Patients with periodontitis face significantly increased risks of implant failure and peri-implantitis. These adverse outcomes are mainly associated with the enrichment of periodontal pathogens and microbial dysbiosis, host immune imbalance, smoking, and poor adherence to supportive periodontal therapy. In addition, complex hard- and soft-tissue defects and occlusal trauma caused by periodontitis further increase the complexity and long-term uncertainty of implant therapy. Therefore, implant treatment in patients with periodontitis should adopt a systematic management strategy centered on “inflammation control, functional reconstruction, and long-term maintenance.” On the premise of periodontal inflammation control and stable maintenance, clinicians should comprehensively evaluate the remaining dentition, hard-tissue and soft-tissue defects, dental implant surgical plan, prosthetic modality, and occlusal load. When necessary, hard-tissue and soft-tissue augmentation procedures should be performed to reconstruct a stable tissue foundation. Digital technologies should also be integrated to coordinate the three-dimensional implant position, tissue support, and biomechanical load distribution, thereby achieving stable functional and esthetic rehabilitation. Further, risk stratification, plaque control, host inflammatory modulation, supportive periodontal therapy, and behavioral interventions should be reinforced to improve the long-term stability and predictability of implant rehabilitation. In the future, the integration of multi-omics technologies, artificial intelligence-based risk prediction, digital-intelligent implant workflows, and novel regenerative materials may further promote individualized precision therapy.

Objective To investigate changes in lactate and histone lactylation during senescence of mouse bone marrow mesenchymal stem cells (BMSCs), to clarify the effects of regulating lactate metabolism on the osteogenic differentiation of senescent BMSCs, and to provide theoretical evidence and an experimental basis for metabolic regulatory interventions in aging-related osteoporosis and impaired bone repair. Methods Approval was obtained from the Institutional Laboratory Animal Ethics Committee. BMSCs were isolated using the whole bone marrow adherence method and surface markers (CD29, CD90, CD11b and CD45) and identified by flow cytometry. A cellular model of BMSCs senescence was established using different concentrations of etoposide (0, 5, 10, 15, and 20 μmol/L). The gene and protein expression levels of senescence-related markers, namely, p53, p21, and p16, were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blot analysis, and the optimal induction concentration was determined using CCK-8 and SA-β-gal assays. BMSCs were divided into a control group and an etoposide-induced senescence group to examine lactate production and the expression of histone lactylation-related enzymes, including Ldha, Ep300, and Sirt2. Western blot analysis was used to analyze pan-lysine lactylation（Pan-Kla） and histone H3 lysine 18 lactylation （H3K18la). During the lactate production inhibition experiments, BMSCs were divided into three groups: control, senescence group (treated with 10 μmol/L etoposide), and senescence+ GNE-140 group (treated with 10 μmol/L etoposide and 1 μmol/L GNE-140). qRT-PCR, Western blot, and SA-β-gal staining were performed to assess the effects of lactate production inhibition on cellular senescence phenotypes. During osteogenic differentiation, BMSCs were assigned to a control group, senescence group (treated with 10 μmol/L etoposide), senescence+ 5 mmol/L sodium lactate group, and senescence+ 10 mmol/L sodium lactate group. The levels of Pan-Kla and H3K18la were detected by Western blot. The mRNA expressions of runt-related transcription factor 2 (Runx2), transcription factor Sp7 (Sp7) and alkaline phosphatase (Alpl) were detected by qRT-PCR. The protein expressions of collagen type I (COL1), RUNX2, osterix (OSX) and osteocalcin (OCN) were detected by Western blot, and mineralized nodule formation was observed by Alizarin Red S staining. Results Flow cytometry analysis indicated that the isolated BMSCs highly expressed CD29 (97.3%) and CD90 (95.7%). Etoposide induced BMSC senescence by activating the p53-p21 signaling pathway, with an optimal concentration of 10 μmol/L. Compared with the control group, BMSCs exhibited decreased lactate production, reduced mRNA expression of Ldha and Ep300 (P<0.001), upregulated Sirt2 expression (P<0.01), and diminished levels of Pan-Kla and H3K18la modification (P<0.001). Further inhibition of lactate production with GNE 140 further increased the expression levels of p53 and p21 and the percentage of SA β gal positive cells (P<0.01). In osteogenic differentiation experiments, the expression levels of Runx2, Sp7, Alpl mRNA and COL1, RUNX2, OSX, OCN proteins, as well as the mineralized nodule formation ability of senescent BMSCs, were decreased (P<0.05); exogenous supplementation with 5 mmol/L and 10 mmol/L sodium lactate can increase the levels of panolactic lactation and histone lactation, and improved the osteogenic differentiation capacity and mineralized nodule formation of senescent BMSCs. Conclusion BMSC senescence is associated with reduced lactate production and decreased histone lactylation levels. Exogenous supplementation with sodium lactate partially rescues osteogenic differentiation impairment in senescent BMSCs.

Objective To investigate the therapeutic effect of a dual-network hydrogel-microneedle (MN) on inhibiting oral squamous cell carcinoma (OSCC) recurrence and promoting tissue repair, thereby providing a foundation for the clinical treatment of OSCC. Methods A Schiff base hydrogelformed between chitosan (CS) and poly(ethylene glycol) dibenzaldehyde (PEG-CHO), combined witha coordination-crosslinked hydrogel formed between sodium alginate (SA) and Cu²⁺, were jointly integrated to form the CS/PEG-CHO/SA/Cu²⁺ (CPSC) dual-network hydrogel base. The hydrogel formulation was optimized based on characterization by scanning electron microscopy, Fourier transform infrared spectroscopy, rheology, and swelling tests. Subsequently, 5-fluorouracil (5-FU) and gold nanorod (GNR) were incorporated into the CPSC hydrogel to fabricate an MN loaded with 5-FU/GNR (FG). The mechanical strength and dissolution behavior of FG MNs were characterized, and their photothermal performance was evaluated under near-infrared (NIR) irradiation using thermal imaging. The mouse fibroblast cell line L929 cells and the human oral mucosal epithelial-derived cell line GMSM-K cells were co-cultured with FG MNs for 2 and 4 days, respectively, and cell viability was assessed by the Cell Counting Kit-8 (CCK-8) assay and dead/live staining. Separately, the human tongue OSCC cell line Cal-27 cells were divided into four groups: a control group (cultured in complete medium), 5-FU MN group (co-cultured with 5-FU-loaded MNs), GNR MN+ NIR group (co-cultured with GNR-loaded MNs followed by NIR irradiation at 0.4 W/cm² for 5 min), and FG MN+ NIR group (co-cultured with FG MNs followed by identical NIR irradiation). After 24 and 48 h of co-culture, Cal-27 cell viability was assessed using both CCK-8 assay and dead/live staining. All animal experiments were approved by the Institutional Animal Ethics Committee. A subcutaneous Cal-27-derived OSCC postoperative recurrence model was established in BALB/c nude mice. The mice were divided into four groups: a control group, 5-FU MN group, GNR MN+ NIR group, and FG MN+ NIR group. Mice in the control group received no intervention, while the other groups were treated with the corresponding MN patches. Additionally, the GNR MN+ NIR and FG MN+ NIR groups received NIR irradiation (0.4 W/cm², 5 min). Tumors were excised and their volumes measured on day 7, and tumor recurrence and wound healing were assessed on day 14. Results A dual-network hydrogel-MN was successfully constructed, demonstrating favorable mechanical and dissolution properties. Upon NIR irradiation for 5 min, the temperature rapidly increased to 48.4°C, reaching the threshold for effective tumor ablation. CCK-8 and dead/live staining results showed that FG MNs exhibited no cytotoxicity toward L929 and GMSM-K cells, indicating good cytocompatibility. However, Cal-27 cell viability in the chemotherapy-photothermal combination group was lower than that in the other three groups, with a statistical difference (P<0.0001). In the nude mouse model, subcutaneous Cal-27 tumors were resected 7 days post-implantation. No statistical difference in tumor volume was observed among groups at this timepoint, confirming successful model establishment. By postoperative day 14, the control group displayed complete tumor recurrence with unhealed wounds, while the 5-FU and GNR MN+ NIR groups showed mild recurrence and partial wound healing. The FG MN+ NIR group demonstrated superior efficacy in both inhibiting tumor recurrence and promoting tissue repair compared with all other groups, with a statistical difference (P<0.0001). Conclusion The dual-network hydrogel-MN system effectively suppresses postoperative recurrence of Cal-27-derived subcutaneous OSCC and promotes tissue repair through chemo-photothermal combined therapy.

Objective To investigate the effects of grain size and immersion dyeing time on the dye penetration depth and color parameters of zirconia, and analyze the dyeing behavior in relation to the material's pore characteristics to provide experimental evidence for developing personalized immersion staining protocols for clinical applications targeting zirconia with different microstructures. Methods A total of 135 pre-sintered zirconia specimens with three different grain sizes were fabricated using computer aided design/manufacturing technology and divided into three groups (S1, S2, S3; n=45). Randomly select 6 specimens from each group, among which 3 zirconia pre sintered specimens are soaked in 10 mL A2 staining solution for 60 s, dried and sintered, and the other 3 are not treated. Observe the microstructure of the outer surface and bonding surface of the specimen under SEM, and use Image J software to count and measure the grain size. From each group, three randomly selected specimens were subjected to mercury intrusion porosimetry to analyze porosity and pore size distribution. For the remaining specimens, the bottom surface (10 × 10 mm) was designated as the staining surface and immersed in 10 mL of A2 staining liquid. The remaining specimens were stained at six time gradients (10, 20, 30, 60, 90, 120 s). After staining, half of the specimens were sectioned perpendicular to the stained surface and fully sintered to measure the staining penetration depth. The other half were directly fully sintered. A spectrophotometer was used to measure the color parameters (L*, a*, b*) of the stained surface, and the color difference (ΔE₀₀) relative to a standard A2 shade tab was calculated. Results The average grain sizes (G) for the three groups were G_S1=(221.64±62.16) nm, G_S2=(197.80±46.72) nm, and G_S3=(150.21±42.11) nm; the average porosities (P) were P_S1=37.82%, P_S2=46.02%, and P_S3=47.36%. Both grain size and staining time significantly affected the staining outcome of zirconia (P<0.001), with a significant interaction effect (P<0.001). Staining penetration depth increased with prolonged staining time and decreased grain size (P<0.001). All fully sintered specimens exhibited a perceptible color difference (ΔE₀₀>0.8) compared with the standard A2 shade tab (VITA, USA). Specifically, specimens from group S1 stained for 20 s, group S2 stained for 60 s, and group S3 stained for 10 s exhibited color differences below the clinically acceptable threshold (ΔE₀₀<1.8), meeting clinical thickness requirements. Specimens stained for other time intervals exceeded the clinically acceptable color difference threshold (ΔE₀₀>1.8). Conclusion The porosity of pre-sintered zirconia with different grain sizes varied. Higher porosity correlated with deeper staining penetration. The staining time required to achieve the standard A2 shade differed among zirconia materials with different grain sizes. In clinical applications, the immersion dyeing protocol for zirconia should be optimized based on the grain size and pore characteristics of zirconia with different grain sizes, so as to avoid color deviations caused by improper dyeing time.

Objective To investigate the effect of different pre-stretching on the force degradation of elastomeric chains methods and provide experimental evidence for its application in clinical orthodontic treatment. Methods One control group (no pre-stretched treatment) and 15 experimental groups (pre-stretched to 25%, 50%, and 100% of the original length in 1-5 cycles) were set up by taking five loop lengths of short elastomeric chain and long elastomeric chain samples, respectively. The elastomeric chains from both the control and experimental groups were mounted on the testing fixture at identical initial lengths. To simulate tooth movement, the fixation device was adjusted to reduce the distance by 0.35 mm weekly. The remaining force of each group was measured at different time points over a 4-week period. Further, the experiment was conducted in a simulated salivary environment with additional thermal cycling. Results Pre-stretching length and cycles showed a significant interaction effect on the remaining force of elastomeric chains (P<0.001). For short elastomeric chains, the groups pre-stretched to 25% (P=0.001) and 50% (P=0.005) of the original length for 3 cycles showed significantly higher remaining force values than the control group at 24 h. At 7, 14, 21, and 28 d, the groups pre-stretched to 25%, 50%, and 100% of the original length for 3 cycles consistently maintained higher remaining force values than the control group (P<0.001). Within the groups of 3 pre-stretching cycles, no significant differences in remaining force were observed among the 50% group and the 25% (P=0.617) or 100% (P=0.229) groups at 7 d. However, at 14 d, the remaining force of the 50% group was significantly higher than that of both the 25% (P=0.003) and 100% (P=0.027) groups. At 21 d, the 50% group maintained a significantly higher remaining force compared to the 100% group (P=0.020), but the difference compared to the 25% group did not reach statistical significance (P=0.052). By 28 d, the remaining force of the 50% group remained significantly higher than that of both the 25% (P=0.003) and 100% (P=0.003) groups. For long elastomeric chains, the 50% pre-stretch (3 cycles) group showed significantly higher remaining force values than the control group at 8 h (P=0.005) and 24 h (P<0.001). Throughout the experimental period at 7, 14, 21, and 28 d, the remaining force values of the 25% (7, 14 d: P<0.001; 21 d: P=0.003; 28 d: P=0.008), 50% (P<0.001), and 100% (P<0.001) original length pre-stretching for 3 cycles groups were consistently higher than those of the control group. Within the groups of 3 pre-stretching cycles, the remaining force of the 50% original length pre-stretching for 3 cycles group was significantly higher than that of the 25% original length pre-stretching for 3 cycles group at all of the time points from 7 to 28 d (P<0.001). Although no statistically significant differences were observed between the 50% and 100% groups at 14 d (P=0.068), the 50% group exhibited significantly higher remaining force than the 100% group at 7 d (P<0.001), 21 days (P=0.005), and 28 days (P<0.001). Conclusion Appropriate pre-stretching methods can effectively delay the force degradation of the elastomeric chain. Pre-stretching to 50% original length for three cycles can maximize the delay of the force degradation of the elastomeric chain.

Objective To investigate the factors influencing follow-up visit behavior among patients with chronic periodontitis after supragingival scaling, and to provide evidence for early identification of high-risk dropouts and improvement of treatment continuity. Methods This study was approved by the Institutional Medical Ethics Committee, and written informed consent was obtained from all participants. A retrospective analysis was conducted on 572 patients with chronic periodontitis who received supragingival scaling at the Outpatient Department of The Affiliated Stomatological Hospital of Nanjing University School of Medicine from July 2022 to July 2023 and required subsequent periodontal sequential therapy. Data regarding sex, age, monthly income, education level, oral health literacy, reason for visit, and satisfaction with care were collected. Patients were divided into a follow-up group and a dropout group based on whether they adhered to the scheduled appointments within 12 months. Chi-square tests and independent samples t-tests were used for univariate comparisons between the groups. Variables with P<0.05 in the univariate analysis (gender, education level, monthly income, reason for visit, oral health literacy, and satisfaction with care), along with age (as a covariate), were included in a multivariate logistic regression model to analyze the factors influencing follow-up behavior. Results Among the 572 patients, 239 attended follow-up visits, while 333 dropped out, resulting in a dropout rate of 58.22%. Univariate analysis revealed statistically significant differences between the two groups in terms of gender, education level, monthly income, reason for visit, oral health literacy, and satisfaction with care (P<0.05). Multivariate logistic regression analysis showed that patients referred for treatment had significantly lower compliance (OR=0.241, 95% CI: 0.154-0.377, P<0.001). Conversely, higher oral health literacy scores (OR=1.159, 95% CI: 1.056-1.272, P=0.002) and higher satisfaction with care (OR=4.090, 95% CI: 1.732-9.656, P=0.001) were associated with better follow-up adherence. Conclusion Follow-up behavior in patients with chronic periodontitis after supragingival scaling is primarily influenced by the reason for visit, oral health literacy, and satisfaction with care. These factors can serve as intervention targets to reduce dropout rates in clinical practice.

Oral potentially malignant disorders (OPMDs) are a group of oral mucosal diseases with different morphological characteristics that have an increased risk of progressing to oral squamous cell carcinoma (OSCC). Epidemiological studies indicate that approximately 4.67% of the global population may have an OPMD, and meta-analysis results show that the risk of progression to OSCC in patients with OPMD is 2.5 times that of the general population. The progression of an OPMD to OSCC is a complex process driven by risk factors including smoking, alcohol consumption, betel quid chewing, and oral microbiota. It is characterized by intricate interactions among genetic alterations, epigenetic modifications, and dysregulation of the tumor microenvironment. At the molecular level, the intrinsic basis of epithelial carcinogenesis is established by genomic loss of heterozygosity and cascading dysregulation of critical signaling pathways, while crucial external support for malignant transformation is provided by the immunosuppressive microenvironment, including M2 macrophage polarization, immune evasion mediated by programmed death-ligand 1, and the pro-tumorigenic effects of oral microbiota. Although a variety of therapeutic modalities (e.g., pharmacotherapy, surgical treatment, and photodynamic therapy) have been employed for the prevention of OPMD malignant transformation, no universally accepted treatment has been proven to completely eradicate the risk of cancer development at present. In recent years, artificial intelligence technologies have demonstrated promising performance in predicting the malignant transformation risk of OPMD by integrating multi-dimensional clinical, pathological, and molecular data, thereby providing new decision-support tools for advancing individualized risk stratification and precise follow-up management. This review summarizes recent advances in the prevention of OPMD malignant transformation, with the aim of offering a reference for the clinical management of OPMDs.

Temporomandibular joint (TMJ) is the only synovial joint in the oral and maxillofacial region, with its disc being a critical fibrocartilaginous structure that distributes stress and maintains the stability of joint movement. Various factors can lead to TMJ disc destruction, resulting in TMJ dysfunction and facial deformities. In recent years, research on TMJ disc destruction has become a frontier in the field of oral and maxillofacial surgery. Previous research and literature reviews have mainly focused on diagnosis and treatment, with a lack of reviews on the progress of basic research related to disc destruction. This review summarizes current progress in the etiology, pathological features, molecular mechanisms, and tissue-engineered repair materials of TMJ disc destruction, providing reference for basic research and clinical prevention and treatment. Studies have shown that the causes of TMJ disc destruction include mechanical damage (e.g. anterior disc displacement, malocclusion, trauma), chronic inflammation (e.g. TMJ osteoarthritis, rheumatoid arthritis), and susceptibility factors such as age and sex, as well as psychosocial factors. Its main manifestations are alterations in the ultrastructure and mechanical properties of collagen fibers. Its molecular mechanisms include abnormal angiogenesis, imbalanced fibrocartilage cell homeostasis under mechanical or inflammatory stimulation, and abnormal stem cell differentiation. The present study focuses on the development and optimization of tissue engineered biomaterials through cell sources, scaffold materials, and growth factors. Future studies should focus on the molecular mechanisms of TMJ disc destruction, regulation of disc development during embryonic and postnatal stages, development and translation of novel biomaterials, as well as the application of artificial intelligence in material design, molecular target screening, and clinical decision-making.

Skeletal Class II malocclusion is a common dentofacial deformity in adolescents, primarily characterized by mandibular retrognathism. Functional appliance therapy during the pubertal growth spurt to guide mandibular advancement is considered the gold standard. However, traditional functional appliances are often associated with limitations such as bulkiness, poor esthetics, and soft tissue irritation, which can compromise patient compliance. With advancements in digital orthodontics, clear aligner technology integrated with mandibular advancement (clear aligner mandibular advancement, CAMA) has emerged as a novel strategy for treating adolescent skeletal Class II malocclusion, offering advantages in esthetics and comfort while significantly improving patient compliance. CAMA exhibits multidimensional clinical advantages in adolescent malocclusion correction: ① Its mechanical mechanism based on material viscoelasticity optimizes temporomandibular joint stress distribution and induces physiological condylar remodeling, microscopically manifested as increased trabecular fractal dimensions; ② While ensuring mandibular growth, it effectively controls molar eruption through the "bite block effect," providing an optimal solution for vertical control in high-angle cases, and the enhanced precision wing design significantly improves torque control of lower incisors; ③ It improves oropharyngeal airway morphology and respiratory function, benefiting patients' overall health. Although CAMA holds significant value in treating skeletal Class II malocclusion, current research remains insufficient regarding the specific proportions of skeletal versus dental effects, long-term stability of treatment outcomes, and therapeutic boundaries for severe skeletal discrepancies, with most studies being retrospective or short-term. Future research should prioritize prospective multicenter randomized controlled trials, establish personalized diagnostic and treatment systems integrating artificial intelligence-assisted design and biomechanical simulation, and comprehensively analyze multiple factors including temporomandibular joint adaptability to further enhance the clinical value of CAMA.