Influence of the inclination of the plate of an intra-oral tracing device on the condylar position registered by tapping movement

The object of this study was to determine the best inclination of the intra-oral tracing device to get optimum condylar position with the registration of tapping movement. Three appliances with different tracing plate inclinations were used in five healthy subjects. The tracing plates were set at 0 degrees to occlusal plane (horizontal); at the angle formed by drawing a line from condylar point to the stylus position at occlusal plane (inclined); then at the angle half to inclined (half-inclined). Subjects made Gothic arch and tapping movements (n = 30) at a 30 mm interincisal distance with the head Camper plane horizontal. The incisal and condylar points were tracked with a 6-degree-of-freedom jaw movement tracking system. The location of gothic arch apex, the distribution and mean position of 30 tapping points from intercuspal position were analyzed in incisal and condylar point between the appliances. Data were analyzed with repeated measures one-way anova. Results showed that mean position of tapping points were significantly different among the appliances. Half-inclined appliance recorded tapping points in a convergent area nearer to intercuspal position (IP) than other appliances. In all appliances, the contact points of the tapping movement were anterior to Gothic arch apex.     

改良游离牙龈移植技术临床效果评价

目的:评价种植体周围改良游离牙龈移植技术的临床效果。方法:选择36例患者42个下颌后牙区种植位点,种植后颊侧龈缘中点处角化龈宽度均小于2 mm。修复前2个月采用改良游离牙龈移植技术,即供区使用个性化腭护板,受区使用个性化移植物压板。术后观察移植物的成活情况。术后即刻,术后2、6、12个月对种植体颊侧角化龈宽度进行测量。术后1、3、6 d用目测类比法（VAS）记录患者术创疼痛。采用SPSS 25.0软件包对数据进行配对t检验和单因素方差分析。结果:42个种植位点移植瓣均成活。术前种植体颊侧角化龈宽度平均（0.39±0.41）mm,术后12个月平均（4.17±0.43）mm,与术前相比,平均增加（3.78±0.21）mm,平均收缩量为（1.12±0.12）mm。结论:改良游离牙龈移植技术可有效增加种植体颊侧角化龈宽度,术后1年移植物收缩量较小,患者术后疼痛不明显。     

钛板坚强内固定治疗下颌骨骨折136例报告

目的：总结钛板坚强内固定术治疗下颌骨骨折的临床疗效。方法：收集1998～2004年136例下颌骨骨折病例，行钛板坚强内固定术治疗，分别在手术后1个月、3个月、6个月复查，拍摄X线片，观察骨折线对位愈合情况、咬合关系及开口度等功能恢复情况。结果：136例中134例一期愈合，2例延期愈合。X线片示骨折线对位良好，咬合关系及开口度均恢复良好。结论：钛板坚强内固定术治疗下颌骨骨折效果好，方法可靠，操作简单。     

上颌斜面导板在增强支抗和调整咬合中的应用

目的探讨上颌斜面导板在加强下前牙支抗及治疗末期调整后牙尖窝关系中的作用。方法选择需下颌后牙前移而下前牙不能过多后移或治疗后期后牙尖窝关系不理想的患者62例,其中29例戴用上颌斜面导板加强下前牙支抗或治疗末期调整后牙尖窝关系,33例未戴用上颌斜面导板,对两组治疗前后的头颅侧位片进行测量并对组内和组间的差异进行统计学分析。结果上颌斜面导板能增强下前牙支抗,在关闭下前牙或下后牙间隙时,斜面导板阻挡下前牙,防止下前牙舌倾及后移,保证前牙覆牙合、覆盖正常。上颌斜面导板还可打开后牙咬合,使上下颌后牙脱离锁结,便于后牙前移及后牙尖窝关系的调整。结论上颌斜面导板能缩短治疗时间,使治疗效果更理想。     

Septoclasts expressing epidermal fatty acid-binding protein (E-FABP,FABP5) in endochondral ossification

BackgroundLong-chain fatty acids (LCFAs) and retinoic acid (RA) are abundant in the growth plates (GPs) of long bones; however, their roles have not been elucidated. We observed that epidermal fatty acid-binding protein (E-FABP/FABP5) with a high affinity for both LCFAs and RA is exclusively expressed in the septoclasts located at the chondro-osseous junction (COJ) of the GP.HighlightsE-FABP expressed in septoclasts is involved in both LCFA metabolism and RA signaling as an intracellular transporter of both LCFAs and RA. Septoclasts with shortened cytoplasmic processes are associated with cartilage resorptive activity downregulation because of E-FABP deficiency or excess or deficiency of RA. In ontogeny, the septoclasts are differentiated from the pericytes and involved in the resorption of the uncalcified matrix of the cartilage templates in endochondral ossification.ConclusionSeptoclasts originate from pericytes and express E-FABP to play crucial roles in uncalcified matrix resorption by LCFA metabolism and RA signaling during endochondral ossification.     

不同形状小型钛板在髁突骨折固定中的效果评价

目的评估3种不同形状小型钛板固定髁状突颈骨折的临床效果。方法回顾分析采用1块小型钛板治疗22例29侧髁状突颈骨折患者,其中用I形钛板固定10侧,L形钛板固定8侧,X形钛板固定11侧。结果在应用I板或L形板固定的病例中,2侧出现螺钉松动,5侧出现骨折段移位。而在应用X形板固定的病例中,未出现螺钉松动和骨折段的移位。结论应用1块X形钛板行髁状突颈骨折内固定,不仅具有双板的固定效果,而且有创伤相对较小,手术时间相对减少,节省费用等优点。     

个体化钛支架在构筑颌骨三维形态中的应用

目的　在运用快速成型技术制作的颌骨模型上作成个体化钛支架 ,以构筑颌骨三维形态。方法　 18例颌骨缺损患者进行个体化钛支架联合游离组织瓣修复重建。其中 10例上颌骨缺损以钛网支架重建上颌骨前壁、外侧及底壁 ,如内侧壁缺损则一并恢复 ,其口鼻创面以前臂皮瓣或串联腓骨肌瓣修复 ;8例下颌骨缺损以钛板支架塑形 ,联合游离腓骨 ,精确恢复下颌骨外形及髁突生理位置。结果　所有的病例随访 6～ 12个月 ,除 1例于术后9个月眶外侧壁复发外 ,其余未见肿瘤复发。皮瓣除 2例因术后放疗部分坏死外全部成活。所有患者面部外形均非常满意 ,张口度 2 .5～ 4cm ,正常进食。上颌骨重建病人无口鼻瘘 ,语音较为清晰 ,下颌髁突均在正常解剖生理位置 ,面部软组织亦很对称。结论　个体化钛支架应用于颌骨重建 ,能够较为精确地恢复颌骨外形 ,有利于术中引导移植骨准确对位 ,可避免术后的继发功能障碍 ,有效节省手术时间 ,其在复杂颅颌面疾病诊治中的应用前景非常乐观。     

Spatial frequency processing conditions on intraoral computed radiography

Radiographic information on the imaging plate was read with a pixel size of 50 μm×50 μm and recorded with 100 μm×100 μm. Various frequency-enhanced images were produced by an unsharp masking process that can maximize the spatial frequency enhancement at 0.25, 0.50, 1.00, 2.00, and 4.00 cycles/mm. Using these images, the effect of frequency enhancement processing for the X-ray diagnosis of normal anatomical structures and simulated bone changes on intraoral computed radiography was investigated. The imaging conditions under which the most valuable radiographic images for diagnosis of normal anatomical structures were obtained was a frequency type that diminished the low level density area, a non-linear gradation and an enhancement rank of 4 at the spatial frequency of 2.00 cycles/mm. These iamges projected a higher image quality than conventional periapical films. In addition, the intraoral computed radiography had equivalent or better ability to detect fine-simulated bone changes compared to conventional periapical films. These findings suggest that the spatial frequency enhancement area needed to obtain images with significant diagnostic value, equivalent to or better than conventional periapical film images, is 2.00 cycles/mm in intraoral computed radiography, with maximal spatial resolution of 5.00 cycles/mm.     

直丝弓矫治器结合小平导矫治前牙深覆(牙合)

目的 :总结直丝弓矫治器结合小平导矫治前牙深覆牙合的临床效果。方法 :选择安氏Ⅱ类错牙合 3 0例 ,男 12例 ,女 18例 ,年龄 11— 14岁。均采用直丝弓固定矫治器 ,结合上颌小平导打开咬合。矫治前拍摄头颅定位侧位片 ,待咬合打开 ,后牙有接触时拍阶段头颅定位侧位片。选择头影测量指标 2 2项 ,对测量结果进行t检验。结果 :MP -SN、PP -MP、S -Ar -Go三项指标在戴小平导前后均有显著性差异 ,说明下颌平面角增大 ,并且主要是下颌骨后旋的结果。S -Go、N -Me、ANS -Me在戴用后也有显著增大。这均有利于改善低角病例的面形。L1-MP(mm)、Overbite(mm )戴小平导后显著减小 ,而U 6-PP(mm)、L6-MP(mm)显著增大 ,说明下前牙明显压低 ,上下后牙明显升高。结论 :直丝弓矫治器结合上颌小平导矫治前牙深覆牙合是一种快速有效解除前牙深覆牙合的方法。     

可吸收钉板在上颌骨及全面部骨折中的应用

目的　评价可吸收钉板在上颌骨与全面部骨折中的应用。方法　选择2011年6月至2018年7月在武汉大学口腔医院口腔颌面创伤与颞下颌关节外科接受治疗的涉及上颌骨骨折的患者244例。全面部骨折的纳入标准是同时包含上颌骨骨折、颧骨颧弓眶骨骨折和下颌骨骨折。所有患者均主动要求使用可吸收钉板系统进行内固定。对其人口统计学信息、治疗情况和随访结果进行回顾性分析。结果　244例患者的上颌骨骨折部位全部使用可吸收钉板进行内固定，其中男145例，女99例；年龄6～73岁，平均35岁；上颌骨Le FortⅠ型骨折36例，Le Fort Ⅱ型骨折111例，Le Fort Ⅲ骨折型97例。涉及额骨骨折3例，鼻骨-眶-筛骨（NOE）复合体骨折42例，上颌骨矢状骨折37例，全面部骨折36例。全面部骨折患者中，颧骨颧弓眶骨、上颌骨、下颌骨同时使用可吸收钉板固定的有14例；仅颧骨颧弓眶骨、上颌骨同时使用可吸收钉板固定的有6例；仅颧骨颧弓眶骨使用可吸收钉板固定的有14例；另外2例患者的情况与上述三种分类均不符合。所有患者术前均有面部畸形，且出现咬合紊乱。复位和修复全面部骨折的方法按照“由简单到复杂”进行序列复位固定的原则。术后并发症情况：3例轻度错牙合畸形，1例颧骨部分缺损，1例眼球内陷，4例创伤瘢痕，2例眼睑下睑萎缩，2例颞肌萎缩。结论　灵活应用可吸收钉板进行上颌骨及全面部骨折复位固定具有可行性。软组织问题引起的手术后并发症，包括撕裂和不对称，难以避免。