Abstract:Objective To develop an improved U-Net deep learning model integrated with the convolutional block attention module(CBAM)for segmenting maxillary sinus(MS)and maxillary posterior teeth(MPT)structures in cone-beam computed tomography(CBCT)images,and to evaluate the segmentation accuracy of the U-Net CBAM model.Methods Using 35 CBCT datasets(containing 70 MS cases and 280 MPT)annotated by endodontic specialists as the ground truth,a U-Net CBAM model incorporating dual channel-spatial attention mechanisms was developed.The model was trained using three-fold cross-validation,and its segmentation accuracy was evaluated and compared with U-Net and EfficientNet models.Evaluation metrics included Dice coefficient(DSC),Jaccard similarity index(JSI),and volume consistency metrics.Results All three models achieved DSC and JSI values above 0.90 and 0.84 for MS segmentation,and above 0.83 and 0.76 for MPT segmentation,respectively.The U-Net CBAM model demonstrated the highest performance,with DSC and JSI values of 0.935 and 0.895 for MS segmentation,and 0.887 and 0.796 for MPT segmentation.In comparison,the baseline U-Net showed lower accuracy,yielding DSC values of 0.902(MS)and 0.830(MPT),and JSI values of 0.842(MS)and 0.709(MPT).Volume consistency analysis revealed a strong linear correlation(R2＞0.9)between U-Net CBAM automated segmentation and manual annotations.Conclusion Compared to U-Net and EfficientNet,the enhanced U-Net model with CBAM exhibited superior performance in segmenting MS and MPT structures in CBCT images,confirming the effectiveness of channel-spatial attention mechanisms in identifying complex anatomical structures.This study provides a valuable framework for multi-target segmentation in small-sample oral imaging applications.

Abstract:Objective To construct and validate a nomogram model for predicting the severity of dental caries in adolescents.Methods A total of 2 647 adolescents aged 12-18 years with dental caries from Yinchuan,Ningxia were analyzed.Candidate predictors included sociodemographic characteristics,parental health information,lifestyle and dietary habits,oral hygiene practices,and oral health behaviors.The cohort was randomly divided into a training set(n=1855)and a validation set(n=792)at a 7:3 ratio.Variable selection was performed using least absolute shrinkage and selection operator(Lasso)regression,followed by multivariable logistic regression to construct the nomogram.Model performance was assessed by the area under the receiver operating characteristic curve(AUC),calibration plots with the Hosmer-Lemeshow test,and decision curve analysis(DCA).Results Seven independent predictors were identified:parental education,smoking status,frequency of sweet consumption,self-rated oral health,previous dental visit,and toothache experience in the past 12 months.The nomogram achieved an AUC of 0.710(95％CI:0.683-0.737)in the training set and 0.746(95％CI:0.707-0.785)in the validation set.Calibration showed good agreement between predicted and observed outcomes(Hosmer-Lemeshow P=0.603 and 0.639).DCA demonstrated favorable clinical utility across a wide range of threshold probabilities.Conclusion The developed a nomogram model based on readily available sociodemographic and behavioral factors showed good discrimination,calibration,and clinical applicability for predicting severe caries in adolescents,and may support early prevention and targeted intervention strategies.

Abstract:Objective To evaluate the effectiveness of personalized teaching strategies based on artificial intelligence in the course of oral mucosal diseases.Methods A systematic sampling method was used to select 20 undergraduate dental students from the class of 2019,2020,and 2021 cohorts,totaling 60 students.They were randomly assigned to traditional teaching model(Group A)and AI-assisted personalized teaching(Group B).The learning outcomes of the two groups were assessed through theoretical examinations and AI-simulated standardized patient assessments.Questionnaires were also administered to obtain subjective feedback on the different teaching modes.Results The findings indicated that Group B scored significantly higher in both theoretical and simulated assessments than Group A(P＜0.000 1),with Group B achieving an average score of(85.6±4.9)compared to(78.4±6.2)for Group A.Additionally,the AI-based teaching strategy significantly enhanced students'interest in learning,increased their mastery of course knowledge points,and made them more willing to participate in classroom interactions(P＜0.05).Conclusion The personalized strategies based on artificial intelligence effectively enhanced students'academic performance and interest in the course of oral mucosal diseases.The results provide new insights and practical references for personalized teaching in the field of medical education,demonstrating the broad potential of AI in educational reform.

Abstract:The root canal anatomical structure of the maxillary first molar is relatively complex.Clinically,more attention is often paid to the root canal variations of the mesial buccal root,while the variations of the distal buccal root(DB)are often overlooked.Failure to fully identify,prepare,clean,and fill the additional root canals is one of the important factors leading to the failure of root canal treatment.This study reviews the existing in vivo and in vivo research methods on the anatomical characteristics of the distal buccal root of the maxillary first molar.It focuses on analyzing the influence of different methods(such as the transparent specimen method,Micro-CT,and Cone-Beam CT)on the detection rate of variations,and explores the possible causes of the differences in the detection rates as well as the classification characteristics of multiple root canals in the DB root.Advancements in the understanding of DB root morphology provide valuable insights into the anatomical complexity of the root canal system and offer guidance for enhancing radiographic evaluation and intraoperative exploration strategies,ultimately aiming to improve the success rate of root canal therapy.

Abstract:Objective This in vitro study aimed to evaluate the efficacy and safety of Er:YAG(Erbium-doped Yttrium Aluminum Garnet)laser technology for the removal of zirconia restorations from titanium abutments in dental implants.Methods A total of 120 zirconia plates(10 mm × 10 mm)of varying thicknesses(1 mm,2 mm,3 mm;10 plates per thickness)were bonded to 120 titanium blocks(20 mm× 10 mm× 10 mm)using four types of dental cements:Glass Ionomer Cement(GIC),Zinc Polycarboxylate Cement(ZPCC),Zinc Phosphate Cement(ZPC),and Resin Cement(Clearfil SA Luting,RC).After 24 hours,an Er:YAG laser(300 mJ,15 Hz,4.5 W)was applied for 2 minutes under a constant tensile force of 2 N to debond the zirconia plates.The removal efficacy,adhesive residue,and thermal effects were analyzed via universal testing machine,scanning electron microscopy(SEM),and X-ray diffractometry(XRD).Shear bond strength(MPa)and debonding time(s)were statistically evaluated using Kruskal-Wallis and Bonferroni-corrected Wilcoxon tests.Results Laser debonding succeeded in all 1 mm and 2 mm zirconia plates in the GIC group,while only 1 mm plates were successfully removed in the ZPCC and ZPC groups.In RC group,no plates were successfully debonded by laser.XRD analysis confirmed minimal thermal damage to zirconia,indicating negligible thermal conduction during laser ablation.Conclusion The Er:YAG laser demonstrated good efficacy in removing zirconia plates from titanium substrates with controlled thermal damage on both titanium and zirconia materials,offering a promising approach for non-destructive restoration retrieval in implant dentistry.

Abstract:Objective To investigate and analyze the oral health status and knowledge,attitude and practice(KAP)of oral health among floating reproductive-aged women in Xi'an,and to provide a theoretical basis for the formulation and optimization of public health policies related to oral health for this group.Methods A total of 212 randomly selected floating reproductive-aged women who came from Xi'an Women's and Children's hospital for premarital or preconception check-ups in Xi'an were examined for oral health and their KAP regarding oral health was surveyed.Results Among the 212 floating reproductive-aged women in Xi'an,the prevalence of dental caries was 50.47％,the rate of healthy periodontal status was only 14.15％,the rate of periodontal probing calculus was 80.66％,the detection rate of gingival bleeding was 52.36％,the rate of shallow periodontal pockets was 13.67％,the rate of deep periodontal pockets was 1.42％,and the prevalence of impacted wisdom teeth was 69.81％.The periodontal status of floating reproductive-aged women in Xi'an was affected by their teeth-cleaning habits.Women with teeth-cleaning habits had better periodontal status.Conclusion The oral health status of floating reproductive-aged women in Xi'an is worrying,and their awareness of oral health needs to be improved.It is recommended that they develop the habit of teeth cleaning.

Abstract:AIM:To investigate serum levels of C1q/TNF-related protein 3(CTRP3)and cytokine receptor like factor 1(CYTL-1)in patients with chronic periodontitis,and to assess their correlation with periodontal and inflammatory indicators.METHODS:90 patients with chronic periodontitis admitted to our hospital were enrolled as the periodontitis group.Based on the periodontal severity,they were classified into a mild group(33 cases)and a moderate to severe group(57 cases).Another 40 oral health patients who underwent physical examinations at our hospital during the same period were as the healthy control group.The periodontal indicators-including probing depth(PD),bleeding index,plaque index(PLI),attachment loss(AL),and gingival index-were recorded.Serum levels of Interleukin-1β,Interferon-γ(IFN-γ),Tumor necrosis Factor-α(TNF-α),CTRP3,and CYTL-1 were measured by enzyme-linked immunosorbent assay.The correlation between serum CTRP3、CYTL-1 and gingival crevicular fluid and periodontal indicators was analyzed;the value of CTRP3 and CYTL-1 in diagnosing the severity of chronic periodontitis was compared.RESULTS:Compared with the healthy control group,patients with chronic periodontitis had significantly higher serum levels of IL-1β,IFN-γ,and TNF-α,and significantly lower levels of CTRP3 and CYTL-1(P＜0.05).The moderate-to-severe group exhibited higher levels of inflammatory markers and worse periodontal parameters than the mild group(P＜0.05),accompanied by lower CTRP3 and CYTL-1 concentrations(P＜0.05).Serum CTRP3 and CYTL-1 levels were negatively correlated with IL-1β,IFN-γ,TNF-α,PD,BI,PLI,AL,and GI(P＜0.05).Combined detection of CTRP3 and CYTL-1 yielded a significantly greater area under the ROC curve(AUC)for diagnosing disease severity compared to either marker alone(P＜0.05).CONCLUSION:The serum levels of CTRP3 and CYTL-1 are significantly decreased in patients with chronic periodontitis,and are related to periodontal status and systemic inflammation.They can be used to diagnose the severity of chronic periodontitis,and combined detection has more diagnostic value.

Abstract:AIM:To investigate periodontal self-management health behaviors and influencing factors among adolescent orthodontic patients using the COM-B model.METHODS:A sample of 305 orthodontic patient treated adolescents was selected.The adolescents' cognition of malocclusion,the Self-Efficacy Scale for Self-care,the Social Support Scale,and the Self-management Scale were used.The COM-B theory was used to explain how ability,motivation,and opportunity influence periodontal health self-management among patients.RESULTS:The self-management health behavior score for adolescent patients on fixed orthodontic therapy was 53.07±7.5.Orthodontic treatment duration,and cause of treatment significantly influenced self-management.Regression analysis pinpointed malocclusion cognition and treatment understanding as key ability factors,and self-efficacy in check-ups,brushing,and diet as crucial motivational factors.These factors collectively accounted for 43.2％of variance,with ability contributing 7.3％and motivation 15.4％.CONCLUSION:Healthcare professionals should consider patients' factors to strengthen adolescents' malocclusion cognition,foster oral health beliefs,teach cleaning,encourage check-ups,promote balanced diets,enhance self-efficacy,and improve periodontal self-management among orthodontic patients.

Abstract:AIM:The multi-target mechanism of Salidroside in the treatment of periapical inflammation was systematically revealed by integrating network pharmacology and molecular docking techniques.METHODS:SwissTargetPrediction,SEA and SuperPred multi-platform combined prediction of salidroside action targets;Based on GeneCards,DisGeNET and CTD three databases,the related targets of periapical inflammation were screened.The PPI interaction network was constructed using STRING platform,and topological feature analysis was carried out by Cytoscape 3.10.0 to identify key hub targets.GO/KEGG multi-dimensional functional enrichment analysis was carried out using the"Weisheng"online system,and the target-pathway interaction network was constructed.The core target(PDB ID acquisition)was selected for molecular docking verification through AutoDock4.RESULTS:Target intersection analysis identified 39 key regulatory targets,including DPP4,GAPDH,MMP9 and other core proteins.KEGG pathway enrichment revealed 90 significant signal axes,among which IL-17 and Rap1 signaling pathways showed outstanding regulatory value.Molecular docking verification showed that salidroside had strong binding properties with 6 key targets(binding energy ≤-6.8 kcal/mol).CONCLUSION:This study found that salidroside achieves three-dimensional therapeutic effect of periapical inflammation(immune regulation-inflammation control-tissue regeneration)through multi-target synergistic regulatory mechanism,especially through IL-17 signaling axle-mediated inflammation regulation and Rap1 pathway driven bone repair process.This study provides an innovative mechanism explanation and theoretical basis for the treatment of oral inflammatory diseases by traditional Chinese medicine monomeric.

Abstract:AIM:To obtain the cognition of general dentists in comprehensive hospitals regarding the diagnosis and treatment of avulsed permanent teeth through questionnaire surveys,thereby providing a scientific basis for standardizing the treatment of avulsed permanent teeth.METHODS:General dentists from five comprehensive hospitals were selected as the research subjects.Questionnaires were distributed via Wenjuanxing platform to explore their knowledge about the definition,epidemiology,treatment principles,and prognostic factors of avulsed permanent teeth.RESULTS:A total of 89 valid questionnaires were collected.The results showed that 87.64％of general dentists knew the definition of avulsed permanent teeth,but only about half consider it to be clinically common.77.53％of general dentists believed that maintaining the vitality of periodontal ligament prior to replantation is of crucial significance for the prognosis.However,their knowledge about root surface treatment before replantation,fixation methods after teeth replantation,and the choice of storage media was inadequate.Approximately 63％of the dentists encounter patients with permanent teeth avulsion each year.The majority thought that replantation time,storage conditions for teeth,patient age,root development stage,and oral hygiene status were critical factors influencing prognosis.However,the timing of the first review after replantation was poorly understood.CONCLUSION:Although general dentists in comprehensive hospitals have a basic knowledge about avulsed permanent teeth,they need further training about treatment principles,prognostic factors,and postoperative management.This will promote the attention on permanent teeth avulsion,and improve the long-term prognosis after dental replantation.

Abstract:AIM:To explore and analyze the correlation between the levels of melatonin and heat shock protein 70(HSP70)in serum and gingival crevicular fluid and periodontal indicators and lesion severity in patients with chronic periodontitis.METHODS:The 120 patients with chronic periodontitis and 120 healthy individuals who underwent physical check ups in Department of Stomatology,Sinopharm North Hospital from May 2021 to May 2024 were selected as the study subjects and included in the periodontitis group and the healthy group,respectively.According to the severity of chronic periodontitis,120 patients with chronic periodontitis were assigned into mild group(n=39),moderate group(n=53),and severe group(n=28).ELISA method was used to detect the levels of melatonin and HSP70 in serum and gingival crevicular fluid.Pearson and Spearman methods were used to analyze the correlation between serum and gingival crevicular fluid melatonin,HSP70 levels with periodontal indicators,lesion severity in patients with chronic periodontitis.ROC curve was used to evaluate the diagnostic value of serum and gingival crevicular fluid melatonin and HSP70 levels in patients with severe chronic periodontitis.RESULTS:The levels of serum and gingival crevicular fluid inflammatory factors IL-6,TNF-α,and HSP70 in the periodontitis group were obviously higher than those in the healthy group,while the levels of IL-10 and melatonin were obviously lower than those in the healthy group(P＜0.05).The level of melatonin in the serum and gingival crevicular fluid of the severe group was obviously lower than that of the moderate and mild groups,and the level of HSP70 was obviously higher in the moderate and mild groups(P＜0.05).The values of periodontal indicators PLI,AL,SBI,and PD increased sequentially in the mild,moderate,and severe groups(P＜0.05).The level of melatonin in serum and gingival crevicular fluid of patients with chronic periodontitis was negatively correlated with periodontal indicators PLI,AL,SBI,PD,and lesion severity,while the level of HSP70 was positively correlated with periodontal indicators PLI,AL,SBI,PD,and lesion severity(P＜0.05).The combination of melatonin and HSP70 in serum and gingival crevicular fluid had a higher AUC in the diagnosis of severe chronic periodontitis patients than the single diagnostic value of melatonin and HSP70(P＜0.05).CONCLUSION:Melatonin expression is downregulated in serum and gingival crevicular fluid of patients with chronic periodontitis,while HSP70 expression is upregulated.Both are related to periodontal indicators and the lesion severity.

Abstract:AIM:to evaluate the effects of sealing materials with different content of fillers and fissure surface treatments on the pit and fissure sealing.METHODS:A total of 600 first molar teeth of 150 children age 6 to 9 years old were selected,and randomly divided into 3 groups to get pit and fissure sealing with ClinproTM,Helioseal F,Fissurit F.This split-mouth design was conducted in this study.The first molars were cleaned with little brush on the right side of mouth,and P1 ultrasonic tip was used to clean the first molars on the other side.The sealant expulsion rates and caries prevalence rates were compared 6 and 12 months after treatments.RESULTS:When the sealant was the same,at 6 months after treatment,the expulsion rate of Fissurit F sealant in the brush cleaning group was significantly higher than that in ultrasonic cleaning group(P＜0.05),at 12 months after treatment,the expulsion rates of ClinproTM and Fissurit F sealant in the brush cleaning group were significantly higher than that in ultrasonic cleaning group,respectively(P＜0.05).When the fissure surface treatment was the same,at 6 months after treatment,the expulsion rate of Helioseal F sealant in the brushing cleaning group was the lowest,which was significantly lower than that of ClinproTM sealant(P＜0.05),and the expulsion rate of Fissurit F sealant in the ultrasonic cleaning group was the lowest,which was significantly lower than that of ClinproTM sealant.Otherwise,Furthermore,the caries prevalence rate for the three sealants was lower in ultrasonic cleaning group than that in brush cleaning group,but there was no statistical difference between the two groups,respectively(P＞0.05).CONCLUSION:The use of ultrasonic tip to clean the pits and fissure shows more effective than little brush in the process of pit and fissure sealing,and on this basis,the sealants with high filler content show the better sealing effect,which is recommended for clinical application.

Abstract:Dental avulsion is one of the most serious types of dental trauma,and its clinical management and prognosis greatly affect the patient's tooth appearance,function,and quality of life.Tooth replantation is currently the preferred method for treating avulsion.The healing of replanted teeth is a complex process,and the success rate of treatment varies greatly depending on the specific situation.Currently,scholars have made various efforts to improve the prognosis of replanted teeth.This article reviewed the root treatment methods that may promoted the healing of periodontal tissues in replanted teeth.

Abstract:AIM:To investigate the intervention effect of mixed reality(MR)technology assisted psychological nursing on the anxiety in edentulous patients with dental implantation.METHODS:80 patients with edentulous jaw implant restoration were randomly divided into a control group receiving traditional psychological nursing and an experimental group receiving MR psychological care.The psychological status was analyzed using the Modified Dental Anxiety Scale(MDAS),the blood pressure was monitored using the multi parameter monitor,the perceived usefulness and usability were analyzed with the Technology Acceptance Model(TAM)scale,and nursing satisfaction was analyzed through a questionnaire survey.RESULTS:After psychological nursing intervention,the MDAS scores and the blood pressure of both groups were significantly lower than those of before psychological nursing(P＜0.05),and the MDAS scores of the experimental group were lower than that of the control group(10.7±1.39 vs.12.1±1.34,P＜0.05),and the experimental group presented lower blood pressure than the control group(128.5±10.7 mmHg vs.136.4±11.6 mmHg,P＜0.05);The TAM scale indicated that the experimental group had better perceived usefulness(4.48±0.62)and ease of use(4.35±0.54)than the control group(3.33±0.57,P＜0.05;3.68±0.53,P＜0.05);In terms of nursing satisfaction,the experimental group was higher than the control group(95％vs.82.5％,P＜0.05).CONCLUSION:MR assisted psychological nursing has high acceptance,can alleviate the anxiety in edentulous patients with dental implantation,and nursing satisfaction,which demonstrating significant clinical applicability.

Abstract:Under the guidance of the national strategy of"Healthy China",the plan and requirements for the construction of health work in China are clearly put forward.Facing the strategic needs of healthy China in the new era,it is an important teaching reform direction to train compound oral preventive dentistry talents who can meet the requirements of laid-off positions in the new situation.The Preventive dentistry Teaching and Research Department of Stomatology Hospital of Air Force Medical University has carried out a deep exploration and practice on the teaching mode of"Preventive dentistry"course and put forward a teaching reform aiming at the training of competency in composite posts.This article introduces the new model,new strategy and new path of the teaching reform of"Preventive dentistry"from many angles,to provide reference and help for the teaching reform of related courses in other universities.