Parental Knowledge of Pre-Hospital Management of Avulsed Permanent Tooth in Children at Kath

BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered as the treatment of choice. OBJECTIVE: The study was undertaken to assess the knowledge of parents who accompany their children to the pediatric dental clinic, KATH on the pre-hospital management of avulsed permanent tooth in children. METHODS: A researcher administered structured questionnaire was used to collect data on the knowledge of pre-hospital management of avulsed permanent tooth from 83 parents who accompanied their wards to the pediatric dental clinic at KATH. RESULTS: A total of 83 parents were involved in the study. 30 (36%) were males while 53 (64%) were females. The majority of the parents (57%) were either university trained or had attended college of education. Only 32 parents (39%) were aware of the possibility of replantation. Majority of the parents chose non-physiologic media as the transport media of choice and only 10% would attempt self-replantation before seeking professional help. 76 parents (92%) had no previous education on pre-hospital management of avulsed tooth. CONCLUSION: The results obtained from this study indicate that parental knowledge on pre-hospital management of avulsed permanent tooth is low hence the need for massive public educational campaigns.

High-resolution CT-scan data reveals the tooth replacement pattern of the Late Jurassic tyrannosauroid Guanlong wucaii (Dinosauria, Theropoda)

The Tyrannosauridae,which is characterized by specialized pachydont dentition and putative bone-cracking predatory strategies,is one of the most extensively studied theropod lineages.Although tooth replacement patterns,crucial for understanding feeding behaviors,have been thoroughly studied in this group,studies on non-tyrannosaurid tyrannosauroids are relatively scarce.This study utilizes high-resolution CT data to investigate the tooth replacement pattern in two specimens of Guanlong wucaii,a Late Jurassic tyrannosauroid,and provides insights into the evolution of tooth replacement across Tyrannosauroidea.Second-generation replacement teeth,a rarity observed mainly in giant predatory theropods(e.g.some tyrannosaurids),were detected in the dentary dentition of the juvenile Guanlong.Zahnreihen reconstructions display a consistent cephalad alternating tooth replacement pattern in the maxilla and the dentary of both of the examined individuals,with Z-spacing values exceeding 2.0.As Guanlong grows,the Z-spacing value in the maxillary dentition increases,resembling the ontogenetic changes documented in the Tyrannosauridae.Additionally,like Tarbosaurus,Guanlong also displays a discontinuity between the tooth replacement waves at the premaxilla-maxilla boundary.This study thus demonstrates that some tyrannosaurid-like tooth replacement patterns were acquired before the origin of the Tyrannosauridae.

Association between Tooth Loss and Hypertension: A Systematic Review

Background: An independent relationship between tooth loss and hypertension appears to exist. Objectives: The aim of this study was to systematically review the relationship between tooth loss/number of teeth and hypertension. Materials and Methods: This review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. We searched all the relevant studies in international databases of PubMed and Google Scholar search engines from January 2000 to December 2023. Results: Fourteen studies (11 cross sectionals, 2 descriptives and 1 Cohort) met the inclusion criteria for this review. Most cross-sectional studies showed that participants with more tooth loss exhibited a greater proportion of hypertension and higher systolic blood pressure than those with less tooth loss. Cohort study showed that the loss of 8 or more teeth was associated with a higher risk of developing hypertension. Descriptive studies reported that missing teeth were marginally significantly associated with hypertension. Conclusion: This study has revealed a significantly higher SBP in patients with fewer remaining teeth or more tooth loss. In addition, those with more tooth loss showed a higher risk of hypertension than those with less tooth loss.

Single Tooth Segmentation on Panoramic X-Rays Using End-to-End Deep Neural Networks

In dentistry, panoramic X-ray images are extensively used by dentists for tooth structure analysis and disease diagnosis. However, the manual analysis of these images is time-consuming and prone to misdiagnosis or overlooked. While deep learning techniques have been employed to segment teeth in panoramic X-ray images, accurate segmentation of individual teeth remains an underexplored area. In this study, we propose an end-to-end deep learning method that effectively addresses this challenge by employing an improved combinatorial loss function to separate the boundaries of adjacent teeth, enabling precise segmentation of individual teeth in panoramic X-ray images. We validate the feasibility of our approach using a challenging dataset. By training our segmentation network on 115 panoramic X-ray images, we achieve an intersection over union (IoU) of 86.56% for tooth segmentation and an accuracy of 65.52% in tooth counting on 87 test set images. Experimental results demonstrate the significant improvement of our proposed method in single tooth segmentation compared to existing methods.

Effect of different interventions on orthodontic tooth movement acceleration:A network meta-analysis

Objective: To explore the effectiveness of various interventions in accelerating tooth movement, a systematic review and net-work meta analysis were used to draw a conclusion. Methods: MEDLINE, EMBASE, Willey Library, EBSCO, Web of Science Databases, and Cochrane Central Register of Controlled Trials databases to identify relevant studies. ADDIS 1.16.6 and Stata 16.0 software were used for NMA. Results: Five thousand five hundred and forty-two articles were searched out. After screening by two independent investigators, forty-seven randomized controlled trials, 1 390 participants, were included in this network meta-analysis. A total of 11 interventions involving Piezocision (Piezo), Photobiomodulation therapy (PBMT), Plate- let-rich plasma(PRP), Electromagnetic field(EF), Low intensity laser therapy(LLLT), Low intensity pulsed ultrasound(LI-PUS), Low-frequency vibrations(LFV), Distraction osteogenesis(DAD), Corticotomy(Corti), Microosteoperforations (MOPS), Traditional orthodontic(OT)were identified and classified into 3 classes including surgical treatment, non-surgical treatment and traditional orthodontic treatment. According to SUCRA probability ranking of the best intervention effect, when orthodontic treatment lasted for 1 month, PBMT (90.6%), Piezo(87.4%) and MOPs(73.6%)were the top three interventions to improve the efficiency of canine tooth movement. When orthodontic treatment lasted for 2 months, Corti (75.7%), Piezo (69.6%) and LFV(58.9%)were the top three interventions for improving the mobility efficiency of canine tooth movement. When orthodontic treatment lasted for 3 months, Cort (73.3%), LLLT(68.4%)and LFV(60.8%)were the top three interventions for improving the mobility efficiency of canine tooth movement. Conclusion: PBMT and Piezo can improve the efficiency of canine tooth movement significantly after 1 month, while Corti and LFV can improve the efficiency of canine tooth movement better after 2 and 3 months.

Comparative Study of the Rock-breaking Mechanism of a Disc Cutter and Wedge Tooth Cutter by Discrete Element Modelling

The operation of a shield tunnel boring machine(TBM)in a high-strength hard rock stratum results in significant cutter damage,adversely affecting the thrust and torque of the cutter head.Therefore,it is very important to carry out the research on the stress characteristics and optimize the cutter parameters of cutters break high-strength hard rock.In this paper,the rock-breaking performance of cutters in an andesite stratum in the tunnel of Qingdao Metro Line No.8 was investigated using the discrete element method and theoretical analysis.The rock-breaking processes of a disc cutter and wedge tooth cutter were simulated by software particle flow code PFC^(3D),and the rock-breaking degree,stress of the cutter,and rock-breaking specific energy were analyzed.The rock damage caused by the cutter in a specific section was divided into three stages:the advanced influence,crushing,and stabilizing stages.The rock-breaking degree and the tangential and normal forces of the wedge tooth cutter are larger than that of the disc cutter under the same conditions.The disc cutter(wedge tooth cutter)has the highest rock-breaking efficiency at a cutter spacing of 100 mm(110 mm)and a penetration depth of 8 mm(10 mm),and the rock-breaking specific energy is 11.48 MJ/m^(3)(12.05 MJ/m^(3)).Therefore,two types of cutters with different penetration depths or cutter spacing should be considered.The number of teeth of wedge tooth cutters can be increased in hard strata to improve the rock-breaking efficiency of the shield.The research results provide a reference for shield cutterhead selection and cutter layout in similar projects.

Three-Dimensional Conjugate Tooth Surface Design and Contact Analysis of Harmonic Drive with Double-Circular-Arc Tooth Profle

A three-dimensional conjugate tooth surface design method for Harmonic Drive with a double-circular-arc tooth profle is proposed. The radial deformation function of the fexspline (FS), obtained through Finite Element (FE) analysis, is incorporated into the kinematics model. By analyzing the FS tooth enveloping process, the optimization of the overlapping conjugate tooth profle is achieved. By utilizing the hobbing process, the three-dimensional machinable tooth surface of FS can be acquired. Utilizing the coning deformation of the FS, simulations are conducted to analyze the multi-section assembly and meshing motion of the machinable tooth surface. The FE method is utilized to analyze and compare the loaded contact characteristics. Results demonstrate that the proposed design method can achieve an internal gear pair consisting of a circular spline with a spur gear tooth surface and the FS with a machinable tooth surface. With the rated torque, approximately 24% of the FS teeth are engaged in meshing, and more than 4/5 of the tooth surface in the axial direction carries the load. The contact patterns, maximum contact pressure, and transmission error of the machinable tooth surface are 227.2%, 40.67%, and 71.24% of those on the spur gear tooth surface, respectively. It clearly demonstrates exceptional transmission performance.

A Rare Case: Multiple Mandibular Arteriovenous Malformation with High Output: May a Tooth Extraction Alone Turn to a Catastrophic Condition?

Background: Arteriovenous malformations (AVM) in mandible and neck are potentially life-threatening conditions because of possible massive hemorrhage. They are often first diagnosed by dentists as bleeding. In this case, we report how a tooth extraction turned to a catastrophic condition in a patient with multiple AVMs in the mandibular, submandibular and hyoid region. Case: A 19-year-old male patient diagnosed with AVMs in the mandibular and submandibular regions was admitted to our hospital with the complaint of leaky hemorrhage around the lower left 3rd molar tooth. Tooth extraction was planned after embolization procedure. The patient was intubated uneventfully using video laryngoscope. However, an acute bleeding of more than 1600 ml occurred in one minute just after the mouth opener was inserted. The patient was transferred to the Interventional Radiology and other branches of the high-flow AVM were embolized. The patient was taken back to the operating room and the tooth was extracted uneventfully. Conclusion: In AVM cases, trauma should be minimized during induction of general anesthesia and intubation should be performed gently with fiberoptic bronchoscopy or video laryngoscopy. We conclude that a multidisciplinary approach as applied to our patient would be valuable in such cases.

Single cell RNA sequencing reveals mesenchymal heterogeneity and critical functions of Cd271 in tooth development

BACKGROUND Accumulating evidence suggests that the maxillary process,to which cranial crest cells migrate,is essential to tooth development.Emerging studies indicate that Cd271 plays an essential role in odontogenesis.However,the underlying mechanisms have yet to be elucidated.AIM To establish the functionally heterogeneous population in the maxillary process,elucidate the effects of Cd271 deficiency on gene expression differences.METHODS p75NTR knockout(Cd271-/-)mice(from American Jackson laboratory)were used to collect the maxillofacial process tissue of p75NTR knockout mice,and the wildtype maxillofacial process of the same pregnant mouse wild was used as control.After single cell suspension,the cDNA was prepared by loading the single cell suspension into the 10x Genomics Chromium system to be sequenced by NovaSeq6000 sequencing system.Finally,the sequencing data in Fastq format were obtained.The FastQC software is used to evaluate the quality of data and CellRanger analyzed the data.The gene expression matrix is read by R software,and Seurat is used to control and standardize the data,reduce the dimension and cluster.We search for marker genes for subgroup annotation by consulting literature and database;explore the effect of p75NTR knockout on mesenchymal stem cells(MSCs)gene expression and cell proportion by cell subgrouping,differential gene analysis,enrichment analysis and protein-protein interaction network analysis;understand the interaction between MSCs cells and the differentiation trajectory and gene change characteristics of p75NTR knockout MSCs by cell communication analysis and pseudo-time analysis.Last we verified the findings single cell sequencing in vitro.RESULTS We identified 21 cell clusters,and we re-clustered these into three subclusters.Importantly,we revealed the cell–cell communication networks between clusters.We clarified that Cd271 was significantly associated with the regulation of mineralization.CONCLUSION This study provides comprehensive mechanistic insights into the maxillary-process-derived MSCs and demonstrates that Cd271 is significantly associated with the odontogenesis in mesenchymal populations.

Tooth arrangement design of retractable DTH hammer bit used for drilling while casing

Down-the-hole(DTH)hammer with casing while drilling(CWD)is a technology that has been proven to be able to alleviate many of the problems faced by complex formations.However,the drill bit is suffered from rapid wear,low drilling efficiency,and high energy consumption due to the unreasonable tooth arrangement and impact energy selection in drilling process,which affect the application effect of this technology.ABAQUS software was used for numerical simulation of rock breaking behavior under impact load with the single,three,and five teeth arrangement drill bit respectively,to improve the application effect and solve the aforementioned technical problems.Based on the calculated parameters of tooth arrangement,we designed a novel drill bit for hard rocks and provided a theoretical basis for the tooth arrangement of largediameter drill bits.

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。

Periostin表达在乳恒牙替换中的临床意义

目的 探讨Periostin在替牙期对骨改建和自噬的影响,研究Periostin在乳恒牙替换过程中调节骨代谢平衡的作用机制。方法 收集笔者所在医院因乳牙根尖周病及多生牙拔除的牙根周围粘连牙槽骨,体外培养成骨细胞,分为实验组和对照组各15例,实验组培养基中加Periostin,原位杂交法检测标本中Periostin、骨代谢基因、自噬基因的m RNA水平。蛋白质印记法检测成骨细胞中骨代谢蛋白,自噬蛋白表达。结果 原位杂交结果显示,实验组Periostin表达低于对照组(P<0.05),核因子κB受体活化因子配体(receptor activator of nuclear factor-κb ligand,RANKL)、LC3、BECN1表达及RANKL/骨保护素(osteoprotegerin,OPG)值高于对照组(均P<0.05),OPG表达差异无统计学意义(P>0.05);蛋白质印迹法显示实验组RANKL、RANKL/OPG、LC3Ⅱ、Beclin-1、LC3Ⅱ/LC3Ⅰ与对照组比较水平低(均P<0.05),OPG、LC3Ⅰ较对照组差异无统计学意义(均P>0.05)。结论 Periostin通过降低RANKL表达及改善过强自噬状态,从而减少炎症所致的骨吸收。

无托槽隐形矫治器内收前牙时后牙移动趋势及牙周膜应力分布

目的 :利用三维数字化技术对无托槽隐形矫治器内收前牙时后牙移动趋势及牙周膜应力分布进行分析。方法 :选择广西壮族自治区人民医院2017年6月—2022年6月收治的88例患者CBCT数据,将其输入Mimics 20.0软件中,对其各部位进行初步抽取,使用STL文件进行存储。通过Geomagic Studio 2014软件进行修补和优化,在优化基础上,构建无托槽隐形矫治器和牙周膜模型。利用Ansys Workbench19.0 FEM软件对6个FEM模型进行模拟仿真与观测,分析当前牙整体回收时,不同组别患者支抗牙的初始移动趋势与牙周膜范式等效应力分布。采用SPSS 21.0软件包对数据进行统计学分析。结果:所有患者支抗牙均发生不同程度牙根部颊向移动等倾向,其中,第二前磨牙位置移动在近中咬合方向上表现最为明显;而水平矩形附件组与垂直矩形附件组成相对关系,牙周膜最大范式等效应力大范围分布于牙颈部,接着是根尖区,以NA组支抗牙的范式等效应力值最大。附件垂直矩形组中,所有患者牙周膜最大范式等效应力值显著小于水平矩形组。结论:正畸牙附件设计对前牙回收时的位置移动具有较强抑制作用,在一定程度上提升了牙三维方向移动的精确性。无托槽隐形矫治器应用初期,患者牙周膜受到的范式等效应力较大。

拔除下颌近中水平完全埋伏阻生牙保留颊侧骨板的效果探讨

目的:探讨微创手术拔除下颌近中水平完全埋伏阻生牙时保留颊侧骨板的效果。方法 :选取近中低位水平埋伏阻生牙86颗,随机分为2组,试验组以球钻开窗,暴露牙冠远中面,保留颊侧骨板,使用仰角手机配合加长车针行多次T形截冠,去除牙冠,微创拔除。对照组采用球钻去除远中及颊侧骨板,暴露远中及颊部牙冠,T形截冠,其余操作均一致。观察2组患者术后肿胀程度、开口受限程度以及疼痛视觉模拟量表(VAS)评分,检测C反应蛋白水平以及抗溶血链球水平;1个月后检查邻近第二磨牙牙周探诊深度(probing depth,PD)、出血指数(bleeding index,BI)及临床附着丧失(clinical attachment loss,CAL)水平。采用SPSS 25.0软件包对数据进行统计学分析。结果:试验组术后肿胀程度显著轻于对照组(P<0.05),开口受限与疼痛程度无显著差异(P>0.05)。试验组C反应蛋白水平显著高于对照组(P<0.05),抗溶血链球菌水平2组之间比较无显著差异(P>0.05)。术后1个月,对照组PD和CAL均显著高于试验组(P<0.05),2组BI比较无显著差异(P>0.05)。结论:保留颊侧骨板微创拔除下颌近中水平完全埋伏阻生牙患者术后反应更轻,创口愈合更好。

牙周系统治疗联合意向性牙再植术治疗重度牙周炎1例

本文报告1例牙周系统治疗联合意向性牙再植术治疗重度牙周炎的临床病例。患者为65岁女性,在牙周系统治疗后,对保留无望的患牙32行意向性牙再植术,随访2年保住了天然牙,取得了良好的治疗效果。

舌侧活动翼不同翼拉伸长度内收下前牙的生物力学特征

背景:舌侧活动翼矫治技术是一种新型舌侧矫治技术,不同翼的拉伸长度影响前牙转矩控制效果,目前尚无相关的生物力学研究。目的:探讨舌侧活动翼矫治技术内收下前牙时牙列的位移趋势以及不同翼拉伸长度对下颌前牙生物力学效应的影响。方法:利用锥形束CT采集患者下颌骨以及下牙列数据信息,通过Mimics软件进行三维重建,建立舌侧活动翼内收下前牙的三维有限元模型。在ANSYS软件中分别分析工况A(2 mm拉伸长度)、工况B(2.5 mm拉伸长度)、工况C(3 mm拉伸长度)和工况D(3.5 mm拉伸长度)时下颌前牙的初始位移。结果与结论:①下牙列初始位移趋势:中切牙舌向倾斜移动伴有压低,侧切牙、尖牙轻度舌侧移动伴近中舌向扭转,第二前磨牙远中倾斜并伴有明显舌倾,第一磨牙整体表现为近中倾斜并伴有近中牙冠外翻。因此在下颌拔牙内收病例中,对第二前磨牙的舌向移动应给予重视,临床中可以通过相应的技术予以抵消。②前牙各方向位移趋势:从工况A到工况D,矢状方向:中切牙冠根位移差值由-11.891μm变为-5.7574μm,表示中切牙由倾斜移动向整体移动转变;侧切牙冠根位移差值由-11.8281μm变为-6.71145μm,尖牙冠根位移差值由-7.5723μm变为-4.6955μm,表示侧切牙及尖牙的倾斜移动也在向整体移动转变。垂直方向:从工况A到工况D,切牙的压低量逐渐增大,尖牙的压低量逐渐减小。结果表明,翼的拉伸长度会影响前牙的倾斜移动趋势;随着翼的不断拉伸,下前牙的转矩控制效果越好。

自驱修孔钻头动力参数及钻齿结构研究

自驱修孔钻头是修复失效长钻孔的有效技术手段,为进一步提高修孔速度和瓦斯抽采效果,本文基于射流反冲理论,分析了射流反冲力与喷嘴参数的关系,构建了自驱修孔钻头旋转力学理论模型。采用LS-DYNA开展不同结构钻齿破煤过程,分析了不同钻进压力和扭矩作用下钻齿对煤体破坏形式和钻齿破煤体积变化规律,并开展了破煤实验验证数值模拟结果。形成了自驱修孔钻头参数确定方法,设计了自驱修孔钻头,并在郑煤集团超化煤矿22煤柱面底抽巷进行了工程实验。研究结果表明:(1)喷嘴张角α和偏心角β是决定钻进压力和扭矩分配的关键参数,通过调控张角和偏心角可实现钻进压力和扭矩的最优匹配。(2)相同钻进参数条件下,钻齿结构对破煤体积影响较大,阶梯钻齿破煤效果最优。在钻进压力为120N、扭矩0.6N·m时,阶梯型钻齿结构的修孔钻头能够实现钻进压力和扭矩最优匹配。(3)确定了最优修孔钻头结构参数为:钻头外径28 mm;后置喷嘴张角20°,偏心角90°;前置喷嘴张角90°,偏心角0°。(4)工程应用结果表明:瓦斯抽采纯量提高了1.96倍,瓦斯抽采体积分数提高了3.98倍,修孔速度提高了1.2倍。通过改进钻头动力参数及优化钻齿结构,设计的自驱修孔钻头在工程实践中达到了提高修孔速度和瓦斯抽采效果的目的。

横向冲击载荷下齿形双螺母防松性能

针对螺栓连接结构在舰船爆炸冲击中容易发生松动的现象,设计了一种齿形双螺母的防松结构。利用局部滑移理论分析齿形双螺母的防松原理,采用有限元仿真法,通过预紧力和微滑移的变化量对其防松性能进行分析,并研究了齿形双螺母防松性能的影响因素及其影响规律。研究结果表明:横向冲击载荷下,齿形双螺母预紧力下降慢,微滑移变化小,具有较好的防松性能;当楔形角与螺纹升角相同时,防松效果最差;楔形角越大,齿形数量越多,齿形双螺母的防松效果越好。

咀嚼型洁齿骨活性成分体外抑菌试验和临床应用效果评估

为了评估咀嚼型洁齿骨对成年犬口腔健康状况的改善情况及其主要活性成分的体外抑菌效果,本试验采用牛津杯法定性检测咀嚼型洁齿骨中主要活性成分对变异链球菌、粘性放线菌、嗜酸乳杆菌、牙龈卟啉单胞菌和具核梭杆菌具核亚种的抑菌活性;并选取30只临床健康成年犬,经超声波洁牙后,随机分为3个组,对照组正常饲喂,试验1组和试验2组分别添加不同品牌的洁齿骨,每间隔30 d由同一名兽医对试验犬的牙菌斑、牙结石和牙龈炎进行医学评分并测定犬口气值。结果显示:咀嚼型洁齿骨中活性成分茶多酚、厚朴酚、杜仲提取物、金银花提取物、溶菌酶和保鲜复合酶对5种口腔常见致病菌的生长抑制效果相对较好;洁牙后90 d,试验1组和试验2组犬牙菌斑和牙结石评分均显著低于对照组(P<0.05);洁牙后30和90 d,试验2组犬牙龈炎评分显著低于对照组(P<0.05);与对照组相比,洁牙后饲喂咀嚼型洁齿骨明显改善了犬口臭情况,试验2组犬口气测定值均低于试验1组,差异不显著(P>0.05)。结果表明,咀嚼型洁齿骨一定程度上可以缓解犬口腔健康状况,且添加活性成分的洁齿骨效果相对较好。

倾斜种植在上颌后牙区的应用现状

上颌后牙区缺牙患者通常由于牙槽骨病理性吸收萎缩、增龄性骨丧失、上颌窦气化等原因导致牙槽骨高度降低,在对这类患者进行种植修复时,因骨量的不足,导致种植修复方案的设计与实施难度增大。为了解决此类问题,有学者提出倾斜种植的治疗方案来满足骨量不足患者的种植修复需求。文章从应用类型、优势、生物力学等方面出发,对倾斜种植进行阐述。