Orthognathic surgery, which involve osteotomy and repositioning of the maxillomandibular complex, has recently emerged as a crucial method of correcting dentofacial deformities. The optimal placement of the maxillomandibular complex holds utmost significance during orthognathic surgery because it directly affects the surgical outcome. To accurately achieve the ideal position of the maxillomandibular complex, with the rapid advancements in digital surgery and 3D-printing technology, orthognathic surgery has entered an era of “Precision Surgery” from the pervious “Empirical Surgery.” This article provides comprehensive insights into our extensive research and exploration of the treatment modality known as “precision orthognathic surgery” over the years. We also present the technical system and application in“Ortho+X” treatment modality to offer valuable references and assistance to our colleagues in the field.

Implant treatment in the esthetic area requires stable osseointegration and successful esthetic outcomes. Achieving this goal requires careful consideration of accurate implant axis and ideal three-dimensional position. Owing to the high esthetics and the special anatomical structure of the maxillary, a successful implant means a synthesized deli-beration of the residual bone dimensions, soft-tissue thickness, and the relationship of the residual alveolar ridge with the planned restoration. This article offers an in-depth analysis of the clinical decisions and key factors affecting the implant direction in the esthetic area.

Crown replacement has remained one of the difficult methods for installing fixed prosthesis but is often performed because of aesthetic factors and invasion of biological width. This article focuses on the clinical scenario in which preexisting crown margin has defects. Given that clinical decisions regarding restoration management and perio-dontal tissues have to be made with caution, a decision tree of the decision making process for natural abutments in aesthetic area with preexisting defected crown margin is presented. The re-establishment of a new crown margin is the key to the success of a new restoration, and the new margin should be located at the proper esthetic position and right biological position. It should have fine, smooth, and continuous morphology.

Objective This study aims to analyze and summarize the characteristics of supernumerary teeth by using cone-beam computed tomography (CBCT). Methods A total of 718 patients with 1 138 supernumerary teeth were retrospectively collected. Age, gender, number, location, morphology, eruption status, and accompanying symptoms of the supernumerary teeth were statistically analyzed. The relationship relative to jaws, gender, and eruption status were analyzed and discussed. Results The average age of the patients was 9.54±5.32 years, and the male to female ratio was 2.88∶1. About 77.02% of the patients sought medical advice during the mixed dentition period, and 50.70% had one supernumerary tooth. These supernumeraries were most commonly conical in shape, and 85.76% of them were in the incisor region, 92.09% in the upper jaw, 46.75% in inverted position, and 86.20% unerupted. Overall, 65.29% of them had fully developed roots, and 60.63% had an impact on adjacent structures. Significant differences were found in eruption status, morphology, zoning, direction, root development, and impact on adjacent structures between the supernumerary teeth located in the upper and lower jaws (P<0.05). Significant differences were also detected in gender, morphology, zoning, orientation, root development, and impact on adjacent structures between erupted and unerupted teeth (P<0.05). The incidence of supernumerary teeth in the incisor region was higher in males than that in females. Moreover, the root of supernumeraries was more completely developed in males than in females (P<0.05). Conclusion For supernumerary teeth, CBCT images can provide accurate three-dimensional radiographic data and are valuable for clinical diagnosis and treatment planning.

Objective This study aims to evaluate the correlation between differences in intraoperative jumping gaps and soft tissue changes around immediate implant placement and provisionalization (IIPP) in the maxillary anterior region. Results will provide a basis for clinical evaluation of the change trend and long-term stability of the labial soft tissue contours of patients with different jumping gaps. Methods Thirty-two patients with single tooth loss in the maxillary aesthetic area were enrolled, and they all received immediate implant placement and restoration. All patients were divided into three groups: A, B, and C according to the size of the jumping gap, group A: horizontal defect dimension (HDD) ≤2 mm; group B: 2 mm<HDD≤3 mm; group C: HDD>3 mm. Geomagic studio 2013 was used to quantitatively analyze the contour volume of the soft tissue around the implant and the level of the labial gingival margin. The pink esthetic score (PSE) was used for the final aesthetic evaluation. Results All implants had osseointegration within 6 months after the surgery. The average thickness of soft tissue contour volume changed by 0.62 mm±0.15 mm, and the average PES was 11.09±0.99. The changes in the gingival mucosa levels in the three groups at 6 months after operation were 0.45 mm±0.11 mm, 0.40 mm±0.12 mm, and 0.35 mm± 0.11 mm, respectively. The changes in the average thickness of the soft tissue contour volume in the three groups at 6 months after the operation were 0.77 mm±0.16 mm, 0.63 mm±0.17 mm, and 0.54 mm±0.11 mm. A moderate negative correlation was found between the jumping gap size and the gingival mucosa level, and the average thickness changed. No significant correlation was found between size of jumping gap and PES. Conclusion Although the contour volume of the labial soft tissue continuously decreased within 6 months after IIPP in the maxillary anterior region, the surgical procedure can achieve a satisfactory aesthetic effect, and the level of soft tissue around the implant can be well maintained.

Objective This study aimed to explore the stress distribution of surface-mounted inlays with two ceramic materials and different strategies for fiber post-restoration on pulp-penetrating non-carious cervical lesion in a maxillary first premolar to provide minimally invasive and reasonable restorative methods. Methods The cone beam computed tomography data of the standard right upper first premolar were selected. Healthy control (HC) and defective control (DC) finite element models were established. Then, eight experimental models were established according to two different ceramic materials (IPS e.max CAD [LD] and Lava Ultimate [LU]) and different locations of fiber post (without fiber post [NP], fiber post in buccal root canal [B], fiber post in palatal root canal [P], fiber post in both root canals [BP]), namely, LD_NP, LD_B, LD_P, LD_BP, LU_NP, LU_B, LU_P, and LU_BP. Axial load F1 and lateral load F2 were applied. Maximum principal stress and displacement of the buccal tip were investigated using finite element analysis software. Then, the percentage change of the following indicators in each experimental group was analyzed: stress of defective tip with group DC, stress of enamel and dentine, and displacement of buccal tips with group HC. It was considered similar when the percentage change was less than 5%. Results LD and LU groups could effectively reduce the stress of the defective tip, but the decreasing amplitude in the former was greater than that of the latter. For the stress of surface-mounted inlays and resin adhesive layer, LD groups were higher than LU groups, and no significant difference in stress peak was found among different experimental groups in the same material. In addition, fiber posts in double root canals could significantly reduce buccal tip displacement. Conclusion For pulp-penetrating non-carious cervical lesions, the restorative strategy of surface-mounted inlays could be applied. Compared with Lava Ultimate, IPS e.max CAD could better protect the defective tip tooth. Furthermore, fiber posts in double root canals could decrease overall deformation and increase the retention of surface-mounted inlays.

Periodontitis is a chronic inflammatory disease that destroys the integrity of tooth-supporting tissue. Periodontitis is listed as a major oral disease by the World Health Organization and is a public-health problem affecting global oral and systemic health. The fourth national oral health epidemiological survey has revealed that periodontitis is one of the most common oral problems in China. With the development of science and medicine, increased attention is being paid to the importance of oral health and its influence on general health. Accordingly, stomatologists are required to master more relevant information on clinical diagnosis and treatment, as well as to pay more attention to the diagnosis and treatment methods of patients with different systemic diseases. This article expounds the diagnosis and treatment strategy of patients with systemic disease periodontitis. We aimed to help stomatologists make more reasonable diagnosis and treatment decisions.

Objective This study aimed to remove occlusal veneers of varied thicknesses and compositions by Er:Yag laser in vitro and analyze the interfacial microstructure between veneers and tooth that irradiated by laser, by which experimental evidence could be provided to support the non-invasive removal of occlusal veneerby laser. Methods Fresh mandibular premolars extracted for orthodontic requirements were collected for tooth preparation. Three kinds of ceramic materials (Vita Suprinity, Vita Mark Ⅱ, and Upcera Hyramic) were selected to fabricate occlusal veneer with different thicknesses (1.0, 1.5, and 2.0 mm). One week later, Er:Yag laser (2.5 W and 3.5 W) was used to irradiate and remove the occlusal veneer and recorded the timespan. After the removal operation, the micro-morphologies of samples were examined by scanning electron microscope. Results Upcera Hyramic veneer failed to be removed (>20 min); the operation span at 2.5 W, Vita Suprinity (96.0 s±16.0 s) was longer than Vita MarkⅡ(84.5 s±19.5 s) in the 1.0 mm group (P<0.05), and Vita Suprinity (246.5 s±13.5 s) was longer than Vita MarkⅡ(170.0 s±14.0 s) in the 1.5 mm group (P<0.05). At 3.5 W, Vita Suprinity (381.0 s±24.0 s) was longer than Vita MarkⅡ(341.5 s±26.5 s) in the 2.0 mm group. Conclusion Increasing laser power could shorten the operation span and facilitate the removal of occlusal veneers with the same thickness and composition. The occlusal veneer was sustained when insufficient laser power was applied. With the same laser power and ceramic thickness, laser penetration could interfere with the integral of the ceramic structure when the laser interacted with the bonding layer. With the same ceramic composition and laser power, the operation span and laser power increased with the thickness of the occlusal veneer. However, the laser was incapable of removing occlusal resin veneer directly.

Traditionally, vital pulp therapy (VPT) is mainly indicated for young permanent teeth. However, in recent years, VPT has been increasingly applied to mature permanent teeth. VPT was previously thought to be effective only for teeth with normal pulp or reversible pulpitis. However, an increasing body of evidence has demonstrated that VPT can successfully manage permanent teeth with irreversible pulpitis or apical periodontitis. This work discusses which teeth with irreversible pulpitis or apical periodontitis are suitable for VPT, the recommended method to evaluate and select this kind of case, and the clinical procedure involved to operate such a case.

Zirconia crown has been widely used in the field of prosthodontics. Traditional zirconia exhibits excellent mechanical properties but lacks translucency. The introduction of transparent zirconia significantly enhances its aesthetic performance. In clinical applications, factors affecting the aesthetic results of full zirconia crown should be comprehensively considered, and the most suitable restoration should be chosen. Additionally, clinicians need to design appropriate tooth preparation dimensions and methods based on an individual patient’s actual situation. During the clinical bonding process of zirconia, proper surface treatment of the tooth and restoration is essential. The selection of suitable adhesives is crucial for achieving optimal bonding strength and aesthetics.

Orthodontics is a discipline that is based on aesthetics. It coordinates the relationship among nose, lip, and chin through the movement of teeth and the adjustment of jaw relationship. Orthodontists need to fully analyze the patient’s soft tissue profile before treatment. They also need to analyze the existing problems and those that may be solved or caused during orthodontics to guide the design of orthodontic treatment and effectively improve the clinical effect of orthodontics. This article reviews the aesthetic preconditions that guide the design of orthodontic treatment from the perspective of orthodontists.

In the field of prosthodontics, the use of virtual patients for biomimetic restoration holds great promise for various applications. Virtual patients consist of digitized data that encompasses details on the morphology, structure, and spatial relationships within the maxillofacial and intraoral regions. Nonetheless, there are several challenges associated with acquiring digital data, achieving accurate alignment, and recording and transferring dynamic jaw movements. This paper aims to concentrate on the process of constructing virtual patients, highlight the key and challenging aspects of virtual patient construction, and advocate for the extensive adoption and utilization of virtual patient technology.

With the development of periodontal regenerative technology, an increasing number of scholars reported that advanced periodontitis involving teeth can be preserved through intentional replantation. Intentional replantation has become the last possible method to preserve natural teeth for advance periodontitis with signs of tooth extraction. However, the indications of intentional replantation are strict, and the success of the operation is closely related to the condition of cases and the operation skills of doctors. In this article, the operation steps and criteria of intentional replantation were summarized by introducing three success cases of advanced periodontitis involving teeth preserved by intentional replantation. The relevant factors that affect the prognosis of intentional replantation in advanced periodontitis involving teeth preservation were analyzed to help clinicians preserve natural teeth.

Objective This study aimed to observe the outcomes of iRoot BP Plus full pulpotomy in primary molars with partial irreversible pulpitis retrospectively. Methods Collect 102 cases of primary molars with partial irreversible pulpitis undergoing iRoot BP Plus full pulpotomy from January 2019 to August 2023, with a follow-up period of 24-47 months. Based on the presence of irreversible pulpitis symptoms before surgery, the included cases will be divided into asymptomatic group (n=53) and symptomatic group (n=49). Observe the clinical and imaging success rates of both groups. Results Clinical success rates were 96.2% and 97.9% in asymptomatic and symptomatic groups, and radiographic success rates were 96.2% and 93.9% respectively. Conclusion iRoot BP Plus full pulpotomy can be used for the treatment of primary molars with partial irreversible pulpitis under an enhanced pulpotomy protocol.

At present, the commonly used clinical protocols of oral cosmetic restoration are mostly based on the oral aesthetic indexes proposed by Western developed countries (referred to as Western aesthetics), which are different from the oral aesthetic indexes unique to Chinese people (referred to as Chinese aesthetics). In the design of restoration schemes and the evaluation of restoration effects, these differences have a large or small effect on the doctor-patient-technology triad. Improper handling could directly weaken the cooperation efficiency of the three parties, reduce patient satisfaction, and even lead to medical disputes in serious cases. From doing a good job of oral cosmetic restoration in China, the connotative characteristics of Chinese oral aesthetics are introduced in this paper, and the value of oral aesthetic analysis in diagnosis and treatment is discussed. The process and method of aesthetic analysis and assessment through the modified Chinese psychosocial impact of dental aesthetics questionnaire and the evaluation ruler of the expected value of oral cosmetic restoration are further introduced in detail.

Pregnancy is a special period for developing and treating oral diseases. Oral emergencies during pregnancy need to be handled appropriately. Changes in the physiological environments and personal habits of pregnant women increase susceptibility to some oral diseases. However, clinical treatment strategies are limited due to the need to ensure the safety of pregnant women and fetuses. Pregnant women should obtain oral health knowledge and enhance their awareness. Dentists should adhere to the principle of “prevention before pregnancy, controlling symptoms during pregnancy, and treating diseases after pregnancy” for different pregnancy periods. They should also formulate appropriate treatment plans to control emergencies, prevent disease progression, and avoid harmful effects on pregnant women by using the safest, simplest, and most effective strategies that avoid adverse effects on fetuses. Pregnant women and dentists should combine prevention and treatment while collaborating in maintaining oral health during pregnancy. This article focuses on the principles of treatment during pregnancy, and the treatment timing, clinical management, and treatment strategies of different diseases causing oral emergencies during pregnancy are reviewed.

At present, the commonly used clinical protocols of oral comestic restoration are mostly based on the aesthetic indicators proposed by Western developed countries (referred to as Western aesthetics). Mechanically copying the Western aesthetic scheme, ignoring the difference between it and the Chinese oral aesthetic indicators (referred to as Chinese aesthetics), is unable to effectively support personalized cosmetic restoration diagnosis and treatment. In addition, new technologies and new solutions for cosmetic restoration, which are developing rapidly in recent years, are emerging one after another, but many popular concepts are confusing and lack of proper hierarchical diagnosis and treatment norms, and there is indeed an urgent need for discussion and clarity. From the perspective of serving clinical application, this paper discusses the deficiencies of the Chinese translation of the word “aesthetics”, the diffe-rence and connection between aesthetics and cosmetology, and the relationship between cosmetic restoration and fixed restoration. It also discusses the difference between anterior teeth, esthetic zone and exposed zone, the diagnostic and therapeutic value of oral aesthetic analysis, as well as the application methods of desensitization, suggestion, and other therapies in difficult oral cosmetic restoration cases. We further introduce the decision tree and the clinical pathway for restoration and reconstruction of teeth in exposed zone guided by aesthetic analysis, and introduce the clinical process of aesthetic analysis and evaluation, the clinical triclassification of oral cosmetic restoration, and the corresponding clinical classification diagnosis and treatment points.

Objective This study aimed to compare the differences among four kinds of mechanical Ni-Ti files including T-Flex, Reciproc Blue (RB), ProTaper Gold (PTG), and ProTaper Universal (PTU) in dentinal microcrack generation after root canal preparation in vitro by using micro-computed tomography (micro-CT) analysis. Methods A total of 32 freshly extracted double-root-canal premolars with an angle not exceeding 10° were selected and established as root canal preparation models in vitro. Then, the specimens were randomly assigned to four experimental groups (n=8) according to the different Ni-Ti systems used for root canal preparation: group T-Flex, group RB, group PTG, and group PTU. The voxel size of the micro-CT was set at 17.18 μm. Pre- and post-operative cross-sectional images of roots (n=56 940) were scanned and analyzed to identify the presence of dentinal microcracks. The results of each group were expressed by the quantity and percentage of sectional images with microcracks. McNemar test was used to determine whether a significant difference existed in the existence of dentinal microcracks before and after instrumentation. The level of significance was set at P<0.05. Results Overall, 11.04% of the images presented dentinal defects (n=6 288). Dentinal microcracks were observed in 9.82%, 10.79%, 12.27%, and 11.25% of the post-instrumentation images from groups T-Flex, RB, PTG, and PTU, respectively. However, all these dentinal microcracks were already present in the corresponding pre-operative images. No new microcrack of premolars were generated after the root canal preparation utilizing the aforementioned systems. Conclusion Denti-nal microcracks already existed in advance in extracted teeth before root canal preparation. Root canal preparation using the T-Flex, RB, PTG, and PTU systems did not induce the formation of new dentinal microcracks on the straight root canals of premolars.

Complicated crown root fracture is a serious combined fracture of the enamel, dentin, and cementum in dental trauma. The treatment method is complicated. During the procedure, the condition of pulp, periodontal, and tooth body should be thoroughly evaluated, and a multidisciplinary approach combined with sequential treatment is recommended. This case reported the different treatment and repair processes of one case of two affected teeth after complicated crown root fracture of upper anterior teeth, including regrafting of broken crown after flap surgery at the first visit, direct resin repair to remove broken fragments, and pulp treatment and post-crown repair at the second visit. After 18 months of follow-up, the preservation treatment of the affected teeth with complicated crown root fracture was achieved. Therefore, fragment reattachment and post-crown restoration are feasible treatment options for children with complicated crown root fracture.

Robotic surgery is known as the “third technological revolution” in the field of surgery, and is an important milestone in the development of modern surgery. However, our country’s innovative surgical robot industry is still in its early stages, and it is only being utilized in certain surgical fields. To explore the effectiveness of the application of domestic surgical robot in oral and maxillofacial surgery, the author successfully completed a case of benign parotid tumor resection with the assistance of a domestic autonomous robot. The operation was successful, facial nerve function was preserved, and postoperative wound healing was good.

Objective To solve the current problems of loosening and dislodging caused by the high elastic modulus of solid implants, we attempted to study a gradient porous dental implant that can lower the stress concentration and reduce the elastic modulus. Methods SolidWorks software was utilized to design the abutment and mechanical structure of the gradient porous implant. The mechanical properties of the gradient porous implant were evaluated by an orthogonal experimental design from four aspects: pore shape, pore diameter, porous layer height, and circumferential distribution. ANSYS software was used to evaluate the distribution of Von-Mises stress in the implant and its surrounding bone tissues under different structural combination parameters to derive the optimal combination of gradient porous implant parameters. Results The effects of the four factors, namely, pore shape, pore diameter, porous layer height and pore distribution, on the maximum Von-Mises stress on the implant were as follows. As the pore shape became smaller and the circumferential distribution decreased, the Von-Mises stress decreased significantly. The pore diameter went from 500 μm to 600 μm and then to 700 μm. The Von-Mises stress decreased and then increased. It increased with the increase in the height of the porous layer. Conclusion The final optimal combination of parameters for the gradient porous implant was as follows: square pore shape, pore diameter of 600 μm, porous layer height of 3 mm, and quadratic step in pore distribution.

Objective The machine learning algorithm was used to construct a prediction model of children’s dental caries to determine the risk factors of dental caries in children and put forward targeted measures and policy suggestions to improve children’s oral health. Methods Stratified cluster random sampling was adopted in this study. In accordance with different policies and measures in Sichuan Province, 12-year-old students from 3-4 middle schools in eight cities of Sichuan Province were randomly selected for questionnaire survey, oral examination, and physical examination. Multivariate logistic regression analysis of risk factors for dental caries in 12-year-old children was conducted. The dataset was randomly divided into training set and validation set at a ratio of 7∶3. Four machine learning algorithms, including random forest, decision tree, extreme gradient boosting (XGBoost), and Logistic regression, were constructed using R version 4.1.1, and the prediction effects of the four prediction models were evaluated using the area under receiver operating characteristic curve (AUC). Results A total of 4 439 children aged 12 years were included in this study. The incidence of permanent teeth caries was 50.93%. The results of multivariate logistic regression analysis showed that body mass index, highest educational background of the father, highest educational background of the mother, whether to brush teeth, how many times a day, use of toothpaste when brushing teeth, duration of brushing teeth, mouthwash after meals, eating before going to bed after brushing teeth, sweet drinks, snacks, going to dental clinic to examine teeth, and age of brushing teeth were the factors influencing children’s dental caries (P<0.05). The AUC values predicted by random forest, decision tree, Logistic regression, and XGBoost were 0.840, 0.755, 0.799, and 0.794, respectively. In the random forest model, the variable with the highest contribution was eating before bed after brushing. Conclusion A prediction model of dental caries in children was established on the basis of random forest, showing good prediction effect. Taking preventive measures for the main factors affecting the occurrence of dental caries in children is beneficial.

To keep or extract severe periodontitis damaged teeth is one of the controversial topics in the dentistry from ancient times to present. From different perspectives, professions, technologies, time, and economics, there may be different choices with unidentified consensus. Based on the author’s own understanding, experience, literature review, and other aspects, this article proposes some exchange views on influencing factors, abandoning consideration, preserving possibility, and how to detect and prevent the development of lesions. The aim is to stimulate more thinking and accumulate clinical evidence-based data among peers, in order to facilitate cooperation and promote oral health.

Objective The aim of this study was to demonstrate a novel jaw position adjustment technique derived from digital twins and evaluate the application effect of digital technology-assisted optimization in the process of adjusting jaw position on patients with temporomandibular disorders (TMD). Methods A total of 74 patients with TMD who attended the Department of Temporomandibular Joint, West China Hospital of Stomatology, Si-chuan University, between June 2022 and May 2023 were selected. The patient’s initial computed tomography (CT) and bilateral temporomandibular joint data obtained by magnetic resonance imaging (MRI) were collected. The 148 joints were divided into the normal disc-condyle relationship (N) group, disc displacement with reduction (DDWR) group, and disc displacement without reduction (DDWoR) group. Assisted by digital technology, the patient’s CT data were reconstructed, and a personalized reference plane was established to adjust the jaw position. A three-point bite guiding splint was designed by the adjusted occlusal space and then fabricated by 3D printing technology. It was worn by the patients and then reviewed by MRI. Before and after the adjustment of jaw position, the amount and direction of condyle and disc displacement and the angle between condyle and disc were measured as the evaluation indexes of the effect of the adjustment. The correlation with condylar displacement was evaluated. Results In the N group, the disc moved backward and downward along the X and Z axes by (-0.60±0.62) and (0.51±0.71) mm, respectively. In the DDWR group, the disc moved backward and upward along the X and Z axes by (-1.33±1.38) and (-0.09±1.31) mm, respectively. In the DDWoR group, the disc moved forward and downward along the X and Z axes by (0.49±1.76) and (1.35±1.76) mm, respectively. The angle between the condyle and the disc decreased after adjustment of the jaw position in all three groups. All patients showed improvement in symptoms after adjustment. Conclusion Digital technology-assisted jaw position adjustment can simplify the process, reduce the sensitivity of the technique, and improve patients’ disc-condyle structure and symptoms. Therefore, its application in the treatment of patients with TMD is of great clinical significance.

Anterior diastema is a common esthetic defect in China. The general treatment for a patient with diastemata, including orthodontics and direct and indirect restorations, is a multidisciplinary clinical procedure covering the orthodontics, operative dentistry, general dentistry, and prosthodontics department. Given the diversity of departments and the complex etiology of this defect, decision-making regarding the closing methods and time selection is undefined and unintegrated, which makes the long-term stability of closure unpredictable. This article proposed an etiology-based decision tree with actual measurement of diastemata width for diastemata closure. The decisional steps include classifying the etiological factors based on patients' medical history and clinical manifestation to evaluate the stability of diastemata. After maintaining the stability of diastemata, contemporary and multidisciplinary treatment plans were selected in accordance with the measured width of diastemata and patients' cosmetic psychology, economics, and available time. These decision trees focus on the challenges of collaboration among dental departments, propose an objective and efficient ways for connections, and promote efficient and effective diastemata closure.

Facial nerve training can prevent facial expression muscle atrophy and promote the recovery of facial para-lysis in patients with peripheral facial paralysis. However, there is still a lack of specific and unified technical standards for facial nerve training, which results in a variety of clinical training methods and uneven levels. In order to standardize the application of facial nerve function training technology for nursing staff, the study convened relevant domestic experts, based on evidence-based combination with the disease characteristics of peripheral facial paralysis and expert clinical experience, conducted in-depth interviews with experts, expert correspondence and expert meetings, and finally formulated the expert consensus on facial nerve function training in patients with peripheral facial paralysis. Overall, suggestions for standardizing the timing, training methods, evaluation methods, health education and other aspects were provided for clinical reference.

Objective This study aims to explore the status quo of health literacy and quality of life in elderly patients with chronic periodontitis and determine their correlation to understand the influencing factors of health literacy and quality of life. Methods A total of 150 elderly patients with chronic periodontitis were investigated using the general information questionnaire, Oral Health Literacy-Adult Questionnaire, and Oral Health Impact Profile for Chronic Periodontitis. Results The total scores of health literacy and quality of life of elderly patients with chronic periodontitis were 6.59±4.11 and 29.25±9.42, respectively. The total score of health literacy was negatively correlated with the total score of quality of life (r=-0.234, P<0.01). Regression analysis showed that age, place of residence, education level, and disease understanding were the influencing factors of health literacy. Family history, smoking, and education level were the influencing factors of quality of life. Conclusion The health literacy level of elderly patients with chronic periodontitis is insufficient, and their quality of life needs to be improved. Improving the health literacy of patients is an effective way to improve their quality of life. Nursing staff must formulate corresponding health education strategies to improve the health literacy of patients and improve their quality of life.

Objective This study aims to investigate the correlation between serum Galectin-3 levels and the risk of periodontitis in patients with type 2 diabetes mellitus (T2DM). Methods A total of 140 patients with T2DM admitted to the endocrinology department of Weifang People’s Hospital, Affiliated to Weifang Medical College from July 2021 to November 2022 were selected and divided into T2DM without periodontitis group (T2DM group, n=67) and T2DM with periodontitis group (T2DMP group, n=73) according to whether they were combined with periodontitis. In the same period, 65 non-periodontitis volunteers with normal blood glucose were selected as healthy control group (NC group). Blood samples of all subjects were collected, and serum Galectin-3 levels and related laboratory indices were detected and compared among the three groups. Results Serum Galectin-3 levels in the NC, T2DM, and T2DMP groups were 3.81 (3.49, 4.15), 4.82 (4.25, 5.26), and 6.83 (5.19, 7.28) ng/mL, respectively. After adjusting for the influence of baseline data by multiple linear regression, serum Galectin-3 levels in the T2DMP and T2DM groups were significantly higher than those in the NC group (all P<0.05). Multiple linear regression analysis showed that serum Galectin-3 levels were positively correlated with homeostatic model of the insulin resistance index (β=0.254, 95%CI:0.089-0.419, P=0.003), glycosylated hemoglobin A1c (β=0.397, 95%CI: 0.049-0.745, P=0.026), and clinical attachment loss (β=0.298, 95%CI: 0.024-0.572, P=0.033). After adjusting for the effects of covariates, binary logistic regression showed that serum Galectin-3 levels were significantly associated with the risk of periodontitis in patients with T2DM (OR=2.146, 95%CI: 1.260-3.655, P=0.005). Trend test showed that the risk of periodontitis in patients with T2DM increased with increasing serum Galectin-3 levels (P_trend=0.011). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of serum Galectin-3 in predicting T2DM periodontitis was 0.861 (95%CI: 0.801-0.920, Z=11.806, P<0.001). Conclusion Serum Galectin-3 levels were elevated in patients with T2DM and pe-riodontitis and associated with the risk of periodontitis.

Stevens-Johnson syndrome (SJS), also known as the multifactorial erythematous drug eruption, is a class of adverse reactions of the skin and mucous membranes primarily caused by drug allergy often involving the oral cavity, eyes, and external genital mucosa, generally accompanied by fever, and can be life-threatening in severe cases. In February 2022, the Department of Stomatology, the First Affiliated Hospital of Zhengzhou University admitted a patient with huge inflammatory hyperplasia of bilateral lingual margins secondary to SJS. Upon admission, no other obvious symptoms were observed except for tongue hyperplasia. The patient suffered from a severe adverse drug reaction caused by acetaminophen 2 months ago and was complicated by liver dysfunction and pulmonary infection. After 1 month of treatment and rehabilitation, he developed a secondary tongue mass and was subsequently admitted to Dept. of Oral and Maxillofacial Surgery Ward 2, the First Affiliated Hospital of Zhengzhou University. After completing the examination, the tongue mass was surgically removed. After a follow-up of 11 months, the patient’s condition was satisfactory and no temporary discomfort was observed. The case of tongue mass secondary to SJS is extremely rare. If a stomatologist encounters a similar case, we should carefully inquire about the drug allergy history and recent medication history, and be alert to whether or not they had adverse drug reactions recently.

Langerhans cell histiocytosis (LCH) is a group of unexplainable abnormal proliferation and aggregation of Langerhans cell. LCH can be classified into four clinical variants: Letterer-Siwe disease, Hand-Schüller-Christian disease, eosinophilic granuloma, and congenital self-healing LCH. LCH is most prevalent in children. Lesions can be localized in a single system or multiple organs, and clinical manifestations vary depending on the affected organs. The skin and mucocutaneous tissues are the starting point of the affected tissue. This study presents a LCH case characterized by transient self-healing. This case can further provide references for the clinical diagnosis and treatment of LCH.

Objective This work aimed to evaluate the effect of artificial aging on the translucency and color difference (ΔE) of ultra-translucent zirconia and provide a reference for clinical application. Methods The discs of ultra-translucent zirconia from six brands (Wieland, 3M ESPE, Amann Girrbach, Kuraray Noritake, Upcera, and Besmile) were cut and sintered according to each manufacturer’s product instructions; the experimental groups were named ZNT, LVP, AG, KAT, UPC, and BSM, respectively. IPS e.max Press was used as the control group (PLT). The specimens (n=6) were prepared with a diameter of 14 mm and a thickness of 1 mm. The specimens were subjected to artificial aging treatment according to the following conditions: in an autoclave at 134 ℃ at 0.2 MPa for 4, 8, and 12 h. According to the CIE1976Lab system, the CIE L*, a*, and b* values of the specimens before and after aging were measured by a co-lorimeter. The translucency parameter (TP) and ΔE were calculated. Results The mean TP values of each group before aging inorder were PLT>KAT>AG>ZNT>BSM>UPC>LVP. We found no significant difference in translucency in all experimental groups after aging for 4 and 8 h compared with those before aging. After 12 h of aging, the TP values of the KAT and ZNT groups were not significantly different from those before aging, but the TP values of the AG, BSM, LVP, and UPC groups were significantly lower than those before aging (P<0.05). The TP value of the control group was significantly higher than that of the other experimental groups at different stages (P<0.05). ΔE=3.3 was considered the visible color difference, and ΔE was less than 3.3 in all groups after 4 h of aging. After aging for 8 h, ΔE of the UPC group was slightly higher than 3.3. ΔE of the BSM and UPC groups was greater than 3.3 after 12 h of aging. Conclusion The TP and ΔE of different brands of ultra-translucent zirconia may change after various aging times. The translucency of some zirconia showed a decreasing trend and the color difference showed an increasing trend with the aging time.

Objective This study aims to understand the prevalence and treatment status of dental caries in preschool children aged 3-5 years in China among the past five years. Methods Databases including CNKI, WanFang data, VIP, MEDLINE, EMBASE were systematically searched for the epidemiological literature of dental caries in preschool children in China from 2017 to 2022 for Meta-analysis. Subgroup analysis was carried out by sex, age, geographical region, ethnology, and residence. Results The Meta-analysis enrolled 27 literatures, including 72 788 preschool children; of which, 38 344 children had dental caries. The merged prevalence of dental caries in preschool children was 59.3% (95%CI: 54.6%-63.9%), and the merged filling rate of caries was 5.7% (95%CI: 2.5%-8.8%). In the subgroup analysis, the merged prevalence rates of caries in children aged 3, 4, and 5 years were 46.9% (95%CI: 42.5%-51.4%), 59.0% (95%CI: 55.1%-62.8%), and 67.3% (95%CI: 62.5%-72.2%), respectively, and the difference was significant. In addition, significant differences were found among different regions. The merged prevalence of dental caries in preschool children was the highest in northwest China (68.6%, 95%CI: 55.5%-81.8%) and the lowest in central China (49.1%, 95%CI: 47.3%-51.0%). The merged prevalence of dental caries was not significantly different among preschool children of different genders, ethnicities, and residence. Conclusion The prevalence of dental caries in preschool children aged 3-5 years in China is high and continuously increases. The oral health of preschool children should be comprehensively strengthened, and a three-level strategy should be implemented to prevent diseases.

Objective This study aims to investigate bond strength between zirconia and resin cement through surface treatments with Er: YAG laser, Nd: YAG laser, and Si-Zr coating. Methods Seventy-five round pre-sintered zirconia discs with a diameter of 18 mm and a thickness of 1.5 mm were prepared by a powder compactor. Fifty discs were randomly divided into five groups of 10 discs each and were subjected to five surface treatments: no treatment (control group), sandblasting with alumina particles (sandblasting group), Er: YAG laser treatment (Er: YAG laser group), Nd:YAG laser treatment (Nd: YAG laser group), and Si-Zr coating treatment (Si-Zr coating group). The discs were then bonded to composite resin columns with resin cement. The shear bond strength of each group was tested with a universal tester. Roughness tester, scanning electron microscope (SEM), and energy dispersive spectroscopy were used to analyze surface performance. Results The bond strength of the Si-Zr coating group was higher than that of the remaining groups (P<0.05). The difference in bond strength between the sandblasting group and the Er: YAG laser group was not statistically significant (P>0.05), but both of them had higher bond strength than the Nd: YAG laser group (P<0.05). The Si-Zr coating group had the highest surface roughness (P<0.05). The surface roughness of the sandblasting, Er: YAG laser, and Nd: YAG laser groups was higher than that of the control group (P<0.05), but the difference among the three groups was not statistically significant (P>0.05). SEM observations showed irregular scratches on the surface of the sandblasting group and large pits with holes on the surface of the Er: YAG and Nd: YAG laser groups. In the Er: YAG laser group, the crystal structure was replaced by a smooth surface with a large amount of microcracks due to partial melting. Complex porous structures that comprised “island-like” structures and mass pores among the grains were observed on the surface of the Si-Zr coating. Only Zr, O, and Y were detected on the surfaces of the control, Er: YAG laser, and Nd: YAG laser groups. Al was found on the surface of the sandblasted group, and a higher proportion of Si was detected on the surface of the Si-Zr coating group. Conclusion Er: YAG laser and Nd: YAG laser treatment on the zirconia ceramic surface could increase roughness and improve the bond strength to resin cement. Si-Zr coating treatment is an effective alternative for increasing the roughness and bond strength of zirconia surface and is superior to sandblasting and laser treatments.

Objective This study aimed to compare the effectiveness of ultrasound and acoustic and laser cleaning of curved root canals. Methods A total of 92 molars with independent root canals with a curvature of 20°-40° were prepared and standardized at 04 25# and stained with gentian violet solution for 72 h. Among them, 52 were randomly divi-ded into four groups for final rinsing (n=13): NI group, PUI group, EDDY group, and PIPS group. Ten samples in each group were cut horizontally along the long axis perpendicular to the root and divided into curved upper, curved, and apical segments. Images were taken with a stereomicroscope and Image J measurements were taken to calculate the depth of rinse penetration. The remaining three samples from each group were split along the long axis of the dentin, photographed by scanning electron microscope to record the dentin tubule exposure and staining layer, and scored for staining layer by double-blind method. SPSS 26.0 software was used to perform statistical analysis and select the best flushing method. An extra 40 samples were randomly divided into four groups for detection of flushing fluid penetration depth (n=10): 10, 20, 30, and 40 s. Results In the upper part, the mean depth of infiltration was not significantly different between the experimental and control groups (P>0.05). The PIPS group had a significantly lower smear layer score than the control group and the EDDY group (P<0.01). In the curved segment, the mean depth of infiltration was significantly greater in the PUI group than in the control group (P<0.05); the tarnish layer score was lower in each experimental group than in the control group. At the top, the mean depth of infiltration was greater in the PUI and PIPS groups than in the control group (P<0.05), and the smear layer score was lower in the PIPS group than in the other groups (P<0.05). After the time was changed, the depth of infiltration of PUI increased only in the apical segment as the flushing time increased. Conclusion The PUI and PIPS methods facilitate the penetration of irrigation solution into the dentin canal in curved root canals, especially in the apical segment. The PIPS technique is effective in removing the smear layer in curved root canals.

Objective To investigate possible cross-talk genes, associated pathways, and transcription factors between chronic periodontitis (CP) and chronic obstructive pulmonary disease (COPD). Methods The gene expression profiles of CP (GSE10334 and GSE16134) and COPD (GSE76925) were downloaded from the GEO database. Differential expression and functional clustering analyses were performed. The protein‑protein interaction (PPI) network was constructed. The core cross-talk genes were filtered using four topological analysis algorithms and modular segmentation. Then, functional clustering analysis was performed again. Results GSE10334 detected 164 differentially expressed genes (DEGs) (119 upregulated and 45 downregulated). GSE16134 identified 208 DEGs (154 upregulated and 54 downregulated). GSE76925 identified 1 408 DEGs (557 upregulated and 851 downregulated). The PPI network included 21 nodes and 20 edges. The final screening included seven cross-talk genes: CD79A, FCRLA, CD19, IRF4, CD27, SELL, and CXCL13. Relevant pathways included primary immunodeficiency, the B-cell receptor signaling pathway, and cytokine-cytokine receptor interaction. Conclusion This study indicates the probability of shared pathophysiology between CP and COPD, and their cross-talk genes, associated pathways, and transcription factors may offer novel concepts for future mechanistic investigations.

Objective This study aims to investigate clinical outcomes, imaging changes, and age differences with regard to temporomandibular joint disc condylar complex with anterior disc displacement without reduction (ADDWoR). Methods A total of 37 patients (45 lateral joints) with ADDWoR who were admitted to The First Affiliated Hospital of Zheng Zhou University from January 2016 to June 2023 were selected. The patients were composed of 4 males and 33 females and had an average age of 23.5 years. The average course of the disease was 14.4 months. Clinical and magnetic resonance imaging (MRI) data were collected at the end of initial diagnosis and follow-up, and the length and thickness of the articular disc, the angle of the disc condyle, and the height of the condyle were measured. The statistical significance of the changes was assessed using SPSS 25.0 software package. Results At the end of follow-up, disc displacement in three patients (three lateral joints) was healed. Approximately 48.4% of the patients felt that limitation of mandibular movement was not alleviated; 58.3% of patients reported that pain during mouth opening was not reduced; 54.5% reported pain while chewing; 33.3% of the patients showed facial deviation, and only one showed remission. The mean disk-condyle angle increased from 61.63° to 67.81°. The average length of articular disc shortened from 8.20 mm to 7.27 mm, and the height of the condyle significantly decreased from 23.17 mm to 22.76 mm (P<0.05). The absorption ratio of the condyle increased, and no significant differences in the changes of joint soft and hard tissues between the adolescent and adult groups (P>0.05). Conclusion In different age groups of patients with ADDWoR, clinical symptoms cannot be completely relieved. The disc is anteriorly displaced and shortens, condylar height decreases, and secondary facial asymmetry and mandibular retraction occur.

Conventional periodontal regenerative surgery has limited effect on tooth with severe periodontitis-related alveolar bone defects. This article reported a case of regenerative treatment in severe distal-bone defect of mandibular first molar. The treatment involved applying 3D printing, advanced/injectable platelet-rich fibrin, and guided tissue-regeneration technology. After the operation, the periodontal clinical index significantly improved and the alveolar bone was well reconstructed.

The clinical demand for occlusal reconstruction increases rapidly with increasing number of patients who have lost their normal occlusion because of tooth wear and dentition defects. Occlusal reconstruction is a special type of restoration defined as a comprehensive restoration of the function of the stomatognathic system by reestablishing a uniform and stable occlusal relationship between the upper and lower dentitions. Occlusal function analysis is an important part of occlusal reconstruction to achieve accurate restoration design and adjustment. Digital occlusal function analysis was conducted to monitor the movement of the mandible and obtain related data for the parameter design of occlusal reconstruction. Preoperative design, intraoperative adjustment, and postoperative verification were achieved, thereby improving the efficiency and accuracy of occlusal reconstruction.

Objective This study aims to determine the effects of low-level laser (LLL) on the expression of interleukin-6 (IL-6), tumor necrosis factor (TNF)-α, osteoprotegerin (OPG), and receptor activator of nuclear factor-κB ligand (RANKL) in human periodontal ligament cells (HPDLCs) stimulated by high glucose; and identify the molecular mechanism of LLL therapy in the regulation of periodontal inflammation and bone remodeling during orthodontic treatment in diabetic patients. Methods HPDLCs were cultured in vitro to simulate orthodontic after loading and irradiated with LLL therapy. The cultured cells were randomly divided into four groups: low glucose Dulbecco’s modification of Eagle’s medium (DMEM)+stress stimulation (group A), high glucose DMEM+stress stimulation (group B), hypoglycemic DMEM+LLL therapy+stress stimulation (group C), and hyperglycemic DMEM+LLL therapy+stress stimulation (group D). Groups C and D were further divided into C1 and D1 (energy density: 3.75 J/cm²) and C2 and D2 (energy density: 5.625 J/cm²). Cells in groups A, B, C, and D were irradiated by LLL before irradiation. At 0, 12, 24, 48, and 72 h, the supernatants of the cell cultures were extracted at regular intervals, and the protein expression levels of IL-6, TNF-α, OPG, and RANKL were detected by enzyme-linked immunosorbent assay. Results 1) The levels of IL-6 and TNF-α secreted by HPDLCs increased gradually with time under static pressure stimulation. After 12 h, the levels of IL-6 and TNF-α secreted by HPDLCs in group A were significantly higher than those in groups B, C1, and C2 (P<0.05), which in group B were significantly higher than those in groups D1, and D2 (P<0.01). 2) The OPG protein concentration showed an upward trend before 24 h and a downward trend thereafter. The RANKL protein concentration increased, whereas the OPG/RANKL ratio decreased with time. Significant differen-ces in OPG, RANKL, and OPG/RANKL ratio were found among group A and groups B, C1, C2 as well as group B and groups D1, D2 (P<0.05). Conclusion 1) In the high glucose+stress stimulation environment, the concentrations of IL-6 and TNF-α secreted by HPDLCs increased with time, the expression of OPG decreased, the expression of RANKL increased, and the ratio of OPG/RANKL decreased. As such, high glucose environment can promote bone resorption. After LLL therapy, the levels of IL-6 and TNF-α decreased, indicating that LLL therapy could antagonize the increase in the levels of inflammatory factors induced by high glucose environment and upregulate the expression of OPG in human HPDLCs, downregulation of RANKL expression in HPDLCs resulted in the upregulation of the ratio of OPG/RANKL and reversed the imbalance of bone metabolism induced by high glucose levels. 2) The decrease in inflammatory factors and the regulation of bone metabolism in HPDLCs were enhanced with increasing laser energy density within 3.75-5.625 J/cm². Hence, the ability of LLL therapy to modulate bone remodeling increases with increasing dose.

Objective This clinical study aimed to evaluate the accuracy of a fully digital technique for measuring sagittal condylar inclination (SCI), as well as validating whether differences existed between the left and right SCI values of the same participant, to provide a reference for clinical practice. Methods Ten participants with good occlusal relationship and normal temporomandibular joint were recruited. Three methods were used to measure the SCI values of the participants, namely, A (mechanical facebow transferring and mechanical articulator-based measuring method with physical protrusive interocclusal registration), B (face scan-based virtual facebow and virtual articulator-based measuring method with digital protrusive interocclusal registration), and C (jaw motion tracking system-based measuring method). With the group subjected to methods A and C as the control, the SCI values obtained by the three methods were statistically analyzed. The left and right SCI values of the same participant were also compared. Results The left and right SCI values measured by method A were 41.70°±7.09° and 42.80°±8.62°, those by method B were 35.09°±12.49° and 37.63°±12.10°, and those by method C were 39.43°±8.72° and 38.45°±6.91°. No significant difference existed among the SCI values measured by the three methods (P>0.05). Meanwhile, no statistical difference existed between the SCI values on the left and right sides of the same participant (P>0.05). Conclusion The accuracy of the virtual facebow and digital protrusive occlusal registration based SCI measuring method was the same as that of mechanical facebow based and jaw motion tracking system-based methods. The SCI values on the left and right sides of the same participant were similar. Clinically, an appropriate SCI measurement and setting strategy can be selected based on the actual situations.