透明质酸钠治疗颞下颌关节结构紊乱 临床随机对照试验的系统评价

目的 通过总结颞下颌关节腔内注射透明质酸钠的临床随机对照试验,评价其治疗颞下颌关节结构紊乱的有效性与安全性.方法 明确探究透明质酸钠治疗颞下颌关节结构紊乱的有效性与安全性的研究问题后,电子检索Medline、Cochrane图书馆临床随机对照试验库、荷兰医学文摘、欧洲灰色文献数据库和中国生物医学文献数据库,检索时间截至...     

The efficacy of intra-articular sodium hyaluronate in patients with reducing displaced disc of the temporomandibular joint

In this clinical trial, we examined the efficacy of intra-articular hyaluronic acid (HA) treatment in 38 patients with reducing displaced disc of the temporomandibular joint (TMJ). Subjects received two unilateral upper space injections of HA or physiological saline solution with 1 week apart. Efficacy was based on the following measurements: pain and sound intensity of the joint measured by visual analogue scale (VAS), modified Helkimo's clinical dysfunction index and the intensity of joint vibration during opening and closing the mouth measured by accelerometers. These measurements were performed before the first injection and 1 and 6 months after the last injection. In the treatment group (n=19), all measurements improved significantly at month 1 and at month 6 compared with the baseline (P < 0.01). The same measurements, in the placebo group (n=19), did not show any change, except for the pain intensity which improved at month 1 and month 6 (P < 0.05). The change in baseline measurements of all of the efficacy criteria at month 1 and at month 6 in the treatment group was significantly better compared with the change obtained with placebo at the same time intervals. This study demonstrates that intra-articular sodium hyaluronate (Orthovisc) injection into the TMJ is an effective treatment for a reducing displaced disc.     

Dissolution of porcine incisor pulps in sodium hypochlorite solutions of varying compositions and concentrations

BACKGROUND: The solubility of dental pulp tissue in sodium hypochlorite has been extensively investigated but results have been inconsistent; due most likely to variations in experimental design, the volume and/or rate of replenishment of the solutions used and the nature of the tissues assessed. Traditionally, the sodium hypochlorite solutions used for endodontic irrigation in Australia have been either Milton or commercial bleach, with Milton being the most common. Recently, a range of Therapeutic Goods Administration (TGA) approved proprietary sodium hypochlorite solutions, which contain surfactant, has become available. Some domestic chlorine bleaches now also contain surfactants. The purpose of this study was to perform new solubility assessments, comparing Milton with new TGA approved products, Hypochlor 1% and Hypochlor 4% forte, and with a domestic bleach containing surfactant (White King). METHODS: Ten randomly assigned pulp samples of porcine dental pulp of approximately equal dimensions were immersed in the above solutions, as well as representative concentrations of sodium hydroxide. Time to complete dissolution was measured and assessed statistically. RESULTS: White King 4% showed the shortest dissolution time, closely followed by Hypochlor 4% forte. White King 1% and Hypochlor 1% each took around three times as long to completely dissolve the samples of pulp as their respective 4% concentrations, while Milton took nearly 10 times as long. The sodium hydroxide solutions showed no noticeable dissolution of the pulp samples. CONCLUSIONS: The composition and content of sodium hypochlorite solutions had a profound effect on the ability of these solutions to dissolve pulp tissue in vitro. Greater concentrations provided more rapid dissolution of tissue. One per cent solutions with added surfactant and which contained higher concentrations of sodium hydroxide were significantly more effective in dissolution of pulp tissue than Milton.     

Saliva electrophoretic protein profiles in infants: changes with age and impact of teeth eruption and diet transition

Objective

The objective of this study was to describe the changes in salivary protein profiles in infants between the ages of 3 and 6 months, and to evaluate the impact of teeth eruption and introduction of solid foods on such profiles.

Design

73 infants were followed longitudinally at 3 and 6 months of age. Their whole saliva proteins were separated by SDS–PAGE electrophoresis and semi-quantified by image analysis. Amylase activity was also measured on a sub-sample of the population (n = 42 infants). Bands which abundance was significantly different between the two ages according to paired comparisons were identified by mass spectrometry techniques.

Results

Out of 21 bands, 13 were significantly different between 3 and 6 months of age. Two short variants of amylase increased in abundance with age, as did amylase activity. Other changes possibly translated developmental physiological events, for example maturation of the adaptive immune system. The balance between S-type cystatins and cystatins A and B was modified, in favour of S-type cystatins at 6 months of age. Teeth eruption resulted in an increase in albumin abundance, whilst introduction of solid foods was associated with higher levels of β-2 microglobulin and S-type cystatins.

Conclusions

Salivary profiles were modified substantially between the ages of 3 and 6 months. Both teeth eruption and diet had an impact on abundance changes for some proteins, revealing dynamic interactions between saliva proteome, oral physiology and diet.     

Toxicity of concentrated sodium hypochlorite used as an endodontic irrigant

AIM: To present a clinical case that illustrates the toxicity of concentrated sodium hypochlorite (NaOCl) on vital tissues. SUMMARY: The severe clinical consequences of extruding concentrated NaOCl into the periradicular tissues during root canal irrigation are described. After diagnosis of external resorption in tooth 34, endodontic treatment was initiated. Following irrigation with a concentrated NaOCl solution, a rapidly developing swelling and haematoma were visible. During the next few days, an extensive bruise and local necrosis of the oral mucosa developed. After healing of the involved tissues, the canal was prepared and obturated. At this time, no clinical symptoms remained. KEY LEARNING POINTS: * The use of concentrated NaOCl as a root canal irrigant might cause severe clinical problems when extruded into vital tissues. * The present report confirms the known toxicity of NaOCl to soft tissues following inadvertent extrusion. * To avoid extrusion, it is always prudent to confirm the length and integrity of the root canal system before irrigating with concentrated solutions.     

The effects of phenytoin and sodium valproate on the periodontal health of adult epileptic patients

The periodontal health of 30 adult epileptic patients treated with either sodium valproate or phenytoin was compared with a control group (n = 15) of otherwise healthy patients. The 3 groups were matched for age and sex. Patients on phenytoin therapy showed significantly higher plaque scores (P less than 0.05), gingival index (P less than 0.05) and pocketing (P less than 0.05) than patients in the control group. The % of gingival hyperplasia was significantly higher (P less than 0.05) in the phenytoin-treated patients than those on sodium valproate or in the control group. However, patients on phenytoin therapy had significantly less bone loss than those on sodium valproate (P less than 0.05) or in the control group (P less than 0.01). No significant differences were observed between the sodium valproate group and the control group on any of the parameters assessed. The results from this study would suggest that sodium valproate has no unwanted effects on periodontal health and may be considered a safe alternative, regarding the periodontal aspects, to phenytoin for the treatment of adult onset epilepsy.     

表面活性剂加氟化钠涂料对牙骨质表面显微硬度的体外研究

目的 :探讨表面活性剂加氟化钠涂料防治根面龋是否优于单独用氟化钠涂料或洗必泰涂料。方法 :在离体牙釉 -牙骨质界下开窗 4mm× 4mm ,分别经洗必泰加氟化钠涂料 (简称氟泰涂料 )、洗必泰涂料、氟化钠涂料等处理后进行矿化实验和抗龋实验 ,然后测定各组牙骨质表面的显微硬度。结果 :3组矿化实验前、后牙骨质表面硬度相比 ,氟泰涂料组和氟化钠涂料组较洗必泰组均有显著差异 ,且氟泰组比氟化钠组硬度值显著增加。抗龋实验前、后牙骨质表面显微硬度值相比 ,氟泰组、氟化钠组无显著差异 ,洗必泰组、对照组均有显著差异。结论 :用氟泰涂料改善牙骨质表面硬度与氟化钠组具相同效果 ,且优于氟化钠组。     

阿仑膦酸钠对延期再植干燥狗牙愈合的影响

目的探讨阿仑膦酸钠(alendronate,ALN)溶液浸泡对延期再植干燥狗牙愈合的影响。方法选用成年杂种狗2条,以上颌双侧第1、2、5牙和下颌双侧第2、3、5牙为受试牙,右侧受试牙归入实验组,左侧受试牙归入对照组。所有受试牙均先做根管处理。7d后拔牙,自然干燥60min;实验组牙再植前被置于1mmol/L的阿仑膦酸钠溶液中浸泡5min;对照组牙再植前不被作其他任何处理。再植12周后取出含牙骨块。经脱钙、切片、HE染色后,对牙根的愈合情况进行组织形态学评价。结果实验组牙骨质愈合的百分比均值明显高于对照组者(P<0.01);实验组牙根炎症性吸收与替代性吸收的百分比均值分别低于对照组者(P<0.05)。结论ALN能有效地改善延期再植干燥牙的愈合,增加牙骨质愈合,减少牙根炎症性吸收与替代性吸收。     

Effect of maintaining apical patency on irrigant penetration into the apical third of root canals when using passive ultrasonic irrigation: an in vivo study

Introduction

The complex anatomy of the root canal system has been shown to limit the penetration of irrigating solutions into the apical third; hence, the aim of this study was to determine whether the use of a patency file is related to the presence of a radiopaque irrigating solution in the apical third of human root canals after using passive ultrasonic activation in vivo.

Methods

Forty human root canals were randomly divided into two groups. Apical patency was maintained in one group (n = 21) during shaping and cleaning procedures with a no. 10 K-file 1 mm beyond the working length (WL) but not in the other group (n = 19). In both groups, the canals were shaped with the Pro Taper system (Dentsply-Maillefer, Ballaigues, Switzerland). Irrigation was performed with 1 mL of a solution prepared with a radiopaque contrast medium and sodium hypochlorite 5.25%, and then passive ultrasonic irrigation (PUI) was applied after the shaping procedure. Digital images were taken, and a calibrated reader determined the presence or absence of the irrigating solution in the apical third.

Results

There were significantly more canals with irrigant in the apical third after PUI when apical patency was maintained with a no. 10 file 1 mm beyond the WL than when apical patency was not maintained throughout the cleaning and shaping procedures (P = .02).

Conclusions

Maintaining apical patency and then using PUI improves the delivery of irrigants into the apical third of human root canals.