Healing of experimental gingival recession defects treated with amnion allograft: Histologic and histometric analysis in dogs

ObjectivesThis study was conducted to compare the healing response of localized gingival recession defects treated with a coronally advanced flap (CAF) and either an amnion allograft membrane (AM) or a connective tissue graft (CTG).MethodsGingival recession defects were surgically created in six healthy mongrel dogs at the labial root surface of the maxillary canines, bilaterally. Using a split mouth design, the defects were treated with CAF and either AM (CAF/AM) or CTG (CAF/CTG). Three animals for each group were scarified at 1 and 3 months. Segments containing the defects were prepared for histological and histometric analysis.ResultsBoth techniques showed similar clinical findings with adequate root coverage. Histologically, healing was characterized by the formation of new cementum and new connective tissue attachment in the CAF/AM group; in the CAF/CTG group, healing was characterized by junctional epithelium, coronally, and connective tissue fibers parallel to the root surface, apically. Histometrically, the CAF/AM group revealed a substantially shorter epithelial length and a longer, new cementum compared with those of the CAF/CTG group after a healing period of 3 months.ConclusionsWithin the limits of this study, we concluded that the AM allograft could promote periodontal healing in gingival recession defects.     

异种脱细胞真皮基质修复膜在口腔黏膜下纤维性变手术治疗中的应用

目的:评价异种脱细胞真皮基质修复膜在口腔黏膜下纤维性变手术治疗中的应用效果。方法:8例重度口腔黏膜下纤维性变患者,经鼻腔气管插管全麻下切除双侧颊部翼下颌韧带前方区域纵行的纤维条索,术中被动开口度达正常范围后,剪取相应大小的异种脱细胞真皮基质修复膜覆盖黏膜缺损创面,间断缝合后,碘纺纱包加压固定。术后10～14d拆除纱包与缝线后开始开口训练,定期随访并进行类固醇皮质激素黏膜下局部注射等辅助治疗,通过伤口愈合、瘢痕软化及开口度改善等指标评价手术效果。采用SPSS16.0软件包对数据进行单因素方差分析。结果:8例患者双侧颊部纤维条索切除后形成的手术创面,采用异种脱细胞真皮基质修复膜进行修复均获得成功,无感染或排异等并发症发生。术后随访6～18个月,患者颊部原手术区黏膜红润,质地柔软,开口困难明显改善。术前开口度为(12.04±2.93)mm,术中开口度为(35.46±3.17)mm,术后6个月时的开口度为(29.33±4.28)mm,经统计学分析,差异具有显著性(P<0.05)。结论:应用异种脱细胞真皮基质修复膜修复重度口腔黏膜下纤维性变手术治疗中的黏膜缺损创面,能够起到促进创面早期愈合、减轻瘢痕形成与改善开口困难的作用,其操作简单易行,值得临床推广应用。     

以胚鼠脱细胞真皮构建口腔黏膜固有层的实验研究

目的:探讨以胚鼠脱细胞真皮构建组织工程化口腔黏膜固有层的可行性。方法:取胚鼠皮肤制备脱细胞真皮支架,将体外培养的人口腔黏膜成纤维细胞复合入胚鼠脱细胞真皮支架中,分别于接种后的1、4、7 d行HE染色、荧光显微镜及电镜检测。结果:胚鼠脱细胞真皮支架行HE染色显示未见细胞残留,表皮-真皮结合面保存波浪状基底膜样结构,HE、荧光显微镜及电镜检测均显示成纤维细胞复合入胚鼠脱细胞真皮支架后可黏附、生长、增殖。结论:以胚鼠脱细胞真皮体外构建的口腔黏膜固有层具有较好的组织构架,为进一步研究成纤维细胞-上皮细胞相互作用机制和构建全层口腔黏膜提供良好的实验模型。     

Foreign body reaction to calcium hydroxylapatite after lip augmentation

BACKGROUND: Dentists need to be aware of soft-tissue lesions resulting from cosmetic facial/lip procedures that involve the use of injectable materials. Common side effects detected on clinical examination may include edema, bruising and noninflammatory lip nodules. CASE DESCRIPTION: A 51-year-old woman visited a dental clinic with the chief complaint of a lump on the mucosal aspect of her lower lip. She reported having noted the lesion a few weeks before seeking care at the clinic. Several weeks later, the lesion persisted and new lesions were detected. The clinician excised the initial lesion only. CLINICAL IMPLICATIONS: The lip nodules were associated with a cosmetic procedure and were inflammatory in nature. This is the first granulomatous response reported as a result of injections with calcium hydroxylapatite (Radiesse, BioForm Medical, San Mateo, Calif.). Poor patient recollection of his or her medical history may result in confusion with pathological processes such as infection, neoplasia or malignancy.     

组织补片在腭裂修复术软组织缺损中的应用

目的：探索一种软腭有效延长的新方法。方法：7例腭裂患者应用口腔组织补片植入鼻腔侧菱形创面，观察伤口愈合情况。结果：7例患者伤口均一期愈合，术后13d及63d鼻咽显微镜检查可见口腔组织补片全部成活，未见明显挛缩。结论：口腔组织补片的植入可去除或减少腭裂修复术中产生的鼻腔侧菱形创面愈合后的瘢痕，保证软腭延长的效果，有利于恢复语音功能。     

真皮乳头细胞促毛发生长和黑素生成的分子调节机制研究进展

越来越多的证据显示真皮乳头细胞(DPC)是毛囊周期性更新的组织中心。一方面它通过旁分泌的方式分泌大量的细胞因子,刺激隆突区上皮干细胞和黑素细胞干细胞(MeSC)分化、增殖和移行,启动毛发生成。另一方面DPC通过调节干细胞的微环境,譬如真皮乳头的大小、真皮乳头与隆突区的距离以及毛囊隆突区周围的淋巴引流与神经支配等协调完成对毛发生长周期的调节。最新研究显示DPC至少有4个细胞亚群,分别诱导单谱系瞬时扩增上皮细胞形成多层同心圆排列的毛干与毛鞘。还发现持续的心理应激可导致支配隆突区的交感神经过度活跃,交感神经末梢释放大量的去甲肾上腺素可诱导MeSC快速增殖,导致MeSC库耗竭和毛干色素脱失。通过对DPC促毛发生长和黑素生成的分子调节机制的认识,有望在体外大规模培养DPC用于细胞移植治疗人类秃发疾病。     

他克莫司阳离子微乳凝胶的兔眼刺激性研究及房水药动学研究

目的 研究他克莫司阳离子微乳凝胶对兔眼的刺激性及房水药动学。方法 通过HE染色处理的兔眼组织病理切片观察该制剂的眼部刺激性。采用角膜穿刺术抽取兔眼房水,通过液相色谱-质谱联用仪进行房水药动学研究。结果 他克莫司阳离子微乳凝胶对兔眼无明显刺激性,其房水药动学参数AUC为(128.34±13.09)ng·h/ml,是他克莫司阳离子纳米乳AUC(113.61±12.36)ng·h/ml的1.13倍,是市售他克莫司滴眼液Talymus^?AUC(68.25±10.82) ng·h/ml的1.88倍。结论 他克莫司阳离子微乳凝胶眼部刺激性小、滞留时间长且生物利用度高,具有较好的临床应用前景。     

中国乳腺癌术后假体乳房重建补片材料应用现状

假体为基础的乳房重建（IBBR）可以减少或避免自体组织乳房重建手术供区的损伤和瘢痕,近十年来逐渐成为了乳腺癌术后主要的乳房重建方式,同时随着材料学的进步和乳腺外科的发展,补片材料辅助技术已经广泛应用于IBBR手术。特别是对于需要植入较大假体的病例,借助人工材料联合胸肌,起到“延伸”肌肉组织、无张力覆盖假体的作用,使重建乳房下皱襞更为饱满、自然,进一步降低手术创伤的同时也增加了重建乳房的美学效果。近期在国内进行的补片材料应用情况调查显示：我国区域经济发达状况和患者的经济条件是选择乳房重建和人工补片应用的主要因素。此外,由于中国女性乳房的形态特点不同于欧美女性,对于乳房体积较小的假体乳房重建,较少应用人工补片,因此,国内重建补片材料的应用更具个体化和区域性。