Objective: To investigate the biomechanical characteristics of thermoformed mouthguards and three-dimensional (3D)-printed mouthguards through the 3D finite element method (FEM), and to provide a theoretical basis for the selection of mouthguards in clinical and sports scenarios. Methods: A healthy male student volunteer aged 24 years was recruited in the Xi'an Physical Education University in January 2024, and the volunteer signed a written informed consent form. Both types of mouthguards were custom-made individually: the thermoformed mouthguard was fabricated using a traditional vacuum thermoforming process, and the 3D-printed mouthguard was fabricated using a stereolithography 3D printing process. The volunteer wore the two types of mouthguards respectively, and after confirming that the mouthguards fit well and the occlusion was stable, CT scanning of the maxilla and mandible was performed with a spiral CT scanner. 3D finite element models containing the teeth, jaw bones, temporomandibular joint (TMJ) articular disc and the corresponding mouthguards were established based on the acquired CT tomographic scan data. A constant load of 800 N perpendicular to the coronal plane of the human body with a duration of 0.15 s was applied to the lateral region corresponding to the anterior tooth area of the two mouthguard models to simulate the mechanical state of the anterior tooth area under impact in boxing. The magnitude and distribution law of stress on the teeth, jaw bones and TMJ articular disc under the protection of the two mouthguards during impact were compared and analyzed. Results: There were significant differences in the biomechanical performance of the 3D finite element models corresponding to the two types of mouthguards when the load was applied to the lateral region corresponding to the anterior tooth area of the mouthguards. Under the protection of the thermoformed mouthguard, stress concentration was observed in the maxillomandibular-dental hard tissue complex, the cervical region of the mandibular anterior teeth, as well as the condylar side and glenoid fossa side of the TMJ articular disc. The peak von Mises stress of the maxillary anterior teeth was 75.382 MPa, and obvious stress accumulation was detected on the condylar side and glenoid fossa side of the articular disc, with the peak stress values of 0.531 MPa and 0.476 MPa respectively. Under the protection of the 3D-printed mouthguard, the stress was uniformly dispersed in the maxillomandibular-dental hard tissue complex and the mesial and distal sides of the articular disc. The peak von Mises stress of the maxillary anterior teeth was 73.262 MPa, no obvious stress concentration was found on the glenoid fossa side of the articular disc, and the stress on the condylar side was evenly distributed in the mesial and distal regions of the articular disc. Conclusions: The 3D-printed mouthguard has better protective performance, which can effectively avoid stress concentration in the mandibular anterior tooth area and realize uniform stress distribution in the mesial and distal regions of the condylar side of the articular disc. The two types of mouthguards have similar protective performance on the maxillary anterior teeth, while the 3D-printed mouthguard has more advantages in the comprehensive biomechanical protective performance for the entire stomatognathic system. 目的： 通过三维有限元法（FEM）探讨热压型护齿器及三维打印护齿器的生物力学特征，为护齿器的选择提供依据。 方法： 于西安体育学院招募1名健康学生志愿者（24岁男性），戴用热压型护齿器和三维打印护齿器后分别进行上下颌骨CT扫描，通过CT数据建立三维有限元模型，对两种护齿器模型前牙区对应外侧区域施加垂直于人体冠状面的800 N持续0.15 s的载荷以模拟受击状态，对比分析受到击打时两种护齿器防护下牙齿、颌骨、关节盘的应力大小及分布。 结果： 载荷加载于护齿器前牙区对应外侧区域时两种三维有限元模型生物力学表现存在差别。热压型护齿器防护下，应力集中于上下颌骨-牙体硬组织复合体、下颌前牙颈部及颞下颌关节盘近髁突侧和近关节窝侧；上颌前牙von Mises应力峰值为75.382 MPa，颞下颌关节盘近髁突侧及近关节窝出现明显应力累积，分别为0.531与0.476 MPa。三维打印护齿器防护下，应力均匀分散于上下颌骨-牙体硬组织复合体及颞下颌关节盘近远中侧，上颌前牙von Mises应力峰值为73.262 MPa，颞下颌关节盘近关节窝侧未见应力集中，近髁突侧应力分散于关节盘近远中侧。 结论： 三维打印护齿器的防护性能更优，可避免下颌前牙应力集中，使颞下颌关节盘应力均匀分布于近髁突近远中侧；两种护齿器对上颌前牙的保护性能相近，但三维打印护齿器对整个口颌系统的综合生物力学防护性能更优。.
Objective: To explore the regulatory mechanism of transient receptor potential cation channel subfamily M member 2 (TRPM2) on the osteogenic differentiation capacity of bone marrow mesenchymal stem cells (BMMSCs), and to clarify the role of TRPM2-regulated mitophagy in the progression of periodontitis. Methods: Twelve TRPM2 gene knockout (TRPM2-/-) mice and twelve wild-type (WT) mice were used in this study. A periodontitis model was established by silk ligation on the maxillary second molars of mice, with sham operation performed in the control group, and the modeling lasted for 10 days. The mice were divided into four groups (n=6 per group): WT sham operation group, WT periodontitis group, TRPM2-/- sham operation group, and TRPM2-/- periodontitis group. In the periodontitis group, silk ligation was performed on the maxillary second molars of mice, while no silk ligation was conducted in the sham operation group. Micro-CT was employed to collect imaging data for three-dimensional reconstruction. CTvox and CTAn v1.15.4.0 software were used to quantify the distance from the cementoenamel junction to the alveolar bone crest (CEJ-ABC) and bone volume fraction (BV/TV) in maxillary bone tissues of the mice in four groups. Statistical analysis was performed subsequently. Immunohistochemical staining was conducted to detect the expression intensity of Runt-related transcription factor 2 (RUNX2) in periodontal tissues in maxillary bone tissues of the mice in four groups. BMMSCs were isolated from the femurs of the two types mice and cultured in vitro, followed by induction for osteogenic differentiation. Alizarin red S (ARS) staining and alkaline phosphatase (ALP) staining were used to evaluate the osteogenic differentiation potential of BMMSCs. Western blotting (WB) was performed to determine the expression levels of osteogenic-related markers [RUNX2, bone morphogenetic protein 2 (BMP2), ALP, osteopontin (OPN)]. Meanwhile, transmission electron microscopy (TEM) was used to observe intracellular mitophagy status. WB was applied to detect the expression of autophagy-related proteins [microtubule-associated proteins 1A/1B light chain 3 (LC3), PTEN-induced putative kinase 1 (PINK1), Parkin RBR E3 ubiquitin protein ligase (Parkin)], and immunofluorescence colocalization labeling was used to assess the fluorescence intensity of LC3, translocase of the outer mitochondrial membrane 20 (Tomm20), and Lysosomal-associated membrane protein (LAMP). Results: No statistically significant differences were observed in bone volume fraction, trabecular number, and trabecular separation between TRPM2-/- and WT mice (all P>0.05). However, the buccal and palatal CEJ-ABC values in the TRPM2-/- periodontitis group [(265.40±21.72) μm and (273.30±17.56) μm, respectively] were significantly lower than those in the WT periodontitis group [(416.50±20.90) μm and (428.00±17.59) μm, respectively] (both P<0.001). In addition, the relative expression level of RUNX2 in periodontal tissues of the TRPM2-/- periodontitis group [(15.03±0.48) %] was significantly higher than that of the WT periodontitis group [(11.95±0.40) %] (P<0.001). In vitro experiments (ALP and ARS staining) demonstrated that the osteogenic differentiation capacity of BMMSCs derived from TRPM2-/- mice was significantly enhanced compared with that from WT mice. WB results showed that the expression levels of osteogenic-related markers (RUNX2, BMP2, ALP, OPN) in BMMSCs from TRPM2-/- mice were all upregulated compared with WT mice (all P<0.05, respectively), and so as the protein levels of mitophagy-related indicators (LC3 and BECLIN1)(both P<0.001). Furthermore, TRPM2 deficiency remarkably upregulated the expression of proteins related to the PINK1/Parkin pathway (all P<0.001). Conclusions: TRPM2 regulates the osteogenic differentiation capacity of BMMSCs through mitophagy, thereby participating in the progression of periodontitis. Therefore, targeting TRPM2 is expected to serve as a novel and effective strategy for the treatment of periodontitis. 目的： 探讨瞬时受体电位阳离子通道亚家族M成员2（TRPM2）对骨髓间充质干细胞（BMMSCs）成骨分化能力的调控机制，阐明其所调控的线粒体自噬在牙周炎发展中的作用。 方法： 构建TRPM2基因敲除小鼠12只、野生型小鼠12只，分别对小鼠上颌第二磨牙进行丝线结扎牙周炎造模和假手术，造模10 d，将24只小鼠分为野生型假手术组、野生型牙周炎组、TRPM2-/-假手术组、TRPM2-/-牙周炎组，每组6只（牙周炎组采用丝线结扎小鼠上颌第二磨牙，假手术组无丝线结扎）。采用显微CT采集影像数据，进行三维重建，使用分析软件 CTvox软件及CTAn v1.15.4.0 软件测量4组小鼠上颌骨组织釉质牙骨质界（CEJ）到牙槽嵴顶（ABC）的距离（CEJ-ABC）、骨体积分数（BV/TV）并进行统计学分析。免疫组织化学染色检测4组小鼠上颌骨牙周组织内Runt相关转录因子2（RUNX2）的表达强度。体外从野生型及TRPM2-/-两种小鼠股骨中体外分离培养 BMMSCs并进行成骨诱导，茜素红S（ARS）与碱性磷酸酶（ALP）染色检测其成骨分化能力，通过蛋白质印迹法（WB）检测成骨相关指标RUNX2、骨形态发生蛋白2（BMP2）、ALP、骨桥蛋白（OPN）的表达，同时用透射电子显微镜（TEM）观察野生型及TRPM2-/-两种小鼠BMMSCs内线粒体的自噬状况，WB检测自噬相关指标微管相关蛋白轻链3（LC3）、PTEN诱导激酶 1（PINK1）、Parkin RBR型E3泛素蛋白连接酶（Parkin），免疫荧光共定位标记检测LC3、线粒体外膜转位酶20（Tomm20）、溶酶体相关膜蛋白（LAMP）荧光强度。 结果： TRPM2 基因敲除小鼠BV/TV、骨小梁数目、骨小梁分离度与野生型小鼠相比差异均无统计学意义（均P>0.05），但 TRPM2-/-牙周炎组小鼠颊、腭侧CEJ-ABC［分别为（265.40±21.72）、（273.30±17.56）μm］均分别显著低于野生型牙周炎组小鼠［分别为（416.50±20.90）、（428.00±17.59）μm］（均P<0.001）。此外，TRPM2-/-牙周炎组小鼠牙周组织内RUNX2相对表达量［（15.03±0.48）%］显著高于野生型牙周炎组小鼠［（11.95±0.40）%］（P<0.001）。体外ARS、ALP染色结果显示，TRPM2-/-小鼠的 BMMSCs 成骨分化能力较对照组显著增强，WB结果显示与野生型小鼠相比，TRPM2-/-小鼠的 BMMSCs 成骨相关指标RUNX2、BMP2、ALP、OPN的表达均显著增强（均P<0.05），且线粒体自噬相关蛋白水平LC3、BECLIN1均显著升高（均P<0.001）；同时，TRPM2 缺失可显著上调 PINK1/Parkin 通路相关蛋白的表达（均P<0.001）。 结论： TRPM2可通过线粒体自噬调控 BMMSCs 的成骨分化能力进而参与牙周炎进展，因此，靶向 TRPM2 有望成为治疗牙周炎的新型有效策略。.
Objective: To investigate the role and mechanism of interleukin-1β+ (IL-1β+) neutrophils in bone regulation of periodontitis in mice. Methods: The periodontitis model was established by local oral infection with Porphyromonas gingivalis (Pg). Twenty 8-week-old male C57BL/6J mice were randomly divided into 2 groups (10 mice in each group) using a random number table method: the control group [con group, 2% carboxymethylcellulose (CMC) without Pg applied topically to both buccal sides of the maxilla in mice] and the experimental group [periodontitis (PD) group, 2% CMC with Pg applied topically to both buccal sides of the maxilla in mice]. Micro-CT was used to evaluate maxillary alveolar bone. Single-cell transcriptome sequencing was employed to analyze the content of different immune cells in the diseased maxilla of mice and to screen for differentially expressed genes. HE staining and immunohistochemical staining were used to observe changes in the maxillary periodontal tissues of mice. Flow cytometry and immunofluorescence staining were applied to detect the content and expression of IL-1β+ neutrophils in the maxilla. In vitro experiments involved stimulating neutrophils with Pg to detect the expression of IL-1β, followed by sorting IL-1β+ neutrophils and constructing a co-culture model with mouse embryo osteoblast precursor cells (MC3T3-E1 cells). Alkaline phosphatase staining and alizarin red staining were used to assess the osteogenic differentiation of MC3T3-E1 cells. Western blotting was used to analyze changes in the Toll-like receptor 4-nuclear factor-κB (TLR4-NF-κB) signaling pathway. Results: The periodontitis model was successfully established in vivo. The height from the cementoenamel junction to the alveolar crest (CEJ-ABC) on the buccal side of mice in the PD group [(232.90±25.29) μm] was significantly increased compared with that in the con group [(149.50±16.69) μm, P<0.001]. The palatal CEJ-ABC [(190.70±10.67) μm] was also significantly higher than that of mice in the con group [(151.80±11.29) μm, P<0.001]. Single-cell transcriptome sequencing of mouse maxillary alveolar bone revealed that the distribution ratio of neutrophils in the PD group (0.62±0.04) was significantly higher than that in the con group (0.44±0.05, P=0.010), and the expression of IL-1β in neutrophils was significant (P=0.003). Immunohistochemical staining showed that the height of the maxillary alveolar bone in the PD group was reduced than that in the con group, as well as the bone formation ability. Flow cytometry revealed that the proportion of IL-1β+ neutrophils in the diseased maxilla of the PD group [(13.66 ± 1.14)%] was significantly higher than that in the con group [(4.40±0.47)%, P<0.001], and immunofluorescence staining also indicated an increase of IL-1β+ neutrophils in the maxillary alveolar bone of the PD group. After in vitro stimulation of neutrophils with Pg, the expression of IL-1β increased (P=0.047). After co-culturing IL-1β+ neutrophils with MC3T3-E1 cells, alizarin red staining showed a decrease in mineralized nodules, and the alkaline phosphatase staining became lighter. The protein expression levels of TLR4 and pp65 increased. All the above changes could be partially or completely reversed by TLR4 inhibitors. Conclusions: IL-1β⁺ neutrophils are significantly increased in the diseased maxillary alveolar bone of mice with periodontitis, which inhibit the osteogenic differentiation of MC3T3-E1 cells and are associated with the TLR4-NF-κB signaling pathway, providing a scientific basis for immunotherapy for bone regeneration in periodontitis. 目的： 探讨小鼠牙周炎骨调节中白细胞介素-1β阳性（IL-1β+）中性粒细胞的作用及其机制。 方法： 采用口腔局部感染牙龈卟啉单胞菌（Pg）的方式建立小鼠牙周炎模型，将20只8周龄C57BL/6J雄性小鼠通过随机数字表法随机分为2组（每组10只），对照组［使用不含Pg的2%羧甲基纤维素（CMC）局部涂抹于小鼠上颌双颊侧］和牙周炎组（PD组，使用含Pg的2%CMC局部涂抹于小鼠上颌双颊侧），显微CT评估两组小鼠上颌牙槽骨吸收情况，利用单细胞转录组学测序分析小鼠病变上颌骨中不同免疫细胞含量和筛选差异基因，使用HE染色和免疫组织化学染色等方法观察两组小鼠上颌牙周组织的变化，采用流式细胞术和免疫荧光染色等方法检测病变上颌骨内IL-1β+中性粒细胞的含量和表达。体外实验通过Pg刺激中性粒细胞后检测IL-1β的表达，进而分选IL-1β+中性粒细胞，与小鼠胚胎成骨细胞前体细胞（MC3T3-E1）构建共培养模型，茜素红染色和碱性磷酸酶染色评估MC3T3-E1的成骨分化情况；通过蛋白质印迹法分析Toll样受体4-核因子κB（TLR4-NF-κB）信号通路的变化。 结果： 体内实验成功构建小鼠牙周炎模型，PD组小鼠颊侧第二磨牙釉质牙骨质界到牙槽嵴顶的距离（CEJ-ABC）［（232.90±25.29）μm］较对照组［（149.50±16.69）μm］显著增加（P<0.001），腭侧第二磨牙CEJ-ABC［（190.70±10.67）μm］亦显著大于对照组小鼠［（151.80±11.29）μm］（P<0.001）；小鼠病变上颌骨的单细胞转录组学测序发现，PD组小鼠的中性粒细胞分布比例（0.62±0.04）较对照组（0.44±0.05）显著增加（P=0.010），IL-1β在中性粒细胞中表达显著（P=0.003）。HE染色和免疫组织化学染色发现，与对照组小鼠相比，PD组小鼠的上颌牙槽骨高度显著降低，骨形成能力下降。流式细胞术检测发现，PD组小鼠病变上颌骨中的IL-1β+中性粒细胞比例［（13.66±1.14）%］显著高于对照组［（4.40±0.47）%］（P<0.001），免疫荧光染色也显示PD组颌骨内的IL-1β+中性粒细胞增多。Pg体外刺激中性粒细胞后，IL-1β的表达显著增加（P=0.047），将IL-1β+中性粒细胞与MC3T3-E1共培养，MC3T3-E1成骨诱导后茜素红染色显示矿化结节减少，碱性磷酸酶染色变浅，TLR4、pp65的蛋白表达水平升高，上述变化均可被TLR4抑制剂部分或全部逆转。 结论： IL-1β+中性粒细胞在牙周炎小鼠病变颌骨中显著增加，抑制MC3T3-E1细胞的成骨分化，与TLR4-NF-κB信号通路相关，为牙周炎骨再生的免疫治疗提供了依据。.
Objective: To evaluate the pulp prognosis and related influencing factors of traumatic teeth with dislocating periodontal injuries, and to provide references for the clinical treatment of dislocating traumatic teeth. Methods: A retrospective study design was adopted. Clinical data of 245 patients (345 affected teeth) who visited the Department of General Dentistry & Emergency of the School of Stomatology of The Fourth Military Medical University from January 2021 to December 2023 were collected. All cases met the diagnostic criteria for dislocating injuries specified in the International Association of Dental Traumatology(IADT) guidelines for the management of traumatic dental injuries, with complete data and a follow-up period of≥6 months. Variables including patient gender, age, type of trauma, apical foramen closure status, stage of root development (Nolla stage), time to consultation after trauma and type of pulp tissue prognosis were recorded. SPSS 21.0 software was used for univariate chi-square tests, linear-by-linear Association test and multivariate Logistic regression analysis to identify factors associated with pulp tissue prognosis. Results: Among the 345 affected teeth, only 44.3%(153/345) achieved pulp survival. Univariate analysis showed that age, apical foramen closure status and type of injury had significant effects on pulp prognosis (all P<0.05). Linear-by-linear Association analysis showed that the pulp necrosis rate increased significantly with advancing Nolla stage (χ²=22.05, P<0.001). Multivariate logistic regression analysis showed that apical closure and injury type were independent risk factors for pulp prognosis. The pulp survival rate was highest in teeth with subluxation [67.2%(78/116)] and lowest in those with lateral luxation [28%(21/75)]. Additionally, teeth with open apical foramina had a higher survival rate[68.3%(56/82)] than those with closed apical foramina[36.9%(97/263)](χ²=24.99,P<0.001). Conclusions: Apical foramen closure status, type of injury and stage of root development are key influencing factors for the pulp prognosis of traumatic teeth with dislocating periodontal injuries. The risk of pulp necrosis increased with the degree of root development.Teeth with subluxation have the best pulp prognosis, while those with closed apical foramina, extrusive luxation, lateral luxation, or intrusive luxation are more prone to pulp necrosis. Clinically, targeted intervention and enhanced follow-up should be implemented for these high-risk cases. 目的： 评估脱位性牙周组织损伤外伤牙的牙髓预后及相关影响因素，为脱位性外伤牙的临床治疗提供参考。 方法： 采用回顾性研究设计，收集2021年1月至2023年12月于空军军医大学口腔医院急诊与综合临床科就诊，符合国际牙外伤学会牙外伤诊治指南中脱位性损伤诊断标准，资料完整且观察期≥6个月的245例患者（345颗患牙）临床资料，记录患者性别、年龄、外伤类型、根尖孔闭合情况、牙根发育程度（Nolla分期）、外伤后就诊时间及牙髓组织预后类型。通过单因素卡方检验、线性关联趋势检验及多因素Logistic回归分析与牙髓组织预后相关的因素。 结果： 345颗患牙中，44.3%（153/345）牙髓存活。单因素分析显示，年龄、根尖孔闭合情况及损伤类型对牙髓预后均有显著影响（均P<0.05）。趋势分析显示，牙髓坏死率随Nolla分期增加呈显著上升趋势（χ²=22.05，P<0.001）。多因素Logistic回归分析表明，根尖孔闭合情况及损伤类型是牙髓预后的独立危险因素。亚脱位患牙牙髓存活率最高［67.2%（78/116）］，侧方移位最低［28%（21/75）］，根尖孔开放患牙的存活率［68.3%（56/82）］显著高于根尖孔闭合者［36.9%（97/263）］（χ²=24.99，P<0.001）。 结论： 根尖孔闭合情况、损伤类型及牙根发育程度是脱位性牙周组织损伤外伤牙牙髓预后的关键影响因素。牙髓坏死风险随牙根发育程度增加而升高，亚脱位患牙牙髓预后最佳，根尖孔闭合及部分脱出、侧方移位、挫入患牙更易发生牙髓坏死，临床需针对性加强干预与随访。.
Objective: To investigate the disease types, clinical characteristics, and emergency manage ment measures for critical cases in the oral emergency department, and to provide a reference for improving the basic emergency rescue capabilities of dental practitiers. Methods: A retrospellive analysis was conducted on patients with complete medical records who were admitted to the Department of Oral Emergency, Peking University School and Hospital of Stomatology from January 2006 to September 2025. Basic information and rescue data of the patients were collected, and the disease composition, key characteristics of clinical treatment and disease outcome were studied and analyzed. Results: A total of 92 patients were included, with an average age of 47 years (4 to 88 years, median 49 years). There were 62 male patients (67.4%) and 30 female patients (32.6%). Among the critically ill patients who visited the oral emergency department in the past 20 years, 61.9% were diagnosed with maxillofacial hemorrhage and cardiovascular accidents, accounting for 38.0% (35/92) and 23.9% (22/92) of the rescued patients, respectively, which were the most common diagnoses in emergency rescue. The next most common were upper airway obstruction in 17 cases and vasovagal syncope in 13 cases, accounting for 32.6% of the rescued patients. Among the 35 cases of maxillofacial hemorrhage, 20 patients (57.1%) had maxillofacial trauma, and 17 patients (48.6%) developed hemorrhagic shock. The study observed that secondary hemorrhage and airway obstruction caused by maxillofacial tumors were common causes of oral critical rescue, accounting for 34.3% (12/35) and 12/17 of the hemorrhage and airway obstruction cases, respectively. The study observed that 5 patients with airway obstruction caused by space infection received emergency treatment, accounting for 29.4% (5/17) of the airway obstruction patients. In the rescue work of oral emergencies, electrocardiogram monitoring (98.9%, 91/92), oxygen inhalation (96.7%, 89/92), and opening of venous access (78.3%, 72/92) were the most commonly used supportive treatment techniques; tracheal intubation was the main measure for respiratory system emergency rescue, followed by cricothyrotomy and tracheotomy. All 15 patients with cardiac arrest received cardiopulmonary resuscitation treatment, and 8 patients underwent defibrillation. Adrenaline was the most frequently used drug in emergency rescue, mainly applied to patients with cardiac arrest and anaphylactic shock, followed by nitroglycerin, lidocaine, dopamine, aspirin, and midazolam. The rescue success rate of the 92 cases receiving emergency treatment was 91.3% (84/92), and 8 deaths included 3 cases of cardiac arrest caused by airway obstruction and 5 cases of respiratory and circulatory failure. Conclusions: Dental practitioners should be able to quickly identify medical emergencies and immediately carry out emergency rescue. Oral departments should be equipped with relevant emergency drugs and equipment, and medical staff should receive regular emergency skills training to improve their ability to handle medical emergencies and enhance medical safety. 目的： 研究口腔门急诊危重病例的疾病类型、特点及临床应对措施，为提高口腔科医师基本急救能力提供参考。 方法： 回顾性纳入2006年1月至2025年9月就诊于北京大学口腔医学院·口腔医院急诊科、病例资料完整的危急重症患者。收集患者的主要诊断、年龄、性别等基本信息及其抢救资料，研究和分析疾病构成、临床处置关键特点和疾病转归。 结果： 共纳入92例患者，中位年龄49岁（范围4~88岁）；男性患者62例（67.4%），女性30例（32.6%）。92例患者中，诊断为颌面部出血（35例）和心血管意外（22例）者共占61.9%（57/92），是急救患者中最常见的诊断；其次为上呼吸道梗阻（17例）和血管迷走性晕厥（13例），占抢救患者的32.6%（30/92）。35例颌面部出血病例中，颌面部创伤占57.1%（20/35），48.6%（17/35）出现了失血性休克。颌面部肿瘤继发出血和阻塞呼吸道是口腔危重症抢救的常见病因，分别占出血病例的34.3%（12/35）、呼吸道梗阻病例的12/17。5例接受急救的患者是间隙感染引起的呼吸道梗阻，占呼吸道梗阻患者的29.4%（5/17）。心电监护［98.9%（91/92）］、吸氧［96.7%（89/92）］、开放静脉通路［8.3%（72/92）］是口腔急症抢救中最常用的支持治疗技术；气管插管术是呼吸系统急救的主要措施。15例心脏骤停的患者全部接受了心肺复苏治疗，其中8例进行了电除颤。肾上腺素是急救中使用频率最高的药品，主要应用于心脏骤停和过敏性休克患者。92例病例抢救成功率为91.3%（84/92），8例死亡病例包括3例呼吸道梗阻导致心脏骤停，5例为呼吸循环衰竭。 结论： 口腔科医务人员应能迅速识别医疗紧急情况并立即开展急救。口腔科室应配备相关急救药品和设备，医务人员应定期接受急救技能的培训，提高处理医疗紧急情况的能力，提升医疗安全。.
Objective: To develop N-terminal 15-peptide of statherin (SN15)-poly(amido amine) (PAMAM) by grafting the statherin-derived peptide SN15 onto a PAMAM dendrimer for enhanced tooth adsorption and remineralization, and to evaluate its efficacy in promoting the remineralization of demineralized enamel in a simulated oral environment. Methods: SN15 peptides were grafted onto the surface of PAMAM by mercapto-Michael addition reaction. The adhesion force and adsorption capacity of SN15-PAMAM and PAMAM towards hydroxyapatite (HA) were compared and investigated using atomic force microscopy (AFM), among other techniques. The ability of enamel remineralization induced by SN15-PAMAM in simulated saliva environment and under simulated oral acid shock were studied by a coating method. The blank control group was treated with an equal volume of deionized water. The SN15-PAMAM or PAMAM rinse groups were treated with SN15-PAMAM or PAMAM, followed by phosphate-buffered saline rinsing. The nano-amorphous calcium phosphate (NACP) group was treated by NACP only. Each group had a sample size of 6. Transverse microradiography (TMR) and other assays were performed. Results: AFM results showed that the adhesion force between the SN15-PAMAM group and the HA surface was (9.3±1.5) nN, which was significantly higher than that of the PAMAM group [(2.8±1.3) nN] (P<0.05). In the simulated saliva environment for inducing enamel remineralization, the SN15-PAMAM group demonstrated the most significant recovery of surface hardness, reaching 74.48%, which was superior to the 40.72% recovery observed in the PAMAM group. Under simulated oral acid shock, the difference between the two groups became even more pronounced: the hardness recovery for SN15-PAMAM was 61.83%, while for PAMAM it was only 25.19%. Under simulated daily oral acid challenge conditions, SN15-PAMAM and NACP exhibited a synergistic effect. TMR results revealed that the lesion depth in the SN15-PAMAM+NACP group was (38.95±2.70) μm, significantly lower than that in the SN15-PAMAM group [(74.81±3.10) μm], the NACP group [(75.56±3.66) μm], and the blank control group [(106.40±2.35) μm] (all P<0.05). Conclusions: PAMAM, modified with the statherin-derived peptide SN15, enhances enamel remineralization by improving its adsorption to the enamel surface. 目的： 探讨富酪蛋白N端15个氨基酸片段（SN15多肽）改性聚酰胺-胺（PAMAM）（SN15-PAMAM）在仿真口腔环境中促脱矿牙釉质再矿化的作用。 方法： 通过巯基-迈克尔加成反应接枝SN15多肽至PAMAM表面，制备SN15-PAMAM。通过原子力显微镜（AFM）等检测，对比PAMAM和SN15-PAMAM（每组样本量为6）与羟基磷灰石（HA）表面的吸附力和吸附量。采用涂层处理法研究SN15-PAMAM或SN15-PAMAM联合纳米无定形磷酸钙（NACP）（SN15-PAMAM+NACP组）在模拟唾液环境下诱导脱矿牙釉质再矿化的能力、在模拟口腔酸冲击条件下诱导牙釉质再矿化的能力（空白组为等量去离子水处理，SN15-PAMAM冲洗组或PAMAM冲洗组为SN15-PAMAM或PAMAM处理后进行磷酸盐缓冲液冲洗，NACP组为仅用NACP，每组样本量为6）。 结果： AFM显示，SN15-PAMAM组与HA表面的吸附力为（9.3±1.5）nN，显著大于PAMAM组［（2.8±1.3）nN］（P<0.05）。模拟唾液环境下诱导脱矿牙釉质再矿化时，SN15-PAMAM组牙釉质表面硬度恢复最明显，达到74.48%，强于PAMAM组（40.72%）。而模拟口腔酸冲击条件下，二者差距更明显，SN15-PAMAM冲洗组为61.83%，PAMAM冲洗组则仅为25.19%。模拟口腔酸冲击条件下，SN15-PAMAM联合NACP，二者发挥协同效应，横断显微放射照相（TMR）检测结果显示，SN15-PAMAM+NACP组的病变深度为（38.95±2.70）μm，显著低于SN15-PAMAM组、NACP组和空白组［分别为（74.81±3.10）、（75.56±3.66）、（106.40±2.35）μm］（P<0.05）。 结论： SN15-PAMAM可通过增强在牙釉质表面的吸附性，提高脱矿牙釉质的再矿化能力。.
Objective: To investigate the effect and underlying molecular mechanism of interleukin-10 (IL-10) secreted by M2 macrophages on the osteogenic differentiation ability of rat bone marrow mesenchymal stem cells (BMMSCs) after irradiation. Methods: Between February 2024 and April 2025, eight healthy male SD rats aged 2 to 3 weeks were selected, primary BMMSCs and macrophages from SD rats were cultured in vitro. Macrophages were polarized to the M2 phenotype, and their surface markers were identified by flow cytometry and immunofluorescence. The experiment was divided into four groups: normal BMSC control group (CON), 4 Gy irradiation group (4Gy), 4 Gy irradiation+M2 macrophage co-culture group (4Gy+8 μm), and 4 Gy irradiation+M2 macrophage co-culture+IL-10 neutralizing antibody group(4Gy+8 μm+m/r IL-10). An in vitro cellular irradiation model was established by exposing BMMSCs to X-ray radiation at a dose of 4 Gy. A non-contact co-culture system between M2 macrophages and irradiated BMMSCs was established using Transwell chambers with an 8 μm pore size. After 48 hours of co-culture, ELISA was used to detect the IL-10 concentration in the supernatant of each group, and Western blot was used to measure the expression levels of key osteogenic differentiation markers [alkaline phosphatase(ALP),Runt-related transcription factor 2(RUNX2),osteocalcin(OCN)] and STAT3 signaling pathway-related proteins (p-STAT3, STAT3) in BMMSCs. The specific role of IL-10 was verified by adding an IL-10 neutralizing antibody. Results: Cell counting kit-8 assay results showed that on day 7 post-irradiation, the absorbance value of the 4 Gy Irradiation group (0.241±0.093) was significantly lower than that of the control group (1.794±0.083) (t=21.63, P<0.001). Western blotting analysis indicated that the expression levels of osteogenic markers ALP and RUNX2 in the irradiation group (0.819±0.074, 0.785±0.074) were significantly lower than those in the control group (1.000±0.067, 1.000±0.056) (t=3.16, P=0.034; t=4.01, P=0.016, respectively). Immunofluorescence analysis revealed that the fluorescence intensities of RUNX2 and ALP in the irradiation group (19.932±1.291, 7.316±0.089) were markedly weaker compared to the control group (31.154±3.352, 30.789±1.455). After co-culture with M2 macrophages, the proportion of viable cells in the co-culture group [(77.800±1.758)%] was significantly higher than that in the Irradiation group [(61.933±2.732)%] (P<0.001). Furthermore, the IL-10 concentration in the supernatant of the co-culture group [(46.39±1.879) pg/ml] was significantly higher than that in the irradiation group [(7.530±0.239) pg/ml] (t=36.74, P<0.001). Western blot results demonstrated that the expression levels of ALP, RUNX2, and OCN in the co-culture group were significantly higher than those in the Irradiation group (t=8.07, P=0.015; t=5.01, P=0.038; t=3.07, P=0.918, respectively). Adding 1 μg/ml IL-10 neutralizing antibody to the co-culture system significantly reduced the IL-10 level in the supernatant [(6.521±0.460) pg/ml] compared to the co-culture group [(26.270±6.486) pg/ml] (t=5.06, P=0.037). The p-STAT3/STAT3 ratio in the neutralizing antibody group (0.840±0.071) was significantly lower than that in the co-culture group (1.289±0.156) (t=4.27, P=0.051), and the osteogenic differentiation capacity of BMMSCs was also notably attenuated. Conclusions: M2 macrophages can improve the osteogenic differentiation ability of BMMSCs after irradiation damage by secreting IL-10 and activating the STAT3 signaling pathway. 目的： 探究M2巨噬细胞分泌白细胞介素-10（IL-10）对辐照后骨髓间充质干细胞（BMMSCs）成骨分化能力的影响及潜在分子机制。 方法： 2024年2月至2025年4月期间，取8只健康2~3周龄雄性SD大鼠，分别在体外培养大鼠原代BMMSCs和巨噬细胞，诱导巨噬细胞极化为M2型，通过流式细胞术和免疫荧光鉴定其表面标志物。实验细胞分为正常BMMSCs对照组（对照组）、4 Gy辐照组（辐照组）、4 Gy辐照+M2巨噬细胞共培养组（共培养组）、4 Gy辐照+M2巨噬细胞共培养+IL-10中和抗体组（中和抗体组）。采用4 Gy剂量的X射线对BMMSCs进行辐照，构建体外细胞辐照模型；通过8 μm孔径Transwell小室建立M2巨噬细胞与辐照后BMMSCs的非接触共培养体系，共培养48 h后，利用ELISA检测各组细胞上清液中IL-10含量，蛋白质印迹法检测BMMSCs成骨分化关键指标［碱性磷酸酶（ALP）、Runt相关转录因子2（RUNX2）、骨钙素（OCN）］及STAT3信号通路相关蛋白（p-STAT3、STAT3）的表达水平；通过添加IL-10中和抗体，验证IL-10的特异性功能。 结果： 细胞计数试剂盒-8结果显示，辐照后7 d，4 Gy辐照组的细胞吸光度值（0.241±0.093）显著低于正常BMMSCs对照组（1.794±0.083）（t=21.63，P<0.001）。蛋白质印迹法结果分析显示，4 Gy辐照组细胞的成骨分化指标ALP和RUNX2表达量（0.819±0.074、0.785±0.074）均显著低于正常BMMSCs对照组（1.000±0.067、1.000±0.056）（t=3.16，P=0.034；t=4.01，P=0.016）。免疫荧光分析结果显示，4 Gy辐照组成骨指标RUNX2和ALP的荧光强度（19.932±1.291和7.316±0.089）显著弱于正常BMMSCs对照组（31.154±3.352和30.789±1.455）；辐照后的BMMSCs与M2巨噬细胞共培养后，共培养组活细胞比例［（77.800±1.758）%］较辐照组［（61.933±2.732）%］显著增加（P<0.001），且共培养组上清中的IL-10含量［（46.39±1.879）pg/ml］显著高于4 Gy辐照组［（7.530±0.239）pg/ml］（t=36.74，P<0.001），蛋白质印迹法结果表明共培养组的成骨指标ALP、RUNX2和OCN的表达量均显著高于4 Gy辐照组（t=8.07，P=0.015；t=5.01，P=0.038；t=3.07，P=0.918）；在共培养体系中加入1 μg/ml的IL-10中和抗体，其上清液中的IL-10含量［（6.521±0.460）pg/ml］显著低于共培养组［（26.270±6.486）pg/ml］（t=5.06，P=0.037），中和抗体组p-STAT3/STAT3比值（0.840±0.071）显著低于共培养组（1.289±0.156）（t=4.27，P=0.051），BMMSCs成骨分化能力亦明显减弱。 结论： M2巨噬细胞可通过分泌IL-10激活STAT3信号通路，进而改善辐照损伤后BMMSCs的成骨分化能力。.
Objective: To explore a three-dimensional point cloud completion method based on an octree diffusion model for intelligent generation of personalized dental crown occlusal morphology, and to evaluate the similarity and functional adaptability of the generated crown occlusal surfaces compared with natural teeth. Methods: A total of 780 intraoral scan datasets of unilateral maxillary and mandibular second premolars to second molars were selected from the DCPR-GAN database (https://github.com/Sukhum169/DCPR-GAN). The data were obtained from Peking University School and Hospital of Stomatology and Nanjing Stomatological Hospital, involving patients aged 35-50 years. Among them, 720 cases were used for model training and 60 for testing. An octree-structured diffusion model was constructed to achieve two stages of three-dimensional crown morphology generation: unconditional generation and mask-conditioned generation. In the unconditional generation stage, Earth mover's distance (EMD) was used as the metric for morphological discrepancy, and the occlusal contact areas of generated crowns (DM-U) were compared with those of natural teeth. Statistical analysis was performed using the Kruskal-Wallis test. In the conditional generation stage, clinical intraoral scan data were collected from 12 healthy volunteers at Peking University School and Hospital of Stomatology between September 2024 and February 2026, including six males and six females aged 22-24 years. Crowns were generated for the diffusion model generated crown with the mask condition group (DM group) and compared among four groups: natural teeth (NA group), technician-designed crowns (TE group), and automatically generated crowns (AT group). Three-dimensional coordinate deviations and euclidean distance errors of five anatomical landmarks were analyzed. Root mean square error (RMSE) of the three-dimensional surface was calculated using natural teeth as the gold standard. Statistical analysis was performed using the Friedman test. Results: In the unconditional generation evaluation, EMD results showed a coverage rate of 50.88%, a minimum matching distance (MMD) of 1.74, and a 1-nearest neighbor accuracy (1-NNA) of 0.504, indicating high similarity between generated crowns and natural teeth in feature space. Comparison of occlusal contact area showed no statistically significant difference between the DM and NA groups (χ²=0.75, P=0.387). In the conditional generation evaluation, the RMSE values for the TE, AT, and DM groups were 0.39 (0.11), 0.37 (0.13), and 0.31 (0.10) mm, respectively, with no significant overall difference among the three groups (χ²=3.50, P=0.174). Conclusions: The three-dimensional point cloud completion method based on an octree diffusion model can effectively learn the occlusal morphology of natural crowns and achieve personalized reconstruction of crown occlusal surfaces. The generated crown occlusal morphology demonstrated similarity to natural teeth and functional adaptability comparable to technician-designed methods. 目的： 探索一种基于八叉树扩散模型的三维点云补全方法，用于个性化牙冠(牙合)面形态智能生成，并评估生成的牙冠(牙合)面形态与天然牙相似性及功能适配性。 方法： 选取开源数据集（来自北京大学口腔医学院·口腔医院及南京市口腔医院的开源数据，患者年龄35~50岁）上下颌单侧第二前磨牙至第二磨牙口内扫描数据780例，其中720例用于模型训练，60例用于测试。构建基于八叉树结构的扩散模型，进行牙冠三维形态无条件生成及掩码条件生成。无条件生成阶段采用推土机距离（EMD）作为形态差异距离度量指标，并采用Kruskal-Wallis检验比较无条件生成牙冠（DM-U）与天然牙咬合接触面积差异。条件生成阶段收集12例2024年9月至2026年2月来自北京大学口腔医学院·口腔医院健康学生志愿者的口内扫描数据，男女各6例，年龄22~24岁，分别生成掩码条件扩散模型生成牙冠（DM组），并与天然牙（NA组）、技师设计牙冠（TE组）及软件设计牙冠（AT组）进行4组间比较。分析5个解剖标志点三维坐标偏差及欧氏距离误差，并以天然牙为金标准计算三维表面均方根误差（RMSE）。采用Friedman检验进行统计分析。 结果： 无条件生成中，EMD结果显示覆盖率为50.88%，最小匹配距离（MMD）为1.74，1-最近邻准确率（1-NNA）为0.504，提示生成牙冠与天然牙在特征空间有较高的相似性。咬合接触面积比较显示DM组与NA组差异无统计学意义（χ²=0.75，P=0.387）。条件生成中，TE组、AT组、DM组RMSE值分别为0.39（0.11）、0.37（0.13）、0.31（0.10）mm，3组间总体差异无统计学意义（χ²=3.50，P=0.174）。 结论： 基于八叉树扩散模型的三维点云补全方法能有效学习天然牙冠(牙合)面形态，实现个性化牙冠(牙合)面重建，生成的牙冠(牙合)面与天然牙相似性及功能适配性与技师设计方法相当。.
Objective: To automatically estimate children's physiological age from pediatric panoramic radiographs, employing a two-stage approach which involves permanent teeth staging assessment followed by physiological age conversion, as well as an end-to-end approach. Methods: From 3 367 radiographs of children aged 4 to 11 years, collected at Pediatric Dentistry, Peking University School and Hospital of Stomatology, between November 2012 and August 2020, 640 images were randomly assigned into training set-1 (392 images), validation set-1 (118 images), and test set-1 (130 images) using Python (version 3.9) scripts. Using manual annotations of Demirjian's stages for 8 left mandibular teeth as gold standard, a YOLOv5-based deep learning model (staging-judgment-model) was trained and validated, whose performance was assessed using metrics including accuracy and weighted Kappa. Using chronological age as ground truth, random forest models (age-machine-models) were developed based on automatic staging of teeth 31-37 or 31-38. The full dataset (3 367 images) was randomly allocated into training set-2 (2 031 images), validation set-2 (673 images), and test set-2 (663 images) to train a ResNet-50-based deep learning model (age-deep-model). An external test set (907 images) from the Clinical Division Peking University School and Hospital of Stomatology from June 2022 to December 2022 was collected. Performance was assessed using mean absolute error (MAE), root mean square error (RMSE), and coefficient of determination (R²). Class activation maps were used to reveal the areas of concern for the age-deep-model. Images with an absolute difference between inferred and actual ages exceeding 3 standard deviations from the mean difference were selected for manual reviews. Results: The staging-judgment-model achieved an overall accuracy of 75.95%, with a linear-weighted Kappa of 0.87 and quadratic-weighted Kappa of 0.95. In the test set-1, the MAE, RMSE and R² of the age-machine-models based on automatic staging of teeth 31-37 were 0.592 years, 0.757 years and 0.879, while ones of the age-machine-models based on automatic staging of teeth 31-38 were 0.594 years, 0.754 years and 0.879. In the test set-2, the MAE, RMSE and R² of the age-deep-model were 0.621 years, 0.800 years and 0.918 respectively. The gradient class activation map revealed that the areas of concern for age-deep-model gradually shifted from the crown of the posterior deciduous teeth to the apical area of the posterior permanent teeth with increasing age. The staging-judgment-model might mistake later teeth development stages for earlier ones, resulting in an underestimated assessment of physiological age by age-machine-models. Similarly, orthodontic appliance images might lead the age-deep-model to generate an underestimated age estimation. Conclusions: This study enabled fully automated physiological age inference via two complementary approaches, demonstrating potential for preliminary screening of children with dental developmental abnormalities. Further optimization is required prior to clinical implementation. 目的： 探索基于曲面体层X线片（以下简称曲面体层片）综合应用两阶段和端到端方法推断儿童生理年龄在临床数据中的真实表现，为算法优化与临床应用提供依据。 方法： 从北京大学口腔医学院·口腔医院儿童口腔科2012年11月至2020年8月间拍摄的符合标准的3 367张曲面体层片中抽取640张图像，使用Python（3.9版本）编写程序随机分配为训练集-1（392张图像）、验证集-1（118张图像）和测试集-1（130张图像）。以医师标注的左下象限8颗恒牙的Demirjian分期为金标准构建以YOLOv5为骨干网络的深度学习模型（以下简称分期判断模型），计算分期判断模型的准确率和加权Kappa值，以实际年龄为标准构建基于牙位分期结果换算生理年龄的随机森林模型（以下简称年龄-机器模型）。将全部3 367张图像使用Python（3.9版本）编写程序随机分配为训练集-2（2 031张图像）、验证集-2（673张图像）和测试集-2（663张图像），以实际年龄为标准构建以ResNet-50为骨干网络的深度学习模型（以下简称年龄-深度模型）。收集北京大学口腔医学院·口腔医院第一门诊部2022年6月至2022年12月拍摄的全部4~11岁儿童曲面体层片作为外部测试集（907张图像）。计算年龄-机器模型在测试集-1中、年龄-深度模型在测试集-2中的平均绝对误差（MAE）、均方根误差（RMSE）、决定系数（R²）评价年龄推断的准确性。在测试集-2中使用类激活热力图探索年龄推断深度模型所关注的图像区域。在外部测试集中筛选推断年龄与实际年龄差值的绝对值超过差值均值3倍标准差的图像进行人工审阅。 结果： 分期判断模型整体准确率为75.95%，线性加权Kappa值为0.87，二次加权Kappa值为0.95。在测试集-1中，基于31—37牙位的年龄-机器模型MAE为0.592岁，RMSE为0.757岁，R²为0.879；基于31—38牙位的年龄-机器模型MAE为0.594岁，RMSE为0.754岁，R²为0.879。在测试集-2中，年龄-深度模型MAE为0.621岁，RMSE为0.800岁，R²为0.918。年龄-深度模型的关注区域随着年龄增加从乳牙后牙的冠部逐渐向恒牙后牙的根尖区域转移。分期-判断模型偏向牙齿发育早期可导致年龄-机器模型推断年龄偏低，存在矫治器影像可导致年龄-深度模型推断年龄偏低。 结论： 本研究基于机器学习和深度学习技术实现了儿童生理年龄的全自动推断，能初步筛选出牙齿发育状况异常的儿童，但实际应用前仍需进一步优化。.
This article focuses on the series of viewpoints on the prevention and treatment of medication-related osteonecrosis of the jaw issued by the American Association of Oral and Maxillofacial Surgery (AAOMS), and puts forward several uncertain issues from a clinical perspective. The points of doubt in diagnosis include the definition of drug categories and the threshold of bone exposure duration, as well as the significance of imaging features of bone lesions for diagnostic and treatment decisions. The concerns in terms of prevention include drug risks and disease incidence, tooth extraction and drug holiday, intervention measures promoting bone wound healing and their effectiveness. In terms of treatment, with integration of the author's practical experience, the discussion points focused on the dominant principles of non-surgical treatment, the identification and confirmation of the surgical bone incision boundary, the application of buccal fat pads, chin flaps and submandibular gland transposition, as well as the applicable conditions for permanent repair of fibular transplantation, temporary repair of reconstruction plate bridging, compromise mandibular resection and maxillary sinus opening, etc. The article suggests seeking evidence-based research on the above issues. 本文围绕美国口腔颌面外科学会（AAOMS）发布的关于药物相关性颌骨坏死防治的系列意见书，从临床角度对其带有不确定性的若干问题提出商榷意见。在诊断方面的质疑点包括对药物类别和骨暴露持续时间阈值的界定、骨病变影像学特征对诊断和治疗决策的意义；在预防方面的关注点包括药物风险与疾病发生率、拔牙与药物假期、促进骨创愈合的干预措施及其有效性；在治疗方面融入了笔者的实践体会，讨论点集中于非手术治疗的主导原则，手术中对手术切骨边界的确认，颊脂垫、颏瓣和颌下腺转位的应用，以及腓骨移植永久性修复、重建板桥接暂时性修复、姑息性下颌骨切除和上颌窦开放适用条件等。文章建议对上述问题寻求循证研究。.
Objective: To investigate the teaching effectiveness of the "Symptom-Disease-Skill" three-stage step-by-step teaching approach in the standardized training of residents in the dental emergency department. Methods: This was a randomized controlled trial.From June 2024 to December 2025, 17 groups (179 residents) undergoing their first rotation in the Emergency Department of Peking University School and Hospital of Stomatology were selected and randomly assigned to an experimental group (8 groups, 87 residents, receiving step-by-step teaching) and a control group (9 groups, 92 residents, receiving traditional teaching).The "Symptom-Disease-Skill" three-stage step-by-step teaching model included:symptom deconstruction, disease deduction and differential diagnosis, and skill integration with progressive practice.The Mini-CEX scale was used at the beginning and end of the rotation to assess residents'competencies in medical history, physical examination, clinical diagnosis, treatment planning, humanistic care, and procedural skills by observing the actual process of managing a typical patient with a toothache. Data were statistically analyzed using SPSS 26.0 software, including independent samples t-test, paired t-test, and χ² test. Results: Baseline levels were consistent between the two groups at the start of the rotation. At the end of the rotation, scores in both groups showed significant improvement compared to baseline (P<0.001). Intergroup comparison revealed that at the end of the rotation, the experimental group scored significantly higher than the control group in medical history taking (mean difference: -0.35, 95%CI: -0.67 to -0.03, P=0.033), physical examination (mean difference: -0.38, 95%CI: -0.72 to -0.03, P=0.034), clinical diagnosis (mean difference: -0.40, 95%CI: -0.75 to -0.06, P=0.021), and treatment planning (mean difference: -0.40, 95%CI: -0.73 to -0.08, P=0.015). For the clinical treatment, there was no significant difference in the distribution of patient case complexity between the two groups.The procedural skills score of the experimental group was significantly better than that of the control group at the end of the rotation (mean difference: -0.44, 95%CI: -0.80 to -0.07, P=0.019). Conclusions: The "Symptom-Disease-Skill" three-stage step-by-step teaching model can effectively enhance the comprehensive clinical competency of dental emergency residents. It demonstrates superior effectiveness compared to traditional teaching methods, particularly in the areas of medical history taking, examination, diagnosis, treatment planning, and procedural skills, making it a valuable clinical teaching approach worthy of promotion in dental emergency training. 目的： 探讨“症状—疾病—技能”三段式渐进教学法在口腔急诊住院医师规范化培训中的教学效果。 方法： 本研究为整群随机对照试验。于2024年6月至2025年12月，选取北京大学口腔医学院·口腔医院口腔急诊科首次轮转的住院医师17组（179人），采用随机数字表法将其分为实验组（8组87人，接受渐进式教学）与对照组（9组92人，接受传统教学）。“症状—疾病—技能”三段式渐进教学模式包括症状解构、疾病推导与鉴别诊断、技能整合与渐进实践。采用迷你临床演练评估量表于入科及出科时，通过观察接诊急性牙痛患者的实际过程，评估住院医师的问诊技巧、体格检查、临床诊断、治疗设计、人文关怀与操作技能。数据采用SPSS 26.0软件进行统计分析，包括独立样本t检验、配对t检验及χ²检验。 结果： 两组住院医师入科时的基线水平差异无统计学意义（P>0.05）。出科时，两组各项评分均显著高于入科时（均P<0.001）。组间比较显示，实验组出科时的问诊技巧（P=0.033）、体格检查（P=0.034）、临床诊断（P=0.021）及治疗设计（P=0.015）评分均显著高于对照组。在临床操作方面，两组患者病情复杂程度分布及入科时操作水平差异无统计学意义（P>0.05）。实验组在出科时的操作技能评分亦显著高于对照组（P=0.019）。 结论： “症状—疾病—技能”三段式渐进教学模式可有效提升口腔急诊住院医师的临床综合能力，尤其在问诊、检查、诊断、治疗设计及操作技能方面效果优于传统教学方法，是一种值得推广的口腔急诊临床教学模式。.
In the critical stage of digital and intelligent transformation of stomatology, artificial intelligence (AI) technology has shown significant advantages in diagnosis, treatment planning and other fields. However, limited by the nature of disembodied intelligence, the clinical execution end still faces the "last centimeter" bottleneck such as weak environmental perception and lack of dynamic interaction. As a new AI paradigm emphasizing the closed loop of "perception-decision-action", embodied intelligence provides a new theoretical direction and technical path to break through the execution limitations of existing digital technologies. This paper sorts out the technical core of embodied intelligence and its adaptation logic to oral clinical scenarios. From the perspective of different evaluation dimensions, it compares the conventional medical robot autonomy classification with intelligence-oriented frameworks, and further introduces the embodied intelligence grading system in the context of oral healthcare, systematically describes the development direction of core technologies such as visuo-tactile fusion perception, oral-specific world model, and simulation-to-reality (Sim2Real) simulation training, prospects its application scenarios in subspecialties such as oral implantology, prosthodontics, endodontics, and orthodontics, and puts forward expert suggestions on core issues such as data islands, regulatory ethics, and technical boundaries faced by the current field, so as to provide a reference for the rational development and standardized application of oral embodied intelligence. 在口腔医学数智化转型的关键阶段，人工智能技术已在诊断分析、方案设计等领域展现出显著优势，但受限于离身智能的本质，临床执行端仍存在环境感知弱、动态交互缺失以及长程预测能力不足等瓶颈。具身智能作为强调“感知-决策-执行”闭环的新型人工智能范式，为突破现有数字化技术的执行局限提供新的理论方向与技术路径。本文结合口腔诊疗场景的特点，对具身智能的技术内核与口腔诊疗场景的适配逻辑进行梳理。在此基础上，从不同评价维度出发，分析传统医疗机器人自主性分级体系的不足，创新性地提出适配口腔领域的具身智能分级标准，系统阐述视触融合感知、口腔专属世界模型、仿真到现实迁移训练等核心技术的发展方向，展望具身智能在口腔种植、口腔修复、牙体牙髓病及口腔正畸等专科的应用场景，并对当前领域面临的数据孤岛、监管伦理、技术边界等核心问题提出专家倡议，以期为口腔具身智能的理性发展与规范应用提供参考。.
Objective: To systematically investigate the current status of postoperative health education needs among patients with maxillofacial trauma, so as to provide evidence for establishing staged and individualized clinical health education programs. Methods: A cross-sectional survey was conducted among 469 patients with maxillofacial trauma admitted to the Emergency Department of West China Hospital of Stomatology, Sichuan University from January to May 2025. Data were collected using a validated health education needs questionnaire for patients with maxillofacial trauma. Medians and interquartile ranges were used for descriptive statistics; nonparametric tests were applied for group comparisons, and Spearman rank correlation was used for correlation analysis. Results: The median age of the included patients was 6.0 years old, and 78.7%(369/469) of patients were under 18 years old. The most frequent injury site was the lower third of the face, accounting for 51.0%(239/469). The median scores of items V1-V8 and V10-V20 were all 5.0. Gender had no significant effect on the scores of health education needs (P>0.05). Age-stratified analysis showed that 13 items (V1, V4, V10-V20) had significantly higher scores in patients under 18 years old than in those aged 18 years and older (all P<0.05). All items (V1-V20) differed significantly among postoperative time stages (all P<0.05), with scores immediately after operation consistently higher than those at 6 days or more postoperatively (all P<0.05). Regarding injury sites, significant differences were found in items V6 and V17 (all P<0.05), Patients with injuries in the upper third of the face had higher needs for pharmacological and non-pharmacological management of postoperative scars than those with injuries in the lower third (P<0.05). Correlation analysis revealed that health education needs for items V1-V3, V8, and V10-V20 were negatively correlated with age (P<0.05), and all items V1-V20 were negatively correlated with postoperative time (P<0.05). Conclusions: Postoperative health education needs in patients with maxillofacial trauma are influenced by age, postoperative time, and injury site. Clinical practice should abandon the one-size-fits-all education model and establish staged, individualized health education focused on the early postoperative period and targeted at children and adolescents, so as to improve rehabilitation outcomes and quality of life. 目的： 系统调查颌面部创伤患者术后健康教育知识需求的现状，为构建分阶段、个性化的临床健康教育方案提供依据。 方法： 采用横断面调查设计，选取2025年1至5月四川大学华西口腔医院急诊科收治的469例颌面部创伤患者为研究对象，使用颌面部创伤患者健康教育需求问卷进行调查。采用中位数及四分位间距进行统计描述，采用非参数检验进行统计推断；采用 Spearman 秩相关进行相关性分析。 结果： 本研究纳入患者中位年龄为 6.0岁，其中<18岁患者占78.7%（369/469）；创伤部位以面下1/3最常见［51.0%（239/469）］。V1~V8及V10~V20条目需求得分中位数均为 5.0 分。性别对患者各条目健康教育知识需求得分的差异无统计学意义（P>0.05）。年龄分层分析显示，在<18岁患者中13 个条目（V1、V4、V10~V20）知识需求得分均显著高于≥18岁患者（均P<0.05）。术后时间阶段分析，V1~V20 所有条目得分在不同术后阶段间的差异均有统计学意义（均P<0.05），两两比较结果显示，术后即刻的需求得分均显著高于术后6 d及以上阶段（均P<0.05）。伤口部位分析显示，V6与V17条目得分差异有统计学意义（P<0.05），两两比较可见，创伤位于面上1/3的患者对术后瘢痕药物与非药物管理的知识需求显著高于面下1/3患者（P<0.05）。相关性分析显示，变量V1~V3、V8、V10~V20等条目健康教育知识需求与年龄、术后时间均呈负相关（均P<0.05）。 结论： 颌面部创伤患者术后健康教育需求受年龄、术后时间及创伤部位影响，临床应摒弃“一刀切”教育模式，着力构建以术后早期为核心、以儿童青少年为重点对象的分阶段、个性化健康教育，以改善康复预后与生活质量。.
Objective: To apply an individual and precise occlusal design method based on physiological tooth displacement for the digital design of posterior full crowns, and to explore its clinical effectiveness. Methods: This was a prospective randomized controlled study. From February 2024 to January 2025, patients who visited the Department of Prosthodontics, Peking University School and Hospital of Stomatology, with tooth defects in the second premolars or first molars and planned for full-crown restoration were enrolled. After tooth preparation, intraoral scanning was performed to obtain data of the maxillary and mandibular posterior dentitions and occlusal buccal surfaces on the side of the prepared tooth. Patients were randomly assigned using a random number method to undergo restoration design. Control: full crowns were designed according to a conventional protocol, using an automatically registered occlusal relationship based on the buccal surfaces. The occlusal clearance values were set based on previous studies and the clinical experience of the dental technician. Experimental: an individual occlusal design technique based on physiological tooth displacement was employed. Intraoral scan data underwent single-tooth segmentation and registration to derive virtual occlusal relationships in occlusion, followed by calculation of occlusal clearances of adjacent teeth. The occlusal clearance for the full crown was set as the mean value of the adjacent teeth's occlusal clearances. After fabrication of zirconia full crowns for both groups, they were delivered for clinical try-in. Occlusal evaluations were performed before and after occlusal adjustment. Primary outcomes included qualitative evaluation of occlusal fitness (qualitatively classified into three categories: acceptable occlusion, high occlusion and low occlusion) and occlusal adjustment height, while secondary outcomes comprised occlusal adjustment volume, articulating paper markings, occlusal clearance values, and occlusal adjustment time. Results: A total of 38 patients [12 males, 26 females; age: (39.5±13.2) years] were included in this study. Thirty-eight posterior full crowns were fabricated, with 19 allocated to the test group and 19 to the control group. The occlusal status before occlusal adjustment was as follows: in the test group, 4 crowns had acceptable occlusion, 15 had high occlusion, and none had low occlusion; in the control group, 1 crown had acceptable occlusion, 14 had high occlusion, and 4 had low occlusion. The number of cases with acceptable occlusion was significantly higher in the experimental group than in the control group (U=122.00, P=0.022). The occlusal adjustment height of the experimental group [(39.1±17.0) μm] was significantly lower than that of the control group [(79.5±50.2) μm] (t=-2.85, P=0.009). No significant differences were observed in adjustment time, volume, or articulating paper evaluation (all P>0.05). Conclusions: Using a virtual occlusal registration method for single-tooth segmentation based on the physiological tooth mobility and quantitatively referencing the occlusal contacts of adjacent teeth, this study significantly improved the occlusal suitability of full crowns and reduced the occlusal adjustment required. 目的： 应用基于牙齿生理动度的个性化咬合接触设计方法进行后牙全冠数字化设计，探讨其临床应用效果。 方法： 本项研究为前瞻性随机对照试验，纳入2024年2月至2025年1月于北京大学口腔医学院·口腔医院修复科就诊的第二前磨牙或第一磨牙牙体缺损、拟行全冠修复的患者，牙体预备后口内扫描获得预备体所在侧上下颌后牙牙列和咬合状态下上下颌后牙牙列颊侧面（简称咬合颊侧面）数据，采用随机数法随机分组，进行修复体设计：对照组根据咬合颊侧面数据自动配准的咬合关系，常规设计全冠，根据前期研究及技师临床经验设置全冠的咬合间隙值；试验组采用基于牙齿生理动度的个性化咬合接触设计流程，对口内扫描数据进行单牙分割配准，获得咬合状态下的虚拟咬合关系，继而计算邻牙咬合间隙，设置全冠的咬合间隙为邻牙咬合间隙均值。两组设计完成后加工氧化锆全冠，进行临床试戴。调（牙合）前后分别进行咬合评价，主要指标为咬合适合性定性评价（定性分为咬合合适、咬合过高和咬合过低3类）和调（牙合）高度，次要指标包括调（牙合）体积、咬合间隙和调（牙合）时间等。 结果： 共纳入38例患者，其中男性12例，女性26例，年龄（39.5±13.2）岁；共制作38个后牙全冠，试验组和对照组各19个，调（牙合）前试验组咬合合适4个、咬合过高15个、无咬合过低，对照组咬合合适1个、咬合过高14个、咬合过低4个，其中试验组咬合合适结果显著多于对照组（U=122.00，P=0.022）；试验组调（牙合）高度［（39.1±17.0）μm］显著小于对照组［（79.5±50.2）μm］（t=-2.85，P=0.009）。试验组与对照组的调（牙合）时间、调（牙合）体积、咬合间隙差异均无统计学意义（均P>0.05）。 结论： 本项研究通过基于牙齿生理动度的个性化咬合接触设计方法（结合单牙分割咬合配准并定量参考邻牙咬合接触）进行后牙全冠数字化设计，可显著提高全冠的咬合适合性，减少调（牙合）量。.
Objective: To develop a micro-CT pulp cavity image segmentation model based on few-shot transfer learning, enabling efficient and accurate segmentation of the pulp cavity with limited training samples, thereby supporting three-dimensional(3D) anatomical research of the pulp cavity and digital root canal treatment. Methods: Extracted teeth (n=110) due to pathological reasons were collected from the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University, between January 2025 and September 2025. These teeth were scanned using micro-CT. The acquired images were randomly divided (simple random sampling) into a training set (10 teeth), a test set (90 teeth), and an independent test set (10 teeth) at a ratio of 1∶9∶1. 3D pulp cavity images were meticulously annotated by two oral clinicians (attending physicians) to establish the ground truth for segmentation. By introducing a cross-domain adaptation strategy, the natural image segmentation foundation model, segment anything model (SAM), was transferred to the task of pulp cavity image segmentation under the guidance of a limited number of training samples, thereby constructing an automatic micro-CT pulp cavity image segmentation model (PulpSAM). Multi-dimensional quantitative and qualitative analyses were performed to compare the segmentation performance on the pulp cavity (entire pulp cavity, apical 3 mm, and lateral accessory canals) achieved by deep learning models obtained with different numbers of training samples (0, 1, 3, and 10 teeth), i.e., SAM, PulpSAM-1, PulpSAM-3, and PulpSAM-10. These results were also compared with those of the U-Net and nnU-Net models. Additionally, the time required for three methods (manual annotation, fully automated model segmentation, and model segmentation followed by manual refinement) was compared. Results: Under training sample sizes of 1, 3, and 10 teeth, all PulpSAM models achieved high segmentation performance, with median Dice coefficient, Intersection over Union (IoU), precision, recall, and accuracy all≥92.3%, median 95% Hausdorff distance (95%HD)≤0.04 mm, and median average symmetric surface distance (ASSD) of 0.02 mm. These metrics were significantly superior to those of the SAM model (all P<0.008 3). The pulp cavity volume and relative volume difference (RVD) segmented by each PulpSAM model were significantly smaller than those of the SAM model (all P<0.008 3). Except for ASSD and precision, the other seven segmentation accuracy metrics of PulpSAM-3 were significantly better than those of PulpSAM-1 (all P<0.008 3). Compared with PulpSAM-10, PulpSAM-3 showed significantly higher recall, ASSD, and pulp cavity volume (all P<0.008 3), and significantly lower precision and absolute RVD (all P<0.008 3). No statistically significant differences were observed between PulpSAM-3 and PulpSAM-10 in Dice coefficient, IoU, accuracy, or 95%HD (all P>0.008 3). All segmentation accuracy metrics of each PulpSAM model were significantly superior to those of the corresponding U-Net and nnU-Net models (all P<0.017). The segmentation times required for manual annotation, PulpSAM-3 automatic segmentation, and PulpSAM-3 segmentation followed by manual refinement were 3 354.6 (852.0), 190.0 (27.9), 646.4 (171.5) s, respectively, with statistically significant differences among the three methods (χ²=25.80, P<0.001). Conclusions: This study developed the PulpSAM model based on a few-shot transfer learning strategy, achieving efficient and accurate automatic segmentation of the pulp cavity in micro-CT images. 目的： 构建一种基于少样本迁移学习的显微CT牙髓腔影像自动分割模型，为牙髓腔三维解剖研究及数字化根管治疗提供技术支持。 方法： 收集2025年1至9月武汉大学口腔医院口腔颌面外科门诊提供的因疾病拔除的110颗离体牙，进行显微CT扫描，数据通过简单随机抽样以1∶9∶1的比例分为训练集（10颗）、测试集（90颗）和独立测试集（10颗）。由2名口腔主治医师精细标注离体牙三维牙髓腔影像，建立分割金标准。通过引入跨领域适配策略，在少量训练样本指导下将自然图像分割基础模型——分割一切模型（SAM）迁移至牙髓腔影像分割，构建显微CT牙髓腔影像自动分割模型（PulpSAM）。通过多维度定量和定性分析比较不同数目（0、1、3及10颗牙）训练样本获得的深度学习模型（SAM、PulpSAM-1、PulpSAM-3和PulpSAM-10）对牙髓腔（整个髓腔、根尖3 mm和侧副根管）分割结果的影响，并与U-Net和nnU-Net模型进行对比。比较人工标注、模型自动分割（选择以上结果最好的PulpSAM模型）及模型分割（结果最好的PulpSAM模型）结合人工精修3种方法所需时间。 结果： 1、3和10颗牙训练样本下，各PulpSAM模型分割性能均较高，Dice系数、交并比、精确率、召回率和准确度中位数均≥92.3%，95%豪斯多夫距离（95%HD）中位数均≤0.04 mm，平均对称表面距离（ASSD）中位数均为0.02 mm，均显著优于SAM模型相应指标（均P<0.008 3），各PulpSAM模型分割的牙髓腔影像体积及相对体积差异（RVD）均显著小于SAM模型相应指标（均P<0.008 3）。除ASSD和精确率外，PulpSAM-3的其他7个分割准确性指标均显著优于PulpSAM-1（均P<0.008 3）。PulpSAM-3召回率、ASSD和牙髓腔影像体积均显著大于PulpSAM-10（均P<0.008 3），精确率和RVD绝对值均显著小于PulpSAM-10（均P<0.008 3）；两者Dice系数、交并比、准确度和95%HD差异均无统计学意义（均P>0.008 3）。各PulpSAM模型的所有分割准确性指标均显著优于相应U-Net和nnU-Net模型（均P<0.017）。人工标注、PulpSAM-3分割、PulpSAM-3分割结合人工精修3种方法的分割时间分别为3 354.6（852.0）、190.0（27.9）和646.4（171.5）s，三者间差异有统计学意义（χ2=25.80，P<0.001）。 结论： 基于少样本迁移学习构建的PulpSAM模型可实现显微CT牙髓腔影像的高效、高精度自动分割。.
Objective: To investigate the longitudinal patterns of tooth mobility and identify prognostic factors for mobile teeth in patients with periodontitis, providing an evidence-based basis for retaining natural teeth in clinical practice. Methods: A retrospective analysis was conducted on the clinical data of 44 patients with periodontitis (including 524 mobile teeth) treated at the Department of Periodontology, School and Hospital of Stomatology, Shandong University from January 2021 to October 2025. Clinical indices and radiographic data were collected following initial periodontal therapy and during the maintenance phase. Linear mixed-effects models were employed to process repeated measurement data to analyze the trends in mobility changes and associated factors. Receiver operating characteristic curves were utilized to analyze the predictive performance and optimal cutoff values of key indicators. Results: Teeth of Grade Ⅰ and Ⅱ mobility showed significant improvement at 3 months, with the improvement rates of 60.1% (185/308) and 73.9% (116/157), respectively. Improvement for Grade Ⅲ mobility was slower, reaching a peak of approximately 61.0% (36/59) after 1 year. Multivariate analysis indicated that higher residual bone-to-root ratio (β=-0.353 3, P=0.006), periodontal splinting (β=-0.233 6, P=0.002), and female gender (β=-0.177 2, P<0.001) were the primary independent protective factors promoting mobility improvement. The optimal cutoff value for the residual bone-to-root ratio in predicting mobile tooth survival was 0.24 (area under the curve=0.81). Conclusions: Tooth mobility exhibits significant dynamic reversibility following standardized periodontal treatment. Grade Ⅲ mobility should not be considered an absolute indication for extraction. Particularly in cases where the residual alveolar bone covers more than one-quarter of the root length, it is recommended to consider periodontal splinting and maintain a follow-up period of at least one year, so as to formulate more precise strategies for retaining mobile teeth and preserve natural teeth to the greatest extent possible. 目的： 探究牙周炎松动牙的纵向变化规律及预后预测因子，为临床保留天然牙提供循证依据。 方法： 回顾性分析2021年1月至2025年10月于山东大学口腔医院牙周科就诊的44例牙周炎患者的临床资料，共纳入524颗松动牙。收集患者在牙周基础治疗后及维护期的临床指标及影像学数据。采用线性混合效应模型处理重复测量数据以分析松动度变化趋势及相关因素，利用受试者工作特征曲线分析关键指标的预测效能及最佳截断值。 结果： Ⅰ度和Ⅱ度牙周炎松动患牙在牙周基础治疗后3个月时松动度显著改善，改善率分别为60.1%（185/308）和73.9%（116/157）；Ⅲ度松动患牙松动度改善较慢，1年后改善率达峰值，为61.0%（36/59）。多因素分析显示，较高的剩余骨根比（β=-0.353 3，P=0.006）、松牙固定（β=-0.233 6，P=0.002）及女性（β=-0.177 2，P<0.001）为促进牙周炎患牙松动度改善的主要独立保护因素。剩余骨根比预测松动牙存留的最佳截断值为0.24（曲线下面积为0.81）。 结论： 牙周炎松动患牙经规范牙周治疗后的松动度表现出动态可逆性。Ⅲ度松动非绝对拔牙指征，尤其当超过1/4根长仍存在骨支持时，建议牙周治疗中可考虑松牙固定且至少随访观察1年，从而制订更为精准的松动牙保留策略，尽可能保留天然牙。.
Objective: To investigate the mechanism by which an 810-nm diode low-level laser (LLL) promotes angiogenesis through activation of the nuclear factor erythroid 2-related factor 2/heme oxygenase-1 (NRF2-HO-1) signaling pathway, and to provide a theoretical basis for the repair of acute soft-tissue injury. Methods: 1. In vitro experiments, oxidative stress injury in human umbilical vein endothelial cells (HUVECs)was induced by treatment with 100 μmol/L H2O2 for 12 h. The cells were divided into a control group, an H2O2 group, and low-level laser intervention groups. The intervention groups received 810-nm diode laser irradiation at energy densities of 2 J/cm2 (E1 group), 4 J/cm2 (E2 group), and 8 J/cm2 (E3 group). Cell proliferation was assessed using the CCK-8 assay. Cell migration was evaluated using wound-healing and Transwell assays. Tube formation on Matrigel was performed to assess in vitro capillary-like structure formation. Intracellular reactive oxygen species (ROS) levels were measured using the 2', 7'-dichlorodihydrofluorescein diacetate (DCFH-DA) probe, and mitochondrial membrane potential was detected using the JC-1 probe. Immunofluorescence staining was performed to detect NRF2 nuclear translocation and HO-1 expression. 2. In vivo experiments, SPF male Sprague-Dawley rats (200-250 g) were used to establish a full-thickness skin wound model. The rats were randomly divided into a control group and a LLL therapy (LLLT) group. The LLLT group received 810-nm laser irradiation at an energy density of 40 J/cm2 on the wound area, whereas the control group received no laser treatment. Wound area and healing rate were measured using ImageJ software. Histological changes were observed by HE and Masson staining, and angiogenesis was evaluated by CD31 immunofluorescence staining. Results: Compared with the control group, H2O2 treatment significantly decreased the proliferative activity of HUVECs, increased intracellular ROS levels, and reduced mitochondrial membrane potential. After LLL irradiation, cell proliferation increased in all treatment groups compared with the H2O2 group. In particular, the E2 group (4 J/cm2) showed optical density values of 1.24±0.11, 1.43±0.06, and 1.83±0.14 at 24, 48, and 72 h, respectively, which were higher than those in the H2O2 group (P<0.05). The wound-healing assay showed significant differences in migration rates among groups (P<0.001), with the E2 group showing a migration rate of (%56.07±5.61%), compared with (24.83%±4.31%) in the H2O2 group. Transwell assay results also showed significant differences in the number of migrated cells among groups (P<0.001); the E2 group had 74.62±5.98 migrated cells, which was higher than the 20.21±6.55 cells observed in the H2O2 group. Tube formation analysis showed significant differences in the number of tubes among groups (P<0.05), with the E2 group exhibiting 43.95±3.47 tubes compared with 26.74±4.65 in the H2O2 group. ROS levels decreased and mitochondrial membrane potential increased after LLL treatment. Immunofluorescence analysis showed that the NRF2 nuclear/cytoplasmic fluorescence intensity ratio increased to 2.07±0.46 in the LLL group, compared with 1.39±0.26 in the H2O2 group (P<0.05), accompanied by increased HO-1 expression. In the animal experiment, wound healing rates in the LLL group at days 3, 7, and 14 were (37.98±1.14)%, (54.15±6.39)%, and (90.25±2.25)%, respectively, which were higher than those in the control group [(23.16±2.86)%, (34.95±0.39)%, and (77.22±6.01)%] (P<0.05). Histological observation showed increased collagen deposition and more capillary-like structures in the LLL group. Conclusions: 810 nm low-level laser may attenuate H2O2-induced oxidative stress damage in HUVECs by activating the NRF2-HO-1 signaling pathway, thereby improving cell proliferation, migration, and in vitro tube formation capability, as well as promoting acute wound healing in rats. 目的： 探讨810 nm二极管低能量激光（LLL）通过激活NRF2-HO-1信号通路促进血管生成的作用机制，为急性软组织创伤修复机制提供理论依据。 方法： 体外实验：评估不同能量密度LLL对人脐静脉内皮细胞（HUVECs）的生物学影响，采用100 μmol/L H2O2刺激12 h建立氧化应激损伤模型。细胞分为对照组、H2O2组及LLL干预组，其中LLL干预组分别给予2 J/cm2（E1组）、4 J/cm2（E2组）和8 J/cm2（E3组）能量密度810 nm二极管LLL照射。通过细胞计数（CCK-8）法检测对细胞增殖活性影响，划痕实验和Transwell实验评估细胞迁移能力，基质胶成管实验分析血管形成能力，2′，7′-二氯二氢荧光素二乙酸酯（DCFH-DA）荧光探针和5，5′，6，6′-四氯-1，1′，3，3′-四乙基苯并咪唑基羰花青碘化物（JC-1）检测氧化应激水平和线粒体膜电位，免疫荧光法观察核因子E2相关因子2（NRF2）核转位及血红素加氧酶-1（HO-1）表达。体内实验：选取48只SPF级雄性SD大鼠，体重200~250 g，建立大鼠皮肤全层急性创伤模型，LLL组给予40 J/cm2能量密度810 nm二极管LLL照射创面，对照组不进行激光处理。通过ImageJ软件测量创面面积计算愈合率；HE染色及Masson染色观察创面组织学变化；CD31免疫荧光染色评估新生血管形成情况。 结果： 与对照组相比，H2O2组HUVECs细胞增殖活性降低，活性氧水平升高，线粒体膜电位下降。经LLL干预后，E1、E2、E3组的细胞增殖活性均显著高于H2O2组（均P<0.05）；其中E2组在24、48、72 h时的细胞吸光度值（1.24±0.11、1.43±0.06、1.83±0.14）均显著高于H2O2组（P<0.05）。划痕实验结果显示，各组细胞迁移率差异有统计学意义（P<0.001），其中E2组迁移率（56.07%±5.61%）显著高于H2O2组（24.83%±4.31%）（P<0.05）。Transwell实验显示，E2组迁移细胞数［（74.62±5.98）个］显著高于H2O2组［（20.21±6.55）个］（P<0.001）。成管实验结果显示，各组管腔数量、节点数及分支数差异均有统计学意义（P<0.05），E2组管腔数量（43.95±3.47）显著高于H₂O₂组（26.74±4.65）。ROS检测结果显示，LLL干预后细胞内ROS水平较H2O2组降低；JC-1检测结果显示线粒体膜电位较H2O2组升高。免疫荧光结果显示，LLL干预后NRF2核/浆荧光强度比值（2.07±0.46）显著高于H2O2组（1.39±0.26）（P<0.05），同时HO-1蛋白表达水平增加。动物实验结果显示，LLL组在术后3、7、14 d创面愈合率［分别为（37.98±1.14）%、（54.15±6.39）%、（90.25±2.25）%］均显著高于对照组［（23.16±2.86）%、（34.95±0.39）%、（77.22±6.01）%］（均P<0.05）；组织学观察可见胶原沉积增加及毛细血管样结构增多。 结论： 810 nm二极管LLL可能通过激活NRF2-HO-1信号通路减轻H2O2诱导的HUVECs氧化应激损伤，改善细胞增殖、迁移及体外血管形成能力，并促进大鼠急性创面愈合。.
The classification system for periodontal diseases proposed by the European Federation of Periodontology (EFP) and the American Academy of Periodontology (AAP) in 2018 provides a standardized framework for the diagnosis and classification of periodontitis (the 2018 new classification of periodontal diseases). However, its application in epidemiological studies still faces numerous challenges. In 2024, to address these issues, the new framework for the application of 2018 periodontal status classification scheme to epidemiological survey data (the ACES framework) was formally introduced to accommodate the practical needs for epidemiological investigations. This paper systematically outlines the key points for the standardized application of new classifications in epidemiological studies, focusing on four aspects: case diagnosis, staging, extent and grading description. In terms of case diagnosis, it emphasizes the need to report edentulous and non-classified cases, clarifies the threshold for detectable interproximal clinical attachment loss (CAL), and standardizes the diagnosis of gingivitis. Regarding staging, it provides detailed guidelines for the standardized use of parameters such as CAL, probing depth, furcation involvement, as well as the standardization of data recording for tooth loss due to periodontitis and methods for calculating opposing pairs. For extent description, it specifies the definitions and calculation methods for generalized and localized periodontitis. Regarding grading, this paper highlights the difference between direct and indirect methods for grading assignment. This paper provides a reference for clinicians and researchers on the proper implementation of the new classification in epidemiological studies, enhancing the comparability of results across different studies and promoting the standardized epidemiological research in periodontology. 2018年欧洲牙周病联合会和美国牙周病学会提出的牙周病分类体系（2018年牙周病新分类）为牙周炎的诊断和分类提供了标准化框架，但其在流行病学研究中的应用仍面临诸多挑战。为解决这些问题，Holtfreter等学者于2024年正式提出对2018年牙周病新分类在流行病学调查数据中应用的框架（ACES框架）进行调整，以适应流行病学调查的实际需求。本文系统阐述了牙周病新分类在流行病学研究中规范应用的关键要点，包括病例诊断、分期、范围和分级描述4个方面。在病例诊断方面，本文强调需报告无牙颌及无法分类病例，明确可探测的邻面临床附着丧失阈值标准，规范牙龈炎诊断。在分期方面，本文详细说明了临床附着丧失、探诊深度、根分叉病变等参数的规范使用，以及因牙周炎失牙数据记录和对(牙合)牙对计算方法的标准化。在范围描述方面，本文明确了广泛型和局限型牙周炎的定义和计算方法。在分级方面，本文指出了直接和间接判定方法的差异。临床医师和研究者在流行病学研究中正确、规范地实施新分类将促进不同研究间结果的可比性，推动牙周病学流行病学研究的标准化。.
Objective: To investigate the efficacy of periodontally accelerated osteogenic orthodontics (PAOO) in expanding the labial root movement range of maxillary anterior teeth in adult patients with skeletal Class Ⅲ malocclusion undergoing camouflage orthodontic treatment. Methods: A total of 42 adult patients with mild to moderate skeletal class Ⅲ malocclusion undergoing camouflage orthodontic treatment at the Orthodontics Department of Hangzhou Stomatological Hospital from August 2016 to December 2024 were selected. The patients were divided into two groups based on whether PAOO was performed on the labial side of the maxillary anterior teeth (21 patients in each group): Experimental group received camouflage orthodontic treatment combined with PAOO; Control group received only camouflage orthodontic treatment. To further evaluate the efficacy of PAOO on tooth movement in different alveolar bone conditions, the experimental group was subdivided as follows: ①Based on the presence or absence of fenestration or dehiscence, the group was divided into fenestration group, dehiscence group, and non-bony defect group; ②Based on alveolar bone thickness before orthodontic treatment, the group was divided into thin alveolar bone group and thick alveolar bone group. Cone Beam Computed Tomography (CBCT) was used to analyze the indicators such as changes in the labial root displacement and alveolar bone thickness of 3, 6 and 9 mm below the CEJ of maxillary anterior teeth before (T0) and after (T1) orthodontic treatment. Lateral cephalometric radiographs were used to measure the A-point. Results: Compared with the control group, the experimental group showed a significant increase in alveolar bone thickness at 3, 6, and 9 mm below the CEJ of the maxillary anterior teeth (all P<0.05). Compared with the non-bony defect group, the dehiscence group showed a significant decrease in labial displacement [non-bony defect group (1.00±1.18) mm; dehiscence group (0.31±0.70) mm; t=-2.18, P=0.034] and a significant increase in alveolar bone thickness [non-bony defect group (-0.05±0.83) mm; dehiscence group (1.38±1.17) mm; t=4.49, P<0.001] at 3 mm below the CEJ. There were statistically significant differences in labial root displacement at 3 mm below the CEJ [thin alveolar bone group (0.54±0.79) mm; thick alveolar bone group (0.96±0.81) mm; t=-2.29, P=0.025], changes in alveolar bone thickness at 3 mm [thin alveolar bone group (0.49±0.70) mm; thick alveolar bone group (0.03±0.69) mm; t=2.89, P=0.009] and 6 mm below the CEJ [thin alveolar bone group (1.05±0.77) mm; thick alveolar bone group (0.57±0.97) mm; t=2.36, P=0.021] between the thin alveolar bone group and the thick alveolar bone group. Conclusions: Camouflage orthodontic treatment combined with PAOO can expand the labial movement range of the maxillary anterior teeth to a certain extent, facilitating safe labial displacement.At the completion of orthodontic treatment, sites with pre-existing bone dehiscence exhibit superior osteogenic outcomes. Furthermore, compared to those with thinner labial alveolar bone before orthodontic treatment, patients with thicker alveolar bone can achieve better labial movement outcomes. 目的： 探究牙周辅助加速成骨正畸（PAOO）术拓展成人骨性Ⅲ类错（牙合）畸形患者掩饰性正畸治疗中上前牙牙根唇向移动范围的疗效。 方法： 选取2016年8月至2024年12月于杭州口腔医院正畸科行掩饰性正畸治疗的轻中度成年骨性Ⅲ类错（牙合）畸形患者42例，按上前牙唇侧是否施行PAOO术分为2组（每组21例）：试验组，行掩饰性正畸治疗联合PAOO术；对照组，只进行单纯掩饰性正畸治疗。为进一步了解PAOO术对不同牙槽骨状况的正畸牙移动范围的疗效差异，将试验组上前牙根据如下特征划分亚组：①根据有无骨开窗/骨开裂分为骨开窗组、骨开裂组及非骨缺损组；②根据正畸前牙槽骨厚度分为薄牙槽骨组及厚牙槽骨组。正畸治疗前（T0）和结束时（T1）使用锥形束CT（CBCT）对上前牙釉质牙骨质界（CEJ）水平下3、6、9 mm处进行影像学分析，用头颅侧位片测上牙槽座点（A点），以分析正畸前后上前牙牙根唇向位移量、牙槽骨厚度变化量、A点位置等指标的变化。 结果： 与对照组相比，试验组牙槽骨厚度变化量在上颌中切牙、侧切牙及尖牙CEJ下3、6、9 mm处均显著增加（均P<0.05）。与非骨缺损组相比，骨开裂组在CEJ下3 mm处的唇向位移量显著减少［非骨缺损组：（1.00±1.18）mm，骨开裂组：（0.31±0.70）mm；t=-2.18，P=0.034］、牙槽骨厚度显著增加［非骨缺损组（-0.05±0.83）mm，骨开裂组：（1.38±1.17）mm；t=4.49，P<0.001］。薄牙槽骨组与厚牙槽骨组在CEJ下3 mm处唇向位移量［薄牙槽骨组：（0.54±0.79）mm，厚牙槽骨组：（0.96±0.81）mm；t=-2.29，P=0.025］、CEJ下3 mm［薄牙槽骨组：（0.49±0.70）mm，厚牙槽骨组：（0.03±0.69）mm；t=2.89，P=0.009］、6 mm处牙槽骨厚度变化量［薄牙槽骨组：（1.05±0.77）mm，厚牙槽骨组：（0.57±0.97）mm；t=2.36，P=0.021］差异均有统计意义。 结论： 掩饰性正畸治疗联合PAOO术可在一定程度上拓展上前牙唇向移动范围，有助于上前牙唇向安全移动；正畸术后可见骨开裂牙成骨疗效更佳；与正畸前唇侧牙槽骨厚度较薄者相比，拥有较厚牙槽骨可获得更优的唇向移动疗效。.
Objective: To investigate the consistency between the small open-close movement trajectories of the mandibular incisor point in healthy subjects and the theoretical hinge axis circular movement trajectory, and to analyze the influence of the starting mandibular position on these trajectories. Methods: Twenty healthy volunteers, including 11 men and 9 women, were recruited from the postgraduate student population of the Department of Prosthodontics, Peking University School and Hospital of Stomatology. The age of the participants was (28.0±5.6) years. Mandibular small open-close movement trajectories initiated from the centric relation position (CRP) and the intercuspal position (ICP) were recorded using the mandibular movement recording system, designated as CRP group and ICP group, respectively. Multi-source data from the subjects were used to construct static virtual patients, and the theoretical hinge axis circular movement trajectory of the mandibular incisor point was virtually constructed as the reference group. Trajectory deviation and trajectory flatness between CRP or ICP group and reference groups were calculated in the mathematical computing software, followed by statistical analysis to verify the influence of the CRP or ICP starting position on the small open-close movement trajectory of the mandibular incisor point. Results: Trajectory deviation for small open-close movements initiated from CRP and ICP in the 20 subjects was (1.07±0.17) and (1.08±0.17) mm (t=0.30, P=0.767), respectively. Trajectory flatness for the CRP and ICP-initiated small open-close movement trajectories was (0.54±0.15) and (0.59±0.12) mm (t=1.20,P=0.245), respectively. Conclusions: The small open-close movement trajectories of the mandibular incisor point initiated from both CRP and ICP exhibit good circular movement characteristics, with the starting position showing no significant influence on the trajectory. 目的： 分析健康受试者下颌切点的小开闭口运动轨迹与经验铰链轴（AHA）运动轨迹的一致性，探讨起始颌位对下颌切点小开闭口运动轨迹的影响。 方法： 于北京大学口腔医学院·口腔医院修复科研究生群体中招募20名健康志愿者（男性11名，女性9名）作为受试者，年龄（28.0±5.6）岁。使用下颌运动记录系统采集受试者下颌切点（下颌左右中切牙近中切点连线的中点）以正中关系位（CRP）或牙尖交错位（ICP）为起始颌位的小开闭口运动轨迹，作为实验组（分别为CRP组和ICP组）。用受试者多源数据构建静态虚拟患者，并虚拟构建下颌切点AHA运动（以AHA为轴的圆周运动）轨迹作为参考组。在数学计算软件中分别计算2个实验组与参考组轨迹之间的轨迹偏差和轨迹平面偏差，并进行统计学比较，以分析以CRP和ICP为起始颌位对受试者下颌切点小开闭口运动轨迹的影响。 结果： CRP组和ICP组轨迹偏差分别为（1.07±0.17）和（1.08±0.17）mm（t=0.30，P=0.767），CRP组和ICP组轨迹平面偏差分别为（0.54±0.15）和（0.59±0.12）mm（t=1.20，P=0.245），两组差异均无统计学意义。 结论： 下颌切点以CRP和ICP为起始颌位的小开闭口运动轨迹均呈现良好的圆周运动特征，与AHA运动轨迹的一致性较好。.