成人非拔牙正畸后面部软组织变化的三维测量研究

目的 研究非拔牙正畸治疗对成年女性面部软组织外形的影响.方法 选取39例2011～2013年完成治疗的骨性Ⅰ类或轻度Ⅱ类错(牙合)年轻女性,平均年龄(25.3±4.0)岁,接受非拔牙正畸治疗.治疗前(T0)、治疗结束(T1)拍摄X线头颅定位侧位片和面部激光扫描图像,在同一坐标系中重叠三维扫描图像并完成测量.结果 正畸后唇部软组织变化无统计学意义;在颧弓下区和下颌角区软组织凸度平均减小1.5mm,颞部和颊部平均减小1.0mm,眶下区、鼻翼旁和颧骨额弓区无显著性变化.结论 本研究基于激光扫描的面部软组织三维分析方法可用于临床研究,初步证实了成人非拔牙正畸后面部不同区域的软组织有一定的变化趋势.     

正畸治疗前后患者颜面美的感知变化及相关因素研究

目的探讨接受正畸治疗的患者对颜面美的感知变化及相关影响因素,用于指导临床治疗提高患者的满意度。方法选取12例矫治完成的病例图像制作调查问卷。随机选择于山东大学口腔医院接受正畸治疗的患者100例,分别在其正畸治疗前(对照组)及治疗一年半后(治疗组),评价问卷中病例颜面美的改变,并进行统计学分析。结果接受正畸治疗的患者对颜面美的感知度显著提高。其中文化水平较高的中年女性患者对颜面美的感知度提高最为显著,而高中以下的少年男性患者对颜面美的感知度提高不明显。拔牙及不拔牙患者对颜面美的感知度均提高,但提高的程度无显著差异。结论患者对颜面美的感知会随着正畸治疗的进行而提高,正畸治疗中要注重患者的审美心理及行为的变化,适时调整矫治方案,加强同患者的沟通,提高患者的满意度。     

正畸治疗结束女性患者微笑像主观评价相关因素分析

目的通过对治疗结束女性患者微笑像的主观评价,了解影响微笑美学主观评价的相关因素;探讨专业正畸医生与普通人对微笑美学的评价的一致性。方法14-27岁正畸治疗结束女性80名,Ⅰ类骨型、牙齿排列整齐,覆合覆盖正常,磨牙和尖牙关系均为I类关系。拔牙42例,非拔牙38例。收集面下三分之一微笑像,将全部图片随机编号,按照恒定的顺序排列后分发到评价人员手中,分别由10名有经验正畸医生和10名普通人对微笑像做主观评价（VAS）。结果专业正畸医生和普通人对微笑像的评分差异有统计学意义（P〈0．001）;拔牙组和非拔牙组微笑像的美学得分差异不显著。正畸医生与普通人微笑主观评价（VAS评分）与微笑指数呈正相关,与微笑高度、牙龈暴露程度、尖牙宽度比例、可见牙列宽度比例呈负相关。结论拔牙与非拔牙矫治本身对微笑美学主观评分的影响无显著差异,牙龈暴露程度是影响微笑美学主观评分的主要因素。     

不同拔牙模式正畸矫治对成年女性牙弓宽度和软组织正貌的影响

目的：研究不同拔牙模式对安氏Ⅱ1错牙合成年女性治疗前后牙弓宽度和面部软组织正貌的影响。方法：将40例安氏Ⅱ1错牙合需拔牙矫治的成年女性患者随机分为两组。 A组拔除上颌2颗第一前磨牙,下颌拔除2颗第二前磨牙,B组拔除4颗第一前磨牙。分析比较两组病例治疗前后牙弓宽度和面部软组织正貌指标的变化。结果：正畸治疗后,组内比较显示两组病例上下颌尖牙间宽度均增加,上下颌第一磨牙间宽度均减小,差异有统计学意义（P＜0.05）;组间比较仅下颌尖牙和下颌第一磨牙间宽度变化有统计学意义（P＜0.05）,B组下颌尖牙宽度增加量大于A组,B组下颌第一磨牙牙弓宽度减小量小于A组。治疗前后比较,两组病例在面宽、口裂宽、下颌角间宽、容貌面长和鼻下颏下距的差异均无统计学意义（P＞0.05）。Pearson相关性分析显示牙弓宽度与软组织正貌指标之间无相关关系（P＞0.05）。结论：安氏Ⅱ1错牙合病例正畸矫治后成年女性软组织正貌的变化不受拔牙模式影响,不同拔牙模式仅影响矫治后牙弓宽度的变化。     

凸面型成年女性正畸治疗后切牙与唇位置变化的CBCT研究

目的 研究凸面型成年女性正畸拔牙矫正后切牙位置和唇组织改变及其相关性.方法 选取39例2017—2021年完成正畸治疗的凸面型年轻女性,采用正畸拔牙矫治.对治疗前后的CBCT进行3D重叠,测量分析软硬组织变化及相关性.结果 正畸治疗后,SNA、U1?SN、上下唇到E线距离及鼻唇角的改变具有统计学意义.上中切牙内收量与治...     

颏部形态与正畸矫治拔牙设计的相关性研究

目的 探讨颏部突度对临界拔牙病例矫治设计的影响.方法 选取50例年龄15～18岁之间已完成正畸治疗的错[牙合]畸形患者,男22名,女28名,平均年龄16.5岁.其中25例为拔牙矫治,拔除4个第一前磨牙,25例采用非拔牙矫治.矫治后侧貌良好,覆合覆盖正常,完成头影测量19项,并对50例临床牙[牙合]畸形拔牙与非拔牙病例正畸治疗前牙颌面硬组织、及软组织治疗前后变化进行对比的回顾性研究,进行成组设计和配对设计t检验,并进行拔牙概率的回顾性分析.结果 治疗前拔牙组与非拔牙组在Pog-NB与L1-NB测量项目在两组之间存在显著性差异,Pog-NB与拔牙概率存在高度相关关系.拔牙组颏部突度明显小于非拔牙组,下切牙唇倾度明显大于非拔牙组.而上前牙突度、倾斜度及上下颌骨突度项目在两组间不存在显著性差异.治疗前、后软组织在两组病例无统计学意义的差异.结论 对于临界拔牙病例制定矫治计划时,为达到良好的侧貌,避免产生正畸面容,要综合考虑影响侧貌的鼻唇颏协调一致.颏部突度越大,拔牙的概率越小,下切牙可在一定程度上唇倾来调整患者侧面曲线使其更为协调.     

正畸拔除下颌前磨牙对第三磨牙萌出影响的测量研究

目的:评价正畸拔除下颌前磨牙对下颌第三磨牙萌出角度和间隙的影响.方法:选取23 例正畸非拔牙矫治病例(男性12 例,女性11 例,平均年龄13.5 岁),23 例拔除下颌第一前磨牙矫治病例(男性12 例,女性11 例,平均年龄13 岁),21 例拔除下颌第二前磨牙矫治病例(男性11 例,女性10 例,平均年龄14.07 岁),在治疗前和治疗后拍摄全颌曲面断层片,测量下颌第三磨牙的轴倾角度和萌出间隙,使用SPSS 17.0软件对3 组病例的数据进行配对t检验.结果:拔除下颌第一前磨牙组患者RS,LS,Rratio,Lratio在治疗后显著增大(P<0.01);拔除下颌第二前磨牙组患者RM3,LM3等指标在治疗后增大(P<0.05),RS,LS,Rratio,Lratio等指标在治疗后显著增大(P<0.01).结论:正畸拔除下颌前磨牙较非拔牙矫治可以增加下颌第三磨牙的萌出间隙;拔除下颌第二前磨牙可以改善第三磨牙的萌出角度.     

临界病例拔牙与非拔牙治疗后侧貌突度变化的研究

目的比较正畸拔牙与不拔牙治疗对临界病例侧貌突度的影响。方法由5位正畸专家判断出的33个临界病例，根据其实际接受的治疗方式分为3组:①不拔牙治疗组12例患者;②拔4个第一双尖牙治疗组13例患者;③拔4个第二双尖牙治疗组8例患者。用结构重叠法，以眼耳平面(阳平面)为水平参照平面，对33例患者治疗前后头颅侧位片上反映侧貌突度的解剖标志点进行测量和比较。结果拔牙组和不拔牙组患者治疗后，仅上下切牙的突度有显著性差异(P < 0.01);而两种不同的拔牙方式对患者侧貌突度的影响无显著性差异(P > 0.05)。结论对于临界病例，拔牙治疗与不拔牙治疗对侧貌突度的影响主要表现为对上下切牙突度的改变，其对上下基骨及侧貌软组织突度的影响并不明显。     

成人正畸患者减数下颌第一恒磨牙即刻植骨对于牙槽嵴保持作用的初步研究

目的评价减数下颌第一恒磨牙后即刻植骨对正畸治疗中牙槽嵴的保持效果。方法选取32名需要减数下颌第一恒磨牙的成年正畸患者,共40个牙位。随机分成拔牙后即刻植骨与非植骨两组。拔牙（植骨）后,患者均进行常规正畸治疗。拍摄拔牙前（To）、拔牙后一年（T1）的锥体束CT,采用Invivo Dental5．0软件进行三维测量,比较两组TO-T1牙槽嵴高度、宽度的变化。结果植骨组在拔牙后一年,距离牙槽嵴顶3mm、6mm处牙槽嵴宽度分别减小了0．71mm,0．39mm。非植骨组在3mm、6mm、9mm处牙槽嵴宽度分别吸收了4．1mm,2．4mm,1．1mm,配对T检验显示差异具有极显著统计学意义。在牙槽嵴高度的保持上,非植骨组降低了1．72InIn,差异具有极显著统计学意义,植骨组则没有统计学差异。结论对减数下颌第一恒磨牙的成年正畸病例,即刻植骨延缓了牙槽嵴顶处骨质的吸收。     

不同类型正畸患者对颜面美感知的差异及相关因素研究

目的：调查不同类型的正畸患者对颜面美的感知差异,为正畸医师进行诊断设计提供美学参考。方法：选取45例初诊患者的面像（正面像、正面微笑像、侧面像、正面咬合像）制作调查问卷。另随机选取213例正畸患者在治疗前对问卷中病例资料的颜面美进行评价,进行统计学分析。结果：①．性别、年龄、文化程度等因素会影响患者对颜面美的感知度,婚姻状况对患者颜面美的感知影响不明显。中青年、女性、文化程度较高者比少年、男性、文化程度较低者对颜面美的感知度相对较高。②．正畸患者对安氏Ⅲ类病例颜面美的评价最低,其次是安氏Ⅱ1类病例,对安氏Ⅱ2类、安氏I类病例的美学评价较高。结论：不同背景患者对颜面美的感知度不同,提示进行正畸治疗前应充分了解患者的美学倾向,制定个性化的矫治方案。     

Clinical and pathological aspects on some odontogenic tumors

Odontogenic tumors constitute a very diverse group of lesions that reflects the complex processes of odontogenesis. Controversies over their classification/subtyping, terminology and diagnosis have been persisted, which has direct bearings on therapeutic and/or prognostic implications.     

Can you be too old for oral implants? An update on ageing and plasticity in the oro‐facial sensorimotor system

This review focuses on the capacity of the brain for plasticity and the utility and efficacy of oral implants in helping to restore oro‐facial sensorimotor functions, especially in elderly patients. The review first outlines the components of the oro‐facial sensorimotor system which encompasses both oro‐facial tissues and a number of brain regions. One such region is the sensorimotor cortex that controls the activity of the numerous oro‐facial skeletal muscles. These muscles are involved in a number of functions including reflexes and the more complex sensorimotor functions of mastication, swallowing and speech. The review outlines the use by the brain of sensory inputs from oro‐facial receptors in order to provide for exquisite sensorimotor control of the activity of the oro‐facial muscles. It highlights the role in this sensorimotor control played by periodontal mechanoreceptors and their sensory inputs to the brain, and how oral implants in concert with the plastic capacity of the brain may, at least in part, compensate for reduced sensorimotor functioning when teeth are lost. It outlines findings of ageing‐related decrements in oro‐facial sensorimotor functions and control. The changes in oro‐facial tissues and the brain that underlie these ageing‐related functional alterations are also considered, along with adaptive and compensatory processes that utilise the brain's capacity for plasticity. The review also notes the evidence t hat rehabilitation that incorporates adjunctive approaches such as sensorimotor training paradigms in addition to oral prostheses such as implants may enhance these processes and help maintain or facilitate recovery of sensorimotor functioning in the elderly.     

Tumor microenvironment in oral cancer: novel approaches for immunotherapy

Squamous cell carcinoma of the head and neck (SCCHN), which arises from the squamous mucosal epithelium of the oral cavity, pharynx and larynx, is a major health problem in the US and other parts of the world, especially in developing countries.     

牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形远期疗效评价

目的：评价牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形的远期疗效。方法伴牙槽骨缺损的成人错畸形3例,平均年龄29岁。经正颌-正畸联合会诊制订治疗计划,按照牙槽骨再生正畸及正颌-正畸联合治疗模式,分别进行系统治疗并随访2~3 a。结果3例患者均顺利完成治疗,面型及咬合关系获得良好改善;牙槽骨缺损区正畸牙移动到位且未见医源性牙周并发症,牙槽骨缺损区骨量增加明显且远期效果稳定。结论针对伴牙槽骨缺损的成人患者,牙槽骨再生正畸是一种较为理想的技术。     

Management of acute open flexor tendon injuries of the hand and wrist: basic sciences,surgical factors and rehabilitation pertinent to optimizing outcome

Flexor tendon injuries to the hand and wrist represent a significant resource burden to the UK NHS. A good understanding of tendon basic science and repair techniques is crucial for the surgeon undertaking their repair and rehabilitation. Furthermore, this is a common topic assessed in the FRCS(Orth) examination. This article will summarize the basic science relating to tendon structure, physiology and injury. Additionally, it will present key surgical and rehabilitation factors relevant to clinical outcomes.     

In vitro calibration and validation of a digital subtraction radiography system using scanned images

OBJECTIVES: To calibrate and validate a digital subtraction radiography system using scanned images for quantification of alveolar bone changes by means of computer-assisted densitometric image analysis (CADIA) in vitro. MATERIALS AND METHODS: Noise levels were determined using 10 standardized periapical radiographs of the same lower molar region in a human dry skull. For validation of the system, radiographs were taken before and after bovine bone particles in measures with increments of 2 mg weighing from 2 to 20 mg were added into each socket of three dry skulls. Radiographs were developed and scanned into a computer with a flatbed scanner. After digitization, the images were subjected to alignment, normalization and subtraction. Appropriate regions of interest (ROIs) were selected and their CADIA values were calculated for the determination of noise levels, and correlations between the CADIA values and the actual bone mass were performed. RESULTS: When the threshold value was 7, the percentage of pixels deviating from the set threshold value was small (0-11.3%). There were statistically significant correlations between the actual bone mass and the CADIA value for anterior sockets (p<0.001, r2=0.89) and posterior sockets (p<0.001, r2=0.9). For pooled data of both anterior and posterior sockets, the correlation was also statistically significant (p<0.001, r2=0.88). CONCLUSIONS: A high and statistically significant correlation between the actual bone mass and CADIA value was obtained, which suggests that the system could be suitable for the detection of small alveolar bone changes.     

伴囊肿的上颌埋伏阻生中切牙早期引流助萌治疗

目的:探讨采用引流助萌的方法对伴囊肿的上颌埋伏阻生中切牙的早期治疗。方法:选取单侧上颌中切牙埋伏阻生、处于替牙早期伴囊肿的患者8例。外科囊肿切除同时对埋伏阻生上颌中切牙引流助萌治疗。治疗前后拍摄CBCT,Dolphin11.0软件测量矫治前后阻生牙及对侧正常同名牙的冠根长度。结果:8例患者的埋伏阻生上颌中切牙平均矫治时间6.7个月。矫治后阻生牙和对侧正常同名牙的冠根长度均有生长。阻生牙冠根长度较对侧正常同名牙明显短(P<0.05)。结论:本研究所采用引流助萌方法为埋伏阻生牙的矫治提供了一个安全、有效的新途径。     

Fabrication and characterisation of a novel biomimetic anisotropic ceramic/polymer-infiltrated composite material

Objective

To fabricate and characterise a novel biomimetic composite material consisting of aligned porous ceramic preforms infiltrated with polymer.