口腔门诊治疗并发晕厥106例回顾分析

目的：通过对1983年以来，孝感市中心医院口腔中心门诊治疗并发晕厥106例的回顾性分析，探讨口腔门诊治疗并发单纯性晕厥的原因及一些相关因素，增强医患双方的防治意识，安全顺利的进行口腔门诊治疗。方法：对106例单纯性晕厥反应，采取现场询问式调查的方法，对其一般情况，口腔门诊治疗经历，治疗时的心态，口腔门诊治疗的了解，以及不同口腔治疗晕厥发生情况等进行调查、归纳、分析。结果：1)晕厥的发生与患者的年龄有关，12～40岁口腔门诊治疗经历欠缺的患者是口腔门诊治疗并发晕厥的高危人群。2)口腔患者进行治疗前心理准备充足与否对并发晕厥反应的影响较大。3)晕厥在口腔门诊某些治疗中发生率较高，拔牙术最多，其次为脓肿切排。86％(92例)属因畏惧疼痛导致紧张而诱发的血管抑制性晕厥。4)晕厥多发生于治疗初期(93：13)。结论：口腔门诊治疗并发晕厥临床表现多不严重，但对患者就诊和医师的治疗影响明显，切实做好口腔治疗错误信息，消除和减轻他们的疑虑和畏惧的紧张心情，对保障口腔门诊治疗安全尤为重要。     

200例牙周牙髓联合病变的临床诊疗观察

目的 研究牙周牙髓联合病变的治疗方法,探讨最佳的治疗方案。方法 牙周牙髓联合病变患者200例。根据病因分别行根管治疗、牙周治疗和综合治疗,并观察疗效。结果 治疗结束12个月后观察,单纯的病因治疗和综合治疗2组间比较有显著性差异(P<0.05)。结论 牙周牙髓联合病变者采取综合治疗,能够取得良好的效果。?     

牙周序列治疗在牙周炎患者正畸过程中的临床疗效观察

目的：评价牙周序列治疗在牙周炎患者正畸治疗中所起的作用。方法：选择26例要求正畸治疗的成人牙周炎患者,在正畸治疗前开始牙周序列治疗并持续至正畸治疗结束,记录治疗前和牙周治疗后1个月、正畸治疗结束时的PLI、PD、BI、CAL。结果：成人牙周炎患者经过序列治疗和正畸治疗后各项牙周检查指标较治疗前差别均有统计学意义（P〈0.05）。结论：牙周炎患者在牙周序列治疗控制炎症后进行正畸治疗可以达到较好的效果。     

综合治疗对牙周病患者切牙区牙龈乳头美学重建的效果观察

目的研究分析牙周病基础治疗、正畸及修复治疗对牙周病患者切牙区牙龈乳头的美学重建效果。方法选取本院口腔中心收治的31例深覆、既往不良修复导致牙周病的患者作为研究对象,采取牙周病基础治疗、正畸及修复治疗的综合疗法,观察患者治疗前后不同时间段牙龈乳头相关指标的变化情况。结果基础治疗后患者的探诊深度(Probing Depth,PD)、牙龈指数(Gingival Index,GI)、菌斑指数(Plaque Index,PLI)、龈沟出血指数(Sulcus Bleeding Index,SBI)、临床牙周平均附着丧失(Clinical Attachment Level,CAL)指标较治疗前显著的降低(P<0.05)。患者进行正畸治疗后即刻、修复治疗后6个月的PD、GI、PLI、SBI、CAL指标均显著低于治疗前(P<0.05),与基础治疗后比较差异无统计学意义(P>0.05)。修复治疗后6个月患者的龈乳头指数分布显著优于修复治疗后即刻(Z=-4.327,P<0.001)。修复治疗后6个月患者PH测定值较修复治疗后即刻显著的提高且差异具有统计学意义(P<0.05)。结论采取牙周病基础治疗、正畸及修复相结合的综合治疗对深覆()、既往不良修复导致牙周病具有良好的治疗效果,使得患者前牙区获得较理想的美学效果。     

An evaluation of the duration and the results of orthodontic treatment

abstract – In 1,486 schoolchildren with various anomalies, different needs of orthodontic treatment, and treated with different techniques, the following variables were studied: uncompleted orthodontic treatment and reason for cessation of treatment, duration of active treatment, duration of retention period, complete registration period, results of treatment. One to five years after the end of treatment, 300 cases were examined regarding relapse, opinion of treatment, and opinion of the results of treatment.     

Shaping and filling root canals during root canal re‐treatment

Re‐treatment of primary root canal treatment associated with post‐treatment disease has become an important component of daily endodontic practice. Basically, the management of cases requiring re‐treatment should comply with the general rules of primary root canal treatment namely accurate diagnosis, antiseptic treatment consisting of cleaning and shaping the root canals, followed by effective disinfection, canal filling, and a coronal restoration that prevents re‐infection. Nevertheless, re‐treatment represents a distinct treatment modality of its own, which in several respects differs from primary treatment of teeth with vital or necrotic pulps. The aim of this review is to present current knowledge on root canal preparation and filling during root canal re‐treatment.     

Effectiveness of phase I orthodontic treatment in an undergraduate teaching clinic

In this retrospective study, the Peer Assessment Rating (PAR) index was used to objectively evaluate the effectiveness of Phase I (early) orthodontic treatment provided in an undergraduate teaching clinic. Pre-treatment and post-treatment casts of ninety-three patients were analyzed. All patients selected for Phase I orthodontic treatment had Class I skeletal relationships and did not require complex orthodontic treatment such as growth modification or treatment of occlusions with missing or impacted teeth. The mean age of patients who received Phase I orthodontic treatment was 9.9 years. The mean initial PAR score for the sample was 29.70 +/-9.84. The mean reduction in PAR score was 14.9 points corresponding to a 50.2 percent decrease in the PAR score following Phase I orthodontic treatment. Seventy-three percent of the patients experienced at least a 30 percent reduction in their PAR score following Phase I (early) orthodontic treatment. The mean cost of $381.00 for the Phase I orthodontic treatment was found to be influenced by the length of treatment, type of Phase I treatment provided, age at start of treatment, and percentage reduction in PAR score. The greatest success rate for the Phase I orthodontic treatment occurred with either fixed or a combination of fixed and removable appliances. Over half of the patients recommended for Phase I orthodontic treatment in the undergraduate dental clinic were successfully treated and did not require Phase II treatment. For them, there was both a treatment and a financial benefit to the Phase I orthodontic treatment.     

牙周牙髓病损预后的临床分析

目的 通过临床病例回顾分析牙周牙髓病损原发病因的诊断，治疗方案的选择对患牙预后的重要性。方法 选择31颗牙周牙髓病损患牙，临床详细检查，根据患牙的分类选择相应牙周，牙髓治疗方法，6－24个月评价临床愈合。结果 源于牙髓感染的牙周病损，牙周治疗需要量小，预后最好；源于牙周感染的牙髓病损，患牙预后取决于牙周病变程度，牙髓治疗未显著提高骨缺损的修复。评估牙周牙髓联合病变的预后，需监测阶段性治疗效果，牙周治疗需要量大。结论 牙周牙髓病损的临床需详细分析原发病因，选择优化治疗方案，监测阶段性治疗效果。     

SEITO - Stockholm Eastman Index of Treatment Outcome

To obtain high quality in orthodontics; it is important to evaluate the treatment. There are many indices for evaluation of treatment outcome however all of them compare treatment outcome with ideal occlusion. Therefore Stockholm Eastman Index of Treatment Outcome (SEITO) was invented. This index relates the treatment outcome to the treatment goal. SEITO is a morphological index based on criteria from the records including study casts, and/or intra oral photos. METHOD: The outcome of treatment is related to the treatment goal as stated in the records. Pre-treatment goals are divided into subgroups; overjet, vertical relation anterior/lateral), anterior cross bite, transverse relations, impacted teeth and space crowding/ spacing. Each subgroup is scored; the points are 0, 1, 3 or 5 depending on the severity of the malocclusion. The points for each subgroup are added to give a total sum of treatment goal points. Each post-treatment subgroup above is evaluated. If the treatment goal is fulfilled, the treatment outcome points are equal to the treatment goal points. If not - there is a reduction in the outcome points. Finally the outcome points are expressed as a percentage of the treatment goal points and form a measure of the success of treatment. CONCLUSION: SEITO index is a simple and quick way to obtain a picture of the quality of treatment outcome, and the only orthodontic index that relates the treatment outcome to the treatment goal.     

Different Orthodontic Treatment Effects in Angle Class III Patients

The aim of this study was to compare the different treatment effects observed in Angle Class III patients treated either exclusively in the primary dentition or receiving treatment initiated during the early mixed dentition. 14 patients from five families were enrolled in this retrospective study. The treatment course, appliances, treatment length and treatment outcomes were compared. The skeletal changes were assessed by analyzing cephalometric radiographs taken prior to, during and after completion of orthodontic treatment. In those patients receiving treatment in the primary dentition only, the course of treatment was more continuous and only one appliance had to be used. Moreover, the treatment time was shorter compared to those patients starting treatment in the early mixed dentition (5.4 +/- 2.1 vs 21.1 +/- 9.7 months). Treatment exclusively in the primary dentition showed better dentoalveolar results.     

Standardized and individualized diagnosis and treatment of oral squamous cell carcinoma: opportunities and challenges

如何提高口腔鳞状细胞癌（OSCC）患者的疗效,一直是临床与基础研究的重点。恶性肿瘤规范化诊治的目的就是提高疗效,而在规范化诊治基础上的个体化治疗,有可能进一步提高疗效。本文在OSCC现有诊治指南的基础上,针对OSCC临床分期的更新内容、外科治疗的肿瘤手术切缘、早期OSCC的颈部淋巴结清扫、局晚期OSCC术前诱导治疗和术后辅助治疗等方面,探讨OSCC的规范化和个体化诊治的机遇与挑战,分享临床研究思路,旨在优化现有治疗方案、提高治疗效果、完善治疗指南。     

成人髁突骨折保守治疗与手术治疗的系统评价

目的：评价保守治疗或手术治疗成人髁突骨折的疗效。方法：运用循证医学方法，选用开口度、咬合关系2个结局变量，利用SPSS11．0软件包中R×C列联表的妒检验对不同骨折部位治疗方法的选择是否相同进行假设检验。综合评价国内外已公开发表的关于成人髁突骨折经保守治疗或手术治疗的疗效研究。总样本361例，手术例数共246例，非手术例数115例。其中，高位骨折手术例数49例，非手术例数71例；中位骨折手术例数70例，非手术例数19例；低位骨折手术例数127例；非手术例数25例。结果：（1）高位骨折，手术组开口度恢复情况好于非手术组；中位骨折，手术组开口度恢复情况与非手术组相同；对于低位骨折，手术组开口度恢复情况与非手术组亦相同。（2）高位骨折，手术组咬合关系恢复率高于非手术组：中位骨折，手术组咬合关系恢复情况与非手术组相同：低位骨折．手术组咬合关系恢复情况与非手术组相同。结论：髁突高位骨折经手术治疗后，开15度及咬合关系均优于非手术治疗：中位骨折及低位骨折经手术治疗与非手术治疗后，开口度及咬合关系无显著差异。     

小针刀联合运动疗法治疗颞下颌关节盘不可复性前移位的效果评价

目的 评价小针刀联合运动疗法治疗颞下颌关节盘不可复性前移位的临床疗效。方法 选取32 例颞下颌关节盘不可复性前移位患者,随机分为实验组（16例）和对照组（16例）,2组患者均接受健康指导、手法复位、运动训练,实验组同时给予小针刀治疗。治疗前和治疗后3、6个月,比较分析2组患者疼痛视觉模拟评分（VAS）、最大开口度（maximum mouth opening, MMO）、Fricton颞下颌关节紊乱指数;MRI检查治疗后3、6个月时2组患者的颞下颌关节盘-髁关系。采用SPSS 19.0软件包对数据进行统计学分析。结果 对照组治疗前平均MMO为 25.95 mm,治疗结束后增大到 38.71 mm,3 个月和 6 个月复诊时平均MMO分别为38.94和38.94 mm;实验组治疗前平均MMO为 26.3 mm,联合治疗结束后增大到41.06 mm,3 个月和 6 个月复诊时分别为41.04和41.19 mm。对照组16例患者治疗前VAS为 3.93,治疗后降为1.60,3个月、6个月复诊时分别降为1.18、0.62;实验组联合治疗前VAS为4.063,治疗后降为0.80,3个月、6个月复诊时分别降为0.375、0.25。治疗后3个月和6个月比较,2组患者Fricton颞下颌关节紊乱指数明显改善,治疗前、后及2组间治疗效果有显著差异（P<0.05）。MRI检查提示,2组患者治疗前均诊断为不可复性关节盘前移位。3个月时,对照组16例患者中,6例为可复性关节盘前移位;6个月时,3例患者复发为不可复性关节盘前移位。实验组患者复位后3个月复查时有5例为可复性关节盘前移位,6个月时不可复性关节盘前移位患者为2例。经统计学分析,2组患者颞下颌关节盘-髁关系比治疗前均显著改善（P<0.05）,治疗后2组间治疗效果无显著差异（P>0.05）。结论 小针刀联合运动疗法较单纯运动疗法治疗颞下颌关节盘不可复性前移位效果更理想。     

Treatment planning instruction in North American dental schools, 1984-85

A questionnaire developed to determine the structure and processes associated with dental treatment planning curricula was sent to the 70 American and Canadian dental schools in 1984. Information was solicited on administrative organization of treatment planning, faculty and their qualifications, time committed to and placement of treatment planning in the curriculum, teaching methods, evaluation procedures, clock hours for preclinical and clinical instruction, scope of clinical treatment plans, subject matter in the curriculum, textbook utilization, graduation requirements, and the inclusion of treatment planning examinations by the regional licensing board. Sixty-two schools responded, a response rate of 88 percent. The administrative and curricular structure of treatment planning depended primarily on the clinical and departmental organization of the school. The majority of respondents had an average of four full-time faculty members, usually affiliated with a department of oral diagnosis, responsible for teaching treatment planning. Eighty-one percent of the respondents offer preclinical treatment planning information and 85 percent develop clinical treatment plans, varying from identification of general treatment areas to comprehensive, sequential treatment plans with appropriate alternatives. The findings indicated that there is no definite distinction between oral diagnosis and treatment planning in many schools. Currently, there are no curricular guidelines focused exclusively on the principles of dental treatment planning.     

牙周基础治疗联合心理治疗对灼口综合征的疗效观察

目的：观察牙周基础治疗联合心理治疗对灼口综合征（BMS）的临床疗效.方法：将108例BMS患者随机分为实验组和对照组各54例,实验组给予牙周基础治疗联合心理治疗,对照组给予心理治疗,分别于治疗后1个月、6个月后应用直观类比标尺法（visual analogous scale,VAS）对疗效进行评估.结果：治疗后1个月复诊,实验组和对照组比较差异无统计学意义（P＞0.05）;治疗后6个月复诊,实验组疼痛指数较治疗前和治疗后1个月减少（P＜0.05）,总有效率高于对照组,实验组与对照组比较差异有统计学意义（P＜0.05）.结论：牙周基础治疗联合心理治疗对BMS具有良好的治疗效果.     

正畸-牙周联合治疗成人牙周病伴错畸形

目的:探讨正畸治疗对错畸形伴牙周病的治疗作用。方法:通过对20例安氏Ⅰ类错、深覆、深覆盖、上下颌牙列稀疏、上颌前突伴牙周病的病人采取正畸-牙周联合治疗,并对患牙牙周、牙槽骨情况进行对比观察。治疗时间12～18个月。结果:20例病人的错畸形得到有效矫正,达到个别正常。矫治结束时牙周情况较矫治前有明显改善(P<0.05)。使用牙周夹板固定保持器进行保持,可达到稳定的远期治疗效果。结论:对安氏Ⅰ类错、深覆、深覆盖、上下颌牙列稀疏、上颌前突伴牙周病的病人采用牙周洁治、牙周夹板、正畸联合治疗,效果良好。     

Satisfaction with orthodontic treatment outcome

Objectives:To examine factors associated with treatment outcome satisfaction in a group of adolescent patients.Materials and Methods:One hundred and twenty patients (60 girls and 60 boys; mean age, 14.3 years; standard deviation [SD], 1.73 years) were consecutively recruited. The inclusion criteria for all patients were as follows: adolescents with a permanent dentition in need of orthodontic treatment and a treatment plan involving extractions (two or four premolars) followed by fixed appliances in both jaws. Questionnaire 1, concerning treatment motivation and expectations, was assessed prior to treatment start. Questionnaire 2 was assessed after active treatment and included questions about satisfaction with treatment outcome, quality of care and attention, and perceived pain and discomfort during active treatment.Results:One hundred and ten patients completed the trial (54 boys and 56 girls; mean age, 16.9 years; SD, 1.78 years). Median values for satisfaction with treatment outcome were generally high. There was a clear correlation (P ≤ .001) between satisfaction with treatment outcome and patients'' perception of how well they had been informed and cared for during treatment. Pain and discomfort during treatment also strongly affected treatment satisfaction. Sex, treatment time, and Peer Assessment Rating index pre- and posttreatment as well as expectations for future treatment showed no correlation with treatment satisfaction.Conclusions:Care and attention was the variable showing the highest correlation with satisfaction with treatment outcome. Patients'' perceptions of pain and discomfort during treatment had an overall negative correlation with treatment satisfaction. Satisfaction with treatment outcome is a complex issue and requires further exploration in future research.     

安氏Ⅱ类错[牙合]拔牙与非拔牙矫治病例牙槽嵴吸收的对比研究

目的：了解拔牙与非拔牙矫治在治疗安氏Ⅱ类错[牙合]时牙槽嵴高度的变化情况。方法：选取双期矫治病例16例,摆式矫治器病例18例及拔牙矫治病例20例,治疗前后均拍摄上前牙根尖片,比较上前牙治疗前后”CEJ—AC距离”在三个治疗组中的平均变化量,并作方差分析及组间LSD—t检验。结果：治疗结束时,三治疗组的CEJ—AC变化量存在组间差别,并具有统计学意义如〈0．05）,其中双期矫治组和摆式矫治器组的CEJ—AC分别增加了0．19mm和0．21mm,两组间无统计学差异（p〉0．05）,均小于拔牙矫治组的0．41mm,并有显著的统计意义（p〈0．001）。三治疗组在治疗结束时的CEJ—AC距离均不超过2mm。结论：双期矫治、摆式矫治器及拔牙矫治在治疗安氏Ⅱ类错[牙合]时,均会造成牙槽嵴高度下降,其中拔牙矫治的下降程度较为严重,但三种方法均未造成具有临床意义的牙槽骨丧失。     

Adult patients' view of orthodontic treatment outcome compared to professional assessments

One important aspect in evaluating the outcome and quality of orthodontic treatment is the patient's own assessment. The objective of this study was to evaluate the course and outcome of orthodontic treatment in adults from the patient's vs the operator's point of view. In a previous study, the orthodontic treatment of 88 adults was evaluated using the IOTN and PAR Index before and after treatment. Fifty-nine patients answered treatment questionnaires on 1. the reason for seeking treatment, 2. dentofacial aesthetics, 3. treatment outcome, 4. course of treatment, 5. attitude, 6. social well-being. Depending on the original treatment goal, the patient population was divided into an Ideal Group and a Compromise Group. In 75% of the patients, dissatisfaction with dental aesthetics was the prime motive for seeking treatment; correlations with PAR parameters (overjet and maxillary anterior teeth) were weak. In general, a high degree of patient satisfaction with orthodontic treatment was registered. As regards satisfaction with post-treatment dental aesthetics there were no significant differences between the groups. Comparison of professional assessment with the subjective rating by patients revealed discrepancies in that the patients' rating of outcome tended to be more positive. The differentiation between ideal and compromise treatment goals proved useful. In the Compromise Group, a high level of patient satisfaction was attained with a shorter treatment duration and lower appliance involvement. 92% considered their major pre-treatment need to have been met, and 95% would have had the treatment performed again.     

Documentation of oral findings with symbols and the symbolic plan of treatment. Study of reliability and practical worth

The oral status and a plan of treatment were drawn with aid of special symbols on 141 patients of a policlinic. The treatment was managed of 1. dentists in postgradual education with strict order to follow the plan of treatment, 2. dentists which were given the recommendation to act on plan, 3. dentists without knowledge of treatment plan. A control inspection in every case was done one year afters start of treatment. The group 1 showed the best result followed of group 2. Group 3 had the worst result of treatment. This statement is right for treatment of caries, endodontic and prosthetic treatment but not for periodontal treatment. In this field the differences were small between the 3 groups. Even group 1 had insufficient results of periodontal treatment.