RESUMO
OBJECTIVE: To compare the manual time and preliminary clinical effects between the digital manufactured occlusal splints for sleep bruxism patients with those of traditional hard splints. METHODS: Sixteen individuals (18 to 44 y/o) with clinically diagnosed sleep bruxism were selected based on the inclusion criteria. All patients were divided into two groups, and a random control method was applied. Digital splints (test group) were designed and milled using CAD/CAM. Hard splints (control group) were made of transparent acrylic resin in laboratory office. The manual time spent including impression obtaining, splint production and clinical occlusal adjustment was recorded. A visual analog scale was used to report the subjective evaluations. The maximum depth loss and volumetric loss of the occlusal surface of splints in posterior tooth were measured. SPSS software was used for statistical analysis (P = .05). RESULTS: Comparing with control group, the manual time spent in test group was significantly less in all of three procedures (P < .001). The VAS scores for retention were not significantly different (P = .086), but the wearing comfort scores of test group were significantly higher (P < .001). Both maximum depth loss (P = .007) and volumetric loss in test group were significantly less than control group (P = .005). CONCLUSION: In the current study, the digitally manufactured splints exhibit significantly improved comfort and time efficiency than traditional hard splints. Moreover, the new milling material (PEEK) has better wear resistance than acrylic resins.
Assuntos
Bruxismo , Bruxismo do Sono , Resinas Acrílicas , Benzofenonas , Humanos , Cetonas , Placas Oclusais , Polietilenoglicóis , Polímeros , Bruxismo do Sono/terapia , ContençõesRESUMO
Background: The clinical teaching of esthetic implant-supported restoration of the atrophic maxilla is challenging due to the complexity and unpredictability of bone and soft tissue augmentation. The traditional problem-based learning and case-based learning method (PBL-CBL method) with a full digital workflow (digital PBL-CBL method) provides the students a chance to view clinical cases in a more accurate and measurable way. The aim is to evaluate the effectiveness of the new digital PBL-CBL method in teaching complex implant cases in esthetic area. Materials & Methods: A full digital workflow of dental implant therapy was established for patients with severely atrophic anterior maxilla. The digital data of cases done in the new workflow was used as teaching materials in digital PBL-CBL teaching. Fifty-four postgraduate students were randomly selected and divided into three groups, including traditional PBL-CBL group (students taught in a PBL-CBL method with no digital cases), digital PBL-CBL group (students taught in a PBL-CBL method with full digital cases) and control group (students taught in didactic teacher-centered method). After training for three months, a study of the students' opinions on the corresponding teaching method was carried out through a feedback questionnaire. A theory test was used to evaluate students' mastery of knowledge about tissue augmentation and esthetic implant restoration. A case analysis was used to determine whether students could apply the knowledge to problem solving. Results: The digital PBL-CBL method resulted in a higher rate of satisfaction than the traditional PBL-CBL method and the didactic teacher-centered method in all items except for "This approach decreases extracurricular work". Case analysis scores of the digital PBL-CBL group were significantly higher than that of the traditional PBL-CBL group and the control group. For the theory test, the digital PBL-CBL group (61.00 ± 6.80) but not traditional PBL-CBL group (55.22 ± 9.86) obtained a significant higher score than the control group (45.11 ± 12.76), although no significant difference was found between the digital PBL-CBL group and the traditional PBL-CBL group. Conclusion: Compared with other methods, students taught with the digital PBL-CBL method showed higher satisfaction and better performance in acquisition of academic knowledge and ability in solving practical clinical problems. The digital PBL-CBL method provided a promising alternative for teaching complex implant cases at the anterior maxilla.
Assuntos
Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Educação de Graduação em Medicina/métodos , Maxila/cirurgia , Aprendizagem Baseada em Problemas/métodos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Continuous severe horizontal bone defect is common in the aesthetic maxillary anterior area, and presents a major challenge in implant dentistry and requires predictable bone augmentation to increase the width of the alveolar bone. CASE SUMMARY: A 24-year-old man, with a history of well-controlled IgA nephropathy, presented to the Dentistry Department of our hospital complaining of missing his right maxillary anterior teeth 1 mo ago. Severe horizontal alveolar bone defects at sites of teeth 12, 13 and 14 were diagnosed. A modified guided bone regeneration surgical approach stabilizing the absorbable collagen membrane and particulate graft materials by periosteal diagonal mattress suture (PDMS) combined with four corner pins was used for this severe continuous horizontal bone defect. The outcome revealed that the newly formed alveolar ridge dimension increased from 0.72 mm to 11.55 mm horizontally 10 mo postoperatively, with no adverse events. The implant surgery was successfully performed. CONCLUSION: This case highlights that PDMS combined with four corner pins is feasible to maintain the space and stabilize the graft and membranes in severe continuous horizontal bone defect.
RESUMO
Ionic liquid-containing semipermeable membrane devices (IL-SPMDs) were developed to monitor the polycyclic aromatic hydrocarbons in water. Uptake kinetics of naphthalene, 1-methylnaphthalene, phenanthrene, pyrene, chrysene by layflat low-density polyethylene tubing (15 cm x 2 cm) filled with 0.5 ml 1-butyl-3-methylimidazolium hexafluorophosphate ionic liquid were studied in a laboratory continuous-flow system for the duration of 16 days. The device concentration factors were in the range of 830-7800 for the studied PAHs. The kinetic parameters of IL/water partition coefficients, analytes uptake rate constants and sampling rates were estimated using mathematical models. These parameters were used in the field experiment to estimate the concentrations of the PAHs in Lanzhou section of Yellow River in China, with the result in comparison with that obtained by triolein-SPMD.