Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.

Bone grafting is a primary method for treating bone defects. Among various graft materials, xenogeneic bone substitutes are widely used in clinical practice due to their abundant sources, convenient processing and storage, and avoidance of secondary surgeries. With the advancement of domestic production and the limitations of imported products, an increasing number of bone filling or grafting substitute materials isentering clinical trials. Relevant experts have drafted this consensus to enhance the management of medical device clinical trials, protect the rights of participants, and ensure the scientific and effective execution of trials. It summarizes clinical experience in aspects, such as design principles, participant inclusion/exclusion criteria, observation periods, efficacy evaluation metrics, safety assessment indicators, and quality control, to provide guidance for professionals in the field.

Introduction Cleidocranial dysplasia (CCD) is a genetic disorder characterized by distinctive oral manifestations, making dental anomalies a key diagnostic criterion and treatment focus. Methods We retrospectively enrolled 32 patients diagnosed with CCD with detailed dental records (19 males and 13 females; mean age, 20.5 years). The detailed characteristics of impacted permanent teeth and supernumerary teeth were analyzed, and treatment considerations and outcomes for the abnormal dentition were summarized. Results Among permanent teeth, 43.53% were impacted. A significant variation in the likelihood of tooth impaction was observed depending on the tooth position. On the basis of nonlinear regression analysis, this study identified a clear trend correlating the probability of impacted teeth with the sequence of permanent tooth eruption, with this probability exhibiting a distinct increase followed by a decrease (with R2 values in female and male patients of 0.65 and 0.84, respectively). In addition, 27 patients (84.4%) had supernumerary teeth, with 206 supernumerary teeth identified, predominantly of the supplemental premolar type (75.73%). There was a correlation between the morphology of supplemental teeth and their locations in the dentition. Among 10 patients with follow-up periods of >2 years, 117 impacted teeth were recorded, 61 teeth were involved in the treatment, 16 (26.23%) erupted after the extraction of retained deciduous or supernumerary teeth, and 33 teeth (54.10%) were successfully erupted through orthodontic traction. However, orthodontic treatment requires an extended period, and the periodontal conditions of treated teeth may require long-term maintenance. Conclusions This study reveals a potential relationship between tooth impaction and the sequence of tooth eruption. It also distinguishes the distribution and morphologic characteristics of supernumerary teeth in patients with CCD from those in the general population. In addition, by analyzing clinical data, this study provides a summary of treatment considerations and outcomes for abnormal dentition in patients with CCD.

Background Perforation of the lingual cortex while placing dental implants in the interforaminal region of the mandible can cause severe hemorrhage. The purpose of this study was to evaluate the features of mandibular lingual foraminals (MLFs) and locational relationship between them and lingual mucosal vessels (LMVs) by CT/MRI fusion volumetric images. Methods 37 images within complete anterior mandibular region using both MSCT and three-dimensional volumetric interpolated breath-hold examination (3D-VIBE) MRI were taken from our imaging archives. After exclusion of 11 for lesions or artifacts, 26 CT/MRI fusion volumetric images were included to evaluate the frequency, diameter, and position of MLFs. The anterior mandibular region was divided into 4 equal segments under each teeth, and 40 regions were got from C5 to D5. Furthermore, the positional relationship between MLFs and LMVs was analyzed in this coordinate system. Results 62 MLFs (73.81%) were located below the incisors, followed by premolars (21.43%) and canines (4.76%). Female bias, the mean diameter of the female was 0.08 mm while the male was 0.21 mm. The total number of LMVs was most distributed on lingual side of C1 and D1. According to Spearman’s correlation coefficient, the location of MLFs was related to LMVs. The MLFs in fourth segment of D1 were positively moderately correlated with LMVs in fourth segment of D4, while the MLFs in third segment of C1 showed a weak positive correlation with LMVs in third segment of D4. Conclusions The features and the correlation between MLFs and LMVs in CT/MRI fusion volumetric images may offer reference to dentists when only MLFs can been seen on routine preoperative CT examination of implants. Trial registration Retrospectively registered. (D2018-072)

口腔锥形束CT(cone-beam computed tomography,CBCT)临床实践标准化文件的建立是保障CBCT合理使用、获得精准诊疗信息,以及维护患者合理权益的前提.在过去CBCT发展的近20年间,国际上陆续发布与CBCT临床实践相关的各类声明、共识或指南等标准化文件近30部,为当地从业人员使用CBCT的方方面面提供指导.这些标准化文件在涵盖的内容以及制定的方法学上有所不同,随着近年临床实践指南相关方法学的完善,以及各级学会、机构对高质量标准化文件的要求,未来CBCT相关标准化文件的制定和更新需要在完整性和科学性两方面达到更高的水平.鉴于此,本文对国内外已有标准化文件的涵盖内容以及制定方法进行了总结和回顾,以期为国内高质量CBCT标准化文件的制定提供参考.

为培养合格的口腔临床医生,加强考试管理,严格过程性考核,四川大学华西口腔医学院口腔颌面影像专业基地实施了全过程、多元化的考核改革.在过程性考核部分,首先,通过增加学员工作量表的填写,及时反馈学员培训情况,真实反映考勤记录;其次,在临床培训与理论教学中,综合评价学员的课堂表现,提升其综合思考临床问题的能力.在结果性考核部分,弱化传统理论考核方法,强化综合性临床问题研究能力.考核前指导学员灵活选题,规范PPT格式;考核后综合评分,由专家提出意见,提升学员的临床自信、科研自信,帮助学员在有限的培训时间内拓展学习深度与广度.通过对考试方式的梳理、考核结果的分析,"全过程、多元化"考核模式能够更真实地反映学员培训成果,为规范化培训进一步地改进和推广建立良好的基础.

目的 运用锥形束CT(CBCT)研究牙源性因素对上颌窦黏膜增厚的影响,同时,通过对上颌窦黏膜增厚的随访,研究口腔治疗的作用.方法 回顾性分析2017年8—12月四川大学华西口腔医院就诊的患者,通过CBCT图像筛选出上颌窦最大黏膜厚度>2 mm的患者,评估上颌窦底及上颌窦黏膜增厚与患牙的关系,同时,记录患牙及其治疗的情况,观察随访前后上颌窦黏膜增厚的变化.结果 黏膜厚度与炎症距窦底的距离呈极弱负相关(P<0.05,r=-0.154),而根尖距窦底的距离与黏膜厚度无直接相关性(P>0.05).在治疗组中,窦底破坏组的黏膜厚度变化较窦底连续组大,黏膜厚度变化与根尖距窦底的距离呈弱负相关(P<0.01,r=-0.382),黏膜厚度变化与炎症距窦底的距离呈中等程度负相关(P<0.001,r=-0.524).结论 上颌窦炎的严重程度可能更大程度上取决于根尖周炎症边缘距窦底的远近而与单纯的根尖位置没有明显的关系.但从治疗效果来讲,炎症病变离上颌窦越近,上颌窦底越易被破坏,上颌窦炎受牙源性因素影响越大,口腔治疗的效果也越好.

目的:评价猪小肠黏膜下层(SIS)可吸收生物膜用于牙槽骨和/或软组织修复重建的有效性和安全性.方法:采用随机、单盲、平行对照、多中心、非劣效临床试验设计.主要评价指标为术后0 d及180 d术区牙槽嵴最大长度、最大高度和最大宽度的改变.次要观察指标为术区牙槽骨增生和吸收变化,牙槽骨基质边缘线变化,试验用膜是否破损,手术切口愈合,排异反应及填充后症状.通过不良事件发生频率和严重程度评价SIS可吸收生物膜安全性.结果:本研究共入组280例,完成272例,脱落8例,脱落率为2.86％.180天影像学有效率FAS(PPS),试验组83.57％(91.34％)、对照组81.43％(92.62％),试验组率-对照组率率差(95％CI),FAS结果为2.14％(-6.75％,11.04％),PPS结果为-1.28％(-8.03％,5.46％),组间差别无统计学意义.180 d牙槽骨增生和吸收变化、牙槽骨基质边缘线变化,术后12 d试验用膜破损情况、临床手术切口愈合情况,各访视点排异反应和填充状况组间无显著性差异.两组治疗不良事件及严重不良事件发生情况组间差别无统计学意义.结论:SIS可吸收生物膜对于引导牙槽骨和/或软组织修复重建的效果非劣于Bio-Gide可吸收生物膜.

为了不断提高口腔医学影像学临床教学质量,设计制作口腔医学影像检查虚拟仿真实训系统,并将其应用于四川大学华西口腔医学院2017级八年制本科生临床实习前的岗前培训.应用结果显示,所有学生通过反复训练均获得满分.另外,问卷调查结果显示,近90％的学生对该系统表示满意,所有学生均认可该系统及各个模块的使用价值,93.1％的学生表示愿意在临床实习前通过该系统进行岗前培训.因此,将口腔影像虚拟仿真教学系统应用于本科教学可以弥补传统口腔影像教学中的不足,取得更好的教学效果.

Background Cleidocranial dysplasia (CCD) is a rare and underdiagnosed congenital disorder in dentistry. The purpose of this study was to illustrate and quantify the maxillofacial bone abnormalities detected on panoramic radiographs from a relatively large retrospective case series and to provide a series of diagnostic references for dentists to indicate the presence of disease and help in making an early and accurate diagnosis. Methods The dental panoramic radiographs of thirty CCD patients aged 11 to 45 years (18 males and 12 females) were examined retrospectively. The dentition states, including supernumerary teeth and impacted teeth, were recorded. Twelve quantified measurements were adopted to determine the abnormalities of maxillofacial bones, including the degree of the zygomatic arch downward bend, bicondylar breadth, ramal height, mandibular height, mandibular aspect ratio, mandibular body height, condylar height, coronoid height, distance between the coronoid process and the condyle, bigonial width, gonial angle and best-fit gonial circle diameter. The Wilcoxon rank-sum test was used to compare the findings of the CCD patients with those of their matched controls (n = 300). Results Supernumerary teeth were detected in 27 patients (90.0%), and all 30 patients presented impacted teeth. Compared to the matched controls, the CCD patients had a significantly larger degree of zygomatic arch downward bend (ZAD), a larger diameter of the best-fit gonial circle (BGC), and a shorter distance between the coronoid process and the condyle (DCC) in panoramic radiographs (P < 0.001). According to the reference cutoff values established from the 5th or 95th percentile of the measurements in the control group, ZAD higher than 6.90 mm, DDC less than 22.37 mm and BGC higher than 52.41 mm were significantly associated with the CCD features identified. Other panoramic measurements were not significantly different between the two groups. Conclusions Panoramic radiographs had great value in the diagnosis of CCD. In this study, we identified some dental and maxillofacial features on panoramic radiographs from a relatively large retrospective case series of CCD. A series of reliable quantitative indicators were provided for dentists that can indicate the presence of disease and improve the diagnostic specificity.

background: the aim of the study was to compare the volume of the tooth in-vitro between four cone beam computed tomography (CBCT) scanners and one multi-slice computed tomography (MSCT) system. Materials and methods: 42 teeth in-vitro was scanned with four CBCT systems (Accuitomo 3D, Vatech Imlagraphy, NewTom 3G, CRANE 3Dx) and one MSCT scanner (Philips Brilliances 16). 3D models were created from the six systems. The reference (gold standard) model was obtained with a high resolution laser scanner. The scanning results from the six systems were compared with the gold standard in volume. Results: The laser-scan sample volume was statistically significantly distinct from the MSCT-scan volume (P<0.05). There was a statistically significant difference between the laser-scan teeth volume and CBCT-scan volume (P<0.05). There was a statistically significant difference between the MSCT-scan teeth volume and CBCT-scan volume (P<0.05). The measurements of the CBCT-scanned samples deviated from those of the laser-scanned teeth volumes by 5.97%, 6.19%, 5.95%, 5.61 % for the Accuitomo, Vatech Imlagraphy, NewTom, CRANE 3Dx, separately. The measurements of the MSCT-scanned samples deviated from those of the laser-scanned teeth volumes by 10.98%. Conclusion: The results showed that the volume of the teeth scanned by MSCT and CBCT increased comparing to that of laser scan. The deviation of the volume measurement of MSCT-scan models tended to be larger than that of CBCT-scan models comparing to the gold standard.

Background: Odontogenic keratocyst (OKC) has been reclassified back into the cystic category in 2017 WHO classification. However, it is uncommon OKC involved other bones except jaws. For superimposition of craniofacial structures in X-ray plain film and the rarity of OKC involving zygoma, diagnosis and treatment may be difficult in a certain degree. Methods: The literature on OKCs involving zygoma was reviewed first. Then, retrospective research was carried out on the records of patients admitted to our hospital during a 36-year period. General clinic data, treatments, follow-up results and syndrome associated were analyzed. Results: To the best of our knowledge, there has been only one reported case in the English literature since 1948. But 5 cases were found in our database. 4/5 patients were observed multiple lesions and suspected with Gorlin syndrome. All patients were treated by enucleation with curettage. Two of them experienced recurrence in the follow-up period ranging from 16 to 418 moths. Conclusions: OKCs involving zygoma are really rare cases. Most patients with zygomatic involvements of OKCs displayed multiple lesions in both jaws and were suspected with Gorlin syndrome in this retrospective study. When patient was suspected with OKCs in maxilla, rational reserve of CT scanning was needed for excluding the extension into the zygoma. Cone-beam and multislice spiral computed tomography aided the precise definition and appropriate treatment for OKC involving the rare location zygoma.

Purpose: As a common oral disease, Apical periodontitis $\boldsymbol{(AP)}$ was often reported to misdiagnosed by periapical radiography. By contrast, CBCT has higher sensitivity and specificity. So we try to use Cone Beam Computer Tomography(CBCT) in the diagnosis of $\boldsymbol{AP},$ The study aims to investigate the prevalence of $\boldsymbol{AP}$ , the severity of periapical lesions and dental treatment, using CBCT scans in an adult Chinese population. Methods: All CBCT scans were taken at West China Hospital of Stomatology Sichuan University between January 2012 and December 2012 in this study. They received these scans for various reasons. The CBCT images were viewed by two examiners collectively (an experienced endodontist and an experienced radiologist respectively). For all scans, the age, total number of teeth, teeth with evidence of AP, number of endodontically treated teeth and location of teeth of each patient were considered. Percentages and the $\boldsymbol{x2}$ test were used for statistical analysis. Results: 3552 patients and 39810 teeth were assessed in this study. $\boldsymbol{AP}$ was found in 7.79% teeth. Higher prevalence of AP was found in molars $\boldsymbol{(P < 0.0 5)}$ , and the prevalence of $\boldsymbol{AP}$ increased with age. Different endodontically treatment had effect on the prevalence of $\boldsymbol{AP},$ , and 68.36% root filled teeth presented periapical lesion on CBCT. The severity of $\boldsymbol{AP}$ was moderate in more than 60% teeth, and bone destruction was easily found in anterior teeth. In all teeth with $\boldsymbol{AP},$ , the rate of root filled was 61.30%. Higher rate of root filled was found in young patients and anterior teeth. Age and location of teeth had effect on the prevalence and treatment of $\boldsymbol{AP},$ Root filled teeth had higher prevalence of AP.

Stafne骨腔(SBC)是一种罕见的下颌骨骨质的凹陷缺损,常发生在下颌骨后份,在临床上极易被误诊为颌骨囊肿或肿瘤而进行不必要的手术治疗.本文通过回顾国内外研究,对SBC的病因、临床表现、影像学特点进行综述,总结其典型的影像学表现,介绍其影像表现的多样性,为临床准确诊断提供指导.

Aim: To quantitatively evaluate the relationship between nasal appearance and nasal septum deviation in unilateral complete cleft patients using cone-beam computed tomography. Method: Cone-beam computed tomography images of 180 patients with unilateral cleft lip/palate from June 2014 to June 2017 were used in the study. None of the subjects had undergone septoplasty. The data were compared between the 2 groups to elucidate the relationship between nasal appearance and deviated nasal septum in unilateral complete cleft patients. Results: The mean age of a total of 180 patients (126 males and 54 females) was 14.58 years, with a standard deviation of 7.10 years, ranged from 6 years old to 49 years old. Columella nasi symmetry parameters show slight positive significant association with angle of nasal septal deviation on transerve plan (r = 0.250, P < 0.001), TRSD (r = 0.323, P < 0.001) and coronal range of nasal septal deviation (r = 0.294, P < 0.001), and moderate positive significant association with coronal angle about septal deviation (r = 0.404, P < 0.001) Conclusions: Columella nasi symmetry affected by septal deviation, whereas there is lack of evidence to say symmetry of nasal tip and base affected by septal deviation. The symmetry of nasal tip and alar base are not just determined by nasal septum deviation. The nasal septum deviation show difference in different cleft type.

目的 探讨"全程式、多元化"考核模式在口腔颌面影像诊断学教学中的应用效果.方法 2018年12月选取该院口腔八年制本硕博连读学生30名,对口腔颌面影像诊断学课程实施"全程式、多元化"考核模式改革,在过程性考核部分,首先通过增加理论课随堂测试环节,实时评估当堂课的掌握情况;其次在小班实验课堂教学中对学生的课堂综合表现进行打分,增加翻转课堂的参与度;在结果 性考核部分,首先针对八年制博士研究生培养目标,增加文献汇报部分,综合测试学生科研基础;其次期末笔试在内容上弱化传统理论题目,强化应用性读片考试内容.结果 实施"全程式、多元化"考核模式改革后在过程性考核中学生平均随堂测试成绩(93±6)分,出勤率为全勤;在实验室教学中学生的学习积极性和课堂参与度得到了提高;在结果 性考核中学生能准确理解文献,对文中内容进行综合评价,展现了较强的阅读能力和逻辑思维能力;但学生的读片成绩差距较大,最低51分,最高84分,平均(65±11)分.结论 通过对考试方式的梳理、考试成绩的分析、学生对考试模式改革的反馈,"全程式、多元化"考核模式改革取得了一定的成功,为进一步的改进和推广应用建立了良好的基础.

口腔影像检查具有特殊性,部分检查手段在检查过程中会直接接触患者口腔唾液,存在一定感染风险.然而长期以来口腔影像检查的感染控制不受重视,存在各种不规范的情况.本文结合国家相关防控指南以及口腔影像检查的特点,提出疫情期间的口腔影像检查防控策略和建议,供口腔医生参考,也为未来提高口腔影像检查的感染控制力度提出新的要求.

Purpose: To accurately evaluate the imaging characteristics of 32 patients with Stafne bone defect (SBD) using CBCT images. Methods: The radiographic data were collected from 32 SBD cases. First, the age, sex, location and the clinical diagnosis of the patient were collected. Additionally, the relationship between the defect and the adjacent anatomical structures such as the mandibular inferior cortex and mandibular canal were recorded. The situation of the buccal cortex were also described. The correlation between age and size was evaluated using Pearson's correlation coefficient. Results: Mean patient age was 53.30 years. Men (n=28) were more affected than women (n=4). The occurrence in the right (n=21, 65.625%) side was slightly higher. 14 defects were diagnosed as “cyst” and only 2 patients were diagnosed correctly. The relationship to the mandibular canal was categorized as separated (37.50%), contacted (18.75%), or go-through (43.75%). The relationship to the mandibular inferior cortex was classified as separated (21.88%), contacted (37.50%), or resorbed (40.62%). The situation of the buccal cortical was defined as: separated (25%), contacted (18.75%), thinning (31.25%), expanded and thinning (18.75%), or discontinuity (6.25%). The mean size on CBCT was 15.27 mm in length, 9.36 mm in height and the Pear- son's correlation coefficient showed no obvious correlation between age and length or the depth. The CBCT showed that the relationship of the defect to the adjacent anatomical structures was more closer than it in the plain images. The adiographic imaging features of SBD can help to improve the diagnostic accuracy.

建设高水平本科教育是教育部对当代高等教育提出的新要求.口腔颌面影像诊断学教研室,应用先进的教学理念、方法、设备,不断在教学模式、考核模式、网络辅助及虚拟教学技术等方面改革创新,建立了学科融合式教学模式与全过程性考核模式,开发应用创新教学工具,构建了以培养高素质综合应用型口腔医学人才为核心的颌面影像诊断学创新教学体系,并取得了良好的教学效果.

住院医师规范化培训是毕业后医学教育的重要组成部分,是成长为合格医生的磨砺之路.口腔颌面影像学是连接口腔基础学科及各口腔临床学科的桥梁学科,然而目前国内口腔医学毕业生在口腔影像诊断方面的能力尚存在较大不足,亟需再教育、再学习的跟进与补充.针对口腔颌面影像诊断学的专业特点,以及口腔住院医师规范化培训 的现状与问题,从教学计划制定、教学方式创新、考核体系改革等方面进行了初步实践和探索,通过融入融合式教学、互联网+等教学方式,优化口腔影像科规范化培训模式,以期提高住院医师规范化基地的水平,进一步完善住院医师规范化培训工作.