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*

Objective:To investigate the effect of serum 25-hydroxyvitamin D3 level on ovarian reservation function and artificial insemination outcomes in infertile patients.Methods:A retrospective analysis was conducted based on clinical data of 108 infertile patients who underwent artificial insemination at Yan'an People's Hospital from January 2021 to January 2024. The patients' baseline data and test results of laboratory indicators were collected. Patients enrolled were divided into vitamin D deficiency group (73 cases) and non-vitamin D deficiency group (35 cases) according to serum 25-hydroxyvitamin D3 [25(OH)D3] level, and divided into pregnant group (60 cases) and non-pregnant group (48 cases) according to artificial insemination outcome. Baseline data and laboratory indicators of different groups were compared in order to analyze factors that influence failure of artificial insemination in infertile patients. Measurement data with normal distribution was represented by ±s. Comparison between groups was performed by two-sample t-test. Enumeration data was represented by n(%). Comparison between groups was performed by χ2 test. Logistic regression analysis was used to identify risk factors of artificial insemination failure in infertile patients. Results:Serum 25(OH)D3 and anti-Mullerian hormone (AMH) levels and antral follicle count (AFC) in the vitamin D deficiency group were lower than those in the non-vitamin D deficiency group [(14.9±2.6) μg/L vs. (22.6±2.1) μg/L, (3.0±1.0) μg/L vs. (3.4±1.0) μg/L, (9.9±2.3) vs. (11.1±2.6)], and the differences were statistically significant ( t=15.28, P<0.001; t=2.28, P=0.025; t=2.31, P=0.023). In the vitamin D deficiency group, serum 25(OH)D3 and AMH levels were positively correlated with AFC (r=0.40 and 0.37, both P<0.001). The proportion of retrieved oocytes ≥ 8, AFC, serum 25(OH)D3 and AMH levels in the pregnant group were higher than those in the non-pregnant group [56.7% (34/60) vs. 31.2% (15/48), (11.3±2.4) vs. (9.0±2.2), (23.2±2.2) μg/L vs. (10.1±2.0) μg/L, (3.5±1.1) μg/L vs. (2.6±0.7) μg/L], and the differences were statistically significant ( χ2=6.95, P=0.008, t=5.22, P<0.001; t=32.01, P<0.001; t=4.80, P<0.001). Multivariate logistic regression analysis results showed that low serum 25(OH)D3, AMH, and AFC were risk factors of artificial insemination failure in infertile patients (odds ratios=0.49, 0.56, 0.31, 95%CI: 0.25-0.96, 0.33-0.95, 0.11-0.87, P=0.037, 0.032, 0.026). Conclusions:Serum 25-hydroxyvitamin D3 level is closely related to ovarian reservation function in infertile patients. Moreover, it is a risk factor of artificial insemination failure.

Objective:To investigate the effect of serum 25-hydroxyvitamin D3 level on ovarian reservation function and artificial insemination outcomes in infertile patients.Methods:A retrospective analysis was conducted based on clinical data of 108 infertile patients who underwent artificial insemination at Yan'an People's Hospital from January 2021 to January 2024. The patients' baseline data and test results of laboratory indicators were collected. Patients enrolled were divided into vitamin D deficiency group (73 cases) and non-vitamin D deficiency group (35 cases) according to serum 25-hydroxyvitamin D3 [25(OH)D3] level, and divided into pregnant group (60 cases) and non-pregnant group (48 cases) according to artificial insemination outcome. Baseline data and laboratory indicators of different groups were compared in order to analyze factors that influence failure of artificial insemination in infertile patients. Measurement data with normal distribution was represented by ±s. Comparison between groups was performed by two-sample t-test. Enumeration data was represented by n(%). Comparison between groups was performed by χ2 test. Logistic regression analysis was used to identify risk factors of artificial insemination failure in infertile patients. Results:Serum 25(OH)D3 and anti-Mullerian hormone (AMH) levels and antral follicle count (AFC) in the vitamin D deficiency group were lower than those in the non-vitamin D deficiency group [(14.9±2.6) μg/L vs. (22.6±2.1) μg/L, (3.0±1.0) μg/L vs. (3.4±1.0) μg/L, (9.9±2.3) vs. (11.1±2.6)], and the differences were statistically significant ( t=15.28, P<0.001; t=2.28, P=0.025; t=2.31, P=0.023). In the vitamin D deficiency group, serum 25(OH)D3 and AMH levels were positively correlated with AFC (r=0.40 and 0.37, both P<0.001). The proportion of retrieved oocytes ≥ 8, AFC, serum 25(OH)D3 and AMH levels in the pregnant group were higher than those in the non-pregnant group [56.7% (34/60) vs. 31.2% (15/48), (11.3±2.4) vs. (9.0±2.2), (23.2±2.2) μg/L vs. (10.1±2.0) μg/L, (3.5±1.1) μg/L vs. (2.6±0.7) μg/L], and the differences were statistically significant ( χ2=6.95, P=0.008, t=5.22, P<0.001; t=32.01, P<0.001; t=4.80, P<0.001). Multivariate logistic regression analysis results showed that low serum 25(OH)D3, AMH, and AFC were risk factors of artificial insemination failure in infertile patients (odds ratios=0.49, 0.56, 0.31, 95%CI: 0.25-0.96, 0.33-0.95, 0.11-0.87, P=0.037, 0.032, 0.026). Conclusions:Serum 25-hydroxyvitamin D3 level is closely related to ovarian reservation function in infertile patients. Moreover, it is a risk factor of artificial insemination failure.

[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.

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.

The correct working posture of dentists is not only the premise of clinical diagnosis, treatment quality and safety but also an important guarantee for the occupational health of dentists. Presently, research on the working posture of dental professionals and related influencing factors is relatively mature internationally. Still, the dental curriculums in our country have not systematically introduced theoretical knowledge and standards related to working posture. This review analyzes and summarizes previous literature on the importance of dental working posture, criteria, assessment methods, and influencing factors, in hopes of providing references and theoretical supports for future guidelines and standards.

The consumption of a high-fat diet(HFD)has been linked to osteoporosis and an increased risk of fragility fractures.However,the specific mechanisms of HFD-induced osteoporosis are not fully understood.Our study shows that exposure to an HFD induces premature senescence in bone marrow mesenchymal stem cells(BMSCs),diminishing their proliferation and osteogenic capability,and thereby contributes to osteoporosis.Transcriptomic and chromatin accessibility analyses revealed the decreased chromatin accessibility of vitamin D receptor(VDR)-binding sequences and decreased VDR signaling in BMSCs from HFD-fed mice,suggesting that VDR is a key regulator of BMSC senescence.Notably,the administration of a VDR activator to HFD-fed mice rescued BMSC senescence and significantly improved osteogenesis,bone mass,and other bone parameters.Mechanistically,VDR activation reduced BMSC senescence by decreasing intracellular reactive oxygen species(ROS)levels and preserving mitochondrial function.Our findings not only elucidate the mechanisms by which an HFD induces BMSC senescence and associated osteoporosis but also offer new insights into treating HFD-induced osteoporosis by targeting the VDR-superoxide dismutase 2(SOD2)-ROS axis.