中华口腔医学杂志最新文献

The professional terms "persistent apical periodontitis" and "refractory apical periodontitis" are both used to describe clinical cases that periapical lesions fail to heal after root canal therapy. Both share similarities and differences in terms of their connotations, pathogenesis, treatment methods, and prognosis. Using suitable term to describe this type of disease has always been a dilemma in clinical practice, scientific research, or academic exchanges. Based on extensive literature searches, clinical research findings and experience, this paper systematically analyzes the reasons for the formation of these two terms and their clinical significance, providing guidance for clinicians to understand and manage this type of disease, and to use the medical terminology accurately.

Objective: To explore the clinical characteristics and treatment status in elderly patients with oral emergencies, and to provide a reference for improving emergency care level for this population. Methods: A retrospective study was performed on the patients aged 80 years and above in the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2022 to December 2024. Gender, age, systemic conditions, disease types and treatment strategies were statistically analyzed. Results: A total of 3 470 patients were enrolled, including 1 403 males (1 403/3 470) and 2, 067 females (2 067/3 470), with a male-to-female ratio of 0.68∶1. The age range was 80 to 101 years, with median age of 84 years. Elderly patients had a wide variety of diseases involving multiple disciplines, in which acute toothache [38.3%(1 330/3 470)], maxillofacial trauma [10.1%(352/3 470)], infectious diseases [10.1%(349/3 470)], hemorrhage [9.0%(312/3 470)], and temporomandibular joint emergencies [6.4%(223/3 470)] were the most prevalent. Comorbid systemic diseases were present in 63.0% of patients, showing an increasing trend with advancing age. Hypertension [43.8%(1 519/3 470)], cardiovascular and cerebrovascular diseases [27.6%(958/3 470)], and diabetes mellitus [16.9%(588/3 470)] were the most common comorbidities. Emergencies were effectively managed in 69.6% (2 414/3 470) patients. 30.4% (1 056/3 470) patients had no effective resolution, mostly due to the need for scheduled treatment under electrocardiographic monitoring or surgical tooth extraction. Whether electrocardiographic monitoring was needed varied between the two groups with different age characteristics. Conclusions: Elderly patients with oral emergencies have a diverse range of diseases involving multiple disciplines, and the risk of treatment complications is relatively high due to their complex comorbid systemic conditions. Clinicians should formulate individualized treatment plans based on patients' systemic status in clinical treatment.

Objective: To analyze the angle of maxillary posterior guiding inclination (referred to as maxillary guiding inclination) during mandibular protrusive and lateral movements, as well as its relationship with the trajectory angle of the corresponding mandibular posterior buccal cusp apex (referred to as mandibular trajectory angle), providing the feasibility of directly using mandibular movement trajectory for occlusal design and pre-adjustment of digital prostheses. Methods: Eighteen medical student volunteers with individual normal occlusion aged 23-27 years were recruited from Peking University School and Hospital of Stomatology. Their maxillary and mandibular dentition models and occlusal relationship data were obtained via intraoral scanning. Mandibular movement trajectories were recorded using a mandibular motion analyzer. Geomagic Studio software aligned coordinate systems between dental models and kinematic data. Using the occlusal plane as a reference, the angles of the guiding inclinations (the distal surfaces and lingual surfaces of the buccal cusps) of each maxillary posterior tooth during protrusive and lateral movements (hereinafter referred to as the guiding inclinations), as well as the trajectory angles of the corresponding mandibular buccal cusp apices during mandibular lateral and protrusive movements (hereinafter referred to as the trajectory angles), were measured respectively. The variation regularity of each angle and the correlation between the angles were analyzed. Results: The guiding inclination varied among different tooth positions and differed from the trajectory angles. The protrusive guiding inclination (16.31°-27.40°) was smaller than the protrusive trajectory angles (34.29°-35.99°). The maxillary guiding inclination decreased first and then increased, while the latter remained relatively stable, with no statistically significant correlation between them (r=0.23, 0.31, 0.30, 0.05, all P>0.05). The lateral guiding inclination gradually decreased from the first premolar to the second molar (31.48°-13.06°), whereas the lateral trajectory angles remained relatively stable (22.32°-17.10°). A positive correlation existed between them (r=0.74, 0.65, 0.61, 0.62, all P<0.05). Conclusions: During mandibular protrusion, the guiding inclination varies significantly while the trajectory angles remain relatively stable, with no correlation observed between them. In contrast, during lateral mandibular movement, the guiding inclination and trajectory angles show a positive correlation.

The emergence profile of an implant prosthesis is very important to maintain the health and aesthetic shape of soft tissue around prostheses. The reasonable design of the emergence profile of an implant-supported interim prosthesis not only preserves the soft tissue around the implant but is also very important for long-term stability and an ideal aesthetic outcome. This article summarizes the concepts, tissue composition, design, and transfer method of the ideal emergence profile of an implant prosthesis in the aesthetic area, and the application of digital technology to transfer the emergence profile, to provide a reference for clinical practice.

The orthognathic surgery aims to treat dentofacial deformities, with the fundamental principle of addressing both appearance and function, and combining surgical and orthodontic treatments. This approach integrates orthodontics and orthognathic surgery to resolve issues related to facial appearance and occlusal relationships. With the development of socio-economic conditions and the widespread dissemination of scientific knowledge, patients' awareness and acceptance of orthognathic surgery have continuously increased. The accumulation of clinical experience has led scholars to realize that orthognathic surgery not only affects appearance and occlusion but also has a significant impact on joint health and upper airway width. These two factors-joint and airway-have become essential considerations in the planning of orthognathic surgery. In addition, psychological factors are gaining increasing prominence in the preoperative evaluation of orthognathic surgery, and the importance of patients' psychological assessment has also been gradually recognized by scholars. Through long-term clinical practice, scholars have continuously summarized experiences and lessons, and the new concept of orthognathic surgery as a 'five-in-one' approach involving appearance, occlusion, joints,airway and psychology has gradually become clear. In this article, the authors summarized the latest domestic and international literature and clinical experience from their own institution to emphasize the importance and necessity of considering joint, airway and psychology in orthognathic surgery, based on the emphasis of appearance and occlusion.

Accounting for more than 90% of oral malignancies, oral squamous cell carcinoma (OSCC) is recognized as the predominant histological subtype of oral cancer. The overall five-year survival rate of patients with advanced OSCC remains unsatisfactory.With the rapid advancement of transcriptomics, molecular biology, and nucleic acid delivery technologies, increasing attention has been directed toward RNA-based therapeutics as a promising approach for OSCC treatment, owing to their capacity for precise regulation of oncogenes, signaling pathways, and the tumor microenvironment. Included among the major forms of RNA therapeutics are small interfering RNA, micro RNA, messenger RNA, long non-coding RNA, and circular RNA. By modulating oncogenes, tumor microenvironment-related factors, and signaling pathways associated with therapeutic resistance, suppression of tumor proliferation, invasion, and metastasis can be achieved, while apoptosis induction and the enhancement of chemo-radiotherapeutic sensitivity may also be promoted.Considerable potential has therefore been demonstrated by RNA therapeutics in the treatment of OSCC. Nevertheless, multiple obstacles continue to hinder their clinical translation, among which insufficient in vivo stability, limited delivery efficiency, off-target effects, and the specific oral environment are particularly prominent. In this review, the theoretical basis of RNA therapy, recent advances in its application to OSCC, RNA delivery systems, and the current challenges faced are comprehensively summarized, with the aim of providing references for future research on precision therapy for OSCC.

Objective: To investigate the role of psychological factors in the development and progression of factitious oral ulcer (FOU) among children and adolescents, and to evaluate the clinical efficacy of a comprehensive intervention strategy based on standardized psychological assessment. Methods: In a prospective real-world study, 35 patients aged 3-16 years with FOU who visited the Department of Stomatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine were enrolled from April 23, 2024, to August 30, 2025. Stratified by age, systematic psychological assessment was performed using the parent symptom questionnaire (PSQ), strengths and difficulties questionnaire (SDQ), screen for child anxiety related emotional disorders, and depression self-pating scale for children. All patients received topical recombinant bovine basic fibroblast growth factor and oral health education. Those with abnormal psychological scores received individualized psychological education and clinical psychology referral. Patients with low serum zinc concentration received zinc supplementation. The overall clinical effectiveness rate, ulcer area, pain visual analog scale (VAS) score, cessation of self-injurious behavior, psychological scores, and recurrence were assessed at baseline, 2, 4, and 12 weeks post-treatment. Results: All 35 patients completed the study, with a mean age of (8.34 ± 2.79) years and a male proportion of 65.7% (23/35). Abnormal psychological scores were present in 82.9% (29/35) of patients. At 12 weeks post-treatment, the clinical effectiveness rate was 91.4% (32/35), with a cure rate of 88.6% (31/35); significant reductions in ulcer area and pain VAS score were observed compared to baseline (both P<0.001). The entire cohort showed significant improvements in the PSQ total score (conduct problems) at 4 and 12 weeks (both P<0.05), and the SDQ total difficulties score at 12 weeks compared to baseline (P<0.05). By week 12, 37.1% (13/35) of patients had successfully ceased self-injurious behavior. Multivariate logistic regression identified cessation of self-injurious behavior as an independent protective factor against ulcer recurrence (OR=0.080, 95%CI: 0.007-0.918, P=0.042). Conclusions: Psychological factors play a central role in FOU, with a high prevalence of anxiety, emotional, and behavioral problems among affected children. A comprehensive intervention strategy, guided by precise psychological assessment and integrating topical treatment, psychological-behavioral intervention, and nutritional supplementation, effectively promotes ulcer healing, improves psychological and behavioral status, and reduces recurrence.

Porphyromonas gingivalis, a keystone pathogen in periodontitis, has been confirmed to be associated with various systemic diseases. In recent years, increasing attention has been paid to the link between Porphyromonas gingivalis and neurodegenerative disorders. However, researches on its association with Parkinson disease still lack a systematic review. Starting from the epidemiological evidence connecting Porphyromonas gingivalis and Parkinson disease, this research reviews their clinical and pathological correlations, along with potential underlying mechanisms, aiming to provide insights for further exploration of its pathogenesis and future prevention or treatment strategies.