With the advent of big data era and improvement of computer performance, the artificial intelligence (AI) technology has rapidly boosted in the field of stomatology. Dental caries is one of the cutting-edge research domains in stomatology. The application of AI in dental caries is expected to promote intelligent, precise and high-efficient diagnosis and treatment of caries. This article focuses on the application of AI in medical-aided diagnosis, treatment and risk prediction of caries and discusses their challenges.

Objective To observe the effect of wrist-hand orthosis combined with modified constraint-induced movement therapy(mCIMT)on upper limb and hand function in patients with stroke. Methods From February,2022 to December,2023,32 patients after stroke in Huashan Hospital,Fudan University were randomly assigned to control group(n=16)and experimental group(n=16).Both groups underwent routine re-habilitation,and wore constraint glove almost four hours a day.The experimenal group wore dynamic wrist-hand orthosis four hours everyday,additionally;five days every week,for three weeks.They were evaluated with Wolf Motor Function Test(WMFT),Action Reach Arm Test(ARAT),the strength of gripping,Amount of Use(AOU)and Quality of Movement(QOM)of Motor Activity Log(MAL),Hamilton Anxiety Scale(HAMA)and Hamil-ton Depression Scale(HAMD)before and after treatment,while root mean square ratio of affected/healthy exten-sor muscle of wrist was measured with surface electromyography Results After treatment,the scores of WMFT,ARAT,MAL-QOM,HAMA and the root mean square ratio of affected/healthy extensor muscle of wrist improved in both groups(|t|＞2.179,P＜0.05),and the improvement of WMFT score and the strength of gripping was greater in the experimental group than in the control group(|t|＞2.343,P＜0.05);the strength of gripping,the scores of MAL-AOU and HAMD improved in the experimental group(|t|＞2.819,P＜0.05). Conclusion mCIMT assisted with dynamic wrist-hand orthosis could improve upper limb and hand function in stroke pa-tients.

Endo-periodontal lesions(EPLs)involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for endodontic diseases is categorized into static guided endodontics (SGE), necessitating a meticulously designed template, and dynamic guided endodontics (DGE), which utilizes an optical triangulation tracking system. Based on cone-beam computed tomography (CBCT) images superimposed with or without oral scan (OS) data, a virtual template is crafted through software and subsequently translated into a 3-dimensional (3D) printing for SGE, while the system guides the drilling path with a real-time navigation in DGE. DGT was reported to resolve a series of challenging endodontic cases, including teeth with pulp obliteration, teeth with anatomical abnormalities, teeth requiring retreatment, posterior teeth needing endodontic microsurgery, and tooth autotransplantation. Case reports and basic researches all demonstrate that DGT stand as a precise, time-saving, and minimally invasive approach in contrast to conventional freehand method. This expert consensus mainly introduces the case selection, general workflow, evaluation, and impact factor of DGT, which could provide an alternative working strategy in endodontic treatment.
Humans ; Consensus ; Endodontics/methods* ; Tooth ; Printing, Three-Dimensional ; Dental Care ; Cone-Beam Computed Tomography ; Root Canal Therapy

ObjectiveTo clarify the feasibility of the 3D scanning volume method for distal upper limb volume measurement, and to analyze its scorer reliability and criterion-related validity. MethodsFrom January to March, 2022, a therapist (operator A) who had not been exposed to 3D scanning volume method and water displacement method was trained to use a handheld 3D laser scanner and a spilt cup to measure the volume of a PVC distal upper limb model. The operation time of 30 operations of each method was recorded. The learning curves of the two methods were plotted using cumulative sum (CUSUM) analysis. The curve was cut into the learning stage and the mastery stage by the vertex of peak. The times required to reach the mastery stage and the operation time of the mastery stage for the two methods were recorded. A total of 20 healthy subjects were recruited from Huashan Hospital of Fudan University. Two trained therapists (operator A and operator B) measured the bilateral distal upper limb volume using a handheld 3D laser scanner, and operator A measured the bilateral distal upper limb volume using a spilt cup. ResultsThe fitting learning curve of the 3D scanning volume method (R² = 0.984) reached its peak after eight times of operation; while that of the water displacement method (R² = 0.494) reached its peak after five times of operation. At mastery stage, the operator spent less time using 3D scanning volume method than using water displacement method (P < 0.05). The intraclass correlation coefficient between the two operators were both 0.979 for bilateral distal upper limb volume measure (P < 0.001). The Pearson coefficients was above 0.979 between 3D scanning volume method and water displacement method (P < 0.001). ConclusionA therapist can master the use of the 3D scanning volume method after eight times of operation, and the operation time of 3D scanning volume method is shorter than that of water displacement method at mastery stage. The 3D scanning volume method is well reliable and valid, that can be used as an alternative to the water displacement method for distal upper limb volumetric measurement.

Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.
Consensus ; Dental Care ; Dental Caries/prevention & control* ; Humans ; Prevalence

Regenerative endodontic procedures (REPs) is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis. The ultimate objective of REPs is to regenerate the pulp-dentin complex, extend the tooth longevity and restore the normal function. Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports, case series, cohort studies, and randomized controlled studies. However, variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics. The heterogeneity in protocols may cause confusion among dental practitioners, thus guidelines and considerations of REPs should be explicated. This expert consensus mainly discusses the biological foundation, the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis, as well as the main complications of this treatment, aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies, suggesting REPs may become a more consistently evidence-based option in dental treatment.
Humans ; Consensus ; Regenerative Endodontics ; Dental Pulp Necrosis/therapy* ; Dentists ; Professional Role ; Dental Care

Objective:To explore the application of the Simodont dental trainer in preclinical manual dexterity training for dental students of different grades, and to discuss its effect by quantitatively evaluating their practice results.Methods:The evaluation was conducted among 118 students in the Department of Stomatology, Shantou University Medical College from Batch 2015 to Batch 2018. Each student had five different manual dexterity modules for training. Each module had three levels of difficulty and was required to be completed in 30 minutes. The assessment index included Target, Leeway Bottom and Sides, Container Bottom and Sides, which was provided by the Simodont dental trainer. The operating time (in seconds), the displacement of the dental hand pieces and the dental mirrors (in meters) were simultaneously recorded. SPSS 25.0 was used for statistical analysis.Results:For the index Target, Leeway Bottom and Sides, Container Bottom and Sides, the results showed that there was a statistical difference between students who passed pre-clinical training and who did not take the professional course ( P < 0.001). For the index Target, differences were showed among students from different grades in all modules ( P < 0.001). Conclusion:The circle module, channel module, hollow-circle module and cross-module in the Simodont dental trainer have sensitivity to discriminate the manual dexterity of different levels of dental students. The further assessment of the discrimination of the manual dexterity is required for assume-block module. The Simodont dental trainer can quantitatively measure the manual dexterity of dental students, which is important for the quantitative evaluation of dental preclinical education.