松本歯科大学

Osteoporosis is a major and growing health concern in the Asia-Pacific region, y et it remains widely underdiagnosed and undertreated due to limited access to dual-energy X-ray absorptiometry (DXA) in many areas. Artificial intelligence (AI) offers new opportunities to improve osteoporosis screening and management, but unvalidated tools pose risks of inconsistent care. This consensus was developed to provide regionally harmonized guidance on the safe, effective, and equitable use of AI in osteoporosis care. Purpose The aim of this work was to establish expert consensus recommendations on the role of AI in osteoporosis screening and management in the Asia-Pacific region. Key objectives were to define appropriate applications of AI (e.g., imaging-based bone assessment and fracture risk prediction) and specify minimum standards for validation and reporting, addressing region-specific implementation challenges and ensuring that AI use aligns with clinical guidelines and ethical principles. Methods This consensus was developed through multidisciplinary collaboration among experts across the Asia-Pacific region. Each participant reviewed draft statements, contributed feedback during virtual meetings, and provided insights based on clinical experience and current evidence. Consensus was reached iteratively until full agreement was achieved for all statements. The process integrated global best practices and regional adaptations, drawing from peer-reviewed studies, international AI guidelines, and local fracture registry data. The final recommendations emphasize the validation, transparency, and ethical implementation of AI within regional healthcare systems, ensuring compatibility with local regulations. Ultimately, twelve consensus statements were established to guide the responsible use of AI for osteoporosis screening and management in the Asia-Pacific region. Results The panel produced 12 consensus statements covering the role of AI as an adjunct for opportunistic osteoporosis screening rather than a diagnostic tool, requirements for imaging quality and AI model transparency, standards for validation and performance reporting, integration of AI with clinical risk stratification, demonstration of clinical utility in real-world settings, adherence to data protection laws and ethical AI principles, training of clinicians in AI use, strategies for implementation and monitoring (including post-market surveillance and feedback loops), and recognition of technical, clinical, and equity limitations of AI. All 12 statements give extensive recommendations for using AI to improve osteoporosis management while ensuring patient safety, accuracy, and equity. Conclusion This first Asia-Pacific consensus on AI in osteoporosis concludes that AI, when appropriately validated and implemented, can help bridge the osteoporosis care gap by identifying high-risk patients who would otherwise remain undiagnosed, thus facilitating earlier intervention. It emphasizes that AI should complement-not replace-standard diagnostic methods and clinical judgment. The guidance emphasizes validation, transparency, and ethical oversight to facilitate early intervention while minimizing risks associated with unvalidated or premature AI adoption.

Glandular odontogenic cyst (GOC) is a rare odontogenic cyst characterized by distinctive epithelial features and is known for its potential for local aggressiveness and recurrence. Because its clinical presentation and imaging characteristics substantially overlap with those of other odontogenic cysts and tumors, establishing a preoperative diagnosis is often challenging, and a definitive diagnosis relies on histopathological evaluation. We report the case of a 46-year-old man in whom panoramic radiography, computed tomography (CT), and magnetic resonance imaging (MRI) failed to yield diagnostic specificity, and who was ultimately diagnosed with GOC based on histopathological examination. Panoramic radiography revealed a multilocular radiolucent lesion extending from the right mandibular body to the right mandibular ramus. Unenhanced CT images demonstrated lingual cortical thinning with focal discontinuity and buccal cortical thinning that was largely preserved. MRI showed a relatively homogeneous intermediate signal on T1-weighted images and a layered appearance on T2-weighted images, characterized by homogeneous high signal intensity superiorly and heterogeneous intermediate-to-high signal intensity inferiorly; however, none of these findings were specific to GOC. The lesion was removed en bloc under general anesthesia. Histopathological examination revealed features consistent with glandular odontogenic cyst, including non-keratinized stratified squamous epithelium of variable thickness with cuboidal cells, as well as mucous and clear cells, leading to a definitive diagnosis. This case highlights the diagnostic difficulty of GOC based solely on clinical and radiographic findings and underscores the indispensable role of histopathological assessment in establishing a definitive diagnosis.

Objectives This study aimed to evaluate the effects of spontaneously formed mesenchymal stromal cells (MSCs) spheroids on alveolar bone regeneration and inflammatory responses following tooth autotransplantation in a murine model. Methods Spontaneous spheroids were generated from mouse calvaria-derived MC3T3-E1 cells using a low-adhesion culture system. Extracted molars were transplanted with spheroids embedded in a collagen-based scaffold. Monolayer cells, scaffold, and tooth-only groups served as controls. Bone regeneration was assessed by micro-CT and histological analyses at 1, 2, and 4 weeks post-transplantation. Gene expression related to osteogenesis and inflammation was analyzed by quantitative PCR. Results In vitro analyses demonstrated that MC3T3-E1 spheroids exhibited significantly increased alkaline phosphatase activity, mineralization, and expression of pluripotency and osteogenesis related genes compared with monolayer cells. In vivo, the spheroid group showed significantly enhanced new bone formation, with higher bone volume fraction (BV/TV) throughout the observation period (p < 0.05). Expression of osteogenic markers, including osteocalcin (OCN) and collagen type I, was significantly upregulated, whereas inflammatory cytokines IL-6 and TNF-α were consistently suppressed. Histological evaluation revealed organized collagen fiber alignment suggestive of periodontal ligament-like tissue regeneration. Conclusions MSC-derived spontaneous spheroids promote alveolar bone regeneration and suppress inflammatory responses following tooth autotransplantation. This spheroid-based strategy may improve regenerative outcomes in tooth autotransplantation.

Background: D-amino acids are increasingly recognized as bioactive molecules with diverse physiological and pathological roles in humans, particularly in the gut, kidneys, and nervous system. Advances in analytical techniques have revealed their widespread presence in biological fluids, including plasma, urine, cerebrospinal fluid, amniotic fluid, and saliva, challenging the long-standing assumption that D-amino acids are absent or biologically insignificant in mammals. Scope: This review systematically summarizes the current knowledge on D-amino acid sources, distribution, metabolic regulation, and biological functions, with emphasis on their roles in human physiology and disease. Key findings: Accumulating evidence indicates that major D-amino acids, including D-serine, D-aspartate, and D-alanine, are derived from multiple sources such as diet, intestinal microbiota, and endogenous racemization processes. Rather than being passive metabolic byproducts, D-amino acids are now understood to participate in host–microbe interactions, neurotransmission, and renal physiology. Importantly, a consistent trend across studies is their dual and concentration-dependent nature, exhibiting beneficial effects under physiological conditions but potential cytotoxic effects at elevated levels. Conclusions and perspectives: Overall, D-amino acids represent multifunctional biomolecules with tightly regulated physiological roles and context-dependent pathological implications. However, major gaps remain in understanding their quantitative dynamics, tissue-specific regulation, and microbiota-dependent metabolism. Future studies addressing these mechanisms will be essential for establishing their clinical utility as biomarkers and for developing D-amino acid-based therapeutic and nutritional strategies.

BACKGROUND:Dental and oral health activities that promote awareness of oral health are essential in children's nutrition education. We aimed to evaluate the effects of the Comprehensive Awareness Modification of Mouth, Chewing And Meal (CAMCAM) program for kids, in which participants gather monthly to learn about oral health and nutrition while consuming a textured meal at community children's cafeterias. METHODS:This single-group pre-post pilot intervention without a control group included 52 children and 32 parents/guardians who regularly attended two community children's cafeterias in Tokyo, Japan. They participated monthly in six sessions in which they were provided a "munchy" textured meal and a 10-minute lecture on chewing, oral health, and food and nutrition. Participants completed questionnaires assessing their awareness of the subject and food intake frequency, before and after the intervention. Changes in awareness and behaviors following participation in the program were analyzed. RESULTS:The median ages of the children and parents were 8.5 (6-16) and 43.0 (36-50) years, respectively. The frequency of self-observation of the oral cavity among children increased. Daily fluoride use frequency increased from 61.5% to 76.9% (p = 0.020). The number of children who reported not considering nutritional balance decreased from 63.5% to 38.5% (p = 0.022). The number of parents/guardians who actively practiced a nutritionally balanced diet non-significantly increased from 56.2% to 75.0%. Food intake frequencies for meat, dairy products, and tubers, among caregivers, and that for rice, tubers, and fruits among children increased post-intervention. The number of participants who did not consider the number of chewing cycles decreased. CONCLUSION:Participation in CAMCAM-P for kids was associated with favorable changes in oral health awareness and attitudes toward nutritional balance among children and parents/guardians. As a pilot study without a control group, these findings should be considered preliminary. Larger controlled studies are warranted to confirm effectiveness.