Vital pulp therapy (VPT) is a critical approach for preserving the function and vitality of mature permanent teeth. Current diagnostic paradigms are progressively shifting toward dynamic evaluation of pulp inflammatory status and reparative potential. However, clinical symptoms of affected teeth often diverge from true histopathological conditions, leading to uncertainties in determining pulp preservation extent and the prognosis during VPT, which poses challenges for precise treatment of irreversible pulpitis. This article systematically reviews the clinical diagnosis of VPT in cases of irreversible pulpitis, relevant molecular biomarkers, the role of pulp capping materials, and advances in prognostic evaluation, with the aim of providing evidence-based references for the precise clinical implementation of VPT.

To evaluate the feasibility and clinical value of vital pulp therapy in the treatment of chronic hyperplastic pulpitis in young permanent teeth.

The pulpotomy was used in two cases of young permanent teeth with chronic hyperplastic pulpitis. Combined with literature review, the pathological basis, indications, key operational points, and restorative strategies were discussed.

After a follow-up of 12 to 30 months, the two teeth maintained favorable pulp vitality. Radiographic examination revealed no periapical abnormalities, and continued root development was observed in case 2.

Under strict indication control, vital pulp therapy provides a minimally invasive and effective treatment option for chronic hyperplastic pulpitis in young permanent teeth, which helps preserve pulp vitality and promote root development.

Root fracture represents a severe form of dental trauma, particularly in young permanent teeth. It often leads to displacement of the coronal fragment, compromising the blood supply of dental pulp. Improper management can readily result in complications such as pulp necrosis and inflammatory root resorption, ultimately affecting the long-term survival of the tooth. This article reports a complex case of an 8-year-old male patient with multiple horizontal root fractures accompanied by coronal displacement in the maxillary central incisors. Through a comprehensive conservative approach utilizing resin-reinforced fiber tape for flexible splinting, supplemented by occlusal adjustment and a protective splint, the affected teeth achieved favorable biological healing over a 2-year follow-up period. Although diffuse pulp canal obliteration occurred in the involved teeth, clinical examination revealed no abnormalities and their functional status was good.

This case report presents a successful case of autologous tooth transplantation assisted by three-dimensional (3D) printing technology combined with delayed partial pulpotomy. Preoperative cone-beam computed tomography (CBCT) data of the patient were collected, and Mimics software was used to design and construct a 3D template for the transplanted tooth. After disinfection, the template was used to guide the preparation of the alveolar socket at the recipient site. Following the extraction of the hopeless tooth, the recipient socket was prepared with the aid of the template. 3D printing-assisted digital surgery enabled accurate preparation of the recipient site, reduced the extraoral time of the transplanted tooth, and preserved the viability of the periodontal membrane. The physical dimension of the apical foramen is a critical determinant of revascularization of the transplanted dental pulp. In this case, the apical foramen diameters of the mesial and distal roots were 0.68 mm and 0.91 mm, respectively. Postoperatively, vital pulp preservation was achieved in the distal root with a larger apical foramen. This case provides a novel clinical reference for vital pulp preservation during mature autologous permanent tooth transplantation.

Mechanotransduction is a biological process through which cells perceive mechanical signals from the microenvironment via mechanoreceptors and convert them into intracellular biochemical signals to regulate cellular behavior. In vital pulp preservation therapy, the directional differentiation of dental pulp stem cells (DPSCs) is a critical step for the regeneration of the pulp-dentin complex. Recent studies have shown that mechanical signals in the microenvironment can significantly regulate the odontogenic differentiation of DPSCs through mechanotransduction mechanisms. This article systematically elucidates the perception and transduction mechanisms of mechanical signals, analyzes the regulatory effects of these signals on the behavior of DPSCs, and summarizes the current deficiencies of pulp capping materials in active regulation, as well as the application prospects of bioactive materials designed based on mechanical signal regulation for promoting the functional regeneration of the pulp-dentin complex. Future research should focus on constructing material systems that integrate mechanical and biochemical regulation, shifting the design of pulp capping materials from passive coverage to active mechanical guidance, thereby providing new strategies for achieving structurally and functionally integrated vital pulp preservation.

To explore the risk factors between the extraction of the mandibular third molars (M3M) and the injury of the inferior alveolar nerve (IAN), and to construct a preoperative risk evaluation model for M3M extraction.

From January 2023 to December 2024, a total of 724 M3Ms extracted at the Hospital of Stomatology, Sun Yat-sen University were retrospectively enrolled in this study. The subjects were divided into the IAN injury group and the non-IAN injury group based on whether IAN injury occurred after M3M extraction. Chi-square test was used to compare the clinical characteristic indicators between the two groups. Univariate and multivariate logistic regression analyses were conducted to explore the risk factors between M3M extraction and IAN injury.

Chi-square test showed statistically significant differences between the two groups, including age, gender, M3M impaction depth, M3M root curvature, relative position of the inferior alveolar canal (IAC), IAC morphology, and IAN exposure. Univariate logistic regression analysis indicated that these indicators were independent risk factors for IAN injury. Multivariate logistic regression analysis revealed that patients aged 30 or above had a higher risk of IAN injury than those under 30 (OR = 2.250) ; female patients had a higher risk of IAN injury than male patients (OR = 3.223) ; the deeper the M3M impaction, the higher the risk of IAN injury (OR = 2.977) ; curved roots had a higher risk of IAN injury than non-curved roots (OR = 3.875) ; the risk of IAN injury was lower when the nerve was located on the lingual side of M3M than on the buccal side (OR = 0.263) ; the closer the root was to the IAC, the higher the risk of IAN injury (OR = 1.942) ; and IAN exposure after M3M extraction increased the risk of IAN injury (OR = 5.566). Based on the predictive values of multivariate logistic regression analysis, a ROC curve was drawn, with an AUC of 0.861, a sensitivity of 0.843, and a specificity of 0.789.

Female patients over 30 years old and the dumbbell-shaped IAC located on the lingual side of the low-positioned impacted M3M should be regarded as high-risk cases for IAN injury. If M3M root curvature and IAN exposure after extraction are also found, the risk of IAN injury would be even higher after M3M extraction.

To retrospectively evaluate the 5-year survival rate of abutment teeth and identify prognostic factors in patients with moderate-to-severe reduced dentition and periodontal disease of residual teeth after receiving removable partial dentures retained by telescopic crowns.

A total of 126 patients (150 dentures, 471 abutment teeth) who underwent telescopic denture restoration for moderate-to-severe reduced dentition with periodontal disease of residual teeth at Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University between January 2012 and January 2022 were included. The 5-year survival rate of abutment teeth was calculated via the Kaplan-Meier method. The Log-rank test and Cox proportional hazards regression model were utilized to evaluate the effects of abutment distribution (linear sagittal support/linear transverse support, triangular support, quadrilateral support), tooth mobility, regular follow-up, age, gender, and jaw position on abutment survival.

The 5-year cumulative survival rate of all abutment teeth was 83.00% (95% CI: 78.93%-87.28%). No significant difference was found among different abutment distributions (χ² = 2.872, P = 0.412). Grade Ⅲ mobile abutments had a significantly lower 5-year survival rate than Grade Ⅰ/Ⅱ (χ² = 13.461, P = 0.001). Patients with regular follow-up showed significantly higher survival rate than non-regular follow-up counterparts (χ² = 9.176, P = 0.002) .

In the restoration of moderate-to-severe reduced dentition combined with periodontal disease of residual teeth, the 5-year survival rate of abutment teeth for telescopic dentures is generally acceptable. Higher mobility increases the risk of failure, while regular follow-up helps improve the long-term survival rate of abutment teeth. It is recommended that the mobility of abutment teeth be comprehensively evaluated in the repair design and that the management of follow-up compliance be strengthened.

The displacement of a dental bur during impacted tooth extraction and migration to the duodenum is a rare clinical complication. This article reports a case of accidental swallowing and displacement of a dental bur to the duodenum during impacted tooth extraction, and reviews the risk factors, diagnosis, management strategies, and preventive measures based on literature analysis, providing reference for clinical prevention.

Head and neck cancer (HNC) is a prevalent malignancy worldwide. Notably, oral squamous cell carcinoma (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC) are characterized by a high incidence rate and garner significant clinical attention within the field of oral and maxillofacial surgery. Constrained by the heterogeneity of therapeutic responses and drug resistance, the overall survival rate of patients with HNC has not witnessed significant improvement over the past decade. This article provides an overview of the current status of radiotherapy, chemotherapy, immunotherapy, targeted therapy, and multidimensional combination therapies. Furthermore, it systematically reviews the research status of predictive biomarkers associated with therapeutic efficacy in OSCC and OPSCC. In the realm of radiotherapy and chemotherapy, human papillomavirus (HPV) infection status remains a well-established independent prognostic factor, while the application of liquid biopsy offers a novel approach for the dynamic evaluation of treatment outcomes. Regarding immunotherapy, although programmed cell death-ligand 1 (PD-L1) expression and tumor mutational burden (TMB) possess certain predictive value, the heterogeneity of the tumor microenvironment (TME) significantly influences treatment outcomes. In the field of targeted therapy, despite the widespread clinical application of epidermal growth factor receptor (EGFR) -targeted treatments, reliable predictive biomarkers remain lacking. By systematically analyzing the predictive utility and limitations of various biomarkers, this review aims to provide theoretical references for personalized treatment decision-making and the future development of integrated multidimensional biomarker strategies in OSCC and OPSCC.

The post-and-core crown is a widely accepted method to restore endodontically treated teeth with compromised tooth structure. Currently, cast metal post-and-core systems and prefabricated fiber posts are the most frequently options in dental clinical practice, but both also come with advantages and limitations. The development of computer aided design and computer aided manufacturing (CAD/CAM) custom fiber post-and-core represents one of the significant choices in the advancement of post-core restoration material. Therefore, this review evaluates the progress of post-and-core restoration using CAD/CAM integrated fiber post-and-core from the aspects of material, properties and clinical application, so as to provide reference for its extensive application in the future.