During restorative dental procedures,complete control over the operative site is critical for patient comfort,safety,and the operator’s access and visibility.The success of a fixed prosthesis depends on accurate impr...During restorative dental procedures,complete control over the operative site is critical for patient comfort,safety,and the operator’s access and visibility.The success of a fixed prosthesis depends on accurate impression making of the prepared finish lines on the abutment teeth.To optimise long-term outcomes for the fixed restoration,gingival retraction techniques should be used to decrease the marginal discrepancy among the restoration and the prepared abutment.Accurate marginal positioning of the restoration along the prepared finish line of the abutment is essential for therapeutic,preventive,and aesthetic purposes.展开更多
Two novel aggregation-induced emission(AIE)-active probes,TPA-H and TPA-2 F,were designed and synthesized based on a triphenylamine(TPA)core.Systematic characterization demonstrated that both probes exhibit excellent ...Two novel aggregation-induced emission(AIE)-active probes,TPA-H and TPA-2 F,were designed and synthesized based on a triphenylamine(TPA)core.Systematic characterization demonstrated that both probes exhibit excellent biocompatibility(cell viability>90%at concentrations up to 50μmol/L)and outstanding LD-targeting speci⁃ficity with minimal colocalization with other organelles such as mitochondria and lysosomes.During early differentia⁃tion of 3 T 3-L 1 adipocytes,both TPA-2 F and TPA-H clearly visualized small and nascent LDs that were difficult to be detected with BODIPY,indicating superior imaging sensitivity compared to the existing fluorescent probes for LDs.Moreover,TPA-2 F demonstrated exceptional photostability,retaining over 90%of its initial fluorescence intensity after 100 continuous laser scanning cycles,significantly outperforming TPA-H.This work not only provides two high-performance LD imaging tools but also highlights the potential of AIE luminogens(AIEgens)in organelle-specific bioimaging,offering promising avenues for early diagnosis and mechanistic research of lipid-related metabolic diseases.展开更多
Gel-based flexible wearable sensors have attracted considerable interest in aquatic environments.However,the development of underwater conductive gel sensors with outstanding anti-swelling,mechanical,and sensing capab...Gel-based flexible wearable sensors have attracted considerable interest in aquatic environments.However,the development of underwater conductive gel sensors with outstanding anti-swelling,mechanical,and sensing capabilities faces significant challenges.The aim of this study is to develop anti-swelling and conductive zwitterionic gels and investigate their applications in wireless underwater strain sensing.Multi-functional zwitterionic gels were fabricated by copolymerizing[2-(methacryloyloxy)ethyl]dimethyl-(3-sulfopropyl)ammonium hydroxide(SBMA)and acrylic acid(AA)in a mixed solution of aluminum chloride(AlCl3)and poly(vinyl alcohol)(PVA)under ultraviolet light(360 nm).PSBMA was switched from a neutral polymer to a positively charged polymer because of the combination of Al^(3+)with the negative groups SO_(3)^(−).The water molecules were eliminated because of electrostatic repulsion.The gels exhibited anti-swelling properties(swelling ratio<11%),high stretchability(600%strain),and toughness(2451 kJ/m^(3)).The PPAS-Al^(3+)gel was integrated with a wireless Bluetooth system to construct underwater wearable strain sensors that could accurately capture the signals caused by human joint movements and speech recognition even in water.Antibacterial activity(>98.9%inhibition)and stable wireless sensing have potential applications in the fields of wearable sensors,underwater communication,and intelligent healthcare.展开更多
Nociceptive pain is a cardinal feature of traumatic and inflammatory bone diseases.However,whether and how nociceptors actively regulate the immune response during bone regeneration remains unclear.Here,we found that ...Nociceptive pain is a cardinal feature of traumatic and inflammatory bone diseases.However,whether and how nociceptors actively regulate the immune response during bone regeneration remains unclear.Here,we found that neutrophil-triggered nociceptive ingrowth functioned as negative feedback regulation to inflammation during bone healing.A unique Il4ra^(+)Ccl2^(high) neutrophil subset drove intense postinjury TRPV1^(+)nociceptive ingrowth,which in return dissipated inflammation by activating the production of pro-resolving mediator lipoxin A4(LXA4)in osteoblasts.Mechanistically,osteoblastic autophagy activated by nociceptor-derived calcitonin gene-related peptide(CGRP)suppressed the nuclear translocation of arachidonate 5-lipoxygenase(5-LOX)to favor the LXA4 biosynthesis.Moreover,in alveolar bone from patients with Type Ⅱ diabetes,we found diminished nociceptive innervation correlated with reduced autophagy,increased inflammation,and impaired bone formation.Activating nociceptive nerves by spicy diet or topical administration of a clinical-approved TRPV1 agonist showed therapeutic benefits on alveolar bone healing in diabetic mice.These results reveal a critical neuroimmune interaction underlying the inflammation-regeneration balance during bone repairing and may lead to novel therapeutic strategies for inflammatory bone diseases.展开更多
Neonicotinoids(NEOs),a fourth-generation pesticide group,are extensively utilized for crop protection in agriculture.However,their excessive use can negatively impact the environment and human health.Biodegradation of...Neonicotinoids(NEOs),a fourth-generation pesticide group,are extensively utilized for crop protection in agriculture.However,their excessive use can negatively impact the environment and human health.Biodegradation offers an eco-friendly method for eliminating these insecticides.This study employed bacterial strains Stutzerimonas sp.SA1 and Pseudomonas sp.SA3,isolated from pesticide-contaminated agricultural soil,to degrade the various NEOs including acetamiprid(AC),imidacloprid(IM),thiamethoxam(TH),and clothianidin(CL).Numerous intermediate compounds were detected during biodegradation,and potential pathways were discussed.The highest reduction of chemical oxygen demand of clothianidin(87%)and acetamiprid(72%)were observed in Stutzerimonas sp.SA1 and Pseudomonas sp.SA3 were AC 72%and CL 66%respectively.A bacterial consortium effectively breakdown the NEOs through the secretion of nitrile hydratase(NH)enzyme.Fourier-transform infrared spectroscopy results confirmed the presence of functional groups alkane and carbonyl in the NEOs residue.The Gas Chromatography Mass Spectrometry data revealed that the Stutzerimonas sp.SA1 has the highest potential of biodegradation efficiency(BE)AC(89%)and IM(87%)than the other NEOs respectively.The Pseudomonas sp.SA3 shoved the higher BE in the AC(90%),IM(97%)and TH(85%)than the bacterium Stutzerimonas sp.SA1.The results suggest that these bacteria produce the degradative enzymes effectively and utilize the NEOs as a carbon source.The results suggest that these bacteria produce the NH degradative enzymes and utilize the NEOs as a carbon source.In conclusion,the strains Stutzerimonas sp.SA1 and Pseudomonas sp.SA3 were identified as potential candidate for the biomineralization and removal of NEOs contaminated environment.展开更多
Tooth developmental anomalies are a group of disorders caused by unfavorable factors affecting the tooth development process,resulting in abnormalities in tooth number,structure,and morphology.These anomalies typicall...Tooth developmental anomalies are a group of disorders caused by unfavorable factors affecting the tooth development process,resulting in abnormalities in tooth number,structure,and morphology.These anomalies typically manifest during childhood,impairing dental function,maxillofacial development,and facial aesthetics,while also potentially impacting overall physical and mental health.The complex etiology and diverse clinical phenotypes of these anomalies pose significant challenges for prevention,early diagnosis,and treatment.As they usually emerge early in life,long-term management and multidisciplinary collaboration in dental care are essential.However,there is currently a lack of systematic clinical guidelines for the diagnosis and treatment of these conditions,adding to the difficulties in clinical practice.In response to this need,this expert consensus summarizes the classifications,etiology,typical clinical manifestations,and diagnostic criteria of tooth developmental anomalies based on current clinical evidence.It also provides prevention strategies and stage-specific clinical management recommendations to guide clinicians in diagnosis and treatment,promoting early intervention and standardized care for these anomalies.展开更多
Prosthodontics,deals in the restoration and replacement of missing and structurally compromised teeth,this field has been remarkably transformed in the last two decades.Through the integration of digital imaging and t...Prosthodontics,deals in the restoration and replacement of missing and structurally compromised teeth,this field has been remarkably transformed in the last two decades.Through the integration of digital imaging and threedimensional printing,prosthodontics has evolved to provide more durable,precise,and patient-centric outcome.However,as we stand at the convergence of technology and healthcare,a new era is emerging,one that holds immense promise for the field and that is artificial intelligence(AI).In this paper,we explored the fascinating challenges and prospects associated with the future of prosthodontics in the era of AI.展开更多
During dental examinations and treatments,many dentists are using magni-fication to improve their vision.The dental operating microscope serves as the most effective tool for this purpose,enhancing the quality,longevi...During dental examinations and treatments,many dentists are using magni-fication to improve their vision.The dental operating microscope serves as the most effective tool for this purpose,enhancing the quality,longevity,and outcome of clinical work.This review will explore the latest research and data on the importance of magnification devices in dentistry,including diagnostic methods,treatment options and ergonomics in specialities such as restorative dentistry,endodontics,pedodontics,periodontics,and prosthodontics.This review aims to provide insights into the optimal magnification for different clinical situations,the specific benefits of dental operating microscopes for each dental branch,and their limitations.展开更多
Digital technologies have become an integral part of complete denture restoration.With advancement in computer-aided design and computer-aided manufacturing(CAD/CAM),tools such as intraoral scanning,facial scanning,3D...Digital technologies have become an integral part of complete denture restoration.With advancement in computer-aided design and computer-aided manufacturing(CAD/CAM),tools such as intraoral scanning,facial scanning,3D printing,and numerical control machining are reshaping the workflow of complete denture restoration.Unlike conventional methods that rely heavily on clinical experience and manual techniques,digital technologies offer greater precision,predictability,and efficacy.They also streamline the process by reducing the number of patient visits and improving overall comfort.Despite these improvements,the clinical application of digital complete denture restoration still faces challenges that require further standardization.The major issues include appropriate case selection,establishing consistent digital workflows,and evaluating long-term outcomes.To address these challenges and provide clinical guidance for practitioners,this expert consensus outlines the principles,advantages,and limitations of digital complete denture technology.The aim of this review was to offer practical recommendations on indications,clinical procedures and precautions,evaluation metrics,and outcome assessment to support digital restoration of complete denture in clinical practice.展开更多
Hypoxemia is a common pathological state characterized by low oxygen saturation in the blood.This condition compromises mucosal barrier integrity particularly in the gut and oral cavity.However,the mechanisms underlyi...Hypoxemia is a common pathological state characterized by low oxygen saturation in the blood.This condition compromises mucosal barrier integrity particularly in the gut and oral cavity.However,the mechanisms underlying this association remain unclear.This study used periodontitis as a model to investigate the role of platelet activation in oral mucosal immunopathology under hypoxic conditions.Hypoxia upregulated methyltransferase-like protein 4(METTL4)expression in platelets,resulting in N6-methyladenine modification of mitochondrial DNA(mtDNA).This modification impaired mitochondrial transcriptional factor A-dependent cytosolic mtDNA degradation,leading to cytosolic mtDNA accumulation.Excess cytosolic mt-DNA aberrantly activated the cGAS-STING pathway in platelets.This resulted in excessive platelet activation and neutrophil extracellular trap formation that ultimately exacerbated periodontitis.Targeting platelet METTL4 and its downstream pathways offers a potential strategy for managing oral mucosa immunopathology.Further research is needed to examine its broader implications for mucosal inflammation under hypoxic conditions.展开更多
Guided bone regeneration(GBR)membranes are extensively utilized in dental implantation.However,the existing GBR membranes showed insufficient space-maintaining capability and poor bone promoting ability,affecting the ...Guided bone regeneration(GBR)membranes are extensively utilized in dental implantation.However,the existing GBR membranes showed insufficient space-maintaining capability and poor bone promoting ability,affecting the effectiveness of clinical bone augmentation,which in turn resulted in poor implant outcomes and even failure.In this study,we designed a novel magnesium reinforced sandwich structured composite membrane,consisting of an inner magnesium scaffold and a PLGA/collagen hybrid(mixture of poly(lactic-co-glycolic acid)and collagen)top and bottom layer.The magnesium scaffold provided mechanical support and released Mg^(2+)to enhance osteogenesis.The PLGA/collagen hybrid regulated membrane degradation and improved biocompatibility,promoting cell adhesion and proliferation(P<0.05).The PLGA/collagen hybrid regulated the release of magnesium ions,such that the MgP10C(mass ratios of PLGA and collagen=100:10)group showed the best in vitro osteogenic effect.Further mechanism exploration confirmed that MgP10C membranes significantly enhanced bone defect repair via the MAPK/ERK 1/2 pathway by the Mg^(2+)released from the composite membranes.In rat calvarial defect and rabbit alveolar defect model(P<0.05),the in vivo osteogenic effect of the MgP10C group was superior to that of other groups.Finite element analysis models validated the support effect of composite membranes,demonstrating lower stress and a significant reduction in strain on the bone graft in the MgP10C group.In conclusion,the magnesium-reinforced sandwich structure composite membrane,with its spacemaintaining properties and osteoinductive activity,represents a new strategy for GBR and enhancing osteogenic potential that meets directly clinical needs.展开更多
Magnesium-based materials,including magnesium alloys,have emerged as a promising class of biodegradable materials with potential applications in cancer therapy due to their unique properties,including biocompatibility...Magnesium-based materials,including magnesium alloys,have emerged as a promising class of biodegradable materials with potential applications in cancer therapy due to their unique properties,including biocompatibility,biodegradability,and the ability to modulate the tumor microenvironment.The main degradation products of magnesium alloys are magnesium ions(Mg^(2+)),hydrogen(H_(2)),and magnesium hydroxide(Mg(OH)_(2)).Magnesium ions can regulate tumor growth and metastasis by mediating the inflammatory response and oxidative stress,maintaining genomic stability,and affecting the tumor microenvironment.Similarly,hydrogen can inhibit tumorigenesis through antioxidant and anti-inflammatory properties.Moreover,Mg(OH)_(2) can alter the pH of the microenvironment,impacting tumorigenesis.Biodegradable magnesium alloys serve various functions in clinical applications,including,but not limited to,bonefixation,coronary stents,and drug carriers.Nonetheless,the anti-tumor mechanism associated with magnesium-based materials has not been thoroughly investigated.This review provides a comprehensive overview of the current state of magnesium-based therapies for cancer.It highlights the mechanisms of action,identifies the challenges that must be addressed,and discusses prospects for oncological applications.展开更多
Blister wounds are featured with over-generated wound exudate and extensive skin peeling,call for breathable temporary skin with effective exudate management,and function as an extracellular matrix to accelerate regen...Blister wounds are featured with over-generated wound exudate and extensive skin peeling,call for breathable temporary skin with effective exudate management,and function as an extracellular matrix to accelerate regeneration of wound skin.Traditional extracellular matrix(ECM)mimicked nanofibrous 3D scaffold and corresponding hydrogel composites suffer from poor mechanical strength,and the wound exudate management behavior is seldom studied.Herein,we proposed the strategy to enhance the mechanical properties of a 3D nanofiber scaffold via constructing a long nanofiber(NF)and sodium alginate(SA)aerogel interpenetrated architecture(NF/SA).The as-prepared scaffold was then evaluated as temporary skin for a full-thickness defect wound.After absorption of blister fluid,the aerogel transferred into a hydrogel and imparted a wet wound care environment with a water-vapor transmission rate of(6001.90±522.04)g/(m^(2)·24 h),and Young s modulus of(2.97±0.38)MPa.The exudate was continuously refreshed by a directed and dynamic pump,followed by volatilization driven by Brownian motion.Meanwhile,the NF/SA scaffold exhibited decent compatibility with blister fluid.The basic fibroblast growth factor(bFGF)-loaded NF/SA improved the wound healing rate by 36.46%on Day 3 and 15.34%on Day 7 in the full-thickness defect wound model.展开更多
Bone repair and regeneration is a complex spatiotemporal process recruiting a variety of cell types,which need to precisely mediated for effective healing post-damage.The concept of osteoimmunology emphasizes the exte...Bone repair and regeneration is a complex spatiotemporal process recruiting a variety of cell types,which need to precisely mediated for effective healing post-damage.The concept of osteoimmunology emphasizes the extensive and intricate crosstalk between the bone and the immune system.Despite the significant advancements in understanding osteoimmunology,the precise role of dendritic cells(DCs)in this field remains under investigation.As key antigen-presenting cells,DCs are critical in orchestrating adaptive immune responses and maintaining tissue homeostasis.Recent researches have further revealed the potential of DCs to influence the development or acceleration of inflammatory and autoimmune bone disease,as well as their interaction with skeletal cells in the context of bone repair and regeneration.展开更多
The success rate of apexification is primarily determined by multiple factors,including the material used,the size of the open apex compared to the length of the root,and the technique used in each case.The main objec...The success rate of apexification is primarily determined by multiple factors,including the material used,the size of the open apex compared to the length of the root,and the technique used in each case.The main objective of this review was to provide an update on the present management of open apex to identify factors and circumstances that may influence the success of apexification using different materials and techniques.Future research on apexification should focus on how to treat open apices with wide periapical lesions without surgery.Previously,the predictability of these parameters with non-surgical procedures was uncertain,but now,with the use of a dental operating microscope,it has become more predictable.Another reason could be that extra visits are no longer required due to major advances in the armamentarium and materials used for apexification.展开更多
BACKGROUND The primary issue in managing edentulous patients is the severely resorbed mandibular ridge,particularly in older individuals with diminished adaptive capacities.This compromised situation leads to the fabr...BACKGROUND The primary issue in managing edentulous patients is the severely resorbed mandibular ridge,particularly in older individuals with diminished adaptive capacities.This compromised situation leads to the fabrication of inadequate dentures that lack retention and stability,potentially causing psychosocial issues.AIM To determine the difference in retentive capacity between three attachment systems in implant-retained overdentures.METHODS Three edentulous mandibular models were fabricated using heat-cured polymethacrylate resin,with two implant replicas placed in the intra-foraminal region of each model.30 acrylic resin mandibular overdentures were fabricated with provisions for three different overdenture attachment systems:A prefabricated ball/O-ring attachment,a locator attachment system,and an equator attachment system.Each model was subjected to 15000 pulls using a universal testing machine to remove the overdenture from the acrylic model and the force data were recorded.RESULTS The ball/O-ring attachment system demonstrated superior retentive capacity for 15 years,while the locator and equator attachment systems maintained excellent retentive capacity for 5 years.CONCLUSION The ball/O-ring attachment system outperformed better than the other two attachment systems regarding retentive capacity.The locator and equator attachment systems presented sufficient retentive abilities until 15000 cycles.After 7500 cycles,significant differences in retentive force between the systems evolved.展开更多
Tumor cell-intrinsic programmed death-ligand 1(PD-L1)signals mediate tumor initiation,progression and metastasis,but their effects in ameloblastoma(AM)have not been reported.In this comprehensive study,we observed mar...Tumor cell-intrinsic programmed death-ligand 1(PD-L1)signals mediate tumor initiation,progression and metastasis,but their effects in ameloblastoma(AM)have not been reported.In this comprehensive study,we observed marked upregulation of PD-L1 in AM tissues and revealed the robust correlation between elevated PD-L1 expression and increased tumor growth and recurrence rates.Notably,we found that PD-L1 overexpression markedly increased self-renewal capacity and promoted tumorigenic processes and invasion in hTERT^(+)-AM cells,whereas genetic ablation of PD-L1 exerted opposing inhibitory effects.By performing highresolution single-cell profiling and thorough immunohistochemical analyses in AM patients,we delineated the intricate cellular landscape and elucidated the mechanisms underlying the aggressive phenotype and unfavorable prognosis of these tumors.Our findings revealed that hTERT^(+)-AM cells with upregulated PD-L1 expression exhibit increased proliferative potential and stem-like attributes and undergo partial epithelial-mesenchymal transition.This phenotypic shift is induced by the activation of the PI3KAKT-mTOR signaling axis;thus,this study revealed a crucial regulatory mechanism that fuels tumor growth and recurrence.Importantly,targeted inhibition of the PD-L1-PI3K-AKT-mTOR signaling axis significantly suppressed the growth of AM patientderived tumor organoids,highlighting the potential of PD-L1 blockade as a promising therapeutic approach for AM.展开更多
BACKGROUND Advanced materials and techniques are used to successfully manage the apexification of immature teeth with open apices.The use of mineral trioxide aggregate(MTA),bioceramic sealers,and sodium hypochlorite(N...BACKGROUND Advanced materials and techniques are used to successfully manage the apexification of immature teeth with open apices.The use of mineral trioxide aggregate(MTA),bioceramic sealers,and sodium hypochlorite(NaOCl),combined with internal heating and ultrasonic activation,ensures that canals are cleaned,disinfected,and sealed properly.Magnification devices,such as dental operating microscopes(DOM),provide precise visualization for accurate material placement,while the micro apical placement system ensures void-free MTA delivery.This modern approach improves procedural outcomes,lowers iatrogenic errors,and increases long-term success in apexification,making it a dependable and predictable treatment option for immature teeth.CASE SUMMARY Apexification is a regenerative endodontic procedure that involves creating a calcified barrier at the apex of a nonvital tooth with an open apex.This technique is commonly used in immature teeth with necrotic pulps to ensure proper root canal sealing.Traditionally,calcium hydroxide was the preferred material,but advances have introduced bioceramic cements like MTA or Biodentine,which provide superior results with less treatment time.Apexification not only helps to maintain the tooth's structural integrity but also prevents further complications,making it an important procedure in such cases.CONCLUSION This case demonstrates the effectiveness of integrating advanced materials,precise irrigation protocols,and magnification tools in the apexification of immature teeth with open apices.The use of MTA created a stable apical barrier,while bioceramic sealers enhanced the seal and promoted long-term healing.NaOCl with internal heating,ultrasonic activation,and double-sided vented needles ensured thorough irrigation and disinfection,especially in complex canal anatomy.展开更多
The oral microenvironment plays a pivotal role in determining stem cell fate,driving both regeneration and pathological transformation.Emerging evidence suggests that post-translational modifications(PTMs)play a role ...The oral microenvironment plays a pivotal role in determining stem cell fate,driving both regeneration and pathological transformation.Emerging evidence suggests that post-translational modifications(PTMs)play a role as dynamic molecular signatures that regulate key signaling networks in dental-derived mesenchymal stem cells.These PTMs not only influence stem cell self-renewal and differentiation in periodontal tissue regeneration but also contribute to cancer stem cell plasticity and therapeutic resistance in oral squamous cell carcinoma(OSCC).At the pathway level,PTM programs interface with Wnt/β-catenin and bone morphogenetic protein/SMAD axis and integrate mitogen-activated protein kinase(p38/c-Jun N-terminal kinase)→runt-related transcription factor 2 in regeneration,whereas in OSCC/cancer stem cell they converge on Janus kinase/signal transducer and activator of transcription 3,phosphatidylinositol 3-kinase/protein kinase B/mammalian target of the rapamycin,and transforming growth factor-beta/SMAD-driven epithelial-mesenchymal transition.This review expounds on recent advances in PTM-mediated regulatory mechanisms in dentalderived mesenchymal stem cells,outlines their functional implications in inflammatory and tumor microenvironments,and discusses translational strategies-including localized,time-staged PTM modulation for regeneration and pathwayanchored combinations for OSCC-for regenerative medicine and targeted cancer therapies.Future research directions emphasize the integration of single-cell and spatial multi-omics with PTM profiling as a new approach to precision-based dental and oncological therapies.展开更多
BACKGROUND The management of immature permanent teeth with open apices in pediatric patients presents unique challenges,particularly in cases of nonvital pulp.Modern advancements in materials and techniques have signi...BACKGROUND The management of immature permanent teeth with open apices in pediatric patients presents unique challenges,particularly in cases of nonvital pulp.Modern advancements in materials and techniques have significantly improved the predictability and success of apexification procedures.In this case,a 16-yearold patient presented with an immature necrotic tooth requiring apexification.Contemporary approaches incorporate calcium silicate-based materials such as mineral trioxide aggregate(MTA),Biodentine,and bioceramic putty,along with bioceramic sealers and enhanced canal cleaning including internal heating and ultrasonic activation with sodium hypochlorite(NaOCl)for disinfection,and sealing.Additionally,magnification tools such as dental operating microscopes ensure precise visualization for accurate material placement,while a micro-apical placement(MAP)system guarantees void-free MTA delivery.These advancements improve procedural outcomes and minimize the risk of iatrogenic errors,making apexification a more predictable and reliable treatment option in pediatric patients with immature teeth.CASE SUMMARY A 16-year-old patient presented with a nonvital maxillary central incisor with an open apex,secondary to trauma.Due to the lack of apical closure,traditional root canal obturation was not feasible.Apexification was chosen as the treatment modality to induce the formation of a calcified apical barrier,allowing for proper root canal sealing.Historically,calcium hydroxide was the material of choice for apexification,requiring multiple visits and prolonged treatment duration.However,the introduction of bioceramic materials such as MTA has revolutionized the procedure,offering superior outcomes with reduced treatment time.In this case,the apexification procedure involved thorough canal disinfection using NaOCl,enhanced by internal heating,ultrasonic activation,and double-sided vented needle irrigation.Under the dental operating microscope,MTA was precisely placed at the apex using a MAP system,ensuring a dense,void-free apical barrier.The remaining canal space was subsequently sealed with a bioceramic sealer to promote long-term stability and healing.CONCLUSION This case highlights the effectiveness of a modern approach for apexification in a pediatric patient.The use of advanced materials and techniques facilitated the formation of a stable apical barrier,ensuring long-term tooth retention and function.By incorporating precise irrigation protocols,internal heating,ultrasonic activation,and magnification tools,the treatment achieved thorough disinfection and optimal material placement.These advancements make apexification a predictable and reliable treatment option for young patients with immature necrotic teeth,preserving their natural dentition and preventing future complications.展开更多
文摘During restorative dental procedures,complete control over the operative site is critical for patient comfort,safety,and the operator’s access and visibility.The success of a fixed prosthesis depends on accurate impression making of the prepared finish lines on the abutment teeth.To optimise long-term outcomes for the fixed restoration,gingival retraction techniques should be used to decrease the marginal discrepancy among the restoration and the prepared abutment.Accurate marginal positioning of the restoration along the prepared finish line of the abutment is essential for therapeutic,preventive,and aesthetic purposes.
文摘Two novel aggregation-induced emission(AIE)-active probes,TPA-H and TPA-2 F,were designed and synthesized based on a triphenylamine(TPA)core.Systematic characterization demonstrated that both probes exhibit excellent biocompatibility(cell viability>90%at concentrations up to 50μmol/L)and outstanding LD-targeting speci⁃ficity with minimal colocalization with other organelles such as mitochondria and lysosomes.During early differentia⁃tion of 3 T 3-L 1 adipocytes,both TPA-2 F and TPA-H clearly visualized small and nascent LDs that were difficult to be detected with BODIPY,indicating superior imaging sensitivity compared to the existing fluorescent probes for LDs.Moreover,TPA-2 F demonstrated exceptional photostability,retaining over 90%of its initial fluorescence intensity after 100 continuous laser scanning cycles,significantly outperforming TPA-H.This work not only provides two high-performance LD imaging tools but also highlights the potential of AIE luminogens(AIEgens)in organelle-specific bioimaging,offering promising avenues for early diagnosis and mechanistic research of lipid-related metabolic diseases.
基金financially supported by the Fundamental Research Program of the Shanxi Province(No.202203021211023).
文摘Gel-based flexible wearable sensors have attracted considerable interest in aquatic environments.However,the development of underwater conductive gel sensors with outstanding anti-swelling,mechanical,and sensing capabilities faces significant challenges.The aim of this study is to develop anti-swelling and conductive zwitterionic gels and investigate their applications in wireless underwater strain sensing.Multi-functional zwitterionic gels were fabricated by copolymerizing[2-(methacryloyloxy)ethyl]dimethyl-(3-sulfopropyl)ammonium hydroxide(SBMA)and acrylic acid(AA)in a mixed solution of aluminum chloride(AlCl3)and poly(vinyl alcohol)(PVA)under ultraviolet light(360 nm).PSBMA was switched from a neutral polymer to a positively charged polymer because of the combination of Al^(3+)with the negative groups SO_(3)^(−).The water molecules were eliminated because of electrostatic repulsion.The gels exhibited anti-swelling properties(swelling ratio<11%),high stretchability(600%strain),and toughness(2451 kJ/m^(3)).The PPAS-Al^(3+)gel was integrated with a wireless Bluetooth system to construct underwater wearable strain sensors that could accurately capture the signals caused by human joint movements and speech recognition even in water.Antibacterial activity(>98.9%inhibition)and stable wireless sensing have potential applications in the fields of wearable sensors,underwater communication,and intelligent healthcare.
基金The National Natural Science Foundation of China(No.82130027,82301020,82100966)Young Elite Scientists Sponsorship Program by CAST(2024QNRC001)+5 种基金The China Postdoctoral Science Foundation(2023M732283)The National Key Research and Development Program of China(No.2023YFC2413600)The Shanghai Sailing Program(23YF1422000,21YF1424400)Innovative Research Team of High-level Local Universities in Shanghai(SHSMU-ZLCX20212400)Young Elite Scientists Sponsorship Program by CAST(2021QNRC001)Shanghai Pujiang Program(24PJD054).
文摘Nociceptive pain is a cardinal feature of traumatic and inflammatory bone diseases.However,whether and how nociceptors actively regulate the immune response during bone regeneration remains unclear.Here,we found that neutrophil-triggered nociceptive ingrowth functioned as negative feedback regulation to inflammation during bone healing.A unique Il4ra^(+)Ccl2^(high) neutrophil subset drove intense postinjury TRPV1^(+)nociceptive ingrowth,which in return dissipated inflammation by activating the production of pro-resolving mediator lipoxin A4(LXA4)in osteoblasts.Mechanistically,osteoblastic autophagy activated by nociceptor-derived calcitonin gene-related peptide(CGRP)suppressed the nuclear translocation of arachidonate 5-lipoxygenase(5-LOX)to favor the LXA4 biosynthesis.Moreover,in alveolar bone from patients with Type Ⅱ diabetes,we found diminished nociceptive innervation correlated with reduced autophagy,increased inflammation,and impaired bone formation.Activating nociceptive nerves by spicy diet or topical administration of a clinical-approved TRPV1 agonist showed therapeutic benefits on alveolar bone healing in diabetic mice.These results reveal a critical neuroimmune interaction underlying the inflammation-regeneration balance during bone repairing and may lead to novel therapeutic strategies for inflammatory bone diseases.
基金supported by the Ongoing Research Funding program(No.ORF-2025-398),King Saud University,Riyadh,Saudi Arabia.
文摘Neonicotinoids(NEOs),a fourth-generation pesticide group,are extensively utilized for crop protection in agriculture.However,their excessive use can negatively impact the environment and human health.Biodegradation offers an eco-friendly method for eliminating these insecticides.This study employed bacterial strains Stutzerimonas sp.SA1 and Pseudomonas sp.SA3,isolated from pesticide-contaminated agricultural soil,to degrade the various NEOs including acetamiprid(AC),imidacloprid(IM),thiamethoxam(TH),and clothianidin(CL).Numerous intermediate compounds were detected during biodegradation,and potential pathways were discussed.The highest reduction of chemical oxygen demand of clothianidin(87%)and acetamiprid(72%)were observed in Stutzerimonas sp.SA1 and Pseudomonas sp.SA3 were AC 72%and CL 66%respectively.A bacterial consortium effectively breakdown the NEOs through the secretion of nitrile hydratase(NH)enzyme.Fourier-transform infrared spectroscopy results confirmed the presence of functional groups alkane and carbonyl in the NEOs residue.The Gas Chromatography Mass Spectrometry data revealed that the Stutzerimonas sp.SA1 has the highest potential of biodegradation efficiency(BE)AC(89%)and IM(87%)than the other NEOs respectively.The Pseudomonas sp.SA3 shoved the higher BE in the AC(90%),IM(97%)and TH(85%)than the bacterium Stutzerimonas sp.SA1.The results suggest that these bacteria produce the degradative enzymes effectively and utilize the NEOs as a carbon source.The results suggest that these bacteria produce the NH degradative enzymes and utilize the NEOs as a carbon source.In conclusion,the strains Stutzerimonas sp.SA1 and Pseudomonas sp.SA3 were identified as potential candidate for the biomineralization and removal of NEOs contaminated environment.
基金supported by the grants No.82370912 from the National Natural Science Foundation of ChinaNo.2022020801010499 from the Bureau of Science and Technology of Wuhan,ChinaNo.2042023kf0231 from the Fundamental Research Funds for the Central Universities,China。
文摘Tooth developmental anomalies are a group of disorders caused by unfavorable factors affecting the tooth development process,resulting in abnormalities in tooth number,structure,and morphology.These anomalies typically manifest during childhood,impairing dental function,maxillofacial development,and facial aesthetics,while also potentially impacting overall physical and mental health.The complex etiology and diverse clinical phenotypes of these anomalies pose significant challenges for prevention,early diagnosis,and treatment.As they usually emerge early in life,long-term management and multidisciplinary collaboration in dental care are essential.However,there is currently a lack of systematic clinical guidelines for the diagnosis and treatment of these conditions,adding to the difficulties in clinical practice.In response to this need,this expert consensus summarizes the classifications,etiology,typical clinical manifestations,and diagnostic criteria of tooth developmental anomalies based on current clinical evidence.It also provides prevention strategies and stage-specific clinical management recommendations to guide clinicians in diagnosis and treatment,promoting early intervention and standardized care for these anomalies.
文摘Prosthodontics,deals in the restoration and replacement of missing and structurally compromised teeth,this field has been remarkably transformed in the last two decades.Through the integration of digital imaging and threedimensional printing,prosthodontics has evolved to provide more durable,precise,and patient-centric outcome.However,as we stand at the convergence of technology and healthcare,a new era is emerging,one that holds immense promise for the field and that is artificial intelligence(AI).In this paper,we explored the fascinating challenges and prospects associated with the future of prosthodontics in the era of AI.
文摘During dental examinations and treatments,many dentists are using magni-fication to improve their vision.The dental operating microscope serves as the most effective tool for this purpose,enhancing the quality,longevity,and outcome of clinical work.This review will explore the latest research and data on the importance of magnification devices in dentistry,including diagnostic methods,treatment options and ergonomics in specialities such as restorative dentistry,endodontics,pedodontics,periodontics,and prosthodontics.This review aims to provide insights into the optimal magnification for different clinical situations,the specific benefits of dental operating microscopes for each dental branch,and their limitations.
基金supported by National Natural Science Foundation of China(82325012)General project of State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration(2024MS05).
文摘Digital technologies have become an integral part of complete denture restoration.With advancement in computer-aided design and computer-aided manufacturing(CAD/CAM),tools such as intraoral scanning,facial scanning,3D printing,and numerical control machining are reshaping the workflow of complete denture restoration.Unlike conventional methods that rely heavily on clinical experience and manual techniques,digital technologies offer greater precision,predictability,and efficacy.They also streamline the process by reducing the number of patient visits and improving overall comfort.Despite these improvements,the clinical application of digital complete denture restoration still faces challenges that require further standardization.The major issues include appropriate case selection,establishing consistent digital workflows,and evaluating long-term outcomes.To address these challenges and provide clinical guidance for practitioners,this expert consensus outlines the principles,advantages,and limitations of digital complete denture technology.The aim of this review was to offer practical recommendations on indications,clinical procedures and precautions,evaluation metrics,and outcome assessment to support digital restoration of complete denture in clinical practice.
基金supported by the National Natural Science Foundation of China(82325012)the Youth Fund of the National Natural Science Foundation of China(82301043)+1 种基金the Natural Science Basic Research Program of Shaanxi (Program No.2024JC-YBQN-0980)the Shaanxi Key Scientific and Technological Innovation Team(2020TD-033).
文摘Hypoxemia is a common pathological state characterized by low oxygen saturation in the blood.This condition compromises mucosal barrier integrity particularly in the gut and oral cavity.However,the mechanisms underlying this association remain unclear.This study used periodontitis as a model to investigate the role of platelet activation in oral mucosal immunopathology under hypoxic conditions.Hypoxia upregulated methyltransferase-like protein 4(METTL4)expression in platelets,resulting in N6-methyladenine modification of mitochondrial DNA(mtDNA).This modification impaired mitochondrial transcriptional factor A-dependent cytosolic mtDNA degradation,leading to cytosolic mtDNA accumulation.Excess cytosolic mt-DNA aberrantly activated the cGAS-STING pathway in platelets.This resulted in excessive platelet activation and neutrophil extracellular trap formation that ultimately exacerbated periodontitis.Targeting platelet METTL4 and its downstream pathways offers a potential strategy for managing oral mucosa immunopathology.Further research is needed to examine its broader implications for mucosal inflammation under hypoxic conditions.
基金supported by the National Key Research and Development Program of China(2021YFC2400700)the National Science Foundation of China(82370924,82170929)+5 种基金the Beijing Natural Science Foundation Haidian Original Innovation Joint Fund Project(L222090)the Fujian Province Natural Science Foundation of China(2021J01803)the Postdoctoral Fellowship Program of 5CPSF(GZC20230141)the Beijing Municipal Natural Science Foundation-Changping Innovation Joint Fund Project(L234074)Industry-University-Research Innovation Fund for Chinese Universities(2024GR021)the Innovation research program(HHKT-00-03).
文摘Guided bone regeneration(GBR)membranes are extensively utilized in dental implantation.However,the existing GBR membranes showed insufficient space-maintaining capability and poor bone promoting ability,affecting the effectiveness of clinical bone augmentation,which in turn resulted in poor implant outcomes and even failure.In this study,we designed a novel magnesium reinforced sandwich structured composite membrane,consisting of an inner magnesium scaffold and a PLGA/collagen hybrid(mixture of poly(lactic-co-glycolic acid)and collagen)top and bottom layer.The magnesium scaffold provided mechanical support and released Mg^(2+)to enhance osteogenesis.The PLGA/collagen hybrid regulated membrane degradation and improved biocompatibility,promoting cell adhesion and proliferation(P<0.05).The PLGA/collagen hybrid regulated the release of magnesium ions,such that the MgP10C(mass ratios of PLGA and collagen=100:10)group showed the best in vitro osteogenic effect.Further mechanism exploration confirmed that MgP10C membranes significantly enhanced bone defect repair via the MAPK/ERK 1/2 pathway by the Mg^(2+)released from the composite membranes.In rat calvarial defect and rabbit alveolar defect model(P<0.05),the in vivo osteogenic effect of the MgP10C group was superior to that of other groups.Finite element analysis models validated the support effect of composite membranes,demonstrating lower stress and a significant reduction in strain on the bone graft in the MgP10C group.In conclusion,the magnesium-reinforced sandwich structure composite membrane,with its spacemaintaining properties and osteoinductive activity,represents a new strategy for GBR and enhancing osteogenic potential that meets directly clinical needs.
文摘Magnesium-based materials,including magnesium alloys,have emerged as a promising class of biodegradable materials with potential applications in cancer therapy due to their unique properties,including biocompatibility,biodegradability,and the ability to modulate the tumor microenvironment.The main degradation products of magnesium alloys are magnesium ions(Mg^(2+)),hydrogen(H_(2)),and magnesium hydroxide(Mg(OH)_(2)).Magnesium ions can regulate tumor growth and metastasis by mediating the inflammatory response and oxidative stress,maintaining genomic stability,and affecting the tumor microenvironment.Similarly,hydrogen can inhibit tumorigenesis through antioxidant and anti-inflammatory properties.Moreover,Mg(OH)_(2) can alter the pH of the microenvironment,impacting tumorigenesis.Biodegradable magnesium alloys serve various functions in clinical applications,including,but not limited to,bonefixation,coronary stents,and drug carriers.Nonetheless,the anti-tumor mechanism associated with magnesium-based materials has not been thoroughly investigated.This review provides a comprehensive overview of the current state of magnesium-based therapies for cancer.It highlights the mechanisms of action,identifies the challenges that must be addressed,and discusses prospects for oncological applications.
基金Natural Science Foundation of Shanghai(General Program,22ZR1409500)China Postdoctoral Science Foundation(23M742317,GZB240446)+3 种基金Shanghai Science and Technology Innovation Action Plan(22S31905500)Medical Engineering Fund of Fudan University(yg2021-032)Fundamental Research Project of CNTAC(J202104)Program of Introducing Talents of Discipline to Universities(BP0719035)。
文摘Blister wounds are featured with over-generated wound exudate and extensive skin peeling,call for breathable temporary skin with effective exudate management,and function as an extracellular matrix to accelerate regeneration of wound skin.Traditional extracellular matrix(ECM)mimicked nanofibrous 3D scaffold and corresponding hydrogel composites suffer from poor mechanical strength,and the wound exudate management behavior is seldom studied.Herein,we proposed the strategy to enhance the mechanical properties of a 3D nanofiber scaffold via constructing a long nanofiber(NF)and sodium alginate(SA)aerogel interpenetrated architecture(NF/SA).The as-prepared scaffold was then evaluated as temporary skin for a full-thickness defect wound.After absorption of blister fluid,the aerogel transferred into a hydrogel and imparted a wet wound care environment with a water-vapor transmission rate of(6001.90±522.04)g/(m^(2)·24 h),and Young s modulus of(2.97±0.38)MPa.The exudate was continuously refreshed by a directed and dynamic pump,followed by volatilization driven by Brownian motion.Meanwhile,the NF/SA scaffold exhibited decent compatibility with blister fluid.The basic fibroblast growth factor(bFGF)-loaded NF/SA improved the wound healing rate by 36.46%on Day 3 and 15.34%on Day 7 in the full-thickness defect wound model.
基金supported by the“Pioneer and Leading Goose+X”research and development program of Zhejiang Province Science and Technology Department(2024C03193)the National Natural Science Foundation of China(No.82271026)Start-up Fund of Stomatology Hospital,School of Stomatology,Zhejiang University School of Medicine(2023PDF017).
文摘Bone repair and regeneration is a complex spatiotemporal process recruiting a variety of cell types,which need to precisely mediated for effective healing post-damage.The concept of osteoimmunology emphasizes the extensive and intricate crosstalk between the bone and the immune system.Despite the significant advancements in understanding osteoimmunology,the precise role of dendritic cells(DCs)in this field remains under investigation.As key antigen-presenting cells,DCs are critical in orchestrating adaptive immune responses and maintaining tissue homeostasis.Recent researches have further revealed the potential of DCs to influence the development or acceleration of inflammatory and autoimmune bone disease,as well as their interaction with skeletal cells in the context of bone repair and regeneration.
文摘The success rate of apexification is primarily determined by multiple factors,including the material used,the size of the open apex compared to the length of the root,and the technique used in each case.The main objective of this review was to provide an update on the present management of open apex to identify factors and circumstances that may influence the success of apexification using different materials and techniques.Future research on apexification should focus on how to treat open apices with wide periapical lesions without surgery.Previously,the predictability of these parameters with non-surgical procedures was uncertain,but now,with the use of a dental operating microscope,it has become more predictable.Another reason could be that extra visits are no longer required due to major advances in the armamentarium and materials used for apexification.
文摘BACKGROUND The primary issue in managing edentulous patients is the severely resorbed mandibular ridge,particularly in older individuals with diminished adaptive capacities.This compromised situation leads to the fabrication of inadequate dentures that lack retention and stability,potentially causing psychosocial issues.AIM To determine the difference in retentive capacity between three attachment systems in implant-retained overdentures.METHODS Three edentulous mandibular models were fabricated using heat-cured polymethacrylate resin,with two implant replicas placed in the intra-foraminal region of each model.30 acrylic resin mandibular overdentures were fabricated with provisions for three different overdenture attachment systems:A prefabricated ball/O-ring attachment,a locator attachment system,and an equator attachment system.Each model was subjected to 15000 pulls using a universal testing machine to remove the overdenture from the acrylic model and the force data were recorded.RESULTS The ball/O-ring attachment system demonstrated superior retentive capacity for 15 years,while the locator and equator attachment systems maintained excellent retentive capacity for 5 years.CONCLUSION The ball/O-ring attachment system outperformed better than the other two attachment systems regarding retentive capacity.The locator and equator attachment systems presented sufficient retentive abilities until 15000 cycles.After 7500 cycles,significant differences in retentive force between the systems evolved.
基金supported by the postdoctoral fellowship program of CPSF(GZC20241270)the China Postdoctoral Science Foundation(2024M762496).
文摘Tumor cell-intrinsic programmed death-ligand 1(PD-L1)signals mediate tumor initiation,progression and metastasis,but their effects in ameloblastoma(AM)have not been reported.In this comprehensive study,we observed marked upregulation of PD-L1 in AM tissues and revealed the robust correlation between elevated PD-L1 expression and increased tumor growth and recurrence rates.Notably,we found that PD-L1 overexpression markedly increased self-renewal capacity and promoted tumorigenic processes and invasion in hTERT^(+)-AM cells,whereas genetic ablation of PD-L1 exerted opposing inhibitory effects.By performing highresolution single-cell profiling and thorough immunohistochemical analyses in AM patients,we delineated the intricate cellular landscape and elucidated the mechanisms underlying the aggressive phenotype and unfavorable prognosis of these tumors.Our findings revealed that hTERT^(+)-AM cells with upregulated PD-L1 expression exhibit increased proliferative potential and stem-like attributes and undergo partial epithelial-mesenchymal transition.This phenotypic shift is induced by the activation of the PI3KAKT-mTOR signaling axis;thus,this study revealed a crucial regulatory mechanism that fuels tumor growth and recurrence.Importantly,targeted inhibition of the PD-L1-PI3K-AKT-mTOR signaling axis significantly suppressed the growth of AM patientderived tumor organoids,highlighting the potential of PD-L1 blockade as a promising therapeutic approach for AM.
文摘BACKGROUND Advanced materials and techniques are used to successfully manage the apexification of immature teeth with open apices.The use of mineral trioxide aggregate(MTA),bioceramic sealers,and sodium hypochlorite(NaOCl),combined with internal heating and ultrasonic activation,ensures that canals are cleaned,disinfected,and sealed properly.Magnification devices,such as dental operating microscopes(DOM),provide precise visualization for accurate material placement,while the micro apical placement system ensures void-free MTA delivery.This modern approach improves procedural outcomes,lowers iatrogenic errors,and increases long-term success in apexification,making it a dependable and predictable treatment option for immature teeth.CASE SUMMARY Apexification is a regenerative endodontic procedure that involves creating a calcified barrier at the apex of a nonvital tooth with an open apex.This technique is commonly used in immature teeth with necrotic pulps to ensure proper root canal sealing.Traditionally,calcium hydroxide was the preferred material,but advances have introduced bioceramic cements like MTA or Biodentine,which provide superior results with less treatment time.Apexification not only helps to maintain the tooth's structural integrity but also prevents further complications,making it an important procedure in such cases.CONCLUSION This case demonstrates the effectiveness of integrating advanced materials,precise irrigation protocols,and magnification tools in the apexification of immature teeth with open apices.The use of MTA created a stable apical barrier,while bioceramic sealers enhanced the seal and promoted long-term healing.NaOCl with internal heating,ultrasonic activation,and double-sided vented needles ensured thorough irrigation and disinfection,especially in complex canal anatomy.
文摘The oral microenvironment plays a pivotal role in determining stem cell fate,driving both regeneration and pathological transformation.Emerging evidence suggests that post-translational modifications(PTMs)play a role as dynamic molecular signatures that regulate key signaling networks in dental-derived mesenchymal stem cells.These PTMs not only influence stem cell self-renewal and differentiation in periodontal tissue regeneration but also contribute to cancer stem cell plasticity and therapeutic resistance in oral squamous cell carcinoma(OSCC).At the pathway level,PTM programs interface with Wnt/β-catenin and bone morphogenetic protein/SMAD axis and integrate mitogen-activated protein kinase(p38/c-Jun N-terminal kinase)→runt-related transcription factor 2 in regeneration,whereas in OSCC/cancer stem cell they converge on Janus kinase/signal transducer and activator of transcription 3,phosphatidylinositol 3-kinase/protein kinase B/mammalian target of the rapamycin,and transforming growth factor-beta/SMAD-driven epithelial-mesenchymal transition.This review expounds on recent advances in PTM-mediated regulatory mechanisms in dentalderived mesenchymal stem cells,outlines their functional implications in inflammatory and tumor microenvironments,and discusses translational strategies-including localized,time-staged PTM modulation for regeneration and pathwayanchored combinations for OSCC-for regenerative medicine and targeted cancer therapies.Future research directions emphasize the integration of single-cell and spatial multi-omics with PTM profiling as a new approach to precision-based dental and oncological therapies.
文摘BACKGROUND The management of immature permanent teeth with open apices in pediatric patients presents unique challenges,particularly in cases of nonvital pulp.Modern advancements in materials and techniques have significantly improved the predictability and success of apexification procedures.In this case,a 16-yearold patient presented with an immature necrotic tooth requiring apexification.Contemporary approaches incorporate calcium silicate-based materials such as mineral trioxide aggregate(MTA),Biodentine,and bioceramic putty,along with bioceramic sealers and enhanced canal cleaning including internal heating and ultrasonic activation with sodium hypochlorite(NaOCl)for disinfection,and sealing.Additionally,magnification tools such as dental operating microscopes ensure precise visualization for accurate material placement,while a micro-apical placement(MAP)system guarantees void-free MTA delivery.These advancements improve procedural outcomes and minimize the risk of iatrogenic errors,making apexification a more predictable and reliable treatment option in pediatric patients with immature teeth.CASE SUMMARY A 16-year-old patient presented with a nonvital maxillary central incisor with an open apex,secondary to trauma.Due to the lack of apical closure,traditional root canal obturation was not feasible.Apexification was chosen as the treatment modality to induce the formation of a calcified apical barrier,allowing for proper root canal sealing.Historically,calcium hydroxide was the material of choice for apexification,requiring multiple visits and prolonged treatment duration.However,the introduction of bioceramic materials such as MTA has revolutionized the procedure,offering superior outcomes with reduced treatment time.In this case,the apexification procedure involved thorough canal disinfection using NaOCl,enhanced by internal heating,ultrasonic activation,and double-sided vented needle irrigation.Under the dental operating microscope,MTA was precisely placed at the apex using a MAP system,ensuring a dense,void-free apical barrier.The remaining canal space was subsequently sealed with a bioceramic sealer to promote long-term stability and healing.CONCLUSION This case highlights the effectiveness of a modern approach for apexification in a pediatric patient.The use of advanced materials and techniques facilitated the formation of a stable apical barrier,ensuring long-term tooth retention and function.By incorporating precise irrigation protocols,internal heating,ultrasonic activation,and magnification tools,the treatment achieved thorough disinfection and optimal material placement.These advancements make apexification a predictable and reliable treatment option for young patients with immature necrotic teeth,preserving their natural dentition and preventing future complications.
