Autologous bone grafting is considered as “gold standard” in the alveolar ridge augmentation techniques. In situ onlay grafting uses grafts adjacent to edentulous sites without a separate donor site. Several studies have revealed the satisfactory short-term performance of this less invasive modified technique, but no information is available of stability of alveolar ridge reconstructed by in situ onlay grafting and implant performance after occlusal loading in a mid-term follow-up. This study is to retrospectively evaluate the radiographic and patient reported outcomes (PROMs) of a modified onlay grafting technique and the subsequent implantation in anterior maxilla using in situ grafts without a second bone harvesting region. A total of 83 patients contributed 119 edentulous deficiency sites, and 104 implants were placed in anterior maxilla. 44 patients received in situ onlay grafting using subnasal grafts and 39 patients received ex situ onlay grafting using mandibular symphysis grafts. Alveolar ridge height and multileveled widths were assessed using cone-beam computed tomography (CBCT) prior grafting and at five subsequent time points. Clinical parameters and PROMs were evaluated with a visual analog scale (VAS) during the follow-up. Approximately 6 months after onlay grafting, dental implants were placed followed by fixed prosthetic rehabilitation. Implant survival and success rates were assessed with a mean follow-up of 42.90 months. The horizontal bone resorption at cervical level after 1-year occlusal loading of in situ group (1.73

Purpose:Osteoporosis is characterized by an acidic and oxidative stress microenvironment driven by excessive osteoclast activity, which impairs osteogenesis and leads to dysregulated bone remodeling. This study aims to develop selenium-doped calcium hydroxide nanoparticles (SeCaNP) to simultaneously inhibit osteoclastogenesis and promote osteogenic differentiation, thereby providing a multi-targeted microenvironment-modulating strategy for osteoporosis therapy. Methods:SeCaNP was synthesized via a coprecipitation method and characterized using TEM, XRD, and acid-neutralization assays. In vitro, bone marrow-derived macrophages (BMMs) and bone marrow mesenchymal stem cells (BMSCs) were co-cultured with SeCaNP to assess osteoclast activity and osteogenic differentiation. In vivo, an ovariectomy (OVX)-induced osteoporosis mouse model was established and treated with local injections of SeCaNP. Therapeutic efficacy and biosafety were systematically evaluated. Results:SeCaNP significantly upregulated GPx1 expression, effectively scavenged reactive oxygen species (ROS), and neutralized the intracellular acidic microenvironment, thereby markedly inhibiting osteoclastogenesis. Concurrently, SeCaNP promoted BMSC cytoskeletal remodeling and significantly enhanced osteogenic differentiation and mineralization, upregulating key markers (RUNX2, ALP, OPN, OCN). RNA-seq analysis indicated that SeCaNP regulated osteogenesis-related membrane signaling platforms and extracellular matrix assembly. In vivo, SeCaNP treatment significantly ameliorated OVX-induced bone loss, notably improving bone mineral density (BMD) and trabecular microarchitecture parameters (BV/TV, Tb.N, Tb.Th). Furthermore, SeCaNP upregulated BMP-2 expression and serum BALP levels without inducing systemic toxicity. Conclusion:SeCaNP effectively overcomes the limitations of conventional osteoporosis therapies by integrating acid neutralization, antioxidant properties, and osteogenic support. Through a dual-regulatory mechanism that inhibits bone resorption and promotes bone formation, SeCaNP successfully reconstructs the pathological bone microenvironment and reverses bone loss, highlighting its significant potential as a microenvironment-modulating biomaterial for anti-osteoporotic therapy.

Permanent molar loss is commonly encountered in clinical practice, and eruption of the opposing teeth caused by their prolonged absence increases the complexity of restorative treatment. How to rapidly and efficiently regain precise restorative space presents a clinical challenge. Orthodontic temporary anchorage devices (TADs) have been regarded as a minimally invasive treatment alternative with absolute anchorage and can simplify orthodontic intrusion. This digital technique aims to simulate the definitive restorative treatment outcome using a digital workflow that guides the design and 3-dimensional (3D) printing of a metal occlusal veneer with implant guides to intrude the target teeth. This intrusion system enables the precise control of the target tooth movement, thereby facilitating subsequent restorative treatment and ensuring a more favorable outcome.

Sepsis, a life-threatening condition caused by systemic infection, demands rapid and accurate diagnostic methods for early intervention. Lipopolysaccharides (LPS), a key biomarker for Gram-negative bacterial infections, are critical targets for sepsis detection. This study presents a novel giant magnetoimpedance (GMI) biosensor utilizing cobalt-based amorphous microwires (AMs) arranged in a spaced equidistant array structure to achieve ultrasensitive LPS detection. The array design significantly enhances the effective sensing area, improving sensitivity and reducing the detection limit. The biosensor employs a sandwich detection system involving LPSspecific aptamers and magnetic beads (MBs) for signal amplification. Results demonstrate an impressive detection limit of 1.8 pg/mL for LPS, with excellent linearity (R2=0.9226) and specificity against common blood components. Additionally, a compact biosensor testing device was developed, achieving a detection limit of 13.1 pg/mL, suitable for point-of-care applications. This work highlights the potential of GMI-based biosensors as a rapid, sensitive, and cost-effective tool for sepsis diagnosis.

Clear aligner treatment is a novel technique in current orthodontic practice. Distinct from traditional fixed orthodontic appliances, clear aligners have different material features and biomechanical characteristics and treatment efficiencies, presenting new clinical challenges. Therefore, a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique. This expert consensus discusses case selection and grading of treatment difficulty, principle of clear aligner therapy, clinical procedures and potential complications, which are crucial to the clinical success of clear aligner treatment.

Alveolar cleft is a common developmental malformation in the maxillofacial region, often occurring with cleft lip or palate. The traditional “gold standard” iliac bone grafting implants only cancellous bone in the alveolar cleft region. However, this approach provides insufficient initial mechanical support and is prone to structural collapse and accelerated bone resorption. This study used digital guide plate assisted cortico-cancellous iliac crest bone grafting to repair alveolar clefts, aiming to provide better structural support while reducing bone resorption. This study retrospectively reviewed 39 patients with unilateral alveolar clefts, including 21 cases in the autogenous iliac cancellous bone grafting group (cancellous bone group, mean age 15.33 ± 5.36 years) and 18 cases in the digitally guided autogenous iliac cortical-cancellous composite bone grafting group (composite bone group, mean age 14.17 ± 4.05 years). Preoperative and 6-month postoperative assessments were performed using CBCT for three-dimensional evaluation. The study compared the bone graft volume, new bone fill rate, alveolar width in the grafted area, and bone density between the two groups. Postoperatively, the composite bone group exhibited markedly greater bone graft volume (698.58 ± 197.43 mm³ versus 378.23 ± 176.65 mm³, P < 0.01) and significantly higher new bone fill rate for volume, area, and height relative to the cancellous bone group. The composite bone has a clear advantage in maintaining alveolar ridge width compared to cancellous bone. Compared with the traditional “gold standard” grafting, digital guide plate assisted cortico-cancellous iliac crest bone grafting for alveolar cleft repair significantly increased the bone graft volume. The surgical method introduced in this study provides a new option for the precise repair and functional reconstruction of alveolar clefts and has a broad application prospect.

Aim or purpose: This study investigates the impact of obstructive sleep apnea (OSA)-related hypoxic stress on the secretion and immunity of salivary glands (SG), with a particular focus on macrophage modulation. We aim to explore the role of macrophages in maintaining SG homeostasis under low-oxygen conditions and identify potential salivary biomarkers for OSA diagnosis. Materials and methods: Using a C57BL/6J mouse model of OSA, we exposed mice to varying levels of intermittent hypoxia to simulate OSA conditions. SG function was assessed by measuring salivation rates, mucus secretion, and calcium crystal deposition. The immune cell composition, particularly macrophages, was analyzed using immunohistochemistry, flow cytometry and RNA sequencing. The in vivo macrophage phagocytosis was evaluated through retroductal infusion of fluorescent latex beads. The interaction between salivary epithelial cells and macrophages was examined through in vivo imaging and gene expression analysis. Saliva from OSA patients was collected to validate findings and explore potential biomarkers. Results: OSA-induced hypoxia led to a significant reduction in salivary flow rate and changes in glandular morphology. Macrophages in the ductal regions showed reduced numbers and impaired phagocytic function. Elevated levels of IL-34 and CSF1, key macrophage-related factors, were observed in both mice and human saliva, correlating with the severity of OSA. Conclusions: Hypoxic stress associated with OSA disrupts both salivary secretion and immune surveillance, particularly through macrophage dysfunction. These findings suggest that salivary macrophage-related biomarkers could serve as non-invasive tools for OSA diagnosis and monitoring, providing insights for targeted therapeutic interventions in SG and immune system health.

Aim or purpose: Cancellous bone grafting, considered the gold standard for alveolar cleft repair, has a drawback of high bone resorption rate. This research evaluates the efficacy of digital guide plate-assisted cortico-cancellous iliac crest bone grafting, aiming to minimize bone resorption and optimize treatment outcomes. Materials and methods: This retrospective study was approved by the Ethics Committee of this institution and analyzed 39 unilateral alveolar cleft patients from January 2018 to December 2023. Group 1 (n=21, mean age 15.33 ± 5.36 years) received iliac cancellous bone grafts, and Group 2 (n=18, mean age 14.17 ± 4.05 years) underwent digital guide plate-assisted iliac cortico-cancellous bone grafts. Preoperative and postoperative CBCT were conducted to assess new bone formation rates, alveolar width, bone density, and nasal base symmetry. Statistical analyses were performed using the t-test. Results: The composite bone group exhibited the new bone formation rate of 61.25%, markedly superior to 38.86% of cancellous bone group, and had a significant advantage in preserving alveolar width over the cancellous graft. Conclusions: It is suggested through the new method, surgeons can accurately determine the size and shape of the bony defect preoperatively. The prepared bone harvesting guides could be more precise, simplifying the bone harvesting surgery and minimizing trauma. It is discovered that the cortico-cancellous iliac crest bone in alveolar cleft bone grafting yields better results than cancellous bone grafting and offers superior mechanical properties, structural support, blood supply reconstruction, and nasal contouring, and the canines can erupt normally postoperatively.

Aim or purpose: This study investigates the regulatory and reparative capabilities of dental pulp stem cells (DPSCs) on synovitis in temporomandibular joint osteoarthritis (TMJOA) rat models. It elucidates their specific mechanisms of action on synovial macrophages. Materials and methods: Sprague-Dawley rats were divided into control, OA, and DPSCs treatment groups. A TMJ arthritis model was induced using monosodium iodoacetate (MIA) and complete Freund's adjuvant (CFA). DPSCs were injected weekly into the TMJs for 4 weeks. Synovitis repair was evaluated using histology analysis. In vitro, a co-culture system of M1-polarized macrophages with DPSCs was established. Effects on macrophage polarization and efferocytosis were assessed using various techniques including mRFP-GFP-LC3 lentivirus transfection, Mito-Tracker Red and Lyso-Tracker Green staining, transmission electron microscopy, and Western blot. Results: In the rat model, DPSCs reduced cell infiltration and collagen deposition, increased anti-inflammatory CD206, decreased inflammatory CD86, and enhanced macrophage phagocytosis of apoptotic cells. DPSCs upregulated autophagosome expression, promoted co-localization with mitochondria and lysosomes, and modulated mitochondrial mitophagy proteins in M1 macrophages. Inhibition of mitophagy partially attenuated the M2 polarization effect and phagocytosis induced by DPSCs. Conclusions: DPSCs effectively reduce M1-polarized macrophage infiltration, promote M2-polarized macrophages, and enhance efferocytosis by promoting mitochondrial autophagy, providing a novel therapeutic strategy for TMJOA synovitis.

The objective of this retrospective cohort study was to measure the root distance, bone thickness and bone density in maxillary anterior region with different vertical skeletal patterns based on CBCT data, and provide reference for the optimal site for miniscrew insertion in anterior aesthetic region. 60 adult patients(18-29years) with skeletal Class I angle (ANB angle = 2° ± 2°) were selected and divided into three groups (n = 20) according to vertical skeletal patterns.The population was divided into 3 groups according to the measured SN-GoGn angle: hypodivergent (SN-GoGn < 27°), average (27°≤ SN-GoGn ≤ 37°) and hyperdivergent (SN-GoGn > 37°) groups. The CBCT data was processed and measured by Dolphin Imaging and Mimics Medical. Measurement indicators included interradicular distances (IRD), overall bone thickness (OBT), cortical bone thickness (CBT), cortical and cancellous bone density (CoBD CaBD). One-way ANOVA test of variance was used for statistical comparisons. IRD increased with apical height, reaching an maximum average measurement of 4.750 ± 1.226 mm at 10 mm axial section. Within the same axial section, the IRD of the region between the two central incisors was significantly larger than that of the other regions. There was no statistical difference in IRD among different vertical skeletal patterns. OBT increased with vertical height in the 2–6 mm axial sections, and no significant difference among three groups. There was a statistical difference of the CBT at 4–8 mm axial sections among the three groups (P < 0.05), but not at 10 mm axial section. There was no statistical difference (P < 0.05) of CaBD among different vertical skeletal patterns. However, there are statistically difference of CoBD in many regions between hypodivergent and hyperdivergent groups. The anatomical structure in anterior aesthetic region of individuals varies greatly, and interradicular distances is not affected by vertical skeletal pattern. However, in general, hypodivergent patients have higher bone density and greater bone thickness than that of hyperdivergent patients, which means more safe regions to choose for miniscrew insertion.

INTRODUCTION AND AIMS:Maxillary transverse deficiency (MTD) affects approximately 10% of adults, but conventional expansion treatments are often ineffective and risky in mature patients due to suture fusion. Although microimplant-assisted rapid palatal expansion (MARPE) improves outcomes, it relies on sufficient bone thickness, posing a challenge for individuals with thin palatal bone. This study evaluates a digitally personalized MARPE approach, guided by cone-beam computed tomography-based bone mapping, for adults with MTD and thin bone (<2.5 mm). METHODS:A retrospective analysis was conducted on 18 patients. Custom MARPE appliances were designed using computer-aided design/computer-aided manufacturing technology, with microimplants placed strategically using surgical guides. Skeletal, dental, and zygomatic changes were assessed via pre- and postexpansion cone-beam computed tomography and cephalograms. RESULTS:All patients were successfully treated without implant failure. Significant skeletal expansion was achieved: anterior nasal spine width increased by 5.19 mm, posterior nasal spine by 4.49 mm, and maxillary basal width by 4.05 mm (all P < .01). Dental side effects were minimal. Significant three-dimensional remodelling of the zygomaticomaxillary complex was observed, along with sagittal improvements in SNA and ANB angles (0.57° and 1.54°, respectively) and increased anterior facial height (2.00 mm, P < .01). All measurements showed high reliability (intraclass correlation coefficient >0.90). CONCLUSION:Personalized MARPE demonstrated promising results for MTD in patients with thin palatal bone, providing significant skeletal expansion with minimal adverse dental effects. CLINICAL RELEVANCE:This study provides evidence that a digitally personalized MARPE protocol, guided by CBCT, is a feasible and well-tolerated treatment approach for adults with maxillary transverse deficiency and critically thin palatal bone. It provides significant skeletal expansion with minimal dental side effects, offering a viable solution for a patient population that has limited and high-risk treatment options.

Severe dental crowding and protrusion often necessitate symmetric extraction for correction. However, asymmetric extraction may serve as a viable, albeit challenging, treatment option when the prognosis of individual tooth is poor. In this report, we present a case where asymmetric extraction was employed to address severe dental crowding and deviated midlines, resulting in satisfactory outcomes following retention. We report a case of a 31-year-old woman with severe dental crowding and deviated dental midlines. A fixed appliance, micro-implant anchorage, and asymmetric extraction, including a mandibular canine with severe buccal malposition, were applied to the patient. The treatment outcomes demonstrated successful achievement of the treatment objectives, with well-aligned teeth exhibiting solid interdigitation and the dental midlines aligned with the facial midline. At the 21-month follow-up, midline stability, favorable occlusal interdigitation, and improved smile line were observed. Asymmetric extraction may be considered a viable approach for patients with individual tooth of poor prognosis. Treatment stability can be achieved through well-interdigitated occlusion and the use of various retention methods.

[This corrects the article DOI: 10.3892/etm.2021.9882.].

Available remedies for diabetic oral mucosa wounds often prove inadequate, chiefly due to complications like bacterial infiltration, oxidative harm, and hindered angiogenesis throughout wound restoration. This study addresses the significant gap in effective therapeutic options by developing an injectable hydrogel, DCE1, designed to enhance healing in diabetic oral ulcers. Here, we present DCE1, composed of a polysaccharide matrix of dialdehyde xanthan gum and quaternary chitosan, integrated with epigallocatechin-3-gallate nanoparticles. DCE1 generates a shielding hydrogel barrier when administered locally, exhibiting potent sterilization and reactive oxygen species-clearing properties. Such benefits shift the wound healing process from an inflammatory to a proliferative stage. Notably, the DCE1 dressing is fully biodegradable post-treatment, ensuring complete absorption by the body after fulfilling its therapeutic role. In conclusion, our findings demonstrate that the DCE1 hydrogel significantly accelerates oral mucosa wound repair in both in vitro and in vivo models. This advancement represents a promising therapeutic strategy for diabetic oral ulcers, ultimately contributing to improved clinical outcomes in the management of this challenging condition.

The temporomandibular joint (TMJ) comprises the mandibular condyle, the articular surface of the temporal bone, and the articular disc. The articular cartilage in the TMJ is classified as fibrocartilage, which has distinct zones: the fibrous, proliferative, mature, and hypertrophic zones. TMJ osteoarthritis (TMJOA) is a prevalent condition affecting the TMJ, with its pathogenesis involving multiple factors such as trauma, occlusal instability, joint overload, and others. Current treatment options encompass noninvasive, minimally invasive, and surgical interventions. However, no definitive cure has been found. Tissue engineering offers a novel approach to treating TMJOA by promoting cartilage repair and regeneration by constructing artificial cartilage grafts made from a combination of cells, bioactive factors (BFs), and biodegradable scaffolds. Among the scaffolds commonly used in research are hydrogels, nanoparticles, and three-dimensional-printed structures, with mesenchymal stem cells serving as the primary cell source. Additionally, exosomes and gene therapy have shown promise in TMJOA treatment. Despite significant progress, optimizing the integration of seed cells, BFs, and scaffold materials remains a critical focus for future research. This article provides an in-depth review of the latest advancements in TMJ condylar cartilage tissue engineering.Impact StatementThis review comprehensively overviews tissue engineering advancements for temporomandibular joint condylar cartilage regeneration. It highlights key progress in scaffolds, cell-based therapies, bioactive factors, and gene therapies. The review offers valuable insights for future research and potential clinical applications, contributing significantly to developing novel therapeutic strategies for temporomandibular joint osteoarthritis.

Synovitis is a key factor in temporomandibular joint osteoarthritis (TMJOA) and could be an early sign of the disease. Notably, synovitis and its macrophage component represent a target of interest for developing treatments. Dental pulp stem cells (DPSCs) are derived from the neural crest, coincidentally with maxillofacial tissues, thus attracting significant interest in situ maxillofacial regenerative medicine. However, there is a relative scarcity of studies investigating the role of DPSCs in the temporomandibular joint (TMJ) synovial macrophage. This study aimed to evaluate the regulatory and reparative capabilities of DPSCs on synovitis in TMJOA rat models and to elucidate their specific mechanisms of action on synovial macrophages. In vivo, three groups were established: the control group, which had neither induction nor treatment; the OA group, consisting of rats with OA but without any treatment; and the DPSCs treatment group, where rats with OA received DPSCs therapy. Progressive TMJOA was induced in rats via intra-articular injection of complete Freund’s adjuvant and sodium iodoacetate. After 2 weeks, DPSCs were injected into the joint cavity as a therapeutic intervention. Meanwhile, normal saline was injected into the joints of rats in both the control and OA groups. Four weeks after treatment, histological analysis was performed to evaluate the repair of synovitis. In addition, an in vitro co-culture system, consisting of macrophages and DPSCs. Each group was assessed using techniques, including mRFP-GFP-LC3 lentivirus transfection, Mito-Tracker Red and Lyso-Tracker Green staining, transmission electron microscopy, and Western blot analysis. Furthermore, apoptotic primary neutrophils were co-cultured with polarized macrophages to observe the phagocytic ability of macrophages towards apoptotic primary neutrophils under different treatments in vitro. In the rat model, compared with the OA group, the DPSCs group exhibited reduced cell infiltration and collagen deposition, along with elevated levels of anti-inflammatory CD206 and decreased levels of inflammatory CD86, and enhanced the ability of macrophages to phagocytize apoptotic cells in vivo and in vitro. Notably, DPSCs exhibited enhanced efficacy in upregulating autophagosome expression, promoting co-localization with mitochondria and lysosomes, and modulating the expression of mitochondrial mitophagy proteins. Furthermore, inhibition of mitophagy in M1 macrophages partially attenuated the M2 polarization effect and phagocytosis induced by DPSCs. DPSCs significantly mitigate synovitis in TMJOA rats by enhancing M2 polarization and efferocytic functions of macrophages. This study underscores the potential of DPSCs as a therapeutic strategy for TMJOA by modulating synovial macrophage functions through the regulation of mitophagy.

This retrospective study aimed to compare the masseter muscle morphology, static and dynamic occlusion, and temporomandibular joint (TMJ) characteristics among adult patients with skeletal Class II malocclusion exhibiting different vertical patterns. Additionally, the correlations among these three factors were examined. A total of 87 adult participants (mean ± standard deviation age = 25.98 ± 4.58 years) were included in the study and categorized into four groups: skeletal Class I, skeletal Class II high-angle, average-angle, and low-angle. Cone beam computed tomography (CBCT) images were obtained before and after treatment, enabling the evaluation of masseter morphology, occlusion, and TMJ variables. These were assessed using One-Way ANOVA. Pearson correlation analysis was used to identify relationships between masseter morphology, occlusion, and TMJ variables. Significant intergroup differences were observed in masseter morphology indexes (TMM, CSAMM) (P < 0.05), occlusal indexes (AU6, AL6, TU6, TL6, AOP-FH, POP-FH, U1L1-FH, COS, COW, U6-U6, LAD, SAD, CSACo, and HFo) (P < 0.05), and TMJ indexes (AJS, SJS, PJS, MJS, CJS, and LJS) (P < 0.05). Furthermore, masseter morphology (TMM, CSAMM) demonstrated significant negative correlations with HU7, HL7, AU6, AL6, TU6, POP-FH, COW, and PJS (P < 0.05). Conversely, significant positive correlations were identified with TL6, COS, U6-U6, LAD, CSACo, LAA, HFo, AEI, AJS, SJS, MJS, CJS, and LJS (P < 0.05). The masseter muscle’s morphology measured by CBCT significantly influences occlusion and TMJ characteristics in skeletal Class II adults, affecting occlusal planes, curves, condylar position, and articular fossa morphology. These findings highlight masticatory muscles’ role in stomatognathic dysfunction etiology. Future orthodontic planning and TMJ evaluation should incorporate CBCT-based muscle assessments to support more comprehensive treatment strategies.

OBJECTIVE:To investigate the changes in condyle-glenoid fossa relationship after maxillary skeletal expansion (MSE) and to verify the correlation between the condyle positional changes and expansion effect. METHODS:In this study, 20 patients (mean age 21.1 ± 5.7 years, 8 male, 12 female) with maxillary transverse deficiency (MTD) were treated with the MSE appliance, which contained molar bands and a expander with four micro-implants. The CBCT images were taken before expansion (T0), after expansion (T1) and after 6 months of maintenance (T2). The posterior TMJ space (PS), superior TMJ space (SS), anterior TMJ space, coronal lateral TMJ space (CLS), coronal medial TMJ space (CMS), condyle axis angle, maxillary basal bone width (BWM), inter-molars width, nasal bone width, molar inclination and molar palatal cusp height (U6H) were measured using Dolphin Imaging. RESULTS:At T1, compared with T0, the PS and SS significantly increased by 0.41 mm (P = .008) and 0.3 mm (P = .007). But only the SS significantly increased by 0.21 mm (P = .025) at T2. There was a significant difference of 0.37 mm (left-right, P = .014) between the left and right SS at T0, but no significant difference at T1 and T2. The increased BMW showed weak positive correlations with the change of PS (P = .015) and CMS (P = .031), and the decreased U6H showed weak negative correlations with the change of PS (P = .015) and CLS (P = .031) at T1. CONCLUSIONS:The use of MSE led to an increase in the SS and PS, which were weakly correlated with BWM and U6H. But this effect in the TMJ space gradually diminished after 6 months of maintenance, and the symmetry of the condyle-fossa relationship was preserved.

ObjectivesTo investigate the alveolar bone morphology of the mandibular second and third molars in skeletal Class III patients from a buccolingual direction.MethodsSixty skeletal Class III patients were recruited. The alveolar bone width, buccal cortical bone thickness and lingual cortical bone thickness were measured in five planes from mesial to distal and at five depths from gingival to root. The effects of the gender of the patients, the second molar lingual inclination and the third molar on alveolar bone width and cortical bone thickness were evaluated. To explore the effect of third molar extraction on alveolar bone morphology, the measurements before and after third molar extraction were compared.ResultsThe impacted third molar had significantly greater alveolar bone width and thicker buccal cortical bone at the cervical third of the molar, while the erupted third molar had greater alveolar bone width at the apical third. Three weeks after third molar extraction, these advantages would weaken owing to the reconstruction of the alveolar bone. Patients with lingually inclined molar were observed to own thicker lingual cortical bone. Males tended to have greater alveolar bone width, but no significant differences were shown in this study.ConclusionsThe growth of the third molar and the second molar lingual inclination affect the alveolar bone morphology of the mandibular second and third molars significantly, but gender has trivial effects on the morphology. The alveolar bone morphology of the mandibular second and third molars would change 3 weeks after third molar extraction.

BackgroundEarly diagnosis in oral cancer is essential to reduce both morbidity and mortality. This study explores the use of uncertainty estimation in deep learning for early oral cancer diagnosis.MethodsWe develop a Bayesian deep learning model termed 'Probabilistic HRNet', which utilizes the ensemble MC dropout method on HRNet. Additionally, two oral lesion datasets with distinct distributions are created. We conduct a retrospective study to assess the predictive performance and uncertainty of Probabilistic HRNet across these datasets.ResultsProbabilistic HRNet performs optimally on the In-domain test set, achieving an F1 score of 95.3% and an AUC of 96.9% by excluding the top 30% high-uncertainty samples. For evaluations on the Domain-shift test set, the results show an F1 score of 64.9% and an AUC of 80.3%. After excluding 30% of the high-uncertainty samples, these metrics improve to an F1 score of 74.4% and an AUC of 85.6%.ConclusionRedirecting samples with high uncertainty to experts for subsequent diagnosis significantly decreases the rates of misdiagnosis, which highlights that uncertainty estimation is vital to ensure safe decision making for computer-aided early oral cancer diagnosis.