Objective To investigate the mechanical effects of various height combinations of canine long-arm hooks and micro-im-plant anchorage on the retraction of maxillary anterior teeth in clear aligner treatment.It focuses on analyzing the stress distribution within the periodontal ligament and the movement tendencies of the anterior teeth,providing scientific evidence for optimizing orthodon-tic treatment strategies.Methods Three-dimensional finite element models were developed using CBCT scan data of patients and soft-ware including Mimics,Geomagic Studio,and Hypermesh.The models incorporated 16 different configurations of canine long-arm hooks(4,6,8,10 mm)and micro-implant anchorage(6,8,10,12 mm).Elastic traction forces of 3/16,3.5 oz were applied to these models.Simulations assessed how these variables influenced periodontal ligament stress distribution and the movement patterns of the maxillary anterior teeth.Results Stress during anterior teeth retraction was predominantly concentrated in the cervical and apex re-gions of the periodontal ligament,where it interfaced with the alveolar bone,indicating significant local concentration.Increasing the height of micro-implant anchorage and traction hooks markedly reduced positional changes in both the crown and apex.Specifically,when hooks exceeded 8 mm and anchorage heights surpassed 10 mm,canine movement became more uniform,preventing extrusion and minimizing the deepening of the overbite.Additionally,combinations of high traction hooks and high micro-implant anchorage promoted more uniform tooth movement,reducing unnecessary tipping and rotation.Conclusion In the retraction of maxillary anterior teeth with clear aligners,using high-position micro-implant anchorage and high-position traction hooks significantly enhances torque control of anterior teeth and effectively prevents deepening of the overbite.

Objective:To systematically investigate the causal effects of exposure factors on nonsyndromic cleft lip with or without cleft palate (NSCL/P) using a phenome-wide mendelian randomization (MR-PheWAS) framework and identify pleiotropic loci.Methods:This study integrated genome-wide association study (GWAS) data for NSCL/P, including 1 069 cases and 1 724 controls, and systematically evaluated causal associations between exposures and NSCL/P using the MR-PheWAS framework. GWAS summary data for 2 106 Asian population-exposure phenotypes were obtained from the IEU OpenGWAS database. The inverse-variance weighted (IVW) method served as the core causal inference model, supplemented by weighted median and MR-Egger regression to verify the robustness of causal associations. Additionally, multivariable MR analysis was conducted to adjust for confounding effects, alongside sensitivity tests (Cochran′s Q and MR-PRESSO). Genetic correlations were analyzed using LD Score regression, and cross-phenotype pleiotropy analysis (PLACO/CPASSOC) was employed to identify shared genetic loci. Pathway enrichment and gene annotation data were integrated to explore potential biological mechanisms.Results:MR analysis identified serum calcium ( OR=0.12, P=0.019), high-density lipoprotein (HDL, OR=0.61, P=0.039), and mean corpuscular hemoglobin concentration (MCHC, OR=0.39, P=0.032) as protective factors, whereas serum sodium ( OR=21.41, P=0.013) was a risk factor. Furthermore, in subsequent analyses of genetic correlation and genetic overlap, a strong association was observed between serum calcium and NSCL/P. Cross-trait analysis localized pleiotropic loci to 16q24.2 and 3q21.1, involving CASR and CSTA, with significant enrichment in vitamin D response pathways. Conclusions:Numerous environmental exposure factors may have a causal impact on the outcomes of NSCL/P, and metabolic homeostasis (especially calcium signaling) plays a significant role in the pathogenesis of NSCL/P. Further genetic analyses identified potential pleiotropic loci primarily located at 16q24.2 and 3q21.1, involving key genes such as CASR and CSTA, and enriched in vitamin D response pathways. This study highlights the crucial position of genetic-environmental factors in the development of cleft lip and palate.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To investigate the three-dimensional changes in hard and soft tissues before and after treatment with digitally fabricated maxillary skeletal expanders in patients with maxillary transverse deficiency.Methods Twenty late adolescents or adults with maxillary transverse deficiency treated at the Orthodontic Department of Affiliated Stomatological Hospital of Nanjing Medical Uni-versity using digitally fabricated maxillary skeletal expanders were included.Cone-beam computed tomography(CBCT)scans were ob-tained before and after treatment.Three-dimensional measurements were analyzed using Dolphin 3D 11.95 software,and statistical anal-ysis was performed with SPSS software.Paired t-tests were used to compare pre-treatment and post-treatment changes in hard and soft tissues.Results Significant increases were observed in anterior midpalatal suture width,posterior midpalatal suture width,maxillary apical base width,and maxillary alveolar width(P＜0.001).No significant changes were found in alveolar ridge inclination,alveolar ridge height,LSNA(P＞0.05).Significant increases occurred in apical distance,cementoenamel junction distance,and inter-fossa distance(P＜0.001),while first molar inclinationand ∠U1-SN remained stable(P＞0.05).Significant improvements were noted in upper airway volume,nasal floor base width,and nasal cavity width(P＜0.001).Conclusion For late adolescents or adults with max-illary transverse deficiency,digitally fabricated maxillary skeletal expanders can achieve near-parallel expansion of the midpalatal suture,effectively improving maxillary transverse dimensions and airway volume while minimizing dental side effects.

Objective:The aim of this research was to study the transverse changes during molar distalization with clear aligner treatment,and to evaluate the predictability.Methods:This retrospective study included the following two parts:(1)20 patients treated with Invisalign system were selected.Their digital models were measured with OrthoCAD(Align Technology)and then com-pared with the initial ClinCheck arch width to verify the consistency between them;(2)34 patients whose maxillary molars were dis-talized,and 12 patients whose maxillary and mandibular molars were both distalized,were involved.The widths between canines,premolars and molars were recorded from Clincheck software at T0(initial),T1(Invisalign-predicted),and T2(pretreatment,from the refinement ClinCheck plan)and then compared.Results:The measured value of dental arch width of OrthoCAD and ClinCheck were consistent.After wearing the first stage appliance,the width between maxillary and mandibular teeth at T2 ranges from 1.63 to 3.45 mm.In the maxilla,the width at T1 differed from that at T2 and the predictability ranged from 80.43％to 82.29％,while the predictability ranged from 88.88％to 93.08％in the mandible.Conclusion:(1)The arches were expanded during molar distaliza-tion with clear aligners;(2)The predictability ranged from 80.43％to 93.08％.It can be considered that the actual width change is close to the target change.

Objective:To systematically investigate the causal effects of exposure factors on nonsyndromic cleft lip with or without cleft palate (NSCL/P) using a phenome-wide mendelian randomization (MR-PheWAS) framework and identify pleiotropic loci.Methods:This study integrated genome-wide association study (GWAS) data for NSCL/P, including 1 069 cases and 1 724 controls, and systematically evaluated causal associations between exposures and NSCL/P using the MR-PheWAS framework. GWAS summary data for 2 106 Asian population-exposure phenotypes were obtained from the IEU OpenGWAS database. The inverse-variance weighted (IVW) method served as the core causal inference model, supplemented by weighted median and MR-Egger regression to verify the robustness of causal associations. Additionally, multivariable MR analysis was conducted to adjust for confounding effects, alongside sensitivity tests (Cochran′s Q and MR-PRESSO). Genetic correlations were analyzed using LD Score regression, and cross-phenotype pleiotropy analysis (PLACO/CPASSOC) was employed to identify shared genetic loci. Pathway enrichment and gene annotation data were integrated to explore potential biological mechanisms.Results:MR analysis identified serum calcium ( OR=0.12, P=0.019), high-density lipoprotein (HDL, OR=0.61, P=0.039), and mean corpuscular hemoglobin concentration (MCHC, OR=0.39, P=0.032) as protective factors, whereas serum sodium ( OR=21.41, P=0.013) was a risk factor. Furthermore, in subsequent analyses of genetic correlation and genetic overlap, a strong association was observed between serum calcium and NSCL/P. Cross-trait analysis localized pleiotropic loci to 16q24.2 and 3q21.1, involving CASR and CSTA, with significant enrichment in vitamin D response pathways. Conclusions:Numerous environmental exposure factors may have a causal impact on the outcomes of NSCL/P, and metabolic homeostasis (especially calcium signaling) plays a significant role in the pathogenesis of NSCL/P. Further genetic analyses identified potential pleiotropic loci primarily located at 16q24.2 and 3q21.1, involving key genes such as CASR and CSTA, and enriched in vitamin D response pathways. This study highlights the crucial position of genetic-environmental factors in the development of cleft lip and palate.

Objective To investigate the mechanical effects of various height combinations of canine long-arm hooks and micro-im-plant anchorage on the retraction of maxillary anterior teeth in clear aligner treatment.It focuses on analyzing the stress distribution within the periodontal ligament and the movement tendencies of the anterior teeth,providing scientific evidence for optimizing orthodon-tic treatment strategies.Methods Three-dimensional finite element models were developed using CBCT scan data of patients and soft-ware including Mimics,Geomagic Studio,and Hypermesh.The models incorporated 16 different configurations of canine long-arm hooks(4,6,8,10 mm)and micro-implant anchorage(6,8,10,12 mm).Elastic traction forces of 3/16,3.5 oz were applied to these models.Simulations assessed how these variables influenced periodontal ligament stress distribution and the movement patterns of the maxillary anterior teeth.Results Stress during anterior teeth retraction was predominantly concentrated in the cervical and apex re-gions of the periodontal ligament,where it interfaced with the alveolar bone,indicating significant local concentration.Increasing the height of micro-implant anchorage and traction hooks markedly reduced positional changes in both the crown and apex.Specifically,when hooks exceeded 8 mm and anchorage heights surpassed 10 mm,canine movement became more uniform,preventing extrusion and minimizing the deepening of the overbite.Additionally,combinations of high traction hooks and high micro-implant anchorage promoted more uniform tooth movement,reducing unnecessary tipping and rotation.Conclusion In the retraction of maxillary anterior teeth with clear aligners,using high-position micro-implant anchorage and high-position traction hooks significantly enhances torque control of anterior teeth and effectively prevents deepening of the overbite.

Objective To investigate the three-dimensional changes in hard and soft tissues before and after treatment with digitally fabricated maxillary skeletal expanders in patients with maxillary transverse deficiency.Methods Twenty late adolescents or adults with maxillary transverse deficiency treated at the Orthodontic Department of Affiliated Stomatological Hospital of Nanjing Medical Uni-versity using digitally fabricated maxillary skeletal expanders were included.Cone-beam computed tomography(CBCT)scans were ob-tained before and after treatment.Three-dimensional measurements were analyzed using Dolphin 3D 11.95 software,and statistical anal-ysis was performed with SPSS software.Paired t-tests were used to compare pre-treatment and post-treatment changes in hard and soft tissues.Results Significant increases were observed in anterior midpalatal suture width,posterior midpalatal suture width,maxillary apical base width,and maxillary alveolar width(P＜0.001).No significant changes were found in alveolar ridge inclination,alveolar ridge height,LSNA(P＞0.05).Significant increases occurred in apical distance,cementoenamel junction distance,and inter-fossa distance(P＜0.001),while first molar inclinationand ∠U1-SN remained stable(P＞0.05).Significant improvements were noted in upper airway volume,nasal floor base width,and nasal cavity width(P＜0.001).Conclusion For late adolescents or adults with max-illary transverse deficiency,digitally fabricated maxillary skeletal expanders can achieve near-parallel expansion of the midpalatal suture,effectively improving maxillary transverse dimensions and airway volume while minimizing dental side effects.

Objective:The aim of this research was to study the transverse changes during molar distalization with clear aligner treatment,and to evaluate the predictability.Methods:This retrospective study included the following two parts:(1)20 patients treated with Invisalign system were selected.Their digital models were measured with OrthoCAD(Align Technology)and then com-pared with the initial ClinCheck arch width to verify the consistency between them;(2)34 patients whose maxillary molars were dis-talized,and 12 patients whose maxillary and mandibular molars were both distalized,were involved.The widths between canines,premolars and molars were recorded from Clincheck software at T0(initial),T1(Invisalign-predicted),and T2(pretreatment,from the refinement ClinCheck plan)and then compared.Results:The measured value of dental arch width of OrthoCAD and ClinCheck were consistent.After wearing the first stage appliance,the width between maxillary and mandibular teeth at T2 ranges from 1.63 to 3.45 mm.In the maxilla,the width at T1 differed from that at T2 and the predictability ranged from 80.43％to 82.29％,while the predictability ranged from 88.88％to 93.08％in the mandible.Conclusion:(1)The arches were expanded during molar distaliza-tion with clear aligners;(2)The predictability ranged from 80.43％to 93.08％.It can be considered that the actual width change is close to the target change.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.