prosthodontics

口腔修复
  • DOI:
    文章类型: English Abstract
    目的:分析成形方向对表面特性的影响,弹性模量,印刷零件的弯曲强度和断裂韧性以及成形方向与力方向之间的关系,为口腔义齿基托树脂材料的临床应用提供科学依据和指导。
    方法:使用3D打印技术打印义齿基托树脂样品。样品的形状和尺寸参考用于测试常规义齿基托材料的当前标准。用于物理性能测试的样品为圆柱形(直径为15毫米,厚度为1毫米),并沿Z轴(0°,45°,90°)。使用扫描电子显微镜观察不同样品的微观形貌。通过颜色稳定剂观察不同样品的颜色稳定性。使用表面粗糙度测试仪分析样品的表面粗糙度。测量维氏硬度以分析样品的硬度。用于机械性能测试的样品为矩形(弹性模量和弯曲强度:长度为64mm,宽度为10毫米,高度为3.3毫米;断裂韧性:长度为39毫米,8毫米的宽度,和4毫米的高度),分为两组:W组和H组。W组沿Z轴从下到上打印,长度×宽度为底面平行于X,Y轴平面,而H组沿Z轴从下往上打印,长度×高度为平行于X的底面,Y轴平面。两组的成形角度均分为0°,45°,90°。弹性模量,通过万能力学试验机研究了不同试样的弯曲强度和断裂韧性。采用SPSS22.0软件进行统计分析。
    结果:不同样品的微观形貌和粗糙度与印刷方向密切相关,0°之间存在显著差异,45°,和90°标本。0°试样具有最光滑的表面(粗糙度<1μm)。45°试样的表面是最粗糙的(粗糙度>3μm)。0°试样的显微硬度最好[(196.13±0.20)MPa],与90°样品[(186.62±4.81)MPa相比有显著差异,P<0.05]。不同样品的力学性能也与印刷方向密切相关。弹性模量,弯曲强度,与其他组相比,W组45°样品的断裂韧性最高。弹性模量测定结果表明,在H组中,45°试样的弹性最大,与0°和90°标本有显著差异(P<0.05)。W组0°和45°试样的弹性模量均高于90°试样(P<0.05)。弯曲强度结果表明,H组不同角度的试样之间没有显着差异。W组90°试样的抗弯强度最小,90°与0°和45°试样有显著性差异(P<0.05);W组0°和45°试样的弯曲强度明显高于H组0°和45°试样(P<0.05)。断裂韧性结果表明,H组试样的断裂韧性均低于义齿基托标准规定的1.9MPam1/2。W组45°样品最高,与0°和90°样品相比差异显著(P<0.05)。W组样品的90°样品低于1.9MPam1/2。W组45°试样的断裂韧性明显高于H组(P<0.05)。
    结论:0°样品具有相对较好的物理性质。45°样品具有最好的机械性能。但试样(H组和W组90°试样)的断裂韧性尚未达到临床要求。这表明3D打印义齿基托树脂的特性受到打印方向的影响。只有当印刷样品在各个方向上的性能都满足标准的最低要求时,它们可以用于临床实践。
    OBJECTIVE: To analyze the influence of forming direction on the surface characteristics, elastic modulus, bending strength and fracture toughness of printed parts and the relationship between forming direction and force direction, and to provide scientific basis and guidance for the clinical application of oral denture base resin materials.
    METHODS: The 3D printing technology was used to print denture base resin samples. The shape and size of the samples referred to the current standard for testing conventional denture base materials. The samples used for physical performance testing were cylindrical (with a diameter of 15 mm and a thickness of 1 mm) and printed at different angles along the Z axis (0°, 45°, 90°). Scanning electron microscope was used to observe the microscopic topography of the different samples. The color stability of different samples was observed by color stabilizer. The surface roughness of the samples was analyzed by using surface roughness tester. The Vickers hardness was measured to analyze the hardness of the samples. The samples used for mechanical performance testing were rectangular (elastic modulus and bending strength: A length of 64 mm, a width of 10 mm, and a height of 3.3 mm; fracture toughness: A length of 39 mm, a width of 8 mm, and a height of 4 mm), divided into two groups: W group and H group. The W group was printed from the bottom up along the Z axis with the length × width as the bottom surface parallel to the X, Y axis plane, while the H group printed from the bottom up along the Z axis with the length × height as the bottom surface parallel to the X, Y axis plane. The forming angles of both groups were equally divided into 0°, 45°, and 90°. The elastic modulus, bending strength and fracture toughness of different samples were studied through universal mechanical testing machine. SPSS 22.0 software was used for statistical analysis.
    RESULTS: The microscopic topography and roughness of different samples were closely related to the printing direction, with significant differences between the 0°, 45°, and 90° specimens. The 0° specimens had the smoothest surface (roughness < 1 μm). The surface of the 45° specimen was the roughest (roughness>3 μm). The microhardness of the 0° sample was the best [(196.13±0.20) MPa], with a significant difference compared with the 90° sample [(186.62±4.81) MPa, P < 0.05]. The mechanical properties of different samples were also closely related to the printing direction. The elastic modulus, bending strength, and fracture toughness of the 45° samples in the W group were the highest compared with the other groups. The results of elastic modulus showed that in the H group, the 45° specimens had the highest elastic mo-dulus, which was significantly different from the 0° and 90° specimens (P < 0.05). The elastic modulus of 0° and 45° specimens in the W group were higher than those in 90° specimens (P < 0.05). The bending strength results showed that there was no significant difference between the specimens from dif-ferent angles in the H group. The bending strength of the 90° specimens in the W group was the smallest, and there was a significant difference between 90° and the 0° and 45° specimens (P < 0.05); And the bendind strength of the 0° and 45° specimens in the W group was significantly higher than that of the 0° and 45° specimens in the H group (P < 0.05). The fracture toughness results showed that the fracture toughness of the H group specimens was lower than 1.9 MPa m1/2, which was specified in the denture base standard. The 45° samples in the W group were the highest, with significant differences compared with the 0° and 90° samples (P < 0.05). And the 90° samples of the W group specimens were lower than 1.9 MPa m1/2. And the fracture toughness of the 45° specimen in the W group was significantly higher than that of all the specimens in the H group (P < 0.05).
    CONCLUSIONS: The 0° samples had relatively better physical properties. The 45° samples had the best mechanical properties. But the fracture toughness of specimens (H group and 90° samples of W group) did not yet meet clinical requirements. That indicated that the characteristics of the 3D printing denture base resin were affected by the printing direction. Only when the performance of the printed samples in all directions met the minimum requirements of the standard, they could be used in clinical practice.
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  • 文章类型: Journal Article
    In the field of prosthodontics, the use of virtual patients for biomimetic restoration holds great promise for various applications. Virtual patients consist of digitized data that encompasses details on the morphology, structure, and spatial relationships within the maxillofacial and intraoral regions. Nonetheless, there are several challenges associated with acquiring digital data, achieving accurate alignment, and recording and transferring dynamic jaw movements. This paper aims to concentrate on the process of constructing virtual patients, highlight the key and challenging aspects of virtual patient construction, and advocate for the extensive adoption and utilization of virtual patient technology.
    在口腔修复领域,构建虚拟患者进行数字化仿生修复展现出广阔的应用前景。虚拟患者由包含口颌面部信息的数字化素材构成,能准确地反映出口颌面结构的形态和空间关系。然而,在数字化素材的获取、精确配准过程和动态颌位关系的记录与转移中,均存在诸多挑战。本文将围绕虚拟患者的构建流程,阐述目前构建虚拟患者的关键点和难点,推动虚拟患者技术在口腔修复领域的普及和推广。.
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  • With the development and application of technologies such as facial scanning, intraoral scanning, virtual facebow and mandibular movement tracking in prosthodontics, dynamic virtual patients are gradually applied to preoperative analysis, esthetic diagnosis, treatment planning, and restorative implementation, becoming a research hotspot in recent years. This review focuses on data acquisition, construction of dynamic virtual patients and their application advantages, aiming to provide a reference for the clinical application of related digital technologies.
    随着面部扫描、口内扫描、虚拟面弓、下颌运动轨迹记录等技术在口腔修复领域的发展及应用,动态虚拟患者技术逐渐被应用于口腔修复的术前分析、美学诊断、治疗设计及修复体制作,并成为近年的研究热点。本文从口腔动静态数据获取、动态口腔虚拟患者的构建、动态口腔虚拟患者的应用优势等方面对动态虚拟患者技术在口腔修复领域中的应用和研究展开综述,以期为相关数字化技术的临床应用提供参考。.
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  • 文章类型: Journal Article
    目的:这篇综述旨在总结现有技术,材料类别,以及增材制造(AM)牙科陶瓷的口腔修复应用,与当前主流的计算机辅助设计/计算机辅助制造(CAD/CAM)减法制造(SM)方法相比,评估可实现的精度和机械性能,并讨论未来的前景和方向。
    方法:本文基于最新的评论,最先进的研究,以及有关AM技术和牙科陶瓷修复应用的现有ISO标准。PubMed,WebofScience,和ScienceDirect是搜索叙事评论的来源之一。
    结果:可用的AM技术相对较少,其应用仅限于牙冠和固定局部义齿。尽管AM牙科陶瓷的精度和强度与SM相当,它们具有相对较差的曲面精度和较低的强度可靠性的局限性。此外,功能梯度增材制造(FGAM),AM的潜在方向,能够实现仿生结构,如天然牙齿;然而,目前缺乏具体的研究。
    结论:AM牙科陶瓷尚未充分开发用于大规模临床应用。然而,通过额外的研究,AM有可能取代SM成为陶瓷修复体的主流制造技术。
    OBJECTIVE: This review aims to summarize the available technologies, material categories, and prosthodontic applications of additive manufacturing (AM) dental ceramics, evaluate the achievable accuracy and mechanical properties in comparison with current mainstream computer-aided design/computer-aided manufacturing (CAD/CAM) subtractive manufacturing (SM) methods, and discuss future prospects and directions.
    METHODS: This paper is based on the latest reviews, state-of-the-art research, and existing ISO standards on AM technologies and prosthodontic applications of dental ceramics. PubMed, Web of Science, and ScienceDirect were amongst the sources searched for narrative reviews.
    RESULTS: Relatively few AM technologies are available and their applications are limited to crowns and fixed partial dentures. Although the accuracy and strength of AM dental ceramics are comparable to those of SM, they have the limitations of relatively inferior curved surface accuracy and low strength reliability. Furthermore, functionally graded additive manufacturing (FGAM), a potential direction for AM, enables the realization of biomimetic structures, such as natural teeth; however, specific studies are currently lacking.
    CONCLUSIONS: AM dental ceramics are not sufficiently developed for large-scale clinical applications. However, with additional research, it may be possible for AM to replace SM as the mainstream manufacturing technology for ceramic restorations.
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  • 文章类型: Journal Article
    目的:本研究旨在开发和评估一种简单的,评估植入物保留假体框架的失配性和无源性的非破坏性方法。
    方法:使用由两个植入物支撑的3个单位螺钉保留的框架来模拟下颌骨后部部分缺牙区域的康复,并分为以下五组(每组n=10):OP=用常规方法在Co-Cr中铸造的单件框架(对照组);Co-Cr框架通过激光切割并焊接(=LAS)或钨Cr-CAM-氧化锆-CAD框架=TIG使用拧紧一个或两个螺钉的共聚焦激光扫描显微镜测量水平|X|和垂直|Y|不配合。通过重复测量和Bonferroni校正的双向ANOVA分析数据(α=0.05)。
    结果:在两个螺钉拧紧(290µm)和一个螺钉拧紧(388和340µm)的OP组中观察到最大的|X|不合适。通过激光或TIG切割和焊接的常规铸件组的平均值较低(235.35µm,拧紧两个螺钉;和275µm,一个螺钉拧紧)比OP框架。然而,这些值仍然超过研磨的Co-Cr和氧化锆框架的值(拧紧两个螺钉的情况下,190和216µm)。在所有阅读条件下,每个接受测试的框架始终保持垂直|Y|失配水平低于53µm的阈值;然而,与通过常规铸造方法获得的框架相比,铣削框架表现出更高的垂直失配。
    结论:框架,无论是用激光焊接铸造和切片,还是用Co-Cr铣削,与其他制造方法相比,表现出改善的边缘失配和增强的被动配合。此外,使用共聚焦激光扫描显微镜是非常有效的无源性和失配分析。
    OBJECTIVE: This study aimed to develop and evaluate a simple, non-destructive method for assessing the misfit and passivity of implant-retained prostheses frameworks.
    METHODS: To simulate the rehabilitation of a mandible posterior partially edentulous area using 3-unit screw-retained frameworks supported by two implants were fabricated and divided into the following five groups (n = 10 in each group): OP = one-piece framework cast in Co-Cr with the conventional method (control-group); Co-Cr frameworks sectioned and welded by laser (=LAS) or tungsten inert gas (=TIG); Co-Cr CAD-CAM = milled Co-Cr framework; Zir CAD-CAM = milled zirconia framework. The horizontal |X| and vertical |Y| misfits were measured using confocal laser scanning microscopy with one or both screws tightened. Data were analyzed by a two-way ANOVA with repeated measures and Bonferroni correction (α = 0.05).
    RESULTS: The greatest |X| misfit was observed in the OP group with both screws tightened (290 µm) and one screw tightened (388 and 340 µm). The conventional casting groups sectioned and welded by laser or TIG had lower mean values (235.35 µm, both screws tightened; and 275 µm, one screw tightened) than the OP framework. However, these values still exceeded those of the milled Co-Cr and zirconia frameworks (190 and 216 µm with both screws tightened). Across all reading conditions, every framework subjected to testing consistently maintained vertical |Y| misfit levels below the threshold of 53 µm; however, the milled frameworks exhibited higher vertical misfits than the frameworks obtained by the conventional cast method.
    CONCLUSIONS: The frameworks, whether cast and sectioned with laser welding or milled from Co-Cr, exhibit improved marginal misfit and enhanced passive fit when compared to other fabrication methods. Additionally, the use of confocal laser scanning microscopy is highly effective for passivity and misfit analysis.
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  • 文章类型: Journal Article
    以深度学习为代表的人工智能在种植牙修复领域备受关注。它广泛应用于手术图像分析,种植计划设计,假体形状设计,和预后判断。本文主要介绍了深度学习在口腔种植修复全过程中的研究进展。分析了当前研究的局限性,并展望了未来的发展方向。
    Artificial intelligence represented by deep learning has attracted attention in the field of dental implant restoration. It is widely used in surgical image analysis, implant plan design, prosthesis shape design, and prognosis judgment. This article mainly describes the research progress of deep learning in the whole process of dental implant prosthodontics. It analyzes the limitations of current research, and looks forward to the future development direction.
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  • DOI:
    文章类型: English Abstract
    目的:探讨4种口腔修复材料对咀嚼和牙龈功能的影响。
    方法:收集2019年10月至2022年1月接受口腔修复治疗的167例牙体缺损患者。将其随机分为4组,其中纯钛组41例,钴铬合金组40例,镍铬合金组43例,二氧化锆组43例。记录并比较4组患者治疗6个月后的疗效及满意度。咀嚼功能(咀嚼效率,咬合力),牙龈功能[菌斑指数(PLI),牙龈指数(GI)和沟出血指数(SBI)],龈沟液炎症相关指标[肿瘤坏死因子α(TNF-α),白细胞介素-6(IL-6),天冬氨酸转氨酶(AST)和碱性磷酸酶(碱性磷酸酶,ALP)]治疗前后测定并比较4组。采用SPSS20.0软件包进行统计学分析。
    结果:4组疗效差异无统计学意义(P>0.05)。治疗前后,4组咀嚼效率和咬合力差异无统计学意义(P>0.05).治疗前,PLI没有显着差异,GI,SBI,龈沟液重量,TNF-α,4组龈沟液中IL-6、AST和ALP的表达(P>0.05).与治疗前相比,PLI,4组患者治疗后GI、SBI均下降(P<0.05),降低顺序为钴铬合金组≈镍铬合金组<纯钛组<二氧化锆组。治疗前,龈沟液的重量没有显着差异,TNF-α,4组龈沟液中IL-6、AST和ALP的表达(P>0.05).颌骨流体的重量,TNF-α,龈沟液中IL-6、AST、ALP明显升高(P<0.05),增加顺序为氧化锆组<纯钛组<钴铬合金组≈镍铬合金组。4组修复体完整性和颜色满意度比较差异无统计学意义(P>0.05)。但4组患者的边缘适应度和敏感性满意度差异有统计学意义(P<0.05).
    结论:纯钛,钴铬合金,镍铬合金和二氧化锆可用于治疗牙列缺陷,它们都可以获得令人满意的咀嚼功能。此外,二氧化锆修复具有改善牙龈功能和龈沟液炎症相关指标的作用,具有广阔的应用前景。
    OBJECTIVE: To investigate the effect of 4 kinds of prosthodontic materials on masticatory and gingival function.
    METHODS: A total of 167 patients with dental defects who underwent prosthodontic treatment from October 2019 to January 2022 were collected. They were randomly divided into 4 groups with 41 cases in the pure titanium group, 40 cases in the cobalt-chromium alloy group, 43 cases in the nickel-chromium alloy group and 43 cases in the zirconium dioxide group. The curative effect and satisfaction degree after 6 months of treatment in 4 groups were recorded and compared. The masticatory function (chewing efficiency, bite force), gingival function[plaque index(PLI), gingival index(GI) and sulcus bleeding index(SBI)], gingival crevicular fluid inflammation-related indicators[tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6), aspartate aminotransferase(AST) and alkaline phosphatase (alkaline phosphatase, ALP)] before and after treatment were measured and compared in 4 groups. Statistical analysis was performed with SPSS 20.0 software package.
    RESULTS: There was no significant difference in curative effect in 4 groups(P>0.05). Before and after treatment, there was no significant difference in mastication efficiency and bite force in 4 groups(P>0.05). Before treatment, there was no significant difference in PLI, GI, SBI, gingival crevicular fluid weight, TNF-α, IL-6, AST and ALP in gingival crevicular fluid in 4 groups(P>0.05). Compared with before treatment, PLI, GI and SBI in 4 groups were decreased after treatment (P<0.05), and the decrease was in the order of cobalt-chromium alloy group≈nickel-chromium alloy group<pure titanium group<zirconia dioxide group. Before treatment, there was no significant difference in the weight of gingival crevicular fluid, TNF-α, IL-6, AST and ALP in gingival crevicular fluid in 4 groups(P>0.05). The crevicular fluid weight, TNF-α, IL-6, AST and ALP in gingival crevicular fluid were significantly increased(P<0.05), and the increase was in the order of zirconia group<pure titanium group<cobalt-chromium alloy group≈nickel-chromium alloy group. There was no significant difference in restoration integrity and color satisfaction in 4 groups(P>0.05), but there was significant difference in marginal fitness and sensitivity satisfaction in 4 groups(P<0.05).
    CONCLUSIONS: Pure titanium, cobalt-chromium alloy, nickel-chromium alloy and zirconium dioxide can be used for the treatment of dentition defects, and they all can obtain satisfactory chewing function. In addition, zirconium dioxide restoration has the effect of improving gingival function and inflammation-related indicators of gingival crevicular fluid with a broader application prospect.
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  • 文章类型: Randomized Controlled Trial
    背景:传统中医牙科课堂教学模式注重知识细节的指导,但较少的框架和学习者的动机。这里,我们将思维导图和PBL教学(MBL)相结合引入了中国牙科学生的口腔修复课程。本研究旨在评估MBL在口腔修复中的有效性和效率,并从学生的角度进行观察。基于他们对学习过程的反应。
    方法:我们前瞻性招募了56名口腔医学四年级本科生,这些参与者被随机分配到联合思维导图教学组(MBL)或基于问题的学习组(PBL)参加口腔修复学课程.还对两组进行了匿名问卷调查,以评估学生的看法和经验,使用封闭式和开放式项目。使用描述性统计和专题分析对数据进行分析。
    结果:学生对封闭项目的反应表明他们在PBL和MBL中的经验是积极的,包括增加动力,提高对知识的记忆,加强纪律联系,提高团队精神,MBL组的评分相当高。然而,导师指导的能力分数包括记忆和框架部分,MBL组明显高于PBL组(双向方差分析,p<0.01,p<0.001)。同时,自我感知能力得分,包括动机,框架和团队合作部分,MBL组明显高于PBL组(双向方差分析,p<0.01,p<0.001,p<0.05)。
    结论:我们的研究结果表明,MBL教学法可以帮助整合知识结构并增强临床推理能力。MBL是牙科学生口腔修复课程中一种有效且组织良好的方法。
    BACKGROUND: The traditional Chinese dentistry classroom teaching model focuses on the instruction of knowledge details, but less on the frameworks and learners\' motivation. Here, we introduced a combination of mind mapping and PBL instruction (MBL)into the prosthodontics course for Chinese dental students. This study aimed to evaluate the effectiveness and efficiency of MBL in prosthodontics and make observations from the students\' perspectives, based on their response with the learning process.
    METHODS: We prospectively enrolled 56 fourth-year undergraduates of stomatology, and these participants were randomly allocated into either the combined mind map teaching group (MBL) or the problem-based learning group (PBL) to attend the prosthodontics course. An anonymous questionnaire was also administered to both groups to evaluate the students\' perceptions and experiences, using closed and open-ended items. Data were analyzed using descriptive statistics and thematic analysis.
    RESULTS: The students\' responses to closed items indicate their experience in PBL and MBL to be positive, including increased motivation, improved memory of knowledge, enhanced discipline connection and raised teamwork, with fairly higher ratings for the MBL group. However, the tutor-guided competence scores including the memory and framework part, were significantly higher for MBL group than PBL group (two-way ANOVA, p < 0.01, p < 0.001, respectively). Meanwhile, the self-perceived competence scores including the motivation, framework and teamwork part, were significantly higher for MBL group than PBL group (two-way ANOVA, p < 0.01, p < 0.001, p < 0.05, respectively).
    CONCLUSIONS: Our findings suggest that MBL teaching approach can help in integration of knowledge structure and enhance clinical reasoning. MBL is an effective and well-organized method in prosthodontics course for dental students.
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  • 文章类型: Review
    目标:数字化和人工智能的激增导致机器人在各个领域的广泛应用,但它们在牙科中的应用起步较晚。本范围综述旨在全面探讨和绘制机器人在牙科临床应用的现状。
    方法:使用迭代方法从四个在线数据库中收集尽可能多的证据,包括PubMed,中国国家知识基础设施,日本科技信息聚合器,电子,以及电气和电子工程师协会,从1980年1月到2022年12月。
    结果:从搜索结果中选出113篇符合条件的文章,发现大多数机器人是在美国开发和应用的(n=56;50%)。机器人在口腔颌面外科的临床应用,口腔种植,口腔修复术,正畸学,牙髓,和口服药物。机器人在口腔颌面外科和口腔种植方面的发展相对较快和全面。大约51%(n=58)的系统已经达到临床应用,而49%(n=55)处于临床前阶段。其中大多数是硬机器人(90%;n=103),他们的发明和发展主要集中在研究周期长、成分多样的大学研究小组。
    结论:牙科机器人的研究和应用之间仍然存在局限性和差距。虽然机器人技术有可能取代临床决策,将其与牙科相结合以获得最大利益仍然是未来的挑战。
    OBJECTIVE: The surge in digitalization and artificial intelligence has led to the wide application of robots in various fields, but their application in dentistry started relatively late. This scoping review aimed to comprehensively explore and map the current status of the clinical application of robots in dentistry.
    METHODS: An iterative approach was used to gather as much evidence as possible from four online databases, including PubMed, the China National Knowledge Infrastructure, the Japan Science and Technology Information Aggregator, Electronic, and the Institute of Electrical and Electronics Engineers, from January 1980 to December 2022.
    RESULTS: A total of 113 eligible articles were selected from the search results, and it was found that most of the robots were developed and applied in the United States (n = 56; 50%). Robots were clinically applied in oral and maxillofacial surgery, oral implantology, prosthodontics, orthodontics, endodontics, and oral medicine. The development of robots in oral and maxillofacial surgery and oral implantology is relatively fast and comprehensive. About 51% (n = 58) of the systems had reached clinical application, while 49% (n = 55) were at the pre-clinical stage. Most of these are hard robots (90%; n = 103), and their invention and development were mainly focused on university research groups with long research periods and diverse components.
    CONCLUSIONS: There are still limitations and gaps between research and application in dental robots. While robotics is threatening to replace clinical decision-making, combining it with dentistry to gain maximum benefit remains a challenge for the future.
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  • 文章类型: Case Reports
    对称拔除前磨牙是牙齿拥挤和突出的常用正畸治疗方法。然而,当患者患有门牙强直时,治疗方案的建立常常困扰着正畸医生。一名有门牙外伤史的青少年患者因牙齿突出和拥挤而寻求治疗。在他的下位上颌中切牙撞击时,注意到特有的沉闷的金属声音,并且检测到这些牙齿在外力作用下缺乏正常的活动性。创伤后的随访X光片显示上颌中切牙的牙根吸收。根据临床和放射学发现,初步诊断为上颌中切牙强直。选择了涉及上颌中切牙和下颌第一前磨牙拔除的正畸和修复治疗方案的组合,以解决功能和美学问题。治疗后,排列良好的牙列,改善微笑美学,获得了更和谐的面部轮廓,这些结果在随访期间保持稳定。此病例报告说明了一种可行的治疗策略,用于解决因门牙弯曲而引起的困境。这在文献中是不寻常的。
    Symmetric extraction of premolars is a frequently used orthodontic treatment for dental crowding and protrusion. However, when a patient has incisors with ankylosis, the establishment of a treatment protocol often plagues orthodontists. An adolescent patient with a history of incisor trauma sought treatment for dental protrusion and crowding. Upon percussion of his infrapositioned maxillary central incisors, characteristic dull metallic sounds were noted, and a lack of normal mobility of these teeth under the application of external forces was detected. Follow-up radiographs after the trauma showed replacement root resorption of the maxillary central incisors. Based on clinical and radiological findings, ankylosis of the maxillary central incisors was tentatively diagnosed. A combination of orthodontic and prosthodontic treatment options involving extraction of the maxillary central incisors and mandibular first premolars was chosen to resolve the functional and esthetic problems. After treatment, well-aligned dentition, improved smile esthetics, and a more harmonious facial profile were achieved, and these outcomes remained stable during the follow-up period. This case report illustrates a viable treatment strategy for tackling predicaments caused by ankylosed incisors, which is unusual in the literature.
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