微创牙冠延长术联合纳米树脂修复龈下楔状缺损的效果

目的 探讨微创牙冠延长术联合纳米树脂修复龈下楔状缺损的临床效果。方法 选择西安碑林和 荣口腔诊所2020年1月-2021年12月收治的70例龈下楔状缺损患者为研究对象，随机分为研究组与对照组， 各35例。对照组给予常规牙冠延长术联合纳米树脂修复，研究组给予微创牙冠延长术联合纳米树脂修复， 比较两组修复成功率、牙周相关指标变化及术后疼痛程度。结果 研究组修复成功率为94.29%，高于对照 组的74.29%（P＜0.05）；研究组术后2个月与6个月PD与AL均低于对照组（P＜0.05）；两组术后BI、MD 比较，差异无统计学意义（P＞0.05）；研究组术后1、3、5 d VAS评分均低于对照组（P＜0.05）。结论 微 创牙冠延长术联合纳米树脂修复可有效降低附着丧失及探针深度，提高修复成功率，且术后疼痛轻微，有 较好的临床价值。     

Multifunctional anatomical prototypes (MAPs): Treatment of excessive gingival display due to altered passive eruption

Objective

To describe a strategy using digital technologies for improving the diagnosis, treatment planning, and surgical execution of patients with excessive gingival display (EGD) due to altered passive eruption (APE).

Clinical Considerations

An important component for successful patient's management is to fulfill their esthetic expectations whilst delivering predictable and long-term therapeutic outcomes. To achieve this goal in patients with excessive gingival display due to altered passive eruption, it is essential to perform an accurate diagnosis and to communicate to the patient the expected customized results using digital technologies. Computer-aided designed and manufactured multifunctional anatomical prototypes (MAPs) may contribute to these purposes. Additionally, they can guide the surgical crown lengthening procedure or serve as a reference during the surgical guide fabrication providing information of the required anatomical landmarks.

Conclusions

This novel strategy protocol for diagnosis, communication, and treatment management of patients with excessive gingival display follows functional and biological principles within the frame of a digital workflow, which improves the diagnostic capabilities, enhances communication, and guides the surgical treatment as shown in the 12 months follow-up of the reported case.

Clinical Significance

Developing a virtual patient by combining multiple digital data sets including cone-beam computed tomography (CBCT), intra-oral scans and digital photography, supports the clinician and the patient to achieve a comprehensive diagnosis and to better communicate the expected results to the patient. Furthermore, this digital treatment exercise based on anatomical and biological principles will facilitate the surgical precision and the achievement of successful outcomes, thus fulfilling the patient needs and expectations.     

Surgical techniques for mesenteric lengthening in ileoanal pouch surgery: a systematic review

Aim

The key to successful construction of an ileal pouch–anal anastomosis (IPAA) following proctocolectomy in patients with ulcerative colitis or familial adenomatous polyposis is the ability of the pouch reservoir to reach the anus well vascularized and without tension. The aim of this systematic review was to provide an overview of previously described different surgical lengthening techniques to achieve adequate length for a tension-free IPAA.

Method

Pubmed, Embase and Cochrane Library databases were systematically searched. Two reviewers conducted a systematic search with combinations of keywords for the surgical procedure and surgical lengthening techniques. All publications that reported one or more surgical lengthening techniques during IPAA surgery in adult patients were selected, consisting of reviews, cohort studies, case reports, human cadaver studies and expert opinions. The primary outcomes measured were the different surgical lengthening techniques and the step-by-step approach they involve that can be used during surgery to achieve adequate length for an IPAA.

Results

Of 1577 records reviewed, 19 articles were included in this systematic review describing at least 1181 patients (i.e. one review, four retrospective studies, five human cadaver studies, two case reports and seven expert opinions). A total of six different surgical lengthening techniques with various subtechniques were found and described, consisting of pouch folding, construction of different types of pouches, stepladder incisions, skeletonization of vessels, division and ligation of mesenteric vessels and using an interposition vein graft. No prospective or randomized controlled trials were performed regarding this topic. Quality assessment showed a medium quality of the included studies.

Conclusion

Different surgical lengthening techniques are described in a step-by-step approach to create adequate mesenteric length during IPAA surgery, in patients in whom the ileal pouch cannot reach the dentate line.     

前牙残根正畸牵引加牙冠延长在前牙牙体缺损修复中的应用效果

探讨前牙牙体缺损修复中应用前牙残根正畸牵引加牙冠延长治疗的临床效果。方法 选取 我院2022年3月-2023年3月收治的120例前牙牙体缺损患者为研究对象，随机分为对照组和观察组，各 60例。对照组予以牙冠延长术治疗，观察组予以前牙残根正畸牵引加牙冠延长治疗，比较两组修复效果、 牙周健康情况和并发症发生情况。结果 观察组修复优良率为96.67%，高于对照组的80.00%（P＜0.05）；两 组治疗后的牙周探诊深度、牙龈指数、牙齿松动度均低于治疗前，且观察组低于对照组（P ＜0.05）；观察 组并发症发生率为5.00%，低于对照组的20.00%（P＜0.05）。结论 前牙牙体缺损修复中应用前牙残根正畸 牵引加牙冠延长治疗可改善患者的牙周健康情况，提升修复效果，降低并发症发生风险。