Objective To explore the regulatory role of farnesol in Candida albicans (C. albicans) biofilm cAMP-PKA signaling pathway and its correlation with drug resistance. Methods Standard, fluconazole-resistant, wild and high RAS1 gene expression strains of C. albicans were cultured to different phases of the biofilm (6,12,24,36 h), and the sessile minimal inhibitory concentration 50%(SMIC₅₀) of fluconazole were determined by XTT reduction after farnesol treatment. The regulatory effects of farnesol on the expression of genes related to the cAMP-PKA signaling pathway in standard and fluconazole-resistant strains of C. albicans, such as RAS1, CYR1, PDE2 were examined using qPCR; the effects of farnesol on the protein expression of the pathway were analyzed by Western blot. RAS1 gene expression of the wild and high RAS1 gene expression strains was measured by qPCR. Results ① Compared with the standard strain, resistant strains of C. albicans had higher levels of biofilm SMIC₅₀ at 6, 12 and 24 h; there was no significant difference in RAS1 expression (P>0.05), while CYR1 expression increased significantly at 6 and 24 h in the biofilm (P<0.01), and PDE2 expression decreased at 6 h in the biofilm (P<0.01). ②After treatment with farnesol, the resistance of the biofilm of the standard strain and drug-resistant strain decreased. Compared with no treatment with farnesol, the expression of RAS1 in the biofilm of the standard strain and drug-resistant strain decreased at all time points (P<0.01); CYR1 expression decreased in the biofilm at 6, 24 and 36 h, and increased in the biofilm at 12 h (P<0.01); PDE2 expression increased in the 12 h biofilm (P<0.01). ③Compared with the wild strain, the high expression strain of RAS1 gene showed higher SMIC₅₀ in the biofilm at 12 and 24 h, and significantly higher expression of RAS1 gene in the biofilm at 12, 24 and 36 h (P<0.01). ④After treatment with farnesol, the resistance of wild-type strains and high expression strains of RAS1 gene decreased. Compared with the untreated group, the expression of RAS1 gene in the biofilm of wild-type and RAS1 gene high expression strain decreased at 12 and 24 h (P<0.01). Conclusion Farnesol can affect the sensitivity of C. albicans biofilm to fluconazole by regulating the expression of resistance molecules RAS1, CYR1 and PDE2 in the cAMP-PKA pathway. The regulatory effect varies at different stages of biofilm formation.

Objective To investigate the correlation between the Balkwill angle and occlusal plane angles and temporomandibular joint (TMJ) morphology in adults with skeletal Class Ⅱ division 2 malocclusion. Methods Thirty-five adult patients with skeletal Class Ⅱ division 2 low angle (study group) and 35 adult patients with skeletal Class Ⅰ average angle (control group) were included. The Invivo Dental 5 software was employed to acquire the data of Balkwill angle, occlusal plane angle (FH-OP), posterior occlusal plane angle (FH-POP), mandibular occlusal plane angle (FH-MOP), DPO (vertical distance from condylar center to the MOP) and the TMJ measurement items. Results The mean values of FH-OP, FH-POP and FH-MOP were lower in the study group than control group (P<0.05). The average value of Balkwill angle and DPO were higher in the study group than the control group (P<0.05). Significant differences were found in the measurement results of the mediolateral diameters of the condyle, width of condylar head, the articular eminence inclination and height, superior joint space between two groups. DPO had a medium correlation with mediolateral diameters of the condyle, glenoid fossa depth and articular eminence height. And FH-MOP angle had a medium correlation with mediolateral diameters of the condyle and articular eminence height. There was a medium correlation between the Balkwill angle and articular eminence height, a weak correlation with mediolateral diameters of the condyle, articular eminence inclination, condylar length and glenoid fossa depth. Conclusion The results indicated that the DPO had a significant impact on TMJ morphology, followed by FH-MOP, and finally Balkwill angle in skeletal Class Ⅱ division 2 low angle malocclusion.

Objective To establish an animal model of anterior displacement of the temporomandibular joint disc in rabbits and observe the pathological changes of condylar cartilage under stress by using HE staining, immunohistochemical staining and immunofluorescence staining. Methods Thirty adult New Zealand white rabbits were randomly divided into a Sham operation group and four experimental groups, with six rabbits in each group. The Sham operation group underwent a sham operation, while the experimental groups were used to establish an animal model of anterior displacement of the temporomandibular joint disc. The experimental groups were further divided into a model group (no postoperative treatment), a 2-APB (TRPM7 inhibitor) group, a PDTC (NF-κB specific inhibitor) group, and a Diclofenac group. Two weeks after the operation, the experimental animals were sacrificed, and pathological sections of the condylar cartilage were made. HE staining was used to observe the pathological changes of the condylar cartilage, and immunohistochemical staining and immunofluorescence staining were used to observe the expression of NF-κB and its inflammatory factors. Results ① HE staining showed that the pathological changes of the condylar cartilage were obvious at the 2^nd week. Compared with the 2-APB group, PDTC group, and Diclofenac group, the pathological changes in the model group were more obvious. ② Immunohistochemical staining showed that the expression of TRPM7, NF-κB, IL-1, IL-6, TNF-α and MMP-3 in the model group was higher than that in the sham operation group. After treatment with 2-APB, PDTC or diclofenac, the expression of TRPM7, NF-κB, IL-1, IL-6, TNF-α and MMP-3 decreased. ③ Immunofluorescence staining showed that the expression of NF-κB in the model group was higher than that in the sham operation group. After treatment with 2-APB, PDTC or diclofenac, the expression of NF-κB decreased. Conclusion ① Under stress, the condylar bone undergoes early remodeling, and the apoptosis of condylar chondrocytes increases with the extension of loading time within a certain period. ② Diclofenac, 2-APB and PDTC can all reduce the apoptosis of condylar cells, and inflammatory factors also play an important role in the apoptosis of condylar chondrocytes.

Objective To evaluate the efficacy and safety of different surgical approaches for extracting high-positioned supernumerary teeth in the maxillary anterior midline region. Three surgical methods, the labial approach, the palatal approach, and a longitudinal incision beside the upper lip frenum were compared. Methods A total of 102 patients were recruited from the Department of Oral and Maxillofacial Surgery at the Affiliated Stomatological Hospital of Anhui Medical University between January and September 2024. They were randomly assigned via a random-digit table to three groups: the labial approach group (n=32), the palatal approach group (n=34), and the longitudinal incision beside the upper lip frenum group (n=36). Operation time, bone removal volume, postoperative midfacial swelling, degree of pain, and patient satisfaction across the three groups were recorded and compared. Results The average operation time in the labial approach group ((20.50±3.02) min) and the longitudinal incision group ((21.66±2.31) min) were both significantly shorter than that in the palatal approach group ((29.19±3.40) min). In contrast, the palatal approach group demonstrated markedly lower postoperative swelling and pain scores (P< 0.05), along with the highest patient satisfaction, as reflected in the OHIP-14 scale. However, the palatal approach required the greatest bone removal volume, measuring (91.19 ± 9.86)mm³. Conclusion Despite the palatal approach yielding superior outcomes in terms of postoperative pain control, swelling reduction, and patient satisfaction, it necessitated longer operation time and involved greater bone removal. Meanwhile, the labial approach and the longitudinal incision beside the upper lip frenum were comparable in all measured parameters, showing no statistically significant differences. Therefore, when extracting high midline impacted teeth in the maxillary anterior region, the choice of surgical approach should balance safety, minimal invasiveness, and patient satisfaction.

Objective To investigate the effect of arbutin (Arb) on osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs) under inflammatory conditions and the mechanism of NF-κB signaling pathway in this process. Methods The effects of Arb on the proliferation and osteogenic differentiation of hPDLSCs were analyzed by CCK-8, alkaline phosphatase staining, Alizarin Red staining, and Western blot. After establishing an inflammatory model using lipopolysaccharide (LPS), the effect of Arb on the expression levels of inflammatory factors in hPDLSCs was analyzed by RT-qPCR. The effect of Arb on osteogenic differentiation of hPDLSCs was analyzed, and the effect of Arb on the NF-κB pathway was analyzed by Western blot. After adding the NF-κB signaling pathway activator PMA to the culture system, whether the effect of Arb on hPDLSCs changed was analyzed. Results 100 nmol/L Arb did not affect the proliferation of hPDLSCs, but significantly promoted cell osteogenic differentiation and inhibited the expression of inflammatory factors under LPS stimulation. Arb reduced the activation effect of LPS on the NF-κB signaling pathway and the inhibitory effect on cell osteogenic differentiation, while the efficacy of Arb was partially eliminated by PMA. Conclusion Arb alleviates the inhibitory effect of LPS on osteogenic differentiation of hPDLSCs by inhibiting NF-κB signaling.

Objective To compare the clinical and functional differences between transoral and submandibular approach in mandibular segmental resection and reconstruction with free fibula flaps (FFFs). Methods Patients who underwent mandibular segmental resection and FFFs reconstruction in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Nanjing Medical University from January 2015 to March 2023 were retrospectively analyzed. All cases were divided into transoral approach and submandibular approach groups. Clinical characteristics of the patients were recorded including age, gender, follow-up time, pathological diagnosis, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, James Brown classification of mandibular defect and number of fibular segments. The perioperative indexes, such as average operation time, average bleeding volume, average blood transfusion volume, average drainage volume, average hospitalization time and postoperative complications such as malocclusion, fistula, infection, flap failure, and restriction of mouth opening were compared between the two groups. The University of Washington Quality of Life Questionnaire was used to investigate the appearance, function of swallow and speech more than 6-month postoperatively. Results The average intraoperative bleeding and postoperative drainage were significantly lower in the transoral approach group than in the submandibular approach group (P=0.013 9, P=0.001 9). The appearance score was significantly higher in the transoral approach group than in the submandibular approach group(83.52±12.37) vs. (67.19±13.64)(P<0.000 1). The differences between the two groups in other variables were not statistically significant. Conclusion Cases of transoral approach had significantly better aesthetic outcomes compared with those of submandibular approach.

Objective This experiment aims to evaluate the clinical efficacy of a novel adjustable titanium mesh fixation tent screw by comparing its bone augmentation effects with those of conventional titanium screws combined with prefabricated titanium mesh in cases where simultaneous implant placement is not feasible, thereby providing a new bone augmentation strategy. Methods This prospective study included 14 patients (20 bone augmentation sites) with severe alveolar bone defects treated at the Implant Center of the Department of Prosthodontics, Changsha Stomatological Hospital, from January 2023 to August 2023. The sites were randomly divided into two groups: the experimental group (novel tent screw group) received bone augmentation using novel tent screws combined with prefabricated titanium mesh, while the control group (conventional titanium screw group) underwent bone augmentation with conventional titanium screws combined with prefabricated titanium mesh. Cone beam computed tomography (CBCT) was performed preoperatively (T0), immediately postoperatively (T1), and 6 months postoperatively (T2) to measure alveolar bone width at 2, 6, and 10 mm below the crest and alveolar bone height at the intended implant sites. Vertical and horizontal bone volume changes, bone graft resorption, bone augmentation success rates, and postoperative complication rates were analyzed. Statistical analysis was conducted using SPSS 25.0. Results At 6 months postoperatively, vertical bone augmentation in the experimental group (3.26 ± 2.02) mm was significantly greater than in the control group (1.80 ± 0.64) mm (P<0.05). Horizontal bone augmentation at 2 mm below the crest in the experimental group (4.45 ± 2.46 ) mm was significantly higher than in the control group (2.45 ± 1.02) mm (P<0.05), but no significant differences were observed at 6 and 10 mm below the crest (P>0.05). Both groups exhibited low vertical and horizontal bone resorption with no significant differences. The bone augmentation success rate was 100% in both groups. The complication rate was 27.3% in the experimental group and 25% in the control group, with no statistically significant difference (P>0.05). Conclusion For severe alveolar bone defects where simultaneous implantation is not feasible, the novel tent screw combined with prefabricated titanium mesh achieves superior vertical and horizontal bone augmentation. Compared to conventional titanium screws, the novel tent screw demonstrates significantly better vertical bone augmentation and horizontal augmentation at 2 mm below the crest, effectively restoring alveolar ridge contours.

Objective To discuss the efficacy of direct resin filling restoration, improved atraumatic restorative treatment (ART), and Hall technique in treating deciduous molars in children. Methods A total of 120 children with 180 deciduous molars who came to the Department of Oral Surgery of our hospital from January 2023 to August 2023 were selected and randomly divided into three groups: direct resin filling restoration group(40 people, 60 teeth), improved ataumatic restorative treatment group(40 people, 62 teeth), and Hall technique group(40 people, 58 teeth). The behavioral performance classification and degree of anxiety of the children during the treatment process and the treatment time were compared among the three groups. The clinical efficacy after 3 months, 6 months, and 12 months of treatment was compared and the reasons for failure were analyzed. Results The treatment time of the Hall technique group was significantly shorter than that of the improved ART group and direct filling group, and the differences in treatment time of the three groups had statistical significance(P<0.05). The Hall technique and improved ART technique were more easily accepted by the children, and the degree of anxiety and behavioral performance classification of the three groups had statistically significant differences(P<0.05). At the 12-month follow-up, the success rate of the direct filling restoration group was significantly different from that of the improved ART technique group and the Hall technique group, and the difference was statistically significant(P<0.05). However, the success rate of the improved ART technique group was not significantly different from that of the Hall technique group(P>0.05). Conclusion The success rate of the improved ART technique group and the Hall technique group is higher than that of the direct filling restoration group, and is more easily accepted by children. The pain level and degree of anxiety are lighter, and the treatment time of the Hall technique is shorter, which is more conducive to the repair of tooth decay.

Objective To evaluate the effect and safety of celecoxib preemptive analgesia on pain during root canal treatment of mandibular posterior pulpitis. Methods Patients(n=120) with irreversible pulpitis of mandibular posterior teeth who underwent root canal treatment were randomly divided into group A as control group, group B as ibuprofen group and group C as celecoxib group. Standard oral doses of placebo, 300 mg ibuprofen, and 200 mg celecoxib were respectively given 0.5 hours before surgery. During the operation, 2% lidocaine was used for inferior alveolar nerve block anesthesia. Pulp opening, pulp extraction, root canal preparation, root canal calcium hydroxide disinfection and drug sealing were completed. The degree of pain before, during, and after treatment was evaluated using digital rating scale (NRS) 0-10, and the onset, duration, and adverse effects of anesthesia were recorded. Results All cases had different degree of pain. However, the NRS score in celeoxib group was lower than that in ibuprofen group and control group (P<0.05). There was no significant difference in NRS score between ibuprofen group and control group (P>0.05), but postoperative score of ibuprofen group was lower than control group (P<0.05). There was no significant difference in the duration of anesthesia among the three groups (P>0.05). The onset time of anesthesia in celecoxib group was shorter than that in ibuprofen group and control group (P<0.05). The onset time of anesthesia in ibuprofen group was shorter than that in control group (P<0.05). There was no significant difference in the incidence of anesthesia adverse reactions among the three groups (P>0.05). Conclusion In the root canal treatment of mandibular posterior tooth irreversible pulpitis, oral celecoxib can effectively improve the effect of inferior alveolar nerve block anesthesia, shorten the onset time of anesthesia, reduce the intraoperative and postoperative pain of patients, and do not increase the incidence of adverse reactions, which is worthy of promotion and application.

Dyskeratosis congenita is a hereditary short telomere disease caused by mutations in telomerase-related genes. The classic clinical manifestations are oral leukoplakia, nail dystrophy, and skin pigmentation. This article reported a 7-year-old male child diagnosed with dyskeratosis congenita but with dorsal tongue erosion as the first manifestation. Genetic testing results confirmed DKC1 gene mutations and a literature review was performed.

Subgingival air polishing can effectively remove plaque and soft deposits attached to the tooth surface and implant surfaces. It is an adjunctive treatment method for periodontitis and peri-implantitis, offering good cleaning efficiency with minimal damage to the root surface and implant surface. Additionally, it promotes the reattachment of fibroblasts to the root surface and osteoblast integration on the implant surface. Subgingival air polishing can improve clinical attachment levels and also shows better therapeutic effects when combined with flap surgery. It provides higher comfort for patients and lower operational difficulty for the dentist. This article aims to analyze and summarize in vivo and in vitro studies, reviewing the therapeutic progress of subgingival air polishing in the treatment of periodontitis and peri-implantitis.

Maxillofacial fractures are common and frequently occurring diseases in Oral and Maxillofacial Surgery. The traditional clinical diagnosis and treatment process is easily affected by complex maxillofacial anatomy and differences in doctors’ experience in reading X-rays and making diagnoses. In recent years, artificial intelligence technology has provided new solutions for the accurate diagnosis and treatment planning of maxillofacial fractures. Automating image analysis through computer vision methods improves diagnostic accuracy and efficiency and assists in formulating treatment plans, showing broad application prospects and value. This article reviews and summarizes the research on the application of artificial intelligence in the auxiliary diagnosis and treatment of maxillofacial fractures at home and abroad, analyzes its advantages and disadvantages, and looks forward to future research trends.

External apical root resorption(EARR)is one of the most common side effects of orthodontic treatment. Contact with surrounding anatomical structures during tooth movement is a significant cause for EARR. However, a comprehensive review of factors leading to EARR due to direct contact of surrounding anatomical structures with the root apex during orthodontic treatment is still lacking. This review summarizes the anatomical structures related to EARR, including alveolar bone, incisive canal, maxillary sinus, adjacent teeth, and bone islands. Alveolar bone, incisive canal, and adjacent teeth can directly cause EARR during orthodontic treatment, while the impact of the maxillary sinus and bone islands on EARR has not been discovered so far. Analyzing the anatomical structures around the tooth roots can help develop more effective methods to prevent or reduce the occurrence of EARR during orthodontic treatment.