Aesthetic replacement of an anterior tooth using the natural tooth as a pontic; an innovative technique

This article presents a novel technique for replacing an anterior tooth. A new modification to the clinical technique of direct fabrication of a resin-bonded bridge was employed, in which the patient’s natural tooth was used as a pontic. Treatment with this modification led to overall improved aesthetics and reduced treatment cost. The natural tooth pontic was stabilized in the extraction socket with a resin-wire splint as a provisional restoration to maintain the gingival architecture while the permanent bridge was being constructed.     

Aesthetic discourses in early childhood settings: Dewey,Steiner, and Vygotsky

Early childhood, when young children are already capable of undergoing aesthetic experience, must be the starting point for aesthetic education. Despite increasing attention to the significant values of the arts in early childhood classrooms, no theoretical framework to support aesthetic education has been established. This article introduces the theories of John Dewey, Rudolf Steiner and Lev Vygotsky, whose ideas and thoughts have many important implications for the arts and aesthetic education for young children. These scholars' historical backgrounds and theories on human learning, the arts and aesthetics have been explored to support the practical dimension of aesthetic education at the early childhood level.     

Comparative analysis of transmittance for different types of commercially available zirconia and lithium disilicate materials

PURPOSE

Translucency and colour stability are two most important aspects for an aesthetic dental restoration. Glass ceramic restorations are popular amongst clinicians because of their superior aesthetic properties. In the last decade, zirconia has generated tremendous interest due to its favorable mechanical and biological properties. However, zirconia lacks the translucency that lithium disilicate materials possess and therefore has limitations in its use, especially in esthetically demanding situations. There has been a great thrust in research towards developing translucent zirconia materials for dental restorations. The objective of the study was to evaluate and compare the transmittance of a translucent variant of zirconia to lithium disilicate.

MATERIALS AND METHODS

Two commercially available zirconia materials (conventional and high translucency) and 2 lithium disilicate materials (conventional and high translucency) with standardized dimensions were fabricated. Transmittance values were measured for all samples followed by a microstructural analysis using a finite element scanning electron microscope. One way analysis of variance combined with a Tukey-post hoc test was used to analyze the data obtained (P=.05).

RESULTS

High translucency lithium disilicate showed highest transmittance of all materials studied, followed by conventional lithium disilicate, high translucency zirconia and conventional zirconia. The difference between all groups of materials was statistically significant. The transmittance of the different materials correlated to their microstructure analysis.

CONCLUSION

Despite manufacturers'' efforts to make zirconia significantly more translucent, the transmittance values of these materials still do not match conventional lithium disilicate. More research is required on zirconia towards making the material more translucent for its potential use as esthetic monolithic restoration.     

Oral disorders associated with the experience of verbal bullying among Brazilian school-aged children: A case-control study

BackgroundDental features have been considered a potential target of verbal bullying (VB) among school-aged children. The authors conducted a study to investigate the association between the presence of oral disorders and the occurrence of VB among 8- through 10-year-old school-aged children.MethodsThe study included 445 school-aged children 8 through 10 years old. VB was verified by a specific validated question from the Child Perceptions Questionnaire 8-10 index. Oral disorders such as untreated caries, fluorosis, clinical consequences of untreated caries, and malocclusion were evaluated. The Pearson χ² test and bivariate and multivariate conditional logistic regression analyses were used for statistical analysis.ResultsA total of 390 school-aged children completed the study. The results of the multivariate logistic regression model showed that a severe malocclusion (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.03 to 5.10), a greater maxillary misalignment (OR, 2.23; 95% CI, 1.05 to 4.73), and the presence of a tooth with pulp exposure (OR, 2.93; 95% CI, 1.58 to 5.45) were significantly associated with the occurrence of VB.ConclusionChildren aged 8 through 10 years with a severe malocclusion, larger maxillary misalignment, or the presence of pulp exposure had increased odds of experiencing VB compared with children without those oral health conditions.Practical ImplicationsOnce oral disorders involved in VB are identified, appropriate approaches should be used to address this issue. With this course of action, oral health care professionals may use the treatment and preventive care to eliminate potential factors for peer aggression.     

妇科恶性肿瘤患者经腹手术后早进食的研究

目的 探讨妇科恶性肿瘤患者经腹手术后6h即给予半流质饮食的安全性和临床意义。方法 以60例经腹手术的妇科恶性肿瘤患者为研究对象，随机分成实验组30例和对照组30例，实验组术后6h即给予半流质饮食，而对照组则采用传统方法术后6h进流食，在肛门排气后方改为半流食，比较2组患者术后恶心、呕吐发生情况，肠蠕动恢复时间、肛门排气时间、固体饮食恢复时间、体质量差、血糖、尿酮体、血清前白蛋白变化隋况、伤口愈合情况及肠梗阻发生情况。结果 2组患者无一例发生窒息或吸人性肺炎；无一例出现肠梗阻而需胃肠减压；实验组患者术后6h进半流质饮食后恶心的发生率明显高于对照组（χ^2=5．51，P〈0．05），固体饮食恢复时间较对照组提早近18h（t=4．11，P〈0．05），第7天血清前白蛋白值显著高于对照组（t=3．60，P〈0．05），而在呕吐、尿酮体、肠蠕动恢复时间、排气时间、手术前后体质量差和术后第2天血清前白蛋白值等方面差异无统计学意义（P〉0．05）。结论 妇科恶性肿瘤患者经腹手术后6h给予半流质饮食是安全的，而且有助于提早恢复固体饮食，改善患者营养状况，促进术后康复。     

医学美学在口腔修复中的应用

目的：探讨分析医学美学应用于口腔修复治疗的临床疗效及患者的满意程度,为临床口腔修复选择最佳的治疗方案提供依据。方法回顾性分析2008年1月-2013年1月进行前牙大面积牙体缺损治疗的400例患者（400颗牙齿）的临床资料,按照随机的方法将其分为实验组和对照组,每组200例,实验组根据患者的年龄、性别、肤色等个人条件差异,因人而异的制定修复方案,充分是将医学美学应用于口腔修复科前牙大面积牙体缺损病人的治疗;对照组患者仅给予常规的恢复功能的治疗,比较两组患者的临床疗效、远期治疗效果及患者的满意程度,比较两组间的差异。结果实验组的根折、牙龈炎症等发生率明显小于对照组,具有统计学意义,P〈0．05。实验组患者的满意程度达100%远高于对照组,具有统计学意义, P〈0.05。结论口腔修复前牙牙体缺损应充分考虑患者的年龄、性别、肤色等个体差异,制作因人而异的修复体,将医学美学充分应用于修复体的制备,修复体能呈现自然和谐之美,提高患者的满意度,减少医患纠纷的发生,且具有良好的远期效果,优于传统的仅恢复功能的修复操作,值得在临床上广泛应用。     

Stability of nasal symmetry following primary cleft lip and nasal repair: five years of follow-up

Despite advances in cleft lip treatment, various levels of residual deformity remain after primary repair of cleft lip and palate. The aim of the current study was to compare the stability of short- and long-term postoperative nasal symmetry. This retrospective study included 100 consecutive non-syndromic patients with unilateral complete cleft lip who underwent primary cleft lip repair with follow-up of 5 years. Measurements taken from basal and frontal standard photograph views, obtained preoperatively (T1) and immediately (T2), 1 year (T3), and 5 years postoperative (T4), were analysed. Paired and independent t-tests were applied to assess the significance of differences and relationships, while the inter-class correlation coefficient was used to assess reliability; P < 0.05 was considered significant. The male to female ratio was 1:1; mean age at the time of surgery was 0.43 ± 0.25 years. All patients showed significant improvements following unilateral complete cleft lip repair. All variables measured at T3 revealed a significant relapse when compared to T2, except alar base position, which showed a constant mean across all postoperative follow-ups. Late relapse (T3–T4) was not significant for alar collapse, alar base position, or columellar angle (all P > 0.05). On the other hand, columellar height (P = 0.003), and nostril height (P = 0.038) and width (P = 0.007) showed significant improvements during the late relapse period. In conclusion, the majority of the relapse and changes following the nasal cleft repair occurred within the first postoperative year. However, nasal asymmetries tended to remain stable or reduced during the first 5 postoperative years.     

[Translated article] Artificial intelligence in dermatology: A threat or an opportunity?

The worldwide explosion of interest in artificial intelligence (AI) has created a before-and-after moment in our lives by generating great improvements in such sectors as the automotive and food production industries. AI has even been called the fourth industrial revolution. Machine learning through AI is helping to improve professional processes and promises to transform the health care sector as we know it in various ways: 1) through applications able to promote health in the general population by providing high-quality information and offering advice for different segments of the population based on prediction models; 2) by developing prediction models based on anonymized clinical data, for preventive purposes in primary care; 3) by analyzing images to provide additional decision-making support for health care providers, for improving specialist care at the secondary level; and 4) through robotics applied to processes that promote health and well-being. However, the medical profession harbors doubts about whether this revolution is a threat or an opportunity owing to a lack of understanding of AI technology and the methods used to validate its applications. This article outlines basic aspects of AI as it is applied in dermatology and reviews the main advances achieved in the last 5 years.     

VIP-CT瓣在美学区即刻种植即刻修复中的临床应用

目的 探讨采用血管化骨膜-结缔组织夹层(VIP-CT)瓣在美学区即刻种植即刻修复中的临床效果。方法 选择合适的上颌前牙区单牙微创拔牙后即刻种植即刻修复患者共30例,均采用VIP-CT瓣关闭拔牙创口,制作临时冠诱导牙龈成形,且术后3个月左右行最终修复。修复完成后当天、6个月及12个月,以粉红美学指数(PES)对种植体周围软组织进行美学评价;同时以视觉模拟评分法(VAS)对患者进行主观满意度调查。结果 在追踪评估期间内,2例患者未按时复诊退出评估,剩余28例患者各时期的PES评分分别为(12.23±1.56)、(11.47±1.42)和(11.35±1.21)分,术后创面均完全封闭,唇侧丰满度较好,种植体周围软组织形态恢复正常,患者满意度较高。结论 在美学区即刻种植即刻修复中采用VIP-CT瓣可以获得良好的美学修复效果。     

种植义齿修复美学区单个牙齿的软组织美学评价

目的评价牙种植体支持的单冠修复牙列缺损的软组织美学效果及患者的满意度。方法观察16例患者21颗单个牙种植体支持的冠修复体周围的软组织状况并与邻牙或对侧同名牙相比较,用PES计分标准进行计分,并对患者的满意度进行调查。结果 PES得分最高14分,最低10分,平均得分12.35±1.05,其中,软组织的质地平均得分最高,为1.97±0.14,软组织水平得分最低,为1.49±0.42,94%患者对修复结果表示满意,6%患者表示基本满意。PES评分结果与患者满意度调查结果呈正相关关系（相关系数r=0.809）,结果具有统计学意义（P〈0.001）。结论美学区种植修复能够满足患者对美观的要求,PES计分标准可以客观地对种植修复的软组织美学效果进行评价。