Application of machine learning in oral and maxillofacial surgery

Oral and maxillofacial anatomy is extremely complex,and medical imaging is critical in the diagnosis and treatment of soft and bone tissue lesions.Hence,there exists accumulating imaging data without being properly utilized over the last decades.As a result,problems are emerging regarding how to integrate and interpret a large amount of medical data and alleviate clinicians’workload.Recently,artificial intelligence has been developing rapidly to analyze complex medical data,and machine learning is one of the specific methods of achieving this goal,which is based on a set of algorithms and previous results.Machine learning has been considered useful in assisting early diagnosis,treatment planning,and prognostic estimation through extracting key features and building mathematical models by computers.Over the past decade,machine learning techniques have been applied to the field of oral and maxillofacial surgery and increasingly achieved expert-level performance.Thus,we hold a positive attitude towards developing machine learning for reducing the number of medical errors,improving the quality of patient care,and optimizing clinical decision-making in oral and maxillofacial surgery.In this review,we explore the clinical application of machine learning in maxillofacial cysts and tumors,maxillofacial defect reconstruction,orthognathic surgery,and dental implant and discuss its current problems and solutions.

Effect of metformin on stem cells:Molecular mechanism and clinical prospect

Metformin is a first-line medication for type II diabetes.Numerous studies have shown that metformin not only has hypoglycemic effects,but also modulates many physiological and pathological processes ranging from aging and cancer to fracture healing.During these different physiological activities and pathological changes,stem cells usually play a core role.Thus,many studies have investigated the effects of metformin on stem cells.Metformin affects cell differentiation and has promising applications in stem cell medicine.It exerts anti-aging effects and can be applied to gerontology and regenerative medicine.The potential anticancer stem cell effect of metformin indicates that it can be an adjuvant therapy for cancers.Furthermore,metformin has beneficial effects against many other diseases including cardiovascular and autoimmune diseases.In this review,we summarize the effects of metformin on stem cells and provide an overview of its molecular mechanisms and clinical prospects.

Promotion effect of TGF-β-Zfp423-ApoD pathway on lip sensory recovery after nerve sacrifice caused by nerve collateral compensation

Resection of oral and maxillofacial tumors is often accompanied by the inferior alveolar nerve neurectomy,resulting in abnormal sensation in lower lip.It is generally believed that spontaneous sensory recovery in this nerve injury is difficult.However,during our follow-up,patients with inferior alveolar nerve sacrifice showed different degrees of lower lip sensory recovery.In this study,a prospective cohort study was conducted to demonstrate this phenomenon and analyze the factors influencing sensory recovery.

Computational technology for nasal cartilage-related clinical research and application

Surgeons need to understand the effects of the nasal cartilage on facial morphology,the function of both soft tissues and hard tissues and nasal function when performing nasal surgery.In nasal cartilage-related surgery,the main goals for clinical research should include clarification of surgical goals,rationalization of surgical methods,precision and personalization of surgical design and preparation and improved convenience of doctor–patient communication.Computational technology has become an effective way to achieve these goals.Advances in three-dimensional(3D)imaging technology will promote nasal cartilage-related applications,including research on computational modelling technology,computational simulation technology,virtual surgery planning and 3D printing technology.These technologies are destined to revolutionize nasal surgery further.In this review,we summarize the advantages,latest findings and application progress of various computational technologies used in clinical nasal cartilage-related work and research.The application prospects of each technique are also discussed.

Xenogeneic stem cell transplantation:Research progress and clinical prospects

Organ transplantation is the ultimate treatment for end-stage diseases such as heart and liver failure.However,the severe shortage of donor organs has limited the organ transplantation progress.Xenogeneic stem cell transplantation provides a new strategy to solve this problem.Researchers have shown that xenogeneic stem cell transplantation has significant therapeutic effects and broad application prospects in treating liver failure,myocardial infarction,advanced type 1 diabetes mellitus,myelosuppression,and other end-stage diseases by replacing the dysfunctional cells directly or improving the endogenous regenerative milieu.In this review,the sources,problems and solutions,and potential clinical applications of xenogeneic stem cell transplantation will be discussed.

Application of vascular endothelial cells in stem cell medicine

Stem cell medicine is gaining momentum in the development of therapy for various end-stage diseases.The search for new seed cells and exploration of their application prospects are topics of interest in stem cell medicine.In recent years,vascular endothelial cells(VECs)have attracted wide attention from scholars.VECs,which form the inner lining of blood vessels,are critically involved in many physiological functions,including permeability,angiogenesis,blood pressure regulation,immunity,and pathological development,such as atherosclerosis and malignant tumors.VECs have significant therapeutic effects and broad application prospects in stem cell medicine for the treatment of various refractory diseases,including atherosclerosis,myocardial infarction,diabetic complications,hypertension,coronavirus disease 2019,and malignant tumors.On the one hand,VECs and their extracellular vesicles can be directly used for the treatment of these diseases.On the other hand,VECs can be used as therapeutic targets for some diseases.However,there are still some obstacles to the use of VECs in stem cell medicine.In this review,advances in the applications and challenges that come with the use of these cells are discussed.

Tetrahedral framework nucleic acid carrying angiogenic peptide prevents bisphosphonate-related osteonecrosis of the jaw by promoting angiogenesis

The significant clinical feature of bisphosphonate-related osteonecrosis of the jaw(BRONJ)is the exposure of the necrotic jaw.Other clinical manifestations include jaw pain,swelling,abscess,and skin fistula,which seriously affect the patients’life,and there is no radical cure.Thus,new methods need to be found to prevent the occurrence of BRONJ.Here,a novel nanoparticle,t FNA-KLT,was successfully synthesized by us,in which the nanoparticle tetrahedral framework nucleic acid(tFNA)was used for carrying angiogenic peptide,KLT,and then further enhanced angiogenesis.TFNA-KLT possessed the same characteristics as tFNA,such as simple synthesis,stable structure,and good biocompatibility.Meanwhile,tFNA enhanced the stability of KLT and carried more KLT to interact with endothelial cells.First,it was confirmed that tFNA-KLT had the superior angiogenic ability to tFNA and KLT both in vitro and in vivo.Then we apply tFNA-KLT to the prevention of BRONJ.The results showed that tFNA-KLT can effectively prevent the occurrence of BRONJ by accelerating angiogenesis.In summary,the prepared novel nanoparticle,tFNA-KLT,was firstly synthesized by us.It was also firstly confirmed by us that tFNA-KLT significantly enhanced angiogenesis and can effectively prevent the occurrence of BRONJ by accelerating angiogenesis,thus providing a new avenue for the prevention of BRONJ and a new choice for therapeutic angiogenesis.

Advances in regenerative medicine applications of tetrahedral framework nucleic acid-based nanomaterials: an expert consensus recommendation

With the emergence of DNA nanotechnology in the 1980s, self-assembled DNA nanostructures have attracted considerable attention worldwide due to their inherent biocompatibility, unsurpassed programmability, and versatile functions. Especially promising nanostructures are tetrahedral framework nucleic acids(t FNAs), first proposed by Turberfield with the use of a one-step annealing approach. Benefiting from their various merits, such as simple synthesis, high reproducibility, structural stability, cellular internalization, tissue permeability, and editable functionality, t FNAs have been widely applied in the biomedical field as threedimensional DNA nanomaterials. Surprisingly, t FNAs exhibit positive effects on cellular biological behaviors and tissue regeneration,which may be used to treat inflammatory and degenerative diseases. According to their intended application and carrying capacity,t FNAs could carry functional nucleic acids or therapeutic molecules through extended sequences, sticky-end hybridization,intercalation, and encapsulation based on the Watson and Crick principle. Additionally, dynamic t FNAs also have potential applications in controlled and targeted therapies. This review summarized the latest progress in pure/modified/dynamic t FNAs and demonstrated their regenerative medicine applications. These applications include promoting the regeneration of the bone,cartilage, nerve, skin, vasculature, or muscle and treating diseases such as bone defects, neurological disorders, joint-related inflammatory diseases, periodontitis, and immune diseases.

Mini suture anchor: An effective device for reduction and fixation of displaced temporomandibular joint disc with intracapsular condylar fracture

Purpose::The main aim is to provide clinical reference for the application of mini suture anchor in the reduction and fixation of displaced temporomandibular joint(TMJ)disc with intracapsular condylar fracture.Methods::From October 2018 to October 2019,21 patients(31 sides)with intracapsular condylar fractures and articular disc displacement from West China Hospital of Stomatology,Sichuan University were included.The selection criteria were:(1)mandibular condylar fractures accompanied by displacement of the TMJ disc,confirmed by clinical examination,CT scan and other auxiliary examinations;(2)indication for surgical treatment;(3)no surgical contraindications;(4)no previous history of surgery in the operative area;(5)no facial nerve injury before the surgery;(6)informed consent to participate in the research program and(7)complete data.Patients without surgical treatment were excluded.The employed patients were followed up at 1,3,6 and 12 months after operation.Outcomes were assessed by success rate of operation,TMJ function and radiological examination results at 3 months after operation.Data were expressed as number and percent and analyzed using SPSS 19.0.Results::All the surgical procedures were completed successfully and all the articular discs were firmly attached to the condyles.The articular disc sufficiently covered the condylar head after the fixation.The fixation remained stable when the mandible was moved in each direction by the surgeons.No complications occurred.The functions of the TMJ were well-recovered postoperatively in most cases.CT scan revealed that the screws were completely embedded in the bone without loosening or displacement.Conclusion::Mini suture anchor can provide satisfactory stabilization for the reduced articular disc and also promote the recovery of TMJ functions.