Clinical application of CAD/CAM technology in 3D printed dental model used for removable splints fabrication in the treatment of traumatized anterior permanent teeth in children.

OBJECTIVES: To evaluate the effectiveness of computer-aided design (CAD)/computer-aided manufacturing (CAM) in designing and manufacturing 3D-printed dental models used to make thermoplastic removable splints for children with traumatized anterior permanent teeth. METHODS: A total of 28 patients with dental trauma (subluxation, extrusive luxation, and lateral luxation) were divided into experimental (14 patients) and control groups (14 patients). The experimental group was treated with the removable splint made using a new 3D printed dental model designed with CAD/CAM technology, while the control group received a wire-composite splint. Follow-up was performed at week 2 and 1, 2, 3, 6, 12, 18, and 24 months post-treatment, and every year after that. The traumatized teeth were evaluated according to clinical symptoms, tooth color, mobility, position, percussion pain, abnormal percussion sounds indicating ankylosis or other pathosis, swelling, fistula of gums, vitality test, and radiographic examination. RESULTS: No significant difference was found in gender and age between the two groups. The experimental group had 23 traumatic teeth, and the control group had 24 traumatic teeth. Traumatic teeth in the two groups most commonly involved open apex teeth (>90 %). The average follow-up time for the experimental and control group was 35.47±14.23 and 32.92±14.79 months (P > 0.05), respectively. The pulp survival rate and periodontal healing rate in the experimental group (86.96 %, 91.30 %) were higher compared to the control group (62.50 %, 75.00 %) (all P > 0.05). CONCLUSION: A removable splint made by a 3D printed dental model designed with CAD/CAM technology achieved an equivalent treatment effect to a wire-composite splint. CLINICAL SIGNIFICANCE: A 3D-printed dental model designed with CAD/CAM technology can be used to fabricate removable splints, which in turn can decrease iatrogenic injuries frequently encountered during the traditional model production process. For example, taking the impression directly from the patient's mouth can cause displacement of a traumatized tooth or even exfoliation. The removable splints produced using a new 3D-printed dental model can meet clinical treatment requirements of traumatized teeth, especially for children and adolescents with occlusal trauma in mixed dentition.

Risk Factors for Infection of Sutured Maxillofacial Soft Tissue Injuries.

Background: Maxillofacial soft tissue injuries (STIs) are common and frequent in emergency departments. The aim of this study was to analyze factors causing infection of maxillofacial STIs. Patients and Methods: Patients with maxillofacial STIs who received sutures and had complete medical records were evaluated. Gender, age, American Society of Anesthesiologists (ASA) grade, diabetes mellitus, wound age, wound length, wound contamination, wound type, and sites were analyzed using univariable analysis and binary logistic regression. Results: There were 3,276 cases included. In the univariable analysis, there was no significant difference in the infection rate between genders or between the wound age groups. In binary logistic regression, age, wound length, wound type, and physician level were risk factors for infection: age of 18-44 years (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.7-2.9), 44-64 years (OR, 3.1; 95% CI, 2.3-4.3), and ≥65 years (OR, 2.6; 95% CI, 1.7-4.1); wound length of 4-8 cm (OR, 1.7; 95% CI, 1.3-2.2) and >8 cm (OR, 2.4; 95% CI, 1.1-5.1); intra-oral wounds (OR, 1.6; 95% CI, 1.1-2.4) and communicating wounds (OR, 3.2; 95% CI, 2.3-4.4); junior specialists (OR, 1.6; 95% CI, 1.2-2.2); and lip (OR, 3.7; 95% CI, 1.1-12.0) and cheek (OR, 4.7; 95% CI, 2.3-17.1) sites. Wound contamination, ASA grade, and diabetes mellitus were not significantly different from wound infection in binary regression analysis. Conclusions: Age (>18 years old), wound length (>4 cm), intra-oral wounds, communicating wounds, suturing by junior surgeons, and lip or cheek injuries may be risk factors for maxillofacial STI infection. Even if the penetrating wound age exceeds 24 hours, it is meaningful to suture if there is no serious infection. For wounds at high risk of infection, further measures should be considered to reduce the possibility of infection, such as improving the surgical training of junior surgeons and improving the patient's wound care.

A Retrospective Study of Oral Emergency Services During COVID-19.

OBJECTIVES: This study was performed to examine changes in the number of patient visits and types of oral services in an oral emergency department from the beginning to the control stage of the coronavirus disease 2019 (COVID-19) outbreak in Beijing. METHODS: The numbers of daily oral emergency visits from January 20 to March 24, 2020, at a dental university hospital in Beijing and daily newly confirmed COVID-19 cases in Beijing during the same period were collected and analysed. All oral emergency patient information (including sex, age, and oral diagnosis) was also collected and analysed. Patients with incomplete medical data were excluded. RESULTS: In total, 12,416 patients were included in this study. The number of daily emergency visits was negatively correlated with the number of newly confirmed local COVID-19 cases in Beijing (P < .001). The number of daily emergency visits during the COVID-19 stable period in Beijing was greater than that during the outbreak period (P < .001). Compared to those in the COVID-19 outbreak period, the percentages of females, children and adolescents, patients with acute toothache, and patients with nonurgent cases were higher in the stable period, and the numbers of patients with toothache, trauma, infection, and nonemergency conditions increased in the COVID-19 stable period (P < .001). CONCLUSIONS: COVID-19 significantly influenced the number of patient visits and the percentages of patients with oral emergency situations in the oral emergency department. There were obvious differences in treatment seeking for oral emergencies between the COVID-19 periods in Beijing. There was an inverse relationship between daily oral emergency visits and daily confirmed COVID-19 cases in Beijing.

Epidemiology of maxillofacial soft tissue injuries in an oral emergency department in Beijing: A two-year retrospective study.

BACKGROUND/AIMS: Maxillofacial soft tissue injuries (STIs) may differ in epidemiological characteristics from other maxillofacial injuries. The aim of this study was to investigate the epidemiology of maxillofacial STIs in a public oral emergency department in Beijing, China, from 2017 to 2018. MATERIAL AND METHODS: In this retrospective study, 5949 patients with maxillofacial STIs and complete medical records were evaluated. Gender, age, etiology, visit date and time, interval between accident and treatment, anatomic injury site, treatment modality, and the number of associated maxillofacial bone fractures or tooth injuries were analyzed. RESULT: There were 3831 males and 2118 females (ratio 1.81:1). Patients younger than 10 years were the most frequently seen group (44.2%). Among adults, 20- to 29-years-old (16.2%) was the most prominent age group. The month of May (11.8%) had the highest incidence of maxillofacial STIs, and February (4.5%) had the lowest incidence. The average number of daily visits was significantly higher on holidays than on workdays. Of the 5949 patients, 45.9% attended at night, 2021 patients had dental trauma, and 31 had jaw fractures. The lips were the most common site of STIs, followed by the chin and gingiva. Lip and gingival STIs were more common in the 0- to 10-years-old group. Chin STIs were more common in the 20- to 39-years-old group. A fall was the leading cause of injury, especially in patients younger than 10 years and older than 70 years. Approximately 56.7% of the falls resulted in injuries to the lower one-third of the face. Sports injuries were more common among 10- to 29-years-old individuals. CONCLUSION: STIs of the maxillofacial region were most likely to occur at night, in May and during holidays. Males, children younger than 10 years and 20- to 29-years-old adults were high-risk populations. Most maxillofacial STIs involved the lips, and one-third of the patients had dental trauma.

Iodine-125 Interstitial Brachytherapy for Pediatric Desmoid-Type Fibromatosis of the Head and Neck: A Case Report.

Desmoid-type fibromatosis (DF) is a locally aggressive benign soft tissue tumor. It is rarely observed in the head and neck region and is particularly uncommon in the parotid gland. This report describes the case of a 32-month-old girl with DF of the head and neck. The tumor was resected with gross residual tumors. Recurrence occurred 3 months later and then the patient was treated with iodine-125 interstitial brachytherapy. The tumor was completely absent 6 months after brachytherapy. No recurrence was found 60 months after brachytherapy during follow-up. No severe toxicities or growth abnormalities were observed. Very-low-dose rate brachytherapy as the sole modality could be a reasonable alternative for the treatment of inoperable DF of the head and neck, which avoids the risk of cosmetic deformity caused by surgery, especially in pediatric patients. In addition, long-term follow-up is recommended.