上海口腔医学最新文献

Purpose: To investigate the changes of nasolabial soft tissues before and after full-arch implant supported fixed restoration in maxillary edentulous patients and the influencing factors of the changes.

Methods: Fifty patients who underwent full-arch implant fixed restoration in the Department of Second Dental Center of Shanghai Ninth People's Hospital from January 2016 to July 2023 were selected. Patient's medical history, CBCT, and three-dimensional facial scan data were collected before and after restoration. Paired t test or Wilcoxon signed-rank test were used to compare the changes in soft tissues before and after restoration. The correlation between changes and patient's basic information, implant protocol and residual bone parameters were analyzed using bivariate correlation analysis. Akaike information criterion was used to select the multivariate linear regression model of each soft tissue index change.

Results: After implant fixed restoration, the upper lip height (sn-sto), the upper vermillion height (ls-sto), and the upper vermilion area (UVA) significantly increased (P＜0.01), while the distance from ls to the E-line (ls-E) significantly decreased (P＜0.01), the nasolabial angle (∠cm-sn-ls) significantly decreased (P＜0.01), and the cutaneous upper lip height(sn-ls) did not change significantly(P＞0.05). Except for sn-sto and sn-ls, the remaining soft tissue changes were positively correlated with age (P＜0.01). Other residual bone parameters, implant protocol, and gender were not significantly related to each soft tissue change. Multivariate stepwise regression analysis showed that each soft tissue change was broadly related to age and preoperative soft tissue condition, and partially related to bone morphology.

Conclusions: The nasolabial soft tissues of maxillary edentulous patients change significantly after implant fixed restoration, mainly the expansion and protrusion of the red part of the lip. The changes in facial soft tissues are primarily related to the patient's age and pre-existing soft tissue condition, with older patients and those with more atrophic original soft tissue morphology observing more apparent improvements in fullness. The change in lip prominence is also related to the residual bone shape.

Purpose: To understand the cognitive level of parents of children with autism towards their oral health behaviors and oral health care, and to provide assistance in developing better oral health plans for children with autism.

Methods: Totally 117 children and parents with autism who visited our hospital from January to December 2018 were selected as the experimental group,while 121 non-autistic children during the same period were selected as the control group, the children's oral hygiene was checked. Questionnaire survey was conducted on the oral health behaviors of pediatric patients, including daily brushing frequency, use of toothpaste, assistance from parents in brushing teeth, and frequency of snacking. At the same time, standardized measures were adopted to evaluate the oral health knowledge of parents, obtain their level of understanding oral health-related knowledge, and record the basic situation of parents. SPSS 21.0 software package was used for statistical analysis.

Results: The proportion of children with autism who have dental caries and periodontal health problems was relatively high, at 74.36% and 52.14%, respectively. Most pediatric patients had poor oral health behaviors, with a low proportion of brushing teeth ≥2 times per day and consistently using toothpaste, accounting for 17.09% and 13.68%, respectively. In addition, the score of oral health knowledge of parents of children in the experimental group [(6.40±2.55)] was lower than those in the control group [(6.95±2.47)], but there was no significant difference (P＞0.05). 93.16% of the children in the experimental group were taken care of full-time by their mother (72.65%) or father (20.51%), and most of the patients's income was not high. The main caregivers and their education level, family income in the control group were significantly different from those in the experimental group (P＜0.05). Factors affecting the oral health of autism patients included brushing habits, primary caregivers and parents' highest level of education.

Conclusions: Parents of autistic children have a poor understanding of their children's oral health behaviors, as well as health care. Therefore, education of oral health towards the parents of children with autism should be strengthened with the aim of improving their awareness of oral health and jointly maintaining their health.

Purpose: To analyze the effects of fixed appliance and invisible appliance without bracket on anterior tooth root and alveolar bone in patients with mild to moderate overcrowding of Class Ⅰmalocclusion.

Methods: A total of 120 patients with mild to moderate dental crowding were selected from January 2018 to February 2022,and divided into control group and experimental group by random number table method, with 60 cases in each group. The control group was treated with traditional fixed appliance, while the experimental group was treated with invisible appliance without bracket. Cone-beam CT(CBCT) was taken before and 12 months after treatment to measure the root length and alveolar bone height and thickness of maxillary central incisor teeth, height of alveolar bone of anterior teeth lip and lingual side and cusp teeth in both groups. Statistical analysis was performed with SPSS 22.0 software package.

Results: The root length changes of maxillary central incisor, lateral incisor and cusp teeth in the experimental group were significantly lower than those in the control group before and after treatment(P＜0.05). The alveolar bone height changes in the labial side and lingual palatine side of upper anterior teeth, labial side and lingual palatine side of inferior anterior teeth in the experimental group before and after treatment were significantly lower than those in the control group(P＜0.05). The thickness changes of labiolingual alveolar bone at the neck, middle root and apex of upper and inferior anterior teeth in the experimental group were significantly lower than those in the control group before and after treatment(P＜0.05).

Conclusions: Compared with fixed appliance, invisible appliance without bracket can reduce root resorption and the loss of alveolar bone height and thickness in the treatment of Class I patients with mild to moderate dental crowding.

Purpose: The established automatic AI tooth segmentation algorithm was used to achieve rapid and automatic tooth segmentation from CBCT images. The three-dimensional data obtained by oral scanning of real isolated teeth were used as the gold standard to verify the accuracy of the algorithm.

Methods: Thirty sets of CBCT data and corresponding 59 isolated teeth were collected from Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The three-dimensional tooth data in CBCT images were segmented by the algorithm. The digital information obtained by scanning the extracted teeth after processing was used as the gold standard. In order to compare the difference between the segmentation results and the scanning results of the algorithm. The Dice coefficient(Dice), sensitivity (Sen) and average symmetric surface distance (ASSD) were selected to evaluate the segmentation accuracy of the algorithm. The intra-class correlation coefficient(ICC) was used to evaluate the differences in length, area, and volume between the single tooth obtained by the AI system and the digital isolated tooth. Due to the existence of CBCT with different resolution, ANOVA was used to analyze the differences between groups with different resolution, and SNK method was used to compare them between two groups. SPSS 25.0 software package was used to analyze the data.

Results: After comparing the segmentation results with the in vitro dental scanning results, the average Dice value was (94.7±1.88)%, the average Sen was (95.8±2.02)%, and the average ASSD was (0.49±0.12) mm. By comparing the length, area and volume of a single tooth obtained by the digital isolated tooth and the AI system, the ICC values of the intra-group correlation coefficients were 0.734, 0.719 and 0.885, respectively. The single tooth divided by the AI system has a good consistency with the digital model in evaluating the length, area and volume, but the segmentation results were still different from the real situation in terms of specific values. The smaller the voxel of CBCT, the higher the resolution, the better the segmentation results.

Conclusions: The CBCT tooth segmentation algorithm established in this study can accurately achieve the tooth segmentation of the whole dentition in CBCT at all resolutions. The improvement of CBCT resolution ratio can make the algorithm more accurate. Compared with the current segmentation algorithms, our algorithm has better performance. Compared with the real situation, there are still some differences, and the algorithm needs to be further improved and verified.

Purpose: To determine the latent class and heterogeneous associations of oral health behaviors (OHB) with caries in preschool children aged 3-6 years, and to develop effective oral health interventions for improving their health status.

Methods: Latent class analysis(LCA) was applied to classify eight OHBs in three dimensions: oral hygiene, dietary habits, and preventive protection in 595 preschool children. Optimal classes were determined using model fitting and explanatory metrics, and marginal effects were estimated using bivariate association and multivariate regression models. The correlation between OHBs and caries was explored using Chi-square and correspondence analysis with SPSS 27.0 software package.

Results: Among 595 preschool children, caries prevalence was 54%, and OHBs were classified into two latent classes: favorable (88%) and unfavorable (12%). Unfavorable OHBs were associated with higher caries prevalence (58% vs. 52%), poorer caries status (mean dmft: 3.52 vs. 2.44), and lower regular examination experience (63% vs. 66%) compared to favorable OHBs. The difference in caries severity distribution between the two classes was statistically significant (P＜0.05).

Conclusions: Oral health behaviors in preschool children are heterogeneous and associated with caries. Effective interventions for improving OHBs in preschool children should be tailored according to this heterogeneity.

Purpose: To evaluate the application effect of PDCA cycle teaching mode in the standardized training and teaching of dental residents in prosthodontics speciality.

Methods: A total of 46 dental residents in Shanghai Stomatological Hospital from 2020 to 2022 were selected as the research subjects, and divided into experimental group (n=23) and control group(n=23), the control group adopted conventional teaching method, while the experimental group adopted PDCA cycle teaching method on the basis of the control group. The theoretical assessment, clinical operation assessment and satisfaction of the teaching effect of the two groups of residents were compared with SPSS 20.0 software package.

Results: The theoretical assessment, clinical operation assessment and satisfaction of the residents in the experimental group were all higher than the data obtained in the control group, and the difference was statistically significant(P＜0.05).

Conclusions: Compared with the traditional model teaching group, PDCA cycle teaching model can train the dental residents more personalized, better improve the clinical comprehensive quality and professional level, and achieve good feedback effect.

Purpose: To explore the impact of minimally invasive circumferential resection on inflammatory response and alveolar crest resorption in patients with dental defect implantation.

Methods: A total of 198 patients who received dental implantation in Lishui Hospital of Traditional Chinese Medicine from June 2021 to June 2023 were selected and divided into minimally invasive group (n=100) and traditional group (n=98) according to treatment methods. Minimally invasive surgery was performed in the minimally invasive group and traditional flap surgery was performed in the traditional group.Surgical related indicators, levels of inflammatory factors, pain mediators, alveolar crest bone resorption, implant loosening, quality of life and complication rates were compared between the two groups. SPSS 27.0 software package was used for statistical analysis.

Results: The surgery time, postoperative VAS scores and postoperative pain reaction time in the minimally invasive group were significantly lower than those in the traditional group(P＜0.05). In the minimally invasive group, the concentrations of IL-8, TNF-α, INF-γ,serum amyloid A(SAA), substance P(SP), calcitonin gene-related peptide(CGRP) and 5-hydroxytryptamine(5-HT) were significantly lower than the traditional group (P＜0.05). The amount of alveolar crest bone absorption in minimally invasive group was significantly lower than that in the traditional group(P＜0.05). There was no significant differences in implant loosening and retention rates between the two groups(P＞0.05). OHIP-14 scores across all dimensions in the minimally invasive group were significantly lower than in the traditional group (P＜0.05). There was no significant difference in complication rate between the minimally invasive group and the traditional group (P＜0.05).

Conclusions: Compared with the traditional surgery, minimally invasive circumferential surgery has better performance in reducing operation time, postoperative inflammatory factors and pain mediators, alveolar crest and parietal bone absorption and improving oral health, which can be widely used in dental implantation.

Purpose: To explore the effect of narrative medicine teaching practice on the narrative ability and empathy ability of dental interns and establish an effective narrative medicine teaching system.

Methods: From June 2022 to May 2023, atotal of 34 dental undergraduate students participating in clinical practice were divided into two groups, with 14 students in experimental group and 20 in control group. During clinical internships, the experimental group took narrative medicine into practice including theoretical lectures, close reading, parallel chart, seminars and so on. Interpersonal Reactivity Index(IRI) was used to evaluate the empathy of the students in the two groups, and a questionnaire survey was conducted on the narrative medicine practice of the experimental group. SPSS 12.0 software package was used for data analysis.

Results: The total score and module scores of empathy scale in the experimental group did not change significantly after the practice compared with before the practice. The score of "personal distress" module in the control group decreased significantly after the practice (P＜0.05), indicating that students in the control group who did not receive narrative education had a decrease in empathy after clinical practice. The questionnaire and parallel charts reflected that the interns' narrative ability and the understanding for medical psycho-social factors of experimental group students had been enhanced.

Conclusions: Narrative medicine practice is helpful to improve narrative ability and empathy ability, cultivate professional quality and ease the doctor-patient relationship. It should be continuously promoted during the dental undergraduate teaching and dentist's practicing career.

Purpose: To investigate the therapeutic efficacy of a new composite gel of carboxymethyl chitosan/β-dextran in rat dry socket model.

Methods: Carboxymethyl chitosan/oat β-dextran composite gel was prepared, its viscosity, appearance and shape, and stability in oral wet environment were investigated. Staphylococcus aureus was selected for in vitro inhibition test. Blank negative control group, carboxymethyl chitosan/oat β-dextran composite gel group, and iodoform gauze positive control group were established respectively, and the maxillary first molars were extracted to establish a dry socket model in SD rats, to preliminarily evaluate the healing effect of alveolar fossa wounds. The maxillary bone and gingival fixed decalcification were also taken and histopathologically observed for healing as well as immunofluorescence to detect differences in the expression of inflammatory factors between the groups. SPSS 19.0 software package was used for statistical analysis.

Results: The compound gel group had obvious antibacterial effect, which can effectively exert local anti-inflammatory and antibacterial efficacy. Compared with the blank control group, visual observation of wound healing, histopathological observation and immunofluorescence inflammatory factor labeling showed that the composite gel group had significant effect on inflammation inhibition and wound healing, which was comparable to the iodoform gauze group.

Conclusions: Carboxymethyl chitosan/oat β-dextran composite gel has significant antibacterial and anti-inflammatory effects and can accelerate the healing of dry socket wounds in rats, which is expected to provide an efficient antibacterial and accelerated healing therapeutic measure for the treatment of clinical dry socket.