二氧化氯在口腔科的应用

二氧化氯(ClO2)是英国科学家Humpheny Davey于1811年发现的.ClO2具有强大的氧化作用,其氧化能力是氯气的2.63倍.因其抗菌广谱、高效、无毒、环保,被世界卫生组织(WHO)列为AI级消毒剂.ClO2最早仅用于造纸与纺织等工业的漂白脱色.     

甲基丙烯酸甲酯单体对小鼠肝、肺、肾功能的影响

目的:研究口腔义齿修复常用材料甲基丙烯酸甲酯单体对小鼠肺、肝、肾组织的影响.方法:雄鼠50只分成2组,实验组和对照组.实验组小鼠强迫吸入挥发的甲基丙烯酸甲酯单体,对照组吸入空气,分别活体眼球后取血,血清检测ALP、GPT、GOT反映对肝功影响.颈椎脱臼处死法处死后取肝、肺、肾组织,包埋切片,观察其病理改变.结果:经统计学分析,血清中碱性磷酸酶、谷丙转氨酶、谷草转氨酶的含量实验组与对照组比较,有显著性差异(P<0.05);组织病理切片可直接观察到:实验组小鼠肺组织出现炎细胞浸润、纤维样变、肺泡破裂的现象.肾组织中肾小球萎缩、玻璃样变,及肾小囊、肾小管内纤维素样渗出.结论:甲基丙烯酸甲酯引起了小鼠肝功的变化及肺肾组织的病理学改变,提示甲基丙烯酸甲酯对小鼠肝、肺、肾都有毒性作用.     

口腔医学专业在地震灾害中的救灾方式和目标——四川省汶川地震口腔医学专业救灾案例和重建需求

2008年5月12日,四川省汶川县发生8级特大地震,陕西、北京、上海、天津、山西、河南、湖北等全国多个省市有明显震感.截至2008年6月16日,四川汶川地震已造成69170人遇难,374159人受伤.本文结合四川省汶川地震口腔医学专业救灾案例和经验,讨论口腔医学专业在国家特别重大地震灾害事件中急救阶段、安置阶段、重建阶段的救灾方式和目标,认为口腔医学专业在地震灾害中应为灾区急救和恢复重建做出更大的贡献.     

193例增厚结节状鲜红斑痣临床分析

目的:通过分析鲜红斑痣增厚结节与年龄、性别的关系,了解鲜红斑痣增厚结节形成的过程,为临床治疗提供参考.方法:对193例确诊为鲜红斑痣的患者,按其临床表现分为无增厚结节组、增厚组、增厚结节组3组.按年龄分为0～19岁和≥20岁2段,然后对与增厚结节形成相关的年龄、性别等因素进行统计学分析.采用SAS6.12软件包.分别对数据进行Fisher确切概率计算和Kruskal-Wallis检验.结果:无增厚结节组165例,占85.49%,增厚组10例,占5.18%;增厚结节组18例、占9.33%.3组之间的年龄分布有统计学差异(P<0.01).0～19岁段94例,≥20岁段99例,增厚结节鲜红斑痣的分布有年龄差异(P<0.01),但无性别差异(P>0.01).结论:随年龄增加,部分鲜红斑痣患者形成增厚、结节病灶,且发生年龄有差异.     

上唇钙化上皮瘤1例

一、临床资料 患者,男,29岁.两月前发现右侧上唇近口角处有一小肿物,黄豆大小,质软,无压痛,局部无发红,皮温不高,无发痒,全身无发热,无咽痛,牙痛史.曾于外院就诊,给予抗生素口服,具体药物名称不详,无明显疗效.近一周来,患者自觉肿物增大较明显,局部略有肿胀不适.     

右下唇腺泡细胞癌1例

患者,女,38岁.下唇右侧无痛性肿物4年就诊.4年前患者偶然发现下唇右一"黄豆"大小肿物,活动,无疼痛及其他不适,生长缓慢,未曾就诊.近半年来,自觉肿物生长加快,前来就诊.查体:右侧下唇内侧-2.5cm×2cm×1.5cm大小肿物,与表面皮肤无粘连,边界清楚,中等偏硬,表面结节状,无疼痛,活动,与粘膜有少量粘连,粘膜色泽正常,下唇无麻木,双侧颌下及颈部未及肿大淋巴结.     

有必要发展牙体牙周显微治疗吗?

某些外科手术,在显微镜下可直接吻合微细血管等,使移植的皮瓣或某些器官可以存活,从而发展了显微外科.不用显微镜,显微外科就无从谈起.这可以说是外科学中的一次革命.100多年前,在牙体制洞时,就已用放大镜或用观剧镜来检查所做洞壁的情况,它可起到某些协助作用.     

敬告作者

《国际口腔医学杂志》大量刊登原创性论著,欢迎广大作者踊跃投稿。     

敬告作者

《国际口腔医学杂志》大量刊登原创性论著,欢迎广大作者踊跃投稿。     

臭氧对4种细菌的灭活作用

目的:观察不同浓度臭氧在不同作用时间下对金黄色葡萄球菌、变形链球菌、表皮葡萄球菌和肺炎链球菌的灭活作用.方法:用碘滴定法测定打开臭氧发生器不同机组及不同时间时的臭氧浓度,按载体定量杀菌试验,将经臭氧作用的载体与相同环境下未经臭氧作用的载体上的细菌洗下,各取洗脱液50μl,接种于TSA平板并置厌氧箱(90%N2,10%CO2,37°C)培养24～48h后,进行活菌菌落计数.所得数据采用SAS 6.12软件包进行X.检验.结果:臭氧浓度越高、作用时间越长.杀菌效果越好.臭氧浓度2.73mg/L、作用45min时,对4种细菌的杀灭率达100%.结论:臭氧对4种细菌有良好的灭活作用,且杀菌效果有随臭氧浓度增加而增强的趋势.     

显微CT对下颌活髓第一磨牙疑难牙根纵裂的诊断价值

目的评价显微CT（MCT）对下颌活髓第一磨牙疑难牙根纵裂的诊断价值。方法对本院牙片未能诊断、经MCT确诊的疑难牙根纵裂的下颌活髓第一磨牙56颗患牙的病史、临床表现等进行回顾性分析。并按MCT所显示纵裂根形态、患牙牙根总数、纵裂位置及纵裂根根管数对患牙进行统计分析。结果56颗疑难患牙中绝大多数仅有轻中度松动、[牙合]面磨耗和牙周炎的症状;54颗（93.1%）下颌第一磨牙所有近中根均为双根管扁根,其中42颗（77.8%）除具有上述特征外且只有两个牙根,此类牙发生牙根纵裂有显著统计学差异（P〈0.00）。结论牙根纵裂与慢性咬合创伤、牙周疾病和牙根解剖变异密切相关。     

255例牙冠折裂的临床分析

目的分析长期咀嚼过程中牙冠折裂的发生情况,并初步探讨冠折发生的相关因素。方法以2005年12月-2007年12月在兰州市第一人民医院口腔科就诊的255颗冠折牙为研究对象,对折裂牙的患者性别、年龄、牙位、折裂位置及形态等进行分析。结果255颗冠折牙中,1）上颌第一磨牙76颗（29.8%）,下颌第一磨牙45颗（17.6%）,上颌第二磨牙41颗（16.1%）,下颌第二磨牙37颗（14.5%）,上颌第二前磨牙32颗（12.5%）,上颌第一前磨牙15颗（5.9%）,下颌第二前磨牙9颗（3.5%）;2）折裂位置与窝沟重叠者158颗（62.0%）,发生于牙尖斜面者97颗（38.0%）。3）正常者85颗（33.3%）,面形态异常者55颗（21.6%）,型异常者115颗（45.1%）。结论牙位及形态等与牙冠折裂的发生具有一定的关系。力是牙冠折裂的基本因素,但不是唯一因素。     

后牙折裂发病情况的临床观察和分析

目的 探讨牙折裂的原因,提出预防和治疗的方法。方法 对89例患者89颗折裂牙的发病年龄、性别、牙位及病史进行分类比较。结果 89例患者中,男46例,女43例,男女之比为1.07∶1。31～60岁71例,占79.78%,其中41～50岁比例最高,达40.70%。第一磨牙折裂牙最多见。牙折前无治疗史的57个,有治疗史的32个,包括牙髓干尸治疗25个,根管治疗7个。结论 牙折裂多见于磨牙区,且第一磨牙发病率最高,这与牙本身组织结构的缺陷、咬合创伤有关,也与牙本质中有机质、无机质相对含量随年龄变化有关。有效的牙体牙髓治疗与修复,包括充填体的选择,根管治疗后作全冠修复,以及严格的备洞原则及治疗后调牙合,具有早期治疗和预防牙折裂作用。?     

E-max铸瓷高嵌体修复后牙牙体缺损的临床研究

目的评价E-max铸瓷高嵌体修复磨牙和前磨牙牙体缺损的临床效果。方法使用E-max铸瓷高嵌体修复根管治疗后牙体缺损患牙共173颗,其中磨牙128颗,前磨牙45颗,并于修复后即刻及修复后1年、2年、3年进行临床随访,采用改良美国公共卫生机构评价标准进行临床效果评价。结果修复后1年、2年、3年的累计失访牙数为3颗、3颗、8颗。第3年时,复诊病例中无1颗发生高嵌体脱落;继发龋的发生率仅为0.6%（1/165）;牙体完整性也较为理想,除7颗边缘釉质崩裂外,无牙体折断发生;崩瓷或瓷裂发生率为3.0%（5/165）;颜色匹配性评级,与邻牙的颜色及半透明性一致、少许不一致的比例分别为90.3%（149/165）和9.7%（16/165）;边缘适合性和邻接点正常的比例均为97.0%（160/165）。结论采用E-max铸瓷高嵌体是修复根管治疗后牙体缺损较为可靠的一种方法。     

Risk indicators for posterior tooth fracture

BACKGROUND: Identifying posterior teeth that are at heightened risk of developing cusp fracture is an inexact science. Risk indicators based on controlled observations are not available, and dentists' assessments vary. METHODS: The authors conducted a case-control study of cusp fracture in restored posterior teeth. They evaluated 39 potential risk indicators identified in previous uncontrolled studies for an association with fracture in 200 patients with fractures and 252 patients without fractures. These risk indicators delineated patients' clinical characteristics and behaviors, as well as clinical characteristics of individual teeth. The authors used logistic regression to develop models identifying risk indicators associated with fracture, both between case and control subjects and between case and comparison teeth in case subjects. RESULTS: Two risk indicators appeared in both models. The presence of a fracture line and an increase in the proportion of the volume of the natural tooth crown occupied by the restoration substantially increased the odds of fracture (P < .001). Additional risk indicators were unique to the case subject-control subject model, including subject age and other measures related to the relative size of the restoration or to loss of dentinal support. Neither patient behaviors such as clenching, grinding and biting hard objects nor occlusal characteristics such as guidance, cusp anatomy and general wear patterns were strong predictors of fracture risk. CONCLUSIONS: Among posterior teeth with restorations, two clinical features were strongly associated with the risk of cusp fracture: presence of a fracture line in the enamel and proportional volume of the restoration. CLINICAL IMPLICATIONS: Dentists assessing the risk of fracture should consider a detectable fracture line or a high ratio of restoration-to-total-crown volume as important indicators of elevated risk.     

Mobility of premolars under load in partially edentulous dentition

The mobility of the upper and lower premolars under load was investigated in relation to the interproximal contact and occlusal facets. The mobility was measured on ten subjects with the molars missing in the bucco-lingual and mesio-distal direction, using a non-contact sensor system, when a 500 gram load was applied in the horizontal direction, during hard biting in intercuspation and biting of foods. The ratio of the tooth movement in the bucco-lingual direction to the mesio-distal direction was larger in the upper premolars than in the lower ones. As the total mobility increased, the tooth movement was larger on the buccal side than on the lingual side of the upper jaw, on the lingual side than on the buccal side of the lower jaw, and on the mesial side than on the distal side of both jaws. The direction of the movement did not coincide with the direction of the load, due to the horizontal rotation. When biting, the first premolars showed a mesial movement and the second premolars showed a more distal movement than the first premolars. A correlation between the direction of the tooth movement during hard biting and that of the facets was observed.     

A survey of cusp fractures in a population of general dental practices

PURPOSE: This study was conducted to expand the knowledge on the incidence of complete cusp fractures of posterior teeth in Dutch general practices. MATERIALS AND METHODS: During a 3-month period, data were obtained from 28 general practitioners, representing 46,394 patients. For each new case of complete cusp fracture, clinicians recorded information using a standard form with questions relating to location of the fracture, cause of fracture, and restorative status of the tooth prior to the cusp fracture. RESULTS: There were 238 cases of complete cusp fracture recorded. The results of this study indicate an incidence rate of cusp fractures of 20.5 per 1,000 person-years at risk. Molars were more frequently registered with cusp fractures than premolars (79% vs 21%). Maxillary molars presented more fractures of buccal cusps (66% vs 34%), while mandibular molars presented more fractures of lingual cusps (75% vs 25%). Almost 77% of the cases had been restored on three or more surfaces. Statistical analysis revealed a positive correlation between history of endodontic treatment and subgingival fracture location. Mastication was most frequently reported as the cause for fracture (54%), although one can argue whether the occlusal force was the cause or the immediate reason. CONCLUSION: This study revealed that complete cusp fracture is a common phenomenon in dental practice and has shown differences in cusp fracture with respect to tooth type and restorative status of the tooth. Teeth with a history of endodontic treatment are susceptible to unfavorable subgingival fracture locations.     

Dental injuries in association with mandibular condyle fractures

Abstract A total of 356 patients with mandibular condyle fractures were studied regarding associated dental injuries. One third of the patients had injured teeth, on average, 3.7 teeth had been injured per accident. Dental traumas were distributed equally between the anterior (incisors and canines) and posterior teeth (premolars and molars) in both jaws. In unilateral condylar fracture cases maxillary dental injuries involved more often premolars and/or molars of the fracture side than those of the non-fracture side. The mean number of dental traumas in the mandible was higher in cases of simultaneous mandibular body fracture than without, whereas the presence of mandibular body fracture did not affect number of associated dental injuries in the maxilla. The dental injuries were mostly to hard tissue (78%), which were commonest in men, 20 to 29 years of age, and in victims of violence or fall accidents. Severe dental injuries in association with mandibular condyle fractures were more common in accidents due to traffic and miscellaneous causes than in those due to violence. Severe dental injuries were more often encountered when simultaneous mandibular body fracture was present than when it was not and more so in bilateral than unilateral condylar fracture cases. The most important factor correlating with the severity of dental injuries was the presence of bilateral condylar fracture.     

一种新的牙齿记录法

目的:介绍一种新的牙齿记录法,以达到简便而准确地描述和记录牙齿的目的。方法:T或t作为记录牙齿的标识字符,T代表恒牙,t代表乳牙。用数字1～8和1～5从牙弓中线向远端对恒牙和乳牙编号。用"字母加数字"的方式对恒牙和乳牙、上颌牙和下颌牙、前牙和后牙以及牙位进行记录。结果:恒牙标记为T1～T8,乳牙标记为t1～t5。上、下颌恒牙分别标记为UT1～UT8和LT1～LT8。上、下颌乳牙分别标记为Ut1～Ut5和Lt1～Lt5。前牙、前磨牙和磨牙分别标记为T(1-3)、T(4、5)和T(6-8)。乳前牙和后牙分别标记为t(1-3)和t(4、5)。恒牙牙位用上下标牙位记录法或"UR、UL、LR、LL"加"T1～T8"标记。乳牙牙位用上下标牙位记录法或"UR、UL、LR、LL"加"t1～t5"标记。结论:新的牙齿记录法能简便而准确地标记牙齿、上下颌牙齿、前牙和后牙以及牙位。     

基于锥形束CT的多生牙新分类方法临床意义研究

目的　应用锥形束CT（cone-beam CT,CBCT）对多生牙进行新的临床分类,并分析新分类方法的临床意义。方法　收集2016—2019年首都医科大学附属北京友谊医院口腔科的CBCT影像资料5100例,其中多生牙患者209例,共计多生牙278颗。应用CBCT对多生牙进行新的临床分类,包括萌出型、骨埋伏高位型、骨埋伏低位型、骨埋伏复杂型和牙弓外型,并分析其临床意义。结果　（1）临床资料分析：多生牙发生率为4.1%,其中有1颗多生牙的患者占76.6%,有2颗多生牙的患者占19.1%,有3颗及以上多生牙的患者占4.3%。多生牙好发部位依次为：上颌切牙区、上颌磨牙区、下颌尖牙及前磨牙区、上颌尖牙及前磨牙区、下颌磨牙区。34.9%的多生牙对邻近恒牙产生了继发影响,以萌出错位及阻生为主,主要发生在上颌切牙区。（2）新分类方法的临床意义分析：上颌切牙区多生牙以骨埋伏低位型及萌出型为主,尖牙、前磨牙及磨牙区多生牙以萌出型为主。不同类型多生牙对邻近恒牙产生继发影响的发生率不同或不全相同（χ2 = 26.057,P < 0.001）,提示对邻近恒牙易产生继发影响的多生牙类型依次为：萌出型、骨埋伏复杂型、骨埋伏高位型、牙弓外型、骨埋伏低位型。结论　基于CBCT的多生牙新分类方法简单实用,其中萌出型、骨埋伏复杂型及骨埋伏高位型多生牙更易产生错牙合畸形,建议尽早拔除多生牙、定期随访,必要时正畸治疗。