2×4矫治器配合下后牙面树脂垫治疗乳前牙反的临床研究

目的 探讨2×4矫治器配合下后牙(验)面树脂垫早期阻断矫治乳前牙反(袷)的临床效果.方法 乳牙期前牙反(胎)患者46例,平均年龄(4.2±0.6)岁,采用2×4矫治器配合下后牙(给)面树脂垫高咬合进行早期阻断矫治.配对t检验比较头颅定位侧位片的牙、颌、面测量值在矫治前后的差异.结果 矫治后所有患者乳前牙反(胎)解除.与矫治前相比,上中切牙角(UA-SN)增加11.57° (P ＜0.001),上牙弓长度(is-ms)增加2.26 mm(P＜0.01)；下中切牙角(LA-MP)减小4.38°(P＜0.01),下牙弓长度(ii-mi)减少1.04 mm(P ＜0.01).ANB增大1.44°.结论 2×4矫治器配合下后牙(拾)面树脂垫是早期阻断矫治乳前牙反(殆)的有效方法,患儿易于配合.     

保留完整性下颌骨及牙列行舌癌和口底癌联合根治术的近期疗效观察

目的 为提高舌癌、口底癌患者术后生存质量,探讨保留完整的下颌骨及牙列的舌癌、口底癌联合根治方法,并评价其近期疗效.方法 收集随访2013年5月至2014年11月该科室采用保留完整的下颌骨和牙列的方式行舌癌、口底癌根治术的5例患者的临床资料,通过术后患者面形、语言、舌运动、咬合和进食等情况以及肿瘤有无复发和转移,来评价患者口腔功能状况和手术疗效.结果 随访3～18个月,未发现肿瘤局部复发和远处转移.全部患者术后均面部外形对称无畸形、咬合关系无错乱,咀嚼、语言和吞咽功能良好.结论 保留完整的下颌骨和牙列的舌癌、口底癌联合根治方法既能根治肿瘤,又使患者获得良好的生存质量.     

应用Demirjian法测量乳牙列期儿童的牙龄研究

目的观察乳牙列期儿童在4~6岁期间恒牙胚生长发育规律,探索Demirjian法在该群体牙龄研究的适用性。方法在深圳市幼儿园小班随机抽取4岁左右汉族儿童75名(男童40名,女童35名),连续三年定期拍摄的全颌曲面断层X光片进行牙齿生长发育观察,并采用Demirjian法进行牙龄研究。结果在4~6岁乳牙列期儿童第二磨牙、第二前磨牙和第一前磨牙处于牙冠发育阶段,第一磨牙、尖牙、侧切牙、中切牙处于牙根发育阶段。同龄女童的牙齿发育阶段显著领先于男童。除3.5~4.5岁组男童及4.5~5.5岁组女童的牙龄估计值与实际年龄差异无统计学意义外,各组提示Demirjian法评估值与实际年龄有差异(P0.05)。结论 Demirjian法不能直接用于4~6岁乳牙列期儿童牙龄评估,后期需进一步扩大样本,探讨该年龄段儿童的牙龄评估曲线。     

种植牙技术在牙列游离端缺失患者修复治疗中的应用

目的探究牙列游离端缺失患者采取种植牙修复法治疗的临床效果。方法72例牙列游离端缺失患者,以其就诊时间先后顺序为依据分为对照组与观察组,每组36例。对照组患者行活动义齿修复法治疗,观察组患者行种植牙修复法治疗。比较两组患者修复效果;治疗前后牙槽骨骨吸收量及语言功能评分、咀嚼功能评分、美观度评分;治疗前后生活质量调查表(QOL)评分;术后不良反应发生情况。结果观察组患者的修复总有效率94.44%显著高于对照组的77.78%,差异具有统计学意义(P<0.05)。治疗前,观察组牙槽骨骨吸收量为(0.47±0.15)mm,对照组牙槽骨骨吸收量为(0.46±0.17)mm,两组患者比较差异无统计学意义(P>0.05);观察组治疗后牙槽骨骨吸收量为(0.51±0.15)mm低于对照组的(0.65±0.12)mm,语言功能、咀嚼功能及美观度评分分别为(9.71±0.21)、(8.86±0.35)、(9.26±0.37)分,均高于对照组的(8.02±0.63)、(6.11±0.42)、(7.35±0.46)分,差异均具有统计学意义(P<0.05)。观察组治疗前后QOL评分为(64.40±10.21)、(85.64±7.69)分,对照组治疗前后QOL评分为(63.54±10.15)、(70.25±8.36)分。治疗前,两组患者的QOL评分比较差异无统计学意义(P>0.05);治疗后,两组患者的QOL评分高于治疗前,且观察组患者的QOL评分高于对照组,差异均具有统计学意义(P<0.05)。观察组患者的术后不良反应发生率5.56%低于对照组的25.00%,差异具有统计学意义(P<0.05)。结论种植牙修复法对牙列游离端缺失疗效理想,可有效改善患者咀嚼和语言功能,减少牙槽骨骨吸收量以保证种植牙稳定性,且美观度更显著,因此该种修复方法值得在临床中推广应用。     

Skeletal class II malocclusion caused by mouth breathing in a pediatric patient undergoing treatment by interceptive guidance of occlusion

A 7-year 10-month-old boy was evaluated for mouth breathing and snoring habits. Examination revealed soft convex tissues, maxillary protrusion, mandibular retrusion, and a class II sagittal osteofascial pattern. The patient failed a water holding test. He was clinically diagnosed with skeletal class II malocclusion caused by mouth breathing. Under interceptive guidance of occlusion (iGo), the malocclusion improved with fixed maxillary expansion using functional appliances and interventional treatment of mouth breathing by lip closure exercises. These treatments enabled the patient to gradually return to nasal breathing and guided him to develop physiological occlusion for a coordinated jaw-to-jaw relation. At the 5-year 2-month post-correction follow-up visit (at the age of 13 years), the patient had stable occlusion, a coordinated osteofascial pattern, and normal dentition, periodontium, and temporomandibular joints.     

替牙期骨性Ⅲ类单侧完全性唇腭裂患者修复术后口周力的分布特征

目的:通过与同龄非唇腭裂正常 儿童比较,研究替牙期骨性Ⅲ类单侧完全性唇腭裂(unilateral cleft lip and palate,UCLP)患者上下颌不同位点口周力的特征。 方法:选取替牙期6～12岁UCLP患者20例(男14例,女6例)为UCLP组;同龄正常 儿童21例(男14例,女7例)为对照组。采用口周肌压力采集系统测量每个研究对象息止 位时双侧上下颌中切牙、尖牙或乳尖牙、第一前磨牙或乳磨牙、第一恒磨牙的唇颊、舌腭侧龈缘的口周力。使用SPSS 25.0统计软件对数据进行统计分析。 结果:1．UCLP组上颌口周力裂侧大于非裂侧( P<0.05),下颌口周力两侧无差异( P>0.05)。2. UCLP组上颌口周力大于对照组( P<0.05),两组上颌唇颊侧的口周力均在第一前磨牙/乳磨牙区最大,在中切牙区最小。3. UCLP组下颌唇颊侧口周力小于对照组( P<0.01),下颌中切牙舌侧区UCLP组大于对照组( P<0.05)。4. UCLP组上颌牙弓内外口周力差值大于对照组( P<0.05),下颌差值小于对照组( P<0.01)。 结论:替牙期骨性Ⅲ类UCLP患者口周力较同龄非唇腭裂正常 儿童存在异常。     

Impact of anterior occlusal conditions in the mixed dentition on oral health–related quality-of-life item levels:: A multivariate analysis

ObjectivesTo evaluate the impact of anterior occlusal conditions in the mixed dentition on item-level analysis of oral health–related quality of life (OHRQoL).Materials and MethodsA population-based cross-sectional study of 787 children aged 8 to 10 years was conducted. The Child Perceptions Questionnaire (CPQ_8-10) was used to evaluate OHRQoL, and the analysis of item levels was performed on CPQ_8-10 domains. Anterior occlusal characteristics were diagnosed according to the Dental Aesthetic Index criteria. Individual analyses were performed relating the outcome as independent variables. The variables with P < .20 in the individual analyses were tested in multiple logistic regression models, and those with P < .10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI).ResultsNo associations were found with regard to anterior occlusal characteristics (P < .001) after the variables of the previous determinants were adjusted for multivariate analysis. However, the following variables were significantly associated with negative impact on OHRQoL item levels: sex, in oral symptoms (OR = 1.42; CI, 1.07–1.89) and emotional well-being (OR = 1.34; CI, 1.00–1.79); race, in oral symptoms (OR = 1.48; CI, 1.10–1.98), emotional well-being (OR = 1.54; CI, 1.14–2.06), and social well-being (OR = 1.34; CI, 1.00–1.80); and family income in functional limitation (OR = 1.46; CI, 1.06–2.02), emotional well-being (OR = 1.71; CI, 1.21–2.42), and social well-being (OR = 1.59; CI, 1.14–2.21).ConclusionsAnterior occlusal conditions did not affect the levels of OHRQoL items.