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Postoperative delirium in oral and maxillofacial surgery: a scoping review. 口腔颌面外科术后谵妄:范围界定综述。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-07-23 DOI: 10.1186/s13005-024-00439-9
Eman Alhammadi, Julian Max Kuhlmann, Majeed Rana, Helmut Frohnhofen, Henriette Louise Moellmann

Background: Postoperative delirium (POD) in the oral and maxillofacial settings has gained more attention in recent decades. Due to advances in medical technology, treatment possibilities have expanded treatment for elderly and frail patients. This scoping review explores the correlation between POD and oral and maxillofacial surgery, summarizing screening and management protocols and identifying risk factors in this surgical field.

Methods: This review follows the Scoping Review extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR). A comprehensive literature search was performed using multiple databases, focusing on articles published from 2002 to 2023 that discuss delirium in oral and maxillofacial surgery settings. The review was registered beforehand in the Open Science Framework ( https://osf.io/r2ebc ).

Results: From the initial 644 articles, 68 met the inclusion criteria. These studies highlighted the significant heterogeneity in POD diagnosis methods. The review identifies multiple risk factors across the preoperative, intraoperative, and postoperative phases that influence the occurrence of POD. Significant and independent risk factors in multiple regression analysis were highlighted, creating a clinical prediction list for the occurrence of POD.

Conclusion: It is crucial to preoperatively identify patients at risk for POD and actively modify these risks throughout the patient's hospital stay. Implementing nonpharmacological preventive measures for at-risk patients is recommended to decrease the incidence of POD. Future research should focus on creating standardized specialty-specific protocols incorporating validated assessment tools and addressing the full spectrum of risk factors associated with POD.

背景:近几十年来,口腔颌面部手术后谵妄(POD)越来越受到关注。由于医疗技术的进步,老年和体弱患者的治疗范围也有所扩大。本范围界定综述探讨了 POD 与口腔颌面外科之间的相关性,总结了筛查和管理方案,并确定了该外科领域的风险因素:本综述遵循系统综述和荟萃分析首选报告项目(PRISMA-ScR)的范围界定综述扩展。我们使用多个数据库进行了全面的文献检索,重点检索 2002 年至 2023 年间发表的讨论口腔颌面外科谵妄的文章。该综述已事先在开放科学框架(https://osf.io/r2ebc )中注册。结果:在最初的 644 篇文章中,有 68 篇符合纳入标准。这些研究凸显了 POD 诊断方法的显著异质性。综述确定了影响 POD 发生的术前、术中和术后阶段的多种风险因素。在多元回归分析中强调了重要且独立的风险因素,从而建立了一个发生 POD 的临床预测列表:结论:术前识别有 POD 风险的患者并在患者住院期间积极改变这些风险至关重要。建议对高危患者实施非药物预防措施,以降低 POD 的发生率。未来的研究应侧重于创建标准化的专科方案,其中纳入经过验证的评估工具,并解决与 POD 相关的所有风险因素。
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引用次数: 0
Bi-institutional analysis of microbiological spectrum and therapeutic management of parotid abscesses. 腮腺脓肿微生物谱和治疗方法的双机构分析。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-07-12 DOI: 10.1186/s13005-024-00438-w
Marcel Mayer, Julia Esser, Sarah Victoria Walker, Sami Shabli, Axel Lechner, Martin Canis, Jens Peter Klussmann, Lisa Nachtsheim, Philipp Wolber

Background: A parotid abscess (PA) is a complication of an acute bacterial parotitis with a potentially life-threatening course. To date, data on the diagnosis and therapy of PA is sparse and mostly consists of case reports or case series. Therefore, this study aimed at comprehensively analyzing the microbiological spectrum and the therapeutic management in a bi-institutional setting.

Methods: A retrospective clinical chart review was performed to identify all patients surgically treated for PA at two tertiary care centers in Germany. Data on demographics, clinical management and microbiological data including species identification, pathogenicity, type of antibiotic therapy, adjustment of antibiotics, antibiotic sensitivity testing, and smear test results were extracted. Intervention-related variables and etiology were analyzed for their statistical association with outcome variables.

Results: Overall, 85 patients were included. Most patients (92.9%) underwent surgical incision. Around half of the patients (45.9%) were treated under local anesthesia. No facial nerve palsy was observed. The most frequently detected pathogens were Streptococci (n = 23), followed by Staphylococcus aureus (n = 6) including one case of methicillin-resistant Staphylococcus aureus. Most patients (68.2%) received an aminopenicillin ± beta-lactamase inhibitor as empiric antibiotic therapy. In 6 cases the antibiotic therapy was modified after receiving the antibiogram. Four patients (5.2%) presented with recurrent PA. Etiology was idiopathic (42.4%), followed by tumorous (12.9%), obstructive, and immunosuppressive (each 11.8%). Patients with a dental focus (p = 0.007) had a longer duration of hospitalization.

Conclusion: The results show that the surgical therapy of PA under local anesthesia is safe. A dental examination should routinely be performed to rule out a dental focus. Obtaining a microbiological specimen in order to modify antibiotic therapy if necessary and a histopathological specimen to rule out a tumorous etiology is obligate.

背景:腮腺脓肿(PA)是急性细菌性腮腺炎的一种并发症,病程可能危及生命。迄今为止,有关腮腺脓肿诊断和治疗的数据很少,且大多为病例报告或系列病例。因此,本研究旨在全面分析双机构环境中的微生物谱和治疗方法:方法:对德国两家三级医疗中心所有接受过 PA 手术治疗的患者进行回顾性临床病历审查。提取了人口统计学、临床管理和微生物学数据,包括物种鉴定、致病性、抗生素治疗类型、抗生素调整、抗生素敏感性检测和涂片检测结果。对干预相关变量和病因与结果变量的统计学关联进行了分析:共纳入 85 名患者。大多数患者(92.9%)接受了手术切开。约半数患者(45.9%)在局部麻醉下接受治疗。未发现面神经麻痹。最常检测到的病原体是链球菌(23 例),其次是金黄色葡萄球菌(6 例),包括一例耐甲氧西林金黄色葡萄球菌。大多数患者(68.2%)接受了氨青霉素±β-内酰胺酶抑制剂作为经验性抗生素治疗。有 6 例患者在接受抗生素图谱检查后修改了抗生素疗法。4 名患者(5.2%)出现复发性 PA。病因是特发性(42.4%),其次是肿瘤性(12.9%)、阻塞性和免疫抑制性(各占 11.8%)。有牙科病灶的患者(P = 0.007)住院时间更长:结果表明,局部麻醉下的 PA 手术治疗是安全的。应常规进行牙科检查以排除牙源性病灶。获取微生物标本以便在必要时调整抗生素治疗,获取组织病理学标本以排除肿瘤病因是必须的。
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引用次数: 0
CRISPR/Cas9-mediated knock out of ITGB6 in human OSCC cells reduced migration and proliferation ability. CRISPR/Cas9 介导的人 OSCC 细胞 ITGB6 基因敲除降低了迁移和增殖能力。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-18 DOI: 10.1186/s13005-024-00437-x
Maximilian Geyer, Fabian Geyer, Ute Reuning, Sarah Klapproth, Klaus-Dietrich Wolff, Markus Nieberler

Background: The treatment of oral squamous cell carcinoma (OSCC) remains challenging and survival rates have not been improved significantly over the past decades. Integrins have been recognized driving the cancer progression and high expression levels cause poor outcomes in patients afflicted with OSCC. Integrin αvβ6 and its subunit integrin beta 6 (ITGB6) were discovered to enhance the invasiveness by providing beneficial effects on downstream pathways promoting the cancer progression. The objective of this study was to establish a CRISPR/Cas9-mediated knock out of ITGB6 in the human OSCC cell line HN and investigate the effects on the migration and proliferation ability.

Methods: ITGB6 knock out was performed using the CRISPR/Cas9-system, RNPs, and lipofection. Monoclonal cell clones were achieved by limiting dilution and knock out verification was carried out by sanger sequencing and FACS on protein level. The effects of the knock out on the proliferation and migration ability were evaluated by using MTT and scratch assays. In addition, in silico TCGA analysis was utilized regarding the effects of ITGB6 on overall survival and perineural invasion.

Results: In silico analysis revealed a significant impact of ITGB6 mRNA expression levels on the overall survival of patients afflicted with OSCC. Additionally, a significantly higher rate of perineural invasion was discovered. CRISPR/Cas9-mediated knock out of ITGB6 was performed in the OSCC cell line HN, resulting in the generation of a monoclonal knock out clone. The knock out clone exhibited a significantly reduced migration and proliferation ability when compared to the wildtype.

Conclusions: ITGB6 is a relevant factor in the progression of OSCC and can be used for the development of novel treatment strategies. The present study is the first to establish a monoclonal CRISPR/Cas9-mediated ITGB6 knockout cell clone derived from an OSCC cell line. It suggests that ITGB6 has a significant impact on the proliferative and migratory capacity in vitro.

背景:口腔鳞状细胞癌(OSCC)的治疗仍然充满挑战,在过去几十年中,生存率一直没有显著提高。整合素被认为是癌症进展的驱动因素,高表达水平导致 OSCC 患者预后不佳。研究发现,整合素αvβ6及其亚基整合素β6(ITGB6)可通过对促进癌症进展的下游通路产生有益影响来增强侵袭性。本研究的目的是在人OSCC细胞系HN中建立CRISPR/Cas9介导的ITGB6基因敲除,并研究其对迁移和增殖能力的影响:方法:利用CRISPR/Cas9系统、RNPs和脂质感染技术敲除ITGB6。方法:利用 CRISPR/Cas9 系统、RNPs 和脂质体感染技术进行 ITGB6 基因敲除,通过限制稀释获得单克隆细胞克隆,并通过桑格测序和 FACS 在蛋白质水平上对基因敲除进行验证。通过 MTT 和划痕试验评估了基因敲除对细胞增殖和迁移能力的影响。此外,还就ITGB6对总存活率和神经周围侵袭的影响进行了TCGA硅学分析:硅学分析显示,ITGB6 mRNA表达水平对OSCC患者的总生存率有显著影响。此外,研究还发现ITGB6的神经周围侵袭率明显较高。在 OSCC 细胞系 HN 中进行了 CRISPR/Cas9 介导的 ITGB6 基因敲除,从而产生了一个单克隆基因敲除克隆。与野生型相比,基因敲除克隆的迁移和增殖能力明显降低:ITGB6是OSCC进展的一个相关因素,可用于开发新型治疗策略。本研究首次从OSCC细胞系中建立了单克隆CRISPR/Cas9介导的ITGB6基因敲除细胞克隆。研究表明,ITGB6对体外增殖和迁移能力有显著影响。
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引用次数: 0
Orthodontic findings and treatment need in patients with amelogenesis imperfecta: a descriptive analysis. 成骨不全症患者的正畸结果和治疗需求:描述性分析。
IF 3 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-14 DOI: 10.1186/s13005-024-00436-y
Stephan Christian Möhlhenrich, Sachin Chhatwani, Peter Schmidt, Kristian Kniha, Jan Postberg, Andreas G Schulte, Jochen Jackowski, Stefan Zimmer, Gholamreza Danesh

Introduction: Amelogenesis imperfecta (AI) is a genetically determined, non-syndromic enamel dysplasia that may manifest as hypoplasia, hypomaturation, or hypocalcification and can commonly be classified into four primary groups. In this retrospective analysis, specific orofacial characteristics are described and associated with each of the AI types based on a patient cohort from Witten/Herdecke University, Germany.

Methods: Data from 19 patients (ten male and nine female, mean age 12.27 ± 4.06 years) with AI who presented at the Department of Orthodontics between July 2011 and December 2023 were analyzed. Baseline skeletal and dental conditions were assessed, including the presence of hypodontia, displacements, and taurodontism. AI was classified into classes I-IV based on phenotype. Treatment needs were evaluated according to the main findings following the German KIG classification, while the radiological enamel situation was determined using panoramic radiographs.

Results: An approximately equal distribution between classes II and III was found and a slight inclination toward a dolichofacial configuration (ΔML-NSL: 5.07 ± 9.23°, ΔML-NL: 4.24 ± 8.04°). Regarding orthodontic findings, disturbance in tooth eruption as well as open bite were the most prevalent issues (both 36.8%, n = 7). The most common AI classes were type I and II, which show an almost even distribution about the skeletal classes in sagittal dimension, while dolichofacial configuration was found most frequently in vertical dimension.

Conclusion: Both clinical and radiological orthodontic findings in context with AI are subject to extensive distribution. It seems that no specific orofacial findings can be confirmed in association with AI with regard to the common simple classes I-IV. It may be more appropriate to differentiate the many subtypes according to their genetic aspects to identify possible associated orthodontic findings.

简介釉质发育不全(AI)是一种由基因决定的非综合征性釉质发育不良,可表现为釉质发育不全、釉质发育不全或釉质缺钙,通常可分为四个主要类型。在这项回顾性分析中,根据德国威滕/赫德克大学的患者队列,描述了每种人工釉质发育不全类型的具体口面部特征及其相关性:分析了 2011 年 7 月至 2023 年 12 月期间在正畸科就诊的 19 名 AI 患者(男性 10 人,女性 9 人,平均年龄为 12.27 ± 4.06 岁)的数据。对患者的骨骼和牙齿基线状况进行了评估,包括是否存在牙列不齐、牙列移位和牙槽骨发育不良。根据表型将 AI 分为 I-IV 类。根据德国KIG分类法的主要结果评估治疗需求,同时使用全景X光片确定放射性釉质情况:结果:发现II级和III级之间的分布大致相同,并略微倾向于双颌结构(ΔML-NSL:5.07 ± 9.23°,ΔML-NL:4.24 ± 8.04°)。在正畸结果方面,牙齿萌出紊乱和开牙合是最常见的问题(均为 36.8%,n = 7)。最常见的AI类型是I型和II型,这两种类型在矢状维度上的骨骼类型分布几乎均匀,而在垂直维度上最常见的是双颌结构:结论:AI 患者的临床和放射学正畸结果都有广泛的分布。就常见的简单I-IV类而言,似乎没有特定的口面部发现与AI有关。根据遗传学方面对许多亚型进行区分,以确定可能的相关正畸结果可能更为合适。
{"title":"Orthodontic findings and treatment need in patients with amelogenesis imperfecta: a descriptive analysis.","authors":"Stephan Christian Möhlhenrich, Sachin Chhatwani, Peter Schmidt, Kristian Kniha, Jan Postberg, Andreas G Schulte, Jochen Jackowski, Stefan Zimmer, Gholamreza Danesh","doi":"10.1186/s13005-024-00436-y","DOIUrl":"10.1186/s13005-024-00436-y","url":null,"abstract":"<p><strong>Introduction: </strong>Amelogenesis imperfecta (AI) is a genetically determined, non-syndromic enamel dysplasia that may manifest as hypoplasia, hypomaturation, or hypocalcification and can commonly be classified into four primary groups. In this retrospective analysis, specific orofacial characteristics are described and associated with each of the AI types based on a patient cohort from Witten/Herdecke University, Germany.</p><p><strong>Methods: </strong>Data from 19 patients (ten male and nine female, mean age 12.27 ± 4.06 years) with AI who presented at the Department of Orthodontics between July 2011 and December 2023 were analyzed. Baseline skeletal and dental conditions were assessed, including the presence of hypodontia, displacements, and taurodontism. AI was classified into classes I-IV based on phenotype. Treatment needs were evaluated according to the main findings following the German KIG classification, while the radiological enamel situation was determined using panoramic radiographs.</p><p><strong>Results: </strong>An approximately equal distribution between classes II and III was found and a slight inclination toward a dolichofacial configuration (ΔML-NSL: 5.07 ± 9.23°, ΔML-NL: 4.24 ± 8.04°). Regarding orthodontic findings, disturbance in tooth eruption as well as open bite were the most prevalent issues (both 36.8%, n = 7). The most common AI classes were type I and II, which show an almost even distribution about the skeletal classes in sagittal dimension, while dolichofacial configuration was found most frequently in vertical dimension.</p><p><strong>Conclusion: </strong>Both clinical and radiological orthodontic findings in context with AI are subject to extensive distribution. It seems that no specific orofacial findings can be confirmed in association with AI with regard to the common simple classes I-IV. It may be more appropriate to differentiate the many subtypes according to their genetic aspects to identify possible associated orthodontic findings.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"36"},"PeriodicalIF":3.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of a porcine training model for microvascular fasciocutaneous free flap reconstruction. 开发用于微血管筋膜皮游离皮瓣重建的猪训练模型。
IF 3 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-03 DOI: 10.1186/s13005-024-00435-z
Christopher-Philipp Nobis, Katharina Grottschreiber, Manuel Olmos, Tobias Moest, Manuel Weber, Marco Kesting, Rainer Lutz

Background: In reconstructive surgery, improvements are needed in the effective teaching of free flap surgery. There is a need for easily accessible and widely available training without high financial costs or ethical concerns while still providing a realistic experience. Our aim was to develop an appropriate training model for microvascular flaps.

Methods: We identified pig head halves as most appropriate regarding availability, cost, and realism. These accrue largely by the food industry, so no animals need to be sacrificed, making it more ethical from an animal welfare perspective. We evaluated the suitability as flap donor site and analyzed the vascular anatomy of 51 specimens.

Results: Anatomical evaluation revealed a reliable and constant vascular anatomy, allowing the design of a flap model that can effectively illustrate the entire process of microvascular flap surgery. The process was divided into 6 key steps. The flap can be harvested after marking the vascular pedicle 5.3 cm from the lateral corner of the mouth. Skin island design and subsequent tissue dissection follow until a fasciocutaneous flap is raised, similar to a radial flap. Upon completion of flap harvesting, it can be freely transferred for defect reconstruction. Microvascular anastomosis can be performed on recipient vessels in the cervical region, and the difficulty can be individually adjusted.

Conclusions: The developed training model is a reasonable compromise in terms of surgical realism, availability, didactic value, and cost/time effectiveness. We believe it is a powerful and effective tool with high potential for improving surgical education and training.

背景:在整形外科中,需要改进游离皮瓣手术的有效教学。我们需要一种既不需要高昂的经济成本或道德问题,又能提供真实体验的培训模式。我们的目标是为微血管瓣建立一个合适的培训模型:方法:我们认为猪头半身在可用性、成本和逼真度方面最合适。这些猪头主要来自食品行业,因此无需牺牲动物,从动物福利的角度来看更符合道德规范。我们评估了皮瓣供体部位的适宜性,并分析了 51 个标本的血管解剖结构:结果:解剖学评估揭示了可靠、恒定的血管解剖结构,从而设计出一种能有效说明微血管瓣手术全过程的皮瓣模型。整个过程分为 6 个关键步骤。在距嘴角外侧 5.3 厘米处标记血管蒂后,即可采集皮瓣。随后进行皮岛设计和组织剥离,直至形成筋膜皮瓣,类似于桡侧皮瓣。皮瓣采集完成后,可自由转移用于缺损重建。微血管吻合术可在颈部受体血管上进行,难度可单独调整:所开发的培训模型在手术真实性、可用性、教学价值和成本/时间效益方面都是一个合理的折衷方案。我们相信它是一个强大而有效的工具,在改善外科教育和培训方面具有很大的潜力。
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引用次数: 0
Automatic extraction of facial median sagittal plane for patients with asymmetry based on the EDMA alignment algorithm. 基于 EDMA 对齐算法,为不对称患者自动提取面部正中矢状面。
IF 3 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-18 DOI: 10.1186/s13005-024-00430-4
Yujia Zhu, Aonan Wen, Ning Xiao, Zixiang Gao, Shengwen Zheng, Xiangling Fu, Yijiao Zhao, Yong Wang

Background: We aimed to establish a novel method for automatically constructing three-dimensional (3D) median sagittal plane (MSP) for mandibular deviation patients, which can increase the efficiency of aesthetic evaluating treatment progress. We developed a Euclidean weighted Procrustes analysis (EWPA) algorithm for extracting 3D facial MSP based on the Euclidean distance matrix analysis, automatically assigning weight to facial anatomical landmarks.

Methods: Forty patients with mandibular deviation were recruited, and the Procrustes analysis (PA) algorithm based on the original mirror alignment and EWPA algorithm developed in this study were used to construct the MSP of each facial model of the patient as experimental groups 1 and 2, respectively. The expert-defined regional iterative closest point algorithm was used to construct the MSP as the reference group. The angle errors of the two experimental groups were compared to those of the reference group to evaluate their clinical suitability.

Results: The angle errors of the MSP constructed by the two EWPA and PA algorithms for the 40 patients were 1.39 ± 0.85°, 1.39 ± 0.78°, and 1.91 ± 0.80°, respectively. The two EWPA algorithms performed best in patients with moderate facial asymmetry, and in patients with severe facial asymmetry, the angle error was below 2°, which was a significant improvement over the PA algorithm.

Conclusions: The clinical application of the EWPA algorithm based on 3D facial morphological analysis for constructing a 3D facial MSP for patients with mandibular deviated facial asymmetry deformity showed a significant improvement over the conventional PA algorithm and achieved the effect of a dental clinical expert-level diagnostic strategy.

研究背景我们旨在为下颌偏斜患者建立一种自动构建三维(3D)正中矢状面(MSP)的新方法,从而提高美学评估治疗进展的效率。我们开发了一种基于欧氏距离矩阵分析的欧氏加权普氏分析(EWPA)算法,用于提取三维面部MSP,自动为面部解剖地标分配权重:招募 40 名下颌骨偏斜患者,分别作为实验组 1 和实验组 2,使用基于原始镜像配准的 Procrustes 分析(PA)算法和本研究开发的 EWPA 算法构建患者各面部模型的 MSP。作为参照组,使用专家定义的区域迭代最近点算法构建 MSP。将两个实验组的角度误差与参照组的角度误差进行比较,以评估其临床适用性:结果:两种 EWPA 算法和 PA 算法为 40 名患者构建的 MSP 的角度误差分别为 1.39 ± 0.85°、1.39 ± 0.78°和 1.91 ± 0.80°。两种 EWPA 算法在中度面部不对称患者中表现最佳,在重度面部不对称患者中,角度误差低于 2°,比 PA 算法有显著改善:基于三维面部形态分析的EWPA算法在构建下颌偏斜面部不对称畸形患者的三维面部MSP方面的临床应用比传统的PA算法有显著改善,达到了口腔临床专家级诊断策略的效果。
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引用次数: 0
Preoperative assessment of bone density for dental implantation: a comparative study of three different ROI methods. 牙科植入术前骨密度评估:三种不同 ROI 方法的比较研究。
IF 3 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-17 DOI: 10.1186/s13005-024-00434-0
Shiuan-Hui Wang, Lih-Jyh Fuh, Michael Y C Chen, Ming-Tzu Tsai, Heng-Li Huang, Shin-Lei Peng, Jui-Ting Hsu

Background: Dental cone beam computed tomography (CBCT) is commonly used to evaluate cancellous bone density before dental implant surgery. However, to our knowledge, no measurement approach has been standardized yet. This study aimed to evaluate the relationship between three different regions of interest (ROI) methods on cancellous bone density at the dental implant site using dental CBCT images.

Methods: Patients' dental CBCT images (n = 300) obtained before dental implant surgery were processed using Mimics (Materialise, Leuven, Belgium). At the potential implant sites, the rectangle, cylinder, and surrounding cylinder ROI methods were used to measure bone density. Repeated measures one-way analysis of variance was performed to compare the three ROI methods in terms of measurement results. Pearson correlation analysis was performed to identify the likely pair-wise correlations between the three ROI methods.

Results: The density value obtained using the surrounding cylinder approach (grayscale value [GV],523.56 ± 228.03) was significantly higher than the values obtained using the rectangle (GV, 497.04 ± 236.69) and cylinder (GV,493 ± 231.19) ROI methods in terms of results. Furthermore, significant correlations were noted between the ROI methods (r > 0.965; p < 0.001).

Conclusions: The density measured using the surrounding cylinder method was the highest. The choice of method may not influence the trends of measurement results.

Trial registration: This study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH111-REC3-205. Informed consent was waived by the Institutional Review Board of China Medical University Hospital, CMUH111-REC3-205, owing to the retrospective nature of the study.

背景:牙科锥形束计算机断层扫描(CBCT)通常用于在牙科种植手术前评估松质骨密度。然而,据我们所知,目前还没有标准化的测量方法。本研究旨在利用牙科锥形束计算机断层扫描图像,评估三种不同兴趣区(ROI)方法与牙科植入部位松质骨密度之间的关系:方法:使用 Mimics(比利时鲁汶的 Materialise 公司)处理患者在牙科种植手术前获得的牙科 CBCT 图像(n = 300)。在可能的种植部位,使用矩形、圆柱和周围圆柱 ROI 方法测量骨密度。对三种 ROI 方法的测量结果进行了重复测量单因素方差分析比较。为了确定三种 ROI 方法之间可能存在的成对相关性,还进行了皮尔逊相关分析:结果:使用环绕圆柱体方法获得的密度值(灰度值 [GV],523.56 ± 228.03)明显高于使用矩形(GV,497.04 ± 236.69)和圆柱体(GV,493 ± 231.19)ROI 方法获得的值。此外,ROI 方法之间还存在明显的相关性(r > 0.965;p 结论):使用环绕圆柱体方法测得的密度最高。方法的选择可能不会影响测量结果的趋势:本研究已获中国医科大学附属医院机构审查委员会批准,批准号:CMUH111-REC3-205。由于本研究为回顾性研究,中国医科大学附属医院机构审查委员会(CMUH111-REC3-205)免除了知情同意。
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引用次数: 0
Halitosis in young patients with chronic kidney disease: findings from a randomized controlled trial. 年轻慢性肾病患者的口臭:随机对照试验的结果。
IF 3 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-15 DOI: 10.1186/s13005-024-00428-y
Karolin Charlotte Hoefer, Anna Greta Barbe, Anne Adams, Christoph Schoppmeier, Michael Jochen Wicht, Lutz T Weber, Michael J Noack, Isabelle Graf

Background: Chronic kidney disease (CKD) directly affects oral health. Yet data about halitosis in young CKD patients and the impact of dental prophylaxis is limited. Therefore, as part of this randomized clinical trial, halitosis in young CKD patients undergoing intensive or standard oral preventive procedures was to be explored.

Methods: Three volatile sulfur compounds (hydrogen sulfide, methyl mercaptan and dimethyl sulfide) were measured in 30 young patients with CKD (mean age 14.2 years; 16 males, 14 females). Breath samples were taken after 3 and 6 months and analyzed with selective gas chromatography (OralChroma). Tongue coating (Winkel Index) and clinical indices to determine local inflammation or oral hygiene (Papillary Bleeding Index and Quigley-Hein Index) were assessed. Within an extended anamnesis, patients and their mothers and nurses were questioned about the perceived halitosis. Corresponding quotes were noted verbatim. Patients were randomized to either intensive need-related oral health care measures (oral preventative program, OPP) or a one-stage standard prevention (treatment as usual, TAU).

Results: While there were no differences in volatile sulfur compound levels between TAU and OPP at the three time points of measurements (p > 0.05), there was a tendency towards a reduction in dimethyl sulfide and hydrogen sulfide of affected patients within the OPP group over time. Looking at potential differences between both groups with regard to tongue coating, significant differences were observed between baseline and 3 months after study start in the OPP group, and between baseline and 6 months after study start in the TAU group (p < 0.05). The burden of halitosis was frequently reported by patients' mothers and nurses.

Conclusions: Young CKD patients regularly suffered from halitosis and dimethyl sulfide was its main source. Preventive measures mainly resulted in a reduction of tongue coating.

Trial registration: The German Clinical Trial Register (# DRKS00010580).

背景:慢性肾脏病(CKD)直接影响口腔健康。然而,有关年轻的 CKD 患者口臭以及牙科预防措施的影响的数据却很有限。因此,作为这项随机临床试验的一部分,将对接受强化或标准口腔预防程序的年轻 CKD 患者的口臭情况进行调查:方法:在 30 名年轻的慢性肾脏病患者(平均年龄 14.2 岁;男性 16 人,女性 14 人)中测量了三种挥发性硫化合物(硫化氢、甲硫醇和二甲基硫醚)。分别在 3 个月和 6 个月后采集呼吸样本,并使用选择性气相色谱法(OralChroma)进行分析。对舌苔(Winkel 指数)和确定局部炎症或口腔卫生的临床指数(乳头出血指数和 Quigley-Hein 指数)进行了评估。在详细的病史询问中,患者及其母亲和护士都被问及口臭的感受。逐字记录了相应的引语。患者被随机分配到与需求相关的强化口腔保健措施(口腔预防计划,OPP)或单阶段标准预防(常规治疗,TAU):结果:在三个测量时间点上,TAU 和 OPP 的挥发性硫化合物水平没有差异(P > 0.05),但随着时间的推移,OPP 组受影响患者的二甲基硫醚和硫化氢有减少的趋势。从两组患者舌苔的潜在差异来看,OPP 组患者在基线与研究开始后 3 个月之间,TAU 组患者在基线与研究开始后 6 个月之间存在显著差异(p 结论:OPP 组和 TAU 组患者在基线与研究开始后 3 个月之间存在显著差异,TAU 组患者在基线与研究开始后 6 个月之间存在显著差异:年轻的慢性肾脏病患者经常口臭,而二甲基硫醚是口臭的主要来源。预防措施主要是减少舌苔:试验注册:德国临床试验注册(# DRKS00010580)。
{"title":"Halitosis in young patients with chronic kidney disease: findings from a randomized controlled trial.","authors":"Karolin Charlotte Hoefer, Anna Greta Barbe, Anne Adams, Christoph Schoppmeier, Michael Jochen Wicht, Lutz T Weber, Michael J Noack, Isabelle Graf","doi":"10.1186/s13005-024-00428-y","DOIUrl":"10.1186/s13005-024-00428-y","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) directly affects oral health. Yet data about halitosis in young CKD patients and the impact of dental prophylaxis is limited. Therefore, as part of this randomized clinical trial, halitosis in young CKD patients undergoing intensive or standard oral preventive procedures was to be explored.</p><p><strong>Methods: </strong>Three volatile sulfur compounds (hydrogen sulfide, methyl mercaptan and dimethyl sulfide) were measured in 30 young patients with CKD (mean age 14.2 years; 16 males, 14 females). Breath samples were taken after 3 and 6 months and analyzed with selective gas chromatography (OralChroma). Tongue coating (Winkel Index) and clinical indices to determine local inflammation or oral hygiene (Papillary Bleeding Index and Quigley-Hein Index) were assessed. Within an extended anamnesis, patients and their mothers and nurses were questioned about the perceived halitosis. Corresponding quotes were noted verbatim. Patients were randomized to either intensive need-related oral health care measures (oral preventative program, OPP) or a one-stage standard prevention (treatment as usual, TAU).</p><p><strong>Results: </strong>While there were no differences in volatile sulfur compound levels between TAU and OPP at the three time points of measurements (p > 0.05), there was a tendency towards a reduction in dimethyl sulfide and hydrogen sulfide of affected patients within the OPP group over time. Looking at potential differences between both groups with regard to tongue coating, significant differences were observed between baseline and 3 months after study start in the OPP group, and between baseline and 6 months after study start in the TAU group (p < 0.05). The burden of halitosis was frequently reported by patients' mothers and nurses.</p><p><strong>Conclusions: </strong>Young CKD patients regularly suffered from halitosis and dimethyl sulfide was its main source. Preventive measures mainly resulted in a reduction of tongue coating.</p><p><strong>Trial registration: </strong>The German Clinical Trial Register (# DRKS00010580).</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"32"},"PeriodicalIF":3.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quantitative evaluation of vertical control in orthodontic camouflage treatment for skeletal class II with hyperdivergent facial type. 对骨骼II级超分化面型的正畸伪装治疗中的垂直控制进行定量评估。
IF 3 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-14 DOI: 10.1186/s13005-024-00432-2
Yan-Ning Guo, Sheng-Jie Cui, Ye Liu, Yu Fu, Jie-Ni Zhang, Yan-Heng Zhou, Xue-Dong Wang

Background: In this study, we sought to quantify the influence of vertical control assisted by a temporary anchorage device (TAD) on orthodontic treatment efficacy for skeletal class II patients with a hyperdivergent facial type and probe into the critical factors of profile improvement.

Methods: A total of 36 adult patients with skeletal class II and a hyperdivergent facial type were included in this retrospective case-control study. To exclude the effect of sagittal anchorage reinforcement, the patients were divided into two groups: a maxillary maximum anchorage (MMA) group (N = 17), in which TADs were only used to help with anterior tooth retraction, and the MMA with vertical control (MMA + VC) group (N = 19), for which TADs were also used to intrude the maxillary molars and incisors. The treatment outcome was evaluated using dental, skeletal, and soft-tissue-related parameters via a cephalometric analysis and cast superimposition.

Results: A significant decrease in ANB (P < 0.05 for both groups), the retraction and uprighting of the maxillary and mandibular incisors, and the retraction of protruded upper and lower lips were observed in both groups. Moreover, a significant intrusion of the maxillary molars was observed via the cephalometric analysis (- 1.56 ± 1.52 mm, P < 0.05) and cast superimposition (- 2.25 ± 1.03 mm, P < 0.05) of the MMA + VC group but not the MMA group, which resulted in a remarkable decrease in the mandibular plane angle (- 1.82 ± 1.38°, P < 0.05). The Z angle (15.25 ± 5.30°, P < 0.05) and Chin thickness (- 0.97 ± 0.45°, P < 0.05) also improved dramatically in the MMA + VC group, indicating a better profile and a relaxed mentalis. Multivariate regression showed that the improvement in the soft tissue was closely related to the counterclockwise rotation of the mandible plane (P < 0.05).

Conclusions: TAD-assisted vertical control can achieve intrusion of approximately 2 mm for the upper first molars and induce mandibular counterclockwise rotation of approximately 1.8°. Moreover, it is especially important for patients without sufficient retraction of the upper incisors or a satisfactory chin shape.

背景:在这项研究中,我们试图量化临时固定装置(TAD)辅助下的垂直控制对骨骼分级为II级的面部过度分化患者的正畸治疗效果的影响,并探究改善面型的关键因素:这项回顾性病例对照研究共纳入了 36 名骨骼分级为 II 级且面部过度分化的成年患者。为了排除矢状锚固加固的影响,患者被分为两组:上颌最大锚固(MMA)组(17 人)和上颌最大锚固加垂直控制(MMA + VC)组(19 人),前者仅使用 TAD 来帮助前牙牵引,后者也使用 TAD 来侵入上颌磨牙和切牙。通过头颅测量分析和石膏叠加,使用牙齿、骨骼和软组织相关参数对治疗效果进行评估:结果:ANB 明显降低(PTAD 辅助垂直控制可使上第一磨牙内收约 2 毫米,并诱导下颌逆时针旋转约 1.8°。此外,对于上切牙未充分后缩或下巴形状不理想的患者来说,这一点尤为重要。
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引用次数: 0
Accuracy of dynamic navigation compared to static surgical guides and the freehand approach in implant placement: a prospective clinical study. 前瞻性临床研究:动态导航与静态手术导板和徒手方法在种植体植入中的准确性比较。
IF 3 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-14 DOI: 10.1186/s13005-024-00433-1
Hamza Younis, Chengpeng Lv, Boya Xu, Huixia Zhou, Liangzhi Du, Lifan Liao, Ningbo Zhao, Wen Long, Sadam Ahmed Elayah, Xiaofeng Chang, Longlong He

Background: Computer-guided implant surgery has improved the quality of implant treatment by facilitating the placement of implants in a more accurate manner. This study aimed to assess the accuracy of implant placement in a clinical setting using three techniques: dynamic navigation, static surgical guides, and freehand placement. We also investigated potential factors influencing accuracy to provide a comprehensive evaluation of each technique's advantages and disadvantages.

Materials and methods: Ninety-four implants in 65 patients were included in this prospective study. Patients were randomly assigned to one of three groups: dynamic navigation, static surgical guides, or freehand placement. Implants were placed using a prosthetically oriented digital implant planning approach, and postoperative CBCT scans were superimposed on preoperative plans to measure accuracy. Seven deviation values were calculated, including angular, platform, and apical deviations. Demographic and consistency analyses were performed, along with one-way ANOVA and post-hoc tests for deviation values.

Results: The mean global platform, global apical, and angular deviations were 0.99 mm (SD 0.52), 1.14 mm (SD 0.56), and 3.66° (SD 1.64°) for the dynamic navigation group; 0.92 mm (SD 0.36), 1.06 mm (SD 0.47), and 2.52° (SD 1.18°) for the surgical guide group; and 1.36 mm (SD 0.62), 1.73 mm (SD 0.66), and 5.82° (SD 2.79°) for the freehand group. Both the dynamic navigation and surgical guide groups exhibited statistically significant differences in all values except depth deviations compared to the freehand group (p < 0.05), whereas only the angular deviation showed a significant difference between the dynamic navigation and surgical guide groups (p = 0.002).

Conclusion: Our findings highlight the superior accuracy and consistency of dynamic navigation and static surgical guides compared to freehand placement in implant surgery. Dynamic navigation offers precision and flexibility. However, it comes with cost and convenience considerations. Future research should focus on improving its practicality.

Trial registration: This study was retrospectively registered at the Thai Clinical Trials Register-Medical Research Foundation of Thailand (MRF) with the TCTR identification number TCTR20230804001 on 04/08/2023. It was also conducted in accordance with the Declaration of Helsinki and approved by the institutional ethics committee at the Xian Jiaotong University Hospital of Stomatology, Xian, China (xjkqII[2021] No: 043). Written informed consent was obtained from all participants.

背景:计算机辅助种植手术可以更准确地植入种植体,从而提高了种植治疗的质量。本研究旨在评估在临床环境中使用动态导航、静态手术导板和徒手植入三种技术植入种植体的准确性。我们还调查了影响准确性的潜在因素,以全面评估每种技术的优缺点:这项前瞻性研究包括 65 名患者的 94 个种植体。患者被随机分配到三组中的一组:动态导航组、静态手术导板组或徒手植入组。种植体植入采用修复导向的数字化种植规划方法,术后CBCT扫描与术前规划叠加以测量准确性。计算了七个偏差值,包括角度偏差、平台偏差和根尖偏差。对偏差值进行了人口统计学和一致性分析,以及单因素方差分析和事后检验:结果:动态导航组的全局平台、全局根尖和角度偏差平均值分别为 0.99 毫米(标清 0.52)、1.14 毫米(标清 0.56)和 3.66°(标清 1.64°);动态导航组的全局平台、全局根尖和角度偏差平均值分别为 0.92毫米(标清0.36)、1.06毫米(标清0.47)和2.52°(标清1.18°);徒手组为1.36毫米(标清0.62)、1.73毫米(标清0.66)和5.82°(标清2.79°)。与徒手组相比,除深度偏差外,动态导航组和手术导板组在所有数值上都有显著的统计学差异(P 结论:我们的研究结果表明,动态导航组和手术导板组的准确性和一致性更胜一筹:我们的研究结果表明,与徒手植入相比,动态导航和静态手术导板在植入手术中具有更高的准确性和一致性。动态导航具有精确性和灵活性。然而,它也有成本和便利性方面的考虑。未来的研究应侧重于提高其实用性:本研究于2023年8月4日在泰国临床试验登记处--泰国医学研究基金会(MRF)进行了回顾性登记,登记号为TCTR20230804001。该研究还按照《赫尔辛基宣言》进行,并获得了中国西安交通大学口腔医院机构伦理委员会的批准(xjkqII[2021]No: 043)。所有参与者均已获得书面知情同意。
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引用次数: 0
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Head & Face Medicine
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