Exosomes have emerged as promising therapeutic agents in regenerative medicine. This review introduces a novel cell type-oriented perspective to systematically analyze exosomal properties in regenerative therapies. To our knowledge, this review is the first to comprehensively compare exosomes based on cellular source type, offering unprecedented insights into selecting optimal exosome producers for targeted regenerative applications. Factors beyond cellular origin influencing exosomal therapeutic efficacy, such as donor sites and collection methods, are also explored here. By synthesizing key advances, we propose promising research directions in the end. We aim to accelerate the development of more effective exosome-based regenerative therapies and highlight underexplored directions in this rapidly evolving field.

Background: Orofacial clefts (OFCs) are congenital craniofacial malformation caused by embryonic developmental abnormalities, characterized by incomplete fusion of the upper lip and/or palate, leading to feeding difficulties, speech impairments, and other functional challenges. OFCs represent the most prevalent congenital malformations of oral and maxillofacial region. We aim to characterize disease burden of OFCs across regions and countries, analyze temporal trends from 1990 to 2021, examine relationship with Socio-demographic Index (SDI), explore gender disparities and predict future epidemiological patterns.Methods: Utilizing GBD 2021 database for 204 countries/regions, we analyzed age-standardized metrics including disability-adjusted life years (DALYs), prevalence, mortality, incidence, using tools like DisMod-MR 2.1 for Bayesian meta-regression. SDI, calculated from educational attainment, per capita income, and fertility rates (range 0–1), stratified nations into quintiles. Statistical analyses included SDI-burden correlations and future projections using Bayesian age-period-cohort (BAPC) modeling, implemented through R software.Results: In 2021, there are a total of 4124006.8 cases of OFCs worldwide, with an age-standardized prevalence rate (ASPR) of 53.4 per 100,000 (95% UI: 43–64). The age-standardized incidence rate (ASIR) was 3.0 per 100,000 (95% UI: 2.2–3.9), while age-standardized deaths rate (ASDR) of 0 per 100,000 (95% UI: 0–0.1). Additionally, age-standardized DALYs rate was 5.8 per 100,000 (95% UI: 3.5–9.8). Regionally, low- to middle-SDI regions demonstrated the highest ASPR and ASIR, whereas low-SDI areas showed the most severe ASDR and DALYs rate. In contrast, high-SDI regions consistently exhibited the lowest burden across all metrics. At the subregional level, South Asia recorded the greatest ASPR, while Central Asia had the peak ASIR. Oceania displayed the highest ASDR and DALYs rate. Country-specific analysis identified Palestine with the maximum ASPR, Kazakhstan with the highest ASIR, Papua New Guinea with the greatest ASDR, and Afghanistan with the most elevated DALYs rate.Conclusion: The global OFCs burden demonstrated consistent decline from 1990–2021, with persistent male predominance. Regional disparities correlate strongly with SDI, particularly affecting Central Asia, South Asia, and Africa populations.

Background: Mandibular sagittal split ramus osteotomy (SSRO) is a routine surgery to correct mandibular deformities, such as mandibular retrusion, protrusion, deficiency, and asymmetry. However, nonunion/malunion of the fragments and relapse caused by fixation failure after SSRO are major concerns. Rigid fixation to maintain postosteotomy segmental stabilization is critical for success. Additionally, understanding the biomechanical characteristics of different fixation methods in SSRO with large advancements is extremely important for clinical guidance. Therefore, the aim of the present study was to evaluate the biomechanical characteristics of different SSRO methods by finite element analysis.Methods: SSRO finite element models with 5-, 10-, 15-, and 20-mm advancements were developed. Seven fixation methods, namely, two types of bicortical screws, single miniplate, dual miniplates, grid plate, dual L-shaped plates, and hybrid fixation, were positioned into the SSRO models. Molar and incisal biomechanical loads were applied to all models to simulate bite forces. We then investigated the immediate postoperative stability from four aspects, namely, the stability of the distal osteotomy segment, osteotomy regional stability, stress distribution on the mandible, and implant stress performance.Results: The stability of the distal osteotomy segment and osteotomy region decreased when the advancement increased. All seven fixation methods displayed favorable biomechanical stability under minor advancement (5 mm). With large advancements, bicortical screws, dual miniplates, and grid plates provided better stability. The von Mises stress was concentrated around the screws close to the osteotomy region for the proximal segment for all fixation methods, and the von Mises stress on implants increased with larger advancements. With small advancements, five fixation methods endured tolerable maximum stresses of <880 MPa. A single miniplate and dual L-shaped plates generally suffered high stresses using larger advancements. The biomechanical characteristics were similar under molar and incisal loads.Conclusions: The current study investigated the biomechanical properties of seven fixation devices after SSRO under molar and incisal loads. Generally, bicortical screws, grid plates, and dual miniplates provided better biomechanical stability using finite element analysis.

Background: The mandibular sagittal split ramus osteotomy (SSRO) is a routine operation performed to correct mandibular deformity including mandibular retrusion, protrusion, deficiency, and asymmetry. The SSRO remains a challenging procedure for junior surgeons due to a lack of adequate morphological knowledge necessary for success in clinical practice. Virtual reality (VR) and three-dimensional printed (3DP) models have been widely applied in anatomy education. The present randomized, controlled study was performed to evaluate the effect of traditional educational instruments, VR models, and 3DP models on junior surgeons learning the morphological information required to perform SSRO.Methods: Eighty-one participants were randomly assigned to three learning groups: Control, VR, and 3DP. Objective and subjective tests were used to evaluate the learning effectiveness of each learning instrument. In the objective test, participants were asked to identify 10 anatomical landmarks on normal and deformed models, draw the osteotomy line, and determine the description of SSRO. In the subjective test, participants were asked to provide feedback regarding their subjective feelings about the learning instrument used in their group.Results: The objective test results showed that the VR and 3DP groups achieved better accuracy in drawing the osteotomy line (p = 0.027) and determining the description of SSRO (p = 0.023) than the Control group. However, there was no significant difference among the three groups regarding the identification of anatomical landmarks. The VR and 3DP groups gave satisfactory subjective feedback about the usefulness in learning, good presentation, and enjoyment. The Control and 3DP groups reported positive feelings about ease of use.Conclusion: The current findings suggest that VR and 3DP models were effective instruments that assisted in the morphological understanding of SSRO-related anatomical structures. Furthermore, 3DP models may be a promising supplementary instrument to bridge the gap between conventional learning and clinical practice.

Orbital hypertelorism correction is still a less precise procedure, with a simple preoperative design and surgical results often depending on the operator’s experience. In recent years, computer-assisted technology has been fully utilized in craniofacial surgery. This article aims to explore the clinical results of computer-assisted technology in orbital hypertelorism correction and discuss its advantages and effects on treatment. Four patients with orbital hypertelorism underwent intracranial and extracranial combined box osteotomy correction. Preoperative computed tomography scans were performed, and 3-dimensional 3D digital technology was used to measure the orbital spacing, virtually design the 3D cutting scheme, and guide the intraoperative 3D cutting to improve the accuracy of periorbital osteotomy and reduce the surgical risk. Four patients underwent successful surgery, and the average distance of the medial orbital wall was decreased from 43.6 to 23.4 mm. Computer-assisted box osteotomy shortens the operative time and provides better corrective results.

Melanoma incidence is increasing worldwide, prompting exploration into novel risk factors beyond traditional exposures like ultraviolet radiation. Recent studies suggest that metabolic and circadian disruptions may also contribute to melanoma development, yet their influence is poorly understood. This study examines the relationships between metabolic syndrome (MetS), circadian syndrome (CircS) and melanoma risk, emphasizing differences between different genders. Using National Health and Nutrition Examination Survey (NHANES) data (2007–2018), this cross-sectional study applied logistic regression to assess MetS and CircS associations with melanoma risk, adjusting for demographic and lifestyle factors. Receiver operating characteristic curves evaluated predictive ability, and restricted cubic spline models examined dose-response patterns. Among 29,132 participants, 209 reported a melanoma diagnosis. Individuals with MetS or CircS showed a higher melanoma risk. Analysis by gender revealed stronger associations in males than in females. In males, melanoma risk rose sharply when more than two MetS components were present, indicating a dose-response pattern. Additionally, the triglyceride glucose index levels showed more notable predictive value in females than males. MetS and CircS are associated with a higher melanoma risk, with a greater effect of MetS components in males. These findings highlight the potential relevance of metabolic and circadian health in understanding melanoma risk patterns.