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Harold C. Slavkin: A Transformative Leader of Our Times. 哈罗德-斯拉夫金我们时代的变革领袖。
Pub Date : 2024-06-01 Epub Date: 2024-05-09 DOI: 10.1177/00220345241247784
D V Kleinman, M C Alfano, Y Chai, R N D'Souza

Harold (Hal) C. Slavkin, DDS, the 22nd president of the American Association for Dental, Oral, and Craniofacial Research (1993 to 1994), died on December 22, 2023. During a career that spanned almost 6 decades, Hal distinguished himself as an international authority on craniofacial biology and an advocate for oral health equity. He served as dean of the University of Southern California's dental school, founded the school's Center for Craniofacial Molecular Biology, created the nation's first PhD program in craniofacial biology, and served as the sixth director of the National Institute of Dental and Craniofacial Research. Hal's studies of the molecular and cellular underpinnings of craniofacial malformations prepared him to champion translational research later in his career, when his work with patient advocates revealed the importance of applying new discoveries to clinical practice. A visionary thinker, skilled administrator, progressive educator, compelling communicator, researcher, scholar, and mentor, Hal was known as a Renaissance leader. He rejoiced in fostering collaborative synergies among people and organizations. Throughout his life, family was his central grounding force. He and his wife, Lois, advanced a wide range of social and community initiatives and took great pride in their children, grandchildren, and great-grandchildren. We remember Hal for his indelible spirit, unflappable enthusiasm for science, fierce advocacy for social justice, and infectious zest for life. Here, we outline his multidimensional accomplishments through the lenses of academia, government, and nonprofit organizations. Although it is with heavy hearts that we bid goodbye to this remarkable man, our spirits are lightened by the many gifts he left behind.

美国牙科、口腔和颅面研究协会第 22 任主席(1993-1994 年)、牙科博士哈罗德-斯拉夫金(Harold (Hal) C. Slavkin)于 2023 年 12 月 22 日去世。在将近 60 年的职业生涯中,哈尔作为颅面生物学方面的国际权威和口腔健康公平的倡导者表现突出。他曾担任南加州大学牙科学院院长,创建了该学院的颅面分子生物学中心,创立了美国第一个颅面生物学博士项目,并担任美国国家牙科和颅面研究所第六任所长。哈尔对颅颌面畸形的分子和细胞基础的研究为他在职业生涯后期倡导转化研究做好了准备,他与患者权益倡导者的合作揭示了将新发现应用于临床实践的重要性。作为一位富有远见的思想家、娴熟的管理者、进步的教育者、令人信服的沟通者、研究者、学者和导师,哈尔被誉为文艺复兴时期的领导者。他乐于促进人与人之间、组织与组织之间的协作协同。在他的一生中,家庭是他的核心支柱。他和妻子露易丝推动了广泛的社会和社区活动,并为他们的子女、孙子女和曾孙子女感到自豪。我们缅怀哈尔,是因为他那永不磨灭的精神、对科学的不懈热情、对社会正义的积极倡导以及对生活的感染力。在此,我们从学术界、政府和非营利组织的角度概述了他多方面的成就。虽然我们怀着沉重的心情向这位杰出的人告别,但他留下的许多礼物让我们的心情更加轻松。
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引用次数: 0
AZGP1 Aggravates Macrophage M1 Polarization and Pyroptosis in Periodontitis. AZGP1 会加剧牙周炎中巨噬细胞 M1 的极化和脓毒血症。
Pub Date : 2024-06-01 Epub Date: 2024-03-15 DOI: 10.1177/00220345241235616
S Yang, Y Yin, Y Sun, D Ai, X Xia, X Xu, J Song

Periodontal tissue destruction in periodontitis is a consequence of the host inflammatory response to periodontal pathogens, which could be aggravated in the presence of type 2 diabetes mellitus (T2DM). Accumulating evidence highlights the intricate involvement of macrophage-mediated inflammation in the pathogenesis of periodontitis under both normal and T2DM conditions. However, the underlying mechanism remains elusive. Alpha-2-glycoprotein 1 (AZGP1), a glycoprotein featuring an MHC-I domain, has been implicated in both inflammation and metabolic disorders. In this study, we found that AZGP1 was primarily colocalized with macrophages in periodontitis tissues. AZGP1 was increased in periodontitis compared with controls, which was further elevated when accompanied by T2DM. Adeno-associated virus-mediated overexpression of Azgp1 in the periodontium significantly enhanced periodontal inflammation and alveolar bone loss, accompanied by elevated M1 macrophages and pyroptosis in murine models of periodontitis and T2DM-associated periodontitis, while Azgp1-/- mice exhibited opposite effects. In primary bone marrow-derived macrophages stimulated by lipopolysaccharide (LPS) or LPS and palmitic acid (PA), overexpression or knockout of Azgp1 markedly upregulated or suppressed, respectively, the expression of macrophage M1 markers and key components of the NLR Family Pyrin Domain Containing 3 (NLRP3)/caspase-1 signaling. Moreover, conditioned medium from Azgp1-overexpressed macrophages under LPS or LPS+PA stimulation induced higher inflammatory activation and lower osteogenic differentiation in human periodontal ligament stem cells (hPDLSCs). Furthermore, elevated M1 polarization and pyroptosis in macrophages and associated detrimental effects on hPDLSCs induced by Azgp1 overexpression could be rescued by NLRP3 or caspase-1 inhibition. Collectively, our study elucidated that AZGP1 could aggravate periodontitis by promoting macrophage M1 polarization and pyroptosis through the NLRP3/casapse-1 pathway, which was accentuated in T2DM-associated periodontitis. This finding deepens the understanding of AZGP1 in the pathogenesis of periodontitis and suggests AZGP1 as a crucial link mediating the adverse effects of diabetes on periodontal inflammation.

牙周炎中的牙周组织破坏是宿主对牙周病原体的炎症反应的结果,而这种反应在 2 型糖尿病(T2DM)的情况下可能会加剧。越来越多的证据表明,巨噬细胞介导的炎症与正常和 T2DM 条件下牙周炎的发病机制密切相关。然而,其根本机制仍然难以捉摸。甲型-2-糖蛋白 1(AZGP1)是一种具有 MHC-I 结构域的糖蛋白,与炎症和代谢紊乱都有关系。在这项研究中,我们发现 AZGP1 主要与牙周炎组织中的巨噬细胞共定位。与对照组相比,AZGP1在牙周炎中增高,在伴有T2DM时进一步增高。在牙周炎和 T2DM 相关牙周炎的小鼠模型中,腺相关病毒介导的 Azgp1 在牙周中的过表达显著增强了牙周炎症和牙槽骨丧失,并伴随着 M1 巨噬细胞的升高和热蛋白沉积,而 Azgp1-/- 小鼠则表现出相反的效应。在受到脂多糖(LPS)或 LPS 和棕榈酸(PA)刺激的原发性骨髓衍生巨噬细胞中,Azgp1 的过表达或基因敲除分别显著上调或抑制了巨噬细胞 M1 标记和 NLR 家族含吡林域 3(NLRP3)/caspase-1 信号转导的关键成分的表达。此外,在LPS或LPS+PA刺激下,Azgp1表达的巨噬细胞的条件培养基诱导了人牙周韧带干细胞(hPDLSCs)更高的炎症激活和更低的成骨分化。此外,NLRP3或caspase-1抑制剂可挽救Azgp1过表达诱导的巨噬细胞M1极化和脓毒症升高以及对hPDLSCs的相关不利影响。总之,我们的研究阐明了AZGP1可通过NLRP3/casapse-1途径促进巨噬细胞M1极化和热凋亡,从而加重牙周炎,而这在T2DM相关牙周炎中表现得更为明显。这一发现加深了人们对AZGP1在牙周炎发病机制中作用的认识,并表明AZGP1是糖尿病对牙周炎症产生不良影响的关键环节。
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引用次数: 0
Systematic Review of Prognosis Models in Predicting Tooth Loss in Periodontitis. 预测牙周炎牙齿脱落的预后模型的系统性回顾。
Pub Date : 2024-06-01 Epub Date: 2024-05-10 DOI: 10.1177/00220345241237448
D Y Chow, J R H Tay, G G Nascimento

This study reviews and appraises the methodological and reporting quality of prediction models for tooth loss in periodontitis patients, including the use of regression and machine learning models. Studies involving prediction modeling for tooth loss in periodontitis patients were screened. A search was performed in MEDLINE via PubMed, Embase, and CENTRAL up to 12 February 2022, with citation chasing. Studies exploring model development or external validation studies for models assessing tooth loss in periodontitis patients for clinical use at any time point, with all prediction horizons in English, were considered. Studies were excluded if models were not developed for use in periodontitis patients, were not developed or validated on any data set, predicted outcomes other than tooth loss, or were prognostic factor studies. The CHARMS checklist was used for data extraction, TRIPOD to assess reporting quality, and PROBAST to assess the risk of bias. In total, 4,661 records were screened, and 45 studies were included. Only 26 studies reported any kind of performance measure. The median C-statistic reported was 0.671 (range, 0.57-0.97). All studies were at a high risk of bias due to inappropriate handling of missing data (96%), inappropriate evaluation of model performance (92%), and lack of accounting for model overfitting in evaluating model performance (68%). Many models predicting tooth loss in periodontitis are available, but studies evaluating these models are at a high risk of bias. Model performance measures are likely to be overly optimistic and might not be replicated in clinical use. While this review is unable to recommend any model for clinical practice, it has collated the existing models and their model performance at external validation and their associated sample sizes, which would be helpful to identify promising models for future external validation studies.

本研究回顾并评估了牙周炎患者牙齿缺失预测模型的方法和报告质量,包括回归模型和机器学习模型的使用。研究筛选了涉及牙周炎患者牙齿缺失预测模型的研究。截至 2022 年 2 月 12 日,通过 PubMed、Embase 和 CENTRAL 在 MEDLINE 中进行了检索,并进行了引文追逐。这些研究探讨了牙周炎患者在任何时间点用于临床的牙齿缺失评估模型的开发或外部验证研究,所有预测范围均为英语。如果所开发的模型不是用于牙周炎患者、未在任何数据集上开发或验证、预测的结果不是牙齿脱落,或者是预后因素研究,则排除这些研究。CHARMS 检查表用于数据提取,TRIPOD 用于评估报告质量,PROBAST 用于评估偏倚风险。共筛选出 4,661 条记录,并纳入了 45 项研究。只有 26 项研究报告了任何类型的绩效衡量标准。报告的 C 统计量中位数为 0.671(范围为 0.57-0.97)。由于对缺失数据的处理不当(96%)、对模型性能的评估不当(92%)以及在评估模型性能时没有考虑模型的过度拟合(68%),所有研究都存在较高的偏倚风险。目前有许多预测牙周炎患者牙齿脱落的模型,但评估这些模型的研究存在较高的偏倚风险。模型的性能指标可能过于乐观,在临床使用中可能无法复制。虽然本综述无法向临床实践推荐任何模型,但它整理了现有模型及其在外部验证中的模型性能以及相关样本量,这将有助于为未来的外部验证研究确定有前途的模型。
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引用次数: 0
High-Performance Dental Resins Containing a Starburst Monomer. 含星爆单体的高性能牙科树脂。
Pub Date : 2024-05-01 Epub Date: 2024-03-28 DOI: 10.1177/00220345241232312
S Q Dai, W Zhou, L Y Duan, K Tang, Z Y Yang, R J Cao, F R Tay, L N Niu, J H Chen

Dimethacrylate-based chemistries feature extensively as resin monomers in dental resin-based materials due to their distinguished overall performance. However, challenges endure, encompassing inadequate mechanical attributes, volumetric shrinkage, and estrogenicity. Herein, we first synthesized a novel resin monomer, 9-armed starburst polyurethane acrylate (NPUA), via the grafting-onto approach. Compared to the primary commercial dental monomer 2,2-bis [p-(2'-hydroxy-3'-methacryloxypropoxy) phenyl] propane (Bis-GMA) (with a viscosity of 1,174 ± 3 Pa·s and volumetric shrinkage of 4.7% ± 0.1%), the NPUA monomer achieves the lower viscosity (158 ± 1 Pa·s), volumetric shrinkage (2.5% ± 0.1%), and cytotoxicity (P < 0.05). The NPUA-based resins exhibit the higher flexural strength, flexural modulus, hardness, and hydrophobicity and lower volumetric shrinkage, water absorption, and solubility compared to the Bis-GMA (70 wt%)/TEGDMA (30 wt%) resins. The NPUA-based composites exhibit significantly higher flexural strength, flexural modulus, and hardness and lower volumetric shrinkage (171.4 ± 3.0 MPa, 12.6 ± 0.5 GPa, 2.0 ± 0.2 GPa, and 3.4% ± 0.2%, respectively) compared to the Bis-GMA group (120.3 ± 4.7 MPa, 9.4 ± 0.7 GPa, 1.5 ± 0.1 GPa, and 4.7% ± 0.2%, respectively; P < 0.05). This work presents a viable avenue for augmenting the physicochemical attributes of dental resins.

基于二甲基丙烯酸酯的化学物质因其卓越的综合性能而被广泛用作牙科树脂基材料的树脂单体。然而,它也面临着机械性能不足、体积收缩和雌激素性等挑战。在此,我们首先通过接枝-本体法合成了一种新型树脂单体--9-臂星形聚氨酯丙烯酸酯(NPUA)。与主要的商用牙科单体 2,2-双[对-(2'-羟基-3'-甲基丙烯酰氧基丙氧基)苯基]丙烷(Bis-GMA)(粘度为 1,174 ± 3 Pa-s,体积收缩率为 4.7% ± 0.1%)相比,NPUA 单体的粘度(158 ± 1 Pa-s)、体积收缩率(2.5% ± 0.1%)和细胞毒性(P < 0.05)都更低。与 Bis-GMA(70 wt%)/TEGDMA(30 wt%)树脂相比,NPUA 基树脂具有更高的抗弯强度、抗弯模量、硬度和疏水性,以及更低的体积收缩率、吸水性和溶解性。与 Bis-GMA 组(分别为 120.3 ± 4.7 MPa、9.4 ± 0.7 GPa、1.5 ± 0.1 GPa 和 4.7% ± 0.2%;P < 0.05)相比,NPUA 基复合材料的抗弯强度、抗弯模量和硬度明显更高,体积收缩率更低(分别为 171.4 ± 3.0 MPa、12.6 ± 0.5 GPa、2.0 ± 0.2 GPa 和 3.4% ± 0.2%)。这项研究为提高牙科树脂的物理化学属性提供了一条可行的途径。
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引用次数: 0
Social Disadvantage and Multimorbidity Including Oral Conditions in the United States. 美国的社会劣势和包括口腔疾病在内的多病症。
Pub Date : 2024-05-01 Epub Date: 2024-03-19 DOI: 10.1177/00220345241228834
A Mirza, R G Watt, A Heilmann, M Stennett, A Singh

Existing studies on multimorbidity have largely excluded oral diseases in multimorbidity prevalence estimates. The reason behind this is somewhat unclear, as chronic oral conditions are highly prevalent, affecting over half the global population. To address this gap, we examined the relationship between social disadvantage and multimorbidity, stratifying by the inclusion and exclusion of oral conditions. For participants aged 30 y and over (n = 3,693), cross-sectional analysis was carried out using the US National Health and Nutrition Survey (2013-2014). Multimorbidity was defined as having 2 or more chronic conditions. Five medical conditions were examined: diabetes, asthma, arthritis, cardiovascular disease, and depression, as well as 4 oral health conditions: caries, periodontal disease, number of teeth, and edentulousness. Education and income poverty ratio were selected as measures of social disadvantage. Multimorbidity prevalence estimates according to social disadvantage were analyzed on an absolute and relative scale using inverse probability treatment weighting (IPTW), adjusting for age, sex, and ethnicity. The inclusion of oral health conditions in the assessment of multimorbidity increased the overall prevalence of multimorbidity from 20.8% to 53.4%. Findings from IPTW analysis demonstrated clear social gradients for multimorbidity estimates stratified by the exclusion of oral conditions. Upon inclusion of oral conditions, the prevalence of multimorbidity was higher across all social groups for both education and income. Stratifying by the inclusion of oral conditions, the mean probability of multimorbidity was 27% (95% confidence interval [CI], 23%-30%) higher in the low-education group compared to the high-education group. Similarly, the mean probability of multimorbidity was 44% (95% CI, 40%-48%) higher in the low-income group. On a relative scale, low education was associated with a 1.52 times (95% CI, 1.44-1.61) higher prevalence of multimorbidity compared to high education. Low income was associated with a 2.18 (95% CI, 1.99-2.39) higher prevalence of multimorbidity. This novel study strongly supports the impact of chronic oral conditions on multimorbidity prevalence estimates.

现有的多病症研究在估算多病症患病率时大多不包括口腔疾病。这背后的原因尚不清楚,因为慢性口腔疾病的发病率很高,影响着全球一半以上的人口。为了填补这一空白,我们研究了社会不利条件与多病症之间的关系,并根据口腔疾病的纳入和排除情况进行了分层。我们利用美国国家健康与营养调查(2013-2014 年)对 30 岁及以上的参与者(n = 3,693 人)进行了横断面分析。多病症的定义是患有 2 种或 2 种以上慢性疾病。研究对象包括五种疾病:糖尿病、哮喘、关节炎、心血管疾病和抑郁症,以及四种口腔健康状况:龋齿、牙周病、牙齿数量和无牙。教育程度和收入贫困率被选为衡量社会不利条件的指标。使用反概率处理加权法(IPTW)对社会不利条件下的多病症患病率估计值进行了绝对和相对分析,并对年龄、性别和种族进行了调整。将口腔健康状况纳入多病评估后,多病的总体患病率从 20.8% 增加到 53.4%。IPTW 分析结果显示,在排除口腔疾病的情况下,多病症估计值的社会梯度非常明显。在纳入口腔疾病后,所有社会群体的多病症患病率在教育程度和收入方面都较高。根据口腔状况进行分层,与高学历群体相比,低学历群体的多病患病平均概率高出 27%(95% 置信区间 [CI],23%-30%)。同样,低收入组患多病的平均概率比高学历组高 44%(95% 置信区间,40%-48%)。相对而言,与高学历相比,低学历者的多病症患病率要高出 1.52 倍(95% CI,1.44-1.61)。低收入与多病症患病率高出 2.18 倍(95% CI,1.99-2.39)有关。这项新颖的研究有力地证明了慢性口腔疾病对多病患病率估计的影响。
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引用次数: 0
Exploring Recent Decreases in First Molar Sealants among US Children. 探索美国儿童第一颗臼齿密封剂最近的减少情况。
Pub Date : 2024-05-01 Epub Date: 2024-02-27 DOI: 10.1177/00220345241231774
M Lin, S O Griffin, C H Li, L Wei, L Espinoza, C Y Wang, G Thornton-Evans

Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and 2015 to 2018. We explore whether this decrease could be associated with possible changes in 1) clinical sealant delivery, 2) dental materials (i.e., increased use of glass ionomer [GI] sealants resulting in an inability to detect sealant fragments that still provide preventive benefits or increased use of composite restorations leading to misclassifying sealants as restorations), and 3) examination sensitivity and specificity. We used NHANES data to estimate the prevalences of sealants, untreated caries, and restorations in ≥1 first permanent molar among children aged 7 to 10 y and used Medical Expenditure Panel Survey data to estimate the annual clinical delivery of sealants and fluoride treatments. We examined changes in outcomes between 2 periods (P < 0.05) controlling for selected sociodemographic characteristics. NHANES sealant examination quality was based on the reference examiner's replicate examinations. The adjusted prevalence of sealants decreased relatively by 27.5% (46.6% vs. 33.8%). Overall, untreated caries decreased. Untreated caries and restoration decreased among children without sealants. Annual clinical sealant delivery did not change, whereas fluoride treatment delivery increased. The decrease in sealant prevalence held when assessed for various age ranges and NHANES cycle combinations. While sealant examination specificity remained similar between the periods, sensitivity (weighted by the proportion of exams by each examiner) decreased relatively by 17.4% (0.92 vs. 0.76). These findings suggest that decreased sealant prevalence was not supported by decreased clinical sealant delivery nor increased use of composite restorations. Decreased examination sensitivity, which could be due to an increased use of GI sealants, could contribute to the decrease in sealant prevalence. The decrease in caries among children without sealants could suggest the increased use of GI sealants. However, we could not rule out that the decrease in caries could be attributable to increased fluoride treatment delivery.

对美国国家健康与营养调查(NHANES)数据的分析表明,在 2011 年至 2014 年和 2015 年至 2018 年期间,儿童的封闭剂使用率显著下降。我们探讨了这种下降是否与以下方面可能发生的变化有关:1)临床密封剂供应;2)牙科材料(即玻璃离子聚合物密封剂的使用增加,导致无法检测到仍能提供预防益处的密封剂碎片,或复合修复体的使用增加,导致将密封剂误认为修复体);3)检查敏感性和特异性。我们使用 NHANES 数据估算了 7-10 岁儿童中封闭剂、未治疗的龋齿和≥1 颗第一恒磨牙修复的流行率,并使用医疗支出小组调查数据估算了每年封闭剂和氟化物治疗的临床用量。我们研究了两个时期之间结果的变化(P < 0.05),并对选定的社会人口特征进行了控制。NHANES 密封剂检查质量基于参考检查人员的重复检查结果。调整后的封闭剂使用率相对下降了 27.5%(46.6% 对 33.8%)。总体而言,未经治疗的龋齿有所减少。在未使用封闭剂的儿童中,未经治疗的龋齿和修复有所减少。每年的临床封闭剂用量没有变化,而氟化物治疗用量有所增加。在对不同年龄段和 NHANES 周期组合进行评估时,封闭剂使用率的下降趋势保持不变。虽然封闭剂检查的特异性在不同时期保持相似,但敏感性(按每位检查人员的检查比例加权)相对下降了 17.4%(0.92 对 0.76)。这些发现表明,临床封闭剂用量的减少或复合树脂修复体使用量的增加并不支持封闭剂使用率的下降。检查敏感性的降低可能是由于消化道封闭剂使用的增加,这也可能是封闭剂使用率降低的原因之一。未使用封闭剂的儿童的龋齿率下降,可能表明使用消化道封闭剂的情况有所增加。不过,我们也不能排除龋齿减少的原因可能是氟化物治疗的增加。
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引用次数: 0
Letter to the Editor, "Autophagy Plays a Crucial Role in Ameloblast Differentiation". 致编辑的信,“自噬在成釉细胞分化中起关键作用”。
Pub Date : 2024-04-01 Epub Date: 2023-11-15 DOI: 10.1177/00220345231210462
S Sukseree, R Gruber, E Tschachler, L Eckhart
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引用次数: 0
Biological Properties of 3D-Printed Zirconia Implants with p-Cell Structures. 具有 p 细胞结构的 3D 打印氧化锆假体的生物特性。
Pub Date : 2024-04-01 Epub Date: 2024-02-19 DOI: 10.1177/00220345231222819
W Qin, M H Shen, N Gan, B H Xing, J Sun, Z Zhao, T Jiao

Research on 3-dimensional (3D) printed porous zirconia-based dental implants is still in its infancy. This study aimed to evaluate the biological responses of novel zirconia implants with p-cell structures fabricated by 3D printing. The solid zirconia samples exhibited comparable density, 3-point flexural strength, and accelerated aging properties compared to specimens prepared previously by conventional methods. Cell-based experiments showed that the p-cell structure promoted cell proliferation, adhesion, and osteogenesis-related protein expression. Mechanical tests showed that both p-cell and control implants could withstand a torque of 35 Ncm without breaking. The mean maximum breaking loads of p-cell and control implants were 1,222.429 ± 115.591 N and 1,903.857 ± 250.673 N, respectively, which were much higher than the human physiological chewing force and human mean maximum occlusal force. An animal experiment showed that the bone trabeculae around the implants were significantly thicker, more numerous, and denser in the p-cell group than in the control group. This work could provide promising guidance for further exploring 3D printing techniques for porous zirconia bionic implants in dentistry.

有关三维(3D)打印多孔氧化锆牙科植入物的研究仍处于起步阶段。本研究旨在评估通过三维打印技术制造的具有多孔结构的新型氧化锆种植体的生物反应。与之前用传统方法制备的样本相比,固体氧化锆样本表现出相当的密度、三点抗弯强度和加速老化性能。基于细胞的实验表明,p-细胞结构促进了细胞增殖、粘附和成骨相关蛋白的表达。机械测试表明,p-细胞和对照组植入物都能承受 35 Ncm 的扭矩而不断裂。p-cell 种植体和对照组种植体的平均最大断裂载荷分别为 1,222.429 ± 115.591 N 和 1,903.857 ± 250.673 N,远高于人体生理咀嚼力和人体平均最大咬合力。动物实验表明,p-细胞组种植体周围的骨小梁明显比对照组厚、多、密。这项研究为进一步探索牙科中多孔氧化锆仿生种植体的 3D 打印技术提供了很好的指导。
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引用次数: 0
Intelligently Quantifying the Entire Irregular Dental Structure. 智能量化整个不规则牙齿结构
Pub Date : 2024-04-01 Epub Date: 2024-02-19 DOI: 10.1177/00220345241226871
H Liu, J Duan, P Zeng, M Shi, J Zeng, S Chen, Z Gong, Z Chen, J Qin, Z Chen

Quantitative analysis of irregular anatomical structures is crucial in oral medicine, but clinicians often typically measure only several representative indicators within the structure as references. Deep learning semantic segmentation offers the potential for entire quantitative analysis. However, challenges persist, including segmentation difficulties due to unclear boundaries and acquiring measurement landmarks for clinical needs in entire quantitative analysis. Taking the palatal alveolar bone as an example, we proposed an artificial intelligence measurement tool for the entire quantitative analysis of irregular dental structures. To expand the applicability, we have included lightweight networks with fewer parameters and lower computational demands. Our approach finally used the lightweight model LU-Net, addressing segmentation challenges caused by unclear boundaries through a compensation module. Additional enamel segmentation was conducted to establish a measurement coordinate system. Ultimately, we presented the entire quantitative information within the structure in a manner that meets clinical needs. The tool achieved excellent segmentation results, manifested by high Dice coefficients (0.934 and 0.949), intersection over union (0.888 and 0.907), and area under the curve (0.943 and 0.949) for palatal alveolar bone and enamel in the test set. In subsequent measurements, the tool visualizes the quantitative information within the target structure by scatter plots. When comparing the measurements against representative indicators, the tool's measurement results show no statistically significant difference from the ground truth, with small mean absolute error, root mean squared error, and errors interval. Bland-Altman plots and intraclass correlation coefficients indicate the satisfactory agreement compared with manual measurements. We proposed a novel intelligent approach to address the entire quantitative analysis of irregular image structures in the clinical setting. This contributes to enabling clinicians to swiftly and comprehensively grasp structural features, facilitating the design of more personalized treatment plans for different patients, enhancing clinical efficiency and treatment success rates in turn.

不规则解剖结构的定量分析在口腔医学中至关重要,但临床医生通常只测量结构内的几个代表性指标作为参考。深度学习语义分割为整个定量分析提供了可能。然而,挑战依然存在,包括边界不清导致的分割困难,以及在整个定量分析中获取临床所需的测量地标。以腭齿槽骨为例,我们提出了一种人工智能测量工具,用于不规则牙齿结构的整体定量分析。为了扩大适用范围,我们加入了参数更少、计算要求更低的轻量级网络。我们的方法最终使用了轻量级模型 LU-Net,通过补偿模块解决了边界不清晰造成的分割难题。我们还进行了额外的釉质分割,以建立测量坐标系。最终,我们以符合临床需求的方式呈现了结构内的全部定量信息。该工具取得了出色的分割结果,在测试集中,腭齿槽骨和釉质的狄斯系数(0.934 和 0.949)、相交大于结合(0.888 和 0.907)和曲线下面积(0.943 和 0.949)都很高。在随后的测量中,该工具通过散点图将目标结构内的定量信息可视化。在将测量结果与代表性指标进行比较时,该工具的测量结果显示与基本真实值没有显著的统计学差异,平均绝对误差、均方根误差和误差间隔都很小。布兰德-阿尔特曼图和类内相关系数表明,与人工测量结果相比,两者的一致性令人满意。我们提出了一种新颖的智能方法来解决临床环境中不规则图像结构的整个定量分析问题。这有助于临床医生快速、全面地掌握结构特征,为不同患者设计更个性化的治疗方案,从而提高临床效率和治疗成功率。
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引用次数: 0
Composite Containing Calcium Phosphate Particles Functionalized with 10-MDP. 含有 10-MDP 功能化磷酸钙颗粒的复合材料。
Pub Date : 2024-04-01 Epub Date: 2024-01-29 DOI: 10.1177/00220345231225459
R A A da Silva, R B Trinca, H S Vilela, R R Braga

The phosphate ester monomer 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) is capable of bonding to hydroxyapatite and, for this reason, is a key component of several self-etch adhesives. In this study, dicalcium phosphate dihydrate particles (DCPD; CaHPO4.2H2O) were functionalized with 10-MDP and used to formulate an experimental composite with 50 vol% inorganic content (3:1 DCPD:silanated barium glass ratio) dispersed in a BisGMA/TEGDMA matrix. The tested hypothesis was that DCPD functionalization would improve the composite's mechanical performance without compromising Ca2+ release. Composites containing nonfunctionalized DCPD or only reinforcing glass (in both cases, with or without 10-MDP mixed in the resin phase) were used as controls. Materials were tested for degree of conversion (DC; by Fourier transform infrared spectroscopy), water sorption (WS) and solubility (SL; according to ISO 4049), biaxial flexural strength (BFS)/modulus (FM) after 24 h and 5 mo in water, and 28-d Ca2+ release in water (by plasma-coupled optical emission spectroscopy). Data were analyzed using analysis of variance/Tukey test (alpha: 5%). DCPD functionalization did not interfere with DC. The composite containing functionalized DCPD showed significantly lower WS and SL in comparison with the material formulated with nonfunctionalized particles. The presence of 10-MDP (as a functionalizing agent or dispersed in the resin phase) reduced the composite's initial BFS and FM. After 5 mo in water, the composite with functionalized DCPD and both glass-only composites were able to maintain their mechanical properties at levels statistically similar to what was observed after 24 h. Ca2+ release was significantly reduced in both formulations containing 10-MDP. In conclusion, DCPD functionalization with 10-MDP increased the composite's resistance to hydrolytic degradation, improving its mechanical stability after prolonged water storage. However, the impaired water transit at the particle-matrix interface led to a reduction in Ca2+ release.

磷酸酯单体 10-甲基丙烯酰氧癸基二氢磷酸酯(10-MDP)能够与羟基磷灰石结合,因此是几种自刻蚀粘合剂的主要成分。在这项研究中,二水磷酸二钙颗粒(DCPD;CaHPO4.2H2O)被 10-MDP 功能化,并用于配制一种无机物含量为 50 Vol%(DCPD:硅烷化玻璃钡比例为 3:1)、分散在 BisGMA/TEGDMA 基质中的实验复合材料。测试假设是,DCPD 功能化将改善复合材料的机械性能,同时不影响 Ca2+ 的释放。含有未官能化 DCPD 或仅含有增强玻璃的复合材料(在这两种情况下,树脂相中都混有或不混有 10-MDP)被用作对照组。对材料的转化度(DC;通过傅立叶变换红外光谱法)、吸水性(WS)和可溶性(SL;根据 ISO 4049 标准)、在水中浸泡 24 小时和 5 个月后的双轴抗弯强度(BFS)/模量(FM)以及在水中浸泡 28 天后的 Ca2+ 释放量(通过等离子体耦合光学发射光谱法)进行了测试。数据采用方差分析/Tukey 检验(α:5%)进行分析。DCPD 功能化不会干扰 DC。与使用非官能化颗粒配制的材料相比,含有官能化 DCPD 的复合材料的 WS 和 SL 明显较低。10-MDP 的存在(作为官能化剂或分散在树脂相中)降低了复合材料的初始 BFS 和 FM。在水中浸泡 5 个月后,含有功能化 DCPD 的复合材料和两种纯玻璃复合材料都能保持其机械性能,在统计上与 24 小时后观察到的情况相似。总之,用 10-MDP 对 DCPD 进行官能化可增强复合材料的抗水解降解能力,从而提高其在长时间储水后的机械稳定性。然而,颗粒-基质界面上的水分传输受阻导致 Ca2+ 释放量减少。
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Journal of dental research
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