微创正颌外科的进展

微创外科是指以内镜外科代替传统外科，借助专门的器械，利用微小切口和微小创伤的外科治疗手段。与传统手术方法相比，有着诸多优越性，近年来逐渐被口腔颌面外科医师应用到一些常见疾患的诊治上，但是在正颌外科领域，微创技术的使用刚刚起步。国外一些学者进行了部分动物实验和尸体模拟操作，也有少数的临床实践报道，而国内尚未见专门的报道。本文就微创正颌外科的研究近况和发展等作一综述。     

微创拔牙在糖尿病患者中的应用

目的:探讨和总结微创拔牙技术在糖尿病患者中的临床应用效果。方法 :2009-06—2013-06期间,采用微创拔牙技术拔除糖尿病人患牙95颗,记录术前、术中及术后1、7、14 d复诊时,患者症状及拔牙创情况。结果:术后感染2例,感染率2.35%;术中低血糖1例(1.25%);术后疼痛5例(5.88%);术后肿胀3例(3.53%)。结论:微创拔牙技术疗效可靠、操作简便,在糖尿病患者中是目前值得推广的较好拔牙方法。     

微创拔牙201颗临床总结

目的:探讨和总结微创拔牙技术在临床应用中的效果。方法:2009-03—2011-03间采用微创拔牙技术拔除195例共201颗牙齿。记录并分析术中患者的感觉和表现,术后1、3、7d复诊时患者的感觉、症状及拔牙创情况。结果:应用微创拔牙技术,本次所选病例术后感染或干槽症发生率为0%,拔牙畏惧率2.56%,术中断根1.03%,术中疼痛11.79%,术后疼痛4.62%,术后肿胀4.10%,术后张口受限2.56%。结论:微创拔牙技术疗效可靠,操作简便,是值得推广的较好拔牙方法。     

Use of dyes in cariology

The property of dyes to enhance contrast by their colour can be used in clinical dentistry and in investigations in vitro or in vivo. They have been used for indication of affected dental tissues, improvement of diagnostic methods, enhancement of patient awareness and information about specific processes. The development of particular dye systems, aimed at clinical application, is often laborious because of toxic effects, lack of specificity, irreversible staining or difficulties with removal of the dye. Clinically used dyes are often visually observed, which means a qualitative assessment of the staining, while quantification of the staining, if performed at all, is confined mostly to laboratory experiments. In this paper the application of dyes, arranged according to their specific purpose in cariology, is discussed, and a brief historical overview is given of the development of two particular dye applications for which commercial dye systems are now available. If certain requirements are met, dyes can be of great help in detection and quantification when used with several diagnostic methods.     

Decision making in cariology

By conducting an oral examination, during radiographic examination and in treatment planning procedures dentists make numerous decisions. A dentist will be required to make his decisions explicit. Decision trees and decision analyses may play an important role. In a decision analysis, the probability of correct and incorrect decisions are multiplied by the utility of the decision outcomes. The treatment outcome with the highest expected utility should be selected. Complex decision tasks such as the estimation of an individual's caries risk or the diagnosis of bone disorders are currently available as computer applications. Also, a preliminary version of a computer programme which detects caries lesions from bitewing radiographs independent from the dentist has become available. It is expected that the applicability of decision analyses will increase when implemented in the dental practice software packages.     

Invasive and noninvasive dental analgesia techniques

Although needle-administered local anesthesia has been an essential tool of modern dentistry, it has also been responsible for many patients' fears of dental visits. Several new techniques have recently evolved that may offer viable alternatives. Two of these operate via electronic mechanisms that interfere with pain signals, two others involve transmucosal modes of administration, and a fifth technique involves an intraosseous pathway for anesthesia administration. Each of these techniques has different indications for dental procedures, but none is intended to replace needle administration in dentistry. This overview highlights the salient features of these alternative dental anesthesia techniques.     

无痛微创拔牙技术在齿槽外科的应用

目的：观察丙泊酚＋局麻涡轮钻拔牙法在困难牙拔除中的应用。方法：选择拔牙患者60例，随机分为治疗Ⅰ组（丙泊酚＋局麻涡轮钻拔牙法）、治疗Ⅱ组（局麻涡轮钻拔牙法），对照组（传统拔牙法），记录各组患者麻醉前、局麻时、拔牙中平均动脉压（MAP）、心率（HR）、氧饱和度（SpO2），拔牙时间，拔牙感受。结果：Ⅰ组患者MAP、HR波动小，感觉痛苦小，Ⅰ、Ⅱ组患者拔牙时间短，3组患者SpO2无差异。结论：丙泊酚＋局麻涡轮钻拔牙法，值得在困难牙拔除中应用。