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Reflections on the current state of early orthodontic treatment
Li Huang
West China Journal of Stomatology    2025, 43 (2): 151-157.   DOI: 10.7518/hxkq.2025.2024323
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Early orthodontic treatment has been a hot spot and focus of development in recent years in the field of orthodontics, pediatric dentistry, and general practice dentistry. However, there are still some misconceptions, such as excessive or premature intervention, strict control of indications, exaggeration of the role of early orthodontic treatment. This article starts from the analysis of the current status of early orthodontic treatment in China and combines the latest literature and reviews at home and abroad to analyze the nine issues that dentists and the public are concerned about one by one, including whether early orthodontic treatment is a new concept, whether it is necessary, the timing of early orthodontic treatment, the indications for early orthodontic treatment, whether it can provide a non-tooth extraction or non-surgical opportunity, whether it can completely change the facial profile such as retrognathia and growth pattern of the mandible, whether it can treat habitual mouth breathing or adenoid face or obstructive sleep apnea, the role of myofunctional therapy with prefabricated appliances in early orthodontic treatment, whether transparent aligners are superior to traditional aligners in early orthodontic treatment, with the aim of promoting the standardization of early orthodontic treatment. Early orthodontic treatment must choose the right indications, master the basic principles and techniques of orthodontics, and choose the most suitable treatment method and timing for the child.

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Postextraction infections, prevention, and treatment
Cao Yubin, Ye Li, Pan Jian
West China Journal of Stomatology    2024, 42 (4): 426-434.   DOI: 10.7518/hxkq.2024.2023427
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Postoperative infection is one of the most common complications of tooth extraction. It may manifest as localized infection or develop to systemic infection. Clinically, oral surgeons can prevent postoperative infections by urging patients to strengthen oral hygiene, applying antibiotics in a rational and compliant manner, and choosing appropriate surgical methods for tooth extraction. For the treatment of infection, the oral surgeon should formulate a response strategy on the basis of different diagnoses. For local infections such as dry socket, delayed alveolar osteitis, gap infection, and marginal osteomyelitis of the jaws, the infection can be controlled by local debridement, therapeutic use of antibiotics, and incise and drain if necessary. For patients suspected of necrotizing fasciitis, timely extensive debridement should be made to reduce the area of tissue necrosis. For those who have received radiotherapy or anti-resorptive drugs, tooth extraction should follow the recommendations of the relevant clinical guidelines or expert consensus to minimize the risk of osteonecrosis of the jaws. For patients with poor systemic health or dysfunction of the immune system, attention should be paid to identifying infective endocarditis and intracranial infection to ensure the life safety of patients. In this study, the author intends to combine literature review and clinical experience to tackle postextraction infection and its prevention to provide a reference for colleagues on oral and maxillofacial surgery.

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Expert consensus on classification and diagnosis of congenital orofacial cleft
Li Chenghao, An Yang, Duan Xiaohong, Guo Yingkun, Liu Shanling, Luo Hong, Ma Duan, Ren Yunyun, Wang Xudong, Wu Xiaoshan, Xie Hongning, Zhu Hongping, Zhu Jun, Shi Bing
West China Journal of Stomatology    2025, 43 (1): 1-14.   DOI: 10.7518/hxkq.2025.2024306
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Congenital orofacial cleft, the most common birth defect in the maxillofacial region, exhibits a wide range of prognosis depending on the severity of deformity and underlying etiology. Non-syndromic congenital orofacial clefts typically present with milder deformities and more favorable treatment outcomes, whereas syndromic congenital orofacial clefts often manifest with concomitant organ abnormalities, which pose greater challenges for treatment and result in poorer prognosis. This consensus provides an elaborate classification system for varying degrees of orofacial clefts along with corresponding diagnostic and therapeutic guidelines. Results serve as a crucial resource for families to navigate prenatal screening results or make informed decisions regarding treatment options while also contributing significantly to preventing serious birth defects within the development of population.

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Periodontic-orthodontic-orthognathic combined treatment of adult Class Ⅱ skeletal malocclusion with idiopathic gingival fibromatosis: a case report
Yang Kuan, Zeng Xinyi, Chen Shuo, Duan Dingyu, Li Jihua, Duan Peipei
West China Journal of Stomatology    2025, 43 (2): 280-288.   DOI: 10.7518/hxkq.2024.2024254
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Idiopathic gingival fibromatosis is a rare, benign condition of unknown etiology characterized by extensive gingival overgrowth. This case reports a severe skeletal Class Ⅱ adult female patient with idiopathic gingival fibromatosis. The patient underwent multidisciplinary treatment involving periodontics, orthodontics, and orthognathic surgery, resulting in remarkable crown height elongation, substantial improvements in occlusal function and aesthetics, and stable long-term follow-up outcomes. This case provides a reference for future clinical practice.

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Research progress in problem-solving nickel-titanium rotary instrument in endodontics
Cui Chen, Quan Jingjing, Wei Xi
West China Journal of Stomatology    2024, 42 (6): 699-705.   DOI: 10.7518/hxkq.2024.2024225
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Root canal therapy is the primary treatment method for pulpal and periapical diseases. Various advanced endodontic instruments for mechanical preparation have been marketed. The emergence of nickel-titanium rotary instruments has greatly improved the efficiency of root canal preparation. New demands have been put forward for nickel-titanium rotary instruments as a result of the deepening of clinicians’ awareness of root canal anatomy system as well as the purpose and prognosis of root canal treatment. These clinical-oriented demands accelerate instrument reform and innovation. This work presents new marketed nickel-titanium systems and discusses the advantages and limitations of these systems and how they perform in terms of the efficiency and outcome of root canal preparation.

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Research status and prospects of biodegradable magnesium-based metal-guided bone regeneration membranes
Chen Liangwei, Han Jianmin, Guo Chuanbin
West China Journal of Stomatology    2024, 42 (4): 415-425.   DOI: 10.7518/hxkq.2024.2024140
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Biodegradable magnesium-based metal-guided bone regeneration (GBR) membranes possess excellent mechanical properties, biodegradability, and osteopromotive capabilities, making them ideal implants for the treatment of maxillofacial bone defects. This review summarizes the current status and future research trends related to magnesium-based GBR membranes. First, the research history and application fields of magnesium-based metals are introduced, and the advantages of the use of magnesium-based materials for GBR membranes, including their mechanical properties, biocompatibility, osteopromotive performance, and underlying mechanisms are discussed. Finally, this review addresses the current limitations of magnesium-based GBR membranes and their applications and prospects in the field of dentistry. In conclusion, considerable advancements have been in fundamental and translational research on magnesium-based GBR membranes, which lays a crucial foundation for the treatment of maxillofacial bone defects.

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Comparison of upper airway volume and hyoid position after camouflage orthodontic or orthodontic-orthognathic treatment in patients with skeletal class Ⅲ malocclusion with normal-angle vertical pattern
ChingCho Hsu, Liu Haojie, Lin Chengzhao, Liu Zhenhao, Zhai Ye, Guo Shuyu, Xu Rongyao
West China Journal of Stomatology    2025, 43 (1): 53-62.   DOI: 10.7518/hxkq.2025.2024184
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Objective This study aims to compare the effects of two orthodontic treatment modalities for skeletal class Ⅲ malocclusion on specific changes in airway volume, morphology, palatal angle, mandibular rotation, and bone displacement. Results provide scientific evidence for the selection of orthodontic treatment plans and reduce the risk of developing obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Thirty-six patients diagnosed with skeletal class Ⅲ malocclusion at the Department of Orthodontics, the Affiliated Stomatological Hospital of Nanjing Medical University from September 2018 to December 2023 were divided into two groups: orthodontic-orthognathic treatment group (18 patients) and camouflage orthodontic treatment group (18 patients). Changes in airway volume, cross-sectional area, palatal angle, mandibular, and tongue positions were observed through pre- and post-operative cone beam computed tomography and 3D cephalometric measurements. Results In the camouflage orthodontic treatment group, nasopharyngeal volume and oropharyngeal volume statistically increased after treatment (P<0.05). In the orthodontic-orthognathic treatment group, changes in nasopharyngeal volume, nasopharyngeal airway, distance from posterior tongue to pharyngeal wall, palatal angle, mandibular rotation, and hyoid bone displacement were statistically significant after surgery (P<0.05). In the comparison between the two groups after treatment, changes in the distance from posterior tongue to pharyngeal wall, palatal angle, and distance from hyoid bone to sella turcica point were statistically significant (P<0.05). Conclusion Patients in the orthodontic-orthognathic treatment group showed significantly greater changes in oropharyngeal cross-sectional area, palate angle, and tongue position compared with patients in the camouflage orthodontic treatment group. As individuals susceptible to OSAHS often exhibit mandibular retrusion and decreased minimum airway cross-sectional area, special attention should be paid to airway morphology changes when adopting orthodontic-orthognathic treatment to avoid adverse consequences.

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Three-dimensional finite element feature analysis of the mandible and morphology and position of temporomandibular joint in patients with unilateral and bilateral molar scissor bite
Chu Tianhao, Zhang Xueying, Wang Haocheng, Ma Haojie, Liu Yuanyuan
West China Journal of Stomatology    2025, 43 (1): 114-125.   DOI: 10.7518/hxkq.2024.2024169
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Objective The objective of this study is to measuring the morphology and position of bilateral temporomandibular joints in patients with unilateral and bilateral molar scissor bite and simulating the deformation of the mandible during occlusion, in order to provide thesis for the diagnosis of temporomandibular joint disease in patients with unilateral and bilateral molar scissor bite. Methods This study was a retrospective study. A total of 10 patients with unilateral molar scissor bite (the unilateral molar scissor bite group) and 10 patients with bilateral molar scissor bite (the bilateral molar scissor bite group) were selected as the experimental group, and 20 adult patients with classⅠ of angle classification of similar ages were selected as the control group. All patients underwent cone beam computed tomography scans, by measuring the width of the fossa, height of the fossa, articular eminence inclination, long axis of the condyle, minor axis of the condyle, horizontal angle of the condyle and the space of the temporomandibular joint, compare temporomandibular joint morphology and position. The three-dimensional finite element analysis of the mandible morphology was carried out to evaluate the force and deformation of the mandible by using software to simulate the occlusion of the patients. It was further explored the relationship between the force of the mandible morphology and the possible temporomandibular joint disorder symptoms of the patients. Results Intergroup comparisons for the unilateral molar scissor bite group and left sides of the other groups revealed that the superior articular space in the group with unilateral molar scissor bite was shorter than that in the control group (P<0.05); the long axis of the condyle in the unilateral and bilateral molar scissor bite group were both shorter than that of the control group (P<0.05); among which the unilateral group was larger than the bilateral group, and the minor axis of the condyle in bilateral molar scissor bite group was smaller than in the control group (P<0.05), and the unilateral and bilateral condylar groups were larger than the control group (P<0.05); and the condylar horizontal angle in the unilateral and bilateral groups were larger than that in the control group (P<0.05). The normal sides of the unilateral molar scissor bite group and right sides of the other groups had smaller superior articular space than the control group (P<0.05); and the condylar long-axis in bilateral group was smaller than the control group (P<0.05); and the normal side of the condylar short-axis unilateral group was larger than that of the bilateral condylar group. Three-dimensional finite element analysis: the condyle of patients with molar scissor bite was a concentrated area of deformation during the bite of the mandible, when the first molar occlusion of the scissors bite side was simulated, the maximum deformation was located in the condyle in the X-axis and Z-axis directions. The amount of deformation was greater than that of the scissor bite side in the X-axis direction, while in the Z-axis direction, the normal side was greater than the scissor bite side. The maximum sites of local deformation in the X-axis direction were located in anterior and posterior the transverse crest of scissor bite side, and the minimum sites of local deformation was at 1/3 of the anterior slope of the inner pole of the normal side, the maximum local deformation sites in the Z-axis direction were located in the outer pole and below the outer pole of the normal side. The X-axis deformation value was the largest in the molars occlusion on the normal side, the Y-axis deformation value was in the premolars occlusion on the normal side, and the Z-axis deformation value was the largest in the centric occlusion, the deformation value of the condyle was not most significant in molar scissor bite. Conclusion Unilateral and bilateral molar scissor bite resulting in a short condyle morphology, and the bilateral group had a shorter condylar morphology than the unilateral group. The condyle of the patient with molar scissor bite is a concentrated area of poor occlusal deformation, and the largest sites of deformation are distributed near the transverse ridge of the inner and outer poles of the condyle. Different occlusion conditions have an effect on condylar deformation values, but do not indicate whether there is a clear association between them.

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New concepts, methods, and techniques for unilateral cleft lip repair
Shi Bing
West China Journal of Stomatology    2025, 43 (3): 299-304.   DOI: 10.7518/hxkq.2025.2025018
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The unilateral cleft lip repair surgery has undergone over a century of development, marked by achievements and difficulties. Although the development of the methods for cleft lip repair has passed the period of rapid advancement, there remains an urgent need in clinical practice to further improve these methods in order to enhance clinical outcomes. This article aims to improve cleft lip repair methods by analyzing and elaborating on various aspects, including the attributes of cleft lip repair, the shift in concepts of cleft lip repair, innovations in surgical techniques, technical improvements, and classifications and repair methods for correcting secondary deformities. The analysis is based on the author's research and experience.

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A case of hypophosphatemia rickets with unidentified apical periodontitis as the initial symptom of diagnosis
Shi Yuan, Su Jimei, Lü Lihua, Wu Dingwen
West China Journal of Stomatology    2024, 42 (6): 832-838.   DOI: 10.7518/hxkq.2024.2024175
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Hypophosphatemia rickets is a rare disease that is divided into two categories, namely, hereditary and acquirability. Its clinical manifestations include growth disorders, limb deformities and dysfunction, poor mineralization of the teeth, and growth retardation in children as well as hyperparathyroidism, osteoarthritis, osteomalacia, and pseudofracture in adults. Oral manifestations include non-carious teeth with recurrent apical periodontitis, periapical abscess and even cellulitis, periodontitis, and early tooth loss. X-linked hypophosphatemia rickets (XLHR) accounts for approximately 80% of all hypophosphatemia rickets. We report a 3-year-old child with XLHR whose first diagnosis was apical periodontitis of multiple non-carious and non-traumatic teeth. Through medical history, clinical examination, laboratory examination, radiographic findings, genotype testing, and literature analysis, we analyze the pathogenesis, clinical manifestations, radiographic features, diagnosis and differential diagnosis, treatment, and follow-up. This work provides reference for clinical diagnosis and treatment and reduces missed diagnosis and misdiagnosis by dentists.

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Clinical analysis of changes in the position of the condyle and temporomandibular joint after repair of mandibular defects
Li Shensui, Tian Xudong, Wu Yadong, Wang Weili, Tang Zhenglong
West China Journal of Stomatology    2025, 43 (3): 422-430.   DOI: 10.7518/hxkq.2025.2024337
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Objective This retrospective study aimed to investigate factors influencing positional changes of the condyle and temporomandibular joint (TMJ) following mandibular defect reconstruction with bone flaps, and to evaluate the biomechanical impacts of flap reconstruction on condylar positioning, thereby providing evidence for optimizing surgical protocols and TMJ functional rehabilitation. Methods A retrospective study was conducted on 90 patients undergoing mandibular segmental resection with immediate bone flap reconstruction at Guizhou Medical University Affiliated Stomatological Hospital (June 2019 to May 2024). After strict screening, 50 cases with complete data were analyzed. Clinical parameters (defect size, location, reconstruction method) and craniofacial CT scans at four timepoints [preoperative (T0), 7-10 days (T1), 3 months (T2), and 6 months (T3) postoperatively] were collected. Mimics 20 software facilitated 3D reconstruction for measuring TMJ anterior/posterior/superior joint spaces (Kamelchuk method) and calculating condylar position via the Pullinger index [Ln (posterior/anterior space)]. Vitral and Krisjane methods quantified mandibular linear parameters (ramus length, condylar pole distances to the sagittal plane, angulation) and glenoid fossa morphology. Statistical analyses were performed using SPSS 21.0. Results Mandibular defect size and location were significant factors influencing postoperative condylar position changes (P<0.05). Compared to preoperative measurements, postoperative condylar anterior, posterior, and superior joint spaces were significantly increased (P<0.001). The most pronounced anterior condylar displacement occurred within 7-10 days postoperatively (P<0.05). In patients with condyle resection, postoperative joint space and angle changes were significant; in patients with condyle preservation, only superior and anterior joint space changes were statistically significant (P<0.05). Additionally, from T1 to T2, the changes in condylar medial-lateral distance, superior joint space, and anterior joint space were negatively correlated with the preoperative condylar position. Compared with preoperative,in the T0-T1 period, condylar medial-lateral distance, posterior joint space, and articular tubercle angle changes were significantly negatively correlated with time (P<0.05). Notably, the angle between the condylar long axis and the coronal axis showed a sustained negative trend from T1 to T3 (P<0.05). Conclusion Condylar position changes after mandibular defect repair with bone flap reconstruction are associated with the size and location of the defect. Additionally, adaptive remodeling of the temporomandibular joint (TMJ) joint space occurs postoperatively. The phenomenon of anterior displacement of the condyle in the early postoperative period (7-10 days) shows a trend of reduction with prolonged follow-up time, and further sample size research is needed.

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L-shape technique with concentrated growth factor for horizontal bone defects in the maxillary anterior region: a clinical and radiographic study
Shi Ruiwen, Yang Hu, Liu Yue, Shi Yilin, Zhang Shengben, Liu Yu, Song Feng, Lan Jing
West China Journal of Stomatology    2025, 43 (1): 76-83.   DOI: 10.7518/hxkq.2024.2024268
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Objective To study the clinical effect of the L-shape technique combined with concentrated growth factor on the horizontal bone defects of maxillary anterior teeth. Methods Twenty-five implants from 25 patients who underwent single maxillary anterior tooth implantation with simultaneous bone grafting were selected as the study subjects. Based on the bone grafting techniques, the patients were divided into a test group (L-shaped technique with guided bone regeneration combined with concentrated growth factor, 11 cases) and a control group (traditional guided bone regeneration combined with concentrated growth factor, 14 cases). The early discomfort and wound healing conditions in the two groups at two weeks after surgery were compared. The horizontal bone thickness, vertical bone thickness, and grayscale values in the augmentation area were measured immediately postsurgery and six months after surgery. Implant stability, hard tissue resorption within six months, and grayscale values were compared between the two groups. Results Differences in early discomfort, wound healing, implant stability, and grayscale values between the two groups were not statistically significant (P>0.05). Vertical bone thickness in the test group was significantly better than that in the control group at six months after surgery (P<0.05). The variation in horizontal bone thickness in the test group was significantly higher than that in the control group (P<0.05). Conclusion The application of the L-shape technique with concentrated growth factor for horizontal bone defects in the anterior maxillary area yielded satisfactory short-term results in terms of bone augmentation, early discomfort, wound healing, and implant stability at six months after surgery.

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Guided bone regeneration therapy based on plaque control of peri-implantitis with follow-up at 7 years
Su Wenqi, Zhang Dandan, Cheng Yan, Cui Wenjie, Lei Lang, Li Houxuan
West China Journal of Stomatology    2025, 43 (1): 133-139.   DOI: 10.7518/hxkq.2024.2024131
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Peri-implantitis is a pathologic condition associated with dental plaque that occurs in the implant tissue and is characterized by inflammation of the mucous membrane surrounding the implant, followed by the progressive loss of supporting bone. In this study, a case of guided bone regeneration therapy based on plaque control of peri-implant inflammation was reported. Four years after surgery for the left second premolar implant, the patient presented with “left lower posterior tooth swelling and discomfort for more than 2 years”. The X-ray periapical film showed a decrease in distal bone mineral density of implant, and the clinical diagnosis was peri-implantitis of the left second premolar. Implants underwent guided bone regeneration and regular periodontal maintenance treatment. Re-examination at 3.5 months, 11 months, 18 months, and 7 years showed that the alveolar bone height and bone mineral density were stable, and the periodontal depth became shallow. However, the gingival recession was mild. In the present case, follow-up at 7 years demonstrated that the clinical periodontal indexes could be remarkably improved after complete periodontal treatment for peri-implantitis, and the alveolar bone could be well restored and regenerated.

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Clinical study of the effect of the metal precrown restoration in the first deciduous molar on the composite resin filling in the second deciduous molar
Wang Chunxian, Zhang Yu
West China Journal of Stomatology    2024, 42 (6): 773-777.   DOI: 10.7518/hxkq.2024.2024189
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Objective The effect of metal precrown restoration of distal proximal maxillofacial caries in the first deciduous molar on the composite resin filling of mesio-adjacent maxillofacial caries in the second deciduous molar was investigated. Methods A total of 80 children aged 4-8 who visited our clinic were selected, and 120 teeth were examined. Two consecutive deciduous molars in one jaw were considered a single case when the distal proximal maxillary surface of the first deciduous molar and the mesial proximal maxillary surface of the second deciduous molar simultaneously had caries. The teeth were randomly divided into two groups: group A (68 cases), in which the first and second molars were repaired with composite resin, and group B (52 cases), in which the first deciduous molar was repaired with metal precrown after composite resin filling and the second deciduous molar was filled with composite resin. The two groups were compared in terms of the success rate of composite resin filling in the second deciduous molar. Results At 3 months, no significant difference (P>0.05) was found between groups A (92.65%) and B (96.15%). At 6 months, no significant difference (P>0.05) was observed between groups A (89.71%) and B (94.23%). At 12 months, statistically significant difference (P<0.05) was found between groups A (73.53%) and B (88.46%); At 24 months, statistically significant difference (P<0.05) was found between groups A (66.18%) and B (86.54%). Conclusion Compared with composite resin filling of the first deciduous molar, the metal precrown restoration of the first deciduous molar can improve the success rate of composite resin filling of the second deciduous molar.

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A cross-sectional study on improving clinical efficiency through centralized digital impression
Xu Yingxin
West China Journal of Stomatology    2025, 43 (1): 63-67.   DOI: 10.7518/hxkq.2024.2024159
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Objective This study aims to explore the effect of improving clinical efficiency by replacing traditional impression workflow with centralized digital impression workflow. Methods The department of prosthodontics in Center of Stomatology, Peking University Shenzhen Hospital has improved the clinical workflow by replacing the traditional impression made by doctors using impression materials for each patient with a centralized digital impression made by one technician for all patients in the department. This cross-sectional study recorded the chairside time required for impression taking in patients undergoing single posterior zirconia full crown restoration before clinical process improvement; the time required for centralized digital impression production; the comfort level of patients; and the adjacency relationship, occlusal contact relationship, and time required for prostheses adjusting (i.e., whether centralized digital impressions would compromise the quality of pro-stheses and increase the time of prostheses adjusting). Results The average time to make a traditional impression was (9.98±1.41) min, and the average time required for each patient to make a centralized digital impression was (5.98±1.49) min, which was shorter than that to used make a traditional impression (P<0.05). Centralized digital impression made patients feel more comfortable compared with traditional impression (P<0.05). The adjacency relationship of restorations by centralized digital impression was more appropriate (P<0.05), and no significant difference in occlusal relationship was found (P>0.05). The time required for adjusting prostheses also had no significant differences (P>0.05). Conclusion Centralized digital impression can improve clinical efficiency for patients undergoing single posterior zirconia crown restoration. The time for impression taking is shorter, and patients feel more comfortable without compromising the quality of the prostheses.

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Application value of generative artificial intelligence in the field of stomatology
Ye Yuanlong, Zeng Wei, Chen Jinlong, Liu Lei
West China Journal of Stomatology    2024, 42 (6): 810-815.   DOI: 10.7518/hxkq.2024.2024144
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Objective This study aims to compare and analyze three types of generative artificial intelligence (GAI) and explore their application value and existing problems in the field of stomatology in the Chinese context. Methods A total of 36 questions were designed, covering all the professional areas of stomatology. The questions encompassed various aspects including medical records, professional knowledge, and translation and editing. These questions were submitted to ChatGPT4-turbo, Gemini (2024.2) and ERNIE Bot 4.0. After obtaining the answers, a blinded evaluation was conducted by three experienced oral medicine physicians using a four-point Likert scale. The value of GAI in various application scenarios was evaluated. Results Gemini scored 45, ERNIE Bot scored 38, and ChatGPT scored 33 for clinical documentation and image production. For research assistance, Gemini achieved 45, ERNIE Bot had 39, and ChatGPT scored 35. Teaching assistance capabilities were rated at 54 for ERNIE Bot, 50 for Gemini, and 48 for ChatGPT. In patient consultation and guidance, Gemini scored 78, ERNIE Bot scored 59, and ChatGPT scored 48. Overall, the total scores were 218, 190, and 164 for Gemini, ERNIE Bot, and ChatGPT, respectively. Among GAI applications, the top scoring categories were article translation and polishing (26), patient-doctor communication documentation (23), and popular science content creation (23). The lowest scoring categories were literature search and reporting (13) and image generation (12). Conclusion In the Chinese context, the application value of GAI is the highest for Gemini, followed by ERNIE Bot and ChatGPT. GAI shows significant value in translation, patient-doctor communication, and popular science writing. However, its value in literature search, reporting, and image generation remains limited.

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Clinical study on deciduous fused teeth and inherited permanent teeth
Qiu Fenfang, Meng Shan, Chong Yangyang, Song Xiaoli
West China Journal of Stomatology    2025, 43 (1): 92-97.   DOI: 10.7518/hxkq.2024.2024304
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Objective This study aimed to investigate the clinical characteristics of deciduous fused teeth and their inherited permanent-tooth performance type by using panoramic radiographs. Methods A total of 14 404 panoramic radiographs of 3- to 6-year-old children with deciduous dentition were collected from January 2023 to July 2024. The incidence of deciduous fused teeth was observed, and the abnormality of permanent teeth was recorded. SPSS 24.0 software was used for statistical analysis. Results The incidence of deciduous fused teeth was 3.06% (441/14 404). The order of dental position was as follows: mandibular deciduous incisors and cusp teeth fused (58.18%) > mandibular deciduous central and lateral incisors fused (30.91%) > maxillary deciduous central and lateral incisors fused (8.89%) > deciduous incisors and supernumerary teeth fused (2.02%). Deciduous fused teeth were found in 226 boys and 215 girls, with no significant difference between the sexes (P>0.05). We observed one pair (87.76%, 387/441) and two pairs (12.24%, 54/441) of fused teeth (54/441), respectively. A total of 287 pairs of fusion teeth on the right side more than 208 pairs on the left side, and the difference between them was statistically significant (P<0.01). More fusion teeth existed in mandibular deciduous teeth (443 pairs) than in maxillary ones (54 pairs), and the difference between them was statistically significant (P<0.01). More unilateral deciduous teeth (387 subjects) were found than bilateral ones (54 subjects), and the difference between them was statistically significant (P<0.01). Three types of deciduous fused teeth with inherited permanent teeth were observed as follows: 1) 49.49% (245/495) of inherited permanent teeth was absent, 2) 46.67% (231/495) of inherited permanent teeth was not absent, and 3) the number of fused permanent teeth accounted for 3.84% (19/495). Conclusion The incidence of deciduous fused teeth was 3.06%, mostly occurring in the lower anterior teeth region, with no gender difference. One pair of fused teeth is commonly observed, more often on the right than the left. These fusions occur more frequently in the mandible than the maxillary, and unilateral cases are more common than bilateral ones. Deciduous fused teeth had a certain impact on inherited permanent teeth. Pediatric dentists should pay attention to and closely observe whether any abnormality exists in the permanent dentition for early detection to prevent the harm caused by deciduous fused teeth.

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Effect of laser process parameters on the pores, surface roughness, and hardness of laser selective melting of dental cobalt-chrome alloys
Sang Lei, Yan Jiazhen, Li Ning, Xin Chenglai, Wang Qun, Liu Chang
West China Journal of Stomatology    2024, 42 (4): 462-469.   DOI: 10.7518/hxkq.2024.2023400
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Objective To address the quality problems caused by high porosity in the preparation of dental cobalt-chrome alloy prosthetics based on selective laser melting (SLM) technology, we investigated the influence mechanism of different forming process parameters on the microstructure and properties of the materials. Moreover, the range of forming process parameters that can effectively reduce defects was precisely defined. Methods The effects of laser power, scanning speed, and scanning distance on the pore properties, surface roughness, and hardness of dental cobalt-chrome alloy were investigated by adjusting the printing parameters in the process of SLM. Through metallographic analysis, image analysis, and molten pool simulation, the pore formation mechanism was revealed, and the relationship between the porosity and energy density of SLM dental cobalt-chrome alloy was elucidated. Results When the linear energy density was higher than 0.18 J/mm, the porosity defect easily appeared at the bottom of the molten pool. When the laser energy density was lower than 0.13 J/mm, defects occurred in the gap of the molten pool due to insufficient melting of powder. In particular, when the linear energy density exceeded the threshold of 0.30 J/mm or was below 0.12 J/mm, the porosity increased significantly to more than 1%. In addition, we observed a negative correlation between free surface roughness and energy density and an inverse relationship between macroscopic hardness and porosity. Conclusion On the basis of the conditions of raw materials and molding equipment used in this study, the key process parameters of SLM of molding parts with porosity lower than 1% were successfully determined. Specifically, these key parameters included the line energy density, which ranged from 0.13 J/mm to 0.30 J/mm, and the scan spacing should be strictly controlled below 90 μm.

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Progress in clinicopathological diagnosis of oral potentially malignant disorders
Cui Yingying, Ding Chuanyang, Peng Chaoran, Zhang Jianyun, Cai Xinjia, Li Tiejun
West China Journal of Stomatology    2025, 43 (3): 314-324.   DOI: 10.7518/hxkq.2025.2024427
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As the field of oral pathology has evolved, the nomenclature and classification of oral mucosal diseases with a remarkable risk of malignant transformation have undergone several modifications. In 2005, the World Health Organization (WHO) introduced the concept of oral potentially malignant disorders (OPMDs) as an alternative to the terms for oral precancerous lesions and precancerous conditions. In the consensus report by the WHO Collaborating Center for Oral Cancer of 2021, OPMD is defined as “any oral mucosal abnormality that is associated with a statistically increased risk of developing oral cancer.”This definition encompasses a range of conditions, in-cluding oral leukoplakia, oral submucous fibrosis, proliferative verrucous leukoplakia, oral lichen planus, and other lesions. In light of the complex etiology, unclear pathogenesis, and carcinogenesis of OPMDs, early and precise diagnosis and treatment can contribute to the secondary prevention of oral cancer. For this reason, this review, which aims to provide a basis for the precise clinical diagnosis of OPMDs, was performed. Its aim was achieved by reviewing the historical evolution and research progress of the nomenclature, classification, and histopathological diagnostic criteria of OPMDs.

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Causes and prevention strategies of postoperative nausea and vomiting after orthognathic surgery
Luo Kai, Liu Le, Zhao Le, Tang Yanglu, Luo En, Ji Yang
West China Journal of Stomatology    2025, 43 (3): 305-313.   DOI: 10.7518/hxkq.2025.2025072
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Postoperative nausea and vomiting (PONV) are common complications that mainly occur within 24 h after orthognathic surgery. The incidence of nausea and vomiting after orthognathic surgery remains high and is a difficult problem for patients and surgeons. These complications not only affect wound healing and increase the risk of postoperative bleeding. Vomit and blood may also cause nausea and vomiting, which results in a vicious cycle. Frequent nausea and vomiting are a painful experience and more serious than postoperative pain. They are one of the main reasons for postoperative infection, delayed discharge, and increased hospitalization costs and affect patient satisfaction. In this review, the author combined literature review and clinical experience and summarized and analyzed the causes of orthognathic nausea and vomiting and prevention and treatment strategies to improving the related clinical process.

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Application of temporomandibular joint prosthesis in oral and maxillofacial surgery: strategic thinking and prospects
Bi Ruiye, Zhu Songsong
West China Journal of Stomatology    2024, 42 (5): 551-557.   DOI: 10.7518/hxkq.2024.2024187
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The temporomandibular joint (TMJ) is the critical functional unit in the human stomatognathic system. Damage of the TMJ causes orofacial dysfunction and secondary jaw deformities, leading to seriously decreased quality of life in patients. The TMJ prosthetic replacement is an important treatment method for severe joint destruction because of its remarkable advantages compared with other methods. In recent years, this technique has gradually attracted wide attention in China, but it has not been popularized on a large scale in our country because of several limitations. Thus, in this study, the clinical experience of patients with TMJ prosthetic replacement in clinical units was summarized, and the treatment principles, treatment processes, and technical advantages were systematically discussed, aiming to promote the popularization and application of TMJ prosthetic replacement in China.

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Advantages of remimazolam for sedation in impacted tooth extraction
Ba Kai, Ni Duan, Du Ruobing, Wei Xueqin
West China Journal of Stomatology    2024, 42 (4): 476-480.   DOI: 10.7518/hxkq.2024.2023450
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Objective This study aims to compare the sedative effects of remimazolam and midazolam during impacted tooth extraction to provide a comfortable sedation treatment for patients with dental anxiety. Methods A prospective randomized controlled trial was conducted, in which 60 patients undergoing intravenous sedation for mandibular impacted third molar extraction were evenly divided into either the remimazolam or midazolam group. Prior to receiving a nerve blocker, the patients were sedated with remimazolam or midazolam. Various parameters were recorded and analyzed, including onset time, awakening time, recovery time, modified dental anxiety scale (MDAS) scores before and after surgery, patient-doctor satisfaction levels, postoperative side effects within 24 hours, heart rate (HR), and mean arterial pressure (MAP) at different time points. Results Compared with the midazolam group, patients in the remimazolam group demonstrated significantly shorter onset, awakening, and recovery times as well as lower postoperative MDAS scores and higher levels of patient-doctor satisfaction. Fewer postoperative side effects were reported in the remimazolam group, although the differences were not statistically significant. Conclusion The use of remimazolam demonstrates faster onset and recovery, superior efficacy in reducing dental anxiety, and enhanced satisfaction among patients and doctors, thereby presenting distinct advantages for sedation treatment for patients with dental anxiety.

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Effects of collagen modification on the osteogenic performance of different surface-modified titanium samples in vitro
Dong Danni, Huang Yanling, Lai Yingzhen, Yin Ge
West China Journal of Stomatology    2024, 42 (4): 452-461.   DOI: 10.7518/hxkq.2024.2023451
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Objective The aim of this study was to evaluate the effects of collagen modification on the osteogenic performance of different surface-modified titanium, including alkaline etching, alkaline etching followed by silanization, and alkaline etching followed by dopamine modification. The proliferation, adhesion, and osteogenic differentiation abilities of MC3T3-E1 cells on the surfaces with collagen modification were analyzed and compared. Methods Collagen was immobilized on the surfaces of pure titanium (Ti-C), alkaline-etched titanium (Ti-Na-C), alkaline-etched and silanized titanium (Ti-A-C), and alkaline-etched and dopamine-modified titanium (Ti-D-C), with pure titanium (Ti) as the control group. The surface morphology was observed by scanning electron microscopy (SEM), and the surface elemental composition was analyzed by X-ray photoelectron spectroscopy (XPS). Contact angle measurements were conducted to evaluate the hydrophilicity of the surfaces. MC3T3-E1 cells were cultured on the surfaces, and their proliferation, adhesion, and osteogenic differentiation abilities were assessed using CCK-8 assay, laser scanning confocal microscope, alkaline phosphatase (ALP) staining, Alizarin red staining and quantitative analysis, as well as real-time quantitative polymerase chain reaction (RT-qPCR) to evaluate the mRNA expression levels of osteogenic-related genes, including ALP, typeⅠcollagen (COL-1), osteocalcin (OCN), osteopontin (OPN). Results SEM and XPS results confirmed the successful immobilization of collagen on the titanium surfaces, with the Ti-Na-C group exhibiting a higher amount of collagen modification. Contact angle measurements showed improved hydrophilicity of the surfaces after collagen modification. CCK-8 results indicated good compatibility of the materials with MC3T3-E1, with enhanced cell proliferation on the collagen-modified surfaces. Cell fluorescence staining revealed better cell spreading on the collagen-modified surfaces, and ALP and Alizarin red staining results suggested that the Ti-Na-C group exhibited the best osteogenic performance, with significantly higher absorbance values in the Alizarin red quantification analysis. RT-qPCR analysis showed that the Ti-Na-C group had the highest expression of the osteogenic-related gene OPN. Conclusion Among the different collagen modification approaches employed in this study, collagen modification on alkaline-etched titanium surfaces showed the most conducive effects on MC3T3-E1 cell adhesion, spreading, proliferation, and osteogenic differentiation. This approach can be considered as the optimal collagen modification strategy for enhancing osteogenesis on titanium surfaces.

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Preliminary exploration and reliability analysis of clinical diagnostic method for marginal velopharyngeal insufficiency
Huang Xinyi, Mao Qirong, Yin Heng, Wu Min, Shi Bing, Zheng Qian, Li Jingtao
West China Journal of Stomatology    2025, 43 (3): 376-382.   DOI: 10.7518/hxkq.2025.2024425
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Objective A stable, reliable, and easily implementable clinical diagnostic method for marginal velopharyngeal insufficiency (MVPI) was established on the basis of the subjective hearing judgement of hypernasality and objective examination of velopharyngeal closure to address the lack of unified diagnostic criteria for MVPI. Methods Nasopharyngeal fiberscopy and speech assessment results were collected from postoperative patients with cleft palate. These results were used to analyze the differences in the distribution of nasal resonance in patients with different velopharyngeal closure ratios and the correlation between velopharyngeal closure ratios and nasal resonance status. Mild-to-moderate hypernasality with its corresponding elopharyngeal closure ratio was employed to establish the diagnostic criteria of MVPI. The reproducibility of the criteria and whether the patients with MVPI diagnosed by using the criteria exhibited significantly different speech characteristics compared with other patients were verified. Results A strong correlation was found between velopharyngeal closure ratios and nasal resonance (P<0.001). Mild-to-moderate hypernasality mainly corresponded to velopharyngeal closure ratios ranging from 90% to 99%, and the combination of the two characteristics as the diagnostic criteria for MVPI demonstrated good consistency (Kappa value=0.789, P<0.001). Moreover, under the diagnostic criteria, significant differences in nasal resonance (P<0.001), nasal emission (P=0.007), and misarticulation (P<0.001) were found between patients with velopharyngeal insufficiency and those with MVPI. Conclusion Combining the subjective hearing judgement of mild-to-moderate hypernasality with velopharyngeal closure ratios over 90% under nasopharyngeal fiberscopy provides a reliable and effective clinical method for diagnosing MVPI.

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Clinical decision of centric relation
Yu Haiyang, Yan Zhebin, Xie Chenyang, Wu Qin
West China Journal of Stomatology    2024, 42 (5): 558-565.   DOI: 10.7518/hxkq.2024.2024147
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Centric relation (CR) was used in the complete dentures for edentulous jaws firstly. Then, CR was gradually applied in the clinical diagnosis and treatment of dentate jaws. Regarding the application of CR in dentate jaws, there are many doubts about its rationality. For instance, should CR be the core of diagnosis and treatment of temporomandibular disorders? Should CR be used as the jaw position of establishing occlusion in occlusal reconstruction? Should CR serve as the target jaw position in orthodontic treatment? Meanwhile, varieties of CR clinical applications are objective. According to the existing evidence, this paper summarizes the applicable conditions of several main clinical situations with little controversy. We preliminarily put forward the decision tree for the clinical application of CR, which can be used as a reference in clinical practice.

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Effectiveness of bone plate reduction combined with resorbable plate fixation in the treatment of large mandibular cysts
Hu Yifan, Sun Qingyan, Wang Chenyi, Zhai Xiaoting, Jiang Hua, Liu Huawei
West China Journal of Stomatology    2024, 42 (4): 470-475.   DOI: 10.7518/hxkq.2024.2023438
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Objective This study aims to observe the clinical effect of bone plate reduction in combination with a resorbable plate on large mandibular cysts. Methods Between October 2017 and September 2022, patients with large mandibular cysts in the presence of labial and buccal cortical bone were involved in the study. Intraoral approach was performed for bone plate reduction. Cone beam computed tomography (CBCT) scan was reviewed at 3, 6, and 9 months postoperatively to observe postoperative complications. Osteogenic results were assessed at these times to determine the clinical outcomes of this procedure. Results Eleven cases with large mandibular cysts in the presence of cortical bone were evaluated. The average thickness of the cortical bone on the labial and buccal sides was measured to be about (1.98±0.37) mm before surgery, with a mean value of (0.73±0.17) mm at the thinnest part of the plate and up to 0.51 mm at the thinnest part of the plate. The cystic cavities were well revealed during the surgeries, which were completed successfully. Postoperatively, the wounds healed in one stage without infection. The percentages of cyst shrinkage were 20.01%, 41.76%, and 73.41% at 3, 6, and 9 months after surgery, respectively. Quantitative measurement of bone mineral density in the jaws by CBCT with MIMICS software. The bone mineral densities of the adult bone were 313.78, 555.85, and 657.45 HU at the 3, 6, and 9 month time intervals, respectively. No significant change in the patient’s maxillofacial appearance were observed from the preoperative period as assessed by the patient’s and observer’s visual analog scale. Conclusion Bone plate reduction is an effective treatment for large mandibular cysts of the oral and maxillofacial region with the presence of cortical bone.

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Design strategy of hydrogel wound dressings based on oral special environment
Xu Rui, Pan Zhao, Zou Duohong
West China Journal of Stomatology    2024, 42 (6): 689-698.   DOI: 10.7518/hxkq.2024.2024262
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Oral wounds caused by injuries, surgeries, diseases, and chemical irritations bring pain to the patient and increase the risk of infection. Effective wound protection and repair are crucial for improving patients’ quality of life and maintaining oral health. Wound dressings provide ideal healing conditions by isolating the wound from the oral environment. However, in the highly moist, microbiologically rich environment of the oral cavity, maintaining the stability of wound dressings remains a considerable challenge. Hydrogels show promising prospects for oral applications and are gradually becoming a research hotspot for addressing the challenges of oral wound protection and repair due to their excellent biocompatibility and versatile performance. In this paper, the current design strategies of hydrogel wound dressings that overcome the unique oral environment, achieve sustained adhesion and fulfill their functions are reviewed to provide new insights for the design of ideal oral wound barrier materials.

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Mechanism of mangiferin in the treatment of oral submucous fibrosis based on Gene Expression Omnibus database chip mining combined with network pharmacology and molecular docking
Song Ziyi, Yang Chao, Zhang Yunlong, Zhang Zhujiang, Ren Tianjiao, Zhang Xinyue, Li Xue
West China Journal of Stomatology    2024, 42 (4): 444-451.   DOI: 10.7518/hxkq.2024.2024050
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Objective This study aims to investigate the primary target and potential mechanism of mangiferin (MF) in treating oral submucous fibrosis (OSF) through Gene Expression Omnibus (GEO) database chip mining, network pharmacology, and molecular docking techniques. Methods Potential therapeutic targets for OSF were identified using GEO chip data. The potential targets of MF were predicted, and disease-related targets for OSF were collected from databases. A Venn diagram was created using the EVenn platform to identify overlapping targets. The protein-protein interaction (PPI) network was constructed using the STRING database. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using the DAVID platform. Cytoscape 3.10.1 software was used to visualize a drug-target-pathway-disease network, while AutoDocktools 1.5.6 software was employed for molecular docking analysis. Results A total of 356 potential targets for MF and 360 disease-related targets for OSF were obtained from multiple databases. The top 15 key target proteins in the PPI network were selected as significant candidates. GO function and KEGG pathway enrichment analyses revealed that MF treatment primarily involved advanced glycation end products-receptor (AGE-RAGE), epidermal growth factor receptor (EGFR), and other signaling pathways associated with OSF pathogenesis. Molecular docking analysis demonstrated that MF exhibited a strong binding activity toward AKT serine kinase 1 (AKT1), tumor necrosis factor (TNF), and other core targets. Conclusion These findings suggest that MF may exert its therapeutic effects on OSF through a multitarget approach involving various signaling pathways.

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Application of digital impression and model in removable partial dentures for Kennedy classⅠandⅡdentition defects
Huang Jianbo, Mei Ziyu, Huang Gang, Guo Yalin, Meng Xiangfeng
West China Journal of Stomatology    2024, 42 (4): 481-485.   DOI: 10.7518/hxkq.2024.2024103
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Objective This study aimed to evaluate the application of digital impression and resin model technology in removable partial dentures (RPD) for Kennedy classⅠandⅡdentition defects. Methods Patients with Kennedy classⅠorⅡdental defect were selected and grouped in accordance with the following denture production processes: digital impression/resin model/cast cobalt-chromium alloy framework group (group A), digital impression/resin model/laser printed titanium framework group (group B), alginate impression/plaster model/cast cobalt-chromium alloy framework group (group C), and alginate impression/plaster model/laser printed titanium framework group (group D), with 40 cases in each group. The final RPD was examined in place in the mouth, and the evaluation indicators included the retention force of clamp ring, the tightness of connector and base, and the accuracy of occlusion. The evaluation scores of each index were used for analysis on the Kruskal-Wallis rank-sum test. Results No statistically significant difference in the score of each index was found among the four groups in RPD. Conclusion The cast cobalt-chromium alloy and laser-printed titanium framework RPD using digital impression and resin model can meet the clinical restoration requirements of patients with Kennedy classⅠandⅡdentition defects.

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Geometric position relationship between gingival, preparation, restoration margins and the cementation (adhesive) layer in the marginal area: new classification and scheme for margin position
Yu Haiyang, Luo Tian
West China Journal of Stomatology    2025, 43 (2): 163-174.   DOI: 10.7518/hxkq.2025.2024379
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The current low quality of fixed restoration margins is highly correlated with the high incidence of margin-related complications. It is also related to the unclear spatiotemporal geometric position relationship among the consensus definitions of the gingival margin (G), preparation margin (P), and restoration margin (R). This paper discusses the existing problem of the existing term “gingival margin” as a surface anatomical landmark; proposes the term “free gingival margin line” that conforms to geometry and measurement and has importance as a surface anatomical landmark; and clarifies the participants that exist in the marginal area. These participants include the P, R, and G; cementation (adhesive) layer; and gingival sulcus. Moreover, this paper discusses the various iatrogenic damages induced by entering the gingival sulcus via the P, R, and cementing (adhesive) layer. Through the discussion of the design deficiencies of the subgingival and biologically oriented preparation technique, the physiological and clinical importance of the concept of gingival sulcus/gingival sulcus fluid + supercrestal tissue attachment (biological width) = first periodontal protective barrier was analyzed. The value of preserving the physiological role of the gingival sulcus is emphasized. Furthermore, the newly defined RPG distance represents the distance between the successive P or R line and free G line and can be measured in the clinical procedure of tooth preparation. The optimal solution is 0-200 µm, that is, RPG200: the P and R are located on the free G line and the distance between these margins is less than 200 µm. This distance not only has the aesthetic effect of invisibility to the naked eye, it also has a minimal effect on the G and gingival sulcus and is convenient for doctors and patients to clean. Furthermore, in accordance with the positional relationship between the three margins and cementation (adhesive) layer, a new classification of marginal positions is proposed. This classification overcomes the problems of incomplete inclusion objects and uncontrolled risk factors in the previous classification. It also has the advantages of strong practicability, good efficiency of main control geometric quantity, and clear risk control points. The new design scheme and classification of the margi-nal position of RPG200 proposed in this paper provide a new understanding for margin design and complication prevention in the future.

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Application of intraoral scanning registration implant robot in dental implant surgery
Jin Nenghao, Qiao Bo, Zhu Liang, Meng Fanhao, Lin Quanquan, Li Liangbo, Xing Lejun, Zhao Rui, Zhang Haizhong
West China Journal of Stomatology    2024, 42 (6): 804-809.   DOI: 10.7518/hxkq.2024.2024213
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Objective This paper aims to investigate the application of intraoral scanning and cone beam computed tomography (CBCT) registration implant robot in dental implant surgery. Methods The data of 40 cases with dental defect of robot-assisted implantation from November 2023 to May 2024 were retrospectively analyzed. Before the operation, the intraoral scan data and CBCT data of the positioning markers were automatically fused with the initial CBCT images, and the registration error was calculated. The average registration error of positioning markers was determined during the operation, and the implantation accuracy was analyzed after the operation. Results The intraoral scan data and CBCT data of 40 patients with dental defect wearing positioning markers were successfully registered with the initial CBCT image, and the registration errors were (0.157±0.026) mm and (0.154±0.033) mm, respectively. Statistical analysis showed no statistical significance between them. The registration errors of the marker was (0.037 3±0.003 6) mm. A total of 55 implants were performed, and the total deviations of the implant point and the apical point were (0.78±0.41) and (0.89±0.28) mm, respectively. The transverse deviations of the implant point and the apical point were (0.44±0.36) and (0.58±0.25) mm, respectively. The depth deviations of the implant point and the apical point were (0.51±0.32) and (0.54±0.36) mm, respectively. The deviation of the implant angle was 1.24°±0.67°. Conclusion The fusion technology based on intraoral scanning and CBCT registration can meet the accuracy requirements of preoperative registration of oral implant robots. The technology increases the choice of registration methods before robot-assisted dental implant surgery and reduces the multiple radiation exposuresof the patient.

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Current status and influencing factors of fear of surgery in patients with oral and maxillofacial tumors
Zhang Yu, Kuang Lixia, Bi Xiaoqin, Zhan Xueli, Zhang Tianyu
West China Journal of Stomatology    2024, 42 (4): 494-501.   DOI: 10.7518/hxkq.2024.2024039
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Objective This study aimed to investigate the incidence and severity of surgical fear in patients with oral and maxillofacial tumors. Methods The survey participants were composed of patients with oral and maxillofacial tumors, who were scheduled to undergo surgery. A general information questionnaire, the Surgical Fear Questionnaire (SFQ), the Patient Health Questionnaire (PHQ)-9, and the Generalized Anxiety Disorder (GAD)-7 score were used for the investigation. Results A total of 203 patients were investigated. Among them, 85.22% had fear of surgery. The median score of SFQ was 20, and the quartile was (6, 36). The patients were categorized into none, mild, moderate, and severe groups according fear level. Gender, diabetes, obvious discomfort before surgery, PHQ-9, and GAD-7 scores were the variables with statistical difference in each fear level. Multifactor analysis showed that women were more likely to have moderate and severe fear than men (OR=2.19, P=0.03; OR=2.72, P=0.01), patients with obvious preoperative discomfort symptoms were more inclined to have no fear (OR=4.73, P=0.02), and patients with diabetes were more likely to have severe fear (OR=3.33, P=0.02). The incidence rates of depression and anxiety were 31.03% and 24.63%, respectively. The incidence of anxiety and depression in patients with severe fear was 40.00%. Surgical fear was moderately positively correlated with anxiety (r=0.491, P<0.001) and depression (r=0.514, P<0.001). Conclusion The fear of surgery in patients with oral and maxillofacial tumors is common and distributed in all levels. Medical staff can screen and assess patients with moderate and severe fear of surgery in accordance with the influencing factors and implement targeted interventions to reduce fear of surgery, anxiety, and depression on the basis of the source of fear.

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Interpretation of Clinical Practice Specifications for Permanent Tooth Extraction (2023 Edition)
Chai Juan, Zhang Xin, Liu Changkui, Jia Sen, Liao Xiaoyu, Hu Kaijin
West China Journal of Stomatology    2025, 43 (2): 158-162.   DOI: 10.7518/hxkq.2025.2024434
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In May 2023, the Chinese Stomatological Association promulgated the group standard of “Clinical Practice Specifications for Permanent Tooth Extraction”. These specifications were formulated after repeated discussions and revisions guided by relevant literature and the opinions of well-known experts in the field across the country. However, the content of the group standard is not elaborated and is limited to its writing form and requirements. As a consequence, medical workers might not easily understand and comprehend its content and knowledge points, which also limits its dissemination and wide use in primary medical units. This study aims to sort out and interpret the content of the 2023 edition of the “Clinical Practice Specification for Permanent Tooth Extraction” to help medical staff understand and apply it in clinical practice.

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Potential correlation between chronic periodontitis and Parkinson’s disease
Yang Rongxia, Zong Yingrui, Zhang Chen
West China Journal of Stomatology    2024, 42 (4): 521-530.   DOI: 10.7518/hxkq.2024.2024010
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Objective This study aims to investigate possible hub genes, associated pathways, and transcription factors between chronic periodontitis (CP) and Parkinson’s disease (PD). Methods Gene expression profiles of CP (GSE16134, GSE23586, and GSE10334) and PD (GSE20141 and GSE49036) were downloaded from the gene expression omnibus (GEO) database for differential expression analysis and functional clustering analysis. The protein-protein interaction (PPI) network was constructed, and hub genes were screened by four topological analysis algorithms and modular segmentation. Functional clustering analysis was performed. The hub genes were validated by external datasets of CP and PD, and causal relation was further assessed by Mendelian randomization (MR). Results After merging the data, 1 211 differentially expressed genes (DEGs) were screened in the CP datasets; of which, 551 were upregulated and 660 were downregulated. A total of 2 407 DEGs were screened in the PD dataset, of which, 1 438 were upregulated and 969 were downregulated. The PPI network included 145 nodes and 126 edges. Four hub genes (FCGR3B, PRF1, IL18, and CD33) and three transcription factors (HSF1, HSF2, and HSF4) were finally screened. The relevant pathway was predominantly natural killer (NK) cell-mediated toxic effects. The MR results suggest a possible positive causal relationship between CP and the risk of developing PD. Conclusion This study indicated the probably shared pathophysiology and possible causal relationship between CP and PD and may offer novel concepts and therapeutic targets for future mechanistic investigations.

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Standardized treatment of oral cancer under the guidance of clinical practice guidelines of National Comprehensive Cancer Network
Qiu Siqi, Li Yuehan, Liu Fayu
West China Journal of Stomatology    2024, 42 (5): 566-571.   DOI: 10.7518/hxkq.2024.2024168
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Oral cancer represents a serious public health problem affecting oral and system health with a high global incidence. Treatment strategies for oral cancer vary in different disciplines and are likely to be limited to certain doctor’s personal experience. While clinical practice guidelines are considered to enable doctors to determine the most appropriate and consistent treatment strategy according to the patient’s situation. National Comprehensive Cancer Network (NCCN) clinical practice guidelines have become the most prevalent in global clinical oncology practice. This article mainly focuses on cases to discuss the normalized treatment strategy for oral cancer in different stages based on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Head and Neck Cancers, Version 3, 2024.

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Craniofacial features and incisor position design of esthetics population after orthodontic treatment
Cheng Junxin, Zhu Yujie, Li Yuelin, Zheng Yingcheng, Wang Jun
West China Journal of Stomatology    2024, 42 (5): 609-623.   DOI: 10.7518/hxkq.2024.2023443
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Objective This study aims to provide craniofacial features and incisor position prediction models among esthetics population after orthodontic treatment. Methods A total of 338 patients with esthetic profiles were selected from 1 055 post-orthodontic adults based on inclusion and exclusion criteria and scored by five dental students. Mean values of cephalometric measurement were demonstrated with gender and sagittal skeletal pattern (ANB) differences assessed by generalized estimating equation. Correlations among age, skeletal, and soft tissue variables in different genders were determined. Multivariate analysis was used to assess the influence of skeletal and soft tissue variables on orthodontic incisor position. Results Within the esthetic cohort after orthodontic treatment, gender differences existed in cranial and mandibular length, mandibular rotation, protrusion of pogonion, inclination of maxillary incisors, upper lip thickness, lower 1/3 face height, and nose protrusion. However, in class Ⅰ malocclusion, the development of the chin showed no significance, whereas the protrusion of the lower lip significantly differed between genders, with less protrusion in males. In males, the protrusion of lip and chin varied among groups, with thinner basic upper lip thickness of class Ⅱ than class Ⅰ and greater lower lip height of class Ⅲ than class Ⅰ. In females, the protrusion and height of the upper lip and chin varied in groups, with thicker basic upper lip thickness of class Ⅲ than class Ⅰ. Upper lip thickness, female basic upper lip thickness, and female lower lip height were correlated with age. The protrusion of the upper lip was mainly correlated with posterior cranial base, mandibular body length, ANB in male and SNA, ANB, sagittal maxillary length, mandibular rotation, and protrusion of pogonion in female. The protrusion of the lower lip in males was mainly correlated with ramus height, mandibular rotation, protrusion of pogonion in male and ANB, mandibular rotation, and protrusion of pogonion in females. After employing skeletal variables to fit dental parameters, optimal results were achieved in male IMPA (adjusted R2=0.712) and female G Vert-U1 (adjusted R2=0.795). After employing skeletal and soft tissue variables simultaneously, optimal results were achieved in male and female G Vert-U1, which was mainly influenced by the protrusion of the chin and nasal base in males (adjusted R2=0.836) and the protrusion of the nasal base as well as ANB in females (adjusted R2=0.842). Conclusion This study demonstrated the craniofacial features of esthetics population after orthodontic treatment and revealed the correlation of gender, age, skeleton, and soft tissues to provide reliable prediction models for aesthetic orthodontic incisor position.

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Heterogeneity of Wnt1-Cre-marked and Pax2-Cre-marked first branchial arch cranial neural crest cells in mice
Xu Jue, Liu Shuang, Fu Honggao, Shao Meiying, Chen Meiling, Huang Zhen
West China Journal of Stomatology    2024, 42 (4): 435-443.   DOI: 10.7518/hxkq.2024.2023374
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Objective This study aimed to explore the heterogeneity and gene ontology of Wnt1-Cre-marked and Pax2-Cre-marked first branchial arch cranial neural crest cells (CNCs) in mice. Methods The embryos of Wnt1-Cre;R26RmTmG and Pax2-Cre;R26RmTmG at embryonic day (E)8.0-E9.25 were collected for histological observation. We performed immunostaining to compare green fluorescent protein (GFP)-positive CNCs in Pax2-Cre;R26RAi9 and Wnt1-Cre;R26RAi9 mice at E15.5. Single-cell RNA sequencing (scRNA-seq) was used to analyze the first branchial arch GFP-positive CNCs from Wnt1-Cre;R26RmTmG and Pax2-cre;R26RmTmGmice at E10.5. Real time fluorescence quantitative polymerase chain reaction (q-PCR) was performed to validate the differential genes. Results Wnt1-Cre-marked and Pax2-Cre-marked CNCs migrated from the neural plateto first and second branchial arches and to the first branchial arch, respectively, at E8.0. Although Wnt1-Cre-marked and Pax2-Cre-marked CNCs were found mostly in cranial-facial tissues, the former had higher expression in palate and tongue. The results of scRNA-seq showed that Pax2-Cre-marked CNCs specifically contributed to osteoblast differentiation and ossification, while Wnt1-Cre-marked CNCs participated in limb development, cell migration, and ossification. The q-PCR data also confirmed the results of gene ontology analysis. Conclusion Pax2-Cre mice are perfect experimental animal models for research on first branchial arch CNCs and derivatives in osteoblast differentiation and ossification.

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The role of uncoupling protein 2 in experimental periodontitis-associated renal injury in rats
Li Qiong, Ma Haonan, Shang Yaqi, Xin Xirui, Liu Xinchan, Wu Zhou, Yu Weixian
West China Journal of Stomatology    2024, 42 (4): 502-511.   DOI: 10.7518/hxkq.2024.2023378
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Objective This study aims to explore changes in uncoupling protein 2 (UCP2) in experimental periodontitis-associated renal injury induced by ligation and investigate the effect of UCP2 on renal injury induced by periodontitis. Methods Twelve Wistar male rats were randomly divided into two groups: control and periodontitis groups. A periodontal model was built by ligating the maxillary first molars area with 0.2 mm orthodontic ligature wire. After 8 weeks, the intraoral condition of the rats was observed and periodontal clinical indices such as gingival bleeding index (BI), periodontal probing depth (PD), and tooth mobility (TM) were detected. The maxillary bone was scanned by Micro CT to observe the alveolar bone resorption. The tissue mineral density (TMD), bone mineral density (BMD), bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular bone separation (Tb.Sp) were recorded, and the distance from the enamel bone boundary to the alveolar crest (CEJ-ABC) of the maxillary first molar was measured. The oxidative stress indexes such as malondialdehyde, glutathione (GSH), and superoxide dismutase (SOD) were detected using frozen rat kidney tissue. The gene expression of UCP2, nuclear factor erythroid 2-related factor 2 (Nrf2), and peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) was observed by quantitative real-time polymerase chain reaction (qRT-PCR) test. The gingival tissue of the rats was used for immunohistochemical staining to observe the expression of the UCP2 protein. The fixed rat kidney tissue was used for hematoxylin-eosin (HE), periodic acid-schiff (PAS), MitoSOX Red, JC-1, and immunohistochemical staining to observe the renal histopathology, the level of reactive oxygen species (ROS), the level of mitochondrial membrane potential, and the expression of UCP2, Nrf2, and PGC-1α protein. Rat serum was collected to detect renal function indices, namely, blood urea nitrogen (BUN), creatinine (Cre), and albumin (Alb). Results Compared with the control group, the periodontitis group showed red, swollen, and soft gingival tissue, with gingival probing bleeding, periodontal PD increased, tooth loosening, alveolar bone resorption, decreased TMD, BMD, BV/TV, and Tb.Th indices, and increased Tb.Sp index, CEJ-ABC, and gingival UCP2 protein expression. Compared with the control group, the levels of MDA and ROS in the kidney tissue of periodontitis rats and the gene and protein expression of UCP2 increased, and the levels of MMP, GSH, and SOD and the gene and protein expression of Nrf2 and PGC-1α decreased. Renal functional indices, namely, BUN, Cre, and Alb, were not significantly different between the two groups. Conclusion UCP2 may play a role in renal injury induced by periodontitis through oxidative stress.

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Removal of fiber post under the guidance of digital guide plate and one-piece glass fiber posts-and-cores repair: a clinical report
Xu Yuchen, Yin Lu
West China Journal of Stomatology    2024, 42 (4): 538-542.   DOI: 10.7518/hxkq.2024.2023344
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This study explores the potential application of computer aided design (CAD)/computer aided manufac-turing (CAM) for one-piece glass fiber posts and cores in restoring tooth defects post-removal of a broken fiber post using a digital guide plate. This paper reports a fractured left upper incisor fiber post removed using a customized needle and digital guide plate. Following root canal retreatment, CAD/CAM integrated fiber post-core and zirconia full crown restoration were completed. The occlusion testing was conducted using the T-Scan Ⅲ system. This study offers insights for managing secondary repair after fiber post fractures.

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Efficacy evaluation of zirconia crown on primary molars with caries defects
Deng Shuman, Niu Shanshan, Gao Qi, Zhang Li, Chen Zhixiao, Liu Meng
West China Journal of Stomatology    2024, 42 (5): 652-659.   DOI: 10.7518/hxkq.2024.2024122
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Objective This study aimed to estimate the therapeutic effects of preformed metal crown (PMC) and prefabricated zirconia crowns (ZC) on decayed primary morals in children, as well as to analyze the possible influencing factors. Methods A retrospective cohort study was performed on the data of 192 patients (aged 3 to 8) in the Stomatological Department of Shenzhen Children’s Hospital from October 2021 to December 2021. The decayed mandibular first molars were selected and restored by vital-pulp therapy followed by PMC and ZC, including 96 cases (96 caries) in the PMC group and 96 cases (96 caries) in the ZC group. Oral clinical examination was performed at 3 months, 1 year, and 2 years after treatment, overwiewing the clinical therapeutic effects and periodontal status of PMC and ZC groups, as well as recording the crown integrity, gingival index (GI), probing bleeding index (BI), plaque index (PLI) and various prosthetic indices. Results No significance differences existed in the periodontal status of PMC and ZC groups at 3 months, 1 year, and 2 years after treatment (P>0.05). However, the GI, BI, and PLI in the PMC group were higher than those in the ZC group at 3 months, 1 year, and 2 years after treatment, and the difference was dramatically significant (P<0.05). No significances difference existed in various prosthetic indices (P>0.05), as well as in the GI, BI, and PLI, between the two groups (P>0.05). No significant differences existed in various prosthetic indices between genders after PMC restoration (P>0.05). The scores of girls in various prosthetic indices after ZC restoration were higher than those of boys (P<0.05). Pearson correlation analysis indicated an inverse correlation between age in the PMC group and the GI, BI, PLI, and FDI indices (P<0.01), rather than in the ZC group (P>0.05). Conclusion PMC and ZC can be applied to restore deciduous molar caries. The periodontal status of deciduous teeth in ZC group was superior to that in the PMC group. The periodontal status of deciduous teeth in PMC group may be stable with increased age.

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