正畸治疗诱导阻生上颌尖牙的自发萌出

目的 探讨阻生上颌尖牙正畸治疗诱导自发萌出的方法,总结合适的临床处理策略,为阻生尖牙的合理治疗提供依据.方法 选择13例恒牙列患者(男6例,女7例)的17颗阻生上颌尖牙,通过正畸治疗在相应牙弓位置为尖牙预留充足的间隙,待其自发萌出后直接粘结矫正装置排入牙列正常位置.结果 预留间隙2～24个月后阻生尖牙自发萌出,治疗后尖牙及邻牙牙周状况良好.结论 当阻生尖牙错位不严重,扩弓或减数拔牙即能为阻生尖牙提供足够萌出间隙,判断其能自行萌出时,可采取正畸诱导自萌的方法进行治疗.     

上颌尖牙埋伏阻生的外科-正畸联合治疗

目的:探讨尖牙埋伏阻生的外科-正畸联合治疗方法。方法:20例患者28颗上颌埋伏阻生尖牙,先用滑动直丝弓矫治器初步排齐牙列后,再局部间隙扩展,采用外科闭合式助萌技术,暴露埋伏尖牙牙冠,粘贴托槽,再进行正畸牵引导萌。结果:24颗埋伏尖牙均牵引入正常牙列,牙髓、牙周情况正常。有4颗尖牙因横位阻生和根冠成角采用外科拔除。结论:通过外科手术暴露和正畸牵引导萌联合治疗,能有效矫治埋伏阻生尖牙。     

上颌埋伏尖牙的外科—正畸治疗

目的　对上颌埋伏尖牙进行外科—正畸治疗。方法　先用方丝弓固定矫治器进行间隙扩展 ,然后根据上颌埋伏尖牙的位置及与邻牙的关系 ,分析其阻生的病因 ,采用外科翻瓣导萌术 ,暴露埋伏尖牙的牙冠 ,粘贴托槽 ,再选择不同的方向和方法对 12例患者的 14颗上颌埋伏尖牙进行正畸牵引导萌。结果　 11颗埋伏尖牙均已萌出后排齐 ,牙髓和牙周情况正常。结论　只有通过从上颌埋伏尖牙的位置关系 ,分析其阻生的病因 ,选择正确的外科手术暴露和正畸牵引导萌的方法 ,才能有效地矫治上颌埋伏尖牙。     

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目的比较手术—正畸联合治疗唇侧和腭侧上颌埋伏阻生尖牙的临床疗效。方法对广东省深圳市宝安区人民医院口腔正畸门诊2004—2009年收治的60例埋伏阻生尖牙患者(均为单颗埋伏阻生尖牙患者,共60颗牙),根据全口曲面断层片和X线定位片分为唇侧组和腭侧组各30颗牙,通过手术开窗去除阻力骨、暴露部分牙冠、黏结正畸附件,在固定矫正技术的牵引下将埋伏阻生的尖牙纳入正常牙弓内。对比两组治疗的成功率和治疗所需的时间。结果治疗成功率唇侧组为80.0%,腭侧组为96.7%,两组比较差异有统计学意义(P<0.01)。术后正畸牵引的时间腭侧组为(9.2±3.2)个月,而唇侧组为(15.1±4.1)个月,明显长于腭侧组,两组比较差异亦有统计学意义(P<0.01)。结论经手术开窗正畸牵引,上颌埋伏阻生尖牙的成功率腭侧组大于唇侧组,牵引到位的时间腭侧组也较唇侧组短。     

上颌埋伏尖牙导萌的临床研究

目的探讨上颌埋伏尖牙不同的治疗方法。方法对18例患者的25颗上颌埋伏尖牙进行治疗。首先用直丝弓矫治器拓展埋伏牙的间隙;随后根据患者的年龄、根尖的发育程度、埋伏牙的位置及与邻牙的关系采用不同的导萌方法。9颗上颌埋伏尖牙应用正畸助萌法进行治疗,16颗通过外科翻瓣导萌术进行治疗。结果 25例埋伏牙顺利萌出至正常位置,尖牙及邻近侧切牙牙髓、牙周正常,但正畸助萌法导萌的尖牙牙龈形态更佳。结论正畸助萌法矫治上颌埋伏尖牙效果更佳。     

上颌尖牙埋伏阻生的临床分析

目的对上颌尖牙埋伏阻生的患病特点及治疗结果进行分析,以期为临床治疗上颌尖牙埋伏阻生提供参考数据。方法在北京大学口腔医学院·口腔医院正畸科门诊2001年1月至2005年1月期间诊治的10505例错(牙合)畸形患者中,经CT检查选出上颌尖牙埋伏阻生患者215例(汉族),共有埋伏阻生尖牙248颗。统计上颌尖牙埋伏阻生在正畸患者中所占比例,χ~2检验分别比较患者性别、唇腭侧阻生以及相应治疗情况的差异。结果上颌尖牙埋伏阻生在正畸门诊患者中约占2．05%,女性：男性为1．8∶1,唇侧：腭侧为2．1∶1。“外科手术暴露+正畸牵引”的方式在治疗中占主导地位。“外科手术拔除”的治疗方式在腭侧埋伏阻生尖牙中的应用多于唇侧,差异有统计学意义(P＜0.01)。结论本组患者上颌尖牙埋伏阻生以女性、唇侧多见,临床对唇腭侧尖牙埋伏阻生的治疗存在一定差异。     

上颌尖牙阻生的病因

牙齿阻生的病因,主要与牙弓长度不足有关。然而,腭向阻生的尖牙,其病因则不是这样。本文目的是通过对腭向阻生和唇向未萌尖牙病因的研究,分析牙弓长度和尖牙阻生之间的关系。作者对手术和正畸治疗的46个上颌未萌尖牙进行了观察,其中40个腭向阻生,6个唇向未萌出,比例为6.6∶1。牙弓长度测量分为四类:1.牙弓长度过大;2.牙弓长度足够;3.牙间隙不足;4.上颌基骨凹陷。1～2类表明有足够间隙,3～4类表明牙弓长度不足。腭向阻生的尖牙     

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目的：探讨阻生上颌尖牙合适的临床处理策略,为其合理治疗提供依据。方法回顾2000-2012年期间在大连市口腔医院正畸科接受治疗的35例阻生上颌尖牙病例的临床资料,总结分析尖牙阻生状况及相应的治疗措施和疗效。临床处理方法包括拔除、助萌和导萌。结果拔除2例;只做正畸治疗的助萌法16例,留出足够间隙后等待阻生尖牙自行萌出,观察时间5～24个月,均取得良好治疗效果,矫治后阻生尖牙牙龈形态及牙根状况良好;正畸附加外科手术牵引的导萌法17例,除1例21岁男性患者外,其余16例均牵引到位,但矫治后部分阻生尖牙牙龈形态不如助萌法矫治后。结论当阻生上颌尖牙牙体严重畸形、根弯曲短小及高位近远中向横位阻生时考虑拔除;阻生上颌尖牙近远中向错位不严重,扩弓或减数拔牙即可为阻生尖牙留出足够萌出间隙,判断其能自然萌出时首选助萌法;阻生上颌尖牙近远中向错位严重或阻生尖牙已伤及邻牙牙根、仅用正畸治疗无法去除阻生尖牙萌出障碍时采用导萌法,导萌术后的牵引需注意控制牵引方向及大小,要避免伤及邻牙牙根,尽量使阻生牙从附着龈萌出,有利于形成良好的牙龈形态。     

上颌埋伏尖牙外科正畸联合治疗

目的：探讨上颌埋伏尖牙通过外科导萌和正畸联合治疗的临床效果。方法：对28颗上颌埋伏尖牙利用固定矫治器为其提供间隙，通过翻瓣去骨显露埋伏牙牙冠，再牵引入牙列。结果：26颗上颌埋伏尖牙排入牙列。结论：外科正畸联合方法是可靠的上颌埋伏尖牙治疗方法。     

上颌恒尖牙萌出障碍的研究进展

上颌恒尖牙(permanent maxillary canines)位于双侧口角,在人类的咀嚼、发音及美观中起着重要作用。上颌恒尖牙阻生和异位萌出需要外科开窗助萌以及复杂的正畸治疗,花费患者大量的时间和费用。该文就上颌恒尖牙的萌出过程及其阻碍因素作一综述,为尖牙阻生或异位萌出的病因研究、早期预测及阻断性治疗提供参考。     

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.     

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。     

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.     

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.

CBCT与RVG对下颌恒切牙根管形态评估的对比研究

目的:对比CBCT法与数字化X线成像法(RVG)对下颌恒切牙根管形态评估的差异。方法:对101颗离体牙进行唇舌向及近远中向数字化X线片拍摄和CBCT高清牙列模式扫描,对图像进行根管数目、Vertucci根管分型、根管钙化和根尖口开口位置的评估,并通过CBCT图像建立偏角度投照的三角函数模型,计算偏向投照的角度。结果:CBCT法显示有30颗为双根管,RVG近远中向投照显示有36颗为双根管,卡方检验显示对根管数目和Vertucci根管分型两种方法均具有显著性差异(P<0.05)。两种方法对根管钙化和根尖口开口位置的评估均不具有显著性差异。30颗双根管牙中下颌恒切牙唇舌向双根管的最大距离(LaL)在0~1.5 mm之间的,85.7%的为Vertucci III型,LaL在1.5~2 mm之间的,66.7%为Vertucci IV和V型。以根尖片上双根管显示距离为1 mm计算,LaL在1~2 mm之间的,偏向投照角度为26.6°~45.0°,LaL在0.1~1 mm之间的,偏向投照角度为45.0°~84.3°。结论:CBCT高清牙列模式扫描和RVG投照对于根管数目和Vertucci根管分型的评估具有显著性差异,对于根管钙化和根尖口开口位置的评估不具有显著性差异。LaL在1~2 mm之间时,偏角度投照的临床可操作性较强。