平阳霉素地塞米松联合治疗口腔颌面部脉管畸形

目的 评价平阳霉素(PYM)与地塞米松联合应用病变内注射治疗口腔颌面部各种脉管畸形的疗效。方法 采用PYM和地塞米松联合病变内注射治疗口腔颌面部脉管畸形患者200例(225个瘤体)5～7d注射一次，3～5次为一个疗程。结果 200例患者治疗1～5次后，经过6～36m随诊，治愈率和基本治愈率为86．5％，好转为11％，总有效率达97．5％。静脉畸形、淋巴管畸形、混合性畸形、微静脉畸形的治愈率和基本治愈率分别为91．4％、80％、90．5％、36．3％，而动静脉畸形应用PYM与地塞米松联合治疗基本无效，2．5％的患者在治疗过程中出现溃疡，3．5％出现发热副反应。结论 PYM和地塞米松联合瘤内注射是治疗口腔颌面部脉管畸形一种较佳的治疗方法，疗效高，安全可靠，但应对脉管畸形病变进行正确分类，掌握其适应证。     

Methodological Considerations in the Analysis of Cost Effectiveness in Dentistry

Cost-effectiveness analysis is a technique applied with increasing frequency to help make rational decisions in health care resource allocation. This article reviews the ten general principles of cost-effectiveness analysis outlined by the Office of Technology Assessment of the US Congress and describes a model for such analyses used widely in medicine, but only recently applied in dentistry. The imperative for the formulation of the best current information on both the effectiveness of dental practices and their costs is made more urgent because of the now universally recognized belief that resources available to meet the demands for health care are limited. Today's environment requires critical allocation decisions within categorical health problems, across diseases, or relative to other health problems. If important health benefits or cost savings are to be realized, then these analytic approaches must become widely understood, accepted, and appropriately applied by key decision makers in the dental health sector.     

Learning root debridement with curettes and power-driven instruments. Part II: Clinical results following mechanical,nonsurgical therapy

BACKGROUND, AIMS: In a manikin study we recently assessed how effectively student operators were able to learn scaling with curettes (GRA) and power-driven instruments (PP). Calculating the debrided root area effectiveness was low in both groups without systematic training or without a motivational program. After 10 weeks (20 h) of training, operators reached a high effectiveness of 84.7% (GRA) and 81.6% (PP). The purpose of the present study was to evaluate the clinical outcome of nonsurgical treatment as performed by these student operators. METHODS: In a clinical trial, 19 students trained in the use of Gracey curettes for 10 weeks (=20 h) (GRA10) and Periopolisher system for 1 week (=2 h) (PP1), and 20 students trained in the use of Gracey curettes for 1 week (GRA1) and the Periopolisher for 10 weeks (PP10) treated one patient each in a split-mouth design. At baseline and 6 months, we recorded probing depth (PD), probing attachment level (PAL) and bleeding on probing (BOP) by computer-assisted probing. Statistical analysis was carried out for moderate (category B) and deep sites (category C). Groups were compared using Student's t-tests (p<0.05). RESULTS: Category B sites showed a PD reduction of 1.2/1.0 mm (GRA10/GRA1) and 1.1 mm (PP10/PP1). PAL gain was 0.5/0.3 mm (GRA10/GRA1) and 0.4/0.2 mm (PP10/PP1). In category C sites, PD reduction was 2.1/2.3 mm (GRA10/GRA1) and 2.0 mm (PP10/PP1) with a PAL gain of 0.6/0.9 mm (GRA10/GRA1) and 0.4 mm (PP10/PP1). BOP was significantly lower in all groups. CONCLUSION: The results show that student operators who had received a systematical training on manikins and had attained different effectiveness results were able to treat periodontally diseased patients successfully using both Gracey and Periopolisher instruments.     

Biofilm reduction and staining potential of a 0.05% chlorhexidine rinse containing essential oils

To cite this article:
Int J Dent Hygiene 9 , 2011; 60–67
DOI: 10.1111/j.1601‐5037.2009.00437.x
Hofer D, Meier A, Sener B, Guggenheim B, Attin T, Schmidlin PR. Biofilm reduction and staining potential of a 0.05% chlorhexidine rinse containing essential oils. Abstract: Objectives: To assess the biofilm reduction and discolouration potential of a new 0.05% chlorhexidine (CHX) digluconate solution, containing additional essential oil and alcohol components, compared with that of standard control CHX solutions (0.05% and 0.2% CHX). Methods: The potential to reduce total viable counts of growing mixed microbial populations was examined using the Zurich biofilm model. Biofilms were created on sterile pellicle‐coated hydroxyapatite discs and exposed to test substances at different time points. After 64.5 h, mean colony‐forming units and SDs were determined. Colour change measurements using light reflection analysis were carried out on saliva preconditioned bovine dentin and enamel samples, as well as on composite and glass ceramic restorative materials, after successive immersions in a standardized tea brew and the CHX solutions. Results: The test solution was able to reduce biofilm formation by 3 log steps compared with a negative (water) control. This was significantly less effective than the standard control CHX solutions, which reduced viable counts by 6 log steps. Both the test and control solutions exhibited staining on all surfaces. Staining was most pronounced on dentin, followed by enamel and to a significantly lesser degree on the restorative materials. Furthermore, the staining caused by the test solution on these restorative materials was generally lower than that caused by the control solutions. Conclusions: The test solution exhibited an antimicrobial activity. The composition, however, seems to hamper its effectiveness. Accordingly, it produced statistically significant, although by trend less, staining on restorative materials.     

单个前牙种植体即刻种植和即刻修复的牙龈美学效果评价

目的:评价种植体即刻种植即刻修复的牙龈美学效果及患者对美观的满意度.方法:观察28例患者28枚ITI种植体在单个前牙种植体即刻种植即刻临时冠修复,对种植义齿周围的牙龈美观状况及相应的软组织健康状况进行观察,并对患者满意度进行调查,托槽弓丝固定3个月,6个月后行永久烤瓷冠修复.结果:12个月时所有种植体都发生了骨结合现象,种植义齿周围的软组织外形正常,牙问乳头外形大小与菌斑附着,龈炎并不相关.患者对即刻种植修复的美学效果均非常满意.结论:在严格掌握适应证的前提下,单个前牙即刻种植修复比延期修复可获得更佳的软组织外形,尤其是牙间乳头外形大小达到更理想的美学效果.     

口腔鳞癌4种新辅助化疗方案的成本-效果分析

目的 :探讨口腔鳞癌 4种新辅助化疗方案所产生的经济效果。方法 :收集我院 1995 .6.-2 0 0 3 .5 .间12 2例进行了 2个疗程新辅助化疗的住院口腔鳞癌患者 ,随机分为 4组 (Ⅰ～Ⅳ ) ,Ⅰ组 :卡铂 平阳霉素 氨甲碟呤 (CPM ) ;Ⅱ组 :平阳霉素 氨甲碟呤 (PM ) ;Ⅲ组 :卡铂 5 -氟脲嘧啶 (CF) ;Ⅳ组 :平阳霉素 (P) ,应用药物经济学的成本 -效果分析方法对 4种口腔鳞癌新辅助化疗方案进行评价。结果 :两个化疗疗程后 ,Ⅰ～Ⅳ组有效率分别为 61.3 6%、5 8.0 6%、65 .3 9%、42 .86% ;成本 -效果比分别为 49.2 9、78.63、2 9.11、10 2 .10。结论 :在 4种新辅助化疗方案中 ,CF方案疗效最好而成本 -效果比最低 ,因而CF方案为临床最合理方案     

Caries reductions related to the use of fluorides: a retrospective cohort study

AIM: To test whether topical fluoride regimes provided additional caries protection to the first molar teeth of children exposed to fluoridated toothpaste and optimally fluoridated water supplies. PARTICIPANTS AND METHODS: This two-year retrospective cohort study included 660, 8-year-old-children. A cluster sampling technique was used to select three groups of 220 children. Group 1 was selected from schools using fluoride mouthrinses (Programme 1). Group 2 was selected from schools applying fluoride gel (APF 1.23%) in addition to the weekly fluoride mouthrinse (Programme 2). Oral health education and oral hygiene instruction were provided to both groups. The control group was selected from schools in the same area that had not adopted any oral health preventive programme. All children were exposed to optimally fluoridated water and fluoridated toothpaste for the last two years or more. Participants were examined for DMFS scores of their first molars using WHO criteria by one examiner (MLRS). RESULTS: The percentage caries free children in Control, Programme 1 and Programme 2 were 55%, 65% and 65.5%, respectively. The differences between Programme 1 and 2 in relation to the Control Group were statistically significant (P < 0.05). There was no difference between Programme 1 and 2 (P = 0.92). CONCLUSIONS: Weekly fluoride rinsing combined whether or not with fluoride gel applications once every three months, provided additional caries-preventive benefits to children with high levels of caries and exposed to optimally fluoridated drinking water and toothpaste. There was no difference in caries levels between children having fluoride rinses and those having fluoride rinses and fluoride gel.     

达格列净治疗84例糖尿病肾病的临床疗效观察

目的：描述在真实世界中达格列净对于糖尿病肾病治疗的疗效和安全性。方法： 在我院服用达格列净的84例糖尿病肾病患者中,回顾性分析达格列净对于血糖、血压、体重、血脂、蛋白尿、肾功能的疗效,比较治疗前后临床治疗的差异性,并记录治疗过程中的副作用以评价其安全性。结果：84例患者平均年龄52.47岁,男性56 例(66.7%),平均糖尿病病史8年,合并肥胖或超重34例(40.4%),合并糖尿病视网膜病变患者47 例(56.0%),高血压69 例(82.1%),平均24小时蛋白尿3.1 g/天,平均eGFR 87.1 ml/min/m²。在随访过程中,共有12例(14.3%)停用达格列净(男性4例、女性8例)。女性更容易发生泌尿系感染(p=0.024,OR=10.0)。达格列净显著降低糖化血红蛋白(p<0.001),空腹血糖(p<0.001)、胰岛素用量(p<0.001)、体重(p=0.02)、BMI(p=0.02)、收缩压(p=0.04)、蛋白尿(p=0.05)。结论：本研究依据真实世界的观察性数据,支持达格列净相对安全,是糖尿病肾病治疗的一个良好选择。     

经口腔前庭入路腔镜甲状腺全切除术治疗cN0甲状腺乳头状癌临床研究

目的 探讨经口腔前庭入路腔镜全甲状腺切除术（TOETVA）的有效性及安全性。方法 回顾性分析2017年7月至2019年7月浙江大学医学院附属第二医院甲状腺外科收治的行全甲状腺切除术且病理学检查确诊为甲状腺乳头状癌（PTC）的110例病人的临床资料,术前影像学检查提示无淋巴结转移（cN0）。其中51例行TOETVA（经口组）,59例行开放甲状腺手术（开放组）,对比两组临床病理学指标、手术效果以及随访情况。结果 两组病人术中喉返神经信号减弱比例、中央区淋巴结清扫数目、单双侧甲状腺清扫比例、淋巴结转移阳性率、阳性淋巴结数目及术后并发症（声音嘶哑、饮水呛咳、暂时性甲状旁腺功能减退及感染）差异均无统计学意义（P＞0.05）。术后随访6个月,经口组与开放组病人的Tg和PTH水平差异无统计学意义（P=0.560、0.206）,且均未发现两组有甲状腺残留及甲状腺癌复发转移征象。结论 TOETVA在有效性及安全性方面不劣于开放手术,且体表无手术瘢痕,尤其适合有美容要求的临床低危PTC病人。