Twelve-month evaluation of the atraumatic restorative treatment approach for class Ⅲ restorations:An interventional study

BACKGROUND Atraumatic restorative treatment(ART)may be appropriate for populations without accessibility and affordability.More data are required regarding the success rate of ART in anterior teeth.AIM To evaluate the clinical performance of restoring class III cavities in anterior teeth of permanent dentition using the ART approach.METHODS A longitudinal interventional field study was carried out at two rural primary health centers,Tumkur district,India.A total of 54 teeth in 39 patients were evaluated for the survival rate of class III restorations in permanent anterior teeth using the ART approach in children and adult populations.Evaluation of ART restoration was carried out using Frencken J criteria,the mean procedure time,patient acceptance and reported pain severity during the ART approach were evaluated using a visual analog scale.Calculation of the cost of ART was also performed.RESULTS The mean time taken to perform the ART procedure was 14.79±5.8 min with the majority of patients reporting only mild pain.At 6 mo follow-up,72.2%remained in a good state,but this reduced to 27%at 12 mo.The cumulative survival rate of the restorations was 94.4%at 6 mo and 80.9%at 12 mo follow-up.Estimation of the direct cost for a single class III restoration was 186.50 INR(2.64 USD).CONCLUSION ART may be a good comprehensive option for basic oral health care for underserved or inaccessible populations,and preventive care for patients.

Root Canal Treatment Outcome and Restorative Condition of Teeth Treated by Undergraduates—A Clinical and Radiographic Evaluation

Background: The aim was to evaluate the nonsurgical Root Canal Treatment (nRCT) outcome, the restorative condition and the relationship between the coronal restoration quality and the outcome of teeth endodontic treated by undergraduates at the University of Caxias do Sul School of Dentistry (UCS-SD), Brazil, between 2019 and 2021. Materials and Methods: Data from the endodontically treated cases were retrieved, and the patients were recalled for a follow-up appointment at the university. The endodontic diagnosis, radiographs, and the presence of definitive restorations were analyzed in the clinical records. During the follow-up appointment, endodontically treated teeth were classified as present or absent. The nRCT was classified as successful (complete or incomplete healing) or failure (uncertain or unsatisfactory healing). Coronal restoration was classified as absent or present. When it was present, it was classified as permanent or temporary, and its quality as adequate or inadequate restoration. The results were presented as percentages. Results: A total of 257 teeth were endodontically treated. The most prevalent diagnosis was Chronic Apical Periodontitis (33.33%) and the most commonly treated teeth were premolars (46.15%). A total of 52 (21%) treated teeth were clinically and radiographically reexamined. The success rate for the nRCT was 98.08%. About 61.54% of this sample had a definitive composite resin restoration. Conclusion: The nRCT success rate was high. Special attention should be given to the presence and quality of the definitive restoration. Clinical Implications: There was no statistically significant impact between the coronal restoration and the nRCT success (P > 0.05).

Evolution mechanism and treatment timing of penetrating fissures

The Inner Mongolia mining area in western China are characterized by the development of numerous penetrating fissures,resulting in severe land damage.It is significant to reveal the underlying evolution mechanism and identify treatment timing for restoring the ecological environment.The Guanbanwusu mining subsidence area in Inner Mongolia,China was selected as the research case for this study.The evolution mechanism of different penetrating fissures was revealed by field measurement,physical simulation and theoretical analysis.The treatment timing prediction model for the mining subsidence area was established based on the enhanced Weibull time function.The results show that the ground fissures are mainly step-type and collapse-type fissures.The breaking form of overlying strata determines their vertical opening and horizontal dislocation.The high mining intensity in the western mining area results in a shortened period of dynamic fissure expansion and reduced closure degree.The damage extent of the overlying strata exhibits zoning characteristics both vertically and horizontally.The relative standard deviation of the prediction model is only 3.7%.Concurrently,the prediction model is employed to determine the optimal timing for treatment in the study area,estimated to be 259 days.Subsequently,once this threshold is reached,the study area undergoes treatment and restoration of its e cological environment.This study addresses the knowledge gap in this field by highlighting the interconnectedness between rock strata structure and evolution mechanism of penetrating fissures,thereby providing a method for determining the treatment timing in mining subsidence areas.

Restoration or Rehabilitation of the Faleme River Affected by Mining Activities: What Methods?

The Faleme River, a West Africa long transboundary stream (625 km) and abundant flow (>1100 million m3) is affected by severe erosion because of mining activities that takes place throughout the riverbed. To preserve this important watercourse and ensure the sustainability of its services, selecting and implementing appropriates restorations techniques is vital. In this context, the purpose of this paper was to present an overview of the actions and techniques that can be implemented for the restoration/rehabilitation of the Faleme. The methodological approach includes field investigation, water sampling, literature review with cases studies and SWOT analysis of the four methods presented: river dredging, constructed wetlands, floating treatment wetlands and chemical precipitation (coagulation and flocculation). The study confirmed the pollution of the river by suspended solids (TSS > 1100 mg/L) and heavy metals such as iron, zinc, aluminium, and arsenic. For the restoration methods, it was illustrated through description of their mode of operation and through some case studies presented, that all the four methods have proven their effectiveness in treating rivers but have differences in their costs, their sustainability (detrimental to living organisms or causing a second pollution) and social acceptance. They also have weaknesses and issues that must be addressed to ensure success of rehabilitation. For the case of the Faleme river, after analysis, floating treatment wetlands are highly recommended for their low cost, good removal efficiency if the vulnerability of the raft and buoyancy to strong waves and flow is under control.

From single to combinatorial therapies in spinal cord injuries for structural and functional restoration

Spinal cord injury results in paralysis, sensory disturbances, sphincter dysfunction, and multiple systemic secondary conditions, most arising from autonomic dysregulation. All this produces profound negative psychosocial implications for affected people, their families, and their communities;the financial costs can be challenging for their families and health institutions. Treatments aimed at restoring the spinal cord after spinal cord injury, which have been tested in animal models or clinical trials, generally seek to counteract one or more of the secondary mechanisms of injury to limit the extent of the initial damage. Most published works on structural/functional restoration in acute and chronic spinal cord injury stages use a single type of treatment: a drug or trophic factor, transplant of a cell type, and implantation of a biomaterial. Despite the significant benefits reported in animal models, when translating these successful therapeutic strategies to humans, the result in clinical trials has been considered of little relevance because the improvement, when present, is usually insufficient. Until now, most studies designed to promote neuroprotection or regeneration at different stages after spinal cord injury have used single treatments. Considering the occurrence of various secondary mechanisms of injury in the acute and sub-acute phases of spinal cord injury, it is reasonable to speculate that more than one therapeutic agent could be required to promote structural and functional restoration of the damaged spinal cord. Treatments that combine several therapeutic agents, targeting different mechanisms of injury, which, when used as a single therapy, have shown some benefits, allow us to assume that they will have synergistic beneficial effects. Thus, this narrative review article aims to summarize current trends in the use of strategies that combine therapeutic agents administered simultaneously or sequentially, seeking structural and functional restoration of the injured spinal cord.

Partially Coverage Restoration: An Esthetically Conservative Treatment for a Complex Cavity Restoration

Dental materials have been continuously developing over a long period of time. Every effort has been made to develop the physical and mechanical properties of the materials to mimic the natural tooth substances. However, that has not yet been achieved, making it necessary to apply conservative dental treatments. Conservative treatments are procedures which minimize the amount of defective tooth structure removed while maximizing the remaining amount of intact tooth structure, and defining the margin of the restoration at the supragingival level. In a substantially destructed tooth, the direct restoration, which is the most conservative restoration, has the limitations on the retention or creation of the proper contour of the restoration. The indirectly partial coverage restoration has recently gained in popularity. This treatment preserves the tooth structure while allowing reconstruction of the destructed structure to enable correct and proper tooth functioning and also provides a satisfactory cosmetic appearance. The purpose of this paper is to review and compare the various conservative techniques of partial coverage restorations and the full coverage treatment with crowns.

Postoperative changes of manometry after restorative proctocolectomy in Korean ulcerative colitis patients

To investigate the changes of postoperative anal sphincter function and bowel frequency in Korean patients with ulcerative colitis (UC). METHODSA total of 127 patients with UC who underwent restorative proctocolectomy (RPC) during 20 years were retrospectively analyzed. The parameters of anal manometry and bowel frequency were compared according to the 6-mo intervals until 24 mo postoperatively. Manometry was used to measure the maximal squeezing pressure (MSP) and maximal resting pressure (MRP). RESULTSMSP decreased after surgery until 6 mo (157 to 142 mmHg); thereafter, it improved and was recovered to and maintained at the preoperative value at 12 mo postoperatively (142-170 mmHg, P < 0.001). Although the decreased MRP (65 to 56 mmHg) improved after 18 mo (62 mmHg), it did not completely recover to the preoperative value. The decreased rectal capacity after surgery (90 to 82 mL) gradually increased up to 150 mL at 24 mo. Although bowel frequency showed significant gradual decreases at each interval, it was stabilized after 12 mo postoperatively (6.5 times/d). CONCLUSIONPostoperative changes of manometry and bowel frequency after restorative proctocolectomy in Korean patients with UC were not different from those in Western patients with UC.

基于审美分析的口腔美容修复分类诊疗方案(一):基本概念、决策树及临床路径

当前美容修复临床方案多基于欧美国家提出的口腔美感指标(简称欧美审美)制定,但机械地照搬欧美口腔美容修复方案,忽视了其与中国人口腔美感指标(简称中式审美)的差别,是无法有效支撑国人个性化口腔美容修复诊治的。另外,近年发展迅猛的美容修复新技术、新方案层出不穷,但不少热门概念的内涵混淆不清,也缺乏应有的分级诊疗规范,急需讨论明晰。本文从服务好口腔美容修复临床运用出发,探讨了中译词“美学”的不足与误用,美学与美容的区别与联系,美容修复与固定修复的相关关系,还讨论了前牙区、美学区与暴露区的差别、口腔审美分析的诊疗价值,以及脱敏、暗示等疗法在口腔疑难美容修复病例中的运用方法。进一步介绍了审美分析引导的暴露区牙位修复重建的决策树及临床路径,并案析介绍了审美分析评估临床流程、口腔美容修复临床三分类及相应的临床分类诊疗要点。

基于生态系统脆弱性评价的典型岩溶区生态治理分区

文章以广西平果果化石漠化生态修复示范区为研究对象,基于“成因-结果”模型选取7个指标建立生态系统脆弱性评价指标体系,利用GIS技术和层次分析法进行生态系统脆弱性评价,通过单参数分析法计算各评价指标对生态系统脆弱性的贡献率,分析造成研究区生态系统脆弱性的主要影响因素。结果表明:研究区微度、轻度、中度、重度和极度脆弱生态系统脆弱性等级面积占比分别为36.43%、33.90%、18.91%、9.34%和1.43%,造成研究区生态系统轻度、中度脆弱的主要因素是岩性和土地利用方式,造成研究区生态系统重度、极度脆弱的主要因素是生态环境退化。依据评价结果,基于土地利用现状,结合坡度、地块面积等条件,划定生态治理分区并制订相应治理措施。其中,封山育林区应禁止一切人为破坏活动;人工造林区可在植被盖度较低的地块种植阳性树种,在植被群落高度较高、盖度适中的地块种植中性和阴性树种;林下种植区可引进赤苍藤、金银花等特色经济植物;草地改良区可引进桂牧一号、菊苣草、甜象草等优质牧草;园地改造区可在现有经果林下套种赤苍藤、金银花等矮杆经济作物;特色经济植物种植区可引进赤苍藤、树仔菜等常绿经济植物;退耕还林区因地制宜造林种草;矿山修复区采用多种技术手段复垦复绿;非治理区保持现状。

缺陷树脂修复体的临床处理策略

在五十余年的应用中,复合树脂直接粘接修复术已凸显出优异的临床效能。然而,修复效果并非一劳永逸,如何处理缺陷树脂修复体已成为口腔医生需要抉择的临床问题。依据修复体质量评价标准,缺陷树脂修复体的概念和分类得以细化,修补而非替换逐渐成为缺陷树脂修复体临床处理的首选方法。本文在回顾树脂修复体修补现况基础上,基于缺陷树脂修复体的问题表现进行治疗方案的归纳总结,进一步根据现代技术发展阐述陈旧树脂修补时,待粘接界面处理方法,以期为缺陷树脂修复体的临床处理提供更为明确的方案决策和处理技术。

生物炭基复合水凝胶的制备及应用研究进展

生物炭基复合水凝胶具有优异的理化性质,近年来在诸多领域有所研究并得到应用。本文综述了生物炭基复合水凝胶的制备方法,如物理交联法和化学交联法;总结了生物炭基复合水凝胶在去除水体污染物、土壤改良、作物增产、缓释肥料和缓解植物重金属胁迫方面的应用,阐明了相关应用机制及作用机理;在此基础上,展望了生物炭基复合水凝胶未来的研究方向,分析了生物炭基复合水凝胶在应用中存在的问题和潜在的风险,并提出了相应建议。

数字化技术辅助牙列缺损患者的种植修复与咬合重建——基本修复程序

咬合重建是复杂的口腔治疗程序,对治疗的精准度要求较高,尤其是涉及种植支持固定修复体的咬合重建治疗。而数字化技术的辅助有利于提高治疗的精准性,为种植修复患者的咬合重建治疗提供长期稳定的保障。本文旨在探讨联合应用神经肌肉分析系统和电子面弓的数字化技术,辅助牙列缺损患者的种植修复与咬合重建的基本修复程序,以期供临床参考。

复合树脂多层修复技术与复合树脂直接粘接修复技术在前牙间隙美学修复中的效果对比

目的:对比分析复合树脂多层修复技术与复合树脂直接粘接修复技术在前牙间隙美学修复中的效果。方法:纳入笔者医院2020年6月-2021年6月收治的98例(共104颗患牙)前牙间隙患者作为研究对象,按照随机数表法分为A组和B组,各49例。A组患者接受复合树脂多层修复技术,B组患者接受复合树脂直接粘接修复技术。对比两组修复效果、美学效果和治疗总费用,比较两组修复前和修复30d后、6个月后的咬合力、咀嚼效率和焦虑自评量表(Self-ratinganxietyscale,SAS)、抑郁自评量表(Self-rating depression scale,SDS)评分。结果:修复30 d后,A组优秀率高于B组(P<0.05),两组良好率和不良率比较无统计学意义(P>0.05)。修复6个月后,A组优秀率和不良率均高于B组(P<0.05),两组良好率比较无统计学意义(P>0.05)。患者的咬合力在时间、交互作用上差异有统计学意义(P<0.05),在组间作用上差异无统计学意义(P>0.05)。患者的咀嚼效率在时间、组间、交互作用上差异均有统计学意义(P<0.05)。修复6个月后,两组患者咬合力和咀嚼效率均较修复30d后和修复前升高,且A组咬合力和咀嚼效率高于B组(P<0.05)。A组修复后的边缘密合性、颜色匹配性、修复体崩裂、继发龋损、形态匹配、修复体脱落和牙龈健康评分均低于B组(P<0.05)。患者的SAS评分和SDS评分在时间、组间、交互作用上有统计学意义(均P<0.05)。修复30d后和修复6个月后,两组患者SAS和SDS评分均较修复前降低,且A组低于B组(P<0.05)。A组治疗总花费高于B组(P<0.05)。结论:与复合树脂直接粘接修复技术相比,在前牙间隙美学修复中应用复合树脂多层修复技术可取得更佳的修复效果,有助于恢复患者咬合力和咀嚼功能,使患者获得良好美学效果,改善其心理状态。但治疗总花费相对较高,临床治疗需结合患者经济情况选择合适治疗方案。

无托槽隐形矫治联合种植修复治疗错[牙合]畸形伴牙列缺损的修复效果及对咀嚼功能的影响

目的:探究无托槽隐形矫治联合种植修复治疗错[牙合]畸形伴牙列缺损的修复情况及对咀嚼功能的影响。方法:采用随机数字表法将2020年7月-2022年7月笔者医院就诊的60例错[牙合]畸形伴牙列缺损患者分为两组,每组30例。对照组给予传统直丝弓矫治技术联合种植修复,观察组给予无托槽隐形矫治联合种植修复。比较两组的种植修复效果及治疗前后牙周健康指标、牙周美观度,采用种植体稳定系数判定种植体稳定性,分析联合治疗对患者咀嚼功能的影响。结果:两组的种植修复成功率比较差异无统计学意义(P>0.05);观察组倾斜牙扶正时间及转位牙扭正时间短于对照组,治疗后咀嚼效率高于对照组(P<0.05);观察组治疗后龈沟出血指数、菌斑指数评分低于对照组,红色美学指数、白色美学指数和ISQ治疗后3个月的评分均高于对照组(P<0.05);两组并发症发生率对比差异无统计学意义(P>0.05)。结论:对错[牙合]畸形伴牙列缺损患者给予无托槽隐形矫治联合种植修复治疗,可改善患者的咀嚼功能及牙周健康状况,提高牙周美观度及种植体稳定性。

口腔种植修复治疗牙列缺损伴牙周炎对牙周指数的影响

目的观察口腔种植修复治疗牙列缺损伴牙周炎的效果并分析对牙周指数的影响。方法回顾性分析2022年1月至2024年1月合肥市口腔医院收治的120例牙列缺损伴牙周炎患者的临床资料,按照患者采取的不同治疗方法将其分为研究组(60例)与对照组(60例)。对照组患者采用传统修复治疗方法,研究组患者采用口腔种植修复治疗方法。比较两组患者治疗前后的牙周指数、炎症因子水平、边缘骨吸收量、基质金属蛋白酶(MMP)水平、种植体存留率。结果研究组种植体存留率高于对照组,差异有统计学意义(P<0.05)。研究组治疗后菌斑指数(PLI)、牙袋深度(PD)、龈沟出血指数(SBI)、MMPs水平、C反应蛋白(CRP)、白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)高于对照组,差异有统计学意义(P<0.05);两组的边缘骨吸收量(MBL)比较,差异无统计学意义(P>0.05)。结论口腔种植修复治疗牙列缺损效果较为显著,种植体留存率较高,且不会增加牙槽骨吸收,但会刺激机体,引发炎症反应,对牙周炎也无明显改善效果。

农田土壤重金属污染风险及治理措施研究

针对农田土壤重金属污染严重的问题,提出一种基于风险评价的治理措施。采用单因子污染指数法建立综合环境实际污染风险评价方程,利用Hakanson指数法建立潜在环境污染风险评价方程,联立方程组,将重金属污染敏感度、多元素协同合作、平均污染浓度以及毒性水平作为污染风险评价指标。实验以广东省农田土壤情况为基础,使用换土法、有机农业化肥生态修复法、微生物治理法以及土壤改良剂法,根据风险评价结果针对不同情况给出针对性治理措施。实验结果证明,所提风险评价精准度高,治理措施能够有效去除土壤中的重金属污染。

基于多层次模糊评价法的青海木里废弃矿山生态修复评估研究

高原地区废弃矿区亟需针对性的措施对其进行生态修复。以青海木里江仓矿区为研究对象,提出了3种生态修复措施,并基于模糊评价法对生态修复工作进行综合评估。研究结果表明:采用全机械化清理的模式可以有效治理江仓矿区边坡稳定性不足的问题;通过地貌整形、渣土改良和土壤重构等手段能够修复改造废弃矿区的地质环境;种植抗寒、抗旱、耐碱性强的高原草种可以有效改善废弃矿区的植被覆盖率,采取多种生态修复措施后江仓矿区的生态环境综合评估结果有了明显的提高。研究结果可以为高原地区废弃矿山的生态修复工程提供建议和参考。

煤矿矿山地质环境保护与治理恢复措施实践研究

以某煤矿为研究案例,结合实地调查和地质勘察结果,综合分析工程项目的地质环境保护与治理恢复分区,并结合地质环境治理恢复目标和矿山环境保护治理任务,从地面塌陷治理恢复工程、含水层破坏治理恢复工程以及地形地貌景观及土地资源治理恢复工程三个角度介绍矿山地质环境保护与治理恢复工作内容。同时,为保障治理恢复工程开展中各类问题的及时发现和处理,在工程项目中引入矿山地质环境监测工程内容。现如今,相关矿山地质环境保护与治理恢复工程措施均已经得到有效应用,并在应用中表现出良好的社会效益、经济效益以及环境效益。

磨牙根管治疗后行全冠修复的必要性分析

目的探讨磨牙根管治疗后直接充填治疗与全冠修复治疗的牙体保存率差别。方法选取我院口腔科2017年10月至2020年10月62例磨牙根管治疗患者进行效果追踪调查。结果随访2年,全冠修复治疗患者的牙体保存率明显优于直接充填治疗患者,两组比较差异有统计学意义(P<0.05)。结论磨牙根管治疗后及时进行全冠修复可有效保存患者牙体,延长患牙使用时间,减少患者失牙痛苦,从而更有效地提高患者生活质量,值得推广。