Objective To analyze the compositional characteristics of human alveolar bone in periodontal health and periodontitis at the mid-root and apical regions using Raman spectroscopy, and to investigate differences in inorganic mineral components and collagen secondary structure. Methods Right maxillary central incisors and surrounding alveolar bone samples were obtained from cadaveric jaws with periodontal health or periodontitis. The samples were divided into mid-root and apical regions. Raman spectra were collected from alveolar bone within approximately 1 mm of the tooth root. Quantitative analyses of inorganic mineral parameters and collagen secondary structure were performed. Results In healthy alveolar bone, the mineral-to-matrix ratio in the mid-root region was higher than that in the apical region and was also higher than the mineral-to-matrix ratio in the mid-root region of periodontitis alveolar bone. In periodontitis alveolar bone, the mineral-to-matrix ratios of the mid-root and apical regions were similar. No significant differences were observed in carbonate substitution or bone crystallinity among different alveolar bones or regions. Amide Ⅰ band analysis showed a decreased relative content of α-helix structures and increased relative contents of random coil and β-sheet structures in periodontitis alveolar bone, with more pronounced changes in the mid-root region. The intensity ratio of fitted amide Ⅲ band peak areas(I_{1 245}/I_{1 270}) in the mid-root region of periodontitis alveolar bone was higher than that in the apical region. Conclusion Raman spectroscopy reveals alterations in alveolar bone mineralization and collagen secondary structure under periodontal health and periodontitis, with compositional differences among root regions.

Objective To investigate the role of cimifugin in regulating macrophage polarization in periodontitis. Methods The effects of cimifugin at various concentrations (0, 20.4, 40.8, 81.6, 163.2, 326.5, 653.0, 1 306.0 μmol/L) on the viability of RAW264.7 cells were assessed using the CCK-8 and live/dead cell staining to determine the optimal concentration for subsequent experiments. Immunofluorescence staining was employed to observe the impact of cimifugin on M1 and M2 macrophage polarization phenotypes (CD86 and CD206). RT-qPCR was utilized to analyze changes in the expression levels of inducible nitric oxide synthase (iNOS), interleukin (IL)-1β, CD86, IL-6, tumor necrosis factor-α (TNF-α), CD206, and arginase-1 (Arg-1) in macrophages treated with cimifugin. A murine periodontal inflammation model was established, and the animals were divided into a periodontitis group (PD group), a periodontitis + cimifugin group (PD+Cimifugin group), and a sham surgery control group (Control group). Micro-CT was used for scanning and reconstruction, and CTAn software was employed to measure the cemento enamel junction-alveolar bone crest distance (CEJ-ABC), bone mineral density (BMD), relative bone volume/total volume (BV/TV), and trabecular separation (Tb.Sp). HE staining was performed to observe changes in periodontal tissues, while TRAP staining was used to quantify osteoclasts. Immunohistochemistry (IHC) was conducted to analyze the expression of IL-1β and IL-10. Results Cimifugin concentrations≤326.5 μmol/L did not significantly affect macrophage proliferation and viability (P>0.05). Cimifugin at 326.5 μmol/L inhibited the expression of M1 macrophage markers iNOS, IL-1β, CD86, IL-6, and TNF-α, while promoting the expression of M2 macrophage markers CD206 and Arg-1 (P<0.000 1). Compared to the PD group, the PD+Cimifugin group exhibited significant improvements in CEJ-ABC, BMD, BV/TV, and Tb.Sp (P<0.01), reduced inflammatory cell infiltration and osteoclast numbers in periodontal tissues (P<0.05), significantly elevated IL-10 expression (P<0.000 1), and markedly decreased IL-1β expression (P<0.01). Conclusion Cimifugin alleviates periodontal inflammation and reduces bone defects by inhibiting M1 macrophage polarization and promoting M2 macrophage polarization.

Objective To investigate the fixation efficacy of a digital occlusion-guided periodontal splint for loose teeth with periodontitis and evaluate its subsequent clinical outcomes. Methods The surface of polyetheretherketone (PEEK) material was etched with 98% concentrated sulfuric acid for 0, 60, 90 s, and 5 min, respectively. The surface micromorphology was observed by scanning electron microscopy, and the changes in mechanical properties were measured using a universal testing machine to determine the final etching conditions. Ten patients with periodontitis Stage Ⅲ and anterior tooth loosening who visited Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University from March 2024 to September 2025 were selected. The loose teeth were fixed using a digitally 3D-printed occlusal positioning guide device and acid-etched PEEK periodontal splints. Periodontal pocket depth, attachment loss, and plaque index of the teeth in the splint fixation area were recorded and compared before splint fixation and at 3rd, 6th, and 12th months after fixation. Results Based on the results of scanning electron microscope observation of surface morphology and mechanical strength testing with a universal testing machine after etching, the optimal etching condition was determined as etching with 98% concentrated sulfuric acid for 90 s. At 3rd, 6th, and 12th months after fixation, the patients’ periodontal pocket depth and plaque index were significantly lower than those before fixation (P<0.05), while there was no statistically significant difference in clinical attachment loss (P>0.05). Conclusion The digitally fabricated PEEK periodontal splint guided by the occlusal positioning device exhibits favorable clinical fixation effect and holds promising prospects for clinical application.

Objective To investigate how highly alkali-resistant Enterococcus faecalis(HAR E. faecalis) regulates Z-DNA binding protein 1(ZBP1) and macrophage PANoptosis(pyroptosis, apoptosis, necrosis). Methods Highly alkali-resistant Enterococcus faecalis was constructed by continuous alkaline subculturing. RAW264.7 macrophages were infected with either the highly alkali-resistant or standard Enterococcus faecalis(E. faecalis). Flow cytometry, live/dead cell staining, confocal microscopy, and Western blot were employed to analyze ZBP1 expression levels and macrophage death pathways. Small interfering RNA(siRNA) was used to knock down ZBP1 expression in macrophages, followed by the same infection protocol. Western blot was used to analyze changes in the expression of PANoptosis markers after ZBP1 knockdown. Results The highly alkali-resistant Enterococcus faecalis exhibited a weaker ability to upregulate the expression of ZBP1 and PANoptosis markers in macrophages compared to the standard strain. Following ZBP1 knockdown, the expression of these markers decreased, with no significant differences observed between the two strains. Conclusion Highly alkali-resistant Enterococcus faecalis induces compromised macrophage PANoptosis by weak activation of ZBP1, which impairs the host’s ability to completely eradicate the bacteria, thereby possibly favoring the occurrence and development of persistent apical periodontitis.

Objective To identify risk factors influencing cortical bone defect of the mandibular canal related to mandibular third molar with high-risk of inferior alveolar nerve injury (IAN-risk M3). Methods A retrospective study was conducted on 2 516 patients (3 389 M3s) with IAN-risk M3s who attended the Affiliated Stomatological Hospital of Nanjing Medical University between January 2018 and December 2021. All patients underwent panoramic radiography and cone-beam computed tomography (CBCT). Mandibular canal cortical bone condition was assessed on CBCT, and multivariate Logistic regression analysis was performed to determine significant risk factors for cortical bone defect. Results The incidence of mandibular canal cortical bone defect associated with IAN-risk M3 was 38.15%. Mesioangular, middle and low levels impactions, Class Ⅱ and Class Ⅲ impactions, mandibular canal positioned lingual to or between the M3 roots, and a narrow canal morphology were significant risk factors for cortical bone defect. Conclusion Mandibular canal cortical bone defect associated with IAN-risk M3s have a relatively high prevalence and were significantly correlated with radiographic characteristics. Preoperative CBCT evaluation in such cases can assist clinicians in optimizing surgical strategies for third molar extraction and reducing the risk of inferior alveolar nerve injury.

Objective To investigate the radiographic features of tooth resorption in supernumerary teeth (ST) and impacted teeth (IT) using cone-beam computed tomography (CBCT). Methods CBCT data from 7 655 patients collected between January 2018 and December 2023 were reviewed. A total of 155 ST and 31 IT exhibiting resorption were identified. Two evaluators analyzed and classified the teeth based on pulp chamber morphology, site of resorption, degree of tooth structure destruction, and anatomical position according to a novel classification system. The correlation between gender and the prevalence rate was examined. Results The prevalence of ST resorption was 3.66%, which was significantly higher in females (4.83%) than in males (3.17%)(χ²=5.27,P=0.022<0.05). The predominant characteristics of the lesions were coronal dentin resorption, pulp cavity expansion, and enamel defects (54.8%). The prevalence of IT resorption was 0.59%, with no significant difference between females (0.79%) and males (0.35%)(χ²=3.56, P=0.059). The main radiographic characteristics of resorption included resorption of coronal and radicular dentin, enlargement of the pulp chamber, and enamel defects(32.3%). Conclusion The prevalence of tooth resorption is low in ST and IT. The prevalence of resorption in ST shows a gender difference. However, the pattern and direction of resorption in ST and IT show no gender differences. The novel categorization method predicated on CBCT imaging features may serve as a clinical foundation for diagnosing the resorption of ST and IT.

Objective To investigate the effects of different surface treatments on the flexural strength and surface morphology of CAD/CAM resin-ceramic composites. Methods Three resin-ceramic composites—UPCERA Hyramic, Shofu Block HC, and Vita Enamic were subjected to four surface treatments: no treatment (NT), 50 μm Al₂O₃ sandblasting (SB), hydrofluoric acid etching (HF), and Er:YAG laser etching (Er:YAG). The three-point flexural strength was tested immediately and after 10 000 thermal cycles in accordance with ISO 6872 standards. Surface morphology was examined using scanning electron microscopy (SEM). The flexural strength data were analyzed using one-way ANOVA, two-way ANOVA and LSD post hoc tests (α=0.05). Results Compared with the control group, the three-point flexural strength of all three resin-ceramic composites showed no significant change after HF treatment (P>0.05), while it decreased significantly after Er:YAG treatment and SB treatment, with the differences being statistically significant (P<0.05). After thermocycling, the strength of both Vita Enamic and Shofu Block HC decreased significantly in all groups (P<0.05), whereas the SB and Er:YAG groups of Vita Enamic showed no statistically significant decline (P>0.05). SEM analysis revealed alterations in surface morphology in all treated groups before and after thermocycling, with the HF group displaying the least pronounced changes. Conclusion For CAD/CAM resin-ceramic composites, hydrofluoric acid etching has the least detrimental effect on flexural strength and surface morphology. Caution should be exercised when employing Er:YAG laser etching or sandblasting treatments. However, for Vita Enamic, the influence of both sandblasting and Er:YAG laser treatment on the flexural strength is minimal after thermocycling.

Objective To qualitatively and quantitatively assess the three-dimensional changes in facial soft tissues in non-extraction adult orthodontic patients before and after treatmentusing 3dMD technology. The study systematically analyzes the trends of facial landmark changes and investigates the patterns of soft tissue variation in different facial regions. Methods The study included 52 non-extraction adult orthodontic patients(treatment group) and 17 untreated adults(control group). For the treatment group, 3D facial images were captured using the 3dMD system before treatment(T0) and after treatment(T1). 3D facial images of the control group were obtained at a one-year interval. The image data were imported into Geomagic Wrap software for registration. Absolute color maps were generated for qualitative analysis of 3D changes across facial regions. Additionally, 26 soft tissue landmarks were selected for quantitative analysis to compare differences within and between the two groups. Results The facial soft tissue changes in the treatment group before and after orthodontic treatment were symmetrical. After treatment, the overall facial profile exhibited a trend of retraction or posterior displacement, with the temporal, mandibular angle, and oral commissure regions showing more pronounced alterations. Quantitative analysis revealed statistically significant negative changes at the FT,Go' and Ch relative to the G' (P<0.05). Compared with the control group, the changes at the FT and Go' showed significant differences (P<0.05). Conclusion Non-extraction orthodontic treatment in adult patients does not compromise bilateral facial symmetry. However, it may lead to a reduction in soft tissue fullness in the temporal and mandibular angle regions. Therefore, comprehensive communication with patients prior to treatment is essential to guide them in establishing realistic therapeutic expectations.

Objective To analyze the morphological changes of masticatory muscles (medial pterygoid, lateral pterygoid, and masseter) before and after unilateral temporomandibular joint disc repositioning surgery, and to identify effective evaluation indicators, thereby providing a more comprehensive basis for assessing surgical efficacy. Methods A retrospective analysis was performed on MRI data from 94 patients with unilateral anterior disc displacement between January 2022 and December 2023, including those with disc displacement without reduction (ADDwoR, n=78) and with reduction (ADDwR, n=16). Morphological parameters of the bilateral medial pterygoid muscle, superior/inferior heads of the lateral pterygoid muscle, and masseter muscle were measured. Masticatory changes before and after surgery were analyzed in ADDwoR patients. Results In ADDwoR patients, the affected-side/healthy-side volume ratio of the masseter muscle was 0.79. In ADDwR patients, the masseter volume ratio was 0.91. Postoperatively, the masseter volume ratio in ADDwoR patients increased to 1.00, with morphology tending to approximate the healthy side. Conclusion Unilateral ADDwoR is manifested with significant masseter atrophy. Postoperative masseter symmetry improves but does not fully recover. Changes in masseter symmetry before and after surgery can serve as an important indicator for evaluating surgical efficacy and reflecting functional and aesthetic improvements in the maxillofacial muscle groups.

Objective To investigate the clinical effect of long-term comprehensive prevention and treatment of dental caries in children and its influence on caries-related factors. Methods Children who visited continuously for three consecutive years(2019—2022)according to the requirements of the “Comprehensive Children’s Caries Prevention Program” were selected. Comprehensive caries prevention and treatment measures were carried out, including periodic specialized examinations, personalized health education, fluoride application, pit and fissure sealing, and caries filling. Information on dietary habits, oral hygiene, caries status values, and the number of new caries teeth were recorded. Stata 17 software for linear regression analysis was used to analyze the clinical effect of comprehensive prevention and treatment measures, and the association between caries risk factors and caries incidence during the process. Results A total of 544 children met the criteria and were included in the study. The results showed that comprehensive prevention and treatment was the main determinant of the number of caries teeth before and after intervention(P<0.001). Gender, age and initial caries risk had no statistically significant effect on new caries;oral hygiene, dietary habits, and caries status values had significant effects on caries incidence. Conclusion Long-term comprehensive prevention and treatment of dental caries in children has a definite effect on reducing the incidence of dental caries and optimizing dietary habits is worthy of particular emphasis to enhance preventive outcomes.

Secretory carcinoma of the salivary gland is a rare low-grade malignant salivary gland tumor characterized by the distinctive ETV6-NTRK3 fusion gene. It was formally included in the 2017 WHO Classification of Head and Neck Tumors. This tumor most commonly arises in the parotid gland, followed by the submandibular gland and minor salivary glands of the oral cavity, with primary occurrence in the tongue being extremely rare. Only one case of tongue involvement has been reported in the literature, and that was located at the base of the tongue; no cases originating in the anterior tongue have been documented to date.This report describes a case of secretory carcinoma arising in the anterior tongue. The patient was a middle-aged male who presented with a mass in the anterior tongue. The tumor was completely resected surgically. Postoperative hematoxylin and eosin (HE) staining revealed a tumor exhibiting multiple growth patterns, including tubular, papillary, cystic, and solid architectures, accompanied by eosinophilic secretory material and focal necrosis. Combined with characteristic immunohistochemical findings, the final diagnosis was secretory carcinoma of the salivary gland. The rare site of occurrence in this case increased the difficulty of preoperative diagnosis, highlighting the need for clinicians to consider the possibility of secretory carcinoma when encountering solid masses in the tongue. This article, combined with a literature review, summarizes the clinicopathological features, molecular mechanisms, and differential diagnosis of this tumor type, with the aim of enhancing awareness of this entity and increasing vigilance regarding its occurrence at unusual sites.

In this 17-year-old case, considering the patient was young and the principle of preserving teeth and pulp was followed, the vital pulpotomy was first used to preserve part of the vital pulp. However, the internal root resorption image was found in the first follow-up three months after the operation, so the treatment plan was changed to root canal therapy. Through this case study, the reasons for the failure of pulp preservation and internal root resorption after permanent pulpotomy were discussed, in order to provide a new idea for the treatment of mature permanent teeth with carious pulp exposure in the future.

In recent years, the high incidence of oral diseases has driven the emergence of new therapeutic materials. Among them, electrospinning technology can prepare nanofibers with good biological properties and mimic the natural extracellular matrix, thus showing great potential in the field of dentistry. This paper first briefly introduces the preparation process and key properties of the electrospinning technology and then classifies the research progress of electrospinning nanofibers in various subdisciplines of stomatology according to the clinical needs. Finally, the challenges of electrospinning technology in the diagnosis and treatment of oral diseases are discussed in order to provide useful references for the basic research and clinical transformation of stomatology.

Patients with temporomandibular joint osteoarthritis (TMJOA) often suffer from muscle pain, restricted mouth opening, and impaired jaw movement due to bone degeneration of the condyle. Currently, the clinical treatment for TMJOA patients mainly focuses on alleviating the patient’s clinical symptoms, but cannot achieve the repair and regeneration of damaged tissues. In this paper, the current research progress of strategies for repairing and regenerating the condylar osteochondral is reviewed, and new research directions for promoting condylar tissue regeneration are looked into, in order to provide theoretical basis and guidance for further research and clinical application of TMJOA.