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4 - Vol 28, No.4, 2025
- Chin J Dent Res 2025;28(4):315–322; doi:10.3290/j.cjdr.b6745461
- Expert Consensus on 5-aminolevulinic Acid Photodynamic Therapy for Oral Potentially Malignant Disorders
- Chinese Stomatological Association Group Standards T/CHSA 032-2021; Society of Oral Medicine, Chinese Stomatological Association
- Photodynamic therapy (PDT) utilising 5-aminolevulinic acid (5-ALA) has emerged as a significant non-invasive treatment for oral potentially malignant disorders (OPMDs). PDT involves the use of a photosensitiser (5-ALA), light and oxygen to selectively target and destroy diseased tissues via photochemical reactions. This therapy has shown promising results in treating various OPMDs, such as oral leucoplakia, oral erythroplakia and oral lichen planus. This consensus document outlines the clinical application of 5-ALA-PDT, providing a comprehensive guide for oral mucosal specialists and stomatology departments. The consensus includes detailed recommendations on irradiation dose, irradiation time, light source selection, pre-treatment preparation, clinical diagnosis, treatment protocols, efficacy evaluation and management of post-treatment adverse events. The goal is to standardise 5-ALA-PDT procedures to improve clinical outcomes and provide a scientific basis for the treatment of OPMDs. By offering guidance on patient selection, lesion assessment and therapeutic strategies, this document aims to address current clinical challenges and enhance the effectiveness of PDT in managing oral
  mucosal diseases.
  
  Keywords: 5-aminolevulinic acid, consensus, oral potentially malignant disorders, photodynamic therapy
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- Chin J Dent Res 2025;28(4):307–313; doi:10.3290/j.cjdr.b6745468
- Virtual Simulation Software for Oral Histopathology to Assist Dental Students in Making Tooth Ground Sections and Enhancing Knowledge of Dental Hard Tissues
- Zhuo LIN, Yi Cheng HONG, Yun Yi HUANG, Xuan Yi CHEN, Zhi Pei CHEN, Yi Jiao LI, Xue Cong LI, Xiao Hua CHEN, Meng XU
- Objective: To evaluate the effects of a novel software developed to assist dental students in making tooth ground sections and gaining knowledge of dental hard tissues.
  Methods: Students were divided into three groups (class-use group, after-class-use group and control group) and taught how to make real sections or allowed to use the aforementioned software to make virtual tooth ground sections on the computer. The present authors then assessed the efficiency of making the first tooth ground sections, the quality of ground sections and performance skills.
  Results: The sectioning time for the class-use group was less than that for the after-class-use group and control group (P = 0.027), and the quality of sections for the class-use group was higher (P = 0.036). In the objective test 1 week later, the after-class-use group performed better than the control group (P = 0.019). Users agreed that the software stimulated their interest and improved their learning results.
  Conclusion: This software is an efficient tool to help students to make tooth ground sections and study the histology of dental hard tissues in a simple and functional way.
  
  Keywords: dental hard tissue, oral histopathology, tooth ground sections, virtual software
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- Chin J Dent Res 2025;28(4):297–305; doi:10.3290/j.cjdr.b6745473
- Divergent Oral Microbiome after Rinsing with of H₂O₂, Chlorhexidine and Essential Oil Mouthrinses: a Proof of Principle Study
- Lin HE, Zheng HE, Yi ZHANG, Fei WU, Hui LIU, Xing Gang LIU, Dong Xiang ZHENG, Rui Qi SHAO, Lei HU, Qing Song JIANG
- Objective: To compare the effects on the oral microbiome after rinsing with hydrogen peroxide (H2O2), chlorhexidine and essential oil mouthrinses and identify formulations that suppress pathogenic bacteria while preserving beneficial species and maintaining oral microbial balance.
  Methods: Twelve healthy volunteers were randomly assigned to three groups: H2O2, chlorhexidine and essential oil mouthrinse. Saliva samples were collected at three time points: before and 5 minutes and 1 hour after rinsing with mouthrinse. Microbiome composition was analysed using 16S rRNA gene sequencing.
  Results: Alpha and beta diversity showed no statistically significant differences among time points. The genus-level microbiome composition remained relatively stable in the H2O2 and essential oil groups but changed significantly in the chlorhexidine group. In the H2O2 group, Neisseria decreased significantly, while Actinomyces increased. In the chlorhexidine group, Porphyromonas, Veillonella, Streptococcus, Neisseria and Gemella decreased significantly. In the essential oil group, Leptotrichia decreased, and Haemophilus increased significantly.
  Conclusion: Essential oil mouthrinse and chlorhexidine exhibit stronger bacteriostatic effects against oral pathogens than H2O2. However, chlorhexidine may disrupt microbial equilibrium, whereas essential oil mouthrinse more effectively preserves a stable oral microbiome. Thus, essential oil mouthrinse could serve as a viable alternative to chlorhexidine for oral microbiome management, though its long-term efficacy requires further investigation.
  
  Keywords: chlorhexidine, essential oil mouthrinse, microbial diversity, oral microbiome ecology, 16S rRNA sequencing
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- Chin J Dent Res 2025;28(4):287–295; doi:10.3290/j.cjdr.b6745490
- Hyperbaric Oxygen Therapy Promotes Bone Healing in Patients with Maxillary Sinus Lateral Augmentation and Diabetic Mice Potentially through the Nrf2 Pathway
- Yue WANG, Bao Hua XU, Jing YANG, Qiang SUN
- Objective: To assess the impact of hyperbaric oxygen (HBO) therapy on bone healing in diabetic patients and explore potential mechanisms in an animal experiment.
  Methods: Four non-diabetic patients undergoing maxillary sinus lateral augmentation were assigned to either standard care (control group) or HBO treatment for 5, 6 or 9 weeks. Bone core samples were collected for immunochemistry during the preparation for implant insertion. Additionally, 12 db/db diabetic mice and 12 control mice with tibia defects were subjected to HBO treatment. After 7 days, the bone repair process was assessed using microcomputed tomography (microCT), histology, immunohistochemistry and Western blot analyses.
  Results: HBO improved bone formation in the implant areas of patients treated for 5, 6 and 9 weeks, increasing local vascular endothelial growth factor, bone morphogenetic protein-2 and osteocalcin expression. Diabetic mice exhibited impaired bone healing, but HBO-treated groups (diabetic or non-diabetic) showed enhanced new bone formation. Increased osteocalcin and runt-related transcription factor 2 and decreased tartrate-resistant acid phosphatase expression were detected. The nuclear factor erythroid-derived 2-related factor 2 (Nrf2) pathway and its downstream proteins catalase and heme oxygenase-1 were upregulated after HBO.
  Conclusion: HBO enhances bone healing in both patients and diabetic mice, and is potentially mediated through the Nrf2 pathway.
  
  Keywords: bone healing, hyperbaric oxygen therapy, diabetes, Nrf2 signalling pathway
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- Chin J Dent Res 2025;28(4):277–286; doi:10.3290/j.cjdr.b6745493
- Comparison of Marginal Fit and Mechanical Performance of Three-unit Implant-supported Fixed Dental Prostheses Fabricated Using a Fully Digital Workflow and Conventional Workflow
- Shi Qing SHI, Dan Ni GUO, Mo Di HENG, Bo CHEN, Shao Xia PAN
- Objective: To compare the marginal fit and mechanical performance of three-unit implantsupported fixed dental prostheses (ISFDPs) fabricated using fully digital and conventional workflows.
  Methods: Three-unit ISFDP specimens in this study simulated the restoration of three consecutively missing teeth in the mandibular posterior region. Twenty-four specimens were divided into three groups: the zirconia fully digital (ZFD) group received zirconia ISFDPs fabricated using a fully digital workflow; the polyetherketoneketone fully digital (PFD) group received polyetherketoneketone (PEKK) ISFDPs fabricated using a fully digital workflow; and the zirconia control (ZC) group received zirconia ISFDPs fabricated using a conventional workflow. Marginal gaps between restorations and abutments during passive and active fit were measured, and initial screw loosening torque values of restorations were recorded. After undergoing 1,200,000 cycles of vertical loading, the restorations were reassessed for marginal gaps and loosening torque values.
  Results: Marginal fit under passive and active fit in the ZFD group showed no significant difference in relation to the ZC group. Marginal gaps in the PFD group (134.39 ± 41.13 μm) under passive fit were significantly larger than in the ZFD group, and decreased significantly under active fit (22.28 ± 10.45 μm). No significant difference in marginal fit was observed before and after cyclic loading in all groups. No significant difference was found in loosening torque change between the ZFD and ZC groups, whereas the change in the PFD group (median −2.13%, Q25 −3.30%/Q75 0.28%) was significantly lower than in the ZC group (median −5.83%, Q25−8.46%/Q75 −3.75%).
  Conclusion: Three-unit ISFDPs fabricated using fully digital and conventional workflows exhibit similar marginal fit and mechanical performance. Additionally, PEKK ISFDPs demonstrate clinically acceptable marginal fit and mechanical performance.
  
  Keywords: cyclic loading, fixed prostheses, fully digital workflow, marginal fit, polyetherketoneketone
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- Chin J Dent Res 2025;28(4):261–276; doi:10.3290/j.cjdr.b6745502
- An Auxiliary Measurement Method for Marginal Bone Loss around Dental Implants Based on Periapical Radiographs
- Tao GAO, Rong TAN, Su Kun TIAN, Hu CHEN, Hao Ran WANG, Jian Guo XU
- Objective: To develop an efficient and accurate method for the precise quantification of periimplant marginal bone loss, aiming to overcome the limitations of conventional assessments that rely heavily on expert subjective judgment and to enhance the monitoring of marginal bone level stability and facilitate the early detection of clinical risk factors.
  Methods: This research proposes an efficient automatic quantification method for marginal bone loss based on the YOLOv8-pose model. By detecting and localising keypoints associated with peri-implant bone loss, this method enables automated identification of marginal bone loss characteristics. Model performance is evaluated using the marginal bone loss rate to assess its effectiveness in predicting the severity of resorption on both sides of the implant.
  Results: The precision of keypoint detection for marginal bone loss features exceeds 98%, and the mean radial error of six keypoints in most images is less than 10 pixels, with the minimum error reaching only 2.89 pixels. In predicting marginal bone loss severity on both implant sides, the model achieves accuracies of 0.906 and 0.844, respectively, demonstrating robust predictive capability and application potential.
  Conclusion: The YOLOv8-pose-based method effectively addresses the inefficiency and subjectivity of traditional assessments by enhancing the automation and objectivity of peri-implant marginal bone loss detection. It provides valuable technical support for accurate evaluation and clinical decision making in peri-implant marginal bone loss.
  
  Keywords: convolutional neural network, dental implant, keypoint detection, marginal bone loss, periapical radiographs
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- Chin J Dent Res 2025;28(4):253–260; doi:10.3290/j.cjdr.b6745509
- rs2033806 at PAX3 Gene Associated with Non-syndromic Oral Cleft among the Chinese Population
- Yue YOU, Cheng Wei YANG, Si Di ZHANG, Si Xuan JIA, Mu Jia LI, Shi Jun DUAN, Jia Lin SUN, Bing SHI, Zhong Lin JIA
- Objective: To explore the association of PAX3 gene variants and non-syndromic orofacial cleft lip/palate (NSCL/P) among the Han Chinese population in Western China.
  Methods: A total of 1,626 NSCL/P patients, 886 non-syndromic cleft palate only (NSCPO) patients and 2,255 controls were recruited for association analysis. A total of 8 NSCPO patients, 7 non-syndromic cleft lip only (NSCLO) patients, and 3 normal controls were recruited for RNA sequencing. Blood samples were collected, genotype data for single nucleotide polymorphisms (SNPs) on the PAX3 gene were obtained and multi-level association analyses were conducted to explore their relationship with NSCL/P, including functional predictions of disease-related SNPs. Additionally, RNA sequencing was performed to investigate differences in PAX3 gene expression between patients with NSCL/P and controls. The study was conducted in PLINK analysis.
  Results: rs2033806 was significantly associated with NSCL/P, whereas rs1430651 was marginally associated with NSCL/P. None were significantly associated with NSCPO. In addition, rs2033806 was also associated with the subtypes NSCLP and NSCLO.
  Conclusion: rs2033806 at PAX3 showed different frequency distributions between non-syndromic oral cleft (NSOC) patients and controls, providing new insights into the aetiologies of NSOC.
  
  Keywords: non-syndromic orofacial cleft lip with cleft palate, non-syndromic cleft lip only, PAX3, singular nucleotide polymorphism
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- Chin J Dent Res 2025;28(4):241–251; doi:10.3290/j.cjdr.b6745523
- Mechanotransduction and Alveolar Bone Remodelling: a Narrative Review of Dynamics and Mechanisms
- Ramya RAMADOSS, Reena DAS, Abigail VIOLA E, Rajashree PADMANABHAN, Pratibha RAMANI
- Mechanotransduction is the biological process by which physical forces are converted into biochemical signals, playing a central role in alveolar bone remodelling. This remodelling is influenced by external stimuli such as mechanical stress, bone loss, and medication-related osteonecrosis. While most in vivo studies have focused on mechanotransductive changes within the periodontal ligament (PDL), it is increasingly recognised that the alveolar bone itself plays a broader and more complex role in this dynamic process. This narrative review presents a qualitative synthesis of literature sourced from PubMed, Scopus and Web of Science, emphasizing the cellular and molecular pathways involved in mechanotransduction within alveolar bone. A deeper understanding of these mechanisms is essential for advancing applications in orthodontic tooth movement, dental implant osseointegration, and musculoskeletal tissue engineering. Moreover, insights into the biomechanical regulation of bone may facilitate the development of improved biomaterials and regenerative strategies in clinical dentistry and orthopaedics.
  
  Keywords: alveolar bone remodelling, mechanobiology, mechanotransduction
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