无牙颌患者种植即刻修复临床观察

目的:通过对上、下颌无牙颌患者即刻修复效果1年的回顾性研究,分析其成功率及相关影响因素。方法:从2009年7月至2010年9月,胡忠医院种植修复科行无牙颌即刻修复病例共18例118枚,8例60枚植入上颌无牙颌,10例58枚植入下颌无牙颌,术后丙烯酸树脂临时义齿即刻修复。3~6月后永久固定修复。结果:18例118枚种植体中,101枚即刻修复,12~26个月后种植体累积存留率100%,修复体成功率100%。结论:无牙颌即刻修复具有较好的短期临床效果     

自主研发CAD/CAM种植导板制作系统在无牙颌种植修复中的临床应用研究

目的评价自主研发CAD/CAM种植导板制作系统在无牙颌种植修复中的临床应用。方法选择5例单颌无牙颌患者。锥形束CT扫描采集数据,导入自主研发种植导板软件进行导板的数字化设计,快速成型机制作种植导板。在导板引导下进行无牙颌种植手术,植入ITI种植体。3个月后复查,行种植义齿修复。术后定期随访。结果为5例患者制作完成丙烯酸树脂CAD/CAM种植导板,在导板引导下采用不翻瓣术式共植入38枚ITI种植体,初期稳定性良好,术后反应小。术后3个月骨结合良好,仅1枚种植体脱落。5例患者均采用固定式种植修复,术后6个月及1年的随访显示,修复体功能和美观良好。结论该自主研发的CAD/CAM种植导板制作系统应用于无牙颌种植手术,能实现术前精确设计和术中精确控制种植体位置,减少了手术创伤和术后并发症,取得良好的种植修复效果。     

个性化氧化锆基台在前牙区种植一次诱导牙龈成型的美学观察

目的:探讨CAD/CAM个性化氧化锆基台一次诱导牙龈成型在前牙区种植修复获得的美学效果.方法:42例患者在上前牙区植入42枚种植体后,制作CAD/CAM个性化基台进行一次牙龈成形,6个月后永久修复,对修复后即刻和修复后1年分别进行美学效果评价.结果:42例患者均获得较好的美学效果.修复后即刻和1年后PES的均值分别为11.87±1.95、11.65±2.11,WES均值分别为8.09±1.39、7.98±1.37,PES/WES总均值分别为19.96±3.34、19.63±3.48,VAS均值分别为92.30±5.43、89.12±6.24.结论:利用CAM/CAM个性化氧化锆基台一次诱导牙龈成型,能较好地符合患者个体的生理机能需求,短期观察美学效果稳定.     

氧化锆基台在种植体支持的全瓷修复中的应用

目的探讨氧化锆基台的应用及种植体支持的全瓷修复体的临床效果。方法选择安多键内连接种植系统φ4.0×10mm种植体植入缺牙区,上颌植入6个月、下颌植入3个月后安装自制的氧化锆基台;将基台予以磨改预留修复间隙,取印模,灌制石膏模型;应用CAD/CAM制作全瓷冠、桥;将全瓷修复体与基台粘接固位;应用MINRAY口内数字X线摄片系统和X线摄片定位仪,拍摄安装氧化锆基台时和全瓷修复体粘接后36个月时的X线片进行测量,对比分析。结果自制的氧化锆基台能与种植体顺利装配,应用该基台和CAD/CAM制作的全瓷冠、桥修复体完成的15例患者18颗种植义齿全瓷修复的即刻效果满意,追踪30~36个月,所有患者的种植义齿使用良好,修复体和基台均无松动脱落与折裂、折断,牙周无炎症及牙槽骨吸收,部分患者的牙槽骨显示增高,患者满意度高。结论应用氧化锆基台配合CAD/CAM氧化锆全瓷冠、桥修复体,不仅可获得满意的美学效果,还有益于种植义齿周围组织的健康。     

无牙颌种植后即刻负重的临床回顾研究

目的探讨无牙颌患者种植后进行即刻负重修复技术的可行性和临床效果。方法从2012年1月至2015年3月间,共22例无牙颌患者合计140枚种植体植入后行即刻负重,均于48 h内完成种植体支持的临时义齿修复,4~6个月后行永久修复。对该修复方案下的种植体留存率、种植体边缘骨吸收情况、种植体稳固性及周围龈组织状况以及患者应用的临床效果进行观察和研究。结果 22例共140枚种植体行即刻负重,其中有3枚种植体失败,种植体留存率为97.9%。种植体负重后6个月和12个月的边缘骨吸收量分别为(0.62±0.11)mm和(0.74±0.13)mm。通过对患者的病例回顾发现共有4例发生不同程度的机械并发症,包括修复体折裂、重衬、人工牙脱落等。种植体周围龈组织健康,未出现明显的红肿。临时义齿固位良好,患者满意度高。结论选择适当的病例,应用种植外科和修复技术对无牙颌患者行即刻负重修复是可行的,可获得理想的临床效果,近期疗效可靠。     

牙种植即刻修复的临床研究

目的 探讨牙种植体植入后即刻修复的临床可行性、技术特点并评估其近期临床效果。方法 从1999年3月至2003年12月间,共24例患者行种植体植入后即刻修复。3例无牙颌患者在下颌前部各植入4个专用种植体,1周内完成种植体支持的连杆式上部结构覆盖义齿修复;21例牙列缺损患者共植入30个种植体,均于1周内在种植体上部完成树脂单冠或联冠修复,4-6个月后行种植体烤瓷冠修复。所有患者均于术后1、3、6、12个月,之后每12个月复查1次。结果 24例共42个种植体即刻负重。平均负重28个月(最短3个月,最长49个月),种植体无脱落、无感染,种植体周围未出现X线透影,未见明显骨吸收。患者对修复效果满意。结论 严格掌握适应证和特殊设计的种植系统,应用改良的种植外科和修复技术对一些牙列缺损及无牙颌患者行种植即刻修复,近期疗效满意。     

数字化导板引导下全口种植即刻负重可行性与精准度的研究

目的 探究数字化导板引导下全口种植即刻负荷的可行性,根据影像学数据评价导板引导的种植精准度,探讨可能影响植体位置精度的相关因素.方法 按照准入排除标准,收集2017年至2019年使用数字化导板引导下的全口种植即刻负重固定修复患者16例(98枚植体),跟踪随访患者评价长期的临床修复效果.利用CBCT数据测量30颗植体实际...     

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当前,随着数字化信息技术的不断进步,计算机技术已应用到口腔种植领域。数字化技术辅助下的无牙颌患者种植修复治疗,不仅可提高种植体植入的精度,还能减小手术创伤并可实现即刻修复。本文将对无牙颌种植固定修复的数字化导板设计流程、数字化导板优势、技术局限及缺点等方面进行分析总结,为无牙颌患者的种植修复治疗提供参考。     

“All-on-4”种植即刻修复技术的临床应用研究

目的：评价应用＂All-on-4＂种植即刻修复技术对牙列缺失患者进行种植即刻修复的临床效果,探讨其技术要点及临床意义。方法：2008年4月至2009年11月共29例患者（男15例,女14例）接受了＂All-on-4＂种植即刻修复。29例（上无牙颌8例,下无牙颌15例,双颌无牙颌6例）共植入140枚种植体,在种植体植入当天完成即刻修复,一共完成35件＂All-on-4＂即刻义齿。即刻修复后观察种植体边缘骨吸收情况、追踪种植体和即刻修复体的存留率、患者满意率。平均追踪14.8个月（10～29个月）。结果：140枚种植体中,8枚于植入后6～8周脱落。其余132枚种植体至最后一次复查临床稳定,种植体存留率：94.3%。上颌种植体存留率89.3%,下颌种植体存留率97.8%,存在统计学差异（p〈0.05）。即刻修复义齿的存留率94%（33/35）。边缘骨吸收程度为（0.8±0.4）mm。患者满意率100%。结论：＂All-on-4＂种植即刻修复技术应用于无牙颌患者近期效果好,患者满意度高。远期效果需要进一步观察。     

牙周炎患者种植修复即刻负荷的临床应用及体会

目的:探讨牙周炎患者种植修复时采取即刻负荷的临床效果。方法:牙周炎患者6例,完善的牙周治疗后在下颌颏孔间植入四枚种植体,于术后48小时内用SynCone基台即刻负荷过渡义齿,并定期复诊检查。结果:术后随访12～40个月,植体无松动,无明显骨吸收,义齿使用良好,患者满意。结论:牙周炎患者经完善治疗后接受种植即刻负荷的修复方法,近期效果满意,远期效果需进一步观察。     

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.     

《口腔医学》杂志2007年度有关信息的分析

目的通过对《口腔医学》2007年全年文献的回顾和分析,了解我国口腔临床医学的研究现状。方法阅读2007年《口腔医学》全年的文献,对各种信息进行了分类汇总,根据设计类型对临床一次性文献进行了分类,并对其中的试验性研究文章进行质量分析。结果《口腔医学》2007年全年的一次性文献274篇,基础和临床文献分别为108和166篇,以临床文献为主(60.58%)。在临床研究文献中,属于观察性、分析性和试验性的文献分别为97、9和60篇,观察性文献所占比例为36.14%,高于以往的报道。60篇观察性文献中,全都设有对照;统计方法应用得当者44篇;真正做到随机、盲法的分别只有4和2篇。结论我国口腔临床方面的研究水平近年来提高明显,但设计的科学性方面有待提高。     

口腔医学专业本科毕业生就业现状的调查分析和教育思考

目的研究口腔医学专业的教学如何面向市场,推出令用人单位满意的人才。方法采用问卷调查的方法对浙江省内有代表性的19家包含口腔医疗服务单位进行了调查,同时进行大学生就业心态调查问卷调查。结果医学生的就业心态出现多元化;毕业生不再一味追求高学历,更多的人选择了先就业后进修的道路。大多数用人单位着眼于提高医务人员的服务水平和质量,对毕业生的综合素质有了更高的要求。结论学校要尽力拓宽毕学生的就业渠道,提供更多的就业信息,树立面向基层的观念。     

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.     

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.     

口底癌34例临床分析

目的探讨口底癌的临床特性、治疗方法及预后。方法对我院自1992—2002年住院治疗的34例口底癌患者进行回顾性分析。结果34例口底癌患者中,男28例(82.4%),女6例(17.6%),男女比为4.7∶1,平均发病年龄58岁。发病部位:前口底22例(64.7%),后口底12例(35.3%)。淋巴结转移率41.2%。单纯手术组、化疗加手术组、放疗加手术组、化疗加手术加放疗组的5年生存率分别为45.5%、60.0%、50.0%、62.5%。结论口底癌以中老年患者好发,男性居多。易发生淋巴结转移,综合疗法疗效较好。