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Increased Fluorohydroxyapatite across Dentin after Fluoride Iontophoresis. 氟化物离子注入后牙本质上的氟羟基磷灰石增加
Pub Date : 2024-07-01 Epub Date: 2024-05-29 DOI: 10.1177/00220345241254017
O Ajcharanukul, P Kosakarn, M Sujjapong, S Berkbandee, P Bussabong

Due to the multiple factors contributing to dentin demineralization and hypersensitivity among individuals, the effectiveness of the available treatments in the long term remains unclear. A recent study reported a simple strategy to potentially mimic natural remineralization with increased crystallization on the enamel caries using fluoride iontophoresis. Such an effect is also ideal for accomplishing dentin biomineralization and structural strength. This study aimed to investigate structural and compositional characteristics and permeability changes after fluoride iontophoresis with different polarities, cathodal iontophoresis (CIP), anodal iontophoresis (AIP), and the control without iontophoresis for the treatment of etched dentin under simulated pulpal pressure. The 24 premolars were divided into 3 groups: CIP, AIP, and topical application of 5% sodium fluoride (NaF) for 40 s. Relative to before treatment, iontophoresis with both polarities significantly decreased the permeability with a visible increase in occluding tubules containing crystal formation and growth throughout the dentin structure and depth. The CIP not only restored the etched dentin surface into a sound condition but also reinforced the dentin across the structure and depth by the synergistic effects of remineralization, increasing crystal formation and transformation toward the more crystalline structure of fluorohydroxyapatite. Following topical treatment, X-ray diffraction analysis and Raman spectra revealed a significant reduction in the crystal size and crystallinity associated with the raised B-type carbonate substitution into the hydroxyapatite compared with that in the sound dentin. The result was the first to reveal the ideal strategy to rapidly restore the etched dentin surface into a sound condition, including reinforcing the dentin across the structure and depth by the synergistic effects of decreasing permeability, increasing crystal formation, and transformation toward the more crystalline structure of fluorohydroxyapatite using the 5% NaF applied with the DC cathode iontophoresis. The technique is noninvasive and simple and deserves further development for clinical application.

由于导致牙本质脱矿和个人过敏症的因素多种多样,现有治疗方法的长期有效性仍不明确。最近的一项研究报告了一种简单的策略,即使用氟离子透入疗法,通过增加釉质龋齿的结晶来模拟自然再矿化。这种效果也是实现牙本质生物矿化和结构强度的理想方法。本研究旨在调查不同极性的氟离子透入(阴极离子透入(CIP)、阳极离子透入(AIP)和不使用离子透入的对照组)治疗模拟牙髓压力下蚀刻牙本质后的结构和成分特征以及渗透性变化。24 颗前臼齿分为 3 组:与治疗前相比,两种极性的离子透入疗法都能显著降低渗透性,在整个牙本质结构和深度中,含有晶体形成和生长的闭塞小管明显增加。CIP 不仅能将蚀刻的牙本质表面恢复到良好状态,还能通过再矿化、增加晶体形成和向氟羟基磷灰石晶体结构转化的协同作用,在整个牙本质结构和深度上强化牙本质。局部治疗后,X 射线衍射分析和拉曼光谱显示,与健全牙本质相比,晶体尺寸和结晶度显著减小,这与羟基磷灰石中的 B 型碳酸盐取代度提高有关。该结果首次揭示了将蚀刻牙本质表面快速恢复到健全状态的理想策略,包括通过使用直流阴极离子透入法施加 5%NaF,在降低渗透性、增加晶体形成以及向氟羟磷灰石更多晶体结构转化的协同作用下,在整个牙本质结构和深度上对其进行加固。该技术无创、简单,值得进一步开发用于临床。
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引用次数: 0
Brittle-Ductile Threshold in Lithium Disilicate under Sharp Sliding Contact. 尖锐滑动接触下二硅酸锂的脆性-延展阈值
Pub Date : 2024-07-01 Epub Date: 2024-06-14 DOI: 10.1177/00220345241256279
M Bawazir, C H Lim, P Arnés-Urgellés, M Lu, H Huang, Y Zhang

Computer-aided design (CAD)/computer-aided manufacturing (CAM) milling and handpiece grinding are critical procedures in the fabrication and adjustment of ceramic dental restorations. However, due to the formation of microfractures, these procedures are detrimental to the strength of ceramics. This study analyzes the damage associated with current brittle-regime grinding and presents a potential remedy in the application of a safer yet still efficient grinding regime known as "ductile-regime grinding." Disc-shaped specimens of a lithium disilicate glass-ceramic material (IPS e.max CAD) were obtained by cutting and crystallizing the lithium metasilicate CAD/CAM blanks (the so-called blue blocks) following the manufacturer's instructions. The discs were then polished to a 1 µm diamond suspension finish. Single-particle micro-scratch tests (n = 10) with a conical diamond indenter were conducted to reproduce basic modes of deformation and fracture. Key parameters such as coefficient of friction and penetration depth were recorded as a function of scratch load. Further, biaxial flexure strength tests (n = 6) were performed after applying various scratch loads to analyze their effects on ceramic strength. Scanning electron microscopy (SEM) and focused ion beam (FIB) were used to characterize surface and subsurface damage. Statistical analysis was performed using one-way analysis of variance and Tukey tests. While the SEM surface analysis of scratch tracks revealed the occurrence of both ductile and brittle removal modes, it failed to accurately determine the threshold load for the brittle-ductile transition. The threshold load for brittle-ductile transition was determined to be 70 mN based on FIB subsurface damage analyses in conjunction with strength degradation studies. Below 70 mN, the specimens exhibited neither strength degradation nor the formation of subsurface cracks. Determination of the brittle-ductile thresholds is significant because it sets a foundation for future research on the feasibility of implementing ductile-regime milling/grinding protocols for fabricating damage-free ceramic dental restorations.

计算机辅助设计(CAD)/计算机辅助制造(CAM)铣削和手机研磨是制作和调整陶瓷牙科修复体的关键程序。然而,由于微裂纹的形成,这些程序对陶瓷的强度不利。本研究分析了当前脆性机制研磨所造成的损害,并提出了一种潜在的补救措施,即应用一种更安全但仍然有效的研磨机制,即 "韧性机制研磨"。根据制造商的说明,通过切割和结晶偏硅酸锂 CAD/CAM 坯料(即所谓的蓝块),获得了二硅酸锂玻璃陶瓷材料(IPS e.max CAD)的圆盘状试样。然后将圆盘抛光至 1 µm 的金刚石悬浮表面。使用锥形金刚石压头进行单颗粒微划痕测试(n = 10),以再现变形和断裂的基本模式。记录了摩擦系数和穿透深度等关键参数与划痕载荷的函数关系。此外,在施加各种划痕载荷后还进行了双轴挠曲强度测试(n = 6),以分析它们对陶瓷强度的影响。扫描电子显微镜(SEM)和聚焦离子束(FIB)用于表征表面和次表面损伤。统计分析采用单因子方差分析和 Tukey 检验。虽然扫描电子显微镜(SEM)对划痕痕迹的表面分析表明存在韧性和脆性去除模式,但未能准确确定脆性-韧性转变的阈值载荷。根据结合强度退化研究进行的 FIB 表面下损伤分析,脆性-韧性转变的阈值载荷被确定为 70 mN。低于 70 mN 时,试样既不会出现强度下降,也不会形成表面下裂纹。脆性-韧性阈值的确定具有重要意义,因为它为今后研究实施韧性机制研磨/磨削协议以制造无损伤陶瓷牙科修复体的可行性奠定了基础。
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引用次数: 0
Inflammation Triggers Chondrocyte Ferroptosis in TMJOA via HIF-1α/TFRC. 炎症通过 HIF-1α/TFRC 触发颞下颌关节畸形中的软骨细胞铁凋亡
Pub Date : 2024-07-01 Epub Date: 2024-05-20 DOI: 10.1177/00220345241242389
B Y Chen, J L Pathak, H Y Lin, W Q Guo, W J Chen, G Luo, L J Wang, X F Sun, Y Ding, J Li, T G H Diekwisch, C Liu

Inflammation and loss of articular cartilage are considered the major cause of temporomandibular joint osteoarthritis (TMJOA), a painful condition of the temporomandibular joint (TMJ). To determine the cause of TMJ osteoarthritis in these patients, synovial fluid of TMJOA patients was compared prior to and after hyaluronic lavage, revealing substantially elevated levels of interleukin (IL) 1β, reactive oxidative stress (ROS), and an overload of Fe3+ and Fe2+ prior to lavage, indicative of ferroptosis as a mode of chondrocyte cell death. To ask whether prolonged inflammatory conditions resulted in ferroptosis-like transformation in vitro, we subjected TMJ chondrocytes to IL-1β treatment, resulting in a shift in messenger RNA sequencing gene ontologies related to iron homeostasis and oxidative stress-related cell death. Exposure to rat unilateral anterior crossbite conditions resulted in reduced COL2A1 expression, fewer chondrocytes, glutathione peroxidase 4 (GPX4) downregulation, and 4-hydroxynonenal (4-HNE) upregulation, an effect that was reversed after intra-articular injections of the ferroptosis inhibitor ferrostatin 1 (Fer-1). Our study demonstrated that ferroptosis conditions affected mitochondrial structure and function, while the inhibitor Fer-1 restored mitochondrial structure and the inhibition of hypoxia-inducible factor 1α (HIF-1α) or the transferrin receptor 1 (TFRC) rescued IL-1β-induced loss of mitochondrial membrane potential. Inhibition of HIF-1α downregulated IL-1β-induced TFRC expression, while inhibition of TFRC did not downregulate IL-1β-induced HIF-1α expression in chondrocytes. Moreover, inhibition of HIF-1α or TFRC downregulated the IL-1β-induced MMP13 expression in chondrocytes, while inhibition of HIF-1α or TFRC rescued IL-1β-inhibited COL2A1 expression in chondrocytes. Furthermore, upregulation of TFRC promoted Fe2+ entry into chondrocytes, inducing the Fenton reaction and lipid peroxidation, which in turn caused ferroptosis, a disruption in chondrocyte functions, and an exacerbation of condylar cartilage degeneration. Together, these findings illustrate the far-reaching effects of chondrocyte ferroptosis in TMJOA as a mechanism causing chondrocyte death through iron overload, oxidative stress, and articular cartilage degeneration and a potential major cause of TMJOA.

颞下颌关节骨关节炎(TMJOA)是颞下颌关节(TMJ)的一种疼痛性疾病,炎症和关节软骨损失被认为是其主要原因。为了确定这些患者颞下颌关节骨关节炎的病因,我们比较了透明质酸灌洗前后颞下颌关节骨关节炎患者滑膜液的情况,结果发现白细胞介素(IL)1β、反应性氧化应激(ROS)水平大幅升高,灌洗前Fe3+和Fe2+超负荷,这表明软骨细胞死亡的一种模式是铁变态反应。为了探究长期的炎症条件是否会导致体外的类铁变态反应,我们让颞下颌关节软骨细胞接受IL-1β处理,结果发现与铁平衡和氧化应激相关的细胞死亡有关的信使RNA测序基因本体发生了变化。在大鼠单侧前交叉咬合条件下,COL2A1表达减少,软骨细胞减少,谷胱甘肽过氧化物酶4(GPX4)下调,4-羟基壬烯醛(4-HNE)上调。我们的研究表明,铁变态反应会影响线粒体的结构和功能,而抑制剂 Fer-1 可恢复线粒体结构,抑制缺氧诱导因子 1α(HIF-1α)或转铁蛋白受体 1(TFRC)可挽救 IL-1β 诱导的线粒体膜电位损失。抑制 HIF-1α 会下调 IL-1β 诱导的 TFRC 表达,而抑制 TFRC 不会下调 IL-1β 诱导的 HIF-1α 在软骨细胞中的表达。此外,抑制 HIF-1α 或 TFRC 可下调 IL-1β 诱导的 MMP13 在软骨细胞中的表达,而抑制 HIF-1α 或 TFRC 可挽救 IL-1β 抑制的 COL2A1 在软骨细胞中的表达。此外,TFRC 的上调会促进 Fe2+ 进入软骨细胞,诱导 Fenton 反应和脂质过氧化反应,进而引起铁变态反应、软骨细胞功能紊乱和髁状软骨退化加剧。这些发现共同说明了软骨细胞铁变态反应在 TMJOA 中的深远影响,它是一种通过铁超载、氧化应激和关节软骨变性导致软骨细胞死亡的机制,也是 TMJOA 的潜在主要病因。
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引用次数: 0
Expression of Concern: "Porphyromonas gingivalis Evades Immune Clearance by Regulating Lysosome Efflux". 表达关切:"牙龈卟啉单胞菌通过调节溶酶体外流逃避免疫清除"。
Pub Date : 2024-07-01 Epub Date: 2024-05-23 DOI: 10.1177/00220345241251822
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引用次数: 0
Letter to the Editor, "Cannabinoids and Acute Dental Pain". 致编辑的信,"大麻素与急性牙痛"。
Pub Date : 2024-07-01 Epub Date: 2024-06-18 DOI: 10.1177/00220345241238688
M S Mozaffari
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引用次数: 0
Diagnostic Strategies for Restorations Management: A 70-Month RCT. 修复管理诊断策略:为期 70 个月的临床试验
Pub Date : 2024-07-01 Epub Date: 2024-05-16 DOI: 10.1177/00220345241247773
V H Digmayer Romero, C Signori, J L S Uehara, A F Montagner, F H van de Sande, G S Maydana, E T Chaves, F Schwendicke, M M Braga, M-C Huysmans, F M Mendes, M S Cenci

We aimed to evaluate the impact of 2 visual diagnostic strategies for assessing secondary caries and managing permanent posterior restorations on long-term survival. We conducted a diagnostic cluster-randomized clinical trial with 2 parallel groups using different diagnostic strategies: (C+AS) based on caries assessment, marginal adaptation, and marginal staining aspects of the FDI (World Dental Federation) criteria and (C) based on caries assessment using the Caries Associated with Restorations or Sealants (CARS) criteria described by the International Caries Detection and Assessment System (ICDAS). The treatment for the restoration was conducted based on the decision made following the allocated diagnostic strategy. The restorations were then clinically reevaluated for up to 71 mo. The primary outcome was restoration failure (including tooth-level failure: pain, endodontic treatment, and extraction). Cox regression analyses with shared frailty were conducted in the intention-to-treat population, and hazard ratios (HRs) and 95% confidence intervals (95% CIs) were derived. We included 727 restorations from 185 participants and reassessed 502 (69.1%) restorations during follow-up. The evaluations occurred between 6 and 71 mo. At baseline, C led to almost 4 times fewer interventions compared with the C+AS strategy. A total of 371 restorations were assessed in the C group, from which 31 (8.4%) were repaired or replaced. In contrast, the C+AS group had 356 restorations assessed, from which 113 (31.7%) were repaired or replaced. During follow-up, 34 (9.2%) failures were detected in the restorations allocated to the C group and 30 (8.4%) allocated to the C+AS group in the intention-to-treat population, with no significant difference between the groups (HR = 0.83; 95% CI = 0.51 to 1.38; P = 0.435, C+AS as reference). In conclusion, a diagnostic strategy focusing on marginal defects results in more initial interventions but does not improve longevity over the caries-focused strategy, suggesting the need for more conservative approaches.

我们的目的是评估用于评估继发龋和管理永久性后牙修复体的两种视觉诊断策略对长期存活率的影响。我们进行了一项诊断分组随机临床试验,分为两个平行组,使用不同的诊断策略:(C+AS)基于FDI(世界牙科联盟)标准的龋坏评估、边缘适应性和边缘染色方面;(C)基于国际龋病检测和评估系统(ICDAS)描述的与修复体或封闭剂相关的龋坏(CARS)标准进行龋坏评估。根据所分配的诊断策略做出的决定进行修复治疗。然后对修复体进行长达 71 个月的临床再评估。主要结果是修复失败(包括牙齿层面的失败:疼痛、牙髓治疗和拔牙)。在意向治疗人群中进行了共享虚弱的 Cox 回归分析,得出了危险比 (HR) 和 95% 置信区间 (95%CI)。我们纳入了 185 名参与者的 727 个修复体,并在随访期间重新评估了 502 个(69.1%)修复体。评估时间为 6 至 71 个月。在基线阶段,与 C+AS 策略相比,C 导致的干预减少了近 4 倍。C 组共评估了 371 个修复体,其中 31 个(8.4%)进行了修复或更换。相比之下,C+AS 组共评估了 356 个修复体,其中 113 个(31.7%)进行了修复或更换。在随访期间,在意向治疗人群中,C组和C+AS组分别有34颗(9.2%)和30颗(8.4%)修复体出现失败,组间差异不显著(HR = 0.83; 95% CI = 0.51 to 1.38; P = 0.435,C+AS为参照)。总之,以边缘缺损为重点的诊断策略会导致更多的初始干预,但与以龋齿为重点的策略相比,并不能提高寿命,这表明需要采取更保守的方法。
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引用次数: 0
Orofacial Complications of the Connective Tissue Disease Systemic Sclerosis. 结缔组织病系统性硬化症的口面部并发症。
Pub Date : 2024-07-01 Epub Date: 2024-05-23 DOI: 10.1177/00220345241249408
M Sharma, A Fadl, A Leask

Scleroderma (systemic sclerosis, SSc) is an autoimmune fibrosing connective tissue disease of unknown etiology. SSc patients show increased levels of autoantibodies, profibrotic cytokines, and extracellular matrix remodeling enzymes that collectively cause activated (myo)fibroblasts, the effector cell type of fibrosis. Despite these impacts, no disease-modifying therapy exists; individual symptoms are treated on a patient-to-patient basis. SSc research has been principally focused on symptoms observed in the lung and skin. However, SSc patients display significant oral complications that arise due to fibrosis of the not only skin, causing microstomia, but also the gastrointestinal tract, causing acid reflux, and the oral cavity itself, causing xerostomia and gingival recession. Due to these complications, SSc patients have impaired quality of life, including periodontitis, tooth loss, reduced tongue mobility, and malnutrition. Indeed, due to their characteristic oral presentation, SSc patients are often initially diagnosed by dentists. Despite their clinical importance, the oral complications of SSc are severely understudied; high-quality publications on this topic are scant. However, SSc patients with periodontal complications possess increased levels of matrix metalloproteinase-9 and chemokines, such as interleukin-6 and chemokine (C-X-C motif) ligand-4. Although many unsuccessful clinical trials, mainly exploring the antifibrotic effects of anti-inflammatory agents, have been conducted in SSc, none have used oral symptoms, which may be more amenable to anti-inflammatory drugs, as clinical end points. This review summarizes the current state of knowledge regarding oral complications in SSc with the goal of inspiring future research in this extremely important and underinvestigated area.

硬皮病(系统性硬化症,SSc)是一种病因不明的自身免疫性纤维结缔组织病。SSc 患者体内的自身抗体、促纤维化细胞因子和细胞外基质重塑酶水平升高,共同导致纤维化的效应细胞类型--活化(肌)成纤维细胞。尽管存在这些影响,但目前尚无改变病情的疗法;只能根据患者的不同症状进行治疗。对 SSc 的研究主要集中在肺部和皮肤的症状上。然而,SSc 患者会出现严重的口腔并发症,这不仅是因为皮肤纤维化导致小口畸形,还因为胃肠道纤维化导致胃酸倒流,以及口腔本身纤维化导致口腔干燥和牙龈萎缩。由于这些并发症,SSc 患者的生活质量受到影响,包括牙周炎、牙齿脱落、舌头活动能力下降和营养不良。事实上,由于其特征性的口腔表现,SSc 患者通常由牙医进行初步诊断。尽管 SSc 具有重要的临床意义,但对其口腔并发症的研究却严重不足;有关这一主题的高质量出版物非常少。不过,有牙周并发症的 SSc 患者体内基质金属蛋白酶-9 和白细胞介素-6、趋化因子(C-X-C motif)配体-4 等趋化因子的水平都有所升高。虽然针对 SSc 进行了许多临床试验,主要是探索抗炎药物的抗纤维化作用,但这些试验都没有将口腔症状作为临床终点,而口腔症状可能更适合使用抗炎药物。本综述总结了有关 SSc 口腔并发症的知识现状,旨在激励未来在这一极其重要且研究不足的领域开展研究。
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引用次数: 0
Chronic Phenotypes Underlying Radiation-Induced Salivary Gland Dysfunction. 辐射诱发唾液腺功能障碍的慢性表型。
Pub Date : 2024-07-01 Epub Date: 2024-05-29 DOI: 10.1177/00220345241252396
J A Gunning, K H Limesand

Head and neck cancer (HNC) is the sixth most diagnosed cancer, and treatment typically consists of surgical removal of the tumor followed by ionizing radiation (IR). While excellent at controlling tumor growth, IR often damages salivary glands due to their proximity to common tumor sites. Radiation damage to salivary glands results in loss of secretory function, causing severe and chronic reductions in salivary flow. This leads to the patient-reported sensation of dry mouth, termed xerostomia, which significantly reduces quality of life for HNC patients and survivors. The mechanisms underlying salivary gland damage remain elusive, and therefore, treatment options are scarce. Available therapies provide temporary symptom relief, but there is no standard of care for permanent restoration of function. There is a significant gap in understanding the chronic mechanistic responses to radiation as well as treatments that can be given in the months to years following cessation of treatment. HNC cases are steadily rising; particularly, the number of young patients diagnosed with nonfatal human papillomavirus + HNC continues to increase. The growing number of HNC diagnoses and improved prognoses results in more people living with xerostomia, which highlights the mounting need for restorative treatments. Mechanisms underlying chronic damage include decreases in acinar differentiation markers, increases in acinar cell proliferation, immune and inflammatory dysregulation, and metabolic changes including increases in amino acids and reductions in glycolysis and oxidative phosphorylation, fibrosis, and dysregulated neuronal responses. Currently, promising treatment options include adenoviral gene transfers and stem cell therapy. Thus, this review describes in depth known mechanisms contributing to chronic damage and discusses therapeutic advances in treating chronically damaged glands. Understanding the chronic response to radiation offers potential in development of new therapeutics to reverse salivary gland damage and improve the quality of life of HNC survivors.

头颈癌(HNC)是第六大确诊癌症,治疗方法通常包括手术切除肿瘤,然后进行电离辐射(IR)。虽然电离辐射能很好地控制肿瘤生长,但由于唾液腺靠近常见的肿瘤部位,因此经常会受到损伤。唾液腺受辐射损伤后会丧失分泌功能,导致唾液流量长期严重减少。这导致患者报告的口干感觉,即口腔干燥症,大大降低了 HNC 患者和幸存者的生活质量。唾液腺损伤的内在机制仍然难以捉摸,因此治疗方案也很少。现有疗法能暂时缓解症状,但还没有永久恢复功能的标准疗法。对辐射的慢性机理反应以及停止治疗后数月至数年内的治疗方法的了解还存在很大差距。HNC 病例正在稳步上升;尤其是被诊断患有非致命性人类乳头瘤病毒 + HNC 的年轻患者人数持续增加。HNC 诊断病例的增加和预后的改善导致更多的人患有口腔干燥症,这凸显了对修复性治疗日益增长的需求。慢性损伤的机制包括尖锐湿疣分化标志物减少、尖锐湿疣细胞增殖增加、免疫和炎症失调、代谢变化(包括氨基酸增加、糖酵解和氧化磷酸化减少)、纤维化和神经元反应失调。目前,有希望的治疗方案包括腺病毒基因转移和干细胞疗法。因此,本综述深入阐述了导致慢性损伤的已知机制,并讨论了治疗慢性损伤腺体的疗法进展。了解辐射的慢性反应为开发新的治疗方法以逆转唾液腺损伤和改善HNC幸存者的生活质量提供了可能。
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引用次数: 0
Detecting Mandible Fractures in CBCT Scans Using a 3-Stage Neural Network. 利用三阶段神经网络检测 CBCT 扫描中的下颌骨骨折
Pub Date : 2024-06-24 DOI: 10.1177/00220345241256618
N van Nistelrooij, S Schitter, P van Lierop, K El Ghoul, D König, M Hanisch, A Tel, T Xi, D G E Thiem, R Smeets, L Dubois, T Flügge, B van Ginneken, S Bergé, S Vinayahalingam

After nasal bone fractures, fractures of the mandible are the most frequently encountered injuries of the facial skeleton. Accurate identification of fracture locations is critical for effectively managing these injuries. To address this need, JawFracNet, an innovative artificial intelligence method, has been developed to enable automated detection of mandibular fractures in cone-beam computed tomography (CBCT) scans. JawFracNet employs a 3-stage neural network model that processes 3-dimensional patches from a CBCT scan. Stage 1 predicts a segmentation mask of the mandible in a patch, which is subsequently used in stage 2 to predict a segmentation of the fractures and in stage 3 to classify whether the patch contains any fracture. The final output of JawFracNet is the fracture segmentation of the entire scan, obtained by aggregating and unifying voxel-level and patch-level predictions. A total of 164 CBCT scans without mandibular fractures and 171 CBCT scans with mandibular fractures were included in this study. Evaluation of JawFracNet demonstrated a precision of 0.978 and a sensitivity of 0.956 in detecting mandibular fractures. The current study proposes the first benchmark for mandibular fracture detection in CBCT scans. Straightforward replication is promoted by publicly sharing the code and providing access to JawFracNet on grand-challenge.org.

继鼻骨骨折之后,下颌骨骨折是面部骨骼最常见的损伤。准确识别骨折位置对于有效处理这些损伤至关重要。为了满足这一需求,我们开发了一种创新的人工智能方法--JawFracNet,用于自动检测锥形束计算机断层扫描(CBCT)中的下颌骨骨折。JawFracNet 采用三阶段神经网络模型,处理 CBCT 扫描的三维斑块。第一阶段预测补丁中下颌骨的分割掩模,第二阶段预测骨折的分割,第三阶段对补丁是否包含骨折进行分类。JawFracNet 的最终输出是整个扫描的骨折分割,它是通过汇总和统一体素级和斑块级预测而获得的。本研究共纳入了 164 个无下颌骨骨折的 CBCT 扫描和 171 个有下颌骨骨折的 CBCT 扫描。对 JawFracNet 的评估表明,在检测下颌骨骨折方面,其精确度为 0.978,灵敏度为 0.956。本研究首次提出了在 CBCT 扫描中检测下颌骨骨折的基准。通过在grand-challenge.org网站上公开共享代码和提供JawFracNet的访问权限,促进了直接复制。
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引用次数: 0
Spatial Multi-omics Reveals the Role of the Wnt Modulator, Dkk2, in Palatogenesis'. 空间多组学揭示了 Wnt 调制器 Dkk2 在腭裂发生过程中的作用"。
Pub Date : 2024-06-23 DOI: 10.1177/00220345241256600
J O Piña, R Raju, D M Roth, E W Winchester, C Padilla, J Iben, F R Faucz, J L Cotney, R N D'Souza

Multiple genetic and environmental etiologies contribute to the pathogenesis of cleft palate, which is the most common of the inherited disorders of the craniofacial complex. Insights into the molecular mechanisms regulating osteogenic differentiation and patterning in the palate during embryogenesis are limited and needed for the development of innovative diagnostics and cures. This study used the Pax9-/- mouse model with a consistent phenotype of cleft secondary palate to investigate the role of Pax9 in the process of palatal osteogenesis. Although prior research has identified the upregulation of Wnt pathway modulators Dkk1 and Dkk2 in Pax9-/- palate mesenchyme, limitations of spatial resolution and technology restricted a more robust analysis. Here, data from single-nucleus transcriptomics and chromatin accessibility assays validated by in situ highly multiplex targeted single-cell spatial profiling technology suggest a distinct relationship between Pax9+ and osteogenic populations. Loss of Pax9 results in spatially restricted osteogenic domains bounded by Dkk2, which normally interfaces with Pax9 in the mesenchyme. Moreover, the loss of Pax9 leads to a disruption in the normal osteodifferentiaion of palatal osteogenic mesenchymal cells. These results suggest that Pax9-dependent Wnt signaling modulators influence osteogenic programming during palate formation, potentially contributing to the observed cleft palate phenotype.

腭裂是颅面综合征中最常见的遗传性疾病,多种遗传和环境病因是腭裂的发病机理。目前对胚胎发育过程中调控腭骨分化和模式化的分子机制的了解还很有限,需要开发创新的诊断和治疗方法。本研究使用具有一致继发性腭裂表型的 Pax9-/- 小鼠模型来研究 Pax9 在腭骨生成过程中的作用。虽然之前的研究发现了Pax9-/-腭间质中Wnt通路调节剂Dkk1和Dkk2的上调,但空间分辨率和技术的限制限制了更有力的分析。在这里,通过原位高度多重靶向单细胞空间谱分析技术验证的单核转录组学和染色质可及性测定的数据表明,Pax9+和成骨细胞群之间存在不同的关系。缺失 Pax9 会导致空间受限的成骨域,该域以 Dkk2 为界,而 Dkk2 通常与间充质中的 Pax9 相互连接。此外,Pax9的缺失还导致腭骨成骨间充质细胞的正常成骨分化过程中断。这些结果表明,依赖于Pax9的Wnt信号调节器会影响腭形成过程中的成骨编程,从而可能导致观察到的腭裂表型。
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Journal of dental research
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