Dental caries is a chronic infectious disease that predominantly affects the hard tissues of the teeth and represents one of the most prevalent global health problems in children. The process of dental caries treatment is often painful and challenging for children, imposing a significant burden on both families and society. Therefore, the prevention of early childhood caries (ECC) is particularly important. Modern caries prevention and control focus on managing caries risk factors, with oral microbiota playing a crucial role in the development and progression of the disease. Many caries risk assessment tools now consider oral microbiota as a key risk factor. For children, saliva samples serve as an ideal testing medium due to their non-invasive and easy-to-handle nature. Using salivary microorganisms as biomarkers in caries risk assessment not only improves the convenience of evaluation but also offers valuable evidence to support early intervention efforts. This article reviews the cariogenic role of salivary microorganisms and their potential as functional biomarkers for ECC risk assessment, discusses the latest progress in their application within ECC risk prediction models, and provides a theoretical foundation for constructing a more comprehensive ECC risk prediction model.

The oral cavity has complex physiological characteristics and unique anatomical environment, which is difficult to accurately simulate using traditional two-dimensional in vitro models. Organ-on-a-chip technology, an emerging method that mimics the physiological functions and characteristics of organs in vitro, utilizes microfluidic perfusion systems to recreate the structure and functional units of living tissues. This approach accurately reflects the dynamic biological processes of oral tissues, aiding in the understanding of the pathological mechanisms of diseases such as dental caries, periodontitis, and oral cancer, while also assessing the efficacy and safety of new drugs. This review highlights the applications of organ-on-a-chip technology in oral disease research, focusing on dental chips, mucosal chips, oral cancer chips, and salivary gland chips. Despite current challenges such as model standardization and high costs, organ-on-a-chip technology is poised to play a significant role in future oral medical research.

Environmental factors play a pivotal role in the pathogenesis of pemphigus vulgaris (PV). As a significant environmental component, the gut microbiota has been increasingly recognized for its influence on the progression of various autoimmune diseases. Interventions targeting the gut microbiota have emerged as a novel therapeutic strategy for autoimmune disorders. Recent studies have demonstrated a strong correlation between gut dysbiosis and the development and progression of PV. This review comprehensively examines the role of gut microbiota in PV pathogenesis, potential mechanisms through which microbiota dysregulation influences PV, and potential therapeutic approaches targeting gut microbiota for PV intervention. The findings provide a theoretical foundation and research directions for elucidating the pathogenesis of PV and exploring innovative treatment strategies.

Objective: To review the associated risk of postoperative hematoma after retrospective analysis on patients with oral squamous cell carcinoma after ablative and reconstructive surgery. Methods: An observational and retrospective analysis of patients with oral squamous cell carcinoma was designed to report the incidence of hematoma in patients undergoing functional neck dissection, radical resection of oral cancer, and repair with free flap in Nanjing Stomoligical Hospital between September 2020 and September 2024. The demographic variables, preoperative laboratory data, and related operative variables were analyzed. Results: A total of 239 patients were finally included, 20 cases had maxillofacial and cervical hematoma, with an incidence rate of 8.3%. There were statistically significant differences in the clinical stage, lymph node metastasis rate, operative time, intraoperative blood transfusion, and activated partial thromboplastin time (APTT) between the hematoma group and the non-hematoma group (P<0.05). Multivariate logistic regression analysis showed that intraoperative blood transfusion was an independent predictor of maxillofacial and cervical hematoma. Conclusion: Intraoperative blood transfusion can serve as an indicator for predicting postoperative hematoma in the maxillofacial and neck regions following radical resection of oral cancer combined with free flap reconstruction.

Objective: To summarize and analyze the clinical data of patients with medication-related osteonecrosis of the jaw (MRONJ) who underwent surgical treatment and to explore the impact of surgical methods and other factors on disease prognosis. Methods: A retrospective analysis was conducted on the data of 173 patients with stage 2-3 MRONJ who underwent surgery at Nanjing Stomatological Hospital from January 2013 to October 2024. Results: A total of 144 cases were cured and 29 cases relapsed. The overall cure rate was 83.2%, and the cure rate of the mandible was significantly lower than that of the maxilla (P<0.05). Bone tube technique (for refractory stage 2) and titanium plate reconstruction (for stage 3 mandible) significantly improved the cure rate (P<0.05), while there was no significant difference in prognosis for stage 3 maxilla with window drainage and subtotal resection (P>0.05). Conclusion: There is no significant gender difference in the incidence of MRONJ. The prognosis of surgery for mandibular MRONJ is worse than that for maxillary MRONJ. Bone tube technique and titanium plate reconstruction are key to improving prognosis.

Objective: To analyze the impact of preoperative cleft management measures on the outcomes of alveolar cleft bone grafting in adolescents. Methods: A retrospective analysis was conducted on 110 patients with unilateral complete alveolar cleft who underwent cancellous iliac bone grafting at the Affiliated Stomatology Hospital of Nanchang University. The patients were divided into four groups based on the cleft management measures adopted: preoperative orthodontics group, preoperative extraction group, intraoperative extraction group, and no intervention group. Cone-beam computed tomography (CBCT) was collected both preoperatively and at least 3 months postoperatively. The postoperative osteogenesis outcomes were evaluated using the Padwa three-dimensional assessment scale, and the postoperative wound dehiscence rate and infection rate were compared among the groups. Results: The clinical success rates of the preoperative orthodontics group, preoperative extraction group, intraoperative extraction group, and no intervention group were 97.2%, 86.4%, 90.5%, and 90.3%, respectively. There was no statistically significant difference among the four groups (P=0.438). The intraoperative extraction group had higher postoperative wound dehiscence rate (P=0.237) and infection rate (P=0.482) compared with the other three groups. Only 36.8% of the cases in this group achieved Class Ⅰ surgical outcomes, which was lower than that of the other three groups (P=0.303). Conclusion: Preoperative orthodontics and preoperative extraction are effective cleft management measures for alveolar cleft bone grafting in adolescents. Performing extraction during the bone grafting surgery may have a negative impact on the clinical outcomes.

Objective: To investigate the effects of leukocyte-platelet-rich fibrin (L-PRF) on postoperative pain, swelling, and soft tissue healing following extraction of mandibular third molars with varying difficulty levels. Methods: This retrospective study analyzed 146 consecutive cases of mandibular third molar extraction performed at our institution between November 2021 and October 2022. Patients were stratified into two groups based on surgical records: the PRF group (receiving L-PRF placement in the extraction socket) and the control group (undergoing natural healing without biomaterial intervention). Comparative assessments of postoperative pain, swelling, and soft tissue healing parameters were conducted between the groups. Results: The PRF group exhibited statistically significant reductions in both pain and swelling scores at postoperative days 1, 2, and 3 compared to the control group (P<0.05). Furthermore, the PRF group demonstrated superior soft tissue healing outcomes at day 7 postoperatively, as evidenced by significantly lower healing index scores (P<0.01). These therapeutic advantages were particularly pronounced in cases of moderate surgical difficulty (P<0.05). Conclusion: L-PRF application yields optimal clinical benefits in moderately difficult mandibular third molar extractions, demonstrating significant efficacy in mitigating postoperative pain and swelling while promoting enhanced soft tissue healing.

Objective: To detect the expression pattern of inflammatory markers in the epithelium and stroma of the patients with oral mucosal diseases. Methods: Sixty patients, with 20 cases of oral bullous diseases (OBDs), 20 cases of oral lichen planus (OLP), and 20 cases of oral leukoplakia (OLK), from December 2020 to December 2024, were enrolled in present study. Immunohistochemical (IHC) staining was performed to assess the expressions of angiotensin-converting enzyme 2 (ACE2), transmembrane protease serine 2 (TMPRSS2), interleukin-1β (IL-1β), and complement C3 (Complement 3, C3) in oral mucosal tissues and cells. The epithelial-stromals expression characteristics and their clinical significance were analyzed. Results: IHC for OBDs, OLP, and OLK tissues results revealed that ACE2 expressed mainly in the cellular membranes of the epithelial stratum spinosum and basale, while weakly in the stromal cells (P<0.01). TMPRSS2 expressed widely in the whole epithelial layers, particularly in glandular ductal epithelium, while weakly in the stromal cells (P<0.01). The expressions of IL-1β and C3 in the epithelium and stroma of OLK were significantly higher than those of OLP (P<0.01). Conclusion: ACE2 and TMPRSS2 primarily participate in maintaining the basic functions of the oral mucosal epithelial barrier and do not exhibit specificity in the inflammatory pathological changes of OBDs, OLP, and OLK. Compared to OBDs and OLP, IL-1β and C3 are more suitable for assessing the inflammatory status of the epithelium and stroma in OLK tissues.

Objective: To clarify the application value of direct microscopy using fluorescence staining method in oral candidal infection. Methods: Two hundred and sixty-three patients suspected of oral candidiasis were included for fungal culture, fluorescence staining direct microscopy, and potassium hydroxide (KOH) microscopy examination. Results: The sensitivity, specificity, the positive predictive value, and the negative predictive value of direct microscopy using fungal fluorescence staining of 263 samples were 61.73%, 96.15%, 87.72%, and 84.95%, respectively. While the sensitivity, specificity, the positive predictive value, and the negative predictive value of KOH microscopy were 16.67%, 96.32%, 66.67%, and 72.35%, respectively. Using fungal fluorescence staining method to examine patients with oral lichen planus and oral candidiasis, the sensitivity was found to be 35.29% and 88.46%, respectively. The sensitivity of KOH method was only 5.88% and 35%, respectively. Conclusion: The fluorescence staining direct microscopy method had high sensitivity, simple operation, and rapid results, which could provide effective laboratory support for clinical diagnosis and treatment.

Objective: To investigate the characteristics of healthcare-seeking behavior and treatment status of patients with recurrent aphthous ulcer (RAU). Methods: A field survey was conducted on 300 RAU patients seeking medical care at the Department of Stomatology, the 940th Hospital of Joint Logistics Support Force of Chinese PLA, from May 2023 to January 2025. The survey included patient classification, initial healthcare-seeking behavior, and treatment conditions. Results: The patients predominantly chose primary healthcare institutions for their first visit, and this choice was significantly influenced by their place of residence and ABC classification (P<0.0001). In terms of treatment approaches, top-tier specialty hospitals typically adopt more standardized treatment protocols based on RAU ABC classification, whereas primary healthcare institutions employ diverse treatment methods, with a risk of antibiotic misuse. Furthermore, the study revealed the significant impact of ABC classification on treatment strategies (P=0.007). Conclusion: The healthcare-seeking behavior of RAU patients is significantly influenced by residence and ABC classification. Primary healthcare institutions play an important role in the diagnosis and treatment of RAU, but lack sufficient treatment standardization, with widespread inappropriate antibiotic use. It is recommended to strengthen standardized training on RAU diagnosis and treatment in primary healthcare institutions and establish a regional referral mechanism to improve treatment quality and patient medication safety.

Objective: To conduct a comparative study on the mechanical properties of novel ultrafine nickel-titanium rectangular wires and conventional nickel-titanium (NiTi) round wires under simulated oral temperature conditions. Methods: Three types of novel ultrafine NiTi rectangular wires (OO, Size 1: 0.006×0.025 inches; Size 2: 0.008 × 0.023 inches; Size 3: 0.010×0.022 inches) and five ultrafine NiTi round wires Diameter of (0.012-0.016 inches) from four brands (3M, PT, XY, LS) were selected. A three-point bending test was performed using an universal testing machine at 37 ℃ water bath conditions to evaluate differences in mechanical properties, including average unloading force, platform length, and stress hysteresis values. Results: The OO size 1 rectangular archwire exhibited the lowest mean unloading force (0.40±0.02 N), which was significantly lower than that of all other brands of NiTi round wires (3M, PT, XY, LS; P<0.0001). The stress hysteresis values increased with increasing archwire dimensions in OO rectangular wires, but remained lower than those of superelastic/heat-activated round wires from other brands. Conclusion: Novel ultrafine NiTi rectangular wires provide clinically equivalent light and stable orthodontic forces, comparable to those of conventional NiTi round wires, while enabling early torque control. Their application in initial alignment phases may reduce the frequency of wire changes and lower treatment costs compared to conventional round wire protocols.

Objective: To investigate the effect of ursolic acid (UA) on bone remodeling in orthodontic tooth movement model rats by modulating Hedgehog signaling pathway. Methods: A rat model of orthodontic tooth movement was constructed, and the successfully modeled rats were assigned into model group, L-UA, M-UA, H-UA groups (15, 30, 60 mg/kg UA by gavage), and H-UA+Cyclopamine group (60 mg/kg UA by gavage+15 mg/kg Hedgehog signaling pathway inhibitor Cyclopamine by intraperitoneal injection), each with 10 rats. Another 10 normal rats were designated as Control group. The Control group and the model group were given an equal amount of physiological saline once a day for 28 consecutive days. A vernier caliper was used to measure the distance of orthodontic tooth movement in rats. HE staining was used to observe the bone remodeling of periodontal tissue. TRAP staining was used to observe osteoclasts in rat periodontal tissue. Immunohistochemistry was applied to test the expression intensity of bone morphogenetic protein-2 (BMP-2) in periodontal tissue. Western blot was applied to test changes of Shh, Ptch-1, and Gli-1 proteins in rat periodontal tissue. Results: For the Control group, the model group showed loss of normal maxillary structure in rat tissue, widened tension side periodontal ligament, and active alveolar bone remodeling (P<0.05). For the model group, the L-UA group, M-UA group, and H-UA group showed a growth in new bone formation on the tension side of the maxilla in rats, and a gradual reduction in bone resorption cavities in a dose-dependent manner (P<0.05). For the H-UA group, the H-UA+Cyclopamine group had a narrower periodontal gap on the pressure side of the maxilla, with obvious resorption pits on the surface of the dental bone (P<0.05). For the Control group, the model group showed an increase in the number of osteoclasts in the periodontal tissue, an increase in orthodontic tooth movement distance, an increase in BMP-2 intensity in the periodontal tissue, and a downregulation of Shh, Ptch-1, and Gli-1 proteins (P<0.05). For the model group, the L-UA group, M-UA group, and H-UA group showed a decrease in the number of osteoclasts in rat periodontal tissue, a growth in orthodontic tooth movement distance, BMP-2 intensity, Shh, Ptch-1, and Gli-1 proteins in periodontal tissue (P<0.05). For the H-UA group, the H-UA+Cyclopamine group showed a growth in the number of osteoclasts in periodontal tissue, a reduction in orthodontic tooth movement distance, BMP-2 intensity, Shh, Ptch-1, and Gli-1 proteins in periodontal tissue (P<0.05). Conclusion: UA can promote bone remodeling in orthodontic tooth movement model rats by activating the Hedgehog signaling pathway.

Preformed metal crowns are commonly used for restoration following endodontic treatment in deciduous or mixed dentition. However, these crowns suffer from poor aesthetics, hypersensitivity, and inadequate fit to dental tissues. These issues have been addressed by integrating digital technology with polyetheretherketone (PEEK), a novel material. This case report details a fully digital workflow to produce personalized PEEK prefabricated crowns for deciduous teeth using intraoral scanning, dental CAD software, and a PEEK cutting machine. This approach offers a new method for restoring dental defects in pediatric patients.

Postherpetic neuralgia (PHN) is often secondary to an acute attack of herpes zoster. Inflammation and edema appear in the virus-infected neural canal, compressing the nerves and causing pain. When the herpesvirus infects the second or third branch of the trigeminal nerve, the mucosa in the innervated area may experience unilateral pain or dysodynia for several days, or pain in multiple teeth in a quadrant may also occur. The symptoms are similar to pulpitis pain. Sometimes patients experience severe unilateral pain without developing a rash, which increases the difficulty of clinical diagnosis. This paper reports the diagnosis and treatment of a patient with toothache caused by postherpetic neuralgia. The etiology, clinical manifestations, diagnosis, and treatment were discussed.

Pedunculated odontogenic tumor (POT) is a rare benign tumor that is easily misdiagnosed clinically. In this paper, we reported a case of mandibular swelling as the first symptom, initially diagnosed as ameloblastic fibroma (AF), and then recurred and finally diagnosed as POT. The clinicopathological features of the tumor were discussed in relation to the reasons for recurrence, with a view to providing reference for the clinical diagnosis and treatment of POT in oral and maxillofacial surgery.

This case report systematically documents the examination, diagnosis, and treatment of an adult patient presenting with skeletal Class Ⅲ malocclusion accompanied by posterior crossbite. To address the three-dimensional skeletal and dental discrepancies, in accordance with the patient's chief complaints, a sequential treatment approach was adopted involving micro-implant-assisted maxillary expansion, micro-implant-assisted mandibular dentition distalization, and straight-wire appliance technique. Post-treatment evaluation revealed significant improvements in dental alignment, occlusal relationship, facial profile, and periodontal health.