Clinical evaluation of autonomous robotic-assisted full-arch implant surgery: A 1-year prospective clinical study.

OBJECTIVES: This prospective clinical study aimed to evaluate the accuracy and 1-year clinical follow-up performance of dental implant placement with an autonomous dental implant robot (ADIR) system in full-arch implant surgery. MATERIALS AND METHODS: Twelve patients with edentulous arches or final dentition received 102 implants using the ADIR system. Global platform deviation, global apex deviation, and global angular deviation between the planned and actual implants were calculated after surgery. Data were statistically analyzed for factors including jaws, implant positions, patient sequences, implant systems, and implant length. Surgery duration was recorded. Patients were followed for 3 months and 1 year after surgery. Periodontal parameters, buccal bone thickness (BBT), and facial vertical bone wall peak (IP-FC) were recorded. RESULTS: Among the 102 implants, the mean (SD) global platform deviation, global apex deviation, and global angular deviation were 0.53 (0.19) mm, 0.58 (0.17) mm, and 1.83 (0.82)°, respectively. The deviation differences between the mandible and maxilla did not show statistical significance (p > .05). No statistically significant differences were found for the jaws, implant positions, patient sequences, implant systems, and implant length to the deviations (p > .05). The periodontal parameters, the BBT, and IP-FC remained stable during 1-year follow-up. CONCLUSION: The ADIR system showed excellent positional accuracy. The 1-year follow-up after full-arch implant surgery indicated that the ADIR system could achieve promising clinical performance. Additional clinical evidence is requisite to furnish guidelines for the implementation of the ADIR system in full-arch implant surgery.

Correlation between intraosseous thermal change and drilling impulse data during osteotomy within autonomous dental implant robotic system: An in vitro study.

OBJECTIVES: This study aims at examining the correlation of intraosseous temperature change with drilling impulse data during osteotomy and establishing real-time temperature prediction models. MATERIALS AND METHODS: A combination of in vitro bovine rib model and Autonomous Dental Implant Robotic System (ADIR) was set up, in which intraosseous temperature and drilling impulse data were measured using an infrared camera and a six-axis force/torque sensor respectively. A total of 800 drills with different parameters (e.g., drill diameter, drill wear, drilling speed, and thickness of cortical bone) were experimented, along with an independent test set of 200 drills. Pearson correlation analysis was done for linear relationship. Four machining learning (ML) algorithms (e.g., support vector regression [SVR], ridge regression [RR], extreme gradient boosting [XGboost], and artificial neural network [ANN]) were run for building prediction models. RESULTS: By incorporating different parameters, it was found that lower drilling speed, smaller drill diameter, more severe wear, and thicker cortical bone were associated with higher intraosseous temperature changes and longer time exposure and were accompanied with alterations in drilling impulse data. Pearson correlation analysis further identified highly linear correlation between drilling impulse data and thermal changes. Finally, four ML prediction models were established, among which XGboost model showed the best performance with the minimum error measurements in test set. CONCLUSION: The proof-of-concept study highlighted close correlation of drilling impulse data with intraosseous temperature change during osteotomy. The ML prediction models may inspire future improvement on prevention of thermal bone injury and intelligent design of robot-assisted implant surgery.

Endoscopic cyanoacrylate injection therapy for refractory high-risk peptic ulcer bleeding by conventional endoscopic therapy.

OBJECTIVE: To evaluate the efficacy and safety of endoscopic cyanoacrylate injection therapy for refractory high-risk peptic ulcer bleeding by conventional endoscopic therapy. METHODS: 154 patients with refractory high-risk peptic ulcer bleeding by conventional endoscopic therapy at the Affiliated Hospital of Zunyi Medical Univesity and the People's Hospital of Liupanshui City from January 2018 to December 2021were enrolled in this study. Endoscopic intracellular cyanoacrylate injection was first carried out. When failure, perintravascullar injection was carried out. The data were retrospectively collected. RESULTS: Among the 154 patients, 102 patients (66.23%) obtained successful intravascular injection and perivascular injection was performed in 52 patients (33.77%). Immediate hemostatic rate for active bleeding achieved 93.18%. Overall rebleeding rate within 30 days was 12.99% and successful hemostasis rate achieved 87.01%. Immediate hemostatic rate and successful hemostasis rate in intravascular injection patients were markedly superior over perivascular injection. Rebleeding rate in intravascular injection patients was markedly lower than that in perivascular injection patients. 14 patients complicated abdominal pain and no other complication occurred. CONCLUSION: Endoscopic cyanoacrylate injection therapy, especial intravascular injection, was effective and safe, with high successful hemostasis rate for refractory high-risk peptic ulcer bleeding by conventional endoscopic therapy.

Implant placement with an autonomous dental implant robot: A clinical report.

Ideal implant placement is the basis for long-term implant survival and satisfactory restoration outcomes. Static and dynamic computer-assisted guidance have been used to improve the accuracy of implant placement, but both have shortcomings that robots can overcome. This clinical report describes the use of an autonomous implant robot to complete the placement of 2 adjacent implants with immediate postoperative restoration.

A completely digital workflow to fabricate a double-layered template for anterior esthetic veneers.

In the esthetic restoration of anterior teeth, trial restorations are an efficient way of communicating among patients, doctors, and dental laboratory technicians. Although the development of digital technologies has made it popular to design digital diagnostic waxing in a software program, problems such as the polymerization inhibition of silicone materials and time-consuming trimming remain. The silicone mold based on a 3-dimensionally printed resin cast still has to be transferred to the digital diagnostic waxing and to the patient's mouth to generate a trial restoration. A digital workflow is proposed to fabricate a double-layer guide to reproduce the digital diagnostic waxing in the patient's mouth. This technique is suitable for esthetic restorations of anterior teeth.

Sequence-Reversible Construction of Oxygen-Rich Block Copolymers from Epoxide Mixtures by Organoboron Catalysts.

Switchable catalysis, in combination with epoxide-involved ring-opening (co)polymerization, is a powerful technique that can be used to synthesize various oxygen-rich block copolymers. Despite intense research in this field, the sequence-controlled polymerization from epoxide congeners has never been realized due to their similar ring-strain which exerts a decisive influence on the reaction process. Recently, quaternary ammonium (or phosphonium)-containing bifunctional organoboron catalysts have been developed by our group, showing high efficiency for various epoxide conversions. Herein, we, for the first time, report an operationally simple pathway to access well-defined polyether-block-polycarbonate copolymers from mixtures of epoxides by switchable catalysis, which was enabled through thermodynamically and kinetically preferential ring-opening of terminal epoxides or internal epoxides under different atmospheres (CO2 or N2) using one representative bifunctional organoboron catalyst. This strategy shows a broad substrate scope as it is suitable for various combinations of terminal epoxides and internal epoxides, delivering corresponding well-defined block copolymers. NMR, MALDI-TOF, and gel permeation chromatography analyses confirmed the successful construction of polyether-block-polycarbonate copolymers. Kinetic studies and density functional theory calculations elucidate the reversible selectivity between different epoxides in the presence/absence of CO2. Moreover, by replacing comonomer CO2 with cyclic anhydride, the well-defined polyether-block-polyester copolymers can also be synthesized. This work provides a rare example of sequence-controlled polymerization from epoxide mixtures, broadening the arsenal of switchable catalysis that can produce oxygen-rich polymers in a controlled manner.

Pseudo Polyampholytes with Sensitively Ion-Responsive Conformational Transition Based on Positively Charged Host-Guest Complexes.

Biological polyampholytes are ubiquitous in living organisms with primary functions including serving as transporters for moving chemical molecular species across the cell membranes. Synthetic amphoteric macromolecules that can change their phase states depending on the environment to simulate some properties of natural polyampholytes are of great interest. Here, the implementation of synthetic pseudo polymeric ampholytes is explored with ion-recognition-triggered conformational change. The phase transition behaviors of the ion-recognition-creative polyampholytes that contain deprotonated carboxylic acid groups as negative charges and 18-crown-6 units for forming positively charged host-guest complexes are systematically investigated. The ion-recognition-triggered phase transition behaviors of pseudo polyampholytes significantly depend on cation species and concentrations. Only those specific ions such as K+ , Ba2+ , Sr2+ and Pb2+ ions that can form 1:1 host-guest complexes with 18-crown-6 units in polymers enable control over conformational change like that of traditional pH-dependent polyampholytes. By regulating the content of carboxylic acid groups to match the content of ion-recognized positive charges provided by the host-guest complexes, the pseudo polyampholytes are more sensitive to the recognizable cations. Such ion-recognition-triggered amphoteric characteristics make the pseudo polyampholytes act like biological proteins, nucleic acids, and enzymes as molecular transporters, genetic code storage, and biocatalysts in artificial systems.

Liobagrus brevispina, a new species of torrent catfish (Siluriformes: Amblycipitidae) from the upper Chang-Jiang basin, South China.

A new species of Liobagrus is unearthed in the Nan-Jiang flowing into the Jialing-Jiang of the upper Chang-Jiang basin in which currently recognized Chinese congeners have a concentrated distribution. This small-sized (less than 100.0 mm LS ) torrent fish belongs to the species group defined by the presence of a smooth posterior edge of the pectoral-fin spine and upper and lower jaws of equal length or a lower jaw slightly longer than the upper jaw in length. It is distinct from Liobagrus aequilabris and Liobagrus formosanus by the presence of a pectoral-fin spine extending short of (vs. beyond) the vertical through the dorsal-fin origin, maxillary barbels reaching the middle of the pectoral fin (vs. pectoral-fin insertion or slightly beyond), 17-19 anal-fin rays (vs. 15-16 in L. formosanus), 39-41 (vs. 35-37 in L. aequilabris) post-Weberian vertebrae and the pectoral-fin spine length 3.6%-7.4% of LS (vs. 7.6-10.5 in L. aequilabris). It differs from Liobagrus marginatoides by the presence of upper and lower jaws of equal length (vs. a lower jaw slightly longer than the upper jaw in length) and a rounded or unevenly rounded (vs. subtruncate) caudal fin. The validity of the new species is confirmed by its monophyly recovered in a cytochrome b gene-based phylogenetic analysis and its significant genetic distance with sampled congeneric species.

A modified endoscopic submucosal dissection for a superficial hypopharyngeal cancer: a case report and technical discussion.

BACKGROUND: Adequate working space and a clear view for the dissected lesion are crucial for endoscopic submucosal dissection (ESD). Pharyngeal ESD requires that an otorhinolaryngologist creates working space by lifting the larynx with a curved laryngoscope. However, many countries do not have this kind of curved laryngoscope, and the devices could interfere with endoscope because of the narrow space of the pharynx. To overcome these issues, we used a transparent hood (Elastic Touch, slit and hole type, M (long), Top company, Tokyo Japan) instead of the curved laryngoscope to create adequate working space by pushing the larynx, and pharyngeal ESD could be done by gastroenterologists. CASE PRESENTATION: A 64-year-old male patient was admitted to our hospital because of chronic persistent swallowing dysfunction for 2 years. Oesophagogastroduodenoscopy showed a superficial hypopharyngeal cancer in the right pyriform sinus. We used a transparent hood (Elastic Touch, slit and hole type, M (long), Top company, Tokyo Japan) instead of the curved laryngoscope to create adequate working space by pushing the larynx, and dental floss tied to a haemoclip was applied to create counter traction during ESD. The lesion was pathologically confirmed as superficial squamous cell carcinoma and resected completely. CONCLUSIONS: This is the first report of modified ESD for a superficial hypopharyngeal cancer. The modified ESD enables early pharyngeal superficial cancer to be removed completely under endoscope by gastroenterologist.

Controllable Microfluidic Fabrication of Microstructured Materials from Nonspherical Particles to Helices.

This work reports on a facile and flexible strategy based on the deformation of encapsulated droplets in fiber-like polymeric matrices for template synthesis of controllable microstructured materials from nonspherical microparticles to complex 3D helices. Monodisperse droplets generated from microfluidics are encapsulated into crosslinked polymeric networks via an interfacial crosslinking reaction in microchannel to in situ produce the droplet-containing, fiber-like matrices. By stretching and twining the dried fiber-like matrices, the encapsulated droplets can be flexibly engineered into versatile shapes for template synthesis of controllable nonspherical microparticles and helices. Moreover, magnetic helices can be fabricated by simply dispersing magnetic Fe3 O4 nanoparticles in the droplets to achieve rotational and translational motion under a rotated magnetic field. This work provides a simple and versatile strategy for the template synthesis of advanced functional microstructured materials with flexible shapes.

Monodisperse and fast-responsive poly(N-isopropylacrylamide) microgels with open-celled porous structure.

A simple and efficient method is developed to fabricate monodisperse and fast-responsive poly(N-isopropylacrylamide) (PNIPAM) microgels with open-celled porous structure. First, numerous fine oil droplets are fabricated by homogeneous emulsification method and are then evenly dispersed inside monodisperse PNIPAM microgels as porogens via the combination of microfluidic emulsification and UV-initiated polymerization methods. Subsequently, the embedded fine oil droplets inside the PNIPAM microgels are squeezed out upon stimuli-induced rapid volume shrinkage of the microgels; as a result, a spongelike open-celled porous structure is formed inside the PNIPAM microgels. The open-celled porous structure provides numerous interconnected free channels for the water transferring convectively inward or outward during the volume phase transition process of PNIPAM microgels; therefore, the response rates of the PNIPAM microgels with open-celled porous structure are much faster than that of the normal ones in both thermo-responsive shrinking and swelling processes. Because of the fast-responsive characteristics, the microgels with open-celled porous structure will provide ever better performances in their myriad applications, such as microsensors, microactuators, microvalves, and so on.

Competitive molecular-/ion-recognition responsive characteristics of poly(N-isopropylacrylamide-co-benzo-12-crown-4-acrylamide) copolymers with benzo-12-crown-4 as both guest and host units.

Novel dual molecular- and ion-recognition responsive poly(N-isopropylacrylamide-co-benzo-12-crown-4-acrylamide) (PNB12 C4 ) linear copolymers with benzo-12-crown-4 (B12C4) as both guest and host units are prepared. The copolymers exhibit highly selective sensitivities toward γ-cyclodextrin (γ-CD) and Na(+) . The presence of γ-CD induces the lower critical solution temperature (LCST) of PNB12 C4 copolymer to shift to a higher value due to the formation of 1:1 γ-CD/B12C4 host-guest inclusion complexes, while Na(+) causes a negative shift in LCST due to the formation of 2:1 "sandwich" B12C4/Na(+) host-guest complexes. Regardless of the complexation order, when γ-CD and Na(+) coexist with PNB12 C4 , competitive complexation actions of B12C4 as both guest and host units toward γ-CD and Na(+) finally form equilibrium 2:2:1 γ-CD/B12C4/Na(+) composite complexes, and the final LCST values of PNB12 C4 copolymer reach almost the same level. The results provide valuable guidance for designing and applying PNB12 C4 -based smart materials in various applications.

The evolution of robotics: research and application progress of dental implant robotic systems.

The use of robots to augment human capabilities and assist in work has long been an aspiration. Robotics has been developing since the 1960s when the first industrial robot was introduced. As technology has advanced, robotic-assisted surgery has shown numerous advantages, including more precision, efficiency, minimal invasiveness, and safety than is possible with conventional techniques, which are research hotspots and cutting-edge trends. This article reviewed the history of medical robot development and seminal research papers about current research progress. Taking the autonomous dental implant robotic system as an example, the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.

Fully automatic AI segmentation of oral surgery-related tissues based on cone beam computed tomography images.

Accurate segmentation of oral surgery-related tissues from cone beam computed tomography (CBCT) images can significantly accelerate treatment planning and improve surgical accuracy. In this paper, we propose a fully automated tissue segmentation system for dental implant surgery. Specifically, we propose an image preprocessing method based on data distribution histograms, which can adaptively process CBCT images with different parameters. Based on this, we use the bone segmentation network to obtain the segmentation results of alveolar bone, teeth, and maxillary sinus. We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks. The tooth segmentation results can obtain the order information of the dentition. The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods. Its average Dice scores on the tooth, alveolar bone, maxillary sinus, and mandibular canal segmentation tasks were 96.5%, 95.4%, 93.6%, and 94.8%, respectively. These results demonstrate that it can accelerate the development of digital dentistry.

Portable diagnosis method of hyperkalemia using potassium-recognizable poly(N-isopropylacrylamide-co-benzo-15-crown-5-acrylamide) copolymers.

A novel, simple, portable, and low-cost method for diagnosis of hyperkalemia by using K(+)-recognizable poly(N-isopropylacrylamide-co-benzo-15-crown-5-acrylamide) [poly(NIPAM-co-B15C5Am)] linear copolymer as indicator is presented in this work. The pendent 15-crown-5 units in the linear copolymers can selectively and specifically recognize K(+) to form stable 2:1 "sandwich" host-guest complexes, which cause the copolymer chains to change from the hydrophilic state to the hydrophobic state isothermally, whereas other tested metal ions (e.g., Li(+), Na(+), Cs(+), Mg(2+), Ca(2+), Sr(2+), Ba(2+), Cu(2+), Fe(3+), Pb(2+), Cd(2+), Cr(3+)) cannot be recognized. With increasing the 15-crown-5 content or the K(+) concentration, the poly(NIPAM-co-B15C5Am) linear copolymers exhibit higher sensitivity to K(+). The hyperkalemia can be simply diagnosed by observing the K(+)-induced optical transmittance change of human blood samples with poly(NIPAM-co-B15C5Am) linear copolymer as an indicator. Normal blood samples with low potassium level containing the poly(NIPAM-co-B15C5Am) linear copolymer are almost transparent since the copolymer is hydrophilic and soluble at the operating temperature. However, severe hyperkalemia samples with high potassium level become completely cloudy since the copolymer is hydrophobic and insoluble at this temperature. The presented diagnosis method with poly(NIPAM-co-B15C5Am) linear copolymer as indicator is quite simple and low-cost, and it would bring a new candidate material to design simple and portable tools for diagnosis of hyperkalemia in the general population. Moreover, the results in this work provide valuable guidance for building novel poly(NIPAM-co-B15C5Am)-based artificial K(+)-recognizable "smart" or "intelligent" systems in various application fields.

Novel Digital Mouth Preparation Technique for Fabricating Implant-Retained Removable Partial Dentures with Distal Extension: a Case Report.

Implant-retained removable partial dentures (RPDs) are commonly used to resolve the complications associated with traditional distal extension RPDs; however, this technology does not consider the necessity and importance of parallelism between the path of RPD insertion and the long axis of the implant. This clinical report presents a novel digital preparation technique that involves the preparation of parallel guiding planes on abutment teeth and implant insertion in the distal extension area using a computer-aided design and manufacturing template. This clinical case of implant-retained RPDs illustrates the fabrication and application of the digital template. Using this technique, the path of RPD insertion is parallel to the long axis of the implant. As a result, the components of the implant-retained RPD, including the abutment teeth, implants and attachments, can demonstrate greater longevity.

Clinical Applications of Polyetheretherketone in Removable Dental Prostheses: Accuracy, Characteristics, and Performance.

The high-performance thermoplastic polyetheretherketone (PEEK) has excellent mechanical properties, biocompatibility, chemical stability, and radiolucency. The present article comprehensively reviews various applications of PEEK in removable dental prostheses, including in removable partial dentures (RPDs) (frameworks and clasps), double-crown RPDs, and obturators. The clinical performance of PEEK in removable dental prostheses is shown to be satisfactory and promising based on the short-term clinical evidence and technical complications are scarce. Moreover, the accuracy of RPDs is a vital factor for their long-term success rate. PEEK in removable dental prostheses is fabricated using the conventional lost-wax technique and CAD/CAM milling, which produces a good fit. Furthermore, fused deposition modeling is considered to be one of the most practical additive techniques. PEEK in removable prostheses produced by this technique exhibits good results in terms of the framework fit. However, in light of the paucity of evidence regarding other additive techniques, these manufacturers cannot yet be endorsed. Surface roughness, bacterial retention, color stability, and wear resistance should also be considered when attempting to increase the survival rates of PEEK removable prostheses. In addition, pastes represent an effective method for PEEK polishing to obtain a reduced surface roughness, which facilitates lower bacterial retention. As compared to other composite materials, PEEK is less likely to become discolored or deteriorate due to wear abrasion.

Composite dissolvable microneedle patch for therapy of oral mucosal diseases.

A composite microneedle patch (MN patch) is developed for oral transmucosal administration. To improve the oral transmucosal drug delivery efficiency, the composite MN patch is designed to consist of an array of 100 dissolvable microneedles (MNs) with drug-loaded tips and a backing layer. The MNs are composed of two parts, the hyaluronic acid (HA) tip part and the polyvinylpyrrolidone (PVP) base part. Due to the small size and sufficient mechanical strength, the HA-PVP MNs can painlessly penetrate the oral mucosa barrier and deliver drugs directly to the basal layer or submucosa. Betamethasone sodium phosphate (BSP), as the model drug, is concentrated in the HA tip parts to avoid the drug waste caused by mucosa elasticity. Considering the special moist environment and saliva flow in the mouth, a double-layer backing layer composed of a poly(vinyl alcohol) (PVA) adhesive layer and an ethyl cellulose (EC) waterproof layer is designed and constructed, which could reduce the saliva flow effects. The in vitro and in vivo results demonstrate that the MN patch could achieve rapid and efficient BSP release in oral mucosa due to the rapid dissolution of HA. The proposed MN patch provides a novel strategy for the therapy of oral mucosal diseases.