Cleft lip and palate is a common congenital developmental defect, which is mainly manifested as congenital oral and maxillofacial malformations. In patients with cleft lip and palate, jaw deformity often involves three-dimensional orientation, among which the correction of sagittal dysmorphism is the key point and difficulty in its diagnosis and treatment. In this article, we will elaborate on the indications and corrective methods for the treatment of maxillary retraction of cleft lip and palate, and introduce our experience in the sequential treatment of cleft lip and palate maxillary retraction in order to promote the standardization of its diagnosis and treatment.

Multiple supernumerary teeth, combined with numerous impacted teeth, can lead to various malocclusions, posing significant treatment challenges. While certain genes associated with syndromic cases of multiple supernumerary and impacted teeth have been identified, the etiologies of non-syndromic cases still largely remain elusive. Here, we report a treatment of a 12-year-old boy who presented with 10 supernumerary teeth and 6 impacted teeth, accompanied by a genetic analysis to explore the underlying etiology. During the treatment, fifteen teeth were extracted, and various skilled techniques, including the closed-eruption technique and the application of by-pass arches, were utilized. Post-treatment, traction was successful for all the impacted teeth, without any tooth mobility or reduction in gingival height. Space closure, well-aligned teeth, and excellent functional occlusion were achieved. Furthermore, comprehensive genetic analysis was conducted through whole-exome sequencing on the patient and his parents, which revealed a potential link between the patient’s numerous supernumerary teeth and abnormal mineralization. Notably, the p.Ser496Pro variant in the TCF7L2 gene was identified as a potential candidate variant in this patient. Overall, our findings not only report the treatment of a rare case involving multiple supernumerary and impacted teeth but also offer valuable insights into the molecular basis of supernumerary teeth.

Cleft lip and palate (CLP) is one of the most common birth defects worldwide. It typically results in significant maxillary dysplasia, causing severe oral function problems and substantially affecting the patient’s facial aesthetics. Maxillary anterior segmental distraction osteogenesis (MASDO) has gained popularity in recent years as an effective treatment for correcting maxillary dysplasia. However, the evaluation of its effectiveness in patients with CLP varies across different studies. Our research was aimed at providing evidence of the effects of MASDO among CLP patients. A meta-analysis covered Medline, Web of Science, Embase, Scopus, and Cochrane Library. Controlled clinical trial studies published before February 2024 and analyzed changes in maxillary cephalometric landmarks before and after MASDO among patients with maxillary hypoplasia and CLP were included. Our meta-analysis included 10 papers in total. One study was at low risk of bias, seven were at medium risk, and two were at serious risk. MASDO significantly increased the maxillary length. The mean SNA angle increased by 6.43° (95

Orthodontic tooth movement (OTM), a process of alveolar bone remodelling, is induced by mechanical force and regulated by local inflammation. Bone marrow-derived mesenchymal stem cells (BMSCs) play a fundamental role in osteogenesis during OTM. Macrophages are mechanosensitive cells that can regulate local inflammatory microenvironment and promote BMSCs osteogenesis by secreting diverse mediators. However, whether and how mechanical force regulates osteogenesis during OTM via macrophage-derived exosomes remains elusive. Mechanical stimulation (MS) promoted bone marrow-derived macrophage (BMDM)-mediated BMSCs osteogenesis. Importantly, when exosomes from mechanically stimulated BMDMs (MS-BMDM-EXOs) were blocked, the pro-osteogenic effect was suppressed. Additionally, compared with exosomes derived from BMDMs (BMDM-EXOs), MS-BMDM-EXOs exhibited a stronger ability to enhance BMSCs osteogenesis. At in vivo, mechanical force-induced alveolar bone formation was impaired during OTM when exosomes were blocked, and MS-BMDM-EXOs were more effective in promoting alveolar bone formation than BMDM-EXOs. Further proteomic analysis revealed that ubiquitin carboxyl-terminal hydrolase isozyme L3 (UCHL3) was enriched in MS-BMDM-EXOs compared with BMDM-EXOs. We went on to show that BMSCs osteogenesis and mechanical force-induced bone formation were impaired when UCHL3 was inhibited. Furthermore, mothers against decapentaplegic homologue 1 (SMAD1) was identified as the target protein of UCHL3. At the mechanistic level, we showed that SMAD1 interacted with UCHL3 in BMSCs and was downregulated when UCHL3 was suppressed. Consistently, overexpression of SMAD1 rescued the adverse effect of inhibiting UCHL3 on BMSCs osteogenesis. This study suggests that mechanical force-induced macrophage-derived exosomal UCHL3 promotes BMSCs osteogenesis by targeting SMAD1, thereby promoting alveolar bone formation during OTM.

针对牙槽骨弹性模量在认识其结构生物力学行为及在口腔正畸治疗方案中的重要作用,应用电子散斑干涉方法对牙槽骨材料的弹性模量进行了实验研究.首先为减少误差采用有限元数值模拟得到牙槽骨梁-质量球的单自由度振动模型优化尺寸,并依此利用电子散斑干涉技术对12个试样进行了共振模态测量,基于悬臂梁等效弹簧刚度模型及振动频率测量值获得了不同部位的牙槽骨在不同湿度下的弹性模量.实验结果表明:不同牙位、牙根轴向层面的牙槽骨弹性模量值存在明显差异,磨牙间的牙槽骨弹性模量明显小于前磨牙部位,根尖处牙槽骨弹性模量显著大于根中部位.测量结果与已有文献的接触测量方法获得的牙槽骨弹性模量值及分布特性相一致,证明了骨材料弹性模量的非接触散斑干涉测定技术的可行性与有效性.相比之下,该测试方法对试样约束及加载方式要求较低,具有实验操作简单、非破坏性测量、可多次重复实验的优势.

Studies concerning the mechanical properties of the human periodontal ligament under dynamic compression are rare. This study aimed to determine the viscoelastic properties of the human periodontal ligament under dynamic compressive loading. Ten human incisor specimens containing 5 maxillary central incisors and 5 maxillary lateral incisors were used in a dynamic mechanical analysis. Frequency sweep tests were performed under the selected frequencies between 0.05 Hz and 5 Hz with a compression amplitude that was 2% of the PDL's initial width. The compressive strain varied over a range of 4%-8% of the PDL's initial width. The storage modulus, ranging from 28.61 MPa to 250.21 MPa, increased with the increase in frequency. The loss modulus (from 6.00 MPa to 49.28 MPa) also increased with frequency from 0.05 Hz- 0.5 Hz but remained constant when the frequency was higher than 0.5 Hz. The tanδ showed a negative logarithmic correlation with frequency. The dynamic moduli and the loss tangent of the central incisor were higher than those of the lateral incisor. This study concluded that the human PDL exhibits viscoelastic behavior under compressive loadings within the range of the used frequency, 0.05 Hz- 5 Hz. The tooth position and testing frequency may have effects on the viscoelastic properties of PDL.

Implants made of porous titanium alloy and fabricated by 3D printing are increasingly used in clinical research. However, porous titanium alloys do not integrate very well with surrounding bone tissue, and bone ingrowth into the implants is not substantial. Schwann cells (SCs) and SC-derived exosomes can effectively promote nerve regeneration, but their role in bone tissue regeneration and repair has not been studied. Therefore, we added SC-derived exosomes to bone marrow stromal cell (BMSC) cultures and observed their effect on BMSCs in vitro; then, we combined exosomes with porous Ti6Al4V scaffolds and observed their effects on bone regeneration and repair in vivo. We found that SC-derived exosomes could promote the migration, proliferation and differentiation of BMSCs and that combining exosomes with porous titanium alloy can effectively improve the efficacy of titanium alloy scaffolds in bone repair. The combination of exosomes and porous Ti6Al4V implants may constitute a new therapeutic strategy for treating bone defects.