Clinical application of perforator vessel location guide plate for fibular musculocutaneous flaps / 口腔疾病防治

Objective@#Based on 3D printing technology, explore the precision of a perforator vessel location guide plate for fibular musculocutaneous flaps before the transplantation of fibular osteocutaneous flaps and evaluate its application effects.@*Methods@#This study was reviewed and approved by the ethics committee, and informed consent was obtained from the patients. From May 2019 to October 2022, 14 patients with jaw defects who needed to undergo fibular perforator flap transplantation at the First Affiliated Hospital of Xinjiang Medical University were selected. For the seven patients in the guide plate group, CTA was combined with Mimics software to reconstruct both lower limbs, and the perforator vessel positioning guide for locating perforator vessels was designed; the two ends of the guide plate were designed as fixed ends, with the upper end fixed to the knee joint and the lower end fixed to the ankle joint, and the guide plate was fabricated by a 3D printer. For the seven patients in the control group, a conventional handheld Doppler probe was used for perforator vessel location. The average operation time, bleeding volume, recovery time, deviation of perforator vessel location, postoperative flap-related complications, postoperative donor site shape satisfaction, and lower extremity functional scale (LEFS) score were recorded. SPSS 25.0 software was used for statistical analysis.@*Results@#The average operation time, bleeding volume, recovery time, deviation of perforator vessel location and postoperative donor site shape satisfaction were significantly better in the guide plate group than in the control group (P<0.05); moreover, the differences in postoperative flap-related complications and LEFS scores were not statistically significant (P>0.05).@*Conclusion@#Based on 3D printing technology, fibular musculocutaneous flap perforator vessels can be more accurately located using a guide plate and the knee and ankle as fixed points, and this method can effectively stabilize the guide position, prevent soft tissue offset, and improve positioning accuracy and thus deserves to be generalized.

Simultaneous implantation and tooth preparation technology guided by 3D-printed guide / 华西口腔医学杂志

Using digital technologies in concurrently performing missing tooth implantation and preparation of remaining teeth is a solution to reduce the number of visits and improve efficiency. This paper proposes a digital process for simultaneously implanting and preparing teeth. It integrates implant surgical guide and 3D-printed tooth preparation guide into a single guide and completes guided implant placement and precise tooth preparation. Based on "repair-oriented" virtual implant planning, the implant surgical guide can improve the efficiency and predictability of implant placement, and its linear accuracy is about 1 mm. The tooth preparation guide precisely guides tooth preparation and restoration space visualization, ensuring the quality of the tooth preparation. The two guides have different design accuracy requirements, and thus their combination improves the overall guiding accuracy requirements. The concurrent application of the two guides minimizes the clinical operation time, number of visits, and economic burden of patients.

Cirugía guiada y reconstrucción tisular luego de un fracaso: la importancia del diagnóstico y la planificación. Reporte de caso clínico / Guided surgery and tissue reconstruction after failure: the importance of diagnosis and planning. Report of a clinical case

La realización de un nuevo tratamiento luego de un fracaso con implantes dentarios representa un gran desafío para el profesional especialistas en implan-tología, así como para el paciente que debe someter-se a un nuevo procedimiento para rehabilitarse. En estos casos, el diagnóstico y la planificación exhaus-tiva previa nos permiten optimizar el tiempo y los re-cursos, arribando al resultado esperado de forma eficiente. En este reporte de caso se presenta la re-habilitación de una paciente que acude a la consulta con un fracaso implantario previo y con alta deman-da estética. Se diseñó una guía quirúrgica de preci-sión para la colocación de un implante Straumann®Bone Level Tapered 3,3 NC ­ Narrow CrossFit® ø 3,3 mm 8 mm junto a la regeneración ósea guiada para compensar la deficiencia de los tejidos circundantes. La rehabilitación protésica consistió en una corona cemento atornillada en disilicato de litio. En el control al año pudo valorarse la estabilidad de la rehabilita-ción protésica, así como de los tejidos circundantes y el contorno estético junto al perfil de emergencia mimético logrado al final del tratamiento (AU)

Carrying out a new treatment after a failure with dental implants represents a great challenge for the implantology specialist professional, as well as for the patient who must undergo a new procedure to rehabilitate. In these cases, the diagnosis and prior exhaustive planning allow us to optimize time and resources, arriving at the expected result efficiently. This case report presents the rehabilitation of a patient who comes to the clinic with a previous implant failure and with high aesthetic demand. A precision surgical guide was designed for the placement of a Straumann® Bone Level Tapered 3.3 NC ­ Narrow CrossFit® ø 3.3 mm 8 mm implant together with guided bone regeneration to compensate for the deficiency of the surrounding tissues. The prosthetic rehabilitation consisted of a screw-retained cement crown in lithium disilicate. In the one-year control, the stability of the prosthetic rehabilitation, as well as the surrounding tissues and the aesthetic contour, together with the mimetic emergence profile achieved at the end of the treatment, could be assessed (AU)

Research progress on root position measurement methods in orthodontic treatment using cone beam CT / 口腔疾病防治

@#Root position plays an important role in healthy, stable, and aesthetic orthodontic treatment. In the past, two-dimensional radiographic images were used to assess the accuracy and precision of tooth root positions. In recent years, the use of cone beam CT (CBCT) and its reconstructed images to measure the three-dimensional spatial position and angle of root position has become mainstream. The root position is mainly described by measuring the relationship between the root and adjacent structures in the buccolingual, vertical, and mesiodistal directions as well as the root angle. The thickness of the alveolar bone on the buccolingual side of the root represents the buccolingual position, the vertical height in the alveolar bone and the relationship between apex and maxillary sinus represents the vertical position, the interroot alveolar bone thickness represents the mesiodistal position of the root, and the root angle is mostly based on incisal mandibular plane angle, angulation, torque, and other angles in the traditional two-dimensional measurement. Fitting CBCT and digital model data can be used to monitor the relationship between root and alveolar bone during orthodontic treatment, but a more comprehensive, standardized three-dimensional tooth root position measurement method is required to make full use of the root data provided by CBCT to study the relative optimal position of the tooth root at different anatomical levels, which combines with computer technology to optimize the digital design of orthodontic diagnosis and treatment.

Study on the application of oral digital design in aesthetic restoration of anterior teeth of cleft lip/palate patients / 华西口腔医学杂志

OBJECTIVES@#A study was conducted to investigate the clinical effects of oral digital design on the aesthetic restoration of anterior teeth of cleft lip/palate patients.@*METHODS@#Nine adult cleft lip/palate patients who need aesthetic restoration of anterior teeth were recruited. Digital information of patients' dental arches, the surrounding soft tissue and face were captured by digital camera and scanner. The aesthetic analysis and design were conducted using keynote and 3shape software and were demonstrated to the patients. The optimized treatment plan was ensured by communicating with the patients. Digital wax-up models were exported and printed into resin diagnostic models, which were then utilized in the treatment process to guide the doctors and the technicians in tooth preparation and in making the final restorations, respectively. The adhesive procedure was completed after satisfactory try-in. Aesthetics assessment was conducted in accordance with the anterior esthetic evaluation form. The scores of patient's satisfaction were recorded on a questionnaire containing six items of aesthetic index and doctor-patient communication. Patients were interviewed and examined after 1, 3, 6, and 12 months, respectively, and the clinical effects of restorations were evaluated.@*RESULTS@#All nine patients had satisfactory clinical results. The aesthetic defects of the patients were effectively addressed. All treatments met the requirements of the preoperative digital designs. The patients' scores were all above 90 on the satisfaction scale. At 12 months after the operation, the clinical effects of restorations of all cases achieved A class in each evaluation indicator.@*CONCLUSIONS@#For cleft lip/palate patients with esthetic defect in the anterior teeth, the digital design plays an important role in optimizing the treatment plan and guides the whole treatment process. This design can help clinicians achieve predictable satisfactory aesthetic results.

Precise tooth preparation technique guided by 3D printing guide plate with quantitative hole / 华西口腔医学杂志

The minimum amount of tooth preparation that can be fully controlled is crucial in achieving long-term, stable, and effective aesthetic restoration, which is also a major difficulty in aesthetic restoration. The tooth preparation can be imple-mented efficiently and accurately through digital technology based on the fixed-deep hole guiding technology. Prior the actual tooth preparation, the technology first designs the virtual contour, layering, and virtual occlusion of the prosthesis on the computer. Then, virtual tooth preparation is carried out by cutting back according to the virtual prosthesis. Next, the virtual drilling operation plan is designed according to the shape of the virtual tooth preparation and the contour of the abutment tooth. Finally, the tooth preparation guide plate is designed and printed in 3D. It realizes the whole process of quantitative and precise guidance of dental preparation, visualizes the restoration space, reduces the clinical operation time, and guarantees the quality of dental preparation. It also promotes the improvement of the teaching quality of digital practical exercises.

Diseño de la sonrisa en PowerPoint / Smile design in PowerPoint

Digital Smile Design (DSD - Diseño Digital de la Sonrisa) es un software ideado por el Dr. Christian Coachman que permite diagnosticar, diseñar y comunicar al técnico dental y al paciente el resultado final pretendido mediante la rehabilitación oral. El objetivo de esta comunicación es divulgar cómo diseñar digitalmente la sonrisa utilizando PowerPoint, con los mismos fines y resultados del programa original. PowerPoint es un programa del paquete Office del sistema operativo Windows (Microsoft, Inc., Estados Unidos), por lo que esta herramienta permite acercar el diseño digital de la sonrisa a la gran mayoría de los odontólogos, quienes de esta manera pueden elaborar sus propios diseños de la sonrisa de sus pacientes de forma gratuita.

The Digital Smile Design is a software developed by Dr. Christian Coachman, which allows to diagnose, design and communicate to the dental technician and the patient the intended final result in oral rehabilitation. The objective of this technical note is to show how to digitally design the smileusing PowerPoint, with the same goals and results that theoriginal program executes. PowerPoint is a software that isin the operating system of Microsoft Windows. Therefore, the development that we have achieved in the use of this tool for digital smile design allows the vast majority of dentists toelaborate their own patients’ smile designs for free.

Caso clínico em Zircônia ultra translúcida ZOLID FX monolítica e maquiada, integrando o Desenho Digital do Sorriso com articulador ARTEX e o articulador virtual no CAD/CAM odontológico / Super high-translucent ZOLID FX Zirconia, combined with Digital Smile Desing and ARTEX virtual articulatores on CAD/CAM ­ case report

Este caso clínico foi realizado com as técnicas e os conceitos mais modernos da Odontologia na atualidade, iniciado pela análise multidisciplinar do conceito Digital Smile Design, do Dr. Coachman e grande equipe, com a qual conseguimos uma análise prévia e uma previsibilidade estética com medidas exatas para o procedimento técnico. Utilizou-se o sistema sem ajuste da AmannGirbach, que combina modelos precisos, com o articulador ARTEX e o sistema CAD/CAM CERAMILL completo. O trabalho foi realizado com ZIRCÔNIA ZOLID FX, monolítica e maquiada, material de última geração que tem uma altíssima translucidez. Esse conjunto de técnicas juntas diminuem o tempo de ajuste nas peças definitivas que chegam à clínica glazeadas e prontas para serem colocadas em boca.

This case was carried out with the most modern techniques and concepts of dentistry. The multidisciplinary analysis of the concept Digital Smile Design, Dr. Coachman and great team, has provided a previous analysis and an aesthetic predictability with precise measures for the technical procedure. We used the system without adjusting the Amann-Girbach,that combines accurate models with ARTEX articulator and complete CAD CAM Ceramill system. The work was made with monolithic ZOLID FX Zirconia, super high-translucent materal. This set of techniques decreases the time of adjustment of definitive pieces that reach the clinic glazed and ready to be placed in the mouth.

Application of completely digital design technology in fabricating ceramic crowns to copy preoperative tooth:A case report and literature review / 吉林大学学报(医学版)

Objective:To fabricate an all-ceramic crown which copies the morphology of preoperative tooth in one patient with only small occlusal dentin defects with completely digital design (CDD)technology,and to find a more precise and feasible solution to fix the tooth detect.Methods:The tooth treated with root canal therapy had the complete axial surface and small occlusal dentin defects.In order to keep the morphology of preoperative tooth,the digitized crown was designed with the information of preoperative tooth by oral scanning with CS3500 and using the"Biogeneric Copy"function of exocad design software,then the digitized information of the teeth was collected and transformed and the simulate zirconia crown was mode by 3D colloidal deposition technique.The patient's comfort and satisfaction were investigated by observing the morphology,the interproximal contacts,and the occlusion of crown.Results:The morphology of definitive restoration was similar to the preoperative tooth,which presented good interproximal contact and occlusion,and the patient was greatly satisfied without discomfort and foreign body sensation.Conclusion: A more accurate and personalized restoration approach can be implemented with the application of CDD to fabricate new ceramic crowns which copy the preoperative tooth.

Strategy and practice of the healthy cosmetic management for patients with high dental caries susceptibility / 华西口腔医学杂志

A new clinic conception, healthy cosmetic management (HCM), was innovated introduced into diagnose and treatment of patients with high caries risk. The priority of HCM should be given to aesthetic restoration of teeth, taking consideration of the conserving of tissue and pulp of teeth and the balance between health and aesthetics, which may reach to the goal of the individual clinic treatment. HCM includes five steps: 1) caries risk assessment; 2) detection of initial caries; 3) digital aesthetic design; 4) minimally invasive therapy; 5) behavior management of caries and doctor-patient communication pattern. In this article, HCM is introduced into two aspects: process management and clinical protocols, followed by the combination of the clinical practice.

Design of digitized anterior approach screw fixation program：Clinical application in the treatment of type Ⅱ odontoid fractures / 中国组织工程研究

10.3969/j.issn.2095-4344.2013.26.024