Oral submucous fibrosis (OSF) is an oral potentially malignant disorader that may be closely related to betel chewing and other factors. The pathogenic mechanism of OSF is still unclear, and there is no cure for OSF. Currently, there are many clinical treatments for OSF, such as medications, including steroids, pentoxifylline, lycopene, turmeric, salvia miltiorrhiza, and aloe vera, lasers, and surgery. In order to evaluate the safety and efficacy of these methods to improve the maximum mouth opening, alleviate the burning sensation, increase tongue flexibility, and other symptoms that accompany OSF, researchers have completed some evidence-based studies in recent years. We searched PubMed, Embase, Web of Science, The Cochrane Library, CNKI, Wanfang, and VIP databases for systematic reviews or meta-analyses of OSF research and treatment published over the last 10 years (July 2014-July 2024). Current evidence-based studies have shown that pentoxifylline, hyaluronidase combined with steroids, lycopene, curcumin, salvia miltiorrhiza combined with steroids, and aloe vera are effective in improving maximum mouth opening and alleviating the burning sensation in patients with OSF. The evidence levels of hyaluronidase combined with steroids, lycopene, curcumin, salvia miltiorrhiza combined with steroids, and aloe vera were all A, and pentoxifylline was B. Lycopene was more effective than other positive drugs in improving maximum mouth opening in patients, and aloe vera was more effective than positive drugs in improving the burning sensation in the early stage of treatment. In addition, antioxidants are good for improving OSF symptoms and have promising application. Lasers can improve maximum mouth opening and alleviate pain and other OSF symptoms, but laser treatment is costly and the level of evidence is C. Surgery is effective in improving maximum mouth opening, but it is traumatic and the level of evidence is C. However, the current evidence-based data are not of high quality, and additional well-designed multi-center, large-sample, randomized controlled clinical trials with long follow-up periods and standardized outcome indicators are needed in the future.

Objective To investigate the changes of mitochondrial homeostasis of human gingival fibroblasts (HGFs) in periodontitis, and to provide a basis for exploring the mechanism of periodontitis. Methods This study has been reviewed and approved by the Ethics Committee. Gingival tissue was collected from patients who underwent periodontal surgery at the Department of Periodontology, School of Stomatology, the Fourth Military Medical University, from June 1, 2023 to December 31, 2023. All of the subjects signed informed consent forms prior to surgery. Gingival connective tissues were collected from patients with chronic periodontitis (CP group) and healthy individuals (control group) undergoing flap surgery and crown lengthening surgery, respectively. There were 6 cases in each group. The primary HGFs obtained from healthy periodontal subjects were cultured and divided into the control group (cultured in complete medium for 24 h) and the Pg.LPS group (cultured in medium with 5μg/mL Pg.LPS for 24 h). The number, morphology, and structure of mitochondria in gingival connective tissue and HGFs were observed by transmission electron microscopy. The number, circumference, and surface area of mitochondria were quantitatively analyzed. MitoSOX^TMRed, TMRM, and an ATP kit were used to determine the production levels of mitochondrial reactive oxygen species, mitochondrial membrane potential, and ATP in each group of HGFs. Results Transmission electron microscopy showed that the morphology and structure of mitochondria were abnormal in the gingival connective tissues of the periodontitis group and HGFs, which were stimulated by Pg.LPS. The mitochondrial ridges were broken or were not visible in these groups. The number of mitochondria decreased significantly, and the surface area and circumference of the mitochondria increased significantly (P < 0.05). In addition, after stimulation by Pg.LPS, the reactive oxygen species level in HGFs was significantly higher than that in the control group (P < 0.05). The mitochondrial membrane potential and the level of ATP production was significantly lower than that of the control group (P < 0.05). Conclusion The number, morphological structure, and function of mitochondria in HGFs changed significantly in periodontitis. The mitochondrial homeostasis is closely related to the occurrence and development of periodontitis.

Objective To explore the expression and clinical significance of histone deacetylase 5 (HDAC5) in oral squamous cell carcinoma (OSCC) and provide a research basis for targeted therapy of HDAC5. Methods Screening sample data of OSCC patients in TCGA database, and receiver operating characteristic (ROC) curve analysis was used to evaluate the prognostic value of HDAC5 in OSCC. Kaplan-Meier analysis was also used to analyze the correlation between HDAC5 and the prognosis of OSCC patients. Further, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used to explore the potential role of HDAC5 in OSCC. Finally, the study was approved by the ethics committee and the expression level of HDAC5 in OSCC was detected by immunohistochemistry (IHC), while the relationship between HDAC5 and the clinical pathological characteristics of OSCC patients was analyzed. Results The expression of HDAC5 can be used to assess the prognosis of OSCC patients (AUC=0.743). High expression of HDAC5 was significantly correlated with low survival probability in OSCC patients (P < 0.05). OSCC patients with high HDAC5 expression in G3/G4 pathological grading (P=0.022), OSCC patients with high HDAC5 expression in the T3/T4 stage (P=0.028), and OSCC patients with high HDAC5 expression in lymph node metastasis (P=0.019) had lower survival probability. GO and KEGG enrichment analyses showed that genes differentially expressed with HDAC5 were mainly enriched in axon generation, neuronal cell body formation, collagen fiber synthesis, neuroactive ligand receptor interactions, gated channel activity, and extracellular matrix (ECM)-receptor interaction pathways (P < 0.05). The IHC results showed that HDAC5 was highly expressed in OSCC (P < 0.05). The high expression group of HDAC5 had higher T staging (P=0.041) and lymph node metastasis (P=0.010). Conclusion HDAC5 is highly expressed in OSCC and can predict the prognosis of OSCC, and HDAC5 could serve as a therapeutic target for OSCC.

Objective To analyze the trends and hotspots in research related to microbiomes and microbes of dental caries; in addition, the study seeks to provide a reference for caries research. Methods We searched the Web of Science Core Collection (WOSCC) to extract relevant literature in the field of microbiomes and microbes of dental caries published from 2014 to 2023. We used bibliometric visualization evaluation methods such as CiteSpace to conduct visualized analysis of factors that include the number of publications, journals, countries, authors, institutions, co-cited references, and keywords. Results A total of 3 192 references were extracted, including 2 664 articles and 528 reviews. The number of annual publications is increasing. The United States and China lead the number of publications, with the United States demonstrating a greater capacity for international collaboration. The top 10 journals in percentage of literature are mainly in the field of dentistry followed by the field of microbiology. The author cooperation networks with the highest number of publications include the network led by Zhou Xuedong of Sichuan University, and the network led by Xu Hockin H.K and Weir Michael D of the University of Maryland, Baltimore. The research on microbiomes and microbes of dental caries focuses on the cariogenic toxicity and interaction of microorganisms, oral microbiomes, and the relationship between dental caries and systemic diseases. The articles with high citation frequency mainly involve topics such as dental caries, oral biofilm, oral microbiota, and Streptococcus mutans. Keyword research showed that “dental caries,” “Streptococcus mutans,” “bacteria,” “dental plaque,” and “antibacterial activity” have been the primary focus of research in the last decade. The number of keywords, such as “health” and “oral health,” is on the rise. The latest emergence of “gut microbiome/microbiota” suggests that the oral gut microbiome axis is at the forefront of research in this field, and researchers’ focus is gradually shifting toward the connection between dental caries and systemic diseases. Conclusion Over the last decade, the number of publications in the field microbiomes and microbes of dental caries has increased annually. This research trend will be the multi-omics of the overall oral microbiome, and new research methods and techniques will contribute to the field of cariology.

Objective To compare the effect of different scanning parameters of cone beam computed tomography (CBCT) on displaying trabecular microstructure in the anterior region of the mental foramen of the mandible, and to provide a basis for the rational selection of CBCT scanning parameters. Methods This study was approved by the Ethics Committee of the Affiliated Stomatological Hospital, Medical School of Nanjing University. An in vitro study was conducted using CBCT (ProMax 3D Mid) to scan eight dry human mandibular specimens with five scanning protocols: Group A: 90 kV/6.3 mA, Group B: 90 kV/8.0 mA, Group C: 90 kV/10.0 mA, Group D: 75 kV/8.0 mA, and Group E: 60 kV/8.0 mA, resulting in a total of 40 CBCT images. Entrance surface dose (ESD) and computed tomography dose index (CTDI) under different scanning conditions were recorded. The original CBCT images were imported into the image analysis software (Hiscan Analyzer) to measure four trabecular bone microstructural parameters in the region of interest of the mandible: trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular space (Tb.Sp), and bone volume/tissue volume (BV/TV). A total of 108 CBCT images were retrospectively collected from clinical implant patients using any of the 90 kV/6.3 mA, 90 kV/8.0 mA, or 90 kV/10.0 mA scanning conditions, and the above four parameters of the region of interest of the mandible were also measured. SPSS 26.0 software was used to compare the differences in the four trabecular bone microstructural parameters between the CBCT images of the mandibular specimens in vitro and clinical patients in vivo. Results The in vitro study results showed that reducing the tube voltage and tube current would lead to a decrease in the ESD and CTDI. When the tube voltage was maintained at 90 kV and the tube current was changed, BV/TV, Tb.N, and Tb.Th values increased with the increase of tube current; Tb.Sp values decreased with the increase of tube current, but there was no statistically significant difference in the four bone morphological parameters (P > 0.05). When the tube current was maintained at 8.0 mA and the tube voltage was altered, BV/TV and Tb.N decreased with the increase of tube voltage, Tb.Sp values increased with the increase of tube voltage, and BV/TV, Tb.N, and Tb.Sp showed statistically significant differences (P < 0.05). In clinical patients undergoing CBCT scanning, when the tube voltage was 90 kV and the tube current was different (6.3, 8.0, 10.0 mA), there was no statistically significant difference in the four bone morphological parameters (P > 0.05). Conclusions In this study, when the tube voltage was fixed at 90 kV, there was no difference in the trabecular microstructure of the anterior region of the mandible when the tube current was increased. When CBCT scanning of clinical patients needs to show the trabecular microstructure of the anterior region of the mandible, the tube current can be appropriately reduced to decrease the radiation dose received by the patient. Thus, it is recommended to use the parameters 90 kV and 6.3 mA for CBCT scanning.

Objective To retrospectively analyze the epidemiological characteristics of supernumerary teeth in patients aged 4-18 years old and the influencing factors on the selection of anesthesia methods, and to provide a reference for the selection of anesthesia plans for children and adolescents with supernumerary teeth. Methods This study is a retrospective study approved by the Institutional Ethics Committee. Based on clinical electronic medical record system and cone beam CT (CBCT) data, a retrospective analysis was conducted on 2 210 patients 4-18 years of age who underwent supernumerary tooth extraction at the School of Stomatology, Fourth Military Medical University from August 2019 to July 2021. Inclusion criteria: ① Age 4-18 years old; and ② The American Society of Anesthesiologists (ASA) classifies anesthesia into grades I-II; and ③ Have complete oral and anesthesia case records and relevant imaging data. Exclusion criteria: ① Incomplete medical records or unclear imaging data; and ② Patients with ASA grade II or above. Patients’ gender and age, the number of supernumerary teeth, arch, location, orientation, eruption status, reason for appointment, anxiety level, degree of cooperation, anesthesia method, and other relevant information were collected and statistically analyzed. Results A total of 1 865 eligible patients were included, with an average age of (8.9±3.2) years old. There were more male patients (71.37%, 1 331 cases) than female patients (28.63%, 534 cases) (P < 0.001), with a gender ratio of 2.49:1. The majority of supernumerary teeth were single (75.97%, 1 417/1 865), primarily located in the maxilla (97.2%, 1 812/1 865) and the anterior dental region (94.2%, 1 757/1 865), and in a centric position (77.3%, 1 442/1 865). The majority of patients with erupted supernumerary teeth were active in seeking treatment (97.67%, 335/343). Patients with supernumerary teeth located in the maxilla and mandible bones, as well as in the nasal floor, were mainly referred to the department for diagnosis, accounting for 94.38%(1 361/1 442) and 90.00% (72/80) (χ²=1 363.24, P < 0.001), respectively. Regarding anesthesia methods, the largest proportion of patients received nitrous oxide sedation-assisted local anesthesia or nerve block anesthesia, accounting for 38.07% (710/1 865), followed by local anesthesia, accounting for 35.23% (657/1 865). The proportion of patients receiving midazolam intravenous sedation with local anesthesia or nerve block anesthesia and general anesthesia was relatively small, accounting for 20.86% (389/1 865) and 5.84% (109/1 865). Patients 13-18 years of age with supernumerary teeth in the mandibular and posterior regions and without anxiety had the highest proportion of local anesthesia use (P < 0.001). In contrast, patients who had supernumerary teeth located at the base of the nose (50%), severe anxiety (94.12%), and poor cooperation (98.18%) had the highest proportion of general anesthesia use (P < 0.001). There was no significant difference (P = 0.35) in the incidence of intraoperative and postoperative complications after the extraction of supernumerary teeth. However, the proportion of anesthesia-related complications, such as dizziness, coughing, and respiratory depression, occurring in patients who received general anesthesia was higher than local anesthesia, accounting for 3.81% (P = 0.006). Conclusion There is a gender difference in the incidence of supernumerary teeth in patients 4-18 years of age, with a higher prevalence in males. The majority of supernumerary teeth are single and located in the maxillary anterior region, predominantly in a centric position. Patients whose teeth had erupted were more likely to seek medical treatment voluntarily, while patients with supernumerary teeth located in the maxilla and mandible bones, as well as in the nasal floor were more likely to be referred to the department. Patients with high levels of anxiety, poor cooperation, young age, multiple teeth, and high surgical difficulty were more inclined to choose general anesthesia.

Periodontitis is a chronic inflammatory disease caused by plaque microorganisms, which is the main cause of tooth loss in adults in China. Due to the complexity of periodontitis, their pathogenesis is still unclear. Ferroptosis is a form of iron-dependent regulation of cell death, which affects the function of glutathione peroxidase (GPX4) in the cell through different signaling pathways, thus decreasing antioxidant capacity, accumulation of reactive oxygen species and lipid peroxidation, eventually causing cell and tissue damage. Recent studies have found that iron overload, oxidative stress and lipid peroxidation are closely related to the occurrence and development of periodontitis. This article reviews the characteristics of ferroptosis and the relationship between ferroptosis and inflammatory diseases, especially periodontitis, to provide new ideas for the diagnosis, treatment, and prognosis evaluation of periodontitis. ferroptosis is mainly manifested as the disruption of the body's redox homeostasis, decreased antioxidant capacity, activation of damage related molecular patterns, release of pro-inflammatory mediators, and induction or exacerbation of inflammation. Iron dependent oxidative stress and lipid peroxidation are simultaneously involved in the regulation of ferroptosis and inflammatory diseases. Pathogenic bacteria of periodontitis can induce ferroptosis of periodontal ligament stem cells, thereby activating the release of inflammatory factors such as interleukin-17, tumor necrosis factor alpha, and hypoxia inducible factor-1 alpha, exacerbating periodontitis; In addition, inflammatory factors activated by ferroptosis play an important role in alveolar bone homeostasis, and ferroptosis is involved in the process of lipopolysaccharide induced inflammation of gingival fibroblasts. Future research can focus on exploring the molecular mechanisms and therapeutic targets of ferroptosis in periodontitis, providing new strategies for the prevention and treatment of periodontal disease.

Tooth wear is a common and complex oral problem, with a gradually increasing global incidence. Tooth wear not only affects the oral function and esthetics of patients but may also lead to tooth sensitivity, temporomandibular joint diseases, and other related complications. The continuous progress of digital technology has shown significant potential for the diagnosis and treatment of tooth wear. In recent years, researchers have extensively studied the application of digital technology in tooth wear research from the perspectives of digital support devices, cutting-edge deep learning applications, technology diagnosis, design and prediction, and current limitations. Such studies have provided a deep exploration of the micrometer-level resolution advantages of three-dimensional oral scanning technology in the early detection of tooth wear, which can assist in precise clinical and scientific research practices. Deep learning technology can also achieve image recognition and automated analysis to reduce human error and improve diagnostic efficiency, while quantitative analysis techniques guide clinical decision-making by more accurately calculating the tooth volume, surface area, and wear depth. Finally, simulation techniques can be employed to enhance understanding of the biomechanical and chemical mechanisms of tooth wear and predict its progression. These studies have also highlighted the current difficulties in data management, privacy protection, and obtaining high-quality big data, as well as technical barriers and insufficient evidence-based medical evidence in this field. Nevertheless, digital technology will undoubtedly improve and play an increasingly important role in future dental practice.

Dysbiosis can cause microenvironmental dysregulation, which can further lead to local or systemic diseases, such as caries, inflammatory bowel disease, obesity, and diabetes. Dysbiosis is primarily manifested as the disturbance of metabolic processes and products. Arginine plays an important role in various metabolic processes and homeostasis of the microbial flora and the host. This study aims to explore the potential therapeutic value of arginine and its metabolism and homeostasis regulation in diseases associated with oral-intestinal dysbiosis. Host and microbial homeostasis can be restored by regulating the composition or function of host microbiota, and arginine has been found to exhibit significant clinical potential in restoring host microbiota composition and function. For example, arginine can reduce the risk of caries by regulating the relative abundance of Streptococcus mutans and Streptococcus sanguineus. Additionally, arginine metabolism may play a therapeutic role in inflammatory bowel disease and obesity by regulating the relative abundance of Firmicutes and Bacteroidetes. In addition, supplementation of arginine and its metabolite polyamine has clinical prospects in the treatment of diabetic patients with ketoacidosis. Although studies have demonstrated the therapeutic role of arginine in oral, intestinal, and metabolism-related diseases, the specific mechanism is yet to be explored. In addition, further research is required to determine the optimal clinical dosage of arginine that can maintain microbiota homeostasis without causing any side effects.

Platelets, small cell fragments in the blood that prevent bleeding, are closely associated with hemostasis and thrombosis and play an important role in the inflammatory response. Periodontitis is a chronic inflammatory disease caused by periodontopathogenic bacteria, resulting in local and systemic inflammatory responses that are associated with many systemic diseases. In recent years, several animal and human studies have demonstrated the correlation between periodontitis and platelets from three aspects: gingiva, and gingival crevicular fluid, and found that activated platelets play a very important role in the development and progression of periodontitis. Porphyromonas gingivalis and inflammatory mediators S100A8/A9 activate platelets, which then combine with leukocytes to form platelet-leukocyte aggregates. These aggregates can migrate into periodontal tissue, producing proinflammatory cytokines, thereby promoting the development and progression of periodontitis. Available studies also suggest that initial periodontal therapy reduces platelet activation and platelet-leukocyte aggregate formation, which may reduce the risk of cardiovascular diseases (CVDs) in patients with periodontitis. Additionally, studies found that antiplatelet drugs can inhibit periodontal inflammation and promote periodontal tissue repair and that P. gingivalis-induced expression of CD40L on platelets may be an important mediator between periodontitis and CVD. These reports suggest that platelets can serve as novel therapeutic targets for the treatment of periodontitis. This review aims to discuss the current literature on the correlation and interaction mechanisms between periodontitis and platelets.