Objective: To systematically explore the intervention efficacy of annexin A5 (AnxA5) on temporomandibular joint osteoarthritis (TMJOA) induced by complete Freund's adjuvant (CFA) in rats. Methods: Thirty-two 6-week-old male SD rats (weighing 200-250 g) were assigned to histological analysis (n=20) or micro-CT analysis (n=12). The TMJOA model was established by bilateral intra-articular injection of CFA, while the control group received saline. Three days later, TMJOA rats were randomly divided into three groups (n=8 each): CFA model group (saline injection), CFA+HA group [hyaluronic acid (HA), once weekly for 2 weeks], and CFA+AnxA5 group (AnxA5 injection every 3 days for 4 injections). The saline group was injected with the same frequency and dosage of saline as that of AnxA5. The changes in the structure of the temporomandibular joint were observed through HE and safranin O-eosin green staining, and the total thickness of the cartilage (TC), the thickness of the hypertrophic chondrocyte layer (HL), the thickness of the fibrocartilage layer (FL), as well as the thickness of the anterior band (A), Intermediate zone (In) and posterior bands (P) of the articular disc were measured.The changes in the content of glycosaminoglycans in the condylar cartilage matrix were observed by Alcian blue and toluidine blue staining. The contents of MMP 13, collagen Ⅱ and TNF-α in the condylar cartilage matrix were observed by Immunohistochemical staining. The infiltration quantity of M1-type macrophages was observed by immunofluorescence staining. The situation of subchondral bone remodeling of the condyle was observed by micro-CT, data such as bone volume fraction (BV/TV), trabecular number (Tb.N), and trabecular thickness (Tb.Th) were collected and calculated. Results: The results of HE and safinin-O fast green staining showed that compared with the thickness of each layer of cartilage and the thickness of the articular disc in the saline group [TC: (306.85±39.87) μm, HL: (123.16±27.19) μm, FL: (43.87±7.01) μm, A: (263.55±13.55) μm, In: (155.91±26.80) μm, P: (263.12±36.21) μm], the TC and HL in the CFA model group were significantly thinner [(218.30±38.32) and (79.90±18.54) μm ](P<0.001), FL was significantly thicker [(67.69±13.46) μm] (P<0.001), and the A, In and P of the articular disc were significantly thicker [respectively (305.27±23.37), (200.96±18.75) and (321.92±16.86) μm] (P<0.001). Compared with the CFA model group, the TC [(252.76±32.23) and (270.37±21.87) μm] and HL [(108.15±11.13) and (108.41±17.30) μm] in the CFA+HA treatment group and the CFA+AnxA5 intervention group were significantly thicker (P<0.05), while FL [(46.08±5.99) and (45.58±5.27) μm] was significantly thinner (P<0.01). The thickness of the A, In and P of the articular disc in the CFA+HA treatment group [(272.54±19.66), (180.24±14.47) and (273.79±29.28) μm] and in the CFA+AnxA5 intervention group [(263.66±10.68), (168.60±9.87) and (279.31±25.79) μm] were significantly thinner (P<0.05). The results of Alcian blue and toluidine blue staining showed that in the saline group, the staining of the condylar hypertrophic layer was obvious and uniform, while in the CFA model group, it was lightly stained, and in some areas, it was even unstained. After treatment with HA and AnxA5, the staining became relatively intense, and the loss of glycosaminoglycans slowed down.The IHC staining results showed that compared with the saline group (MMP13: 0.24±0.03,COL-Ⅱ:0.36±0.12), the content of MMP13 increased (0.37±0.07), and the content of COL-Ⅱ decreased (0.16±0.03) (both P<0.001). Compared with the CFA model group, the CFA+HA treatment group and the CFA+AnxA5 intervention group showed significantly decreased MMP13 levels (0.29±0.04 and 0.29±0.08) (both P<0.05) and significantly increased COL-Ⅱ levels (0.21±0.04 and 0.22±0.03, both P<0.01).The results of HE and IF staining showed that compared with the saline group, there was a large infiltration of inflammatory cells in the synovium of rats in the CFA model group and the number of M1-type macrophages increased (P<0.001). Compared with the CFA model group, both the CFA+HA treatment group and the CFA+AnxA5 intervention group showed a significant reduction in M1 macrophage numbers (P<0.05, P<0.01). The IHC staining results showed that compared with the saline group, the content of TNF-α in the CFA model group increased (P<0.001), while in the CFA+HA treatment group and CFA+AnxA5 intervention group, the content of TNF-α decreased (P<0.05;P<0.001).The Micro-CT results showed that compared with the saline group, the CFA model group exhibited significant decreases in condylar BV/TV, Tb.N, and Tb.Th (P<0.001, P<0.01, P<0.001).The difference between the CFA+HA treatment group and the CFA model group was not statistically significant. Compared with the CFA model group, the CFA+AnxA5 intervention group showed significantly higher BV/TV, Tb.N and Tb.Th (P<0.01, P<0.05, P<0.05). Conclusions: In the CFA-induced inflammation-dominated rat TMJOA model, AnxA5 can protect cartilage homeostasis, inhibit synovial inflammatory response, and simultaneously improve abnormal subchondral bone remodeling. 目的： 系统探究膜联蛋白A5（AnxA5）对弗式完全佐剂（CFA）诱导的大鼠颞下颌关节骨关节炎（TMJOA）的干预疗效。 方法： 本实验选取6周龄雄性SD大鼠（体重200~250 g）32只（其中20只用于组织学检测，12只用于显微CT检测），采用双侧关节腔内注射生理盐水或CFA法分别建立大鼠对照模型（生理盐水组8只）和TMJOA模型（24只）。3天后，将TMJOA模型大鼠按照随机数字表法分为3组，每组8只；注射与AnxA5频次及用量一致的生理盐水为CFA模型组；每周注射1次透明质酸（HA），连续注射2次为CFA+HA治疗组；每隔3天注射1次AnxA5，连续注射4次，为CFA+AnxA5干预组；生理盐水组注射与AnxA5频次及用量一致的生理盐水。通过HE和番红O-固绿染色观察颞下颌关节结构的改变，并测量软骨总厚度（TC）、肥大软骨细胞层（HL）、纤维软骨层（FL）的厚度，以及关节盘前带、中带、后带的厚度；通过阿利新蓝和甲苯胺蓝染色观察髁突软骨基质中糖胺聚糖含量的变化；通过免疫组织化学染色（IHC）观察髁突软骨基质中基质金属蛋白酶13（MMP13）、Ⅱ型胶原蛋白（COL-Ⅱ）和肿瘤坏死因子α（TNF-α）含量的变化；通过免疫荧光染色（IF）观察M1型巨噬细胞的浸润数量；通过显微CT观察髁突软骨下骨重塑的情况，采集计算骨体积分数（BV/TV）、骨小梁数量（Tb.N）和骨小梁厚度（Tb.Th）数据。 结果： HE染色和番红O-固绿染色结果显示，与生理盐水组的软骨各层厚度［TC、HL、FL分别为（306.85±39.87）、（123.16±27.19）和（43.87±7.01）μm］及关节盘厚度［前带、中带、后带分别为（263.55±13.55）、（155.91±26.80）和（263.12±36.21）μm］相比，CFA模型组大鼠的TC和HL［（218.30±38.32）和（79.90±18.54）μm］均显著变薄（均P<0.001），FL［（67.69±13.46）μm］显著增厚（P<0.001），关节盘前带、中带、后带［分别为（305.27±23.37）、（200.96±18.75）和（321.92±16.86）μm］均显著增厚（P<0.001）；与CFA模型组相比，CFA+HA治疗组和CFA+AnxA5干预组的TC［（252.76±32.23）和（270.37±21.87）μm］及HL［（108.15±11.13）和（108.41±17.30）μm］均显著增厚（P<0.05），FL［（46.08±5.99）和（45.58±5.27）μm］均显著变薄（P<0.01），关节盘前带、中带和后带厚度［CFA+HA治疗组分别为（272.54±19.66）、（180.24±14.47）和（273.79±29.28）μm，CFA+AnxA5干预组分别为（263.66±10.68）、（168.60±9.87）和（279.31±25.79）μm］均显著变薄（P<0.05）。阿利新蓝和甲苯胺蓝染色结果显示，生理盐水组髁突肥大层染色明显且均匀，CFA模型组淡染，部分区域甚至失染，CFA+HA治疗组和CFA+AnxA5干预组染色相对浓郁，糖胺聚糖流失减缓。IHC结果显示，与生理盐水组的MMP13（0.24±0.03）和COL-Ⅱ（0.36±0.12）相比，CFA模型组的MMP13含量（0.37±0.07）显著升高，COL-Ⅱ含量（0.16±0.03）显著降低（均P<0.001）；与CFA模型组相比，CFA+HA治疗组和CFA+AnxA5干预组的MMP13含量（0.29±0.04和0.29±0.08）均显著降低（均P<0.05），COL-Ⅱ含量（0.21±0.04和0.22±0.03）均显著升高（均P<0.01）。HE和IF染色结果显示，与生理盐水组相比，CFA模型组大鼠滑膜大量炎症细胞浸润，M1型巨噬细胞数量增多（P<0.001），与CFA模型组相比，CFA+HA治疗组和CFA+AnxA5干预组的M1型巨噬细胞数量均显著减少（P<0.05，P<0.01）。IHC染色结果显示，相比于生理盐水组，CFA模型组TNF-α含量显著升高（P<0.001）；与CFA模型组相比，CFA+HA治疗组和CFA+AnxA5干预组中TNF-α的含量显著降低（P<0.05；P<0.001）。显微CT结果显示，与生理盐水组相比，CFA模型组大鼠髁突的BV/TV、Tb.N、Tb.Th均显著降低（P<0.001，P<0.01，P<0.001）；CFA+HA治疗组与CFA模型组的差异无统计学意义（P>0.05）；CFA+AnxA5干预组的BV/TV、Tb.N和Tb.Th均显著高于CFA模型组（P<0.01，P<0.05，P<0.05）。 结论： 在CFA诱导的炎症主导型大鼠TMJOA模型中，AnxA5可保护软骨稳态、抑制滑膜炎症反应，同时改善软骨下骨异常重塑。.
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 investigate the current application status and potential of artificial intelligence (AI) large language models (LLM) in oral mucosal disease consultation. Methods: A questionnaire survey was conducted to inform the utilization of AI for oral mucosal disease-related consultations among patients attending the Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University in November 2025, and to compare the factors influencing AI usage behavior and satisfaction. Nine standardized clinical questions concerning the etiology, symptoms, treatment, care, and prognosis of oral leukoplakia (OLK) were put into major LLM platforms. The responses were quantitatively scored by ten oral medicine specialists for accuracy, clarity, relevance, completeness, and practicality using the Quality Analysis of Medical Artificial Intelligence (QAMAI) tool. Concurrently, the readability of the responses was assessed using the Alpha Readability Chinese (ARC) tool. Results: A total of 200 patients with oral mucosal diseases were included. Only 37.5% (75/200) had ever used AI for related consultations. AI usage rate was significantly correlated with younger age and higher education level (P<0.001). Merely 40.0% (30/75) of users were relatively satisfied with current AI consultations, and only 21.3% (16/75) would adopt AI's treatment or care suggestions. However, 96.0% (72/75) expressed positive willingness to continue using AI for future consultations. Based on the QAMAI total scores for the nine typical OLK-related clinical questions, DeepSeek (25.4 points) and Tencent Hunyuan (25.3 points) performed best, rated as "very good quality", while the other models were rated "good quality." All models scored relatively low on the "sources and references" dimension. ARC readability analysis indicated that ByteDance Doubao had the best readability (weighted total score 0.511), while DeepSeek and Tencent Hunyuan had relatively poor readability (0.358 and 0.369, respectively). Conclusions: This study indicates that while current usage rates and satisfaction with AI consultation among patients with oral mucosal diseases need improvement, the future willingness to use it is strong. The systematic evaluation of six mainstream Chinese LLMs reveals significant disparities in their professional information quality and text readability for OLK consultation, alongside a prevalent lack of reliable evidence-based support. This underscores that enhancing the comprehensive quality of AI-generated responses is crucial for realizing its clinical application value. 目的： 探讨人工智能（AI）大语言模型（LLM）在口腔黏膜病疾病咨询中的应用现状与潜力。 方法： 通过问卷调查的形式了解2025年11月于四川大学华西口腔医院口腔黏膜病科就诊患者使用AI进行口腔黏膜病相关咨询的情况，并对AI使用行为和满意度的影响因素进行比较。将收集的口腔白斑病患者关注的病因、症状、治疗、护理、转归等方面的9个临床问题进行标准化后输入6种主流LLM平台（Kimi、字节豆包、通义千问、文心一言、腾讯混元、DeepSeek）获取回答，根据医学AI质量分析工具（QAMAI）的要求，由10名口腔黏膜病专科医师对获得回答的准确性、清晰度、相关性、完整性和实用性进行量化打分；同时，使用汉语文本可读性工具ARC评估回答的可读性。 结果： 本研究共纳入200例口腔黏膜病患者，仅37.5%（75/200）曾使用过AI进行口腔黏膜病相关咨询。AI使用率与年龄、受教育程度显著相关（P<0.001）。仅40.0%（30/75）的患者对当前AI咨询较为满意，仅21.3%（16/75）的患者会采纳AI的治疗或护理建议，而96.0%（72/75）的患者对未来继续使用AI进行咨询表现出积极意愿。与口腔白斑病相关的9个典型临床咨询问题的QAMAI总分显示，DeepSeek（25.4分）和腾讯混元（25.3分）表现最佳，评价等级为“质量非常好”，其余模型则被评为“质量良好”。在“来源与参考文献”维度，各模型普遍得分较低。ARC可读性分析显示，字节豆包的可读性最佳（加权总分0.511分），而DeepSeek和腾讯混元的可读性相对较差（分别为0.358和0.369分）。 结论： 当前口腔黏膜病患者对AI咨询的使用率与满意度均有待提升，但其未来使用意愿强烈；6种主流中文LLM在口腔白斑病咨询中的专业质量与文本可读性存在显著差异，且普遍缺乏可靠的循证支持，提示提升AI回答的综合质量是实现其临床应用价值的关键。.
Objective: To investigate the differences in the changes of periodontal ligament area (PDLA) and related clinical indicators before and after maxillary central incisor movement under different orthodontic treatment regimens. Methods: This study was designed as a retrospective case-control trial. A total of 49 orthodontic patients (98 maxillary central incisors) who received the treatment in the Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, from May 2021 to December 2022 were enrolled. The cone beam CT (CBCT) images and medical records before and after treatment were collected. Patients were divided into two groups based on extraction or anchorage type: extraction group (52 incisors) and non-extraction group (46 incisors), implant anchorage group (41 incisors) and non-implant anchorage group (57 incisors). The PDLA of the bilateral maxillary central incisors before and after treatment in each group were measured using the CBCT periodontal ligament segmentation network. Orthodontic measurement and analysis software were adopted to determine the root length, palatal displacement of the incisal edge and apex, and the inclination angle of maxillary central incisors (U1-NA angle). The reduction in root length (ΔRL) and its percentage (ΔRL%), the reduction in PDLA (ΔPDLA) and its percentage (ΔPDLA%), as well as the reduction in U1-NA angle (ΔU1-NA angle) after orthodontic treatment were calculated. The Mann-Whitney U test was used to compare the differences in each measurement index among the groups. Spearman's correlation analysis was performed to explore the correlations between the ΔPDLA and the palatal displacement of the incisal edge, ΔU1-NA angle, and ΔRL of the maxillary central incisors. Results: After orthodontic treatment, the ΔRL, ΔRL% and ΔPDLA in the extraction group were 0.82 (0.85) mm, 6.34% (7.29%) and 9.89 (15.98) mm2, respectively, showing significant differences compared with those in the non-extraction group [0.45 (0.71) mm, 3.89% (7.99%), 5.46 (8.65) mm2] (all P<0.05). Whereas there was no statistically significant difference in ΔPDLA% between the extraction group and the non-extraction group (P>0.05). No statistically significant differences were observed in ΔRL, ΔRL%, ΔPDLA, or ΔPDLA% between the implant anchorage group and the non-implant anchorage group (P>0.05). The palatal displacement of the incisal edge and ΔU1-NA angle of the maxillary central incisors in the extraction group were 2.90 (4.05) mm and 6.69°±7.90°, respectively, which were significantly greater than those in the non-extraction group [-0.25 (3.28) mm, -1.60°±9.17°] (both P<0.05). The palatal displacement of the incisal edge [2.70 (4.95) mm] in the implant anchorage group were also significantly larger than those in the non-implant anchorage group [1.00 (3.25) mm] (P<0.05). The ΔPDLA was significantly positively correlated with the palatal displacement of the incisal edge (r=0.44, P<0.001), ΔRL (r=0.36, P<0.001), and ΔU1-NA angle (r=0.42, P<0.001), with the strongest correlation observed between ΔPDLA and the palatal displacement of incisal edge. Conclusions: Although extraction treatment increased root resorption during the palatal movement of maxillary central incisors, it did not significantly affect the PDLA of these teeth. Implant anchorage did not increase the risk of the root resorption or PDLA reduction during the palatal movement of maxillary central incisors. Compared with the measurement of RL, the application of the CBCT periodontal ligament segmentation network for PDLA measurement enabled a more comprehensive evaluation of changes in the periodontal supporting tissues of the maxillary central incisors. 目的： 通过锥形束CT牙周膜分割网络探讨不同矫治方案移动上颌中切牙前后牙周膜面积（PDLA）及相关临床指标变化量的差异。 方法： 本项研究为回顾性病例对照研究，收集2021年5月至2022年12月于首都医科大学附属北京友谊医院口腔科就诊的49例（98颗上颌中切牙）错(牙合)患者正畸治疗前后的锥形束CT及病历资料，根据是否进行减数正畸治疗以及是否使用种植体支抗分别将研究对象分为减数正畸组（52颗）与非减数正畸组（46颗），种植体支抗组（41颗）与非种植体支抗组（57颗）。采用锥形束CT牙周膜分割网络测量各组患者正畸治疗前后双侧上颌中切牙PDLA，采用正畸测量分析软件测量上颌中切牙牙根长度（RL）、切缘及根尖点腭向移动量及上颌中切牙倾斜角度（U1-NA角），计算正畸治疗前后上颌中切牙RL减少量（ΔRL）及减少比值（ΔRL%）、PDLA减少量（ΔPDLA）及PDLA减少比值（ΔPDLA%）和U1-NA角减少量（ΔU1-NA角）；采用Mann-Whitney U检验比较各组各指标差异，采用Spearman相关性分析探讨ΔPDLA与上颌中切牙切缘点腭向移动量、ΔU1-NA角及ΔRL的相关关系。 结果： 减数正畸组ΔRL、ΔRL%、ΔPDLA分别为0.82（0.85）mm、6.34%（7.29%）、9.89（15.98）mm2，均显著大于非减数正畸组［0.45（0.71）mm、3.89%（7.99%）、5.46（8.65）mm2］（均P<0.05）；而减数正畸组ΔPDLA%与非减数正畸组差异无统计学意义（P>0.05）。种植体支抗组与非种植体支抗组ΔRL、ΔRL%、ΔPDLA、ΔPDLA%差异均无统计学意义（均P>0.05）。减数正畸组上颌中切牙切缘点腭向移动量和ΔU1-NA角分别为2.90（4.05）mm、6.69°±7.90°，均显著大于非减数正畸组［-0.25（3.28）mm、-1.60°±9.17°］（均P<0.05）；种植体支抗组上颌中切牙切缘点腭向移动量［2.70（4.95）mm］显著大于非种植体支抗组［1.00（3.25）mm］（P<0.05）。ΔPDLA与上颌中切牙切缘点腭向移动量（r=0.44，P<0.001）、ΔRL（r=0.36，P<0.001）、ΔU1-NA角（r=0.42，P<0.001）均呈显著正相关，且与上颌中切牙切缘点腭向移动量相关程度最高。 结论： 减数正畸虽在上颌中切牙腭向移动过程中可增加牙根吸收，但未显著影响上颌中切牙PDLA；种植体支抗未增加上颌中切牙腭向移动过程中牙根吸收及PDLA减小的风险；相比RL的测量，应用锥形束CT牙周膜分割网络测量PDLA能更全面评价上颌中切牙牙周支持组织的变化。.
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 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 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 (ALP, RUNX2, 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 blot 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 (0.879±0.020, 1.045±0.059, 1.173±0.082, respectively) were significantly higher than those in the Irradiation group (0.749±0.031, 0.858±0.050, 0.785±0.073, respectively) (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（ALP、RUNX2、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天，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（分别为0.879±0.020、1.045±0.059、1.173±0.082）均显著高于4 Gy辐照组（分别为0.749±0.031、0.858±0.050、0.785±0.073）（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 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 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。.
Objective: To identify the active ingredients of modified-Zengshengping (ZSP-M) that inhibit the progression of oral squamous cell carcinoma (OSCC) through salivary metabolomics and computer virtual screening, and to screen potential key pharmacodynamic substances. Methods: An experimental tongue OSCC model induced by 4-nitroquinoline-1-oxide (4NQO) was established in 20 C57BL/6 mice. The experiment was divided into a normal group, a 4NQO group, a Zengshengping-original (ZSP-O) group, and a ZSP-M group (n=5). After 24 weeks, the number and volume of tongue tumors were recorded, and the tongue tissue was subjected to HE staining to calculate epithelial structure and cellular characteristic scores. Twelve SD rats were divided into a treatment group and a control group. They were administered ZSP-M or distilled water via gavage, and saliva samples were collected three days later. The prototype components of ZSP-M in saliva were analyzed and identified using ultra-high-performance liquid chromatography-tandem mass spectrometry. The prototype components were further subjected to computer-based absorption, distribution, metabolism, excretion, toxicity prediction, and molecular docking to screen potential key pharmacodynamic substances of interest. The impact of these potential key pharmacodynamic substances on the proliferation of human tongue squamous cell carcinoma cell lines CAL27 and SCC25 was evaluated using cell counting kit-8 assay. Results: The tumor incidence of OSCC in the ZSP-M group of C57BL/6 mice [(1.60±0.24) tumors] was significantly lower than that in the 4NQO group [(2.60±0.24) tumors] (P<0.05), and the pathological score of cytological features [(5.40±0.55) points] was significantly lower than that in the 4NQO group [(7.40±0.55) points] (P<0.05). A total of 16 prototype components entered the saliva, with 10 in positive ion mode and 6 in negative ion mode. Through computer-aided virtual screening, maackiain (MA), scutellarin (SC), chlorogenic acid (CGA), and vitexin-2-O-rhamnoside (VOR) were identified as potential key pharmacodynamic substances with strong binding potential to target proteins. In vitro experimental results showed that all four key pharmacodynamic substances could inhibit the proliferation of CAL27 and SCC25 at 48 and 72 hours (all P<0.05). Compared to the control group, the most significant proliferation inhibition occurred at a high concentration of 100 μmol/L (P<0.01), with the inhibitory effect weakened when the concentration was reduced to 10 μmol/L. Among them, MA demonstrated the most outstanding effect, with an SCC25 cell inhibition rate of (15.16±0.28)% after 72 hours of treatment with 100 μmol/L concentration (P<0.001). Conclusions: ZSP-M can inhibit the development of experimental OSCC, and MA, SC, VOR, and CGA have been identified as potential key pharmacological substances for ZSP-M to enter saliva and exert anticancer activity, reflecting the characteristics of multi-component and multi-target treatment in traditional Chinese medicine formulas. 目的： 通过唾液代谢组学与计算机虚拟筛选，鉴定改良增生平（ZSP-M）阻断口腔鳞状细胞癌（OSCC）进展的有效成分，筛选潜在的关键药效物质。 方法： 在20只C57BL/6小鼠中建立4-硝基喹啉-1-氧化物（4NQO）诱导的实验性舌OSCC模型，实验分为正常组、4NQO组、增生平原方（ZSP-O）组和ZSP-M组，每组5只，24周后记录各组小鼠舌背肿物数量及体积，对舌体组织进行HE染色，计算组织结构和细胞学特征得分。将12只SD大鼠分为给药组和对照组，每组6只，进行ZSP-M或蒸馏水灌胃，3 d后收集唾液，利用超高效液相色谱-质谱联用技术分析鉴定ZSP-M的入唾液原型成分。对原型成分进行计算机吸收、分布、代谢、排泄、毒性预测和分子对接，筛选值得关注的潜在关键药效物质。通过细胞计数评估潜在关键药效物质对人舌鳞状细胞癌细胞系CAL27和SCC25增殖的影响。 结果： ZSP-M组C57BL/6小鼠舌部OSCC的肿瘤发生数量［（1.60±0.24）个］显著少于4NQO组［（2.60±0.24）个］（P<0.05），细胞学特征病理评分［（5.40±0.55）分］显著低于4NQO组［（7.40±0.55）分］（P<0.05）。共16个原型成分进入唾液，正离子模式下10个，负离子模式下6个，经过计算机辅助虚拟筛选，确定高丽槐素、野黄芩苷、绿原酸、牡荆素-2-O-鼠李糖苷（VOR）为潜在的关键药效物质，与靶点蛋白具有较强的结合可能性。体外实验结果显示，4个关键药效物质均能在48、72 h显著抑制CAL27、SCC25增殖（均P<0.05），与对照组相比，在100 μmol/L的高浓度处理下，药效物质的增殖抑制作用最显著（P<0.01），浓度降低至10 μmol/L时，抑制作用减弱。其中，高丽槐素效果最突出，与对照组相比，100 μmol/L高丽槐素处理72 h后，SCC25细胞的抑制率为［（15.16±0.28）%］（P<0.001）。 结论： ZSP-M能抑制实验性OSCC的发展，高丽槐素、野黄芩苷、绿原酸、VOR被确定为ZSP-M进入唾液并发挥抗癌活性的潜在关键药效物质，体现了中药复方多成分、多靶点治疗的特点。.
Objective: To investigate the incidence of the foramen of Huschke (FH) in the tympanic plate using cone beam CT (CBCT), to measure its morphological dimensions, and to evaluate potential associations with side (left/right) and gender. Methods: A retrospective review was conducted on CBCT scans from 400 patients (representing 800 tympanic plate sides) examined at the Hospital of Stomatology, Jilin University between January and June 2024. The cohort included 192 males and 208 females, with a median age (interquartile range) of 34 years (19, 52).Two radiologists identified the FH and measured its size on multi-planar reconstructed images. The presence of the FH was compared regarding gender and side. Differences in FH size between left and right sides in the axial, sagittal, and coronal planes, as well as size differences between genders within the same planes, were analyzed. The potential influence of age and gender on FH incidence, along with the relationship between age and FH size in the axial plane, were also assessed. A p-value of less than 0.05 was considered statistically significant. Results: The overall incidence of FH was 19.5% (78/400, 95%CI: 0.156-0.234), comprising a unilateral incidence of 13.0% (52/400, 95%CI: 0.098-0.162) and a bilateral incidence of 6.5% (26/400, 95%CI:0.041-0.089). The incidence rate was 6.8% (54/800, 95%CI: 0.051-0.085) for the left side and 6.3% (50/800, 95%CI: 0.046-0.079) for the right side. No statistically significant difference in FH incidence was observed between males and females (P>0.05), nor was there a significant difference in the side of occurrence between genders (P>0.05). However, binary logistic regression indicated a trend towards significance for gender (OR=0.615, 95%CI: 0.371-1.021, P=0.060). The FH morphology was generally oval. The median FH size was 2.0 (1.54, 2.37) mm in the axial plane, 1.82 (1.53, 2.33) mm in the sagittal plane, and 2.18 (1.69, 2.67) mm in the coronal plane. No significant differences in FH size were found between the left and right sides across these planes (P>0.05), nor were there significant size differences between males and females in any plane (P>0.05). Binary logistic regression and Spearman correlation analysis revealed no significant association between age and FH incidence (OR=0.998, P=0.753), or between age and FH size in the axial plane (left side P=0.915, right side P=0.702). Conclusions: The incidence of the foramen of Huschke, is approximately 19.5%. It typically exhibits an oval shape. The presence and size of the FH appear stable in adulthood, showing no significant correlation with age. CBCT proves to be an effective imaging modality for visualizing the tympanic plate and holds significant value for the clinical diagnosis and preoperative assessment of the foramen of Huschke. 目的： 利用锥形束CT（CBCT）探究颞骨鼓板上胡施克氏孔（FH）的发生率并测量分析其形态大小，评估其与左右侧别、性别的关联差异，为耳部及颞下颌关节疾病的临床诊断与治疗提供数据参考。 方法： 回顾性分析2024年1至6月于吉林大学口腔医院行CBCT检查的400例（800侧颞骨鼓板）患者的影像资料，其中男性192例，女性208例，年龄为34（19，52）岁。由两名放射科主治医师在多平面重建图像上识别并测量FH的孔径大小，孔径大小用“M（Q1，Q3）”表示。分析比较不同性别及侧别FH存在差异。左侧与右侧FH在横断面、矢状面及冠状面的大小差异及同一截面不同性别患者的FH孔径大小差异。分析年龄和性别对FH发生率的影响，以及年龄与FH横断面大小的关系。 结果： FH的总发生率为19.5%（78/400，95%CI：0.156~0.234），其中单侧FH发生率为13.0%（52/400，95%CI：0.098~0.162），双侧为6.5%（26/400，95%CI：0.041~0.089）。不同侧FH发生率（基于侧数）分别为：左侧6.8%（54/800，95%CI：0.051~0.085），右侧6.3%（50/800，95%CI：0.046~0.079）。男性与女性的FH发生率、发生侧别差异均无统计学意义（P>0.05）；但二元Logistic回归提示性别影响因素处于边缘显著水平（OR=0.615，95%CI：0.371~1.021，P=0.060）。FH形态大致呈椭圆形，横断面孔径为2.0（1.54，2.37）mm，矢状面孔径为1.82（1.53，2.33）mm，冠状面孔径为2.18（1.69，2.67）mm，在以上3个CBCT截面所测得的左右两侧FH孔径大小、男性与女性的FH孔径大小差异均无统计学意义（P>0.05）。二元Logistic回归及 Spearman 相关分析显示，年龄与FH发生率（OR=0.998，P=0.753）、横断面上孔径大小（左侧P=0.915，右侧P=0.702）均无显著关联。 结论： FH在CBCT影像中的发生率约为19.5%，形态呈椭圆形，其存在与大小在成年后趋于稳定，与年龄无显著相关。CBCT可有效地呈现颞骨骨板影像，对临床诊断与术前评估FH具有重要参考价值。.
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 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。.
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 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。.
The past decade has been a critical period for Oral Emergency Medicine in China, marked by a transition from decentralized practice to systematic development and from experience-based care to guideline-oriented approaches. With the establishment of the Society of Oral Emergency Committee of Chinese Stomatological Association in 2016 as a milestone, the discipline oral emergency medicine has achieved remarkable progress in academic development, clinical services, personnel training, and scientific research. These achievements include the establishment of a discipline connotation tailored to Chinese specific conditions, continuous improvement in diagnostic and therapeutic standards and service accessibility, steady advancement in standardization, the initial formation of a professional workforce, and a significant increase in international influence. Meanwhile, the discipline still faces challenges, including an underdeveloped theoretical framework, imbalanced regional resource allocation, a shortage of specialized professionals, and imperfect multidisciplinary collaboration mechanisms. Drawing on international practices related to oral emergencies and the development experience of emergency medicine in China, this article proposes future goals for discipline construction: establishing a clear disciplinary status, building a systematic theoretical framework, improving the clinical service chain, strengthening the personnel training mechanism, and building scientific research platforms. These efforts aim to advance oral emergency medicine in China from initial establishment to mature development, providing robust support for the"Healthy China"strategy. 过去10年是中国口腔急诊医学从分散实践到系统发展、从经验主导到规范引领的关键时期。以2016年中华口腔医学会口腔急诊专业委员会成立为里程碑，我国口腔急诊医学在学科建设、临床服务、人才培养及科学研究等领域取得显著成就，确立了符合国情的学科内涵，诊疗水平与服务可及性持续提升，规范化建设稳步推进，人才队伍初具规模，国际影响力显著增强。同时，学科发展仍面临理论体系尚未形成、区域资源配置不均衡、专业人才储备不足、多学科协同机制不完善等挑战。本文借鉴国际口腔急诊相关实践及国内急诊医学发展经验，提出未来学科建设目标：明确学科定位、构建系统理论体系、完善临床服务链条、健全人才培养机制、搭建科研创新平台，以推动中国口腔急诊医学从初步形成走向成熟发展，为“健康中国”战略提供有力支撑。.
Objective: To develop an automatic oral lesion segmentation model (TopoFormer) that integrates topological data analysis (TDA) with a Transformer architecture, thereby improving the accuracy and robustness of lesion segmentation for oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC). Methods: Experiments were conducted on a public comprehensive oral cavity image dataset released by Piyarathne et al., containing 2 271 oral white-light photographs from 623 patients and covering three categories: At the patient level, the data were stratified and randomly split into training, validation, and test sets with a ratio of 0.8/0.1/0.1. SegFormer was used as the backbone network, and a self-designed topological attention module (TAM) was embedded in the deep feature space. TAM leveraged persistent homology to extract robust topological structures from feature maps and dynamically suppressed low-persistence noise. Performance was evaluated using the Dice similarity coefficient (DSC), mean intersection over union (mIoU), mean pixel accuracy (mPA), 95% Hausdorff distance (HD95), and Betti number error (BNE), and was compared with mainstream segmentation networks (U-Net, DeepLabV3+, and SegFormer). Results: On the test set, TopoFormer achieved a DSC of 0.801, an mIoU of 71.1%, an mPA of 82.31%, reduced HD95 to 9.62 pixels, and obtained a BNE of 1.28. Compared with the baseline model, the proposed model effectively reduced false positives caused by specular reflections and produced smoother and more continuous lesion boundaries. Conclusions: TopoFormer demonstrates higher accuracy and robustness in segmenting OPMD and OSCC lesions. Topological priors can enhance segmentation performance in complex oral environments, indicating use potential in computer-aided diagnosis. 目的： 构建一种融合拓扑数据分析（TDA）与Transformer（变换器架构）的口腔病损自动分割模型（TopoFormer），提升口腔潜在恶性疾患（OPMD）及口腔鳞状细胞癌（OSCC）病损分割的准确性与鲁棒性。 方法： 本研究采用包含623例患者、共计2 271张Piyarathne等发布的综合口腔腔体图像公开数据集进行实验验证，数据涵盖口腔癌、OPMD及良性病变三类，以患者为单位按照0.8/0.1/0.1的比例分层随机划分训练集、验证集与测试集，以语义分割模型（SegFormer）为骨干网络，在深层特征空间嵌入自行设计的拓扑注意力模块（TAM）。该模块利用持续同调理论提取特征图中的稳健拓扑结构，动态抑制低持久性的噪声干扰。采用Dice相似系数（DSC）、平均交并比（mIoU）、平均像素精度（mPA）、95%豪斯多夫距离（HD95）及贝蒂数误差（BNE）作为评价指标，与主流分割网络（U-Net，DeepLabV3+，SegFormer）进行对比。 结果： 实验结果显示，本研究提出的 TopoFormer模型在测试集上的DSC达到0.801，mIoU达到71.1%，mPA达到82.31%，HD95降至9.62像素，贝蒂数误差为1.28。与基线模型相比，新模型有效减少了由反光引起的假阳性误判，且病损边缘分割更加平滑连续。 结论： TopoFormer在OPMD及OSCC病损分割中表现出更高的准确性与鲁棒性，拓扑先验能提升复杂口腔环境下的分割性能，具有辅助诊断的应用潜力。.