骨性Ⅲ类错正畸-正颌联合治疗后软硬组织稳定性研究

目的探讨骨性Ⅲ类错患者正颌手术后不同阶段的软硬组织变化以及稳定性。方法24例骨性Ⅲ类错患者行正畸-正颌联合治疗,矫治前(T0)和手术3个月后(T1)、矫治结束时(T2)、矫治结束2年后(T3)均拍摄X线头颅定位侧位片,对4个阶段17个软硬组织标志点矢状向的变化进行统计学分析。结果手术后与矫治前除鼻部软组织点外,其余各点变化有统计学意义(P<0.01);手术后几个阶段的比较,上颌标志点基本保持稳定(P>0.05),而下颌不及上颌稳定。T3与T1比较,下颌颏前点(Po)、颏顶点(Gn)和颏下点(Me)以及软组织颏前点(Pos)的变化比较明显(P<0.05)。结论骨性Ⅲ类错患者经正畸-正颌联合治疗后侧貌改善明显。长期观察,上颌骨比较稳定,下颌有一定的复发趋势。     

骨性安氏Ⅱ类错经外科-正畸联合治疗后颜面软组织侧貌的变化

目的:探讨骨性安氏Ⅱ类错　患者采用外科-正畸联合治疗后颜面软组织侧貌在矢状和垂直方向上的变化。方法:选用华西医科大学口腔医院正畸科连续收治的骨性安氏Ⅱ类错　患者22 例,男7 例,女15 例,年龄20～30 岁。在术前及术后6～12 个月摄取X线头侧位片, 对16 个软硬组织标志点的变化进行矢状、垂直向的分析。结果:在矢状向上,上唇沟点、上唇缘点、上唇下点后退均大于2 mm( P < 0101) ;与上切牙点后移量之比为0159∶1～0164∶1 ;颏唇沟软、硬组织点前移量之比为0183∶1 ,软组织颏前点与硬组织颏前点前移量之比为0195∶1。在垂直向上,鼻尖点、鼻底点、上唇缘点平均向上移动量均小于1 mm( P > 0105) ;但软组织颏前点、颏唇沟、下唇缘点、下唇上点向上移动量均大于2 mm( P < 0105) ,与相应的硬组织移动量之比为1107∶1～1134∶1。结论:骨性安氏Ⅱ类错牙合患者经外科-正畸联合治疗后颜面软组织侧貌改善明显。在矢状方向,上下颌软组织改变量均小于硬组织;但在垂直方向,下颌软组织的改变却比硬组织更明显。     

骨性安氏Ⅱ类错(牙合)经外科——正畸联合治疗后颜面软组织侧貌的变化

目的:探讨骨性安氏Ⅱ类错患者采用外科-正畸联合治疗后颜面软组织侧貌在矢状和垂直方向上的变化.方法:选用华西医科大学口腔医院正畸科连续收治的骨性安氏Ⅱ类错患者22例,男7例,女15例,年龄20～30岁.在术前及术后6～12个月摄取X线头侧位片,对16个软硬组织标志点的变化进行矢状、垂直向的分析.结果:在矢状向上,上唇沟点、上唇缘点、上唇下点后退均大于2mm(P<0.01);与上切牙点后移量之比为0.59:1～0.64:l;颏唇沟软、硬组织点前移量之比为0.83:1,软组织颏前点与硬组织颏前点前移量之比为0.95:1.在垂直向上,鼻尖点、鼻底点、上唇缘点平均向上移动量均小于1mm(P>0.05);但软组织颏前点、颏唇沟、下唇缘点、下唇上点向上移动量均大于2mm(P<0.05),与相应的硬组织移动量之比为1.07:l～1.34:1.结论:骨性安氏Ⅱ类错患者经外科-正畸联合治疗后颜面软组织侧貌改善明显.在矢状方向,上下颌软组织改变量均小于硬组织;但在垂直方向,下颌软组织的改变却比硬组织更明显.     

正畸正颌联合治疗骨性Ⅲ类错(牙合)畸形侧貌软硬组织变化及相关性分析

目的:测量骨性Ⅲ类错(牙合)畸形正畸正颌联合治疗前后侧貌软硬组织变化及相关性分析,评估正畸正颌联合治疗的美学效果,为更好地预测术后美学性数值提供研究支持。方法:选择32例严重的骨性Ⅲ类错(牙合)畸形患者,并在正畸治疗前、后拍摄CBCT。通过CBCT获得精确的头影侧位片,选择头影测量标记点,测量侧貌相关的角度、厚度、距离。对侧貌相关的角度、软组织厚度进行配对t检验,并对软硬组织的矢状面距离变化进行Pearson相关分析。结果:鼻唇角、颏唇角、下颌平面与SN前下交角、下中切牙长轴与SN后下交角差异显著(P<0.05),上中切牙长轴与SN后下交角差异无统计学意义(P>0.05)。LL’处软组织厚度、Bs处软组织厚度增加,差异有统计学意义(P<0.05),Sn处软组织厚度、UL’处软组织厚度、Pos处软组织厚度差异无统计学意义(P>0.05)。软/硬组织对应点:鼻下点/A点、上唇缘点/上中切牙点、下唇缘点/下中切牙点、颏唇沟点/B点、软组织颏前点/颏前点、软组织颏顶点/颏顶点的矢状向距离变化显著相关,相关系数分别为0.69、0.59、0.73、0.85、0.90、0.97。结论:骨性Ⅲ类错(牙合)畸形患者正畸正颌手术治疗后,侧貌美观明显改善。相关性分析显示,术后颏部位置预测性佳,唇位置预测性差,下颌比上颌更具有可预测性。     

骨性Ⅲ类错(牙合)正畸-正颌联合治疗后软硬组织稳定性研究

目的 探讨骨性Ⅲ类错(牙合)患者正颌手术后不同阶段的软硬组织变化以及稳定性.方法 24例骨性Ⅲ类错(牙合)患者行正畸-正颌联合治疗,矫治前(T0)和手术3个月后(T1)、矫治结束时(T2)、矫治结束2年后(T3)均拍摄X线头颅定位侧位片,对4个阶段17个软硬组织标志点矢状向的变化进行统计学分析.结果 手术后与矫治前除鼻部软组织点外,其余各点变化有统计学意义(P＜0.01);手术后几个阶段的比较,上颌标志点基本保持稳定(P＞0.05),而下颌不及上颌稳定.T3与T1比较,下颌颏前点(Po)、颏顶点(Gn)和颏下点(Me)以及软组织颏前点(Pos)的变化比较明显(P＜0.05).结论 骨性Ⅲ类错(牙合)患者经正畸-正颌联合治疗后侧貌改善明显.长期观察,上颌骨比较稳定,下颌有一定的复发趋势.     

骨性Ⅲ类错牙合患者正畸正颌联合治疗前后面部软组织变化的研究

目的探讨骨性Ⅲ类错牙合患者正畸正颌联合治疗前后面部软组织变化的特征。方法选择在江苏省口腔医院正畸科就诊的14例骨性Ⅲ类错牙合畸形的患者为研究对象,分别于正畸正颌联合治疗前、后拍摄3dMD,利用3dMD vultus软件对颌面部软组织进行重建,然后选取面部软组织有代表性的17个三维标志点并测量线距和角度,比较骨性Ⅲ类错牙合患者正畸正颌联合治疗前后的差异。结果面凸角、鼻唇角、颏唇角、上唇长度,鼻翼宽度及鼻基底宽度有统计学差异,P<0.05。结论①3dMD提供了三维测量软组织的一种方法。②骨性Ⅲ类错牙合患者正畸正颌联合治疗前后面型改善。     

骨性安氏Ⅱ类错经外科—正畸联合治疗后颜面软组织侧貌的变化

目的 :探讨骨性安氏Ⅱ类错患者采用外科—正畸联合治疗后颜面软组织侧貌在矢状和垂直方向上的变化。方法 :选用华西医科大学口腔医院正畸科连续收治的骨性安氏Ⅱ类错患者 2 2例 ,男 7例 ,女 15例 ,年龄 2 0～30岁。在术前及术后 6～ 12个月摄取X线头侧位片 ,对 16个软硬组织标志点的变化进行矢状、垂直向的分析。结果 :在矢状向上 ,上唇沟点、上唇缘点、上唇下点后退均大于 2mm(P <0 0 1) ;与上切牙点后移量之比为 0 5 9∶1～0 6 4∶1;颏唇沟软、硬组织点前移量之比为 0 83∶1,软组织颏前点与硬组织颏前点前移量之比为 0 95∶1。在垂直向上 ,鼻尖点、鼻底点、上唇缘点平均向上移动量均小于 1mm(P >0 0 5 ) ;但软组织颏前点、颏唇沟、下唇缘点、下唇上点向上移动量均大于 2mm(P <0 0 5 ) ,与相应的硬组织移动量之比为 1 0 7∶1～ 1 34∶1。结论 :骨性安氏Ⅱ类错患者经外科—正畸联合治疗后颜面软组织侧貌改善明显。在矢状方向 ,上下颌软组织改变量均小于硬组织 ;但在垂直方向 ,下颌软组织的改变却比硬组织更明显     

不同骨面型成人颏部软组织厚度的CBCT初步研究

目的 利用CBCT结合Dolphin Imaging 11.0软件对不同骨面型成人颏部软组织厚度进行探讨研究。 方法 选择拍摄CBCT影像的骨性Ⅰ类、骨性Ⅱ类、骨性Ⅲ类患者各20例,利用Dolphin Imaging 11.0图像分析软件进行三维重建,并对重建后的3D图像进行定位,建立三维参考系,定位硬组织颏前点（Po）、软组织颏前点(Pos)的三维坐标等,利用公式计算颏部软组织厚度即（Po-Pos）之间的距离及在各个坐标轴上的差异。 结果 颏部软组织厚度在骨性Ⅰ类、骨性Ⅱ类、骨性Ⅲ类的男、女性别间无统计学差异（P>0.05）,颏部软组织厚度计算数值在骨性Ⅰ类、骨性Ⅱ类、骨性Ⅲ类未发现显著性差异,但在三维坐标系中,硬组织颏前点Po (x1,y1,z1)在Z轴上骨性Ⅰ类与骨性Ⅱ类和骨性Ⅱ类与骨性Ⅲ类存在显著性差异（P<0.05）,在X轴的线距上,骨性Ⅰ类与骨性Ⅲ类、骨性Ⅱ类与骨性Ⅲ类之间存在显著性差异（P<0.05）。 结论 不同骨面型人群颏部软组织厚度在三维坐标系中存在一定差异,主要体现在水平面上的差异,硬组织颏前点在冠状面上骨性Ⅰ类与骨性Ⅱ类和骨性Ⅱ类与骨性Ⅲ类间有一定的差异,这对正畸治疗的临床诊断、治疗计划的制定等提供一定的参考价值。     

骨性Ⅱ类错 正畸正颌联合治疗前后软硬组织侧貌变化的线性相关分析

目的:通过对骨性Ⅱ类错 畸形患者正畸正颌联合治疗前后头颅定位侧位片指标的测量分析,探讨影响软组织侧貌的因素及贡献。 方法:选取40例骨性Ⅱ类错 畸形女性患者,对其正畸正颌联合治疗前后头颅定位侧位片进行测量分析,采用SPSS 24.0对治疗前后软硬组织的变化量进行线性回归分析。 结果:发现21组指标变化量间存在线性关系,其中软硬组织颏前点矢状向变化量呈极强相关性( r＝0.862, P<0.001),比率为0.935∶1;多元逐步后退回归分析显示上、下唇突点内收量分别与上、下中切牙内收量相关性更大等。 结论:骨性Ⅱ类错 畸形在正畸正颌联合治疗前后软组织移动量与硬组织移动量间存在着一定的线性比例关系,临床可根据患者诉求进行硬组织移动量的设计。     

骨性Ⅱ类错 正畸正颌联合治疗前后软硬组织侧貌变化的线性相关分析

目的:通过对骨性Ⅱ类错 畸形患者正畸正颌联合治疗前后头颅定位侧位片指标的测量分析,探讨影响软组织侧貌的因素及贡献。 方法:选取40例骨性Ⅱ类错 畸形女性患者,对其正畸正颌联合治疗前后头颅定位侧位片进行测量分析,采用SPSS 24.0对治疗前后软硬组织的变化量进行线性回归分析。 结果:发现21组指标变化量间存在线性关系,其中软硬组织颏前点矢状向变化量呈极强相关性( r＝0.862, P<0.001),比率为0.935∶1;多元逐步后退回归分析显示上、下唇突点内收量分别与上、下中切牙内收量相关性更大等。 结论:骨性Ⅱ类错 畸形在正畸正颌联合治疗前后软组织移动量与硬组织移动量间存在着一定的线性比例关系,临床可根据患者诉求进行硬组织移动量的设计。     

Clinical experiences with patients with facial bone deformities associated with hemifacial microsomia.

Eighteen adult patients with hemifacial microsomia were treated with a combination of skeletal and augmentation surgery. Three typical cases are presented. In principle, skeletal and augmentation surgery have recently been performed in combination in a single stage. Groin flaps and scapular or scapular ostocutaneous flaps have mainly been employed for augmentation surgery.     

Vasovagal syncope with asystole associated with intravenous access

Two cases of vasovagal syncope (VVS) during venous access are reported. Both patients had a history of fainting episodes and experienced bradycardia with asystole, hypotension, and fainting. Pain and phobic stress during venous access triggered an increase in parasympathetic tone, resulting in bradycardia with asystole and hypotension in both cases. Hypotension and bradycardia likely caused cerebral hypoperfusion, leading to fainting. The intense parasympathetic tone triggered by somatic or emotional stress was likely responsible for directly depressing the sinus node, leading to asystole and bradycardia. Bradycardia with asystole progressing to syncope is a potentially fatal dysrhythmia in patients with cardiovascular disease or older patients with decreased cardiac function. Appropriate treatment for VVS includes the administration of intravenous fluids, vagolytics, ephedrine, and the rapid use of the Trendelenburg position. Intravenous fluids and atropine were used to treat the present patients.     

Inflammation associated with implants with different surface types

OBJECTIVES: The aim of this study was to determine the nature of the inflammatory infiltrate associated with different transmucosal implant surfaces in dogs. METHODS: Three experimental and one control single-stage implants were randomly placed on each side of the jaw in eight dogs. The transmucosal portion of the test implants consisted of an acid-etched surface (type A), a machined surface with a circumferential groove (type C) and a surface prepared by mild anodic oxidation (type D). The control was a standard machined surface (type B). In order to determine the response to the different surfaces, plaque control was carried out twice weekly following placement of the implants for the entire period of the experiment. At 6 months, gingival biopsies and plaque samples were obtained. The area of inflammatory infiltrate and the nature of the infiltrating cell types were determined using immunohistology. Real-time polymerase chain reaction was used to identify putative periodontal pathogens. RESULTS: Inflammatory infiltrates were associated with all implant surfaces and were commonly found subepithelially and perivascularly. T cells were the predominant infiltrating cell type in all lesions, associated with the different surfaces. In all lesions the CD4 : CD8 ratio was approximately 2 : 1. Statistical analysis showed that the type C surface (machined surface with a groove) had significantly larger inflammatory infiltrates than the type B surface (machined surface without a groove; P<0.05). No statistically significant differences were found with respect to the size of the inflammatory infiltrates or in terms of the nature of infiltrating cells. However, despite the intensive plaque control regime, plaque was present on all implant surfaces at the time of biopsy 6 months after placement. All implants had similar numbers of Tannerella forsythia, Fusobacterium nucleatum and Porphyromonas gingivalis. Actinobacillus actinomycetemcomitans, was not detected in any sample. CONCLUSIONS: These results suggest that the development of inflammation associated with implants is independent of surface type, but is nevertheless associated with the presence of plaque. The different surfaces had no influence on the nature of the infiltrate, with T cells being the predominant cell type in all lesions. Finally, the different implant surface types seemed not to influence the peri-implant microbiota. However, the presence of the circumferential groove tended to be associated with larger infiltrates. Whether this is due to increased plaque accumulation remains to be determined.     

Recurrent intraoral pyogenic granuloma with satellitosis treated with corticosteroids

The development of recurrent pyogenic granulomas as multiple satellite lesions has not been reported in the oral cavity. This report describes an unusual case of intraoral pyogenic granuloma recurring multiple times after surgical excisions with the formation of satellite lesions. Due to failure of surgical management, an alternative approach was taken. We illustrate how the lesions were successfully treated with a series of intralesional corticosteroid injections.