Comprehensive 3-dimensional Positional and Morphological Analyses of Condyle and Glenoid Fossa in Patients with Skeletal Class II Malocclusion following Bimaxillary Orthognathic Surgery.

This study aimed to comprehensively and quantitatively characterize 3-dimensional (3D) positional and morphological changes of the condyle and glenoid fossa in patients with skeletal Class II malocclusion treated with bimaxillary orthognathic surgery. Twenty eligible patients treated at our institution from January 2016 to December 2021 with more than 12 months of postoperative follow-up were retrospectively enrolled. Radiographic data of cone-beam computed tomography (CBCT) for each patient were collected at 3 stages: 1 week preoperatively (T0), immediately after surgery (T1), and at least 12 months postoperatively (T2). Positional changes, surface and volumetric alterations of condyle, and bone remodeling in glenoid fossa were measured and compared based on voxel- and surface registrations in visual 3D methods. Most patients exhibited a tendency for condyles to shift posteriorly, laterally, superiorly, and rotated outward, downward, and forward immediately after surgery. Posterior, medial, superior movement and outward, upward, and backward rotation of condyles were observed during follow-up (T1-T2). Bone resorption frequently occurred in the posterior area of condylar surfaces, while bone remodeling was more common in the anterior region of the glenoid fossa. Reduced volume of the condyle was found in most cases, which was not associated with the amount of mandibular advancement. Overall, the condyle and its corresponding glenoid fossa remained relatively stable during the follow-up. Our results reveal positional and morphological alterations in the condyle and the glenoid fossa after bimaxillary orthognathic surgery in patients with skeletal class II malocclusion. These changes predominantly fall within the spectrum of physical adaption.

Effects of single unilaterally impacted mesiodens on maxillary central incisors: A 3D quantitative assessment based on cone-beam computed tomography.

BACKGROUND: Mesiodens usually lead to the malposition and abnormal morphology of maxillary central incisors. AIM: To evaluate the detrimental effects of single unilaterally impacted mesiodens on the three-dimensional positions and morphology of the maxillary central incisor using cone-beam computed tomographic (CBCT) examinations. DESIGN: A total of 321 patients aged 5-17 years with single unilaterally impacted mesiodens were included and divided into two groups: mixed dentition group (5-10 years) and early permanent dentition group (11-17 years). CBCT data for these patients were retrospectively analyzed to compare the inclination, rotation, angulation, and morphology of maxillary central incisors between the affected and contralateral control sides. The morphology, orientation, and spatial location of mesiodens were also assessed. RESULTS: Central incisors on the affected side showed significant palatal crown inclination, shorter root, shorter tooth, and greater crown-to-root ratio in both groups, whereas significant mesial crown angulation was only observed in the mixed dentition group. CONCLUSION: Impacted mesiodentes result in the displacement and impaired root development of central incisors, strongly suggesting timely clinical management of these abnormal teeth, such as the early removal of mesiodens and orthodontic treatments.

Fully automated deep learning model for detecting proximity of mandibular third molar root to inferior alveolar canal using panoramic radiographs.

OBJECTIVE: This study endeavored to develop a novel, fully automated deep-learning model to determine the topographic relationship between mandibular third molar (MM3) roots and the inferior alveolar canal (IAC) using panoramic radiographs (PRs). STUDY DESIGN: A total of 1570 eligible subjects with MM3s who had paired PR and cone beam computed tomography (CBCT) from January 2019 to December 2020 were retrospectively collected and randomly grouped into training (80%), validation (10%), and testing (10%) cohorts. The spatial relationship of MM3/IAC was assessed by CBCT and set as the ground truth. MM3-IACnet, a modified deep learning network based on YOLOv5 (You only look once), was trained to detect MM3/IAC proximity using PR. Its diagnostic performance was further compared with dentists, AlexNet, GoogleNet, VGG-16, ResNet-50, and YOLOv5 in another independent cohort with 100 high-risk MM3 defined as root overlapping with IAC on PR. RESULTS: The MM3-IACnet performed best in predicting the MM3/IAC proximity, as evidenced by the highest accuracy (0.885), precision (0.899), area under the curve value (0.95), and minimal time-spending compared with other models. Moreover, our MM3-IACnet outperformed other models in MM3/IAC risk prediction in high-risk cases. CONCLUSION: MM3-IACnet model can assist clinicians in MM3s risk assessment and treatment planning by detecting MM3/IAC topographic relationship using PR.

The top 100 highly cited articles on surgery-first orthognathic surgery between 2009 and 2022: a bibliometric and visualized analysis.

OBJECTIVES: To reveal research focuses on surgery-first orthognathic surgery by a bibliometric and visualized analysis of the top 100 highly cited articles. STUDY DESIGN: Published papers related to surgery-first orthognathic surgery were retrospectively retrieved from the Web of Science Core Collection from 2009 to 2022. The number of articles, journals, countries/regions, institutions, authors, and keywords were assessed and visualized using CiteSpace software. RESULTS: The top 100 cited articles included 89 research papers and 11 reviews. The average total citation was 21. The most influential article with 146 citations was published by Dr. Liou E.J.W. in 2011. The most common level of evidence was level IV (36 articles). The Journal of Oral and Maxillofacial Surgery had the largest number of papers and the highest total citation frequency. The most productive countries and institutions were Korea/China and Chang Gung Memorial Hospital, respectively. Chen Yu-ray and Choi Jong Woo published 13 and 11 articles with 434 and 299 total citations, respectively. Research interests shifted from skeletal class III malocclusion, accuracy, stability, and relapse to quality of life and virtual surgical planning. CONCLUSION: Our bibliometric analyses provide a comprehensive landscape of the influential topics and developmental trends in surgery-first orthognathic surgery and inspire future studies in this booming field.

Three-dimensional quantitative changes of condyle in patients with skeletal class III malocclusion after bimaxillary orthognathic surgery with 5-year follow-up.

OBJECTIVE: The present study aimed to characterize three-dimensional (3D) long-term quantitative condyle change including positional, surface, and volumetric alterations in patients with skeletal class III malocclusion treated with bimaxillary orthognathic surgery. MATERIAL AND METHODS: Twenty-three eligible patients (9 males, 14 females, mean age: 28.28 years old) treated from Jan. 2013 to Dec. 2016 with postoperative follow-up over 5 years were retrospectively enrolled. Cone-beam computed tomography scan for each patient was conducted at 4 stages: 1 week preoperatively (T0), immediately after surgery (T1), 12 months postoperatively (T2), and 5-year postoperatively (T3). Positional changes, surface, and volumetric remodeling of condyle were measured in segmented visual 3D models and statistically compared between stages. RESULTS: Our 3D quantitative calibrations revealed that the condylar center shifted in anterior (0.23 ± 1.50 mm), medial (0.34 ± 0.99), and superior (1.11 ± 1.10 mm) directions and rotated outward (1.58 ± 3.11°), superior (1.83 ± 5.08°), and backward (4.79 ± 13.75°) from T1 to T3. With regard to condylar surface remodeling, bone formation was frequently observed in the anteromedial areas, while bone resorption was commonly detected in the anterolateral area. Moreover, condylar volume remained largely stable with a minimal reduction during the follow-up. CONCLUSION: Collectively, although condyle undergoes positional changes and bone remodeling after bimaxillary surgery in patients with mandibular prognathism, these changes largely fall in the range of physical adaptations in the long run. CLINICAL RELEVANCE: These findings advance the current understanding of long-term condylar remodeling after bimaxillary orthognathic surgery in skeletal class III patients.

Reliable and efficient emergency rescue networks: A blockchain and fireworks algorithm-based approach.

In recent years, coronavirus disease 2019 (COVID-19) has been a severe issue the world faces. Emergency rescue networks concerning the distribution of relief materials have gained extensive attention to tackle COVID-19 and related emergency issues. However, it is challenging to establish reliable and efficient emergency rescue networks due to information asymmetry and lack of trust among different rescue stations. In this work, we propose blockchain-based emergency rescue networks to track every transaction of the relief materials reliably and make decisions to deliver relief materials efficiently. More specifically, we propose a hybrid blockchain architecture that employs on-chain data verification to authenticate data records and off-chain data storage to reduce storage overhead. Furthermore, we propose a fireworks algorithm to efficiently calculate the optimal allocation strategies for relief materials. The algorithm provides chaotic random screening and node request guarantee techniques with good convergence. The simulation results show that integrating blockchain technology and the fireworks algorithm can significantly improve relief materials' operation efficiency and distribution quality.

Characterizations of three-dimensional root morphology and topological location of mandibular third molars by cone-beam computed tomography.

PURPOSE: This study aimed to delineate three-dimensional (3D) root morphology and topological locations of mandibular third molars (MTMs) by cone-beam computed tomography (CBCT) in a Chinese adult dental population. METHODS: Adult patients with MTMs were retrospectively screened based on CBCT images at our institution between January 2018 and December 2019. Root morphology and spatial locations of these teeth were defined based on CBCT 3D images. Potential associations with epidemiological and clinical/radiological parameters were analyzed using Chi-square or Fisher exact test. Two-tailed P values less than 0.05 were considered statistically significant. RESULTS: A total number of 2680 eligible patients (male/female:0.74; 35 ± 10 years old) with 4180 MTMs were enrolled. The majority of MTMs had 2 roots 3064 (73.30%), followed by 800 (19.14%) 1 root, 302 (7.22%) 3 roots, and 14 (0.33%) 4 roots. More than half of one-rooted MTMs were convergent, followed by club-shaped and C-shaped. Among MTMs with 2 roots, 2860 (93.34%) were M-D (mesio-distal) types. Most MTMs with 3 roots were M-2D (one root in mesial, two roots in distal) types, followed by 2M-D (two roots in mesial, one root in distal) types, and B-2L (one root in buccal, two roots in lingual) types. The presence of root configurations was significantly associated with the angulation, depth, and width classification in two-rooted MTMs (P < 0.05). CONCLUSIONS: Although the morphology and spatial locations of MTMs vary greatly, our results from a large dental population reconfirm that most MTMs have two roots with mesial-distal type of spatial distribution.

Comprehensive characterization of epidemiological and 3D radiographic features of non-third molar impacted teeth in a Chinese dental population.

OBJECTIVE: This retrospective study aimed to comprehensively delineate the epidemiological and 3-dimensional radiographic characteristics of non-third molar (non-M3) impacted teeth in a Chinese dental population. MATERIAL AND METHODS: Patients with impacted teeth except for the third molar (ITEM3) were retrospectively screened via cone-beam CT images from 75,021 patients treated at our institution from June 2012 to December 2018. Demographic and clinical data of patients with ITEM3 were retrieved from medical records. CBCT coupled with 3-dimensional reconstruction was employed to characterize the radiographic features of ITEM3. Associations between these epidemiological, clinical, and radiographic features were further statistically analyzed. RESULTS: Among 1975 eligible patients, 2467 ITEM3s were identified with a prevalence of 2.63% (1975/75,021). Females slightly outnumbered males with a ratio of 1.12:1. The majority of ITEM3 was single (1577, 79.85%) in the maxilla. The maxillary canine teeth were the most frequently impacted (52.45%), followed by maxillary incisors. The mesioangular position was the most common orientation (43.8%), followed by vertical and buccal-lingual orientations. The most frequently associated lesion was external root resorption of the adjacent tooth, which was significantly correlated with the morphology and position of the impacted tooth. CONCLUSION: Most ITEM3 was single, mesioangular, found at maxillary canines, sometimes associated with diverse complications. Our data advance the current understanding of ITEM3 and offer insights into the management of this dental abnormality. CLINICAL RELEVANCE: These findings are useful for clinicians to comprehensively understand the prevalence, radiographic features, and complications of non-M3 impacted teeth.

Neuroprotective effects of oleanolic acid against cerebral ischemia-reperfusion injury in mice.

BACKGROUND/AIM: Stroke is among the most common causes of disability and death in highly developed countries and China. We sought to study the role of oleanolic acid in cerebral ischemia-reperfusion injury. METHODS: Middle cerebral artery occlusion (MCAO) was performed to induce cerebral ischemia-reperfusion injury in mice. For the short-term effects of oleanolic acid (OA) against MCAO, mice administrated with OA (6 mg/kg /d) for 3 days before the injury were evaluated the infarct volume, neurological scores, blood brain barrier permeability and oxidative stress level, while for the long-term effects, MCAO mice were injected daily with OA for 6 weeks, followed by assessments of motor function, behavior and cerebral infarction area. RESULTS: Pretreatment of oleanolic acid alleviated MCAO-induced ischemia-reperfusion injury as indicated by the significant decreases in cerebral infarction area and neurological symptom score at 24 h post injury, Evans blue leakage, expression of matrix metalloproteinase 9 (MMP9) and occludin, dihydroethidium fluorescence, and block malonaldehyde generation. In the long run, OA significantly reduced brain loss, enhanced the motor function, promoted the recovery of nerve function, and improved the learning and memory ability 9 weeks after the ischemia-reperfusion injury. OA also inhibited astrocytes proliferation and microglia activation, promoted the expression of synapse-related proteins, and increased the number of DCX+ cells in the hippocampus. CONCLUSIONS: OA exhibits both short-term and long-term protective effects against the cerebral ischemia-reperfusion injury in mice. The short-term protective mechanism is related to the anti-oxidation of blood-brain barrier, while the long-term protective effect lies in neuroglia modulation, promotion of synaptic connection and neuroregeneration.

[Preparation and properties of fiber-based conductive composite scaffolds for peripheral nerve regeneration].

Objective: To explore the preparation method, physical and chemical properties, and biocompatibility of a conductive composite scaffold based on polypyrrole/silk fibroin (PPy/SF) fiber with "shell-core" structure, and to provide a preliminary research basis for the application in the field of tissue engineered neuroscience. Methods: The conductive fibers with "shell-core" structure were prepared by three-dimensional printing combined with in-situ polymerization. PPy/SF fiber-based conductive composite scaffolds were formed by electrospinning. In addition, core-free PPy conductive fibers and SF electrospinning fibers were prepared. The stability, biomechanics, electrical conductivity, degradation performance, and biological activity of each material were tested to analyze the comprehensive properties of fiber-based conductive composite scaffolds. Results: Compared with pure core-free PPy conductive fibers and SF electrospinning fibers, the PPy/SF fiber-based conductive composite scaffolds with "shell-core" structure could better maintain the stability performance, enhance the mechanical stretchability of the composite scaffolds, maintain long-term electrical activity, and improve the anti-degradation performance. At the same time, PPy/SF conductive composite scaffolds were suitable for NIH3T3 cells attachment, conducive to cell proliferation, and had good biological activity. Conclusion: PPy/SF fiber-based conductive composite scaffolds meet the needs of conductivity, stability, and biological activity of artificial nerve grafts, and provide a new idea for the development of a new generation of high-performance and multi-functional composite materials.

Time-dependent energetic proton acceleration and scaling laws in ultraintense laser-pulse interactions with thin foils.

A two-phase model, where the plasma expansion is an isothermal one when laser irradiates and a following adiabatic one after laser ends, has been proposed to predict the maximum energy of the proton beams induced in the ultraintense laser-foil interactions. The hot-electron recirculation in the ultraintense laser-solid interactions has been accounted in and described by the time-dependent hot-electron density continuously in this model. The dilution effect of electron density as electrons recirculate and spread laterally has been considered. With our model, the scaling laws of maximum ion energy have been achieved and the dependence of the scaling coefficients on laser intensity, pulse duration, and target thickness have been obtained. Some interesting results have been predicted: the adiabatic expansion is an important process of the ion acceleration and cannot be neglected; the whole acceleration time is about 10-20 times of laser-pulse duration; the larger the laser intensity, the more sensitive the maximum ion energy to the change of focus radius, and so on.

Analytical expressions of the front shape of non-quasi-neutral plasma expansions with anisotropic electron pressures.

An analytical expression is proposed to describe the front shape of a non-quasi-neutral plasma expansion with anisotropic electron pressures. It is of significance in the study of ultrashort plasma expansions generated from laser-foil interactions and anisotropic astroplasma expansions in space science. It is found that the plasma front shape depends on the relationship between the ratio of the longitudinal and the transverse temperature of hot electrons kappa;(2) and the electron-ion mass ratio mu . For kappa;(2)(micro,1] , the ion front is a part of an ellipse and the major axis is in the lower-temperature axis. For kappa;(2)< or =micro , the ion front is composed by a part of a hyperbolic and a small pointed projection at the center. In the strongly anisotropic region, there is an ultrashort anomalous plasma emission of tens of femtoseconds at the angle of near 90 degrees . The ion-velocity distribution and angular-energy distribution at the ion front have also been given. Particularly, anomalous positron emissions exist in the electron-positron plasma anisotropic expansion.