腮腺多形性腺瘤术后复发11例临床分析

目的:探讨腮腺多形性腺瘤术后复发的相关因素及临床治疗方法。方法:对11例腮腺多形性腺瘤术后复发病例进行回顾性分析。结果:11例复发病例第2次手术分别采用浅叶切除术、腮腺全切术、扩大切除术。11例中有5例首次术后病理报告为富有细胞型多形性腺瘤,占45.5%;有2例恶变(18%)者术后已辅以放疗。二次手术后随访3～15年,除1例多形性腺瘤恶变者第2次手术后5年复发,其余病例二次术后均未见复发。腮腺多形性腺瘤复发与组织学类型及术式关系密切,富于细胞者易复发,手术越简单其复发率越高。结论:不规范的手术方法是导致腮腺多形性腺瘤复发的直接原因。     

腮腺复发性多形性腺瘤的临床分析--附22例报告

目的：探讨腮腺多形性腺瘤复发、恶变的原因及临床治疗方法。方法：对22例腮腺多形性腺瘤复发患者进行回顾性分析和追踪调查。结果：多数腮腺多形性腺瘤复发病例肿块呈多灶性（18／22），手术越简单其复发率越高，复发间期越短（P＜0．05）。22人中有7例发生恶变，占31．8％，恶变与初发年龄较大有关（P＜0．05），与手术次数关系不大。末次手术分别采用浅叶切除术，腮腺全切术、扩大切除术，对7例有恶变者于术后辅以放射治疗。术后平均追踪54月，除1例多形性腺瘤恶变者于术后30月时肿瘤复发外，其余均未见复发。结论：不恰当的手术方式是导致腮腺性多形性腺瘤复发的直接原因。     

腮腺浅叶多形性腺瘤改良术式的临床疗效分析

目的:探讨腮腺浅叶多形性腺瘤改良术式的临床效果.方法:腮腺多形性腺瘤102例行肿瘤及部分腺体切除术(改良组)与102例腮腺浅叶肿瘤切除术(对照组)比较其术后并发症.结果:随访1～10年,随访率93.1%,两组病例术后均无复发,改良组术后并发症明显低于对照组(p＜0.05).结论:腮腺多形性腺瘤及部分腺体切除术治疗腮腺浅叶多形性腺瘤较传统的肿瘤及腮腺浅叶切除术比较具明显优势.     

83例腮腺浅叶切除术后并发涎瘘的分析

腮腺切除手术是口腔颌面外科最常见的手术之一 ,而术后所发生的并发症中术后瘘发生率最高 ,所以对瘘产生的原因预防及治疗方法的讨论 ,有一定临床价值。本文对 83例腮腺浅叶切除术后所发生的8例瘘进行了分析 ,结合文献报道进行了总结 ,现报告如下。1　临床资料本组病人共 83例 ,男性 41例 ,女性 42例 ;年龄最大 6 4岁 ,最小 1 7岁 ;左侧 43例 ,右侧 40例 ;腮腺良性肿瘤 71例。其中多形性腺瘤 3 6例 ,腺淋巴瘤2 6例 ,单形性腺瘤 9例 ,慢性腮腺炎病人 1 2例 ,83例病人全部行腮腺浅叶切除加面神经解剖术 ,病人术后放置负压引流 ,48～ 72 h后去…     

腮腺多形性腺瘤加部分腺体切除术64例临床分析

腮腺多形性腺瘤是唾液腺肿瘤中最常见者。由于其包膜常不完整 ,因此保留面神经 ,行腺体浅叶或全腺体切除术被认为是腮腺多形性腺瘤的经典手术。作者对 1991～ 2 0 0 2年间厦门市口腔医院病理诊断为腮腺多形性腺瘤的 6 4例 ,经瘤体加部分腺体切除术病例进行临床分析 ,报告如下 :     

唾液腺多形性腺瘤恶变108例临床病理分析

目的:研究唾液腺多形性腺瘤恶变的临床病理特点。方法:回顾分析上海交通大学医学院附属第九人民医院口腔颌面外科1993年1月至2005年5月间唾液腺多形性腺瘤恶变病例的病理与临床资料。结果:108例唾液腺多形性腺瘤恶变病例,男68例,女40例,男女比为1.7∶1;年龄28～92岁,60～70岁最好发(29例),其次为50～60岁(22例)、70～80岁(20例)和40～50岁(19例)。发生于腮腺者68例,腭部20例,下颌下腺15例,其他部位包括唇、咽旁小唾液腺等。恶变成分主要为腺癌(26例),其次为肌上皮癌(19例),黏液表皮样癌(6例,包括低、中、高度恶性),腺样囊性癌(4例),其他有腺鳞癌、上皮-肌上皮癌、腺泡细胞癌、唾液腺导管癌、鳞癌等。5例发生颈部淋巴结转移,约占4.6%,其原发灶的恶变成分主要为腺癌。结论:唾液腺多形性腺瘤恶变多见于中老年男性,好发于腮腺,其次为下颌下腺和腭部,恶变成分多为腺癌和肌上皮癌;发生颈淋巴结转移者,恶变成分多为腺癌。     

Ki-67、p16与腮腺多形性腺瘤术后复发的相关性研究

目的:探讨Ki-67、p16与腮腺多形性腺瘤术后复发生物学行为的相关性.方法:用EnVision免疫组织化学方法观察Ki-67、p16在腮腺多形性腺瘤术后复发者第一次(复发前)手术、第二次(复发后)手术标本,未复发者手术标本中的表达.结果:Ki-67在复发者第一、二次手术与未复发者标本中的表达差异有统计学意义(P＜0.05);p16在复发者第一次手术与未复发者标本中的阳性强度表达构成比差异有统计学意义(P＜0.05).结论:腮腺多形性腺瘤术后复发与其自身的生物学活性有关.     

复发性涎腺多形性腺瘤的临床与病理分析

目的 探讨复发性涎腺多形性腺瘤(recurrent pleomorphic adenoma,RPA)的临床与病理特点.方法 1962～2002年间在我院因涎腺RPA住院手术治疗的患者121例,对其中随诊10年以上的38例患者进行临床与病理分析.结果 腮腺、颌下腺及腭腺最多,复发次数分别为6、12、4次.单发14例,多发24例.腮腺及腭腺复发肿瘤除原手术野、手术切口瘢痕处外,6例多次复发后向腮腺深叶、咽旁及颅底扩展.34例中,病理类型以粘液成分为主型4例,细胞密集型13例,混合型17例.结论 结合病理研究,肿瘤复发的主要原因是残留瘤芽及术中肿瘤包膜破裂种植.复发肿瘤位置表浅、单发者可手术局部摘除,多发、位置深在者需行解剖面神经的肿瘤摘除术.避免涎腺多形性腺瘤术后复发的关键是第一次手术的术式,防止肿瘤包膜破裂并严格遵守无瘤手术原则.     

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目的探讨腮腺多形性腺瘤的治疗方法。方法通过对1992—2009年江苏省徐州市第六人民医院口腔科收治的148例腮腺多形性腺瘤患者的临床资料进行总结,比较分析腮腺浅叶切除术(88例患者)与腮腺区域性切除术(60例患者)两种术式治疗腮腺多形性腺瘤的效果。结果采用腮腺区域性切除术治疗的病例,术后瘢痕、局部凹陷畸形、暂时性面瘫、涎瘘、Frey综合征及腮腺功能等方面明显优于采用腮腺浅叶切除术的病例。两种术式的术后复发率差异无统计学意义。结论应根据肿瘤的部位及大小选择不同的术式,对界限清楚、体积较小的腮腺浅叶多形性腺瘤应尽量采用腮腺区域性切除术,预防面部凹陷畸形,减少并发症;对过大或边界不清的肿瘤仍宜采用传统腮腺浅叶切除术,以减少复发。     

CD44v6在腮腺多形性腺瘤中的表达

初步研究CD44v6在腮腺多形性腺瘤中的表达情况及其与肿瘤复发的关系.采用免疫组织化学SP法对初次手术后复发,又再次入院行复发灶切除术的多形性腺瘤病例10 例2 次术后石蜡标本及10 例正常腮腺组织石蜡标本进行CD44v6检测,分析其与腮腺多形性腺瘤复发关系.结果表明CD44v6在肿瘤组织中的表达高于正常腮腺组织,在复发多形性腺瘤中呈现低表达.CD44v6的表达变异可能与腮腺多形性腺瘤的复发有关.     

不同剂型玻璃离子水门汀溶解性比较研究

目的:研究、比较不同剂型玻璃离子水门汀的溶解性和表面微观形态改变,为临床使用提供依据.方法:将3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)及GC玻璃离子水门汀(双糊剂型)分别在人工唾液中浸泡30 d,冷热循环15000次,烘干测重,比较前后质量变化,计算溶解率,并用扫描电镜观察表面微观改变.结果:不同剂型的玻璃离子水门汀溶解率由高到低分别为3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(双糊剂型).3种玻璃离子水门汀经浸泡溶解后,SEM扫描表面微观形态可观察到GE玻璃离子水门汀(双糊剂型)表面形态改变较少,其他2组玻璃离子水门汀表面微观改变较多.结论:双糊剂型玻璃离子水门汀理化性能及溶解率均低于传统水粉剂型,是未来临床修复治疗的的良好选择.     

Evidence of the validity of a model of determinants of quality of restorative dental care

A model describing the relationship between self-reported quality of restorative dentistry and dentist characteristics for 119 Montana general dentists is presented. The best predictors formed a significant model explaining 22% of the variance of the quality measure. Results are contrasted with a previous estimation of the model for 102 Washington general practitioners. Evidence for the external validity of the model is presented.     

Design of clinical trials of traditional therapies of periodontitis

The present paper on the design of clinical trials of periodontal therapy first addresses the issue of the etiology of periodontal disease. It is suggested that most if not all forms of destructive periodontal disease are caused by microorganisms and that there are different forms of disease with different microbial etiologies. The progressive nature of destructive periodontal disease is subsequently discussed and it is emphasized that, in a given patient, periodontal sites which show signs of inflammation and attachment loss may not over a period of several months and years show further sign of attachment loss. The present methods of assessing periodontal disease do not allow us to discriminate between potentially active and inactive sites in untreated patients. The significance and variability of indicators of periodontal disease such as bleeding on probing, probing pocket depth and probing attachment level measurements are discussed. The errors inherent in the various measurements are analyzed and suggestions are presented describing how alterations in any of the above parameters could be identified and presented in a clinical trial. Of concern for the statistical analysis of clinical data of periodontal disease is the definition of the "experimental unit". For a number of years, the "experimental unit" in periodontal trials was the patient. It is clear, however, that different sites within the same individual show different patterns of disease progression and lesion morphology and often respond differently to periodontal therapy. Statistical analyses must consequently be designed which recognize differences in site-to-site infection and lesion morphology within a common host. Until such analyses are available, the investigator should be wary of pooling data within the same individual, since such pooling may obscure meaningful alternatives which may take place in individual periodontal sites. Some goals of periodontal therapy are subsequently identified. 4 goals are discussed more in detail, namely: to establish conditions which will allow the patient to maintain a dentition without further breakdown of the periodontium; to reduce pocket depth to establish an anatomy in the dentogingival region which with proper maintainance care will prevent the re-establishment of the subgingival infection; to gain attachment as a result of treatment; to assess the effect of a certain chemotherapeutic agent on periodontal disease.     

Experimental evidence of formation of imines in the course of reduction of hydrazones

The reduction of hydrazones is generally suggested to proceed through a reductive cleavage of the nitrogen–nitrogen bond followed by a reduction of the carbon–nitrogen bond. This sequence of reduction processes is here supported for fluorenone (V) and benzophenone (VI) hydrazones as well as by a comparison of the reduction of fluorenone and benzophenone hydrazonium ions (I,III) with corresponding imines (II,IV). Another proof of the presence of imines as intermediates is the splitting of four-electron waves of hydrazones V and VI and hydrazonium ions I and VIII into two waves at pH < 2. This has been interpreted as due to differences in slopes dE_1/2/dpH and pK_a-values of protonated hydrazine derivatives on one side and corresponding imines on the other. In this pH-range imines formed in reductions of VI and VIII are reduced in a single two-electron wave, those of I and V in two one-electron steps. Fluorenone imine (II) is sufficiently stable to allow recording of time-independent current–voltage curves between pH 6 and 11. In this pH-range the imine (II) is reduced in two one-electron steps. Benzophenone imine (IV) has been found stable between pH 4.6 and 12. At pH 4.6–8 the reduction of the imine IV takes place in a single two-electron step, at pH 8–12 in two one-electron steps. Final proof of the initial cleavage of the N–N bond is presented by comparison with the reduction of nitrones.     

Evaluation of efficacy of chemiluminescence for diagnosis of leukoplakia

ObjectiveLeukoplakia is the most common potentially malignant disorder preceding oral cancer. Chemiluminescence has been developed as an adjunct to conventional examination for the diagnosis of these potentially malignant disorders. This study was conducted to assess the efficacy of chemiluminescence in the diagnosis of leukoplakia and to compare the results with histopathological examination.Study designA total of 50 patients with leukoplakia were included from the outpatients attending the Department of Oral Medicine and Radiology, Dental Hospital, Bengaluru, Karnataka, India. These patients were subjected to conventional oral examination followed by chemiluminescent examination with Vizilite (Zila, Fort Collins, CO, USA) and biopsy for histopathological confirmation.ResultsThe sensitivity, specificity, positive predictive value, and negative predictive value of chemiluminescence were 93.75%, 55.56%, 78.95%, and 83.3%, respectively. The overall accuracy of chemiluminescence was 80%. A statistically significant association was observed between histopathology results and chemiluminescence results.ConclusionAlthough it is an easy, safe, minimal time consuming, and noninvasive technique, it has only adjunctive utility and it does not replace biopsy for the diagnosis of leukoplakia.     

正常青年Monson球面半径的测量研究

目的测量正常青年Monson球面半径。方法选择60名(男30名,女30名)正常青年制取全口印模,应用立体摄影成像的原理与方法对Monson球面半径进行测量和统计学处理。结果Monson球面的半径平均为10.173 cm,大于理论值10.160 cm,差异有显著性(P<0.01);男、女性球面半径差异无显著性。结论本实验所得到的数据可作为全口义齿修复中记录颌位关系的一个参量。     

Electrodeposition of bilayers of dithiols

We report an electrochemical method to form a bilayer of dithiol. The cyclic voltammogram of the oxidative deposition of an aromatic dithiol on gold from an alkaline aqueous solution reveals two current peaks separated by more than 400 mV. The integrated charge of the oxidative current peak (B) at the most positive potential is twice that of the other oxidative current peak (A). These two oxidative current peaks were characterized by differential capacitance and electrochemical quartz crystal microbalance (EQCM) measurements. A decrease of the capacity by a factor of two, and an increase of the EQCM frequency change by a factor of two were observed when the potential was scanned from a value where only the first oxidative peak (A) is obtained, to a potential where both oxidative current peaks (A and B) are obtained. Infrared spectra show that the aromatic dithiols adsorb vertically at potentials corresponding to the current peak A and they become tilted for potentials corresponding to the current peak B. The simple relationships between the properties of the two oxidative current peaks are found to be compatible with a step-wise oxidative deposition of a bilayer of dithiol.     

正畸患者切牙影像失真发生情况分析

目的研究正畸患者曲面体层片上的切牙影像失真发生情况，并分析其原因。 方法从中山大学附属口腔医院放射科影像数据库中选取500例正畸患者的曲面体层片和头影测量侧位片，所有曲面体层片均采用咬合杆投照，分别从切牙牙体影像放大、缩小、牙根变短、根尖模糊等评价指标分析上下颌切牙影像失真的发生情况，在头影测量侧位片上测量中切牙根尖-对颌切牙切缘的距离，探讨切牙影像失真发生的原因。采用SPSS 19.0统计软件对所得数据进行统计学检验。 结果500例患者中，切牙牙体影像正常者共417例，切牙牙体影像失真者共83例，影像失真发生率16.6%，其中切牙牙体影像放大17例、牙体影像缩小0例、牙根变短30例，牙根影像变短伴模糊36例。影像失真患者的根尖-切缘距离大于影像正常的患者，差异有统计学意义（F = 5 187.18，P = 0）；影像失真患者的覆盖值大于影像正常的患者，差异有统计学意义（F>477，P = 0）。 结论严重牙颌面畸形如反 、深覆盖是导致曲面体层片的切牙影像失真的主要原因之一。     

5种着色氧化锆陶瓷的细胞毒性评价

目的：对掺杂5种微量着色剂的氧化锆陶瓷的生物安全性进行初步评价.方法：采用四氮唑盐比色法（MTT）细胞毒性评价方法,用5种着色氧化锆陶瓷材料的浸提液体外培养L929小鼠成纤维细胞2 d、4 d、7 d,于倒置相差显微镜下观察细胞形态;用MTT检测各实验组和对照组的吸光度值（OD值）,计算各组细胞的相对增殖率,并按照6级毒性分类法对各实验组进行评级.结果：培养期细胞贴壁生长,细胞形态正常.随着培养天数增加细胞大量增殖,各实验组的毒性评级为0-1级.结论：添加5种微量着色剂的氧化锆陶瓷无细胞毒性,具备体内应用的生物安全基础.