Objective: To explore the value of contrast-enhanced computed tomography (CT) radiomics combined with machine learning algorithms in the preoperative prediction of perineural invasion (PNI) in oral squamous cell carcinoma (OSCC), aiming to provide evidence for assisting clinical treatment decision-making. Methods​: This study was approved by the Ethics Committee of the Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. A total of 250 OSCC patients confirmed by postoperative pathology were included, comprising 128 PNI-positive and 122 PNI-negative cases. The dataset was randomly divided into training (n=175), validation (n=38), and independent testing (n=37) sets in a ratio of 7:1.5:1.5. Regions of interest were delineated on preoperative images, and radiomic features were extracted. After dimensionality reduction and feature selection using methods like Least Absolute Shrinkage and Selection Operator (LASSO) regression, multiple machine learning models, including support vector machine (SVM), random forest, Light gradient boosting machine (LightGBM), and a Stacking ensemble model, were constructed. Model performance was evaluated using metrics such as the area under the receiver operating characteristic curve (AUC), sensitivity, calibration curves, and decision curve analysis (DCA). Model interpretability was analyzed using Shapley additive explanations (SHAP) and grouped permutation feature importance analysis. Results ​: ​ Among the 250 samples analyzed, the LightGBM model based on radiomics demonstrated the best performance on the independent test set, with an AUC of 0.781, outperforming models like SVM (AUC = 0.730) and Random Forest (AUC = 0.691), as well as clinical models (AUCs ranging 0.549-0.711). The LightGBM model showed good calibration (Brier score 0.198), and DCA indicated high clinical net benefit over a wide threshold probability range. Paired DeLong tests revealed no statistically significant differences in AUC between the ensemble (Stacking) model and the corresponding best-performing radiomics-based model. SHAP analysis and grouped permutation feature importance analysis further indicated that the primary discriminative information for the model came from radiomic texture features. Conclusion ​ The LightGBM model based on contrast-enhanced CT radiomics demonstrated good discriminative ability for preoperative prediction of PNI in OSCC. In the independent test set, it achieved the highest AUC. This model holds promise as a non-invasive auxiliary tool for preoperative risk assessment. Given the limited sample size of the independent test set, these results require further validation in larger cohorts and external datasets.

Objective: To investigate whether membrane vesicles (MVs) of Streptococcus mutans （S.mutans） contain autoinducer-2 (AI-2) and to preliminarily explore the effects of these MVs on the growth and biofilm formation of S. mutans. Methods: MVs were isolated from the S. mutans UA159 strain using differential centrifugation. The isolated MVs were characterized by nanoparticle tracking analysis for particle size and concentration and observed by transmission electron microscopy. The presence of AI-2 was identified using the Vibrio harveyi BB170 bioluminescence assay: the BB170 diluent was supplemented with AB medium (control group), MV extract (MVs group), pre-ultrafiltration supernatant (Sup group), or post-ultrafiltration supernatant (Sup-af group). The effects of MVs on growth and biofilm formation were assessed using the S.mutans UA159 strain or a luxS deletion mutant as the control group, compared with experimental groups stimulated with gradient concentrations of MVs (MVs-2.0E+7, MVs-2.0E+8, and MVs-2.0E+9 groups). Growth curves, MTT assay, and colony-forming unit (CFU) counts were used to determine changes in growth capacity. Biofilm formation was evaluated using crystal violet staining, confocal laser scanning microscopy, and the anthrone method for polysaccharide quantification. Results: Enriched S. mutans MVs were successfully obtained, with an average particle size of approximately 94.19 nm and a concentration of 1.87E+11 particles/mL. The bioluminescence assay showed that the luminescence intensity of the Sup group was higher than that of the Sup-af group, and the MVs group exhibited higher intensity than the control group. Assessments via growth curves, MTT assay, and CFU counts indicated no significant differences in the growth capacity of the various S. mutans strains after treatment with different concentrations of MVs. Crystal violet staining quantification and confocal laser scanning microscopy observations revealed that high-concentration MV treatment (2.0E+9 particles/mL group) resulted in lower biofilm mass compared to the control. The anthrone method showed that the production of both water-soluble and water-insoluble polysaccharides was significantly lower in the high-concentration MV group than in the control. Conclusion S. mutans MVs contain the quorum sensing signal molecule AI-2. These MVs do not significantly affect the growth of S. mutans, but they can regulate biofilm formation and exhibit an inhibitory effect at high concentrations.

Objective: To investigate the effect of different pre-stretching on the force degradation of elastomeric chains methods and provide experimental evidence for its application in clinical orthodontic treatment. Methods: One control group (no pre-stretched treatment) and 15 experimental groups (pre-stretched to 25%, 50%, and 100% of the original length in 1-5 cycles) were set up by taking five loop lengths of short elastomeric chain and long elastomeric chain samples, respectively. The elastomeric chains from both the control and experimental groups were mounted on the testing fixture at identical initial lengths. To simulate tooth movement, the fixation device was adjusted to reduce the distance by 0.35 mm weekly. The remaining force of each group was measured at different time points over a 4-week period. Further, the experiment was conducted in a simulated salivary environment with additional thermal cycling. Results: Pre-stretching length and cycles showed a significant interaction effect on the remaining force of elastomeric chains (P<0.001). For short elastomeric chains, the groups pre-stretched to 25% (P=0.001) and 50% (P=0.005) of the original length for 3 cycles showed significantly higher remaining force values than the control group at 24 h. At 7, 14, 21, and 28 d, the groups pre-stretched to 25%, 50%, and 100% of the original length for 3 cycles consistently maintained higher remaining force values than the control group (P<0.001). Within the groups of 3 pre-stretching cycles, no significant differences in remaining force were observed among the 50% group and the 25% (P=0.617) or 100% (P=0.229) groups at 7 d. However, at 14 d, the remaining force of the 50% group was significantly higher than that of both the 25% (P=0.003) and 100% (P=0.027) groups. At 21 d, the 50% group maintained a significantly higher remaining force compared to the 100% group (P=0.020), but the difference compared to the 25% group did not reach statistical significance (P=0.052). By 28 d, the remaining force of the 50% group remained significantly higher than that of both the 25% (P=0.003) and 100% (P=0.003) groups. For long elastomeric chains, the 50% pre-stretch (3 cycles) group showed significantly higher remaining force values than the control group at 8 h (P=0.005) and 24 h (P<0.001). Throughout the experimental period at 7, 14, 21, and 28 d, the remaining force values of the 25% (7, 14 d: P<0.001; 21 d: P=0.003; 28 d: P=0.008), 50% (P<0.001), and 100% (P<0.001) original length pre-stretching for 3 cycles groups were consistently higher than those of the control group. Within the groups of 3 pre-stretching cycles, the remaining force of the 50% original length pre-stretching for 3 cycles group was significantly higher than that of the 25% original length pre-stretching for 3 cycles group at all of the time points from 7 to 28 d (P<0.001). Although no statistically significant differences were observed between the 50% and 100% groups at 14 d (P=0.068), the 50% group exhibited significantly higher remaining force than the 100% group at 7 d (P<0.001), 21 days (P=0.005), and 28 days (P<0.001). Conclusion Appropriate pre-stretching methods can effectively delay the force degradation of the elastomeric chain. Pre-stretching to 50% original length for three cycles can maximize the delay of the force degradation of the elastomeric chain.

Quality control (QC) of biospecimens from oral and maxillofacial tumors patients constitutes a critical foundation for the prevention, diagnosis, treatment, and precision medicine research of these diseases. Biospecimen quality directly governs the discovery and validation of disease biomarkers, the elucidation of pathogenesis, and the efficacy of clinical translation. QC spans the entire biospecimen lifecycle—encompassing collection, processing, storage, transportation, and utilization. Its primary objectives are to ensure sample integrity, reliability, traceability, and consistency, thereby guaranteeing the robustness of research data; the accuracy of molecular subtyping, biomarker identification, and treatment response prediction; and the precision of clinical decision-making. However, current QC frameworks for these biospecimens remain underdeveloped. Drawing on domestic and international technical standards, regulatory guidelines, and recent research advances, this paper elaborates on the importance of implementing a QC management system throughout the biospecimen lifecycle. It focuses on QC methodologies tailored to diverse biospecimen types, examining how standardized sampling procedures, regulated preprocessing workflows, and optimized long-term storage conditions influence sample quality. We aim to provide concrete guidance and a transferable paradigm for establishing standardized QC protocols and an informatics-enabled traceability system specific to oral and maxillofacial tumors. Such efforts are intended to enhance the research value and clinical utility of these biospecimens, furnishing reliable sample resources and technical support for the development of precision diagnostics and therapeutics. Furthermore, we advocate for a dual-track “QC plus Ethics” management framework within biobanks. This approach would reinforce ethical and legal safeguards, establishing a robust barrier to support safe scientific innovation and clinical translation.

Objective: To investigate the effects of curcumin on the biological behavior of oral squamous cell carcinoma (OSCC) cells and its potential molecular mechanisms, as well as to provide experimental evidence for the application of curcumin in the prevention and treatment of OSCC. Methods: All animal experiments in this study were approved by the Institutional Animal Welfare and Ethics Committee and strictly adhered to relevant animal ethics guidelines. Potential intersecting targets of curcumin and OSCC were screened using TCMSP, SwissTargetPrediction, DrugBank, and GeneCards databases, followed by construction of a protein-protein interaction network and gene ontology(GO) /Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Scratch and clone formation experiments were conducted using CAL-27 and SCC-9 cells to detect the effect of curcumin on cell migration and proliferation ability. Combining RNA sequencing analysis of differentially expressed genes, and verifying the changes in mRNA and protein expression of key cellular molecules by curcumin through real-time fluorescence quantitative PCR and Western blot, respectively. Simultaneously establish a CAL-27 xenograft BALB/c nude mouse transplant tumor model and use immunohistochemistry to detect the effect of curcumin treatment on the expression of related proteins in the transplant tumor tissue. Results: A total of 178 intersecting targets were identified, mainly enriched in the PI3K/AKT signaling pathway and lipid metabolism-related pathways. Curcumin significantly inhibited migration and colony formation of CAL-27 and SCC-9 cells in vitro. Transcriptomic analysis identified 828 differentially expressed genes enriched in lipid metabolism and PI3K/AKT pathways. Real-time fluorescence quantitative PCR showed downregulation of PIK3CA, CCND1, BCL2, and FASN, while western blot demonstrated decreased expression of p-AKT and FASN. In vivo, curcumin markedly suppressed tumor growth and reduced the expression of Ki-67, BCL2, and p-AKT in tumor tissues. Conclusion Curcumin may inhibit the migration and proliferation of OSCC cells by regulating the PI3K/AKT signaling pathway and the expression of lipid metabolism-related genes.

Objective: To explore the metabolic molecular mechanism of regulatory T cells (Tregs) resisting ferroptosis under a hypoxic stress microenvironment, and to provide scientific support for finding intervention targets to improve the immune microenvironment of oral squamous cell carcinoma (OSCC). Methods: This study was approved by the Institutional Medical Ethics Committee. Multiplex immunofluorescence was used to detect the distribution of Tregs and the localization of hypoxic regions in clinical pathological specimens from patients with OSCC tissues. Animal experiments were approved by the Laboratory Animal Ethics Committee. A tumor-bearing model was established in C57BL/6 mice. The submandibular, subscapular, inguinal, and popliteal lymph nodes were collected along with the spleen, and were homogenized to prepare single cell suspensions. C57BL/6 mouse naive CD4⁺ T cells were induced to differentiate into Tregs in vitro, and a 1% hypoxic culture model was established. Normoxia and hypoxia groups were established, and Treg viability under hypoxic conditions was assessed by flow cytometry. Transcriptomics and metabolomics were applied to analyze differentially expressed genes, metabolic pathways, and changes in cholesterol metabolites. Western blot was performed to detect the expression of emopamil-binding protein (EBP), glutathione peroxidase 4 (GPX4), ferroptosis suppressor protein 1 (FSP1), and acyl-CoA synthetase long-chain family member 4 (ACSL4). The safe concentration of the EBP inhibitor TASIN-30 was determined by the CCK-8 assay. On this basis, four groups were established: normoxia control, hypoxia, hypoxia+TASIN-30, and hypoxia+TASIN-30+7-dehydrocholesterol (7-DHC). Treg viability in each group was measured by flow cytometry; intracellular Fe2+ content, lipid peroxidation level, and reactive oxygen species (ROS) accumulation were detected by cellular immunofluorescence and flow cytometry; the reduced/oxidized glutathione (GSH/GSSG) ratio was measured using a microplate reader; and mitochondrial morphology was observed by transmission electron microscopy. In vivo tumor-inhibition experiments in C3H/HeJ mice were performed to validate the in vivo effects of EBP inhibition, and clinical prognostic survival analysis based on the TCGA-HNSC cohort was performed to evaluate the clinical prognostic value of ferroptosis resistance in Tregs. Results: Tregs were highly enriched in OSCC tissue, preferentially accumulated in hypoxic areas, and could maintain cell survival under hypoxia. The cholesterol metabolism pathway was upregulated in the hypoxic group, with increased EBP mRNA expression (P < 0.001) and 7-DHC accumulation. Compared with the hypoxic group alone, the hypoxic + TASIN-30 group showed decreased GPX4 and FSP1 expression (P < 0.001, P = 0.003); increased ACSL4 expression (P < 0.001); a decreased viable cell ratio (P < 0.001); increased Fe2+, lipid peroxidation, and ROS levels (P < 0.001); a decreased GSH/GSSG ratio (P < 0.001); and mitochondrial shrinkage. Exogenous supplementation of 7-DHC reversed the effects of EBP inhibition. In vivo inhibition of EBP significantly inhibited tumor growth (P < 0.001). Conclusion Tregs upregulate EBP and promote 7-DHC accumulation in hypoxic microenvironments, thereby inhibiting Treg ferroptosis and maintaining their survival and immunosuppressive function. Inhibition of EBP can weaken the resistance of Tregs to ferroptosis under hypoxia.

Congenital orofacial cleft, the most common birth defect in the maxillofacial region, exhibits a wide range of prognosis depending on the severity of deformity and underlying etiology. Non-syndromic congenital orofacial clefts typically present with milder deformities and more favorable treatment outcomes, whereas syndromic congenital orofacial clefts often manifest with concomitant organ abnormalities, which pose greater challenges for treatment and result in poorer prognosis. This consensus provides an elaborate classification system for varying degrees of orofacial clefts along with corresponding diagnostic and therapeutic guidelines. Results serve as a crucial resource for families to navigate prenatal screening results or make informed decisions regarding treatment options while also contributing significantly to preventing serious birth defects within the development of population.
Humans ; Cleft Lip/diagnosis* ; Cleft Palate/diagnosis* ; Consensus ; Prenatal Diagnosis ; Female

In the field of oral medicine, 3D-printed individualized titanium mesh technology is gradually becoming an important means for the treatment of severe alveolar bone defect augmentation. This article provides a comprehensive analysis of the advantages of this technology, the evaluation of osteogenic effects, and the progress of research in clinical applications. In response to the current issue of variability in bone augmentation outcomes, this paper delves into multiple factors affecting bone augmentation effects, including individualized titanium mesh design (involving the thickness, pore size, pore shape, porosity, contour shape, selection of titanium alloy materials, and 3D printing technology), intraoperative procedures (the accuracy of placement during 3D-printed individualized titanium mesh surgery), and postoperative care (including the prevention of complications, formation of pseudoperiosteum, and stability of the titanium mesh). By integrating the clinical experience and research findings of our team, we propose a series of targeted optimization strategies, including designing, manufacturing, and clinically applying self-positioning individualized titanium meshs (positioning wings + individualized titanium meshs) to improve the positioning accuracy of the titanium mesh; propose individualized treatment processes and titanium mesh design schemes based on specific conditions of alveolar bone defects and soft tissue status; and emphasize the importance of long-term stable fixation of the titanium mesh to reduce the risk of postoperative mesh loosening and displacement. In addition, we appropriately summarize the evaluation methods for the bone augmentation effects of 3D-printed individualized titanium meshes, covering the following key indicators: (1) vertical bone augmentation and horizontal bone augmentation; (2) changes in bone contour morphology; (3) bone volume increase; (4) clinical indicators (surgical success rate, titanium mesh exposure, infection rate, and postoperative recovery); (5) aesthetic effect evaluation; (6) long-term stability; (7) radiological assessment; (8) patient satisfaction; and (9) precision of surgical operation, aiming to assist doctors in comprehensively assessing and in-depth analyzing the surgical outcomes to achieve the best therapeutic effects. The purpose of this article is to provide a reference for the optimization and clinical application of 3D-printed individualized titanium mesh technology and to lay a theoretical foundation for achieving the best osteogenic effects.

Edentulous patients often present with severe alveolar bone resorption, restructured maxillofacial anatomy, and loss of occlusal relationships, making implant-supported rehabilitation technically more challenging—particularly in terms of guide stability, implant positioning accuracy, and prosthesis design. Traditional treatment workflows largely rely on clinician experience, which is inherently subjective and limits the ability to achieve precise, controlled implant placement and predictable restorative outcomes. In recent years, the widespread adoption of digital technologies has brought transformative progress to implantology for edentulous jaws. Innovations span from preoperative imaging and 3D reconstruction, intelligent surgical planning, personalized guide design, dynamic navigation, and robotic-assisted implant placement, to digital prosthesis design and immediate loading protocols. These advancements have markedly improved surgical precision, procedural efficiency, and patient satisfaction. This article systematically reviews the key applications and clinical value of digital technologies across the various stages of implant rehabilitation in edentulous cases. We also highlight current challenges, such as high costs and dependence on specialized equipment. Finally, we explore future directions toward more intelligent and integrated solutions that are driven by advances in artificial intelligence, multimodal image fusion, and robotics.

Objective: To investigate the predictive value of EZH2 expression for malignant transformation in oral leukoplakia (OLK) and to provide a reference for clinical practice. Methods: This study was approved by the institutional ethics committee, and informed consent was obtained from all participants. A total of 114 patients diagnosed with OLK by pathological examination and treated at our hospital between November 2020 and July 2022 were initially enrolled. After excluding those with incomplete data or follow-up, 105 participants were included in the final analysis, comprising 14 in the high EZH2 expression group and 91 in the low EZH2 expression group. Histopathological examination of oral mucosa and immunohistochemical detection of EZH2 protein expression were performed. The follow-up period was 30 months; participants were followed until malignant transformation occurred or until the end of follow-up, at which point they were withdrawn from the study. The exposure factor was the level of EZH2 protein expression, and the outcome was the malignant transformation rate of OLK. Differences in EZH2 expression levels and transformation outcomes were analyzed. Results: There were no statistically significant differences between the high and low EZH2 expression groups in terms of age, sex, history of systemic disease, lifestyle habits, psychological status, diet, and sleep conditions (P > 0.05). Lesions in the high EZH2 expression group were mainly located on the ventral tongue, while in the low EZH2 expression group, they were more commonly found on the dorsal tongue and buccal mucosa. The malignant transformation rate was 28.6% (4/14) in the high expression group and 8.8% (8/91) in the low expression group; these differences were not statistically significant (P=0.053). In univariate Cox regression analysis, the risk of malignant transformation in the high EZH2 expression group was 3.647 times that of the low EZH2 expression group (HR = 3.647, 95% CI: 1.097-12.120, P<0.05). Kaplan-Meier survival analysis showed that over the 30-month follow-up period, the cancer-free survival rate in the high EZH2 expression group was 19.8% lower than in the low expression group, and the difference was statistically significant (P<0.05). In multivariate Cox regression analysis, only moderate and severe epithelial dysplasia were identified as independent risk factors for malignant transformation. The risk of malignant transformation in the moderate and severe dysplasia groups was 10.695 and 13.623 times higher, respectively, than in the mild dysplasia group (HR = 10.695, 95% CI: 2.270-50.396, P<0.05; HR=13.623, 95% CI: 1.918-96.774, P<0.05). EZH2 high expression was not an independent risk factor in the multivariate model (HR= 2.528, 95% CI: 0.752-8.500, P = 0.134). Conclusion High EZH2 protein expression is a risk factor for the malignant transformation of OLK but does not have independent predictive value.