[Computer aided design and 3-dimensional printing for the production of custom trays of maxillary edentulous jaws based on 3-dimensional scan of primary impression].

OBJECTIVE: To establish a digital method for production of custom trays for edentulous jaws using fused deposition modeling (FDM) based on three-dimensional (3D) scans of primary jaw impressions, and to quantitatively evaluate the accuracy. METHODS: A red modeling compound was used to make a primary impression of a standard maxillary edentulous plaster model. The plaster model data and the primary impression tissue surface data were obtained using a 3D scanner. In the Gemomagic 2012 software, several commands were used, such as interactive drawing curves, partial filling holes, local offset, bodily offset, bodily shell, to imitate clinical procedures of drawing tray boundary, filling undercut, buffer, and generating the tray body. A standard shape of tray handle was designed and attached to the tray body and the data saved as stereolithography (STL) format. The data were imported into a computer system connected to a 3D FDM printing device, and the custom tray for the edentulous jaw model was printed layer upon layer at 0.2 mm/layer, using polylactic acid (PLA) filament, the tissue surface of the tray was then scanned with a 3D scanner. The registration functions of Geomagic 2012 was used to register the 3-dimentional surface data, and the point-cloud deviation analysis function of the Imageware 13.0 system was used to analyze the error. The CAD data of the custom tray was registered to the scan data, and the error between them was analyzed. The scanned plaster model surface was registered to the scanned impression surface and the scanned tray data to the CAD data, then the distance between the surface of plaster model and the scanned tissue surface of the custom tray was measured in Imageware 13.0. RESULTS: The deviation between the computer aided design data and the scanned data of the custom tray was (0.17±0.20) mm, with (0.19±0.18) mm in the primary stress-bearing area, (0.17±0.22) mm in the secondary stress-bearing area, (0.30±0.29) mm in the border seal area, (0.08±0.06) mm in the buffer area; the space between the tissue faces of the plaster model and the scanned tissue surface of custom tray was (1.98±0.40) mm, with (1.85±0.24) mm in the primary stress-bearing area, (1.86±0.26) mm in the secondary stress-bearing area, (1.77±0.36) mm in the border seal area, (2.90±0.26) mm in the buffer area. CONCLUSION: With 3D scanning, computer aided design and FDM technology, an efficient means of custom tray production was established.

A double-blind comparative study of Chinese herbal medicine Jinlianqingre Effervescent Tablets in combination with conventional therapy for the treatment of uncomplicated hand, foot, and mouth disease.

Chinese herbal medicine Jinlianqingre Effervescent Tablets (JET) are the recommended control measure for uncomplicated hand, foot, and mouth disease (HFMD) by the Ministry of Health of China. However, high-quality evidence to support this recommendation is limited. A total of 288 patients ranging in age from 1 to 13 years were randomly assigned to JET in combination with conventional therapy (mainly including the reduction of temperature by applying physical cooling paste or warm bathing), or conventional therapy with placebo group for 7 days. The objective was to test the hypothesis that JET combination therapy is more effective than conventional therapy for uncomplicated HFMD. A randomized, double-blind, placebo-controlled trial was designed. Our study showed that, compared with conventional therapy, the median time to fever resolution was significantly shorter in the JET combination therapy (8 vs. 80 h; p < 0.0001); the risk of fever resolution increased in the JET combination therapy [hazard ratio, 19.8; 95% confidence interval (CI), 12.8 to 30.7]; the median healing time of rash or oral ulcer was significantly shorter in the JET combination therapy (14 vs. 74 h; p < 0.0001); and the median symptom score for skin or oral mucosa lesions improved more rapidly in the JET combination therapy during the follow-up period. The median duration of hospital stay was 6 days in the JET combination therapy and 7 days in the conventional therapy (p < 0.0001). No significant adverse events and complications were found in both groups. The addition of JET to conventional therapy reduced fever clearance time, healing time of skin or oral mucosa lesions, and duration of hospital stay in children with uncomplicated HFMD.

[Percentage of tonsil hypertrophy in orthodontic patients with different sagittal skeletal relationship].

Objective: To investigate the prevalence of tonsil hypertrophy in patients with different sagittal skeletal craniofacial patterns, as well as the correlation between tonsil hypertrophy and the type of skeletal pattern. Methods: Lateral cephalograms of patients who visited the Department of Orthodontics Division 1, School of Stomatology, Wuhan University during January to August, 2019 were retrospectively collected. Patients (children: age≥6 and ≤12 year; adults: age≥18 year) were divided into three groups according to the ANB (subspinale-nasion-supramental) angle: the skeletal class Ⅰ group (0°≤ANB≤4°), skeletal class Ⅱ group (ANB>4°) and skeletal class Ⅲ group (ANB<0°). Tonsil hypertrophy was diagnosed with lateral cephalogram by two specifically trained orthodontists independently, according to the Baroni's method. The between-group differences in tonsil hypertrophy prevalence were analyzed using chi-square tests with Bonferroni correction (α=0.017). Results: A total of 1 776 patients (593 children and 1 183 adults) were included, among which 672 (37.8%) were with class Ⅰ, 849 (47.8%) with class Ⅱ, and 255 (14.4%) with class Ⅲ skeletal pattern. The prevalence of tonsil hypertrophy in children was 66.3% (393/593). The proportion of children with tonsil hypertrophy in class Ⅲ group [87.0% (60/69)] were significantly higher than that in class Ⅰ [65.6% (145/221), χ²=11.56, P<0.017] and class Ⅱ [62.0% (188/303), χ²=15.69, P<0.017] groups. The prevalence of tonsil hypertrophy in adults was 23.2% (275/1 183). The proportion of adults with tonsil hypertrophy in class Ⅲ group [42.5% (79/186)] was significantly higher than that in class Ⅰ [19.1% (86/451), χ²=36.50, P<0.017] and class Ⅱ [20.2% (110/546), χ²=35.00, P<0.017] groups. However, there was no significant difference in the prevalence of tonsil hypertrophy between class Ⅰ and class Ⅱ groups for both children (χ²=0.70, P>0.017) and adults (χ²=0.18, P>0.017). Conclusions: The prevalence of tonsil hypertrophy in skeletal class Ⅲ patients was significantly higher than that in patients with skeletal class Ⅰ and Ⅱmalocclusion. Tonsil hypertrophy could be an important risk factor for skeletal class Ⅲ patients.

The effect of clinical interventions on the oral health-related quality of life in older adults.

This paper reviews the literature to assess the effectiveness of oral health interventions in influencing oral health-related quality of life (OHRQoL) in older adults. Clinical studies published in 2010 onwards reporting oral health interventions in older adults and subsequent changes in OHRQoL were systematically searched in Medline, Web of Science and EMBASE databases. Reporting followed Preferred Reporting Items for Systematic Review and Meta-Analysis criteria. Eligibility evaluation and data abstraction from eligible studies were guided by predefined PICO questions and bias assessment by the Quality in Prognosis Studies tool. The search retrieved 144 articles. Of the 20 articles that met the eligibility criteria, 45% (9) reported a statistically significant improvement in OHRQoL. The majority of studies were conducted in adults with complete edentulism (70%) and mainly focused on implant provision to support a removable prosthesis (30%). The search indicates the limited scope of current literature on geriatric dental interventions, focusing mainly on denture realignments, denture fabrication and implant placement. Although the majority of the oral health interventions focused on edentulism and removable prostheses, there are many areas of oral health interventions and their potential impact on OHRQoL in this demographic group that have yet to be explored. © 2022 Australian Dental Association.

The sequential treatment of temporomandibular joint ankylosis with secondary deformities by distraction osteogenesis and arthroplasty or TMJ reconstruction.

The purpose of this study was to evaluate the sequential treatment of patients with temporomandibular joint (TMJ) ankylosis and secondary deformities by distraction osteogenesis and subsequent arthroplasty or TMJ reconstruction. This study included 40 patients treated at a stomatological hospital in China; they ranged in age from 9 to 53years (mean age 24.5years). Ten of these patients were diagnosed with unilateral TMJ ankylosis and 30 with bilateral TMJ ankylosis. Twenty-seven patients also presented obstructive sleep apnoea-hypopnoea syndrome (OSAHS). All patients underwent distraction osteogenesis as the initial surgery, followed by arthroplasty or TMJ reconstruction. Some patients underwent orthognathic surgery to improve occlusion and face shape along with or after arthroplasty or TMJ reconstruction. The therapeutic effects were evaluated in terms of the improvements in maximum inter-incisal opening (MIO), appearance, and respiratory function. After the completion of treatment, all patients showed improvements in MIO and appearance, and the symptom of snoring disappeared. The airway space was significantly increased. Patient follow-up ranged from 6 to 85months (mean 28.3months), and four patients experienced relapse. This study suggests that treating TMJ ankylosis with secondary deformities by distraction osteogenesis as the initial surgery and arthroplasty or TMJ reconstruction as the second-stage treatment may achieve favourable outcomes, especially for patients with OSAHS; however, some patients may require orthognathic surgery.

[Review of bisphosphonate related osteonecrosis of the jaws].

The bisphosphonates (BPs) has been widely used as anti-resorptive agents owing to their anti-osteoclatic action. However, patients treated with BPs for a long time may subsequently develop bisphosphonate-related osteonecrosis of the jaws (BRONJ). Now, the exact pathogenesis of the BRONJ is poorly understood. There were also no standard diagnosis and treatment methods for this complication. The maxilla necrosis related to BRONJ can cause maxillary sinusitis, fistula, and sinus tract, which arose more attention from the otolaryngologists. In this article, the pathogenesis, symptoms, and treatments of BRONJ are systemically reviewed. The aim is to deepen the recognition of this complication to otolaryngologists, and to avoid missed diagnosis and misdiagnosis. It is hoped that an early diagnosis and suitable treatments could be provided for a good prognosis in such patients.

[Progress in research and application of the edentulous custom trays].

Well designed and fabricated custom tray is the precondition to acquire qualified edentulous impression and key to successful complete denture. It has shown that primary impression without custom trays is hard to meet clinical requirements for successful restoration of complete denture. According to the fabrication techniques, edentulous custom tray can be classified into several types such as: compound trimming technique, handcrafted technique with polymerizing acrylic resin based on the study cast, and computer aided design and three dimensional printing(CAD & 3DP) technique based on the primary impression or study cast, etc. With regard to some special edentulous jaws, the custom tray and impression techniques such as open-window, frame cut, closed-mouth custom trays, and so on can be applied to acquire accurate impressions. All above technologies have their own characteristics and emphases. In clinic, appropriate custom trays should be selected according to residual ridge condition, oral status, and other clinical requirements of each edentulous patient.

[Preparation of decalcified bone matrix, bone cement and bone morphogenetic protein composite].

OBJECTIVE: To investigate the most excellent composite proportion and the most convenient composite method of decalcified bone matrix (DBM), bone cement (BC) and bovine bone morphogenetic protein (bBMP) composite. METHODS: The canine DBM and the bBMP were prepared beforehand. First mix the bBMP and DBM together with the proportion of 1:25 with adsorption and directly, then add BC with different weight proportion and finally the complex material was examined by biomechanics, scan electron microscope, determination of bone inductive activity and implanted into the canine femoral defect caused by microwave-induced hyperthermia. RESULTS: The bBMP had strong bone inductive activity and had no affect for this function when combined with DBM with different method. There were irregular gaps in the composite and most of them with diameter less than 100 microns and the porosity of the composite was less than 20% when the proportion of DBM was 40%. So it was unfavorable for the new bone to form and the new blood vessels to reconstruct. The DBM and BC could not be combined together when the proportion of DBM was 80%. While the biomechanical intensity of the composite decreased and the qualities of the new bone forming and new blood vessels reconstructing improved successively when the proportion of DBM was from 50% to 75%. CONCLUSION: It is the most convenient that bBMP is combined with DBM directly while its bone inductive activity could not be affected. The composite material not only has high biomechanical intensity, but also is favorable for new bone to form and new blood vessels to reconstruct when the proportion of DBM is 50% and 60%. So it is favorable for bone repair in the places where need to bear a load. However it is also favorable for bone repair in the places where do not need to bear a load when the proportion of DBM is 75%.

Improvement of corrosion and biological properties of microarc oxidized coatings on Mg-Zn-Zr alloy by optimizing negative power density parameters.

Corrosion and biological properties of microarc oxidized calcium phosphate (CaP) coatings on Mg-Zn-Zr alloy were improved by optimizing negative power density parameters. Scanning electron microscope (SEM) and X-ray diffractometer (XRD) were employed to characterize the coating morphology and phase composition. The in vitro cytotoxicity and systemic toxicity tests were carried out to evaluate the coating biocompatibility. The degradability and bioactivity of the coatings were determined by in vitro simulated body fluid (SBF) immersion test. The coating microstructure, thickness and growth rate can be influenced by negative power density through changing direction of ions movements, rate of ions exchanges and affecting formation of plasma. The CaP coatings reduced the substrate degradation rate. Calcium phosphates, such as hydroxyapatite (Ca10(PO4)6(OH)2, HA) and calcium pyrophosphate (Ca2P2O7, CPP), etc., were induced after 30 days SBF immersion, indicating that the coatings have bioactivity. The CaP coatings have no toxicity to cell and living mice, indicating that the coatings are safe to serve as implants.

Acetal-linked branched poly(dimethyl-aminoethyl methacrylate) as an acid cleavable gene vector with reduced cytotoxicity.

An acid labile branched PDMAEMA/acetal copolymer with amino group was synthesized by the DE-ATRP and followed by Michael addition. The degradation of the polymer was strongly pH-dependent. High nucleic acid transfection efficiency with low cytotoxicity was observed compared to its non-degradable copolymer counterpart.

Untying a nanoscale knotted polymer structure to linear chains for efficient gene delivery in vitro and to the brain.

The purpose of this study was to develop a platform transfection technology, for applications in the brain, which could transfect astrocytes without requiring cell specific functionalization and without the common cause of toxicity through high charge density. Here we show that a simple and scalable preparation technique can be used to produce a "knot" structured cationic polymer, where single growing chains can crosslink together via disulphide intramolecular crosslinks (internal cyclizations). This well-defined knot structure can thus "untie" under reducing conditions, showing a more favorable transfection profile for astrocytes compared to 25 kDa-PEI (48-fold), SuperFect® (39-fold) and Lipofectamine®2000 (18-fold) whilst maintaining neural cell viability at over 80% after four days of culture. The high transfection/lack of toxicity of this knot structured polymer in vitro, combined with its ability to mediate luciferase transgene expression in the adult rat brain, demonstrates its use as a platform transfection technology which should be investigated further for neurodegenerative disease therapies.

High prevalence of early childhood infection by Kaposi's sarcoma-associated herpesvirus in a minority population in China.

In China, KSHV seroprevalence varies considerably among different regions and ethnicities. But in Xinjiang province, located in the northwestern China, there is a very high seroprevalence of KSHV in adults of Kazak and Ughur ethnicities. However, KSHV prevalence in children and the risk factors associated with the acquisition of infection are currently not known. The aim of this study was to investigate the prevalence of KSHV infection and identify associated socioeconomic or behavioural risk factors and the humoral immune response among children in this population. This is a cross-sectional study (N = 178) to screen children and their caregivers from Xinjiang for total KSHV antibodies, KSHV neutralizing antibodies and HIV infection. Structured questionnaires were utilized to investigate risk factors associated with KSHV prevalence. KSHV seroprevalence in children and caregivers in Xinjiang was 48.3% and 64.7%, respectively. Neutralizing antibody was detected in most seropositive caregivers (93.8%) but was detected in only 5.8% of the infected children. A significant association was observed between child KSHV seroprevalence and sharing of food among family members. These results suggest that similar to other endemic areas in Africa, KSHV infection in the minority populations of Xinjiang is likely to be occurring during early childhood, probably via horizontal transmission through saliva, and results in high seroprevalence in the adult population.

Effects of phosphates on microstructure and bioactivity of micro-arc oxidized calcium phosphate coatings on Mg-Zn-Zr magnesium alloy.

Calcium phosphate (CaP) coatings were prepared on Mg-Zn-Zr magnesium alloy by micro-arc oxidation (MAO) in electrolyte containing calcium acetate monohydrate (CH3COO)2Ca·H2O) and different phosphates (i.e. disodium hydrogen phosphate dodecahydrate (Na2HPO4·12H2O), sodium phosphate (Na3PO4·H2O) and sodium hexametaphosphate((NaPO3)6)). Scanning electron microscope (SEM), energy-dispersive X-ray spectrometry (EDS) and X-ray diffractometer (XRD) were employed to characterize the microstructure, elemental distribution and phase composition of the CaP coatings. Simulated body fluid (SBF) immersion test was used to evaluate the coating bioactivity and degradability. Systemic toxicity test was used to evaluate the coating biocompatibility. Fluoride ion selective electrode (ISE) was used to measure F(-) ions concentration during 30 days SBF immersion. The CaP coatings effectively reduced the corrosion rate and the surfaces of CaP coatings were covered by a new layer formed of numerous needle-like and scale-like apatites. The formation of these calcium phosphate apatites indicates that the coatings have excellent bioactivity. The coatings formed in (NaPO3)6-containging electrolyte exhibit thicker thickness, higher adhesive strength, slower degradation rate, better apatite-inducing ability and biocompatibility.

[Total nose reconstruction with a reversed mandibular flap pedicled with the facial artery].

OBJECTIVE: To investigate the method to repair different kinds of nasal defects. METHODS: The reversed mandibular flap pedicled with the facial artery was used. RESULTS: The treatment was completed in one stage and the results were satisfactory in 6 cases. The reconstructed noses showed good shape. CONCLUSIONS: Total nose reconstruction using a reversed mandibular flap is a new operation design and technique. The recipient and the donor sites are very close. The flap with excellent blood supply has a good colour and textural match. The operative procedure and flap transferring are easy.

[Allotransplantation of cryopreserved fetal cartilage in plastic surgery].

OBJECTIVE: To study the applicability of homologous fetal cartilage in plastic surgery. METHODS: Limb and costal cartilage were taken from the dead fetus. The fetal cartilage was then frozen at -80 degrees C and preserved in -196 degrees C liquid nitrogen with a cryoprotective agent. A total of 38 patients received fetal cartilage transplantation. Of them there were 24 saddle nose, 4 auricle defects, 6 secondary deformities of cheiloschisis, 4 mandible deformities. RESULTS: Through follow-up of three and a half years, it was found that none of the transplanted cartilage was absorbed, deformed or rejected due to immunological reaction. The contours were satisfactory except 2 cases with auricle reconstruction. CONCLUSION: The clinical application of homologous fetal cartilages is of value in plastic surgery.

Dynamics of ferroelastic domains in ferroelectric thin films.

Dynamics of domain interfaces in a broad range of functional thin-film materials is an area of great current interest. In ferroelectric thin films, a significantly enhanced piezoelectric response should be observed if non-180 degrees domain walls were to switch under electric field excitation. However, in continuous thin films they are clamped by the substrate, and therefore their contribution to the piezoelectric response is limited. In this paper we show that when the ferroelectric layer is patterned into discrete islands using a focused ion beam, the clamping effect is significantly reduced, thereby facilitating the movement of ferroelastic walls. Piezo-response scanning force microscopy images of such islands in PbZr0.2Ti0.8O3 thin films clearly point out that the 90 degrees domain walls can move. Capacitors 1 microm2 show a doubling of the remanent polarization at voltages higher than approximately 15 V, associated with 90 degrees domain switching, coupled with a d33 piezoelectric coefficient of approximately 250 pm V-1 at remanence, which is approximately three times the predicted value of 87 pm V-1 for a single domain single crystal.