第二前磨牙先天缺失与蝶鞍的相关性研究

目的　探索第二前磨牙先天缺失与蝶鞍大小、形态和鞍桥发生率之间是否有相关性。方法　选取2010—2017年中国医科大学附属口腔医院奉天门诊及正畸二科收治的仅第二前磨牙先天缺失（除第三磨牙外）患者80例作为研究组，另选取同期收治的无恒牙先天缺失（除第三磨牙外）且接受正畸治疗的安氏Ⅰ类患者250例作为对照组。收集两组患者头颅侧位片和曲面体层片，使用Winceph 8.0软件定位相关标记点，并测量蝶鞍的长度、深度和直径，同时记录蝶鞍的形态（扁平形、椭圆形、圆形）以及鞍桥的类型（无鞍桥、部分鞍桥、完全鞍桥）。采用SPSS 17.0统计软件对所得数据进行统计学分析。结果　两组患者的蝶鞍大小、形态比较，差异均无统计学意义（均P > 0.05）。研究组患者鞍桥发生率明显高于对照组，差异有统计学意义（P < 0.001）。两组不同性别患者蝶鞍大小、形态以及鞍桥发生率比较，差异无统计学意义（P > 0.05）。结论　研究组患者鞍桥发生率显著增加，提示第二前磨牙的先天缺失可能与鞍桥的发生有关。不同性别患者的蝶鞍大小、形态和鞍桥发生率均无差异。     

145例少牙多牙症的回顾性研究

目的 应用曲面体层技术探讨少牙多牙症（CHH）的发生率和临床特征。 方法 收集2019年1月—2021年5月就诊的41 648例儿童口腔科患者的曲面体层片,纳入CHH患者145例,观察记录CHH的发生情况。应用SPSS 24.0软件统计分析所得的数据。 结果 CHH的发生率为0.35%（145/41 648）,男性（102例）多于女性（43例）,性别间差异有统计学意义（P<0.001）。恒牙先天缺失特征：缺失1~2颗为主;最好发下颌侧切牙和下颌第二前磨牙;下颌恒牙先天缺失多于上颌恒牙先天缺失,二者差异有统计学意义（P<0.001）;左侧先天缺失与右侧先天缺失差异无统计学意义（P=0.84）。多生牙特征：数目1~2颗;多见于上颌前牙区;多为圆锥形;垂直倒置生长和垂直正位生长为主。 结论 CHH是一种少见的混合牙齿数目异常,男性多于女性,恒牙先天缺失和多生牙的特征与单独发生的恒牙先天缺失/多生牙的特征相似,建议早期诊断和多学科治疗。     

石家庄地区正畸患者恒牙先天缺失的调查分析

目的调查分析石家庄地区正畸患者恒牙先天缺失的发病率及特征。方法对河北医科大学口腔医院正畸科2010~2012年正畸患者中3274名有效病例的病历资料进行回顾分析。通过观察其全颌曲面断层片,分析恒牙先天缺失的发病率及分布差异。结果除第三磨牙外恒牙先天缺失的发病率为9.13,性别间差异无统计学意义（P〉0.05）。个别缺牙例数（缺牙数〈6）占总缺牙例数的95,其中缺失1~2颗牙的例数占总缺牙例数的88.6;多数缺牙例数（缺牙数≥6）占总缺牙例数的5。前、后牙区的缺牙发病情况在缺失1~2颗牙时,主要发生在前牙区,缺失2颗以上时,后牙区的缺失发病率高于前牙区（P〈0.05）;下颌缺牙发病率高于上颌（P〈0.05）。缺牙频率最高的是下颌侧切牙（25.3）,其次是下颌第二前磨牙（18.3）。结论石家庄地区正畸患者恒牙先天缺失（不包括第三磨牙）发病率为9.13,。其中以缺失1~2颗牙最常见,恒牙先天缺失更多的发生在前牙区及下颌,最常见的缺失牙位是下颌侧切牙和下颌第二前磨牙。     

骨性安氏Ⅲ类错牙合畸形与蝶鞍的相关性研究

目的    探讨骨性安氏Ⅲ类错牙合畸形与蝶鞍大小、形态以及鞍桥发生率的相关性,为制定正确的矫治计划提供参考。方法    选取2002—2015年中国医科大学附属口腔医院正畸-正颌联合治疗的骨性安氏Ⅲ类错牙合患者249例为试验组,其中男120例,女性129例;仅接受正畸治疗的安氏Ⅰ类错牙合者患者296例为对照组,其中男150例,女146例;所有患者年龄18 ~ 36岁。Winceph 8.0软件定位蝶鞍相关标记点,测量蝶鞍的长度、深度和直径,记录蝶鞍形态（椭圆形、圆形、扁平状）以及鞍桥类型（无鞍桥、部分鞍桥、完全鞍桥）。采用SPSS 21.0统计软件对所得数据进行统计分析。结果    试验组与对照组蝶鞍长度和深度差异均有统计学意义（均P＜0.05）,而蝶鞍直径差异无统计学意义（ P＞0.05）;两组男性与女性蝶鞍长度差异均有统计学意义（均P＜0.05）,而蝶鞍深度和直径差异均无统计学差异（均P＞0.05）。试验组蝶鞍各形状所占比例从大至小依次为扁平状、圆形和椭圆形,对照组依次为圆形、扁平状和椭圆形,两组男性与女性蝶鞍形态差异均无统计学意义（均P＞0.05）。试验组鞍桥发生率为68.27%,对照组为17.23%,差异有统计学意义（P＜0.05）;两组男性与女性鞍桥类型比较,差异均无统计学意义（均P＞0.05）。结论    骨性安氏Ⅲ类错牙合畸形与蝶鞍大小和形态显著相关,骨性安氏Ⅲ类错牙合患者的鞍桥发生率较对照组明显增加。     

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目的调查分析大连地区正畸患者恒牙先天缺失的发生率及分布,包括第三磨牙。方法随机抽取2008年7月至2011年6月来大连市口腔医院就诊的正畸患者800例(男260例,女540例;年龄9～40岁),通过观察其全颌曲面断层片,分析恒牙先天缺失的发生率及分布。结果包括第三磨牙在内的恒牙先天缺失发生率为36.13%,除第三磨牙外的恒牙先天缺失发生率为12.5%。性别间差异无统计学意义(P>0.05)。除第三磨牙外的轻度先天缺牙例数(缺失1～2颗牙)占87%,中度先天缺牙例数(缺失3～5颗牙)占10%,重度先天缺牙例数(缺失牙≥6颗)占3%。常见的缺失牙位因缺牙程度的不同而不同,轻度缺失时,最常见的缺失牙位在前牙(最多见的是右下侧切牙),随着缺牙程度的加重,常见的缺失牙位在后牙(最常见的是下颌第二前磨牙)。上、下颌的缺牙情况是,轻度缺牙(缺失1～2颗)时,下颌的发生率高于上颌;中、重度缺牙时,上、下颌之间差异无统计学意义(P>0.05)。上、下牙弓左右侧的缺牙发生率差异无统计学意义(P>0.05)。缺失牙≥2颗时,对称缺失占大多数,最常见的对称缺失牙位是下颌第二前磨牙。结论除第三磨牙外,大连地区正畸患者最常见的缺失牙位是下颌侧切牙;随先天缺牙程度加重,则以下颌第二前磨牙先天缺失最常见。     

单纯型恒牙先天缺失患者缺牙特点的临床分析

目的了解单纯型恒牙先天缺失患者的缺牙牙位和临床统计学特点。方法收集183例单纯型恒牙先天缺失患者的病史、口腔检查及曲面断层X线片等资料，分类进行统计学分析。结果牙齿缺失数目、性别差异无统计学意义（P〉0.05）；上下颌、左右侧之间牙齿缺失差异无统计学意义（P〉0.05）；最易缺失的牙齿为下颌第二前磨牙，共缺失154颗；多数牙缺失患者磨牙缺失率为25.00％，较个别牙缺失患者磨牙缺失率（3．05％）明显增高，差异有统计学意义（P〈0．05）。结论不同患者恒牙缺失的临床表现不同；单纯型恒牙先天缺失患者中，除第三磨牙外，最易缺失的牙齿是下颌第二前磨牙，其次是下颌切牙、上颌第二前磨牙及上颌侧切牙     

多个恒牙先天缺失的缺牙特点分析

目的比较分析严重恒牙先天缺失病例的缺牙特点,为临床工作提供参考。方法对37例多个恒牙(≥6个)先天缺失的病例按临床表现分为综合征型和单纯型先天缺牙两组,从恒牙先天缺失数目、牙位分布、余留牙畸形及牙齿大小等方面比较分析严重先天缺牙的表型特点。结果综合征型先天缺牙比单纯型先天缺牙在平均缺牙数目、现存牙齿合并畸形上都表现得更为严重(P<0.05);两组严重缺牙患者先天恒牙缺失的牙位分布在上下颌和左右侧之间均无差别(P>0.05),缺失牙位均呈对称分布,但最易缺失的牙位有所不同;严重先天缺牙患者现存恒牙牙冠宽度较正常值偏小(P<0.05)。结论多个恒牙先天缺失包含复杂的临床表现,综合征型与单纯型的严重先天缺牙在口腔缺牙特点上有明显差异,值得临床鉴别参考。     

邯郸市1895名大学生先天性缺牙的临床特征分析

目的了解河北邯郸市在校大学生恒牙先天性缺失的临床特征。方法随机对邯郸1895名大学生进行恒牙先天缺失临床特征的调查,并对先天缺牙患病率、数目及好发牙位等进行统计分析。结果恒牙先天缺失的总患病率为6.96%,男55例,女76例,性别间无统计学意义(P>0.05);下颌先天缺牙多于上颌(P<0.05);好发牙位为下颌中切牙;以缺1颗牙者最多见,占总人数的62.12%。患者缺牙伴有食物嵌塞者67.42%、邻面龋及继发病变者53.79%、牙合创伤者49.24%、牙周病者31.82%、咬合异常者61.36%。结论邯郸市在校大学生恒牙先天缺失多为少数缺牙,且性别间无统计学意义,下颌缺失牙数多于上颌,先天缺牙影响口腔健康及咬合关系。     

上颌侧切牙先天性缺失与蝶鞍相关性研究

目的 比较上颌侧切牙先天性缺失患者和牙列完整患者的蝶鞍大小,评估鞍桥和上颌侧切牙先天性缺失之间是否存在联系.方法 以上颌侧切牙先天性缺失患者作为试验组,牙列完整者作为对照组,每组各80例.利用Dolphin软件测量蝶鞍的大小,记录蝶鞍鞍桥的钙化程度.结果 两组间的蝶鞍大小除长度以外差异均无统计学意义.试验组与对照组在鞍...     

36例下切牙先天缺失正畸治疗的临床体会

目的探讨下切牙先天缺失的矫治设计。方法以伴有下切牙先天缺失的36例错畸形患者为研究对象，对下切牙缺失的部位、数目、错类型、矫治方法进行分析，并对缺失1颗下中切牙、拔除上颌2颗第一前磨牙和下颌1颗非缺牙侧第一前磨牙的病例及缺失2颗下中切牙、拔除上颌2颗第一前磨牙的病例的Bolton指数分析进行统计学检验。结果36例患者正畸治疗后均取得了较好的疗效。两组拔牙病例之间的Bolton指数全牙比无统计学差异（P>0.05），而前牙比和前牙不调量有统计学差异（P<0.01）。结论先天缺1颗下中切牙上下颌均需拔牙者，在下颌非缺牙侧选择拔1颗前磨牙比拔1颗中切牙对Bolton指数影响要小     

Bridging and dimensions of sella turcica in subjects treated by surgical-orthodontic means or orthodontics only

The aim of the study was to compare the incidence of sella turcica bridging and sella turcica dimensions in 150 Caucasian subjects who had combined surgical-orthodontic correction of their malocclusion with a randomly selected group of 150 Caucasian subjects who were treated contemporaneously by orthodontic means only. Pretreatment lateral cephalometric radiographs were scanned and analyzed. A sella turcica bridge was identified as a continuous band of bony tissue extending from the anterior cranial fossa to the posterior cranial fossa. The dimensions of the sella turcica were measured. In the group treated by combined surgical-orthodontic means, the incidence of bridging was 16.7%, whereas it was 7.3% in the orthodontics-only group (P = .012). Significant increases in the mean surface area (P = .02) and mean perimeter of the sella turcica (P = .01) were found for the combined surgical-orthodontic group compared with the orthodontics-only group. The mean interclinoid distance was significantly smaller in the surgical-orthodontic group (P = .02). These findings appear to indicate the greater likelihood of sella turcica bridging and abnormal sella turcica dimensions in subjects treated by combined surgical-orthodontic means rather than by orthodontics only.     

糖尿病患者唾液流率与口干相关性研究

目的:调查糖尿病患者口干、唾液流率情况并研究其与代谢、病史的相关性。方法:入选1型、2型糖尿病患者21例和54例,同时选择年龄、性别相近的两组健康人群作为对照,在空腹状态下测定静止唾液流率,采用口干问卷(xerostomia questionnaire, XQ)评价4组人群的口干程度。结果:与对照组相比,两组糖尿病患者唾液流率均下降,但2型糖尿病下降程度较小(P>0.05);两组糖尿病患者均诉一定程度的口干,OX量表得分高于对照组(P<0.05);2型糖尿病患者唾液流率低于1型糖尿病,而OX评分高于1型糖尿病,但差异均无统计学意义(P>0.05);以HbA_1C≤6%和病史≤3年(2型糖尿病患者≤5年)为依据对糖尿病患者进行亚组分析,唾液流率和口干程度组间比较差异均无统计学意义(P>0.05)。结论:糖尿病患者均有较明显的口干症状,同时唾液腺分泌均较正常人群减少,在糖尿病患者口腔保健工作中应引起重视。     

不同类型骨性错畸形患者蝶鞍特征研究

目的探讨不同类型骨性错畸形患者的蝶鞍大小、形态和鞍桥发生率。方法选取2016年7月至2019年9月于中国医科大学附属口腔医院第一门诊及正畸二科就诊的骨性Ⅰ类错畸形患者100例(Ⅰ组)、骨性Ⅱ类错畸形患者100例(Ⅱ组)、骨性Ⅲ类错畸形患者100例(Ⅲ组)。收集各组患者头颅侧位片,使用Winceph8.0软件定位相关标记点,并测量蝶鞍的长度、深度和直径,同时记录蝶鞍的形态(扁平形、椭圆形、圆形)以及鞍桥的类型(无鞍桥、部分鞍桥、完全鞍桥),计算各组患者鞍桥发生率。应用SPSS 25.0软件对数据进行统计学分析。结果各组患者蝶鞍大小、形态比较,差异均无统计学意义(均P> 0.05);但其鞍桥发生率比较,差异有统计学意义(P <0.001),其中Ⅲ组患者鞍桥发生率(66.0%)明显高于Ⅰ组(17.0%)和Ⅱ组(34.0%)。不同性别患者蝶鞍大小、形态及鞍桥发生率比较,差异均无统计学意义(均P> 0.05)。结论骨性Ⅲ类错畸形患者的鞍桥发生率显著增加,提示鞍桥的发生可能与颅颌面发育异常相关。     

两种功率PIPS-Er:YAG激光对根管内玷污层去除效果的比较研究

目的: 比较高功率和低功率PIPS-Er:YAG激光对根管内玷污层去除效果。方法: 收集52颗下颌单根管恒前磨牙,按最后冲洗方法不同随机分为4组(n=13):0.3 W、0.9 W PIPS-Er:YAG组,超声组和注射器冲洗组(均为对照组),冲洗结束后将牙纵向劈开分成两份,随机选取一份用扫描电镜分别扫描根尖部、根中部、冠部根管壁并对残留玷污层进行评分,最后比较4组冲洗方法对玷污层去除效果。结果: 0.3 W PIPS-Er:YAG组和0.9 W PIPS-Er:YAG组对玷污层的去除效果相当(P>0.05),两组均优于超声组,但差异无统计学意义(P>0.05),而与注射器冲洗组比较差异均有统计学意义(P<0.05)。结论: 高功率和低功率的PIPS-Er:YAG激光均可促进玷污层的去除,两者去除效果相当,且均优于于超声冲洗和注射器冲洗。     

Morphology of the sella turcica in Axenfeld–Rieger syndrome with PITX2 mutation

Background:  Axenfeld–Rieger syndrome (ARS) is a rare autosomal dominant disorder with an incidence of 1:200 000. Genotype and phenotype are heterogeneous and clinical morphology impresses with variable expressivity. Additionally to the typical craniofacial and dental aberrations anomalies in the morphology of sella turcica are discussed.
Method:  In a multidisciplinary genetic and clinical study four patients of a family with ARS were screened by direct DNA sequencing. Radiographic analysis of the patients was performed for evaluating cranial and dental structures. Additionally, a specific analysis of the morphology of the sella turcica was made on the radiographs.
Results:  Screening for PITX2 and FOXC1 mutations revealed a P64L missense mutation in PITX2 in all four patients. The cephalometric analysis showed a midface hypoplasia associated with a skeletal Class III. All patients showed a sella turcica bridge combined with a prominent posterior clinoid process followed by a steep clivus and an elongated sella turcica.
Conclusion:  The incidence of a sella turcica bridge in combination with a PITX2 mutation would suspect that sella turcica anomalies are typical symptoms of the syndrome. Sella turcica anomalies in association with craniofacial and dental aberrations, such as maxillary retrognathia, skeletal Class III relationship and hypoplasia of teeth, might be important indicators for ARS caused by PITX2 mutation.     

A sella turcica bridge in subjects with dental anomalies

Calcification of the interclinoid ligament (ICL) of the sella turcica, or sella turcica bridging, has been associated with severe craniofacial deviations. Despite no comprehensive study on the sella turcica bridge, a relationship with tooth and eruption disturbances has been reported. In order to investigate whether congenital absence of the second mandibular premolar, or the presence of a palatally displaced canine (PDC), is associated with sella bridging, a retrospective study was performed. Lateral cephalometric radiographs from 20 males and 14 females, aged between 8 and 16 years, with a PDC and second mandibular premolar aplasia were reviewed and compared with a control group. A standardized scoring scale was established to quantify the extent of a sella turcica bridge from each radiograph (no calcification, partially calcified, and completely calcified). The prevalence of complete calcification of the ICL in adolescents with dental anomalies was equal to 17.6 per cent, while an incidence 9.9 per cent was found in the control group. A partially calcified sella turcica was observed in 58.8 per cent of adolescents with dental anomalies compared with 33.7 per cent in the control group. The association between the degree of calcification of the ICL and the presence of dental anomalies in the studied adolescents was statistically significant according to chi-square statistics (P = 0.004). This was confirmed by Fisher's exact test (P = 0.003). According to these findings, the prevalence of a sella turcica bridge in adolescents with dental anomalies is increased, while age and gender do not greatly influence ossification of the ICL. The very early appearance during development of a sella turcica bridge should alert clinicians to possible tooth anomalies in life later.     

A sella turcica bridge in subjects with severe craniofacial deviations

In earlier studies, a sella turcica bridge was stated to occur in 1.75 to 6 per cent of the population. The occurrence of a sella turcica bridge has not previously been studied in a group of patients with craniofacial deviations treated by surgery. Profile radiographs from 177 individuals who had undergone combined orthodontic and surgical treatment at the Copenhagen School of Dentistry were studied. A sella turcica bridge was registered in those subjects where the radiograph revealed a continuous band of bony tissue from the anterior cranial fossa to the posterior cranial fossa across the sella turcica. Two types of sella turcica bridge were identified. A sella turcica bridge occurred in 18.6 per cent of the subjects.