Abstract:To systematically review the research trends and developments in the field of digital technology for root canal therapy,this study used bibliometric methods to visually analyze 383 relevant literature in the Web of Science Core Collection database from 2000 to 2024.Combining VOSviewer and CiteSpace tools,the development trajectory,research hotspots,and cutting-edge directions of this field were explored.The number of publications in the digital field of root canal therapy has shown a significant upward trend,with a leapfrog growth in 2024,indicating sustained growth in various aspects such as technological iteration,clinical demand,policy support,and academic attention in this field.The research hotspots focus on cone beam computed tomography,dynamic navigation systems,artificial intelligence,and 3D printing.Keyword burst analysis shows that machine learning(with the highest burst intensity,2020 to 2024),deep learning(after 2022),and guided endodontics(after 2019)are emerging hotspots in recent years;The core author group has formed and the high impact journals Journal of Endodontics and International Endodontic Journal have formed a dual core knowledge structure,but interdisciplinary collaboration still needs to be strengthened.

Abstract:Objective By improving the U-Net neural network to address the challenge of apical 4mm root canal segmentation,accurate and automated segmentation of premolar structures and intact pulp cavities in CBCT images can be achieved.This provides clinicians with complete and precise 3D root canal anatomical information for treatment.Methods Paired CBCT and Micro-CT data of 84 premolars were collected,with 70 for training and 14 for testing.For the U-Net neural network training,the control group involved manual labeling of CBCT images for training,while the experimental group used registered and labeled CBCT images based on Micro-CT,along with targeted training of apical 4mm root canal segmentation via an apical foramen localization algorithm.After training,both networks were tested using the test set,with Micro-CT-derived 3D models as the reference standard.The overall and apical 4mm root canal segmentation results of the two networks were compared to the reference standard using the Dice Similarity Coefficient for similarity assessment,and the Mean Symmetric Surface Distance and Hausdorff Distance for difference evaluation.Morphological analysis was also conducted for qualitative assessment of the segmentation results.Results The experimental group showed superior performance in all metrics.The Dice similarity coeffcient,mean symmetric surface distance,and Hausdorff distance for dental structure were(97.20±0.48)%,(0.08±0.01)mm,and(0.82±0.23)mm,respectively.For the pulp cavity,these metrics were(86.21±6.10)%,(0.19±0.04)mm,and(1.67±0.51)mm.For the apical 4 mm root canal,they were(71.62±6.13)%,(0.15±0.08)mm,and(0.51±0.12)mm.Morphological analysis also confirmed better segmentation results in the experimental group.Conclusion The modified U-Net neural network,optimized by an apical foramen localization algorithm,can achieve complete segmentation of dental structures and pulp cavities in CBCT images,offering precise 3D anatomical data for root canal therapy.

Abstract:Objective To analyze and evaluate the examination results,paper quality and students'feedback on the course of"Periodontology"for the grade 2020 5+3 integrated and five-year Stomatology major in Nanjing Medical University.The aim is to understand the paper quality and students'performance,assess the teaching quality,and provide a basis for further teaching reform.Methods Conduct the test design;the principles and methods of teaching measurement were used to analyze the test scores,difficulty and distinction of the examination paper.The"Questionnaire Star"form was used to investigate the feedback of students on the course of"Periodontology".Results The average scores for 5+3 integrated and five-year stomatology majors in 2020 were 70.37 and 68.61,with standard deviations of 10.21 and 9.12,respectively.The diffculty coeffcient of the test paper was 0.69.In the test questions,The A2 type questions had the most points lost,the worst differentiation is noun explanations.The questionnaire analysis found that students were 100%satisfied with the teachers'ethics and style during the course,they generally felt that the A2 type question was the most diffcult in the test paper,and suggested adding case study courses.Conclusion The design of the exam questions of"Periodontology"course should be combined with the requirements of the syllabus,adhere to the orientation of clinical literacy,focus on the overall design,grasp the core issues,and control the diffculty gradient.In this way,the application of test questions can accurately grasp the students'mastery of the"Periodontology"course and provide a definitive roadmap for enhancing pedagogical effectiveness.

Abstract:Objective To evaluate the application effect of a WeChat-based modular teaching method(BOPPPS)in the clinical teaching of dental and endodontic nursing,and to provide evidence for improving the quality of continuing education for dental nursing staff.Methods A total of 54 nursing staff members who participated in continuing education in the department of Operative Dentistry and Endodontics between January 2023 to March 2025 were randomly divided into a control group(n=27)or an experimental group(n=27).The control group received a conventional nursing teaching model for teaching and clinical guidance,while the experimental group was taught using a WeChat-based BOPPPS teaching mode The examination results,teaching satisfaction,and critical thinking ability before and after training of the two groups were compared and analyzed.Results At the end of the training,the examination scores and teaching satisfaction scores across all dimensions were significantly higher in the experimental group than in the control group(P<0.05).Prior to training,no significant differences were observed between the two groups in any dimension of the critical thinking ability scale(P>0.05).Following training,the experimental group demonstrated significantly higher scores in all dimensions and in the total critical thinking score compared with the control group(P<0.05),The improvement of some dimension scores and total scores in the experimental group over time was greater than that of the control group(P<0.05).Conclusion The WeChat-based BOPPPS teaching model demonstrates favorable application effects in dental and endodontic nursing continuing education,and may contribute to improved learning outcomes,higher teaching satisfaction,and enhanced critical thinking ability among nursing staff.

Abstract:Advanced glycation end products(AGEs)are key molecules involved in the local periodontal tissue homeostasis mediated by the hyperglycemic microenvironment.AGEs can induce periodontal epithelial barrier disorders,release of pro-inflammatory factors,osteogenesis-osteoclast imbalance,and regenerative repair damage through direct glycosylation or binding to the receptor of AGEs,resulting in periodontal soft and hard tissue homeostasis imbalance.In addition,AGEs can further regulate the functions and intracellular interactions of various immune cells,leading to an inflammatory cascade and aggravating tissue destruction.The purpose of this article is to systematically review the effects,mechanisms and research progress of AGEs in mediating periodontal tissue homeostasis,and to provide new ideas for the prevention and treatment of periodontitis.

Abstract:Objective To explore the influences of spherical self-ligation bracket on clinical curative effect and periodontal status in patients with malocclusion.Methods A total of 82 patients with malocclusion admitted to Daqing Oilfield General Hospital were enrolled as the research objects between January 2022 and January 2024.According to random number table method,they were divided into control group(41 cases,square self-ligation bracket)and observation group(41 cases,spherical self-ligation bracket).The clinical curative effect,cephalometrics indexes,periodontal status,inflammatory factors in gingival crevicular fluid and loads of periodontal pathogenic bacteria before and after treatment,and incidence of adverse reactions during treatment in the two groups were compared.Results After 1 year of treatment,there was no significant difference in response rate of treatment between the two groups(92.68%vs 87.80%,P>0.05).There was no significant difference in cephalometrics indexes between the two groups(P>0.05).In the observation group,the scores for the periodontal plaque index,gingival index,sulcus bleeding index,as well as the levels of inflammatory factors and microbial content,all decreased compared to the control group.(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The correction effect of spherical self-locking bracket and square self-ligation bracket is comparable,the former is more advantageous in terms of inhibiting the invasion of inflammatory factors,reduce the formation of periodontal bacteria and maintaining periodontal health.

Abstract:Objective The new zoning of the dental arch divides the maxillary and mandibular dental arches into the apex of the arch,the right and left shoulder of the arch,and the right and left body of the arch.The aim of the present study was to compare the effectiveness of plaque removal by brushing with the guidance of the new zoning method of the dental arch.Methods Sixty healthy adults were randomly assigned to an experimental or control group(30 each).All refrained from oral hygiene the night before and morning of the study.The control group received training in the Bass toothbrushing technique but did not receive instruction on the new segmented brushing method,while the experimental group followed standardized instructions for the new dental arch segmentation method.Intraoral scans were taken before and after brushing,and plaque removal was evaluated using TMQHPI scores and removal rates.Results After brushing,the mean TMQHPI reduction in the experimental group and control group was 10.47(10.38-10.54)and 6.28(6.14-6.39),respectively,with a statistically significant difference between the two groups(P < 0.01).The plaque removal rates were 58.13%(57.6%-58.5%)and 34.83%(34.1%-35.4%),respectively,with a statistically significant difference between the two groups(P < 0.01).Regional analyses also showed that the experimental group had significantly greater TMQHPI reductions and plaque removal rates in all segmented areas(P < 0.01).Conclusion A new dental arch partitioning method for guided tooth brushing removes plaque more effectively than non-partitioned brushing,making it a practice worth promoting.

Abstract:Objective To explore the effects of Ceramage polymer porcelain onlay in restoring posterior tooth defects and its influence on inflammatory factors in gingival crevicular fluid.Methods A total of 117 patients with posterior tooth defects visited Fuyang Hospital of Traditional Chinese Medicine from March 2021 to March 2024 were randomly divided into the metal-ceramic crown(control group)and the Ceramage polymer ceramic onlay(observation group).The periodontal indicators,masticatory function,inflammatory factors and long-term effects of the two groups were compared,and the incidence of adverse events was also analyzed.Results The plaque index,gingival index and gingival sulcus bleeding index in the observation group were all lower than those in the control group.The mastication efficiency and bite force were higher than those in the control group.The C-reactive protein,interleukin-6 and matrix metalloproteinase were all lower than those in the control group.The qualified rates of restoration shape,tooth sensitivity and gingival adaptability in the control group were all lower than those in the observation group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion Compared with metal-ceramic crown restoration,Ceramage polymer ceramic onlay restoration can promote periodontal health,reduce inflammatory responses,and improve long-term restoration effects.

Abstract:Dental occlusion education is one of the most difficult and important components in the orthodontic residency training curriculum,directly influencing trainees'future clinical competence and treatment outcomes.At present,it is urgent to bridge the gap between the occlusal teaching level and the learning requirements.Taking the orthodontic residency training system at the School of Stomatology,Air Force Medical University as an example,this study addresses four key issues in traditional occlusion education:insufficient foundational knowledge among trainees,limited teaching content,restrictive teaching methods and the constraints of apprenticeship-based instruction.The standardized resident training base applies supplementary theoretical teaching,multi-module systematic teaching,digital and visualized teaching approaches,and standardized teaching methods to enhance the quality of occlusaleducation,and ultimately establish a new teaching mode of orthodontic standardized residency training.This model is characterized by a comprehensive theoretical occlusion framework,standardized clinical occlusal reasoning and practice,and full-spectrum digital support.Through this systematictransformation,significant improvements have been achieved in the orthodontic residency training.

Abstract:Objective To prepare melt electrowriting(MEW)scaffolds with varying strand spacings using polycaprolactone(PCL)as the raw material,and investigate the effects of scaffold architecture on cellular extension and ligamentogenic differentiation of periodontal ligament stem cells.Methods PCL scaffolds with designed strand spacings(100 μm,250 μm,and 500 μm)were successfully prepared using MEW technology.The morphological characteristics of each group were characterized via scanning electron microscopy(SEM).The cellular extension of PDLSCs was assessed by phalloidin staining.The influence of PCL scaffolds with designed strand spacings on ligamentogenic differentiation potentials of PDLSCs was analyzed by quantitative real-time-polymerase chain reaction(qRT-PCR)and immunofluorescent staining.Results Representative SEM images demonstrated that all scaffolds exhibited uniform grid-like structures with strand spacings consistent with the predefined parameters.In vitro cell experiments showed that the 100 μm-spaced scaffolds significantly guided directional cell extension compared to 250 μm and 500 μm groups(P<0.05).The PDLSCs incubated with 100 μm-spaced scaffolds showed increased expression levels of ligamentogenic differentiation-related genes(COL-1、POSTN、ELASTIN)and proteins(COL-1,POSTN)compared with those incubated in 250,and 500 μm-spaced scaffolds(P<0.05).Conclusion The 100 μm-spaced MEW scaffolds demonstrate superior properties in guiding cellular extension and inducing ligamentogenic differentiation,which provides a novel strategy for periodontal ligament regeneration in periodontitis treatment.

Abstract:Objective This study aimed to investigate the therapeutic effect of extracellular vesicles derived from Lactobacillus reuteri(Lr-EVs)on periodontitis.Methods Lr-EVs were isolated from the culture supernatant of Lactobacillus reuteri using ultracentrifugation.The extracted vesicles were characterized by dynamic light scattering,transmission electron microscopy,and Coomassie blue staining.Experimental periodontitis in mouse model was established and the mouse were randomly divided into three groups:a healthy control group,a periodontitis model group,and a periodontitis model group treated with Lr-EVs.The treatment group started to be administered with Lr-EVs suspension via local periodontal tissue injection on the day of modeling,and samples were collected after 2 weeks.Alveolar bone resorption was quantified by Micro-CT analysis.Periodontal tissues was performed using hematoxylin-eosin staining and Masson staining to assess inflammatory infiltration and collagen fiber disruption.The protein expression levels of the M1 macrophage marker that inducible nitric oxide synthase(iNOS)and the proinflammatory cytokine interleukin-1β(IL-1β)in local periodontal tissues were detected by Western blotting.Results(1)Lr-EVs with a characteristic bilayer membrane structure were successfully isolated,exhibiting a peak particle size of approximately 124 nm.(2)Treatment with Lr-EVs significantly attenuated alveolar bone loss(P<0.01)and ameliorated pathological damage to the periodontal tissues.(3)Furthermore,Lr-EVs administration significantly downregulated the protein expression of iNOS and reduced the expression level of the proinflammatory cytokine IL-1β.Conclusion Lr-EVs effectively alleviate periodontal inflammation and alveolar bone resorption through inhibiting M1 macrophage polarization and reducing the secretion of proinflammatory factors.These findings suggest that Lr-EVs represent a promising novel therapeutic strategy for periodontitis.

Abstract:Objective To investigate the understanding and demands of Chinese dental practitioners regarding the teaching priorities of occlusion courses,and to provide references for future precise teaching reform of occlusion courses at different educational levels.Methods Based on the fourth edition of the unified textbook of Occlusion published by People's Medical Publishing House,a large-scale questionnaire survey was conducted among dental practitioners using"Wenjuanxing",which focused on teaching model of occlusion courses,key content areas of occlusion courses,and professional needs.Results A total of 2,140 questionnaires were collected from 31 provinces and autonomous regions in China.Among the respondents,87.13%were dentists,38.74%specialized in general dentistry,and 77.29%had been worked for more than five years.81.59%of the respondents had systematically learned orthodontics knowledge during their studies,and 45.09%had systematically studied orthodontics knowledge at the undergraduate level.Nearly all respondents(98.83%)believed that systematically learning of occlusion is necessary,and 77.94%indicated that such training should occur around the period of undergraduate clinical internship.All respondents agreed with the key knowledge chapters of the traditional undergraduate orthodontics curriculum design,while those working in the fields of temporomandibular disorders and orthodontics focused more on specific areas such as occlusion,biomechanics,temporomandibular joint,and functional examination.Conclusion The teaching of occlusion should be combined with the actual needs of oral clinical practice and designed in a differentiated and hierarchical manner,thereby continuously improving the quality of occlusion teaching.

Abstract:Objective To evaluate the effectiveness of traditional behavior guidance based on animated level-breaking game in proving cooperation and reducing dental fear among 3-6 years old patients during dental treatment.Methods Patients aged 3-6 years who received dental treatment in the Department of Pediatric Dentistry at The School of Stomatology,The Fourth Military Medical University between May 2025 and July 2025 were randomly assigned to either the animated group(behavior guidance based on animated level-breaking game)or the control group(traditional behavior guidance).The two groups were compared in terms of cooperation level,treatment duration,dental fear,and parental satisfaction.Results The animated group showed significantly higher cooperation score during dental treatment compared with the control group(P<0.001).The dental fear scores were significantly lower in the animated group(P<0.05).Parental satisfaction,including evaluation of the behavior guidance method and overall satisfaction,were also higher in the animated group(P<0.05).There was no statistically difference in the treatment duration between the two groups(P>0.05).Conclusion Behavior guidance based on an animated level-breaking game effectively improves children's cooperation during dental treatment,reduces dental fear,and enhances parents'satisfaction.This interactive,game-based approach provides a novel engaging strategy for management in young children.

Abstract:Objective To understand the cognition of the officers of the grass-roots troops in plateau area on oral diseases,the present situation of oral medical service in the grass-roots troops in plateau area and the suggestions on the patrol inspection of oral medical team.Methods The Questionnaire of Oral Disease Cognition and Medical Service Status of Army Officers was designed and made,and the feedback information of grass-roots army officers in plateau area was collected.Multivariate ordered Logistic regression analysis was used to analyze the cognition of diseases,nonparametric rank sum test was used to analyze the current situation of medical services,and frequency percentage analysis was used to analyze the results of consultation suggestions.Results In the cognition of oral diseases,older,military,political and engineering officers and senior officers have a higher degree of cognition of oral diseases.36.8%officers believe that oral diseases have a serious impact on daily work or training.In the investigation of the current situation of oral medical services,51.39%of the units have dental specialists who can't handle oral emergencies,mainly because of the lack or shortage of professional medical equipment(91.90%).45.14%of the units have no dentists and can't handle oral emergencies,and 96.92%of them are recommended to apply for dentists and specialized equipment,instruments and materials.Most of the suggestions are that the oral medical units should carry the equipment for regular rounds(86.81%),and help the doctors in the resident outpatient department(70.83%).Conclusion The officers of plateau troops need to improve their cognitive level.The corresponding medical units need to enrich professional medical equipment and improve the ability of doctors to diagnose and treat oral diseases.Optimize the frequency and time of superior rounds,strengthen counterpart assistance,and provide better oral health protection for officers and soldiers.

Abstract:In recent years,the rapid development of digital technologies has been driving innovation and progress in the field of dental medicine.With the integration of digital technologies,the diagnosis and treatment mode of endodontic diseases has gradually transformed to the digital direction,and the diagnosis and treatment techniques are increasingly moving towards minimally invasive and precision.This article provides an overview of the application of digital technologies in the diagnosis and treatment of operative dentistry and endodontics.

Abstract:Objective To evaluate the efficacy of mechanical nickel-titanium(NiTi)rotary instruments compared with conventional manual treatments in root canal treatment of deciduous teeth.Methods A systematicsearch was conducted in MEDLINE,PubMed,EMBASE,Google Scholar,Cochrane Library up to August 2024.Randomized controlled trials comparing NiTi rotary and manual instruments in primary teeth were included.The primary outcome was root preparation time,while secondary outcomes include root filling time,obturation quality,and clinical or radiographic success rates.Statistical software RevMan 5.4 was used for data analysis.Results Compared with manual instruments,NiTi rotary systems significantly reduced both canal preparation time[SMD=2.72 min,95%CI:2.06-3.39,P<0.000 01]and filling time[SMD=0.72 min,95%CI:0.39-1.05,P<0.000 1].Rotary instrumentation also achieved a higher proportion of optimal obturations[OR=0.46(95%CI:0.29-0.71),P=0.000 6].No significant differences were observed in clinical or radiographic success rates between the two techniques.Conclusion Mechanical NiTi rotary instruments markedly shorten canal preparation and filling times and improve obturation quality compared with manual instrumentation,though long-term clinical and radiographic outcomes appear comparable.

Abstract:Objective To evaluate the inhibitory effects of chlorine dioxide(ClO2)-loaded oral sustained-release hydrogel on Porphyromonas gingivalis(P.gingivalis)and its biofilm,as well as its impact on the secretion of matrix metalloproteinases(MMPs)by human gingival fibroblasts(HGFs).Methods The minimum inhibitory concentration(MIC)of ClO2 hydrogel against P.gingivalis was determined using the microbroth dilution method,while the minimum bactericidal concentration(MBC)was assessed via plate counting.Bacterial viability was quantified using live/dead staining and flow cytometry.The effects on P.gingivalis biofilm were examined using crystal violet staining and scanning electron microscopy(SEM).ELISA was employed to measure the secretion levels of MMP-1 and MMP-2 by HGFs stimulated by P.gingivalis.Results The MIC and MBC of ClO2 hydrogel against P.gingivalis were 250 mg/L and 500 mg/L,respectively.The hydrogel significantly altered the microstructure of P.gingivalis biofilm,reduced biofilm formation,and suppressed the excessive secretion of MMP-1 and MMP-2 in HGFs.Conclusion ClO2-loaded hydrogel exhibits potent antibacterial activity against P.gingivalis,inhibits biofilm formation,and reduces the expression of MMP-1 and MMP-2 in HGFs,thereby protecting periodontal collagen stability.It shows promise as a local therapeutic agent for periodontitis.

Abstract:Objective To comprehensively analyze the research findings in the fields of epidemiology,biology,and immunologybetween periodontitis and lung cancer,with the aim of revealing the potential link between periodontitis and lung cancer and providing a scientific basis for prevention and treatment strategies.Methods The association between periodontitis and lung cancer risk,the role of the oral microbiome in lung cancer,and the possible impact of periodontitis on lung cancer progression were explored through a review of relevant studies.Results Patients with periodontitis have a higher risk of lung cancer,and the oral microbiome is closely related to the occurrence of lung cancer.Periodontal bacteria may affect the development of lung cancer through various mechanisms,including promoting abnormal expression of pulmonary proteins and the release of pro-inflammatory cytokines by immune cells.Conclusion The relationship between periodontitis and lung cancer needs to be studied in depth,and the existing evidence suggests that periodontitis may be a risk factor for lung cancer.This review highlights the potential importance of periodontitis in the prevention and treatment of lung cancer and provides new insights for the prevention and treatment of periodontitis and lung cancer.

Abstract:Although oral health professionals have the ability to diagnose and treat stomatological problems,they face systemic challenges in recognizing interdisciplinary diagnostic and treatment risks amidst the trend of population aging.In order to solve this clinical dilemma,the teaching team carried out the development and implementation of the graduate course"Multidisciplinary Diagnosis and Treatment of Complex Oral Diseases."The reform centers on cultivating"systemic diagnostic thinking"as its core objective,structuring the curriculum around four key dimensions:"theoretical framework,cognitive thinking,skill development,and competency enhancement."The teaching methods have been improved through innovations in course design and instructional approaches,while student capabilities are assessed through simulated Multidisciplinary Team(MDT)case studies.Ultimately,the reform aims to cultivate students'comprehensive diagnostic thinking and clinical competence,fostering the development of oral health professionals with a systemic awareness of diagnostic risks.

Abstract:Objective To investigate the effect of furcation lesions on the prognosis of root canal treatment in primary molars in children.Methods A retrospective cohort study was conducted included children aged 2-8 years who received dental treatment under general anesthesia at the Department of Stomatology,Xi'an Children's Hospital,from 2019 to 2024,with a follow-up period of≥2 years.Clinical and radiographic data were extracted from electronic databases,and exposure factors,outcome variables,and confounding factors were recorded.Patients were divided into Exposure Group 1,Exposure Group 2,and Control Group based on the extent of furcation lesions.Multivariate binary logistic regression analysis was performed.Results At 1 year post-treatment,the risk of failure in teeth with furcation lesions≤1/2 and>1/2 was 3.70 times 95%CI(1.56-9.30),P<0.05 and 9.16 times 95%CI(3.96-23.08),P<0.05 higher,respectively,compared to teeth without furcation lesions.At 2 years post-treatment,the risk of failure in these groups was 2.21 times 95%CI(1.24-4.00),P<0.05 and 6.80 times 95%CI(3.78-12.61),P<0.05 higher,respectively.Conclusion Root bifurcation lesions significantly increase the risk of root canal treatment failure in primary molars,with a higher risk associated with greater extent of lesions.