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  • Research Article
  • 10.7518/hxkq.2025.2025232
Initial exploration of the relationship between homeostatic occlusion and long-term dental implant stability
  • Dec 1, 2025
  • Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
  • Jiang Chen + 1 more

Long-term dental implant stability is governed by the synergistic regulation of multiple factors, with occlusal parameters and marginal bone loss (MBL) progression being of paramount importance. Progressive MBL undermines mechanical retention, predisposing implants to micromotion and jeopardizing their long-term survival. Accumulating evidence has revealed that homeostatic occlusion imbalance, characterized by excessive occlusal loading, aberrant occlusal contacts, and dysfunctional guidance, significantly increases the incidence of peri-implant bone loss, thereby disrupting biomechanical homeostasis. Therefore, this manuscript delineates the mechanistic role of steady-state occlusal imbalance in driving peri-implant MBL and proposes a homeostatic occlusion-based strategy for preventing and controlling such bone loss, aiming to enhance the long-term stability of dental implants.

  • Research Article
  • 10.7518/hxkq.2025.2025249
Clinical decision-making for immediate restoration of terminal dentition: determination and transfer of jaw relations
  • Dec 1, 2025
  • Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
  • Yiping Gu + 2 more

Immediate implant-supported fixed restoration in edentulous jaws demonstrates a success rate comparable to that of conventional implant restoration. However, this approach still presents a certain degree of technique sensitivity. In the field of immediate implant-supported fixed restoration in dentistry, a repeatable and stable jaw relation is the prerequisite for the design and fabrication of prostheses. It also reduces chairside denture placement and occlusal adjustment time and lowers the risk of occlusion-related complications. For patients with terminal dentition, the precise transfer of jaw relation following full-arch implantation serves as the fundamental basis for implant-supported occlusal reconstruction and functional restoration. This process is also a key research focus and challenge in the area of implant-supported occlusal rehabilitation. This review summarizes the procedures and methods for determining and transferring jaw relation in immediate implant-supported fixed restoration. It aims to serve as a basis for clinical decision making in implant-supported fixed restorations for terminal dentition patients.

  • Research Article
  • 10.7518/hxkq.2025.2025077
Comparative study on the accuracy of extraoral scanning versus intraoral scanning in digital impressions for implant restoration in edentulous jaws
  • Dec 1, 2025
  • Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
  • Yongtao Yang + 7 more

To evaluate the accuracy of a self-developed extraoral scanning system based on four-camera stereophotogrammetric technology in the acquisition of three-dimensional positional information on dental implants and conduct a comparative study involving an intraoral scanning system. With the use of an in vitro edentulous jaw model with implants, extraoral (experimental group) and intraoral (control group) scanning systems were employed to obtain STL (Standard Tessellation Language) datasets containing three-dimensional morphological and positional information on scan bodies. In addition, a dental model scanner was used to obtain reference data. The three-dimensional morphological, linear, and angular deviations between groups and reference data were analyzed using Geomagic Wrap 2021 software to compare trueness and precision. The extraoral scanning system demonstrated superior trueness in three-dimensional morphological, linear, and angular deviations compared with the intraoral scanning system, with statistically significant differences (P<0.001). The extraoral scanning system also showed a higher precision in three-dimensional morphological deviation (P<0.001). As the number of implants increased, the extraoral scanning system exhibited increased three-dimensional morphological and linear deviations (P<0.001) but maintained a stable angular deviation. The intraoral scanning system displayed significant increases in three-dimensional morphological, linear, and angular deviations with the increase in the number of implants (P<0.05). The stereophotogrammetry-based extraoral scanning system outperforms intraoral scanning system in terms of the accuracy for multi-unit implant positioning and provides a novel approach for attaining a fully digital workflow for implant rehabilitation in edentulous jaws.

  • Research Article
  • 10.7518/hxkq.2025.2025045
Analysis of risk factors for early failure of simple taper retentive implants
  • Dec 1, 2025
  • Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
  • Xu Zhang + 8 more

To explore the related risk factors of early failure of simple taper retentive implants, and to provide theoretical guidance for clinical work. Collect cases of patients who visited the Department of Stomatology of the Fourth Affiliated Hospital of Nanchang University from January 2021 to June 2024, received simple taper retentive implants, and had complete medical records. Taking the implants as the unit, analyze the influence of patient-related factors (gender, age, smoking history, hypertension history, diabetes history), implant-related factors (implant length, implant diameter, implant surface treatment), and surgical-related factors (implant site, implant timing, simultaneous maxillary sinus floor elevation, simultaneous bone augmentation) on the early failure of implants. Univariate analysis and multivariate analysis were adopted to explore the potential risk factors for early failure of simple taper retentive implants. A total of 3,533 simple taper retentive from 1,681 patients were included during the study period. Among them, 53 implants from 49 patients experienced early failure, with an early failure rate of 2.9% at the patient le-vel and 1.5% at the implant level. Multivariate analysis revealed that smoking (OR=2.148, P=0.021), the anterior mandibular region (OR=3.669, P=0.006), and the posterior maxillary region (OR=2.191, P=0.033) were risk factors for early failure of simple taper retentive implants. In the univariate analysis, simultaneous maxillary sinus floor elevation had a higher risk of early failure, but this effects was no longer significant in the multivariate analysis (P>0.05). Smoking, the anterior mandibular region, and the posterior maxillary region are risk factors for the early failure of simple taper retentive implants, and could be comprehensively considered in the preoperative treatment plan.

  • Research Article
  • 10.7518/hxkq.2025.2025044
Preparation of polycaprolactone-polyethylene glycol-concentrated growth factor composite scaffolds and the effects on the biological properties of human periodontal ligament stem cells
  • Dec 1, 2025
  • Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
  • Li Gao + 5 more

This study investigated the effects of a polycaprolactone (PCL)-polyethylene glycol (PEG) scaffold incorporated with concentrated growth factor (CGF) on the adhesion, proliferation, and osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs). The PCL-PEG-CGF composite scaffold was fabricated using an immersion and freeze-drying technique. Its microstructure, mechanical properties, and biocompatibility were systematically characterized. The hPDLSCs were isolated through enzymatic digestion, and the hPDLSCs were identified through flow cytometry. Third-passage hPDLSCs were seeded onto the composite scaffolds, and their adhesion, proliferation and osteogenic differentiation were assessed using CCK-8 assays, 4',6-diamidino-2-phenylindole (DAPI) staining, alkaline phosphatase (ALP) staining, alizarin red staining, and Western blot analysis of osteogenesis-related proteins [Runt-related transcription factor 2 (Runx2), ALP, and morphogenetic protein 2 (BMP2)]. Scanning electron microscopy revealed that the PCL-PEG-CGF composite scaffold exhibited a honeycomb-like structure with heterogeneous pore sizes. The composite scaffold exhibited excellent hydrophilicity, as evidenced by a contact angle (θ) approaching 0° within 6 s. Its elastic modulus was measured at (4.590 0±0.149 3) MPa, with comparable hydrophilicity, fracture tensile strength, and fracture elongation to PCL-PEG scaffold. The hPDLSCs exhibited significantly improved adhesion to the PCL-PEG-CGF composite scaffold compared with the PCL-PEG scaffold (P<0.01). Additionally, cell proliferation was markedly improved in all the experimental groups on days 3, 5, and 7 (P<0.01), and statistically significant differences were found between the PCL-PEG-CGF group and other groups (P<0.01). The PCL-PEG-CGF group showed significantly elevated ALP activity (P<0.05), increased mineralization nodule formation, and upregulated expression of osteogenic-related proteins (Runx2, BMP2 and ALP; P<0.05). The PCL-PEG-CGF composite scaffold exhibited excellent mechanical properties and biocompatibility, enhancing the adhesion and proliferation of hPDLSCs and promoting their osteogenic differentiation by upregulating osteogenic-related proteins.

  • Research Article
  • 10.7518/hxkq.2025.2025078
Mediation analysis of plasma phosphorylated tau217 in the association between periodontitis and mild cognitive impairment
  • Dec 1, 2025
  • Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
  • Yanbiao Zhang + 7 more

This study aimed to investigate the potential mediating role of plasma phosphorylated tau217 (p-tau217) in the association between periodontitis and mild cognitive impairment (MCI). In this case-control study, patients diagnosed with MCI in the Neurology Department of the First Affiliated Hospital of Shandong Second Medical University from November 2023 to May 2024 were selected as the case group (MCI group). Cognitively normal (CN) volunteers, matched for age and education level and recruited from the physical examination center during the same period, served as the control group (CN group). The general demographic data of the study participants were collected. The Beijing versions of the Montreal Cognitive Assessment (MoCA), clinical dementia rating (CDR), and activities of daily living scale (ADL) were used to assess neuropsychological functions. Clinical periodontal examinations were conducted, the periodontal inflamed surface area (PISA) was calculated, and the periodontitis stage was determined in accordance with the 2018 classification. Fasting elbow venous blood samples were collected in the morning, and blood biochemical indicators were measured. Plasma p-tau217 levels were detected using enzyme-linked immunosorbent assay (ELISA). Statistical analyses were performed using t-test, Mann-Whitney U test, chi-square test, partial correlation analysis, multivariate Logistic regression analysis, multiple linear regression analysis, restricted cubic spline (RCS) regression analysis, and mediation effect analysis. Among the 192 participants, 96 belong to the MCI group and 96 to the CN group. The prevalence of periodontitis was 63.5% in the MCI group and 43.8% in the CN group, with a statistically significant difference (χ²=7.561, P=0.006). The plasma p-tau217 levels in the MCI group were significantly higher than those in the CN group [7.00 (4.27-9.65) ng/mL versus 2.02 (0.80-3.81) ng/mL, Z=-8.108, P<0.001]. Partial correlation analysis revealed that plasma p-tau217 levels were positively correlated with all the clinical periodontal indices (all P<0.001). After adjustments for baseline covariates, multivariate Logistic regression indicated that periodontitis was an independent risk factor for MCI. Patients with periodontitis had a 1.977-fold higher MCI risk than those without periodontitis (OR=1.977, 95%CI: 1.088-3.594, P=0.025). Moreover, the MCI risk for stage Ⅰ/Ⅱ periodontitis and stage Ⅲ/Ⅳ periodontitis was 1.878 times (OR=1.878, 95%CI: 1.029-3.425, P=0.040) and 2.625 times (OR=2.625, 95%CI: 1.073-6.246, P=0.035) higher than that for patients without periodontitis, respectively. Trend test showed that the MCI risk increased with periodontitis severity (Ptrend=0.016). After adjustments for baseline covariates, multiple linear regression analysis showed that periodontitis was an independent risk factor for increased plasma p-tau217 levels (β=3.309, 95%CI: 2.363-4.254, P<0.001). Compared with patients without periodontitis, those with stage Ⅰ/Ⅱ periodontitis (β=1.838, 95%CI: 0.869-2.806, P<0.001) and stage Ⅲ/Ⅳ periodontitis (β=5.539, 95%CI: 4.442-6.636, P<0.001) had significantly higher plasma p-tau217 levels. In addition, trend test indicated that plasma p-tau217 levels increased with periodontitis severity (Ptrend<0.001). After adjustments for baseline covariates, RCS regression analysis further revealed that PISA had a positive linear dose-response relationship with MCI risk (Poverall=0.002, Pnonlinear=0.344) and plasma p-tau217 levels (Poverall<0.001, Pnonlinear=0.140). After adjustments for baseline covariates, mediation analysis showed that plasma p-tau217 mediated the association between periodontitis and MCI, with a mediation proportion of 13.99% (95% Bootstrap CI: 0.38%-49.39%, P=0.038). Periodontitis was independently positively associated with MCI risk, and plasma p-tau217 plays a mediating role in this association.

  • Research Article
  • 10.7518/hxkq.2025.2025318
Interpretation of the group standard: Clinical Protocol for Bone Harvesting and Grafting under Digital Guidance in Oral Implantology
  • Dec 1, 2025
  • Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
  • Jing Wang + 1 more

In recent years, digital bone harvesting and grafting technology in dental implantology has emerged as a cutting-edge advancement in the field of oral medicine, gaining widespread application in the treatment of complex bone defect cases. By integrating digital imaging, virtual design, and precise surgical guidance, this technology has significantly enhanced the success rate of dental implants and improved patient outcomes. However, the rapid development of this technology has also highlighted the lack of standardized clinical protocols, necessitating the establishment of unified guidelines through expert consensus. This article provides a detailed overview of the development process of the group standard Clinical Protocol for Bone Harvesting and Grafting under Digital Guidance in Oral Implantology and offers an in-depth interpretation of its key components, aiming to serve as a valuable reference for clinical practice and academic research.

  • Research Article
  • 10.7518/hxkq.2025.2024469
Case of tooth autotransplantation with robotic surgery assistance
  • Dec 1, 2025
  • Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
  • Yunkun Liu + 6 more

Tooth autotransplantation is a restoration technology that grafts the patient's own teeth to the missing tooth area, usually by using the third molar to replace a nonnormally functioning molar for the purpose of "turning waste into treasure". Robotic surgical assistance has been widely used in the fields of breast cancer, liver cancer, and orthopedics; however, its application in the dental field, particularly in tooth autotransplantation, remains relatively rare. This paper reports a case of tooth autotransplantation with the assistance of a domestic autonomous oral surgery robot, providing a reference for the application of robotic surgery assistance in tooth autotransplantation.

  • Research Article
  • 10.7518/hxkq.2025.2025169
Treatment of root fracture of immature maxillary permanent central incisor combined with impacted supernumerary tooth in the apical region: a case report
  • Dec 1, 2025
  • Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
  • Jingyi Sun + 4 more

Dental trauma is a common oral condition in children. For single-type trauma to young permanent teeth, timely treatment often results in a high survival rate for both the teeth and the pulp. However, in cases of complex dental trauma or when supernumerary teeth are impacted near the apex of the injured tooth, the prognosis is less predictable. This article reports a case of root fracture in an immature maxillary permanent central incisor combined with impacted supernumerary tooth in the apical region. After supernumerary tooth extraction and pulp revascularization therapy, the case demonstrated a good treatment outcome over a nearly 10-year follow-up period.

  • Research Article
  • 10.7518/hxkq.2025.2025298
Management of accidental tooth root displacement into the mandibular canal during tooth extraction
  • Dec 1, 2025
  • Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology
  • Liwen Su + 1 more

The accidental displacement of tooth roots into the mandibular canal is a serious complication during tooth extractions in oral and maxillofacial surgery, often resulting in direct damage to the structural and functional integrity of the inferior alveolar neurovascular bundle (IANB). This article reviews the anatomical features of the mandibular canal, the IANB, and adjacent tooth roots; identifies high-risk factors and anatomically vulnerable sites for root displacement; and outlines the clinical manifestations and radiographic characteristics of intraoperative root intrusion into the mandibular canal. Furthermore, management principles, surgical approaches and techniques, inferior alveolar nerve injury treatment, and prognostic considerations are discussed. The aim of this review is to provide a comprehensive clinical reference for improving surgical outcomes, and reducing postoperative complications.