This consensus was developed to standardize artificial intelligence-assisted imaging detection, data annotation, model validation, and clinical application for alveolar bone fenestration and dehiscence. A multidisciplinary expert panel systematically reviewed the relevant literature, assessed the quality of evidence using the GRADE approach, and formulated recommendations through three rounds of a modified Delphi process and external review. Standardized recommendations were proposed for thin alveolar bone assessment, metallic artifact management, selection of two-dimensional and three-dimensional models, multimodal fusion, external validation, clinical decision support, and data governance, thereby establishing a framework for image acquisition, hierarchical annotation, algorithm evaluation, and clinical application. The consensus rate for the core recommendations was 91.3%. Artificial intelligence may assist in the detection and risk assessment of bone fenestration and dehiscence but cannot replace specialist judgment or direct surgical examination. This consensus provides guidance for dataset development, model development, product evaluation, and clinical application.

Traditional classification of fixed dental prosthesis was based on the morphological extent of crown coverage and has played a significant role in the era of standardized restorative dentistry. However, with the widespread adoption of minimally invasive restorative concepts and the increasing prevalence of extensively damaged teeth, the limitations of the original classification—including ambiguous categorization and rigid tooth preparation protocols—have become increasingly evident. This consensus reorients the classification framework toward the biomechanical essence of prosthesis retention, adopting the primary retention form as the principal criterion. Five major types of fixed prostheses for tooth defects are delineated: crown circumferential retention form-dependent, crown box retention form-dependent, pulp chamber box retention form-dependent, adhesive bonding-dependent, and intraradicular retention-dependent prostheses. These types correspond respectively to the following distinct retention mechanisms: circumferential frictional locking, intracoronal box mechanical locking, pulp chamber box mechanical locking, physico-chemical adhesion at the bonding interface, and post-and-core frictional/adhesive retention within the root canal. The external morphology of the prostheses does not serve as an independent classification determinant. This classification system aims to reduce the overlap and ambiguity inherent in the traditional morphological classification, enabling clinicians to select appropriate retention modalities and devise individualized tooth preparation protocols based on remaining tooth structure. It maximizes the preservation of healthy dental tissues while ensuring retention stability and functional restoration, facilitates effective assessment of prosthesis longevity, and provides a reference for clinical practice, education, and academic standardization in fixed prosthodontics for tooth defects.

Precious metal alloys offer favorable retention and mechanical properties and remain in clinical use for custom post-and-core restorations. Digital methods have been widely applied to the fabrication of customized post-and-core restorations. However, because precious metal alloys remain difficult to process directly using digital manufacturing techniques, current workflows commonly combine digital design with three-dimensional printing of resin patterns followed by investment casting. This process involves multiple steps, including post-space data acquisition, computer-aided design, resin pattern printing, investing and casting, and clinical evaluation. Errors arising at the clinical and laboratory stages may accumulate and affect the final fit. To address the variability in accuracy associated with inconsistent operating parameters and quality-control procedures, this article integrates available evidence and expert opinion to provide recommendations, quality-control targets, and remake criteria for key procedures, including post-space data acquisition, virtual cement space setting, resin pattern printing and post-processing, casting compensation, post-casting processing, and clinical evaluation. The aim is to provide practical guidance for technical procedures that currently lack unified standards but require clinical standardization, thereby promoting the standardized application of digitally assisted investment casting for customized precious metal alloy post-and-core restorations and improving their clinical longevity.

Periodontal infrabony defects are common bone defects in periodontitis. Traditional bone grafting only possesses osteoconductivity, with grafts prone to displacement and a high risk of barrier membrane exposure. The plasma matrix bone block, formed by mixing platelet-rich fibrin with bone granules to create a three-dimensional fibrin scaffold, also known as sticky bone, exhibits both osteoconductive and osteoinductive activities. It can slowly release multiple growth factors, stabilize bone particles, and prevent displacement. This article reviews the material properties of the plasma matrix bone block and its current clinical application in periodontal infrabony defects, aiming to provide a reference for periodontal regenerative therapy.

Objective To evaluate the collagen fiber protection and biocompatibility of dental adhesive modified with methacryloxyethyl cetyldimethyl ammonium chloride(DMAE-CB) and nanoparticles of amorphous calcium phosphate(NACP) for dental defect repair. Methods DMAE-CB and NACP were synthesized in the laboratory and divided into 8 groups (Group A-H) based on the different mass fractions of the two components in the dentin adhesive. Thirty fresh extracted third molars were collected, sectioned into slices and randomly divided into groups. The adhesive-dentin interface of 8 groups was observed using in situ zymography and fluorescence microscopy. Various light-cured dentin adhesive films were prepared, and the static water contact angle was measured using a contact angle goniometer. Extraction solutions were prepared from light-cured films, and the cytotoxicity of the 8 dentin adhesive extraction solutions was evaluated using the CCK-8 assay at different culture time points. Results The distribution range of the fluorescent signal indicated that the experimental group (Group A-G) exhibited stronger inhibition of collagenase activity compared with the control group (Group H). The static water contact angle of the experimental group was significantly lower than that of the control group(P<0.05), indicating improved wettability and penetration potential. The CCK-8 assay showed that all adhesive groups exhibited good biocompatibility, with no statistically significant difference among groups(P>0.05). Conclusion The dentin adhesive modified with DMAE-CB and NACP has improved wettability, enhanced collagenase inhibition, and good biocompatibility.

Objective To investigate the effect of DJK-5 on the bactericidal efficacy and cariogenic virulence factors of Streptococcus mutans (S. mutans) biofilms. Methods S. mutans suspensions were treated with DJK-5 at concentrations of 0, 5, 10, 20, and 40 μg/mL, and bacterial growth was observed. S. mutans biofilms were treated with sterile deionized water (Control group), 2% chlorhexidine (CHX group) and DJK-5 at concentrations of 10, 20, 40 μg/mL. The structural changes in biofilm were observed using laser confocal microscopy. The production of water-insoluble extracellular polysaccharide (IEPS) and pH values were quantified using the anthrone-sulfuric acid method and a pH meter, respectively. Additionally, the effects of 10 μg/mL DJK-5 on the expression of cariogenic virulence genes in S. mutans biofilms were detected by RT-qPCR. Results DJK-5 at concentrations ≥10 μg/mL exhibited an inhibitory effect on the growth of planktonic S. mutans. The higher the concentration of DJK-5, the more pronounced the inhibitory effect. The volume ratios of dead bacteria in the DJK-5 groups were significantly higher than those in the control and chlorhexidine group. The disruption of spatial structure became more severe with increasing DJK-5 concentrations. The pH values in DJK-5-treated biofilms were significantly higher than those in the control group, and the pH levels in the 20 and 40 μg/mL DJK-5 groups were significantly higher than those in the NaF group. The production of IEPS in DJK-5-treated biofilms was significantly lower than that in the control group. The 10 μg/mL DJK-5 group produced significantly more IEPS than the 40 μg/mL DJK-5 group and the NaF group. DJK-5 promoted the expression of gtfC and gbpB genes, while suppressed the expression of ldh, comDE, and relA genes. Conclusion DJK-5 significantly inhibits acid production and IEPS synthesis in biofilms by targeting and modulating the cariogenic virulence factors of S. mutans, thereby demonstrating highly efficient bactericidal activity against biofilms.

Objective To analyze the long non-coding RNA (lncRNA) expression profile in patients with severe periodontitis and explore its potential regulatory mechanisms. Methods Gingiva samples were collected from five patients who underwent tooth extraction due to severe periodontitis (test group) and simultaneous extraction of impacted third molars (control group) at the Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Suzhou Vocational Health College, between November 2024 and December 2024. High-throughput sequencing was performed to identify differentially expressed lncRNAs and mRNAs. Target genes of these lncRNAs were further screened within these mRNAs, followed by GO and KEGG functional enrichment analysis to investigate the potential regulatory roles of these lncRNAs in severe periodontitis. Results High-throughput sequencing results revealed 1 473 significantly differentially expressed lncRNAs and 7 222 differentially expressed mRNAs. GO enrichment analysis indicated that the differentially expressed lncRNAs may be involved in the pathological process of severe periodontitis by regulating biological processes such as apoptosis, adaptive immune response and endoplasmic reticulum stress. KEGG pathway analysis showed that these lncRNAs might influence the development and progression of severe periodontitis through pathways including leukocyte transendothelial migration, Fcγ receptor-mediated phagocytosis, arachidonic acid metabolism, drug metabolism-cytochrome P450, and transcriptional misregulation in cancer. Conclusion The differentially expressed lncRNAs in patients with severe periodontitis may contribute to the pathogenesis and progress by regulating molecular mechanisms involved in adaptive immune response, apoptosis, and endoplasmic reticulum stress.

Objective To explore the changes of condylar position among Class Ⅱ malocclusion patients with clinical symptoms of temporomandibular joint disorder(TMD) through cone beam CT(CBCT) images. Methods Among the patients with Class Ⅱ malocclusion, a retrospective analysis was performed for the CBCT data of 30 patients without clinical symptoms of TMD (NTMD group) and 37 patients with clinical symptoms of TMD (TMD group). Condylar volume, condylar horizontal angle, articular fossa volume, anterior joint space, and posterior joint space were measured by Mimics 21.0 and 3-matic 13.0 software. SPSS 22.0 software was used for statistical analysis. Results The bilateral condyle volume of the NTMD group was significantly different (the right (2 302.71±546.35)mm³, the left (1 679.06±356.07)mm³; P<0.001). The bilateral condylar volume (the right (2 299.19±810.53)mm³, the left (1 683.93±519.61)mm³; P<0.001) and bilateral condylar horizontal angle (the right (13.41°±7.31°), the left (11.30°±6.56°); P=0.015) in the TMD group were significantly different. Conclusion Among the patients with Class Ⅱ malocclusion, patients show asymmetry in the horizontal angles of bilateral condyles in the early stage of TMD. The symmetrical condylar position is crucial for the prevention of TMD, but is not the primary problem for the treatment of TMD.

Objective To investigate the effects of allicin on periodontal tissues in rats with type 2 diabetes mellitus (T2DM) and periodontitis. Methods Forty male SD rats were randomly divided into four groups (A-D), with 10 rats in each group. Group A was the healthy control group, with normal feeding and intragastric administration of normal saline. Group B was the diabetes periodontitis model group, with intragastric administration of normal saline. Groups C and D were diabetes periodontitis model groups treated with 30 and 60 mg/kg allicin, respectively, via intragastric administration. The rats were treated once daily for 4 weeks. During this period, the general condition of the rats was observed, and their fasting blood glucose levels were tracked. Before execution,the gingival index (GI), sulcus bleeding index (SBI), and probing depth (PD) were recorded. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, lactate dehydrogenase (LDH) in rat serum, and malondialdehyde (MDA) in periodontal tissue. Micro-CT scanning was used to assess the periodontal condition, and the distance from the amelocemental junction (CEJ) to the alveolar bone crest (ABC) (CEJ-ABC) was recorded. Periodontal tissue sections were stained with hematoxylin and eosin (HE) to observe pathological changes in periodontal tissue. Results In Group B, the levels of blood glucose, GI, SBI, PD, serum TNF-α, IL-6, LDH, MDA in periodontal tissues, CEJ-ABC, and inflammatory status shown by HE staining were all significantly higher than those in Group A (P< 0.05). The above indicators in Groups C and D were significantly lower than those in Group B, and Group D was significantly lower than Group C (P< 0.05). Conclusion Allicin can inhibit the progression of periodontitis in rats with type 2 diabetes by reducing blood glucose levels, levels of inflammation factors, and decreasing alveolar bone resorption.

Objective To evaluate the clinical efficacy of periodontal endoscope-assisted subgingival debridement compared with periodontal flap surgery for residual deep periodontal pockets in molar regions. Methods A retrospective study with non-inferiority analysis was performed on 40 patients with Stage Ⅲ/Ⅳ periodontitis who presented with residual periodontal pockets of probing depth (PD) ≥ 5 mm in the molar area after initial periodontal therapy.The 40 patients were allocated into two groups: 20 cases (96 teeth, 214 sites) in the endoscopy group received residual deep periodontal pocket debridement using periodontal endoscopy combined with ultrasonic instrumentation. Another 20 cases (78 teeth, 184 sites) in the flap group underwent open flap debridement for residual deep periodontal pockets. Clinical attachment level (CAL), probing depth (PD) and gingival recession (GR) were measured at baseline, 3 and 6 months after surgery to evaluate the efficacy of the two treatment modalities. The intergroup difference in the change of CAL at 6 months postoperatively was defined as the primary outcome indicator. The intergroup difference in the change of CAL at 3 months postoperatively, as well as the intergroup differences in the changes of PD and GR at 3 and 6 months postoperatively, were set as secondary outcome indicators. Based on baseline CBCT measurements, the pattern and severity of alveolar bone resorption and the classification of furcation lesions in the molar region were recorded, and their influences on the efficacy of the two treatments were further evaluated. Results At 6 months postoperatively, in the endoscopy group, the CAL change was (2.25±1.64) mm, PD change was (3.02±1.61) mm, and GR change was (-0.77±0.92) mm; in the flap group, the CAL change was (0.56±1.89) mm, PD change was (1.85±1.60) mm, and GR change was (-1.29±1.26) mm. The improvements in CAL and PD in the endoscopy group were significantly greater than those in the flap group (P<0.000 1), whereas GR was significantly smallerin the endoscopy group (P<0.000 1). At sites with baseline PD ≥7 mm, the PD change in the endoscopy group (4.08±1.60) mm was significantly greater than that in the flap group (2.38±1.75) mm (P<0.001). For grade Ⅰ and Ⅱ furcation involvement, the improvements in CAL and PD in the endoscopy group were also significantly greater than those in the flap group (P<0.05), but no statistically significant difference in ΔPD was found between the two groups in grade Ⅲ furcation involvement. In addition, at sites with horizontal and non-horizontal bone resorption, the endoscopy group showed significantly greater improvements in CAL and PD (P<0.001) and significantly less gingival recession (P<0.05) compared with the flap group. Conclusion Periodontal endoscopy-assisted subgingival debridement can effectively ameliorate periodontal inflammation in molars. Its clinical efficacy is non-inferior to open flap debridement, with prominent advantages indeep periodontal pockets and grade Ⅰ and Ⅱ furcation involvements.Meanwhile, it canbetter preserve periodontal soft tissues, serving as an effective minimally invasive therapeutic option.

Objective To compare the clinical outcomes of osseodensification (OD) and osteotome (OT) techniques in transalveolar sinus floor elevation (TSFE) with simultaneous implant placement. Methods This study enrolled 60 patients (69 implants) undergoing TSFE with simultaneous implantation at Hefei Stomatological Hospital (February 2021 to February 2024). Their residual bone height (RBH) was 4-7 mm. Participants were randomly assigned to the OD group (reverse-rotation drilling for sinus elevation, n=30) or OT group (osteotome mallet technique, n=30). Outcome measurements included intraoperative sinus membrane perforation, implant survival rate, insertion torque (IT), endo-sinus bone gain (ESBG) at baseline and 6 months, and postoperative pain intensity (VAS scores on days 0, 1, 2, and 7). Statistical analysis was performed using SPSS 26.0 with t-tests or Mann-Whitney U tests (α=0.05). Results The sinus membrane perforation rates in the OD group and OT group were 2.78% and 6.06%, respectively. The IT values were (33.33±4.79) N·cm and (29.39±6.47) N·cm, with the OD group showing a significantly higher value than the OT group (P<0.05). On the 0th day after surgery, the VAS score of the OD group was significantly lower than that of the OT group (P<0.05); however, there were no statistically significant differences in VAS scores between the two groups on the 1st, 2nd, and 7th days after surgery (P>0.05). The immediate post-operative ESBG values of the OD group and OT group were (5.01±0.65) mm and (5.02±0.74) mm, respectively, and the ESBG values at 6 months post-operatively were (4.65±0.57) mm and (4.60±0.74) mm, respectively. No statistically significant differences in ESBG were observed between the two groups. At 6 months after surgery, only one implant in OT group fell off, resulting in implant survival rates of 100% (OD group) vs. 96.97% (OT group), with no statistically significant difference (P>0.05). Conclusion While both techniques achieved comparable endo-sinus bone augmentation, OD provided superior primary implant stability and reduced immediate postoperative pain, demonstrating clinical advantages over conventional osteotome methods in TSFE with simultaneous implantation.

Objective To investigate the risk factors associated with mandibular third molar eruption in adolescents undergoing orthodontic treatment and to construct a predictive model utilizing a Logistic regression-back propagation neural network (LR-BPNN) algorithm. Methods A retrospective cohort study was conducted, which included 565 adolescent patients who had completed orthodontic treatment and underwent two consecutive cone-beam computed tomography (CBCT) scans at the Affiliated Stomatological Hospital of Nanjing Medical University. Parameters related to mandibular third molar eruption were collected. Predictors with statistical significance were first selected through Logistic regression analysis and then served as input features for a back propagation neural network (BPNN), thereby forming the LR-BPNN hybrid model. Its performance was evaluated and compared on an independent validation set using metrics such as the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity. Results Logistic regression analysis identified six core influencing factors. The established LR-BPNN hybrid model demonstrated the best predictive performance, achieving an accuracy of 89.94% and an AUC of 0.901, which was significantly higher than those of the conventional Logistic regression model (AUC=0.755) and the full variable BPNN model (AUC=0.893) (P<0.01). Conclusion This study successfully developed and validated an LR-BPNN hybrid model for predicting mandibular third molar eruption. The model exhibits high predictive accuracy and clinical practicality, providing an objective and quantitative decision support tool for assessing impaction risk and formulating personalized extraction and space management strategies in orthodontic practice.

Objective To investigate the precise positioning role of digital surgical guides in microsurgical apicoectomy for refractory periapical periodontitis and their impact on postoperative healing. Methods Thirty patients diagnosed with refractory periapical periodontitis who had failed conventional root canal treatment were enrolled and randomly divided into an experimental group (digital surgical guides assisted microsurgical apicoectomy) and a control group (traditional freehand microsurgery). Cone-beam computed tomography (CBCT) was performed before and after surgery to compare and analyze surgical accuracy. The surgical time, accuracy of root-end resection, and postoperative pain were compared between the two groups. Results The surgical time in the experimental group (24.05±0.92) min was significantly shorter than that in the control group (32.10±0.80) min. In terms of root-end resection accuracy, the experimental group showed more ideal root-end resection length and angle compared to the control group, with statistically significant differences(P<0.001). No significant complications occurred in any of the thirty patients. The control group exhibited more pronounced pain symptoms on the first, third, and seventh days postoperatively, with statistically significant differences between the two groups on the first and third days(P<0.01). Conclusion Digital surgical guides can enhance the precision of surgery for refractory periapical periodontitis, reduce surgical time, and alleviate postoperative pain.

Objective To investigate the application effect of a rotating supervisor-guided resident-led teaching clinic in the standardized residency training for orthodontics. Methods Residents and supervisors rotating through the Orthodontic Clinic of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine between 2020 and 2023 were selected as the study objects. A control group (supervisor-attended teaching clinic) and an experimental group (rotating supervisor-guided resident-led teaching clinic) were established. Evaluations of teaching effectiveness and satisfaction from both residents (16 in the control group and 28 in the experimental group) and supervisors (11 in the control group and 12 in the experimental group) in the two groups were compared. Results Scores for theoretical learning, medical talent cultivation, and satisfaction were similar between the two groups, with no statistically significant differences. Regarding the development of clinical critical thinking ability, resident evaluations significantly increased from (4.25±0.78) to (4.71±0.60)(P=0.032), while supervisor evaluations significantly increased from (4.27±0.47) to (4.73±0.47)(P=0.034). Regarding the ability to formulate treatment plans, resident evaluations significantly increased from (4.19±0.75) to (4.86±0.36)(P=0.001), while supervisor evaluations significantly increased from (3.91±0.83) to (4.82±0.41)(P=0.005). For the improvement of operational skills, supervisor evaluations significantly increased from (3.73±0.91) to (4.73±0.65)(P=0.007). Regarding doctor-patient communication skills, supervisor evaluations significantly increased from (3.82±0.98) to (4.82±0.41)(P=0.008). Mini-clinical evaluation exercise scores of residents increased from (39.63±3.37) to (41.77±3.22)(P=0.043). Conclusion The rotating supervisor-guided resident-led teaching clinic helps improve residents' clinical critical thinking ability, treatment planning ability, operational skills, and doctor-patient communication skills, leading to enhanced teaching effectiveness.

Vitamin D(VD) is a key hormone regulating calcium-phosphorus metabolism and immune homeostasis, and plays an important role in implant osseointegration. This review summarizes the molecular mechanisms by which VD promotes bone formation, including maintenance of calcium-phosphorus homeostasis, regulation of the RANKL/OPG system, and modulation of immune-inflammatory responses. It further focuses on clinical intervention strategies such as systemic supplementation, implant surface modification, and intraoperative delivery, and analyzes their precise application in special pathological conditions such as diabetes mellitus. Finally, the review discusses the potential clinical value and existing controversies regarding VD in implant dentistry, aiming to provide a theoretical basis and clinical reference for rational evaluation and translational application of VD in oral implantology.

Dentinogenesis imperfecta (DGI) is an autosomal dominant genetic disorder characterized by abnormal dentin structure, manifesting as tooth discoloration, enamel fragility, dental wear, and pulp chamber alterations, which significantly impair masticatory function and aesthetics. Molecular genetic studies classify DGI into isolated and syndromic forms, with core pathogenic genes including DSPP and COL1A1/COL1A2. Advances in high-throughput sequencing and molecular diagnostics have facilitated precise disease subtyping and early intervention. Clinical management emphasizes a multidisciplinary approach. In childhood, preventive oral care is paramount, incorporating high-concentration fluoride application, home oral hygiene, and regular follow-up to delay dentin wear and enamel loss. Depending on the severity of tooth defects, restorative options including composite resin veneers, stainless-steel crowns, or full-coverage crowns can be used. In the permanent dentition and adulthood, digital dentistry, CAD/CAM restorations, and implant-supported prostheses can restore occlusal function and aesthetics. Early orthodontic intervention is recommended for patients with malocclusion or dental arch abnormalities. Emerging regenerative medicine, stem cell therapies, and potential gene-based interventions provide promising avenues for personalized and precision treatment. Integrating multidisciplinary collaboration with modern technological advances can optimize oral function and long-term quality of life for DGI patients, offering valuable guidance for clinical management.