A whole-course-repair system based on ROS/glucose stimuli-responsive EGCG release and tunable mechanical property for efficient treatment of chronic periodontitis in diabetic rats.

Elevated glucose levels, multiple pro-inflammatory cytokines and the generation of excessive reactive oxygen species (ROS) are pivotal characteristics within the microenvironments of chronic periodontitis with diabetes mellitus (CPDM). Control of inflammation and modulation of immune system are required in the initial phase of CPDM treatment, while late severe periodontitis requires a suitable scaffold to promote osteogenesis, rebuild periodontal tissue and reduce alveolar bone resorption. Herein, a whole-course-repair system is introduced by an injectable hydrogel using phenylboronic acid functionalized oxidized sodium alginate (OSA-PBA) and carboxymethyl chitosan (CMC). Epigallocatechin-3-gallate (EGCG) was loaded to simultaneously adjust the mechanical property of the OSA-PBA/CMC + EGCG hydrogel (OPCE). This hydrogel has distinctive adaptability, injectability, and ROS/glucose-triggered release of EGCG, making it an ideal drug delivery carrier. As expected, OPCE hydrogel shows favourable antioxidant and anti-inflammatory properties, along with a regulatory influence on the phenotypic transition of macrophages, providing a favourable immune microenvironment. Apart from that, it provides a favourable mechanical support for osteoblast/osteoclast differentiation regulation at the late proliferation stage of periodontal regeneration. The practical therapeutic effects of OPCE hydrogels were also confirmed when applied for treating periodontitis in diabetic rats. In summary, OPCE hydrogel may be a promising whole-course-repair system for the treatment of CPDM.

Evaluation of optimal anterior-posterior position of upper incisors through ANS point: a retrospective study on a Chinese sample.

OBJECTIVES: This study was designed to determine the optimal anterior-posterior (AP) position of upper incisors through Anterior Nasal Spine (ANS) point. MATERIALS AND METHODS: Lateral cephalometric radiographic images of 690 patients were collected and divided into a derivation group and a validation group, and the former were subdivided into a proper AP position (PAP) group and an improper AP position (iPAP) group. The distance from facia-axis (FA) point of upper incisors to the line perpendicular to Frankfort horizontal (FH) plane through ANS (FA-ANS) was measured, and the relationship between FA-ANS and several cephalometric indices were studied through Pearson correlation analysis. Receiver operating characteristic (ROC) curves for different clinical indices were analyzed to evaluate the diagnostic efficiency of optimal AP position of upper incisors. RESULTS: The average value of FA-ANS in PAP group was 0.57±1.99, which was significantly different from FA-ANS in iPAP group. Cephalometric indices such as U1-NA, U1-SN, AB-NPo, UL-TVL, Wits, and ANB were found to be correlated with FA-ANS. The receiver operating characteristic (ROC) curves represented a greater diagnostic efficiency of FA-ANS compared with other clinical indices. CONCLUSIONS: ANS point, as a stable skeletal landmark, could be used to access an optimal AP position of upper incisors, providing aids to clinical diagnosis and treatment goal determination for clinical practice. CLINICAL RELEVANCE: A new index FA-ANS, together with other traditional indices, could help determine the optimal position of upper incisors and provide a personalized therapeutic plan.

RIPK2 inhibitors for disease therapy: Current status and perspectives.

Receptor-interacting protein kinase 2 (RIPK2) belongs to the receptor-interacting protein family (RIPs), which is mainly distributed in the cytoplasm. RIPK2 is widely expressed in human tissues, and its mRNA level is highly expressed in the spleen, leukocytes, placenta, testis, and heart. RIPK2 is a dual-specificity kinase with multiple domains, which can interact with tumor necrosis factor receptor (TNFR), and participate in the Toll-like receptor (TLR) and nucleotide-binding oligomerization domain (NOD) signaling pathways. It is considered as a vital adapter molecule involved in the innate immunity, adaptive immunity, and apoptosis. Functionally, RIPK2 and its targeted small molecules are of great significance in inflammatory responses, autoimmune diseases and tumors. The present study reviews the molecule structure and biological functions of RIPK2, and its correlation between human diseases. In addition, we focus on the structure-activity relationship of small molecule inhibitors of RIPK2 and their therapeutic potential in human diseases.

Accuracy in predicting soft tissue changes of orthodontic class III cases using Dolphin® software.

OBJECTIVES: The prediction of posttreatment outcomes is conducive to the final determination of ideal therapeutic options. However, the prediction accuracy in orthodontic class III cases is unclear. Therefore, this study conducted exploration on prediction accuracy in orthodontic class III patients using the Dolphin® software. MATERIALS AND METHODS: In this retrospective study, lateral cephalometric radiographs of pre- and posttreatment were collected from 28 angle class III adults who received completed non-orthognathic orthodontic therapy (8 males, 20 females; mean age = 20.89 ± 4.26 years). The values of 7 posttreatment parameters were recorded and inserted into the Dolphin® Imaging software to generate a predicted outcome, and then the prediction radiograph and actual posttreatment radiograph were superimposed and compared in terms of soft tissue parameters and landmarks. RESULTS: The prediction showed significant differences with the actual outcomes in nasal prominence (the difference between the prediction and the actual value was - 0.78 ± 1.82 mm), the distance from the lower lip to the H line (0.55 ± 1.11 mm), and the distance from the lower lip to the E line (0.77 ± 1.62 mm) (p < 0.05). Point subnasale (Sn) (an accuracy of 92.86% in the horizontal direction and 100% in the vertical direction in 2 mm) and point soft tissue A (ST A) (an accuracy of 92.86% in the horizontal direction and 85.71% in the vertical direction in 2 mm) were proven to be the most accurate landmarks, while the predictions in the chin region were relatively inaccurate. Furthermore, the predictions in the vertical direction were of higher accuracy compared to the horizontal direction except for the points around the chin. CONCLUSIONS: The Dolphin® software demonstrated acceptable prediction accuracy in midfacial changes in class III patients. However, there were still limitations for changes in the chin and lower lip prominence. CLINICAL RELEVANCE: Clarifying the accuracy of Dolphin® software in predicting soft tissue changes of orthodontic class III cases will facilitate physician-patient communication and clinical treatment.

Evaluation of automated detection of head position on lateral cephalometric radiographs based on deep learning techniques.

BACKGROUND: Lateral cephalometric radiograph (LCR) is crucial to diagnosis and treatment planning of maxillofacial diseases, but inappropriate head position, which reduces the accuracy of cephalometric measurements, can be challenging to detect for clinicians. This non-interventional retrospective study aims to develop two deep learning (DL) systems to efficiently, accurately, and instantly detect the head position on LCRs. METHODS: LCRs from 13 centers were reviewed and a total of 3000 radiographs were collected and divided into 2400 cases (80.0 %) in the training set and 600 cases (20.0 %) in the validation set. Another 300 cases were selected independently as the test set. All the images were evaluated and landmarked by two board-certified orthodontists as references. The head position of the LCR was classified by the angle between the Frankfort Horizontal (FH) plane and the true horizontal (HOR) plane, and a value within - 3°- 3° was considered normal. The YOLOv3 model based on the traditional fixed-point method and the modified ResNet50 model featuring a non-linear mapping residual network were constructed and evaluated. Heatmap was generated to visualize the performances. RESULTS: The modified ResNet50 model showed a superior classification accuracy of 96.0 %, higher than 93.5 % of the YOLOv3 model. The sensitivity&recall and specificity of the modified ResNet50 model were 0.959, 0.969, and those of the YOLOv3 model were 0.846, 0.916. The area under the curve (AUC) values of the modified ResNet50 and the YOLOv3 model were 0.985 ± 0.04 and 0.942 ± 0.042, respectively. Saliency maps demonstrated that the modified ResNet50 model considered the alignment of cervical vertebras, not just the periorbital and perinasal areas, as the YOLOv3 model did. CONCLUSIONS: The modified ResNet50 model outperformed the YOLOv3 model in classifying head position on LCRs and showed promising potential in facilitating making accurate diagnoses and optimal treatment plans.

Evaluation of cuspid cortical anchorage with different sagittal patterns using cone-beam computed tomography: a retrospective study.

BACKGROUND: No studies have focused on cortical anchorage resistance in cuspids, this study aimed to characterize the cortical anchorage according to sagittal skeletal classes using cone-beam computed tomography (CBCT). METHODS: CBCT images of 104 men and 104 women were divided into skeletal class I, II, and III malocclusion groups. Skeletal and dental evaluations were performed on the sagittal and axial cross-sections. One-way analysis of variance followed by least significant difference post-hoc tests was used for group differences. Multiple linear regression was performed to evaluate the relationship between influential factors and cuspid cortical anchorage. RESULTS: All cuspids were close to the labial bone cortex in different sagittal skeletal patterns and had different inclinations. There was a significant difference in the apical root position of cuspids in the alveolar bone; however, no significant difference in the middle or cervical portions of the root was found between different sagittal facial patterns. The middle of the cuspid root was embedded to the greatest extent in the labial bone cortex, with no significant difference between the sagittal patterns. For all sagittal patterns, 6.03 ± 4.41° (men) and 6.08 ± 4.45° (women) may be appropriate root control angles to keep maxillary cuspids' roots detached from the labial bone cortex. CONCLUSIONS: Comparison of skeletal class I, II, and III malocclusion patients showed that dental compensation alleviated sagittal skeletal discrepancies in the cuspid positions of all patients, regardless of the malocclusion class. Detailed treatment procedures and clear treatment boundaries of cuspids with different skeletal patterns can improve the treatment time, periodontal bone remodeling, and post-treatment long-term stability. Future studies on cuspids with different dentofacial patterns and considering cuspid morphology and periodontal condition may provide more evidence for clinical treatment.

A simple method for quick evaluation of the anterior tooth ratio: an observational study.

BACKGROUND: An ideal relationship of anterior teeth is closely related to postoperative function, stability, and aesthetics. Therefore, it is necessary to estimate the proportion of anterior teeth when communicating with patients about possible treatment plans and outcomes. This study aimed to establish a simple method for assessing the proportion of anterior teeth and to identify the standard ratio value to provide references for clinical work. METHODS: Five hundred fourteen patients were divided into derivation, standard, and validation datasets. We first deduced our novel simplified anterior tooth ratio (SATR) by finding the key teeth with the derivation datasets, then established standard values by measuring the standard models, and finally validated the diagnostic performance of SATR. Independent sample t-test was used to select key teeth. Pearson's correlation analysis and linear regression analysis was used to test and verify the correlation between SATR and the anterior Bolton ratio. Chi-square test and diagnostic test were used to verify the diagnostic results using SATR. P values of < 0.05 were considered statistically significant. RESULTS: Patients with an abnormal anterior Bolton ratio were more likely to have variations in the maxillary and mandibular lateral incisors. Therefore, the ratio of maxillary and mandibular lateral incisors was chosen as a simple way to assess the anterior tooth ratio and was defined as SATR (simplified anterior tooth ratio). A positive correlation was observed between SATR and anterior Bolton ratio (r = 0.702, p < 0.001), with the linear regression equation as follows: y = 0.503 + 0.328x, x = SATR, y = anterior Bolton ratio. The standard value of SATR was established (85.69% ± 3.57%) and proven reliable in clinical practice. CONCLUSIONS: The ratio of maxillary and mandibular lateral incisors can be used to estimate the anterior tooth ratio, which showed high reliability and efficiency.

Orthodontic emergencies and mental state of Chinese orthodontic patients during the COVID-19 pandemic.

BACKGROUND: The ongoing COVID-19 pandemic postponed routine follow-up visits of many orthodontic patients, which compromised their treatment process and mental states. This study was aimed to assess orthodontic emergency occurrence and psychological states of Chinese orthodontic patients during this pandemic. METHODS: Orthodontic patients in China were invited to answer an anonymous online questionnaire from February 20, 2020 to March 5, 2020, when routine dental care was suspended in China. The questionnaire included self-assessment of oral hygiene and compliance, orthodontic emergencies, perceptions and feelings about COVID-19 and anxiety self-rating scale, etc. Collected data was statistically analyzed with Chi-square, independent t test and univariable generalized estimating equations regression analysis. RESULTS: A total of 1078 respondents (292 male; 786 female) from 30 provinces of China were included in this study. About one-third (33.67%) of patients reported that they encountered orthodontic problems during the pandemic. Patients with clear aligners reported fewer orthodontic problems than those with fixed appliances or removable appliances. Female patients, elder patients and patients who encountered orthodontic emergencies were more anxious than other patients. CONCLUSIONS: The compliance and occurrence of orthodontic emergencies differed in patients with different orthodontic appliances. Patients with orthodontic emergencies exhibited higher anxiety states.

[Correlation between social psychology and personality characteristics and treatment options for adult patients with skeletal malocclusion].

OBJECTIVE: This study aims to explore factors affecting the dental aesthetic social psychology of patients with skeletal malocclusion and to measure the relationship between the objective orthodontic requirements and the subjective treatment requirements of patients. This work provides a reference for doctors to measure patients' orthodontic treatment needs. METHODS: Adult patients with skeletal malocclusion were chosen as the research object. Questionnaire survey was used to analyze factors influencing the psychosocial impact of dental aesthetics questionnaire (PIDAQ), index of orthodontic treatment need (IOTN), and Eysenck personality questionnaire-revised short scale for Chinese (EPQ-RSC). The relationship among PIDAQ, IOTN, EPQ-RSC, and treatment options was also evaluated. RESULTS: Seventy-two valid questionnaires were collected from adult patients with skeletal malocclusion. 1) The PIDAQ scores significantly differed among different occupations (P<0.05) but were not affected by other general conditions such as gender and age. 2) Patients of different dental health component (DHC) grade and ages had different AC self-assessment scores (P<0.01, P<0.05). The AC self-assessment score was positively correlated with the PIDAQ score (P<0.05). 3) Males accounted for a higher proportion of patients who received treatment. Younger patients (18-28 years old) were more likely to receive treat-ment when their own dental aesthetics were poor. People with the higher monthly expenditure accounted for the larger proportion of surgical patients. 4) The PIDAQ score had no significant effects on the choice of opera-tion (P>0.05). People with low educational level were more likely to receive surgery if their psychosocial impacts of dental aes-thetics were serious. 5) The score of psychoticism scale of EPQ-RSC and the educa-tional level had a mutual influence on the PIDAQ score (P<0.01). Moreover, the neuroticism scale and AC self-assessment scores had a mutual influence on the PIDAQ score (P<0.05). However, this study did not find a correlation between personality traits and treatment options. CONCLUSIONS: Many factors, such as personal natural conditions, subjective aesthetic evaluation of teeth, and psychosocial impacts of dental aesthetics, affect patients' treatment options. Personality characteristics can play a certain role in dental aesthetics social psychology.