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25 December 2025, Volume 34 Issue 6 Previous Issue   

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The effects of hUCMSC-sEVs on osteogenic/odontogenic differentiation of hDPSCs and tube formation ability of HUVECs Kang Jingyi, Wei Rixia, Deng Huidan, Li Quanjie, Wu Yu 2025, 34 (6):  561-570.  doi: 10.19439/j.sjos.2025.06.001 Abstract ( 7 )   PDF (2345KB) ( 3 )   PURPOSE: To investigate the effects of small extracellular vesicles (sEVs) derived from human umbilical cord mesenchymal stem cells(hUCMSCs) on the migration and osteogenic/odontogenic differentiation ability of human dental pulp stem cells(hDPSCs), the migration and tube formation ability of human umbilical vein endothelial cells (HUVECs) and their possible mechanisms. METHODS: hUCMSCs, hDPSCs and HUVECs were cultured and identified, hUCMSC-sEVs and LPSpre-hUCMSC-sEVs were isolated and identified, HUVECs and hDPSCs were assigned to 4 kinds of treatments, including the negative control group(NC), the positive control group(PC), the hUCMSC-sEVs group and the LPSpre-hUCMSC-sEVs group. Cell migration ability was detected by Transwell and wound healing assays. Tube formation capacity of HUVECs was assessed by tube formation experiment. The osteogenic/odontogenic differentiation ability of hDPSCs was evaluated by alizarin red staining and RT-qPCR. High-throughput small RNA sequencing was used to define miRNA profiles in sEVs. RESULTS: hUCMSCs, hDPSCs, HUVECs, hUCMSC-sEVs and LPSpre-hUCMSC-sEVs were successfully isolated and identified. Compared with NC group, both LPSpre-hUCMSC-sEVs group and hUCMSC-sEVs group promoted migration of hDPSCs, migration and tube formation of HUVECs. There was no significant difference between LPSpre-hUCMSC-sEVs group and hUCMSC-sEVs group in promoting migration of hDPSCs (P>0.05). LPSpre-hUCMSC-sEVs group was stronger than hUCMSC-sEVs group in promoting migration and tube formation of HUVECs(P<0.05). The calcium salt deposition in LPSpre-hUCMSC-sEVs group and hUCMSC-sEVs group was higher than that in PC group, and the calcium salt deposition in LPSpre-hUCMSC-sEVs group was higher than that in hUCMSC-sEVs group(P<0.05). The mRNA expression levels of ALP, OSX, OCN and RUNX2 in PC group, hUCMSC-sEVs group and LPSpre-hUCMSC-sEVs group were higher than those in NC group(P<0.05), and hUCMSC-sEVs group and LPSpre-hUCMSC-sEVs group were higher than PC group(P<0.05). In addition, the expression levels of OCN and RUNX2 in LPSpre-hUCMSC-sEVs group were higher than those in hUCMSC-sEVs group(P<0.05), while there was no significant difference in ALP and OSX between LPSpre-hUCMSC-sEVs group and hUCMSC-sEVs group(P>0.05). The expression level of DSPP in PC group and hUCMSC-sEVs group was higher than that in NC group, but the difference was not statistically significant(P>0.05). The expression level of DSPP in LPSpre-hUCMSC-sEVs group was higher than that in PC group (P<0.05). The most highly expressed miRNAs including hsa-miR-21-5p, hsa-let-7a-5p, hsa-miR-100-5p, hsa-miR-26a-5p and hsa-miR-222-3p, and differentially expressed miRNAs including hsa-miR-199a-3p, hsa-miR-122-5p, hsa-miR-1246 and hsa-miR-615-3p were detected, which may be the key factors of LPSpre-hUCMSC-sEVs. CONCLUSIONS: Small extracellular vesicles derived from human umbilical cord mesenchymal stem cells can promote migration and osteogenic/odontogenic differentiation of hDPSCs, as well as migration and angiogenesis of HUVECs, and LPS can enhance these effects, which may be related to miRNAs which are the most abundantly and diffferentially expressed in LPSpre-hUCMSC-sEVs. References | Related Articles | Metrics

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The regulation of PERK on osteogenic differentiation of human periodontal ligament cells Li Lifen, Du Rong, Jiang Long 2025, 34 (6):  571-576.  doi: 10.19439/j.sjos.2025.06.002 Abstract ( 5 )   PDF (1310KB) ( 4 )   PURPOSE: To explore whether RNA-activated protein kinase-like ER resident kinase(PERK) has a regulatory effect on the osteogenic differentiation of human periodontal ligament cells (PDLCs). METHODS: PDLCs were primarily cultured, and siRNA was used to silence the expression of PERK in PDLCs. PDLCs were cultured in osteoblast differentiation-induction medium. Subsequently, the osteogenic differentiation capacity was evaluated using alkaline phosphatase(ALP) staining and alizarin red staining. RESULTS: After osteogenic induction culture of PDLCs in vitro, ALP and alizarin red staining were enhanced, and the deposition of mineral salts increased. Meanwhile, the expression of phosphorylated PERK(p-PERK) in osteogenic PDLCs was higher than cells in the control group. Transfection of si-PERK significantly downregulated PERK protein expression in PDLCs (P<0.05). ALP and alizarin red staining showed that the PERK-/- group had markedly lower ALP staining intensity and calcium salt deposition than the osteogenic induction group, along with decreased activating transcription factor 4(ATF4) protein expression. CONCLUSIONS: PERK regulates the osteogenic differentiation of PDLCs. References | Related Articles | Metrics

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Mechanism of LncRNA H19 regulation of bone-directed induced differentiation of periodontal stem cells through NRF-2/HO-1 signaling pathway in inflammatory microenvironment Qian Yi, Xu Xiaobo, Wu Yan, Gong Wenting, Lu Jun, Liu Shouhong 2025, 34 (6):  577-582.  doi: 10.19439/j.sjos.2025.06.003 Abstract ( 6 )   PDF (1876KB) ( 3 )   PURPOSE: To investigate the effect and underlying mechanism of long non-coding RNA H19 on the osteogenic differentiation of periodontal ligament stem cells(PDLSCs) under inflammatory conditions. METHODS: PDLSCs were subjected to osteogenic and adipogenic induction. Alizarin Red staining and Oil Red O staining were used to observe osteogenic and adipogenic differentiation, respectively. The expression levels of osteogenesis-related genes RUNX-2, ALP, and BSP, as well as LncRNA H19, were measured before and after osteogenic induction. Cells were also cultured in an inflammatory environment to assess the expression of RUNX-2, ALP, BSP, LncRNA H19 and NRF-2/HO-1. Furthermore, LncRNA H19 was upregulated via lentiviral transfection, and subsequent changes in the expression of osteogenic genes (RUNX-2, ALP, BSP) and NRF-2/HO-1 were analyzed. RESULTS: PDLSCs had stem cell properties and could be induced to undergo osteogenic and adipogenic differentiation. During osteogenic differentiation, the expression of osteogenic genes RUNX-2, ALP, BSP and LncRNA H19 increased. Under inflammatory conditions, the expression of RUNX-2, ALP, BSP and LncRNA H19 was downregulated, along with a decrease in NRF-2/HO-1 expression. Upregulation of LncRNA H19 resulted in increased expression of NRF-2/HO-1 as well as osteogenic genes RUNX-2, ALP and BSP. CONCLUSIONS: The inflammatory microenvironment may suppress osteogenic differentiation of PDLSCs by reducing LncRNA H19 expression, which in turn inhibits the NRF-2/HO-1 signaling pathway. References | Related Articles | Metrics

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Finite element analysis of short root teeth under three different moving modes Lu Shengnan, Zhang Ting, He Jiajia, Xiong Bin, Shi Hui 2025, 34 (6):  583-588.  doi: 10.19439/j.sjos.2025.06.004 Abstract ( 7 )   PDF (906KB) ( 3 )   PURPOSE: To detect the mechanical conditions of short root teeth during stepwise and overall retraction in extraction cases of Class I malocclusion patients, and help clinicians better understand the force distribution of short root teeth under different retraction methods. METHODS: CBCT was used to scan the maxillofacial and oral condition of the volunteers. The obtained CBCT data were imported into Mimics 20.0 software for processing. Modelings were conducted using Geomagic Studio 2014 reverse engineering software and NX1911 software. The three-dimensional finite element software Ansys Workbench 2019 was employed to simulate stepwise and overall retraction using an invisible correction model for extraction cases. The displacement trends, stress magnitudes, and stress distribution in the periodontal ligament of maxillary short root teeth were investigated. RESULTS: During the retraction of short root teeth, the stress in the roots appeared on the labial surface. When the canine was first distally moved into position, and then 2-2 retraction by 0.2 mm (condition 2), equal effect force value of the central incisor was the largest. The maximum values of the minimum principal stress and hydrostatic pressure in the periodontal ligament of the central incisor appeared on the labial surface of the cervical root. Among them, the force value was the smallest under the condition of 3-3 overall retraction by 0.2 mm (condition 1). In terms of displacement, the short root teeth exhibited elongation during retraction, with the maximum movement distance in the Y direction observed under condition 1. CONCLUSIONS: The forces on the root and periodontal ligament of the short root teeth are the lightest, and there is a slight root resorption under condition 1. Short root teeth are easy to tipping movements and elongation, with a greater amount of tipping and elongation observed under condition 1. References | Related Articles | Metrics

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The influence of minimally invasive jaw surgery combined with orthodontic treatment for maxillary protrusion on tooth roots and alveolar bone Zhou Qin, Chen Qiwen, Yan Jieya, Liu Jiaqiang 2025, 34 (6):  589-594.  doi: 10.19439/j.sjos.2025.06.005 Abstract ( 5 )   PDF (978KB) ( 3 )   PURPOSE: To explore the effects of minimally invasive jaw surgery combined with orthodontic treatment on the root length of maxillary anterior teeth and alveolar bone thickness after correcting maxillary protrusion, and to provide a reference for the selection of clinical treatment plans. METHODS: A total of 40 female patients with maxillary protrusion who visited Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to February 2024 were selected and divided into two groups according to the treatment plan: the experimental group(n=20) received minimally invasive jaw surgery combined with orthodontic treatment, and the control group(n=20) received orthodontic treatment with simple tooth extraction. The orthodontic treatment course and changes in the root length of maxillary anterior teeth and alveolar bone thickness before and after treatment were compared between the two groups. RESULTS: The space closure time in the experimental group was (7.2±1.15) months, and the total orthodontic treatment time was (19.6±3.35) months, both significantly shorter than those in the control group [(12.93±1.27) months and (27.0±3.22) months, respectively] (P<0.001); there was no significant difference in the alignment and leveling time between the two groups(P=0.63). Root resorption of maxillary anterior teeth occurred in both groups after treatment, but there was no significant difference between the two groups(P>0.05). The thickness of the labial alveolar bone at the root neck and mid-root regions increased in the experimental group after treatment, while it decreased in the control group, and the difference between the two groups was significant (P<0.01). CONCLUSIONS: Minimally invasive jaw surgery combined with orthodontic treatment for maxillary protrusion can significantly shorten the orthodontic treatment course and increase the thickness of the labial alveolar bone of maxillary anterior teeth to reduce the risk of bone dehiscence and fenestration. However, it cannot reduce orthodontically related root resorption. References | Related Articles | Metrics

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Establishment and efficacy evaluation of a risk prediction model for lymphoma in patients with Sjögren’s syndrome Fan Yijia, Lu Xinyue, Lyu Zhongjing 2025, 34 (6):  595-600.  doi: 10.19439/j.sjos.2025.06.006 Abstract ( 5 )   PDF (842KB) ( 6 )   PURPOSE: To investigate the risk factors for lymphoma in patients with primary Sjögren's syndrome (pSS), construct a risk prediction model, and evaluate its predictive efficacy. METHODS: A total of 202 patients diagnosed with pSS at the Department of Stomatology, Affiliated Hospital of Xuzhou Medical University from February 2019 to August 2024 were collected and divided into two groups: lymphoma occurrence group(n=23) and non-occurrence group(n=179). Univariate analysis and multivariate logistic regression were performed to screen risk factors with SPSS 26.0 software package, and a risk prediction nomogram model was established. The model was evaluated by the receiver operator characteristic curve(ROC) and calibration curve(CC). Then, the decision curve analysis(DCA) was plotted. RESULTS: Univariate analysis showed that lymphadenopathy, swollen glands, neutropenia, thrombocytopenia, lymphocytopenia, high IgG levels, interstitial pneumonia, and renal damages had significant differences between two groups (P<0.05). Multivariate logistic regression analysis showed that lymphadenopathy, neutropenia, lymphocytopenia, and high IgG levels were independent risk factors. The area under the curve(AUC) was 0.931. The calibration curve indicated that the model had good predictive performance. The decision curve showed that the prediction model had a high net benefit within the threshold probability range of 5%-95%. CONCLUSIONS: Lymphadenopathy, neutropenia, lymphocytopenia, and high IgG levels can be used as predictive factors for lymphoma occurrence in pSS. This risk prediction model is helpful for assessing the risk of lymphoma occurrence in pSS, thereby actively intervening to reduce the occurrence of lymphoma. References | Related Articles | Metrics

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Evaluation of the effect of Er:YAG laser combined with infiltration resin on dental fluorosis of deciduous teeth Zhang Hongyue, Liu Xiaoli, Dong Jing, Li Xinnan, Xing Congcong, Ma Zhe 2025, 34 (6):  601-605.  doi: 10.19439/j.sjos.2025.06.007 Abstract ( 10 )   PDF (594KB) ( 6 )   PURPOSE: To evaluate the efficacy of Er:YAG laser combined with infiltration resin in the treatment of dental fluorosis of deciduous teeth. METHODS: Eighty-six children treated for deciduous fluorosis teeth at Hebei Medical University Dental Hospital from January 2019 to January 2024 were selected and randomly divided into the control group (n=43, 92 teeth) and experimental group(n=43, 116 teeth). The control group was treated with Opalustre micro-abrasion paste combined with infiltration resin, while the experimental group was treated with Er: YGA laser combined with infiltration resin. Clinical data of both groups were collected, changes in tooth shade, whitening effects and the rate of discoloration removal at baseline, 1 week and 3 months post-treatment were compared. Treatment satisfaction and the incidence of tooth sensitivity were also compared between the two groups. RESULTS: One week and three months post-treatment, the tooth shade scores in the experimental group were 3.42±0.51 and 3.86±0.62, respectively, significantly lower than those in the control group (5.82±0.75 and 7.23±1.02, P<0.05). The total effective whitening rate in the experimental group was 100.00% at both one week and three months post-treatment, significantly higher than that in the control group(94.57% and 84.78%, P<0.05). The rate of discoloration removal in the experimental group was 95.73%, significantly higher than that in the control group (88.13%, P<0.05). The VAS scores for post-operative pain at 2, 12 hours and 1 day in the experimental group were significantly lower than those in the control group(P<0.05). The treatment satisfaction rate in the experimental group was 96.55%, significantly higher than that in the control group (64.13%, P<0.05). The incidence rates of post-operative tooth sensitivity at 2 hours, 1 week and 3 months in the experimental group were 3.45%, 5.17% and 6.03%, respectively, significantly lower than those in the control group(15.22%, 22.83% and 28.26%, P<0.05). CONCLUSIONS: Er:YGA laser combined with infiltration resin demonstrats superior treatment efficacy for deciduous fluorosis teeth compared to the traditional combination of micro-abrasion paste and infiltration resin. It not only effectively improves dental aesthetics, but also reduces dental sensitivity after treatment, and improves patient satisfaction. References | Related Articles | Metrics

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Evaluation of the effect of digital guide plate assistance in anterior tooth implant restoration Ye Qiuping, Luo Shanfeng, Zhu Ting, Jin Qiqi 2025, 34 (6):  606-610.  doi: 10.19439/j.sjos.2025.06.008 Abstract ( 8 )   PDF (897KB) ( 3 )   PURPOSE: To evaluate the effect of digital guide plate assistance in anterior tooth implant restoration. METHODS: A total of 98 patients who underwent anterior tooth implant restoration from January 2022 to January 2024 were selected and divided into the control group and experimental group by the random number table method, with 49 cases in each group. The control group received conventional implant restoration, while the experimental group was assisted by digital guide plates. The deviation between the actual and designed positions of the implants was compared between the two groups. At the 3rd and 6th months postoperatively, the restorative outcomes were evaluated using the modified United States Public Health Service(USPHS) criteria. At the 6th month postoperatively, the patients' periodontal health status was assessed by measuring probing depth (PD), gingival index (GI), sulcus bleeding index (SBI) and plaque index(PLI). Additionally, the pink esthetic score(PES), as well as occlusal and masticatory functions were evaluated. RESULTS: The deviation between the actual position of the implant in the experimental group and the designed position was significantly less than that in the control group. At the 3rd and 6th months postoperatively, the USPHS score, PD, GI, SBI and PLI in the experimental group were significantly lower than those in the control group, while PES, occlusal and masticatory functions were significantly higher than those in the control group(P<0.05). CONCLUSIONS: Digital guide plate assistance can reduce the positional deviation of anterior tooth implants, improve aesthetics and masticatory function, and reduce periodontal inflammation, providing a reliable clinical treatment plan for precise implant restoration in the anterior tooth. References | Related Articles | Metrics

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Construction of a prediction model for peri-implantitis based on logistic regression and analysis of influencing factors Shen Linhan, Yu Hao, Chen Xu, Li Yang 2025, 34 (6):  611-616.  doi: 10.19439/j.sjos.2025.06.009 Abstract ( 7 )   PDF (1279KB) ( 10 )   PURPOSE: To explore the influencing factors of peri-implantitis in patients with dentition defects after oral implant surgery, and to construct and validate a personalized prediction model. METHODS: Patients who underwent oral implant surgery in the Affiliated Suzhou Hospital of Nanjing University Medical School from September 2021 to March 2025 were included retrospectively. Through 1∶1 propensity score matching, 100 cases in the infected group (diagnosed with peri-implantitis) and 100 cases in the non-infected group were finally included. The baseline data of patients and serum interleukin-17A (IL-17A) levels were collected. Binary logistic regression was used to analyze the influencing factors. A nomogram prediction model was constructed based on the screening results, and the prediction performance was evaluated by Bootstrap validation, receiver operating characteristic(ROC) curve and decision tree model. RESULTS: The proportions of diabetes, smoking history, chronic periodontitis history, poor alveolar bone around implants, and IL-17A levels in the infected group were significantly higher than those in the non-infected group(P<0.05). Logistic regression showed that diabetes, smoking history, chronic periodontitis history, poor alveolar bone around implants, and elevated IL-17A were independent risk factors for peri-implantitis(OR>1, P<0.05). The C-index of the nomogram model was 0.905, the area under the ROC curve(AUC) was 0.905 (95%CI: 0.865-0.946, P<0.001), and the optimal cut-off value was 48.80 points (specificity was 0.880, sensitivity was 0.820, Youden index was 0.700). The decision tree model showed that IL-17A was the primary predictor; when IL-17A > 14.380 ng/L, the incidence of peri-implantitis reached 87.50%. CONCLUSIONS: Diabetes, smoking history, chronic periodontitis history, alveolar bone condition around implants and IL-17A level are key influencing factors of peri-implantitis. The constructed nomogram model has excellent prediction performance and can be used for preoperative individualized risk assessment. References | Related Articles | Metrics

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Construction and verification of CAD/CAM-based nomogram model for the failure risk of dental defect restoration with all-ceramic onlay Lei Yanhua, Zheng Haixia 2025, 34 (6):  617-621.  doi: 10.19439/j.sjos.2025.06.010 Abstract ( 5 )   PDF (706KB) ( 6 )   PURPOSE: To analyze the risk factors for the failure of CAD/CAM system-designed all-ceramic onlays in repairing dental defects using the nomogram model. METHODS: Clinical data from 236 patients with dental defects in Yulin First Hospital from January 2019 to January 2021 was conducted. All patients received all-ceramic onlay restorations designed by CAD/CAM system and were followed up for 3 years. According to the follow-up results, they were divided into successful group(n=169) and failed group(n=67). Basic details were collected for each group, including gender, age, smoking history, tooth type, type of tooth defect, dental arch defect status, root canal treatment status, type of ceramic block, measurements of pre-treatment occlusal force, alveolar bone density and periodontal indices [plaque index (PLI), sulcus bleeding index(SBI) and probing depth(PD)]. Logistic regression analysis was used to identify the risk factors for failure after all-ceramic onlay restoration, the prediction model of nomogram was constructed and the fitting effect of the model was evaluated. RESULTS: Logistic regression analysis indicated that older age, comorbid diabetes, smoking history, molar teeth, use of CEREC Blocs ceramic, multi-surface cavity defects, incomplete dental arch post-restoration, high pre-treatment occlusal force, low alveolar bone density, high values of PLI, SBI and PD were related to an increased likelihood of treatment failure(P<0.05). The calibration curve for this predictive model approximates the ideal curve. CONCLUSIONS: Age, history of diabetes, smoking history, condition of the defective tooth and periodontal health status are significant factors influencing the failure of CAD/CAM system-designed all-ceramic onlay restorations for dental defects. References | Related Articles | Metrics

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Evaluation of the efficacy of bone-level implantation combined with orthodontics in patients with dentition defect He Xiaofeng, Jin Dan, Xie Chunyun 2025, 34 (6):  622-625.  doi: 10.19439/j.sjos.2025.06.011 Abstract ( 6 )   PDF (494KB) ( 3 )   PURPOSE: To evaluate the effects of bone-level implantation combined with orthodontics on periodontal health and implant stability in patients with dentition defect. METHODS: A total of 92 patients(92 teeth) with dentition defect admitted to the hospital from January 2020 to January 2023 were selected and divided into 2 groups by random number table method, with 46 cases in each group. All patients in the two groups were treated with bone-level implantation, and the experimental group was treated combined with orthodontics before implantation. The implant success rate 6 months post-surgery, along with the periodontal status before and 6 months after implantation [sulcus bleeding index (SBI), probing depth(PD), plaque index (PLI)], chewing function, bone resorption, implant stability quotient and incidence of complications (occlusal elevation, non-occlusal contact, food impaction and occlusal pain) were compared. RESULTS: The implantation success rate of the experimental group was significantly higher than that of the control group, SBI, PD and PLI after 6 months of implantation were significantly lower than those of the control group, and the surface myoelectric activity of temporal muscle, bilateral masseter muscle and implant stability coefficient at maximum occlusion were significantly higher than those of the control group(P<0.05). There was no significant difference in bone absorption between the two groups(P>0.05), and the complication rate of the experimental group was significantly lower than that of the control group(P<0.05). CONCLUSIONS: Bone-level implantation combined with orthodontics helps improve periodontal health and enhances implant stability in patients with dentition defect. References | Related Articles | Metrics

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Modified Demirjian method to evaluate the development of mandibular permanent teeth in children aged 4 to 11 years old Han Min, Zhang Shaojun, Xi Xun, Zhuang Xuejia, Zeng Xuemin 2025, 34 (6):  626-630.  doi: 10.19439/j.sjos.2025.06.012 Abstract ( 5 )   PDF (868KB) ( 3 )   PURPOSE: The modified Demirjian method was used to evaluate the development of mandibular permanent teeth in children aged 4 to 11 years old, which provided a reference for determining the clinical treatment time and formulating policies for the prevention and treatment of oral chronic diseases. METHODS: A total of 320 panoramic films from 4 to 11 years old, with 160 males and 160 females, met the inclusion criteria. The modified Demirjian scoring method was used to judge the development of 7 permanent teeth or permanent germ on the left side of the jaw, and formed the developmental score line chart and trend chart. Differences in tooth position and gender were analyzed using SPSS 25.0 software package. RESULTS: There was a certain linear relationship between the development trend of each mandibular permanent tooth and the age. The second molar had the largest slope y=0.6619x-0.8843(R2=0.99) and the first molar had the smallest slope y=0.3783x+3.8626(R2=0.9224). Mandibular tooth development had distinct differences in tooth position. The first molars developed earlier than the central incisors, but lagged behind the central incisors during the apical foramen closure stage. Canine developed earlier than the first and second premolars, and second premolars developed later than the first premolars. Female mandibular teeth developed earlier than in men, mainly in the early stages of tooth development and the whole process of canine development. CONCLUSIONS: The development of mandibular permanent teeth in children aged 4 to 11 years old has differences in tooth position and gender, so the modified Demirjian method is suitable for evaluating the development of mandibular permanent teeth in children. References | Related Articles | Metrics

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Evaluation of the effect of surgical navigation combined with CBCT in removing supernumerary teeth with complete bone impaction in the anterior maxillary region Hao Xingke, Wang Jinxiu, Meng Wenrui, Han Miyan, Zhang Bin 2025, 34 (6):  631-635.  doi: 10.19439/j.sjos.2025.06.013 Abstract ( 3 )   PDF (619KB) ( 3 )   PURPOSE: To investigate the effect of surgical navigation combined with CBCT in removing supernumerary teeth with complete bone impaction in maxillary anterior region. METHODS: A total of 82 children (82 teeth) with complete bone impaction in the anterior maxillary region were removed from January 2023 to June 2024, and were divided into 2 groups by random number table method, with 41 patients and 41 teeth in each group. CBCT was taken before operation in 2 groups,the control group underwent surgical extraction and the experimental group underwent dental extraction assisted by surgical navigation system. The exposure time of the impacted teeth, surgery duration and incision length were recorded. Postoperative pain at 1, 6, 12 and 24 hours was assessed using the face, legs, activity, cry, consolability (FLACC) scale. Inflammatory marker levels and complications were compared between the two groups preoperatively and 24 hours postoperatively. RESULTS: The exposure time, operation time and incision length of the experimental group were significantly lower than those of the control group, and the FLACC score and inflammatory factor level at 1, 6 and 12 h after surgery in the experimental group were significantly lower than those in the control group, and the postoperative complications were also significantly decreased (P<0.05). CONCLUSIONS: Surgical navigation combined with CBCT can shorten the operation time, reduce postoperative pain and the risk of postoperative complications. References | Related Articles | Metrics

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The influence of head and neck posture training on the electrical activity of the temporalis and masseter muscles in patients with temporomandibular disorders Lin Minghui, Yang Yang, Wu Zhigang, Cai Bin, Xu Lili 2025, 34 (6):  636-640.  doi: 10.19439/j.sjos.2025.06.014 Abstract ( 6 )   PDF (629KB) ( 3 )   PURPOSE: To explore the effects of head and neck posture training on the electrical activity of the temporalis and masseter muscles in patients with myogenic temporomandibular disorder(TMD) under different head and neck postures. METHODS: Fourteen patients with TMD who attended Hainan West Central Hospital from July 2022 to February 2023 with presence of head forward posture were selected for the study. All patients received head and neck posture training for 4 weeks, 2-3 times per week for 30 min each time. Changes in the electrical activity of bilateral temporalis and masseter muscles were compared between pre- and post-intervention patients in the natural relaxed position, the teeth lightly touching position, and the neutral head and neck position. Mandibular function, pain intensity, and maximal pain-free mouth opening were assessed for pre- and post-comparisons. RESULTS: In TMD patients, the electromyographic amplitude of the anterior fasciculus of the left temporalis muscle and the right masseter muscle was higher in the natural relaxed position than in the neutral head and neck position (3.4±1.4 vs. 2.5±1.0, 2.4±1.6 vs. 1.8±1.1, P<0.05). After head and neck posture training, the patients had lower basal EMG amplitudes of bilateral temporalis and left masseter muscles in the natural relaxed position and the neutral head and neck position compared with the pre-treatment position, and the mandibular function scores and pain were significantly improved(P<0.05). CONCLUSIONS: Different head and neck postures can affect the basal electromyographic amplitude of the masticatory muscles in patients with myogenic TMD, and postural training can effectively relax the temporalis and masseter muscles in patients with TMD, resulting in pain reduction and promoting functional recovery. References | Related Articles | Metrics

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Evaluation of magnetic resonance imaging in the diagnosis of temporomandibular degenerative joint disease Liu Shasha, Xu Lili, Mao Mengying, Lu Shenji, Zhu Ling, Cai Bin 2025, 34 (6):  641-646.  doi: 10.19439/j.sjos.2025.06.015 Abstract ( 4 )   PDF (839KB) ( 3 )   PURPOSE: To evaluate the ability of magnetic resonance imaging(MRI) in diagnosis of degenerative joint disease (DJD). METHODS: A total of 152 patients with temporomandibular joint disorder(TMD) from June 2019 to June 2021 were included. A total of 304 temporomandibular joints(TMJs) were examined both by cone-beam CT (CBCT) and MRI. The sensitivity, specificity and accuracy of MRI for nine types of TMJ abnormalities were calculated with CBCT as gold standard. RESULTS: The sensitivity of MRI for condylar surface erosion, condylar osteophyte formation, condylar osteosclerosis, subcortical cystic degeneration, condylar flattening, fossa bone erosion or sclerosis, fossa bone absorption or proliferation, joint space reduction or fusion, and joint space increase, was 95.9%, 81.0%, 49.2%, 81.3%, 98.1%, 76.7%, 84.4%, 52.8%, and 29.4% respectively. The specificity was 49.4%, 80.8%, 83.7%, 85.3%, 52.5%, 77.5%, 78.1%, 88.4% and 98.3%, respectively. The accuracy was 83.2%, 80.9%, 69.4%, 84.9%, 92.1%, 77.3%, 82.2%, 76.0% and 94.4% respectively. CONCLUSIONS: MRI has high accuracy in the diagnosis of nine types of TMJ bone abnormalities. MRI is suitable for imaging screening and diagnosis of DJD. References | Related Articles | Metrics

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Evaluation of the clinical efficacy of 3% polydocaol in the treatment of low-flow oral mucosal venous malformation Liu Shuang, Sun Ningning, Liu Minda, Dai Wei, Xue Lei, Zhang Enjiao 2025, 34 (6):  647-650.  doi: 10.19439/j.sjos.2025.06.016 Abstract ( 4 )   PDF (1149KB) ( 3 )   PURPOSE: To investigate the clinical efficacy of 3% polidocanol in the treatment of low-flow venous malformations of the oral mucosa. METHODS: A total of 62 patients with low-flow venous malformations of the oral mucosa admitted to the Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of China Medical University from January to December 2024 were selected. All patients were treated with 3% polidocanol foam sclerotherapy and followed up for 1 to 12 months. The therapeutic effects were evaluated through grade assessment, subjective evaluation by patients, and comparison of photos before and after treatment. RESULTS: Among the 62 patients, 52 were cured (83.87%), 8 showed remarkbally improved, and 2 were improved, with a total effective rate of 100%. The number of treatments ranged from 1 to 3 times, with an average of 1.4 times. Visual analogue scale(VAS) of pain showed that immediate postoperative pain score was 3-8 points, which decreased to 0-1 points after 1 month. Adverse reactions occurred in 8 patients postoperatively, all of them returned to normal after 1 month. CONCLUSIONS: 3% polidocanol is a safe, effective, and low-side-effect treatment for venous malformations of the oral mucosa. References | Related Articles | Metrics

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Therapeutic effect of Xipayi Guyin fluid combined with metronidazole in treating periimplantitis and its impact on MMP-8 and NO levels in gingival crevicular fluid Liu Weidong, Jiang Yinhua, Hu Qinni, Xu Hang 2025, 34 (6):  651-655.  doi: 10.19439/j.sjos.2025.06.017 Abstract ( 9 )   PDF (610KB) ( 4 )   PURPOSE: To investigate the therapeutic effect of Xipayi Guyin fluid combined with metronidazole in treating periimplantitis and its impact on the levels of matrix metalloproteinase 8 (MMP-8) and nitric oxide (NO) in gingival crevicular fluid. METHODS: A total of 84 patients with periimplantitis treated in Lishui People's Hospital from January 2021 to January 2024 were selected and divided into experimental group and control group, with 42 patients in each group. The control group was treated with metronidazole alone, while the experimental group was treated with Xipayi Guyin fluid on the basis of metronidazole. The levels of interleukin 6(IL-6), MMP-8, transforming growth factor α(TGF-α), and NO were compared between the two groups before and after treatment, and the number of plaques and degree of bleeding in patients were analyzed based on the plaque index(PLI) and sulcus bleeding index (SBI), and the clinical total effective rate and incidence of adverse reactions after treatment were observed. RESULTS: The total clinical effective rate of the experimental group was 73.81%, which was significantly higher than that of the control group(52.38%)(P<0.05). After treatment, the PLI, SBI, NO, IL-6, MMP-8 and TGF-α level of the two groups were obviously reduced compared to pre-treatment, and there was significant difference between the two groups(P<0.05). The adverse reaction ratio of the experimental group and the control group were 2.38% and 7.14%, respectively, with no significant difference between the two groups (P>0.05). CONCLUSIONS: The combination of Xipayi Guyin fluid and metronidazole can help inhibit the proliferation of oral pathogenic microorganisms, reduce the levels of inflammatory factors such as MPP-8 and regulate NO level. It also helps to strengthen teeth and gums, with controlling effect on the onset of periimplantitis in patients. References | Related Articles | Metrics

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The clinical effect of tunnel technique combined with connective tissue grafting in the treatment of gingival recession with non-carious cervical lesion Guo Fengqin, Zhang Wei, Zhu Hong, Zha Xianfang, Wang Xiaojing 2025, 34 (6):  656-659.  doi: 10.19439/j.sjos.2025.06.018 Abstract ( 6 )   PDF (778KB) ( 3 )   PURPOSE: To evaluate the clinical efficacy of tunnel technique combined with connective tissue grafting in the treatment of gingival recession with non-carious cervical lesion(NCCL). METHODS: Fourteen patients with 26 gingival receding sites who were admitted to Hefei Stomatological Hospital from January 2021 to August 2022 due to gingival receding and sensitivity to cold and heat were selected as the research objects. All patients were treated with tunnel technology combined with connective tissue grafting. Clinical indexes such as gingival receding (GR), probing depth (PD), clinical attachment loss(CAL), keratinized gingival width (KTW) and tooth defect depth were measured before surgery, 3 months after surgery and 6 months after surgery, respectively, to evaluate the clinical efficacy. RESULTS: At 3 and 6 months after surgery, GR and CAL were significantly decreased(P<0.05), and KTW was significantly increased(P<0.05). Three months after operation, the complete root coverage rate was 77.00%, and the average root coverage rate was 94.23%. At 6 months after operation, the complete root coverage rate was 73.00%, and the average root coverage rate was 93.27%. CONCLUSIONS: Tunnel technique combined with connective tissue grafting can be used for the treatment of MillerⅠ and Miller Ⅱ gingival receding with NCCL, and the clinical and aesthetic results are significant and stable. References | Related Articles | Metrics

Literature analysis

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A visual analysis of machine learning in periodontal disease research, 2001-2023 Lin Huili, Chen Jun, Li Wenjie 2025, 34 (6):  660-667.  doi: 10.19439/j.sjos.2025.06.019 Abstract ( 5 )   PDF (1829KB) ( 7 )   PURPOSE: To analyze the literatures related to machine learning in periodontal diseases to understand its applications and research hotspots. METHODS: Literatures related to machine learning in periodontal disease researches included in the Web of Science Core Collection from January 1, 2001 to December 31, 2023 were visualized and analyzed using Bibliometrix 4.4.1, CiteSpace 6.3.R1, and VOSviewer 1.16.18. RESULTS: A total of 127 papers that met the inclusion and exclusion criteria were included, and the number of publications and citation frequency of each year after 2018 showed a rapid upward trend. The high-frequency keywords of related literatures suggested: periodontitis, machine learning, deep learning, and so on. The hotspot of machine learning in periodontal clinical research in the past 2 years was segmentation and feature extraction based on images. The clinical research of machine learning in periodontics focused on combining images to assist in the diagnosis of periodontal disease and peri-implantitis; the basic research of machine learning in periodontics focused on screening biomarkers between periodontal diseases and systemic diseases. CONCLUSIONS: The literature visualization analysis shows the application and hotspots of machine learning in periodontal disease research, which can provide a reference for future research direction. References | Related Articles | Metrics

Dental Education

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Status and development suggestions of Shanghai dental continuing medical education in 2023 Zhang Wenshan, Qi Yan, Wang Xueling 2025, 34 (6):  668-672.  doi: 10.19439/j.sjos.2025.06.020 Abstract ( 5 )   PDF (565KB) ( 3 )   PURPOSE: By analyzing the national continuing medical education programs in the field of dental medicine declared and implemented in Shanghai in 2023, as well as the situation of the participants, this study aimed to understand the current status of continuing medical education in dental medicine in Shanghai and provide suggestions for the transformation and development of continuing education of dental medicine. METHODS: The study collected and analyzed information on 54 national continuing medical education programs in dental medicine and 5 246 participants declared and implemented in Shanghai in 2023 using the online application and feedback system of the national CME project. RESULTS: Shanghai had been approved for a national-level continuing medical education program in dentistry, accounting for 11.07% of the total dental medicine programs in the country. The number of students from 12 western provinces accounted for 5.47% of the total, while the number of students at the grassroots level accounted for 2.88% of the total. Junior and lower-level title students tended to participate in purely theoretical projects, while senior students tended to participate in projects that included practical training and surgical demonstrations. CONCLUSIONS: Shanghai's continuing education resources in dentistry are insufficient, and there is a large difference in the level of trainees. Trainees with different professional titles have different preferences for course content, and the contradiction between dental science and engineering is becoming more prominent. Therefore, by actively sinking educational resources, Shanghai's dental medicine can play a demonstrative and leading role. The course content should be classified and planned to meet the differentiated training needs of the trainees. Innovating the credit management method can stimulate trainees' active learning motivation and better promote the development of continuing education in dental medicine. References | Related Articles | Metrics