直接法纤维增强复合桥在牙周炎病例中的应用

目的:评价前牙区直接法纤维增强复合桥(FRC bridge)修复单颗切牙缺失伴邻牙松动的牙周炎病例临床应用效果。方法:采用直接法FRC bridge连接所有同颌前牙修复单颗切牙缺失伴邻牙松动的牙周炎病例12例,以弹性义齿修复14例同类病例作为对照,修复后1、6及18个月随访,对临床修复效果以及牙周状况进行评价。结果:修复后1、6或18个月,直接法FRC bridge修复组和对照组解剖外形和边缘适应性均优于弹性义齿修复组(P<0.05);牙周袋探诊深度(PD)及探诊出血指数(BOP)随着观察时间延长而逐渐减小;修复前后PD、BOP、牙齿松动度(TM)差异均存在显著性(P<0.05)。结论:直接法FRC bridge修复单颗切牙缺失伴邻牙松动的牙周炎病例,能达到良好的临床美学修复效果,并可改善邻牙牙周状况。     

应用电化学测菌法检测变形链球菌的初步探讨

目的:探讨应用电化学测菌法检测变形链球菌的可行性。方法:利用本课题组前期建立的电化学测菌法检测变形链球菌,记录检测参数,并将电化学测菌法的检测结果与细菌培养结果进行比较。结果:①微流芯片样本通道内层流形成时间为(3.17±0.16)min,从进样到获得稳定电阻抗数据的时间为(10.20±0.16)min。②当变形链球菌浓度为104～109cells/mL时,细菌浓度C的对数与系统阻抗值Z呈良好的线性关系(R2=0.98)。③与细菌培养的检测结果相比,电化学测菌法获得的细菌数多,差异有统计学意义(P<0.05)。④变形链球菌浓度为105cells/mL时,电化学测菌法检测值与细菌培养法检测值之间的线性函数关系式为:y=0.94x+0.32E4(R2=0.95),两种方法的检测值高度正相关(P=0.001<0.01)。结论:电化学测菌法能为变形链球菌的快速检测提供新的思路。     

弧形牵张成骨重建人体下颌骨颏部节段性缺损的三维有限元研究

目的:建立下颌骨颏部节段性缺损弧形牵张成骨的三维有限元模型,研究弧形牵张成骨重建下颌骨颏部节断性缺损过程中,不断变化方向的牵张力对新骨组织形成的影响。方法:建立颏部节段性缺损的三维有限元模型,并把简化后的弧形牵张器有限元模型置入截断后的下颌骨,模拟弧形牵张成骨,并测量在弧形牵张成骨过程中下颌骨整体位移及其von Mises应力分布。结果:在未考虑唇颊侧软组织作用的前提下,弧形牵张成骨形成的新骨向舌侧生长,重建的下颌骨弧度较原下颌骨弧度变小。von Mises应力主要集中于牵张器在下颌骨的固位处。结论:在弧形牵张成骨重建下颌骨缺损过程中,牵张力本身就促使新骨组织向舌侧生长,从而使重建的下颌骨弧度较正常时小。此项研究为临床上如何克服弧形牵张成骨所形成的下颌骨弧度较小的不足,提供了一定的理论依据。     

冠外固位体义齿基牙牙周组织应力分布的三维有限元分析

目的研究下颌第一磨牙缺失、第二磨牙近中倾斜30°或45°时,用栓道附着体义齿或套筒冠义齿2种冠外固位体(extra-coronal retainer,ECR)义齿修复的基牙牙周组织应力分布。方法采用CT扫描技术和Mimics、Freeform、ANSYS软件,建立下颌第一磨牙缺失、第二磨牙近中倾斜30°或45°及ECR义齿修复后的三维有限元模型,模拟加载并计算分析基牙牙周组织应力的分布情况。结果下颌第二磨牙近中倾斜30°、45°模型,修复前第二前磨牙Von Mises应力分别是2.80 MPa、3.47 MPa,栓道附着体义齿修复后分别是19.26 MPa、25.18 MPa,套筒冠义齿修复后分别是19.47 MPa、24.48 MPa,ECR义齿修复后下颌第二前磨牙牙周组织应力明显增大;修复前第二磨牙Von Mises应力分别是20.45 MPa、20.50 MPa,栓道附着体义齿修复后分别是15.02 MPa、11.84 MPa,套筒冠义齿修复后分别是18.04 MPa、12.18 MPa,ECR义齿修复后下颌第二磨牙牙周组织应力明显减小。结论栓道附着体义齿和套筒冠义齿均能改善倾斜基牙牙周组织的应力分布,当下颌第二磨牙近中倾斜角度过大或下颌第二前磨牙牙周状况欠佳时,应该考虑增加近中端基牙数目。     

无牙下颌固定种植义齿带末端悬臂的应力分析

目的:比较不同悬臂设计下颌种植支持全口义齿的骨及种植体应力分布特点,为临床种植修复提供生物力学分析依据。方法:建立3组下颌6个种植支持全口义齿的三维有限元模型,悬臂分别为3、6、9 mm。在悬臂末端垂直加载100 N的力。结果:种植全口义齿悬臂末端垂直加载时,末端种植体骨应力集中,易发生松动失败;末端种植体及中间种植体颈部应力集中,易发生植入体与基桩连接失败;连梁应力集中在与末端种植体连接处,此处易发生折断。悬臂长度增加骨应力、种植体应力及连梁应力明显增加。结论:悬臂越短越有利于力的均匀分布。6个种植体支持短悬臂修复设计较符合生物力学分布原理。     

人工楔状缺损牙颈部硬组织应力分布的有限元接触分析

目的:分析人工楔状缺损患牙颈部硬组织的应力分布。方法:在下颌前磨牙沿釉牙本质界建立三角形缺损,设计楔状缺损模型,模拟紧咬和咀嚼运动中牙的受力情况,对下颌前磨牙颈部硬组织进行非线性接触分析。结果:模拟紧咬和咀嚼运动中牙的受力情况,釉牙本质界缺损的下颌前磨牙缺损区尖端均存在明显的拉应力集中,应力集中区沿釉牙本质界向方延伸,其中尤以侧方运动工作侧一点接触载荷下的应力集中最为明显,应力值最大。结论:釉牙本质界破坏改变了缺损区牙颈部的应力分布。     

Identifying key strategies to promote positive mental health of young people in the state of Kerala,India

In the context of the shortage of resources to close the alarming treatment gap of mental disorders, interventions to promote mental health have become a priority of policy makers in low and middle-income countries (LMICs) like India. In this paper, we document an attempt to identify key strategies to promote positive mental health of young people in the state of Kerala, India. Our results could be used for integrating the concept of positive mental health into public health interventions in the state. Focus group discussions among different groups of stakeholders were used to gather information about their attitudes, perceptions or opinions followed by a Delphi exercise involving policy-makers and experts to come to a consensus approach. In-depth exploration of possible policy options was made possible with the participation of experts in related fields using qualitative techniques. Findings from this qualitative study suggest that a life cycle approach may be helpful in identifying areas for possible effective policy interventions for promoting mental health in young people. Improving education and employment opportunities at a macro-level will have a positive impact on mental health. In conclusion, the promotion of mental health among young people should find a prominent place in health policies at national level.     

Comparison of spherical and realistically shaped boundary element head models for transcranial magnetic stimulation navigation

Objective

MRI-guided real-time transcranial magnetic stimulation (TMS) navigators that apply electromagnetic modeling have improved the utility of TMS. However, their accuracy and speed depends on the assumed volume conductor geometry. Spherical models found in present navigators are computationally fast but may be inaccurate in some areas. Realistically shaped boundary-element models (BEMs) could increase accuracy at a moderate computational cost, but it is unknown which model features have the largest influence on accuracy. Thus, we compared different types of spherical models and BEMs.

Methods

Globally and locally fitted spherical models and different BEMs with either one or three compartments and with different skull-to-brain conductivity ratios (1/1–1/80) were compared against a reference BEM.

Results

The one-compartment BEM at inner skull surface was almost as accurate as the reference BEM. Skull/brain conductivity ratio in the range 1/10–1/80 had only a minor influence. BEMs were superior to spherical models especially in frontal and temporal areas (up to 20 mm localization and 40% intensity improvement); in motor cortex all models provided similar results.

Conclusions

One-compartment BEMs offer a good balance between accuracy and computational cost.

Significance

Realistically shaped BEMs may increase TMS navigation accuracy in several brain areas, such as in prefrontal regions often targeted in clinical applications.