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"Maxillofacial surgery"
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The application of virtual reality and augmented reality in Oral & Maxillofacial Surgery
2019
Background
Virtual reality is the science of creating a virtual environment for the assessment of various anatomical regions of the body for the diagnosis, planning and surgical training. Augmented reality is the superimposition of a 3D real environment specific to individual patient onto the surgical filed using semi-transparent glasses to augment the virtual scene.. The aim of this study is to provide an over view of the literature on the application of virtual and augmented reality in oral & maxillofacial surgery.
Methods
We reviewed the literature and the existing database using Ovid MEDLINE search, Cochran Library and PubMed. All the studies in the English literature in the last 10 years, from 2009 to 2019 were included.
Results
We identified 101 articles related the broad application of virtual reality in oral & maxillofacial surgery. These included the following: Eight systematic reviews, 4 expert reviews, 9 case reports, 5 retrospective surveys, 2 historical perspectives, 13 manuscripts on virtual education and training, 5 on haptic technology, 4 on augmented reality, 10 on image fusion, 41 articles on the prediction planning for orthognathic surgery and maxillofacial reconstruction. Dental implantology and orthognathic surgery are the most frequent applications of virtual reality and augmented reality. Virtual planning improved the accuracy of inserting dental implants using either a statistic guidance or dynamic navigation. In orthognathic surgery, prediction planning and intraoperative navigation are the main applications of virtual reality. Virtual reality has been utilised to improve the delivery of education and the quality of training in oral & maxillofacial surgery by creating a virtual environment of the surgical procedure. Haptic feedback provided an additional immersive reality to improve manual dexterity and improve clinical training.
Conclusion
Virtual and augmented reality have contributed to the planning of maxillofacial procedures and surgery training. Few articles highlighted the importance of this technology in improving the quality of patients’ care. There are limited prospective randomized studies comparing the impact of virtual reality with the standard methods in delivering oral surgery education.
Journal Article
Biofilm Formation on Dental Restorative and Implant Materials
by
RINASTITI M.
,
SISWOMIHARDJO W.
,
VAN DER MEI H. C.
in
Anti-Infective Agents - chemistry
,
antimicrobials
,
Bacterial Adhesion - physiology
2010
Biomaterials for the restoration of oral function are prone to biofilm formation, affecting oral health. Oral bacteria adhere to hydrophobic and hydrophilic surfaces, but due to fluctuating shear, little biofilm accumulates on hydrophobic surfaces in vivo. More biofilm accumulates on rough than on smooth surfaces. Oral biofilms mostly consist of multiple bacterial strains, but Candida species are found on acrylic dentures. Biofilms on gold and amalgam in vivo are thick and fully covering, but barely viable. Biofilms on ceramics are thin and highly viable. Biofilms on composites and glass-ionomer cements cause surface deterioration, which enhances biofilm formation again. Residual monomer release from composites influences biofilm growth in vitro, but effects in vivo are less pronounced, probably due to the large volume of saliva into which compounds are released and its continuous refreshment. Similarly, conflicting results have been reported on effects of fluoride release from glass-ionomer cements. Finally, biomaterial-associated infection of implants and devices elsewhere in the body is compared with oral biofilm formation. Biomaterial modifications to discourage biofilm formation on implants and devices are critically discussed for possible applications in dentistry. It is concluded that, for dental applications, antimicrobial coatings killing bacteria upon contact are more promising than antimicrobial-releasing coatings.
Journal Article
A Randomized Trial of Adenotonsillectomy for Childhood Sleep Apnea
by
Arens, Raanan
,
Ware, Janice
,
Snyder, Karen
in
Adenoidectomy
,
Apnea
,
Biological and medical sciences
2013
This randomized trial showed no effect of early adenotonsillectomy, as compared with watchful waiting, on the primary outcome of attention and executive functioning in children with obstructive sleep apnea. Many secondary outcomes favored early surgery.
The childhood obstructive sleep apnea syndrome is associated with numerous adverse health outcomes, including cognitive and behavioral deficits.
1
The most commonly identified risk factor for the childhood obstructive sleep apnea syndrome is adenotonsillar hypertrophy. Thus, the primary treatment is adenotonsillectomy, which accounts for more than 500,000 procedures annually in the United States alone.
2
Nevertheless, there has been no controlled study evaluating the benefits and risks of adenotonsillectomy, as compared with watchful waiting, for the management of the obstructive sleep apnea syndrome.
The Childhood Adenotonsillectomy Trial (CHAT) was designed to evaluate the efficacy of early adenotonsillectomy versus watchful waiting with supportive . . .
Journal Article
Automated cephalometric landmark detection with confidence regions using Bayesian convolutional neural networks
2020
Background
Despite the integral role of cephalometric analysis in orthodontics, there have been limitations regarding the reliability, accuracy, etc. of cephalometric landmarks tracing. Attempts on developing automatic plotting systems have continuously been made but they are insufficient for clinical applications due to low reliability of specific landmarks. In this study, we aimed to develop a novel framework for locating cephalometric landmarks with confidence regions using Bayesian Convolutional Neural Networks (BCNN).
Methods
We have trained our model with the dataset from the ISBI 2015 grand challenge in dental X-ray image analysis. The overall algorithm consisted of a region of interest (ROI) extraction of landmarks and landmarks estimation considering uncertainty. Prediction data produced from the Bayesian model has been dealt with post-processing methods with respect to pixel probabilities and uncertainties.
Results
Our framework showed a mean landmark error (LE) of 1.53 ± 1.74 mm and achieved a successful detection rate (SDR) of 82.11, 92.28 and 95.95%, respectively, in the 2, 3, and 4 mm range. Especially, the most erroneous point in preceding studies, Gonion, reduced nearly halves of its error compared to the others. Additionally, our results demonstrated significantly higher performance in identifying anatomical abnormalities. By providing confidence regions (95%) that consider uncertainty, our framework can provide clinical convenience and contribute to making better decisions.
Conclusion
Our framework provides cephalometric landmarks and their confidence regions, which could be used as a computer-aided diagnosis tool and education.
Journal Article
Update on Dental Nanocomposites
by
CHEN M.-H.
in
Biological and medical sciences
,
Calcium Phosphates - chemistry
,
Cariostatic Agents - chemistry
2010
Dental resin-composites are comprised of a photo-polymerizable organic resin matrix and mixed with silane-treated reinforcing inorganic fillers. In the development of the composites, the three main components can be modified: the inorganic fillers, the organic resin matrix, and the silane coupling agents. The aim of this article is to review recent studies of the development of dental nanocomposites and their clinical applications. In nanocomposites, nanofillers are added and distributed in a dispersed form or as clusters. For increasing the mineral content of the tooth, calcium and phosphate ion-releasing composites and fluoride-releasing nanocomposites were developed by the addition of DCPA-whiskers or TTCP-whiskers or by the use of calcium fluoride or kaolinite. For enhancing mechanical properties, nanocomposites reinforced with nanofibers or nanoparticles were investigated. For reducing polymerization shrinkage, investigators modified the resin matrix by using methacrylate and epoxy functionalized nanocomposites based on silsesquioxane cores or epoxy-resin-based nanocomposites. The effects of silanization were also studied. Clinical consideration of light-curing modes and mechanical properties of nanocomposites, especially strength durability after immersion, was also addressed.
Journal Article
Cone Beam Computed Tomography in Oral and Maxillofacial Surgery: An Evidence-Based Review
by
Weiss, Robert
,
Read-Fuller, Andrew
in
Computed tomography
,
cone beam computed tomography (CBCT)
,
Dental implants
2019
Cone Beam Computed Tomography (CBCT) is a valuable imaging technique in oral and maxillofacial surgery (OMS) that can help direct a surgeon’s approach to a variety of conditions. A 3-dimensional analysis of head and neck anatomy allows practitioners to plan appropriately, operate with confidence, and assess results post-operatively. CBCT imaging has clear indications and limitations. CBCT offers the clinician 3-dimensional and multi-planar views for a more accurate diagnosis and treatment without the financial burden and radiation exposure of conventional computed tomography (CT) scans. Furthermore, CBCT overcomes certain limitations of 2-dimensional imaging, such as distortion, magnification, and superimposition. However, CBCT lacks the detailed depiction of soft tissue conditions for evaluation of pathologic conditions, head and neck infections, and temporomandibular joint (TMJ) disc evaluation. This review evaluates the evidence-based research supporting the application of CBCT in the various fields of oral and maxillofacial surgery, including dentoalveolar surgery, dental implants, TMJ, orthognathic surgery, trauma, and pathology, and will assess the value of CBCT in pre-operative assessment, surgical planning, and post-operative analysis when applicable. Additionally, the significant limitations of CBCT and potential areas for future research will be discussed.
Journal Article
Cytokine Expression and Accelerated Tooth Movement
by
KHABENSKY I.
,
KHOO E.
,
LIU Y.
in
Alveolar Process - cytology
,
Alveolar Process - immunology
,
Animals
2010
It has been shown that inhibiting the expression of certain cytokines decreases the rate of tooth movement. Here, we hypothesized that stimulating the expression of inflammatory cytokines, through small perforations of cortical bone, increases the rate of bone remodeling and tooth movement. Forty-eight rats were divided into 4 groups: 50-cN force applied to the maxillary first molar (O), force application plus soft tissue flap (OF), force application plus flap plus 3 small perforations of the cortical plate (OFP), and a control group (C). From the 92 cytokines studied, the expression of 37 cytokines increased significantly in all experimental groups, with 21 cytokines showing the highest levels in the OFP group. After 28 days, micro-computed tomography, light and fluorescent microscopy, and immunohistochemistry demonstrated higher numbers of osteoclasts and bone remodeling activity in the OFP group, accompanied by generalized osteoporosity and increased rate of tooth movement.
Journal Article
Research on the application of CBL combined with BOPPPS teaching mode in oral and maxillofacial surgery teaching: a randomized controlled study
by
Gao, Ning
,
Li, Na
,
He, Wei
in
692/700/3032/3053
,
692/700/3032/3053/3054
,
692/700/3032/3053/3055
2024
To discuss the application value of Case-based Learning (CBL) combined with Bridge-In, Objective, Pre-assessment, Participatory Learning, Post-assessment, and Summary (BOPPPS) model into master students’ program of oral and maxillofacial surgery. 38 master’s students in oral and maxillofacial surgery at Y2 and Y3 from January 2022 to December 2022 are selected as the research objects. They are randomly assigned into two learning groups, namely the traditional LBL (Learn-based Learning) (19 participants) and CBL combined with BOPPPS mode (19 participants). Their theoretical knowledge was assessed after training and the modified Mini-Clinical Evaluation Exercise (Mini-CEX) scale was used to score their clinical thinking. At the same time, the Personal Teaching Efficiency and the Teachers’ Sense of Teaching Efficiency (TSTE) were evaluated, and students’ satisfaction with teaching outcomes was investigated. The basic theoretical knowledge, clinical case analysis and total scores of the experimental group were better than those of the control group, with statistically significant difference (
P
<0.05). Based on the evaluation of clinical speculative thinking by the modified Mini-CEX, it is found that except for the medical history writing level without statistically significant difference (
P
>0.05), the other four items and total scores in the experimental group were better than those in the control group, with statistically significant difference (
P
<0.05).The Personal Teaching Efficiency, TSTE and total scores were higher than those before adopting CBL combined with BOPPPS teaching mode, with statistically significant difference (
P
<0.05).The sampled master’s students in experimental group believed that the new teaching method could improve students’ ability to clinical speculative thinking, with statistically significant difference in all aspects (
P
<0.05).More participants in the experimental group suggested that the new teaching mode has increased learning pressure, but without statistically significant difference (
P
>0.05). CBL combined with BOPPPS teaching method can improve students’ clinical critical thinking ability and help them adapt to the clinical rhythm. It is an effective measure to ensure teaching quality and is worthy of promotion. It is worthwhile to promote the application of CBL combined with BOPPPS mode into master’s course of oral and maxillofacial surgery, which not only improve the basic theoretical knowledge and speculative thinking ability of master’s students, but also improve the teaching efficiency.
Journal Article
Quantifying the speed-accuracy trade-off of large language models on oral and maxillofacial surgery multiple-choice questions
by
Tran, Minh Ngoc
,
Pham, Ngo The Minh
,
Ha, Thi Bich Ngoc
in
692/700/3032
,
692/700/3032/3139
,
692/700/3032/3144
2025
Large language models (LLMs) such as GPT-4o, Copilot and Gemini are entering dental curricula, yet their suitability for real-time decision support remains unclear because most evaluations report accuracy alone. This prospective in silico diagnostic-accuracy study benchmarked six engines—GPT-4o, OpenAI o3, Copilot-Quick, Copilot-Deep, Gemini-Flash and Gemini-Pro—against 1766 single-best-answer multiple-choice questions from a contemporary oral and maxillofacial surgery (OMFS) board-review text. Textbook keys served as the reference standard. Overall and domain-level accuracy, intra-model answer consistency and per-batch response latency were recorded; χ² tests compared accuracies and Kruskal–Wallis with multiplicity-adjusted Mann–Whitney U tests compared response times. Accuracy differed significantly across engines (χ² = 97.31,
p
< 0.001), ranging from 77.9% for Copilot-Quick to 88.3% for Gemini-Pro. Reasoning-optimised variants (o3, Copilot-Deep, Gemini-Pro) exceeded their speed-tuned counterparts by 3.8–6.2% points, with the largest gains in trauma, craniofacial deformity and orthognathic surgery domains. These improvements incurred a marked latency penalty: median response times of 2.1–3.1 s versus 0.1–0.2 s for the faster engines. Each additional 3–6 correct answers per 100 items therefore required roughly 2–3 s of extra processing. Items unanswered by all models clustered around rare numeric facts and negatively worded stems. Reasoning-optimised LLMs deliver clinically meaningful accuracy gains on OMFS board questions, but educators and clinicians must weigh this benefit against slower output and maintain expert oversight to mitigate residual knowledge gaps.
Journal Article