Objective To explore the efficacy of a novel injectable hydrogel (GelMA/P11/IL4@LIP) loaded with P11 bacteriophages and interleukin-4 (IL-4) liposomes (LIP) in preventing relapse after maxillary expansion in mice, providing experimental evidence for its clinical application. Methods This study was approved by the experimental animal ethics committee of our hospital. First, 15 7-week-old C57BL/6 mice were used to establish a maxillary expansion model and divided into 5 groups (3 mice in each group): a control group, post expansion day 3 group (PED3 group), post expansion day 7 group (PED7 group), retention for 14 days group (RET group), and relapse for 7 days group (REL group). The mice in each group were sacrificed at their designated time points (day 0, 3, 7, 21, 28), and their maxilla and anterior cranial regions were collected. Bone parameters and the inter-crestal distance (ICD) of maxillary incisor mesial alveolar ridge were measured using micro-computed tomography (micro-CT). Histological staining was performed to evaluate bone formation and resorption, while immunohistochemistry (IHC) was performed for macrophage markers (CD86 and CD206), mesenchymal stem cell markers (glioma-associated oncogene homolog 1 [Gli1]), and osteogenic markers (Runt-related transcription factor 2 [Runx2] and Osterix [OSX]). Next, GelMA/P11/IL4@LIP was synthesized and administered to mouse models of maxillary expansion. A total of 24 7-week-old C57BL/6 mice were divided into 4 groups (6 mice in each group): a blank control group, GelMA group, GelMA/P11 group, and GelMA/P11/IL4@LIP group. All mice underwent palatal expansion. On PED7, the expanders of all 24 mice were cemented with resin to initiate the 14-day retention period. On day 1 of the retention phase, the mice in each group received injections of saline, GelMA, GelMA/P11, or GelMA/P11/IL4@LIP at the midpalatal suture. After the 14-day retention period, three mice in each group were randomly selected and sacrificed, while the other three had their expanders removed and underwent a 7-day relapse before being sacrificed on day 28 (REL). Micro-CT, histological staining, and IHC were performed to evaluate the preventive effect of GelMA/P11/IL4@LIP on post-expansion relapse. Results The mice maxillary expansion model exhibited a decreased ICD at REL compared to RET in micro-CT analysis (P = 0.008). IHC analysis demonstrated prolonged M1 macrophage infiltration, scarce Gli1⁺ mesenchymal stem cells, and insufficient expression of osteogenic markers (RUNX2 and OSX) (P < 0.001). Compared to the blank control and GelMA groups, GelMA/P11/IL4@LIP hydrogel injection in the midpalatal suture led to increased ICD at REL, promoted the timely M2 polarization of macrophages, recruited Gli1⁺ mesenchymal stem cells, and upregulated the expression of RUNX2 and OSX (P < 0.05). Conclusion The mechanism of relapse after maxillary expansion involves the persistent infiltration of M1 macrophages, as well as the inadequate recruitment and insufficient osteogenic differentiation of MSCs in the midpalatal suture. The GelMA/P11/IL4@LIP composite enhanced orofacial mesenchymal stem cell recruitment and promoted the M2 polarization of macrophages, thereby enhancing osteogenesis in the midpalatal suture and preventing post-expansion relapse.

Objective To explore the effects of microwave radiation on cognitive function and neuroinflammation in mice with experimental periodontitis, providing experimental evidence for understanding how environmental exposure may be linked to the risk of neurodegenerative diseases by modulating chronic inflammation as a shared pathological mechanism. Methods This study was approved by the Animal Ethics Committee of the Academy of Military Medical Sciences. C57BL/6J mice were randomly divided into a control group (C group, untreated), a microwave radiation group (R group, exposed to microwave radiation only), a periodontitis group (P group, ligation-induced periodontitis only), and a periodontitis + microwave radiation group (PR group, ligation-induced periodontitis plus microwave radiation exposure). A periodontitis model was established using the silk ligation method. Eight weeks after modeling, the R and PR groups were subjected to whole-body microwave radiation at 2 800 MHz and 10 mW/cm² for 10 h/day for 7 consecutive days. Behavioral tests were conducted: the open field test and elevated plus maze test were used to assess anxiety-like behavior, the Y-maze test to evaluate spatial memory, and the novel object recognition test to assess learning and memory abilities. Micro-CT, hematoxylin & eosin staining (HE), and quantitative real-time polymerase chain reaction (qPCR) were used to analyze periodontal tissue pathology and local inflammation. Serum and brain levels of lipopolysaccharide (LPS), interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were measured using enzyme-linked immunosorbent assay (ELISA). The composition of the oral microbiota was analyzed based on 16S rRNA sequencing. Results Behavioral tests showed that anxiety-like behavior was significantly exacerbated in the R and PR groups, and spatial and recognition memory impairments in the PR and P groups were more severe compared with the R and C groups, respectively (P < 0.05). Histological and molecular biological analyses revealed that periodontal inflammation infiltration, alveolar bone resorption, and local expression of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) were further exacerbated in the PR and P groups compared with the R and C groups, respectively (P < 0.05). ELISA results showed that in serum, LPS levels in group P and group PR were increased compared with group C and group R, respectively. The levels of TNF-α, IL-1β, and IL-6 in group PR were significantly higher than those in group P and group R, with a synergistic increase in TNF-α level (P < 0.05). In brain tissue, LPS and TNF-α, IL-1β, IL-6 levels in group P were significantly higher than those in group C; all the above indicators in group PR were significantly higher than those in group P and group R, and LPS and IL-6 levels showed a synergistic increase (P < 0.05). Oral microbiota analysis found that microwave radiation further reduced microbial diversity on the basis of periodontitis, leading to increased relative abundances of Lactobacillus and Enterococcus, and decreased relative abundances of Staphylococcus. Correlation analysis confirmed that these differential bacterial genera were positively correlated with brain inflammation levels and negatively correlated with cognitive function indicators. Conclusion Microwave radiation exposure can exacerbate cognitive impairment in mice with experimental periodontitis, and its mechanism may be related to aggravated local periodontal damage, disruption of oral microbiota homeostasis, and subsequent induction of systemic and central neuroinflammatory cascades.

Objective To investigate the influence of sinus morphology on the safety of hydraulic sinus floor elevation surgery and provide a biomechanical basis for clinical treatment. Methods After approval by the Medical Ethics Committee of the institution, cone beam computed tomography imaging data from nine patients were collected. The sinus morphologies were classified into slope, flat and concave types. Three-dimensional finite element models of maxillary sinuses with the aforementioned morphologies were constructed using Mimics, Geomagic, Solidworks, and ANSYS software, followed by a simulation of the hydraulic elevation process. The sinus membrane elevation height was set at 1-6 mm. The pressure required for elevation and the equivalent, compressive, tensile, and shear stresses generated on the sinus membrane were recorded and analyzed. The equivalent stress distribution on the sinus membrane was visualized using contour plots. Results The elevation pressure and the equivalent, compressive, tensile, and shear stresses generated on the sinus membrane increased along with the elevation height. When the sinus membrane was lifted to 6 mm, the elevation pressure was (301.17 ± 98.1) kPa, (151.85 ± 3.7) kPa, and (149.36 ± 10.31) kPa in the slope, flat and concave finite element analysis models, respectively. The equivalent stress was (1 023.86 ± 201.99) kPa in the slope sinuses, comparing with (687.91 ± 69.08) kPa and (698.27 ± 96.09) kPa in the flat and concave sinuses. Higher elevation pressure and the equivalent stress, compressive stress and shear stress values were found in the slope sinus than in the flat and concave sinuses under the same elevation height (P < 0.05). Stress distribution analysis revealed that stress was uniformly distributed in the flat sinuses, followed by concave sinuses, but asymmetrically distributed in the slope sinuses. Conclusions The slope sinuses demonstrated inferior safety and efficiency compared with the flat and concave sinuses when performing hydraulic sinus floor elevation surgery.

Objective To explore the feasibility, precision, and clinical value of a personalized primary repair approach centered on digital design, integrating 3D printing technology with multiple materials such as titanium mesh, polyetheretherketone (PEEK), and titanium plates, for complex craniofacial bone defects involving the skull, mandible, orbit, and zygoma resulting from traffic accidents, providing a reference for primary repair of clinically complex craniofacial bone defects. Methods One patient who was admitted in September 2021 with multiple comminuted fractures of the right craniomaxillofacial region and large-area bone defects caused by a traffic accident was selected. Digital design was integrated throughout the entire repair process. First, preoperative computed tomography (CT) data were used for 3D reconstruction of the craniomaxillofacial region; then, based on the model, the anatomical contour of the healthy left side was reproduced via mirroring technology for the defects on the right side. A targeted repair plan was designed: 3D-printed PEEK material was used to reconstruct the right orbital floor and zygomaticomaxillary complex, a 0.6-mm-thick titanium mesh was adopted to repair the right skull defect, and a 2.0-mm-thick titanium plate was applied for rigid internal fixation of the mandibular fracture. A one-stage repair surgery was completed simultaneously. In addition, a literature review was conducted on studies related to the repair of complex combined craniomaxillofacial defects. Results CT examination at 1 week postoperatively showed that the average fitting gap of the implants was 0.3 mm, and the symmetry difference of the facial contour was less than 5 mm. At 3 months postoperatively, the patient’s maximum mouth opening reached 38 mm, the occlusal relationship returned to normal, and the diplopia symptom completely disappeared. During the 6-month postoperative follow-up, no complications such as implant loosening, infection, or displacement occurred; the FACE-Q scale score was 91, indicating a high level of subjective patient satisfaction. The literature review indicated that digital design combined with 3D printing technology can significantly improve the accuracy of complex craniomaxillofacial bone defect reconstruction. PEEK material is suitable for the reconstruction of the orbital floor and zygomaticomaxillary complex. Titanium mesh and plates can ensure the stability of the reconstruction. Multi-materials combined reconstruction represents an important therapeutic strategy for such defects. Conclusion The individualized one-stage repair scheme, centered on digital design and combined with 3D printing technology and multi-materials (titanium mesh, PEEK, and titanium plates), can achieve precise anatomical reduction and simultaneous functional recovery for complex combined craniomaxillofacial bone defects caused by traffic accidents.

Objective To investigate the clinicopathological characteristics and diagnostic-therapeutic strategies of oncocytic mucoepidermoid carcinoma (OMEC) of the parotid gland, and to enhance awareness of this rare variant among clinicians and pathologists. Methods The clinical data, imaging findings, histopathological features, immunophenotype, and molecular characteristics of two patients with parotid OMEC were retrospectively analyzed, and the relevant literature was reviewed. Results Case 1 was a 50-year-old man who presented with a painless mass behind the right earlobe for more than 2 years. The patient underwent extended parotidectomy with preservation of the facial nerve. Histopathological examination revealed that the tumor was predominantly composed of oncocytic cells with a small proportion of mucous cells. Immunohistochemically, the tumor cells were partially positive for cytokeratin 5/6, cytokeratin 7, and P63. Special staining with alcian blue, periodic acid-Schiff, and phosphotungstic acid hematoxylin yielded positive results. The diagnosis of right parotid OMEC was established. No recurrence or metastasis was observed during a 1 year follow-up. Case 2 was a 61-year-old man with a 3-month history of a mass beneath the left ear. After partial parotidectomy at an outside institution, pathological consultation at the Stomatological Hospital of Jilin University demonstrated that the tumor consisted almost entirely of oncocytic cells, exhibited infiltrative growth, and lacked typical mucous, epidermoid, and intermediate cells. Fluorescence in situ hybridization confirmed positive mastermind-like transcriptional activator 2 (MAML2) gene rearrangement, establishing the diagnosis of left parotid OMEC. The patient subsequently underwent total parotidectomy with preservation of the facial nerve, and no recurrence was detected during a short-term 3 months follow-up. A review of the literature indicated that OMEC most commonly arises in the parotid gland and is generally a low-grade malignancy with favorable prognosis. When tumors are composed exclusively of oncocytic cells, exhibit minimal cytological atypia, and lack the classical cellular components of mucoepidermoid carcinoma, they are highly prone to misdiagnosis as oncocytoma, nodular oncocytic hyperplasia, or other benign oncocytic lesions. Accurate differential diagnosis relies on recognition of infiltrative growth patterns, supportive immunophenotypic markers (e.g., P63 positivity), and detection of characteristic MAML2 gene rearrangement. Complete surgical excision remains the treatment of choice. Conclusion OMEC dominated by oncocytic cells carries a high risk of clinical misdiagnosis. Integrating the assessment of infiltrative histopathological features with immunohistochemistry and molecular detection of MAML2 rearrangement is crucial for accurate diagnosis, appropriate assessment of tumor behavior, and optimal surgical decision making.

Early caries confined to the enamel layer represent a critical window for achieving noninvasive intervention in caries management. Caries management has shifted from the traditional “drill-and-fill” model toward a modern paradigm centered on caries risk and lesion management. Based on contemporary concepts, this review systematically summarizes recent advances in early caries management, including caries risk assessment, early diagnosis, treatment strategy selection, and follow-up monitoring, while highlighting the major challenges currently being faced, and further reviewing and discussing the application of artificial intelligence (AI) in early caries management. In terms of risk management, conventional systems including the American Dental Association, Caries Management by Risk Assessment, Cariogram, and the Caries-Risk Assessment Tool remain mainstays in clinical practice. However, AI offers predictive capability through higher-dimensional data processing and the integration of numerous influencing factors, with the potential to improve the accuracy of risk stratification. For diagnosis, visual inspection, tactile examination, and bitewing radiography remain fundamental methods, yet their sensitivity for early caries—particularly proximal lesions—is limited. The application of optical technologies, including quantitative light-induced fluorescence, optical coherence tomography, near-infrared light transillumination, fiber-optic transillumination, and laser-induced fluorescence, enables digital characterization of caries lesions, providing a data foundation for demineralization assessment, lesion activity evaluation, and AI model development. The management of early caries primarily relies on noninvasive and minimally invasive approaches. Remineralization therapy is suitable for superficial lesions, resin infiltration offers the dual advantages of inhibiting lesion progression and improving aesthetics, and microabrasion and bleaching may serve as adjunctive aesthetic treatments. Emerging modalities such as laser, ozone, and photodynamic therapy have also demonstrated potential. Treatment decision-making should comprehensively consider lesion activity, patient caries risk status, demineralization depth, patient compliance, and treatment preferences. However, precise quantification of demineralization depth remains challenging, and standardized decision-making criteria are still lacking. Follow-up management should be individualized based on risk stratification, with attention to lesion changes, patient compliance, and the risk of recurrence. In summary, intelligent and precision-based approaches are expected to define the future of early caries management, and the application of AI in risk prediction, image analysis, and clinical decision support is anticipated to further enhance the efficiency and effectiveness of early caries diagnosis and treatment.

Piezo1 is a Ca²⁺-permeable mechanosensitive ion channel that plays a central role in mechanosensing and signal transduction in dental and periodontal tissues. In tooth tissue, Piezo1 is a key factor mediating dentin sensitive pain. The flow of dentinal tubule fluid induced by external stimulation can activate the Piezo1 channel on odontoblasts, triggering neuronal signals through the pannexin-1-purinergic 2X3 receptor (PANX-1-P2X3) receptor axis, resulting in pain perception. In addition, Piezo1 has a dual regulatory role in the process of pulp inflammation and repair : on the one hand, its expression is up-regulated in an inflammatory environment, which may aggravate pain sensitivity ; on the other hand, it activates the migration, proliferation and odontogenic differentiation of dental pulp stem cells by mediating Ca²⁺influx, ATP release and downstream purinergic 2X7 receptor (P2X7R), MEK / ERK signaling pathways, thereby promoting reparative dentin formation. In periodontal tissue, Piezo1 plays a central role in maintaining periodontal tissue homeostasis and regulating alveolar bone remodeling by sensing mechanical stimuli such as bite force. During orthodontic tooth movement, Piezo1 promotes osteogenic differentiation by activating Wnt / Ca²⁺, Notch and other pathways on the tension side. It affects osteoclast activity by regulating receptor activator of nuclear factor-κB ligand/osteoprotegerin (RANKL/OPG) balance on the pressure side. At the same time, Piezo1 is also a key regulator of periodontal immune microenvironment. It is expressed in immune cells such as macrophages, neutrophils and dendritic cells. Its activation can promote the polarization of macrophages to pro-inflammatory M1 type, enhance the release of pro-inflammatory factors and matrix metalloproteinases, and thus aggravate the inflammatory destruction of periodontal tissue.In view of its multiple functions, Piezo1 has become a potential therapeutic target, including local or systemic application of its inhibitors, mechanical intervention, physical therapy, gene therapy and stem cell therapy, showing a broad clinical transformation prospect in the treatment of oral diseases. In this paper, the structural characteristics, signal transduction mechanism of Piezo1 and its expression distribution, function and regulatory network in tooth tissue and periodontal tissue are reviewed, so as to provide ideas for the development of oral disease treatment strategies targeting Piezo1.

This paper systematically elaborates on the key points of diagnosis and differential diagnosis of salivary gland tumors characterized by a substantial amount of extracellular mucus as a main or prominent feature, and clarifies the core differential features. The term "mucus-rich" specifically denotes that mucus is a major component of the tumor, rather than a focal or minor one. This phenomenon is associated with distinct histogenetic mechanisms: it may result from specific genetic mutations (e.g., AKT1 E17K in mucinous adenocarcinoma) that drive ductal epithelial differentiation into mucus-secreting cells, or from myoepithelial cells secreting glycosaminoglycans that form a myxoid stroma. Salivary gland tumors with abundant extracellular mucus include mucinous cystadenoma, sialadenoma papilliferum-like intraductal papillary tumors, mucinous myoepithelioma, pleomorphic adenoma with mucin-rich stroma, mucinous adenocarcinoma, low-grade mucoepidermoid carcinoma, mucin-rich salivary duct carcinoma and intestinal-type adenocarcinoma. The diagnosis of these tumors is complicated by the dual nature of extracellular mucus: while it is a defining feature of some entities, it can also obscure key diagnostic architectural features in others, leading to histological overlap and inconspicuous diagnostic areas. Given the frequent histological morphological overlap among these tumors, immunohistochemical findings and molecular characteristics have emerged as crucial differential diagnostic criteria. Core differential diagnostic points include the following: histologically, there must be meticulous identification of typical structures obscured by mucin (such as squamoid cells in mucoepidermoid carcinoma and apocrine features in salivary duct carcinoma); in immunohistochemical staining, CK20 is useful for distinguishing intestinal-type adenocarcinoma (positive) from mucinous adenocarcinoma (negative), while androgen receptor aids in differentiating salivary duct carcinoma (positive) from mucoepidermoid carcinoma (negative); and molecular testing plays a critical role in definitive diagnosis (e.g., the AKT1 E17K mutation for mucinous adenocarcinoma, MAML2 rearrangement for mucoepidermoid carcinoma, and MEF2C::SS18 fusion for microsecretory adenocarcinoma). This paper systematically summarizes the core pathological features and differential diagnostic points of mucin-rich salivary gland tumors, aiming to provide a practical reference for clinical pathological diagnosis.

With the rapid development of computer science, the application of artificial intelligence (AI) in the field of medical imaging has become increasingly extensive. The temporomandibular joint (TMJ) is structurally complex, with a high incidence of related disorders and diverse clinical manifestations. This review analyzes the current state of research on AI in TMJ imaging diagnosis. Deep learning models based on U-Net and its derivatives have demonstrated outstanding performance in segmentation of condyle and articular disc. Various object detection and feature extraction algorithms have shown excellent diagnostic efficacy for common conditions, such as osteoarthrosis and disc displacement, with some models even achieving expert-level performance on test datasets. Meanwhile, explainable AI provides intuitive justification for model decisions through techniques such as heatmap visualization. Notably, current studies still face critical challenges, including coverage of disease spectra, integration of multimodal data, and model generalizability. Future studies should focus on developing integrated systems that combine diagnosis, segmentation, generation, and interpretation functions. Through multicenter data validation and algorithmic optimization, these efforts will enhance the clinical applicability and decision transparency of models, ultimately laying the foundation for precise imaging diagnosis and intelligent management of TMJ disorders.