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@#Digital intraoral scanning is a hot topic in the field of oral digital technology. In recent years, digital intraoral scanning has gradually become the mainstream technology in orthodontics, prosthodontics, and implant dentistry. The precision of digital intraoral scanning and the accuracy and stitching of data collection are the keys to the success of the impression. However, the operators are less familiar with the intraoral scanning characteristics, imaging processing, operator scanning method, oral tissue specificity of the scanned object, and restoration design. Thus far, no unified standard and consensus on digital intraoral scanning technology has been achieved at home or abroad. To deal with the problems encountered in oral scanning and improve the quality of digital scanning, we collected common expert opinions and sought to expound the causes of scanning errors and countermeasures by summarizing the existing evidence. We also describe the scanning strategies under different oral impression requirements. The expert consensus is that due to various factors affecting the accuracy of digital intraoral scanning and the reproducibility of scanned images, adopting the correct scanning trajectory can shorten clinical operation time and improve scanning accuracy. The scanning trajectories mainly include the E-shaped, segmented, and S-shaped methods. When performing fixed denture restoration, it is recommended to first scan the abutment and adjacent teeth. When performing fixed denture restoration, it is recommended to scan the abutment and adjacent teeth first. Then the cavity in the abutment area is excavated. Lastly, the cavity gap was scanned after completing the abutment preparation. This method not only meets clinical needs but also achieves the most reliable accuracy. When performing full denture restoration in edentulous jaws, setting markers on the mucosal tissue at the bottom of the alveolar ridge, simultaneously capturing images of the vestibular area, using different types of scanning paths such as Z-shaped, S-shaped, buccal-palatal and palatal-buccal pathways, segmented scanning of dental arches, and other strategies can reduce scanning errors and improve image stitching and overlap. For implant restoration, when a single crown restoration is supported by implants and a small span upper structure restoration, it is recommended to first pre-scan the required dental arch. Then the cavity in the abutment area is excavated. Lastly, scanning the cavity gap after installing the implant scanning rod. When repairing a bone level implant crown, an improved indirect scanning method can be used. The scanning process includes three steps: First, the temporary restoration, adjacent teeth, and gingival tissue in the mouth are scanned; second, the entire dental arch is scanned after installing a standard scanning rod on the implant; and third, the temporary restoration outside the mouth is scanned to obtain the three-dimensional shape of the gingival contour of the implant neck, thereby increasing the stability of soft tissue scanning around the implant and improving scanning restoration. For dental implant fixed bridge repair with missing teeth, the mobility of the mucosa increases the difficulty of scanning, making it difficult for scanners to distinguish scanning rods of the same shape and size, which can easily cause image stacking errors. Higher accuracy of digital implant impressions can be achieved by changing the geometric shape of the scanning rods to change the optical curvature radius. The consensus confirms that as the range of scanned dental arches and the number of data concatenations increases, the scanning accuracy decreases accordingly, especially when performing full mouth implant restoration impressions. The difficulty of image stitching processing can easily be increased by the presence of unstable and uneven mucosal morphology inside the mouth and the lack of relatively obvious and fixed reference objects, which results in insufficient accuracy. When designing restorations of this type, it is advisable to carefully choose digital intraoral scanning methods to obtain model data. It is not recommended to use digital impressions when there are more than five missing teeth.
RESUMO
Objective @#To compare the disinfection effect of 3% (v/v) hydrogen peroxide and 500 mg/L chlorine-containing disinfectants in the independent waterway of a periodontal ultrasonic scaler to provide a reference for clinical waterway disinfection management in stomatology departments.@*Methods @#The 18 ultrasonic scalers were randomly divided into 3 groups of 6 units: the control group, experimental group 1 (3% hydrogen peroxide disinfectant group), and experimental group 2 (500 mg/L chlorine-containing disinfectant group). The replaceable parts of the independent waterway pipes of the 3 groups of ultrasonic scalers were replaced, and the water supply was supplied with sterile distilled water (DW). In the control group, special treatment was not applied to the nonreplaceable pipe part. In experimental group 1, the 3% hydrogen peroxide was used to disinfect nonreplaceable pipelines. In experimental group 2, the nonreplaceable part was disinfected with the 500 mg/L chlorine-containing disinfectant. The water sample was taken from the outlet of the scaler working part in the three groups for monitoring before disinfection, immediately after disinfection and 10 consecutive days after disinfection. Bacteria in the water samples were cultured for the colony counts. Then, the bacterial culture data were compared between groups. The qualified criterion of the water sample was that the number of bacterial colonies was less than or equal to 100 CFU/mL. After disinfection, a bacterial species mass spectrometry identification analysis was carried out when the number of bacterial colonies in each group exceeded the standard for the first time. Biofilms from the inner wall of the tube in the three groups were observed under an electron microscope on the 10th day after disinfection.@*Results @#There were no significant differences between the three groups before disinfection (F = 2.549, P = 0.111). The number of bacterial colonies in the spout of 6 scalers in the control group all exceeded the standard, and three kinds of bacteria were cultured: Sphingomonas melonis, Herbaspirillum huttiense, and Ralstonia pickettii. Compared with those in the control group, the number of bacterial colonies in experimental group 1 decreased significantly for 1-2 days after disinfection (P<0.05) and reached the standard. On the 3rd day after disinfection, the number of bacterial colonies of group 1 increased rapidly and exceeded the standard, and three kinds of bacteria were cultured: Sphingomonas, Herbaspirillum huttiense, and Ralstonia pickettii. For experimental group 2, the number of bacterial colonies decreased significantly compared to the control group on Days 1 to 6 after disinfection, but the number of bacterial colonies increased slightly from the 7th day after disinfection and exceeded the standard. Two kinds of bacteria were cultured: Herbaspirillum huttiense and Ralstonia pickettii. The average number of bacterial colonies 10-day after disinfection in experimental group 2 was lower than that in experimental group 1(P<0.001). Under an electron microscope, the biofilm thickness of the two experimental groups was significantly lower than that of the control group. @* Conclusion @# There is water pollution in the independent waterway of a periodontal ultrasound scaler. Three percent hydrogen peroxide and 500 mg/L chlorine disinfectant both have effective disinfection effects on the outlet water of scalers, and the effect of 500 mg/L chlorine disinfectant is better than that of 3% hydrogen peroxide. The use of 3% hydrogen peroxide to disinfect periodontal ultrasound scaler-independent waterways is recommended for disinfection every other day, and disinfection once a week is recommended for the use of 500 mg/L chlorine disinfectant.
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@#Since an epidemic occur of Corona Virus Disease 2019(COVID-19) in December, 2019, all the dental healthcare service providers in our country have been greatly impacted. The strategy of managing the dental clinics is quite different from that of the medical healthcare clinics, and the key point of the administration of those dental healthcare providers is to focus on the management of outpatient care because they only supply just a little bit of inpatient care service but quite an large amount of outpatient care service. So we think the next step is to make plausible and effective scenarios to protect our dental healthcare staff and patients against corona virus infection during the treatments procedures after the reopening all of our dental clinics. To overcome this harsh condition, the infection prevention and control strategies adopted by the Stomatological Hospital, Southern Medical University were designed to be flexible and could be adjusted promptly according to the national and local governmental orders and latest guidelines released by the Centers for Disease Control and Prevention. All these prevention procedures and protocols were customized to fit our own situation and have been updated for several times based on the latest global pandemic reports. After going through the hardest time in the past four months, it’s considered that our COVID-19 prevention rules have been proved to be efficient and work well. Further more, it has made massive progress for the hospital in improving the capability of dealing with this state of emergency, especially by previewing and triaging patients strictly to cut off the possible coronavirus spreading from the original step, enhancing the standard precautions and those specific protocols made for minimizing the droplets, aerosol and contact transmission of COVID-19 indoors. Besides, a daily supervision system was set up as a routine job and a team of qualified infection prevention specialists were assigned to check and report every incorrect details during the whole procedure of dental practice. Meanwhile, the safety and well-being of the public and our medical workers could be also guaranteed through following those detailed prevention scenarios.
RESUMO
Objective@#This study aims to explore the effect of practice on the triage and acuity scale in the emergency department of Stomatological Hospital. @*Methods @#150 emergency patients admitted to the emergency department from April 2016 to July 2016 were randomly selected as the control group before the implementation of graded district diagnosis and treatment, and 150 emergency patients admitted from August 2016 to November 2016 were selected as the observation group after the implementation of graded diagnosis and treatment. The control group was treated with the traditional nursing treatment mode, and the observation group adopted the triage and acuity scale mode. The efficiency of treatment for the patients and the degree of satisfaction of the patients in terms of the nursing work was compared between the two groups (waiting time, checkup time, start treatment time). @*Results@#A comparison of the patients in the observation group and control group showed that the waiting time (min)(25.63 ± 8.75 vs. 35.57 ± 10.60, t = -8.52, P < 0.001), the time of accepting examination (min)(24.80 ± 7.90 vs. 39.23 ± 12.42, t = -12.01, P < 0.001) and the starting time of treatment （min）(28.67 ± 9.37 vs. 40.47 ± 10.86, t = -10.08, P < 0.001) were significantly lower in the observation group than the control group (P < 0.05). The degree of satisfaction with the nursing work for the patients in the observation group (96.67%) was higher than that of the control group (85.33%), and this difference was statistically significant (χ2=17.647, P=0.001). @*Conclusion@#The application of a triage and acuity scale in the diagnosis and treatment of stomatological emergency patients according to the severity and urgency of disease can ensure the priority of treatment in critically ill patients, the safe and efficient performance of emergency work, and improvements to the efficiency and quality of emergency medical services.