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Molecular Diagnosis of Fibro-osseous Lesions of the Oral and Maxillofacial Region: A Tale from Africa 口腔颌面区纤维骨性病变的分子诊断:一个来自非洲的故事
Pub Date : 2019-05-01 DOI: 10.2174/2542579X01666180613075855
O. Soyele, A. H. Adedapo, H. Adeola
Fibro-osseous lesions (FOLs) are a poorly defined but pathologically diverse group of lesionsaffecting the craniofacial bones and jaw. They are mostly characterized by the replacement ofbone by a benign connective tissue matrix, which may contain foci of mineralization in the form ofwoven bone or cementum-like round acellular intensely basophilic structures. These lesions, althoughdiverse, often present similar clinico-pathological and radiographic features. This often leadsto difficulty in diagnosis and management. Definitive diagnosis is often reached only by incisionalor excisional biopsy in resource-limited settings. Epidemiologically, the incidence and prevalence ofdifferent FOLs have been variable depending on the region. Reports from Africa indicated thatFOLs make up to 10% of all oral biopsies, while others have given lower figures. A good understandingof the pathogenetic mechanism for FOLs is important, and state of the art molecular approachesare bound to improve the diagnosis and delineation of various entities that fall under theFOL category. Not least, the classification and nomenclature of these lesions by the World HealthOrganization (WHO) have changed significantly over the years. Hence, we have presented in thisreview a robust discussion on the pathobiology, emerging molecular markers, diagnostic challenges,future perspectives and recent changes to the classification/nomenclature of FOLs by WHO. In addition,we also discussed the diagnostic bottlenecks encountered during diagnosis of FOL in Africa.
纤维骨性病变(FOLs)是一种定义不清但病理多样的影响颅面骨和颌骨的病变。它们的主要特征是由良性结缔组织基质取代骨,其中可能含有编织骨或骨质状圆形脱细胞强烈嗜碱性结构的矿化灶。这些病变虽然多种多样,但通常表现出相似的临床病理和影像学特征。这往往导致诊断和治疗的困难。在资源有限的情况下,通常只能通过切口或切除活检来确诊。从流行病学的角度来看,不同区域的各种慢性阻塞性肺病的发病率和流行率各不相同。来自非洲的报告表明,fols占所有口腔活检的10%,而其他国家给出的数字更低。很好地理解FOLs的发病机制是很重要的,最先进的分子方法势必会改善fol类别下各种实体的诊断和描述。尤其重要的是,世界卫生组织(世卫组织)对这些病变的分类和命名法多年来发生了重大变化。因此,我们在这篇综述中就病理生物学、新出现的分子标记、诊断挑战、未来前景以及世卫组织对FOLs分类/命名法的最新变化进行了热烈的讨论。此外,我们还讨论了在非洲诊断FOL时遇到的诊断瓶颈。
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引用次数: 1
Platelet Concentrates in Oral Surgery: Indications and Limits. A Literature Review 血小板浓缩物在口腔外科中的应用:适应症和局限性。文献综述
Pub Date : 2019-05-01 DOI: 10.2174/2542579x01666180621154507
G. Marenzi, Med Erda Qorri, P. Sammartino, F. Rusciano, R. Gasparro
Background: Platelet concentrates (PC) are blood-derived products for local applicationable to stimulate regeneration in soft and hard tissues, mimicking the physiological healing process.Their efficacy in oral surgical procedures is controversial and limited.Objective: The study aims to critically analyze the available evidence for the effect of autogenousPC on wound healing of different oral surgical sites reported by more recent clinical studies.Methods: Electronic and manual searches in three databases (Medline, Web of Science, Scopus)were performed to identify the clinical studies from January 2017 to December 2017 which reportedthe actual oral surgical indications and the benefit of local application of PC. All human studiesevaluating PRP or PRF in a randomized controlled trial, case series, case report and systematic reviewwere included. All animal, histologic and in vitro studies were excluded.Results: Fifty-two studies were selected. The use of PRF was proposed in treating many oral surgicalsites. Data availability with regard to the effect of PRF on new bone formation in GBR and horizontal/vertical bone augmentation procedures varied from abundant to absent. Positive results concerningthe effect of PRF on potential post-surgical complication (pain, swelling and trismus) werereported.Conclusion: Few clinical indications could be determined: the literature on the topic was contradictoryand the published data were difficult to interpret. Positive results were generally recorded forsoft tissues and periodontal wound healing. No real benefit of PC application on bone regenerationwas evidenced.
背景:血小板浓缩物(PC)是一种局部应用的血液衍生产品,可刺激软硬组织再生,模拟生理愈合过程。它们在口腔外科手术中的功效是有争议的和有限的。目的:本研究旨在批判性地分析近年来临床研究报告的自生成素对不同口腔手术部位伤口愈合的影响。方法:检索Medline、Web of Science、Scopus三个数据库,检索2017年1月至2017年12月报道口腔外科实际指征及局部应用PC获益的临床研究。纳入所有在随机对照试验、病例系列、病例报告和系统评价中评估PRP或PRF的人类研究。所有动物、组织和体外研究均被排除在外。结果:入选研究52项。PRF在许多口腔手术部位的治疗中得到了应用。关于PRF对GBR和水平/垂直骨增强手术中新骨形成的影响的可用数据从丰富到缺乏。报道了PRF对潜在的术后并发症(疼痛、肿胀和牙关)的积极影响。结论:临床适应症确定少,相关文献相互矛盾,已发表的资料难以解释。软组织和牙周创面愈合结果普遍为阳性。没有证据表明应用PC对骨再生有真正的好处。
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引用次数: 1
Bond Strength of Ceramic and Metal Orthodontic Brackets to Aged Resinbased Composite Restorations 陶瓷和金属正畸托槽与老化树脂基复合修复体的结合强度
Pub Date : 2019-05-01 DOI: 10.2174/2542579X01666180919121640
A. D. Bona, Ricardo Kochenborger, Luís Antônio Di Guida
Background: Dental resin composites undergo chemical and mechanical degradation.Thus, the orthodontist should evaluate aged composite restoration surfaces to select the appropriateprotocol to successfully bond orthodontics accessories.Objective: This study evaluated the shear bond strength (σ) of metal (M) and ceramic (C) bracketsbonded to aged resin-based composite restorations (ACR) after different surface treatments.Methods: ACR specimens (N=160) were fabricated and divided into 8 experimental groups (n=20)as follows: Mo (control)- M bonded to ACR; MA- M bonded to ACR after acid etching using 38%phosphoric acid for 20 s (A); MB- M bonded to ACR after surface roughing using a twelve-bladedbur (B); MBA- M bonded to ACR after B and A; Co (control)- C bonded to ACR; CA- C bonded toACR after A; CB- C bonded to ACR after B; CBA- C bonded to ACR after B and A. All specimenswere stored for 24h before σ testing. Data were statistically analyzed using one-way ANOVA andTukey post-hoc (α=0.05). Fracture surfaces were examined to determine the failure mode.Results: The surface treatments (A, B and BA) produced similar σ values (p>0.05) to ACR whenusing the same bracket type. M bracket showed greater σ than C bracket (p<0.05), probably becauseof different mechanical retention inherent from bracket type. Inhomogeneous stress distributiongenerated complex failures.Conclusion: Considering the needs of an orthodontic treatment and the surface treatments evaluated,sufficient bond strength was produced to ACR, irrespective of bracket type.
背景:牙科树脂复合材料经历化学和机械降解。因此,正畸医生应该评估老化的复合修复表面,以选择合适的方案来成功粘合正畸配件。目的:研究不同表面处理后金属(M)和陶瓷(C)托槽与老化树脂基复合修复体(ACR)的剪切结合强度(σ)。方法:制作ACR标本160份,分为8个实验组(N= 20),分别为:Mo(对照)- M与ACR结合;MA- M在38%磷酸酸蚀20 s (A)后与ACR键合;用十二刃刀进行表面粗加工后与ACR结合的MB- M (B);MBA- M在B和A之后与ACR键合;Co (control)- C键合ACR;CA- C与A后的acr键合;CB- C在B后与ACR键合;CBA- C在B和a后与ACR结合,所有样品保存24h后进行σ测试。数据采用单因素方差分析和事后分析(α=0.05)。对断口表面进行检查以确定其破坏模式。结果:表面处理(A、B、BA)与ACR在相同托槽类型下的σ值相近(p>0.05)。M型托槽的σ值大于C型托槽(p<0.05),这可能是由于托槽类型所固有的机械固位不同所致。不均匀的应力分布产生了复杂的破坏。结论:考虑到正畸治疗的需要和表面处理的评估,无论托槽类型如何,都能产生足够的ACR结合强度。
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引用次数: 3
Antibacterial Profile of Copaifera multijuga Oleoresin and Hydroalcoholic Extract of Leaves Against Oral Pathogens 木檀油树脂及叶水醇提取物对口腔病原菌的抑菌作用
Pub Date : 2019-05-01 DOI: 10.2174/2542579x01666180629100020
Iane Pereira Pimenta, Fariza Abrão, J. J. M. Silva, Larissa Oliveira Costa, H. Rogez, S. Ambrósio, R. Veneziani, J. Bastos, C. Martins
Background: Copaifera multijuga are widely used as medicinal plants in Brazil. Of thevarious ethnopharmacological indications of copaiba oleoresins, the antimicrobial activity had beenhighlighted.Objective: This study aimed to evaluate the oleoresin and the hydroalcoholic extract of leaves fromCopaifera multijuga against oral pathogens in the sessile and in the planktonic modes.Methods: Standard strains from the American Type Culture Collection and clinical isolates whichcause both cariogenic and endodontic infections were used. Was evaluated in terms of its MinimumInhibitory Concentration (MIC) values by the broth microdilution method in 96-well microplates,Minimum Bactericidal Concentration (MBC) and biofilm eradication assay.Results: The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration(MBC) assays showed that the oleoresin was effective against some the bacterial strains. Assessmentof the antibiofilm activity of hydroalcoholic extract of leaves from C. multijuga against the evaluatedmicroaerophilic bacteria in the sessile mode gave IC50 values of 318.0 and 695.6 µg/mL againstS. mitis (ATCC 49456) and A. actinomycetemcomintans (ATCC 43717), respectively. As for the assayedanaerobic bacteria, the hydroalcoholic extract of leaves gave IC50 of 4554.0, 2218.0, and600.1 µg/mL against F. nucleatum (Clinical isolate), P. gingivalis (ATCC 33277), and P. micros(Clinical isolate), respectively, whereas the oleoresin afforded IC50 of 357.1 µg/mL against P.gingivalis (ATCC 33277).Conclusion: The oleoresin and hydroalcoholic extract of leaves displayed satisfactory activityagainst the main oral pathogens in both sessile and planktonic modes. The oleoresin and hydroalcoholicextracts of leaves from C. multijuga are potential candidates for the development of new productsfor dental and oral care.
背景:多刺木是巴西广泛使用的药用植物。在copaiba油树脂的各种民族药理学适应症中,抗菌活性得到了强调。目的:研究多刺木叶油树脂和水醇提取物在无根模式和浮游模式下对口腔病原菌的抑制作用。方法:采用美国型培养收集的标准菌株和引起牙髓和牙髓感染的临床分离株。采用96孔微孔板肉汤微量稀释法、最低杀菌浓度法和生物膜根除试验对其最低抑菌浓度(MIC)进行评价。结果:最低抑菌浓度(MIC)和最低杀菌浓度(MBC)测定表明,油树脂对部分菌株有一定的抑菌效果。在无根模式下,多叶水醇提取物对所评价的微嗜气细菌的抑菌活性的IC50值分别为318.0和695.6µg/mL。分别为mittis (ATCC 49456)和A.放线菌comintans (ATCC 43717)。对所检测的厌氧细菌,叶水醇提取物对临床分离株核心菌(F. nucleatum)、牙龈假单胞菌(P.gingivalis, ATCC 33277)和微假单胞菌(P. micros,临床分离株)的IC50分别为4554.0、2218.0和600.1µg/mL,而油树脂对牙龈假单胞菌(P.gingivalis, ATCC 33277)的IC50为357.1µg/mL。结论:黄芪叶油树脂和水醇提取物对口腔主要病原菌均有较好的抗微生物活性。木参叶的油树脂和水醇提取物具有开发口腔保健新产品的潜力。
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引用次数: 2
Perioperative Dental Management of Patients in The Background of Antithrombotic Use 使用抗栓药物背景下患者围手术期牙科管理
Pub Date : 2019-05-01 DOI: 10.2174/2542579x01666180629094559
G. Sethna, R. Sivasankar, P. Gaitonde, P. Gaitonde
Treatment and perioperative dental management in patients on antithromboticmedications poses a serious challenge to dental professionals due to perceived risk ofbleeding complications. This article aims to study the anticoagulant / antiplatelet drugs currentlyavailable on the market, review contemporary oral anti-thrombotic treatment and offer managementguidelines in such situations based on the review of pertinent literature. Science Direct and Ovid databases, PubMed, Scopus and product literaturewere accessed to review relevant literature with respect to current anti-thrombotic drugs, indicationsfor their use in medical conditions, complications related to their use and drug interactions. Thesearch covered studies published in medical and dental journals in English with a relevant impactfactor over a period of 10 years. Meta analyses, systematic reviews, randomized trials, cohort basedand case-control studies and society-based guidelines were considered. Key words utilized in thesearch criteria included Warfarin, Coumarin, Aspirin, P2Y12 inhibitors, Prasugrel, Clopidogrel, Ticagrelor,Hemorrhage, Anti-thrombin, Platelet aggregation inhibitors and International NormalizedRatio (INR) and were validated by the MeSH dictionaries.Dental practitioners today, are faced with the challenge of conducting surgical procedures onpatients who are on anti-thrombotic medications for a variety of medical/ surgical co-morbid conditions.Although there is consensus amongst various studies regarding continuation of warfarin in therapeuticranges for dento-alveolar surgery, there is insufficient evidence to reach a consensus in thosegroups who are at intermediate or high risk of bleeding. However, most studies and published literaturedo agree that there is no real increased risk of bleeding complications during conduct of these proceduresif the patient’s INR is less than 3.5 along with adequate haemostatic measures.Regardless of the procedure to be performed, every case needs to be titrated on its individualmerit based on both patient and surgical factors. Further, it is recommended that INR valuesshould be established at least 72 hours prior to the surgery, which admits a margin of safety for dosemodification if necessary. A meticulous case history with complementary hemostatic tests and adoptionof adequate local hemostatic measures hold the key to not having the necessity to modify theantiplatelet or anticoagulation treatment in most cases. Additionally, the advent of newer anticoagulantsand antiplatelets have raised the requirement of dedicated Randomized Clinical Trials to answerthe specific clinical questions of bleeding risk versus thrombo-embolic complications in the perioperativemanagement of such patients.
由于出血并发症的风险,抗血栓药物患者的治疗和围手术期牙科管理对牙科专业人员提出了严峻的挑战。本文旨在研究目前市场上可获得的抗凝血/抗血小板药物,回顾当代口服抗血栓治疗,并在相关文献的基础上提供此类情况下的管理指南。检索Science Direct和Ovid数据库、PubMed、Scopus和产品文献,回顾当前抗血栓药物的相关文献、其在医疗条件下使用的适应症、与使用相关的并发症和药物相互作用。该研究涵盖了10年来在英文医学和牙科期刊上发表的相关影响因子的研究。我们考虑了Meta分析、系统评价、随机试验、基于队列和病例对照研究以及基于社会的指南。检索标准中使用的关键词包括华法林、香豆素、阿司匹林、P2Y12抑制剂、普拉格雷、氯吡格雷、替格瑞洛、出血、抗凝血酶、血小板聚集抑制剂、国际标准化比率(INR),并通过MeSH词典进行验证。牙科医生今天面临的挑战是,对各种医疗/手术合并症的抗血栓药物患者进行外科手术。尽管在牙槽牙外科治疗范围内继续使用华法林的各种研究中有共识,但在中高出血风险人群中没有足够的证据达成共识。然而,大多数研究和已发表的文献都同意,如果患者的INR小于3.5并采取适当的止血措施,则在进行这些手术期间出血并发症的风险不会真正增加。无论采取何种手术,每个病例都需要根据患者和手术因素对其个人价值进行滴定。此外,建议INR值应在手术前至少72小时确定,这允许在必要时进行剂量调整的安全范围。在大多数病例中,细致的病史、补充止血试验和适当的局部止血措施是不需要修改抗血小板或抗凝治疗的关键。此外,新型抗凝剂和抗血小板的出现也增加了对专门的随机临床试验的需求,以回答此类患者围手术期管理中出血风险与血栓栓塞并发症的具体临床问题。
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引用次数: 0
Launching of a New Journal and the Challenges of Publishing Scientific Knowledge 创办新期刊与出版科学知识的挑战
Pub Date : 2019-05-01 DOI: 10.2174/2542579X0101190329113306
A. D. Bona
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引用次数: 0
Is Temporomandibular Joint Disc Displacement without Reduction a Plausible Cause of Condylar Hypoplasia? A Case Report 颞下颌关节盘未复位移位是髁突发育不全的合理原因吗?病例报告
Pub Date : 2019-03-29 DOI: 10.2174/2542579X01666180919121059
Yi-Shu Liu, A. Yap, J. Lei, K. Fu
The causes of mandibular condylar hypoplasia can be congenital or acquiredin nature. Cited local causes of acquired hypoplasia include trauma, infection and irradiation.We report a case of hypoplastic condyle that was attributed to temporomandibular joint (TMJ) discdisplacement without reduction (DDwoR). A 16-year-old male presented with restricted mouth opening and right TMJpain for 6 months. He was subsequently diagnosed with DDwoR. Conservative treatment comprisingself-care and moist-heat therapy was administered and he was followed for 27 months withoutany further interventions. During this period, transitions from “normal” morphology to condylarflattening / erosion, and eventually a re-modeled smaller “normal” right TMJ were observed.The present case provided initial support that DDwoR could be a plausible cause ofcondylar hypoplasia in adolescents / young adults.
下颌髁突发育不全的原因可以是先天性的,也可以是后天的。获得性发育不全的局部原因包括创伤、感染和照射。我们报告一例发育不良的髁是归因于颞下颌关节(TMJ)脱位无复位(DDwoR)。16岁男性,表现为张嘴受限,右侧颞下颌关节疼痛6个月。他随后被诊断为DDwoR。保守治疗包括自我护理和湿热疗法,随访27个月,没有任何进一步的干预。在此期间,观察到从“正常”形态到髁突扁平/侵蚀的转变,最终观察到重建的更小的“正常”右侧TMJ。本病例提供了初步支持,DDwoR可能是青少年/年轻人髁突发育不全的一个合理原因。
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引用次数: 1
Meet Our Editor-in-Chief 认识我们的主编
Pub Date : 2019-03-29 DOI: 10.2174/2542579X0101190329113129
A. D. Bona
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引用次数: 0
Correlation Among Methods to Measure Tooth Color in Clinical Trials Evaluating Tooth Bleaching 评价牙齿漂白临床试验中测量牙齿颜色方法的相关性
Pub Date : 2019-03-29 DOI: 10.2174/2542579x01666180416112018
A. Faria-E-Silva
Objective: This study aimed to assess possible differences in results provided by twoshade guides and a spectrophotometer used to measure the color changes during tooth bleaching.Methods: Fifty-six patients underwent two sessions of in-office tooth bleaching with a 35% hydrogenperoxide with a week of an interval between them. The color evaluation was performed usingshade match with two guide scales (Vita Classical, and Vita Bleach Guide) and a spectrophotometerproviding CieLab data. The color was assessed at baseline and 7 days after each session, and 30days after the last session. Data from scales were arranged in scores according to lightness (lowest tohighest) and the color changes were calculated based on baseline data. For CieLab data, ΔL, Δa, Δb,and ΔE were calculated for each assessment time. Differences between the color changes observedin each session were assessed by Wilcoxon test (α = 0.05). Friedman`s test and One-way repeatedmeasures ANOVA were used to analyze color changes among the assessment times. Spearman`s testwas used to evaluate the correlation between the shade guide scores and data from Cielab.Results: All methods of color measurement demonstrated any additional effect of second bleachingsession on color change, and stable color after 30 days (p < 0.001 for all methods). Both shade guidescales presented low correlation coefficients with ΔL, and moderate coefficients with Δb, Δa, andΔE.Conclusion: Despite the weak/ moderate correlation among the methods used to measure toothcolor, all methods showed similar results of tooth bleaching effectiveness.
目的:本研究旨在评估双色光导板和分光光度计测量牙齿漂白过程中颜色变化的结果可能存在的差异。方法:56例患者进行了两次门诊35%过氧化氢牙齿漂白,两次漂白之间间隔一周。颜色评估使用两种指导刻度(Vita classic和Vita Bleach guide)和提供CieLab数据的分光光度计进行色度匹配。在基线和每次治疗后7天以及最后一次治疗后30天评估颜色。量表数据按亮度(从低到高)进行评分,并根据基线数据计算颜色变化。对于CieLab数据,在每个评估时间计算ΔL、Δa、Δb和ΔE。采用Wilcoxon检验(α = 0.05)评价各组观察到的颜色变化的差异。采用Friedman检验和单因素重复测量方差分析分析不同评估时间的颜色变化。斯皮尔曼测试用于评估阴影指南得分与Cielab数据之间的相关性。结果:所有的颜色测量方法都显示了第二次漂白对颜色变化的任何额外影响,并且30天后颜色稳定(所有方法的p < 0.001)。两种遮荫指南均与ΔL呈低相关系数,与Δb、Δa、andΔE呈中等相关系数。结论:虽然牙齿颜色测量方法之间存在弱/中度相关性,但所有方法的牙齿漂白效果结果相似。
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引用次数: 0
Recent Advances in Color and Whiteness Evaluations in Dentistry 牙科颜色和白度评价的最新进展
Pub Date : 2019-03-29 DOI: 10.2174/2542579x01666180719125137
M. M. Pérez, O. Pecho, R. Ghinea, R. Pulgar, A. D. Bona
The final goal of color measurement or shade specification in dentistry isthe reproduction by prosthetic materials of all important appearance characteristics of natural oralstructures. The application of color science in dentistry is an objective way to measure and evaluatesuch structures and dental materials in clinical practice and dental research. Literature on color science was reviewed to present new metrics to evaluate color differencesof dental materials and dental structures. Visual acceptability and perceptibility values of colordifferences are reviewed and new whiteness indexes to describe whiteness in dentistry are presented.In the last decade, the CIELAB 50:50% perceptibility and acceptability thresholds were setto 1.2 and 2.7, respectively, and the CIEDE2000 50:50% perceptibility and acceptability thresholdswere set to 0.8 and 1.8. The CIEDE2000 color-difference formula became increasingly popular indentistry. Developments in color science have led to the description of tooth whiteness and changesin tooth whiteness based on whiteness indexes, with the most relevant being the WID whiteness index,which is a customized index based in CIELAB color space. The application of color science in dentistry has allowed the precise description oftooth color and whiteness. The revised and new CIEDE2000 color-difference formula is expected tofully replace the outdated CIELAB formula in almost all dental applications. Recent psychophysicalstudies have reported values of visual thresholds and new whiteness indexes, which can serve asquality control tools to guide the selection of esthetic dental materials, evaluate clinical performance,and interpret visual and instrumental findings in clinical dentistry, dental research, and subsequentstandardization.
牙科中颜色测量或色度规范的最终目标是通过假体材料再现自然口腔结构的所有重要外观特征。色彩科学在牙科中的应用,是在临床实践和牙科研究中对这些结构和牙科材料进行测量和评价的一种客观方法。本文回顾了有关颜色科学的文献,提出了评估牙齿材料和牙齿结构颜色差异的新指标。综述了色差的视觉可接受性和可感知性值,并提出了描述牙医学中白度的新指标。在过去十年中,CIELAB 50:50%的可感知性和可接受性阈值分别被设置为1.2和2.7,CIEDE2000 50:50%的可感知性和可接受性阈值被设置为0.8和1.8。CIEDE2000色差配方越来越受行业欢迎。随着颜色科学的发展,基于白度指数来描述牙齿白度和牙齿白度的变化,其中最相关的是WID白度指数,这是一个基于CIELAB颜色空间的定制指数。颜色科学在牙科中的应用使牙齿颜色和白度的精确描述成为可能。修订后的新CIEDE2000色差配方有望在几乎所有牙科应用中完全取代过时的CIELAB配方。最近的心理物理学研究报道了视觉阈值和新的白度指数的值,它们可以作为质量控制工具来指导美观牙科材料的选择,评估临床性能,解释临床牙科、牙科研究和随后的标准化中的视觉和仪器结果。
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引用次数: 44
期刊
Current opinion in dentistry
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