Eagle's综合征的诊断和治疗——附7例分析

茎突过长是一种较少见的解剖异常，偶而可伴随有口咽，头颈部的不适或疼痛，并被命名为Ｅａｇｌｅ＇ｓ综合征。本文对７例因茎突过长而致口腔、咽、颈部不适的患者，从发病原因、病理机制、临床表现和体征，诊断及治疗等各方面进行了回顾分析；总结了两种手术途径的适应征和优缺点。作者首次将３维ＣＴ重建成像技术用于Ｅａｇｌｅ＇ｓ综合征的诊断，认为与以前常用的Ｘ线检查方法相比，３维ＣＴ重建成像技术具有更为明显的优点     

PTEN、p27在口腔粘膜白斑和口腔癌组织中的表达及意义

目的　探讨抑癌基因PTEN、p2 7在口腔粘膜白斑 (oralleukoplakia ,OLK)和口腔癌 (oralsquamouscellcancer,OSCC)组织中的蛋白表达及意义。方法　应用免疫组化S -P法检测 10例正常口腔粘膜、2 5例口腔粘膜白斑 (其中白斑伴上皮异常增生 15例 ,白斑不伴上皮异常增生 10例 )及 32例口腔癌组织中抑癌基因PTEN和p2 7的蛋白表达情况。结果　正常口腔粘膜和白斑不伴上皮异常增生组织中PTEN和 p2 7蛋白全部阳性表达 ;白斑伴上皮异常增生组织中PTEN和 p2 7蛋白阳性表达率分别为93.3%、73.3%。OSCC组织中PTEN蛋白阳性表达率为71.9% ,其中高、中、低分化OSCC组织中PTEN蛋白阳性表达率分别为 85 .7%、75 %和 33.3% ,统计学分析表明PTEN在OSCC组织中的蛋白表达与组织分化程度明显相关 (P <0 .0 5 )。OSCC组织中 p2 7蛋白的阳性表达率为4 0 .6 % ,其中高、中、低分化OSCC组织中p2 7蛋白的阳性表达率分别为 4 2 .9%、4 1.7%和 33.3% ,统计学分析表明p2 7在OSCC组织中的蛋白表达与组织分化程度无明显相关 (P >0 .0 5 )。结论　OSCC组织中PTEN和 p2 7蛋白的阴性表达率较高 ,说明PTEN和 p2 7基因突变或缺失在OSCC的发生发展过程中起重要作用。     

An acute injection of Porphyromonas gingivalis lipopolysaccharide modulates the OPG/RANKL system and interleukin‐6 in an ovariectomized mouse model

Background/aims: In the present study, we attempted to develop a simulated model to explore the causal effects of periodontal pathogens on skeletal homeostasis in postmenopausal osteoporosis. Methods: Fifty‐three female adult ICR mice were randomly assigned to an experimental group (ovariectomized) or a control group. A single injection of Porphyromonas gingivalis lipopolysaccharide (P. gingivalis‐LPS, ATCC 33277) or Escherichia coli lipopolysaccharide (E. coli‐LPS) was administered intraperitoneally 4 weeks after an ovariectomy. Concentrations of interleukin‐6 (IL‐6), osteoprotegerin (OPG), and the receptor activator of nuclear factor‐κB ligand (RANKL) in serum were subsequently analyzed using an enzyme‐linked immunosorbent assay (ELISA). Results: Under stimulation with P. gingivalis‐LPS or E. coli‐LPS, the concentration of OPG rose in both groups. The serum level of RANKL showed a decreasing trend 24 h after the injection in both groups. After injection of P. gingivalis‐LPS in both the experimental and control animals, the OPG : RANKL ratio increased 24 h after the booster (22.26–620.99, P < 0.05). The serum level of IL‐6 in the experimental group significantly increased 1–6 h after administration of E. coli‐LPS and 1–3 h after administration of P. gingivalis‐LPS (P < 0.05). Conclusions: A single booster injection of P. gingivalis‐LPS induced short‐term changes in OPG, RANKL, and IL‐6 serum levels in this ovariectomized mouse model.     

口腔种植学虚拟现实三维模型素材库的初步建立

目的:建立口腔种植修复学教学用虚拟现实所需要的数字化三维模型库及相关素材,为制作三维互动化的虚拟现实教学课件提供基础条件。方法:利用现代计算机三维图形技术,在3Dsmax和Rhinoceros三维造型软件中,根据口腔种植学相关实体的三维形态,构建相应数字化三维模型,并结合平面图形软件制作模型贴图和材质。搭建1例口腔种植学典型三维虚拟场景,初步利用虚拟现实软件生成可执行的三维互动教学课件。结果:制作完成了部分常用口腔种植系统的相关三维模型,初步建立起了口腔种植修复学教学用虚拟现实的三维模型素材库,初步搭建了1例典型的口腔种植修复临床治疗场景,编辑生成了可直接操作的三维虚拟现实课件。结论:虚拟现实技术在口腔种植修复学教学中将会有广泛的应用,制作基于个人电脑的虚拟现实教学课件对口腔医学教学也有着较高的实用价值。三维模型素材库的初步建立为开发完善的口腔医学虚拟现实教学系统提供了先期研究基础和所必需的基本素材。     

三维点激光扫描仪的扫描可靠性研究

目的全面评价Roland LPX-1200三维点激光扫描仪的扫描可靠性，为临床研究提供参考。方法规则加工的仿牙齿样模具，使用Roland LPX 1200点激光扫描仪获得其数字化模型，通过比较不同起始位置的扫描结果，评价扫描仪的扫描可重复性；选择长，宽，高三维方向上65项测量项目，比较数字化模型测量与实物测量之间的差异，评价其扫描准确性。结果连续扫描以及改变扫描初始位置引起的扫描随机误差在0．02mm以内；数字化模型测量与实物测量之间的差值均数为0．0012±0．05mm，P〈0．05。结论扫描仪具有良好的可靠性，能满足正畸临床对模型测量精度的要求。     

槟榔碱诱导口腔角质形成细胞凋亡研究

目的:了解槟榔碱(arecoline)对体外培养的人口腔黏膜角质形成细胞(keratinocyte,KC)凋亡的影响。方法:不同浓度的槟榔碱以及在不同时间处理体外培养的KC,在荧光显微镜下观察KC凋亡形态学改变并计算凋亡百分率,用比色法检测Caspase-3活性的改变。结果:1)槟榔碱能以一定时间和浓度依赖方式诱导培养的KC发生凋亡,其细胞凋亡率较正常对照组明显增高(P<0.05)。2)槟榔碱作用KC,其Caspase-3活性较正常对照组明显增高(P<0.05)。结论:槟榔碱可诱导KC凋亡,Caspase-3可能参与了这一细胞凋亡过程的调控。KC凋亡异常可能是口腔黏膜下纤维性变的重要发病机理之一。     

腭穹隆形态对上颌全口义齿基托位移的影响

目的：研究腭穹隆形态对上颌全口义齿基托位移的影响。方法：模拟5种咬合状态，对尖、平、凹3种腭穹隆形态的上颌全口义齿的三维有限元模型进行加载。结果：3种腭穹隆形态上颌全口义齿基托在5种加载方式下，凹型腭穹隆形态基托的上腭前部及后缘区向黏膜组织的下压位移最大，基托边缘封闭区背离黏膜组织的位移最小。基托的位移方式因加载方式不同而不同。结论：上颌全口义齿基托位移方式及大小与加载方式有关；腭穹隆形态对上颌全口义齿基托位移方式无明显影响，对位移值大小有影响。     

A removal torque and histomorphometric study of commercially pure niobium and titanium implants in rabbit bone

Screw-shaped commercially pure (c.p.) niobium and c.p. titanium implants were inserted in rabbit bone. After a healing period of 3 months, a significantly higher removal torque was demonstrated to unscrew the niobium implants (average 32.9 Ncm) compared to the c.p. titanium implants (average 25.3 Ncm). In the histomorphometric part of the study, there were no significant differences in bone-to-metal contact between the 2 implant materials. An average of 41.1% bony contact was demonstrated for the niobium screws compared to an average of 37.2% for the c.p. titanium ones. Our removal torque findings could be related to the differences that we observed between the 2 implant surfaces as indicated by SEM. Since niobium implants showed a more irregular surface topography and niobium is a softer metal than c.p. titanium, this seems the most probable reason for the differences observed in removal torque between the 2 metals. Hypothetically, a more "positive biocompatibility" of the c.p. niobium in comparison to the c.p. titanium remains as another possible reason for the observed differences. However, against such a difference in biocompatibility between c.p. niobium and c.p. titanium, there is the very similar amount of bony contact registered in the histomorphometric analysis.     

应用3DSS、Solid Works及ALGOR建立下颌第一磨牙三维有限元模型

目的:利用三维扫描仪(3DSS)辅助建立下颌第一磨牙三维有限元模型。方法:利用3DSS扫描正常第一磨牙获取所需的三维表层点云图像,再利用Solid Works软件对其进行实体化操作,获得三维实体模型;最后在ALGOR软件中进行模型单元划分。结果:建立包括牙釉质、牙本质的下颌第一磨牙三维有限元模型,总节点数为209636个,四面体单元数为215238个。结论:利用3DSS、Solid Works、ALGOR辅助建模,大大提高了建模的精度、速度,为有限元生物力学分析研究提供了一种更为精确、简便的建模方法。     

Binding of Actinobacillus actinomycetemcomitans lipopolysaccharides to Peptostreptococcus micros stimulates tumor necrosis factor α production by macrophage‐like cells

Peptostreptococcus micros is a gram‐positive bacterium that has been associated with periodontitis and endodontic infections. In this study, we hypothesized that P. micros binds the immunomodulating component lipopolysaccharide derived from gram‐negative bacteria to increase its capacity to stimulate cytokine production by host cells. The ability of P. micros to bind Actinobacillus actinomycetemcomitans lipopolysaccharide was demonstrated by an enzyme‐linked immunosorbent assay and by immunoelectron microscopy. Pretreatment of P. micros cells with A. actinomycetemcomitans lipopolysaccharide was associated with a 49‐fold increase in tumor necrosis factor alpha production by human monocytic cells U937 differentiated into adherent macrophages, compared to the stimulation with untreated P. micros. This effect was suppressed by incorporating polymyxin B, a lipid A‐binding substance, during treatment of macrophage‐like cells with lipopolysaccharide‐coated P. micros cells. This is the first study reporting a binding interaction between lipopolysaccharide and a gram‐positive bacterium. This interaction represents a new mechanism that could promote the inflammatory response during periodontitis.