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.     

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.     

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。     

Fluor Protector用于过度磨耗引起的牙本质过敏的脱敏治疗

牙本质过敏是牙齿在受到外界刺激,特别是化学刺激和机械刺激所引起的酸痛症状,其特点是发作迅速,疼痛尖锐,时间短[1]。牙本质过敏是口腔科常见病和多发病,因磨损而刚刚外露的牙本质,对酸和甜的食物、温度改变以及探触刺激可能发生酸痛感,影响患者进食。这种牙本质过敏症,可在数     

比喻修辞手法在医学论文中的运用

比喻就是打比方,是利用一事物来说明有相似之处的另一事物的修辞手法.撰写医学论文时如能巧妙地运用比喻修辞格,就能把抽象的事物变得具体,把深奥的道理变得浅显,从而大大增强书面语言的表现力.比喻的基本结构分为三部分:本体(被比喻的事物)、喻词(表示比喻关系的词语)和喻体(打比方的事物),根据上述基本结构的不同,比喻可分为明喻、暗喻、借喻三种基本类型,此外饰喻、博喻这两种比喻变式在医学类文章中也时有出现.     

CAD／CAM制作的长期暂冠

最终修复体与长期暂冠（LTP）之间的区别一直没有界定。自凝塑料暂冠虽可直接在临床制作，但只能在短时间内使用．而技工室制作的带有或不带有金属支架的暂时修复体虽经久耐用，但价格较贵。计算机辅助设计／计算机辅助制作（CAD／CAM）技术的应用提供了一种可靠．价廉．美观的暂时修复体制作方法。本文讨论了应用CAD／CAM技术制作LTP的多种选择。     

蜂胶醇封闭牙本质小管的扫描电镜观察

目的:研究不同浓度蜂胶醇封闭牙本质小管的效果,为蜂胶脱敏治疗提供形态学依据. 方法:将35个新鲜上颌前磨牙随机分为A、B、C、D、E、F、G7组,制作3㎜×3㎜×2㎜牙本质磨片,清洁,酸蚀.A、B、C组分别涂10、20、30 g/L的蜂胶醇,D组涂含氟涂膜,E组作为空白对照组,扫描电镜观察牙本质小管封闭情况,筛选蜂胶最佳浓度(记作X).F组涂抹浓度为X的蜂胶,G组涂含氟涂膜,用牙刷刷洗标本表面,扫描电镜观察牙本质小管封闭情况.结果:30 g/L的蜂胶醇能够完全封闭牙本质小管,且渗入沉淀达一定深度,经过刷牙后封闭效果没有明显减弱.结论:蜂胶对牙本质小管具有良好的封闭作用,在治疗牙齿感觉过敏症方面具有进一步研究价值.     

第二届海峡西岸口腔内科学术论坛通知

由中华医学会批准,福建省口腔医学会和厦门市医学会联合主办、厦门市口腔医院承办的"第二届海峡西岸(海西)口腔内科学术论坛"将于2009年7月17-21日在厦门召开。授予国家级继续教育学分8分。届时将有全国(包括台湾)三门学科(牙体     

Pentoxifylline therapy: a new adjunct in the treatment of oral submucous fibrosis.

OBJECTIVE: This study was designed to determine the effect of pentoxifylline (Trental) on the clinical and pathologic course of oral submucous fibrosis. This drug is a methylxanthine derivative that has vasodilating properties and was envisaged to increase mucosal vascularity. STUDY DESIGN: This investigation was conducted as a randomized clinical trial incorporating a control group (Standard drug group SDG, multivitamin, and local heat therapy) in comparison to pentoxifylline test cases (Experimental drug group EDG, 400mg 3 times daily, as coated, sustained release tablets). The stipulated treatment period was 7 months and a total of 29 cases of advanced fibrosis (14 test subjects and 15 age and sex matched diseased controls) were included in this study and 100% compliance was reported at the end ofthe test period. RESULTS: Mild gastric irritation that could be managed by diet protocols was the only untoward symptom reported during this trial. Review of the patients and controls was done at an interval of 30 days and subjective and objective measurements were recorded. The follow up data at each visit with respect to each other and to base-line values was calibrated using a nonparametric test of Mann-Whitney (Kruskal-Wallis test). Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (t=11.285, p= 0.000), tongue protrusion (t= 3.898, p = 0.002), and relief from perioral fibrotic bands (p = 0.0001554). Subjective symptoms of intolerance to spices (p = 0.0063218), burning sensation of mouth (p = 0.0005797), tinnitus (p=0.000042), difficulty in swallowing (p=0.0000714). and difficulty in speech (p=0.0000020) were also recorded significant improvement at the end of the trial period. CONCLUSION: This pilot investigation points to the effectiveness of pentoxifylline as an adjunct therapy in the routine management of oral submucous fibrosis.     

口腔黏膜下纤维性变的病因、致病机理、诊断与治疗

口腔黏膜下纤维性变是一种能形成瘢痕、组织纤维化的慢性疾病。流行病学研究显示,咀嚼槟榔是导致口腔黏膜下纤维性变的危险因素。在中国的口腔黏膜下纤维性变患者均有咀嚼槟榔的习惯。研究证实,嚼槟榔、吸烤烟和饮白酒可增加口腔黏膜下纤维性变的风险。口腔黏膜下纤维性变被广泛认为是一种口腔癌前病变,病理表现为慢性炎症、结缔组织内广泛的胶原纤维沉积、上皮固有层或其下结缔组织内的局部炎症改变。口腔黏膜下纤维性变的癌变发生率为7%~30%。口腔黏膜下纤维性变的治疗主要采用曲安奈德和丹参酮注射液行黏膜下局部注射,对改善患者的张口度及口腔黏膜的烧灼痛效果良好,其治疗总有效率可达93%。本文就口腔黏膜下纤维性变的病因、致病机理、诊断与治疗进行阐述,以供同道们临床参考之用。     

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口腔黏膜下纤维性变(oral submucous fibrosis,OSF)是一种慢性、隐匿性、具有癌变倾向的口腔黏膜疾病。其主要临床表现为口腔黏膜纤维化、进食刺激性食物时口内疼痛,严重者可致张口和进食困难。目前,OSF的诊断手段主要包括临床检查和病理诊断。本文旨在结合笔者的临床经验和最新的相关文献,评述OSF诊断方法的研究进展,如分子生物学方法在OSF诊断中的应用、OSF合并症的诊断等。     

Evaluating the efficacy of pentoxifylline in the treatment of oral submucous fibrosis: A meta‐analysis

Oral submucous fibrosis (OSMF ), a potentially malignant oral cavity disorder that causes speech and mastication problems, lacks an established treatment regimen; moreover, no treatment can effectively reverse the course of OSMF . A meta‐analysis was conducted to investigate the efficacy of the peripheral vasodilator, pentoxifylline, in the treatment of OSMF . We searched five different databases for studies meeting our eligibility criteria (up to June 30, 2017). Statistical analyses were performed using RevMan 5.3 software. Three randomized controlled trials (247 OSMF patients) were selected. Pentoxifylline increased the objective sign maximal mouth opening (MMO ; WMD : ?4.59, 95% CI : ?8.65, ?0.53; p  <  0.05) following short‐term (under 1 month; WMD : ?1.94, 95% CI : ?3.12, ?0.77; p  <  0.05) and long‐term (over 1 month; WMD : ?5.44, 95% CI : ?6.81, ?4.07; p  <  0.05) application. Pentoxifylline improved the subjective symptom burning sensation (WMD : ?0.11, 95% CI : ?0.17, ?0.05; p  <  0.05) only following long‐term application (WMD : 0.42, 95% CI : 0.18, 0.96; p  <  0.05). The efficacy on MMO and burning sensation increased with time. Although OSMF lacks definitive treatment modalities, our meta‐analysis shows that pentoxifylline effectively improves the objective signs and subjective symptoms of OSMF and its therapeutic efficacy increases with time.     

Vasodilator isoxsuprine alleviates symptoms of oral submucous fibrosis

Objectives

The aim of the study was to compare the effectiveness of vasodilator isoxsuprine to dexamethasone with hyaluronidase injections and physiotherapy in the treatment of oral submucous fibrosis.

Materials and methods

Forty patients with oral submucous fibrosis were randomly assigned into three groups. Group A patients (n?=?15) received 10 mg isoxsuprine tablets four times per day, group B (n?=?15) biweekly dexamethasone with hyaluronidase intralesional injections, and group C (n?=?10) placebo tablets. In addition, all patients were instructed physiotherapy exercises. The treatment time was 6 weeks and patients were followed-up for 4 months thereafter. The effect of the treatment was evaluated by measurements of inter-incisal distance and oral burning sensation and evaluation of histological findings of the diseased mucosa.

Results

Mouth opening increased and burning sensation decreased significantly in all groups, but the effects were significantly greater in groups receiving either oral isoxsuprine or dexamethasone with hyaluronidase injections in addition to physiotherapy. The decrease in burning sensation occurred more rapidly in patients receiving intralesional dexamethasone with hyaluronidase. Histological improvement was not observed in any of the groups.

Conclusions

Oral isoxsuprine as well as dexamethasone with hyaluronidase injections combined to physiotherapy alleviate symptoms of oral submucous fibrosis significantly more efficiently than physiotherapy alone.

Clinical relevance

Oral isoxsuprine can be considered as a new candidate drug for the treatment of oral submucous fibrosis. Physiotherapy exercises provide relief of symptoms and should be instructed to all patients.     

丹参联合曲安奈德局部注射治疗口腔黏膜下纤维性变的临床研究

目的探讨丹参联合曲安奈德局部注射治疗口腔黏膜下纤维性变引起的口腔灼痛和张口受限的疗效。方法将丹参注射液和曲安奈德注射液混合均匀,局部注射到双侧病变颊黏膜下和翼颌韧带区,每周1次,连续10次为1个疗程。观察颊黏膜色泽、弹性变化,记录治疗前、治疗1个疗程后口腔灼痛症状和张口度。结果1个疗程后,35例患者病变区颊黏膜色泽均逐渐变红润、质地变软;自觉口腔灼痛症状均减轻或基本消退;其中29例患者张口受限得到改善,上下切牙切缘距离由治疗前的（17.05±4.31）mm,增加到（28.50±6.02）mm,治疗前后差异有统计学意义（t=6.55,P〈0.05）;其余6例上下切牙切缘间距增加小于或等于2mm,张口度变化不明显。结论丹参联合曲安奈德局部注射治疗口腔黏膜下纤维性变引起的口腔灼痛和张口受限有较确切的临床疗效。     

A scoring system for the early detection of oral submucous fibrosis based on a self-administered questionnaire

OBJECTIVES: The aims of the present study were to evaluate the frequent clinical complaints of oral submucous fibrosis (OSF) and to develop a scoring system for early detection of the disease by a self-administered questionnaire. METHODS: A total of 296 subjects were recruited, including 123 OSF patients without oral cancer and 173 betel quid chewers without OSF or oral cancer. A self-administered questionnaire was used to collect the symptom profile from study subjects. Their maximal mouth opening (MMO) between upper and lower incisor edges was measured and recorded by well-trained nurses. A binary logistic regression model examining the likelihood of OSF based on the eight symptoms of interest was used to develop the scoring system. RESULTS: Among 79 OSF subjects with an MMO < 35 mm, the most frequent complaint was trismus (87.3%), followed by burning sensation (76.0%) and xerostomia (72.2%). Among 44 OSF subjects with an MMO > or = 35 mm, burning sensation (68.2%) was the most frequent complaint, followed by trismus (54.5%) and xerostomia (54.5%). Six frequent complaints including trismus, burning sensation, xerostomia, sore throat, numbness, and oral ulceration were utilized to develop a scoring system for the early detection of OSF. The scoring system had an area under the receiver operating characteristic curve of 0.90. CONCLUSION: This study suggests a screening questionnaire of frequent complaints for the early detection of OSF.     

Management of oral submucous fibrosis: an overview

Oral submucous fibrosis is a disease due to a chronic, insidious change in fibroelasticity, characterized by burning sensation in the oral cavity, blanching, and stiffening of the oral mucosa and oro-pharynx leading to trismus and inability to open the mouth. The symptoms and signs depend on the progression of the lesions and number of affected sites. It is predominantly seen in Indians and other Asians. Once, the disease has developed, there is neither regression nor any effective treatment. It is considered as a pre-malignant stage of oral cancer and reported risk of malignant transformation varies from 2.3-7.6%.The common etiological factor considered for this unremitting disease is use of areca nut; however, the precise pathogenesis still remains elusive and controversial. A wide range of treatment consisting of drug management, surgical therapy, and physiotherapy have been attempted till date; with varying degrees of benefit, but none of them have proved to be a cure for this disease. This field remains open for clinical trials and research. This paper aims to provide an overview on various management modalities available for oral submucous fibrosis.     

芦荟治疗口腔黏膜病的系统评价

目的 系统性评价芦荟治疗口腔黏膜病的有效性及安全性。方法 使用计算机文献检索确定所有以这为主题的已发表的文章。使用特定的关键字用PubMed、Cochrane、Database、Embase、Cbm、Cnki、万方和维普数据库,检索建库至2017年5月收录的关于芦荟治疗口腔黏膜病的随机对照实验(randomized controlled trials ,RCT)。由两名研究人员使用Cochrane Reviewer Hand booker 5.1系统分别独立进行文献筛选和质量评价。结果 25项研究符合纳入标准。临床诊断为口腔黏膜病变的研究样本患者人群从20例到120例。25项研究中包括5项口腔扁平苔藓（oral lichen planus ,OLP）、6项口腔粘膜下纤维化（oral submucous fibrosis,OSMF）、8项口腔溃疡（oral ulcer）、3项放射性口腔黏膜炎（radioaction oral mucositis）,其他研究为灼口综合征（burning mouth syndrome,BMS）、义齿性口炎（denture stomatitis）和口干（xerostomic）。大多数研究表明,芦荟治疗口腔疾病的有效性具有显著的统计学意义,且未发现有任何副作用。结论 芦荟治疗口腔黏膜病虽然有一定的效果,但仍需扩大临床对照试验来证明芦荟在口腔黏膜疾病治疗中的有效性及安全性。     

Aloe vera in treatment of oral submucous fibrosis: A systematic review and meta‐analysis

The management of oral submucous fibrosis (OSF) is quite challenging, and as yet, no effective therapy is available for its management. The present systematic review and meta‐analysis sought to assess the effectiveness of aloe vera in alleviating pain and clinical signs of OSF. A comprehensive search in PubMed/Medline, Scopus, and Web of Science databases was conducted to identify the relevant randomized clinical trials. RevMan 5.3 software was used for data analysis. Six randomized controlled trials fulfilled the inclusion criteria. The results of meta‐analysis showed statistically significant differences between aloe vera and control groups in alleviating pain/burning sensation at the end of the first and second month, in favor of aloe vera, but no significant differences were found at the end of the third month. With regard to objective clinical outcomes, no statistically significant differences were found between the groups. Aloe vera has a promising effect in reducing pain/burning sensation and clinical improvement in patients with OSF. However, owing to the marked heterogeneity of the included studies, conducting well‐designed trials with long follow‐up periods, standardized outcome measures and adequate sample sizes are warranted.