Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective To investigate the role of CISD1 in gefitinib-resistant non-small cell lung cancer(NSCLC),so as to provide a potential therapeutic target for the treatment of gefitinib-resistant NSCLC.Methods Bioinformatics online platforms TIMER2.0 and HPA were used to analyze the expression level of CISD1 in lung cancer.TIMER2.0 and GEPIA2.0 were used to analyze the correlation between the expression levels of CISD1 and SLC7A11 in lung cancer.The correlation between CISD1 and overall survival rate of lung cancer patients was analyzed using KMPLOT.Human lung carcinoma cell line PC9 and gefitinib-resistant cell line PC9/GR were treated with gefitinib,and cell viability was detected using the CCK8 method.shCISD1 lentivirus infection was used to knockdown CISD1 in PC9/GR cells.Western blotting was employed to detect the protein expression levels of CISD1 and SLC7A11.PC9/GR cells were divided into shNC+DMSO group,shNC+gefitinib group,shCISD1 group,shCISD1+ferrostatin-1 group,and shCISD1+gefitinib group.Plate clone formation assay was used to detect cell proliferation capacity.FerroOrange fluorescent probe and C11-BODIPY fluorescent probe were used to detect intracellular free Fe2+content and intracellular lipid peroxide level,respectively.Results CISD1 was significantly overexpressed in lung carcinoma(P＜0.001).The expression level of CISD1 was negatively correlated with the overall survival rate of lung cancer patients and negatively correlated with the expression level of SLC7A11.Compared with the DMSO control group,gefitinib treatment significantly reduced clone formation and CISD1 protein expression levels in both PC9 and PC9/GR cells(P＜0.05),but the reduction was less pronounced in PC9/GR cells.shCISD1 infection significantly inhibited the protein expression levels of CISD1 and SLC7A11 in PC9/GR cells(P＜0.05)and enhanced the sensitivity of PC9/GR cells to gefitinib.Compared with the shNC+DMSO group,both the shNC+gefitinib group and the shCISD1 group showed significantly reduced clone formation ability(P＜0.05),but increased Fe2+and lipid peroxidation levels(P＜0.05).Compared with the shCISD1 group,the shCISD1+ferrostatin-1 group showed significantly increased clone formation ability(P＜0.05),but decreased Fe2+and lipid peroxidation levels(P＜0.05).Compared with the shNC+gefitinib group,the shCISD1+gefitinib group showed significantly reduced clone formation ability(P＜0.05),but increased Fe2+and lipid peroxidation levels(P＜0.05).Conclusion Knockdown of CISD1 promotes the sensitivity of NSCLC to gefitinib by inducing ferroptosis,which provides a new potential therapeutic target for the treatment of gefitinib-resistant NSCLC.

Objective To investigate the role of CISD1 in gefitinib-resistant non-small cell lung cancer(NSCLC),so as to provide a potential therapeutic target for the treatment of gefitinib-resistant NSCLC.Methods Bioinformatics online platforms TIMER2.0 and HPA were used to analyze the expression level of CISD1 in lung cancer.TIMER2.0 and GEPIA2.0 were used to analyze the correlation between the expression levels of CISD1 and SLC7A11 in lung cancer.The correlation between CISD1 and overall survival rate of lung cancer patients was analyzed using KMPLOT.Human lung carcinoma cell line PC9 and gefitinib-resistant cell line PC9/GR were treated with gefitinib,and cell viability was detected using the CCK8 method.shCISD1 lentivirus infection was used to knockdown CISD1 in PC9/GR cells.Western blotting was employed to detect the protein expression levels of CISD1 and SLC7A11.PC9/GR cells were divided into shNC+DMSO group,shNC+gefitinib group,shCISD1 group,shCISD1+ferrostatin-1 group,and shCISD1+gefitinib group.Plate clone formation assay was used to detect cell proliferation capacity.FerroOrange fluorescent probe and C11-BODIPY fluorescent probe were used to detect intracellular free Fe2+content and intracellular lipid peroxide level,respectively.Results CISD1 was significantly overexpressed in lung carcinoma(P＜0.001).The expression level of CISD1 was negatively correlated with the overall survival rate of lung cancer patients and negatively correlated with the expression level of SLC7A11.Compared with the DMSO control group,gefitinib treatment significantly reduced clone formation and CISD1 protein expression levels in both PC9 and PC9/GR cells(P＜0.05),but the reduction was less pronounced in PC9/GR cells.shCISD1 infection significantly inhibited the protein expression levels of CISD1 and SLC7A11 in PC9/GR cells(P＜0.05)and enhanced the sensitivity of PC9/GR cells to gefitinib.Compared with the shNC+DMSO group,both the shNC+gefitinib group and the shCISD1 group showed significantly reduced clone formation ability(P＜0.05),but increased Fe2+and lipid peroxidation levels(P＜0.05).Compared with the shCISD1 group,the shCISD1+ferrostatin-1 group showed significantly increased clone formation ability(P＜0.05),but decreased Fe2+and lipid peroxidation levels(P＜0.05).Compared with the shNC+gefitinib group,the shCISD1+gefitinib group showed significantly reduced clone formation ability(P＜0.05),but increased Fe2+and lipid peroxidation levels(P＜0.05).Conclusion Knockdown of CISD1 promotes the sensitivity of NSCLC to gefitinib by inducing ferroptosis,which provides a new potential therapeutic target for the treatment of gefitinib-resistant NSCLC.

Ameloblastoma is a benign tumor characterized by locally invasive phenotypes,leading to facial bone destruction and a high recurrence rate.However,the mechanisms governing tumor initiation and recurrence are poorly understood.Here,we uncovered cellular landscapes and mechanisms that underlie tumor recurrence in ameloblastoma at single-cell resolution.Our results revealed that ameloblastoma exhibits five tumor subpopulations varying with respect to immune response(IR),bone remodeling(BR),tooth development(TD),epithelial development(ED),and cell cycle(CC)signatures.Of note,we found that CC ameloblastoma cells were endowed with stemness and contributed to tumor recurrence,which was dominated by the EZH2-mediated program.Targeting EZH2 effectively eliminated CC ameloblastoma cells and inhibited tumor growth in ameloblastoma patient-derived organoids.These data described the tumor subpopulation and clarified the identity,function,and regulatory mechanism of CC ameloblastoma cells,providing a potential therapeutic target for ameloblastoma.

With the development of regeneration technology,intentional replantation(IR)has gradually become the important treat-ment.Some affected teeth that are difficult to be cured by conventional methods,such as refractory periapical periodontitis,radicular groove and combined periodontal-endodontic lesions,can be preserved through IR.IR is effective in the treatment of teeth with severe periodontal destruction.This article reviews the historical development,clinical operation and influencing factors,and provides refer-ence for exploring the treatment plan of IR for a single tooth with severe periodontal destruction and the preservation of patients'natural dentition.

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.

Objective To investigate the clinical application value of contrast-enhanced ultrasound (CEUS) in hepatic artery thrombosis (HAT) after pediatric liver transplantation. Methods Clinical data of 126 pediatric recipients undergoing liver transplantation were retrospectively analyzed. The incidence of HAT after pediatric liver transplantation was summarized. Color Doppler ultrasound and CEUS manifestations of HAT were compared. Results According to color Doppler ultrasound, 17 cases were highly suspected with HAT. Nine cases were highly suspected with HAT by CEUS, who were subsequently confirmed by CT angiography (CTA) or surgery. CEUS manifestations of HAT showed that hepatic artery was not seen surrounding the portal vein during the arterial phase or even portal venous phase. Hepatocyte necrosis occurred in 4 patients with HAT, and no perfusion of intrahepatic contrast agent was observed on CEUS. Conclusions CEUS yields high clinical application value in the diagnosis of HAT after pediatric liver transplantation. It has significant advantages compared with traditional CTA, which could be widely applied in clinical practice.

Objective:To explore the value of 5G-based robotic remote ultrasound diagnosis system in musculoskeletal joint injuries.Methods:From March to December 2020, 58 volunteers at a training base who felt musculoskeletal pain or paresthesia were selected and performed both robotic remote ultrasound (remote ultrasound group) and conventional ultrasound (portable ultrasound group). The two types of examinations were compared, the consistency of the two diagnosis results was analyzed by the Kappa test, and the the difference of the diagnosis results was compared by McNemar test.Results:Among the 58 volunteers, 40 cases were positive by both methods and 11 volunteers had 2-3 positive results. There were 59 positive results in the remote ultrasound group and 64 positive results in the portable ultrasound group. The positive rate of the examination sites from high to low was knee joint>foot and ankle joint >hand and wrist joint >shoulder joint>elbow joint, calf and hip. The diagnosis results of the two groups were in good consistency (Kappa=0.782, P<0.001), and there was no statistically significant difference in the diagnosis results between the two groups (χ 2=3.2, P=0.063). Five more diseases with positive results were detected in the portable ultrasound group: 1 meniscus injury, 1 medial collateral ligament injury, 1 soft tissue injury around the metatarsal, 1 biceps tendinitis with effusion and 1 cubital ulnar nerve subluxation. Conclusions:The 5G-based robotic remote ultrasound system has good consistency with conventional ultrasound in the diagnosis of musculoskeletal injures. It can be applied to the ultrasound diagnosis of musculoskeletal joint injuries in remote areas.

Chronic periodontitis is a disease of periodontal supporting tissue infection caused by various causes. It was believed that the oral bacteria were the initiator of chronic periodontitis, and the host immune factors would affect the developing process and outcome of periodontitis, although the specific regulatory mechanism was not completely clear. Extracellular vesicles, subcellular components produced by cell paracrine, may carry a variety of genetic information to mediate intercellular communication. Extracellular vesicles have been found to be closely related to tumors and cardiovascular, cerebrovascular, neurological and immune system diseases and provide a research pathway for the early diagnosis, etiological therapy and vaccine design. Various extracellular vesicles are released from periodontal ligament stem cells, gingival mesenchymal stem cells, bone marrow mesenchymal stem cells, osteoblasts, osteoclasts, immune cells and periodontal pathogenic bacteria. These extracellular vesicles release for mutual communication and regulation, and further affect the pathogenesis of chronic periodontitis. In the present article, the characteristics of extracellular vesicles from periodontal tissues and periodontal pathogenic bacteria were introduced, the research progress of extracellular vesicles involved in the regulation of chronic periodontitis was reviewed and the potential value of extracellular vesicles in the diagnosis and treatment of chronic periodontitis was prospected.

Objective:To investigate the effect of antibiotics application in perioperative period on carotid artery and serum interluekin-6 (IL-6) in chronic periodontitis (CP) rats with hyperlipidemia (HL) or diabetes mellitus (DM).Methods:The models of CP rats with HL or DM were established in different batches. The rats were divided into groups as follows: A and A' were normal control groups, n=7 in each group; B(HL) and B'(DM) were groups of HL and DM, n=7 in each; C(HL+CP) and C'(DM+CP) were groups of CP with HL and CP with DM, n=21 in each. After the establishment of the models, groups C and C' were divided into C1 and C1' non-intervention group, C2 and C2' simple tooth extraction group and C3 and C3' antibiotic-assisted tooth extraction, with 7 rats in each of the groups. Two time interventions were performed to extract experimental teeth (bilateral maxillary first and second molars) in groups C2, C2', C3 and C3'. Serum samples were collected at 5 time points before and after tooth extraction (T1: before the first tooth extraction; T2: one week after the first tooth extraction; T3, T4, T5: the first, third and fifth week after the second tooth extraction), respectively. The absolute content of IL-6 in serum was detected by enzyme-linked immunosorbent assay (ELISA). Ratio of the absolute content in the experimental groups and control groups were calculated as the relative content of IL-6. At the end of the experiments, all rats were euthanasia and the bifurcation vascular tissues of carotid artery were collected for the observation of the carotid artery pathology and plaque formation and the measurement of the thickness of carotid intimal-medial layer (IMT). Results:Carotid artery pathology observation showed the IMT in group C was significantly thickened and the group C2 was the most thickened one (compared with group A, P＜0.01). Elastic fibers in groups C1 and C2 were disordered or even broken and disappeared, presenting typical atherosclerotic plaques, which were diffuse calcium salt deposits in the intimal-medial layers and protrude into the lumen. Elastic fibers in group C3 were ranged in ordered relatively without obvious fracture and the number of plaques was significantly reduced. The vascular walls in rats of groups B' and C' were incomplete, the IMTs had no obvious changes, elastic fibers were ranged disorderly and broken and the smooth muscle cells had vacuolar changes. In group C2', the vascular wall was significantly thinned and calcified plaques appeared in the artery, which showed multiple calcification lesions penetrating through the intimal-medial layer or even the whole layer. The vascular wall of group C3' was integrity and the elastic fibers arranged relatively clutter-free, the number of plaques was reduced. Results of detections of IL-6 showed the relative contents of IL-6 in groups B, B', C1, and C1' increased with time. At T3 time point, the relative contents of IL-6 in groups C2 and C3 reached the peak, C2 was 10.4 times of group A and C3 was 9.5 times of group A, and then decreased to different low levels. At T5 point, comparisons of the relative contents of IL-6 showed C3 < C2 < C1 (3.2 times, 5.4 times, 9.6 times of group A, respectively). The relative contents of IL-6 in groups C2' and C3' reached the peak at T2 point (4.9 times and 4.5 times of group A, respectively), and then decline with time. At T5 point, comparisons of the relative contents of IL-6 showed C3'< C2'< C1' (1.2 times, 1.4 times and 3.1 times of group A, respectively). Conclusions:Blood vessels were observed more obvious thickened in the tooth extraction without antibiotic of HL+CP rats with calcifications increase. Blood vessels of DM+CP rats became thin and fragile and even the integrity was damaged. Perioperative use of antibiotics might reduce the carotid artery lesions and decrease serum levels of inflammatory cytokines.