Preparation of hard tissues for the implants is usually performed by conventional drilling (drilling at high-speed with irrigation). With the development of modern oral implantology, a new concept of low-speed drilling without irrigation shown the potential to be an alternative to the conventional drilling. Low-speed drilling also named as biologic drilling, comparing with conventional drilling which has many advantages, such as no irrigation, more precise, and avoiding autogenous bone loss. This article reviews the related literatures including in vitro, animal, and clinical studies to analyze the low-speed drilling from temperature change, osseointegration, drilling precision, and drilling time, in order to provide reference for further research and clinical application.

As an extracellular vesicle (EVs), exosomes have been identified as important mediators involved in intercellular communication in multiple studies. In neoplastic diseases, exosomes shed cells in the tumor microenvironment can carry abnormal amounts of proteins, nucleic acids, and some other cargos, internalized by other cells to regulate the signaling pathways in it, which in turn affect the development of tumors. Currently, exosomes microRNAs, as biomarkers of tumor diagnosis and prognostic, are widely concerned. Meanwhile, targeting exosomes as carriers to deliver microRNAs for tumor treatment is also one of the research hotpots. Here, we focus on the exosome microRNAs, review the mechanism of exosomes microRNAs in the occurrence and development of oral squamous cell carcinoma (OSCC), and summarize their application as a potential molecular biomarkers in disease diagnosis and targeted therapy.

Currently, the prevalence of temporomandibular joint disorders is high and affects the quality of life of patients, of which anterior disc displacement (ADD) of the temporomandibular joint (TMJ) accounts for a large proportion. Anterior repositioning splint (ARS) is considered to be one of the effective conservative treatments for ADD, which effectively relieves clinical symptoms such as pain and popping, and improves the range of motion of the jaw. Due to the wide application of this therapy, its exact mechanism has attracted increasing attention. However, the existing operation methods of ARS, its therapeutic mechanism, and its long-term efficacy are not yet finalized. In view of the current different opinions on ARS treatment, this review attempts to provide research advances in ARS-related treatments to help clinicians understand and select appropriate operational methods.

Objective: To investigate the influencing factors of temporomandibular disorders (TMD) in young people, and to construct a TMD risk prediction model for young people based on machine learning (ML) methods in order to provide a more accurate and effective risk assessment tool. Methods: A total of 960 eligible college students were included in the study. Univariate analysis and the least absolute shrinkage and selection operator (LASSO) regression algorithm were used to screen for risk factors. Six ML methods were used to construct the TMD risk prediction model and the Shapley additive explanations (SHAP) algorithm was used to interpret the final model. Results: A total of 12 predictors were included in the model construction, and the random forest (RF) model performed best among the 6 ML models. The model had an area under the receiver operating characteristic (ROC) curve (AUC) of 0.863 (95%CI: 0.812-0.915), an accuracy of 0.732, a sensitivity of 0.898, a specificity of 0.728, a positive predictive value (PPV) of 0.864, and a negative predictive value (NPV) of 0.703 on the external test set. The calibration curve showed that the predictive performance of the model was basically consistent with the actual situation, and the decision curve analysis (DCA) showed that the model had good clinical applicability. Conclusion: The TMD risk prediction model for young people constructed based on the ML method has good prediction performance and clinical applicability, which can help the clinic to carry out more efficient disease management and more accurate medical interventions.

Objective: To construct and apply a mandibular interaction module in the orthognathic surgery design software based on mandibular movement trajectory. Methods: Based on CCMF Plan orthognathic planning software, the space matrix algorithm was used to solve the mandibular motion trajectory data to achieve the restoration of mandibular motion. The patient's personalized mandibular rotation axis was fitted according to the distance importance sampling algorithm, and the position relationship between the rotation axis and the condyle was analyzed. The mandibular rotation axis was used to guide surgical planning to verify the accuracy of intraoperative condylar position realization. Results: A mandibular movement interaction module was developed, which could reproduce the patient's mandibular movement and guide the ramus rotation by the mandibular rotation axis. The error between the simulated mandible trajectory and the real trajectory was about 1 mm, and the root mean square value (RMS) of the mandible model at the same opening was about 0.3 mm. The angle deviation and distance deviation of the condyle were about 3° and 1.5 mm, respectively. Conclusion: The mandibular movement interactive module can accurately fit the mandibular rotation axis and restore the patient's personalized mandibular movement. The accuracy of condylar position after operation meets the clinical requirements.

Objective: To investigate the risk factors on prognostic survival of patients with deep neck infection (DNI). Methods: Clinical materials from 196 patients that were admitted to the two principal hospitals in Xinjiang Uygur Autonomous Region between January 2010 and August 2024 due to DNIs were retrospectively analyzed. In addition to assessing patient’s demographic characteristics, the independent risk factors that could predict clinical prognosis for patients due to serious complications and long-term hospitalization were identified by performing analyses of the univariate and multivariate logistic regression model. Results: According to multivariate logistic regression analyses, the presence of comorbidities (P₁=0.013,P₂<0.001) and neutrophil-to-lymphocyte ratio (NLR) (P₁=0.005,P₂=0.008) were independent risk factors for severe complications and long-term hospitalization in patients with DNI. The presence of comorbidities had good diagnostic value for severe complications and long-term hospitalization in DNI patients, with area under curve (AUC) of 0.77 and 0.82, respectively. The NLR level also showed good evaluating performance, with AUC=0.81 and AUC=0.82, respectively. In addition, the AUC value for diagnosing severe complications based on white blood cell count (WBC) was 0.90; other AUC values for predicting long-term hospitalization (>10 days) of patients based on different origin of infection, C-reactive protein (CRP), and procalcitonin (PCT) levels were 0.69, 0.73, and 0.71, respectively. Conclusion: This present study found that the combination of variables for both complications and long-term hospitalization are promising for prognostic purposes.

Objective: To investigate the effect of repositioning splint on temporomandibular disorders (TMD) by measuring the cross-sectional area of bilateral masseter muscles and the width of joint capsule by high-frequency ultrasound. Methods: Twenty-three patients with temporomandibular joint pain and joint play sound visited our department were randomly selected as the experimental group, and 20 healthy volunteers as control group. Experimental group was received positioning grind splint treatment. The thickness of bilateral masseter muscle and the width of joint capsule were measured by high-frequency ultrasound before treatment and 1, 2, and 3 months after treatment, and compared with the control group. The changes of symptoms before and after treatment in the experimental group were recorded. Results: In the experimental group, the average thickness of bilateral masseter muscle was 9.42 mm in the non-occlusal state and 13.04 mm in occlusal state before treatment. In the control group, the average thickness of bilateral masseter muscle was 8.48 mm in the non-occlusal state and 10.27 mm in occlusal state. There was statistical significance between two groups before treatment (P<0.001). Additional, the masseter muscle thickness had significant difference each month after treatment in the experimental group (P<0.001). The joint capsule width in the jaw plate had no statistically significant difference between two groups before treatment (P>0.05). After treatment, the symptoms of pain and ringing were significantly improved, and the cure rate was 52.2%. Conclusion: The effect occlusal plate is significant. High-frequency ultrasound can be used as an effective tool to evaluate the treatment effect of occlusal plate, providing a basis for clinical diagnosis and evaluation of the clinical effect of TMJ disorders.

Objective: To analyze the risk factors for postoperative infection in patients with maxillofacial fractures and construct a risk prediction model. Methods: From January 2022 to January 2024, 81 patients with oral and maxillofacial fractures who developed infection after surgical treatment at Xuzhou Medical University Affiliated Hospital were selected as the research subjects. Meanwhile, 70 patients with oral and maxillofacial fractures who did not develop infection after surgery at the same hospital during the same period were selected as the control group. Clinical data of patients were retrospectively collected and multiple logistic regression analysis was performed to screen for independent risk factors. A risk prediction model was constructed and its predictive value was evaluated. Results: The study found that operation duration ≥3 h, diabetes, and the number of titanium nails ≥20 were independent risk factors for postoperative infection of maxillofacial fractures (P<0.05). According to the selected independent risk factors, a prediction model for postoperative infection risk of patients with maxillofacial fractures was constructed: Logit (P) =-0.747+operation duration×1.730+diabetes×1.789+number of titanium nails×1.078. Hosmer-Lemeshow good of fit test showed that the fitting accuracy of the model was good (χ²=2.015, P=0.365). The calibration curve showed that the prediction probability was close to the actual probability, indicating that the model had a good calibration degree. The receiver operating characteristic (ROC) curve indicated that the area under the curve (AUC) of the predictive model was 0.728, suggesting that the model possessed moderate discriminative capacity. Decision curve analysis (DCA) revealed that within the horizontal axis range of 0.3-0.8 the predictive model's curve lay above the two extreme curves, suggesting that the model's clinical utility was acceptable. Conclusion: Postoperative infection in patients with maxillofacial fractures is related to the operation duration, diabetes, and the number of titanium nails. The risk prediction model based on it has certain diagnostic value.

Objective: To analyze the postoperative response and influencing factors of general dental anesthesia in children through a case-control study. Methods: One hundred and thirty-six children underwent general dental anesthesia were selected and divided into poor prognosis group and good prognosis group. General data of patients were collected, and univariate and multivariate conditional Logistic regression analysis was used to screen out the factors related to adverse reactions after general anesthesia. Results: Among 136 children, 1 case was missed follow-up after surgery and excluded the survey. Among children included, 41 cases had postoperative adverse reactions, with an incidence of 30.37%. The results of univariate analysis showed that the postoperative extubation time <2 h in the good prognosis group was higher than that in the poor prognosis group (P<0.05), and the preoperative malnutrition, total number of treated teeth, total number of extractions and sedation were lower than those in the poor prognosis group (P<0.05). Multivariate Logistic regression analysis showed that preoperative malnutrition (OR=10.359, 95%CI: 4.429-24.416), more total treated teeth (OR=60.223, 95%CI: 18.852-192.379) and more total extractions (OR=68.499, 95%CI: 15.252-307.618) were the risk factors for postoperative adverse reactions in children undergoing elective dental general anesthesia (P<0.05). Conclusion: Preoperative malnutrition, the number of treated teeth, and the number of extracted teeth are the risk factors of postoperative adverse reactions in children, and timely intervention should be given during clinical surgical treatment.

Objective: To evaluate the clinical effect of celecoxib preemptive analgesia combined with nitrous oxide sedation in the extraction of mandibular impacted third molar teeth. Methods: A total of 120 patients who had unilateral impacted mandibular third molar were selected and divided into control group, nitrous oxide group, celecoxib group, and experimental group with 30 cases in each group. Control group was performed minimally invasive tooth extraction. Nitrous oxide group was inhaled nitrous oxide for tooth extraction. Celecoxib group received oral celecoxib 0.4 g for tooth extraction 30 minutes before surgery. The experimental group took celecoxib 0.4 g orally 30min before surgery, and then used nitrous oxide inhalation system for tooth extraction. Local anesthesia intraoperative and 2, 4, 6, 12, 24, 48 h postoperative visual analogue scale (VAS) scores were recorded. Modified dental anxiety scale (MDAS) before and after surgery were recorded. The interval of first analgesic administration 48 h after surgery and the total dose, mean arterial pressure (MAP) and heart rate (HR) in T0 (5 min before surgery), T1 (local anesthesia), T2 (tooth extraction), and T3 (5 min after surgery) were also recorded. Results: Compared with the control group, the scores of 4 and 6 h VAS in celecoxib group, the scores of local anesthesia and VAS during operation in nitrous oxide group, and the scores of local anesthesia, during operation, and 4 and 6 h VAS after operation in experimental group were significantly decreased (P<0.05). Compared with celecoxib group, the scores of local anesthesia and operative VAS in nitrous oxide group were significantly decreased, and those in experimental group were significantly decreased (P<0.05). Compared with nitrous oxide group, the 4 and 6 h VAS scores of experimental groups were significantly decreased (P<0.05). Postoperative MDAS scores of four groups were lower than those before surgery, and there was no statistical significance between preoperative and postoperative MDAS scores (P>0.05). Compared with the control group, the duration of drug administration between celecoxib group and experimental group was significantly increased, and the dose was significantly decreased (P<0.05). Compared with nitrous oxide group, the duration of drug administration in celecoxib group and experimental group was significantly increased, and the dose was significantly decreased (P<0.05). Compared with the control group, MAP and HR of the other three groups showed no statistical significance at T0, while node differences were statistically significant at other times (P<0.05). Conclusion: Celecoxib advanced analgesia combined with nitrous oxide sedation and analgesia has significant analgesic effect in mandibular impacted third molar extraction, which can reduce postoperative pain and the use of emergency analgesic drugs, reduce intraoperative blood pressure fluctuation of patients, and improve the comfort of diagnosis and treatment.

Objective: To explore the clinical application of comfort medical technology in the oral treatment of children with child dental phobia (CDF). Methods: Ninety-four children with CDF were divided into control (Ctrl) group and experimental (Exp) group, with 47 cases in each group. The Ctrl group received traditional restraint treatment, while the Exp group received oral comfort treatment. The levels of fear before and after treatment were compared between two groups, including the children's fear survey schedule-dental subscale (CFSS-DS), the early childhood oral health impact scale (ECOHIS), pain level (using the Wong Baker Facial Expression Scale), and Heart rate variability before and after treatment [using heart rate (HR), low frequency power (LF), high frequency power (HF), and LF/HF]. Results: The CFSS-DS score of children in the Ctrl group significantly increased after treatment, while the ECOHIS score significantly decreased (P<0.05). However, the CFSS-DS score and ECOHIS score in the Exp group were significantly reduced than those before treatment and in the Ctrl group (P<0.05). Compared with the Ctrl group, the pain level of children in Exp group was significantly reduced (P<0.05). HR, LF, and LF/HF levels of the two groups of children before treatment were significantly higher than those at the time of diagnosis, while the HF levels were significantly lower than those at the time of diagnosis, and the changes in the above indicators in the Exp group were smaller than those in the Ctrl group (P<0.05). Meanwhile, the levels of HR, LF, and LF/HF in the Exp group decreased after treatment compared to those before treatment and the Ctrl group, the HF level was significantly higher than that before treatment and in the Ctrl group (P<0.05). Conclusion: Comfortable medical technology can not only reduce the fear and pain level of children with CDF, improve oral related quality of life, but also reduce changes in heart rate variability and improve comfort.

Objective: To observe the clinical efficacy of iRoot BP plus pulp capping treatment for deep caries of permanent teeth after 3 years, and to explore the feasibility and influencing factors of this treatment method. Methods: One hundred and twelve mature permanent teeth diagnosed with deep caries or reversible pulpitis were selected from our department from January 2019 to September 2020. The caries were selectively removed under a dental surgical microscope and pulp capping treatment was completed. The follow-up period was more than 3 years, and the treatment effect was evaluated through imaging examinations and clinical indicators. Kaplan Meier survival analysis was used to calculate the survival rate of live pulp, and χ² test was used to examine the impact of various variables on clinical efficacy. Results: The Kaplan Meier survival curve showed that the 3-year survival rate of 112 mature permanent teeth after pulp capping was 91.1%, 82 affected teeth underwent indirect pulp capping, and 30 affected teeth underwent direct pulp capping after pulp exposure during caries removal. The 3-year survival rates were 92.7% and 86.7%, respectively. The efficacy of pulp capping was not correlated with gender, age, preoperative diagnosis, tooth type (anterior teeth, premolars, molars), cavity shape (Class Ⅰ, Ⅱ, Ⅲ), tooth position, and pulp capping method (P>0.05). Conclusion: iRoot BP plus as a pulp capping agent has a good therapeutic effect on mature permanent teeth diagnosed with deep caries or reversible pulpitis, and the study variables have no significant impact on prognosis.

Objective: To evaluate the effects of different deep margin elevation (DME) materials and lifting heights on the biomechanical behavior characteristics of inlay in mandibular first molar with subgingival defects. Methods: Three-dimensional finite element models of mandibular first molars were established based on Micro CT three-dimensional image data. Seven groups of three-dimensional finite element models of mandibular first molar inlay restoration with different DME heights were established through computer-aided design simulation of DME and inlay restoration. The stress distribution and magnitude of each part and interface of the model under two different DME materials (flowable resin and packable resin) and seven different DME heights were studied and compared through three-dimensional finite element simulation analysis. Results: With the increase of DME height, the peak of maximum principal stress (MPS) of the inlay itself continued to rise, while the peak of MPS of the DME layer, the peak of interfacial tensile stress (ITS) between the DME layer and the inlay, and the peak of ITS between the DME layer and the tooth continued to decrease. At the same DME layer height, the peak of MPS of the DME layer, the peak of ITS between the DME layer and the inlay, and the peak of ITS between the DME layer and the tooth were all smaller than those of the packable resin group. The changes in DME layer material and height had no significant effect on other observation indicators. Conclusion: Low elastic modulus DME material and increased DME height are beneficial to reduce the stress of the model and interface. Therefore, it is recommended to choose flowable resin as DME material in clinical operation and appropriately lift the DME layer height.

Objective: To explore the effects of glucose transporter (GLUT) 1 and GLUT2 mediated glucose uptake on early tooth development in mice. Methods: The mandibular molar tooth germ and maxillary incisor tooth germ during embryonic day 13.5 (E13.5), E14.5, E16.5, E18.5, and postnatal day 1 (P1) were collected. RT-qPCR and Western blot were used to detect Glut1 and Glut2 mRNA and protein levels in tooth germ. Immunohistochemical staining was used to detect GLUT1, GLUT2, Ki67, and glycogen levels in tooth germ. The mandibular molar tooth germ was cultivated in glucose-free DMEM medium and high glucose DMEM medium with different concentrations of Phloretin (0 mmol/L, 0.25 mmol/L, 0.5 mmol/L) for 9 days. Results: (1) During E13.5, GLUT1 was strongly expressed in enamel organ, with active cell proliferation and abundant deposition of glycogen in dental lamina and odontotheca. During E14.5 and E18.5, the expression of GLUT1 was gradually decreased in enamel organ, cell proliferation was decreased, and glycogen was heavily deposited in enamel organ and dental papillae. During P1, GLUT1 was highly expressed in middle layer and inner enamel epithelium, with increased cell proliferation and minimal deposition of glycogen in dental papilla. During the entire stage of tooth germ development, GLUT2 expression was relatively low. (2) GLUT1 was strongly expressed in preameloblasts and preodontoblasts cells, but less expressed in differentiated ameloblasts and odontoblasts cells. GLUT2 and GLUT1 exhibited opposite expression trends. (3) 0.5 mmol/L Phloretin could inhibit the development of tooth germ in E13.5 stage, while 0.25 mmol/L root bark extract didn’t inhibit the development of tooth germ in E13.5 and E14.5 stage, but could cause tooth germ to shrink and had a concentration dependent effect on Phloretin. Glucose-free culture medium could inhibit the development of explant dental germ in E13.5 and E14.5 stages. Conclusion: The expression of GLUT1 and GLUT2 in early tooth development were precisely spatiotemporal regulated, and GLUT1 and GLUT2 mediated glucose uptake played an important role in early tooth development in mice.

This paper reports a case of residual crown and replacement of crowns in the aesthetic area repaired by vertical tooth preparing and soft tissue shaping (BOPT technique). Satisfactory results were achieved.

Enamel pearl, fused teeth, and supernumerary teeth are common dental dysplasia in clinic. The fusion of permanent tooth with supernumerary tooth is few reported. And the fusion of permanent tooth with supernumerary tooth combined with enamel pearl is extremely rare. This article reports a case of inflammation caused by buccal enamel pearl, and lingual fused supernumerary tooth in the right mandibular second molar, which was misdiagnosed as pericoronitis of wisdom teeth, and provides clinical analysis after literature review.

Inferior alveolar nerve injury is a common complication of mandibular impacted third molar extraction, and the branching of the inferior alveolar nerve usually increases the risk of intraoperative nerve damage. This article reports a case of a mandibular nerve canal with a posterior canal branch located near the impacted tooth. The course and clinical risks are discussed through CBCT combined with relevant literature.

Syphilis is an infectious disease mainly transmitted through sexual contact. The oral damage of early syphilis is varied, which is easy to be misdiagnosed. Penicillin is the first choice for the treatment of syphilis, but some patients have allergic reactions or other problems, which puts a lot of limitations on the use of it. This article reports a case of syphilis with a nodule as the first sign on the lower lip with penicillin allergy and, who was treated by doxycycline with good effect, aiming to emphasize early detection, diagnosis and treatment of syphilis.