中华口腔医学杂志最新文献

{"title":"[Modified submental artery island flap for reconstruction of mandibular defects caused by medication-related osteonecrosis of the jaw: technical note and clinical outcomes].","authors":"Y W Zou, J N Li, Y H Zhou, T Zhu, M Y Yang, B Zhou, Y Zhang, Y X Guo","doi":"10.3760/cma.j.cn112144-20260212-00114","DOIUrl":"10.3760/cma.j.cn112144-20260212-00114","url":null,"abstract":"<p><p><b>Objective:</b> To summarize the key surgical techniques of the modified submental artery island flap for repairing tissue defects following surgery for mandibular medication-related osteonecrosis of the jaw (MRONJ), and to retrospectively evaluate the therapeutic outcomes. <b>Methods:</b> A total of 116 patients with mandibular MRONJ who underwent surgical treatment at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Peking University International Hospital, and Baoding Second Hospital from June 2021 to September 2025 were included. All patients underwent saucer-like osteotomy preserving mandibular continuity, combined with a modified submental artery island flap for bone defect cavity filling and wound closure. Baseline data (age, sex), clinical data (primary disease, medication strategy, AAOMS stage), and surgical intervention factors (fluorescence guidance, reconstruction plate placement, flap transfer method) were retrospectively analyzed. Regular follow-up was conducted postoperatively via clinical (3 weeks, 6 weeks, and 12 weeks) and imaging examinations (12 weeks) to assess soft tissue and bone wound healing, and to evaluate the overall cure rate. <b>Results:</b> The modified submental artery island flap was utilized to reconstruct tissue defects and achieve wound closure in a series of 116 mandibular MRONJ patients. Among them, 52 were male and 64 were female, with a mean age of 64.9 years. Lung cancer, breast cancer, and prostate cancer were the most common primary diseases. There were 29 patients with AAOMS stage Ⅱ and 87 with stage Ⅲ MRONJ. Seventy-six received antiresorptive agents alone, and the remaining 40 patients received a combination of antiresorptive and antiangiogenic agents. All 116 patients underwent saucer-like osteotomy preserving mandibular continuity, with 66 patients receiving reconstruction plates to enhance the strength of residual mandibular bone. Necrotic bone resection was performed based on clinical judgement in 94 patients, whereas autofluorescence-guided resection was used in 22 patients. Of the 116 cases, 105 were successful and 11 failed, translating to an overall cure rate of 90.5%. Univariate and multivariate statistical analyses revealed that none of the variables examined had a statistically significant effect on treatment outcome. <b>Conclusions:</b> The modified submental artery island flap provides an effective approach for reconstructing mandibular MRONJ defects, enabling reliable soft tissue coverage and favorable clinical outcomes. This technique shows considerable potential for widespread application in preserving mandibular continuity and function, presenting a safe and effective option in the surgical management of MRONJ.</p>","PeriodicalId":23965,"journal":{"name":"中华口腔医学杂志","volume":"61 8","pages":"1158-1165"},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Focusing on the challenges in the diagnosis and treatment of osteonecrosis of the jaw: toward precision therapeutic strategies].","authors":"Y He","doi":"10.3760/cma.j.cn112144-20260401-00206","DOIUrl":"10.3760/cma.j.cn112144-20260401-00206","url":null,"abstract":"<p><p>Osteonecrosis of the jaw (ONJ) is one of the most challenging diseases in the field of oral and maxillofacial surgery, mainly including osteoradionecrosis of the jaw (ORNJ) and medication-related osteonecrosis of the jaw (MRONJ). With the continuous improvement in comprehensive treatment strategies for head and neck malignancies and the increasingly widespread clinical use of antiresorptive agents and antiangiogenic drugs, the incidence of ONJ has shown a gradual upward trend. Clinically, the disease is commonly characterized by exposed necrotic bone, chronic infection, progressive destruction of the jawbone, and functional impairment, which not only severely compromises patients' quality of life but also poses substantial challenges to clinical management. In recent years, significant progress has been achieved in the understanding of the pathogenesis of ONJ, the establishment of classification and staging systems, and the development of consensus guidelines for standardized diagnosis and treatment, leading to notable improvements in clinical management. Meanwhile, advances in precision medicine, digital surgery, and regenerative medicine have provided new perspectives and therapeutic strategies for the management of ONJ. Based on recent domestic and international research progress, this article discusses the clinical challenges, advances in diagnosis and treatment, and future development directions of ONJ, aiming to provide insights for further improving diagnostic and therapeutic strategies and promoting continued research in this field.</p>","PeriodicalId":23965,"journal":{"name":"中华口腔医学杂志","volume":"61 8","pages":"1091-1097"},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Interpretation of \"sleep-disordered breathing and orthodontics: an American Association of Orthodontists white paper update\"].","authors":"T T Zhao, Z J Liu, F Hua, H He","doi":"10.3760/cma.j.cn112144-20260316-00167","DOIUrl":"10.3760/cma.j.cn112144-20260316-00167","url":null,"abstract":"<p><p>In 2024, the Board of Trustees of the American Association of Orthodontists (AAO) established a special task force consisting of AAO members, academics, and clinicians deeply engaged in the field of dental sleep medicine to evaluate and update the content of the 2019 White Paper entitled Obstructive Sleep Apnea (OSA) and Orthodontics. This paper presents a professional interpretation of the updated white paper. By integrating the national contextual differences in orthodontic clinical practice between China and other countries, it clarifies the core positioning and professional boundaries of orthodontists in the management of sleep-disordered breathing (SDB). Meanwhile, based on the actual clinical situation in China, it provides practical guidance for orthodontists to implement the concepts of the white paper and standardize clinical practices.</p>","PeriodicalId":23965,"journal":{"name":"中华口腔医学杂志","volume":"61 8","pages":"1143-1149"},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ranking the scientificity, transparency, and applicability of Chinese stomatological guidelines and consensus statements (2023-2024)].","authors":"","doi":"10.3760/cma.j.cn112144-20260312-00162","DOIUrl":"10.3760/cma.j.cn112144-20260312-00162","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the scientificity, transparency and applicability of the guidelines and consensus in the field of stomatology published by Chinese experts between 2023 to 2024. <b>Method:</b> Systematic searches were conducted in 8 databases including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, China Biomedical Literature Service System, Chinese Medical Journal Full-text Database, Wanfang Medical Network, PubMed, Web of Science, and Scopus. Guidelines and consensus led by Chinese scholars in the field of stomatology from 2023 to 2024 were included. The comprehensive evaluation of the included guidelines and consensus was conducted based on the scientific, transparent and applicable rankings (STAR) tool, followed by analyzation of the results. <b>Results:</b> Total of 4 guidelines and 33 expert consensuses were included. Calculated based on the total score of 100 points, the highest score was 32.15 while the lowest was 8.10, as well as the average score was 18.02 and the median score was 17.35. The top 3 STAR domains with the highest score rate were recommendations (48.0%), fundings (31.5%), and guideline development groups (31.4%), while the bottom 3 domains with the lowest score rate were registries (0), protocols (1.4%), and clinical questions (6.8%). <b>Conclusions:</b> The overall quality of guidelines and consensus in the field of stomatology in China needs to be improved. It is necessary to strengthen the planning of guideline and consensus formulation, standardize the formulation process. We emphasize that the guideline development group should include experts from multiple disciplines including evidence-based medicine or guideline methodology.</p>","PeriodicalId":23965,"journal":{"name":"中华口腔医学杂志","volume":"61 8","pages":"1205-1212"},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research and application of artificial intelligence in tooth extraction].","authors":"J Zhou, X L Hao, W Zhang","doi":"10.3760/cma.j.cn112144-20260509-00293","DOIUrl":"10.3760/cma.j.cn112144-20260509-00293","url":null,"abstract":"<p><p>Tooth extraction is a common procedure in oral clinical practice. However, imaging interpretation, risk assessment, and perioperative management remain challenging for complex cases. In recent years, artificial intelligence(AI) has been increasingly applied to oral image recognition, anatomical structure segmentation, extraction difficulty assessment, complication risk prediction, surgical planning, and robot-assisted surgery, providing new approaches for improving clinical efficiency and supporting clinical decision-making. Nevertheless, several limitations remain in current studies. The identification of high-risk anatomical structures does not directly translate into actual surgical risk, model prediction endpoints are often disconnected from real-world clinical outcomes, insufficient coverage of rare imaging features limits the clinical applicability of existing models and problems related to uneven data quality, algorithmic limitations, and study design defects coexist. In addition, issues concerning clinical accessibility, responsibility delineation, and ethical regulation have also begun to emerge. We believe that AI should be positioned as a physician-led clinical assistive tool rather than an independent decision-maker. Future research should focus on the construction of high-quality datasets covering rare imaging features, multicenter prospective validation based on clinical outcomes, and the establishment of standardized human-machine collaboration frameworks, so that AI can truly contribute to enhanced safety, optimized clinical workflows, and better patient outcomes in complex tooth extraction.</p>","PeriodicalId":23965,"journal":{"name":"中华口腔医学杂志","volume":"61 8","pages":"1098-1106"},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Soft tissue augmentation for phenotype modification prior to orthodontics treatment in a class Ⅲ malocclusion patient with gingival recession: a 5-year follow-up case report].","authors":"N N Chen, W Zhong, Z Chen, T Yu, Y Q Shen","doi":"10.3760/cma.j.cn112144-20260309-00153","DOIUrl":"10.3760/cma.j.cn112144-20260309-00153","url":null,"abstract":"","PeriodicalId":23965,"journal":{"name":"中华口腔医学杂志","volume":"61 8","pages":"1213-1219"},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress of mesenchymal stem cells in the treatment of medication-related osteonecrosis of the jaw].","authors":"R Q Huang, N Peng, D X Liu","doi":"10.3760/cma.j.cn112144-20260505-00276","DOIUrl":"10.3760/cma.j.cn112144-20260505-00276","url":null,"abstract":"<p><p>Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication characterized primarily by jawbone necrosis, induced by bisphosphonates or other targeted agents for systemic diseases. With the advancement of systemic anticancer therapies, the survival of patients with advanced malignancies has been prolonged, leading to an annual increase in the number of patients with MRONJ. However, there is currently no effective treatment for MRONJ worldwide. Recent studies have indicated that mesenchymal stem cells exhibit significant potential for osteogenic and angiogenic differentiation, proliferation, immunomodulation, and anti-inflammatory effects, thereby providing a novel therapeutic strategy for medication-related osteonecrosis of the jaw. This article reviews the research on mesenchymal stem cell therapy for MRONJ, providing a reference for its clinical research and treatment.</p>","PeriodicalId":23965,"journal":{"name":"中华口腔医学杂志","volume":"61 8","pages":"1220-1226"},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnostic performance of a dual-stage deep learning model based on cone beam CT-derived multi-view two-dimensional slices for assessing ankylosed impacted teeth].","authors":"G L Wu, Z Lu, T J Du, H Qiao, Y Y R Zhang, H Ba, S Wang","doi":"10.3760/cma.j.cn112144-20260304-00148","DOIUrl":"10.3760/cma.j.cn112144-20260304-00148","url":null,"abstract":"<p><p><b>Objective:</b> To develop and validate a dual-layer deep learning model based on cone-beam CT (CBCT)-derived multi-view two-dimensional (2D) slices for the assisted assessment of ankylosed impacted teeth. <b>Methods:</b> The CBCT images of 432 patients with impacted teeth were collected at the Hospital of Stomatology, Xi'an Jiaotong University from January 2023 to June 2025, comprising 600 target teeth and approximately 22 000 derived multi-view 2D slices. Imaging reference standards were established by two experienced oral and maxillofacial residents, with adjudication by a professor in cases of disagreement. Data were split into training and validation sets at a 4∶1 ratio by target tooth. A two-stage deep learning model was developed, including a slice-level classifier for predicting dentoalveolar ankylosis and a lesion-level detector for localizing suspicious ankylotic regions. Model performance was evaluated using area under the receiver operating characteristic curve (ROC-AUC), (PR-AUC), sensitivity, specificity, Brier score, average precision (AP) at intersection over union (IoU) 0.5, and ablation analysis. <b>Results:</b> In the validation set, the slice-level classification model achieved an area under the receiver operating characteristic curve of 0.850, an area under the precision-recall curve of 0.439, and a Brier score of 0.071. At a threshold of 0.5, the sensitivity and specificity were 36.8% and 96.4%, respectively. The lesion-level detection model achieved an average precision of 0.582 at an intersection-over-union threshold of 0.5. Ablation experiments showed that eliminating hard example mining significantly decreased positive recall and overall model performance with an increase in the area under the precision-recall curve from 0.439 to 0.373. <b>Conclusions:</b> The proposed model can provide probabilistic cues and lesion localization evidence for ankylosed impacted teeth, showing potential as an auxiliary tool for radiographic interpretation.</p>","PeriodicalId":23965,"journal":{"name":"中华口腔医学杂志","volume":"61 8","pages":"1187-1195"},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Medication-related osteonecrosis of the jaw: a review and interpretation of international guidelines on oral health management].","authors":"J Zhang, S H Ge","doi":"10.3760/cma.j.cn112144-20260325-00192","DOIUrl":"10.3760/cma.j.cn112144-20260325-00192","url":null,"abstract":"<p><p>Medication-related osteonecrosis of the jaw (MRONJ), a serious adverse effect associated with antiresorptive agents or certain antiangiogenic drugs, has become an important complication of concern to the fields of oral medicine, oncology, and bone metabolism disorders. Its prevention, early identification, and standardized management are of significant clinical importance. To guide clinical practice, several academic organizations have issued relevant guidelines or position papers. Although these guidelines are generally consistent in their overall principles, notable differences remain on certain key issues. This article takes the American Association of Oral and Maxillofacial Surgeons (AAOMS) 2022 position paper as the central framework, and in conjunction with the Scottish Dental Clinical Effectiveness Programme (SDCEP) clinical guidance and other international consensus statements, reviews and analyzes the definition, risk factors, preventive measures, and treatment strategies for MRONJ. This approach aims to facilitate a more comprehensive understanding of the current evidence base and to provide clearer guidance for clinical practice.</p>","PeriodicalId":23965,"journal":{"name":"中华口腔医学杂志","volume":"61 8","pages":"1134-1142"},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of pit and groove retention form with different depths on stress distribution of mandibular first molar occlusal veneers: three-dimensional finite element and Weibull analysis].","authors":"Z H Chen, X Y Du","doi":"10.3760/cma.j.cn112144-20260128-00057","DOIUrl":"10.3760/cma.j.cn112144-20260128-00057","url":null,"abstract":"<p><p><b>Objective:</b> To determine the effect of the occlusal veneer with pit and groove retention form (PGRF) design on the stress distribution and failure probability in the mandibular first molar. <b>Methods:</b> A standard resin molar model of the mandibular first molar was selected to establish three-dimensional finite element models simulating two levels of occlusal wear (0.5 and 1.0 mm), each with 10 groups. Two different restoration designs (common occlusal veneer and PGRF occlusal veneer) were simulated; PGRF was set at four different pit and groove depths (0.25, 0.50, 0.75 and 1.00 mm), and two different computer-aided design and computer-aided manufacturing (CAD/CAM) materials (lithium disilicate glass ceramic with high elastic modulus and resin-matrix ceramic with low elastic modulus) were used. Apply a 241 N load at a 45° angle to the long axis of the tooth, directed at the lingual incline of the buccal cusp of the mandibular first molar. The maximum principal stress (σ_max) and maximum displacement of the occlusal veneer restoration models were calculated. Weibull analysis was used to evaluate the failure probability of the models. <b>Results:</b> The σ_max values of the PGRF occlusal veneer were slightly higher than those of the common occlusal veneer, while those of the dental tissue were lower. With the increase in the PGRF depth, the maximum displacement peak value of the occlusal veneer and cement layer decreased significantly. Compared to a conventional occlusal veneer, preparing a 1 mm deep pit-and-fissure retention form on a 0.5 mm thick occlusal veneer reduces the maximum displacement peak by 44.00 μm for the veneer and 41.37 μm for the adhesive layer. For a 1.0 mm thick occlusal veneer, the same retention form reduces the maximum displacement peak by 43.82 μm for the veneer and 39.89 μm for the adhesive layer. The overall failure probability of the model tended to decrease. <b>Conclusions:</b> This numerical study shows that the design of PGRF on the occlusal veneer may be a favorable restoration strategy that can significantly reduce the debonding tendency of occlusal veneer, and this can improve the clinical longevity of occlusal veneer prostheses.</p>","PeriodicalId":23965,"journal":{"name":"中华口腔医学杂志","volume":"61 8","pages":"1196-1204"},"PeriodicalIF":0.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}