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28 August 2025, Volume 45 Issue 8
Review and Commentary
Pathological calcification in temporomandibular joint osteoarthritis: Mechanisms and targeted therapeutic strategies
HAN Xiaoxiao, QIN Wenpin, JIAO Kai
2025, 45(8):  561-566.  doi:10.13591/j.cnki.kqyx.2025.08.001
Abstract ( 82 )   HTML ( 5)   PDF (801KB) ( 13 )  
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Temporomandibular joint osteoarthritis(TMJ-OA) is a chronic disorder characterized by degeneration of articular cartilage, pain, and functional impairment, with pathological calcification serving as a central pathological hallmark closely associated with disease progression. Recent studies have demonstrated that pathological calcification accelerates joint destruction by altering cartilage biomechanical properties, activating inflammatory responses, and promoting matrix degradation pathways. This review systematically reviews the critical role of pathological calcification in the pathogenesis of temporomandibular joint osteoarthritis(TMJ-OA), with a focus on molecular mechanisms including key signaling pathways, autophagy-derived calcifying vesicles, lysosomal destabilization and organelle crosstalk. It further summarizes novel intervention strategies such as pharmacological treatments, gene therapy, and nanotechnology-based approaches, thereby providing a theoretical foundation for the precise prevention and treatment of TMJ-OA.

Basic and Clinical Research
Effects of nanosilicate functionalized polycaprolactone membrane on bone mesenchymal stem cells-induced bone repairing
XIAO Long, HU Weiqiang, LIN Xuxin, HE Mengjiao, LUO Kai, XU Xiongcheng
2025, 45(8):  567-575.  doi:10.13591/j.cnki.kqyx.2025.08.002
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Objective To fabricate nanosilicate functionalized polycaprolactone (PCL/LAP) electrospun membrane and evaluate its role in bone marrow mesenchymal stem cells (BMSCs)-induced bone repairing. Methods The PCL/LAP electrospun membranes were fabricated via electrospinning technology and co-cultured with rat BMSCs. The cytocompatibility of the membranes was evaluated through cytoskeleton staining, live/dead cell staining and CCK-8 assay. The migration capacity of BMSCs was assessed using scratch assay, Transwell migration experiments and expression of migration-related genes (Pdgf and Tgfβ) was evaluated by qRT-PCR. The osteogenic differentiation and pro-angiogenesis potential were determined by alkaline phosphatase (ALP) staining, alizarin red staining, expression levels of osteogenesis-related genes (Alp, Col1a1, Runx2, Bglap and Bmp2) and angiogenesis-related genes (Angpt1, Fgf2 and Vegfa) along with RUNX2 protein expression. PCL and PCL/LAP electrospun membranes conditioned medium was subsequently used to stimulate vascular endothelial cells (EAhy926). The expression of angiogenesis-associated genes (KDR, ENOS and HIF1A) was quantified by qRT-PCR. Results BMSCs adhered well to the surface of the PCL/LAP membranes, with no significant impact on cell viability (P>0.05). PCL/LAP membranes not only promoted the proliferation (P<0.05), migration (P<0.05), but also enhanced ALP activity and mineralized nodule formation (P<0.05), increased osteogenic differentiation gene and protein expression (P<0.05) of BMSCs. Moreover, PCL/LAP promoted the expression of angiogenic genes of BMSCs (P<0.05), to indirectly regulate angiogenesis-related gene expression in vascular endothelial cells (P<0.05). Conclusion PCL/LAP electrospun membranes exhibit excellent biocompatibility and can promote proliferation, migration, osteogenic differentiation and BMSC-mediated angiogenic differentiation, showing great potential for bone defect repairing as barrier membrane.

Early demineralization of the resin-enamel interface based on optical coherence tomography
SHAN Yufei, HE Jie, ZHOU Lianqi, DING Yujie, WU Tong, SUN Zhida
2025, 45(8):  576-584.  doi:10.13591/j.cnki.kqyx.2025.08.003
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Objective To evaluate the sensitivity of swept-source optical coherence tomography(SS-OCT) in detecting early demineralization at the resin-enamel bonding interface, and the differences in enamel demineralization around restorations among different resins(Filtek Z350 XT, Filtek Bulk Fill, TetricN-Ceram Bulk Fill). Methods Twenty-seven extracted third molars were selected and prepared into 5-mm-thick specimens, and Class Ⅰ cavities measuring 3 mm × 3 mm × 4 mm were created on the occlusal surfaces. The specimens were randomly divided into three groups, with nine teeth in each group, and were respectively filled with Filtek Z350 XT(layered filling of 4 mm), Filtek Bulk Fill(bulk filling of 4 mm in one step), and Tetric N-Ceram Bulk Fill(bulk filling of 4 mm in one step). After applying acid-resistant nail varnish to non-experimental areas, the specimens were placed in a demineralizing solution for 4 weeks. SS-OCT and Micro-CT scans of the resin-enamel bonding interface were performed before demineralization and weekly thereafter to monitor the progression of demineralization and changes in demineralization depth were quantitatively analyzed. Results Both SS-OCT and Micro-CT were capable of non-destructive dynamic monitoring of demineralization at the resin-enamel bonding interface. After demineralization, four types of patterns were observed at the resin-enamel bonding interface. At different stages of demineralization, no significant differences in demineralization depth were detected among the three resins using either SS-OCT or Micro-CT. There was a high level of agreement between the demineralization depth measurements obtained from SS-OCT and Micro-CT at each demineralization stage(ICC: 0.760-0.897). Conclusion The early demineralization of resin-enamelbonding interface can be noninvasively detected by SS-OCT, and there was no significant differenceamong three resins in their ability to resist enamel demineralization around the restoration.

The impact of maxillary anterior protraction combined with rapid arch expansion on buccal corridor and smile aesthetics in the treatment of skeletal Class Ⅲ malocclusion
ZHANG Rongxiu, XU Li, LIU Fang, TIAN Ruixue
2025, 45(8):  585-589.  doi:10.13591/j.cnki.kqyx.2025.08.004
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Objective To explore the impact of maxillary anterior traction combined with rapidarch expansion on parabuccal space and smile aesthetics in patients with skeletal Class Ⅲ malocclusion. Methods The patients with maxillary insufficiency and skeletal Class Ⅲ malocclusion admitted to the First Affiliated Hospital of Bengbu Medical University from January 2021 to June 2023 were retrospectively analyzed. The control group received maxillary protraction treatment, while the experimental group received maxillary protraction combined with rapid arch expansion treatment. The overall treatment effectiveness, buccal corridor area ratio, smile index, smile symmetry ratio, and patient satisfaction with smile aesthetics were compared between the two groups. Results After correction, the total effective rates of the experimental group and the control group were 82.61% and 52.38%, respectively;the area ratio of parabuccal space were 7.10±0.96 and 8.21±1.28, respectively; the smile index were 5.16±0.83 and 6.33±1.03, respectively; the smile symmetry ratio were 0.96±0.18 and 0.83±0.14, respectively; the satisfaction of patients with smile aesthetics were 86.96% and 47.62%, respectively. The differences in the above indexes were statistically significant(P<0.05). Conclusion The maxillary anterior traction combined with rapid arch expansion had a significant effect on the correction of patients with skeletal Class Ⅲ malocclusion, effectively reducing the buccal corridor and enhancing smile aesthetics.

Effects of digitally processed maxillary skeletal expanders on hard and soft tissues in patients with maxillary transverse deficiency
HAO Shushu, LOU Shu, YANG Qifei, CAI Minchun, HU Min, WANG Zhendong
2025, 45(8):  590-595.  doi:10.13591/j.cnki.kqyx.2025.08.005
Abstract ( 58 )   HTML ( 1)   PDF (1720KB) ( 9 )  
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Objective To investigate the three-dimensional changes in hard and soft tissues before and after treatment with digitally fabricated maxillary skeletal expanders in patients with maxillary transverse deficiency. Methods Twenty late adolescents or adults with maxillary transverse deficiency treated at the Orthodontic Department of Affiliated Stomatological Hospital of Nanjing Medical University using digitally fabricated maxillary skeletal expanders were included. Cone-beam computed tomography(CBCT) scans were obtained before and after treatment. Three-dimensional measurements were analyzed using Dolphin 3D 11.95 software, and statistical analysis was performed with SPSS software. Paired t-tests were used to compare pre-treatment and post-treatment changes in hard and soft tissues. Results Significant increases were observed in anterior midpalatal suture width, posterior midpalatal suture width, maxillary apical base width, and maxillary alveolar width(P<0.001). No significant changes were found in alveolar ridge inclination, alveolar ridge height, ∠SNA(P>0.05). Significant increases occurred in apical distance, cementoenamel junction distance, and inter-fossa distance(P<0.001), while first molar inclinationand ∠U1-SN remained stable(P>0.05). Significant improvements were noted in upper airway volume, nasal floor base width, and nasal cavity width(P<0.001). Conclusion For late adolescents or adults with maxillary transverse deficiency, digitally fabricated maxillary skeletal expanders can achieve near-parallel expansion of the midpalatal suture, effectively improving maxillary transverse dimensions and airway volume while minimizing dental side effects.

Convolutional neural network-based diagnosis of the relationship between mandibular third molar and mandibular nerve canal
ZHANG Jinping, YU Xian, CHEN Yiming, WANG Zehui, TAO Yu, WEI Yi, LI Birong, ZHU Bingzhen, ZHANG Juan
2025, 45(8):  596-602.  doi:10.13591/j.cnki.kqyx.2025.08.006
Abstract ( 114 )   HTML ( 3)   PDF (2670KB) ( 7 )  
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Objective To develop an automated system that can accurately determine the relationship between the mandibular third molar and the mandibular nerve canal from panoramic images. Methods A dataset consisting of 600 panoramic images of the oral cavity was selected, and the positions of the mandibular third molar and the mandibular nerve canal were accurately labeled. We compared the research designed TI-YOLOv5 with PANet, Faster R-CNN, Mask R-CNN, ResNeSt-101, and the original YOLOv5 in image segmentation tasks, with evaluation metrics of AP and AP50. Results TI-YOLOv5 achieved AP(average precision) 54.0% and AP50 94.9%, an increase of 4.9 and 6.7 percentage points respectively compared to the original YOLOv5 (AP 49.1%, AP50 88.2%), and surpassed other SOTA methods such as Mask R-CNN (AP 45.1%, AP50 84.2%). Conclusion TI-YOLOv5 is significantly superior to mainstream networks in automatic positioning and relationship classification of mandibular wisdom teeth and neural tubes, with high detection accuracy and discrimination accuracy, and can provide reliable technical support for preoperative risk assessment of mandibular wisdom tooth extraction.

Analysis of different implant implantation methods and changes of alveolar crest vertical membrane thickness
DOU Chenyun, SHEN Wenjing, WANG Jinmei, LI Beibei, ZHEN Penglong, MENG Lingqiang
2025, 45(8):  603-607.  doi:10.13591/j.cnki.kqyx.2025.08.007
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Objective To analyze the relationship between implant placement methods and the change of alveolar crest mucosal thickness under different gingival thickness. Methods A total of 98 patients with posterior tooth loss from June 2022 to December 2022 were selected, and a total of 120 implants were implanted. There were 90 samples in the thin gingiva group (gingiva thickness <3 mm) and 30 samples in the thick gingiva group (gingiva thickness≥3 mm). For the thin gingival cases, three different surgical methods were used for one-stage implantation. Group A (32 teeth) received ridge trimming before implantation. In group B, 30 implants were placed under the bone. In group C, 28 teeth used tent technique to analyze the vertical soft tissue thickness changes of alveolar crest before and 3~4 months after osseointegration. Results The thin gingival group was treated with three different treatments A, B and C. The gingival thickness increased from Ha(1.96±0.35)mm, Hb(1.89±0.42)mm, Hc(1.96±0.29)mm to H'a(2.88±0.23)mm, H'b(2.93±0.30)mm, H'c(2.65±0.22)mm, respectively. The alveolar crest vertical mucosal thickness of the three groups increased significantly (P<0.05). The increase in group A and B (about 1 mm) was slightly higher than that in group C (about 0.6 mm), while there was no significant difference between the control group Hd(3.60±0.24)mm and H'd(3.36±0.47)mm (P>0.05). In addition, the intraoperative gingival thickness measurements (Ha, Hb, Hc, Hd) were basically consistent with the CBCT imaging measurements (HA, HB, HC, HD), and there was no significant difference (P>0.05). Conclusion Careful analysis of the vertical thickness of the alveolar crest to the mucosa before implant surgery and selection of different implantation methods can increase the vertical thickness of the alveolar crest to the appropriate position, thereby maintaining the stability of the bone around the implant and improving the success rate of the implant.

In vitro study on the effect of two acid etching agents on the bonding strength between primary tooth enamel and resin
XU Xiangqin, WU Huaying, LIU Jing
2025, 45(8):  608-612.  doi:10.13591/j.cnki.kqyx.2025.08.008
Abstract ( 41 )   HTML ( 2)   PDF (4999KB) ( 8 )  
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Objective To evaluate the effect of two different acid etching agents on the bonding strength between deciduous enamel and composite resin at different etching times. Methods Seventy primary incisors were made into test specimens and randomly divided into 7 groups(n=10), 6 experimental groups, and 1 blank control group. The specimens were divided into groups and etchedwith two different acid etching agents(35% H3PO4, 15% HCl) for different durations(15, 30, 60 s). After bonding with the composite resin, shear force testing was performed. Additionally, two deciduous molar dental crowns were cut vertically along the gingival axis, with each tooth divided into seven sections and randomly assigned to seven groups. Enamel acid etched specimens were produced and the surface morphology was observed using scanning electron microscopy. Finally, 24 deciduous molars were randomly divided into 3 groups(n=8) according to the etching time(15, 30, 60 s), and each tooth was vertically cut into 2 pieces along the buccal lingual direction, namely the phosphoric acid group and the hydrochloric acid group, and etched for the same time(n=8), for a total of 6 groups. They were bonded with resin and made into specimens. The specimen was cut vertically to the bonding surface into 2 parts. One measurement point was selected for each part, and each group had a total of 16 measurement values. Resin protrusion length was measured under scanning electron microscopy and was statistically analyzed. Results When comparing acid etching for 15, 30, and 60 s, the bonding strength of the phosphate group was higher than that of the hydrochloric acid group. Under scanning electron microscopy, there was no significant difference in the acid etching mode between the two groups, both of which were type 2 acid etching modes dissolved along the glaze column direction. At 15 seconds of acid etching, the enamel surface was uneven, and continuous and uniform dissolution appeared at 30 seconds. The length of resin protrusion increased with the increase of acid etching time, and the phosphoric acid group was greater than the hydrochloric acid group at 15, 30, and 60 s compared between groups. Conclusion The etching time is positively correlated with the shear bonding strength. The best bonding effect is achieved when deciduous teeth are etched with 35% H3PO4for 60 seconds, and the effect of 35% phosphoric acid etching on deciduous tooth enamel is better than that of 15% hydrochloric acid.

Investigation and Study
Survey on oral health status of second-grade primary school students in Suzhou City
ZHANG Yuwen, LI Bei, GE Bing, ZHU Ye, WANG Xiaozhen, BAI Lu, ZHU Peng
2025, 45(8):  613-618.  doi:10.13591/j.cnki.kqyx.2025.08.009
Abstract ( 78 )   HTML ( 1)   PDF (851KB) ( 8 )  
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Objective To investigate the oral health status of second-grade primary school students in Suzhou, provide baseline data for evaluating Suzhou’s “Bright Eyes and Healthy Teeth” public health project, and offer reference for formulating oral health policies for students in Suzhou. Methods A multi-stage, stratified, random sampling method was used to select 1 640 second-grade primary school students from 10 districts(county-level cities) across Suzhou. The oral health survey of primary school students in Suzhou was designedbased on WHO “Basic Methods for Oral Health Surveys”(5th edition). A survey on the students’ oral health status was conducted. Results The caries prevalence, mean DMFT(Decayed, Missing, Filled Teeth), and caries filling rate for primary teeth among second-grade students in Suzhou were 80.73%, 4.25, and 24.48%, respectively. For permanent teeth, the caries prevalence, mean DMFT(Decayed, Missing, Filled Teeth), and caries filling rate were 30.30%, 0.62, and 16.96%, respectively. Specifically, the caries prevalence, mean DMFT, and filling rate for the first permanent molar were 29.88%, 0.59, and 16.94%, respectively. The pit and fissure sealing rate for the first permanent molar was 13.74%. Additionally, the detection rate for gingival bleeding was 58.05%, and for dental calculus, 49.15%. Conclusion The oral health status of second-grade primary school students in Suzhou is concerning.The caries prevalence rate for both primary and permanent teeth is high, while the filling rate is relatively low. Prior to the implementation of oral health programs, the pit and fissure sealing rate for the first permanent molars was low, with significant differences observed between urban and rural areas, as well as among different districts(or county-level cities).

Dental Education
Exploration and reflection on empowering undergraduate practical education of orthodontics through WeChat public accounts
DUAN Peipei, YU Xinle, WANG Yunshi, HAN Xianglong
2025, 45(8):  619-623.  doi:10.13591/j.cnki.kqyx.2025.08.010
Abstract ( 61 )   HTML ( 3)   PDF (1122KB) ( 10 )  
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With the rapid development of information technology, WeChat official accounts have emerged as an essential tool in the education sector, standing out among numerous platforms due to their simplicity and versatile functions. This paper examines the challenges in traditional orthodontic practice teaching and explores innovative approaches and practical outcomes of empowering undergraduate orthodontic practice teaching through WeChat official accounts. Educators utilize the platform to upload instructional videos on archwire bending, creating a “mobile and shared” teaching platform that provides students with additional support for self-learning and clinical practice. Through personalized instruction, students develop a “mind-eye-hand” three-dimensional operational skillset. The study reveals that empowering orthodontic education with WeChat official accounts effectively enhances students’ learning interest, optimizes classroom time, and facilitates a mutual workload reduction for both teachers and students during teaching reforms. Furthermore, it promotes the homogenization, flexibility, and ecological development of teaching content. This model demonstrates promising application prospects and offers new ideas and practical pathways for digital innovation and transformation in dental education.

Review
Research progress of oral hairy leukoplakia
MO Longhui, LIANG Jing, WANG Jiongke, LIU Tiannan, ZENG Xin
2025, 45(8):  624-630.  doi:10.13591/j.cnki.kqyx.2025.08.011
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Oral hairy leukoplakia is an oral mucosal disease caused by Epstein-Barr virusinfection of oral squamous epithelial cells. Oral hairy leukoplakia presents as a non-removable, corrugated and wrinkled white plaque sometimes with hair-like projections, typically occurring on the border of the tongue. It is commonly found in patients infected by human immunodeficiency virus, and it can also be seen in immunocompetent and immunocompromised patients who are not infected by human immunodeficiency virus. The pathogenesis of oral hairy leukoplakia is still unclear, and anti-EBV therapy is the main treatment for oral hairy leukoplakia at present. This paper will review the etiology, pathogenesis, risk factors, epidemiology, clinical manifestations, diagnosis and treatment of oral hairy leukoplakia.

Advances in the assessment of the effectiveness of immediate restorative techniques with full arch implants
ZHANG Xinyue, WANG Yinlin, WANG Baixiang, WANG Huiming
2025, 45(8):  631-636.  doi:10.13591/j.cnki.kqyx.2025.08.012
Abstract ( 80 )   HTML ( 2)   PDF (754KB) ( 8 )  
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The full-arch immediate implant restoration technique is one of the mainstream treatment options for edentulous patients. With the changes in disease patterns, health concepts, and the emphasis on the “patient-centered” philosophy, restoring function is no longer the sole goal of treatment for patients with tooth loss. Other factors such as patient expectations, improvements in quality of life, aesthetics, low economic burden, and convenience of maintenance are also important indicators for evaluating treatment outcomes. Patient-reported outcomes provide a new perspective for assessing the effectiveness of full-arch immediate implant restoration. This study reviews the application and research progress of patient-reported outcomes in full-arch immediate implant restoration techniques, systematically summarizing four evaluation indicators (oral health-related quality of life, quality of life, patient satisfaction, and health economic evaluation), in order to provide reference for clinical decision-making and humanistic care pathways in full-arch immediate implant restoration techniques.

Formation of biofilm on implant surfaces and its impact on implant homeostasis
LIU Yuhan, MENG Weiyan
2025, 45(8):  637-640.  doi:10.13591/j.cnki.kqyx.2025.08.013
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Peri-implant mucositis and peri-implantitis are among the primary risk factors for the failure of dental implants, with plaque biofilm being the initiating factor for these peri-implant diseases. This paper reviews the formation process of plaque biofilm on implant surfaces, the influencing factors of its formation, and its impact on implant homeostasis. It provides insights for the removal of plaque biofilm and the improvement of implant success rates.