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本文报告1例因牙齿根面畸形导致严重根尖病变及牙周破坏的牙周牙髓联合病变的左上侧切牙,瘘道长期不愈,腭侧窄而深牙周袋,严重根尖病变及牙槽骨垂直吸收。通过显微根管治疗、根尖手术、引导牙周组织再生术治疗,实现了控制根尖及牙周感染,达到了保留患牙的目的。 相似文献
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目的:对6个厂家不同氢溴酸右美沙芬口服固体制剂进行体外溶出度考察,比较体外溶出情况,为临床用药提供参考。方法:采用转篮法,转速100 r·min-1,用高效液相色谱法测定氢溴酸右美沙芬口服固体制剂在0.1 mol·L-1盐酸溶液中的溶出曲线;以威布尔方程拟合溶出参数T50、Td、m,并对参数进行方差分析。结果:氢溴酸右美沙普通片、分散片、胶囊以及软胶囊的平均累积溶出度分别为94.3%、101.3%、105.2%、93.4%。溶出参数T50、Td差异较大,其中T50最大的是最小的13.4倍。结论:氢溴酸右美沙片、分散片、胶囊以及软胶囊体外溶出行为差别大,产品质量存在较大差异。 相似文献
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《Journal of endodontics》2019,45(6):768-773
IntroductionThe aim of this study was to compare the shaping ability of 4 different nickel-titanium systems, considering their variation in alloy treatment, kinematics, and design, used to prepare canals with severe curvature using micro–computed tomographic analysis.MethodsThirty-two mesial roots of mandibular molars with severe curvature were matched based on similar morphologic dimensions and assigned to 4 experimental groups (n = 8) according to the canal preparation: ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland), Reciproc (RC; VDW GmbH, Munich, Germany), Reciproc Blue (RCB, VDW GmbH), and TRUShape (TRU; Dentsply Tulsa Dental Specialties, Tulsa, OK) systems. Changes in 2-dimensional (area and perimeter) and 3-dimensional (volume, surface area, and structure model index) morphologic parameters as well as canal transportation were compared among groups using the analysis of variance post hoc Tukey tests with the significance level set at 5%.ResultsPreparation significantly increased all analyzed parameters. No statistically significant differences (P > .05) were observed between RC and RCB or between PTN and TRS in any of the analyzed parameters. In the cervical third, RC and RCB presented higher mean increases than PTN and TRU. In the apical third, there were no statistically significant differences (P > .05) among the systems.ConclusionsThe instruments of greater taper may promote greater morphologic changes. However, regardless of the number of instruments (multiple or single), the type of movement (rotation or reciprocating), the type of heat treatment of alloys, and the particular characteristics of each instrument (taper and design), the evaluated systems did not result in different dimensional changes and canal transportation in the critical apical area. 相似文献
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Rosemary Frey Deborah Balmer Jackie Robinson Merryn Gott Michal Boyd 《Journal of pain and symptom management》2019,57(3):545-555.e1
Context
In most resource-rich countries, a large and growing proportion of older adults with complex needs will die while in a residential aged care (RAC) facility.Objectives
This study describes the impact of facility size (small/large), ownership model (profit/nonprofit) and provider (independent/chain) on resident comfort, and symptom management as reported by RAC staff.Methods
This retrospective “after-death” study collected decedent resident data from a subsample of 51 hospital-level RAC facilities in New Zealand. Symptom Management at the End-of-Life in Dementia and Comfort Assessment in Dying at End of life with Dementia (SM-EOLD and CAD-EOLD, respectively) scales were used by RAC staff who were closely associated with 217 deceased residents. Data collection occurred from January 2016 to February 2017.Results
Results indicated that residents of large, nonprofit facilities experienced greater comfort at the end of life (CAD-EOLD) as indicated by a higher mean score of 37.21 (SD = 4.85, 95% CI = 34.4, 40.0) than residents of small for-profit facilities who recorded a lower mean score of 31.56 (SD = 6.20, 95% CI = 29.6, 33.4). There was also evidence of better symptom management for residents of chain facilities, with a higher mean score for symptom management (SM-EOLD total score) recorded for residents of chain facilities (mean = 28.07, SD = 7.64, 95% CI = 26.47, 29.66) than the mean score for independent facilities (mean = 23.93, SD = 8.72, 95% CI = 21.65, 26.20).Conclusion
Findings suggest that there are differences in the quality of end-of-life care given in RAC based on size, ownership model, and chain affiliation. 相似文献17.
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感染控制对根管治疗的成功至关重要。尽管随着器械及设备的进步,对根管的清理及成形取得了很大的进展;然而,由于根管系统解剖结构错综复杂,使得获取清洁根管面临各种问题。例如:机械预备的宽度有限,不能彻底清理感染牙本质;冲洗技术的运用虽然可以去除根管器械预备后形成的玷污层,但对细菌内毒素的清除还是难以达到理想的效果,而残留的微生物、毒素等若得不到清除可能会在根尖周组织形成持续感染。因此,除外机械预备和冲洗,根管封药也是感染根管治疗过程中的重要步骤。氢氧化钙糊剂以其高效的抗菌作用在临床得到广泛使用。文章将对根管封药的必要性、氢氧化钙的作用机制及临床应用做一介绍。 相似文献
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《The Journal for Nurse Practitioners》2022,18(7):741-746
End-of-life patients face barriers that prevent them from transitioning from the hospital to their preferred place of death. These barriers include a lack of trust, ineffective communication, delayed discharge planning, and difficulty accessing medications and supplies. This quality improvement study examined modifiable barriers identified within an acute care system. The study aimed to provide insight and recommendations for limiting barriers to discharge. A retrospective review of medical records was performed to evaluate for patterns and similarities. The lack of timely advanced care planning and documentation of these discussions are a factor in patients not achieving end of life preferences. 相似文献
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