二次功能印模法全口义齿对改善无牙颌患者口腔健康的效果评价

目的 ：评价对无牙颌患者运用二次功能印模法进行全口义齿修复的临床效果。方法 ：对433例无牙颌患者运用二次功能印模法进行全口义齿修复，修复前后使用老年口腔健康评价指数（Geriatric Oral Health Assessment Index,GOHAI）评估患者口腔健康相关生活质量。根据患者是否有义齿修复史，分为无义齿修复史、局部可摘义齿修复史和全口义齿修复史3组。在全口义齿修复史组中，选取30例患者，使用修复前旧义齿及新义齿咀嚼双色口香糖，采用ViewGum分析计算口香糖的混合程度数据（SDHue值）。采用SPSS 26.0软件包对数据进行统计学分析。结果：3组患者修复后口腔健康相关生活质量均有提升，修复后1个月GOHAI指数均显著高于修复前（P<0.05）。在全口义齿修复史组中，30例患者修复后SDHue值显著低于修复前（P<0.05）。结论：二次功能性印模法操作简便快捷，能够提升患者对全口义齿修复后的满意度。     

游离腓骨复合组织瓣重建单侧上颌骨后可摘局部义齿修复的咀嚼功能研究

目的研究游离腓骨复合组织瓣重建一侧上颌骨缺损后常规局部叉齿修复的[牙合]力与咀嚼效率的恢复。方法选择北京大学口腔医学院游离腓骨复合组织瓣单侧上颌骨缺损修复的28例患者，测定戴用义齿前后健侧、患侧的[牙合]力及咀嚼效率的改变并进行比较分析。结果义齿修复侧上颌第一磨牙平均[牙合]力值为10．73kg，健侧上第颌一磨牙[牙合]力位平均为35．83kg，二者之闻差异有显著性（P〈0．05）。患者戴用义齿前咀嚼效率平均值为75．14％，戴用义齿咀嚼效率平均为81．53％，二者之间差异有显著性（P〈0．05）。结论腓骨复合组织瓣重建上颌骨缺损后有利于术后常规义齿的修复，显著提高了患者咀嚼效率，改善生活质量。     

可摘局部义齿佩戴与口腔健康相关生活质量的关系

目的研究可摘局部义齿治疗前后老年修复患者的口腔健康相关生活质量,为可摘局部义齿治疗计划的制定提供参考。方法收集可摘局部义齿修复的老年牙列缺损患者154例,平均年龄为64.35岁,采用老年口腔健康评价指数(geriatric oral health assessment index,GOHAI)量表中文版进行问卷调查,对可摘局部义齿修复治疗前后的GOHAI得分进行统计学分析。结果可摘局部义齿修复后,患者GOHAI量表中生理功能(Z=-7.989)、心理功能维度(Z=-8.128)和总体得分(Z=-7.932)较治疗前明显升高,差异具有统计学意义(P<0.01)。结论可摘局部义齿修复通过改善患者的口腔生理功能和心理社会功能,可显著提高老年牙列缺损患者的口腔健康相关生活质量。     

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随着现代医学模式向生物-心理-社会医学模式的逐渐转变,对种植义齿修复患者的口腔健康相关生活质量(OHRQoL)的评价,已成为种植义齿修复客观评价标准的补充指标,其从牙种植手术及义齿修复后患者的主观反映对种植义齿的临床效果进行评价,为临床工作者提供更多种植修复的相关信息.本文对种植义齿修复患者的OHRQoL评价进行探讨.     

治疗性义齿对无牙颌患者义齿空间的影响及临床效果评估

目的探究治疗性义齿对无牙颌患者义齿空间变化的影响,并对其临床疗效进行系统性评估。方法对20例接受治疗性义齿治疗的患者进行治疗前后满意度问卷调查,填写口腔健康影响程度量表(oral health impact profile,OHIP?14),收集义齿空间、义齿组织面、咬合印迹、哥特式弓描记图像、黏膜状态、偏侧咬合状态、咬合力、固位稳定、患者咀嚼能力、义齿满意度及OHIP?14评分等数据进行统计分析。结果本研究中受试者通过治疗性义齿的治疗,义齿空间得到改善,义齿的组织面的组织调理剂逐渐分布均匀,咬合印迹逐渐对称、均匀,哥特式弓描记图像显示关节、神经和肌肉逐渐稳定,口腔黏膜转变为健康状态,偏侧咬合情况有所改善,咬合力、固位稳定性和主、客观咀嚼能力也较治疗前有显著提高,在治疗前后的患者满意度及OHIP?14评分均有明显改善,差异有统计学意义(P<0.05)。客观咀嚼能力与义齿的固位稳定性、主观咀嚼能力和义齿满意度呈正相关;而与OHIP?14评分呈负相关。结论治疗性义齿有助于恢复理想的无牙颌义齿的空间,并且能改善患者的口腔健康状况,提高义齿的固位与稳定和咀嚼能力,从而提高患者的满意度,有临床应用的价值与推广的潜力。     

义齿稳固剂提高全口义齿固位力和咀嚼效率的效果

目的评价义齿稳固剂提高全口义齿固位力和咀嚼效率的效果。方法选择牙槽嵴为Ⅲ类或Ⅳ类、戴用全口义齿的无牙颌患者12例,采用自身前后对照,比较使用义齿稳固剂前后下颌义齿的固位力,用吸光度法比较义齿稳固剂使用前后患者的咀嚼效率。结果全口义齿在使用义齿稳固剂后固位力从(0.35±0.08)kg增加至(1.01±0.23)kg,差异具有统计学意义(t=147.58,P<0.01);咀嚼效率吸光度法检测的光密度值从0.463±0.102上升至1.201±0.236,差异具有统计学意义(t=21.62,P<0.01)。结论义齿稳固剂能明显改善全口义齿的固位效果,提高咀嚼效率,是一种可行的提高全口义齿修复效果的材料。     

磁附着体覆盖义齿在口腔修复中的应用86例报告

目的：总结磁附着体覆盖义齿修复的临床效果。方法：选取牙列缺损需进行磁附着体覆盖义齿修复的患者86例。经基牙根管治疗、根帽制作、义齿制作、义齿试戴、完成磁附着体义齿修复。观察磁体固定前、固定后即刻、固定后6周义齿的固位力,测定患者咀嚼效率及不良反应发生情况。结果：磁附着体义齿修复后即刻固位力、固定后6周固位力和即刻咀嚼效率、固定后6周咀嚼效率均优于磁体固定前,且差异具有统计学意义（P＜0．05）。经磁附着体义齿修复后,出现1例不良反应,表现为牙周炎,不良反应发生率为1．16％。结论：磁性附着体用于口腔覆盖义齿修复,能够有效提高固位力及咀嚼效率,不良反应少,临床效果好。     

种植义齿修复的咀嚼效能评价

咀嚼效能的测定可以客观反映咀嚼能力的大小,它是检测口腔修复效果的重要方法之一。新近的研究表明种植义齿修复后咀嚼效能明显改善,但不同的上部结构形式对种植覆盖义齿功能有一定影响;单侧后牙缺失患者经柱状种植体支持固定义齿修复后咀嚼效能与正常牙列人群咀嚼效能相似。     

顽固性全口义齿咬合痛患者软衬修复效果的临床观察

目的:观察silagum硅橡胶软衬材料用于缓解压痛、提高其咀嚼效率、满意度、力的效果;方法:用吸光度法法测定患者软衬前及软衬后、衬后1周、1月、3月的咀嚼效率并用T-ScanⅡ咬合力计测量力及两侧力的平衡状况。通过满意度调查表,了解患者对义齿的固位、稳定、咀嚼功能、舒适度情况的主观评价;结果:衬后患者的咀嚼效率明显改善,力明显升高,两侧力更趋于平衡,主观评价也较为理想;3个月时各项指标达高峰,3个月后开始下降;结论:硅橡胶软衬材料可明显提高此3例患者义齿的固位、稳定效果,并能显著改善患者的压痛状况,提高患者的咀嚼效能、满意度及力,并改善义齿的力平衡,提升总义齿配戴者的生活质量。     

种植义齿与可摘局部义齿修复后患者评价的分析

目的比较牙列缺损患者行可摘局部义齿和种植固定义齿修复的主观感受。方法对23例戴用可摘局部义齿后又行种植义齿修复患者作种植修复前和修复后问卷调查。结果与可摘局部义齿相比,种植固定义齿在咀嚼功能、舒适、固位等方面存在显著差别(P<0.01)。结论种植固定义齿修复能更好地提高口腔功能,满足患者需求。     

Mood and malignancy: head and neck cancer and depression

Head and neck cancer patients have been reported to show high rates of depression. However, it is important to differentiate between depressive symptoms and a depressive disorder. This review critically examines the relationship between head and neck cancer and depression. There appears to be little evidence for depression leading to an increased risk of developing cancer and although depressive symptoms in head and neck cancer patients are common, very few studies have investigated depressive disorders. The studies that investigated the incidence of a comorbid depressive disorder report a prevalence very close to that of the general population, implying that major depression is not a normal response to cancer. Finally, the evidence suggests that comorbidity of depression with cancer has a negative impact on morbidity and mortality. Both psychosocial and biological factors could account for this. Dysregulation of the stress hormone axis and increased inflammation are common in depressive disorders and have been suggested as underlying pathological mechanisms and are both markers of poor prognosis in cancer. This evidence suggests that a relatively small number of patients develop a depressive disorder following a diagnosis of cancer, but for those that do it may have a substantial impact on their prognosis.     

低氧和自噬与肿瘤的发生发展

自噬作为真核生物的一种应激调控机制,既可以促进肿瘤的发生发展,又可以抑制肿瘤的增殖。在肿瘤局部低氧的微环境下,低氧诱导因子-1α、哺乳动物雷帕霉素靶蛋白信号转导通路抑制、内质网应激均可促进自噬的发生。在肿瘤快速地发生发展过程中,肿瘤的糖代谢功能增强、活性氧族增多、窖蛋白1下调以及上皮间质转化的激活均诱导了自噬的发生并促进肿瘤的局部浸润、侵袭转移和耐药,因此,抑制自噬可能为肿瘤治疗提供一种新的策略。     

补体与牙周炎发生发展及其治疗

在牙周炎这一慢性炎症反应过程中,补体不仅可以调解机体防御反应,保护宿主,还可直接作用于免疫细胞或通过调控信号转导通路,协助病原菌进一步感染和破坏牙周组织,最终导致免疫病理性的损伤反应。在免疫炎症反应中,补体不仅可刺激白细胞分泌白细胞介素、肿瘤坏死因子和粒细胞-巨噬细胞集落刺激因子,调节辅助性T细胞和巨噬细胞,促进细胞免疫和T细胞依赖的抗体分泌,增强免疫效应的调节,提高机体免疫力;亦可引起的炎症反应可对组织造成损伤,引起牙周炎。以补体受体拮抗剂干扰补体受体-Toll样受体信号转导通路,有利于机体清除病原菌,达到防治牙周炎的目的。理解补体在牙周炎发生发展中的作用,可为牙周炎治疗探索新途径。     

Molecular biology and its applications in orthodontics and oral and maxillofacial surgery

Molecular biology is an exciting, rapidly expanding field, which has enabled enormously greater understanding of the biology of diseases and malfunctions in many fields. It chiefly concerns itself with understanding the interactions between the various systems of a cell, including the interrelationship of DNA, RNA and protein synthesis and how these interactions are regulated. Since the introduction of molecular biology into modern science, numerous other fields have been enabled to go ““molecular““. Advanced molecular biological techniques showed us new avenue towards finding answers to the questions asked for decades. The first part of this article described the history of molecular biology. It started as a joined discipline of other areas of biology, i.e. genetics and biochemistry in the 1930s and 1940s, and enjoyed its classical period and became institutionalized in the 1950s and 1960s. Major molecular techniques manipulating proteins, DNA and RNA were introduced and their mechanisms were concisely illustrated. The current knowledge of molecular biology and their applications in orthodontic and oral and maxillofacial surgery, i.e. osteoclast differentiation and function, regulation of tooth movement, mechanotransduction/cell-signalling, bone fracture healing, oral cancer as well as craniofacial/dental anomalies and distraction osteogenesis were discussed. Although the problems of introducing molecular technologies are still substantial, it is anticipated that the future of medicine/dentistry will be ““molecular““: molecular prevention, molecular diagnosis and molecular therapy.     

成釉细胞瘤、颌骨囊肿中E-cadherin、vimentin的表达及意义

目的通过免疫组化双染技术检测成釉细胞瘤(ameloblastomas,AM)、颌骨囊肿中E-cadherin、vimentin的表达情况,探索AM中是否存在上皮间充质转化(epithelial-mesenchymal transition,EMT)现象。方法选择37例不同分型的AM、5例颌骨囊肿为研究对象,用免疫组化双染技术检测E-cadherin、vimentin的表达情况,通过计数分析二者共同表达细胞的分布情况。单因素方差分析AM与颌骨囊肿、实性型与单囊型AM的EMT。结果 AM中存在EMT现象,EMT发生特点在实性型与单囊型AM之间、AM与颌骨囊肿之间均无统计学差异。结论 EMT与成釉细胞瘤的侵袭性生物学行为无相关性,EMT存在于AM中可能为肿瘤组织中间质细胞的来源之一。     

Clinical and microbiological effect of scaling and root planing in smoker and non-smoker chronic and aggressive periodontitis patients

OBJECTIVES: To compare the effects of scaling and root planing (SRP) on clinical and microbiological parameters at selected sites in smoker and non-smoker chronic and generalized aggressive periodontitis patients. MATERIALS AND METHODS: Clinical parameters including probing depth (PD), relative attachment level (RAL), and bleeding upon probing (BOP), and subgingival plaque samples were taken from four sites in 28 chronic periodontitis (CP) and 17 generalized aggressive periodontitis (GAgP) patients before and after SRP. Polymerase chain reaction assays were used to determine the presence of A. actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythensis, Prevotella intermedia and Treponema denticola. RESULTS: Both CP and GAgP non-smokers had significantly greater reduction in pocket depth (1.0+/-1.3 mm in CP smokers versus 1.7+/-1.4 mm in non-smokers, p=0.007 and 1.3+/-1.0 in GAgP smokers versus 2.4+/-1.2 mm in GAgP non-smokers, p<0.001) than respective non-smokers, with a significant decrease in Tannerella forsythensis in CP sites (smokers 25% increase and non-smokers 36.3% decrease, p<0.001) and Prevotella intermedia at GAgP sites (smokers 25% reduction versus 46.9% in non-smokers, p=0.028). CONCLUSION: SRP was effective in reducing clinical parameters in both groups. The inferior improvement in PD following therapy for smokers may reflect the systemic effects of smoking on the host response and the healing process. The lesser reduction in microflora and greater post-therapy prevalence of organisms may reflect the deeper pockets seen in smokers and poorer clearance of the organisms. These detrimental consequences for smokers appear consistent in both aggressive and CP.     

Differences between and within human parotid saliva and nasal mucus cAMP and cGMP in normal subjects and in patients with taste and smell dysfunction

J Oral Pathol Med (2010) 40 : 504–509 Background: We previously described some of the moieties in human saliva and nasal mucus including cyclic nucleotides. However, comparison of levels of these latter moieties in saliva and nasal mucus has not been performed and meaning of differences found has not been discussed. Purpose: To compare the levels of cAMP and cGMP in saliva and nasal mucus and to describe the differences in their concentrations and function. Methods: cAMP and cGMP in saliva and nasal mucus were compared in normal subjects and patients with taste and smell dysfunction by use of a spectrophotometric colorimetric ELISA. Results: Both cAMP and cGMP were present in saliva and nasal mucus of normals and patients with levels of both moieties lower in patients than in normals. In normals, cAMP is 6½ times higher in saliva than in nasal mucus whereas cGMP in nasal mucus is 2½ times higher than in saliva. In patients, these differences persist but are less robust. In normals, within saliva, cAMP is 9½ times higher than cGMP whereas within nasal mucus cAMP is half the level of cGMP. In patients, within saliva, these differences persist but at variable differences. Conclusions: Both saliva and nasal mucus cAMP and cGMP play roles in taste and smell function, and differences in their concentrations may offer insight into these roles. In nasal mucus, cGMP may be more relevant than cAMP in activity of olfactory epithelial cell function. In saliva, cAMP may be more relevant as a growth factor in taste bud function than cGMP.     

VEGF及受体在颌面部血管瘤和血管畸形中表达及意义

目的 检测细胞因子血管内皮生长因子(VEGF),血管内皮生长因子受体(VEGFR/KDR)及VEGF mRNA在颌面部血管瘤和血管畸形中的表达,探讨VEGF及其受体与血管瘤发病机制的关系。方法 采用二步EnVision免疫组织化学方法,分别检测27例血管瘤和15例血管畸形组织中VEGF和VEGF/KDR表达;同时采用原位杂交Gene Point法检测VEGF mRNA的表达。结果 VEGF和VEGFR/KDR在血管瘤中高表达,而在血管畸形组中低表达,两者有显著差异(P<0.01);VEGF和VEGF mRNA在血管瘤细胞及周围间质细胞明显表达,VEGFR/KDR主要表达于血管瘤中内皮细胞膜上。结论 VEGF可通过自分泌和旁分泌的形式影响血管瘤内皮细胞的增殖,可能与血管瘤发生、发展和退化有密切相关。     

Diagnosis and management of hemangiomas and vascular malformations of the head and neck

Oral Diseases (2010) 16 , 405–418 Vascular anomalies are congenital errors in vascular development. They frequently involve the head, neck, and oral cavity. Subdivided into vascular tumors (hemangiomas) and vascular malformations, vascular anomalies remain poorly understood. However, growing interest and recent advances in the diagnosis, management, and molecular characterization of these lesions are improving treatment strategies. The role of the multidisciplinary team cannot be overstated. This review provides both basic and up‐to‐date knowledge on the most common vascular anomalies encountered by physicians and practitioners. Because treatment options for vascular anomalies are widely variable and often debated, this report aims to provide a comprehensive approach to these lesions based upon current concepts and practical clinical experience.