China has a large number of patients but a low rate of medical advice-seeking in oral diseases, leading to difficulties in the prevention and treatment of oral diseases. This situation calls for basic oral health examinations, which would increase the public awareness of oral health and fundamentally enhance the effectiveness of comprehensive prevention and control of oral diseases. As a risk-driven primary care service, oral health examination achieves early war-ning, comorbidity management, and resource optimization through standardized protocols. This program enables the early detection and diagnosis of oral diseases, facilitating timely intervention and improving the oral health status of the public. To standardize the flowchart of oral health examinations and ensure the technical results of the examinations conducted by different examination institutions, this study forms an expert consensus on the technical specification of routine oral health examinations for adults. This consensus, which includes oral examination items, oral examination elements, management of abnormal results and follow-up dental cares, provides standardized guidelines for dentists and dental medical institutions, the keystones in the development of prevention and control network for oral diseases, to conduct routine oral health examinations.
OBJECTIVES:To explore whether the difference in mandibular motor function related to the lateral pterygoid muscle is associated with pain and clicking in the temporomandibular joint based on clinical data. METHODS:Outpatient data from January 2022 to August 2025 were collected, and the basic information, joint symptoms, and diagnostic criteria for temporomandibular joint disorder (DC/TMD) of the patients were statistically analyzed. Patients were grouped according to their chief symptoms, and the chi-square test was used to explore whether the chief symptoms were correlated with age and gender. The Mann-Whitney U test was used to examine whether there were differences in lateral movement ability between different genders, and the Kruskal-Wallis H test was used to examine whether there were differences in lateral movement ability between different age groups. Patients were grouped according to whether they had pain, and the Mann-Whitney U test was used to examine whether pain was correlated with lateral movement ability. Binary logistic regression analysis was used to further explore the degree of correlation between joint pain and lateral movement imbalance. Patients were grouped according to different painful sides and relatively restricted sides, and the chi-square test was used to explore the correlation between the two. Multivariate logistic regression analysis was used to further explore the interaction between painful side and relatively restricted side. RESULTS:There was no statistically significant difference between the patient's age, gender, and main symptoms or lateral mobility; there was a statistical difference between the difference in lateral mobility and joint pain; there was a statistical difference between gender and mandibular protrusion ability; relative limitation on one side was a significant predictor of unilateral joint pain, but there was no specific side-specific combination association between the two; there was no statistical correlation between age, gender, and relative limitation on one side and bilateral joint pain. CONCLUSIONS:Abnormal lateral movement has clinical significance in the early diagnosis of temporomandibular joint disorder. The gender-specific incidence of temporomandibular joint disorder may be related to the difference in forward movement ability. The bilateral muscle imbalance reflected by lateral movement imbalance should be taken seriously as a risk factor for joint pain.
OBJECTIVES:This study constructed bone morphogenetic protein 2-loaded polydopamine heparin nanoparticles (B@PH NPs) and vanillin methacrylate (VMA)-grafted GelMA hydrogel microspheres (B@PH/GM-V) and evaluated their physicochemical properties and regulatory effects on osteogenic differentiation under oxidative stress. METHODS:B@PH NPs were prepared through oxidative self-polymerization, and B@PH/GM-V microspheres were fabricated via microfluidic technology. The materials were characterized by using scanning electron microscope, Fourier transform infrared spectrometer (FTIR), and energy-dispersive X-ray spectroscopy (EDS). Swelling, degradation, and drug release behaviors were evaluated. Biocompatibility was assessed through the CCK-8 assay and live/dead staining by using MC3T3-E1 cells. Intracellular reactive oxygen species (ROS) levels were detected with 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) probes, and osteogenic differentiation capacity was evaluated through alkaline phosphatase and alizarin red S staining. RESULTS:The average diameters of B@PH NPs and B@PH/GM-V microspheres were approximately 288.2 nm and 499.1 μm, respectively. FTIR and EDS confirmed successful modification with heparin and VMA. B@PH NPs showed favorable sustained release performance. B@PH/GM-V exhibited good biocompatibility, significantly reduced the ROS levels induced by lipopolysaccharide and H2O2, and promoted the differentiation and mineralization of MC3T3-E1 cells. CONCLUSIONS:B@PH/GM-V hydrogel microspheres possess good biocompatibility, antioxidant activity, and osteogenic effects, showing promising potential for periodontitis-related alveolar bone regeneration.
OBJECTIVES:This study aims to compare the performance of different large language models (LLMs) in pre-exam learning for the Chinese dental licensing examination, with a focus on evaluating their differences in answering, explanation, and teaching effectiveness, to provide a reference for the application of LLMs in dental education. METHODS:Three evaluation scenarios were designed: selecting correct answers, providing answer explanations, and adversarial testing. DeepSeek-R1, Qwen 2.5-MAX, Doubao 1.5 Pro, Xinghuo Spark-X1, ERNIE 4.0 Turbo, GPT-4o, and Huaxi Zhilian were selected for comparative testing. Evaluation metrics included accuracy, net accuracy, and pedagogical effectiveness. RESULTS:In the scenario of selecting correct answers, all LLMs exceeded the passing threshold, with Huaxi Zhilian achieving the highest accuracy (84%). In the answer explanation scenario, Huaxi Zhilian demonstra-ted the highest net accuracy (92%), followed by DeepSeek-R1 (89%), among models. Regarding pedagogical effectiveness, Huaxi Zhilian ranked highest in relevance, practicality, and clarity, whereas GPT-4o led in conciseness, among the investigated LLMs. In adversarial testing, Huaxi Zhilian and DeepSeek-R1 exhibited the smallest declines in accuracy and net accuracy, respectively, among the tested models. CONCLUSIONS:In pre-exam learning for the Chinese dental licensing examination, knowledge-enhanced LLMs specifically optimized for dentistry (e.g., Huaxi Zhilian) outperform reasoning LLMs pretrained on general Chinese corpora (e.g., DeepSeek-R1) and those primarily trained on English corpora (e.g., GPT-4o). However, the performance of all models declines under adversarial conditions. Future research should focus on addressing identified weaknesses to enhance the utility of LLMs in dental education further.
OBJECTIVES:To analyze the characteristics of adverse drug reaction (ADR) in a specialized stomatology hospital and thus provide references for clinical rational drug use and risk management. METHODS:A total of 403 ADR cases reported to the military ADR monitoring system by the School of Stomatology, The Fourth Military Medical University from January 2022 to December 2025 were collected. Descriptive statistical and Pareto chart analyses were conducted by using Excel 2019. RESULTS:ADR reports were predominantly submitted by pharmacists (91.32%). The proportion of male patients was slightly higher than that of females (53.35% vs. 46.65%). Patients aged 41-60 years accounted for the highest proportion (37.72%) of cases. Intravenous administration was the most common route (60.79%). The main drug categories causing ADR were anti-infective (31.02%), antineoplastic (28.78%), and immune system (18.36%) agents. ADR primarily involved the digestive system (32.75%), skin, and appendages (29.53%). Three new ADR cases and 10 severe ADR cases, with all cases involving multiple drug categories, were reported. CONCLUSIONS:ADR in specialized stomatology hospitals exhibit certain specialty-specific characteristics, and high-risk drugs predominate. Although the incidence of severe ADR is low, enhanced monitoring is still required. Establishing an ADR early warning system for stomatology hospitals, promoting multidisciplinary collaboration, and improving clinical medication safety are recommended.
Acute toothache is a common dental emergency. In 2023 and 2024, the American Dental Association successively issued evidence‑based clinical practice guidelines for the pharmacologic management of acute dental pain in children, adolescents, adults, and older adults, establishing a new system that prioritizes nonsteroidal anti‑inflammatory drugs, strictly limits opioids, and implements age‑specific precise management. This article systematically interprets the evidence‑based foundation and age‑specific medication regimens of the guidelines. By integrating relevant Chinese diagnostic and treatment standards, expert consensuses, and the National Essential Medicines List, it explores localized implementation pathways from the perspectives of drug accessibility, prescribing habits, policy alignment, and primary healthcare resource allocation. It proposes age‑stratified analgesic regimens suitable for China and provides actionable recommendations for evidence‑based training, multidisciplinary collaboration, patient education, and pharmaceutical supervision. This article aims to provide Chinese dentists with a decision‑making reference for the pharmacological treatment of acute toothache that incorporates the latest international evidence and local realities, thereby promoting standardized and scientific acute oral pain management in China.
Automation technologies and devices are becoming an increasingly important component of the digital and intelligent transformation of oral healthcare. With on-going advances in artificial intelligence, robotics, and advanced manufacturing, their applications have expanded across oral diagnosis, surgery and treatment, prosthodontics, and orthodontics, as well as oral care and maintenance. These technologies have shown considerable potential for improving diagnostic and therapeutic accuracy, efficiency, consistency, and reproducibility. Importantly, automation in oral healthcare should not be understood simply as the replacement of manual procedures by standalone devices. Rather, it represents the optimization of clinical workflows based on standar-dized data acquisition, algorithm- or rule-based decision-making, and dedicated execution platforms. This review summarizes the current research progress and clinical applications of automation technologies and devices in major oral healthcare scenarios and discusses the characteristics, application scope, and practical challenges of different technical routes. Future directions are also outlined to provide a reference for clinical workflow optimization, technology translation, and device development in oral healthcare.
口腔药物学是口腔医学与现代药物学深度交叉融合产生的重要学科,主要研究口腔疾病预防、诊治和康复中应用药物的药理学、药剂学及治疗学的特点和规律,从而安全、有效、合理地使用药物,并为安全合理使用药物提供指导.近年来,随着分子生物学、材料科学、临床药学的快速发展,口腔药物学领域正经历着从经验用药向精准药物治疗、从传统剂型向智能递送系统的深刻转变.新理论、新技术、新剂型、新药物层出不穷,为口腔疾病的药物治疗带来了前所未有的机遇与挑战.为了更好地推动口腔药物学的发展和进步,我们依托《华西口腔医学杂志》平台组织搭建"口腔药物前沿"专栏,邀请全国口腔临床、口腔基础研究和口腔药学领域的专家和团队,系统梳理口腔药物学领域的最新进展,涵盖核心用药机制、合理治疗策略、新型给药系统、智能材料与组织工程等前沿议题,从不同维度呈现了当前口腔药物学研究的活跃图景,从而推动该领域的学术交流和学科交叉创新,为行业提供权威参考.
The current design of ideal implant sites often fails to include the assessment of the restrictions imposed by the limited geometric space of the surgical area on instrument manipulation. This limitation may cause three-dimensional position blocking during actual surgery, resulting in the inability to complete implantation at the predesigned geometric position. On the basis of the previously proposed new concept and classification system of surgical area mouth opening (SO), this work divides the surgical procedure into two stages: instrument placement and instrument working. The minimum instrument length required to avoid blocking are precisely calculated and different SO requirements are matched by establishing a complete geometric analysis model and defining key geometric parameters. Consequently, a complete pathway from anatomical space assessment, to instrument length selection, and then to guidance method decision is constructed, realizing a comprehensive and accurate assessment of the virtual designed implant site and the evaluation of the accessibility of the implantation operation. This study further improves the clinical decision-making system of SO and provides a complete arithmetic scheme for the clinical implementation of digital preoperative implant designs.
Oral tissue repair faces challenges, including complex types of defects, a harsh local microenvironment, and limitations of conventional therapies. Common diseases, such as periodontitis, maxillofacial tumors, trauma, and congenital deformities, cause defects in the alveolar bone and periodontal tissues, affecting a large population. The demand for tissue repair is increasing with accelerating population aging. Defect sites often exhibit a complex microenvironment accompanied with infection, inflammation, ischemia, and immune imbalance, severely impairing the viability and regene-ration of stem cells. Smart delivery materials function as drug delivery platforms and can respond to endogenous and exo-genous stimuli to achieve the spatiotemporally controlled release of drugs and bioactive factors, enabling targeted and precise therapy. Some of these materials also possess tissue-inductive regenerative properties. Smart delivery materials show important application potential in maxillofacial bone repair, periodontal regeneration, pulp reconstruction, and oral mucosal repair. This review summarizes the design strategies, response mechanisms, and cutting-edge applications of intelligent delivery materials in oral tissue repair. Moreover, it analyzes the critical breakthroughs for their clinical translation from the perspectives of mechanical adaptation and controllable degradation, precise responsive release under complex oral microenvironments, synergistic immunomodulation and anti-infective regeneration, and personalized manufacturing. It thereby provides insights for precision therapy and functional reconstruction in oral tissue repair.
OBJECTIVES:To screen and validate the activity of potential therapeutic substances in wall-broken Ganoderma lucidum spore powder (BGLSP) for promoting ulcer healing. METHODS:The potential active components of BGLSP were screened through network pharmacology combined with molecular docking and verified via the cell counting kit(CCK)-8 assay, cell scratch assay, and a rat oral ulcer model.. RESULTS:Network pharmacology revealed that 25 compounds in BGLSP exert prohealing effects through multiple targets and pathways. Molecular docking identified seven compounds with strong binding affinity. On the basis of their relative contents in BGLSP, ganoderic acid A (GAA) and ganoderic acid G (GAG) were identified as the key potential active constituents promoting ulcer healing. At low concentrations, GAA and GAG showed no cytotoxicity. GAA promoted the migration of human primary gingival fibroblasts in a concentration-dependent manner, whereas GAG showed a promotive effect only at 2.5 µmol/L. GAA and GAG enhanced collagen deposition and angiogenesis in rat oral ulcers, accelerating healing. GAA demonstrated a good effect at low concentrations in the early stage of ulcer healing but a superior effect at high concentrations in the later stage of ulcer healing, whereas GAG exhibited a concentration-dependent promotive effect. Conclusion BGLSP promotes ulcer hea-ling through multicomponent, multitarget, and multipathway synergistic effects. GAA and GAG, as potential active constituents of BGLSP, play important roles in the early hea-ling of oral ulcers.
Dentin dysplasia type Ⅰ (DD-Ⅰ) is a rare autosomal dominant hereditary disorder characterized by abnormal dentin development. Its primary clinical features include markedly shortened tooth roots and pulp chamber closure. The causative genes and molecular mechanisms have not been fully elucidated yet. This study reports a DD-Ⅰ family comprising four affected individuals. Pathogenic mutations were identified and assessed using whole-exome sequencing combined with co-inheritance analysis and bioinformatics methods. Results revealed that the proband exhibited typical DD-Ⅰ clinical phenotypes, including root shortening, pulp chamber closure, and alveolar bone resorption. A highly conserved missense mutation c.353C>A (p.P118Q) in the SSUH2 gene was detected within the family. Bioinforma-tics prediction indicated this mutation significantly alters protein secondary structure and three-dimensional conformation, classified as "likely harmful." Combining bioinformatics analysis with clinical phenotype correlation further validated the causal relationship between this mutation and DD-Ⅰ, providing supplementary experimental evidence for the pathogenicity of the p.P118Q mutation.
OBJECTIVES:Non-syndromic cleft lip with or without cleft palate (NSCL/P) is a common birth defect influenced by genetic and environmental factors, with genetic factors playing a major role. This study aims to investigate the association between the dystrophin (DMD) gene and NSCL/P in a Chinese Han population. METHODS:Four tag single nucleotide polymorphisms (SNPs) in the DMD gene were selected and allelic and genotype-based association analyses were performed on 1 780 patients with NSCL/P and 1 823 normal controls. RESULTS:Comparison with the controls showed that patients with NSCL/P presented three SNPs (rs5971698, rs5928208, and rs5972815) with significant associations with NSCL/P or its subphenotypes. Allelic association analysis revealed that rs5971698 was associated with NSCL/P, unilateral cleft lip with or without cleft palate (UCL/P), left cleft lip with or without cleft palate (LCL/P), unilateral cleft lip and cleft palate (UCLP), left cleft lip and cleft palate (LCLP), unilateral cleft lip (UCL), and left cleft lip only (LCL) (P<0.05); rs5928208 was associated with non-syndromic cleft lip and cleft palate (NSCLP), bilateral cleft lip with or without cleft palate (BCL/P), LCL/P, bilateral cleft lip and cleft palate (BCLP), and LCL (P<0.05); and rs5972815 was associated with UCLP, UCL, and right cleft lip only (RCL)(P<0.05), exhibiting significant laterality bias. Genotype analysis further confirmed these associations. Functional predictions suggested that different alleles at rs5928208 and rs5972815 may influence transcription factor binding affinity. CONCLUSIONS:This study identified associations between SNPs in the DMD gene and NSCL/P in a Western Chinese Han population, providing new evidence for distinct genetic susceptibility loci among NSCL/P subtypes.
OBJECTIVES:To investigate the current medi-cation adherence status and analyze its influencing factors in patients with oral lichen planus (OLP) and thus provide a reference for developing interventions to improve medication adherence in this population. METHODS:A cross-sectional survey was conducted among patients with OLP who attended the Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, between February 2023 and September 2024. Data were collected by using a general information questionnaire, a patient medication questionnaire, and the Morisky medication adherence scale (MMAS-8). Univariate analysis was first performed, and variables with P<0.1 were included in a multiple linear regression model to adjust for interactions and potential confounding effects, assessing the effect of demographic characteristics, disease status, disease cognition, and medication behavior on medication adherence. RESULTS:A total of 388 patients with OLP were included. The mean MMAS-8 score was 5.37, with a median of 5.75 (Q₁, Q₃: 4.00, 7.00). Medication adherence was categorized as low (MMAS-8<6) in 202 patients (52.1%), medium (6≤MMAS-8<8) in 147 patients (37.9%), and high (MMAS-8=8) in 39 patients (10.1%). Univariate analysis and multiple regression model adjustment revealed that educational level and anxiety related to long-term medication were independent negative influen-cing factors for medication adherence. By contrast, awareness of the drug abuse harm and the experience of adverse drug reactions were independent positive influencing factors. CONCLUSIONS:Medication adherence among patients with OLP is generally suboptimal. A high educational level and medication-related anxiety are risk factors for low adherence, whereas sufficient awareness of the harm of drug abuse and the actual experience of adverse drug reactions are associa-ted with good adherence. This situation suggests that differentiated patient education and increased attention to psychological intervention during treatment are necessary in clinical practice to improve medication adherence in patients OLP specifically.
Oral mucosal administration (OMA) can circumvent hepatic first-pass metabolism and avoid gastrointestinal degradation while offering advantages, such as a rapid onset of action, noninvasiveness, and convenience, positioning it as an important complementary and alternative route to conventional oral and parenteral administration. How-ever, the dynamic and moist environment of the oral cavity leads to inadequate formulation adhesion, substantial drug permeation barriers across the mucosa, and suboptimal controlled-release precision. These limitations have driven the development of oral mucosal drug delivery systems (OMDDSs). This paper systematically summarizes the structural and physiological characteristics of the oral mucosa and dissects the core advantages and major challenges of OMA. It further comments on the research progress and application status of various OMDDSs, including tablets, nanoparticles, hydrogels, patches/films, and microneedles, as well as their clinical application in the management of local oral diseases and systemic disorders. Finally, it discusses future directions, such as artificial intelligence-assisted design, breakthroughs in macromolecular delivery, standardized evaluation systems, and theranostic integration, to provide theoretical references and innovative insights for the rational design and clinical translation of novel OMDDSs.
OBJECTIVES:This study aims to integrate network pharmacology, machine learning, and survival analysis to preliminarily explore the molecular mechanisms underlying the inhibitory effects of thalidomide on the malignant transformation of oral leukoplakia (OLK). METHODS:First, multisource databases and an OLK transcriptomic cohort (GSE26549) were integrated to identify the intersecting feature genes between thalidomide and OLK with epithelial dysplasia, followed by pathway enrichment analysis. Subsequently, a protein-protein interaction (PPI) network was constructed, and ensemble machine learning algorithms were applied to screen for core biomarkers. Kaplan-Meier curves and multivariate Cox proportional hazard regression models were utilized to evaluate the clinical prognostic efficacy of these core biomarkers. Finally, molecular docking was employed to validate the physical binding potential between thalidomide and the core biomarkers of OLK. RESULTS:A total of 16 intersecting target genes between thalidomide and OLK with epithelial dysplasia were identified. These genes were primarily enriched in the signaling pathways of the cell cycle, phosphatidylinositol 3-kinase/protein kinase B (PI3K-Akt), and microRNAs in cancer. PPI network analysis combined with ensemble algorithms ultimately identified four core biomarkers: MET proto-oncogene, receptor tyrosine kinase (MET), Aurora kinase A (AURKA), DNA methyltransferase 1 (DNMT1), and poly(ADP-ribose) polymerase 1 (PARP1). Survival analysis revealed that high expression levels of MET (P=0.004) and AURKA (P=0.029) increased the risk of malignant transformation in OLK. Furthermore, MET exhibited crucial independent prognostic value in the multivariate Cox proportional hazard regression model (hazard ratio=2.58, P=0.051). Molecular docking demonstrated that thalidomide could stably bind to the MET receptor (binding energy=-38.178 kJ/mol). CONCLUSIONS:Thalidomide may exert its inhibitory effects against the malignant progression of OLK by primarily targeting MET and synergistically ac-ting on key biomarkers, including AURKA, DNMT1, and PARP1, thereby suppressing downstream PI3K-Akt and cell cycle signaling pathways. This study not only provides robust computational biology evidence for the "drug repurpo-sing" of thalidomide but also highlights a promising pharmacological option for the clinical intervention of OLK's malignant transformation.
OBJECTIVES:This study explores the differences in the characteristics and influencing factors of dental ca-ries in primary and secondary school students in Hunan Province, aiming to prevent and control dental caries. METHODS:The multistage stratified cluster random sampling method was used to select 265 985 primary and secondary school students across Hunan. Participants completed a nationally standardized questionnaire and underwent physical examinations. Statistical description was used to analyze caries characteristics, and structural equation modeling was used to analyze influencing factors. RESULTS:The caries prevalence rate of primary school students was 69.60%, and the decayed, missing, filled teeth (DMFT) index was 3.05±3.30; for secondary school students, the figures were 54.30% and 1.73±2.31, respectively. Structural equation modeling revealed that caries risk in primary and secondary school students was influenced by demographic characteristics (β=0.384 and -0.025), school-based prevention and control (β=0.033 and -0.067), dietary behavior habits (β=0.043 and 0.032), and family size (β=0.024 and 0.009). In secondary school students, psychological factors were additionally associated with caries risk (β=0.024). CONCLUSIONS:Dental caries prevalence and mean DMFT are high among primary and secondary students in Hunan, associated with demographic characteristics, school prevention policies, dietary and hygiene ha-bits, and household size. Targeted interventions addressing these factors are essential for preventing and controlling dental caries and promoting oral health among students.
The application of endodontic microsurgery in complex cases is often limited by difficulties in apex local-ization due to complex anatomical structures.The introduction of digital technologies has provided a novel approach to address this challenge.This article reviews the operational workflows,clinical application points,accuracy,key influenc-ing factors,and clinical application considerations of static navigation,dynamic navigation,and robotic system assis-tance in endodontic microsurgery.Clinical cases are presented to demonstrate the successful application of digital tech-nologies in managing complex endodontic microsurgeries,providing references for clinicians performing such cases.Fur-thermore,the future direction of digital technologies in endodontic microsurgery toward intelligence,standardization,and minimally invasive development is discussed.
Anterior disc displacement without reduction(ADDwoR)is the most common type of temporomandibular disorders(TMDs).Surgical intervention remains one of the most important treatment modalities for this condition.With the increasing adoption of minimally invasive surgery(MIS)concepts in oral and maxillofacial surgery,implementing MIS principles in the surgical management of ADDwoR has become crucial.This article traces the evolution of minimally inva-sive temporomandibular joint surgery,summarizes the current status of MIS applications in ADDwoR,and discusses future directions.It aims to provide a reference for further promoting and implementing MIS concepts in the treatment of TMDs.
Endodontic microsurgery(EMS)can handle challenging endodontic cases effectively.However,the com-plexity and postoperative outcome of EMS are closely related to multiple factors such as the patient's general condition,the affected tooth,and the surrounding anatomical structures.This article draws on international and domestic medical standards,including the American Society of Anesthesiologists,the American Association of Endodontists,the World Health Organization,and the expert consensus on the assessment of root canal treatment difficulty in China.Based on the basic principles,procedures,and anatomical data of EMS,combined with long-term clinical experience,clinical epidemio-logy,and evidence-based medicine,this article analyzes the difficult and complex factors of EMS cases.This work aims to provide references for treatment decisions,doctor-patient communication,application and promotion,clinical tea-ching,and hierarchical referral in EMS.
