胸大肌肌皮瓣脂肪液化的相关危险因素探讨

目的探讨胸大肌肌皮瓣术后发生脂肪液化的相关危险因素。方法对1998年5月至2005年12月采用胸大肌肌皮瓣修复口腔癌术后组织缺损的82例中10例术后发生不同程度脂肪液化的病例,进行Logistic回归分析。结果Logistic单因素回归分析结果表明：肥胖、电刀切开皮下组织、皮岛设计低于第7肋、吸烟等因素与胸大肌肌皮瓣术后发生脂肪液化有关;Logistic多因素回归分析结果表明：胸大肌肌皮瓣术后发生脂肪液化与肥胖、电刀切开皮下组织、皮岛设计低于第7肋等因素有关,而与吸烟无关。结论肥胖、电刀切开皮下组织、皮岛设计低于第7肋等因素是胸大肌肌皮瓣术后发生脂肪液化的危险因素。     

固定桥桥体龈底形态对接触区黏膜微生态影响的研究

目的探讨烤瓷桥桥体龈端不同形态设计对牙槽嵴顶黏膜微生态的影响。方法对60例磨牙烤瓷修复的患者采用常规细菌培养和计算机鉴定的方法进行检测。结果桥体龈端接触区细菌附着量和种类与牙体预备前相比,均有增多。其中,改良鞍式和改良盖嵴式桥体龈端接触区细菌附着量和细菌种类变化的差异有统计学意义(P<0.05);而舟底式桥体龈端接触区细菌附着数量和种类的变化,均无统计学意义(P>0.05)。戴用3个月后,各组链球菌和奈瑟菌的组成比例变化与牙体预备前相比,差异有统计学意义(P<0.05);其余各类细菌组成比例的变化无统计学意义(P>0.05)。结论从对桥体底黏膜微生态的影响考虑,烤瓷桥舟底式桥体优于改良鞍式和改良盖嵴式桥体,是值得临床推广应用的磨牙桥体设计。     

Acupuncture analgesia and its application in cranio-maxillofacial surgical procedures.

BACKGROUND: The present study investigated the use of acupuncture analgesia in maxillofacial surgery. PATIENTS AND METHODS: Acupuncture analgesia was applied in 120 patients. In 20 of these, surgery was carried out under general anaesthesia in combination with acupuncture analgesia. In 100 patients, acupuncture analgesia was applied in addition to traditional postoperative analgesia. In case of troublesome postoperative pain, it was necessary to carry out additional sessions (1-4) of acupuncture stimulation. RESULTS: When acupuncture analgesia was used, the pulse rate and blood pressure during surgery generally remained stable. In the present study serum cortisol was also measured and showed only minor elevation. DISCUSSION: The present study demonstrated favourable results when the first variant of the brake method of acupoint stimulation was used for 40-50 min with additional manual twirling of the needles. This involved inserting needles into the acupoints and, using slow, rolling manual movements increasing the amplitude step-by-step provoking simultaneous especially strong patient sensations. CONCLUSION: Acupuncture analgesia can be a useful adjunct to conventional anaesthesia in maxillofacial surgery.     

微型种植体支抗愈合期稳定性的比较

目的比较不同愈合时间种植体支抗的稳定性。方法10只新西兰大白兔应用种植体60枚,均分为种植即刻组、种植后1周组、2周组、4周组、8周组进行拉出实验和转矩实验。采用单因素方差分析组间差异,相关性分析愈合时间、最大剪切力、最大力矩两两之间的相关性。结果4周与8周组最大剪切力分别为(179·68±24·65)N、(212·06±42·51)N;4周与8周组的最大力矩分别为(0·47±0·13)N·m、(0·61±0·16)N·m,与其他组相比差异均有统计学意义(P<0·05)。愈合时间、最大剪切力、最大力矩两两之间均呈正相关。结论4周是种植体愈合期生物稳定性的一个关键时间点。8周内种植体的生物力学性能与愈合时间呈正相关。     

改良固定反式TBA联合前牵矫治前牙反(牙合)对软组织影响的比较研究

目的：评价应用改良固定反式双阻板矫治器（Twin-block appliance，TBA）联合前方牵引矫治Angle Ⅲ类功能性轻、中度骨性前牙反[牙合]的临床效果。方法：联合矫治15例，对治疗前后临床表现及X线软组织测量进行分析，并与单纯前方牵引组进行比较。结果：联合矫治组上、下颌软组织的变化均十分明显，能较快改善侧貌外形。而单纯前方牵引组侧貌改善较慢，一般需要半年以上。在矫治后上唇前移明显，下唇基部无明显后移。结论：反式TBA联合前牵对上下颌软组织矫治作用较大。     

The galea fascia flap in orbital reconstruction: innovative harvest technique.

AIM: To report the treatment of a recurrent adenoid-cystic carcinoma of the lacrimal gland required orbital exenteration with an en bloc resection of the lateral orbital rim and wall and an anterior portion of the temporal muscle. Reconstruction was planned with both the objectives of a shortened healing time for faster epithetic reconstruction and no visible scars. METHOD: After a cranially extended temporal approach, the dissection of the superficial galea layer was connected with the subcutaneous dissection of the upper and lower eyelid after subciliary incisions. RESULTS: Ample exposure of the temporal, frontal and orbital region was obtained, facilitating the orbital exenteration with en bloc resection of the lateral orbital rim and wall and the anterior portion of the temporal muscle. The epithelialization of the eye socket covered with the galea fascia flap was accelerated, providing faster epithetic reconstruction, without visible scars. CONCLUSIONS: Healing time is accelerated, providing faster epithetic rehabilitation without visible scars, which is important in the postoperative rehabilitation ladder after eye exenteration for both patient and surgeon. Further more ablative surgery within this region gets safer and easier due to the ample exposure of this innovative surgical technique. Further evaluation of the effectiveness and safety of this new approach is advisable.     

A quantitative evaluation of sealing ability of 4 obturation techniques by using a glucose leakage test.

OBJECTIVE: The aim of this study was to evaluate the sealing ability of 4 different obturation techniques by using a glucose leakage test. STUDY DESIGN: Eighty extracted single-rooted maxillary incisors were selected for the study. The teeth were decoronated and the root canals prepared using ProFile rotary instruments to an apical dimension of size 40 (0.06 taper). The specimens were then randomly divided into 4 experimental groups (n = 15) and filled with gutta-percha and sealer by using either cold lateral compaction, warm vertical compaction, Thermafil, or the E & Q Plus system. Another 10 teeth each served as the positive and negative controls. A glucose leakage model was used for quantitative evaluation of the coronal-to-apical microleakage at 24 hours, 1, 2, 3, 5, 8, and 12 weeks. RESULTS: No significant difference in the cumulative amount of leakage was found among the 4 groups at 24 hours and 1 week (Kruskal-Wallis test, P > .05). Lateral compaction showed significantly more leakage than the other 3 techniques at longer intervals (Mann-Whitney U test, P < .008). No significant difference was found between vertical compaction, Thermafil, and E & Q Plus at all observation times. CONCLUSIONS: Warm vertical compaction, Thermafil, and the E & Q Plus system showed a better sealing result than cold lateral compaction of gutta-percha at extended observation periods. The glucose leakage method used in this study was able to provide a nondestructive, quantitative, and long-term evaluation of the sealing ability of root canal fillings.     

一种适合正颌外科的成人个体化头影测量颅颌关系的方法

目的本研究选择在判断矢状向和垂直向颅颌关系中最常用的5项X线头影测量项目并以此为基础,运用多元回归的方法探讨并建立我国成都地区成人个体化颅颌关系浮动正常值,并探讨其应用方法.方法搜集符合纳入标准的未接受过正畸治疗的成都地区18岁至45岁正常(牙合)97例,其中男性48例,女性49例.测量各样本上颌突度(SNA),下颌突度(SNB),上颌相对颅底倾角(NL-NSL),下颌相对颅底倾角(ML-NSL),颅底角(NSBa).对测量项目进行多元统计分析并建立成都地区成人个体化头影测量颅颌关系浮动正常值.结果(1)5个测量项目之间均存在显著相关关系,其中SNB与其余4个测量项目的相关强度最大;(2)以SNB为自变量建立成都地区成人个体化头影测量颅颌关系浮动正常值.结论本研究为成人正畸患者,特别是拟进行正颌外科治疗的成人患者提供了一种辅助性的头影测量诊断方法.