中华口腔医学杂志最新文献

Objective: To analyze the influence of operator's experience on the quality and success rate of root canal treatment with new nickel-titanium instruments, providing support for improving the success rate of root canal treatment with new nickel-titanium instruments in clinic. Methods: Cases of root canal treatment and non-surgical root canal retreatment with 6-12 months recall performed by residents (resident group) with experience of 1-3 years and endodontic specialists (specialist group) with experience of 5-7 years were collected from the electronic medical system of the Department of Endodontics, School of Stomatology, Capital Medical University, from September 2020 to August 2021. All cases were prepared by engine-driven glide path files and controlled memory nickel-titanium finishing files. Chi-square test and logistic regression were used to analyze the differences and influencing factors of complications, filling quality and success rate of root canal treatment between the two groups. Results: A total of 277 cases performed by 24 residents and 3 specialists were included, 169 in the resident group and 108 in the specialist group. The clinical incidence of flare-ups was significantly higher in the resident group [3.6% (6/169)] than in the specialist group [0(0/108)] (P=0.048). There were no significant differences in ledges, root canal transportations, perforations, or instrument separations between the two groups (P>0.05). The prevalence of satisfactory fillings was 62.7% (106/169) in the resident group, which was significantly lower than that in the specialist group [86.1% (93/108)] (P<0.05). The success rate of root canal treatment was 91.7% (155/169) and 94.4% (102/108) in the resident group and the specialist group, respectively, with no significant differences (χ²=0.73,P=0.392). Multivariate analysis showed that the success rate of root canal treatment was related to complications and quality of root fillings (P<0.05). Conclusions: Higher success rate of root canal treatment could be achieved by residents and endodontic specialists with engine-driven glide path files and controlled memory nickel-titanium files.

In recent years, robots have been gradually applied in the field of oral implantation. Compared with static guide and dynamic navigation, robot-assisted implant surgery has the characteristics of high precision, high stability and high safety, but there are still various factors affecting the accuracy of implantation in the operation process. Existing studies focus on the accuracy of robot-assisted oral implant surgery, while there are few studies on the image factors affecting the accuracy of robot-assisted oral implant surgery. Therefore, this paper analyzes the factors affecting the accuracy of robot-assisted oral implant surgery from the aspects of the type and operation of the implant robot, in order to provide evidence for the application of the implant robot in the field of oral implant.

Periodontal disease is a common and frequently-occurring disease in China. Early detection, diagnosis, and treatment of periodontal disease are of great significance for achieving universal oral health and even systemic health. Artificial intelligence endows machines with the ability to mimic human intelligent behavior, and is commonly used in medical field with both physical and virtual forms. Virtual artificial intelligence empowers traditional experience in the application of periodontal disease risk assessment and diagnosis, with the potential to develop a variety of oral health screening tools. It helps to provide new evidence for the prognosis of periodontal disease, improve the accuracy and efficiency of diagnosis, reduce technical sensitivity and further promote the periodontal treatment transformation from "treatment-oriented" to "prevention-oriented". This paper reviews the current applications and progresses of virtual artificial intelligence in periodontal risk assessment and diagnosis, as well as its limitations, providing ideas for future researches on the application of virtual artificial intelligence in this field.

The oral implant surgery robot could achieved basic "surgical operation intelligence"; however, "decision-making artificial intelligence" has not yet been achieved. The author previously discussed the specific concept of decision-making artificial intelligence. During our exploration of decision-making artificial intelligence, our team further integrated the clinical diagnosis and treatment process of oral implantation, along with the data characteristics of decision indicators and the distribution characteristics of demographic information. As a result, we identified five key scientific and technological issues in the process of decision-making artificial intelligence, namely the construction of a specialized annotation database for oral implantation, the prediction of quantitative indicators, the application of three-dimensional imaging, the solution of data imbalance within indicators, and the joint output of multi-property and multimodal indicators in clinical pathways. This paper will review artificial intelligence research in oral implantology and our team's research progress, elaborating on the aforementioned challenges in intelligentization. It aims to provide references for addressing the mentioned scientific issues and guiding future research directions in the construction of decision-making artificial intelligence in oral medicine.

Lingual orthodontic technology has been in existence for over 50 years, undergoing various stages of emergence, development, decline, and maturity. In recent years, with the advancement of digital technology, customized lingual orthodontics has gradually become widely used in clinical practice, representing a significant achievement of digital technology in orthodontic clinical diagnosis and treatment. The integration of digital technology has made customized lingual orthodontics more convenient, precise, and efficient, enhancing patient comfort while significantly reducing the operational difficulty and technical barriers for orthodontists. This article focuses on analyzing the technical characteristics, operational challenges, and coping strategies of customized lingual orthodontics based on digital technology, aiming to provide a reference for clinical practice.

Pediatric dentistry treats patients aged 0-18 years, encompassing the characteristics of general dentistry. The clinical techniques are closely related to restorative dentistry, endodontics, orthodontics, and maxillofacial surgery, while also possessing unique aspects. It particularly focuses on the growth and development patterns of children's dentition and maxillofacial structures. Currently, digital technology has deeply integrated with various clinical disciplines of dentistry, and pediatric dentistry has made significant progress with pediatric-specific digital applications. On one hand, the introduction of mature digital technologies is enabling the digital transformation of pediatric dental treatment models; on the other hand, there is innovative development of new digital technologies tailored to the specific needs of pediatric dental care, filling gaps in the field. Based on years of research in digital technology for pediatric dentistry, our team details the current innovative applications and scientific explorations in this area from these two perspectives. Additionally, we anticipate the potential expansion of digital technologies not yet applied in pediatric dentistry, providing a reference for clinical scholars in the field to conduct exploratory research.

Objective: To explore the digital design and fabrication technology of personalized restorative matrix for dental filling, and to explore the feasibility of direct resin restoration for deep caries lesions in distal neck of mandibular second molar. Methods: For patients with deep caries lesions in the distal neck of the mandibular second molar who visited the Department of Cariology and Endodontology of Peking University School and Hospital of Stomatology from September 2023 to April 2024, after preparing the cavity and gingival retractor, a three-dimensional intraoral scanner was used to obtain three-dimensional data of the patient's dentition. In the dental restoration computer-aided design software, the inlay function was used to generate the restored tooth morphology. The edge range of the personalized restorative matrix was drawn on the restored model by three-dimensional reverse engineering software to achieve edge sealing effect. The selected edge range data was processed with distal shelling to generate a digital model of a personalized restorative matrix with a thickness of 0.5 mm. A metal three-dimensional printer was used to fabricate the titanium alloy restorative matrix, and its application was completed in 10 clinical cases. The marginal adaptation and retention stability of the personalized restorative matrix were evaluated under a dental microscope, and forming effect evaluation was performed through immediate postoperative periapical radiographs. Results: The preliminary clinical application of the personalized restorative matrix fabricated using digital technology revealed that, in the treatment of 10 affected teeth, rubber dam isolation was successfully ensured, resulting in clinically effective direct resin composite restorations with optimal marginal adaptation and reasonable contours. Immediate postoperative periapical radiographs showed good convexity of the filling body, with no overhangs found. Both marginal adaptation and retention stability met the requirements of clinical treatment. Conclusions: The personalized restorative matrix designed in this study can solve the clinical problems of moisture separation and resin forming in the treatment of deep caries lesions in distal neck of the mandibular second molar, and can achieve stable and reliable adhesive restoration effects.

Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients'suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.