maxillofacial prosthesis

  • 文章类型: Case Reports
    众所周知,眼睛是灵魂的窗户。“没有或失去任何面部部分,尤其是视觉,会导致严重的身体和情感创伤。面部的任何部分都会导致患者社会,物理,和心理上的痛苦。眼部假体旨在通过恢复面部外观来提高社会接受度并增强自信心。儿童牙科专家应该是颌面假体团队的一部分,因为幼儿的颌面假体康复可能具有挑战性,尤其是那些不太合作的人。以下病例报告描述了与一名5岁男孩因外伤摘除眼睛有关的这些挑战。此案的目的是提供定制的,由颌面假肢团队以尽可能舒适和防损伤的方式使用丙烯酸眼假肢。
    BansodAV,PisulkarS,BeriA,etal.在儿科患者中使用定制眼部假体进行眼部缺损的康复。IntJClinPediatrDent2024;17(4):479-482。
    It is a well-known saying that the eyes are \"windows to the soul.\" The absence or loss of any facial part, particularly the vision, can lead to severe physical as well as emotional trauma. Losing any part of the face causes the patient societal, physical, and psychological anguish. An ocular prosthesis aims to improve social acceptance and boost self-confidence by restoring the facial appearance. A pediatric dental specialist should be a part of the maxillofacial prosthesis team since maxillofacial prosthetic rehabilitation in young children can be challenging, especially with the less cooperative ones. The following case report describes these challenges in relation to a 5-year-old boy who had his eye enucleated due to trauma. The purpose of the case was to provide custom-built, acrylic ocular prostheses in as comfortable and atraumatic manner as possible by the maxillofacial prosthetic team.
    UNASSIGNED: Bansod AV, Pisulkar S, Beri A, et al. Rehabilitation of an Ocular Defect Using a Custom Ocular Prosthesis in a Pediatric Patient. Int J Clin Pediatr Dent 2024;17(4):479-482.
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  • 文章类型: Journal Article
    涉及颞下颌关节(TMJ)的半关节切除术缺损的修复具有挑战性。这项研究比较了半动脉切除术后使用和不使用虚拟计划的TMJ假体(TMJP)的深回旋动脉(DCIA)皮瓣的功能结果和重建准确性。评估了10例患者:5例使用TMJP(TMJP组),5例没有(对照组)。三维比较显示,带有TMJP的计划和实际DCIA皮瓣之间的平均偏差为0.11±0.04mm。计划和实际TMJP位置的高度相差0.56±0.57mm,腹侧/背侧0.33±0.24mm,内侧/外侧为1.18±0.42mm。张口,laterotrusion,对照组和中线偏差明显大于TMJP组(P=0.024,P=0.008,P=0.024)。DCIA皮瓣的腹侧到背侧平移的偏差略高于文献中的报道值,而高度偏差具有可比性。文献中的偏差较低是由于在两个TMJ都完好无损的情况下使用了DCIA瓣。实际上,内部计划的带有库存TMJP的DCIA皮瓣产生的结果可与更昂贵的患者专用假体相媲美。
    The repair of hemimandibulectomy defects involving the temporomandibular joint (TMJ) is challenging. This study compared the functional outcomes and reconstruction accuracy using a deep circumflex iliac artery (DCIA) flap with and without a virtually planned stock TMJ prosthesis (TMJP) after hemimandibulectomy. Ten patients were assessed: five with a TMJP (TMJP group) and five without (control group). A three-dimensional comparison revealed a mean deviation of 0.11 ± 0.04 mm between the planned and actual DCIA flap with TMJP. The planned and actual TMJP positions differed by 0.56 ± 0.57 mm in height, 0.33 ± 0.24 mm ventrally/dorsally, and 1.18 ± 0.42 mm medially/laterally. Mouth opening, laterotrusion, and midline deviation were significantly greater in the control group than in the TMJP group (P = 0.024, P = 0.008, P = 0.024). The deviation in ventral to dorsal translation for the DCIA flap was slightly higher than reported values in the literature, while height deviation was comparable. Lower deviations in the literature were due to the DCIA flap being used where both TMJs were intact. The in-house virtually planned DCIA flap with stock TMJP yielded results comparable to more expensive patient-specific prostheses.
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  • 文章类型: Journal Article
    目的:根据数据采集方法和用于为部分或全部上颌骨和下颌骨缺损患者制造口内假体的软件工具,评估数字工作流程可行性的当前证据。
    方法:在PubMed中进行了电子搜索,Scopus,和WebofScience使用相关关键词的组合:数字工作流程,数字设计,计算机辅助设计-计算机辅助制造,3D打印,上颌骨切除术,和下颌骨切除术.JoannaBriggs研究所的关键评估工具用于评估所审查研究中的证据质量。
    结果:在总共542个参考文献中,共入选33篇,包括25个上颌假体和8个下颌假体。数字工作流程的使用仅限于制造假体的一个或两个步骤,只有四项研究描述了完整的数字工作流程。最优选的数据采集方法是有或没有锥形束计算机断层扫描组合的口内扫描。
    结论:目前,颌面假体的制造过程需要结合数字和常规方法。简化数据采集方法并提供用户友好且负担得起的软件可以鼓励临床医生更频繁地对需要颌面假体的患者使用数字工作流程。
    OBJECTIVE: To evaluate the current evidence of digital workflow feasibility based on the data acquisition methods and the software tools used to fabricate intraoral prostheses for patients with partial or total maxillary and mandibular defects.
    METHODS: An electronic search was performed in PubMed, SCOPUS, and Web of Science using a combination of relevant keywords: digital workflow, digital designing, computer-assisted design-computer aided manufacturing, 3D printing, maxillectomy, and mandibulectomy. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the quality of evidence in the studies reviewed.
    RESULTS: From a total of 542 references, 33 articles were selected, including 25 on maxillary prostheses and 8 on mandibular prostheses. The use of digital workflows was limited to one or two steps of the fabrication of the prostheses, and only four studies described a complete digital workflow. The most preferred method for data acquisition was intraoral scanning with or without a cone beam computed tomography combination.
    CONCLUSIONS: Currently, the fabrication process of maxillofacial prostheses requires combining digital and conventional methods. Simplifying the data acquisition methods and providing user-friendly and affordable software may encourage clinicians to use the digital workflow more frequently for patients requiring maxillofacial prostheses.
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  • 文章类型: Journal Article
    本文的研究目的,提出了一条新的参考线:前zu线-眶下线(FZ-IOL)。该参考线可以指导手术团队规划下颌角的协调,根据病人的骨骼比例。额骨-眶下线已用于对称化手术,男性化手术,和以前的正颌手术效果不理想。从2021年3月到2022年12月,3名患者接受了严重的面部不对称治疗,主要影响面部的下三分之一。所有病例均采用参考FZ-IOL计划。患者在同一中心接受治疗,在PortuguesdaFace研究所的正颌外科,里斯本,葡萄牙。Frontozygoma-Infraoral线的设计实际上是使用软件从锥形束计算机断层摄影(CBCT)获得的数字成像和医学通信(DICOM)文件重建3D图像。,连接两个轨道边缘。然后,垂直线,绘制垂直于IOL并穿过额骨缝合线的最外侧部分的额骨线。提议的线展示了如何建立适当的参考线对于手术的成功至关重要。参考线的选择应基于患者的解剖结构,对称化过程的复杂性,和手术的预期结果。额骨-眶下线代表了管理下颌角侧向投影的适当参考线,改善下三分之一的面部对称。
    the aim of this paper, is to propose a new reference line: the Frontozygomatic-Infraorbital Line (FZ-IOL). This reference line can guide the surgical team planning mandibular angle harmonization, based on the patient\'s skeletal proportion. The Frontozygomatic-Infraorbital Line has been adopted for symmetrization surgery, masculinization surgery, and in unsatisfactory results of previous orthognathic surgery. From March 2021 to December 2022, 3 patients were treated for severe facial asymmetry affecting mainly the lower third of the face. All cases were planned with the reference FZ-IOL. Patients were treated in the same center, at the Orthognathic Surgery Department of the Instituto Portugues da Face, Lisbon, Portugal. The Frontozygomatic-Infraorbital Line is designed virtually using software to reconstruct a 3D image from a digital imaging and communications in medicine (DICOM) file obtained from a cone beam computer tomography (CBCT). , connecting the two orbital rims. Then, a vertical line, the frontozygomatic line perpendicular to the IOL and passing through the outmost lateral portion of the frontozygomatic suture is drawn. The proposed line demonstrated how establishing appropriate reference lines is crucial for the success of the surgery. The selection of reference lines should be based on the patient\'s anatomy, the symmetrization process\'s complexity, and the surgery\'s desired outcome. The Frontozygomatic-Infraorbital Line represents an adequate reference line for managing mandibular angle lateral projection, improving lower third of the face symmetrization.
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  • 文章类型: Case Reports
    在一种称为阴道发育不全的罕见疾病中,子宫(子宫)可能仅部分发育或根本不发育,而阴道完全不能发育。诊断阴道发育不全是很常见的,当女性在青春期没有开始月经时。这是一种产前疾病,也可能与骨骼或肾脏问题有关。穆勒氏症,Mullerian发育不全,Mayer-Rokitansky-Kuster-Hauser(MRKH)综合征是该疾病的其他名称。治疗方式包括手术和非手术干预,包括使用预制或定制的阴道支架进行新阴道重建和维护。该病例报告描述了一名被诊断为阴道发育不全的27岁女性的新阴道发育,MRKH综合征的特征。定制的透明丙烯酸支架,旨在提供弹性表面,作为管理这种情况的直接和成本有效的替代方案。重要的是,它增强了患者在治疗期间的依从性和舒适度,解决这种先天性异常的生理和心理后果。这种定制的阴道支架不仅提供了实用的解决方案,而且有助于提高患有阴道发育不全的个人的生活质量,从而为解决与这种情况相关的多方面挑战提供了一个有希望的途径。
    In a rare condition known as vaginal agenesis, the uterus (womb) may develop only partially or not at all, while the vagina fails to develop altogether. It is common to diagnose vaginal agenesis, when a female does not start menstruation at puberty. This is a prenatal disorder that may also be linked to bone or kidney issues. Mullerian agenesis, Mullerian aplasia, and Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome are other names for the illness. Treatment modalities encompass surgical and nonsurgical interventions, including the utilization of prefabricated or customized vaginal stents for neovagina reconstruction and maintenance. This case report describes the development of a neovagina in a 27-year-old female diagnosed with vaginal agenesis, a characteristic of MRKH syndrome. A customized clear acrylic stent, designed to provide a resilient surface, serves as a straightforward and cost-efficient alternative for managing this condition. Significantly, it enhances patient\'s compliance and comfort during treatment, addressing both the physical and psychological ramifications of this congenital anomaly. This customized vaginal stent not only provides a practical solution but also contributes to enhancing the quality of life for individuals grappling with vaginal agenesis, thereby offering a promising avenue for addressing the multifaceted challenges associated with this condition.
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  • 文章类型: Case Reports
    面部区域的任何器官的缺失导致不对称的外观。这种不对称的外观会给患者带来社会困境。颌面技师,修复医生,和病人必须紧密合作,以制造一个结论。在植入物上,首先建造了上层建筑。大部分是由环和连接植入物的杆组成。外饰的牢固的丙烯酸树脂基体配有夹子,用作外饰的保持机构。实际的附属物是由硅橡胶制成的。必须极其谨慎地塑造和着色。适当的替代品是保留植入物的耳廓假体。Microtia,畸形,畸形,和外耳的损失,部分或全部,可能是各种遗传遗传条件的结果。为了评估两只耳朵的对称性,使用人工智能(AI)软件。通过crystalwavesxx的Instagram镜头Gridset用于校正和验证患者的双侧对称性。此病例报告主要集中在使用AI制造植入物支持的耳廓假体。
    The absence of any organ of the facial region causes an asymmetrical appearance. This asymmetrical appearance can cause social dilemmas for the patient. The maxillofacial technician, the prosthodontist, and the patient must work closely together to fabricate an epithesis. On the implants, a superstructure is first constructed. Most of it is made up of rings and a bar that joins the implants. The firm acrylic resin base of the epithesis is equipped with clips that serve as the epithesis\'s retention mechanism. The actual epithesis is made of silicone rubber. The epithesis has to be shaped and colored with extreme caution. An appropriate substitute is an auricular prosthesis that is implant-retained. Microtia, deformity, malformation, and loss of the external ear, either partially or completely, can result from a variety of inherited genetic conditions. To evaluate the symmetry of both ears, artificial intelligence (AI) software is used. An Instagram lens Gridset by crystalwavesxx was used to correct and verify the bilateral symmetry of the patient. This case report primarily focuses on the fabrication of implant-supported auricular prostheses using AI.
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  • 文章类型: Journal Article
    这项体外比较研究的目的是评估有机和无机纳米颗粒对颜色稳定性的影响,基线和户外风化6个月时,颌面有机硅弹性体的撕裂强度和硬度。
    使用M511铂硅胶制作了总共240个样本,根据纳米颗粒的类型将其分为4组(n=60)(对照,聚四氟乙烯[PTFE],二氧化钛[TiO2],氧化锌[ZnO])添加,每组进一步分为3个亚组(n=20)进行颜色,撕裂强度(TS)和硬度(H)测试。进行了测试,并在6个月的户外风化前后获得了数据。
    在PTFE组中观察到风化后的最小颜色变化(ΔE=2.23)。在风化前,TiO2组显示最大TS(12.01N/mm),其次是PTFE组(10.85N/mm)。风化后,TiO2组(12.9N/mm)和PTFE组(12.54N/mm)显示最大TS。TiO2组风化前显示最大硬度(24.15肖氏A),PTFE组风化后显示最大硬度(33.43肖氏A)。
    在本研究的局限性内,可以得出结论,将聚四氟乙烯纳米颗粒添加到聚合物中可以增强光学和机械性能,并且可以被认为有利于延长假体的寿命。
    UNASSIGNED: The purpose of this comparative study in vitro was to evaluate the effect of organic and inorganic nanoparticles on colour stability, tear strength and hardness of maxillofacial silicone elastomer at baseline and when subjected to outdoor weathering for 6 months.
    UNASSIGNED: A total of 240 specimens were fabricated using M511 platinum silicone which were divided into total 4 groups (n = 60) based on the type of nanoparticles (control, polytetrafuoroethylene [PTFE], titanium dioxide [TiO2], zinc oxide [ZnO]) added and each group was further divided into 3 subgroups (n = 20) for colour, tear strength (TS) and hardness (H) testing. The tests were conducted and data was obtained both before and after outdoor weathering of 6 months.
    UNASSIGNED: Minimum colour change after weathering was observed in PTFE group (∆E = 2.23). TiO2 group showed maximum TS (12.01 N/mm) followed by PTFE group (10.85 N/mm) before weathering. After weathering, maximum TS was shown by TiO2 group (12.9 N/mm) and PTFE group (12.54 N/mm). TiO2 group showed maximum hardness (24.15 shore A) before weathering and PTFE group showed maximum hardness (33.43 shore A) after weathering.
    UNASSIGNED: Within the limitations of this study, it can be concluded that the addition of polytetrafuoroethylene nanoparticles to the polymer enhances both the optical as well as mechanical properties and can be considered favourable for the extended life of the prosthesis.
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  • 文章类型: Journal Article
    目的:评估原位汗液的影响,油,防晒霜,和消毒液对颜色的稳定性,硬度,面部假体用弹性体的粗糙度。
    方法:标准化和固有色素沉着的标本与同一个人的皮肤接触30天,考虑暴露(每组n=36),没有阐述(对照,C);出汗和油性接触(SO);与防晒霜有关的出汗和油性(SOS);0.12%的二葡糖酸氯己定浸入(CD0.12%);以及所有暴露的试剂(SOSCD)。主要变量是颜色变化(CIELab和国家标准局系统,NBS),肖氏A硬度,和表面粗糙度,在基线和30天测量。通过原子力显微镜(AFM)和扫描电子显微镜(SEM)进行定性分析。通过Kruskal-Wallis测试(颜色)和双向ANOVA(硬度和粗糙度)以及Sidak后测试(α=0.05)分析数据。
    结果:CD0.12%(1.54±0.49)和SOSCD(2.10±1.03)具有相似的效果,并引起最小的颜色变化,认为轻度和明显(NBS),分别。SOS促进了最大的颜色变化(6.99±1.43,NBS:大)和硬度(17.97±0.56);SOS促进了SOSCD(2.25±0.53)之间的中间粗糙度(3.48±1.05),两组相似:C(4.46±0.95),CD0.12%(4.39±1.26)。定性分析显示不规则,密集,干,暴露于防晒霜的标本表面上的白色层,与0.12%的二葡萄糖酸氯己定接触时会减少。
    结论:内源性和外源性因素能够改变弹性体性能。0.12%的二葡糖酸氯己定将汗液引起的变化降至最低,油,和防晒霜。
    OBJECTIVE: To evaluate in situ the influence of sweat, oil, sunscreen, and disinfectant solution on the color stability, hardness, and roughness of elastomer for facial prostheses.
    METHODS: Standardized and intrinsically pigmented specimens remained in contact with human skin from the same person for 30 days, considering exposures (n = 36 per group), absent of exposition (Control, C); sweat and oiliness contact (SO); sweat and oiliness associated with sunscreen (SOS); 0.12% chlorhexidine digluconate immersion (CD0.12%); and all agents exposed (SOSCD). The main variables were color change (CIELab and National Standard Bureau system, NBS), Shore A hardness, and surface roughness, measured at baseline and 30 days. Qualitative analyses were performed by atomic force microscopy (AFM) and scanning electron microscopy (SEM). The data were analyzed by Kruskal-Wallis tests (color) and two-way ANOVA (hardness and roughness) with Sidak post-test (α = 0.05).
    RESULTS: CD0.12% (1.54 ± 0.49) and SOSCD (2.10 ± 1.03) had similar effects and caused the smallest color changes, considered mild and noticeable (NBS), respectively. SOS promoted the greatest color change (6.99 ± 1.43, NBS: large) and hardness (17.97 ± 0.56); SOS promoted intermediate roughness (3.48 ± 1.05) between SOSCD (2.25 ± 0.53), and two similar groups: C (4.46 ± 0.95), and CD0.12% (4.39 ± 1.26). The qualitative analysis showed an irregular, dense, dry, and whitish layer on the surface of the specimens exposed to sunscreen, which was reduced when in contact with 0.12% chlorhexidine digluconate.
    CONCLUSIONS: Endogenous and exogenous factors are capable of altering elastomer properties. The 0.12% chlorhexidine digluconate minimized the changes caused by sweat, oil, and sunscreen.
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  • 文章类型: Case Reports
    创伤,癌症,和先天性异常是导致眼睛损失的三个主要原因。一个人的个人和职业生活都是功能性的,美学,和心理问题,当他们失去一只眼睛。由热固化聚甲基丙烯酸甲酯制成的定制眼部假体可用于修复眼部缺陷。定制眼假体的制造具有多个步骤,包括巩膜板制造,虹膜定位,和表征。本文的主要目的是解释一种新的虹膜定位方法,以获得更好的美容效果。
    Trauma, cancer, and congenital abnormalities are the three main causes of eye loss. A person\'s personal and professional life is left with functional, aesthetic, and psychological problems when they lose one eye. A customized ocular prosthesis made of heat-cured polymethylmethacrylate can be used to restore an eye defect. Fabrication of the customized ocular prosthesis has multiple steps including scleral plank fabrication, iris positioning, and characterization. This article\'s primary goal is to explain a novel method for iris positioning for better cosmetic outcomes.
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  • 文章类型: Journal Article
    背景:颌面修复医生是新千年早期的先进数字技术(ADT)采用者。在过去的二十年中,出现了一系列数字推动者,包括数字成像(内部和表面),数字手术计划,数字功能评估,减法和增材制造,导航,和机器人等。人工智能(AI)是最新的ADT到来,它将是一项具有挑战性的颠覆性技术。ADT已成为颌面修复术中的深刻变革剂。目的是探索颌面修复中ADT接合的过程和水平。
    目的:目的是双重的。首先,目的探讨颌面修复牙接合的ADT。其次,制定讨论文件,以协助美国颌面修复学会(AAMP)建立集体意识,并考虑对数字时代颌面修复术的未来的看法。
    方法:AAMP成员对ADT的兴趣是通过分析AAMP年度大会计划和《义肢牙科杂志》(JPD)上的出版物来评估的。通过选择性的文献综述,进行了颌面修复到数字时代的历史。通过对AAMP成员的调查,评估了颌面修复医生对ADT接合的看法。发展对AI影响力的理解是在回顾相关文献的基础上进行的。
    结果:从2011年到2020年,JPD发表的论文中每年平均有38%涉及ADT的临床使用。从2017年至2019年,在AAMP年度大会上邀请的演讲中有44%包括ADT的临床使用。数字时代的旅程区分了三个时期,形成时期和巩固时期影响了创新数字时代。AAMP成员调查的回复率为59%,并通过31个问题研究了10个领域。在受访者中,89%以为ADT对今后的颌面修复有重要意义。
    结论:讨论文件将有助于AAMP在未来的颌面修复中发展对ADT的集体意识和考虑意见。AAMP成员对ADT的临床应用产生了浓厚的兴趣。一个巨大的挑战是没有正规的教育,培训,或者可以确定ADT的临床能力要求。临床能力要求对于为数字化时代的必然性做好颌面口腔修复准备很重要。讨论文件提出了一个基本问题,即颌面修复医生是否将继续作为ADT和AI的被动最终用户,或者他们将成为已经确定患者护理中ADT和AI临床能力的敬业知识工作者。没有这种知识工作者的角色,作为不可避免的ADT-AI驱动的未来的一部分,颌面修复医生可能会遇到困难。
    BACKGROUND: Maxillofacial prosthodontists were advanced digital technology (ADT) adopters early in the new Millennium. The past two decades saw a range of digital enablers emerge including digital imaging (internal and surface), digital surgical planning, digital functional assessment, subtractive and additive manufacturing, navigation, and robotics among others. Artificial Intelligence (AI) is the latest ADT arrival that will be a challenging disruptive technology. ADT has served as a profound change agent in maxillofacial prosthodontics. The intent was to explore the process and level of ADT engagement in maxillofacial prosthodontics.
    OBJECTIVE: The purpose was twofold. Firstly, to explore maxillofacial prosthodontic engagement of ADT. Secondly, to develop a discussion document to assist the American Academy of Maxillofacial Prosthetics (AAMP) with establishing a collective awareness and considered opinion on the future of maxillofacial prosthodontics in the digital era.
    METHODS: AAMP member interest in ADT was assessed through analysis of AAMP annual congress programs and publications in the Journal of Prosthetic Dentistry (JPD). The history of the maxillofacial prosthodontic journey to the digital era was undertaken with a selective literature review. The perceptions maxillofacial prosthodontists hold on ADT engagement was assessed through a survey of AAMP members. Developing an understanding of the influence AI was conducted with a review of pertinent literature.
    RESULTS: From 2011-2020, an annual mean of 38% of papers published in the JPD involved clinical use of ADT. From 2017-2019, 44% of invited presentations at AAMP annual congresses included clinical use of ADT. The journey to the digital era distinguished three periods with formative and consolidation periods influencing the innovation digital era. The AAMP member survey had a 59% response rate and studied 10 domains through 31 questions. Of the respondents, 89% thought ADT important to the future of maxillofacial prosthodontics.
    CONCLUSIONS: The discussion document will assist the AAMP in developing a collective consciousness and considered opinion on ADT in the future of maxillofacial prosthodontics. Members of the AAMP have a developed interest in clinical applications of ADT. A great challenge is that no formal education, training, or clinical competency requirements for ADT could be identified. Clinical competency requirements are important to prepare maxillofacial prosthodontics for the inevitability of a digital era future. The discussion document poses the fundamental question of whether maxillofacial prosthodontists will remain as passive end users of ADT and AI or will they become engaged knowledge workers that have determined clinical competency in ADT and AI in patient care. Without this knowledge worker role, maxillofacial prosthodontists may experience difficulty being part of the inevitable ADT-AI driven future.
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