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Fissure Sealants or Fluoride Varnish? A Randomized Pragmatic Split-Mouth Trial. 窝沟封闭剂还是氟化物清漆?随机务实分口试验
Pub Date : 2024-07-01 Epub Date: 2024-05-08 DOI: 10.1177/00220345241248630
M-M Uhlen-Strand, L Stangvaltaite-Mouhat, I Mdala, I Volden Klepaker, N J Wang, R Skudutyte-Rysstad

This study aimed to compare the clinical effectiveness of resin-based fissure sealants (FS) and fluoride varnish (FV) in children at high caries risk. A practice-based split-mouth randomized clinical trial was conducted at 9 Public Dental Service (PDS) clinics in Norway. In total, 409 children age 6 to 10 y at high caries risk (d3mft > 0) meeting inclusion criteria were recruited by dentists and dental hygienists during routine examination. Eligibility criteria were 2 fully erupted first permanent molars (FPMs) in the same jaw, with sound occlusal surfaces or with initial caries. Participation was voluntary, caregivers and eligible children were informed about the study, and written parental consent was obtained. FS and FV were randomly applied on contralateral FPMs in the same jaw, with each participant serving as their own control. FS was applied at baseline and thereafter maintained according to clinicians' conventional procedures, whereas FV was applied at baseline, 6 mo, and 12 mo. The study outcome was success, with no need for invasive treatment (caries control), while failure was defined as dentin carious lesion or restoration. Two-level mixed-effects logistic regression analysis was used to compare FS and FV groups. Of 409 recruited children, 369 (90%) children/tooth pairs were examined after 36 mo. Intention-to-treat analysis showed 94.1% adjusted predicted probability (aPP) of success (95% confidence interval [CI] 91.7 to 96.4) in the FS group and 89.6% aPP (95% CI 86.5 to 92.7) in the FV group. In the adjusted analysis, the FV group had a lower OR for success compared with the FS group (OR 0.54, 95% CI 0.24 to 0.87). In the population studied, the clinical effectiveness of FS was statistically significantly higher compared with FV but below the estimated minimal clinically important difference of 10%.

这项研究旨在比较树脂基窝沟封闭剂(FS)和氟化物清漆(FV)对高龋病风险儿童的临床效果。在挪威的9家公共牙科服务(PDS)诊所开展了一项基于实践的分口随机临床试验。牙医和牙科保健师在进行常规检查时,共招募了 409 名符合纳入标准的 6-10 岁龋齿高危儿童(d3mft > 0)。资格标准是同一颌骨内有两颗完全萌出的第一恒磨牙(FPM),咬合面完好或有初期龋齿。参与研究属自愿性质,护理人员和符合条件的儿童均已被告知研究内容,并已获得家长的书面同意。FS和FV随机应用于同一颌骨的对侧FPM,每个参与者作为自己的对照。FS在基线时使用,之后按照临床医生的常规程序进行维护,而FV则在基线、6个月和12个月时使用。研究结果为成功,即无需进行侵入性治疗(龋病控制),而失败则定义为牙本质龋损或修复。两级混合效应逻辑回归分析用于比较 FS 组和 FV 组。意向治疗分析显示,FS 组的成功调整预测概率(aPP)为 94.1%(95% 置信区间 [CI] 91.7 至 96.4),FV 组的成功调整预测概率(aPP)为 89.6%(95% 置信区间 [CI] 86.5 至 92.7)。在调整分析中,与 FS 组相比,FV 组的成功率较低(OR 0.54,95% CI 0.24 至 0.87)。在所研究的人群中,与 FV 相比,FS 的临床有效性在统计学上明显更高,但低于 10% 的最小临床重要性差异。
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引用次数: 0
Response to the Letter to the Editor, "Cannabinoids and Acute Dental Pain". 回应致编辑的信 "大麻素与急性牙痛"。
Pub Date : 2024-07-01 Epub Date: 2024-06-18 DOI: 10.1177/00220345241252118
V Chrepa, S Villasenor, A Mauney, G Kotsakis, L Macpherson
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引用次数: 0
Corrigendum to "Cannabidiol as an Alternative Analgesic for Acute Dental Pain". 大麻二酚作为急性牙痛的替代镇痛剂 "的更正。
Pub Date : 2024-07-01 Epub Date: 2024-06-18 DOI: 10.1177/00220345241257653
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引用次数: 0
Salivary Gland Tissue Recombination Can Modify Cell Fate. 唾液腺组织重组可改变细胞命运
Pub Date : 2024-07-01 Epub Date: 2024-05-07 DOI: 10.1177/00220345241247484
R Sekiguchi, D Martin, A D Doyle, S Wang, K M Yamada

Although mesenchyme is essential for inducing the epithelium of ectodermal organs, its precise role in organ-specific epithelial fate determination remains poorly understood. To elucidate the roles of tissue interactions in cellular differentiation, we performed single-cell RNA sequencing and imaging analyses on recombined tissues, where mesenchyme and epithelium were switched ex vivo between two types of embryonic mouse salivary glands: the parotid gland (a serous gland) and the submandibular gland (a predominantly mucous gland). We found partial induction of molecules that define gland-specific acinar and myoepithelial cells in recombined salivary epithelium. The parotid epithelium recombined with submandibular mesenchyme began to express mucous acinar genes not intrinsic to the parotid gland. While myoepithelial cells do not normally line parotid acini, newly induced myoepithelial cells densely populated recombined parotid acini. However, mucous acinar and myoepithelial markers continued to be expressed in submandibular epithelial cells recombined with parotid mesenchyme. Consequently, some epithelial cells appeared to be plastic, such that their fate could still be modified in response to mesenchymal signaling, whereas other epithelial cells appeared to be already committed to a specific fate. We also discovered evidence for bidirectional induction: transcriptional changes were observed not only in the epithelium but also in the mesenchyme after heterotypic tissue recombination. For example, parotid epithelium induced the expression of muscle-related genes in submandibular fibroblasts that began to mimic parotid fibroblast gene expression. These studies provide the first comprehensive unbiased molecular characterization of tissue recombination approaches exploring the regulation of cell fate.

尽管间充质对诱导外胚层器官的上皮至关重要,但其在器官特异性上皮命运决定中的确切作用仍鲜为人知。为了阐明组织相互作用在细胞分化中的作用,我们对重组组织进行了单细胞 RNA 测序和成像分析,在两种类型的胚胎小鼠唾液腺:腮腺(浆液腺)和颌下腺(主要是粘液腺)之间,间充质和上皮进行了体外交换。我们发现,在重组的唾液腺上皮细胞中,部分诱导了确定腺体特异性针状细胞和肌上皮细胞的分子。与颌下腺间质重组的腮腺上皮开始表达非腮腺固有的粘液性尖腺基因。虽然肌上皮细胞通常并不排列在腮腺尖部,但新诱导的肌上皮细胞密集地排列在重组的腮腺尖部。然而,在与腮腺间质重组的颌下腺上皮细胞中,粘液性尖锐湿疣和肌上皮标记物继续表达。因此,一些上皮细胞似乎具有可塑性,它们的命运仍可随着间质信号的传递而改变,而其他上皮细胞则似乎已经确定了特定的命运。我们还发现了双向诱导的证据:异型组织重组后,不仅上皮细胞,间质细胞也发生了转录变化。例如,腮腺上皮诱导了颌下腺成纤维细胞中肌肉相关基因的表达,这些成纤维细胞开始模仿腮腺成纤维细胞的基因表达。这些研究首次对探索细胞命运调控的组织重组方法进行了全面、无偏见的分子鉴定。
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引用次数: 0
We Are the Ones Who Make a Brighter Day. So, Let's Start Research!! 我们是创造美好生活的人。因此,让我们开始研究吧
Pub Date : 2024-07-01 Epub Date: 2024-05-29 DOI: 10.1177/00220345241253781
S Imazato
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引用次数: 0
Molecular Signatures of Senescence in Periodontitis: Clinical Insights. 牙周炎中衰老的分子特征:临床见解。
Pub Date : 2024-07-01 Epub Date: 2024-06-14 DOI: 10.1177/00220345241255325
K Rattanaprukskul, X-J Xia, M Jiang, E Albuquerque-Souza, D Bandyopadhyay, S E Sahingur

Most of the elderly population is afflicted by periodontal diseases, creating a health burden worldwide. Cellular senescence is one of the hallmarks of aging and associated with several chronic comorbidities. Senescent cells produce a variety of deleterious secretions, collectively termed the senescence-associated secretory phenotype (SASP). This disrupts neighboring cells, leading to further senescence propagation and inciting chronic inflammation, known as "inflammaging." Detrimental repercussions within the tissue microenvironment can trigger senescence at a younger age, accelerate biological aging, and drive the initiation or progression of diseases. Here, we investigated the biological signatures of senescence in healthy and diseased gingival tissues by assessing the levels of key senescence markers (p16, lipofuscin, and β-galactosidase) and inflammatory mediators (interleukin [IL]-1β, IL-6, IL-8, matrix metalloproteinase [MMP]-1, MMP-3, and tumor necrosis factor-α). Our results showed significantly increased senescence features including p16, lipofuscin, and β-galactosidase in both epithelial and connective tissues of periodontitis patients compared with healthy sites in all age groups, indicating that an inflammatory microenvironment can trigger senescence-like alterations in younger diseased gingival tissues as well. Subsequent analyses using double staining with specific cell markers noted the enrichment of β-galactosidase in fibroblasts and macrophages. Concurrently, inflammatory mediators consistent with SASP were increased in the gingival biopsies obtained from periodontitis lesions. Together, our findings provide the first clinical report revealing susceptibility to elevated senescence and inflammatory milieu consistent with senescence secretome in gingival tissues, thus introducing senescence as one of the drivers of pathological events in the oral mucosa and a novel strategy for targeted interventions.

大多数老年人都患有牙周病,给全世界的健康造成了负担。细胞衰老是衰老的标志之一,与多种慢性并发症有关。衰老细胞会产生多种有害分泌物,统称为衰老相关分泌表型(SASP)。这会破坏邻近细胞,导致衰老进一步扩散,并引发慢性炎症,即所谓的 "炎症"。组织微环境中的有害反响可在较年轻时触发衰老,加速生物衰老,并推动疾病的发生或发展。在这里,我们通过评估关键衰老标志物(p16、脂质褐素和β-半乳糖苷酶)和炎症介质(白细胞介素[IL]-1β、IL-6、IL-8、基质金属蛋白酶[MMP]-1、MMP-3 和肿瘤坏死因子-α)的水平,研究了健康和患病牙龈组织中衰老的生物学特征。我们的研究结果表明,与所有年龄组的健康部位相比,牙周炎患者上皮组织和结缔组织的衰老特征(包括 p16、脂褐素和 β-半乳糖苷酶)均明显增加,这表明炎症微环境也会引发年轻病变牙龈组织的衰老样改变。随后使用特异性细胞标记物进行双重染色分析发现,β-半乳糖苷酶在成纤维细胞和巨噬细胞中富集。同时,从牙周炎病变中获取的牙龈活检组织中与 SASP 一致的炎症介质也有所增加。总之,我们的研究结果提供了第一份临床报告,揭示了牙龈组织易受衰老和炎症环境升高的影响,这与衰老分泌组一致,因此衰老是口腔黏膜病理事件的驱动因素之一,也是有针对性干预的新策略。
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引用次数: 0
METTL3 Modulates Ctsk+ Lineage Supporting Cranial Osteogenesis via Hedgehog. METTL3通过刺猬调节支持颅骨生成的Ctsk+系谱
Pub Date : 2024-07-01 Epub Date: 2024-05-16 DOI: 10.1177/00220345241245033
R Xu, R Sheng, W Lin, S Jiang, D Zhang, L Liu, K Lei, X Li, Z Liu, X Zhang, Y Wang, D Seriwatanachai, X Zhou, Q Yuan

N6-methyladenosine (m6A) modification, a eukaryotic messenger RNA modification catalyzed by methyltransferase-like 3 (METTL3), plays a pivotal role in stem cell fate determination. Calvarial bone development and maintenance are orchestrated by the cranial sutures. Cathepsin K (CTSK)-positive calvarial stem cells (CSCs) contribute to mice calvarial ossification. However, the role of m6A modification in regulating Ctsk+ lineage cells during calvarial development remains elusive. Here, we showed that METTL3 was colocalized with cranial nonosteoclastic Ctsk+ lineage cells, which were also associated with GLI1 expression. During neonatal development, depletion of Mettl3 in the Ctsk+ lineage cells delayed suture formation and decreased mineralization. During adulthood maintenance, loss of Mettl3 in the Ctsk+ lineage cells impaired calvarial bone formation, which was featured by the increased bone porosity, enhanced bone marrow cavity, and decreased number of osteocytes with the less-developed cellular outline. The analysis of methylated RNA immunoprecipitation sequencing and RNA sequencing data indicated that loss of METTL3 reduced Hedgehog (Hh) signaling pathway. Restoration of Hh signaling pathway by crossing Sufufl/+ alleles or by local administration of SAG21 partially rescued the abnormity. Our data indicate that METTL3 modulates Ctsk+ lineage cells supporting calvarial bone formation by regulating the Hh signaling pathway, providing new insights for clinical treatment of skull vault osseous diseases.

N6-甲基腺苷(m6A)修饰是由甲基转移酶样3(METTL3)催化的真核信使RNA修饰,在干细胞命运决定中起着关键作用。颅骨的发育和维持由颅缝协调。Cathepsin K(CTSK)阳性的钙质干细胞(CSCs)有助于小鼠钙质骨化。然而,m6A修饰在调控钙骨发育过程中Ctsk+系细胞的作用仍不明确。在这里,我们发现 METTL3 与颅骨非骨形成的 Ctsk+ 系细胞共定位,这些细胞也与 GLI1 的表达有关。在新生儿发育过程中,Ctsk+系细胞中的Mettl3缺失会延迟缝合线的形成并降低矿化度。在成年期的维持过程中,Ctsk+系细胞中Mettl3的缺失会影响犊骨的形成,其特点是骨孔隙率增加、骨髓腔增大、骨细胞数量减少且细胞轮廓不发达。甲基化 RNA 免疫沉淀测序和 RNA 测序数据的分析表明,METTL3 的缺失减少了 Hedgehog(Hh)信号通路。通过杂交 Sufufl/+ 等位基因或局部注射 SAG21 恢复 Hh 信号通路可部分缓解异常。我们的数据表明,METTL3通过调节Hh信号通路来调节支持钙骨形成的Ctsk+系细胞,为临床治疗颅顶骨疾病提供了新的思路。
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引用次数: 0
Deep Learning-Based Facial and Skeletal Transformations for Surgical Planning. 基于深度学习的面部和骨骼变换手术规划。
Pub Date : 2024-07-01 Epub Date: 2024-05-29 DOI: 10.1177/00220345241253186
J Bao, X Zhang, S Xiang, H Liu, M Cheng, Y Yang, X Huang, W Xiang, W Cui, H C Lai, S Huang, Y Wang, D Qian, H Yu

The increasing application of virtual surgical planning (VSP) in orthognathic surgery implies a critical need for accurate prediction of facial and skeletal shapes. The craniofacial relationship in patients with dentofacial deformities is still not understood, and transformations between facial and skeletal shapes remain a challenging task due to intricate anatomical structures and nonlinear relationships between the facial soft tissue and bones. In this study, a novel bidirectional 3-dimensional (3D) deep learning framework, named P2P-ConvGC, was developed and validated based on a large-scale data set for accurate subject-specific transformations between facial and skeletal shapes. Specifically, the 2-stage point-sampling strategy was used to generate multiple nonoverlapping point subsets to represent high-resolution facial and skeletal shapes. Facial and skeletal point subsets were separately input into the prediction system to predict the corresponding skeletal and facial point subsets via the skeletal prediction subnetwork and facial prediction subnetwork. For quantitative evaluation, the accuracy was calculated with shape errors and landmark errors between the predicted skeleton or face with corresponding ground truths. The shape error was calculated by comparing the predicted point sets with the ground truths, with P2P-ConvGC outperforming existing state-of-the-art algorithms including P2P-Net, P2P-ASNL, and P2P-Conv. The total landmark errors (Euclidean distances of craniomaxillofacial landmarks) of P2P-ConvGC in the upper skull, mandible, and facial soft tissues were 1.964 ± 0.904 mm, 2.398 ± 1.174 mm, and 2.226 ± 0.774 mm, respectively. Furthermore, the clinical feasibility of the bidirectional model was validated using a clinical cohort. The result demonstrated its prediction ability with average surface deviation errors of 0.895 ± 0.175 mm for facial prediction and 0.906 ± 0.082 mm for skeletal prediction. To conclude, our proposed model achieved good performance on the subject-specific prediction of facial and skeletal shapes and showed clinical application potential in postoperative facial prediction and VSP for orthognathic surgery.

虚拟手术规划(VSP)在正颌外科手术中的应用越来越广泛,这意味着准确预测面部和骨骼形状的需求非常迫切。由于面部软组织和骨骼之间错综复杂的解剖结构和非线性关系,颌面部畸形患者的颅颌面关系仍不为人所知,面部和骨骼形状之间的转换仍是一项具有挑战性的任务。本研究基于大规模数据集,开发并验证了一种名为 P2P-ConvGC 的新型双向三维(3D)深度学习框架,可实现面部和骨骼形状之间的精确转换。具体来说,该框架采用两阶段点采样策略生成多个非重叠点子集,以表示高分辨率的面部和骨骼形状。面部和骨骼点子集分别输入预测系统,通过骨骼预测子网络和面部预测子网络预测相应的骨骼和面部点子集。在定量评估中,准确度是根据预测的骨骼或面部与相应的地面实况之间的形状误差和地标误差来计算的。形状误差是通过比较预测点集和地面实况计算得出的,P2P-ConvGC 优于现有的最先进算法,包括 P2P-Net、P2P-ASNL 和 P2P-Conv。P2P-ConvGC 在上颅骨、下颌骨和面部软组织的总地标误差(颅颌面地标欧氏距离)分别为 1.964 ± 0.904 mm、2.398 ± 1.174 mm 和 2.226 ± 0.774 mm。此外,双向模型的临床可行性还通过临床队列进行了验证。结果表明,该模型的预测能力很强,面部预测的平均表面偏差误差为 0.895 ± 0.175 毫米,骨骼预测的平均表面偏差误差为 0.906 ± 0.082 毫米。总之,我们提出的模型在特定对象的面部和骨骼形状预测方面取得了良好的性能,并在正颌手术的术后面部预测和 VSP 方面显示出了临床应用潜力。
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引用次数: 0
Recent Advances in Digital Technology in Implant Dentistry. 种植牙数字技术的最新进展。
Pub Date : 2024-07-01 Epub Date: 2024-05-31 DOI: 10.1177/00220345241253794
J Wang, B Wang, Y Y Liu, Y L Luo, Y Y Wu, L Xiang, X M Yang, Y L Qu, T R Tian, Y Man

Digital technology has emerged as a transformative tool in dental implantation, profoundly enhancing accuracy and effectiveness across multiple facets, such as diagnosis, preoperative treatment planning, surgical procedures, and restoration delivery. The multiple integration of radiographic data and intraoral data, sometimes with facial scan data or electronic facebow through virtual planning software, enables comprehensive 3-dimensional visualization of the hard and soft tissue and the position of future restoration, resulting in heightened diagnostic precision. In virtual surgery design, the incorporation of both prosthetic arrangement and individual anatomical details enables the virtual execution of critical procedures (e.g., implant placement, extended applications, etc.) through analysis of cross-sectional images and the reconstruction of 3-dimensional surface models. After verification, the utilization of digital technology including templates, navigation, combined techniques, and implant robots achieved seamless transfer of the virtual treatment plan to the actual surgical sites, ultimately leading to enhanced surgical outcomes with highly improved accuracy. In restoration delivery, digital techniques for impression, shade matching, and prosthesis fabrication have advanced, enabling seamless digital data conversion and efficient communication among clinicians and technicians. Compared with clinical medicine, artificial intelligence (AI) technology in dental implantology primarily focuses on diagnosis and prediction. AI-supported preoperative planning and surgery remain in developmental phases, impeded by the complexity of clinical cases and ethical considerations, thereby constraining widespread adoption.

数字技术已成为牙科种植领域的变革性工具,可在诊断、术前治疗规划、手术过程和修复交付等多个方面显著提高准确性和有效性。通过虚拟规划软件将放射影像数据和口内数据(有时还包括面部扫描数据或电子面弓)进行多重整合,可实现软硬组织和未来修复体位置的全面三维可视化,从而提高诊断精度。在虚拟手术设计中,通过分析横截面图像和重建三维表面模型,结合修复体的排列和个体解剖细节,可以虚拟执行关键程序(如植入、扩展应用等)。经过验证后,利用包括模板、导航、组合技术和种植机器人在内的数字技术,实现了虚拟治疗方案与实际手术部位的无缝对接,最终提高了手术效果和准确性。在修复服务方面,印模、色调匹配和修复体制作的数字化技术不断进步,实现了无缝数字数据转换以及临床医生和技术人员之间的高效沟通。与临床医学相比,人工智能(AI)技术在牙科种植中的应用主要集中在诊断和预测方面。人工智能支持的术前规划和手术仍处于发展阶段,受到临床病例的复杂性和伦理因素的阻碍,从而限制了其广泛应用。
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引用次数: 0
The Role of Pericyte Migration and Osteogenesis in Periodontitis. 牙周膜迁移和骨生成在牙周炎中的作用。
Pub Date : 2024-07-01 Epub Date: 2024-05-31 DOI: 10.1177/00220345241244687
Y Cao, Q Ni, C Bao, C Cai, T Wang, X Ruan, Y Li, H Wang, R Wang, W Sun

A ligature-induced periodontitis model was established in wild-type and CD146CreERT2; RosatdTomato mice to explore the function of pericytes in alveolar bone formation. We found that during periodontitis progression and periodontal wound healing, CD146+/NG2+ pericytes were enriched in the periodontal tissue areas, which could migrate to the alveolar bone surface and colocalize with ALP+/OCN+ osteoblasts. Chemokine C-X-C motif receptor 4 (CXCR4) inhibition using AMD3100 blocked CD146-Cre+ pericyte migration and osteogenesis, as well as further exacerbated periodontitis-associated bone loss. Next, primary pericytes were sorted out by magnetic-activated cell sorting and demonstrated that C-X-C motif chemokine ligand 12 (CXCL12) promotes pericyte migration and osteogenesis via CXCL12-CXCR4-Rac1 signaling. Finally, the local administration of an adeno-associated virus for Rac1 overexpression in NG2+ pericytes promotes osteoblast differentiation of pericytes and increases alveolar bone volume in periodontitis. Thus, our results provided the evidence that pericytes may migrate and osteogenesis via the CXCL12-CXCR4-Rac1 axis during the pathological process of periodontitis.

为了探索周细胞在牙槽骨形成中的功能,我们在野生型小鼠和CD146CreERT2; RosatdTomato小鼠中建立了结扎诱导的牙周炎模型。我们发现,在牙周炎进展和牙周伤口愈合过程中,CD146+/NG2+周细胞在牙周组织区域富集,它们可以迁移到牙槽骨表面并与ALP+/OCN+成骨细胞共定位。使用AMD3100抑制趋化因子C-X-C受体4(CXCR4)可阻断CD146-Cre+周细胞的迁移和成骨,并进一步加剧牙周炎相关骨质流失。接着,用磁激活细胞分选法分选出原发性周细胞,并证明 C-X-C motif趋化因子配体 12(CXCL12)通过 CXCL12-CXCR4-Rac1 信号传导促进周细胞迁移和成骨。最后,在局部注射腺相关病毒使 Rac1 在 NG2+周细胞中过度表达,可促进周细胞的成骨细胞分化,并增加牙周炎患者的牙槽骨体积。因此,我们的研究结果为牙周炎病理过程中周细胞可能通过CXCL12-CXCR4-Rac1轴迁移和成骨提供了证据。
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引用次数: 0
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Journal of dental research
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