This case report details the treatment of a 24-year-old male with an overerupted mandibular right second molar caused by the prolonged absence of opposing teeth. The patient presented with swelling and discomfort in the maxillary right posterior region. Clinical examination revealed an odontoma in the posterior maxilla, as well as a dentigerous cyst associated with the mandibular right third molar. Multidisciplinary treatment involved piezosurgery to remove the odontoma and cyst, followed by bone grafting and molar intrusion. The surgical intervention may have elicited a localized regional acceleratory phenomenon (RAP), which may have contributed to subsequent orthodontic molar intrusion. A distally extended lingual arch appliance combined with mini-implants successfully achieved 7.0 mm of molar intrusion within 7 months. Comprehensive orthodontic treatment was then performed to align the dental arches and restore the occlusal relationship. The treatment concluded with the placement of osseointegrated implants in the maxillary right molar region, successfully restoring normal masticatory function. This case illustrates a possible clinical approach for integrating orthodontics, alveolar bone surgery, implantology, and prosthodontics, and suggests that localized RAP-related bone remodeling may have contributed to the management of a complex dental condition in this selected case.

Compare the long-term outcomes of alveolar bone and gingiva between the modified periodontally accelerated osteogenic orthodontics (PAOO) and the mainstream approach. This retrospective study included 28 orthodontic patients with bone fenestration and dehiscence in the lower anterior teeth. Fourteen patients were treated with the modified PAOO approach, and 14 patients received the mainstream PAOO treatment. Alveolar bone and gingival conditions were evaluated preoperatively (T0), one week (T1), one year (T2), three years (T3), and five years post-surgery (T4). At T4, the measured change in labial cervical third bone thickness (La-CHBT) of the modified group (0.99; 95

Background Peripheral nerve injuries (PNIs) present a persistent clinical challenge due to the intrinsically limited regenerative capacity of peripheral nerves. While dental pulp stem cells (DPSCs) exhibit significant neuroregenerative potential, their therapeutic efficacy is constrained by hostile microenvironments and inherent functional heterogeneity. Genetic modification may offer a promising strategy to enhance their therapeutic capabilities.Methods DPSCs were induced toward neural lineage differentiation, and key gene candidates were identified through qRT-PCR. Lentiviral-mediated gene interference was performed to modulate target gene expression, followed by comprehensive analysis of differentiation outcomes using qRT-PCR, Western blotting, and immunofluorescence assays. RNA sequencing was employed to uncover associated signaling pathways, which were subsequently validated through pharmacological inhibition with specific inhibitors. The therapeutic efficacy of genetically engineered DPSCs was evaluated in a rat model of sciatic nerve crush injury, with neural regeneration quantitatively assessed via neuroelectrophysiological measurements and histological analyses.Results LARP7 positively regulated the Schwann cell-like differentiation of DPSCs, as well as their trophic and anti-inflammatory effects, thus enhancing its therapeutic effects on nerve repair and promoting functional recovery. Mechanistically, we found that LARP7 remodeled cytokine-cytokine receptor interactions, enhancing trophic support while attenuating proinflammatory responses, and activated the PI3K-Akt-mTOR signaling pathway, with ERBB4 serving as a critical downstream effector, promoting DPSCs differentiation into Schwann cell-like phenotypes.Conclusions Collectively, LARP7-mediated changes in DPSCs establish a new therapeutic paradigm that addresses the limitations of current stem cell-based interventions and enables the development of standardized biotherapeutics for peripheral nerve repair.

BACKGROUND:To evaluate musculoskeletal modification after open reduction and internal fixation of condylar fracture by clinical examinations and computed tomography reconstruction to guide the clinical therapeutic strategy. MATERIALS AND METHODS:This retrospective study enrolled patients with condylar fracture treated by open reduction of internal fixation (ORIF) between November 2015 and January 2020 and followed up for over 2 years. Mouth opening, mandible deviation and occlusal relationship were compared before ORIF and 2 years after ORIF. Condyle volume, ramus height, masseter volume and lateral pterygoid volume immediately and 2 years after ORIF were reconstructed and compared among different fracture types (including condylar head, neck and base fractures), fixation types (including screws and plates) and implanted material removal or not using statistical analysis. This retrospective study was subject to inherent limitations, including possible selection bias and lack of standardised imaging protocols. All retrospective data usage complied with institutional ethical approval. RESULTS:The study involved 105 patients with unilateral condylar fractures. Condylar head fractures accounted for 53% of the total, condylar neck fractures for 24% and condylar base fractures for 23%. The average mouth opening increased from 1.4 ± 0.8 cm to 3.8 ± 0.7 cm following the procedure. Mandible deviation decreased from 39.3% to 6.2%. Abnormal occlusal relationships decreased from 84% to none. As the fracture line moved up to the condylar top, more condylar bone resorption and masticatory muscle atrophy tended to occur. Screw fixation showed significant condylar bone resorption compared to plate fixation. The retention of the implanted material showed a significant negative influence on ramus height and condyle volume while removal of the implanted material significantly led to masticatory muscle atrophy. CONCLUSIONS:The musculoskeletal modification after ORIF of a condylar fracture is closely related to fracture type, fixation types and implanted material removal. Surgeons should be aware of these trends and choose therapies accordingly. CLINICAL RELEVANCE:This study revealed that prolonged retention of implanted materials is associated with long-term bone resorption, whereas a second surgery may lead to masticatory muscle atrophy, which provides insight into non-removable implanted materials with mechanical properties closer to human bone.

Background Anterior disc displacement (ADD) is the most common type of temporomandibular joint (TMJ) internal derangement and may lead to condylar resorption (CR) during the adolescence period, but the specific malocclusion associated with ADD and CR remains unclear. Objective This study aimed to investigate the malocclusion associated with TMJ ADD and CR in adolescents. Methods This cross-sectional study included a clinical examination of adolescent patients aged 11-19 years. Magnetic resonance imaging (MRI) was used to diagnose both TMJ ADD and CR. Occlusal measurements were obtained and analysed using 3D scanning models. Results A total of 242 adolescent patients (53 males and 189 females) underwent TMJ MRI examination and dental occlusion scanning. The prevalence of anterior disc displacement without reduction (ADDwoR) was higher in females than that in males (OR > 1, p < 0.05). Deep overbite and posterior scissor bite were significantly associated with anterior disc displacement with reduction (ADDwR), while Angle Class II malocclusion, anterior open bite and posterior scissor bite were significantly associated with ADDwoR (OR > 1, p < 0.05). Adolescents with excessive overjet and anterior open bite were at a higher risk of CR (OR > 1, p < 0.05), whereas those with deep overbite and individual crossbite had a lower risk of CR (OR < 1, p < 0.05). Conclusion Our study offers valuable insights into the association between deep overbite, posterior scissor bite, Angle Class II malocclusion, anterior open bite, excessive overjet and the ADD and CR in adolescents. Orthodontic treatment for adolescent patients should prioritise the health of the TMJ, particularly for these types of malocclusion.

Sepsis poses a significant challenge in clinical management. Effective strategies targeting iron restriction, toxin neutralization, and inflammation regulation are crucial in combating sepsis. However, a comprehensive approach simultaneously targeting these multiple processes has not been established. Here, an engineered apoptotic extracellular vesicles (apoEVs) derived from macrophages is developed and their potential as multifunctional agents for sepsis treatment is investigated. The extensive macrophage apoptosis in a Staphylococcus aureus-induced sepsis model is discovered, unexpectedly revealing a protective role for the host. Mechanistically, the protective effects are mediated by apoptotic macrophage-released apoEVs, which bound iron-containing proteins and neutralized α-toxin through interaction with membrane receptors (transferrin receptor and A disintegrin and metalloprotease 10). To further enhance therapeutic efficiency, apoEVs are engineered by incorporating mesoporous silica nanoparticles preloaded with anti-inflammatory agents (microRNA-146a). These engineered apoEVs can capture iron and neutralize α-toxin with their natural membrane while also regulating inflammation by releasing microRNA-146a in phagocytes. Moreover, to exploit the microcosmic movement and rotation capabilities, erythrocytes are utilized to drive the engineered apoEVs. The erythrocytes-driven engineered apoEVs demonstrate a high capacity for toxin and iron capture, ultimately providing protection against sepsis associated with high iron-loaded conditions. The findings establish a multifunctional agent that combines natural and engineered antibacterial strategies.

Guided bone regeneration gathers significant interest in the realm of bone tissue engineering; however, the interplay between membrane thickness and permeability continues to pose a challenge that can be addressed by the water-collecting mechanism of spider silk, where water droplets efficiently move from smooth filaments to rough conical nodules. Inspired by the natural design of spider silk, an innovative silk fibroin membrane is developed featuring directional fluid transportation via harmoniously integrating a smooth, dense layer with a rough, loose layer; conical microchannels are engineered in the smooth and compact layer. Consequently, double-layered membranes with cone-shaped microporous passageways (CSMP-DSF membrane) are designed for in situ bone repair. Through extensive in vitro testing, it is noted that the CSMP-DSF membrane guides liquid flow from the compact layer's surface to the loose layer, enabling rapid diffusion. Remarkably, the CSMP-DSF membrane demonstrates superior mechanical properties and resistance to bacterial adhesion. When applied in vivo, the CSMP-DSF membrane achieves results on par with the commercial Bio-Gide collagen membranes. This innovative integration of a cross-thickness wetting gradient structure offers a novel solution, harmonizing the often-conflicting requirements of material transport, mechanical strength, and barrier effectiveness, while also addressing issues related to tissue engineering scaffold perfusion.

Abstract Objective This study aimed to investigate the risk factors associated with temporomandibular joint (TMJ) anterior disc displacement (ADD) in relation to dental malocclusion. Methods In this cross-sectional study, a clinical examination was conducted on patients aged 11–35 years who visited the TMJ and Orthodontic Clinic at a hospital. Magnetic resonance imaging (MRI) of the TMJ was performed to diagnose both ADD and condylar resorption (CR). Occlusal measurements were obtained and analyzed using 3D scanning models. Results A total of 552 patients underwent TMJ MRI examination and dental occlusion scanning. The presence of mandibular midline shift > 2 mm and posterior crossbite were found to be associated with unilateral ADD (OR > 1, p < 0.05). Additionally, apart from these malocclusions, anterior open bite > 3 mm showed a strong correlation with unilateral ADD accompanied by CR (OR > 1, p < 0.05). Furthermore, overbite > 4 mm and posterior crossbite were associated with bilateral ADD (OR > 1, p < 0.05). In addition to these malocclusions, Angle Class II malocclusion, overjet > 5 mm, and anterior open bite > 3 mm were strongly correlated with bilateral ADD accompanied by CR (OR > 1, p < 0.05). Conclusions In conclusion, our study highlights the significance of occlusal characteristics in relation to TMJ health. Specific malocclusions, such as mandibular midline shift > 2 mm, posterior crossbite, and overbite > 4 mm appear to be associated with the presence of TMJ ADD. Angle Class II malocclusion, anterior open bite and overjet > 5 mm seem to be associated with progression of ADD. These findings emphasize the crucial importance of early detection and management of malocclusions to prevent or minimize the development of TMJ ADD and associated complications.

Abstract Objective This study aimed to investigate the risk factors associated with temporomandibular joint (TMJ) anterior disc displacement (ADD) in relation to dental malocclusion. Methods In this cross-sectional study, a clinical examination was conducted on patients aged 11–35 years who visited the TMJ and Orthodontic Clinic at a hospital. Magnetic resonance imaging (MRI) of the TMJ was performed to diagnose both ADD and condylar resorption (CR). Occlusal measurements were obtained and analyzed using 3D scanning models. Results A total of 552 patients underwent TMJ MRI examination and dental occlusion scanning. The presence of mandibular midline shift > 2 mm and posterior crossbite were found to be associated with unilateral ADD (OR > 1, p < 0.05). Additionally, apart from these malocclusions, anterior open bite > 3 mm showed a strong correlation with unilateral ADD accompanied by CR (OR > 1, p < 0.05). Furthermore, overbite > 4 mm and posterior crossbite were associated with bilateral ADD (OR > 1, p < 0.05). In addition to these malocclusions, Angle Class II malocclusion, overjet > 5 mm, and anterior open bite > 3 mm were strongly correlated with bilateral ADD accompanied by CR (OR > 1, p < 0.05). Conclusions In conclusion, our study highlights the significance of occlusal characteristics in relation to TMJ health. Specific malocclusions, such as mandibular midline shift > 2 mm, posterior crossbite, and overbite > 4 mm appear to be associated with the presence of TMJ ADD. Angle Class II malocclusion, anterior open bite and overjet > 5 mm seem to be associated with progression of ADD. These findings emphasize the crucial importance of early detection and management of malocclusions to prevent or minimize the development of TMJ ADD and associated complications.

Background Mesenchymal stem cells (MSCs) have become promising candidates for regeneration medicine due to their multidifferentiation potential and immunomodulatory ability. Compared with classic MSCs derived from the bone marrow and fat, dental-derived MSCs show high plasticity, accessibility, and applicability. Therefore, they are considered alternative sources for regeneration medicine. Methods Four types of MSCs were isolated from the dental pulp, periodontal ligament, dental follicle, and alveolar bone of the same donor, and there were five different individuals. We analyzed their morphology, immunophenotype, proliferation rate, apoptosis, trilineage differentiation potential, and the gene expression during osteogenic differentiation. Results Our research demonstrated that DPSCs, PDLSCs, DFPCs and ABMMSCs exhibited similar morphology and immunophenotype. DFPCs showed a higher rate of proliferation and apoptosis. When cultured in the trilineage differentiation medium, all types of MSCs presented the differentiation potential of osteogenesis, adipogenesis, and chondrogenesis. Through staining and genetic analysis during osteogenic induction, ABMMSCs and PDLSCs showed the highest osteogenic ability, followed by DPSCs, and DFPCs were the lowest. Conclusions Overall, our results indicated that different dental-derived stem cells possessed different biological characteristics. For bone tissue engineering, ABMMSCs and PDLSCs can be used as optimal candidates of seed cells.

Periodontitis is an immune inflammatory disease that leads to progressive destruction of bone and connective tissue, accompanied by the dysfunction and even loss of periodontal ligament stem cells (PDLSCs). Pyroptosis mediated by gasdermin-D (GSDMD) participates in the pathogenesis of inflammatory diseases. However, whether pyroptosis mediates PDLSC loss, and inflammation triggered by pyroptosis is involved in the pathological progression of periodontitis remain unclear. Here, we found that PDLSCs suffered GSDMD-dependent pyroptosis to release interleukin-1β (IL-1β) during human periodontitis. Importantly, the increased IL-1β level in gingival crevicular fluid was significantly correlated with periodontitis severity. The caspase-4/GSDMD-mediated pyroptosis caused by periodontal bacteria and cytoplasmic lipopolysaccharide (LPS) dominantly contributed to PDLSC loss. By releasing IL-1β into the tissue microenvironment, pyroptotic PDLSCs inhibited osteoblastogenesis and promoted osteoclastogenesis, which exacerbated the pathological damage of periodontitis. Pharmacological inhibition of caspase-4 or IL-1β antibody blockade in a rat periodontitis model lead to the significantly reduced loss of alveolar bone and periodontal ligament damage. Furthermore, Gsdmd deficiency alleviated periodontal inflammation and bone loss in mouse experimental periodontitis. These findings indicate that GSDMD-driven PDLSC pyroptosis and loss plays a pivotal role in the pathogenesis of periodontitis by increasing IL-1β release, enhancing inflammation, and promoting osteoclastogenesis.

Metabolic skeletal disorders remain a major clinical challenge. The complexity of this disease requires a strategy to address the net effects of both inflammation and impaired bone formation. microRNA-based gene therapy provides several therapeutic advantages totackle these issues. Herein, we describe a microRNA-21 (miR-21) delivery system with an additional therapeutic effect from that of the delivery carrier itself. Poly (salicylic acid) (PSA) is, for the first time, synthesized viapolycondensation of salicylic acid (SA), a bioactive ingredient widely used for anti-inflammation in medicine. PSA can self-assemble into nanoparticles (PSA-NPs) and can effectively deliver genes both in vitro and in vivo. The carrier was then attached to repetitive sequences of aspartate, serine, serine (DSS)6 for delivering miRNAs specifically to bone-formation surfaces. In vitro studies showed that miR-21@PSA-NP could effectively realize the intracellular delivery of miR-21 with low toxicity, while in vivo results indicated that the miR-21@PSA-NP-DSS6 prolonged blood circulation time, enhanced bone accumulation, and significantly improved the efficacy of miR-21-based bone anabolic therapy in osteoporotic mice. The constructed delivery system (miR-21@PSA-NP-DSS6) inherited the advantages of both SA and miR-21, which could ameliorate bone-inflamed niche and rescued the impaired bone formation ability. The synergy of anti-inflammatory and pro-osteogenic effects significantly improved trabecular bone microstructure in osteoporotic mice.

PURPOSE:To evaluate the position and bilateral difference of mandibular ramus region, specifically the condyle, sigmoid notch, and mandibular angle in skeletal class III patients with mandibular asymmetry.MATERIALS AND METHODS:3D-CT images were performed in 50 patients with skeletal class III malocclusion. According to the severity of mandibular asymmetry, 22 cases were included in the control group and 28 cases were included in the symmetry group. The 3D landmarks were measured relative to 6 reference planes and the outcomes among different groups were compared.RESULTS:There are significant differences in the position of mandibular ramus region between both sides in the asymmetry group. The position of condyle was more posterior and internal on the deviated side; and the positions of sigmoid notch and gonion were more posterior, superior, and lateral on the deviated side. Furthermore, the degree of mandibular asymmetry was more highly correlated with the height of ramus and the position of mandibular angle than it was with the height of condyle and the position of sigmoid notch.CONCLUSION:When evaluating mandibular asymmetry and making surgical plans, the position of mandibular ramus should be taken into consideration.

目的 以SLM-CoCrW为对照,评价SLM-CoCrCu的抗菌性及生物相容性,为SLM-CoCrCu的潜在临床应用提供理论依据.方法 选择金黄色葡萄球菌为研究对象,采用平板法验证合金的抗菌性能.选择MC3T3-E1细胞为研究对象,采用CCK-8检测法评价合金对于细胞增殖的影响和细胞毒性等级.采用细胞骨架荧光染色标记法评价细胞在合金表面的粘附及生长,结合增殖率,反映合金的细胞毒性.采用流式细胞术评价材料对细胞早期凋亡的影响.结果 SLM-CoCrCu对金黄色葡球菌的生长有明显抑制作用,对金黄色葡萄球菌抗菌率可达98％,与SLM-CoCrW比较有显著性差异(P<0.01).随培养时间的延长,SLM-CoCrCu细胞数量逐步增长,表现出对细胞增殖的促进作用.SLM-CoCrCu和SLM-CoCrW在与细胞共培养1、3、7 d后,细胞增殖率有显著差异性(P=0.01).共培养1 d后,不含铜组细胞增殖率优于含铜组;共培养3 d及7 d后,含铜组对细胞增殖影响明显优于不含铜组.两者对于细胞粘附及形态上的影响无明显差异.SLM-CoCrCu和SLM-CoCrW对于细胞凋亡的影响无明显差异.结论 SLM-CoCrCu相较于SLM-CoCrW有良好的抗菌性能.同时,SLM-CoCrCu具有良好的生物相容性,对细胞增殖、粘附及形态都无明显影响.

Objective To study the three-dimentional characteristic of mandibular condyle morphology and position of adults with skeletal Class Ⅲ malocclusion and mandibular deviation.Methods Sixty patients with skeletal Class Ⅲ malocclusion and mandibular deviation were included.CT data were stored according DICOM.Maxillary and mandibular three-dimensional reconstruction were performed using Mimics 17.0.To make sure measurements and analyze statistically.Results There was no statistical difference in nondeviation group.In deviation group,the condyle coronal plane,condyle horizontal plane,condylar sagittal plane-FH were higher than those in the contralateral side.Sagittal plane of condyle,height of condyle,inner and outer diameter of condyle,length of external oblique side of condyle were smaller than those of contralateral side.Conclusions Mandibular condyle position of adults with skeletal Class Ⅲ malocclusion and mandibular deviation was asymmetric.The lateral condyle was more laterally and inferiorly positioned on the contralateral side than deviated side.The height of the lateral condylar process,the mesial and lateral diameter of the lateral condyle and the length of the outer inclined plane are smaller than that of the contralateral side.

目的 利用Mimics软件对成人骨性Ⅲ类错(牙合)伴下颌偏斜患者下颌骨髁突的位置特征进行三维测量.方法 对50例骨性Ⅲ类错(牙合)畸形患者(18～34岁)的颅面部进行螺旋CT扫描(偏斜组28例,非偏斜组22例),采集DICOM数据,利用Mimics 17.0软件对骨组织进行三维重建并建立三维坐标系,分离上下颌骨,显露完整的髁突形态,确定标志点及测量相关参考平面,对结果进行统计学分析.结果 非偏斜组两侧测量值差异无统计学意义.偏斜组中,偏斜侧髁突的冠状面和水平面与颅骨冠状面交角均大于对侧,髁突水平面与眼耳平面交角小于对侧,髁突矢状面与眼耳平面交角大于对侧,乙状切迹到眼耳平面和冠状面距离均小于对侧,到正中矢状面距离大于对侧.其余结果差异无统计学意义.结论 骨性Ⅲ类错(牙合)伴下颌偏斜患者的髁突位置不对称.偏斜侧髁突位置相对关节窝向后、内旋转,乙状切迹向后、上、外旋转.偏斜对侧髁突位置相对关节窝向前、外旋转,乙状切迹向前、下、内旋转.左右侧关节间隙无明显差异.