Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surge...Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surgery and sports medicine.The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration.Although leukocyte rich and leukocyte poor PRP's have their own place in literature,the importance of non-platelet components in a platelet concentrate remains a mystery.PC have come a long way since its first appearance in 1954 to the T-PRF,A-PRF and i-PRF introduced recently.These PC find varied applications successfully in periodontics and implant dentistry as well.However,the technique of preparation,standing time,transfer process,temperature of centrifuge,vibration,etc.,are the various factors for the mixed results reported in the literature.Until the introduction of a proper classification of terminologies,the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion.This review intends to clarify all these confusion by briefing the exact evolution of PC,their preparation techniques,recent advances and their various clinical and technical aspects and applications.展开更多
Optimal health during pregnancy is crucial for ensuring the well-being of the mother and the developing fetus.This article is focused on the impact of oral health and the role of personalized oral hygiene management i...Optimal health during pregnancy is crucial for ensuring the well-being of the mother and the developing fetus.This article is focused on the impact of oral health and the role of personalized oral hygiene management in addressing prevalent dental issues among pregnant women,with particular emphasis on periodontal disease and dental caries.Despite the high prevalence of these dental problems and their association with obstetric complications such as pre-term birth and low birth weight,many pregnant women do not receive adequate dental care.This gap in care is often due to misconceptions about the safety of dental treat-ments during pregnancy and lack of awareness on the part of healthcare profes-sionals.Appreciations of the impacts of oral health and personalization of oral hygiene strategies such as tailored education and support,have proven effective in improving oral health in this population.Significant reductions in the incidence of caries and periodontal disease may be achieved by adapting care to the specific needs of each patient,thereby enhancing maternal and fetal health outcomes.Integration of personalized oral hygiene management into maternal health pro-grams and enhancement of ongoing education for pregnant women and healthcare professionals are essential steps in the reduction of pregnancy-related risks and improvement of maternal and neonatal well-being.Core Tip:In this article,we reviewed a recent study on the effects of personalized oral hygiene management on the oral health of pregnant women,as discussed in the article by Men et al.The study demonstrated that personalized oral hygiene interventions significantly improved oral health outcomes during pregnancy by reducing the prevalence of dental caries and periodontal disease.We emphasized the importance of individualized oral care programs that integrate education and tailored support,and we highlighted their significance in enhancing maternal and fetal health.This approach underscores the need for incorporating personalized oral hygiene management into routine prenatal care in order to optimize health outcomes.CONCLUSION This article emphasizes the critical role of personalized oral hygiene management in improving oral health during pregnancy.By tailoring oral care strategies to individual needs,significant improvements in dental health may be achieved,as evidenced by the reduced CAT scores observed in the experimental group in the study by Men et al[25].This personalized approach not only addresses common oral issues such as dental caries and periodontal disease but also underscores the broader implications for maternal and fetal health.Despite the positive results,there remains a gap in consistency in the application of oral health practices during pregnancy,partly due to misconceptions and lack of awareness among patients and healthcare providers.Future research should aim at validating these findings across diverse populations,investigating the impact of oral hygiene interventions at various stages of pregnancy,and evaluating their long-term effects on maternal and fetal health.Integrating personalized oral hygiene management into maternal health programs and promoting continuous education for pregnant women and healthcare professionals are essential steps toward enhancing overall health outcomes.By proactively managing oral health,the risks associated with pregnancy may be reduced while improving maternal and neonatal well-being.展开更多
Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability t...Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability to prevent and treat peri-implantitis is hampered by a paucity of knowledge of how these biomes are acquired and the factors that engender normobiosis.Therefore,we combined a 3-month interventional study of 15 systemically and periodontally healthy adults with whole genome sequencing,finescale enumeration and graph theoretics to interrogate colonization dynamics in the pristine peri-implant sulcus.We discovered that colonization trajectories of implants differ substantially from adjoining teeth in acquisition of new members and development of functional synergies.Source-tracking algorithms revealed that this niche is initially seeded by bacteria trapped within the coverscrew chamber during implant placement.These pioneer species stably colonize the microbiome and exert a sustained influence on the ecosystem by serving as anchors of influential hubs and by providing functions that enable cell replication and biofilm maturation.Unlike the periodontal microbiome,recruitment of new members to the peri-implant community occurs on nepotistic principles.Maturation is accompanied by a progressive increase in anaerobiosis,however,the predominant functionalities are oxygen-dependent over the 12-weeks.The peri-implant community is easily perturbed following crown placement,but demonstrates remarkable resilience;returning to pre-perturbation states within three weeks.This study highlights important differences in the development of the periodontal and peri-implant ecosystems,and signposts the importance of placing implants in periodontally healthy individuals or following the successful resolution of periodontal disease.展开更多
Cancer stem cells(CSCs)are widely acknowledged as primary mediators to the initiation and progression of tumors.The association between microbial infection and cancer stemness has garnered considerable scholarly inter...Cancer stem cells(CSCs)are widely acknowledged as primary mediators to the initiation and progression of tumors.The association between microbial infection and cancer stemness has garnered considerable scholarly interest in recent years.Porphyromonas gingivalis(P.gingivalis)is increasingly considered to be closely related to the development of oral squamous cell carcinoma(OSCC).Nevertheless,the role of P.gingivalis in the stemness of OSCC cells remains uncertain.Herein,we showed that P.gingivalis was positively correlated with CSC markers expression in human OSCC specimens,promoted the stemness and tumorigenicity of OSCC cells,and enhanced tumor formation in nude mice.Mechanistically,P.gingivalis increased lipid synthesis in OSCC cells by upregulating the expression of stearoyl-CoA desaturase 1(SCD1)expression,a key enzyme involved in lipid metabolism,which ultimately resulted in enhanced acquisition of stemness.Moreover,SCD1 suppression attenuated P.gingivalis-induced stemness of OSCC cells,including CSCs markers expression,sphere formation ability,chemoresistance,and tumor growth,in OSCC cells both in vitro and in vivo.Additionally,upregulation of SCD1 in P.gingivalis-infected OSCC cells was associated with the expression of KLF5,and that was modulated by P.gingivalis-activated NOD1 signaling.Taken together,these findings highlight the importance of SCD1-dependent lipid synthesis in P.gingivalis-induced stemness acquisition in OSCC cells,suggest that the NOD1/KLF5 axis may play a key role in regulating SCD1 expression and provide a molecular basis for targeting SCD1 as a new option for attenuating OSCC cells stemness.展开更多
Increased matrix stiffness of nucleus pulposus(NP)tissue is a main feature of intervertebral disc degeneration(IVDD)and affects various functions of nucleus pulposus cells(NPCs).Glycolysis is the main energy source fo...Increased matrix stiffness of nucleus pulposus(NP)tissue is a main feature of intervertebral disc degeneration(IVDD)and affects various functions of nucleus pulposus cells(NPCs).Glycolysis is the main energy source for NPC survival,but the effects and underlying mechanisms of increased extracellular matrix(ECM)stiffness on NPC glycolysis remain unknown.In this study,hydrogels with different stiffness were established to mimic the mechanical environment of NPCs.Notably,increased matrix stiffness in degenerated NP tissues from IVDD patients was accompanied with impaired glycolysis,and NPCs cultured on rigid substrates exhibited a reduction in glycolysis.展开更多
BACKGROUND Lower salivary uric acid concentrations,the most abundant antioxidant agent in saliva,have been observed in patients with periodontitis compared to individuals with periodontal health.However,the independen...BACKGROUND Lower salivary uric acid concentrations,the most abundant antioxidant agent in saliva,have been observed in patients with periodontitis compared to individuals with periodontal health.However,the independent association of salivary uric acid levels with periodontitis,accounting for other risk factors,as well as its association with periodontitis severity,has not been investigated.AIM To the independent association of salivary uric acid levels with periodontitis and the association of salivary uric acid levels with the severity of periodontitis.METHODS This observational and prospective study measured salivary uric acid levels in subjects with periodontitis(characterized by periodontal loss of tissue)and in subjects without periodontitis(periodontal health or localized gingivitis in<30%of sites).Multivariate regression analysis was performed to determine independent factors associated with periodontitis.Spearman’s rho correlation coefficient was used to assess the relationship between salivary uric acid levels and periodontitis severity.A receiver operating characteristic analysis was carried out to evaluate the diagnostic performance of salivary uric acid levels in periodontitis,reporting the area under curve(AUC)and its 95%CI.RESULTS We included 121 subjects,61 of them with periodontitis and 60 without periodontitis(39 with periodontal health and 21 with local gingivitis).Subjects with periodontitis compared to those without periodontitis were older(P<0.001),had higher salivary uric acid levels(P=0.002),higher rate of arterial hypertension history(P=0.001)and higher rate of never-smoker history(P<0.001).The AUC for periodontitis diagnosis by salivary uric acid levels was 66%(95%CI:57%-75%;P<0.001)and the better cut-off point was 111 nmol/mL.Multiple logistic regression analysis showed an independent association of salivary uric acid levels<111 nmol/mL(OR=6.14;95%CI:2.015-18.721;P=0.001)with periodontitis after controlling for age,never-smoker history and arterial hypertension.A negative correlation of salivary uric acid levels and periodontitis severity was observed(rho=-0.32;P<0.001).CONCLUSION The two novel findings of our research were,first,that low salivary uric acid concentrations are independently associated with periodontitis,even after accounting for established risk factors.Second,salivary uric acid levels show a negative correlation with periodontitis severity.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
BACKGROUND In the absence of effective antimicrobials,transplant surgery is not viable,and antirejection immunosuppressants cannot be administered,as resistant infections compromise the life-saving goal of organ trans...BACKGROUND In the absence of effective antimicrobials,transplant surgery is not viable,and antirejection immunosuppressants cannot be administered,as resistant infections compromise the life-saving goal of organ transplantation.AIM To evaluate the efficacy of antimicrobials in preventing resistance in solid organ transplant recipients.METHODS A systematic review was conducted using a search methodology consistent with the preferred reporting items for systematic reviews and meta-analyses.This review included randomized clinical trials that evaluated the efficacy of antimicrobial agents(prophylactic or therapeutic)aimed at preventing antimicrobial resistance.The search strategy involved analyzing multiple databases,including PubMed/MEDLINE,Web of Science,Embase,Scopus,and SciELO,as well as examining gray literature sources on Google Scholar.A comprehensive electronic database search was conducted from the databases’inception until May 2024,with no language restrictions.RESULTS After the final phase of the eligibility assessment,this systematic review ultimate-ly included 7 articles.A total of 2318 patients were studied.The most studied microorganisms were cytomegalovirus,although vancomycinresistant enterococci,Clostridioides difficile,and multidrug-resistant Enterobacterales were also analyzed.The antimicrobials used in the interventions were mainly maribavir,valganciclovir,gancic-lovir,and colistin-neomycin.Of concern,all clinical trials showed significant proportions of resistant microorga-nisms after the interventions,with no statistically significant differences between the groups(mean resistance 13.47%vs 14.39%),except for two studies that demonstrated greater efficacy of maribavir and valganciclovir(mean resistance 22.2%vs 41.1%in the control group;P<0.05).The total reported deaths in three clinical trials were 75,and there were 24 graft rejections in two studies.CONCLUSION All clinical trials reported significant proportions of antimicrobial-resistant microorganisms following interventions.More high-quality randomized clinical trials are needed to corroborate these results.展开更多
BACKGROUND Periodontal disease is a chronic inflammatory condition characterized by periodontal pocket formation,clinical attachment loss,and destruction of alveolar bone.Its conventional treatment primarily involves ...BACKGROUND Periodontal disease is a chronic inflammatory condition characterized by periodontal pocket formation,clinical attachment loss,and destruction of alveolar bone.Its conventional treatment primarily involves mechanical debridement and plaque control,but localized antimicrobial therapy offers site-specific advantages.While antibiotics such as metronidazole and doxycycline are commonly used,green tea extract,which is rich in epigallocatechin gallate,has been proposed as a promising alternative for local drug delivery due to its anti-inflammatory and antimicrobial properties.AIM To compare the clinical efficacy of green tea extract gel and ornidazole gel as adjuncts to scaling and root planing(SRP)in patients with periodontitis.METHODS Teeth with probing pocket depths(PPD)of 4-7 mm were selected.Participants’baseline oral hygiene index-simplified,plaque index,clinical attachment loss,and PPD were recorded.The participants were randomized into two groups:One received green tea extract gel after SRP,and the other received ornidazole gel.Subgingival drug delivery was performed,and participants refrained from brushing or interproximal cleaning for ten days.Their clinical parameters were re-evaluated after one month.RESULTS The PPD decreased significantly from baseline to one month in both groups.However,the green tea extract gel group exhibited superior outcomes to the ornidazole gel group,with a mean difference in PPD of 0.28±0.78 mm at one month(P<0.007).CONCLUSION As an adjunct to SRP,green tea extract gel showed greater efficacy in improving clinical periodontal parameters than ornidazole gel.展开更多
BACKGROUND Artificial intelligence(AI)is transforming healthcare by improving diagnostic accuracy and predictive analytics.Periodontal diseases are recognized as risk factors for systemic conditions,including type 2 d...BACKGROUND Artificial intelligence(AI)is transforming healthcare by improving diagnostic accuracy and predictive analytics.Periodontal diseases are recognized as risk factors for systemic conditions,including type 2 diabetes mellitus,cardiovascular disease,Alzheimer’s disease,polycystic ovary syndrome,thyroid dysfunction,and post-coronavirus disease 2019 complications.These conditions exhibit complex bidirectional interactions,underscoring the importance of early detection and risk stratification.Current diagnostic tools often fail to capture these interactions at an early stage,limiting timely intervention.This study hypothesizes that AI-driven approaches can significantly improve early diagnosis and risk prediction of periodontal-systemic interactions,enhancing clinical outcomes.AIM To evaluate AI’s role in diagnosing and predicting periodontal-systemic interactions in studies from 2010 to 2024.METHODS This systematic review followed PRISMA guidelines(2009)and included peerreviewed articles from PubMed,Scopus,and Embase.Studies with large sample sizes(≥500 participants)were selected,focusing on AI models integrating multiomics data and advanced imaging techniques such as cone beam computed tomography and magnetic resonance imaging.Machine learning models processed structured clinical data,deep learning models combined imaging and clinical data,and natural language processing models extracted insights from clinical notes.RESULTS AI applications significantly enhanced diagnostic and predictive accuracy,reducing diagnostic time by 40%and improving predictive accuracy by 25%in periodontal patients with type 2 diabetes mellitus.Studies with sample sizes of 1000-1500 participants reported diagnostic accuracy improvements up to 92%,with specificity and sensitivity rates of 94%and 90%,respectively.Increasing sample sizes over the years reflected advancements in AI,data collection,and model training,reinforcing model reliability.CONCLUSION AI’s integration of multi-omics and imaging data has transformed early diagnosis and risk prediction in periodontal-systemic interactions,improving clinical outcomes and decision-making.展开更多
The article by Chauhan et al highlights the transformative potential of magnification tools in improving precision and outcomes across various dental specialties.While the authors discuss the advantages of magnificati...The article by Chauhan et al highlights the transformative potential of magnification tools in improving precision and outcomes across various dental specialties.While the authors discuss the advantages of magnification,they do not address the potential integration of artificial intelligence(AI)with magnification devices to further enhance diagnostic and therapeutic efficiency.This letter explores the synergy of AI with magnification tools,emphasizing its applicability in image-guided diagnostics,workflow optimization,and personalized treatment planning.The integration of AI and magnification also paves the way for personalized,data-driven treatment strategies,marking a significant evolution in dental care.However,it is important to acknowledge the limitations and challenges associated with AI,such as data privacy concerns,algorithmic biases,and the need for robust validation before clinical implementation.This discussion underscores the need for interdisciplinary research to realize this potential.展开更多
Inflammation represents a critical immune response triggered by cellular activities and inflammatory mediators following tissue damage.It plays a central role in the pathological progression of diverse diseases,includ...Inflammation represents a critical immune response triggered by cellular activities and inflammatory mediators following tissue damage.It plays a central role in the pathological progression of diverse diseases,including psychiatric disorders,cancer,and immunological conditions,rendering it an essential target for therapeutic intervention.Periodontitis,a prevalent oral inflammatory disease,is a leading cause of tooth loss and poses significant health challenges globally.Traditionally,inflammatory diseases such as periodontitis have been treated with systemic administration of synthetic chemicals.However,recent years have witnessed challenges,including drug resistance and microbial dysbiosis associated with these treatments.In contrast,natural products derived from Chinese medicine offer numerous benefits,such as high safety profiles,minimal side effects,innovative pharmacological mechanisms,ease of extraction,and multiple targets,rendering them viable alternatives to conventional antibiotics for treating inflammatory conditions.Numerous effective anti-inflammatory natural products have been identified in traditional Chinese medicine(TCM),including alkaloids,flavonoids,terpenoids,lignans,and other natural products that exhibit inhibitory effects on inflammation and are potential therapeutic agents.Several studies have confirmed the substantial anti-inflammatory and immunomodulatory properties of these compounds.This comprehensive review examines the literature on the anti-inflammatory effects of TCM-derived natural products from databases such as PubMed,Web of Science,and CNKI,focusing on terms like"inflammation","periodontitis","pharmacology",and"traditional Chinese medicine".The analysis systematically summarizes the molecular pharmacology,chemical composition,and biological activities of these compounds in inflammatory responses,alongside their mechanisms of action.This research seeks to deepen understanding of the mechanisms and biological activities of herbal extracts in managing inflammatory diseases,potentially leading to the development of promising new anti-inflammatory drug candidates.Future applications could extend to the treatment of various inflammatory conditions,including periodontitis.展开更多
BACKGROUND Dental follicle stem cell(DFSC)sheets demonstrate strong extracellular secretion capabilities and efficacy in periodontal regeneration.However,existing methods for producing DFSC sheets lack a comprehensive...BACKGROUND Dental follicle stem cell(DFSC)sheets demonstrate strong extracellular secretion capabilities and efficacy in periodontal regeneration.However,existing methods for producing DFSC sheets lack a comprehensive discussion on the most efficient and cost-effective approaches at the good manufacturing practice(GMP)level.AIM To investigate the culture condition of GMP-compliant DFSC sheets and to compare the properties of DFSC sheets and cell suspensions.METHODS This study explored the optimal conditions for culturing GMP-compliant DFSC sheets,focusing on four key factors:Cell passage,cell concentration,L-ascorbic acid content,and culture duration.We evaluated the characteristics of the cell sheets under varying culture conditions,including cell viability,cell count,appearance,osteogenesis,chondrogenesis,odontogenesis,aging,relative telomere length,and extracellular matrix secretion.A comparison was also made between the periodontal regeneration,osteogenesis,and paracrine capacity of cell sheets cultured under optimal conditions and those of the cell suspensions.RESULTS The GMP-compliant DFSC sheets cultured from passage 4 cells exhibited the highest viability(≥99%,P<0.05)and optimal osteogenic differentiation capacity(optical density≥0.126,P<0.05).When cultured for 10 days,DFSC sheets demonstrated maximal expression of osteogenic,chondrogenic and periostin genes[alkaline phosphatase,Runt-related transcription factor 2,collagen type I,osteopontin,cartilage associated protein,and PERIOSTN(P<0.001);osteocalcin(P<0.01)].Concurrently,they showed the lowest senescent cell count(P<0.01)with no progression to late-stage senescence.At a seeding density of 2500 cells/cm^(2),GMP-compliant DFSC sheets achieved better osteogenic differentiation(P<0.01)and maximal osteogenic,chondrogenic and periostin gene expression(P<0.001),coupled with the highest hydroxyproline secretion(P<0.001)and moderate sulfated glycosaminoglycan production.No statistically significant difference in senescent cell count was observed compared to DFSC sheets at a seeding density of 5000 cells/cm^(2).Supplementation with 25μg/mL L-ascorbic acid significantly enhanced osteogenic gene expression(P<0.001)and elevated hydroxyproline(P<0.01)and sulfated glycosaminoglycan secretion to high ranges.Compared with the cell suspension,the cell sheet demonstrated improved osteogenic,paracrine,and periodontal regenerative capacities in Sprague-Dawley rats.The optimized DFSC sheets demonstrated significantly higher levels of vascular endothelial growth factor and angiopoietin-1(P<0.001)compared to DFSC suspensions,along with enhanced osteogenic induction outcomes(optical density=0.1333±0.01270 vs 0.1007±0.0005774 in suspensions,P<0.05).Following implantation into the rat periodontal defect model,micro-computed tomography analysis revealed superior bone regeneration metrics in the cell sheet group compared to both the cell suspension group and control group(percent bone volume,trabecular thickness,trabecular number),while trabecular spacing exhibited an inverse pattern.CONCLUSION Optimized DFSC sheets cultured under the identified conditions outperform DFSC suspensions.This study contributes to the industrial-scale production of DFSC sheets and establishes a foundation for cell therapy applications.展开更多
BACKGROUND The generation of intrabony defects due to the iatrogenic use of elastic bands is an undesirable situation that can result in persistent gingival inflammation with subsequent bone degradation,thus ultimatel...BACKGROUND The generation of intrabony defects due to the iatrogenic use of elastic bands is an undesirable situation that can result in persistent gingival inflammation with subsequent bone degradation,thus ultimately leading to tooth loss.CASE SUMMARY This clinical case involved a 27-year-old male patient who complained of persistent inflammation and bleeding in the upper anterior region of the gums,despite having undergone dental cleaning for at least 4 years.The dental and medical history indicated the use of removable orthodontic appliances for 8 years,after which braces were placed for 2 years.The intraoral evaluation revealed inflammation and localized suppuration in teeth 11 and 12.Measurements of 2-7 mm for probing depth and 1-5 mm for clinical attachment loss were detected,and combined bone loss was observed via radiographs.Based on the clinical and radiographic findings,localized stage III,grade C periodontitis was diagnosed.During subgingival debridement,two elastic bands emerged around the involved teeth.The bone defects persisted;therefore,they were surgically addressed using a papilla preservation flap and guided tissue regeneration(GTR).CONCLUSION The use of elastic bands of various sizes and elasticities is often essential in multiple orthodontic treatments.However,it is crucial to perform a thorough check-up for each patient during treatment and at the end of treatment to remove any remaining residue of resin,metal bands,or orthodontic bands.Additionally,it is imperative to inform the patients of the importance of attending their follow-up appointments.The use of elastic bands in orthodontics requires special care;moreover,GTR is a management option for intrabony defects associated with the iatrogenic use of bands.展开更多
BACKGROUND Rectal foreign bodies,though uncommon,present diagnostic and therapeutic challenges,particularly when they result from accidental ingestion.The non-specific symptoms and the potential for serious complicati...BACKGROUND Rectal foreign bodies,though uncommon,present diagnostic and therapeutic challenges,particularly when they result from accidental ingestion.The non-specific symptoms and the potential for serious complications necessitate a thorough and methodical approach to diagnosis and treatment.This case report aims to highlight the diagnostic complexities and management strategies involved in treating a patient with a rectal foreign body,focusing on the use of advanced imaging techniques and the importance of a multidisciplinary approach.CASE SUMMARY A 48-year-old male with a history of hypertension presented with a one-year history of post-defecation anorectal pain and mild post-defecation rectorrhagia.Initial evaluation revealed hemodynamic stability and a tender,non-mucosal lesion in the anterior left rectal region.Imaging studies,including colonoscopy,magnetic resonance imaging,and endosonography,identified an erythematous,exophytic lesion and a perirectal abscess containing a foreign body.Surgical inter-vention revealed necrotic tissue and purulent material,along with two solid foreign body fragments(bone or plant matter).Postoperative follow-up showed the patient in good condition,and pathology confirmed the fragments as mature bone.CONCLUSION This case underscores the diagnostic challenges posed by rectal foreign bodies with nonspecific symptoms and no clear history of ingestion.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
BACKGROUND Camellia luteoflora is a unique variety of Camellia in China which is only distributes in Chishui City,Guizhou Province and Luzhou City,Sichuan Province.Its dried leaves are used by local residents as tea t...BACKGROUND Camellia luteoflora is a unique variety of Camellia in China which is only distributes in Chishui City,Guizhou Province and Luzhou City,Sichuan Province.Its dried leaves are used by local residents as tea to drink with light yellow and special aroma for health care.It has high potential economic medicinal value.Colon adenocarcinoma(COAD)is the third most frequent malignancy and its incidence and mortality is increasing.However,the current common treatments for COAD bring great side effects.In recent years,natural products and their various de-rivatives have shown significant potential to supplement conventional therapies and to reduce associated toxicity while improving efficacy.In order to overcome the limitations of traditional treatment methods,the global demand and development of natural anti-COAD drugs were increasingly hindered.AIM To investigate the potential targets and mechanisms of Camellia luteoflora anti-COAD.METHODS Nuclear magnetic resonance and mass spectrometry was used to identified the compounds of Camellia luteoflora.Network pharmacology analysis and survival analysis was used in this study to investigate the anti-COAD effect and mechanism of Camellia luteoflora.RESULTS Firstly,a total of 13 compounds were identified.Secondly,10 active ingredients for 204 potential targets were screened and protein-protein interaction analysis showed that TP53,STAT3,ESR1,MAPK8,AKR1C3,RELA,CYP19A1,CYP1A1,JUN and CYP17A1 were hub targets.GO and KEGG enrichment analyses revealed that Camellia luteoflora exerted anti-COAD effect through multiple functions and pathways.Then,the analysis of survival and stage indicated that TP53 was highly expressed in COAD and the overall survival of high-TP53 and high-CYP19A1 COAD patients was significantly shorter than the low group and there was significant difference in MAPK and RELA expression between different stages.Finally,the molecular docking results demonstrated the binding affinities and sites between active ingredients and TP53,STAT3,ESR1.CONCLUSION Our study systematically demonstrated the potential anti-COAD mechanism of Camellia luteoflora and provided a theoretical basis for its further application in the COAD treatment.展开更多
BACKGROUND Minimally invasive lumbar interbody fusion(LIF)procedures have evolved rapidly in recent years,with robot-assisted(RA)techniques increasingly integrated into clinical practice.However,questions remain regar...BACKGROUND Minimally invasive lumbar interbody fusion(LIF)procedures have evolved rapidly in recent years,with robot-assisted(RA)techniques increasingly integrated into clinical practice.However,questions remain regarding the relative advantages of RA over traditional fluoroscopy-guided and navigation-assisted methods in terms of perioperative,radiographic,and clinical outcomes.This systematic review synthesizes current evidence on these comparisons,focusing on the accuracy of screw placement,perioperative efficiency,radiographic and clinical outcomes,and complications.AIM To investigate the comparative effectiveness of RA vs conventional LIF techniques.METHODS A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 and Cochrane guidelines.Databases searched included PubMed,EMBASE,Web of Science,Scopus,and the Cochrane Library(through May 2025).Eligible studies were randomized controlled trials and observational studies comparing RA with fluoroscopy-or navigation-guided LIF(transforaminal lumbar interbody fusion,lateral lumbar interbody fusion,oblique lumbar interbody fusion)in adults.Two reviewers independently extracted data and assessed risk of bias.The Grading of Recommendations Assessment,Development and Evaluation framework was used to evaluate certainty of evidence.Meta-analyses were performed where data were sufficiently homogeneous.RESULTS Twenty-two studies were included,encompassing a total of 2313 patients-1046 who underwent RA-guided procedures and 1267 who received comparator techniques.Meta-analyses showed that RA significantly improved perfect pedicle screw placement[pooled odds ratio=2.93;95%confidence interval(CI):1.40-6.14;I2=78.2%]and reduced intraoperative blood loss(pooled standardized mean difference=-0.28;95%CI:-0.47 to-0.08;I2=0%).Operative time did not significantly differ between groups(pooled standardized mean difference=0.01;95%CI:-0.30 to 0.31;I2=66%).Radiation dose could not be synthesized quantitatively due to heterogeneous definitions and measurement units.Narratively,RA demonstrated consistent advantages in reducing surgical exposure and adjacent segment degeneration.Clinical and radiographic outcomes,fusion success,and complication rates were generally comparable across groups.CONCLUSION RA LIF improves pedicle screw placement accuracy and reduces blood loss and surgeon radiation exposure while maintaining similar clinical outcomes and safety profiles to conventional techniques.These findings support the integration of RA into spine surgery but highlight the need for high-quality multicenter randomized controlled trials and cost-effectiveness studies to guide broader implementation.展开更多
This article evaluates the transformative potential of large language models(LLMs)as patient education tools for managing inflammatory bowel disease.The discussion highlights their ability to deliver nuanced and perso...This article evaluates the transformative potential of large language models(LLMs)as patient education tools for managing inflammatory bowel disease.The discussion highlights their ability to deliver nuanced and personalized infor-mation,addressing limitations in traditional educational materials.Key consider-ations include the necessity for domain-specific fine-tuning to enhance accuracy,the adoption of robust evaluation metrics beyond readability,and the integration of LLMs with clinical decision support systems to improve real-time patient education.Ethical and accessibility challenges,such as algorithmic bias,data privacy,and digital literacy,are also examined.Recommendations emphasize the importance of interdisciplinary collaboration to optimize LLM integration,en-suring equitable access and improved patient outcomes.By advancing LLM technology,healthcare can empower patients with accurate and personalized information,enhancing engagement and disease management.展开更多
Background:Hypertension is a significant public health concern and a leading cause of cardiovascular diseases worldwide.Urbanization has contributed to an increased prevalence of hypertension by introducing lifestyle-...Background:Hypertension is a significant public health concern and a leading cause of cardiovascular diseases worldwide.Urbanization has contributed to an increased prevalence of hypertension by introducing lifestyle-related risk factors such as physical inactivity,unhealthy dietary patterns,and stress.Region-specific tools for assessing hypertension risk factors are essential for designing effective public health interventions.Objectives:This study aimed to develop and validate a questionnaire to assess the risk factors for hypertension in the urban population of Mysuru and identify the prevalence of key modifiable and nonmodifiable risk factors.Materials and Methods:A cross-sectional study was conducted among 100 participants aged 18-60 years in urban Mysuru.A 40-item questionnaire was developed based on literature review and expert input.It included domains such as sociodemographic factors,lifestyle habits,and clinical history.Reliability was evaluated using Cronbach’s alpha,while construct validity was assessed through exploratory factor analysis.Descriptive statistics and Chi-square tests were used for data analysis.Results:The questionnaire demonstrated high internal consistency(Cronbach’s alpha>0.7)and satisfactory construct validity.Key findings included a high prevalence of low physical activity(60%),high salt intake(50%),and overweight individuals(30%).In addition,40%of participants reported a family history of hypertension,and 18%had prediabetes.These findings emphasize the role of modifiable risk factors in the rising hypertension burden in urban settings.Conclusion:The developed and validated questionnaire is a reliable and valid tool for assessing hypertension risk factors in urban populations.展开更多
文摘Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surgery and sports medicine.The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration.Although leukocyte rich and leukocyte poor PRP's have their own place in literature,the importance of non-platelet components in a platelet concentrate remains a mystery.PC have come a long way since its first appearance in 1954 to the T-PRF,A-PRF and i-PRF introduced recently.These PC find varied applications successfully in periodontics and implant dentistry as well.However,the technique of preparation,standing time,transfer process,temperature of centrifuge,vibration,etc.,are the various factors for the mixed results reported in the literature.Until the introduction of a proper classification of terminologies,the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion.This review intends to clarify all these confusion by briefing the exact evolution of PC,their preparation techniques,recent advances and their various clinical and technical aspects and applications.
文摘Optimal health during pregnancy is crucial for ensuring the well-being of the mother and the developing fetus.This article is focused on the impact of oral health and the role of personalized oral hygiene management in addressing prevalent dental issues among pregnant women,with particular emphasis on periodontal disease and dental caries.Despite the high prevalence of these dental problems and their association with obstetric complications such as pre-term birth and low birth weight,many pregnant women do not receive adequate dental care.This gap in care is often due to misconceptions about the safety of dental treat-ments during pregnancy and lack of awareness on the part of healthcare profes-sionals.Appreciations of the impacts of oral health and personalization of oral hygiene strategies such as tailored education and support,have proven effective in improving oral health in this population.Significant reductions in the incidence of caries and periodontal disease may be achieved by adapting care to the specific needs of each patient,thereby enhancing maternal and fetal health outcomes.Integration of personalized oral hygiene management into maternal health pro-grams and enhancement of ongoing education for pregnant women and healthcare professionals are essential steps in the reduction of pregnancy-related risks and improvement of maternal and neonatal well-being.Core Tip:In this article,we reviewed a recent study on the effects of personalized oral hygiene management on the oral health of pregnant women,as discussed in the article by Men et al.The study demonstrated that personalized oral hygiene interventions significantly improved oral health outcomes during pregnancy by reducing the prevalence of dental caries and periodontal disease.We emphasized the importance of individualized oral care programs that integrate education and tailored support,and we highlighted their significance in enhancing maternal and fetal health.This approach underscores the need for incorporating personalized oral hygiene management into routine prenatal care in order to optimize health outcomes.CONCLUSION This article emphasizes the critical role of personalized oral hygiene management in improving oral health during pregnancy.By tailoring oral care strategies to individual needs,significant improvements in dental health may be achieved,as evidenced by the reduced CAT scores observed in the experimental group in the study by Men et al[25].This personalized approach not only addresses common oral issues such as dental caries and periodontal disease but also underscores the broader implications for maternal and fetal health.Despite the positive results,there remains a gap in consistency in the application of oral health practices during pregnancy,partly due to misconceptions and lack of awareness among patients and healthcare providers.Future research should aim at validating these findings across diverse populations,investigating the impact of oral hygiene interventions at various stages of pregnancy,and evaluating their long-term effects on maternal and fetal health.Integrating personalized oral hygiene management into maternal health programs and promoting continuous education for pregnant women and healthcare professionals are essential steps toward enhancing overall health outcomes.By proactively managing oral health,the risks associated with pregnancy may be reduced while improving maternal and neonatal well-being.
基金supported by National Institutes of Health R03DE027492 to Shareef Dabdoubsupported by National Institutes of Health,project number 7R01DE027857-06supported by National Institutes of Health R56DE033913 awarded to Purnima Kumar.
文摘Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability to prevent and treat peri-implantitis is hampered by a paucity of knowledge of how these biomes are acquired and the factors that engender normobiosis.Therefore,we combined a 3-month interventional study of 15 systemically and periodontally healthy adults with whole genome sequencing,finescale enumeration and graph theoretics to interrogate colonization dynamics in the pristine peri-implant sulcus.We discovered that colonization trajectories of implants differ substantially from adjoining teeth in acquisition of new members and development of functional synergies.Source-tracking algorithms revealed that this niche is initially seeded by bacteria trapped within the coverscrew chamber during implant placement.These pioneer species stably colonize the microbiome and exert a sustained influence on the ecosystem by serving as anchors of influential hubs and by providing functions that enable cell replication and biofilm maturation.Unlike the periodontal microbiome,recruitment of new members to the peri-implant community occurs on nepotistic principles.Maturation is accompanied by a progressive increase in anaerobiosis,however,the predominant functionalities are oxygen-dependent over the 12-weeks.The peri-implant community is easily perturbed following crown placement,but demonstrates remarkable resilience;returning to pre-perturbation states within three weeks.This study highlights important differences in the development of the periodontal and peri-implant ecosystems,and signposts the importance of placing implants in periodontally healthy individuals or following the successful resolution of periodontal disease.
基金supported by the National Natural Science Foundation of China(grant#82370975 and 82170969)。
文摘Cancer stem cells(CSCs)are widely acknowledged as primary mediators to the initiation and progression of tumors.The association between microbial infection and cancer stemness has garnered considerable scholarly interest in recent years.Porphyromonas gingivalis(P.gingivalis)is increasingly considered to be closely related to the development of oral squamous cell carcinoma(OSCC).Nevertheless,the role of P.gingivalis in the stemness of OSCC cells remains uncertain.Herein,we showed that P.gingivalis was positively correlated with CSC markers expression in human OSCC specimens,promoted the stemness and tumorigenicity of OSCC cells,and enhanced tumor formation in nude mice.Mechanistically,P.gingivalis increased lipid synthesis in OSCC cells by upregulating the expression of stearoyl-CoA desaturase 1(SCD1)expression,a key enzyme involved in lipid metabolism,which ultimately resulted in enhanced acquisition of stemness.Moreover,SCD1 suppression attenuated P.gingivalis-induced stemness of OSCC cells,including CSCs markers expression,sphere formation ability,chemoresistance,and tumor growth,in OSCC cells both in vitro and in vivo.Additionally,upregulation of SCD1 in P.gingivalis-infected OSCC cells was associated with the expression of KLF5,and that was modulated by P.gingivalis-activated NOD1 signaling.Taken together,these findings highlight the importance of SCD1-dependent lipid synthesis in P.gingivalis-induced stemness acquisition in OSCC cells,suggest that the NOD1/KLF5 axis may play a key role in regulating SCD1 expression and provide a molecular basis for targeting SCD1 as a new option for attenuating OSCC cells stemness.
基金supported by the National Nature Science Foundation of China(No.82002345 to J.D and 81902179 to L.S)the Gusu Talent Program(No.Qngg2022008 and GSWS2021027 to J.D)the Preliminary Research Project of the Second Affiliated Hospital of Soochow University(No.SDFEYBS1905 to J.D).
文摘Increased matrix stiffness of nucleus pulposus(NP)tissue is a main feature of intervertebral disc degeneration(IVDD)and affects various functions of nucleus pulposus cells(NPCs).Glycolysis is the main energy source for NPC survival,but the effects and underlying mechanisms of increased extracellular matrix(ECM)stiffness on NPC glycolysis remain unknown.In this study,hydrogels with different stiffness were established to mimic the mechanical environment of NPCs.Notably,increased matrix stiffness in degenerated NP tissues from IVDD patients was accompanied with impaired glycolysis,and NPCs cultured on rigid substrates exhibited a reduction in glycolysis.
文摘BACKGROUND Lower salivary uric acid concentrations,the most abundant antioxidant agent in saliva,have been observed in patients with periodontitis compared to individuals with periodontal health.However,the independent association of salivary uric acid levels with periodontitis,accounting for other risk factors,as well as its association with periodontitis severity,has not been investigated.AIM To the independent association of salivary uric acid levels with periodontitis and the association of salivary uric acid levels with the severity of periodontitis.METHODS This observational and prospective study measured salivary uric acid levels in subjects with periodontitis(characterized by periodontal loss of tissue)and in subjects without periodontitis(periodontal health or localized gingivitis in<30%of sites).Multivariate regression analysis was performed to determine independent factors associated with periodontitis.Spearman’s rho correlation coefficient was used to assess the relationship between salivary uric acid levels and periodontitis severity.A receiver operating characteristic analysis was carried out to evaluate the diagnostic performance of salivary uric acid levels in periodontitis,reporting the area under curve(AUC)and its 95%CI.RESULTS We included 121 subjects,61 of them with periodontitis and 60 without periodontitis(39 with periodontal health and 21 with local gingivitis).Subjects with periodontitis compared to those without periodontitis were older(P<0.001),had higher salivary uric acid levels(P=0.002),higher rate of arterial hypertension history(P=0.001)and higher rate of never-smoker history(P<0.001).The AUC for periodontitis diagnosis by salivary uric acid levels was 66%(95%CI:57%-75%;P<0.001)and the better cut-off point was 111 nmol/mL.Multiple logistic regression analysis showed an independent association of salivary uric acid levels<111 nmol/mL(OR=6.14;95%CI:2.015-18.721;P=0.001)with periodontitis after controlling for age,never-smoker history and arterial hypertension.A negative correlation of salivary uric acid levels and periodontitis severity was observed(rho=-0.32;P<0.001).CONCLUSION The two novel findings of our research were,first,that low salivary uric acid concentrations are independently associated with periodontitis,even after accounting for established risk factors.Second,salivary uric acid levels show a negative correlation with periodontitis severity.
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.
文摘BACKGROUND In the absence of effective antimicrobials,transplant surgery is not viable,and antirejection immunosuppressants cannot be administered,as resistant infections compromise the life-saving goal of organ transplantation.AIM To evaluate the efficacy of antimicrobials in preventing resistance in solid organ transplant recipients.METHODS A systematic review was conducted using a search methodology consistent with the preferred reporting items for systematic reviews and meta-analyses.This review included randomized clinical trials that evaluated the efficacy of antimicrobial agents(prophylactic or therapeutic)aimed at preventing antimicrobial resistance.The search strategy involved analyzing multiple databases,including PubMed/MEDLINE,Web of Science,Embase,Scopus,and SciELO,as well as examining gray literature sources on Google Scholar.A comprehensive electronic database search was conducted from the databases’inception until May 2024,with no language restrictions.RESULTS After the final phase of the eligibility assessment,this systematic review ultimate-ly included 7 articles.A total of 2318 patients were studied.The most studied microorganisms were cytomegalovirus,although vancomycinresistant enterococci,Clostridioides difficile,and multidrug-resistant Enterobacterales were also analyzed.The antimicrobials used in the interventions were mainly maribavir,valganciclovir,gancic-lovir,and colistin-neomycin.Of concern,all clinical trials showed significant proportions of resistant microorga-nisms after the interventions,with no statistically significant differences between the groups(mean resistance 13.47%vs 14.39%),except for two studies that demonstrated greater efficacy of maribavir and valganciclovir(mean resistance 22.2%vs 41.1%in the control group;P<0.05).The total reported deaths in three clinical trials were 75,and there were 24 graft rejections in two studies.CONCLUSION All clinical trials reported significant proportions of antimicrobial-resistant microorganisms following interventions.More high-quality randomized clinical trials are needed to corroborate these results.
文摘BACKGROUND Periodontal disease is a chronic inflammatory condition characterized by periodontal pocket formation,clinical attachment loss,and destruction of alveolar bone.Its conventional treatment primarily involves mechanical debridement and plaque control,but localized antimicrobial therapy offers site-specific advantages.While antibiotics such as metronidazole and doxycycline are commonly used,green tea extract,which is rich in epigallocatechin gallate,has been proposed as a promising alternative for local drug delivery due to its anti-inflammatory and antimicrobial properties.AIM To compare the clinical efficacy of green tea extract gel and ornidazole gel as adjuncts to scaling and root planing(SRP)in patients with periodontitis.METHODS Teeth with probing pocket depths(PPD)of 4-7 mm were selected.Participants’baseline oral hygiene index-simplified,plaque index,clinical attachment loss,and PPD were recorded.The participants were randomized into two groups:One received green tea extract gel after SRP,and the other received ornidazole gel.Subgingival drug delivery was performed,and participants refrained from brushing or interproximal cleaning for ten days.Their clinical parameters were re-evaluated after one month.RESULTS The PPD decreased significantly from baseline to one month in both groups.However,the green tea extract gel group exhibited superior outcomes to the ornidazole gel group,with a mean difference in PPD of 0.28±0.78 mm at one month(P<0.007).CONCLUSION As an adjunct to SRP,green tea extract gel showed greater efficacy in improving clinical periodontal parameters than ornidazole gel.
文摘BACKGROUND Artificial intelligence(AI)is transforming healthcare by improving diagnostic accuracy and predictive analytics.Periodontal diseases are recognized as risk factors for systemic conditions,including type 2 diabetes mellitus,cardiovascular disease,Alzheimer’s disease,polycystic ovary syndrome,thyroid dysfunction,and post-coronavirus disease 2019 complications.These conditions exhibit complex bidirectional interactions,underscoring the importance of early detection and risk stratification.Current diagnostic tools often fail to capture these interactions at an early stage,limiting timely intervention.This study hypothesizes that AI-driven approaches can significantly improve early diagnosis and risk prediction of periodontal-systemic interactions,enhancing clinical outcomes.AIM To evaluate AI’s role in diagnosing and predicting periodontal-systemic interactions in studies from 2010 to 2024.METHODS This systematic review followed PRISMA guidelines(2009)and included peerreviewed articles from PubMed,Scopus,and Embase.Studies with large sample sizes(≥500 participants)were selected,focusing on AI models integrating multiomics data and advanced imaging techniques such as cone beam computed tomography and magnetic resonance imaging.Machine learning models processed structured clinical data,deep learning models combined imaging and clinical data,and natural language processing models extracted insights from clinical notes.RESULTS AI applications significantly enhanced diagnostic and predictive accuracy,reducing diagnostic time by 40%and improving predictive accuracy by 25%in periodontal patients with type 2 diabetes mellitus.Studies with sample sizes of 1000-1500 participants reported diagnostic accuracy improvements up to 92%,with specificity and sensitivity rates of 94%and 90%,respectively.Increasing sample sizes over the years reflected advancements in AI,data collection,and model training,reinforcing model reliability.CONCLUSION AI’s integration of multi-omics and imaging data has transformed early diagnosis and risk prediction in periodontal-systemic interactions,improving clinical outcomes and decision-making.
文摘The article by Chauhan et al highlights the transformative potential of magnification tools in improving precision and outcomes across various dental specialties.While the authors discuss the advantages of magnification,they do not address the potential integration of artificial intelligence(AI)with magnification devices to further enhance diagnostic and therapeutic efficiency.This letter explores the synergy of AI with magnification tools,emphasizing its applicability in image-guided diagnostics,workflow optimization,and personalized treatment planning.The integration of AI and magnification also paves the way for personalized,data-driven treatment strategies,marking a significant evolution in dental care.However,it is important to acknowledge the limitations and challenges associated with AI,such as data privacy concerns,algorithmic biases,and the need for robust validation before clinical implementation.This discussion underscores the need for interdisciplinary research to realize this potential.
基金supported by the Scientific and Technological Development Program of Jilin Province,China (Nos.20210203090SF and 20200403119SF)
文摘Inflammation represents a critical immune response triggered by cellular activities and inflammatory mediators following tissue damage.It plays a central role in the pathological progression of diverse diseases,including psychiatric disorders,cancer,and immunological conditions,rendering it an essential target for therapeutic intervention.Periodontitis,a prevalent oral inflammatory disease,is a leading cause of tooth loss and poses significant health challenges globally.Traditionally,inflammatory diseases such as periodontitis have been treated with systemic administration of synthetic chemicals.However,recent years have witnessed challenges,including drug resistance and microbial dysbiosis associated with these treatments.In contrast,natural products derived from Chinese medicine offer numerous benefits,such as high safety profiles,minimal side effects,innovative pharmacological mechanisms,ease of extraction,and multiple targets,rendering them viable alternatives to conventional antibiotics for treating inflammatory conditions.Numerous effective anti-inflammatory natural products have been identified in traditional Chinese medicine(TCM),including alkaloids,flavonoids,terpenoids,lignans,and other natural products that exhibit inhibitory effects on inflammation and are potential therapeutic agents.Several studies have confirmed the substantial anti-inflammatory and immunomodulatory properties of these compounds.This comprehensive review examines the literature on the anti-inflammatory effects of TCM-derived natural products from databases such as PubMed,Web of Science,and CNKI,focusing on terms like"inflammation","periodontitis","pharmacology",and"traditional Chinese medicine".The analysis systematically summarizes the molecular pharmacology,chemical composition,and biological activities of these compounds in inflammatory responses,alongside their mechanisms of action.This research seeks to deepen understanding of the mechanisms and biological activities of herbal extracts in managing inflammatory diseases,potentially leading to the development of promising new anti-inflammatory drug candidates.Future applications could extend to the treatment of various inflammatory conditions,including periodontitis.
基金Supported by National Key Research and Development Program of China,No.2021YFA1100600 and No.2022YFA1104400.
文摘BACKGROUND Dental follicle stem cell(DFSC)sheets demonstrate strong extracellular secretion capabilities and efficacy in periodontal regeneration.However,existing methods for producing DFSC sheets lack a comprehensive discussion on the most efficient and cost-effective approaches at the good manufacturing practice(GMP)level.AIM To investigate the culture condition of GMP-compliant DFSC sheets and to compare the properties of DFSC sheets and cell suspensions.METHODS This study explored the optimal conditions for culturing GMP-compliant DFSC sheets,focusing on four key factors:Cell passage,cell concentration,L-ascorbic acid content,and culture duration.We evaluated the characteristics of the cell sheets under varying culture conditions,including cell viability,cell count,appearance,osteogenesis,chondrogenesis,odontogenesis,aging,relative telomere length,and extracellular matrix secretion.A comparison was also made between the periodontal regeneration,osteogenesis,and paracrine capacity of cell sheets cultured under optimal conditions and those of the cell suspensions.RESULTS The GMP-compliant DFSC sheets cultured from passage 4 cells exhibited the highest viability(≥99%,P<0.05)and optimal osteogenic differentiation capacity(optical density≥0.126,P<0.05).When cultured for 10 days,DFSC sheets demonstrated maximal expression of osteogenic,chondrogenic and periostin genes[alkaline phosphatase,Runt-related transcription factor 2,collagen type I,osteopontin,cartilage associated protein,and PERIOSTN(P<0.001);osteocalcin(P<0.01)].Concurrently,they showed the lowest senescent cell count(P<0.01)with no progression to late-stage senescence.At a seeding density of 2500 cells/cm^(2),GMP-compliant DFSC sheets achieved better osteogenic differentiation(P<0.01)and maximal osteogenic,chondrogenic and periostin gene expression(P<0.001),coupled with the highest hydroxyproline secretion(P<0.001)and moderate sulfated glycosaminoglycan production.No statistically significant difference in senescent cell count was observed compared to DFSC sheets at a seeding density of 5000 cells/cm^(2).Supplementation with 25μg/mL L-ascorbic acid significantly enhanced osteogenic gene expression(P<0.001)and elevated hydroxyproline(P<0.01)and sulfated glycosaminoglycan secretion to high ranges.Compared with the cell suspension,the cell sheet demonstrated improved osteogenic,paracrine,and periodontal regenerative capacities in Sprague-Dawley rats.The optimized DFSC sheets demonstrated significantly higher levels of vascular endothelial growth factor and angiopoietin-1(P<0.001)compared to DFSC suspensions,along with enhanced osteogenic induction outcomes(optical density=0.1333±0.01270 vs 0.1007±0.0005774 in suspensions,P<0.05).Following implantation into the rat periodontal defect model,micro-computed tomography analysis revealed superior bone regeneration metrics in the cell sheet group compared to both the cell suspension group and control group(percent bone volume,trabecular thickness,trabecular number),while trabecular spacing exhibited an inverse pattern.CONCLUSION Optimized DFSC sheets cultured under the identified conditions outperform DFSC suspensions.This study contributes to the industrial-scale production of DFSC sheets and establishes a foundation for cell therapy applications.
文摘BACKGROUND The generation of intrabony defects due to the iatrogenic use of elastic bands is an undesirable situation that can result in persistent gingival inflammation with subsequent bone degradation,thus ultimately leading to tooth loss.CASE SUMMARY This clinical case involved a 27-year-old male patient who complained of persistent inflammation and bleeding in the upper anterior region of the gums,despite having undergone dental cleaning for at least 4 years.The dental and medical history indicated the use of removable orthodontic appliances for 8 years,after which braces were placed for 2 years.The intraoral evaluation revealed inflammation and localized suppuration in teeth 11 and 12.Measurements of 2-7 mm for probing depth and 1-5 mm for clinical attachment loss were detected,and combined bone loss was observed via radiographs.Based on the clinical and radiographic findings,localized stage III,grade C periodontitis was diagnosed.During subgingival debridement,two elastic bands emerged around the involved teeth.The bone defects persisted;therefore,they were surgically addressed using a papilla preservation flap and guided tissue regeneration(GTR).CONCLUSION The use of elastic bands of various sizes and elasticities is often essential in multiple orthodontic treatments.However,it is crucial to perform a thorough check-up for each patient during treatment and at the end of treatment to remove any remaining residue of resin,metal bands,or orthodontic bands.Additionally,it is imperative to inform the patients of the importance of attending their follow-up appointments.The use of elastic bands in orthodontics requires special care;moreover,GTR is a management option for intrabony defects associated with the iatrogenic use of bands.
文摘BACKGROUND Rectal foreign bodies,though uncommon,present diagnostic and therapeutic challenges,particularly when they result from accidental ingestion.The non-specific symptoms and the potential for serious complications necessitate a thorough and methodical approach to diagnosis and treatment.This case report aims to highlight the diagnostic complexities and management strategies involved in treating a patient with a rectal foreign body,focusing on the use of advanced imaging techniques and the importance of a multidisciplinary approach.CASE SUMMARY A 48-year-old male with a history of hypertension presented with a one-year history of post-defecation anorectal pain and mild post-defecation rectorrhagia.Initial evaluation revealed hemodynamic stability and a tender,non-mucosal lesion in the anterior left rectal region.Imaging studies,including colonoscopy,magnetic resonance imaging,and endosonography,identified an erythematous,exophytic lesion and a perirectal abscess containing a foreign body.Surgical inter-vention revealed necrotic tissue and purulent material,along with two solid foreign body fragments(bone or plant matter).Postoperative follow-up showed the patient in good condition,and pathology confirmed the fragments as mature bone.CONCLUSION This case underscores the diagnostic challenges posed by rectal foreign bodies with nonspecific symptoms and no clear history of ingestion.
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.
基金Supported by Guizhou Provincial Basic Research Program(Natural Science),No.ZK[2023]-554and the National Natural Science Foundation of China,No.32360144.
文摘BACKGROUND Camellia luteoflora is a unique variety of Camellia in China which is only distributes in Chishui City,Guizhou Province and Luzhou City,Sichuan Province.Its dried leaves are used by local residents as tea to drink with light yellow and special aroma for health care.It has high potential economic medicinal value.Colon adenocarcinoma(COAD)is the third most frequent malignancy and its incidence and mortality is increasing.However,the current common treatments for COAD bring great side effects.In recent years,natural products and their various de-rivatives have shown significant potential to supplement conventional therapies and to reduce associated toxicity while improving efficacy.In order to overcome the limitations of traditional treatment methods,the global demand and development of natural anti-COAD drugs were increasingly hindered.AIM To investigate the potential targets and mechanisms of Camellia luteoflora anti-COAD.METHODS Nuclear magnetic resonance and mass spectrometry was used to identified the compounds of Camellia luteoflora.Network pharmacology analysis and survival analysis was used in this study to investigate the anti-COAD effect and mechanism of Camellia luteoflora.RESULTS Firstly,a total of 13 compounds were identified.Secondly,10 active ingredients for 204 potential targets were screened and protein-protein interaction analysis showed that TP53,STAT3,ESR1,MAPK8,AKR1C3,RELA,CYP19A1,CYP1A1,JUN and CYP17A1 were hub targets.GO and KEGG enrichment analyses revealed that Camellia luteoflora exerted anti-COAD effect through multiple functions and pathways.Then,the analysis of survival and stage indicated that TP53 was highly expressed in COAD and the overall survival of high-TP53 and high-CYP19A1 COAD patients was significantly shorter than the low group and there was significant difference in MAPK and RELA expression between different stages.Finally,the molecular docking results demonstrated the binding affinities and sites between active ingredients and TP53,STAT3,ESR1.CONCLUSION Our study systematically demonstrated the potential anti-COAD mechanism of Camellia luteoflora and provided a theoretical basis for its further application in the COAD treatment.
文摘BACKGROUND Minimally invasive lumbar interbody fusion(LIF)procedures have evolved rapidly in recent years,with robot-assisted(RA)techniques increasingly integrated into clinical practice.However,questions remain regarding the relative advantages of RA over traditional fluoroscopy-guided and navigation-assisted methods in terms of perioperative,radiographic,and clinical outcomes.This systematic review synthesizes current evidence on these comparisons,focusing on the accuracy of screw placement,perioperative efficiency,radiographic and clinical outcomes,and complications.AIM To investigate the comparative effectiveness of RA vs conventional LIF techniques.METHODS A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 and Cochrane guidelines.Databases searched included PubMed,EMBASE,Web of Science,Scopus,and the Cochrane Library(through May 2025).Eligible studies were randomized controlled trials and observational studies comparing RA with fluoroscopy-or navigation-guided LIF(transforaminal lumbar interbody fusion,lateral lumbar interbody fusion,oblique lumbar interbody fusion)in adults.Two reviewers independently extracted data and assessed risk of bias.The Grading of Recommendations Assessment,Development and Evaluation framework was used to evaluate certainty of evidence.Meta-analyses were performed where data were sufficiently homogeneous.RESULTS Twenty-two studies were included,encompassing a total of 2313 patients-1046 who underwent RA-guided procedures and 1267 who received comparator techniques.Meta-analyses showed that RA significantly improved perfect pedicle screw placement[pooled odds ratio=2.93;95%confidence interval(CI):1.40-6.14;I2=78.2%]and reduced intraoperative blood loss(pooled standardized mean difference=-0.28;95%CI:-0.47 to-0.08;I2=0%).Operative time did not significantly differ between groups(pooled standardized mean difference=0.01;95%CI:-0.30 to 0.31;I2=66%).Radiation dose could not be synthesized quantitatively due to heterogeneous definitions and measurement units.Narratively,RA demonstrated consistent advantages in reducing surgical exposure and adjacent segment degeneration.Clinical and radiographic outcomes,fusion success,and complication rates were generally comparable across groups.CONCLUSION RA LIF improves pedicle screw placement accuracy and reduces blood loss and surgeon radiation exposure while maintaining similar clinical outcomes and safety profiles to conventional techniques.These findings support the integration of RA into spine surgery but highlight the need for high-quality multicenter randomized controlled trials and cost-effectiveness studies to guide broader implementation.
文摘This article evaluates the transformative potential of large language models(LLMs)as patient education tools for managing inflammatory bowel disease.The discussion highlights their ability to deliver nuanced and personalized infor-mation,addressing limitations in traditional educational materials.Key consider-ations include the necessity for domain-specific fine-tuning to enhance accuracy,the adoption of robust evaluation metrics beyond readability,and the integration of LLMs with clinical decision support systems to improve real-time patient education.Ethical and accessibility challenges,such as algorithmic bias,data privacy,and digital literacy,are also examined.Recommendations emphasize the importance of interdisciplinary collaboration to optimize LLM integration,en-suring equitable access and improved patient outcomes.By advancing LLM technology,healthcare can empower patients with accurate and personalized information,enhancing engagement and disease management.
文摘Background:Hypertension is a significant public health concern and a leading cause of cardiovascular diseases worldwide.Urbanization has contributed to an increased prevalence of hypertension by introducing lifestyle-related risk factors such as physical inactivity,unhealthy dietary patterns,and stress.Region-specific tools for assessing hypertension risk factors are essential for designing effective public health interventions.Objectives:This study aimed to develop and validate a questionnaire to assess the risk factors for hypertension in the urban population of Mysuru and identify the prevalence of key modifiable and nonmodifiable risk factors.Materials and Methods:A cross-sectional study was conducted among 100 participants aged 18-60 years in urban Mysuru.A 40-item questionnaire was developed based on literature review and expert input.It included domains such as sociodemographic factors,lifestyle habits,and clinical history.Reliability was evaluated using Cronbach’s alpha,while construct validity was assessed through exploratory factor analysis.Descriptive statistics and Chi-square tests were used for data analysis.Results:The questionnaire demonstrated high internal consistency(Cronbach’s alpha>0.7)and satisfactory construct validity.Key findings included a high prevalence of low physical activity(60%),high salt intake(50%),and overweight individuals(30%).In addition,40%of participants reported a family history of hypertension,and 18%had prediabetes.These findings emphasize the role of modifiable risk factors in the rising hypertension burden in urban settings.Conclusion:The developed and validated questionnaire is a reliable and valid tool for assessing hypertension risk factors in urban populations.
