三种根管预备器械预备弯曲根管的临床研究

目的　比较三种根管预备器械预备后牙弯曲根管的临床情况 ,从而评价镍钛机动根管预备器械的临床应用前景。方法　研究对象为年轻下颌第一恒磨牙 30例 ,分别采用手动不锈钢器械、手动镍钛器械和机动镍钛器械进行根管预备 ,治疗前后分别拍摄可高度重叠的X线片 ,通过计算机扫描和放大比较根管拉直情况以及根尖孔敞开、台阶和侧穿的发生率。并记录各组的操作时间和器械折断发生率。结果　对于低度弯曲的根管 ,不锈钢组比镍钛组更易造成根管拉直 (P <0 .0 1)。对于高度弯曲的根管来说 ,不锈钢组与镍钛组 ,相差更为明显 (P <0 .0 1)。治疗失败在各组均有发生 ,操作时间机动组比手动组要快 (P <0 .0 1)。结论　机动镍钛根管预备器械具有良好的临床应用前景     

Comparative analysis of dental procedure mix in public and private dental benefits programs

BackgroundThere is little published research on whether public and private dental benefits plans affect the types of oral health care procedures patients receive. This study compares the dental procedure mix by age group (children, working-age adults, older adults), dental benefits type (Medicaid and Children’s Health Insurance Program, private), and level of Medicaid dental benefits by state (emergency only, limited, extensive).MethodsThe authors extracted public dental benefits claims data from the 2018 Transformed Medicaid Statistical Information System. To compare procedure mix with beneficiaries who had private dental benefits, the authors used claims data from the 2018 IBM MarketScan dental database. The authors categorized dental procedures into specific service categories and calculated the share of procedures performed within each category. They analyzed procedure mix by age, plan type (fee-for-service, managed care), and adult Medicaid benefit level.ResultsAside from orthodontic services, the dental procedure mix among children with public and private benefits is similar. Among adults with public benefits, surgical interventions make up a higher share of dental procedures than routine preventive services.ConclusionsChildren with public benefits have a procedure mix comparable with those with private benefits. There are substantial differences in procedure mix between publicly and privately insured adults. Even in states that provide extensive dental benefits in Medicaid, those programs primarily finance invasive surgical treatment as opposed to preventive treatment.Practical ImplicationsThere is a need to assess best practices in publicly funded programs for children and translate those attributes to programs for adults for more equitable benefit design and care delivery across public and private insurers.     

树脂基托、钛基托全口义齿戴用前后语音效果的对比研究

目的对全口义齿初戴前后的临床语音适应效果做出主观评价。方法以患者自评和语音专业人员共同评价汉语语音清晰度的方法,分析30例全牙列缺失患者在义齿初戴前、初戴时、初戴后1、2、4、8周的语音变化规律。结果全口义齿初戴时,两实验组均感觉发音不适,初戴1周后,金属基托组已感觉能适应义齿,塑料基托组需2周以上时间。语音清晰度测评显示,义齿初戴后1周,两组之间有显著性差异(P<0.05),此时金属基托组已显示与初戴前有非常显著差异(P<0.01),塑料基托组需2周以上时间。结论减少全口义齿基托厚度,重建腭皱形态,有助于牙列缺失患者语音功能的恢复,其语音清晰度值较高。     

Investigation of MYH14 as a candidate gene in cleft lip with or without cleft palate

Clefts of the orofacial region are among the most common facial defects and are caused by abnormal facial development during gestation. Cleft lip with or without cleft palate (CL/P) is a birth defect with a complex etiology resulting from a mixture of genetic and environmental factors. In the present study we considered myosin 14 ( MYH14 ) as a candidate gene for CL/P. This gene codes for the heavy chain of non-muscle myosin IIC (NMMHC-IIC), maps in the OFC3 region, and shares significant homology with myosin 9, a gene that our group has recently seen to be involved in CL/P. A linkage disequilibrium investigation was conducted with six single nucleotide polymorphisms in MYH14 and a sample of 239 CL/P nonsyndromic patients and their parents. Our family-based investigation provided no evidence of association between MYH14 and CL/P alleles. These data do not support the involvement of MYH14 in CL/P among the Italian population.     

Modified condylotomy versus conventional conservative treatment in painful reciprocal clicking—a preliminary prospective study in eight patients

Modified condylotomy may be relevant in severe painful reciprocal clicking of the temporomandibular joint (TMJ) where conservative treatment is insufficient. The effect of the modified condylotomy was analyzed and compared with conventional nonsurgical treatment in a randomized pilot study of eight patients, 19–44 years of age, with severe painful reciprocal clicking. Before and after treatment, assessments were performed by subjective reports, clinical recordings, and blinded evaluations of radiography and magnetic resonance imaging (MRI). Based on the clinical evaluations before treatment, all conditions were disc displacements with reduction and arthralgia (Research diagnostic criteria for temporomandibular disorders), but based on MRI, one patient had disc displacement without reduction and another had normal disc position. The treatment effect was significantly better and the disorders were significantly more reduced with condylotomy than with conventional nonsurgical treatment (P < 0.05, Mann–Whitney U test). In the surgical group, the clicking and locking had disappeared, the pain during function was significantly reduced (P < 0.05, Friedman ANOVA), and in two patients the disc position was normalized. The clicking still persisted in the nonsurgical patients and the disc position was unchanged. Our conclusion is that modified condylotomy is a promising option to reduce symptoms and signs in severe painful reciprocal clicking.     

五倍子水提取物去除根管内玷污层的扫描电镜观察

目的:观察五倍子对根管内玷污层的去除效果。方法:72个离体单根牙随机分为9组,冲洗液为五倍子组(分别为200、100、50、25、12.5、6.25mg/mL)、30mL/L过氧化氢液加生理盐水组、170g/LEDTA加52.5g/LNaOCl组(阳性对照)、双蒸水组(阴性对照)。根管预备后用各冲洗液冲洗,选根中部分进行扫描电镜观察。样本分为10个区,分别评分,结果进行统计学分析。结果:170g/LEDTA加52.5g/LNaOCl组去除玷污层效果最好,但管周牙本质有过度脱矿现象。25、50、100、200mg/mL五倍子组去除玷污层的效果较好,其去除玷污层的能力随浓度增加而增大,且牙本质小管有缩小的现象,当大于50mg/mL时牙本质小管被堵塞。30mL/L过氧化氢液加生理盐水组和双蒸水组不能去除玷污层。结论:大于6.25mg/mL的五倍子水提取物有去除玷污层的作用,随浓度增大,牙本质小管缩小并出现堵塞。     

颞下颌关节强直治疗方法分析

目的 探讨治疗颞下颌关节强直并有效防止复发的方法.方法 对3例外伤性颞下颌关节强直病例,除将残余关节盘复位缝合外,分别用喙突、残留髁状突及喙突联合钛金属关节头恢复颞下颌关节结构.结果 病例1术后1年复查,张口度为2.5 cm,咬合时下颌偏术侧.病例2术后1年复查,张口度为3.7 cm,咬合关系正常.病例3术后3个月复查,张口度为3.9 cm,前牙轻度开(牙合).结论 恢复关节的"正常"解剖结构,使残余的关节盘复位,保留残留的髁状突,并使其复位固定,有望提高颞下颌关节强直患者手术疗效,减少复发.     

A two-centre study on facial morphology in patients with complete bilateral cleft lip and palate at nine years of age

The aim of this study was to compare craniofacial morphology and soft tissue profiles in patients with complete bilateral cleft lip and palate at 9 years of age, treated in two European cleft centres with delayed hard palate closure but different treatment protocols. The cephalometric data of 83 consecutively treated patients were compared (Gothenburg, N = 44; Nijmegen, N = 39). In total, 18 hard tissue and 10 soft tissue landmarks were digitized by one operator. To determine the intra-observer reliability 20 cephalograms were digitized twice with a monthly interval. Paired t-test, Pearson correlation coefficients and multiple regression models were applied for statistical analysis. Hard and soft tissue data were superimposed using the Generalized Procrustes Analysis. In Nijmegen, the maxilla was protrusive for hard and soft tissue values (P = 0.001, P = 0.030, respectively) and the maxillary incisors were retroclined (P < 0.001), influencing the nasolabial angle, which was increased in comparison with Gothenburg (P = 0.004). In conclusion, both centres showed a favourable craniofacial form at 9-10 years of age, although there were significant differences in the maxillary prominence, the incisor inclination and soft tissue cephalometric values. Follow-up of these patients until facial growth has ceased, may elucidate components for outcome improvement.     

No evidence for a role of CRISPLD2 in non-syndromic cleft lip with or without cleft palate in an Italian population

Non-syndromic cleft lip with or without cleft palate (NSCLP) is a malformation with variable phenotypes, resulting from a mixture of genetic and environmental factors. Some studies have supported a role for the 16q24 region and its candidate gene, CRISPLD2, in clefting. A replication study is necessary to confirm these findings. The aim of the present study was to test, by genetic linkage and association analyses, whether the candidate gene, CRISPLD2, represents a risk factor for NSCLP. The analysis of 39 multigenerational families provided formal exclusion of a linkage between NSCLP and the CRISPLD2 locus under different genetic models and non-parametric analyses. The family-based study of 239 unrelated probands and their parents revealed no association between any particular allele or haplotype and NSCLP. Therefore, the present investigation did not support the hypothesis of the involvement of CRISPLD2 in NSCLP malformation, at least with regard to the Italian population.     

One germline mutation of PTCH gene in a Chinese family with non-syndromic keratocystic odontogenic tumours

Keratocystic odontogenic tumours (KOCTs) are common benign cystic tumours that arise sporadically or associated with nevoid basal cell carcinoma syndrome (NBCCS). PTCH mutation can be found in sporadically or NBCCS associated KOCTs. Few PTCH mutations in families with non-syndromic KOCTs have been reported. Through PCR and gene sequence analysis, the authors discovered one missense mutation c.3277G>C in exon 19 of PTCH gene in a Chinese family with non-syndromic KOCTs. This mutation causes one highly conserved glycine residue transit to arginine on the 10th transmembrane region of PTCH protein. This work revealed that the missense mutation of PTCH is the causative and dominant gene of KOCTs in this family.