Objective To prepare drug-loaded magnetic granular scaffolds and investigate their osteogenesis behavior in vitro. Methods The polycaprolactone (PCL)/gelatin microsphere (PGM) scaffolds were constructed via a double-emulsion method. The phase contrast microscope and field emission scanning electron microscope (FESEM) were applied for morphology observation. Thermal gravity analysis (TGA) and in vitro degradation test were used to figure out the proportion of ingredients and the trend of mass loss. Cell counting kit-8 (CCK-8) assay was conducted to optimize the concentration of nano oil-acid coated Fe₃O₄ particles (OA@Fe₃O₄), and the final Fe-PGM were prepared which were subsequently loaded with recombinant human bone morphogenetic protein-2 (rhBMP-2). The adhesion of rat bone mesenchymal stem cells (rBMSC) on PGM, Fe-PGM and Fe-PGM+BMP-2 was evaluated by inverted fluorescent microscope (IFM). Osteogenesis-related gene expression of rBMSC on PGM, Fe-PGM and Fe-PGM+BMP-2 was detected by quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) 7 and 14 days after osteogenic induction. Results Photos of phase contrast microscope and FESEM demonstrated that PGM was composed of porous PCL skeleton and inner gelatin hydrogel. TGA and in vitro degradation test indicated that PCL and gelation was about 50% (wt.) of PGM respectively. Curve of mass loss in vitro was smooth. Results of CCK-8 showed that no inhibition on the proliferation of rBMSC was found in 0.4% Fe-PGM group compared to that in PGM group (P＜0.05). Acceptable cell adhesion was observed via IFM in PGM, Fe-PGM and Fe-PGM+BMP-2 group. Additionally, involvement of BMP-2 bettered cell sprawl in Fe-PGM+BMP-2 group. qRT-PCR analysis indicated a higher expression level of osteogenesis-related gene in Fe-PGM and Fe-PGM+BMP-2 group than that in PGM group owing to OA@Fe₃O₄, while application of BMP-2 further broadened the gap between Fe-PGM and Fe-PGM+BMP-2 group (P＜0.05). Conclusion The magnetic PGM scaffold has favorable cytological characteristics, and its drug-loading property could further improve adhesion and osteogenic differentiation of rBMSC on it.

Objective To examine the expression of 4-1BB and CD8 in oral lichen planus (OLP) tissues and to investigate the potential mechanism of 4-1BB on CD8⁺ T cell-mediated immune response in OLP. Methods Thirty-one OLP cases(15 erosive and 16 non-erosive) and 15 healthy adults (control group) were selected as study subjects and their clinical pathological data were collected.Immunohistochemistry was used to detect the expression of 4-1BB and CD8. Results The expression of 4-1BB and CD8 in local tissues of OLP were higher than those in the control group(P<0.05), and the expression of 4-1BB and CD8 in OLP were positively correlated(r=0.389,P<0.05). Besides, the expression of 4-1BB and CD8 in erosive OLP were higher than those in non-erosive OLP(P<0.05).There was a difference between OLP subgroups in terms of VAS score, REU score and the degree of basal cell injury (P<0.05). Spearman correlation analysis showed that CD8 was positively correlated with the degree of basal cell injury (P<0.05), and CD8 and 4-1BB were positively correlated with VAS score and REU score(P<0.05). Conclusion There is an abnormal increase of 4-1BB in OLP, and the increase is positively correlated with disease activity progression, suggesting that 4-1BB may be involved in the development of OLP by regulating CD8⁺ T cells.

Objective To study the marginal microleakage of glass fiber post-and-cores and all-ceramic crowns by a one-step method of designing and fabricating simultaneously to provide a theoretical basis for clinical application of this method. Methods Twenty isolated teeth were collected and divided into the experimental group and the control group randomly. Teeth in the experimental group were prepared with post and all-ceramic crown abutment. Post-and-cores and all-ceramic crowns were designed by digital software simultaneously and were then fabricated. Teeth in the control group were prepared with all-ceramic crown abutment and crowns were then manufactured. All samples were subjected to temperature cycling test and methylene blue staining. After incisions, results of coronal microleakage were observed and measured under a stereo microscope. Results The crown dye of all samples penetrated into edges of all-ceramic crowns and tooth tissues, and adhered to surface of the adhesive at shoulders horizontally. In the experimental group, there was no obvious dye penetration at the edge of post-and-cores. Comparing measurement results of the marginal microleakage, there was no statistically significant difference between the experimental group and the control group (P>0.05). Conclusion It is shown that glass fiber post-and-cores and all-ceramic crowns by a one-step method of designing and fabricating simultaneously can meet clinical requirements for the edge suitability of all-ceramic crowns.

Objective Microstructure inspired by octopus suction cups was constructed on the surface of silicone rubber soft lining materials to evaluate its impact on adhesion and provide technical support for further producing tissue surface of complete denture base with it,and explore new ideas to improve retention of complete denture. Methods The experimental group was divided into five groups A-E (100, 200, 300, 400, 500 μm in diameters of suction cups). After producing negative mold of microstructures inspired by octopus suction cups with 3D printing, samples with different sizes were made by turning over the mold with silicone rubber material. The control group was plane silicone rubber samples without microstructure. Accuracy of production technology was evaluated and adsorption force of samples in each group was tested by universal mechanic material tester under simulated oral environment in vitro. Then statistical analysis was conducted. Results The deviation between 3D printing negative mold and predetermined size was about 7%-9%, while that between microstructures made from silicone rubber material and predetermined size reduced to 1%-5%. Bubbles can be found on some surfaces. Adhesion of different groups (the experimental groups A-E and the control group) was (0.20±0.04), (0.16±0.03), (0.13±0.04), (0.12±0.02), (0.14±0.02), (0.12±0.03)N. The adhesion in groups with diameter of 100 μm and 200 μm increased significantly, which was statistically different from the control group (P<0.05). Conclusion On the surface of silicone rubber soft denture liner, constructing microstructures inspired by octopus suction cups with diameter of 100 μm and 200 μm can improve adsorption. Using octopus suction cup-liked microstructures on tissue surface of complete denture base may improve its retention.

Objective To evaluate root resorption of incisors from adult patients with Class Ⅱ division 2 malocclusion treated with three different orthodontic appliances. Methods Thirty patients were selected, including 10 cases treated with conventional MBT appliances, 10 cases with self-ligating appliances and 10 patients with clear aligners. In total, 240 incisors were researched. Cone beam computed tomography (CBCT) data were collected and imported into Dolphin Imaging software, Mimics and 3-Matics software to measure and analyze root variables of incisors pre- and post-treatment. Results The average tooth length(L) showed significant decrease after treatment for all maxillary and mandibular incisors in conventional MBT appliance group, self-ligating appliance group and central incisors, maxillary lateral incisors in clear aligner group. No significant decrease in mandibular lateral teeth average length were observed in clear aligner group. No statistically significant difference in tooth length of maxillary or mandibular central incisors was observed among three groups. In contrast, the reduction of maxillary and mandibular lateral incisors length in the clear aligner group was significantly lower(P＜0.05). The least average length reduction was found in clear aligner group (-0.37±0.11)mm, which was significantly lower than conventional MBT appliancegroup, (-1.32±0.47)mm and self-ligating group, (-1.05±0.38)mm.In addition, the three groups showed a higher prevalence of palatal and proximal resorption than labial and distal resorption. Conclusion Using clear aligners for treatment of Class Ⅱ division 2 malocclusions can effectively reduce severity of incisor root resorption.

Objective To examine the buccolingual inclination of first molars in patients with different skeletal malocclusions to provide theoretical and clinical reference for how to select preadjusted appliances, make treatment plan and prevent complications in different cases. Methods CBCT data of 236 patients (88 males, 148 females) treated at Department of Orthodontics in the Affiliated Stomatological Hospital of Nanjing Medical University from 2016 to 2017, were analyzed to evaluate the discrepancy of buccolingual inclination of first molars with respect to different sagittal and vertical classifications. Results The study showed that the maxillary first molars were more buccally inclined in skeletal Class Ⅲ subjects than Class Ⅰ or Ⅱ subjects, while the mandibular ones were more buccally inclined in skeletal Class Ⅱ subjects than Class Ⅰ or Ⅲ subjects. Differences were statistically significant. Large differences in angle were found among different growth patterns, which showed the most buccal inclination in the maxilla and the most lingual inclination in the mandible for subjects in the high angle group. ANB angle was negatively correlated with buccolingual inclination of maxillary molars but positively correlated with buccolingual inclination of mandibular molars. Conclusion With the increase of sagittal skeletal deformity, the tendency of lingual inclination of maxillary molars and buccal inclination of mandibular molars in skeletal Class Ⅱ patients increases while the tendency in skeletal Class Ⅲ patients is the opposite. The inclinations compensate for the transverse skeletal discrepancy. These should be taken into consideration to avoid clinical complications when treating different skeletal malocclusions.

Objective To investigate the influencing factors of restart in patients receiving clear aligner treatment and provide clinical reference for orthodontics. Methods A total of 354 patients receiving clear aligner treatment were collected and divided into restart group and non-restart group. Twelve factors were analyzed between two groups. SPSS 19.0 was used for statistical analysis, and univariate analysis and multivariate Logistic regression analysis were used to screen out factors related to restart. Results The restart rate of 354 patients with clear aligners was 39.27%, including 31 male patients (8.76%) and 108 female patients (30.51%). Further multivariate analysis showed that the restart risk of adult patients was lower than that of juvenile patients, about 40% of risks faced by juvenile patients (P=0.024). Patients with poor cooperation had a 5.7-fold increased risk of restart (P=0.000). The risk of restart increased about 2.7 times for patients requiring elastic traction cooperation (P=0.006). The restart rate of patient with over 48 treatment steps was 3.6 times higher than that of patients with less than 24 treatment steps (P=0.027). Conclusion Age of the patient (juvenile patient), need for elastic traction, poor cooperation and treatment steps (>48) are the influencing factors which would increase the risk of restart. It is suggested tha monitoring and guidance of these patients should be strengthened in clinic.

Objective To investigate the association between sella turcica and maxillary lateral incisor agenesis by comparing the size of sella turcica between patients with congenital absence of maxillary lateral incisors and complete dentiton. Methods Patients were divided into two groups with 80 patients in each group:the experimental group included patients with agenesis of the maxillary lateral incisor; the control group consisted of patients with complete dentition. Dolphin imaging software was used to evaluate the size and record calcification in the bridge of sella turcica. Results Except for the length of sella turcica, no statistically significant difference was found in the size of sella turcica between the two groups .There was a statistically significant difference in the incidence of bridge between two groups. Statistically significant differences between gender were found neither in the frequency of sella turcica bridge nor in the size of turcica. Conclusion Patients with congenitally missing maxillary lateral incisors had a greater sella turcica length and an increased incidence of sella turcica bridge, compared to the control group.

Objective To investigate and analyze clinical factors of maxillary third molar extraction and effects of various local anatomical factors on maxillary sinus perforation. Methods A total of 1 350 patients who underwent maxillary third molar extraction in the First Affiliated Hospital of Xinjiang Medical University from June 2017 to September 2021 were selected. CBCT was taken before operation. Statistical analysis was carried out from aspects of age, gender, preoperative symptoms, impaction, position, tooth inclination, root development, RS classification, vertical relationship, horizontal relationship, root number, root curvature, root furcation, incision, bone removal and so on. Results Multivariate analysis showed that partial eruption (OR=13.509), non eruption (OR=8.401), mesial impaction (OR=1.262), incision (OR=12.205), osteotomy (OR=23.422), root fracture (OR=15.320) were significantly correlated with maxillary sinus perforation. Root furcation 0° (OR=0.066) is a protective factor for maxillary sinus perforation. Conclusion Maxillary third molar partially erupted, not erupted, mesial impaction, intraoperative incision, intraoperative bone removal and root fracture can significantly increase the risk of maxillary sinus perforation. CBCT should be used to fully evaluate the relationship between anatomical structures of maxillary posterior tooth area before operation, and carry out accurate diagnosis and design, which can effectively reduce the incidence of maxillary sinus perforation.

Objective To explore a new treatment guided classification for cleft palate related speech disorders, so as to provide reference for clinical diagnosis and treatment. Methods A group of 347 patients with cleft palate related speech disorders, treated in the speech rehabilitation clinic of Affiliated Stomatological Hospital of Nanjing Medical University from April 2016 to December 2020, were divided into five basic modes:diagnostic treatment group, traditional treatment group, alpha group, marginal velopharyngeal competency group and early language intervention group. The distribution of each group was calculated.The personal information, surgery information, articulation features, velopharyngeal function and progosis of each group were analyzed retrospectively. Results Among all the subjects, 171 subjects belonged to the diagnostic treatment group, 127 subjects belonged to the traditional treatment group, 33 subjects belonged to alpha group, 10 subjects belonged to marginal hypernasality group, and 6 cases belonged to the early language intervention group. Conclusion The treatment guided classification of cleft palate related speech disorders would not only provide clear guidance for clinical diagnosis and treatment, but may also offer further information for precise rehabilitation treatment.

Objective Using computer-assisted three-dimensional reconstruction technology, to measure and compare changes of oral cavity proper and upper airway volume in patients with jaw deformity secondary to unilateral complete cleft lip and palate (UCLP) before and after bimaxillary surgery, and to evaluate the effect of digital surgery guided orthognathic surgery on airway and speech. Method 3D reconstruction of maxillofacial CBCT and oral scan data before and after bimaxillary surgery was operated for 5 patients with jaw deformity secondary to UCLP admitted from July 2015 to December 2019. Mimics 20.0 software was used to divide boundaries of the oral cavity proper and upper airway on 3D model to measure and analyze the oral cavity proper and upper airway volume and related indicators before the surgery as well as one month and three months after the surgery, and patients' ventilation and voice status was followed up before and after the surgery. Results In these 5 patients, there was no significant difference in measurement values of total oral cavity proper volume and upper airway volume before, 1 month and 3 months after bimaxillary surgery (P>0.05). The lower volume, median sagittal area, length, width and length of the mandible of oral cavity proper were significantly reduced (P<0.05), and the upper volume and height were significantly increased (P<0.05). The upper airway volume of the nasopharyngeal segment and velopharyngeal segment was significantly increased after surgery (P<0.05), and the glossopharyngeal segment and the minimum cross-sectional area were significantly reduced (P<0.05). One patient had slight snoring symptoms after operation, and the mandible moved slightly forward 3 months after operation. There was no significant change in speech of 5 patients. Conclusion There is no significant difference in the total volume of oral cavity proper and the total volume of upper airway in patients with jaw deformity secondary to UCLP before and after orthognathic surgery. This parameter can be personalized and slightly adjust the design process of digital surgery, and can effectively assist the implementation of orthognathic surgery in patients with jaw deformity secondary to cleft lip and palate.

Objective To explore the feasibility of static digital guided surgery with immediate loading in edentulous patients, to evaluate the accuracy of guided implant surgery based on cone-beam computed tomography (CBCT) data, and to discuss factors that may affect accuracy. Methods Sixteen cases where 98 implants were placed into partially and totally edentulous patients from 2017 to 2019 were collected. All surgeries were assisted by digital surgical guide and immediately loaded. Patients were followed up to record survival rate and long-term function of implants. The three-dimensional deviations of 30 actual implants from their designed position were measured based on CBCT data, which aimed to evaluate accuracy. Statistical methods were employed to analyze accuracy related factors. Results The 1-year implant survival rate was 98.98% (97/98); the pink esthetic score (PES) was (9.53±1.68) points; the white esthetic score (WES) was (7.05±1.10) points, and the patient satisfaction was (9.15±0.84) points. 3D deviation at entry was (1.40±1.07) mm, and at apex was (1.54±1.13) mm. Depth deviation was (1.10±1.09) mm, and angle deviation was 4.41°±2.68°. There were significant differences in implants′ deviations among different brands. Timing of implant placement, the supporting mode of surgical guide, the manufacturing method of guide and tooth position did not significantly affect the accuracy of implantation. Conclusion Digital guided implant surgery with immediate loading is a stable and highly repeatable clinical procedure for edentulous patients, which is worthy of application and promotion.

Langerhans cell histiocytosis (LCH), an abnormal proliferative and infiltrative disorder of Langerhans cells, usually involves skeleton, skin, pituitary and can also affect liver, spleen, blood system, lungs, lymph nodes, and central nervous system. LCH is rare in adults. It lacks a recognized therapeutic regimen, and therapies of LCH mainly include surgery, topical injections of steroids, chemotherapy, radiotherapy, and combined therapy. Herein, we report an adult patient with oral single system (SS)-LCH with multifocal bone lesions involving the maxilla and mandible treated with local small-dose radiotherapy. We discuss the therapeutic regimen selection of oral single system LCH combined with multifocal bone lesions, with the help of its diagnosis, treatment experience and previous literature reports.

Optogenetics technology refers to a technology that uses photosensitive proteins of high spatial-temporal specificity to optically control specific genes. Optogenetics technology has been widely used application in researches of clinical treatment targeted at cardiovascular diseases, visual and auditory disorders, metabolic diseases and neurological diseases. Moreover, it has developed into a hotspot technology in fundamental medical researches. Recently, applications of optogenetics technology in the field of stomatology have been gradually increasing, such as the study of taste system, the treatment of trigeminal neuralgia, the study of maxillofacial muscle innervation, etc. This article reviews applications of optogenetics in stomatology.

Aptamer is a short oligonucleotide sequence (ssDNA or RNA), which can bind to specific target like RNA or protein. It has been widely used in fields of biomedicine with advantages of high specificity, low immunogenicity, low cost and so on. The purpose of this article is to summarize its screening and characteristics and progress of research on aptamer in diagnosis, treatment and tissue regeneration in stomatology. In addition, its application prospect in stomatology is reviewed.

With the development of tissue engineering and regeneration, it is possible to regenerate the lost tooth tissue. As a commonly used carrier in tissue engineering, microspheres are suitable for small and irregular dental tissue regeneration. Locally available microspheres have been widely used as injectable cell carriers for tissue repair. At the same time, the targeting and sustained release of microspheres can be used to transport a variety of growth factors and drugs to the designated area. This paper reviews current research on application of microspheres in dental tissue regeneration.

Many studies have shown that temporomandibular joint disorder(TMD) is closely related to body posture. This paper reviews the relationship between TMD and body posture and its mechanism, in order to provide reference for the prevention and treatment of TMD from the perspective of body posture.

Periodontal biomarkers with high specificity and stability can contribute to classifying periodontal diseases by different stages and grades in clinic. Activated matrix metalloproteinase-8 (aMMP-8) can degrade extracellular matrix and basal lamina. Abnormal expression of aMMP-8 is closely related to the initiation and development of periodontitis. In this paper, we reviewed the expression of aMMP-8 in periodontitis, aiming to explore feasibility of aMMP-8 as a biomarker of periodontitis.

Raman spectroscopy can detect structure and composition information of lipid, nucleic acid, protein and water molecules in biological tissue, which is widely used in the medical field. At present, examination and diagnosis of oral diseases mainly rely on imaging examination. With the development of science and technology, Raman spectroscopy has made great progress in the field of stomatology. In this paper, the principle, advantages and application of Raman spectroscopy are reviewed.

Er:YAG laser is a free-running pulsed laser, which belongs to the middle infrared band in the electromagnetic spectrum. It is a hydrodynamic biological laser system with a specific wavelength that allows it to be absorbed by water and hydroxyapatite and can better act on water-bearing tissue, tooth tissue and bone tissue. Compared with traditional clinical operations, Er:YAG laser has the characteristics of accurate cutting, sterilization and faster healing. In enamel treatment, Er:YAG laser can improve the whitening effect of teeth, prolong the retention rate of fissure sealant and reduce the rate of caries. In dentin treatment, Er:YAG laser has little damage in the treatment of dental caries, the desensitization effect is accurate, and the bonding performance of the dentin is improved. When performing hard tissue cutting, Er:YAG laser has precise control of the target tissue, causes small thermal damage, promotes bone healing, and increases the success rate of implant surgery. Er:YAG laser has a good clinical application prospect.