磨牙纵折保留修复的临床观察

目的:探讨利用桩核烤瓷冠辅以牙龈切除术或牙冠延长术修复纵折至龈下的磨牙,以提高纵折磨牙保存成功率的方法。方法:对56例劈裂至龈下的第一磨牙去除牙折片后采用镍铬合金桩核加3种不同种类烤瓷冠(镍铬合金烤瓷冠、金铂合金烤瓷冠、IPS EmpressⅡ铸瓷冠)进行修复,部分配合牙冠延长术或牙龈切除术,随访观察1年,比较直接修复和配合牙周手术对修复效果的影响,以及不同种类烤瓷冠对修复效果的影响。结果:纵折磨牙拔除牙折片后采用桩核烤瓷冠直接修复和配合牙冠延长术修复,随诊观察1年后的修复有效率分别为80%和94.4%,后者治疗效果好于前者,差异有统计学意义。两种修复方法中,失败者均出现在镍铬合金烤瓷冠修复中。结论:修复劈裂至龈下的纵折磨牙采用桩核烤瓷冠配合牙冠延长术或牙龈切除术是一种有效的治疗方法,贵金属烤瓷冠和全瓷冠的应用会进一步提高修复效果。     

Postauthorization safety surveillance of ADVATE [antihaemophilic factor (recombinant), plasma/albumin‐free method] demonstrates efficacy,safety and low‐risk for immunogenicity in routine clinical practice

Summary. Postauthorization safety surveillance of factor VIII (FVIII) concentrates is essential for assessing rare adverse event incidence. We determined safety and efficacy of ADVATE [antihaemophilic factor (recombinant), plasma/albumin‐free method, (rAHF‐PFM)] during routine clinical practice. Subjects with differing haemophilia A severities and medical histories were monitored during 12 months of prophylactic and/or on‐demand therapy. Among 408 evaluable subjects, 386 (95%) received excellent/good efficacy ratings for all on‐demand assessments; the corresponding number for subjects with previous FVIII inhibitors was 36/41 (88%). Among 276 evaluable subjects receiving prophylaxis continuously in the study, 255 (92%) had excellent/good ratings for all prophylactic assessments; the corresponding number for subjects with previous FVIII inhibitors was 41/46 (89%). Efficacy of surgical prophylaxis was excellent/good in 16/16 evaluable procedures. Among previously treated patients (PTPs) with >50 exposure days (EDs) and FVIII ≤2%, three (0.75%) developed low‐titre inhibitors. Two of these subjects had a positive inhibitor history; thus, the incidence of de novo inhibitor formation in PTPs with FVIII ≤2% and no inhibitor history was 1/348 (0.29%; 95% CI, 0.01–1.59%). A PTP with moderate haemophilia developed a low‐titre inhibitor. High‐titre inhibitors were reported in a PTP with mild disease (following surgery), a previously untreated patient (PUP) with moderate disease (following surgery) and a PUP with severe disease. The favourable benefit/risk profile of rAHF‐PFM previously documented in prospective clinical trials has been extended to include a broader range of haemophilia patients, many of whom would have been ineligible for registration studies.     

两种非贵金属烤瓷冠对基牙龈沟液量及其成分的影响研究

目的：探讨钛合金和钴铬合金烤瓷冠对基牙牙周组织的影响。方法：选择需要制作钛合金和钴铬合金烤瓷冠的临床病例各50例,于修复前,戴临时冠1周,戴牙1个月、3个月、6个月提取龈沟液,检测其质量、内毒素、碱性磷酸酶（ALP）及天门冬氨酸基转移酶（AST）活性含量。结果：钛合金和钴铬合金烤瓷组戴临时冠1周时龈沟液量、内毒素、ALP及AST量均有所增高（P〈0.05）;之后4项指标均下降并维持稳定,与牙体预备前无显著性差异（P〉0.05）。结论：两种非贵金属烤瓷冠对基牙牙周组织无不良影响。     

国产二氧化锆修复体在口腔修复中的应用效果分析

目的：分析国产二氧化锆修复体在口腔修复中的应用效果。方法选取2010年1月~2013年12月在笔者所在医院进行口腔修复的患者112例（140牙）作为研究对象,随机分为观察组56例（77牙）,采用国产二氧化锆全瓷修复体进行修复,对照组患者56例（63牙）,采用普通金属烤瓷修复体进行修复,对比两组患者的修复效果。结果观察组患牙治疗后的边缘密合性明显优于对照组,对于修复体折断绷瓷现象明显低于对照组,差异均有统计学意义（P〈0.05）。治疗半年后随访,观察组患者患牙牙龈均正常,对照组出现牙龈异常共25牙,发生率为39.68%。结论国产二氧化锆修复体有良好的颜色选配性、稳定性、形态的可塑性,完全可以取代金属烤瓷修复体,值得临床推广。     

不同材料烤瓷冠修复后对牙周组织的影响分析

目的:探讨不同材料烤瓷冠修复后对牙周组织的影响。方法:将前牙损伤患者60例根据烤瓷冠修复基底冠材料分为氧化锆组和金铂合金组各30例,常规进行修复。结果:所有患者都成功完成修复,两组修复前牙龈指数、牙龈龈沟探诊指数与龈沟液含量对比差异无统计学意义,修复后两组上述指标组间对比差异有统计学意义(P<0.05)。结论:基于金铂合金的烤瓷熔附金属全冠修复体的临床应用对于牙周组织的炎性改变少,有比较好的应用前景。     

烤瓷冠牙体折断后烤瓷冠的再利用

目的:探讨铸造桩核修复牙体折断烤瓷牙冠的方法及临床意义.方法:对30颗患牙采用铸造桩核使原烤瓷冠在已折断的牙上继续使用,观察其临床效果.结果:30颗患牙的铸造桩核就位顺利,烤瓷冠边缘密合,患者满意,修复后随访5年成功率93%,另两颗牙两年后发生了根折,再治疗困难,预后差而失败.结论:铸造桩核修复牙体折断的烤瓷牙冠,方法简便、省时、固位好,值得临床推广应用.     

金属烤瓷冠在折断前牙修复中的应用

目的金属烤瓷冠在折断前牙修复中的应用效果。方法对折断前牙236例391颗牙齿的烤瓷冠进行临床分析。结果出现冠脱位占2.3%,色泽不够理想占11.76%,崩瓷占9.97%,牙龈炎占1.53%,疼痛占0.77%,继发龋0%。结论折断前牙的金属烤瓷冠的修复应该注意适应症的选择;根管桩的植入质量以及修复体的形态、功能和颜色是折断前牙金属烤瓷冠修复成功的关键。