Objective:To integrate implicit templates with deep learning techniques, a novel neural network, the tooth-deformable deep implicit network (T-DDIN), was constructed to achieve high-precision shape completion of tooth defects in a personalized manner.Methods:A total of 550 intraoral scan models were collected from patients treated at the Department of Orthodontics and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University (500 for training and 50 for testing), between March 2022 and March 2024. T-DDIN reconstructed defective tooth morphology using an implicit template and a latent encoding prediction network. During model evaluation, Class Ⅱ cavity defects and occlusal wear defects were simulated in the test set. Morphological restoration was performed using both traditional computer aided design (CAD) methods and the T-DDIN deep learning approach. The two methods were compared based on three-dimensional deviation, occlusal adjustment volumes, cusp angle deviation, and restoration time.Results:The T-DDIN group demonstrated significantly lower three-dimensional deviation for Class Ⅱ cavity defects and occlusal wear restoration [(0.14±0.05) and (0.16±0.09) mm], occlusal adjustment volumes [(0.44±0.03) and (0.49±0.03) mm 3], and difference value of the tooth cusp angles (5.69°±1.90° and 6.04°±0.53°) compared to the traditional CAD group (both P<0.001). No significant differences were observed within the T-DDIN group between the two defect types in terms of three-dimensional deviation ( P=0.098) or occlusal adjustment volume ( P=0.154) or difference value of the tooth cusp angles ( P=0.196). However, in the traditional CAD group, three-dimensional deviation, occlusal adjustment volume and difference value of the tooth cusp angles was significantly higher in occlusal wear restorations than in Class Ⅱ cavity defects restorations ( P<0.001). The T-DDIN group, which involved Class Ⅱ cavity defects and occlusal wear, demonstrated significantly less recovery time of morphology (37.2±7.7) and (39.4±6.2) s compared to the traditional CAD group ( P<0.001). Conclusions:T-DDIN demonstrated superior stability and accuracy in morphological reconstruction for various types of dental defects while significantly reducing restoration time.

Objective:To integrate implicit templates with deep learning techniques, a novel neural network, the tooth-deformable deep implicit network (T-DDIN), was constructed to achieve high-precision shape completion of tooth defects in a personalized manner.Methods:A total of 550 intraoral scan models were collected from patients treated at the Department of Orthodontics and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University (500 for training and 50 for testing), between March 2022 and March 2024. T-DDIN reconstructed defective tooth morphology using an implicit template and a latent encoding prediction network. During model evaluation, Class Ⅱ cavity defects and occlusal wear defects were simulated in the test set. Morphological restoration was performed using both traditional computer aided design (CAD) methods and the T-DDIN deep learning approach. The two methods were compared based on three-dimensional deviation, occlusal adjustment volumes, cusp angle deviation, and restoration time.Results:The T-DDIN group demonstrated significantly lower three-dimensional deviation for Class Ⅱ cavity defects and occlusal wear restoration [(0.14±0.05) and (0.16±0.09) mm], occlusal adjustment volumes [(0.44±0.03) and (0.49±0.03) mm 3], and difference value of the tooth cusp angles (5.69°±1.90° and 6.04°±0.53°) compared to the traditional CAD group (both P<0.001). No significant differences were observed within the T-DDIN group between the two defect types in terms of three-dimensional deviation ( P=0.098) or occlusal adjustment volume ( P=0.154) or difference value of the tooth cusp angles ( P=0.196). However, in the traditional CAD group, three-dimensional deviation, occlusal adjustment volume and difference value of the tooth cusp angles was significantly higher in occlusal wear restorations than in Class Ⅱ cavity defects restorations ( P<0.001). The T-DDIN group, which involved Class Ⅱ cavity defects and occlusal wear, demonstrated significantly less recovery time of morphology (37.2±7.7) and (39.4±6.2) s compared to the traditional CAD group ( P<0.001). Conclusions:T-DDIN demonstrated superior stability and accuracy in morphological reconstruction for various types of dental defects while significantly reducing restoration time.

In the field of prosthodontics,the use of virtual patients for biomimetic restoration holds great promise for various applications.Virtual patients consist of digitized data that encompasses details on the morphology,struc-ture,and spatial relationships within the maxillofacial and intraoral regions.Nonetheless,there are several challenges associated with acquiring digital data,achieving accurate alignment,and recording and transferring dynamic jaw movements.This paper aims to concentrate on the process of constructing virtual patients,highlight the key and chal-lenging aspects of virtual patient construction,and advocate for the extensive adoption and utilization of virtual patient technology.

The incidence of orofacial pain is high, and its pathological mechanism is complex. Currently, there is a lack of long-lasting and effective clinical treatment drugs, resulting in a major economic burden to patients and society. Therefore, it is important to develop more durable and effective drugs for treatment. In recent years, substantial evidence has shown that α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs) play a vital role in somatic and orofacial pain. Among them, subunit phosphorylation regulated by protein kinases and interactions with partner proteins promote the activation and trafficking of AMPARs and signal transduction to regulate the expression of AMPARs. The increase of GluA1-containing AMPARs promotes calcium ion influx, further activating protein kinases and auxiliary proteins, which forms a self-feedback loop. This is an important mechanism that promotes chronic pain. The expression of AMPARs in the trigeminal nervous system and the spinal cord nervous system overlaps, and the above mechanism may also participate in regulating orofacial pain. However, research on AMPARs in orofacial neuropathic pain or cancer-related pain is relatively insufficient, and more in-depth research is needed in the future. Furthermore, there is a lack of clinical evidence for AMPAR antagonists to treat pain. Understanding the regulatory mechanisms of the activation and trafficking of AMPARs and precisely intervening in the activation and trafficking of AMPARs may provide effective strategies for the development of new analgesics and offer new insights for treating orofacial pain.

OBJECTIVES: This study aimed to compare the effects of virtual adjustment on occlusal interferences in mandibular posterior single crown and three-unit bridge restorations by using the mandibular movement track and the movement parameters of a virtual articulator. METHODS: Twenty-two participants were recruited. Digital casts of the maxillary and mandibular arches were obtained using an intraoral scanner, and the jaw registration system was used to record the data of the mandibular movement track and the movement parameters of the articulator. Four kinds of restorations with 0.3 mm occlusal interferences were designed with dental design software. In particular, single crowns were designed for teeth 44 and 46, whereas three-unit bridges were designed for teeth 44-46 and 45-47, and the corresponding natural teeth were virtually extracted. Virtual adjustment of the restorations was performed using two dynamic occlusal recordings, namely, the mandibular movement track and the movement parameters of the virtual articulator. A reverse-engineering software was used to measure the root-mean-square of the three-dimensional deviation of the occlusal surfaces between natural teeth and the adjusted restorations. The differences between the two methods of virtual-occlusion adjustment were compared and analyzed. RESULTS: For the same group of restorations, the three-dimensional deviation of the mandibular movement track group were lower than those of the virtual articulator group, and the differences were statistically significant (P<0.05). For the four groups of restorations adjusted by the same method, the three-dimensional deviation of the 46-tooth single crown was the largest and the smallest three-dimensional deviation was that of the 44-tooth single crown. Statistical differences existed between the 44-tooth single crown and the other groups (P<0.05). CONCLUSIONS For the occlusal design of posterior single crown and three-unit bridge, the mandibular movement track could be a more effective approach to virtual occlusal adjustment than the movement parameters of the virtual articulator.
Humans ; Mouth, Edentulous ; Occlusal Adjustment ; Jaw Relation Record ; Dental Articulators ; Software

PURPOSE: . To compare the sagittal condylar inclination (SCI) in dentate individuals measured by the different methods with mechanical articulator (MA), virtual articulator (VA), and a jaw tracking device (JTD) system. MATERIALS AND METHODS: . A total of 22 healthy dentate participants were enrolled in this study. For MA workflow, the SCI was obtained by a semi-adjustable articulator with protrusive interocclusal records. The SCI was also set on a VA by aligning intraoral scan (IOS) with cone beam computed tomography (CBCT) and facial scan (FS), respectively. These virtual workflows were conducted in a dental design software, namely VAIOS-CBCT and VAIOS-FS . Meanwhile, a JTD system was also utilized to perform the measurement. Intraclass correlation was used to assess the repeatability within workflows. The bilateral SCI values were compared by Wilcoxon matched-pairs signed rank test for each workflow, and Kruskal-Wallis test and post hoc p-value Bonferroni correction were used to compare the differences among four workflows. The agreement of VAIOS-CBCT , VAIOS-FS , and JTD compared with MA was evaluated by Bland-Altman analysis. RESULTS: . Intraclass correlation of the SCI revealed a high degree of repeatability for each workflow. There were no significant differences between the left and right sides (P > .05), except for VAIOS-CBCT (P = .028). Significant differences were not found between MA and VAIOS-FS (P > .05). Bland-Altman plots indicated VAIOS-CBCT , VAIOS-FS , and JTD were considered to substitute MA with high 95% limits of agreement. CONCLUSION . The workflow of VAIOS-FS provided an alternative approach to measure the SCI compared with MA.

Resection of oral and maxillofacial tumors is often accompanied by the inferior alveolar nerve neurectomy, resulting in abnormal sensation in lower lip. It is generally believed that spontaneous sensory recovery in this nerve injury is difficult. However, during our follow-up, patients with inferior alveolar nerve sacrifice showed different degrees of lower lip sensory recovery. In this study, a prospective cohort study was conducted to demonstrate this phenomenon and analyze the factors influencing sensory recovery. A mental nerve transection model of Thy1-YFP mice and tissue clearing technique were used to explore possible mechanisms in this process. Gene silencing and overexpression experiments were then conducted to detect the changes in cell morphology and molecular markers. In our follow-up, 75% of patients with unilateral inferior alveolar nerve neurectomy had complete sensory recovery of the lower lip 12 months postoperatively. Patients with younger age, malignant tumors, and preservation of ipsilateral buccal and lingual nerves had a shorter recovery time. The buccal nerve collateral sprouting compensation was observed in the lower lip tissue of Thy1-YFP mice. ApoD was demonstrated to be involved in axon growth and peripheral nerve sensory recovery in the animal model. TGF-β inhibited the expression of STAT3 and the transcription of ApoD in Schwann cells through Zfp423. Overall, after sacrificing the inferior alveolar nerve, the collateral compensation of the ipsilateral buccal nerve could innervate the sensation. And this process was regulated by TGF-β-Zfp423-ApoD pathway.
Mice ; Animals ; Lip/innervation* ; Prospective Studies ; Mandibular Nerve/pathology* ; Sensation/physiology* ; Trigeminal Nerve Injuries/pathology*

PURPOSE: . The purpose of this in vitro study was to assess whether scanning strategies of virtual interocclusal record (VIR) affect the accuracy of VIR during intraoral scanning. MATERIALS AND METHODS: . Five pairs of reference cubes were added to the digital upper and lower dentitions of a volunteer, which were printed into resin casts. Subsequently, the resin casts were articulated in the maximal intercuspal position in a mechanical articulator and scanned with an industrial computed tomography system, of which the VIR was served as a reference VIR. The investigated VIR of the upper and lower jaws of the resin master cast were recorded with an intraoral scanner according to 9 designed scanning strategies.Then, the deviation between the investigated VIRs and reference VIR were analyzed, which were measured by the deviation of the distances of six selected reference points on the upper reference cubes in each digital cast to the XY-plane between the investigated VIRs and reference VIR. RESULTS: . For the deviation in the right posterior dentitions, RP group (only scanning of right posterior dentitions) showed the smallest deviation. Besides, BP group (scanning of bilateral posterior dentitions) showed the smallest deviation in the left posterior dentitions. Moreover, LP group (scanning of left posterior dentitions) showed the smallest deviation in the anterior dentitions. For the deviation of full dental arches, BP group showed the smallest deviation. CONCLUSION . Different scanning strategies of VIR can influence the accuracy of alignment of virtual dental casts. Appropriate scanning strategies of VIR should be selected for different regions of interest and edentulous situations.

By removing a part of the structure, the tooth preparation provides restorative space, bonding surface, and finish line for various restorations on abutment. Preparation technique plays critical role in achieving the optimal result of tooth preparation. With successful application of microscope in endodontics for >30 years, there is a full expectation of microscopic dentistry. However, as relatively little progress has been made in the application of microscopic dentistry in prosthodontics, the following assumptions have been proposed: Is it suitable to choose the tooth preparation technique under the naked eye in the microscopic vision? Is there a more accurate preparation technology intended for the microscope? To obtain long-term stable therapeutic effects, is it much easier to achieve maximum tooth preservation and retinal protection and maintain periodontal tissue and oral function health under microscopic vision? Whether the microscopic prosthodontics is a gimmick or a breakthrough in obtaining an ideal tooth preparation should be resolved in microscopic tooth preparation. This article attempts to illustrate the concept, core elements, and indications of microscopic minimally invasive tooth preparation, physiological basis of dental pulp, periodontium and functions involved in tool preparation, position ergonomics and visual basis for dentists, comparison of tooth preparation by naked eyes and a microscope, and comparison of different designs of microscopic minimally invasive tooth preparation techniques. Furthermore, a clinical protocol for microscopic minimally invasive tooth preparation based on target restorative space guide plate has been put forward and new insights on the quantity and shape of microscopic minimally invasive tooth preparation has been provided.

Inflammatory orofacial pain, in which substance P (SP) plays an important role, is closely related to the cross-talk between trigeminal ganglion (TG) neurons and satellite glial cells (SGCs). SGC activation is emerging as the key mechanism underlying inflammatory pain through different signalling mechanisms, including glial fibrillary acidic protein (GFAP) activation, phosphorylation of mitogen-activated protein kinase (MAPK) signalling pathways, and cytokine upregulation. However, in the TG, the mechanism underlying SP-mediated orofacial pain generated by SGCs is largely unknown. In this study, we investigated whether SP is involved in inflammatory orofacial pain by upregulating interleukin (IL)-1β and tumour necrosis factor (TNF)-α from SGCs, and we explored whether MAPK signalling pathways mediate the pain process. In the present study, complete Freund's adjuvant (CFA) was injected into the whisker pad of rats to induce an inflammatory model in vivo. SP was administered to SGC cultures in vitro to confirm the effect of SP. Facial expression analysis showed that pre-injection of L703,606 (an NK-1 receptor antagonist), U0126 (an inhibitor of MAPK/extracellular signal-regulated kinase [ERK] kinase [MEK] 1/2), and SB203580 (an inhibitor of P38) into the TG to induce targeted prevention of the activation of the NK-1 receptor and the phosphorylation of MAPKs significantly suppressed CFA-induced inflammatory allodynia. In addition, SP promoted SGC activation, which was proven by increased GFAP, p-MAPKs, IL-1β and TNF-α in SGCs under inflammatory conditions. Moreover, the increase in IL-1β and TNF-α was suppressed by L703, 606, U0126 and SB203580 in vivo and in vitro. These present findings suggested that SP, released from TG neurons, activated SGCs through the ERK1/2 and P38 pathways and promoted the production of IL-1β and TNF-α from SGCs, contributing to inflammatory orofacial pain associated with peripheral sensitization.