北京市东城区牙科X射线机性能及防护检测评价

目的 掌握北京市东城区牙科X射线机质量控制的基本状况,探讨辐射防护中存在的问题,为加强放射防护监管提供依据。方法 依据牙科X射线设备质量控制检测规范（WS 581—2017）对东城区18家医疗机构中的牙科X射线机进行检测和评价。结果 41台牙科X射线机总体合格率为92.68%,进口设备的合格率为100%,国产设备检测合格率为76.92%。6个性能检测指标中,“加载时间偏离”指标合格率为92.68%,“管电压指示的偏离”合格率为95.12%,其余性能指标合格率均为100%;机房防护水平全部合格。结论 北京市东城区牙科X射线机总体运行情况良好,但个别机构重视机房的放射防护,忽视口腔设备的质量控制检测。建议卫生行政部门、监管机构要加强对WS 581—2017标准的宣贯和普及力度,强化监督检查,加大处罚力度,提高各机构人员对牙科X射线机质量控制工作的重视程度,共同维护放射人员和公众的健康。     

种植体颈部锥度和末端倒角的生物力学优化分析

目的:应用Ansys DesignXplorer模块,进行种植体颈部锥度和末端倒角同时变化对颌骨应力影响的分析,为临床优化选择和设计种植体提供理论依据。方法:建立了包含螺纹种植体的下颌骨B/2类骨质的骨块三维有限元模型,设定种植体颈部锥度(T)变化范围为45°~75°,末端倒角(R)变化范围为0.5~1.5mm,观察T和R变化对颌骨平均主应力峰值的影响。结果:随着T和R的变化,垂直向加载时,皮、松质骨的平均主应力峰值分别降低了71.6%和14.8%,颊舌向加载时,皮、松质骨的平均主应力峰值分别降低了68.2%和11.0%;当T变化范围为64°~73°同时R大于0.8mm时,颌骨应力峰值的响应曲线切斜率位于-1和1之间。结论:种植体颈部锥度比末端倒角更易影响皮质骨的应力分布。对于B/2类骨质,从生物力学角度而言,在临床上设计和选择种植体时,种植体的颈部锥度应介于64°~73°之间,种植体的末端倒角应大于0.8mm。     

Association between first oral examination characteristics and dental treatment needs in privately insured children: A claims data analysis

BackgroundEarly childhood caries (ECC) remains the most common, preventable infectious disease among children in the United States. Screening is recommended after the eruption of the first tooth, but it is unclear how the age at first dental examination is associated with eventual restorative treatment needs. The authors of this study sought to determine how provider type and age at first dental examination are associated longitudinally with caries experience among children in the United States.MethodsDeidentified claims data were included for 706,636 privately insured children aged 0 through 6 years as part of the nationwide IBM Watson Health Market Scan (2012-2017). The authors used Kaplan-Meier survival analysis to describe the association between the age of first visit and restorative treatment needs.ResultsA total of 21% of this population required restorative treatment, and the average age at first dental examination was 3.6 years. A multivariable Cox proportional hazards model showed increased hazard for restorative treatment with age at first dental visit at 3 years (hazard ratio, 2.05; 95% CI, 1.97 to 2.13) and 4 years (hazard ratio, 3.99; 95% CI, 3.84 to 4.16).ConclusionThe high proportion of children requiring restorative treatment and late age at first dental screening show needed investments in educating general dentists, medical students, and pediatricians about oral health guidelines for pediatric patients.Practical ImplicationsCommunicating the importance of children establishing a dental home by age 1 year to parents and health care professionals may help reduce disease burden in children younger than 6 years.     

Is antibiotic prophylaxis to prevent infective endocarditis worthwhile?

Infective endocarditis (IE) is a rare condition which is associated with considerable morbidity and mortality. Almost 100 years ago, the links between endocarditis and procedures, particularly dental procedures, were postulated. Over 50 years ago the first guidelines recommending antibiotic prophylaxis (AP), with the aim of preventing IE developing after procedures, were proposed. However, there has only ever been circumstantial evidence in humans that AP prevents IE. The rarity of IE has made a randomised controlled clinical trial impractical to date. This article outlines the history of AP and reviews the evidence base for the use of AP to prevent IE.     

微创去腐技术治疗患者龋齿的临床效果评价

目的:分析微创去腐技术治疗患者龋齿的临床效果。方法:将98例龋齿患者分为观察组和对照组。观察组患者52例,采用微创去腐技术治疗龋齿;对照组患者46例,采用传统高速牙钻去腐治疗龋齿。结果:观察组患者的疼痛评分低于对照组,两组患者的单牙治疗时间、治疗后20个月时充填物完好率对比P>0.05,并发症对比P<0.05。结论:微创去腐技术治疗龋齿患者效果显著。     

Accuracy of the London Atlas,Haavikko’s Method and Cameriere’s European Formula of dental age estimation in Turkish children

Age estimation is a mandatory procedure when the chronological age is unknown or uncertain. Dental development is the preferred characteristic for estimating a child's age. There are many methods for dental age estimation, but their reliability can differ between populations. This study compared the accuracy of three of these methods—the London Atlas (LA), Haavikko's method (HM), and Cameriere's European formula (CF)—in Turkish children living in northwestern Turkey. Panoramic radiographs of 980 children from northwestern Turkey aged between 6.00 and 14.99 years were examined for the whole study group and separately for different ages and sexes by all three methods. Statistical differences between chronological age and dental age were tested using the paired sample t-test and the Wilcoxon signed-rank test. The LA, HM, and CF accuracies were determined based on the mean absolute error. Spearman's rank correlation coefficient showed that the correlation between chronological age and dental age for both sexes was linear for all methods. The LA overestimated the chronological age by 0.09 years, while HM and CF underestimated it by 0.49 and 0.11 years, respectively. The difference between dental age and chronological age was significant in all samples, for all methods, except for the LA in boys. When boys, girls, and the total sample were evaluated, values with the lowest mean absolute error were obtained by HM and were statistically significant in all three groups. Therefore, HM is more accurate than the LA and CF for dental age estimation in Turkish children living in northwestern Turkey.     

Provision of hepatitis B vaccination for primary care dental staff in Scotland

OBJECTIVES: All dental surgeons should be protected from hepatitis B virus (HBV) infection by immunisation, ideally administered and monitored via occupational health services (OHS). This study examined relevant OHS systems in place for dental primary care healthcare workers (DHCW) across all Health Board Areas (HBAs) in Scotland. It also explored the DHCWs' knowledge of, and access to, these systems in three HBAs. METHODS: Data from senior staff in all Scottish Health Boards and Primary Care Trusts were collected by self-completing questionnaires. Information from DHCWs was collected via telephone interviews with General Dental Practitioners (GDPs) and Community Dental Officers (CDOs) in each of Ayrshire and Arran, Highland and Lothian Health Boards. RESULTS: Thirteen of the 15 HBAs had robust HBV vaccination and monitoring systems. However, only 7/15 (47%) of these covered all DHCWs. Seven HBAs provided vaccination and monitoring for CDOs only, leaving GDPs to undertake these responsibilities for themselves. Of the 105 DHCWs approached, 82 gave an interview. These interviews highlighted major differences between HBAs in relation to access of DHCWs to OHS and indicated that CDOs had greater access than GDPs to OHS. Overall, 31% of DHCWs were not satisfied with the OHS available. CONCLUSION: In order to safeguard both staff and patients, significant further work is required to ensure that all DHCWs have access to appropriate OHS support for provision and monitoring of immunisation procedures and related functions such as management of sharps injuries.     

氟化物对牙齿的损害及其治疗

目的 了解氟对牙齿的损害及治疗方法与效果。方法 综合以往有关方面的主要研究结果进行论述。结果 摄入过量氟化物对牙齿产生了严重的损害，用现代方法可对着色型氟斑牙进行治疗，对缺损型氟斑牙可进行修复治疗。     

Stress distribution of different implant connections associated with multiple implant-supported prostheses

Abstract

In some clinical situations, the clinician may encounter previously installed implants that should be associated with other implants for a proper rehabilitation. The aim of this study was to evaluate the biomechanical behaviour of a multiple prosthesis joined by different implant connections using photoelasticity. Photoelastic models with a screwed fixed prosthesis supported by implants with different connection systems (Morse taper, external hexagon, internal hexagon, and Flexcone), and different combinations among them, were fabricated. Each assembly was placed in a circular polariscope, and axial and oblique (45°) loads of 100 N were applied on the occlusal surface of the crowns. The fringe patterns were photographed and the analysis was performed by counting the number of high-intensity fringes and also according to the stress distribution region where they appeared. Among implants of the same connection, the external connections obtained a greater number of high intensity fringes when compared to the internal connections. From the biomechanical point of view, the association between different types of connections obtained positive results.