OBJECTIVE:Stent graft induced aortic intimo-intimal intussusception (SAoII) during thoracic endovascular aortic repair (TEVAR) of type B aortic dissection (TBAD) is a rare complication. This study aimed to report reliable imaging features of SAoII to avoid such a potentially catastrophic event. This retrospective, multicentre observational analysis was registered as a Chinese Clinical Trial (ChiCTR2300073780). METHODS:Patients undergoing TEVAR for TBAD in three centres were reviewed from January 2014 to December 2022. SAoII was defined as intra-procedural partial or circumferential disruption of the aortic intima because of TEVAR, excluding those created by natural disease progression. The imaging features and management of SAoII were summarised. RESULTS:1 643 patients undergoing TEVAR for TBAD were reviewed. Among them, SAoII was observed in 20 patients (mean age, 44.5 ± 11.8 years; 16 men). TEVAR was performed in the acute phase (8 of 20), subacute phase (11 of 20), or chronic phase (1 of 20). Imaging features including displacement of the intima, wire, or delivery system were observed in eight (40%), floating endograft in 17 (85%), intussusception of the intima layer in 13 (65%), true lumen occlusions and visceral artery loss in three (15%), and a single lumen without intimal septa in three (15%) patients. SAoII was observed in 60% (12 of 20) after deployment of the stent graft, in 20% (4 of 20) after introduction of a stent graft delivery system, and in 20% (4 of 20) after the introduction of a super stiff wire. All patients who developed SAoII were endovascularly managed by an additional stent graft; no aortic related death was observed among these patients with SAoII during the median follow up of 51.5 months. CONCLUSION:SAoII is a rare but potentially fatal iatrogenic complication during or after TEVAR; endovascular interventions could be effective to manage this acute complication. Timely and accurate identification of decisive imaging features are key to successful treatment.

OBJECTIVES:To demonstrate the outcome of thoracic endovascular aortic repair (TEVAR) for patients with type B aortic dissection (TBAD) accompanying retrograde intramural haematoma (RTIMH) in zone 0-2. METHODS:Patients were registered in a retrospective multicentre study and divided into 2 groups: presence of RTIMH involving zone 0-2 (group 1) and RTIMH confined to zones 1 and 2 not involving zone 0 (group 2). The primary end-point was any adverse aortic event (AAE), including the development of full dissection in the ascending aorta, aorta-related mortality, reintervention, and procedure-related complications. RESULTS:A total of 155 patients were enrolled, with 68 (43.9%) in group 1 and 87 (56.1%) in group 2. The AAEs occurred in 14 (9.0%) patients, with 8 in group 1 and 6 in group 2, and no significant differences were found between the 2 groups (P = .294). Patients in group 1 were younger (50.1 ± 6.5 vs 55.6 ± 9.2, P = .04) and more often had a primary entry at the inner curvature of the arch (57.4% vs 25.3%, P < .001). In group 1, freedom from reintervention was significantly lower than in group 2 with 79.1% in group 1 and 93.3% in group 2 (P = .02). CONCLUSIONS:In selected cases, TEVAR is an effective alternative treatment modality to open repair for TBAD with RTIMH extending to zone 0. However, the rate of reintervention is higher in those with RTIMH propagation into the proximal ascending aorta, suggesting closer follow-up. CLINICAL REGISTRATION NUMBER:This retrospective multicenter analysis registered as a Chinese Clinical Trial (ChiCTR2300071443).

Autoimmune disease-related critical limb ischemia (AD-CLI) represents a significant portion of no-option critical limb ischemia (NO-CLI). Despite the demonstrated safety and efficacy of cell transplantation for NO-CLI, most studies focused on thromboangiitis obliterans (TAO). There remains a scarcity of reports on cell transplantation for AD-CLI induced by systemic lupus erythematosus (SLE), hypereosinophilic syndrome (HES), and so on. From May 2011 to May 2024, 22 patients with 36 ischemic limbs were enrolled. The primary outcome was amputation, whereas secondary outcomes included toe-brachial index (TBI), Wong-Baker Faces Pain Rating Scale (WBFPS), transcutaneous oxygen pressure (TcPO2), and so on. Among them, 8 had SLE, 11 had HES, and 3 had eosinophilic granulomatous polyangiitis (EGPA). During the follow-up, one EGPA patient died, two patients underwent major amputation, and five underwent minor amputation. The 2-year major and total amputation-free survival rates were 86.4% and 72.7%, respectively. Critical limb ischemia (CLI) relief was observed in 14 patients, with a 1-year cumulative CLI-free survival rate of 61.0%. Significant improvements were noted in postoperative TBI and WBFPS. Autologous cell transplantation showed satisfactory safety and efficacy outcomes for non-TAO AD-CLI patients. Validation of the conclusions awaits more evidence based on the long-term outcomes of a larger number of patients.

Background:Periodontitis is linked to dyslipidaemia, but the mechanism still requires further investigation. Objective:This study aimed to investigate the periodontitis-dyslipidaemia interplay, comparing the impact of periodontitis-associated versus healthy salivary microbiota on systemic lipid metabolism in mice via the oral-gut axis. Design:NHANES analysis established epidemiological link. ApoE-/- mice received salivary microbiota from periodontally healthy (A-PH) or severe periodontitis (A-SP) donors. Serum lipids and gut microbiota were assessed; correlations between microbial shifts and lipid changes were evaluated. Results:NHANES confirmed significant association between self-reported physician-diagnosed bone loss around teeth and hypercholesterolemia (OR=1.266). A-SP mice exhibited higher TC, LDL and non-HDL compared with A-PH group. Gut dysbiosis featured increased proinflammatory genera (Helicobacter and Prevotella) and reduced beneficial bacteria (Mucispirillum, Parasutterella, and Barnesiella). Prevotella positively correlated with TC, Helicobacter with LDL; beneficial genera negatively correlated with atherogenic lipids. Conclusions:Collectively, building upon the NHANES link, our findings demonstrate that the salivary microbiome from periodontitis patients, compared to that from healthy individuals, disrupts systemic lipid metabolism and induces gut dysbiosis in mice. The correlation between specific gut microbial shifts and atherogenic lipid profiles provides experimental support for the mediating role of the oral‒gut axis in linking periodontitis to hyperlipidaemia.

OBJECTIVES:Isolated internal iliac artery aneurysm (IIIAA) is a rare condition, accounting for approximately 0.3% to 0.5% of all intra-abdominal aneurysms. This study aimed to evaluate the outcomes of endovascular treatment for IIIAA using a relatively large cohort. METHODS:A retrospective analysis was conducted on 45 patients diagnosed with IIIAA who were admitted to our hospital between April 2014 and April 2024. Patient demographics, intervention outcomes, and follow-up results were collected and analyzed. RESULTS:A total of 45 patients (only 2 female) with 49 IIIAAs were included, with a mean age of 70.4±9.2 years. The cohort exhibited a high prevalence of cardiovascular and cerebrovascular risk factors, and 31.1% had a history of malignancy. Thirty patients (66.7%) were diagnosed with an incidental IIIAA, while the remaining patients presented with symptoms such as abdominal or lumbar pain, dysuria, or aneurysm rupture. Stent-graft placement alone was performed in 3 patients, coil embolization alone in 5 patients, and the remaining 37 patients underwent a combined approach. The rate of complete distal branch embolization was 69.0% (29/42), and technical success was achieved in 44 patients. The mean follow-up duration was 23.8±21.5 months. During follow-up, 5 patients died from cancer or heart failure. Buttock claudication was observed in 7 patients, with only 1 case remaining unresolved after conservative treatment. Sac dilation was noted in 4 patients who had incomplete distal branch embolization; of these, 3 required re-intervention. The 12-month and 24-month re-intervention-free survival rates were 95.5% and 88.2%, respectively. CONCLUSION:Endovascular treatment, particularly the combination of stent-graft implantation and coil embolization, is both safe and effective for IIIAA, with a mid-term re-intervention-free survival rate of 85.25% and an acceptable risk of pelvic ischemia. Complete embolization of the outflow branches is technically challenging in some cases, and the efficacy of sac embolization as an alternative remains debatable.Clinical ImpactIsolated internal iliac artery aneurysm (IIIAA) is an exceedingly rare condition. This retrospective study identified and included 45 patients with IIIAA who were treated at our institution to evaluate the safety and therapeutic efficacy of endovascular treatment. The majority of patients underwent stent-graft implantation to seal the internal iliac artery ostium, along with coil embolization of the distal branches. The 2-year reintervention-free survival rate for all patients was 85.25%, demonstrating the favorable efficacy of endovascular treatment. However, postoperative sac dilation was observed in 4 patients who did not receive complete distal branch embolization, emphasizing the need for rigorous follow-up in this subset of patients.

Context Head and neck paragangliomas (HNPGLs) are tumors of parasympathetic origin, predominantly associated with pseudohypoxia and pathogenic variants (PVs) in succinate dehydrogenase (SDH) subunits, mainly based on studies in Europeans/Americans. Objective This work aimed to assess the genetics of HNPGLs in a large Chinese cohort and compare them with European cases. Methods A retrospective cohort study was conducted of HNPGLs from 2 Chinese tertiary-care centers and 2 European centers. Participants included 222 Chinese and 205 European HNPGL patients. Main outcome measures included clinical presentation and genetic status assessed via next-generation sequencing of tumor/blood samples. Results The Chinese HNPGL cohort consisted mainly of carotid body HNPGLs (86.9%), fewer jugulotympanic (12.2%), and no vagal HNPGLs. Jugulotympanic HNPGLs showed higher recurrence than carotid body HNPGLs (30.4% vs 8.5%; P = .009). PVs were detected in 62.2% of Chinese patients, predominantly in SDHx genes. PV frequency was higher in carotid body than jugulotympanic HNPGLs (65.8% vs 37%; P = .004), and in more male than female patients (75.9% vs 54.0%; P = .001). Compared to those without SDHx PVs, SDHx PVs carriers were younger (41.0 vs 49.0; P < .001), with more multifocal tumors (20.8% vs 7.6%; P = .007) and less often female (53.1% vs 76.1%; P < .001). Compared with Europeans, Chinese patients were younger (45.0 vs 54.3; P < .001), with fewer multilocal HNPGLs (0.9 vs 13.7%; P < .001), lower rates of recurrence (13.7% vs 28.0%; P = .007), but similar metastasis rates (3.9% vs 5.0%; P = .668). Conclusion This is the first report of HNPGLs in a large Chinese cohort. Clinical presentation and practice as well as ancestry all likely contribute to the differences observed between Chinese and European patients.

Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy with poor patient outcomes. The long non-coding RNA NEAT1 (lncRNA NEAT1) has emerged as a critical driver of HNSCC pathogenesis. This review synthesizes current knowledge on lncRNA NEAT1's aberrant expression, molecular mechanisms, and functional roles in HNSCC. LncRNA NEAT1 is significantly upregulated in tumors and promotes progression by acting as a competing endogenous RNA (ceRNA) for multiple miRNAs, such as miR-125b-5p, miR-204, and miR-34a-5p, thereby regulating downstream targets including SLC1A5, ZEB1, and components of the Wnt/β-catenin pathway. These interactions drive key oncogenic processes, including proliferation, metastasis, epithelial-mesenchymal transition, therapy resistance, and cell death inhibition. Clinically, high lncRNA NEAT1 expression correlates with advanced T stage, lymph node metastasis, and reduced survival, underscoring its potential as a diagnostic and prognostic biomarker. Therapeutically, emerging approaches such as nanoparticle-mediated delivery of siRNA/shRNA offer a promising strategy to target lncRNA NEAT1, potentially synergizing with existing immunotherapies. Although clinical translation remains challenging, lncRNA NEAT1 represents a highly promising biological target for future precision oncology in HNSCC.

Recurrent oral ulcers is a characteristic of Behcet's disease (BD), while xerostomia typifies Sjogren's disease (SD), with emerging evidence implicating gut dysbiosis in their pathogenesis through oral-gut axis interactions. This case report describes a 36-year-old woman with BD and SD who presented with refractory oral ulcers, xerostomia, and dry eyes. Despite conventional therapy, her symptoms persisted until she underwent washed microbiota transplantation (WMT) to address concurrent gut dysbiosis. Remarkably, within 3 months, the frequency of oral ulcers decreased with quicker healing, and dry eye symptoms resolved completely. Two years later, sustained improvement was confirmed, allowing for discontinuation of hydroxychloroquine. Microbial analyses showed a significant difference in the gut and oral microbiota before and after WMT. These findings suggest WMT may offer a novel therapeutic approach for refractory oral manifestations in BD and SD.

Oral squamous cell carcinoma (OSCC) is an aggressive malignancy associated with high morbidity and mortality. RAD51 recombinase (RAD51), a central DNA repair protein, plays a crucial role in homologous recombination and has been implicated in cancer progression through mechanisms such as genomic instability, chemoresistance and immune modulation. However, its specific function and regulatory mechanisms in OSCC remain incompletely elucidated. We conducted an integrated multiomics analysis including differential expression, single-cell transcriptomics, prognostic evaluation, functional enrichment and immune infiltration profiling. Experimental validation was performed using siRNA-mediated RAD51 knockdown in OSCC cell line HSC-3, followed by functional assays to assess proliferation, migration, invasion, reactive oxygen species (ROS) accumulation and chemosensitivity. RAD51 was significantly overexpressed across multiple cancers, including OSCC, and exhibited high diagnostic accuracy for OSCC (AUC = 0.956). Single-cell RNA sequencing revealed elevated RAD51 expression in malignant and proliferating T cells, associating it with aggressive phenotypic traits. High RAD51 expression predicted poor prognosis in OSCC and other cancers. Functional analyses indicated its involvement in the Fanconi anaemia pathway, DNA damage repair and cell cycle regulation. Immune infiltration analysis revealed significant negative correlations with multiple immune cell subtypes and tumour microenvironment scores. Experimentally, RAD51 knockdown suppressed malignant behaviours and enhanced ROS production and chemosensitivity in HSC-3 cells. RAD51 drives OSCC progression by enhancing malignant phenotypes, suppressing immune infiltration, promoting aberrant DNA repair, elevating oxidative stress and promoting therapy resistance. These findings support RAD51's potential as both a prognostic biomarker and a therapeutic target in OSCC.

Periodontitis is a chronic inflammatory disease, having significant impact on systemic conditions. Ulcerative colitis (UC) is a chronic relapsing inflammatory disorder of the intestines. Studies have suggested a potential association between periodontitis and UC. This study aims to elucidate the influence of periodontitis on the progression of UC and to uncover the potential mechanistic pathways involved. A total of 20 male C57BL/6J mice were randomly assigned to four groups: Sham, Periodontitis (P), UC, and Periodontitis + UC (P-UC). A chronic UC model was induced by alternating oral administration of 1% and 0.5% Dextran Sulfate Sodium Salt (DSS) solution, while periodontitis was induced by ligatures. Disease severity was accessed using Disease Activity Index (DAI), histopathology, and intestinal permeability assays. Gut microbiota and periodontal microbiota was analyzed using 16S rRNA sequencing. Tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) were measured by quantitative PCR (qPCR) to evaluate the systemic inflammation burden. Zonula occludens-1 (ZO-1) and occludin in intestinal tissues were assessed using qPCR and immunohistochemistry. Correlation analyses were performed between periodontal destruction indices and markers. A chronic UC model closely resembling clinical conditions was successfully established. The P-UC group exhibited earlier and more pronounced body weight loss than the UC group. Colonic inflammation was exacerbated, with significantly elevated TNF-α and IL-6 expression (P < 0.05). In the P-UC group, intestinal barrier disruption was evident with reduced occludin protein levels (P < 0.01) and increased intestinal permeability (P < 0.05), indicated by serum diamine oxidase (DAO). Both the P-UC and UC groups exhibited notable dysbiosis of the gut microbiota, with the P-UC group showing significantly higher abundance of UC-associated bacteria, such as Muribaculum and Allobaculum (P < 0.05), compared to the UC group. A trend toward reduced abundance of the gut-protective bacterium Akkermansia was also observed (P = 0.06). Pearson correlation analysis confirmed the association between periodontitis and intestinal inflammation, suggesting that intestinal barrier dysfunction and gut microbiota dysbiosis may be key mediators in periodontitis-induced UC exacerbation. Periodontitis may exacerbate UC by increasing harmful gut bacteria, reducing beneficial bacteria, and promoting the secretion of pro-inflammatory cytokines, thereby disrupting the intestinal barrier and worsening UC severity.

Relapsed/refractory multiple myeloma (RRMM) and extramedullary multiple myeloma (EMM) present significant challenges for patients with multiple myeloma (MM) after their disease progresses.Despite notable advancements in treatments like autologous hematopoietic stem cell transplantation (ASCT) and chimeric antigen receptor (CAR)-T-cell therapy, most patients with RRMM and EMM face a short survival period. Currently, there are no effective treatments available. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one of the treatment options for MM. Reduced-intensity conditioning (RIC) regimens have largely replaced myeloablative conditioning (MAC) regimens. RIC is now preferred because it significantly lowers transplant-related mortality, which has dropped to 10-20%. However, RIC regimens are linked to higher relapse rates compared to MAC. To enhance the efficacy of allo-HSCT, it is essential to identify a safer and more effective conditioning regimen. We report a case of EMM involving the breast, supraclavicular region, mediastinum, and pleural effusion, among other sites. The patient did not respond to several treatments, including a proteasome inhibitor (PI) like bortezomib, immunomodulatory drugs (IMiDs) such as lenalidomide, and a monoclonal antibody targeting CD38, like daratumumab. Consequently, we recommended haploidentical hematopoietic stem cell transplantation as a salvage treatment. After undergoing allo-HSCT with a conditioning regimen that mainly included selinexor and helical tomotherapy, the patient achieved a complete remission(CR) and enjoyed long-term disease-free survival for 11 months. Along with existing literature, this case provides encouraging insights for future research on RRMM and EMM, and we anticipate more reports on allo-HSCT cases in the future.

Periodontitis, the sixth most prevalent human disease, involves excessive ROS and mitochondrial dysfunction as key pathological drivers. However, therapeutic strategies simultaneously targeting both mechanisms for optimal regeneration remain scarce. To address this, we developed a ROS-responsive hydrogel (Gel) integrated with mitochondria-targeted liposomes encapsulating Coenzyme Q10 (CoQ10-MLip/Gel). The CoQ10-MLip combines CoQ10 (mitochondrial electron carrier) with arginine residues (mitochondrial-targeting motifs). The phenylboronic ester-based Gel degrades under high ROS, enabling controlled CoQ10-MLip release. Its self-healing properties and injectability ensure prolonged retention in periodontal pockets. This system effectively eliminated ROS, restored mitochondrial integrity, and significantly mitigated periodontal inflammation in vivo. The CoQ10-MLip/Gel platform thus offers a promising strategy for periodontitis treatment and potentially other chronic inflammatory diseases.

The causal relationship between serum 25-hydroxyvitamin D levels and oral diseases remains uncertain due to confounding and reverse causation in observational studies. This bidirectional 2-sample Mendelian randomization (MR) study aims to elucidate the causal relationship between serum 25-hydroxyvitamin D levels and multiple oral pathologies while addressing confounding factors and reverse causation observed in conventional observational studies. Utilizing summary-level genome-wide association study data from the IEU OpenGWAS project, we analyzed serum 25-hydroxyvitamin D levels (“ebi-a-GCST90000618,” n = 4,96,946 Europeans) and oral disease phenotypes from Finnish biobank registries. Instrumental variables for serum 25-hydroxyvitamin D levels were selected under genome-wide significance ( P < 5 × 10 −8 ) with strict clumping thresholds ( r 2 < 0.001, kb = 10,000) and F -statistics > 30. For oral disease exposures, relaxed criteria ( P < 1 × 10 −5 , r 2 < 0.001, F -statistic > 10) were applied to ensure sufficient instrumental variables. Primary analyses employed inverse-variance weighted and MR-Egger methods, supplemented by sensitivity analyses including Cochran’s Q test, leave-one-out validation, funnel plots, and MR-PRESSO for horizontal pleiotropy assessment. Forward MR analysis demonstrated significant inverse causal relationships between genetically elevated serum 25-hydroxyvitamin D levels and risks of perioral dermatitis and lip, oral cavity, pharyngeal malignancies. No statistically significant associations were observed with other oral diseases. Reverse MR analysis revealed a nominal positive association between lichen planus and serum 25-hydroxyvitamin D levels that did not persist after multiple testing correction, with no other reverse causal effects detected. Our findings provide genetic evidence supporting a protective role of serum 25-hydroxyvitamin D levels against specific oral disorders, particularly perioral dermatitis and oropharyngeal malignancies. The bidirectional design effectively mitigated reverse causation concerns, underscoring the robustness of these causal inferences. These results warrant further investigation into vitamin D supplementation as a potential preventive strategy for targeted oral pathologies.

Background: The efficacy of excimer laser ablation (ELA) in de novo atherosclerotic lesions of lower extremity artery disease (LEAD) is unknown. Objectives: This real-world study aimed to evaluate the safety and efficacy of ELA combined with drug-coated balloon (DCB) versus DCB alone in LEAD patients. Methods: In this prospective, multicenter, real-world trial (ChiCTR2100051263), patients with de novo atherosclerotic lesions of LEAD were enrolled and allocated to either ELA + DCB or DCB-alone group in a 1:1 ratio. The primary endpoint was 12-month primary patency, with secondary endpoints including technical success, clinically driven target lesion reintervention (CD-TLR), and changes in ankle-brachial index (ABI). Results: A total of 136 patients were enrolled in the study. At baseline, patients in the ELA + DCB group presented significantly higher Rutherford classification (3.7 ± 0.9 vs. 4.2 ± 1.0, p = 0.007) and longer mean lesion lengths (7.4 ± 2.5 cm vs. 8.4 ± 1.9 cm, p = 0.012). The ELA + DCB group demonstrated significantly superior 12-month primary patency (87.5% vs. 71.2%, p = 0.03) and technical success rates (92.7% vs. 79.4%, p = 0.046) compared to the DCB-alone group. Kaplan-Meier analysis further confirmed sustained patency benefit with ELA + DCB (p = 0.015). Conclusion: In this real-world trial, ELA appears to be a promising therapy for LEAD in terms of safety and efficacy. However, these findings need to be corroborated by larger, randomized studies. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial URL: https://www.chictr.org.cn/. Unique identifier: ChiCTR2100051263 ### Funding Statement This study was supported by Noncommunicable Chronic Diseases-National Science and Technology Major Project (grant no. 2023ZD0504300), the Postdoctoral Fellowship Program and China Postdoctoral Science Foundation (grant no. BX20250267), Youth Fund of Fudan University Affiliated Zhongshan Hospital (grant no. ZSZP202413), Outstanding Resident Clinical Postdoctoral Program of Zhongshan Hospital Affiliated to Fudan University, and the National Natural Science Foundation of China (grant no. 82270507). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study design was approved by the Ethics Committee for the Protection of Human Subjects at Zhongshan Hospital, Fudan University, Shanghai, China. All included patients were informed about the nature of the study and gave their written informed consent. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets analyzed during this study are available from the corresponding author on reasonable request.

Introduction: Stage Ⅲ/IV grade C (Ⅲ/Ⅳ-C) PD in particularly young individuals, characterized by minimal biofilm accumulation, severe bone loss and rapid clinical attachment loss (CAL), often leads to early tooth loss and carries significant risk potential. Case description: A 23 year-old female patient presented with the chief complaint of tooth mobility in 2013.Intraoral examination revealed a palatal periodontal defect of maxillary incisors accompanied by a probing depth of 8mm,gradeⅠmobility, bone loss extending to apical 1/3 as well as 50% PD>3.4 mm and BOP 86%.The diagnosis is Stage Ⅲ Grade C periodontitis. Following non-surgical periodontal therapy, including oral hygiene instruction, full-mouth supragingival scaling subgingival scaling and root planning, standard supportive periodontal therapy was performed biannually over a 12-year period. The latest reevaluation revealed well-maintained periodontal health with tooth mobility decrease and bone regeneration. Discussion: The overall treatment concepts and goals of Ⅲ/Ⅳ-C PD are not markedly different from chronic periodontitis. However, given the young age and extensive bone loss, early and comprehensive treatment along with consistent maintenance is required to halt further periodontal destruction and optimize attachment gain. Conclusion/clinical significance: This case report illustrates that Ⅲ/Ⅳ-C PD can achieve optimal therapeutic outcomes, even bone regeneration, through non-surgical treatment. A successful periodontal management demands collaboration between specialists and patients, encompassing clinical expertise (diagnostic acuity and procedural rigor) and patient adherence. Meanwhile, the successful management, particularly in long-term case, will further reinforce our confidence in periodontal treatment.

AIM:To assess a new material in comparison with free gingival graft (FGG) for increasing the width of keratinised tissue (KT). MATERIAL AND METHODS:Forty-six participants were randomly allocated to the absorbable gradient membrane (AGM) or the FGG group. This trial used inter-patient comparison to establish the non-inferiority of AGM compared to FGG. The primary outcome (KT) was examined from baseline to 3 years after surgery. Secondary outcomes included the plaque index (PI), bleeding index (BI), gingival recession (GR), probing depth (PD), immunoglobulin E (IgE) level, postoperative pain, aesthetics and patient satisfaction. RESULTS:The width of KT in the AGM group was non-inferior to that of the FGG group at all short-term follow-ups (1, 3 and 6 months), with a pre-defined margin of 1 mm. However, this non-inferiority disappeared by 3 years after operation. From 6 months to 3 years, the GR associated with FGG significantly decreased, while that associated with AGM showed no significant change between adjacent time points. No significant differences were observed in PI, BI, PD or IgE levels between the groups. AGM required shorter surgery times and secured better aesthetic outcomes than FGG. CONCLUSION:AGM showed short-term non-inferiority to FGG for KT augmentation. However, the non-inferiority was not sustained at 3 years. TRIAL REGISTRATION:The study was registered with the China Clinical Trial Center under ChiCTR2000034683. Informed consent was obtained from all participants.

ABSTRACT Background Epigallocatechin gallate (EGCG) has anti‐inflammatory and antioxidative stress effects in periodontitis. However, the specific mechanisms involved remain unclear. Our study explored whether the mechanism by which EGCG on alleviates inflammation and oxidative stress in human periodontal ligament fibroblasts (hPDLCs) involves HDAC6. Methods We treated hPDLCs with lipopolysaccharide (LPS) and EGCG, and detected the resultant effects on cell proliferation by the CCK‐8 method. Cells were divided into three groups: control, LPS, and EGCG + LPS. The expression of tumor necrosis factor α (TNF‐α) and interleukin‐1β (IL‐1β) was detected by enzyme‐linked immunosorbent assay (ELISA), and the expression of reactive oxygen species (ROS) was detected using 2′,7′‐dichlorofluorescein diacetate. The expression of histone deacetylase 6 (HDAC6), p62, heat shock protein 70 (Hsp70), Kelch‐like ECH‐associating protein (Keap1), nuclear factor E2‐related factor 2 (Nrf2), and heme oxygenase‐1(HO‐1) mRNA was detected by real‐time quantitative polymerase chain reaction (RT‐qPCR). The protein expression of HDAC6, Nrf2, and nod‐like receptor protein 3 (NLRP3) was detected by western blotting. Results At concentrations of less than 100 μmol/L, EGCG can promote cell proliferation and significantly inhibit the levels of TNF‐α and IL‐1β. Moreover, EGCG can activate the Nrf2 pathway and inhibit ROS production. Furthermore, EGCG inhibited the expression of HDAC6 and promoted the expression of p62 and Hsp70, indicating that the anti‐inflammatory and antioxidant effects of EGCG are closely related to HDAC6. Conclusions EGCG can regulate LPS‐induced oxidative stress levels of hPDLCs through the Keap1/Nrf2/HO‐1 pathway and reduce the expression of HDAC6‐related factors. Therefore, HDAC6 may be a potential target for EGCG in the treatment of periodontal inflammation and oxidative stress.

OBJECTIVE:The removal of impacted third molars by surgery may occur with a series of complications, whereas limited information about the postoperative pathogenesis is available. The objective of this study is to identify changes in gene expression after flap surgical removal of impacted third molars and provide potential information to reduce postoperative complications. METHODS:The gingival tissues of twenty patients with flap surgical removal of impacted third molars and twenty healthy volunteers were collected for gene expression testing. The collected gingival tissues were used RNA sequencing technology and quantitative real-time PCR validation was performed. DEG was mapped to protein databases such as GO and KEGG for functional annotation and, based on annotation information, for mining of differential expression genes in patients with mpacted third molars. RESULTS:A total of 555 genes were differentially expressed. Among the top up-regulated genes, HLA-DRB4, CCL20, and CXCL8 were strongly associated with immune response and signal transduction. Among the top down-regulated genes, SPRR2B, CLDN17, LCE3D and LCE3E were related to keratinocyte differentiation, IFITM5, and BGLAP were related to bone mineralization, UGT2B17 is associated with susceptibility to osteoporosis. KEGG results showed that the DEGs were related to multiple disease-related pathways. CONCLUSION:This first transcriptome analysis of gingival tissues from patients with surgical removal of impacted third molars provides new insights into postoperative genetic changes. The results may establish a basis for future research on minimizing the incidence of complications after flap-treated third molars.

Background Excessive intake of fluoride during enamel growth and development can impair the normal physiological function of ameloblasts, resulting in the formation of dental fluorosis. However, little is known about the function of miRNAs in the formation of dental fluorosis. Aim This study aimed to explore the effects of key miRNAs on the PI3K/AKT signaling pathway and ameloblasts under high fluoride conditions. Materials and Methods LS8 cells were treated with NaF at concentrations of 0.4, 0.8, 1.6, 3.2, and 6.4 mmol/L for 24 h, and cell viability and apoptosis were measured using the CCK-8 assay and flow cytometry. The expression of apoptosis-related proteins was detected by Western blotting. Transcriptome sequencing was performed on FS8 cells after treatment with 1.6 and 3.2 mmol/L NaF for 24 h to identify key miRNAs and validate them. After cell transfection, the effect of miR-214-3p on ameloblasts and the PI3K/AKT signaling pathway was assessed. Results and Discussion NaF treatment significantly reduced the viability and accelerated the apoptosis of LS8 cells. The down-regulated miRNAs predicted target genes that were most enriched in the PI3K/AKT signaling pathway, and the most critical miRNA was miR-214-3p. The expression levels of p-PI3K, p-AKT, and Bcl-2 were significantly up-regulated after overexpression of miR-214-3p in LS8 cells, while the expression of PI3K, AKT, and Bax was significantly down-regulated, which was partially reversed by LY294002. Conclusion Excess fluoride could affect the morphology of ameloblast-like cell lines and induce apoptosis. Overexpression of miR-214-3p inhibited NaF-induced apoptosis in LS8 cells by regulating the PI3K/AKT signaling pathway, inhibiting its phosphorylation, down-regulating the Bax protein, and up-regulating the Bcl-2 protein.