自酸蚀和全酸蚀粘接系统对复合树脂修复术后敏感的影响

目的探讨自酸蚀及全酸蚀粘接系统对复合树脂充填术后敏感的影响。方法需行Ⅰ、Ⅱ类洞修复的患牙120颗,抽签法随机分为6组,每组20颗牙;常规预备洞型;各组分别使用自酸蚀粘接剂：FL．BOND、Adper Prompt、Clearfil SE BOND、Xeno、ONE-UP BONDF和全酸蚀粘接剂Prlmer＆Bond NT粘接,行复合树脂充填,术后1、7、30、90d复诊,评价术后敏感的发生率及敏感程度。结果术后敏感的发生率各组间无统计学差异;术后1、7d全酸蚀Primer＆Bond NT组术后敏感程度明显高于其他各自酸蚀组,各自酸蚀组问无明显差异;术后30、90d各组间术后敏感程度均无显著差异。结论全酸蚀粘接剂在术后7d内导致的术后敏感程度明显重于牙本质自酸蚀粘接剂,术后30d全酸蚀粘接剂与自酸蚀粘接剂均较少引起术后敏感。     

2例静滴头孢噻肟钠致过敏反应的护理

头孢噻肟钠为第三代头孢菌素,抗菌谱广,适用于敏感细菌所致的肺炎及其他下呼吸道感染、尿路感染、脑膜炎、败血症等,现将我科应用头孢噻肟钠致过敏反应的护理报告如下。1病例介绍病例1患者,女性,22岁,咳嗽5天,于2006年11月5日来门诊就诊,患者神志清,精神好,皮肤无异常。既往无使用青霉素及头孢类药物过敏史,门诊诊断为“上呼吸道感染”。遵医嘱给予等渗盐水250ml加头孢噻肟钠3.0静滴,滴速60滴/min。当滴入约20ml左右,患者感到面部瘙痒难忍,并出现散在丘疹,立即停用头孢噻肟钠,给予NS 10ml 地塞米松10mg静推,扑尔敏10mg肌注,于10min后,患者…     

The efficacy of three desensitizing agents in treatment of dentine hypersensitivity

PURPOSE: The purpose of this study was to evaluate the efficacy of three desensitizing agents vs. placebo. MATERIALS AND METHODS: One hundred and six hypersensitive teeth of 26 patients were included in this study, and the baseline hypersensitivity level of all teeth was established as 'moderate' by using Visual Analogue Scale (VAS). The teeth were divided into four groups: to the first group 5% potassium nitrate bio-adhesive gel, to the second 2% sodium fluoride bio-adhesive gel and to the third one step adhesive system Prompt L-Pop were applied as desensitizing agents. Group 4 was the control group in which a desensitizer-free bio-adhesive gel was used as placebo. Post treatment and eighth week control measurements were recorded on VAS. RESULTS: It was observed that the efficacy of three desensitizing agents did not differ from each other (P >0.05) and except for placebo all reduced moderate dentin hypersensitivity effectively (P <0.05). Clinical relevance: Five per cent potassium nitrate, 2% sodium fluoride bio-adhesive gels and one-step bonding agent Prompt L-Pop were effective in reducing moderate dentine hypersensitivity.     

瞬时受体电位通道A1和瞬时受体电位通道M8在冷过敏中的作用

背景 冷过敏是炎性痛和神经病理性疼痛的一个常见症状,其内在机制尚不清楚. 目的 阐明瞬时受体电位通道A1 （transient receptor potential cation channel,subfamily A,member 1,TRPA1）和瞬时受体电位通道M8（transient receptor potential melastatin 8,TRPM8）参与冷过敏的机制. 内容 综述TRPA1和TRPM8的分子结构和门控机制及其在有害的冷、炎性痛和神经病理性疼痛的冷过敏形成、维持中的作用等方面的研究. 趋向 深入研究TRPA1和TRPM8在冷过敏发生中的作用,有助于阐明冷过敏的机制,并为开发拮抗剂提供理论依据.     

Strong association between smoking and the risk of revision in a cohort study of patients with metal‐on‐metal total hip arthroplasty

Thus far the ability to predict who will develop early failure following the insertion of a metal‐on‐metal (MoM) bearing has been very limited. Our objective was to assess the effect of smoking on failure rates in patients with MoM bearing, compared with patients with ceramic‐on‐polyethylene (CoP) bearing. From a prospective hospital‐based registry we included all primary THAs operated upon between 1/2001 and 12/2011 with MoM or CoP bearings of the same cup design and head size (28 mm). We compared revision rates through 10/2013 classified by smoking status and type of bearing. We included 1,964 patients (median age 71, 57% women), 663 with MoM and 1,301 with CoP bearing. Mean follow‐up was 6.9 years (range 1.8–12.8). Revisions were required for 56 THAs. In patients with MoM bearing the adjusted incidence rate of revision among ever‐smokers was four times greater than among never‐smokers (95% CI 1.4–10.9). Among those with CoP bearing, the rate ratio was only 1.3 (95% CI 0.6–2.5). We found a strong association between smoking and increased failure of MoM THAs. In contrast, the association was weak for patients with CoP bearing. Smoking might be a trigger or an effect amplifier for adverse reactions to metal debris from MoM bearings. © 2014 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. J Orthop Res 32:762–768, 2014.     

Remineralization potential of fully demineralized dentin infiltrated with silica and hydroxyapatite nanoparticles

Objective

This study investigates the potential of a novel guided tissue regeneration strategy, using fully demineralized dentin infiltrated with silica and hydroxyapatite (HA) nanoparticles (NPs), to remineralize dentin collagen that is completely devoid of native hydroxyapatite.

Methods

Dentin blocks were fully demineralized with 4 N formic acid and subsequently infiltrated with silica and HA NPs. The remineralizing potential of infiltrated dentin was assessed following a twelve week exposure to an artificial saliva solution by means of TEM, EDS and micro-CT. Measurements were taken at baseline and repeated at regular intervals for the duration of the study to quantify the P and Ca levels, the mineral volume percentage and mineral separation of the infiltrated dentin specimens compared to sound dentin and non-infiltrated controls.

Results

Infiltration of demineralized dentin with nano-HA restored up to 55% of the P and Ca levels at baseline. A local increase in the concentration of calcium phosphate compounds over a period of twelve weeks resulted in a higher concentration in P and Ca levels within the infiltrated specimens when compared to the non-infiltrated controls. Remineralization of demineralized dentin with silica NPs by immersion in artificial saliva was the most effective strategy, restoring 20% of the P levels of sound dentin. Micro-CT data showed a 16% recovery of the mineral volume in dentin infiltrated with silica NPs and a significant decrease in the mineral separation to levels comparable to sound dentin.

Significance

Demineralized dentin infiltrated with silica NPs appears to encourage heterogeneous mineralization of the dentin collagen matrix following exposure to an artificial saliva solution.     

环孢素 A 对大鼠牙槽骨内 DMP1 C 末端和 OPN 表达的影响

目的：观察环孢素A（cyclosporinA,CsA）对大鼠牙槽骨内牙本质基质蛋白1（dentinmatrixprotein,DMP1）C末端和骨桥蛋白（osteopontin,OPN）表达的影响。方法：30只7周龄健康雄性Wistar大鼠,随机等分为对照组和实验组,每组再随机等分为20d、30d和40d3个亚组,实验组大鼠喂饲CsA（30mg／k·d）。免疫组化法染色下颌第一磨牙颊舌向石蜡切片,光镜下观察DMP1C末端和OPN在牙槽骨内的表达情况。结果：与对照组大鼠比较,实验组大鼠牙槽骨内DMP1C末端表达明显下调,OPN表达明显上调;在本实验周期内,上述变化随实验时间的延长而加重。结论：CsA影响大鼠牙槽骨内矿化相关非胶原蛋白DMP1C末端和OPN的表达,推测CsA可能抑制大鼠牙槽骨的矿化。     

三种牙本质脱敏剂治疗（牙合）支托窝牙本质敏感效果分析

目的观察比较诺华敏（NovaMin）、格鲁玛脱敏剂（Gluma）和劲润牙本质保护膜（HybridCoat）3种脱敏剂对验支托窝牙本质敏感治疗的效果。方法选择175颗制备验支托窝的天然牙,随机使用NovaMin、Gluma和HybridCoat进行脱敏,NovaMin组56颗,Gluma组60颗,HybridCoat组59颗,使用视觉模拟评分法记录其敏感度,比较其在连续脱敏5d后即刻、1个月、2个月和3个月的脱敏效果。结果3组患者（牙合）支托窝连续脱敏治疗后,NovaMin组在1个月（P=0．027）、2个月（P=0．023）时的脱敏有效率均高于Gluma组,Gluma组（P=0．040）和HybridCoat组（P=0.012）的即刻脱敏有效率均高于各自3个月时的脱敏有效率,但3个月时组间脱敏有效率差异均无统计意义（P〈0．05）。连续脱敏治疗后,NovaMin组的即刻VAS值高于Gluma组和HybridCoat组（P〈0．05）,而在治疗后1个月和2个月,NovaMin组的VAS值均低于另外2组（P〈0．05）,到3个月时,3组的VAS值差异无统计学意义（P〉0．05）。结论NovaMin脱敏效果持久性好于Gluma和HybridCoat。