口腔颌面部牙源性感染的细菌学研究及治疗现状

<正> 口腔颌面部牙源性感染在临床上十分常见,现代研究表明,厌氧菌在其发病中起着主要作用,最常见的细菌有类杆菌,梭形杆菌,胨球菌,胨链球菌和变异链球菌;治疗时青霉素仍为首选药物,其次为灭滴灵,需要时宜及早建立引流,以免感染扩散,病情加重。牙源性感染是临床上最为多见的炎性疾患,多数牙源性感染发生于因龋病或创伤引起牙髓坏死的病人,牙周炎、冠周炎、外伤以及手术是其次的感染来源。许多牙源性感染最终     

颞颌关节前脱位手法复位的几点体会

颞颌关节前脱位是口腔科急症的常见病之一 ,可发生于任何年龄 ,但多见于成年人 ,往往在大笑 ,大张口后突然发生 ,也可在进行口内治疗时 ,由于张口过久而发生。颞关节前脱位的复位方法虽有多种 ,但首选单纯手法复位 ,为使复位能顺利进行 ,笔者体会应做好以下几点。1.接诊病人时     

干槽症原因分析及护理对策

干槽症为拔牙后常见并发症，可发生于任何牙齿拔除后，其中以下颌第三磨牙拔除后多见。本文对我院几年来发生的干槽症作回顾性分析，从护理角度寻找原因及对策。临床资料本文共收集拔牙后引起干槽症的病人３６例，其中男性１５例，女性２１例，年龄２５～３７岁，平均３１．５岁。发生的牙位为：下颌智齿３２例，其他牙位４例。３６例干槽症按拔牙损伤度分类：Ⅰ：容易挺出或劈开后很容易挺出者，拔牙时间＜５ｍｉｎ。共５例，构成比１３．９％。Ⅱ：创伤程度在Ⅰ～Ⅲ度之间。共１１例，构成比３０．６％。Ⅲ：拔除困难，长时间凿骨、取根或…     

新疆地区2492例口腔颌面部创伤患者临床流行病学分析

目的:分析新疆地区2 492例口腔颌面部创伤患者的临床流行病学特点,并进行探讨。方法:收集新疆地区2012-01—2016-12期间,在新疆各地医院住院治疗的口腔颌面部创伤病人5年间的病例资料,对每位患者的年龄、性别、创伤原因、创伤类型、骨折部位、全身合并损伤及神经损伤等内容进行临床回顾性分析。结果:收集2 492病例,其中男性1 981例,女性511例,男女比为3.88∶1,21～30岁是好发年龄;职业分布上以农民最多,占44.3%;交通事故是主要的创伤原因,占41.8%;创伤类型中多处骨折最常见(37.4%);骨折部位以下颌骨骨折最为常见(31.97%),其次颧部骨折(25.3%);全身合并伤中最常见的是四肢伤(27.5%),其次是颅脑(24.5%)和眼(21.4%);神经损伤病人124例,其中面神经损伤为78例,占62.9%。结论:口腔颌面部创伤发病率与性别、年龄及创伤原因有关;青壮年男性是好发人群;颌面部创伤往往合并四肢、颅脑和眼睛损伤;交通事故是致颌面部损伤的主要原因,居于首位。     

舌根部黏膜相关淋巴组织淋巴瘤1例

<正>黏膜相关淋巴组织淋巴瘤是一种少见的软组织肿瘤,可发生于胃、肠黏膜。至今未见有发生于舌部组织的报道,我科2005年12月收治1例舌根部黏     

局部皮下注氧疗法治疗下颌骨折

下颌骨折后,机体发生一系列的局部和全身生物化学改变,创伤的病理性反应之一是局部或全身的缺氧,随之而来的酸中毒,降低病人对感染的抵抗力。病人机体内聚积的乳酸是机体无氧代谢生成能量的最终产物。     

下颌骨低度恶性肌上皮瘤1例报告

<正>恶性肌上皮瘤又称肌上皮癌,主要发生于腮腺及颌下腺,好发于中老年女性,但发生于下颌骨尤其是青少年男性较为罕见,国内可查到的文献未见报道,现报道如下。 患者,男14 岁。因左面部肿胀3月余,在当地医院用抗生素治疗后,效果较差,于1998年2月26日收住院治疗。 临床检查 患者一般状况良好,全身检查未见异常。专     

颌面部创伤伴颈髓损伤患者的临床观察与治疗体会

目的：总结颌面部创伤合并颈髓损伤患者的临床观察和治疗经验,重视此类患者的早期诊断。方法：回顾性分析15例颌面部创伤伴颈髓损伤患者的临床资料.结果：保守治疗7例,无院内死亡;手术治疗8例,3例死亡．原因均为呼吸衰竭。结论：不要忽视颌面部创伤病人颈椎的检查和保护。一旦合并颈髓损伤,愈后较差．治疗要重视早期诊断及全身的病理、生理变化。     

左面颊部颗粒细胞肉瘤1例

粒细胞肉瘤是一种局限性的原始粒细胞肿瘤 ,以往认为常发生于儿童及青年人 ,好发生于各种扁骨。近年亦有报道发生于眼眶、宫颈、睾丸、小肠等。证实此肿瘤可发生于任何部位。本院去年收治 1例中年男性患者 ,发生于颌面部的粒细胞肉瘤。初诊为非何杰金氏恶性淋巴瘤及胚胎性横纹肌肉瘤。后经免疫组织化学诊断为粒细胞肉瘤。现报告如下 :患者男性 ,44岁 ,因左面颊部包块 2 0余天入院。查体 :左面部有一约蚕豆大包块 ,质硬 ,压痛 ( +) ,活动度差。手术所见 :瘤位于颧弓与上颌外侧壁之间 ,约 3ｃｍ× 4ｃｍ× 4ｃｍ ,质硬 ,中心液化 ,周围未见骨…     

经舌腹正中切开舌根深部脓肿的引流装置

舌根深部脓肿较为少见 ,切开引流的方法很多 ,病人的痛苦大 ,手术的创伤也大 ,并发症很多。经舌腹面正中切开舌根深部脓肿后 ,选用常规的引流装置进行引流 ,虽也可达到治疗的目的 ,但疗程长 ,加重了病人的痛苦 ,同时并发症也增多。本文介绍一种有冲洗和引流双重功能的引流装置     

柠檬精油对牙周致病菌抑制作用及其安全性初步研究

目的:探讨柠檬精油对牙周致病菌的体外抗菌活性及对细胞增殖的影响。方法:采用微量液体稀释法测定柠檬精油对Pg、Fn、Aa、Pi的最小抑菌浓度(minimal inhibitory concentration,MIC)及最小杀菌浓度(minimum bactericidal concentration,MBC);以较低浓度的MIC为标准稀释LEO作为实验组,采用MTT法测定柠檬精油对HUVECs的毒性作用,明确抑菌浓度下LEO的安全性。结果:柠檬精油对牙周主要致病菌均有抑菌作用,Pg、Fn、Aa、Pi的MIC分别是9.0 g/L、4.5 g/L、4.5 g/L、9.0 g/L,Aa、Fn的 MBC是9.0 g/L,Pg、Pi的MBC未测得。1/2MIC、1/20MIC浓度的LEO能够抑制人脐静脉内皮细胞的生长,而低于1/200MIC浓度的LEO则对人脐静脉内皮细胞的生长没有影响,其中1/200MIC浓度的LEO作用明显优于0.02%的CHX。结论:体外环境中,柠檬精油对牙周致病菌Pg、Fn、Aa、Pi具有抗菌活性,低浓度应用对机体相对安全。     

Oral cancer: molecular technologies for risk assessment and diagnosis

Purpose: The effective biomarkers related to diagnosis, metastasis, drug resistance and irradiation sensitivity of oral cancers will help the pathologist and oncologist to determine the molecular taxonomy diagnosis and design the individualization treatment for the patients with oral cancers.     

Stimulated whole saliva components in children with Down syndrome

The authors report on the components of stimulated whole saliva from children with Down syndrome—including pH, flow rate, sialic acid and protein concentrations, and amylase and peroxidase activity. Saliva samples were collected from 35 children aged 6–10 years. Of the participants, 17 had Down syndrome and 18 did not. To stimulate saliva production, the children chewed a piece of parafilm for 10 minutes before the sample was collected. Soon after collecting the saliva sample, the authors measured pH using a portable pH-meter. Sialic acid levels were determined with a thiobarbituric acid assay. Protein content was determined with Folin's phenol reagent. Amylase was assayed and the authors measured the maltose produced by the breakdown of starch and peroxidase using ortho-dianisidine.
No statistically significant difference was observed in levels of sialic acid (free and total) between the two groups. Protein concentration was about 36% higher in the group with Down syndrome. However, the salivary flow rate, pH, and amylase and peroxidase activities were lower among the children with Down syndrome.     

Computer-assisted planning for maxillofacial prosthodontic rehabilitation

Computerized tomography (CT) planning and the use of CT derived surgical templates for implant placement have shown promise for restoring function within months after surgical reconstruction of acquired post-oncologic defects.     

牙髓再生的研究现状

目前,根管治疗术在临床上已得到了广泛的应用并成功的保存了患牙,但其仍有许多术后并发症。随着组织工程技术在口腔领域的应用,构建一种组织工程化牙髓进行牙髓-牙本质复合体的再生治疗成为可能。近年来国内外已有很多关于牙髓再生的研究,并且已经取得了一定成果。本文将对目前国内外牙髓再生的研究进展现状作一综述。     

Effect of Pingyangmycin on human venous malformation endothelial cells

Purpose: Venous malformations are common vascular anomalies with a propensity of the head and neck. Intralesional injection of Pingyangmycin (PYM, bleomycin A5 hydrochloride) is a widely used sclerotherapy method for the treatment of venous malformation.     

Oropharyngeal dysphagia in amyotrophic lateral sclerosis alters quality of life

Dysphagia is one of the most important complications encountered in amyotrophic lateral sclerosis (ALS). Our aim was to determine whether oropharyngeal dysphagia impacted the quality of life (QoL) of patients with ALS. Thirty consecutive patients were recruited (31–82 years, 18 men). Swallowing function was evaluated using a standardised videofluoroscopic barium swallow. All the patients completed a specific questionnaire on quality of life in dysphagia (SWAL‐QoL) immediately after the videofluoroscopy. The results of dysphagia outcome severity scale separated 14 patients with oropharyngeal dysphagia and 16 with normal swallowing function. There was no difference in the average age, weight and body mass index of the two groups (dysphagic patients: 68 ± 11 kg versus non‐dysphagic patients: 69 ± 14 kg). Most of the dysphagic patients had a bulbar affection based on their Norris scores which determine the importance of cranial nerves illness (20 ± 8), significantly lower than those of the non‐dysphagic patients (35 ± 5) (P < 0·0001). There was no difference in the neurological peripheral symptoms evaluated by Amyotrophic Lateral Sclerosis Functional Rating Scale scores (dysphagic patients: 26 ± 7 versus non‐dysphagic patients: 27 ± 8) (ns). The swallowing quality of life questionnaire revealed that the dysphagic patients had significant burden (P < 0·001). They were affected by the necessity to applied a food selection (P < 0·01), by the increase in eating duration (P < 0·05) and described a decrease in eating desire (P < 0·05). They complained of fear regarding the risk of dysphagia (P < 0·05). They also described difficulties with oral communication (P < 0·001). All of those complained about dysphagia which impacted directly mental health (P < 0·05) and social life (P < 0·05). In conclusion, oropharyngeal dysphagia is a common symptom accompanying ALS, which alters the patient's QoL, especially social health.     

拔牙位点保存用复合温敏凝胶的构建及体外表征

目的:制备多壁碳纳米管/羟基磷灰石/壳聚糖复合温敏凝胶,探讨其作为拔牙位点保存材料的理化性能。方法:采用原位沉积方法制备多壁碳纳米管/羟基磷灰石(MWNT/ HA简称HAC)复合无机材料,将其分散至壳聚糖温敏凝胶中,制备壳聚糖/多壁碳纳米管/羟基磷灰石(CS /MWNT/HA简称CS/HAC)复合温敏凝胶,以成胶时间、孔径、孔隙率、机械强度及降解性能为指标优化配方设计,并表征复合温敏凝胶的微观形貌及理化性能。结果:以10 g/L的HAC作为补强成分加入到壳聚糖溶液中,能够在不影响成胶并保证一定孔隙率(84%)的前提下,提高材料的机械性能(抗压强度0.441 MPa),所获复合温敏凝胶具有适宜的临床操作时间(12 min),并具有可控的降解速率。结论:负载HAC的复合温敏凝胶具有良好的成型性,并具有较好的机械性能,在拔牙位点保存领域具有良好的应用前景。     

Interventional neuroradiologic procedures in the head and neck

Interventional radiology and interventional neuroradiology are evolving specialties which can aid the head and neck surgeons in the clinical management of patients with complex vascular lesions.