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25 June 2026, Volume 35 Issue 3 Previous Issue   

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Expert Consensus

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Expert consensus on embolization and sclerotherapy with fibrin glue combined with pingyangmycin for oral and maxillofacial vascular malformations Yang Yaowu, Zheng Jiawei, Fan Xindong, Liu Shaohua, Qin Zhongping, Sun Moyi, Chen Weiliang, Guo Xinkui, Wei Jianhua, Cai Zhigang, Ji Tong, Li Chunjie, Guo Wei, Gong Zhongcheng, Hou Jinsong, Su Lixin, Wang Deming, Wang Yan'an, Ren Guoxin, Chen Anwei, Li Kelei, Na Sijia, Cai Yu, Liu Fayu, Mai Huaming, Wu Haiwei, Yan Zhiwei, Yang Xia, Hou Na 2026, 35 (3):  225-232.  doi: 10.19439/j.sjos.2026.03.001 Abstract ( 15 )   PDF (995KB) ( 9 )   Venous malformations(VMs) are common vascular anomalies in the oral and maxillofacial region, which can cause facial deformities, craniomaxillofacial dysfunction and psychosocial stress in patients. Currently, the treatment of extensive, high-reflux venous malformations and high-flow arteriovenous malformations(AVMs) remains challenging. Fibrin glue combined with pingyangmycin or bleomycin embolosclerotherapy technology treats vascular malformations via the mechanism of immediate embolization, sustained drug release and synergistic fibrosis. Existing real-world research data have demonstrated its potential advantages in managing extensive, quick drainage venous malformations and certain arteriovenous malformations, indicating promising application prospects. The application of this technique has a history of over two decades; however, its promotion has been constrained due to the lack of standardized and guided application protocols. This consensus document elaborated on the background, basic research, and clinical studies related to fibrin glue combined with pingyangmycin embolosclerotherapy, and discusses its mechanism of action in eliminating vascular malformations. By integrating the latest research findings and clinical experiences in the field, as well as incorporating discussions and opinions from experts across multiple medical institutions in China, this consensus provides guidance on clinical applications including indications and contraindications, pre-treatment preparations, procedural standards, prevention and management of potential complications, and comprehensive implementation, so as to serve as a reference for clinical practice. References | Related Articles | Metrics

Original Articles

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Deep learning-based SINet-V2 for localization of root canal orifices in maxillary molars Shen Qiyun, Fu Yujie, Zhou Kefan, Chen Yufei, Zhang Qi 2026, 35 (3):  233-237.  doi: 10.19439/j.sjos.2026.03.002 Abstract ( 11 )   PDF (1083KB) ( 6 )   PURPOSE: To construct a deep learning-based model for root canal orifice localization, aiming to provide a reference for clinically efficient and precise root canal orifice identification. METHODS: Eighty maxillary molars were collected. After pulp chamber opening and cleaning, K-files were inserted to confirm root canal orifice positions, and microphotographs of the pulp chamber floor were captured to establish a conventional root canal orifice dataset. A random function was used to allocate 64 samples to the training set and 16 samples to the test set. Manual annotations of root canal orifices in pulp chamber floor images by an endodontic expert using MITK software served as the reference standard. The training set was input into the search identification network version 2 (SINet-V2) to develop a conventional root canal orifice localization model (NCO-LM). Model performance was evaluated against the reference standard using the following metrics: mean intersection over union (MIoU), root canal number prediction accuracy (NER), mean absolute error (MAE), and average connected domain center distance difference(MDis). Subsequently, light-cured composite resin was applied to cover the root canal orifices of the same 80 molars to simulate calcified pulp chambers. Photographs of the simulated calcified pulp chamber floors were acquired to create a calcified root canal orifice dataset. A calcified root canal orifice localization model (CCO-LM) was trained and tested following the NCO-LM methodology. RESULTS: Both NCO-LM and CCO-LM demonstrated high similarity to the reference standard with minimal localization deviations. NCO-LM achieved an MIoU of (87.42±5.47)%, MAE of (0.000 594±0.000 351), MDis of (1.63±1.40) pixels, and NER of 98.44%. CCO-LM showed an MIoU of (91.87±4.03) %, MAE of (0.000 801±0.000 543), MDis of (1.91±1.31) pixels, and NER of 96.25%. CONCLUSIONS: NCO-LM and CCO-LM models based on the SINet-V2 network, which are capable of accurately locating both conventional root canal orifices and hidden orifices covered by simulated calcifications in pulp chamber floor images. These findings provide a preliminary theoretical foundation for artificial intelligence-assisted real-time clinical root canal orifice localization. References | Related Articles | Metrics

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Biocompatibility assessment of a PDMS-CHXG antibacterial coating on titanium Liu Shaomei, Xia Rong 2026, 35 (3):  238-244.  doi: 10.19438/j.cjoms.2026.03.003 Abstract ( 14 )   PDF (2811KB) ( 8 )   PURPOSE: To evaluate the biocompatibility of polydimethylsiloxane-chlorhexidine (PDMS-CHXG) coatings constructed on titanium surfaces. METHODS: Titanium discs were modified with a PDMS coating, onto which CHXG was grafted at concentrations of 0.4, 0.8, and 1.6 mg/mL. The samples were randomly divided into 5 groups: Ti group (the control group), P group (PDMS only), C1 group (PDMS with 0.4 mg/mL CHXG), C2 group (PDMS with 0.8 mg/mL CHXG) and C3 group (PDMS with 1.6 mg/mL CHXG). Surface characteristics were examined using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). In vitro biocompatibility was assessed using human gingival epithelial cells through cytoskeleton staining, live/dead staining, and CCK-8 assays to evaluate cell viability, adhesion, and proliferation, respectively. For in vivo evaluation, the samples were implanted subcutaneously in Sprague-Dawley rats, and the surrounding tissue response was analyzed by HE staining. RESULTS: Successful fabrication of the PDMS-CHXG coating was verified, with a positive correlation observed between chlorine content and CHXG concentration. While the Ti, P, C1 and C2 groups showed robust cell health and proliferation with normal morphology, the C3 group led to reduced viability, poor adhesion, and proliferative suppression. Accordingly, in vivo data indicated minimal inflammation and similar, thin fibrous capsules for Ti, P, C1 and C2 implants, whereas the C3 group provoked a pronounced inflammatory response with significant fibrous capsule thickening. CONCLUSIONS: The study confirms that a PDMS-CHXG coating with a CHXG concentration of ≤0.8 mg/mL exhibits excellent overall biocompatibility. References | Related Articles | Metrics

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Effect of different types of experimental periodontitis models on periodontal tissue damage and the cGASSTING signaling pathway in mice Qian Xueshen, Lin Xuxin, Hu Weiqiang, Chen Jiao, Xia Rong, Jia Xiaofeng 2026, 35 (3):  245-251.  doi: 10.19439/j.sjos.2026.03.004 Abstract ( 10 )   PDF (1733KB) ( 6 )   PURPOSE: To investigate the effects of different types of experimental periodontitis models on periodontal tissues in mice and explore their potential molecular mechanisms. METHODS: Three models of experimental periodontitis in mice were established: ligature alone, ligature combined with local Porphyromonas gingivalis (Pg) injection, and ligature combined with local Pg topical application. Micro-CT was used to analyze bone volume (BV), bone volume fraction (BV/TV), trabecular separation (Tb.Sp), and bone mineral density (BMD). Histological analyses, including HE and Masson's trichrome staining, were performed to assess changes in alveolar bone. TRAP staining was used to detect osteoclast numbers. Immunohistochemistry was performed to evaluate the expression of TNF-α, IL-1β, cGAS, and STING. RT-qPCR was used to measure the expression of cGAS-STING pathway-related genes, including STING, IFN-β, and TBK1. RESULTS: Compared with the ligature alone and ligature + Pg injection groups, mice in the ligature + Pg topical application group exhibited the most severe alveolar bone loss and the highest number of osteoclasts. Compared with the control group, this model showed significantly increased expression of TNF-α, IL-1β, cGAS, and STING in periodontal tissues, as well as upregulated expression of cGAS-STING pathway-related genes STING, IFN-β, and TBK1. CONCLUSIONS: The ligature combined with local Pg topical application induces more severe periodontal bone loss in mice, and its underlying mechanism may be associated with activation of the cGAS-STING signaling pathway. References | Related Articles | Metrics

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Research on hypoxia-mediated macrophage polarization during the carcinogenesis of oral leukoplakia Zhao Xiaoxian, Zhang Chunye, Zhao Zhengyan, Zhang Ying, Wu Lan 2026, 35 (3):  252-257.  doi: 10.19439/j.sjos.2026.03.005 Abstract ( 13 )   PDF (1510KB) ( 6 )   PURPOSE: To investigate the expression level of hypoxia-inducible factor-1α (HIF-1α) and its impact on macrophage polarization in the immune microenvironment during carcinogenesis of oral leukoplakia (OLK). METHODS: This study employed multiplex immunofluorescence to retrospectively analyze HIF-1α, inducible nitric oxide synthase (iNOS), and CD206 expression in 25 OLK and normal mucosal tissue samples. An in vitro co-culture system was conducted under hypoxic conditions with Leuk-1 and Raw 264.7 cells. Macrophage polarization dynamics were quantitatively assessed by detection of HIF-1α, iNOS, and CD206 expression levels. Subsequently, inhibitor of HIF-1α was used to validate its regulatory role. RESULTS: In a cohort of 25 OLK and normal mucosal tissue samples, iNOS+ cells demonstrated initial elevation during mild dysplasia but significantly decreased in severe dysplasia and oral squamous cell carcinoma (OSCC). Conversely, CD206+ and HIF-1α+ cells exhibited progressive accumulation throughout OLK malignant transformation. Macrophage polarization analysis revealed M1 polarization (CD206/iNOS ratio: 0.68±0.22 to 0.69±0.41) was presented in mild-to-moderate dysplasia, with marked M2 polarization emerging in advanced stages (3.27±1.64 to 5.82±1.32). Correlation analyses identified progressively strengthened associations between HIF-1α and CD206, iNOS, and M2 polarization during disease progression. In vitro experiments under hypoxic conditions confirmed positive correlations between HIF-1α expression and CD206/iNOS levels as well as M2 polarization, while HIF-1α inhibition significantly attenuated M2 polarization. These findings suggest hypoxia-mediated HIF-1α signaling may orchestrate macrophage phenotypic switching during oral carcinogenesis. CONCLUSIONS: During OLK malignant transformation, HIF-1α expression is progressively upregulated, driving the polarization shift of tissue macrophages from pro-inflammatory M1 to pro-tumorigenic M2 phenotypes. References | Related Articles | Metrics

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In vitro study of the effect of 4 edentulous space lengths under Kennedy classification on the precision of digital impressions Zheng Xinyan, Xing Jiaxu, Sun Shuyu, Gan Hongqin, Tian Ruixue, Xie Xiaofei 2026, 35 (3):  258-264.  doi: 10.19439/j.sjos.2026.03.006 Abstract ( 9 )   PDF (1428KB) ( 4 )   PURPOSE: To investigate the effect of 4 edentulous space lengths under Kennedy classification on the overall precision, accuracy and linear precision of digital impressions through in vitro experiments. METHODS: Four types of edentulous models were constructed according to Kennedy classification, with 3 physical models of different edentulous numbers made for each classification, totaling 12 models. A desktop scanner was used to collect reference data, and a digital intraoral scanner was adopted to obtain experimental data. Zirconia balls with a diameter of 3 mm were bonded to the midpoints of the edentulous spaces of all models, and the above scanning process was repeated. Geomagic Wrap 2021 software was used for comparative analysis of the scanning data. RESULTS: There was no significant difference in precision among the groups (P>0.05). The accuracy of Kennedy Ⅰ group decreased significantly with the increase of edentulous space length, the accuracy of the group with the smallest edentulous space in Kennedy Ⅱ group was significantly better than that of the group with the largest edentulous space. In Kennedy Ⅲ and Ⅳ group, the accuracy of the group with the smallest edentulous space was significantly better than that of the other two groups. When grouping by the number of missing teeth, Kennedy Ⅲ group showed the best overall precision. Linear precision analysis revealed that the group with the smallest edentulous space in Kennedy Ⅰ group had the optimal linear precision; in Kennedy Ⅱ-Ⅳ groups, the linear precision decreased with the increase of edentulous space length. Kennedy Ⅲ and Ⅳ group showed better linear precision when grouping by the number of missing teeth(P<0.05). CONCLUSIONS: The length of edentulous space has significant effect on the precision of digital impressions, with the overall trend that as the space length increases, the overall precision and linear precision of digital impressions decrease accordingly. The presence of free-end edentulism leads to a decrease in the overall precision and linear precision of digital impressions. The linear precision of digital impressions is higher when the missing teeth are located in the anterior part of the dental arch. References | Related Articles | Metrics

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Analysis of influencing factors on orthodontic efficacy in adolescent patients and construction of logistic regression model Ma Hui, Sun Han, Pu Chenjie, Xu Qian, Meng Mingmei, He Han 2026, 35 (3):  265-270.  doi: 10.19439/j.sjos.2026.03.007 Abstract ( 10 )   PDF (749KB) ( 10 )   PURPOSE: To analyze the influencing factors of orthodontic efficacy in adolescent patients and construct a logistic regression model. METHODS: A total of 260 adolescent orthodontic patients treated from January 2019 to December 2023 were selected. The therapeutic effect was evaluated using the peer assessment rating (PAR) index. At the 2-year follow-up after treatment completion, patients with a reduction of more than 5 points in the PAR index compared with immediately post-treatment were assigned to the poor efficacy group (n=53), and the remaining patients were assigned to the favorable efficacy group (n=207). Binary logistic regression was used to analyze the risk factors for poor efficacy in adolescent orthodontic patients, and logistic regression model was constructed based on the risk factors. RESULTS: The binary logistic regression analysis showed that anxiety (OR=8.467, 95%CI=2.800-25.609, P<0.001), Angle Class Ⅱ malocclusion (OR=9.624, 95%CI=2.504-36.990, P=0.001), Angle Class Ⅲ malocclusion (OR=4.210, 95%CI=1.146-15.467, P=0.030), root morphology abnormalities (OR=5.927, 95%CI=2.276-15.435, P<0.001), poor oral hygiene (OR=2.943, 95%CI=1.139-7.604, P=0.026) and poor patient compliance (OR=9.620, 95%CI =3.047-30.376, P<0.001) were risk factors for poor treatment outcome in adolescent orthodontic patients, while retainer wearing time (OR=0.773, 95%CI=0.69-0.864, P<0.001) was a protective factor. A logistic regression model was constructed using the risk factors. The Hosmer-Lemeshow goodness-of-fit test showed that χ2=6.648, P=0.575. The area under the curve (AUC) of the model for predicting poor treatment outcomes in adolescent orthodontic patients was 0.939, with a 95%CI of 0.908-0.971. The sensitivity and specificity were 92.5% and 83.6%, respectively, and the practical application accuracy was 89.2%. CONCLUSIONS: The orthodontic efficacy of adolescent orthodontic patients is related to anxiety, types of malocclusions, abnormal root morphology, oral hygiene, compliance and duration of retainer wearing. A logistic regression model constructed through risk factors has high predictive value. References | Related Articles | Metrics

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Therapeutic effect of anti-radiation spray on preventing and treating oral mucositis after hematopoietic stem cell transplantation Song Jie, Zhang Qianqian, Ni Jing 2026, 35 (3):  271-275.  doi: 10.19439/j.sjos.2026.03.008 Abstract ( 7 )   PDF (641KB) ( 6 )   PURPOSE: To explore the clinical efficacy of radiation-resistant liquid wound dressing in preventing and treating oral mucositis (OM) after haematopoietic stem cell transplantation (HSCT). METHODS: A total of 68 patients who developed OM after HSCT at Xuanwu Hospital, Capital Medical University from January 2019 to June 2024 were selected and divided into the control group (n=40, standard oral care) and experimental group (n=28, Kangfu Pen combined with standard oral care) according to the type of intervention methods. The onset time and duration of OM, incidence of OM at different grades, and incidence of dry mouth and other related symptoms were compared between the two groups. Changes in the numerical rating scale (NRS) of pain, serum inflammatory factors [C-reactive protein (CRP) and procalcitonin (PCT)] levels, and body mass index (BMI) were recorded from 3 days before intervention to 21 days after transplantation. RESULTS: The incidence of grade Ⅱ-Ⅳ OM in the experimental group (35.7%) was significantly lower than that in the control group (70.0%, P=0.046); the onset time of OM in the experimental group was significantly later, and the duration was significantly shorter than those in the control group (P<0.001). The incidence of dry mouth in the experimental group (7.2%) was significantly lower than that in the control group (27.5%, P=0.036), and the decrease in BMI was significantly smaller than that in the control group (P<0.001). There were no significant differences in NRS scores, CRP, or PCT levels between the two groups 3 days before intervention (P>0.05); the above indicators in both groups reached the highest values on day 7 after transplantation. The NRS scores, CRP and PCT levels in the experimental group were significantly lower than those in the control group on days 3, 7, 14 and 21 after transplantation (P<0.05). No adverse reactions occurred in either group. CONCLUSIONS: Kangfu Pen is safe and effective in preventing and treating OM after HSCT, and can improve patients' quality of life. Its mechanism of action may be related to inhibiting the expression of inflammatory factors. References | Related Articles | Metrics

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Analysis of changes in the thickness, elasticity and facial aesthetic index of the lip soft tissue before and after implant restoration in patients with maxillary anterior tooth loss Qi Lulu, Jiao Tiejun, Wang Xiaobo, Liang Huiling, Huo Jinrong 2026, 35 (3):  276-280.  doi: 10.19439/j.sjos.2026.03.009 Abstract ( 9 )   PDF (654KB) ( 9 )   PURPOSE: To analyze the changes in the thickness, elasticity and facial aesthetic index of the lip soft tissue before and after implant restoration in patients with maxillary anterior tooth loss. METHODS: A total of 96 patients with missing maxillary anterior teeth who underwent implantation-fixed restoration in the maxillary anterior teeth area from January 2021 to January 2025 were selected. The baseline data, CBCT results and 3D facial scanning data of the patients were collected, and the success rate of implantation and complications were recorded. The changes of lip soft tissue thickness, elasticity and facial aesthetic index were compared before implantation (T0), at insertion of the guide plate (T1) and after final restoration (T2). Pearson correlation analysis was used to evaluate the relationship between postoperative aesthetic outcomes and changes in lip soft tissue. RESULTS: The implant survival rate was 100% (96/96). Postoperative complications included 3 cases of swelling, 2 cases of bleeding, and 5 cases of pain, all of them resolved after treatment. No severe complications such as infection, nerve injury or implant fracture occurred. Compared to T0, upper lip length significantly increased at T1 and T2, while upper lip thickness and nasolabial angle significantly decreased, and lower facial height significantly increased (P<0.05). The pink aesthetic score (PES) at TI and T2 was significantly higher than that at T0 (P<0.05). Pearson correlation analysis showed that PES was positively correlated with the length of the upper lip and the height of the lower face, and negatively correlated with the thickness and nasolabial angle (P<0.05). CONCLUSIONS: Implant-supported fixed restoration in the maxillary anterior region significantly improves lip support and enhances facial aesthetics in patients with anterior tooth loss, with good treatment safety and no serious complication. References | Related Articles | Metrics

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Analysis of influencing factors on crown fracture in endodontically treated teeth without crown restorations Zhu Jiajun, Wang Yi, Yang Ya 2026, 35 (3):  281-287.  doi: 10.19439/j.sjos.2026.03.010 Abstract ( 12 )   PDF (709KB) ( 16 )   PURPOSE: To investigate the intraoral retention time before crown fracture, the severity of crown fracture, and related influencing factors in endodontically treated teeth (ETT) without crown restoration, and to provide evidence for clinical prognosis evaluation and intervention. METHODS: Patients with ETT crown fractures who visited Shanghai Ninth people's Hospital, Shanghai Jiao Tong University School of Medicine from March 2023 to January 2024 were selected. Through medical history collection and oral examination, the intraoral retention time of ETT, the number of missing axial walls after crown fracture, and patients' baseline clinical data were recorded. Univariate and multivariate logistic regression analyses were used to screen for independent risk factors affecting the intraoral retention time and the severity of crown fracture in ETT. RESULTS: A total of 146 patients were included, consisting of 87 males and 59 females, with an average age of (44.63±4.28) years. Among them, there were 51 maxillary posterior teeth and 95 mandibular molars. The average intraoral retention time of ETT was (8.27±3.57) years, and the average number of missing axial walls was (92.25±0.99). Multivariate analysis showed that age, reason for root canal treatment, filling material, jaw position, tooth position, and periodontal status were independent risk factors for shorter intraoral retention time of ETT (P<0.05). Reason for root canal treatment, jaw position, and tooth position were independent risk factors for the severity of ETT crown fracture (number of missing axial walls) (P<0.05). CONCLUSIONS: The retention time of teeth after root canal treatment is correlated with patients' age, reason for root canal treatment, tooth position, and periodontal status. Elderly patients, teeth undergoing root canal treatment due to dental trauma or cracked teeth, mandibular molars, and teeth with poor periodontal status have a higher risk of crown fracture without crown restoration after root canal treatment. References | Related Articles | Metrics

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Comparison of the effects of modified muscle agonists and Twin-block orthodontic appliances in the treatment of skeletal ClassⅡmandibular retraction deformity Zhang Yajun, Wang Hong, Wu Meng 2026, 35 (3):  288-293.  doi: 10.19439/j.sjos.2026.03.011 Abstract ( 10 )   PDF (705KB) ( 8 )   PURPOSE: To compare the effects of modified muscle agonist and Twin-block orthodontic appliance in the treatment of skeletal ClassⅡmandibular retraction deformity. METHODS: A total of 108 patients with skeletal ClassⅡ mandibular retraction deformity admitted to 904th Hospital, Joint Logistics Support Force, Chinese People's Liberation Army from March 2021 to June 2024 were selected and divided into 2 groups according to the random number table method, with 54 cases in each group. The control group was treated with Twin-block orthodontic appliance, while the experimental group was treated with modified muscle activator. The treatment effects were compared between the two groups. RESULTS: The corrective effect of the experimental group was significantly better than that of the control group (P<0.05). After treatment, the hard and soft tissue indicators and upper airway indicators in the experimental group were significantly better than those in the control group (P<0.05). The smile index and parabuccal space ratio of the experimental group were significantly lower than those of the control group, and the symmetry of the smile was significantly higher than that of the control group (P<0.05). The incidence of complications and the recurrence rate one year after treatment in the experimental group were significantly lower than those in the control group (P<0.05). CONCLUSIONS: Compared with Twin-block orthodontic appliance, modified muscle agonist has significant effect in correcting patients with skeletal ClassⅡmandibular retraction deformity. It can improve the smiling aesthetic index of patients, alleviates upper airway stenosis, and has a lower incidence of complications. References | Related Articles | Metrics

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Evaluation of the long-term effects of SGTB combined with fixed appliances in the treatment of skeletal Class Ⅱ malocclusion in adolescents Song He, Li Chunying, Wang Fawen, Zhao Ning, Su Hongru 2026, 35 (3):  294-299.  doi: 10.19439/j.sjos.2026.03.012 Abstract ( 5 )   PDF (394KB) ( 9 )   PURPOSE: To explore the craniofacial growth modification effect of two-stage treatment with sagittal-guidance Twin-block appliance (SGTB) combined with fixed appliances on skeletal Class Ⅱ malocclusion in adolescents, and to evaluate the long-term stability of the functional orthopedic effect of this protocol. METHODS: A total of 21 adolescent patients with Class Ⅱ division 1 malocclusion in the growth and development period were included, with an average initial age of (12.02±1.02) years. All patients received a non-extraction treatment protocol consisting of "stage 1: SGTB functional orthopedics + stage 2: fixed appliance therapy". Cephalometric analysis was performed at the initial stage of treatment (T0), after SGTB removal (T1), at the end of fixed appliance treatment (T2), and during the follow-up period after treatment (T3). Changes in craniofacial skeletal, dental and soft tissue indicators at each time point were compared to evaluate the treatment effect and stability. RESULTS: After two-stage treatment, the sagittal jaw discrepancy was significantly corrected (increased SNB angle, decreased ANB angle, reduced Wits value, and diminished overjet); the overall jaw length increased, and the mandible moved forward (Co-Gn, Co-Go, and Pog-Nperp significantly increased); maxillary growth was slightly inhibited (decreased Ptm-A, P=0.013). In addition, the upper incisors retracted, the lower dentition moved mesially, and the molar relationship was restored to Class Ⅰ. During the follow-up period (T2-T3), there was no significant recurrence of skeletal indicators (such as SNB angle, ANB angle, and Wits value) (P>0.05); only slight physiological rebound occurred in overjet, overbite and nasolabial angle, and the overall stability was good. CONCLUSIONS: The two-stage combined treatment with SGTB appliance and fixed appliances can effectively correct skeletal Class Ⅱ malocclusion, promotes the growth of the condyle and mandible, and shows good stability in long-term follow-up. References | Related Articles | Metrics

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Effect of normal saline at different temperatures on postoperative complications after minimally invasive extraction of impacted mandibular third molars Zhao Jun, Wu Xiaobo, Zhai Qinkai, Liu Na, Chen Zhuo, Wang Yanhui 2026, 35 (3):  300-304.  doi: 10.19439/j.sjos.2026.03.013 Abstract ( 6 )   PDF (1059KB) ( 4 )   PURPOSE: To investigate the effect of normal saline irrigation at different temperatures on postoperative complications during the extraction of impacted mandibular third molars. METHODS: A total of 21 patients who underwent extraction of bilateral impacted mandibular third molars at Hefei Stomatological Hospital from February 2021 to June 2025 were enrolled in this study. A randomized self-controlled design was adopted, where the bilateral impacted teeth were divided into an experimental group (irrigated with 4 ℃ low-temperature normal saline during surgery) and a control group (irrigated with 26 ℃ room-temperature normal saline during surgery). All patients received staged extraction of bilateral impacted teeth, with the two surgeries serving as mutual controls. The visual analog scale (VAS) was used to record the pain scores at 0.5, 2, 6, 12, 24 and 72 hours postoperatively. Meanwhile, the operation time, the degree of edema at 72 hours postoperatively, the dosage of analgesics, mouth opening degree, postoperative bleeding, and the incidence of dry socket were recorded. RESULTS: The VAS scores at 2 and 6 hours postoperatively and the degree of edema at 72 hours postoperatively in the experimental group were significantly lower than those in the control group (P<0.05). No significant differences were found between the two groups in operation time, analgesic dosage, mouth opening degree, postoperative bleeding, the incidence of dry socket or VAS scores at other recorded time points (P>0.05). CONCLUSIONS: Irrigation with 4 ℃ low-temperature normal saline during minimally invasive extraction of impacted mandibular third molars can significantly alleviate postoperative pain at 2 and 6 hours and edema at 72 hours, which is worthy of clinical application. References | Related Articles | Metrics

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Value of LTB4 and hBD-3 expression in gingival crevicular fluid combined with random forest model for predicting the risk of peri-implantitis during the maintenance period of implant restoration patients Wu Yan, Yang Jianxin, Tang Zhaolong 2026, 35 (3):  305-311.  doi: 10.19439/j.sjos.2026.03.014 Abstract ( 10 )   PDF (1080KB) ( 4 )   PURPOSE: To evaluate the value of combining leukotriene B4 (LTB4) and human beta-defensin-3 (hBD-3) expression in gingival crevicular fluid (GCF) with a random forest model for predicting the risk of peri-implantitis (PI) during the maintenance period of implant restoration patients. METHODS: A prospective study was conducted, totally 362 patients who underwent implant restoration from March 2023 to March 2025 were selected. They were divided into PI group(n=61) and non PI group (n=301) according to the occurrence of peri-implantitis during the maintenance period. Baseline data were compared between the two groups, binary logistic regression was used to analyze the influencing factors of peri-implantitis during the maintenance of implant repair patients. The random forest model was constructed using R (R 4.1.0) software package and the randomForest package. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated to test the predictive value of the random forest model for peri-implantitis during the maintenance of patients with implant restoration. RESULTS: The levels of Caspase-1, IL-1β and LTB4 in the PI group were significantly higher than those in the non PI group, and the level of hBD-3 was significantly lower than that in the non PI group (OR>1, P<0.05). hBD-3 was a protective factor for PI during maintenance (OR<1, P<0.05). The variable importance measure (%IncMse) was used to score and rank the feature importance. The top three importance indicators were LTB4, Caspase-1 and IL-1β, respectively. The %IncMse was 29.372, 27.488 and 23.123, respectively. The random forest model was P=0.01. Among the 362 patients, totally 317 were correctly predicted, and the correct rate was 87.57%. The random forest reached a stable performance period when the number was≥100. Based on the test set, a random forest model was established with Caspase-1, IL-1β, LTB4 and hBD-3 to predict the occurrence of peri-implantitis during the maintenance of implant restoration patients. The AUC was 0.841, the sensitivity was 0.833, the specificity was 0.769, the Youden index was 0.603, and the 95%CI was 0.736-0.923, which had good predictive efficacy. CONCLUSIONS: Caspase-1, IL-1βand LTB4 levels are risk factors for peri-implantitis during the maintenance period in patients undergoing implant restoration, while hBD-3 level is a protective factor. Random forest model analysis indicates that LTB4 is a key driver in predicting PI, and the model constructed based on these results demonstrates good predictive performance. References | Related Articles | Metrics

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A study on the clinical effects of resin hybrid ceramic inlays in restoring posterior tooth defects Xu Zhou, Liu Kaiwei, Long Qiao, Lu Weiqing, Cao Jie, Cao Weiyu 2026, 35 (3):  312-318.  doi: 10.19439/j.sjos.2026.03.015 Abstract ( 10 )   PDF (1104KB) ( 4 )   PURPOSE: To compare and evaluate the clinical effects of glass ceramics and resin hybrid ceramics for inlay restorations, thereby providing guidance for the selection of inlay restoration materials. METHODS: Forty patients with posterior tooth defects who underwent inlay restoration at the Department of Prosthodontics, Putuo District Eye & Tooth Disease Control and Prevention Hospital from January 2023 to February 2023 were selected and randomly divided into two groups, which were further categorized based on the material used: lithium disilicate glass-ceramic (e.max ceramic) in the control group, while resin-matrix composite ceramic (Enamic) in the experimental group. Follow-up visits were conducted at 6, 12 and 24 months post-restoration. The restoration effects were evaluated through intraoral examinations according to the modified United States Public Health Service(USPHS) criteria, and plaster models were made to observe the surface conditions of the restorations under scanning electron microscope (SEM). RESULTS: In the Enamic group, 19 restorations achieved grade A in all indices, with a success rate of 95%; while in the e.max group, 15 restorations achieved grade A in all indices, with a success rate of 75%. There was no significant difference in the success rates between the two groups of inlays (P>0.05). CONCLUSIONS: The resin hybrid ceramic demonstrates excellent clinical restoration outcomes after two years, making it a favorable choice for inlay. However, further validation is still needed to compare the long-term clinical performance between VITA Enamic and IPS e.max. References | Related Articles | Metrics

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Construction of a precision medical record homepage system for malignant tumors of the tongue based on knowledge graph Zhou Huining, Yang Yiduo, Wang Yanming, Liu Sutai, He Liu, Wang Yan'an, Xu Hui 2026, 35 (3):  319-324.  doi: 10.19439/j.sjos.2026.03.016 Abstract ( 6 )   PDF (1611KB) ( 4 )   PURPOSE: To address quality issues in the documentation of medical record homepages for malignant tumors of the tongue, such as non-standard diagnostic terminology and inaccurate surgical coding, this study employs knowledge graph technology to construct a clinical coding decision-making workflow for inpatient medical record homepages. METHODS: The quality of 12 201 medical record homepages from the Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, between June 2024 and June 2025 was analyzed, and the existing problems and their causes were summarized. Based on knowledge graph extraction and fusion, combined with expert opinions from clinicians and coding specialists in tongue cancer treatment, a targeted clinical coding decision-making workflow was designed. RESULTS: Among the 12 201 inpatient medical records, totally 8 117 had errors on their homepages (12 889 errors in all). Through Pareto statistical analysis, it was found that incorrect principal diagnosis, omitted additional diagnoses, incorrect principal procedure, and incorrect other procedures were the top four medical record homepage deficiencies, accounting for 87.86%. Addressing these clinical challenges, a knowledge graph encompassing epidemiology and pathology, examination and diagnosis, treatment and medication, and prognosis and follow-up was constructed. Consultations with five clinical experts in tongue cancer treatment and two coding specialists informed the development of a clinician-oriented coding decision-making workflow. CONCLUSIONS: The knowledge graph-based clinical coding decision-making workflow innovatively integrates clinicians into medical record quality management, combining clinical diagnostic logic with homepage coding to improve documentation quality at its source, which provides robust data support for high-quality hospital development. References | Related Articles | Metrics

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Comparison of the efficacy of Twin block and Myobrace in the treatment of skeletal Class Ⅱ malocclusion Li Jinpeng, Lin Yan, Wu Mengting, Jiang Yinhua 2026, 35 (3):  325-330.  doi: 10.19439/j.sjos.2026.03.017 Abstract ( 7 )   PDF (661KB) ( 12 )   PURPOSE: To evaluate the effects of Twin block appliance and Myobrace myofunctional appliance on craniofacial hard and soft tissues in the early treatment of skeletal Class Ⅱ malocclusion in children and to compare the therapeutic outcomes between the two appliances. METHODS: Twenty-eight children with skeletal Class Ⅱ malocclusion who received early functional treatment in Lishui People's Hospital from September 2022 to September 2024 were enrolled in this study. Fourteen patients received treatment with Twin block appliance (Twin block group) and fourteen with Myobrace myofunctional appliance (Myobrace group). Lateral cephalometric radiographs were taken before treatment (T0) and after treatment (T1), respectively. Cephalometric measurements were performed using Uceph 4.2.1 software to compare the differences in the changes of maxillofacial hard and soft tissues between the two groups before and after treatment. RESULTS: In Twin block group, SNB, FMA, IMPA, NP-FH, nasolabial angle, FH-Ns-Pos, and Z angle increased, while SNA, ANB, FMIA, U1-SN, U1-L1, overjet, UL-EP, and LL-EP decreased, the differences were statistically significant (P<0.05). In Myobrace group, SNB, IMPA, overjet, NP-FH, nasolabial angle, FH-Ns-Pos, and Z angle increased, while ANB, FMIA, U1-SN, and LL-EP decreased, the differences were statistically significant (P<0.05). There were no significant differences in the changes of cephalometric indices between the two groups before and after treatment (P>0.05). CONCLUSIONS: Both Twin block appliance and Myobrace myofunction appliance can effectively improve skeletal Class Ⅱ malocclusion in children, with essentially the same efficacy of early orthodontic treatment for the two devices. References | Related Articles | Metrics

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Survival rate and influencing factors of dental implants in patients with chronic periodontitis after standardized periodontal treatment Hao Dan, Chen Donglei, Zhang Zhewei, Guo Haibo 2026, 35 (3):  331-336.  doi: 10.19439/j.sjos.2026.03.018 Abstract ( 12 )   PDF (738KB) ( 4 )   PURPOSE: To investigate the clinical efficacy of dental implant treatment in patients with chronic periodontitis who received standardized periodontal therapy, and to analyze the influence of a history of chronic periodontitis and related factors on dental implant survival rate, so as to provide single-center evidence-based evidence for dental implant treatment in periodontitis patients. METHODS: A total of 232 patients (656 implants inserted) who received dental implant treatment in the Department of Oral Implantology, Nantong Stomatological Hospital from November 2020 to October 2025 were enrolled. According to preoperative periodontal examination findings, they were divided into the experimental group (with a history of periodontitis, 133 patients, 428 implants) and the control group (without a history of periodontitis, 99 patients, 228 implants). Survival analysis of implants was performed using Kaplan-Meier method, and Log-rank test was used to compare survival rates between groups. The effects of periodontitis severity, implant brand and other factors on survival rate were analyzed. RESULTS: The follow-up period ranged from 3 months to 5 years, with a mean time of (2.01±0.56) years. The overall implant survival rate was 92.4%, including 91.8% in the experimental group and 93.4% in the control group, with no significant difference between the two groups (P>0.05). Within the experimental group, there was no significant difference in implant survival rate among patients with different severities of periodontitis (P>0.05), whereas a significant difference was observed among different implant brands (P<0.05). Brand S showed the highest survival rate (94.2%), while Brand C showed the lowest (72.7%). Implant length, placement timing, loading time and prosthesis type had no significant impact on implant survival rate in either group (P>0.05). CONCLUSIONS: After standardized preoperative periodontal treatment and personalized postoperative maintenance, dental implant therapy is safe and feasible in patients with chronic periodontitis, and the implant survival rate shows no significant difference from that in patients without a history of periodontitis. Implant brand may affect the early implant survival rate in periodontitis patients, and implant brands with favorable osseointegration properties can be preferred in clinical practice. References | Related Articles | Metrics