Browsing by Author "Li, Shuning"
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Item Comparison of movement rate with different initial moment-to-force ratios(Elsevier, 2019-08-01) Li, Shuning; Chen, Jie; Kula, Katherine S.; Mechanical Engineering and Energy, School of Engineering and TechnologyIntroduction: The objective of this clinical prospective study was to evaluate the effect of the two treatment strategies, translation or controlled tipping followed by root correction, on canine retraction efficiency, specifically canine movement rate. Methods: Twenty-one patients who needed bilateral maxillary canine retraction to close extraction space as part of their treatment plan were selected for this study. Segmental T-loops designed for controlled tipping or for translation were applied randomly to each side. Two digital maxillary dental casts (taken pre- and post-treatment) were used to measure the tooth displacements of each patient. The coordinate system located at the center of canine crown on the pre-treatment model with the three axes defined in the mesial-distal (M-D), buccal-lingual (B-L), and occlusal-gingival (O-G) directions was used to express the six tooth displacement components. The movement rates on the occlusal plane and in the M-D direction were computed. Movement rates were calculated by dividing the M-D displacements or the resultant displacement on the occlusal plane with the corresponding treatment time. Results: T-loops for controlled tipping moved canines faster (33.3% on occlusal plane and 38.5% in the M-D direction) than T-loops for translation. The differences are statistically significant (p = 0.041 on the occlusal plane and 0.020 in the M-D direction). Conclusion: 1. Moment-to-force ratio (M/F) impacts on the canine movement rate in a maxillary canine retraction treatment with segmented T-loop mechanism. 2. Within the neighborhood of the ratio for translation, lower M/F moves canine faster than higher M/F both on occlusal plane and in the M-D direction.Item Dentists’ Information Needs and Opinions on Accessing Patient Information via Health Information Exchange: Survey Study(JMIR, 2024-01-11) Li, Shuning; Gomez, Grace Felix; Xu, Huiping; Rajapuri, Anushri Singh; Dixon, Brian E.; Thyvalikakath, Thankam; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public HealthBackground: The integration of medical and dental records is gaining significance over the past 2 decades. However, few studies have evaluated the opinions of practicing dentists on patient medical histories. Questions remain on dentists' information needs; their perception of the reliability of patient-reported medical history; satisfaction with the available information and the methods to gather this information; and their attitudes to other options, such as a health information exchange (HIE) network, to collect patient medical history. Objective: This study aims to determine Indiana dentists' information needs regarding patients' medical information and their opinions about accessing it via an HIE. Methods: We administered a web-based survey to Indiana Dental Association members to assess their current medical information-retrieval approaches, the information critical for dental care, and their willingness to access or share information via an HIE. We used descriptive statistics to summarize survey results and multivariable regression to examine the associations between survey respondents' characteristics and responses. Results: Of the 161 respondents (161/2148, 7.5% response rate), 99.5% (n=160) respondents considered patients' medical histories essential to confirm no contraindications, including allergies or the need for antibiotic prophylaxis during dental care and other adverse drug events. The critical information required were medical conditions or diagnosis, current medications, and allergies, which were gathered from patient reports. Furthermore, 88.2% (n=142) of respondents considered patient-reported histories reliable; however, they experienced challenges obtaining information from patients and physicians. Additionally, 70.2% (n=113) of respondents, especially those who currently access an HIE or electronic health record, were willing to use an HIE to access or share their patient's information, and 91.3% (n=147) shared varying interests in such a service. However, usability, data accuracy, data safety, and cost are the driving factors in adopting an HIE. Conclusions: Patients' medical histories are essential for dentists to optimize dental care, especially for those with chronic conditions. In addition, most dentists are interested in using an HIE to access patient medical histories. The findings from this study can provide an alternative option for improving communications between dental and medical professionals and help the health information technology system or tool developers identify critical requirements for more user-friendly designs.Item Hounsfield unit change in root and alveolar bone during canine retraction(Elsevier, 2015-04) Jiang, Feifei; Liu, Sean S.-Y.; Xia, Zeyang; Li, Shuning; Chen, Jie; Kula, Katherine S.; Eckert, George; Department of Orthodontics and Oral Facial Genetics, IU School of DentistryINTRODUCTION: The objective of this study was to determine the Hounsfield unit (HU) changes in the alveolar bone and root surfaces during controlled canine retractions. METHODS: Eighteen maxillary canine retraction patients were selected for this split-mouth design clinical trial. The canines in each patient were randomly assigned to receive either translation or controlled tipping treatment. Pretreatment and posttreatment cone-beam computed tomography scans of each patient were used to determine tooth movement direction and HU changes. The alveolar bone and root surface were divided into 108 divisions, respectively. The HUs in each division were measured. Mixed-model analysis of variance was applied to test the HU change distribution at the P <0.05 significance level. RESULTS: The HU changes varied with the directions relative to the canine movement. The HU reductions occurred at the root surfaces. Larger reductions occurred in the divisions that were perpendicular to the moving direction. However, HUs decreased in the alveolar bone in the moving direction. The highest HU reduction was at the coronal level. CONCLUSIONS: HU reduction occurs on the root surface in the direction perpendicular to tooth movement and in the alveolar bone in the direction of tooth movement when a canine is retracted.Item How Do Dental Clinicians Obtain Up-To-Date Patient Medical Histories? Modeling Strengths, Drawbacks, and Proposals for Improvements(Frontiers, 2022-03) Li, Shuning; Rajapuri, Anushri Singh; Felix Gomez, Grace Gomez; Schleyer, Titus; Mendonca, Eneida A.; Thyvalikakath, Thankam P.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryBackground: Access to up-to-date patient medical history is essential for dental clinicians (DCs) to avoid potential harm to patients and to improve dental treatment outcomes. The predominant approach for dental clinicians (DCs) to gather patients' medical history is through patient-reported medical histories and medical consults. However, studies reported varied concordance and reliability of patient-reported medical conditions and medication histories compared to the patient medical records and this process also places a significant burden on patients. Information technology tools/platforms such as an integrated electronic health record containing an electronic dental record module may address these issues. However, these integrated systems are expensive and technically complex and may not be easily adopted by DCs in solo and small group practice who provide the most dental care. The recent expansion of regional healthcare information exchange (HIE) provides another approach, but to date, studies on connecting DCs with HIE are very limited. Our study objectives were to model different aspects of the current approaches to identify the strengths and weaknesses, and then model the HIE approach that addresses the weaknesses and retain the strengths of current approaches. The models of current approaches identified the people, resources, organizational aspects, workflow, and areas for improvement; while models of the HIE approach identified system requirements, functions, and processes that may be shared with software developers and other stakeholders for future development. Methods: There are three phases in this study. In Phase 1, we retrieved peer-reviewed PubMed indexed manuscripts published between January 2013 and November 2020 and extracted modeling related data from selected manuscripts. In Phase 2, we built models for the current approaches by using the Integrated DEFinition Method 0 function modeling method (IDEF0), the Unified Modeling Language (UML) Use Case Diagram, and Business Process Model and Notation (BPMN) methods. In Phase 3, we created three conceptual models for the HIE approach. Results: From the 47 manuscripts identified, three themes emerged: 1) medical consult process following patient-reported medical history, 2) integrated electronic dental record-electronic health record (EDR-EHR), and 3) HIE. Three models were built for each of the three themes. The use case diagrams described the actions of the dental patients, DCs, medical providers and the use of information systems (EDR-EHR/HIE). The IDEF0 models presented the major functions involved. The BPMN models depicted the detailed steps of the process and showed how the patient's medical history information flowed through different steps. The strengths and weaknesses revealed by the models of the three approaches were also compared. Conclusions: We successfully modeled the DCs' current approaches of accessing patient medical history and designed an HIE approach that addressed the current approaches' weaknesses as well as leveraged their strengths. Organizational management and end-users can use this information to decide the optimum approach to integrate dental and medical care. The illustrated models are comprehensive and can also be adopted by EHR and EDR vendors to develop a connection between dental systems and HIEs.Item Implementation of re-usable, configurable systems engineering model using product lifecycle management platform(2015-08) Zhang, Weijie; El-Mounayri, Hazim; Chen, Jie; Surber, Dan Clifford; Li, ShuningIndustry is facing the challenge of increasing product complexity while at the same time reducing cost and time in a highly competitive global market. Product Lifecycle Management (PLM) and Systems Engineering have the potential to help companies avoid costly product development and launching, as well as failure during use; these two concepts not only share many common characteristics, but also complement each other. PLM provides an information management system that can seamlessly integrate enterprise data, business processes, business systems and, ultimately, people throughout all phases of the product lifecycle. Systems engineering is an interdisciplinary approach to designing, implementing, evaluating, and managing the complex human-made systems over their life cycle. The same underlying methods that improve management of products and services can be used to organize the framework in which PLM systems are implemented, integrated, and evolved. Though several studies have indicated that adopting Systems Engineering with PLM brings many benefits for industries, implementation of PLM based Systems Engineering with PLM has rarely been conducted. Pattern-Based Systems Engineering (PBSE), a form of Model-Based Systems Engineering (MBSE) based on the use of Systematic Metamodel (S* Metamodel), represents a family of manufacturing system, and is used in the life cycle processes of ISO 15288, was implemented here using TEAMCENTER® PLM software as the platform. More specifically, we have implemented the key portion of the General Production Pattern based on S* Metamodel, and demonstrated the benefit through the manufacturing of oil filter case study. The above implementation have resulted in a powerful systems engineering model in PLM that leverages the capabilities of Teamcenter, to enable an enhanced systems engineering approach. Benefits brought to systems engineering practice include: the ability to capture and reflect stakeholders' requirements and changes in product design process promptly and accurately; the ability of systems engineers to create models quickly and prevent mistakes during modeling; the ability of systems engineers to do their job much easily by using reusable and reconfigurable models; the ability to re-use of previous designs in a new process.Item Load System of Segmental T-Loops for Canine Retraction(Elsevier, 2013) Xia, Zeyang; Chen, Jie; Jiang, Feifei; Li, Shuning; Viecilli, Rodrigo F.; Liu, Sean Y.; Orthodontics and Oral Facial Genetics, School of DentistryIntroduction: The orthodontic load system, especially ideal moment-to-force ratios, is the commonly used design parameter of segmental T-loops for canine retraction. However, the load system, including moment-to-force ratios, can be affected by the changes in canine angulations and interbracket distances. We hypothesized that clinical changes in canine position and angulation during canine retraction will significantly affect the load system delivered to the tooth. Methods: The load systems of 2 T-loop groups, one for translation and the other for controlled tipping, from 9 bilateral canine retraction patients were made to the targeted values obtained from finite element analyses and validated. Each loop was tested on the corresponding maxillary dental cast obtained in the clinic. The casts were made before and after each treatment interval so that both initial and residual load systems could be obtained. The pretreatment and posttreatment interbracket distances were recorded for calculating interbracket distance changes. Results: As the interbracket distances decreased, the average retraction-force drop per interbracket distance reduction was 36 cN/mm, a 30% drop per 1 mm of interbracket distance decrease. The average antitipping-moment drops per interbracket distance reductions were 0.02 N-mm per millimeter for controlled tipping and 1.4 N-mm per millimeter for translation, about 0.6% and 17% drops per 1 mm of interbracket decrease, respectively. Consequently, the average moment-to-force ratio increases per 1 mm of interbracket distance reduction were 1.24 mm per millimeter for controlled tipping and 6.34 mm per millimeter for translation. There was a significant residual load, which could continue to move the tooth if the patient missed the next-scheduled appointment. Conclusions: Clinical changes in canine position and angulation during canine retraction significantly affect the load system. The initial planned moment-to-force ratio needs to be lower to reach the expected average ideal value. Patients should be required to follow the office visit schedule closely to prevent negative effects because of significant moment-to-force ratios increases with time.Item Monitoring 3D Printer Performance using Internet of Things (IoT) Application(2017-06-24) Li, Shuning; Freije, Elizabeth; P.e, Paul Yearling; Mechanical Engineering, School of Engineering and TechnologyMost of the current desktop 3D printers are built based on open-source designs from online communities. The largest group of open-source 3D printers is the Self-Replicating Rapid Prototype (RepRap) 3D printers. A RepRap 3D printer needs to connect to a computer or a microprocessor to feed G Code and provide interface for users to control the 3D printer. However, local computer is a relatively expensive solution comparing to the cost of a RepRap 3D printer; while the microprocessor has much less computing capability comparing to a normal computer, and cannot handle computing-intensive jobs like slicing 3D objects or generating G Code. An alternate solution is to use the internet of things (IoT) application to control and monitor 3D printers. IoT is the network of physical devices, vehicles, buildings and other items, allowing objects to be sensed and controlled remotely across existing network. IoT and 3D printing are two important new technologies, which progressively impact a lot of areas of the industries and also our everyday life. Students need to be introduced to these technologies, and get ready for future career opportunities. A multidisciplinary student project is developed to provide students access to both 3D printer and IoT platform, and also learn to collaborate with engineers from other disciplines to solve complex engineering problems. The objective of the project is to design and develop an IoT application to remote monitor the performance of a RepRap 3D printer including the printing progress and the temperatures of the heated bed and hot end. Major tasks involved in the project are: to inspect and upgrade the current 3D printer to avoid any possible compliance issues between the 3D printer and the hardware components or software tools for the IoT application; to connect the 3D printer to the Raspberry Pi microprocessor; and to design and develop the IoT application. The methods and algorithms of connecting a 3D printer to an IoT application is reported, and the IoT application interface and workflow will be presented in the results section. As a pilot study, this project provides first-hand data on the requirements of time and resources to introduce IoT to undergraduate students.Item Multi-level requirement model and its implementation for medical device(2018-08) Wang, Hua; Chen, Jie; Li, Shuning; Dalir, HamidRequirements determine the expectations for a new or modified product. Requirements engineering involves defining, documentation and maintenance of requirements. The rapid improving of technologies and changing of market needs require a shorter time to market and more diversified products. As an important and complex task in product development, it is a huge work to develop new requirements for each new product from scratch. The reusability of requirements data becomes more and more important. However, with the current “copy and paste” approach, engineers have to go through the entire set of requirements (sometimes even more than one set of requirements) to identify the ones which need to be reused or updated. It takes a lot of time and highly relies on the engineers’ experiences. Software tools can only make it easier to capture and locate the requirements, but won’t be able to solve the problem of effective reuse of the existing requirement data. The overall goal of this research is to develop a new model to improve the management of requirements and make the reuse and reconfiguration of existing requirements and requirement models more efficient. Considering the requirements data as an important part of the knowledge body of companies, we followed the knowledge categorization method to classify requirements into groups, which were called levels in the study, based on their changing frequency. There are four levels, the regulatory level, the product line level, the product level and the project level. The regulatory level is the most stable level. Requirements in this level were derived from government and industry regulations. The product line level contains the common requirements for a group of products, the product line. The third level, product level, refers to the specific requirements of the product. And the fourth and most dynamic level, the project level, is about the specific configurations of a product for a project. We chose auto-injector as the application to implement the model, since it is a relatively simple product, but its requirements cover many different categories. There are three major steps in our research approach for the project. The first is to develop requirements and classify them for our model. The development of requirements adopts the goal-oriented model to analyze and SysML, a system modeling language, to build requirements model. And the second step is to build requirements template, connecting the solution of the problem to the information system, standalone requirements management tool or information platform. This step is to find a way to realize the multi-level model in an information system. The final step is to implement the model. We chose two software tools for the implementation, Microsoft Office Excel, a commonly used tool for generating requirements documents, and Siemens PLM suite, Teamcenter, a world leading PLM platform with a requirement module. The results in the study include an auto-injector requirement set, a workflow for using the multi-level model, two requirements templates for implementation of the model in two different software tools, and two automatically generated requirement reports. Our model helps to define the changed part of requirements after analysis of the product change. It could avoid the pitfalls of the current way in reusing requirements. Based on the results from this study, we can draw the following conclusions. A practical multi-level requirements management model can be used for a medical device—the auto-injector; and the model can be implemented into different software tools to support reuse of existing requirement data in creating requirement models for new product development projects. Furthermore, the workflow and guideline to support the application and maintenance of the requirement model can be successful developed and implemented. Requirement documents/reports can be automatically generated through the software tool by following the workflow. And according to our assessment, the multi-level model can improve the reusability of requirements.Item Retrospective Study of the Reasons and Time Involved for Dental Providers' Medical Consults(Frontiers, 2022-05) Li, Shuning; Williams, Karmen S.; Medam, Jayanth Kumar; Patel, Jay S.; Gonzalez, Theresa; Thyvalikakath, Thankam P.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryBackground: Patient-reported medical histories and medical consults are primary approaches to obtaining patients' medical histories in dental settings. While patient-reported medical histories are reported to have inconsistencies, sparse information exists regarding the completeness of medical providers' responses to dental providers' medical consults. This study examined records from a predoctoral dental student clinic to determine the reasons for medical consults; the medical information requested, the completeness of returned responses, and the time taken to receive answers for medical consult requests. Methods: A random sample of 240 medical consult requests for 179 distinct patients were selected from patient encounters between 1 January 2015 and 31 December 2017. Descriptive statistics and summaries were calculated to determine the reasons for the consult, the type of information requested and returned, and the time interval for each consult. Results: The top two reasons for medical consults were to obtain more information (46.1%) and seek medical approval to proceed with treatment (30.3%). Laboratory and diagnostic reports (56.3%), recommendations/medical clearances (39.6%), medication information (38.3%), and current medical conditions (19.2%) were the frequent requests. However, medical providers responded fewer times to dental providers' laboratory and diagnostic report requests (41.3%), recommendations/medical clearances (19.2%), and current medical conditions (13.3%). While 86% of consults were returned in 30 days and 14% were completed after 30 days. Conclusions: The primary reasons for dental providers' medical consults are to obtain patient information and seek recommendations for dental care. Laboratory/diagnostic reports, current medical conditions, medication history, or modifications constituted the frequently requested information. Precautions for dental procedures, antibiotic prophylaxis, and contraindications included reasons to seek medical providers' recommendations. The results also highlight the challenges they experience, such as requiring multiple attempts to contact medical providers, the incompleteness of information shared, and the delays experienced in completing at least 25% of the consults. Practical Implications: The study results call attention to the importance of interdisciplinary care to provide optimum dental care and the necessity to establish systems such as integrated electronic dental record-electronic health record systems and health information exchanges to improve information sharing and communication between dental and medical providers.Item Three-dimensional canine displacement patterns in response to translation and controlled tipping retraction strategies(The Angle Orthodontist, 2015-01) Li, Shuning; Xia, Zeyang; Liu, Sean Shih-Yao; Eckert, George; Chen, Jie; Department of Mechanical Engineering, School of Engineering and TechnologyOBJECTIVE: To validate whether applying a well-defined initial three-dimensional (3D) load can create consistently expected tooth movement in patients. MATERIALS AND METHODS: Twenty-one patients who needed bilateral canine retraction to close extraction space were selected for this split-mouth clinical trial. After initial alignment and leveling, two canines in each patient were randomly assigned to receive either translation (TR) or controlled tipping (CT) load. The load was delivered by segmental T-loops designed to give specific initial moment/force ratios to the canines in each treatment interval (TI), verified with an orthodontic force tester. Maxillary dental casts were made before canine retraction and after each TI. The casts were digitized with a 3D laser scanner. The digital models were superimposed on the palatal rugae region. The 3D canine displacements and the displacement patterns in terms of TR, CT, and torque were calculated for each TI. RESULTS: The method can reliably detect a TR displacement greater than 0.3 mm and a rotation greater than 1.5°. Ninety-two TIs had displacements that were greater than 0.3 mm and were used for further analysis. Most displacements were oriented within ±45° from the distal direction. The displacement pattern in terms of TR or CT was not uniquely controlled by the initial moment/force ratio. CONCLUSIONS: The initial load system is not the only key factor controlling tooth movement. Using a segmental T-loop with a well-controlled load system, large variations in canine displacement can be expected clinically.