Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient's general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
Humans ; Calcium Compounds/therapeutic use* ; Consensus ; Dental Pulp ; Dentition, Permanent ; Oxides/therapeutic use* ; Pulpitis/therapy* ; Pulpotomy/standards*

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

[Objective]To summarize the research status and hotspots of tripterygium glycosides(TG),to provide reference basis for future in-depth research and clinical promotion of TG.[Methods]Computer retrieval of literature related to TG from January 2000 to June 2023 was conducted using the China National Knowledge Internet(CNKI),Wanfang Data,China Science and Technology Journal Database(VIP),China Biology Medicine disc(CBM).Use NoteExpress software to merge,duplicate check,and clean data,and use Excel software to construct an annual publication volume line chart.Visualize and analyze the author,organization,and keywords using VOSviewer 1.6.13 and CiteSpace 6.2 R2 software,and draw relevant graphs.[Results]A total of 1 752 articles were included.Since 2008,the number of publications has shown a decreasing trend in recent years after a gradual increase.A total of 4 186 authors were involved,including 75 core authors,forming a collaborative team represented by DING Ying,LI Zhenbin,LIN Na,CUI Ruiqin,CHEN Weidong and others.The main publishing institutions were the First Affiliated Hospital of He'nan University of Chinese Medicine and He'nan University of Chinese Medicine,followed by Dongzhimen Hospital of Beijing University of Chinese Medicine.The research institutions were relatively independent and scattered,mostly through cooperation between traditional Chinese medicine universities and their affiliated hospitals,with less cross regional cooperation.A total of six clusters of key words had been formed in the network diagram.The research focuses were mainly summarized as the clinical research on the application of TG combination drugs in kidney diseases such as diabetes nephropathy,purpura nephritis and nephrotic syndrome,rheumatic immune diseases such as rheumatoid arthritis,skin and mucosal diseases,and the experimental research on the toxicity and side effects of TG.In recent years,keywords that had emerged included dermatitis,eczema,mizolastin,inflammatory factors,immune function,tacrolimus,and so on.[Conclusion]The clinical efficacy and safety research of TG in kidney diseases,rheumatic immune diseases and other fields are hot topics.Dermatitis,eczema,and other skin and mucosal diseases,as well as the mechanism of TG action and inflammatory factors,may be the future research trends.There is still a need to strengthen cooperation among teams,strengthen basic research on the mechanism of TG action,and explore effective compatibility and detoxification methods,providing reference basis for the clinical application of TG in the future.

AIM:To explore the core target and mechanism of α-Linolenic acid(ALA)in improving neuroinflammation through network pharmacology combined with in vitro experiments.METHODS:Pharmacological studies have shown that ALA has anti-inflammatory,antioxidant,and neuroprotec-tive properties.The targets of α-Linolenic acid were obtained from PharmMapper and Swiss Tar-get Prediction databases,the targets of neuroin-flammation were searched from GeneCards,TTD and OMIM databases,and the potential targets of ALA and neuroinflammation were obtained from Wayne diagram.Protein interaction network(pro-tein-protein interaction,PPI)of potential targets was constructed by STRING website,and the core targets in PPI were screened by Cytoscape 3.8.0 software.At the same time,potential targets are imported into DAVID database,GO and KEGG data were obtained and the results were visualized.Autodock vina and Pymol software were used to dock the selected core targets with ALA and visual-ize the results.An in vitro model of neuroinflamma-tion was constructed,and cell growth status,oxida-tive stress,and migration or repairing capacity were determined by CCK-8 analysis,SOD,MDA and cell scratches,and the expression of IL-6,iba 1,COX-2(PTGS2),and iNOS proteins was determined by ELISA or Western blot experiments.RESULTS:Network pharmacology analysis revealed 46 poten-tial targets of ALA for neuroinflammation,and 10 core targets,including IL-6 and PTGS 2.With 232 entries enriched by GO enrichment analysis and 70 signaling pathways enriched by KEGG enrichment analysis,molecular docking showed that ALA can form hydrogen bonding with COX-2.Experiments showed that ALA could improve cell viability,allevi-ate cell oxidative stress levels,and promote cell mi-gration and motor repair in an in vitro model of neuroinflammation.CONCLUSIONS:ALA may im-prove neuroinflammation by alleviating oxidative stress and inhibiting IL-6 and COX-2 protein expres-sion.

Oral static biofilm model is an important tool for in vitro simulation of oral microecological environment, which has become an important method for studying the pathogenesis of various oral diseases and testing the efficacy of various drugs, oral care products and foods due to its low cost, high throughput, good reliability and easy operation. The establishment of oral static biofilm models allows the selection of different devices, inoculum sources, media, substrates and culture conditions according to the purpose of the study, and the evaluation of biofilm growth by various methods such as measuring biomass, metabolic activity, community structure and performing visualization analysis. This paper summarizes the methodological elements reported in recent years for the establishment and evaluation of oral static biofilm models, and analyzes and discusses the applicability of various methods in the hope of contributing to the research and production practice in related fields.
Biofilms ; Reproducibility of Results

Objective: To analyze the school adaptation and behavioral performance of the first batch of students who return to school during the COVID-19 epidemic, and to provide a theoretical basis for further development of corresponding intervention measures. Methods: The method of cluster sampling was adopted to conduct anonymous questionnaire survey on the first batch of college students who have returned to a certain university. The survey contents included the basic information of the students, the adaptability of the school after returning to school and the corresponding behavior performance. Results: Male students reported high lever of satisfaction than female students on the dormitory environment health (t=10.28, P<0.01), but low satisfaction on school security and logistical support (t=2.26, P=0.02), rural students marked higher score than urban students for the school closed management system (t=2.82, P=0.01), in terns of school security, Logistics, the degree of school s attention to the epidemic prevention and epidemic prevention, non only-child gave high score than the only children; In terms of their own behavior, the rate of seek medical treatment immediately when they develop COVID-19 related symptoms (68.1%) was lower than that of others (81.3%)(χ 2=223.88，P<0.01)；In addition, the percentage of respondents who chose to report COVID-19 related symptoms (79.5%) was lower than that of others (88.7%)(χ 2=97.49，P<0.01). A total of 2 671 college students (98.9%) were able to wear masks every day and 2 457 (90.9%) chose to improve their diet to improve their immunity. Conclusion The first batch of college students who return to school have a high level of satisfaction on school management, and can take active measures to adapt to the life back to school and commit self-protection, however targeted measures to are still needed further strengthen students health education.

Objective: To understand the current situation and influencing factors of Internet addiction among college students after returning to school during the COVID-19 epidemic, and to provide scientific basis for timely intervention measures to adjust the risk factors of Internet addiction. Methods: A cluster sampling method was adopted to conduct a questionnaire survey among 2 700 college students who firstly returned to college using general condition questionnaire and Internet Addiction scale. Results: The detection rate of Internet addiction disorder was 32.4% among returning college students, moreover, the detection rate of Internet addiction in male students(36.0%) was higher than that in female students (31.2%) (χ 2=5.42,P<0.05). The degree of Internet addiction was negatively correlated with the physical health score (r-s=-0.20) and mental health score (r-s=-0.24) of college students (P<0.01). Multivariate Logistic regression analysis showed that compared with introversion, neutral (OR=0.67, 95%CI=0.55-0.82) and extroverted college students (OR=0.59, 95%CI=0.48-0.74) were protective factors for Internet addiction; compared with no exercise, physical exercise ≥3 times or more per week (exercise 3-4 times：OR=0.67, 95%CI=0.51-0.87; ≥5 times：OR=0.67, 95%CI=0.50-0.90) were the protective factors for Internet addiction among college students; family loss during the epidemic was a risk factor for Internet addiction among college students (OR=1.34, 95%CI=1.12-1.60); the risk of Internet addiction was 2.13 times higher for college students who actively sought psychological help than for those who did not seek psychological help (95%CI=1.14-3.96); college students who did not want to go back to school had 1.50 times the risk of Internet addiction as those who did (95%CI=1.26-1.77). Conclusion The current situation of college students online behaviors during COVID-19 is not optimistic, and should arouse sufficient attention from society and universities. In addition, college students returning to school should take more physical exercises and psychological counseling to detect and intervene in psychological problems in time, reduce their psychological burden, and enhance their psychological quality.

Objective: To investigate the sleep quality and influencing factors of the first batch of college students returning to school during COVID-19 epidemic, so as to provide scientific basis for taking corresponding measures. Methods: An anonymous self-administered questionnaire survey was conducted among the first batch of college students returning from a certain university by cluster sampling, which included general demographic characteristics, Trait Coping Style Questionnaire (TCSQ) and Pittsburgh Sleep Quality Index(PSQI). Results: The detection rate of sleep disorders was 19.33%(522/2 701). The mother s education level was high school or technical secondary school or below(OR=2.24, 95%CI=1.47-3.41), never eat breakfast(OR=3.25, 95%CI=1.86-5.68), families were damaged during the outbreak (OR=1.48, 95%CI=1.17-1.87) and negative coping (OR=1.15, 95%CI=1.12-1.17) were risk factors for sleep disorders(P<0.05). Compared to having a very poor relationship with parents, the relationship between parents was average(OR=0.23, 95%CI=0.06-0.89), better(OR=0.23, 95%CI=0.06-0.87), very good (OR=0.19, 95%CI=0.05-0.74) were protective factors for sleep disorders(P<0.05). Exercise once or twice a week during the epidemic(OR=0.76, 95%CI=0.58-1.00), positive coping (OR=0.93, 95%CI=0.91-0.96) were protective factors for sleep disorders(P<0.05). Conclusion In this COVID-19 epidemic, the sleep quality of returning college students was affected to different extent, and the relationship between parents, sports, mother s education, breakfast habits, and family damage during the COVID-19 were factors affecting their sleep quality. Targeted psychological intervention measures should be given to returning college students in the early stage.