唇侧近中倾斜阻生上尖牙的导萌技巧

目的探讨唇侧近中倾斜阻生上尖牙的导萌技巧。方法收集上尖牙唇侧近中倾斜阻生的患者38例。以上颌第1磨牙带环颊侧的钩作为施力点，牵引阻生的尖牙首先向远中倾斜移动并直立，待避开对侧切牙的压迫后，再向牙弓内移动。结果38例矫治效果良好。平均治疗时间18个月。5例拔除埋伏较深的阻生尖牙，关闭牙弓间隙；4例拔除根吸收的侧切牙，19例拔除前磨牙，其余10例未拔牙，均牵引尖牙至牙弓内。矫治过程未加重邻牙牙根吸收。结论上尖牙唇侧近中倾斜阻生时，将上颌第1磨牙带环颊侧钩作为牵引点，应用弹力线牵拉尖牙向远中移动并直立后，再向牙弓内牵引，可以顺利地矫治阻生牙及保护邻牙。     

锥形束CT在上颌埋伏中切牙正畸治疗中的应用

目的:评价锥形束CT(CBCT)在上颌埋伏中切牙正畸治疗中的应用价值。方法:选择在我院就诊的上颌埋伏中切牙患者54例(男32例,女22例),应用CBCT进行扫描和图像三维重建,显示埋伏中切牙的形态、位置、牙根弯曲情况以及与邻牙的关系。结果:经CBCT三维重建后,54例病例均清晰的显示了埋伏中切牙的牙体形态、唇腭向位置、萌出方向、牙根弯曲情况以及与邻牙的关系。结论:CBCT检查能提供准确,直观的信息,对上颌埋伏阻生的诊断,治疗设计具有更好的指导意义。     

上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙发生及牙根吸收的影响因素分析

评估上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙发生及牙根吸收的影响因素。方法 收集2019年3月-2021年3月于溧阳市人民医院就诊的1021例上颌唇侧倒置埋伏中切牙患者临床资料进行回 顾性调查，查阅锥形束CT及X线图像。其中113例发现埋伏牙，按照是否出现牙根吸收分为牙根吸收组 （51例）和牙根未吸收组（62例）。调取资料，包括性别、初诊年龄、平均体质量指数、埋伏牙位置、 近远中分区、是否拔牙、正畸治疗时间、埋伏牙发生个数等。统计上述指标情况，分析正畸矫治后埋伏 牙牙根吸收的单因素和多因素。结果 1021例患者中埋伏牙113例（11.07%）；牙根吸收组平均年龄、2~4 区占比均低于牙根未吸收组（P ＜0.05）；牙根吸收组拔牙率、正畸治疗时间＞2年占比均高于牙根未吸 收组（P ＜0.05）；两组性别、平均体质量指数、埋伏牙位置、病变位置、埋伏牙发生个数比较，差异无 统计学意义（P ＞0.05）；Logistic结果显示，高龄、近远中分区（0~1区）、拔牙、正畸治疗时间＞2年均为 正畸矫治后埋伏牙牙根吸收的高危因素（P ＜0.05）。结论 上颌唇侧倒置埋伏中切牙正畸矫治后埋伏牙牙 根吸收与年龄、近远中分区、拔牙、正畸治疗时间有关，对于高危因素患者，临床应给予重视，采用早期 干预措施，减少损伤。     

应用锥形束CT评价阻生尖牙正畸牵引前后牙槽骨的状态

目的:应用锥形束CT(cone beam computed tomography,CBCT)研究60g和150g牵引上颌唇侧埋伏阻生尖牙过程中根尖及根周硬组织的变化,为临床治疗埋伏阻生尖牙提供参考.方法:选取20例采用直丝弓矫治技术进行正畸治疗的上颌唇侧埋伏阻生尖牙患者,随机分成2组,每组10人.从外科暴露手术开始,利用链状橡皮环分别对上颌埋伏尖牙施加60g和150g牙体长轴方向的力,到阻生牙完全排入牙弓结束,平均10个月.对牵引前、后上颌尖牙牙根长度及牙根周围骨密度的变化进行CBCT分析,采用SPSS 16.0软件对测量数据进行配对t检验.结果:阻生尖牙以60g的力向牙体长轴方向做整体移动时,牙根长度、牙根周围骨密度与移动前比较,差异无显著性(P＞0.05);以150g的力向牙体长轴方向做整体移动时,牙根长度、牙根周围骨密度与移动前比较,差异有显著性(P＜0.05).结论:临床上治疗埋伏阻生尖牙采用小于60g的牵引力向牙体长轴方向做整体移动是行之有效的而且是安全的.     

Characteristics of pulpal blood flow levels associated with non-segmented and segmented Le Fort I osteotomy.

OBJECTIVES: Laser Doppler flowmetry (LDF) is a noninvasive method to assess pulpal blood-flow (PBF). The purpose of this study was (1) to test whether Le Fort I (LF-I) osteotomy may show tooth type-related effects on LDF measurements, and (2) to investigate whether LF-I and tooth type may predict adverse PBF outcomes. MATERIAL AND METHODS: PBF was recorded bilaterally in maxillary incisors, canines, and first premolars in a surgical group of patients who underwent a segmented (n = 14) or nonsegmented LF-I osteotomy (n = 12), and in a nonsurgical group of control subjects (n = 12) who did not undergo orthodontic treatment. PBF measurements were made before surgery (session I), and at intervals between 3 and 5 days (session II), and 55 and 59 days after surgery (session III). The nonsurgical control subjects were tested at similar intervals. An adverse outcome was defined as the presence of "PBF reduction of > 40%." Statistical analysis consisted of univariate analysis of variance for repeated measurements. A multiple logistic regression analysis was used to compute the odds ratio for LF-I and tooth type for adverse outcome versus nonadverse outcome. RESULTS: For the LF-I osteotomy study group there was a significant change in PBF values (P = .000). Analysis of session-related measurements revealed a significant difference between session I- and II-related measurements for the canine (P = .004) of the segmented LF-I osteotomy. Significant increase in risk of a session II-related adverse outcome occurred with a nonsegmented (16.6 odds ratio) (P = .009) and segmented LF-I osteotomy (59.2 odds ratio) (P = .000). The odds ratio that a patient with a segmented LF-I osteotomy might belong to the session III-related adverse outcome group was strong (20.6) and significant (P = .007). CONCLUSIONS: LF-I osteotomy type proved to be linked to changes in tooth type-related LDF measurements; it was an important prognostic determinant of adverse PBF outcomes.     

螺旋CT三维重建方法在埋伏阻生上颌中切牙正畸治疗中的应用研究

目的：研究三维重建方法在正畸矫正上颌埋伏阻生中切牙中的应用。方法：选择在我院就诊的上颌中切牙埋伏阻生患者18例（男8例,女10例）,年龄7～12岁,平均10．5岁。对每个病例进行螺旋cT扫描,将扫描所得DICOM格式数据采用MimiCS软件进行三维重建,根据重建结果设计矫正计划,进行正畸治疗。结果：根据三维重建获得信息,有2例患者进行恒牙拔除,4例患者扩大间隙后等待中切牙自行萌出,12例患者进行开窗手术后固定正畸牵引导萌。所有患者均获得良好的矫治效果。结论：三维重建技术对临床治疗能提供准确、直观的信息,对于上颌中切牙埋伏阻生的诊断、设计、治疗过程中具有很好的指导意义。     

Management of impacted urethral stones in children

Objective: To find out the clinical presentation, site of impaction, management and outcome of children presenting with urinary retention due to urethral stone. Study Design: Case series. Place and Duration of Study: Surgical Unit B of National Institute of Child Health (NICH), Karachi, from April 2009 to January 2010. Methodology: All the patients under the age of 12 years, who presented with urinary retention due to impacted urethral stones were included. Urinary retention due to other causes like trauma, stricture, pelvic masses etc. were excluded. Diagnosis was made on clinical examination (palpable stone in penile urethra) and with the help of radiology. Surgical procedure was tailored according to the site of impaction in urethra. All stones were sent for chemical analysis and patients were followed in Nephrology OPD (stone clinic) for further work-up. Results: There were a total of 19 patients with mean age of 3.94 ± 2.27 years. All were males. Twelve patients (63.1%) had stones impacted in anterior urethra while 7 (36.9%) were found in posterior urethra. Stones in penile urethra were removed in emergency either by meatotomy (when impacted at urethral meatus, n = 3) or following initial supra-pubic decompression of urinary bladder (using wide bore cannula) by urethrolithotomy (n = 6). Stones in bulbous (n = 3) and posterior urethral (n = 7) locations were pushed back into bladder and later removed on elective list by supra-pubic vesicolithotomy. No patient had proximal urinary tract calculi on further work-up. All patients remained well except one who developed retention of urine after a week of discharge. He had urinary tract infection and was treated with antibiotics. All the stones were of calcium oxalate type. Conclusion: Urethral stones must be kept in differential diagnosis in a child who presents with acute urinary retention. Clinical examination can identify causes in significant number of cases. Simple procedures like meatotomy, supra-pubic bladder decompression and urethrolithotomy can relieve the misery in these children.     

Canine teeth impacted in the palate--case report

Maxillary canines have the longest period of development, the deepest area of formation and the most difficult path of all teeth. The maxillary canines are the most likely to remain unerupted or impacted. The maxillary permanent canine is considered important by virtue of its place in the scheme of functional occlusion and its contribution to facial appearance. We successfully orthodontically treated two cases with palatally impacted canines. Although both cases had palatally impacted canines, they were different due to canine position and angulation.     

上颌阻生尖牙的临床诊断与治疗

目的：对阻生上颌尖牙的病因、临床检查、诊断及其相应的治疗进行了临床研究。方法：选取57例上颌尖牙阻生患者，通过病史询问、临床检查、X线片和模型测量的综合分析，从临床角度对阻生牙进行了诊断分类，采用不同的方法进行了矫治，并对矫治效果进行了评估。结果：采取适宜有效的治疗办法，均取得了满意的治疗效果，牙周膜愈合成功率达100％，活髓牙成功率达93．6％，牙龈形态良好者达89．4％。结论：尖牙阻生情况各异，治疗方法多样，根据临床分类选择合适的治疗方法，是矫治成功的关键。     

不同正畸牵引方式在埋伏倒置阻生上颌中切牙患者中的应用效果比较

观察对埋伏倒置阻生上颌中切牙患者采用不同正畸牵引方式的矫治效果。方法 选取我 院2020年1月-2022年8月收治的68例埋伏倒置阻生上颌中切牙患者为研究对象，随机分为对照组和观察 组，每组34例。对照组采用前方牵引器牵引治疗，观察组采用颌间牵引治疗，比较两组临床疗效、牵引 时间及埋伏牙牙根长度。结果 观察组治疗总有效率为97.06%，高于对照组的79.41%，差异有统计学意义 （P＜0.05）；观察组牵引时间为（7.28±2.14）个月，短于对照组的（12.32±3.26）个月，差异有统计学意 义（P ＜0.05）；观察组治疗后埋伏牙牙根长度优于对照组，差异有统计学意义（P ＜0.05）。结论 颌间牵 引在埋伏倒置阻生上颌中切牙患者中的应用效果优于前方牵引器牵引，可提高正畸治疗效果，缩短牵引时 间，还有助于提升患者埋伏牙牙根长度。     

国人上颌美学区牙颈部形态测量及分析

目的：通过对上颌离体前牙及前磨牙颈部形态的测量及分析,获取自然牙颈部的精确数据,指导上颌美学区种植美学修复及种植体美学基台的设计研发。方法：采用高精度游标卡尺对1 788颗离体上颌自然牙（中切牙366颗,侧切牙392颗,尖牙373颗,第一前磨牙313颗,第二前磨牙344颗）的牙颈曲度,颈部宽度和厚度,釉牙骨质界（CEJ）下1.5mm处颈宽、颈厚进行系统测量。运用SPSS13.0软件对所测数据作统计学处理。结果：本研究获得了国人上颌前牙及前磨牙颈部的精确数据（各指标的均值,标准差,最大、最小值,25%、50%、75%四分位间距值）。结论：所得数据填补了国人牙颈部数据测量的空白,同时对CAD/CAM瓷冠颈部制作,上颌美学区种植体直径的合理选择,以及对种植体牙龈美学成型基台的设计研发提供了数据支持。     

成人与青少年在内收上前牙的正畸治疗中牙根吸收的比较研究

目的：探讨成人与青少年在内收上前牙的正畸治疗中牙根吸收的差异。方法：选择运用直丝弓矫治技术矫治完成的上颌前突并拔牙矫治患者79例,其中成人患者38例,青少年患者41例。在其矫治前后的曲面断层片上对4个上颌切牙进行牙根形态观察及冠根长度的测量,以获得正畸治疗后牙根吸收的定性及定量资料。利用SPSS11.0软件对所得资料进行检验分析。结果：治疗后成人患者上颌中切牙的根吸收量大于侧切牙,成人患者上颌中切牙的根吸收量亦大于青少年患者,差异有统计学意义（P〈0.05）;同时,治疗后成人与青少年患者上颌中切牙的牙根吸收等级分布存在差异（P〈0.01）。结论：成人在上颌前牙的内收矫治中中切牙的根吸收风险较大。     

Adenomatoid odontogenic tumors: an analysis of 67 cases in a Thai population.

OBJECTIVE: The aim of this study was to determine the biologic profile of the adenomatoid odontogenic tumor (AOT) in a Thai population. STUDY DESIGN: Sixty-seven cases of AOT registered from January 1974 to May 2006 were studied retrospectively. Age, sex, variants of AOT, site and extent of tumors, associated impacted teeth, initial clinical diagnoses, clinical presentations, and duration of symptoms were analyzed. RESULTS: All AOT cases were intraosseously located, of which 55.2% were follicular and 44.8% extrafollicular. The 2 variants together were found more frequently in the maxilla than in the mandible, with a ratio of 2:1. Females were affected more often than males, with a ratio of 1.8:1. The peak incidence (56.7%) was found in the second decade of life. The majority of AOT lesions (68.7%) was found in the anterior jaws. Adenomatoid odontogenic tumors were observed more often on the left side of jaws (50.7% vs. 38.8%). Canines were the most common teeth associated with follicular AOT (67.5%), and the maxillary canines alone accounted for 51.3% of all cases. The majority of our patients presented with a painless swelling and with duration of symptoms of 6 months and longer. CONCLUSIONS: The distribution and characteristics of AOT in a Thai population are similar to the findings found in other populations. Interestingly, in this series we observed a case involving an impacted deciduous canine and a case associated with an impacted maxillary third molar.     

锥型束CT在上颌Le Fort Ⅰ型截骨术中的应用

目的 探讨提高Le Fort Ⅰ型截骨术的安全性和准确性的方法.方法 对84例上颌正颌手术患者术前行锥型束CT(conebeam computed tomography,CBCT)扫描,提取不同的影像资料,测量定位上颌Le Fort Ⅰ型截骨区域重要解剖结构位置.结果 84例中,术前检查发现上颌窦严重发育不全3例,其各骨壁距离测量值远小于正常值;上颌第3磨牙高位阻生11例;上颌窦分隔8例,鼻中隔偏曲4例;上颌窦囊肿3例.该成像技术对正颌手术患者上颌骨翼腭管位置关系,上颌骨各骨壁的厚度,上颌窦分隔,上颌窦内潜伏病变,上颌高位阻生牙的定位,翼上颌联合情况,以及鼻中隔偏曲情况均有良好的显示,为上颌正颌手术方案设计提供了放射学的颌骨评估基础,可指导Le Fort Ⅰ型截骨的定位设计.结论 CBCT可为上颌Le Fort Ⅰ截骨提供更精准的结构解剖影像,从而提高手术的准确性与安全性.

Abstract：

Objective To improve the accuracy and safety of the Le Fort Ⅰ osteotomy. Methods Eighty-four patients underwent CBCT scan before maxillary orthognathic surgery. The anatomic structures of maxilla were marked and measured. Results In 84 cases, there were 3 cases with severe hypoplasia of maxillary sinus, 11 cases with impacted third molar, 8 cases with separation in maxillary sinus, 4 cases with the deviation of nasal septum, and 3 cases with cysts in maxillary sinus. Form CBCT images, the position of the pterygopalatine canal, the thickness of maxillary wall, hidden lesion of maxillary sinus, the location of Impacted molar, the deviation of nasal septum, and other anatomic structure could be accurately localized. CBCT could provide sufficient and valuable information in diagnosis and design for Le Fort Ⅰ osteotomy. Conclusions CBCT imaging technology could provide precise anatomic images for Le Fort Ⅰ osteotomy. It improves the accuracy and safety of the Le Fort Ⅰ osteotomy.     

Craniofacial development in children with unilateral clefts of the lip, alveolus, and palate treated according to four different regimes. I. Maxillary development.

Lateral skull radiographs of 85 patients with unilateral clefts of the lip, alveolus, and palate treated according to four different regimes were compared at three different ages regarding maxillary development. Regimes that included primary bone grafting to the alveolus at six months of age resulted in inhibited anterior maxillary growth and reduced maxillary inclination. Regimes that included secondary bone grafting after eruption of the incisors but before the eruption of the canines, resulted in better maxillary development, but were not as good as regimes that omitted bone grafting altogether.     

Effect of low-level laser therapy (LLLT) on orthodontic tooth movement

The aim of this study is to evaluate the effects of low-level laser therapy (LLLT) on (1) the velocity of orthodontic tooth movement and (2) the nitric oxide levels in gingival crevicular fluid (GCF) during orthodontic treatment. The sample consisted of 20 patients (14 girls, six boys) whose maxillary first premolars were extracted and canines distalized. A gallium-aluminum-arsenide (Ga-Al-As) diode laser was applied on the day 0, and the 3rd, 7th, 14th, 21st, and 28th days when the retraction of the maxillary lateral incisors was initiated. The right maxillary lateral incisors composed the study group (the laser group), whereas the left maxillary lateral incisors served as the control. The teeth in the laser group received a total of ten doses of laser application: five doses from the buccal and five doses from the palatal side (two cervical, one middle, two apical) with an output power of 20 mW and a dose of 0.71 J /cm². Gingival crevicular fluid samples were obtained on the above-mentioned days, and the nitric oxide levels were analyzed. Bonferroni and repeated measures variant analysis tests were used for statistical analysis with the significance level set at p ≤ 0.05. The application of low-level laser therapy accelerated orthodontic tooth movement significantly; there were no statistically significant changes in the nitric oxide levels of the gingival crevicular fluid during orthodontic treatment.     

微小种植体支抗辅助螺旋扩弓器上颌快速扩弓效果的动物实验研究

目的：应用动物实验观察微小种植体辅助螺旋扩弓器上颌快速扩弓的效果，为临床使用微小种植体进行快速扩弓提供实验依据。方法：选取6个月龄雄性犬8只，随机分为两组，一组利用微小种植体作支抗，另一组按传统方法利用牙齿为支抗进行扩弓。两组实验犬均测量实验前后上颌同名中切牙、尖牙、第一磨牙之间的宽度；各组尖牙、第一前磨牙、第一磨牙牙齿倾斜角度，进行组间前后比较。结果：两组牙弓均能够有效地使上颌横向扩大，但实验组没有发生牙齿倾斜，对照组均观察到支抗牙的颊向倾斜。结论：使用微小种植体辅助螺旋扩弓器进行上颌快速扩弓能够有效地避免利用牙作支抗进行扩弓的缺陷，避免了支抗牙的颊向倾斜。     

Quantitative assessment of nasal changes after maxillomandibular surgery using a 3-dimensional digital imaging system

OBJECTIVE: To evaluate nasal changes after maxillomandibular surgery by means of images taken with a 3-dimensional digital camera. DESIGN: Thirty-two patients (26 female and 6 male) with preoperative and postoperative 3-dimensional photographs were studied. The patients underwent maxillary movement with impaction (upward rotation), maxillary movement with lengthening (downward rotation), or maxillary movement without rotation. With the 3-dimensional imaging software, preoperative and postoperative calculations were performed for interalar width, internostril width, nasal tip projection, and columellar length from the 3-dimensional digital images. The nasolabial angle was also measured. RESULTS: Postoperative interalar and internostril widening was significant (P<.05) for all 3 categories of maxillary movement. However, there was no statistically significant change in nasal tip projection and columellar length. Interestingly, movement of the maxilla with upward rotation did show a statistically significant decrease in the nasolabial angle. CONCLUSIONS: Changes to the nose clearly occur after orthognathic surgery. There was a statistically significant increase in postoperative interalar width and internostril width with maxillary movement. However, no clear correlation could be determined between amount of change and maxillary movement. Interestingly, maxillary advancement did not show any significant change in nasal tip projection or columellar length, with data showing both increases and decreases in measurements. The nasolabial angle in patients who underwent maxillary advancement with impaction (upward rotation) was the only measurement that showed a statistically significant increase.     

Factors that affect variability in impairment of maxillary growth in patients with cleft lip and palate treated using the same surgical protocol

No consensus exists about the causes of restriction of maxillary growth in patients with cleft lip and palate (CLP). The aim of this study was to try to identify causes of this impairment other than the influence of surgical technique and skill. We analysed a sample of 129 consecutively treated 5-year-old children with unilateral cleft lip and palate (UCLP), who were operated on by the same surgeon with the same protocol. Multiple cephalometric measurements of the sample showed a wide distribution of values for maxillary growth. We selected SNA as a value describing maxillary position. Variables investigated were: initial cast measurements; timing of lip and of gingivoalveoloplasty (GAP)/palatal surgery; and presence of permanent lateral incisors. The significance of differences was investigated with Pearson's correlation and analysis of variance (ANOVA). The factor most significantly linked with maxillary protrusion was the presence or absence of the permanent lateral incisor, even when peg laterals and supernumerary laterals were considered. Initial width of the palate measured on infant casts correlated with maxillary growth, but the timing of GAP did not. Although surgical skill and technique may be the most important factors responsible for impairment of maxillary growth, inherent tissue hypoplasia, possibly the lack of lateral incisors, seems to be the most important non-iatrogenic factor.     

三种桩核系统修复前牙残根残冠的临床应用

目的：比较金属铸造桩核、纤维桩核与氧化锆桩核修复前牙残根残冠的临床效果。方法：选择60例患者60颗前牙残根残冠,随机分为3组,每组20例。A组采用金属铸造桩核修复,B组采用氧化锆桩核修复,C组采用纤维桩核修复。随访12个月后对临床效果进行评价。结果：在12个月的观察期间,A组有3例松动脱落,3例出现根折,2例出现牙龈炎症及7例边缘出现黑线;B组各有1例出现根折和牙龈炎症;C组各有1例出现松动脱落,桩核折断和牙龈炎症。所有复诊患者均未见继发性根尖周炎。结论：非金属桩核的粘结性、抗根折能力和美观性均优于金属铸造桩核,并且更有利于牙周组织的健康。三者对牙龈和牙髓疾病控制方面无显著差异。