线上线下混合多元化教学模式在口腔医学本科留学生Orthodontics课程教学中的应用研究

目的探讨线上线下混合多元化教学模式在口腔医学本科留学生Orthodontics课程教学中的应用效果。方法于2020—2023年选取西安交通大学口腔医学院2015—2018级(大五)本科留学生为研究对象,将2015级和2016级留学生设为对照组(18名,传统教学模式),2017级和2018级留学生设为试验组(28名,线上线下混合多元化教学模式)。比较两组的教学效果。结果试验组学生的学习兴趣、课堂表现评分高于对照组(P<0.05);试验组教师的课堂参与评分高于对照组(P<0.05)。试验组的课程考核成绩高于对照组(P<0.05)。结论线上线下混合多元化教学模式在一定程度上可提高学生的学业水平和Orthodontics课程教学效果。

Effect of Dietary Components on the Shear Bond Strength of Orthodontics Brackets after Thermal Aging

Introduction: The stability of orthodontic brackets throughout orthodontic treatment plays a critical role in the treatment’s effectiveness. The present in vitro study was designed to assess the impact of various dietary components on the performance of orthodontic brackets. Methods: Metal orthodontic brackets were bonded to 66 extracted anterior teeth divided into groups based on the solution type: Milk, Gatorade, Cold Coffee, and a control group using water. Each group consisted of 20 teeth except for the control group, which included six teeth. The bracketed teeth were submerged in their respective solutions for 15 minutes three times daily at different intervals to mimic an in vivo environment and were stored in artificial saliva at room temperature (23?C). The specimens underwent artificial aging through 10,000 cycles of thermocycling (representing one clinical year) between 5?C and 55?C. Shade measurements were taken using a VITA Easy Shade device, capturing the classic shade and L*, a*, and b* values. Delta E values were calculated immediately post-bonding and after 7 days, 1 month, 1, and 2 clinical years. The shear bond strength of each bracket was measured using an ultra-tester machine. Results: After two clinical years, significant differences in ΔE color values were observed across all groups, with the most substantial change noted in teeth immersed in cold coffee. Brackets submerged in milk demonstrated lower shear bond strength than other solutions, whereas the control group exhibited the highest shear bond strength (P = 0.01). Conclusion: The study indicates that dietary components significantly influence tooth color stability and the shear bond strength of orthodontic brackets, underscoring the importance of considering these factors in orthodontic treatment planning.

Applications of stem cells in orthodontics and dentofacial orthopedics:Current trends and future perspectives

A simple overview of daily orthodontic practice involves use of brackets, wires and elastomeric modules. However, investigating the underlying effect of orthodontic forces shows various molecular and cellular changes. Also, orthodontics is in close relation with dentofacial orthopedics which involves bone regeneration. In this review current and future applications of stem cells(SCs) in orthodontics and dentofacial orthopedics have been discussed. For craniofacial anomalies, SCs have been applied to regenerate hard tissue(such as treatment of alveolar cleft) and soft tissue(such as treatment of hemifacial macrosomia). Several attempts have been done to reconstruct impaired temporomandibular joint. Also, SCs with or without bone scaffolds and growth factors have been used to regenerate bone following distraction osteogenesis of mandibular bone or maxillary expansion. Current evidence shows that SCs also have potential to be used to regenerate infrabony alveolar defects and move the teeth into regenerated areas. Future application of SCs in orthodontics could involve accelerating tooth movement, regenerating resorbed roots and expanding tooth movement limitations. However, evidence supporting these roles is weak and further studies are required to evaluate the possibility of these ideas.

Role of third molars in orthodontics

The role of third molars in the oral cavity has been extensively studied over the years. Literature includes numerous diagnostic and treatment alternatives regarding the third molars. However, an issue that has not been discussed at the same level is their involvement in orthodontic therapy. The aim of this study is to present a review of the contemporary literature regarding the most broadly discussed aspects of the multifactorial role of third molars in orthodontics and which are of general dental interest too.

Periodontally accelerated osteogenic orthodontics with platelet-rich fibrin in an adult patient with periodontal disease:A case report and review of literature

BACKGROUND In the clinical scenario,adult patients with periodontal diseases and dental malformation,characterized by dental crowding in lower anterior teeth with the thin biotype,often require orthodontic treatment.This case report aimed to evaluate the clinical and radiographic outcomes of periodontally accelerated osteogenic orthodontics(PAOO)combined with autologous platelet-rich fibrin(PRF)in an adult patient with class I malocclusion along with dental crowding,a thin periodontal biotype,and buccal plate deficiency.CASE SUMMARY A 32-year-old female complaining of dental crowding and gingival bleeding was referred to the orthodontic clinic.The patient underwent periodontal risk assessment prior to orthodontic treatment.She was diagnosed with a high risk of gingival recession due to dental crowding,root prominence,loss of buccal plates,and a thin gingival tissue biotype.The treatment regimen included PAOO combined with autologous PRF for alveolar augmentation and interproximal enamel reduction for moderate dental crowding.Clinically,PAOO-assisted orthodontic tooth movement in this case showed enhanced periodontium remodeling.Radiographic outcomes also showed statistically significant improvements(P<0.01)in the mandibular buccal alveolar bone.CONCLUSION This case report suggests the combination of autologous PRF with PAOO to enhance bone augmentation and long-term tissue support in adult orthodontic patients with periodontal disease.

Miniscrew appliances and their use in orthodontics

Anchorage is an important factor in orthodontics and must be properly managed for a successful treatment outcome. Orthodontists have historically used many devices to prevent unwanted tooth movement. The use of miniscrews as a source of skeletal anchorage has become routine in present-day orthodontic practice. Skeletal anchorage opens up alternative treatments, to borderline surgery patients for example, who can now be treated by taking advantage of the biomechanical properties of miniscrews. Because they are bone-borne and provide excellent control over tooth movement in the three spatial planes of movement, mini-implants can be used to serve many purposes in addition to anchorage. Therefore, a variety of successful mini-implant appliances are explained in relation to the three planes of movement: sagittal, vertical, and transverse. The aim of this review is to illustrate the clinical versatility of miniscrews in the three spatial planes of malocclusion in orthodontic and orthopedic management and to define clinical guidelines for the selection, application and biomechanics of mini-implants.

Face Adaptation in Orthodontics

Bilateral Controversy in orthodontic science is widely present in different patterns;one of the most common is the debate between early versus late orthodontic treatment. This paper is going to demonstrate two clinical cases of class III malocclusion which are treated orthodontically, one in early mixed dentition and the other in permanent dentition. The face is highly capable to adapt to the changes achieved by orthodontics provided the earlier treatment begins, the more the face adapts to our standards;the later treatment begins, the more our standards have to adapt to the face.

Microbiological Advances in Orthodontics:An Overview and Detailed Analysis of Temporary Anchorage Devices

Dental biofilm is the initiating factor of oral diseases,such as periodontitis and caries.Orthodontic treatment could alter the microbiome structure balance,and increase the risk of such diseases.Furthermore,fixed appliances can induce temporary changes in the microbiome community,and the changes that clear aligners bring are smaller by comparison.Temporary anchorage devices(TADs)are skeletal anchorages that are widely used in orthodontic treatment.Microorganisms affect the occurrence and development of inflammation surrounding TADs.At present,existing researches have verified the existence of plaque biofilm on the surface of TADs,but the formation of plaque biofilm and plaque composition under different stable conditions have not been fully understood.The development of high-throughput sequencing,molecular biology experiments,and metabonomics have provided new research ideas to solve this problem.They can become an effective means to explore the microbiome surrounding TADs.

Root Resorption of Central Incisor by Impacted Canine in Unusual Transposition: Orthodontics and Implant Rehabilitation: 3-Year Follow-Up

This case presents an unusual transposition of an impacted canine on the central incisor that provides a multidisciplinary approach to its resolution. The patient comes to the consultation for mobility of the central incisor. Clinically, tooth mobility was confirmed with tooth crowding and persistence of the temporary canine. Cone beam tomography (CBCT) observed the atypical position of the permanent canine that caused root resorption of the ipsilateral central incisor and the need to extract both teeth. The conservative treatment of the bone structures during the dental enucleation of the impacted canine carried out by odontosection and the immediate bone grafting of the defect projected an acceptable regeneration of the bone volume for the insertion of the implant. The orthodontic treatment managed to correct the bite, position the upper premolar in the place of the canine tooth and maintain the space to place the implant in the central incisor. The three-year follow-up shows maintenance of the peri-implant crestal bone level, the success of orthodontic treatment with recovery of the patient’s function and aesthetics.

Effect of Periodontal Serial Therapy Combined with Orthodontics on Periodontal Parameters in Patients with Periodontitis

Objective:To investigate the clinical efficacy of periodontal sequence in combination with orthodontic treatment of patients with periodontitis.Methods:Retrospective analysis of periodontitis patients(54 cases)treated at our hospital between February 2018 and June 2019.The clinical data of all the enrolled participants were subjected to periodontal serial combined orthodontic treatment,and all the registered participants were observed at the initial consultation,periodontal serial treatment1 Periodontal parameters at the end of months and at the end of orthodontic treatment,serial periodontal treatment and orthodontic treatment for all enrolled individuals,x-rays and Oral examinations were performed,and the results were analyzed.Results:Compared to the initial visit,all enrolled individuals had a higher plaque index(PLI)after 1 month of periodontal treatment and at the end of orthodontic treatment.Bleeding index(BI),periodontal probe depth(PD),and periodontal attachment loss(CAL)levels were all lower than those detected at the initial visit.The difference was statistically significant(P<0.05);after serial periodontal treatment and orthodontic treatment,the x-ray results showed that the patients’Alveolar bone resorption or regeneration ceased;The results of the oral examination showed that the patient’s occlusal relationship improved significantly and basically returned to normal.Status,a masticatory function was significantly improved,and individual tooth loosening due to occlusal trauma was improved considerably.Conclusion:The combination of periodontal sequence and orthodontic treatment of patients with periodontitis is beneficial to enhance periodontal parameters,improve occlusal relationships,and improve masticatory function.

Effect of maxillary expansion on orthodontics

Objective:To explore the effect of maxillary expansion on orthodontics.Methods:Eight beagle dogs were randomly divided into two groups,with 4 dogs in each group.Dogs in group1 were executed immediately and received the direct physical measurement.The magnetic expansion appliance was used in group 2 for the maxillary expansion.After the expansion,the model was taken again and they were executed after cone beam CT(CBCT) scanning.The model measurement method was adopted in group 1 to measure the dental measurement indicators and width of base bone arch.The CBCT measurement method was employed to measure the above dental indicators and bone indicators.The difference in the indicators measured by different methods was compared and analyzed.Results:Before the expansion,there was no significant difference in the bone measurement indicators between the CBCT measurement method and direct physical measurement method.After the expansion,there was no significant difference in indicators between the CBCT measurement method and direct physical measurement.But there was significant difference among the model measurement method,CBCT measurement method and direct physical measurement method.There was the significant difference in the dental indicators between the CBCT measurement method and model measurement,as well as the bone indicators of posterior marginal spacing of greater palatine foramen,posterior marginal spacing of incisive foramen,width of base bone arch and spacing of implant anchorage.Conclusions:There is no significant difference between the effect of CBCT measurement method and direct physical measurement method,but CBCT is significantly better than the model measurement.

Science and practice:challenges and perspectives of contemporary orthodontics

Whether medicine is a science remains a philosophical question. Yet undeniably advances in science have revolutionarily influenced almost every aspect of medicine including dentistry. It is now exactly one hundred years from Edward H. Angle introduced fixed orthodontic appliances in the early 1900s and established orthodontics as the first dental specialty. Orthodontics has come a long way during its first century. Looking forward to all the challenges and opportunities, it is now time to reflect what science has given to our profession, what for gap still exists between the science and practice in orthodontics, and how we can make science more available to our practice in future.

Clinical evaluation of remineralization potential of casein phosphopeptide amorphous calcium phosphate nanocomplexes for enamel decalcification in orthodontics

Background Enamel decalcification in orthodontics is a concern for dentists and methods to remineralize these lesions are the focus of intense research. The aim of this study was to evaluate the remineralizing effect of casein phosphopeptide amorphous calcium phosphate （CPP-ACP） nanocomplexes on enamel decalcification in orthodontics. Methods Twenty orthodontic patients with decalcified enamel lesions during fixed orthodontic therapy were recruited to this study as test group and twenty orthodontic patients with the similar condition as control group. GC Tooth Mousse, the main component of which is CPP-ACP, was used by each patient of test group every night after tooth-brushing for six months. For control group, each patient was asked to brush teeth with toothpaste containing 1100 parts per million （ppm） of fluoride twice a day. Standardized intraoral images were taken for all patients and the extent of enamel decalcification was evaluated before and after treatment over this study period. Measurements were statistically compared by t test. Results After using CPP-ACP for six months, the enamel decalcification index （EDI） of all patients had decreased; the mean EDI before using CPP-ACP was 0.191＋0.025 and that after using CPP-ACP was 0.183＋0.023, the difference was significant （t=5.169, P 〈0.01）. For control group, the mean EDI before treatment was 0.188±0.037 and that after treatment was 0.187±0.046, the difference was not significant （t=1.711, P 〉0.05）. Conclusion CPP-ACP can effectively improve the demineralized enamel lesions during orthodontic treatment, so it has some remineralization potential for enamel decalcification in orthodontics.

‘Invisible’ orthodontics by polymeric ‘clear’ aligners molded on 3D-printed personalized dental models

The malalignment of teeth is treated classically by metal braces with alloy wires,which has an unfavorable influence on the patients appearance during the treatment.With the development of digitization,computer simulation and three-dimensional(3D)printing technology,herein,a modern treatment was tried using clear polymeric aligners,which were fabricated by molding polyurethane films via thermoforming on the 3D-printed personalized dental models.The key parameters of photocurable 3D printing of dental models and the mechanical properties of the clear aligner film material were examined.The precision of a 3D-printed dental model mainly relied on characteristics of photocurable resin,the resolution of light source and the exposure condition,which determined the eventual shape of the molded clear aligner and thus the orthodontic treatment efficacy.The biocompatibility of the polyurethane filmmaterial was confirmed through cytotoxicity and hemolysis tests in vitro.Following a series of 3D-printed personalized dental models and finite element analysis to predict and plan the fabrication and orthodontic processes,corresponding clear aligners were fabricated and applied in animal experiments,which proved the efficacy and biocompatibility in vivo.Clinical treatments of 120 orthodontic cases were finally carried out with success,which highlights the advantage of the clear aligners as an esthetic,compatible and efficient appliance.

3D打印个性化正畸装置对单根牙垂直移动的三维有限元分析

背景:基于牙齿垂直移动原理,通过数字化设计结合3D打印制作个性化正畸装置,可使个性化正畸装置与单个切牙形成支抗系统。借助微种植体绝对支抗作用可对单根牙在三维方向上进行精准控制。目的:基于生物力学原理设计了牙位11、12、21、22压低移动与伸长移动的个性化正畸装置,通过三维有限元法分析个性化正畸装置的安全性与其对牙齿的移动作用。方法:应用Mimics、Geomagic Wrap、SolidWorks和Ansys Workbench软件分别建立了上颌前牙区(牙位11、12、21、22)牙槽骨-牙周膜-上颌切牙-个性化悬臂微种植体-连接板-个性化托槽的三维有限元模型,每个牙位分别设置个性化压低移动与伸长移动正畸装置,加载300 g拉力或推力,分析个性化正畸装置各部件应力水平,计算牙齿位移与牙周膜应力分布情况。结果与结论:①个性化压低移动正畸装置受到的最大等效应力为162.90 MPa,个性化伸长移动正畸装置受到的最大等效应力239.57 MPa,二者的最大等效应力均位于个性化托槽加力附件的垂直部分,个性化正畸装置各部件所受等效应力均在屈服强度内,均具有良好的安全性;②在个性化正畸装置作用下,牙齿初始位移呈现整体压低或伸长移动的趋势,垂直方向上的位移远远超过在水平方向和矢状方向上的位移;牙周膜根尖或颈部位置出现等效应力峰值,在根尖区牙周膜出现等效应力集中区域;③结果显示,个性化正畸装置可以使牙位11、12、21、22近似达到压低移动或伸长移动的目的,初步证实了个性化垂直移动正畸装置的有效性。

Differences in root stress and strain distribution in buccal and lingual orthodontics: A finite element analysis study

Orthodontic forces can cause stress and strain concentration and microcracks on tooth root surfaces.This study aimed to analyze whether a lingual orthodontic appliance was more likely to cause root stress concentration and root resorption than the traditional buccal appliance.A finite element model of the root of the maxillary central incisor with straight,buccal,and lingual curvatures was established.A load perpendicular to the tooth surface on the buccal and lingual surfaces of the central incisor was applied,and the stress and strain concentration at the root apex was compared.The stress and strain at the root apex of the lingual cingulum group were lesser than those of the buccal group;little difference was observed between the lingual and buccal clinical crown central augmentation groups.The stress and strain at the root apex of the lingual direction movement group were greater than those of the buccal direction movement group.The direction of the root curvature also influenced the amount of stress and strain at the root apex.The difference in the risk of root resorption between lingual and buccal orthodontics is dependent on the height of the bracket placement.The loading direction of the orthodontic force and direction of the root curvature also affect the stress and strain at the root apex.

三维有限元分析不同工况下牵引上颌埋伏尖牙牙周应力分布

背景:在正畸治疗埋伏尖牙过程中,粘接正畸附件的部位、角度、力值对牵引效果及牙周有较大影响,但目前对合适牵引部位、角度和牵引力值大小的相关研究较少。目的:通过三维有限元分析正畸矫治过程中不同牵引力作用下上颌埋伏尖牙的牙周应力分布。方法:选用1例上颌埋伏尖牙患者的锥形束CT扫描数据,建立包括埋伏尖牙、上颌骨骼及其周围支持结构在内的三维有限元模型,在埋伏尖牙唇侧切1/3、中1/3及颈1/3部位,分别施加与牙齿长轴呈60°,90°,120°角的牵引力(30,60,90 g),分析埋伏尖牙牙周膜Von Mises应力分布。结果与结论:①不同工况下埋伏尖牙的牙周应力分布基本相似:在尖牙切1/3施力时,模型中靠近颈部牙周膜Von Mises应力较小,舌面近颈部牙周膜Von Mises应力较大;在尖牙中1/3施力时,模型中靠近颈部牙周膜Von Mises应力较小,唇面近颈部牙周膜Von Mises应力较大;当在尖牙颈1/3施力时,模型中靠近牙颈部牙周膜Von Mises应力较小,唇面中部牙周膜Von Mises应力较大。②当施力部位、角度相同时,随着施加力的增加,牙周膜最大Von Mises应力呈增加趋势;当施加力大小、角度相同时,尖牙切1/3、中1/3及颈1/3部位牙周膜最大Von Mises应力呈递减趋势。在尖牙切1/3部位施加相同大小的力时,随着施力角度的增加,牙周膜最大和最小Von Mises应力均呈减少趋势;在尖牙颈1/3施加相同大小的力时,随着施力角度的增加,牙周膜最大Von Mises应力呈递增趋势。③结果显示,牵引上颌埋伏尖牙尽量在靠近牙颈部的部位粘接托槽,牵引上颌埋伏尖牙时牵引方向与牵引部位有关,牵引力一般为30-60 g之间。

3D打印技术在口腔医学、颌面外科修复重建中的作用与优势

背景:3D打印技术独特的优势为口腔医学的发展开拓了新的思路。目的:总结3D打印技术在口腔医学中的应用进展。方法:利用计算机检索中国知网和PubMed数据库,以“3D打印,口腔科学”为中文检索词进行分类检索,以“Three-Dimensional printing,stomatology,Dentistry,prosthodontics,oral implant,orthodontics,oral and maxillofacial surgery,dental pulp disease,periodontitis”为英文检索词进行关键词检索,经阅读初步排除与文章主题不相符的文献,根据纳入标准和排除标准,最终纳入54篇文献进行汇总。结果与结论:在口腔医学领域,3D打印技术的应用范围正迅速拓展,逐步取代传统的临床诊断和治疗方式,通过结合数字化技术和先进的材料科学,3D打印可以精确地创建三维模型,为口腔疾病治疗提供了个性化解决方案,确保医师能够在手术前进行详尽的规划和预览,提高手术的安全性。3D打印技术在定制化义齿制作、个性化种植、无托槽隐形矫治等多方面呈现出了显著优势,基于此项技术,医师可以根据患者口腔结构和需求实行精准设计与制作,为患者带来良好的治疗体验和预后效果。3D打印技术在微创牙髓治疗及牙周组织再生方面也展现出了巨大潜力,3D打印的支架和植入物可为干细胞提供适宜环境,促进牙周组织的再生和修复,但目前3D打印在再生治疗仍处于发展阶段,还需更多的研究和实践来验证其临床应用的效果和安全性。

正畸过程中牙齿三维方向变化的模型测量方法研究进展

牙齿三维方向上移动效率的评价是评估正畸疗效的重要内容之一。随着科学技术的发展,矫治器及矫正技术不断进步,用于研究正畸矫治牙齿三维方向移动效率的方法和工具也在不断更新。本文以牙齿移动测量方式发展为主线,介绍了由手工石膏模型测量转向利用计算机软件对数字化模型的测量过程和依据,并对三维数字化模型数据获取方式、储存文件格式及可选择的分析处理软件进行了说明,以及回顾了前人对三维数字化模型进行三维重叠的部分研究,总结了目前对光学扫描及X线扫描得到的两种三维模型数据常用的配准方法和配准区域的选择。

舒适护理在口腔正畸患者护理中的应用效果分析

目的:分析舒适护理在口腔正畸患者护理中的应用效果。方法:选取2022年1—6月于南京医科大学附属口腔医院颞颌关节与颌面疼痛科行口腔正畸的患者80例作为研究对象,随机分为对照组与观察组,各40例。对照组实施常规护理,观察组实施舒适护理。比较两组护理效果。结果:护理后,两组各项生活质量评分及舒适度评分高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组满意度及口腔卫生优良率高于对照组,差异有统计学意义(P<0.05)。结论:舒适护理应用于口腔正畸患者护理中的效果显著,能够改善患者口腔卫生状况,提高生活质量、舒适度及满意度。