Odonto-hypophosphatasia (odonto-HPP) is a mild form of hypophosphatasia (HPP) characterised by premature exfoliation of primary and/or permanent teeth accompanied by low serum alkaline phosphatase (ALP) activity levels, without abnormalities of the skeletal system. Tooth agenesis (TA) is a common developmental anomaly characterised by the absence of one or more teeth due to the failure of tooth formation. In this study, the present authors report on a family simultaneously affected by odonto-HPP and TA for the first time. Comprehensive genetic analysis identified two novel missense variants (c.103G>A and c.247G>A) in the ALPL gene associated with odonto-HPP and no pathogenic variants in the reported TA genes, which may expand the genetic spectrum of odonto-HPP and imply an unforeseen additional dental abnormality associated with HPP.
OBJECTIVE:To investigate the impact of spatial positions of the transfer fork registration markers on the accuracy of generating a virtual dentofacial patient. METHODS:An in vitro study was conducted using a mannequin head with a standard maxillary dentition model. Radiopaque gauge markers were fixed on the face and dentition of the mannequin head. CBCT was performed and the distance and angle between the dentition and facial markers were measured in the CBCT as reference values. Intraoral scanners were used to obtain 3D morphological data of the maxilla. Two types of transfer fork were designed and fabricated. The registration markers on transfer fork A were positioned in the midline area, while those on transfer fork B were located at the corners of the mouth on both sides. The transfer forks were digitised and connected to the maxillary dentition within the mannequin head, and facial scanning was performed using a facial scanner five times in each group. A virtual dentofacial patient was built through matching and integration of digital dentition, face and transfer fork data using 3D reverse engineering software (Geomagic Wrap 2021, 3D Systems, Rock Hill, SC, USA). Measurement values including feature lengths and feature angles between six facial gauge markers and three dentition gauge markers were obtained in the virtual patients. RESULTS:The mean trueness and precision of linear difference for virtual patients established using transfer fork A were -1.00 ± 0.11 mm and 0.27 ± 0.02 mm and the angle deviation was -1.88 ± 0.27 degrees, whereas for transfer fork B, the mean trueness and precision of linear difference were 2.66 ± 0.25 mm and 0.83 ± 0.06 mm, and the angle deviation was 3.74 ± 0.87 degrees. There is an overall significant difference in the trueness values of feature lengths (t = -13.963, P = 0.000) and angles (t = -5.985, P = 0.004) between transfer fork groups A and B, with group A showing better trueness and precision. CONCLUSION:Linear and angular errors will be introduced in the process of building up a virtual dentofacial patient using a transfer fork. The trueness and precision of the transfer fork with the matching markers at the centre of the lips are more precise than the transfer fork, with matching markers on both sides of the mouth.
To overcome the reliance on subjective clinical judgment and the inadequacy of international indices in reflecting Chinese orthodontic expertise and patient characteristics, the Chinese Stomatological Association developed an expert consensus on orthodontic treatment outcome evaluation. This first systematically calibrated framework tailored to Chinese populations was established through an extensive process: comprehensive literature review, analysis of the Peer Assessment Rating (PAR) and the American Board of Orthodontics Objective Grading System (ABO-OGS) indices and a large-scale subjective-objective correlation study involving 65 standing committee members evaluating 216 completed cases. The resulting 3D evaluation system encompasses occlusal relationships, root and bone health and facial profile harmony. Occlusal assessment includes six core indicators: incisor horizontal overlap, vertical overlap, sagittal relationship, alignment, occlusal contact and buccal lingual inclination. Root and bone health evaluation mandates CBCT-based assessment of root resorption, fenestration and dehiscence, the first mandatory inclusion of 3D radiographic evaluation in orthodontic outcome standards. Facial profile analysis comprises five cephalometric measurements (ANB, MP/SN, Sn-GPos, UL-E and Bs-GPos) evaluated using a standardised difference method. Each dimension provides detailed specifications for evaluation materials, objective indicators, measurement methods, scoring criteria and a five-grade classification (excellent, good, fair, poor and worst) based on total deduction scores aligned with expert consensus percentiles. This consensus aims to standardise clinical practice, establish a scientific foundation for treatment quality control and specialist certification, provide morphological evaluation criteria for research and enhance orthodontic care quality in China. Despite being focused on static morphology, the framework is designed to accommodate future integration of functional assessment and long-term stability evaluation.
This expert consensus addressed the use of digital full-contour high-translucent/ultra-translucent (HT/UT) zirconia restorations. HT/UT zirconia, stabilised with 4 mol% to 6 mol% yttria, balances flexural strength (550 to 1100 MPa) and enhanced translucency (45% to 55% light transmission) through a cubic-tetragonal microstructure while maintaining excellent biocompatibility and aging resistance. Clinical applications include single crowns, short-span bridges, veneers (0.3 to 1.0 mm) and implant-supported prostheses (screw-/cement-retained with specific thickness requirements). The digital workflow involves precise preparation, digital impressions, computer-aided design, milling, sintering and post-processing (surface polishing to Ra ≤ 0.25 μm). A lack of unified standards causes variable practices in the clinic. This consensus provides guidelines to standardise procedures, promoting predictable quality and long-term success of HT/UT zirconia restorations.
Oral soft tissue defects resulting from trauma, infections, tumour resection or congenital disorders present significant clinical challenges, impairing functions like mastication, speech and aesthetics. Current therapeutic approaches, including free gingival grafts (FGGs) and connective tissue grafts (CTGs), are associated with certain clinical limitations, such as donor site morbidity and structural fragility. Hydrogels are attractive biomaterials for oral soft tissue repair owing to their biocompatibility, tunable mechanics and extracellular matrix-mimicking properties. This review comprehensively explores hydrogel applications in oral wound healing, focusing on the histological structure of oral mucosa and unique challenges of the oral environment; design strategies using natural and synthetic polymers; advanced manufacturing strategies, such as 3D bioprinting, electrospinning and microfluidic organ-on-a-chip technology; and therapeutic applications in mucosa repair, gingival regeneration and periodontal therapy.
OBJECTIVE:To establish cephalometric normative reference values based on the subjective consensus of Chinese orthodontic experts regarding the evaluation of lateral cephalometric radiographs. METHODS:This study included 120 patients in the permanent dentition stage who visited the Department of Orthodontics at Peking University School and Hospital of Stomatology between 2022 and 2025. The participants were divided into two groups: an adolescent group (n = 60, aged 14.40 ± 1.70 years, 30 boys and 30 girls) and an adult group (n = 60, aged 24.33 ± 5.65 years, 30 men and 30 women). Lateral cephalometric radiographs were analysed by two PhD students and one postdoctoral researcher from the Department of Orthodontics. Through statistical analysis, cephalometric normative values were established for Tweed, Downs, Steiner and Peking University analysis methods as well as for soft tissue measurements, and comparisons were made between the two age groups. RESULTS:A reference standard for cephalometric normative values was developed, reflecting the consensus of Chinese orthodontic experts in assessing profile harmony. Significant differences (P 0.05) were identified between the adolescent and adult groups in the normative values of FMA (MPA), GoGN/SN, SE and G-Sn-Pos. CONCLUSION:Expert consensus evaluation of lateral cephalometric radiographs provides a more objective basis for identifying harmonious samples. This enables the derivation of more accurate cephalometric normative values for sagittal skeletal measurements and soft tissue parameters.
OBJECTIVE:To explore and visualise how different degrees of labio-lingual inclination of the maxillary incisors affect the aesthetic assessment of smiling profiles in people with various chin positions. Different perceptions from professionals and non-professionals are outlined in this study. METHODS:A profile photograph with a clear facial contour and a full smile was captured and then edited into a series of 49 smiling profile pictures, with seven variations in both chin position and maxillary incisor inclination. A MaxDiff survey was conducted to rank the photos according to the aesthetic preference of orthodontists and laypeople. The data were then evaluated using count analysis and hierarchical Bayes estimation. RESULTS:Upright and mild lingual inclination (0 to 5 degrees) of the maxillary incisors generally gained higher acceptance in both groups when chin protrusion was not taken into consideration, whereas the opposite was true for labial inclination. The acceptance of excessive lingual inclination (10 to 15 degrees) of the central incisor in laypeople was significantly higher than in orthodontists. Both groups suggested that as chin retrusion increases (6 mm), increasing maxillary incisor lingual inclination (10 degrees) is preferred. When chin retrusion was greater (6 mm), upright or mild lingual inclination (0 to 5 degrees) was considered acceptable by orthodontists, but greater lingual inclination (5 to 15 degrees) was also acceptable by laypeople. CONCLUSION:Both labio-lingual inclination of maxillary incisors and chin position play an essential role in the aesthetic assessment of smile profiles. The ideal value for maxillary incisor inclination varies with chin position.
OBJECTIVE:To compare the marginal fit and mechanical performance of three-unit implant-supported fixed dental prostheses (ISFDPs) fabricated using fully digital and conventional workflows. METHODS:Three-unit ISFDP specimens in this study simulated the restoration of three consecu-tively missing teeth in the mandibular posterior region. Twenty-four specimens were divided into three groups: the zirconia fully digital (ZFD) group received zirconia ISFDPs fabricated using a fully digital workflow; the polyetherketoneketone fully digital (PFD) group received polyetherketoneketone (PEKK) ISFDPs fabricated using a fully digital workflow; and the zir-conia control (ZC) group received zirconia ISFDPs fabricated using a conventional workflow. Marginal gaps between restorations and abutments during passive and active fit were meas-ured, and initial screw loosening torque values of restorations were recorded. After undergoing 1,200,000 cycles of vertical loading, the restorations were reassessed for marginal gaps and loosening torque values. RESULTS:Marginal fit under passive and active fit in the ZFD group showed no significant dif-ference in relation to the ZC group. Marginal gaps in the PFD group (134.39 ± 41.13 µm) under passive fit were significantly larger than in the ZFD group, and decreased significantly under active fit (22.28 ± 10.45 µm). No significant difference in marginal fit was observed before and after cyclic loading in all groups. No significant difference was found in loosening torque change between the ZFD and ZC groups, whereas the change in the PFD group (median -2.13%, Q25 -3.30%/Q75 0.28%) was significantly lower than in the ZC group (median -5.83%, Q25 -8.46%/Q75 -3.75%). CONCLUSION:Three-unit ISFDPs fabricated using fully digital and conventional workflows exhibit similar marginal fit and mechanical performance. Additionally, PEKK ISFDPs demonstrate clinically acceptable marginal fit and mechanical performance.
Mechanotransduction is the biological process by which physical forces are converted into biochemical signals, playing a central role in alveolar bone remodelling. This remodelling is influenced by external stimuli such as mechanical stress, bone loss, and medication-related osteonecrosis. While most in vivo studies have focused on mechanotransductive changes within the periodontal ligament (PDL), it is increasingly recognised that the alveolar bone itself plays a broader and more complex role in this dynamic process. This narrative review presents a quali-tative synthesis of literature sourced from PubMed, Scopus and Web of Science, emphasising the cellular and molecular pathways involved in mechanotransduction within alveolar bone. A deeper understanding of these mechanisms is essential for advancing applications in orthodon-tic tooth movement, dental implant osseointegration, and musculoskeletal tissue engineering. Moreover, insights into the biomechanical regulation of bone may facilitate the development of improved biomaterials and regenerative strategies in clinical dentistry and orthopaedics.
OBJECTIVE:To evaluate the effects of a novel software developed to assist dental students in mak-ing tooth ground sections and gaining knowledge of dental hard tissues. METHODS:Students were divided into three groups (class-use group, after-class-use group and control group) and taught how to make real sections or allowed to use the aforementioned software to make virtual tooth ground sections on the computer. The present authors then assessed the efficiency of making the first tooth ground sections, the quality of ground sections and performance skills. RESULTS:The sectioning time for the class-use group was less than that for the after-class-use group and control group (P = 0.027), and the quality of sections for the class-use group was higher (P = 0.036). In the objective test 1 week later, the after-class-use group performed better than the control group (P = 0.019). Users agreed that the software stimulated their interest and improved their learning results. CONCLUSION:This software is an efficient tool to help students to make tooth ground sections and study the histology of dental hard tissues in a simple and functional way.
Photodynamic therapy (PDT) utilising 5-aminolevulinic acid (5-ALA) has emerged as a signifi-cant non-invasive treatment for oral potentially malignant disorders (OPMDs). PDT involves the use of a photosensitiser (5-ALA), light and oxygen to selectively target and destroy diseased tissues via photochemical reactions. This therapy has shown promising results in treating vari-ous OPMDs, such as oral leucoplakia, oral erythroplakia and oral lichen planus. This consensus document outlines the clinical application of 5-ALA-PDT, providing a comprehensive guide for oral mucosal specialists and stomatology departments. The consensus includes detailed recommendations on irradiation dose, irradiation time, light source selection, pre-treatment preparation, clinical diagnosis, treatment protocols, efficacy evaluation and management of post-treatment adverse events. The goal is to standardise 5-ALA-PDT procedures to improve clinical outcomes and provide a scientific basis for the treatment of OPMDs. By offering guid-ance on patient selection, lesion assessment and therapeutic strategies, this document aims to address current clinical challenges and enhance the effectiveness of PDT in managing oral mucosal diseases.
OBJECTIVE:To assess the impact of hyperbaric oxygen (HBO) therapy on bone healing in dia-betic patients and explore potential mechanisms in an animal experiment. METHODS:Four non-diabetic patients undergoing maxillary sinus lateral augmentation were assigned to either standard care (control group) or HBO treatment for 5, 6 or 9 weeks. Bone core samples were collected for immunochemistry during the preparation for implant insertion. Additionally, 12 db/db diabetic mice and 12 control mice with tibia defects were subjected to HBO treatment. After 7 days, the bone repair process was assessed using microcomputed tom-ography (microCT), histology, immunohistochemistry and Western blot analyses. RESULTS:HBO improved bone formation in the implant areas of patients treated for 5, 6 and 9 weeks, increasing local vascular endothelial growth factor, bone morphogenetic protein-2 and osteocalcin expression. Diabetic mice exhibited impaired bone healing, but HBO-treated groups (diabetic or non-diabetic) showed enhanced new bone formation. Increased osteocalcin and runt-related transcription factor 2 and decreased tartrate-resistant acid phosphatase expression were detected. The nuclear factor erythroid-derived 2-related factor 2 (Nrf2) pathway and its downstream proteins catalase and heme oxygenase-1 were upregulated after HBO. CONCLUSION:HBO enhances bone healing in both patients and diabetic mice, and is potentially mediated through the Nrf2 pathway.
OBJECTIVE:To develop an efficient and accurate method for the precise quantification of peri-implant marginal bone loss, aiming to overcome the limitations of conventional assessments that rely heavily on expert subjective judgment and to enhance the monitoring of marginal bone level stability and facilitate the early detection of clinical risk factors. METHODS:This research proposes an efficient automatic quantification method for marginal bone loss based on the YOLOv8-pose model. By detecting and localising keypoints associated with peri-implant bone loss, this method enables automated identification of marginal bone loss characteristics. Model performance is evaluated using the marginal bone loss rate to assess its effectiveness in predicting the severity of resorption on both sides of the implant. RESULTS:The precision of keypoint detection for marginal bone loss features exceeds 98%, and the mean radial error of six keypoints in most images is less than 10 pixels, with the minimum error reaching only 2.89 pixels. In predicting marginal bone loss severity on both implant sides, the model achieves accuracies of 0.906 and 0.844, respectively, demonstrating robust predictive capability and application potential. CONCLUSION:The YOLOv8-pose-based method effectively addresses the inefficiency and subjec-tivity of traditional assessments by enhancing the automation and objectivity of peri-implant marginal bone loss detection. It provides valuable technical support for accurate evaluation and clinical decision making in peri-implant marginal bone loss.
OBJECTIVE:To explore the association of PAX3 gene variants and non-syndromic orofacial cleft lip/palate (NSCL/P) among the Han Chinese population in Western China. METHODS:A total of 1,626 NSCL/P patients, 886 non-syndromic cleft palate only (NSCPO) pa-tients and 2,255 controls were recruited for association analysis. A total of 8 NSCPO patients, 7 non-syndromic cleft lip only (NSCLO) patients, and 3 normal controls were recruited for RNA sequencing. Blood samples were collected, genotype data for single nucleotide polymorphisms (SNPs) on the PAX3 gene were obtained and multi-level association analyses were conducted to explore their relationship with NSCL/P, including functional predictions of disease-related SNPs. Additionally, RNA sequencing was performed to investigate differences in PAX3 gene expression between patients with NSCL/P and controls. The study was conducted in PLINK analysis. RESULTS:rs2033806 was significantly associated with NSCL/P, whereas rs1430651 was mar-ginally associated with NSCL/P. None were significantly associated with NSCPO. In addition, rs2033806 was also associated with the subtypes NSCLP and NSCLO. CONCLUSION:rs2033806 at PAX3 showed different frequency distributions between non-syn-dromic oral cleft (NSOC) patients and controls, providing new insights into the aetiologies of NSOC.
OBJECTIVE:To compare the effects on the oral microbiome after rinsing with hydrogen peroxide (H2O2), chlorhexidine and essential oil mouthrinses and identify formulations that suppress pathogenic bacteria while preserving beneficial species and maintaining oral microbial bal-ance. METHODS:Twelve healthy volunteers were randomly assigned to three groups: H2O2, chlorhexi-dine and essential oil mouthrinse. Saliva samples were collected at three time points: before and 5 minutes and 1 hour after rinsing with mouthrinse. Microbiome composition was analysed using 16S rRNA gene sequencing. RESULTS:Alpha and beta diversity showed no statistically significant differences among time points. The genus-level microbiome composition remained relatively stable in the H2O2 and essential oil groups but changed significantly in the chlorhexidine group. In the H2O2 group, Neisseria decreased significantly, while Actinomyces increased. In the chlorhexidine group, Porphyromonas, Veillonella, Streptococcus, Neisseria and Gemella decreased significantly. In the essential oil group, Leptotrichia decreased, and Haemophilus increased significantly. CONCLUSION:Essential oil mouthrinse and chlorhexidine exhibit stronger bacteriostatic effects against oral pathogens than H2O2. However, chlorhexidine may disrupt microbial equilibrium, whereas essential oil mouthrinse more effectively preserves a stable oral microbiome. Thus, es-sential oil mouthrinse could serve as a viable alternative to chlorhexidine for oral microbiome management, though its long-term efficacy requires further investigation.
Objective: To investigate the biological function of miR-192-5p in osteogenic and odontogenic differentiation of dental pulp stem cells(DPSCs). Methods: Alkaline phosphatase (ALP) activity assay, Alizarin Red S (ARS) staining and western blot analysis were applied to investigate the osteogenic differentiation potential of DPSCs in vitro. The osteogenic capacity was estimated by subcutaneous transplantation in nude mice in vivo. Carboxyfluorescein diacetate, succinimidyl ester (CFSE) assay was used to examine cell proliferation. Bioinformatics analyses, dual-luciferase reporter assays and real-time reverse transcriptase-polymerase chain reactions (RT-PCR) were applied to explore the regulatory mechanism of miR-192-5p. Results: miR-192-5p decreased the ALP activity, nodule mineralisation and expression of BSP and OCN in DPSCs, and inhibited cell proliferation. Conversely, the miR-192-5p inhibitor motivated the osteogenic and odontogenic differentiation of DPSCs both in vitro and in vivo, along with promoting cell proliferation. COL5A 1 was recognised as the target gene of miR-192-5p through bioinformatics analysis. Furthermore, dual luciferase reporter assays and RT-PCR experiments confirmed this interaction. Subsequent research verified that COL5A 1 knockdown negatively affects the osteo-/odontogenic differentiation of DPSCs, with the PI3K/AKT signalling pathway involved in this process. COL5A 1 knockdown promoted the proliferation of DPSCs. Conclusion: miR-192-5p suppressed osteo/od onto genic differentiation by targeting COL5A 1 in DPSCs and negatively regulated their proliferation. Conversely, COL5A 1 knockdown promoted proliferation.
Biomineralisation is a remarkable biological process in which living organisms exert precise control over the nucleation and growth of inorganic crystalline phases, resulting in the formation of hierarchically structured biocomposites that exhibit exceptional mechanical and functional properties. Since damage to bone and teeth directly affect everyday life, various biomimetic mineralised materials have been engineered for use in biomedical applications. While bioinspired materials typically demonstrate superior mechanical properties and biological functions, significant disparities remain between biomimetic constructs and their natural counterparts, especially concerning mechanical performance and multiscale structural organisation. This review initially describes the dynamic reciprocity between type I collagen fibrils, amorphous calcium phosphate phases and multifunctional non-collagenous protein within mineralisation microenvironments. Furthermore, it evaluates recent progress in advanced biomaterials based on biomimetic mineralisation strategies and seeks to spark innovative and promising solutions for investigators exploring biomineralisation principles in regenerative medicine and hard tissue reconstruction. Existing problems and future directions are discussed.
The diagnosis of a facial sinus tract caused by periapical infection remains difficult due to the wide range of potential aetiologies. The canine is the only maxillary tooth that has been reported to serve as the source of infection for a facial sinus tract. The scenario encountered in the present case was extremely rare as the facial sinus tract was caused by the maxillary molar. The buccal alveolar bone of the maxillary right first molar had been destroyed due to periodontitis and aberrant occlusal force, which caused a periapical abscess in the maxillary right first molar site and ultimately drained extraorally. The purpose of this case report is to illustrate the potential fora periapical lesion of the maxillary molar to induce facial sinus tracts and propose a non-surgical therapeutic approach for such cases.
OBJECTIVE:To investigate the causal role of periodontitis in inducing distal-organ aging and elucidate the mechanism between periodontitis and multi-organ aging by assessing the role of NF-κB signalling in mediating cellular senescence. METHODS:A ligature-induced periodontitis mouse model was established to systematically examine the expression profiles of senescence markers, including senescence-associated secretory phenotype (SASP) regulatory genes (Il1b, Il6, Mmp13), telomere length, and cellular senescence markers (p16^INK4a, p21^CIP1/WAF1 and β-galactosidase) in peripheral blood, bone marrow, aorta, heart, thymus and uterus. To further clarify the mediating role of the NF-κB signalling pathway in periodontitis-induced multi-organ aging, an intervention study was conducted using the specific NF-κB inhibitor BAY 11-7082. RESULTS:The results revealed significantly elevated expression of SASP-related genes in the peripheral blood of periodontitis mice compared to controls (P < 0.01). Various classic molecular hallmarks of aging, such as upregulated expression of SASP genes, shortened telomeres and increased p16 expression, were also observed in multiple distal organs/tissues. Further mechanistic studies revealed that selective inhibition of the NF-κB signalling pathway significantly attenuated the expression of these aging phenotypic markers (P < 0.01), indicating that this pathway plays a critical role in mediating periodontitis-induced systemic aging. CONCLUSION:This study provides direct experimental evidence that periodontitis can promote systemic multi-organ aging via activation of the NF-κB signalling pathway, establishing a theoretical basis for developing therapeutic interventions.
Objective: To evaluate the association between systemic diseases and severity of periodontitis based on Chinese epidemiological data. Methods: Data of dentate subjects (35- to 44-year-old group, 55- to 64-year-old group, and 65- to 74-year-old group) from the Fourth National Oral Health Survey of China were analyzed. Selfreport diagnosis of systemic diseases was based on face-to-face interview. Periodontal status was defined by the 2018 classification scheme and periodontal parameters including bleeding on probing (BOP), probing depth (PD) and attachment loss (AL). Results: The prevalence of systemic diseases, was much higher in subjects with advanced periodontitis but similar in subjects with other periodontal status. The association between systemic diseases and advanced periodontitis is stronger in the younger adult group but weakens with age. Conclusion: Periodontitis is a significant associated with systemic diseases, especially hypertension, heart disease, diabetes among Chinese adults based on the data of the Fourth National Oral Health Survey of China. In view of the worsening health burden of periodontitis, it might be necessary for healthcare providers to be more concerned about prevention and treatment of periodontitis in order to enhance systemic health.
