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Artificial Intelligence Chatbots in Patient Communication: Current Possibilities. 患者交流中的人工智能聊天机器人:当前的可能性。
Pub Date : 2024-11-15 DOI: 10.11607/prd.6925
Massimo Di Battista, Jeremy Kernitsky, Serge Dibart

ChatGPT, an artificial intelligence (AI) chatbot, can generate text prompts based on user input. This study investigated the possibility of utilizing this tool to generate adequate and relevant patient educational and management documents in the context of dental implant surgery. A total of 27 periodontists were surveyed on the accuracy and usefulness of AI-generated documents comprising informational handouts for patients on surgical risks and postoperative instruction sheets for dental implant placement in either smokers or patients with diabetes. These periodontists were also asked in a blinded fashion about their preferences between the generic implant placement consent form currently used at Boston University and two AI-generated consent forms, one generic and one tailored to patients with diabetes. A vast majority of participants found that the information in the AI-generated forms was accurate and useful, and they would feel comfortable using them with their own patients. The AI-generated generic consent form performed at least as well as the humanwritten one, while the personalized AI-generated consent form for patients with diabetes performed significantly better (P < .001). Within the limitations of this study, ChatGPT was able to independently generate accurate and useful informational and management documents for patients.

人工智能聊天机器人ChatGPT可以根据用户输入生成文本提示。本研究调查了在使用该工具进行牙科植入手术的背景下生成充分和相关的患者教育和管理文件的可能性。方法:对二十七名(n=27)牙周病学家进行了人工智能生成的文件的准确性和有用性调查,这些文件包括关于手术风险的患者信息讲义和吸烟者或糖尿病患者种植牙的术后说明书。他们还被以盲法询问了他们在波士顿大学目前使用的通用牙科植入物植入同意书和两种人工智能生成的同意书之间的偏好:一种是通用的,另一种是为糖尿病患者量身定制的。结果:绝大多数参与者发现,人工智能生成的表格中的信息是准确、有用的,并且在与自己的患者一起使用时会感到舒适。人工智能生成的通用同意书的表现与人类书面同意书一样差,而糖尿病患者的个性化知情同意书表现要好得多(结论:在本研究的限制范围内,ChatGPT能够独立生成准确有用的患者信息和管理文件。
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引用次数: 0
Autonomous Dental Implant Robotic System Utilization for Implant Placement and Transcrestal Sinus Elevation Using Osseodensification: A Case Report. 自主种植牙机器人系统利用骨密度进行种植体放置和经颅窦抬高:一例报告。
Pub Date : 2024-11-15 DOI: 10.11607/prd.6832
Mingxu Sun, Chongxia Yue, Sandra Stuhr, Xiaojie Fu, Hom-Lay Wang

Robotic systems have revolutionized various industries, and dentistry is no exception. Recently, due to the robust advancements in artificial intelligence and technology, there has been a significant evolution of dental robotic systems, ranging from surgeon-controlled and robot-assisted operations to more autonomous processes. The present clinical case report describes a 1-year follow-up of the successful use of an autonomous dental implant robot system with an osseodensification protocol for implant osteotomy preparation, maxillary sinus elevation, and simultaneous implant placement at the maxillary second premolar site. A prefabricated provisional prosthesis was delivered immediately after implant placement, with final prosthesis delivery at 3 months. The findings from this report demonstrate the integration and clinical augmentation of more autonomous protocols in the field of implant dentistry using dental robots.

机器人系统已经彻底改变了各个行业,牙科也不例外。最近,由于人工智能和技术的强劲进步,牙科机器人系统发生了重大变化,从外科医生控制的机器人辅助手术到更自主的过程。本临床病例报告描述了一个成功使用自主牙科种植机器人系统的一年随访,该系统具有骨致密化(OD)协议,用于种植体截骨准备、上颌窦抬高和同时在上颌第二前磨牙位置放置种植体。植入假体后立即交付预制临时假体,3个月后交付最终假体。本报告的研究结果表明,在使用牙科机器人的种植牙科领域,更自主的协议得到了整合和临床扩展。
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引用次数: 0
The Anatomy of the Mandibular Incisive Canal and Its Influence in Implant Therapy: A Scoping Review. 下颌切迹管的解剖及其对种植治疗的影响。范围综述。
Pub Date : 2024-11-15 DOI: 10.11607/prd.6826
Juan Francisco Peña-Cardelles, Jovana Markovic, Ahmad Alanezi, Adam Hamilton, German O Gallucci, Alejandro Lanis

The interforaminal region is considered more favorable for implant placement than the posterior mandible in edentulous patients, mainly because the inferior alveolar nerve can interfere with implant placement in the severely resorbed posterior mandible. However, complications in the interforaminal region may occur due to the presence of the mandibular incisive nerve. This scoping review aims to describe the mandibular incisive nerve anatomy related to the potential interference in implant therapy. A comprehensive literature search was conducted in the following databases: MEDLINE (via PubMed), Web of Science, and Scopus. This scoping review was structured according to the Joanna Briggs Institute method. Thirteen studies were included in the review. All of the studies were observational cohort anatomical studies, carried out mainly by CBCT and on cadavers. A total of 1,471 patients/cadavers were studied. The mandibular incisive nerve was present in 87% to 100% of cases, with an average length of 9.97 mm and an average diameter of 1.97 mm. The mandibular incisive nerve may be damaged during drilling and implant placement, especially when using implant lengths > 12 mm. Damage to the mandibular incisive nerve due to implant placement could be present, but it is necessary to conduct more studies focusing on assessing mandibular incisive nerve damage to understand the clinical relevance of this nerve and its associated morbidities, such as neurosensorial alterations. Due to the different anatomical characteristics of this nerve, CBCT analysis is recommended for implant therapy in the anterior mandible to prevent the described complications.

导言:在无牙颌患者中,齿间区被认为比下颌后部更适合植入种植体,这主要是因为在严重吸收的下颌后部植入种植体会受到下牙槽神经的干扰。然而,由于下颌切迹神经的存在,在齿间区域可能会出现并发症:本综述旨在描述下颌切迹神经解剖与种植治疗的潜在干扰有关:在以下数据库中进行了全面的文献检索:材料: 在以下数据库中进行了全面的文献检索:MEDLINE(通过 PubMed)、Web of Science 和 Scopus。根据乔安娜-布里格斯研究所(Joanna Briggs Institute)的方法构建了该范围综述:结果:13 项研究被纳入综述。所有研究均为观察性队列解剖研究,主要通过 CBCT 和尸体进行。共研究了 1471 名患者/尸体。87%-100%的病例存在下颌切迹神经,平均长度为 9.97 毫米,平均直径为 1.97 毫米。下颌切迹神经可能会在钻孔和种植体植入过程中受损,尤其是种植体长度大于 12 毫米时:下颌切迹神经可能会因种植体植入而受到损伤,但有必要进行更多的研究,重点评估下颌切迹神经损伤,以了解该神经的临床意义及其相关病症,如神经感觉改变。由于该神经的解剖特点不同,建议在下颌前部进行种植治疗时进行 CBCT 分析,以防止出现上述并发症。
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引用次数: 0
The Effect of Cement- Versus Screw-Retained Implant Positioning in the Esthetic Zone on Emergence Angle: A Proof-of-Principle Study. 骨水泥与螺钉固定植入物在美容区的定位对出射角的影响:原理验证。
Pub Date : 2024-11-15 DOI: 10.11607/prd.6903
Kenneth Choy, Dylan Sattler, Diane Daubert, I-Chung Wang

Choosing between screw-retained and cement-retained restorations in the esthetic zone may significantly impact the restorative contour. This study analyzes the effect of facial-palatal implant positioning on the facial emergence angle of implant restorations in the anterior maxilla. A total of 133 maxillary anterior implant cases were captured with intraoral scans and used to create digital prosthetic designs. The restoration facial emergence angle and the implant depth were determined using images at the midfacial cross section. Simple logistic and linear regression models were used to analyze the interrelation between the emergence angle, depth, and retention methods. The average facial emergence angle for all restorations in this study was 34.4 degrees. A significant difference in emergence angle was found between screw-retained and cement-retained groups, with averages of 37.3 degrees and 27.9 degrees, respectively. There was no difference in the mean depth between the two groups. A strong negative linear relationship between depth and emergence angle was seen for the screw-retained group. Overall, implant positioning in the anterior maxilla has a significant influence on emergence angle. Facial emergence angle is significantly greater for implants in a screw-retained position. This may be partially alleviated by deeper implant placement.

在美观区选择螺钉保留和水泥保留修复体可能对修复轮廓有重大影响。本研究分析了面腭种植体定位对上颌前部种植体修复体的面出角的影响。133例上颌前牙种植体病例通过口内扫描捕获,并用于创建数字假体设计。修复体的面部出射角和植入物的深度是使用面部中部横截面的图像确定的。使用简单的逻辑和线性回归模型来分析羽化角度、深度和保留方法之间的相互关系。本研究中所有修复体的平均面部出角为34.4度。螺钉固定组和水泥固定组的出角差异显著,平均出角分别为37.3度和27.9度。这两组的平均深度没有差异。螺钉固定组的深度和出射角之间存在很强的负线性关系。总的来说,种植体在上颌骨前部的位置对出角有显著影响。螺钉固定位置的植入物的面部出射角明显更大。这种情况可以通过更深的植入物放置部分缓解。
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引用次数: 0
Alveolar Ridge Preservation Procedures Performed with Freeze-Dried Bone Allograft: Clinical and Histologic Outcomes in a Case Series: Part II. 使用冻干骨异体移植进行牙槽嵴保存术:系列病例的临床和组织学结果:第二部分.
Pub Date : 2024-11-15 DOI: 10.11607/prd.6953
Antonio Barone, Chiara Cinquini, Nicola Alberto Valente, Eugenio Velasco-Ortega, Giacomo Derchi, Emira D'Amico, Giovanna Iezzi

Tooth extractions can result in alveolar bone dimensional changes, necessitating additional bone grafting for implant placement. Alveolar ridge preservation (ARP) aims to counteract postextraction changes. This case series evaluates the bone regenerative properties of a freeze-dried bone allograft (FDBA) and the clinical outcomes of implants in grafted extraction sites. A total of 33 patients were enrolled, undergoing single/multiple tooth extractions followed by ARP. Biopsy samples were harvested during implant placement for histologic and histomorphometric analysis. Clinical outcomes included marginal bone loss and pink esthetic score (PES). Twenty-five patients completed the study. FDBA-augmented sockets exhibited new bone formation adjacent to graft particles. Implants (n = 25) showed 100% survival and success rates at 1 and 2 years. PES improved significantly over time (P < .001), while marginal bone loss did not significantly differ at 1 and 2 years (P = .096). Specimens showed trabecular bone, residual FDBA particles, and marrow spaces. High magnification revealed immature bone and woven bone bridges around graft particles. No inflammatory cells were observed. This case series provides valuable insights into ARP performed with FDBA (as implants were placed after 3 months of healing without any additional bone augmentation), the histologic outcomes were favorable, and implants were successful after a 2-year follow-up period.

简介拔牙会导致牙槽骨的尺寸发生变化,因此有必要进行额外的骨移植以植入种植体。牙槽嵴保留(ARP)的目的是对抗拔牙后的变化。本研究评估了冻干骨异体移植(FDBA)的骨再生特性以及移植拔牙部位种植体的临床效果:本病例系列共纳入 33 名接受单颗/多颗牙拔除术后 ARP 的患者。在植入过程中采集活检组织,进行组织学和组织形态学分析。临床结果包括边缘骨质流失和粉红美学评分(PES)。FDBA增量基台显示出邻近移植颗粒的新骨形成。种植体(25 个)在 1 年和 2 年后的存活率和成功率均为 100%。随着时间的推移,PES明显改善(p结论:该系列病例为使用 FDBA 进行 ARP 提供了有价值的见解;种植体在愈合 3 个月后植入,无需额外的骨增量,组织学结果良好,随访 2 年后种植体成功植入。
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引用次数: 0
Retrospective Study on 57 Direct Interproximal Restorations with Supracrestal Tissue Attachment Violation: Follow-ups Between 10 and 23 Years. 关于 57 例直接近端间修复体上皮组织附着侵犯的回顾性研究:随访 10 至 23 年。
Pub Date : 2024-11-15 DOI: 10.11607/prd.6778
Sandro Pradella, Chiara Morellini, Damiano Formentini, Massimo Del Fabbro

A total of 57 interproximal restorations invading the supracrestal tissue attachment were evaluated in terms of crestal bone loss over a mean period of 15 years (10 to 23 years). The distance from the cavity margin to the bone was measured at T0 (after the restoration; baseline) and controlled using radiographs and a measurable landmark. The mean vertical bone loss was 0.46 mm, with a 96.49% survival rate. Smoking habits (P = .02) and tooth type (P = .03) significantly affected bone loss. The proposed technique could help the clinician in adopting a minimally invasive approach in the treatment of heavily compromised teeth. Future research with rigorous study designs would be interesting to guide the clinical decision-making.

在平均 15 年(10-23 年)的时间里,对 57 个侵犯上牙冠组织附着物的近端间修复体的牙槽骨流失情况进行了评估。龋洞边缘到牙槽骨的距离在 T0 时进行测量,并使用 X 射线和可测量的地标进行控制。垂直方向的平均骨质流失量为 0.46 毫米,存活率为 96.49%。吸烟习惯(p = 0.02)和牙齿类型(p = 0.03)对骨质流失有显著影响。建议的技术有助于临床医生采用微创方法治疗严重受损的牙齿。未来严格的研究设计将有助于指导临床决策。
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引用次数: 0
A Meeting Like No Other. 独一无二的会议
Pub Date : 2024-11-15 DOI: 10.11607/prd.2024.6.e
Gustavo Avila-Ortiz
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引用次数: 0
Beyond the Scope-Embracing a Disruptive Proposition: Periodontal and Implant Microsurgery. 超越范围--树立颠覆性主张:牙周和种植显微外科。
Pub Date : 2024-11-15 DOI: 10.11607/prd.2024.6.c
Rino Burkhardt, Hsun-Liang Chan, Diego Velásquez-Plata
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引用次数: 0
The Assessment of Volumetric Changes for Alveolar Ridge Preservation or Reconstruction by 3D Analysis at Posterior Extraction Sites with Severe Bone Defects Using DBBM-C Collagen Membrane and PRF: A Prospective and Randomized Clinical Trial. 使用 DBBM-C 胶原膜和 PRF 在骨质严重缺损的后拔牙部位通过三维分析评估牙槽嵴保留或重建的容积变化:一项前瞻性随机临床试验。
Pub Date : 2024-11-15 DOI: 10.11607/prd.6971
Haina Yu, Qing Cai, Baosheng Li, Weiyan Meng

Volumetric resorption of the alveolar ridge often occurs in both horizontal and vertical directions following tooth extraction. There is a specific lack of evidence for alveolar ridge reconstruction at molar and premolar sites with severe bone resorption. This randomized controlled trial used 3D and linear analyses to evaluate volumetric changes of the alveolar bone following alveolar ridge reconstruction (ARR) at molar and premolar sites with severe bone resorption as compared to unassisted socket healing before implant placement. A total of 31 patients (15 men, 16 women) with > 50% hard tissue loss in one or more socket walls were recruited and randomized into either a test group (postextraction ARR using deproteinized bovine bone mineral with 10% collagen [DBBM-C] and platelet-rich fibrin [PRF] with a resorbable collagen membrane) or a control group (natural healing after extraction). The clinical, linear, and volumetric implant-related and patient-reported outcomes were analyzed after 4 months of healing. Linear bone assessments revealed significantly greater ridge width gains in the test group (25% in the mesial, midfacial, and distal aspects) and less reduction of vertical bone ridge than in the control group (P < .05). Further, volumetric bone remodeling was significantly higher in the test group (35.1% ± 34.9% for ARR, 14.2% ± 12.8% for control; P < .05). Patient-reported discomfort and keratinized mucosal changes were comparable between groups. ARR with a combination of DBBM-C, PRF, and a resorbable membrane at posterior sites with a severe socket wall deficiency (> 50% bone loss) is a safe and more capable therapeutic method when compared to natural healing and unassisted sockets. Collectively, the present analyses demonstrate that ARR represents an efficient method to maintain and augment crestal bone at posterior extraction sites with severe bone defects when assessed after 4 months of healing.

问题陈述:拔牙后,牙槽嵴通常会在水平和垂直方向发生体积吸收。目的:这项随机对照试验旨在通过三维和线性分析,评估在牙槽骨吸收严重的磨牙和前磨牙部位进行牙槽嵴重建(ARR)后牙槽骨的体积变化,并与非辅助牙槽窝愈合和种植体植入进行比较:共招募了 31 位患者(男性 15 位,女性 16 位),他们的一个或多个牙槽窝壁硬组织缺损超过 50%,被随机分为试验组(拔牙后使用含 10%胶原蛋白的去蛋白牛骨矿物质(DBBM-C)和富血小板纤维蛋白(PRF)及可吸收胶原膜进行牙槽嵴重建)或对照组(拔牙后自然愈合)。然后,经过 4 个月的愈合过程,对临床、线性、体积种植相关结果和患者报告结果进行分析:结果:线性骨评估显示,与对照组相比,试验组的骨嵴宽度明显增加(中面部、中面部和远端各增加 25%),垂直骨嵴减少较少(P<0.05)。此外,试验组的骨体积重塑率明显更高(ARR=35.1±34.9%,对照组=14.2±12.8%,P<0.05)。患者报告的不适感和角化粘膜变化在两组之间具有可比性:结论:与自然愈合和非辅助牙槽相比,在牙槽骨壁严重缺损(骨量损失>50%)的后牙部位使用 DBBM-C、PRF 和可吸收膜组合进行牙槽嵴重建是一种安全且更有效的治疗方法:总之,我们的分析表明,牙槽嵴重建是一种有效的方法,可在骨质严重缺损的后牙拔牙部位维持和增加骨嵴,并在四个月后进行愈合评估。
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引用次数: 0
The Management of Gingival Fenestration: A Series of Three Cases. 牙龈开窗术的处理:一系列的三个案例。
Pub Date : 2024-11-15 DOI: 10.11607/prd.6861
Xuefeng Ren, Tao Liu, Lijun Huo, Nanquan Rao, Lixiao Wang, Qi Luo, Mingzhu Zhang

Gingival fenestration is a relatively uncommon soft tissue lesion in which the root apex is exposed in the oral environment after the destruction of the overlying buccal bone plate and mucosa. At present, no clear etiology or treatment guidelines exist for gingival fenestration. This article reports three successfully treated cases of gingival fenestration associated with chronic periapical infection and can help contribute to treatment guidelines for gingival fenestration. All cases were treated with apicoectomy in conjunction with a connective tissue graft (CTG), and the first steps of each case were as follows: endodontic therapy with root-end resection and retrograde filling, then regenerative surgical therapy. However, slightly different regenerative treatment methods were used during the operation according to the different patient conditions. In Case 1, gingival fenestration in the mandibular left first premolar was treated using a xenograft and CTG. In Case 2, gingival fenestration in the maxillary left lateral incisor was treated using advanced platelet-rich fibrin (A-PRF) and CTG. In Case 3, gingival fenestration in the mandibular left second premolar was treated using CTG. Endodontic treatment was combined with periodontal surgery to achieve predictable results. After 13 to 25 months of follow-up, all cases showed well-healed gingival fenestrations and no discomfort. These three cases show the possibility of using apical excision combined with a CTG and/or bone graft/A-PRF in the treatment of gingival fenestration. Reporting these three cases may help advance the field of gingival fenestration treatment.

目的:本文旨在介绍三种治疗慢性根尖周炎患者牙龈开窗术的方法。牙龈开窗术是一种相对罕见的软组织损伤,在破坏上覆的颊骨板和粘膜后,根尖暴露在口腔环境中。目前,牙龈开窗术尚无明确的病因或治疗指南。本文报告三例牙龈开窗术合并慢性根尖周感染的成功治疗病例。本报告有助于制定牙龈开窗术的治疗指南。方法:所有病例均采用乳头切除术结合结缔组织移植(CTG)治疗。根据患者的不同情况,我们在手术中采用了一些略有不同的治疗方法。在病例1中,我们通过根端切除和逆行充填的牙髓治疗以及使用异种移植物和CTG的再生手术治疗来治疗下颌左第一前磨牙的牙龈开窗术。在病例2中,我们通过根端切除和体外逆行充填的牙髓治疗以及使用先进的富含血小板的纤维蛋白(A-PRF)和CTG的再生外科治疗来治疗上颌左切牙的牙龈开窗术。在病例3中,我们通过根端切除和逆行充填的根管治疗和CTG的再生手术治疗来治疗下颌左第二前磨牙的牙龈开窗术。结果:牙髓治疗与牙周手术相结合,取得了可预测的治疗效果。经过13至25个月的随访,所有病例均显示牙龈开窗术愈合良好,患者没有任何不适。结论:这三例病例显示了使用根尖切除联合CTG和/或骨移植/PRF治疗牙龈开窗术的可能性。报告这三个病例可能有助于推进牙龈开窗术的治疗领域。
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引用次数: 0
期刊
The International journal of periodontics & restorative dentistry
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