Jun Hou

Reconstruction of comminuted Le Fort I fractures is difficult when the tooth-bearing maxilla is divided into multiple fragments and stable skeletal landmarks are limited. The authors describe a hybrid physical-digital planning strategy that uses industrial plasticine as a reversible provisional stabilizer during assembly of 3-dimensionally printed fracture fragments. The dentate fragments are first oriented according to dental arch form, intercuspation, fracture-line morphology, and residual stable anatomy. Small amounts of plasticine are then applied only to the printed models, permitting repeated translation and rotation until the occlusal and skeletal relationships are satisfactory. The reconstructed dentition is digitized to design an occlusal splint that transfers the plan to surgery. The material never contacts the patient, sterile instruments, or the intraoperative splint. In an initial series of 15 patients, the method was feasible for preoperative planning; no infection or nonunion was recorded, although 2 patients had residual occlusal disorder at 6 months. This strategy provides tactile, reversible 3-dimensional planning without claiming the precision of a fully guided, patient-specific reconstruction.

Background/Objectives: Functional outcomes after digitally planned mandibular fracture repair remain incompletely characterized. This study estimated the 12-month frequency of clinician-recorded temporomandibular disorder (TMD) and examined its associations with condylar injury and clinical findings documented at 3 months. Methods: This single-center retrospective cohort included patients treated between September 2021 and June 2023. Of 139 patients eligible after criterion review, 18 (12.9%) lacked an observed 12-month outcome and 121 were analyzed. The endpoint was the treating-team clinical diagnosis after structured symptom review and examination; preserved records did not support full Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I decision rules, subtype assignment, or Axis II instruments. Associations with condylar involvement were estimated using modified-Poisson regression with robust variance; the adjusted model included age, sex, and displacement grade. Associations with 3-month findings were exploratory and multiplicity-controlled. Results: Thirty-three of 121 patients had clinician-recorded TMD at 12 months (27.3%; 95% confidence interval [CI], 20.1–35.8%). TMD occurred in 27 of 47 patients with condylar involvement (57.4%) and 6 of 74 without it (8.1%; risk ratio [RR], 7.09; 95% CI, 3.17–15.86). The adjusted RR was 6.87 (95% CI, 3.06–15.41), with similar results when displacement grade was categorical. Malocclusion, TMJ clicking, TMJ pain, abnormal opening pattern, limited mouth opening, and unilateral chewing at 3 months remained associated after correction (all q ≤ 0.003). Conclusions: Clinician-recorded TMD was concentrated among patients with condylar injury. Associations with early functional abnormalities may reflect persistence or recurrence because several findings overlap with the later endpoint. These data support closer functional surveillance but do not establish causality, independent prediction, or the comparative effectiveness of digital planning.

Objective To assess the performance of a Vision Transformer (ViT)-based deep learning model in classifying oral mucosal diseases (OMD) and to explore the value of the integrated model for clinical support. Design A pilot study that combines publicly available datasets with integrated modelling. Methods Developed an EfficientNet-B0 convolutional neural network and a ViT-B16 model, and tested three integration strategies: average method, weighted method and geometric average method. Evaluation metrics included accuracy, F1 score and inference speed. Diagnostic subject performance was compared between general dentists and oral specialists to validate model efficacy. Results The integrated model outperformed individual models, with the geometric average integration method achieving an accuracy of 94.32%. When used by general dentists, the diagnostic time was reduced from 241 s to 112.4 s, with an accuracy rate of 93%. Conclusions The ViT-enhanced integrated system can improve the classification efficiency of OMD and provide support for non-specialist doctors. However, validation with larger datasets is needed in future research.

Objective: The margin status of oral squamous cell carcinoma patients is considered to be predictive of recurrence and long-term survival. Therefore, precise intraoperative margin assessment is crucial. This study investigated the feasibility of using near-infrared fluorescence imaging technology to guide margin design in oral squamous cell carcinoma patients.Methods: In this retrospective study, indocyanine green solution was intravenously injected preoperatively into patients. Intraoperatively, the surgical area was illuminated using a near-infrared fluorescence imaging system, which caused the lesion to fluoresce in the surgical area. Surgery was performed with the assistance of fluorescence imaging. The fluorescence intensity of the lesion area and surrounding normal tissue was recorded during surgery. Intraoperative margins were sent for rapid pathology, and postoperative margin pathology results were documented.Results: Sixteen patients were included in this study (7 males, 9 females), with an average age of 65.65 ± 12.37 years. Preoperative biopsy and postoperative pathology confirmed oral squamous cell carcinoma in all patients. No cancer cells were found in the margin pathology results. The average fluorescence intensity of the lesion area was 214 ± 4.70, and that of the surrounding normal tissue was 104.63 ± 3.14. There was no significant difference in the fluorescence intensity values of the lesion areas among all patients (F=0.38, P>0.05). There was a significant difference in fluorescence intensity between the lesion area and surrounding normal tissue (t=33.76, P<0.05).Conclusion: Near-infrared fluorescence imaging technology can aid in real-time imaging differentiation of lesion areas based on differences in fluorescence intensity during surgery. The use of this technology can assist surgeons in assessing the safety margin and reliably guide surgery.

Oral squamous cell carcinoma (OSCC) is a common malignancy originating from oral mucosal tissue. OSCC cells employ immune evasion strategies to avoid immune attacks, but research on inhibiting immune evasion and delaying OSCC progression is limited. This study aimed to investigate how SLC3A2 downregulation mediates immune evasion and promotes metastasis in OSCC through bioinformatics analysis and cell experiments. Gene enrichment analysis was performed using human double sulphur death‐related genes from the GSEA database. Differentially expressed genes were selected from the GEO database. Diagnostic models were constructed and validated using gene expression datasets. Immune infiltration and function were analysed through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Cell experiments were conducted to evaluate the impact of SLC3A2 on immune response in OSCC. Ten double sulphur death‐related genes were identified, with SLC3A2 and SLC7A11 being enriched in tongue squamous cell carcinoma‐related diseases. Differential expression analysis revealed five genes (SLC3A2, SLC7A11, RPN1, GYS1 and NDUFS1) of diagnostic significance. GO analysis showed enrichment in amino acid import and transmembrane transport, while KEGG pathway analysis highlighted enrichment in ferroptosis, diabetic cardiomyopathy, and Starch and sucrose metabolism. Experimental verification confirmed higher SLC3A2 expression in OSCC cells. Overexpression of SLC3A2 inhibited cell proliferation and reduced PD‐1 and CTLA‐4 expression. Reduced SLC3A2 expression in OSCC promotes immune evasion and tumour progression by impairing T lymphocyte function. This study provides insights into targeted regulation of SLC3A2 expression for immune response‐based therapies in OSCC.

Objective Restoration of the occlusal relationship is critical in the treatment of maxillofacial fractures. Poor restoration of the occlusal relationship has a serious impact on the patient's oral function and physical and mental health. Materials and Methods This study is based on computer-aided design and manufacturing and aimed to use computed tomography (CT) data to establish a maxillofacial bone model and perform virtual reduction of such fractures. The upper and lower dentition models were established and reconstructed via 3D printing. After the occlusal relationship was determined by the prosthodontist using the model, the occlusal relationship was obtained through an oral three-dimensional scanner. Based on the reconstructed occlusal relationship, an occlusal reduction guide plate was designed and manufactured to precisely reduce the occlusal relationship in patients with maxillofacial fractures. Results This study proposes a design process for occlusal guides for maxillofacial fractures that optimizes the traditional surgical processes and enhances surgical convenience. Conclusion This study presents new ideas for the design of personalized surgical guides for maxillofacial fractures. Clinical Relevance: The application of the occlusal guide can assist the surgeon to accurately reset the occlusal relationship and fix the occlusal relationship, which can significantly improve the operation efficiency.