocycline slowly and steadily. Bacterial growth was completely inhibited when the MCN concentration was higher than or equal to 0.2 mg·mL^-1. GelMA/MCN hydrogels exhibited good biocompatibility at effective antimicrobial concentrations under the simulated periodontitis environment with the enzyme. The in vivo results showed that GelMA/MCN prevented the progression of periodontitis and promoted the repair of bone defects. Conclusion GelMA/MCN composite hydrogel can release minocycline slowly and steadily and has good antibacterial activity and biocompatibility to promote the repair of periodontitis bone defects.

Objective To investigate the feasibility of different thermosensitive composite hydrogels from chitosan derivatives as scaffold materials for periodontal tissue engineering. Methods Three chitosan derivatives with different biological characteristics were prepared, namely, sulfonated chitosan (SCS), phosphorylated chitosan (PCS), and phosphorylated sulfonated chitosan (PSCS). Three thermosensitive composite hydrogels were constructed using basic fibroblast growth factor (bFGF), the chitosan derivatives, and collagen. Twenty male Wistar rats were randomly divided into control group, blank group, bFGF/SCS/collagen composite thermosensitive hydrogel group, bFGF/PCS/collagen compo-site thermosensitive hydrogel group, and bFGF/PSCS/collagen composite thermosensitive hydrogel group. Then, three-wall intrabony defects were established. The defects were treated with the different kinds of thermosensitive composite hydrogels. After 6 weeks of surgery, the animals were killed, and specimens were collected. Then, gross observation, hematoxylin-eosin staining, and Masson staining were performed. Results The bFGF/chitosan derivatives/collagen composite thermosensitive hydrogel groups and the control group had statistical differences in the relative alveolar bone height, relative epithelial down growth and grading count score of periodontal tissue regeneration (P<0.05). Conclusion bFGF/chitosan derivatives/collagen composite thermosensitive hydrogels have good application prospects in periodontal tissue engineering.

Objective This study aimed to investigate the expression of TGFBI in infantile hemangioma (IH) of proliferative stage or involuting stage and detect the effects of TGFBI overexpression or knockdown on the biological beha-vior of hemangioma endothelial cells (HemECs) from proliferative IH by using plasmid and siRNA. Methods TGFBI expression levels in proliferative IH and involuting IH were detected by immunofluorescence. TGFBI overexpression plasmid and negative control plasmid were constructed and transfected into HemECs. siRNA for TGFBI and its negative control siRNA were constructed and transfected into HemECs. Western blot was used to detect the expression of TGFBI in the TGFI overexpression group (OE group) and its negative control (NC group), as well as TGFBI knockdown group (si-TGFBI group) and its negative control (si-NC group), to confirm the efficiency of transfection. CCK-8 assays were performed to assess the viability of HemECs. EdU assays were conducted to investigate the proliferation ability of HemECs. Transwell assays were used to detect the migration ability of HemECs. Tube formation assays were carried out to assess the angiogenic capacity of HemECs. Extracellular acidification rate (ECAR) assays were performed to investigate the glycolysis level of HemECs. Results The results of immunofluorescence showed that TGFBI expression was significantly elevated in proliferative IH compared with that in involuting IH. Western blot showed that TGFBI expression in the OE group was upregulated compared with that in the NC group, and TGFBI expression in si-TGFBI was downregulated compared with that in the si-NC group. The viability, cell proliferation, migration ability, and angiogenic capacity of HemECs were promoted in the OE group compared with those in the NC group, whereas these biological behaviors were inhibited in the si-TGFBI group compared with those in the si-NC group. In ECAR assays, the glycolysis level of HemECs in the OE group was enhanced compared with that in the NC group. Conclusion TGFBI is upregulated in proliferative IH. TGFBI overexpression enhanced the viability, cell proliferation, migration ability, and angiogenic capacity of HemECs, which indicated that TGFBI might play a key role in IH progression by accelerating glycolysis. Thus, targeting TGFBI might be an effective therapeutic strategy for IH.

Objective This work aimed to investigate the transcriptome heterogeneity of dexamethasone-induced congenital cleft palate in homozygous New Zealand rabbits and determine the molecular mechanism underlying the occurrence of congenital cleft palate. Methods Dexamethasone (1.0 mg per day) was administered intramuscularly to 20 New Zealand pregnant rabbits from day 14 to day 17 of gestation, and the palatal phenotype of all offspring of each pregnant rabbit was observed. Eight embryos with a 4∶4 ratio of cleft palate to non-cleft palate were selected and divided into the cleft palate group (CP) and non-cleft palate group (NCP). Their palatal tissues were collected for RNA sequencing. Results A total of 225 differentially expressed genes (Q<0.05) were found in the CP group compared with the NCP group, of which 120 genes were upregulated and 105 genes were downregulated. The GO and KEGG enrichment analyses of these differentially expressed genes were carried out. The results showed significant enrichment in GO classification, which included heterotrimeric G protein complex, extracellular matrix, transcription factor complex, and basement membrane. Meanwhile, GABA ergic synapse, morphine addiction, retrograde endocannabinoid signaling, glutamate synapse, serotonergic synapse, regulation of actin cytoskeleton, and the Apelin signaling pathway were significantly enriched in the KEGG pathway. Compared with the NCP group, the gene expression levels of ARHGEF6 (P<0.05) and ABI2 (P<0.001) decreased in the CP group, and APC increased (P<0.001); these results were confirmed by real-time polymerase chain reaction. Conclusion Abnormal expression levels of the ARHGEF6, APC, and ABI2 genes involved in the regulation of the actin cytoskeleton in the palatal synapse may be associated with the dexamethasone-induced congenital cleft palate in New Zealand rabbits.

Objective This study aimed to summarize the clinical outcomes of surgical treatment for severe medication-related osteonecrosis of the jaw (MRONJ, stages 2 and 3). Methods A retrospective cohort study was conducted to review the patients with severe MRONJ from July 2013 to May 2021. All patients were treated surgically. The characteristics and clinical variables were recorded and analyzed. Results A total of 104 patients (123 MRONJ lesions) were included, including 42 males and 62 females, aged 64.6±9.1 years. The primary disease was malignant in 91 cases and benign in 13 cases. Forty-three cases (35.0%) were stage 2 lesions, and 80 (65.0%) were stage 3 lesions. Thirty-nine (31.7%) lesions were located in the maxilla, and 84 (68.3%) lesions were located in the mandible. The most commonly used bisphosphonates were zoledronic acid (n=89; 85.6%), followed by alendronate (n=10; 9.6%), and pamidronate (n=10; 9.6%). Antiangiogenic agents were administered in 62 (59.6%) patients. The mean duration of bisphosphonate therapy was 34.7±25.8 months, and the mean duration of drug holiday was 10.1±10.7 months. All operations were performed under general anesthesia. For stage 2 lesions, debridement and saucerization were performed to completely resect the lesions, and the wounds were closed without tension through local mucoperiosteum flaps. For stage 3 lesions, after the lesions were completely resected, the bone defect was covered by reconstruction plate fixation and ipsilateral submandibular gland translocation, iodoform gauze, and buccal fat pad accordingly. The follow-up period ranged from 3 months to 6 years; 81.3% (100/123) of the lesions reached mucosal healing at the last follow-up, whereas wound infection and dehiscence occurred in 18.7% (23/123) of the lesions postoperatively. Conclusion Severe MRONJ lesions could be surgically treated to achieve mucosal healing. Vascularized flap reconstruction could be considered if the patient’s general condition could tolerate it.

Objective This study aimed to investigate the oral health knowledge of elementary school teachers and assess their attitude towards oral health education in Zunyi. Methods A total of 636 teachers from 10 primary schools in Zunyi were selected by stratified sampling, and their general information, oral health care habits, results of oral health knowledge questionnaire, and attitude towards oral health and oral health education were investigated. Data were statistically analyzed using SPSS 21.0. Results A total of 614 teachers answered the questionnaires. Only 8.8% brush their teeth for more than three minutes, 23.8% brush their teeth horizontally, 64.7% do not performteeth cleaning, and 78.2% do not use floss. Teachers have a weak understanding that six-year teeth are permanent, that pit and fissure sealing could prevent dental caries, and that dental floss could remove dental plaque. However, their attitude towards oral health and oral health education was found to be good. Conclusion Schools could improve teachers’ oral health know-ledge by organizing training and other activities. Teachers could also play an active role in leading and cultivating school-age children to establish good oral habits.

Objective This study aims to evaluate the color stability and related properties including water sorption and solubility of ten light-cured composite resins in different solutions. Methods A total of 10 composite resins were BeautifilⅡ(B2) and Ceram. X One Universal (CXU), Charisma (CS), Charisma Diamond (CD), Denfil (DF), DX. Universal (DXU), Filtek Z250 (Z250), Filtek Z350 XT (Z350), FS-1 (FS), and Magnafill Putty (MP). Meanwhile, a total of 20 disk-shaped samples were fabricated and randomly divided into four groups (n=5), which were immersed in distilled water (control group), curry, coffee, and red wine for 28 days. The color (CIE L∗a∗b∗) was measured by a spectrophotometer at baseline and 1, 7, 14, 21, and 28 days after immersion, and the color differences were calculated. Water sorption and solubility values were measured ba-sed on ISO 4049: 2019. In addition, three-way ANOVA was used to evaluate the influence of resin materials, solutions, and immersion time on discoloration results, meanwhile, one-way ANOVA was used to compare the water sorption values and solubility values of different materials. Results All samples showed a certain degree of color change with time. Color differences were significantly influenced by materials, solutions, and immersion time (P<0.001). The color changes of the measured materials at any time point: curry>red wine>coffee>distilled water. Thus, all materials showed clinically unacceptable discoloration (ΔE>3.3) after immersing in staining curry, coffee, and red wine for 7 days. Therefore, when immersed in curry for 28 days, CS and DXU had the smallest and the largest color difference. In addition, when immersed in coffee for 28 days, FS showed the smallest color change and DXU showed the largest. Moreover, when immersed in red wine for 28 days, FS showed the smallest color change and Z350 showed the largest. Furthermore, MP and CXU had small color differences in all solutions. Meanwhile, Z350 had the highest water sorption and MP had the lowest. The solubility values of CS and CD were significantly higher than those of other materials. Conclusion The color stability of light-cured composite resin is materials-depended and affected by pigment types and immersion time. Thus, MP and CXU have better color stability. MP has low water sorption.

Objective This study aims to investigate the incidence and clinical characteristics of concomitant hypodontia and hyperdontia (CHH) by performing panoramic radiographs. Methods A total of 41 648 panoramic radiographs of pediatric patients who were admitted to the hospitals from January 2019 to May 2021 were reviewed, and 145 CHH patients were included in the study. The presence of CHH was recorded. SPSS 24.0 software was used for statistical analysis. Results The prevalence of CHH was 0.35% (145/41 648). Males (102 cases) were obviously more than females (43 cases), and the difference between genders was statistically significant (P<0.001). The features of congenital permanent tooth loss in this group were predominantly 1 and 2 teeth missing and preferably mandibular lateral incisors and mandibular second premolars missing. The incidence of congenital permanent teeth loss was higher in the mandible than in the maxilla (P<0.001), but no difference was found in the distribution between left and right (P=0.84). The features of supernumerary teeth in this group were 1 and 2 teeth, mostly in the maxillary anterior area, mostly conical, mostly vertical inversion and orthotopic growth. Conclusion CHH is a rare mixed numeric dental anomaly characterized by congenital missing teeth and supernumerary teeth occurring in the same individual. CHH cases are higher in men than in women. The characteristics of their hypodontia and hyperdontia are similar to those of patients with congenital permanent tooth absence or supernumerary teeth. Early diagnosis of the condition and a multidisciplinary approach for management of such case is recommended.

Objective To investigate the influencing factors of children’s dental fear (CDF) and the relationship of CDF with resilience in children aged 8-9 years in Weifang city to provide evidence for the early prevention and intervention of CDF. Methods Random cluster sampling method was applied. A total of 1 995 children aged 8-9 years from 10 primary schools in four districts of Weifang city were selected from June to October 2021 as the survey objects. General information questionnaire, the children’s fear survey schedule-dental sub-scale, and adolescent resilience scale were used in the investigation. Results The CDF detection rate was 31.78% (634 cases) in children aged 8-9 years in Weifang city, including 28.41% (296 cases) in boys and 35.47% (338 cases) in girls. Multivariate logistic analysis showed that female gender [odds ratio (OR)=1.329, 95% confidence interval (CI)=1.062-1.665], dental caries (OR=1.961, 95%CI=1.330-2.891), dental pain (OR=2.133, 95%CI=1.700-2.676), and dental treatment experience (OR=3.621, 95%CI=2.888-4.540) are risk factors for CDF. Parents with tertiary education or higher (OR=2.123, 95%CI=1.546-2.916; OR=3.304, 95%CI=2.368-4.612), high scores in the positive cognition factor of the psychological resilience-personal strength dimension (OR=1.520, 95%CI=1.141-2.025), high scores in the interpersonal assistance factor of the psychological resilience-support strength dimension (OR=3.819, 95%CI=2.743-5.318), and high scores in the family support factor (OR=5.634, 95%CI=4.047-7.844) were protective factors for CDF occurrence (P<0.05). Conclusion Children with high psychological resilience scores have low CDF incidence, and good parenting practices are beneficial in reducing CDF incidence.

Objective This study aimed to systematically evaluate the safety and clinical efficacy of 4 mm-extra-short implant (ESI) placement in severely atrophic posterior areas. Methods Databases of PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang from January 1, 2010, until August 31, 2022, were searched to identify randomized controlled trials or controlled clinical trials related to ESI and standard implants (SI). An additional hand search of the references of included articles was also conducted. Meta-analyses were carried out with RevMan 5.4 software. Results A total of 11 studies were included, involving six randomized controlled trials and five controlled clinical trials. The meta-analyses indicated that when implants were placed in the posterior area, the implant survival rate between ESI and SI did not significantly differ [RR=1.23, 95%CI (0.66, 2.27), P=0.52]. ESI resulted in significantly stable marginal bone level [MD=-0.16, 95%CI (-0.25,-0.07), P=0.000 7] and less biological complications [RR=0.34, 95%CI (0.19, 0.62), P=0.000 4] but more mechanical complications [RR=2.89, 95%CI (1.05, 7.92), P=0.04]. Conclusion Based on the limited evidence, ESI could achieve clinical outcomes similar to those of SI when the height of the posterior alveolar bone is less than 5 mm, with lower technical sensitivity and fewer postoperative clinical complications than SI. Due to insufficient evidence and limited sample size, further clinical trials are needed to verify the long-term efficacy of ESI.

Objective This study aimed to systematically evaluate the prevalence of dental anxiety in Chinese adults and to provide references for decision making on oral healthcare. Methods We searched PubMed, Web of Science, Ebsco, Embase, The Cochrane Library, WanFang Data, CNKI, and VIP database to collect cross-sectional studies on dental anxiety in Chinese adults from the establishment of the databases to 30 September 2022. After literature screening, data extraction, and evaluation of the risk of bias in the included studies by two researchers independently, R 4.0.4 software was used to perform a Meta-analysis. Results A total of 39 studies were included, including 24 309 subjects. Meta-analysis showed that the prevalence of dental anxiety in Chinese adults was 35.39% [95%CI (31.31%, 40.01%)]. Subgroup analysis showed that the prevalence rates of male and female adults were 32.92% and 44.78%, respectively. The prevalence rates of adults aged 16-39,40-59, ≥60 were 49.37%, 47.13%, and 37.41%, respectively. The prevalence rates of mild, moderate, and severe patients were 13.81%, 15.15%, and 9.24%, respectively. The prevalence rates of adults with elementary school and below, middle school, and university and above education levels were 33.81%, 35.84%, and 36.24%, respectively. The prevalence rates were 39.45% and 45.90% in adults with and without dental-treatment history, respectively. The prevalence rates of adults surveyed in dental and non-dental clinics were 27.10% and 39.31%, respectively. Conclusion The prevalence of dental anxiety in Chinese adults was relatively high, primarily moderate anxiety, and it was more likely to occur in women, young people, and groups with no history of dental treatment. Early intervention should be performed for adults with dental anxiety to improve their awareness of oral healthcare and treatment compliance and thus to promote the oral-health level of adults in China.

Pyostomatitis vegetans (PSV) is a rare disease characterized by pustules. The typical manifestations are “snail-track” lesions, which widely involve multiple parts of the oral mucosa. It is often associated with inflammatory bowel disease. This paper reports a case of a patients with PSV and unilateral circumscribed swelling. Ulcerative colitis was revealed by oral lesions. The clinical manifestations as well as histopathological and immunopathological features of PSV were analyzed and summarized to provide ideas for clinical diagnosis and treatment.

Verrucous xanthoma is a rare benign muco-cutaneous lesion, whereas oral lichen planus is a chronic inflammatory disease relatively common in the clinical setting. Verrucous xanthoma and oral lichen planus can reportedly coexist according to foreign literature. Owing to the low incidence of verrucous xanthoma and the rarity of co-occurrence of these two diseases, the mechanism underlying the co-occurrence of the two diseases remains inconclusive. In this work, a case of oral verrucous xanthoma complicated with oral lichen planus was reported. Related literature was reviewed to discuss the clinical classification, pathological classification, and possible pathogenesis of the two diseases.

Cemento-ossifying fibroma (COF) is a benign mesenchymal odontogenic tumor that commonly occurs in the tooth-bearing areas of the maxilla and mandible. This study reports a COF case located under the left buccal mucosa. The classification and differential diagnosis of this COF case were discussed based on the diagnosis and treatment of this case and previous literature.

Anterior diastema and tooth defects are common clinical issues in restorative dentistry and are often restored by veneers or crowns based on the results of digital smile design and wax-up. Traditional direct resin restoration for closing a diastema is relatively minimally invasive but is time consuming and laborious, and shape control depends on experience. Digital technology can be used to design and transfer the shape of aesthetic restoration more accurately and quickly; thus, it could close anterior diastema and restore defects easily. According to the workflow, this technical process integrates virtual design and practical wax-up, transfers the designed restoration shape by templates, and injects through the preset channel after the template is in place. This clinical technique simplifies the clinical operation and saves clinical time, which can effectively improve the predictability and accuracy of the restoration and reduce technical sensitivity. This digital workflow provides a new technology for closing diastema quickly and effectively.