INTRODUCTION

Dentition defects is one of the most common oral diseases in clinical practice. Progression of this disease causes not only masticatory dysfunction and articulation difficulties but also aesthetic damage, seriously disturbing people’s quality of life[1]. Furthermore, the ability to chew foods at the lesions is markedly reduced, which increases the intestinal burden among patients[2]. Long-term dentition defects also leads to compensatory ptosis of the corner of the mouth, deepening of wrinkles, and other marked changes in appearance. Currently, restorative treatment is the primary method used to fix dentition defects. Through such treatment, oral function and aesthetics of patients can be effectively improved. However, there is a gap between the conventional implant prosthesis and the receptor, resulting in lower reliability of the prosthesis[3] impeding the occlusal recovery of the body[4]. Moreover, in patients with long-term edentulism, the adjacent teeth on both sides tilt to a certain extent, thereby presenting challenges to the denture repair. A study found that implantation aided by 3D printing guide plate can improve the reliability of prosthesis[5]. This study analyzed the effect of orthodontic treatment combined with 3D printing guide plate implantation in dentition defects in an effort to provide scientific verification for its clinical application.

Diabetes develops in more than half of patients with chronic pancreatitis[23]. Most patients with pancreatic tumors have impaired glucose tolerance[24]. Endocrine and exocrine insufficiency are both consequences of advanced fibrosis.

MATERIALS AND METHODS

Clinical data

This prospective study enrolled 86 patients with dentition defects who underwent implant restoration after orthodontic treatment at our hospital between January 2018 and 2019.

In this study, we found that the efficacy in the intervention group was better than that in the control group, and the aesthetics also significantly improved. In the treatment of dentition defects, a substantial inflammatory response inevitably occurs in the alveolar bone of the lesion site, which is markedly destructive to both the bone surface and the periosteal structure. A meta-analysis of studies comparing the clinical outcomes of denture restorations and implants for the treatment of edentulism showed that implant restorations are more effective in the treatment of edentulism than dentures[13]. However, challenges still exists. During implant restoration, the mismatch between the implant and anatomical position of the body[14] causes tooth wear in the gingival and oral tissues[15], and the continuous inflammatory response in gingival tissues[16] further damages the local aesthetics[17]. Involuntary muscle spasms can also be caused by mismatched implant restorations[17], and abnormal changes in appearance can occur as the disease progresses[18]. Complications, due to unpredictability such as pulpal necrosis, root resorption, loosening, and loss of teeth are often observed after dental implantation that therefore not often promoted clinically[19]. In this study, the deviation values at the top and middle parts of the implants in the intervention group were lower than those in the control group, which also confirmed the significant advantage of 3D printing guide plate implantation[20]. In a comparative study of traditional and 3D-printed implant plates, Suo

[21] showed that 3D-printed implant plates had a significant accuracy advantage in the treatment of patients with dentition defects.

Methods

All patients were given an oral health examination. According to the imaging data, orthodontic treatment was adopted, and straight-wire technique or edgewise archwire fixation technique was opted for treatment. By observing the dislocation and inclination of teeth, the tooth space was adjusted in time to correct the lesion occlusion relationship. The patients in the control group received implant restoration: it was carried out in time based on the severity of dentition defects. Before operation, their oral cavity and surrounding skin were disinfected, sterile swabs were laid, and lidocaine (2% concentration) was administered for local anesthesia. Under the action of the guide plate, L-shaped or Hshaped incision was made on the periosteum and bone surface at the implantation point. After fully exposing the alveolar bone, drilling on the top of the alveolar ridge was performed, and the implant restoration was carried out by the imaging characteristics. After the operation, normal saline was used to clean the lesion and bleeding is stopped. After placing appropriate screws, soft tissues were sutured. Patients were given antibiotics routinely after operation, and the sutures were removed 7-10 d after operation.

Patients in the intervention group were treated with 3D printing guide plate implant restoration. Their lesions were scanned with computed tomography (CT) before operation. The model data of the patients were obtained using a 3Shape D700 series scanners from the United States. The occlusal relationship was simultaneously recorded using cone-beam CT and rubber molding. Occlusal rim was adopted for patients without malocclusion. After the relationship between the length, direction, and position of the implant was clear, the aforementioned data were imported into the 3D tool again for 3D reconstruction, and the preoperative plaster cast was confirmed using a laser scanner. The implant guide plate was prepared simultaneously based on real-time data registration during data reconstruction. Thereafter, the implant restoration was completed. Routine antibiotic treatment was administered postoperatively.

Outcome measures

The efficacy was compared in the two groups after surgery. When the dentition defect was repaired and there was no difference in the physiological function and color between the local lesions and normal tooth condition, the treatment was considered significantly effective. When the dentition defect was roughly repaired and there was a slight difference in the physiological function and color between the local lesions and normal tooth condition, the treatment was considered effective. When the dentition defect was not effectively repaired and there was a significant difference in the physiological function and color between the local lesions and normal tooth condition, the treatment was considered ineffective. The overall response rate was calculated as follows: (effective + significantly effective)/ (total number of cases)[6].

Alignment, complete coverage, and occlusal normality after treatment were compared between the two groups.

Before treatment, swallowing, masticatory, and phonic functions did not significantly differ between the groups (

> 0.05). After treatment, masticatory, swallowing, and phonic functions significantly improved in both groups. The masticatory (

= 2.980,

= 0.004), swallowing (

= 2.199,

= 0.031), and phonic functions (

= 3.950,

= 0.004) were significantly better in the intervention group than those in the control group. Further details are provided in Table 4.

In terms of dental function after treatment, the masticatory, swallowing, and phonic functions of the intervention group were significantly better than those of the control group.

小學(xué)低年級學(xué)生的內(nèi)心不夠?qū)Ｗ?，容易被其他事物分散注意力，這時我們教師就要運用巧妙的手段來幫助學(xué)生排除一些事物的干擾，引導(dǎo)學(xué)生將注意力放在文章之中。在進行低年級語文閱讀教學(xué)時，我就引導(dǎo)學(xué)生用手眼相結(jié)合的方法來專心閱讀。例如，在進行文章閱讀時，我就要求學(xué)生在手里拿著筆去做一些標注。手里有了筆，學(xué)生在遇到一些難以理解的句子時就可標注下來，而不是因為句子難懂而跳過或者直接放棄文章；手里有了筆，學(xué)生就可以將文章中的細節(jié)圈出來，從而更加專心地閱讀文章；手里有了筆，學(xué)生的注意力就集中了起來，閱讀效率就能得到提高。隨著這種閱讀與記錄同時進行的習(xí)慣的慢慢養(yǎng)成，學(xué)生在閱讀時的專注程度就會不斷提高。

The quality of life of patients was evaluated before and 6 mo after treatment using the Oral Health Impact Profile for Supported Partial Prostheses[8]. It was rated through the evaluation of the functional limitation, social interaction, and physical pain and discomfort of the patients. Higher scores it obtained, worse quality of life was among patients.

Statistical analysis

The study included 86 patients with dentition defects who were divided into two groups using a random number table, with each group including 43 patients. The control group received traditional implant prosthesis, whereas the intervention group received 3D printing guide plate implantation.

RESULTS

General data

確定變量是指明確實驗中的自變量、因變量和無關(guān)變量。在自然狀態(tài)下，造成某一現(xiàn)象的原因可能很多，也就存在多個變量。只有準確地確定變量，才能具有正確的邏輯推理前提，讓實驗設(shè)計有意義地進行下去。一般而言，實驗課題中都包含著自變量和因變量的關(guān)系，因此只有在明確實驗課題的基礎(chǔ)上，學(xué)生才能很容易確定變量。

Treatment effects

The overall response rate of the intervention group was significantly higher than that of the control group (95.35%

81.40%,

= 4.071,

= 0.044). Further details are provided in Table 2. Pictures of typical cases are shown in Figure 1.

因為視力不好，我只能去學(xué)汽車保養(yǎng)專業(yè)（汽車底盤的三級保養(yǎng)，給汽車底盤的若干個黃油嘴打黃油，給松動的螺絲擰緊，以及底盤清洗，等等）。這是一個很臟的工種，沒有人愿意學(xué)它。上課的時候，班級的學(xué)生只有寥寥幾個，而且個個心不在焉。

Cosmetic appearance

The number of cases with neatly arranged cosmetic appearance (

= 4.497,

= 0.034), complete coverage (

= 4.170,

= 0.041), and normal occlusion (

= 5.512,

= 0.019) was significantly higher in the intervention group than that in the control group. Further details are provided in Table 3.

?？且粔K教師家門口的教學(xué)教研試驗地，因其“接地氣”而倍受廣大師生喜愛。?？⒆銓W(xué)校教育教學(xué)實際，以推進素質(zhì)教育，挖掘、總結(jié)、推廣教研成果為宗旨，宣傳典型經(jīng)驗，探討熱點問題，堅持為教育管理和決策服務(wù)，為教育教學(xué)服務(wù)，為教研員、教師的專業(yè)成長服務(wù)，是促進教師教育教學(xué)理論積淀，幫助教師從課堂教學(xué)實踐走向教育教學(xué)理論研究的便利工具。校刊內(nèi)還有名師的課堂解析和評價，幫助教師學(xué)會觀課和評課，并從課堂實際教學(xué)中汲取養(yǎng)分，提高教師的課堂鑒賞力，從而促進教師的專業(yè)成長。實踐證明，?？膭?chuàng)辦對激發(fā)教師創(chuàng)作興趣，促進教學(xué)理論與實踐相融合，助力教師專業(yè)成長，提高課堂教學(xué)實效性等方面都有重要意義。

Dental function

The masticatory, swallowing, and phonic functions were compared between the two groups before and six months after treatment. These variables were rated using a 5-level Likert scale, with higher scores indicating better outcomes[7].

Implant deviations in the 3D plane

The deviation values and the deviation angle (

= 5.440,

= 0.000) at the top (

= 6.320,

= 0.000) and middle parts of the implants (

= 22.295,

= 0.000) in the intervention group were significantly lower than those in the control group (Table 5).

Quality of life

Before treatment, functional limitation, psychosocial and physical pain and discomfort, and total scores did not significantly differ between the groups (

> 0.05). After treatment, functional limitation, psychosocial and physical pain and discomfort, and total scores decreased in both groups. Functional limitations (

= 2.379,

= 0.020), psychosocial (

= 2.420,

= 0.000), physical pain and discomfort (

= 6.581,

= 0.000), and total scores (

= 2.140,

= 0.035) were significantly lower in the intervention group than in the control group. Further details are provided in Table 6.

哮喘的影響因素非常多，一般來說是由過敏因素引起的，除此之外還有一些精神心理因素。部分患者因?qū)ǚ圻^敏，接觸花粉會引發(fā)哮喘發(fā)作，在觀看一些鮮花盛開的電影時，也會出現(xiàn)哮喘發(fā)作的情況。由于呼吸道炎癥導(dǎo)致的呼吸道痙攣，從而導(dǎo)致患者氣急、喘息、咳嗽，呼吸哮鳴音等情況的出現(xiàn)。在急性期的患者，需要減少刺激，及時給予糖皮質(zhì)激素等藥物進行霧化吸入，同時采取解痙攣、平喘止咳的對癥治療[1]。近些年來，重癥哮喘的患者比例越來越高，這樣的重癥哮喘有別于普通哮喘，重癥哮喘起病較急，往往患者有多年的慢性支氣管炎、支氣管哮喘、肺心病等諸多合并癥的病史。

DISCUSSION

Dentition defect is a prevalent oral disease, and related research has found that nearly 60% of the patients with such disease will develop dental malformation, aggravating the case, which can cause a vicious spiral[9]. Orthodontic treatment before implantation can alleviate malocclusion and jaw malformation, make the mouth more desirable, and maintain the normal physiological alignment between the implant and the normal teeth in the mouth for a longer time. However, implants can only repair dentures, which makes it difficult to improve the beauty and function of teeth in the mouth. If implant restoration is directly implemented, it may expose the patients to the unfavorable implants and aesthetics, and reduce the repair effect because of abnormalities such as the loss of anterior teeth. Therefore, orthodontic treatment before implantation can potentially improve the outcomes of subsequent implant repair[10]. In the treatment of patients with dentition defects, an implant guide plate constitutes a pivotal part in the treatment of multiple missing teeth and poor alveolar bone[9]. Implant guide plates play a considerable guiding role, particularly for doctors with little experience.

Therefore, in the course of implant application, the selection of an appropriate implant guide plate plays a decisive role[10]. The fabrication of implant guide plates has many advantages, and plaster casts are routinely used for their preparation. Although the fabrication process is simple, there have been few analyses of the internal bone tissue structure of the edentulous sites. After implantation, the risk of implant deviation increases markedly[11]. Simultaneously, it is necessary to rely on clinical experience during implantation[12]. During this process, the matching accuracy of the model and tooth may be insufficient owing to the use of the vacuum-formed pressure film technology. During model preparation, it was necessary to rotate the model repeatedly. This process may increase the unreliability of the implant guide plate and further enlarge the offset after treatment. With the continuous clinical application of 3D technology, the anatomical position of the dentition defect site is fully considered in the preparation of the model and its accuracy is greatly improved.

The inclusion criteria were as follows: (1) receiving treatment with orthodontics and desire for a fixed denture restoration; (2) no retention value among all residual teeth in the dentition defects; and (3) signing the informed consent. The exclusion criteria were as follows: (1) severe cardiovascular and cerebrovascular diseases; (2) cognitive dysfunction; (3) inability to perform in this study; and (4) intolerance to the implants or restorations used in this study. This study was approved by the Ethics Committee of our institution.

作者簡介： 詹建兵，男，漢族，浙江龍游人，龍游縣第二高級中學(xué)，科研與信息處主任，信息技術(shù)教師，高級教師，本科學(xué)歷。

In terms of dental function after treatment, the masticatory, swallowing, and phonic functions of the intervention group were significantly better than those of the control group in our study, suggesting that with the use of 3D printing guide plate implantation, the matching of implants to the body is markedly improved, which has a positive role in the recovery of muscle strength at the local lesions. In addition, the quality of life of the intervention group was significantly higher than that of the control group, showing that through the improvement of the tooth function and aesthetics of the patients, the use of 3D printing guide plate implantation has a positive role in improving the quality of life of patients after surgery.

In summary, following the orthodontic treatment combined with 3D printing guide plate implant restoration in patients with dentition defects, the masticatory and phonic functions of the patients significantly improved, so did the quality of life and psychological health. On the basis of these findings, 3D printing guide plate implantation is recommended for clinical application.

3.1.3 規(guī)范無菌操作 Read等［4］一項隨機調(diào)查發(fā)現(xiàn)，置管術(shù)者的口罩、帽子、手套、洗手衣以及巾單等的嚴格無菌能明顯減少中心靜脈置管感染的發(fā)生率。因此置管時應(yīng)監(jiān)督術(shù)者嚴格無菌操作，注藥時加強消毒。

CONCLUSION

To sum up, we have confirmed the significant advantages of 3D printing guide plate implantation, including significant recovery of muscle strength, significant improvement in oral function and quality of life, and a more aesthetic facial appearance in patients at the local lesion site 3D printing guided implant reconstruction is conducive to improving masticatory and phonic functions, and is recommended for clinical application.

ARTICLE HIGHLIGHTS

Research motivation

There exists a gap between the conventional prosthesis and the body, resulting in a decrease in the reliability of the prosthesis, consequently impacting the recovery of the occlusal relationship of the body.

Research objectives

This study aimed to investigate the influence of orthodontic treatment combined with 3D printing guide plate implantation on masticatory and language functions in patients with dentition defects.

Research methods

Data was analyzed using the SPSS 19.0 in this study, in which measurement data were measured as mean ± SD. An independent sample

-test was also conducted. Enumeration data were expressed as

(%), and comparison between groups were made by

test.

< 0.05 indicated statistical significance.

There were 44 women and 42 men aged 36-61 years (average age: 45.67 ± 3.83 years). The average body mass index (BMI) was 24.90 ± 2.22 kg/m

. Seventeen patients had complete perioral dentition defect, 30 had lower tooth losses, and 39 had upper tooth losses. The patients were divided into two groups using a random number table; each group included 43 patients, and there was no significant difference in the types of dentition defect, sex, age, or BMI between the groups (

> 0.05) (Table 1).

Research results

Six months after treatment, CT was performed in both groups, and the data were inputted into the 3D tool for 3D reconstruction. The deviation values and the deviation angles at the top and middle parts of the implants were compared between the two groups.

Research conclusions

Orthodontics combined with 3D printing guide plate implant restoration can significantly improve the masticatory and language functions of patients with dentition defects.

子宮內(nèi)膜癌是一種婦科較為嚴重的惡性腫瘤，在女性婦科腫瘤中排第三位，多發(fā)于絕經(jīng)的中年女性，主要是子宮內(nèi)膜上皮的腫瘤，是一種嚴重危害女性健康和生命的疾病。傳統(tǒng)的診斷方法主要是腹部彩超和陰道彩超，但是由于腹部彩超和陰道彩超的局限性，導(dǎo)致診斷的準確性低，容易發(fā)生錯診、誤診和漏診。隨著醫(yī)學(xué)診斷的發(fā)展，實時超聲彈性成像是一種新型的診斷技術(shù)。本研究對我院婦科收治的74例子宮內(nèi)膜癌浸潤子宮肌層患者進行診斷，探討實時超聲彈性成像的診斷效果，為今后治療的奠定基礎(chǔ)。

Research perspectives

The results of this study on orthodontics combined with 3D printing guide plate implant restoration will lay the foundation for further clinical utility of this method.

FOOTNOTES

Yan LB contributed to methodology and writing - original draft preparation; Zhou YC contributed to software and validation; Wang Y contributed to data curation and investigation; Yan LB and Li LX contributed to data curation and investigation; Li LX contributed to supervision; and all authors have read and agreed to the published version of the manuscript.

This study was approved by the Lintong Rehabilitation and Convalescent center.

This study has not yet been registered.

All patients signed an informed consent form.

The authors have no competing interests to declare.

There is no additional data available.

The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BYNC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

China

現(xiàn)代學(xué)徒制在具體的實踐過程中，必須有企業(yè)的參與，不論是人才培養(yǎng)模式的修訂、人才培養(yǎng)方案的制定等，都是建立在學(xué)校和企業(yè)深度合作的基礎(chǔ)上的。目前校企合作的方式主要有校辦企業(yè)、引企入校和建立合作企業(yè)等多種方式。

Li-Bo Yan 0000-0003-3212-6313; Yu-Chao Zhou 0000-0002-0121-425X; Yang Wang 0000-0003-0981-0811;Li-Xin Li 0000-0002-3707-5204.

Wang JL

A

Wang JL

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