The Use of Eye-Tracking Technology in Dento-Maxillofacial Esthetics: A Systematic Review.

The use of eye-tracking technology in dental esthetics has gained popularity over the past decade because of its ability to assess observers' visual preferences in an objective manner. The goal of this study was to provide a comprehensive review of eye-tracking studies in dentistry, which could provide a reference for the rational and effective application of eye-tracking technology by dentists in the future. A comprehensive search of articles on eye tracking, published from January 1946 to June 2023, was conducted across several databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The major criterion for inclusion was that the study evaluated the use of eye-tracking technology in the field of dentistry. Two independent reviewers screened the eligible studies. A total of 67 articles were identified, 41 of which met our inclusion criteria. The most common application of eye tracking was the assessment of perceptions of changes in specific dental conditions among different classes of observers. Overall differences between groups (different classes of observers, different types of conditions) among different areas or regions of interest were analyzed. This systematic review demonstrated the utility of eye-tracking technology as a quantifiable objective assessment and emerging research tool for evaluating outcomes in several domains of dentistry.

A Novel Anderson-Type POMs-Based Hybrids Flame Retardant for Reducing Smoke Release and Toxicity of Epoxy Resins.

Smoke emission and smoke toxicity have drawn more attention to improving the fire safety of polymers. In this work, a polyoxometalates (POMs)-based hybrids flame retardant (P-AlMo6 ) epoxy resin (EP) is prepared with toxicity-reduction and smoke-suppression properties via a peptide coupling reaction between POMs and organic molecules with double DOPO (bisDOPA). It combines the good compatibility of the organic molecule and the superior catalytic performance of POMs. Compared to pure EP, the glass transition temperature and flexural modulus of EP composite with 5 wt.% P-AlMo6 (EP/P-AlMo6 -5) are raised by 12.3 °C and 57.75%, respectively. Notably, at low flame-retardant addition, the average CO to CO2 ratio (Av-COY/Av-CO2 Y) is reduced by 33.75%. Total heat release (THR) and total smoke production (TSP) are lowered by 44.4% and 53.7%, respectively. The Limited Oxygen Index (LOI) value achieved 31.7% and obtained UL-94 V-0 rating. SEM, Raman, X-ray photoelectron spectroscopy, and TG-FTIR are applied to analyze the flame-retardant mechanism in condensed and gas phase. Outstanding flame retardant, low smoke toxicity properties are attained due to the catalytic carbonization ability of metal oxides Al2 O3 and MoO3 produced from the breakdown of POMs. This work advances the development of POMs-based hybrids flame retardants with low smoke toxicity properties.

Comparison of Postoperative Enophthalmos Between Fresh and Delayed Unilateral Orbital Fractures After Orbital Reconstruction With Titanium Mesh Using Computer-Assisted Navigation.

This study compares postoperative enophthalmos between fresh and delayed unilateral orbital fractures after orbital reconstruction with titanium mesh using computer-assisted navigation. The sample was composed of 45 patients with post-traumatic unilateral enophthalmos who were divided into the fresh fracture group and the delayed fracture group. They underwent orbital reconstruction with standard preformed orbital implants and computer-assisted navigation system. The following parameters were measured with computed tomography images: the degree of enophthalmos, orbital volume, and fracture defect area. Patients were reviewed preoperatively (T0), 1 week postoperatively (T1), and 6 months postoperatively (T2). Computed tomography measurements showed that in both groups, the degree of enophthalmos decreased after surgery but increased significantly from T1 to T2 ( P <0.05). ΔE (difference in the degree of enophthalmos between T1 and T2) was similar in patients with fresh and delayed fractures. There was a significant difference in the degree of ΔE between patients with single-wall orbital fractures and those with two-wall orbital fractures. The findings indicate that postoperative enophthalmos is common in both the groups and is closely related to the degree of preoperative enophthalmos. Furthermore, the recurrence of enophthalmos is similar between the 2 groups, but it is higher in patients with orbital fractures involving 2 walls.

Reconstruction of the temporomandibular joint using a vascularized medial femoral condyle osteocartilaginous flap: an experimental investigation in miniature pigs.

BACKGROUND: Reconstruction of the temporomandibular joint (TMJ) is a significant challenge in maxillofacial surgery. A vascularized medial femoral condyle (MFC) osteocartilaginous flap is a good choice for TMJ reconstruction. In this study, we evaluated the radiographic and histological changes of MFC after TMJ reconstruction. METHODS: A ramus-condyle unit (RCU) defect was created unilaterally in five adult male Bama miniature pigs. The ipsilateral vascularized MFC osteocartilaginous flap was used to reconstruct the TMJ, and the non-operative sides served as controls. Multislice spiral computed tomography (CT) was performed preoperatively, immediately postoperatively, and at two weeks, three months, and six months postoperatively. Three animals were euthanized at 6 months postoperatively. Their reconstructed condyles, natural condyles and the MFCs on the opposite side were collected and subjected to µCT and histological evaluation. RESULTS: In the miniature pigs, the vascularized MFC osteocartilaginous flap was fused to the mandible, thus restoring the structure and function of the RCU. The postoperative radiographic changes and histological results showed that the reconstructed condyle was remodeled toward the natural condyle, forming a similar structure, which was significantly different from the MFC. CONCLUSIONS: In miniature pigs, the RCU can be successfully reconstructed by vascularized osteocartilaginous MFC flap. The reconstructed condyle had almost the same appearance and histological characteristics as the natural condyle.

Detection and classification of mandibular fracture on CT scan using deep convolutional neural network.

OBJECTIVES: This study aimed to evaluate the accuracy and reliability of convolutional neural networks (CNNs) for the detection and classification of mandibular fracture on spiral computed tomography (CT). MATERIALS AND METHODS: Between January 2013 and July 2020, 686 patients with mandibular fractures who underwent CT scan were classified and annotated by three experienced maxillofacial surgeons serving as the ground truth. An algorithm including two convolutional neural networks (U-Net and ResNet) was trained, validated, and tested using 222, 56, and 408 CT scans, respectively. The diagnostic performance of the algorithm was compared with the ground truth and evaluated by DICE, accuracy, sensitivity, specificity, and area under the ROC curve (AUC). RESULTS: One thousand five hundred six mandibular fractures in nine subregions of 686 patients were diagnosed. The DICE of mandible segmentation using U-Net was 0.943. The accuracies of nine subregions were all above 90%, with a mean AUC of 0.956. CONCLUSIONS: CNNs showed comparable reliability and accuracy in detecting and classifying mandibular fractures on CT. CLINICAL RELEVANCE: The algorithm for automatic detection and classification of mandibular fractures will help improve diagnostic efficiency and provide expertise to areas with lower medical levels.

Facile fabrication of multifunctional cotton fabric by AgNC@boronate polymer/crosslinked chitosan.

Multifunctional cotton fabrics (M-CF) have important application prospects in intelligent home decoration and material packaging. In this work, nanoparticles (AgNC@BP) were prepared by coating the surface of silver nanocubes (AgNCs) with borate polymer. Subsequently, M-CF with electromagnetic wave (EMW) absorption, mechanical enhancement, flame-retardancy and antibacterial performances were prepared by immersing cotton fabrics (CF) into AgNC@BP/crosslinked chitosan (CS) solution. Expectantly, AgNC@BP endows AgNC@BP/CS-CF with good flame retardancy and low combustion heat release. That is, the char length of AgNC@BP/CS-CF is 7.9 cm after the vertical burning test (UL-94 V) and the peak heat release rate (pHRR) of AgNC@BP/CS-CF is reduced by 21.4% compared to pure CF. Meanwhile, the tensile strength of AgNC@BP/CS-CF is 18.8% higher than that of CF. Synchronously, the introduction of AgNC@BP can also endow M-CF with better EMW absorption, mechanical and antibacterial properties. In conclusion, this work provides a tactic for fabricating M-CF.

Evaluating the remodeling of condyles reconstructed by transport distraction osteogenesis in the treatment of temporomandibular joint ankylosis.

PURPOSE: This study aimed to evaluate the remodeling of condyles reconstructed by transport distraction osteogenesis (DO) in patients with temporomandibular joint (TMJ) ankylosis. PATIENTS AND METHODS: Twenty-one patients with 26 affected joints were followed up for 34.1 ± 13.3 months. Patients who had undergone gap arthroplasty and TMJ reconstruction by DO were included. Maximal mouth opening (MMO) and occlusion were recorded. Computed tomography images were obtained preoperatively (T0), upon completing distraction (T1), upon removal of the distraction device (T2), and >2 years postoperatively (T3). The following were measured: mandibular ramus height, distance between gonion and Frankfurt plane (Go-FN), condylar width, and condyle-ramus angulation. RESULTS: Of the 21 patients, one showed re-ankylosis, while five exhibited anterior open bite. From T1 to T3, the total amount of resorption of ramus height reached up to 8.2 ± 4.6 mm (p < 0.001), in comparison with a total distraction length of 13.8 ± 4.1 mm; the mean resorption rate was 59.4%. Similarly, Go-FN decreased by 6.2 ± 4.0 mm (p < 0.001). CONCLUSION: Our findings indicated that DO combined with gap arthroplasty was an effective method for the treatment of TMJ ankylosis to improve MMO. The reconstructed condyle exhibited a high frequency of resorption in height.

Association between the clinical features of and types of temporomandibular joint ankylosis based on a modified classification system.

This study aimed to describe the clinical features of different types of traumatic temporomandibular joint (TMJ) ankylosis. Seventy-one patients with 102 ankylosed joints were retrospectively reviewed and categorized into four groups according to the grades of severity: type I, non-bony ankylosis of the joint with almost-normal joint space; type II, lateral bony ankylosis marked by a normal joint space that coexists with a radiolucent line; type III, complete bony ankylosis of the joint characterized by only a radiolucent line; and type IV, extensive bony ankylosis without any radiolucent line. The period of ankylosis, maximal mouth opening (MMO), rate of complications, and histopathological changes were compared among groups. Intergroup comparison showed significant differences in the clinical features of MMO and the incidence of complications (p < 0.05). Younger trauma patients tended to develop more severe types of ankylosis than older patients. Additionally, long post-trauma periods were related to the development of severe ankylosis. MMO was highly negatively correlated with the severity of ankylosis. Significant differences were noted among the four types of ankylosis. Younger trauma patients with long post-trauma periods tended to develop more severe TMJ ankylosis, experience more complications, and face more challenges in treatment than older patients.