Objective To investigate the association between apical periodontitis(AP) and local marginal alveolar bone loss(ABL) based on cone beam computed tomography(CBCT). Methods This study adopted an intra-subject contralateral paired design. A total of 48 patients with 60 pairs of matched teeth were included. Teeth with definite apical periodontitis, defined as a CBCT-periapical index(CBCT-PAI) score ≥3, were assigned to the AP group, while the contralateral teeth with normal periapical status(PAI≤1) served as the control group. ABL was measured on CBCT images, and the alveolar bone loss percentage(ABL%) was calculated. Group comparisons were performed using the Wilcoxon signed-rank test, McNemar test, and Stuart-Maxwell test. Multivariable linear mixed-effects models(LMMs) were used to evaluate the trend association between CBCT-PAI scores and the extent of bone loss. Results The AP group showed significantly greater mean ABL and ABL percentage than the control group. The impact of AP on alveolar bone loss is more significant in the anterior teeth and molars. After adjustment for tooth type and other relevant factors, AP remained an independent factor associated with increased mean ABL and ABL percentage. Among AP teeth, each 1-point increase in CBCT-PAI score was associated with a 0.64 mm increase in mean ABL and a 5.07% increase in ABL percentage. Conclusion Apical periodontitis is significantly associated with increased local marginal ABL.

Objective To investigate the causal relationship between serum sex hormone levels and oral lichen planus (OLP) using Mendelian randomization (MR), with supplementary serological validation. Methods A bidirectional two-sample MR analysis was conducted using publicly available genome-wide association study(GWAS) summary statistics for total testosterone (TT), bioavailable testosterone (BT), estradiol (E2), sex hormone-binding globulin (SHBG), and dehydroepiandrosterone sulfate (DHEAs), alongside OLP data from the FinnGen database. The inverse variance weighted (IVW) method served as the primary analytical approach, supported by sensitivity analyses, while serum SHBG analysis was conducted for verification. Results Genetically predicted higher serum SHBG levels were associated with an increased risk of OLP in males (OR=1.26, P=0.04), but not in females. No causal effects were observed between TT, BT, E2, or DHEAs and OLP in either gender (P>0.05). Reverse MR analyses showed no causal effect of OLP on serum sex hormone levels. Sensitivity analyses supported the stability of these findings. Serological analyses in males showed trends consistent with the MR results, although the differences were attenuated after age adjustment. Conclusion Elevated serum SHBG levels are causally linked to an increased risk of OLP in males, while no significant causal associations are found for TT, BT, E2, or DHEAs.

Objective To investigate the factors influencing changes in residual ridge height (RRH) and maxillary sinus mucosal thickness (MT) in the maxillary molar region of patients with periodontitis. Methods A retrospective analysis was conducted on clinical and cone beam computed tomography(CBCT) data from 200 patients with periodontitis (742 maxillary molars). Factors analyzed included molar loss status, severity of alveolar bone loss, maxillary sinus mucosa (MSM) thickening, treatments received during the observation period, baseline RRH and MT, as well as patients’ gender and age, to evaluate their effects on changes in RRH and corresponding MT. Results The mean change in RRH among the 742 maxillary molars was (-0.30±1.27) mm, with a rate of (-0.05±0.24) mm/month. The mean change in MT was (-0.42±3.55) mm, with a rate of (-0.06±0.61) mm/month. Alveolar bone loss less than the middle third of the root (P=0.010) and initial periodontal therapy during the observation period (P=0.006) were positively correlated with RRH change, whereas baseline RRH (P<0.001) and thickened MSM (P=0.007) were negatively correlated. Alveolar bone loss less than the middle third of the root (P=0.009) and initial periodontal therapy during the observation period (P=0.042) were positively correlated with the rate of RRH change, while baseline RRH (P<0.001) and tooth extraction during the observation period (P=0.010) were negatively correlated. Baseline MT (P<0.05) and tooth extraction after initial therapy during the observation period (P<0.05) were negatively correlated with both the magnitude and rate of MT change. Conclusion During the observation period, both RRH and MT in the maxillary molar region of patients with periodontitis showed an overall decreasing trend. Initial periodontal therapy may reduce alveolar bone loss and promote recovery of inflamed, thickened MSM, whereas tooth extraction has been clearly shown to accelerate alveolar bone loss.

Objective To evaluate the clinical efficacy and safety of the anterior approach for ultrasound-guided superior laryngeal nerve (SLN) block combined with remimazolam for awake tracheal intubation in patients with hypertension and difficult airways. Methods A total of 60 patients with difficult airways and hypertension scheduled for general anesthesia surgery, SBP/DBP≤140/90 mmHg, aged 18-65 years, 18.5≤BMI<28 kg/m², ASA physical statusⅡ-Ⅲ were selected. These patients were randomly divided into a control group(group C) and an observation group(group S) by random number table, 30 patients in each group. The control group received cricothyroid membrane puncture anesthesia, while the observation group received the anterior approach for ultrasound-guided SLN block combined with cricothyroid membrane puncture anesthesia. Both groups of patients received intravenous remimazolam at a dose of 0.1 mg/kg, nasal surface anesthesia and then underwent fiberoptic bronchoscope-guided awake tracheal intubation through the nasal route. MAP and HR were recorded at baseline(T₀), immediately after the tracheal tube enters the glottis(T₁), immediately after the tracheal tube enters the trachea(T₂), 3 min after the tracheal tube enters the trachea(T₃), immediately after extubation(T₄). The Ramsay sedation score was recorded before intubation along with the occurrence of hypoxemia, cough, nausea during intubation, as well as hoarseness and sore throat after extubation. Results Compared with T₀, the increase of MAP at each time point in group S was not statistically significant and HR increased significantly at T₁,T₂, T₃, T₄(P<0.05). In group C, MAP and HR increased significantly at T₁, T₂, T₃ and T₄. There was no statistically significant difference in MAP and HR between the two groups at each time point. The incidence of cough during intubation in group S was significantly lower than that of group C(P<0.05). There was no statistically significant difference in other adverse reactions between the two groups. Conclusion The anterior approach for ultrasound-guided SLN block combined with remimazolam can reduce hemodynamic fluctuations during awake tracheal intubation in patients with hypertension, lower the incidence of coughing during intubation, help control the stress response and improve patient comfort.

Objective To investigate the effect of miR-21-3p on the radiosensitivity of oral squamous cell carcinoma (OSCC) cells. Methods OSCC-related omics data were screened from the GEO database, and bioinformatics analysis was performed to identify differential expression of miR-21-3p. Thirty pairs of tumor tissue samples (cancer and adjacent tissues) were collected from OSCC patients. CAL27 and HN30 cell lines were cultured and irradiated with varying doses of X-rays using an irradiator. qRT-PCR was used to detect miR-21-3p expression level and analyze the effect of different radiation doses, as well as its differential expression in OSCC patients. CAL27 and HN30 cells were divided into groups: Control group, X-ray + control, X-ray + miR-21-3p mimics, and X-ray + miR-21-3p inhibitor. Cell proliferation was assessed by CCK-8 and EdU assays; cell migration was evaluated by wound healing assay; cell invasion was measured by Transwell assay, and clonogenic survival assay was used to detect colony-forming ability. Bioinformatics analysis was conducted to predict the downstream target genes of miR-21-3p; qRT-PCR and dual-luciferase reporter gene assays were used to validate the regulatory effect of miR-21-3p on target genes. Western blot was used to detect phosphorylation levels of key proteins in the PI3K/AKT signaling pathway. Results Bioinformatics analysis revealed that miR-21-3p was highly expressed in OSCC patients. This was further confirmed by qRT-PCR in the 30 collected clinical samples, consistent with the database results. Following irradiation of CAL27 and HN30 cells with increasing doses of X-rays, miR-21-3p expression levels significantly decreased. A significant negative correlation was observed between X-ray dose and miR-21-3p expression. After 10 Gy X-ray irradiation, cell proliferation, colony formation, invasion capacity, and wound healing ability were significantly reduced. Downregulation of miR-21-3p further decreased cell proliferation, invasion, and migration capacity, while upregulation of miR-21-3p significantly attenuated the inhibitory effects of X-ray irradiation on these cellular processes. Bioinformatics analysis identified FBP1 as a downstream target gene of miR-21-3p. qPCR results showed that FBP1 expression was negatively correlated with miR-21-3p levels. The dual-luciferase reporter assay confirmed that miR-21-3p directly targeted the 3' untranslated region(3'UTR) of FBP1. Further investigation revealed that the ratios of p-AKT/AKT and p-PI3K/PI3K decreased following miR-21-3p downregulation and increased following its upregulation. The ratios of p-AKT/AKT and p-PI3K/PI3K were significantly higher in tumor tissues compared to adjacent tissues from OSCC patients. Conclusion miR-21-3p is aberrantly highly expressed in OSCC patients. miR-21-3p reduces the radiosensitivity of OSCC and promotes the proliferation and metastasis of OSCC cells. The molecular mechanism involves targeting FBP1 and activating the PI3K/AKT signaling pathway via phosphorylation.

Objective To investigate the differential expression of the IFI27 gene across various cancers and evaluate its potential as a prognostic biomarker. Methods A pan-cancer analysis was conducted using data from The Cancer Genome Atlas(TCGA) database, incorporating multiple online tools and R software to analyze IFI27 expression in 33 types of cancer, including head and neck squamous cell carcinoma, prostate cancer, and others. The study assessed the relationship between IFI27 gene mutations, DNA methylation, and mRNA expression levels, as well as the correlation between IFI27 expression and tumor immune infiltration. Additionally, the interacting genes of IFI27 were subjected to KEGG and GO enrichment analysis. Results Based on integrated analysis using TIMER2.0 and GEPIA2, IFI27 expression was significantly upregulated in 12 types of cancer tissues, while it was downregulated in 3 types. IFI27 mutations were primarily characterized by copy number variations, and its mRNA expression level was negatively correlated with promoter methylation. Moreover, IFI27 expression was significantly positively correlated with CD8⁺ T cell infiltration in head and neck squamous cell carcinoma and uveal melanoma. In prostate cancer and thyroid cancer, the infiltration level of tumor-associated fibroblasts was influenced by IFI27 expression, with a positive correlation observed between them. Conclusion The expression of IFI27 is significantly upregulated in various cancers compared to normal tissues and has an impact on patient survival outcomes. IFI27 may serve as a prognostic biomarker for head and neck squamous cell carcinoma, thymoma, uveal melanoma, skin cutaneous melanoma, low-grade glioma, and ovarian serous adenocarcinoma.

Objective To compare the detection efficacy of direct microscopic examination and antigen detection in oral candidiasis infection, and provide a basis for clinical selection of rapid detection methods. Methods Oral swabs were collected from patients with suspected oral candidiasis in the Department of Oral Mucosal Diseases at Affiliated Stomatological Hospital of Nanjing Medical University between December 2024 and February 2025. Each specimen was detected by direct microscopic examination, antigen detection and cultivation method. Using the cultivation method as the gold standard, the positive rates of the other two methods were assessed, and the consistency with the cultivation method, and various evaluation indices such as sensitivity, specificity, false negative rate, false positive rate, negative predictive value and positive predictive value were compared. Results The antigen detection method demonstrated a significantly higher positive rate than the direct microscopic examination (P<0.01). Both methods showed consistency with the results of the cultivation method (P<0.05), and the antigen detection method (Kappa=0.417) had a higher degree of consistency. The sensitivity, negative predictive value and positive predictive value of the Candida albicans antigen detection were significantly higher than those of the direct microscopic examination (P<0.05) and the false negative rate was significantly lower than that of the direct microscopic examination (P<0.01). The difference in specificity and false positive rate between the two methods was not significant (P>0.05). Conclusion The antigen detection method has higher positive rate, sensitivity, negative predictive value, positive predictive value and lower false negative rate. It also has a higher degree of consistency with cultivation method. Therefore it is more suitable for rapid clinical diagnosis.

Due to the anatomical differences between peri-implant soft tissues and natural teeth, the treatment of peri-implant soft tissue defects is more challenging and less predictable than the management of gingival recession around natural teeth. This article presents a case report of bilateral peri-implant soft tissue defects in the maxillary anterior region and analyzes the factors influencing the treatment outcome. The patient, a female, presented with facial soft tissue recession around bilateral lateral incisor implants ten years after implantation, which compromised aesthetics. While preserving the original implant crowns, simultaneous hard and soft tissue augmentation was performed on the facial aspect of the implants. Postoperatively, near-complete coverage of the exposed abutments was achieved, along with an improved facial soft tissue contour and aesthetic outcome around the excessively facially positioned implants.

Bite plates are essential auxiliary devices in orthodontic treatment, comprising various types such as fixed bite turbos, removable bite plates, and bite ramps used in clear aligner therapy. By modulating occlusal force distribution and mandibular position, these devices play a critical role in treating diverse malocclusions, including deep bite, crossbite, canted occlusal plane, and scissors bite. This review systematically elucidates the biomechanical foundations of bite plate therapy, covering bite opening, mandibular guidance, vertical control, and the regulation of tooth movement. Furthermore, combined with clinical research data, this article analyzes the specific applications and efficacy of bite plates in both fixed appliance therapy and clear aligner therapy. The findings indicate that fixed bite turbos demonstrate significantly higher efficiency in bite opening compared to removable bite plates, while bite ramps in clear aligner therapy offer more comfortable and precise occlusal guidance. However, strict adherence to indications is required when applying bite plates, with particular caution necessary for high-angle cases. With advancements in digital design and material technology, the application of bite plates in orthodontics is evolving toward greater personalization and precision.

Oral squamous cell carcinoma (OSCC) is the most common malignant tumor of the head and neck region, whose pathogenesis involves a complex, multi-step process with the participation of multiple genes. Epigenetic regulation, particularly histone modifications, plays a critical role in this process. EP300 is a key transcriptional coactivator with intrinsic histone acetyltransferase (HAT) activity. It mediates the acetylation of both histone and non-histone proteins, thereby widely participating in essential biological processes such as chromatin remodeling, gene transcription, cell cycle progression, DNA damage repair, cell differentiation, and apoptosis. Recent studies have revealed a dual and complex role of EP300 in OSCC: while its dysfunction can influence tumor progression, its overexpression may, under certain circumstances, drive tumor growth by activating various oncogenic pathways. This review aims to systematically elucidate the expression status and regulatory mechanisms of EP300 in OSCC, and to elaborate on the molecular mechanisms through which it interacts with multiple signaling pathways (such as p53, Wnt/β-catenin, Notch, and NF-κB) to influence the initiation and progression of OSCC. Furthermore, we will discuss the potential and challenges of targeting EP300 and its related pathways as a novel therapeutic strategy for OSCC, and look into the prospect of future research directions.

Mandibular movement analysis system has undergone innovation from traditional mechanical recording to digital automatic recording technology. The application of digital technology has significantly improved the accuracy and convenience of mandibular movement analysis, making it increasingly widely used in the field of temporomandibular disorders. Mandibular movement analysis system has significantly improved the accuracy of early diagnosis of temporomandibular disorders and provides strong support for the development of the treatment of temporomandibular disorders. The objective of this review is to deeply discuss the research progress and clinical application of digital mandibular movement analysis system in the diagnosis and treatment of temporomandibular disorders, analyze its advantages and limitations, and look forward to the new development trend of this system in the digital background, so as to provide reference for clinical practice and research.

Bone healing complications following jaw fractures can markedly impair facial morphology and oral function and are often difficult to manage. This review summarizes the definition and risk factors of bone healing complications in jaw fractures, with a particular focus on comprehensive management principles for different healing patterns. Treatment strategies for special fracture types are also discussed, along with recent advances in adjuvant biological therapies and physical stimulation modalities relevant to clinical practice.