2种量表在评定青少年主观(牙合)美观程度中的应用

目的:采用视觉模拟量表(visualizedanaloguescale,VAS)和正畸治疗需要指数的美学量表(aestheticcompo鄄nent,AC)分别量化评定青少年的自身牙合美观程度,比较两者的评定效能及信度。应用SPSS11.0统计软件包进行相关分析。方法:随机抽取上海地区11～13岁青少年共302例(男148例,女154例),分别采用2种量表进行牙合美观程度的主观评价,同时由正畸医生进行牙合美观程度的客观评定。结果:Spearman相关检验显示,自评AC及VAS均与性别无关(P>0.05);VAS分值与主观牙合美观满意度显著相关(r=0.80,P=0.000),且与正畸医生的专业评定一致性较高;自评AC等级与主观牙合美观满意度无显著相关性(P=0.441)。结论:应用VAS量表评定青少年主观牙合美观程度的可信度较高且简单易用,适合定量分析,为今后量化评定主观正畸治疗需求提供了一种新方法。     

Effect of caries infiltration technique and fluoride therapy on the colour masking of white spot lesions

Objectives

A carious lesion is initiated through the subsurface demineralization of enamel, and presents clinically as a white spot, interfering with the aesthetics. This lesion should not receive restorative treatment because it is capable of remineralization. The aim of this study was to evaluate the performance of different treatments on masking white spot lesions by assessing the colour change.

Methods

Artificial white spot lesions were produced in bovine enamel of 60 cylindrical-shaped samples. The samples were randomly divided into four groups: CON (control) - immersion in artificial saliva; DF - daily application of 0.05% fluoride solution; WF - weekly application of 2% fluoride gel; and IC - resin infiltration (Icon^® - DMG). The assessment of colour was performed by a spectrophotometer in four distinct stages: baseline, after the production of artificial caries; after 4 weeks; after 8 weeks; and after a new acid challenge. The ΔL values were calculated at each stage in relation to the baseline colour.

Results

The application of RM ANOVA revealed significant differences between the factors’ treatment and time (p = 0.001). For the interaction between factors there were no significant differences (p = 0.27). The Tukey's test (p < 0.05) was then applied and showed that the specimens treated with Icon^® exhibited the lowest means, followed by Group DF, Group CON, and Group WF, in that order.

Conclusion

Resin infiltration was proven to be an effective treatment for masking white spot lesions. Also, after a new acid challenge, the group infiltrated with low viscosity resin presented the lowest means of colour change.     

皮肤良性肿瘤手术切除后创面美容修复的探讨

目的:探讨皮肤良性肿瘤切除后创面美容修复的方法。方法:肿瘤病灶切除后根据创面部位、大小、深度,遵照"宁近勿远,宁简勿繁"的原则,选择适宜的皮瓣、肌皮瓣或皮片修复创面;创面位于功能部位者采用分区植皮技术。所有伤口局部均实施康复治疗。结果:皮片移植的721例中,684例自供皮区切取移植的中厚或全厚皮片成活率均在95%～100%;37例取自切除肿瘤组织表面皮肤的中厚皮片,27例成活率为70%～90%,10例经二期手术植皮愈合,该27例局部有瘢痕形成。166例采用各种皮瓣或肌皮瓣修复创面者,除2例皮瓣全部坏死,二期行皮片移植修复创面外,其余164个各种皮瓣均100%成活,161例术区外形与功能均满意。病灶摘除或切除后伤口直接缝合者230例中,伤口均一期愈合,226例局部无明显瘢痕增生与色素沉着。本组美容修复率达到96.8%。结论:采用美学理论和整形美容技术修复皮肤良性肿瘤切除后,创面可以达到美容修复的目的。     

Esthetic smile designing with porcelain laminates – A case report

Porcelain laminate restorations are one of the most successful treatment modalities for cosmetic improvement of unsightly anterior teeth. Porcelain veneers within reason allow for the alteration of tooth position, shape, size and color. They require a minimal amount of tooth preparation. This case report describes the management of a case of dental fluorosis and unaesthetic gingival contours by gingival reshaping and final esthetic rehabilitation with porcelain laminates.     

Redefining our protocol of the orthognathic surgery-first approach after 10 years of experience

The objective of this study was to update and redefine some concepts of the surgery-first (SF) approach, regarding its indications and contraindications, virtual planning work-up, surgical tips, and postoperative orthodontic benefits, after 10 years of experience. A retrospective analysis was made of orthognathic surgical procedures following the SF protocol between January 2010 and December 2019 to review inclusion and exclusion criteria, diagnostic workflow, surgical tips, and postoperative outcomes. A total of 148 SF procedures were performed during this period, which corresponded to only 9.2% of the total orthognathic surgeries performed, which means that we have broadened the exclusion criteria instead of reducing them. Surgical tips include interdental corticotomies solely in cases of anterior crowding and leaving the intermaxillary fixation miniscrews in place postoperatively for orthodontic skeletal anchorage. The mean duration of postoperative orthodontic treatment was reduced in comparison to conventional surgery (36.8 vs 87.5 weeks). The overall degree of satisfaction was high not only for the patients, but also for the orthodontists and surgeon. SF is especially indicated for patients who desire an immediate aesthetic result, with short-term orthodontics, or for treatment of sleep-related breathing disorders, if they meet the established criteria.     

Biomechanics and clinical implications of complete edentulous state

The edentulous state represents a compromise in the integrity of the masticatory system. It is frequently accompanied by adverse functional and esthetic sequelae, which are varyingly perceived by the affected patient. Perceptions of the edentulous state may range from feelings of inconvenience to feelings of severe handicap because many regard total loss of teeth as equivalent to the loss of a body part. Consequently, the required treatment addresses a range of biomechanical problems that involve a wide range of individual tolerances and perceptions.     

Cognitive vs. affective listening modes and judgments of music - An ERP study

The neural correlates of processing deviations from Western music rules are relatively well known. Less is known of the neural dynamics of top-down listening modes and affective liking judgments in relation with judgments of tonal correctness. In this study, subjects determined if tonal chord sequences sounded correct or incorrect, or if they liked them or not, while their electroencephalogram (EEG) was measured. The last chord of the sequences could be congruous with the previous context, ambiguous (unusual but still enjoyable) or harmonically inappropriate. The cognitive vs. affective listening modes were differentiated in the event-related potential (ERP) responses already before the ending chord, indicating different preparation for the judgment tasks. Furthermore, three neural events tagged the decision process preceding the behavioral responses. First, an early negativity, peaking at about 280 ms, was elicited by chord incorrectness and by disliking judgments only over the right hemisphere. Second, at about 500 ms from the end of the sequence a positive brain response was elicited by the negative answers of both tasks. Third, at about 1200 ms, a late positive potential (LPP) was elicited by the liking judgment task whereas a large negative brain response was elicited by the correctness judgment task, indexing that only at that late latency preceding the button press subjects decided how to judge the cadences. This is the first study to reveal the dissociation between neural processes occurring during affective vs. cognitive listening modes and judgments of music.