Hui Xie

Oral submucous fibrosis (OSF) is a precancerous condition closely associated with areca nut chewing, yet its pathogenesis remains incompletely elucidated. Recent studies have highlighted the critical role of oral microbiota dysbiosis in the progression of OSF. This article systematically reviews alterations in the oral microbiota spectrum associated with OSF, the synergistic pathogenic mechanisms between microbiota and areca nut, core pathways of microbiota-host interactions, and therapeutic strategies based on microbiota modulation. Areca nut chewing modifies the oral microenvironment, suppressing commensal bacteria while enriching pathogens. In OSF patients, pathogenic bacteria such as Fusobacterium nucleatum , Porphyromonas gingivalis , and Candida species are significantly enriched, whereas beneficial bacteria including Lactobacillu s and Streptococcus species are reduced. Microbiota dysbiosis promotes fibrogenesis through multiple mechanisms, including disruption of the mucosal epithelial barrier, activation of TLR/NF-κB and NLRP3 inflammatory pathways, induction of Th17/Treg imbalance, interference with tryptophan and short-chain fatty acid metabolism, and exacerbation of oxidative stress. Microbiota-based therapeutic approaches include probiotics, specific targeted antimicrobial peptides, photodynamic therapy, oral microbiota transplantation, and dietary intervention. Future studies should employ multi-omics integrative analyses to establish causality between microbiota dysbiosis and OSF and to advance the clinical translation of precision microbiota-based therapies.

Betel nut is the fourth most commonly used psychoactive substance globally and is particularly prevalent in the Asia-Pacific region. Betel nut chewing is closely associated with a variety of health hazards, including oral cancer, cardiovascular diseases, and metabolic syndrome. This article reviews the epidemiological characteristics, health hazards, neurobiological mechanisms, and intervention strategies of betel nut addiction. The major active component in betel nut, arecoline, leads to addiction by modulating the cholinergic, dopaminergic, and glutamatergic systems, with the involvement of the gut-brain axis and immune-inflammatory responses. In terms of intervention strategies, pharmacological treatments (such as nicotinic receptor modulators), neuromodulation techniques (such as real-time functional magnetic resonance imaging neurofeedback), cognitive-behavioral therapy, and public health policies have shown potential efficacy. Future research should focus on the development of precision medicine strategies and interdisciplinary integrated intervention models.

Rationale: The management of patients with generalized stage III grade C periodontitis involves complex considerations, particularly in cases of inadequate peri-implant keratinized mucosa. We present a case study highlighting the multidisciplinary management of periodontitis and the feasibility of a modified apically positioned flap procedure to increase the width of the keratinized mucosa at the implant site during the second stage of implant surgery. Patient concerns: A 45-year-old woman presented to our hospital with a 4-year history of tooth mobility that caused difficulty chewing and bleeding gums when brushing. Diagnoses: The patient was diagnosed with generalized stage III grade C periodontitis. Interventions: The patient underwent a initial periodontal therapy, periodontal surgery, endodontic treatment, implant treatment, prosthodontic treatment, soft tissue augmentation procedures during the second stage of implant surgery, and supportive periodontal therapy. Outcomes: The patient showed a healthy periodontal status and stable occlusal function after 5 years of follow-up. Lessons: Multidisciplinary management of generalized stage III grade C periodontitis requires full consideration of systematic periodontal therapy, personalized treatment planning, and patient compliance; in particular, a modified apically positioned flap procedure may serve as an option for soft tissue augmentation at the dental implant site.

Objective: This meta-analysis was conducted to assess the effectiveness of photodynamic therapy (PDT) as an adjunct to conventional mechanical debridement (CMD) for the management of peri-implant mucositis (p-iM). Methods: We systematically searched four databases (PubMed, Embase, Web of Science, and Cochrane Library) for randomized controlled trials (RCTs) investigating PDT + CMD for p-iM from their inception to March 13, 2023. Meta-analysis was performed using RevMan 5.4 software. Results: Seven RCTs met the inclusion criteria. The meta-analysis revealed that PDT + CMD treatment was more effective than CMD alone in reducing probing depth (PD) (Mean Difference [MD]: -1.09, 95% Confidence Interval [CI]: -1.99 to -0.2, P = 0.02) and plaque index (PI) (MD: -2.06, 95% CI: -2.81 to -1.31, P < 0.00001). However, there was no statistically significant difference in the improvement of bleeding on probing (BOP) between the PDT + CMD groups and CMD groups (MD: -0.97, 95% CI: -2.81 to 0.88, P = 0.31). Conclusions: Based on the current available evidence, this meta-analysis indicates that the addition of PDT to CMD significantly improves PD and PI compared to CMD alone in the treatment of p-iM. However, there is no significant difference in improving BOP.

系统性地评价姜黄素治疗口腔黏膜下纤维性变的有效性。 检索Web of Science、PubMed、EBSCO、The Cochrane Library、中国知网、万方和维普7个数据库，检索时限为从建库到2019年6月30日，搜集姜黄素治疗口腔黏膜下纤维性变的随机对照试验，筛选文献，提取数据，用RevMan 5.3软件进行Meta分析。 纳入6个随机对照试验，共350名患者。Meta分析结果显示，姜黄素改善口腔黏膜下纤维性变的最大张口度和烧灼感症状疗效优于安慰剂。改善张口度方面，治疗1个月后，姜黄素疗效不如番茄红素等控制组；但治疗2个月、3个月和6个月后姜黄素组和控制组疗效相似，差异无统计学意义。烧灼感改善方面，治疗3个月后，姜黄素的疗效比控制组更好，且差异有统计学意义；治疗1个月、2个月和6个月后，姜黄素组和控制组的疗效差异无统计学意义。 当前证据显示，姜黄素可以有效地改善口腔黏膜下纤维性变患者的最大张口度和烧灼感等症状。由于纳入研究数量有限和质量不高，上述结论尚需更多高质量研究予以验证。

Background: The purpose of this study is to analyze the registered clinical trials of COVID-19, and to provide a reference for the clinical treatment of COVID-19. Methods: Chinese ClinicalTrial Registry (ChiCTR) and Clinicaltrials.gov databases were searched for clinical trials of COVID-19, which were registered from inception to February 29, 2020, to screen out the clinical trials on the treatment of COVID-19, and the research units and regions, sample size, study types, study stages, and intervention measures were analyzed. Results: There were 226 clinical trials on COVID-19 in the 2 databases, and all of them were registered by research units in China. The top five registered areas were Hubei, Beijing, Shanghai, Guangdong, and Zhejiang. The study type was as follows: interventional study (207, 91.6%) and observational study (18, 8.0%). Clinical trial staging was as follows: exploratory studies/preliminary trials (91, 40.3%), phase I trials (4, 1.8%), phase II trials (12, 5.3%), phase III trials (12, 5.3%), phase IV trials (47, 20.8%), phase I/II trials (2, 0.9%), phase II/III trials (5, 2.2%), and other trials (57, 25.2%). Intervention measures were as follows: there were 143 (63.3%) trials of western medicine treatment, 50 (22.1%) trials of Chinese medicine treatment, and 21 (9.3%) trials of integrated Chinese medicine treatment and western medicine treatment. Conclusion: Researchers have registered a large number of clinical trials in a short time. The number of existing patients of COVID-19 is not enough to support hundreds of clinical trials. There is a lack of multicenter, randomized, double-blind, placebo-controlled trials.

COVID-19 has spread to most countries around the world, infecting millions of people and resulting in the pandemic. This presents great challenges for dental professionals. It is necessary to explore preventive measures for COVID-19 in dental treatments. In this paper, we outline several measures designed to prevent COVID-19 in dental treatments, such as three-level pre-examination triage and two-body temperature tests, three-level protection for medical personnel, gargle before oral treatment, implement the four-hand operation, suctioning saliva during oral treatment, use a rubber dam, strict enforcement of hand hygiene. These measures include recommendations for medical staff and give practical advice for managing treatment. The epidemic has been brought under control and routine oral examination and treatments have gradually been resumed from March 9, 2020, in Hunan province, China. From January 24, 2020, to March 8, 2020, a total of 4,272 patients received oral therapy during the COVID-19 epidemic in our hospital. We followed these guidelines during the COVID-19 epidemic and none of the clinical dental staff, other workers, or patients were infected with COVID-19. These preventive measures for COVID-19 in dental treatments can be used as a reference for oral clinics and stomatological hospitals.

Objectives Explore how to manage oral healthcare during the COVID-19 outbreak. Materials and methods In order to solve oral healthcare during the COVID-19 outbreak, our hospital has taken effective measures: build a team of experts, which provide a 24-h hotline, online video consultation, and online training and push popular science articles on WeChat. For the treatment of emergency patients aside from routine epidemic prevention measures, some special measures for oral treatment need to be added. Results From January 23, 2020, to March 2, 2020, a total of 3035 patients received oral therapy during the COVID-19 epidemic in our hospital. To our knowledge, no oral health worker or patient has been infected with COVID-19 due to oral treatment, and no patients have complained about the suspension of treatment by complaints hotline. Conclusion COVID-19 is a novel challenge for oral healthcare. Attention should be paid to oral healthcare during the outbreak of COVID-19. Clinical relevance These experiences of oral healthcare can be used as a reference by stomatological hospitals and oral clinics during public health emergencies.