透明质酸钠和泼尼松龙对兔颞下颌关节软骨损伤治疗效果的研究

目的 比较局部应用透明质酸钠和泼尼松龙对兔颞下颌关节软骨损伤的治疗效果。方法 选用成年健康新西兰大白兔27只,随机分成4组。第1组:兔颞下颌关节髁突软骨全层损伤后局部应用泼尼松龙(12.5 mg),10只;第2组:兔颞下颌关节髁突软骨全层损伤后局部应用透明质酸钠(5 mg),10只;第3组:兔颞下颌关节髁突软骨全层损伤手术对照组,5只;第4组:正常对照组,2只。分别于术后1、2、4、8、12周处死,对髁突软骨及其修复组织进行大体形态学及组织学检查。结果 第1、2组实验动物的髁突软骨损伤区为纤维结缔组织增生,术后12周时,损伤区充满致密的纤维结缔组织,胶原纤维排列有序,与关节面平行。修复组织的质量类似,但第2组髁突软骨的退行性改变较第1组明显减轻。结论 泼尼松龙和透明质酸钠都能促进髁突软骨损伤后的修复,在预防颞下颌关节软骨的退行性改变方面,透明质酸钠优于泼尼松龙。     

羧甲基壳聚糖对兔颞下颌关节软骨修复的作用

目的：比较羧甲基壳聚糖与透明质酸钠对兔颞下颌关节软骨损伤后修复的作用。方法：27只新西兰白兔，随机分成4组：A组10只、B组10只、C组5只、D组2只。A、B、C组于下颌髁突功能面制造直径2mm、深2．0-2．5mm的骨、软骨缺损，局部分别应用羧甲基壳聚糖、透明质酸钠、生理盐水2．0ml处理，D组为健康对照组。术后1、2、4、8、12周处死实验动物，D组动物和手术组于术后1周和12周同时处死。取髁突标本进行大体形态和组织学观察。结果：B、C组软骨损伤区形成骨纤维组织修复，术后12周，C组出现明显的软骨退行性变，B组无明显退变：A组软骨缺损区形成软骨样组织修复，且与邻近正常软骨层相连续，未见明显的软骨退变。结论：羧甲基壳聚糖有明显促进关节软骨再生修复和减轻关节软骨退变的作用；透明质酸钠无明显促进关节软骨再生修复的作用，但具有减轻关节软骨退变的作用。     

透明质酸钠对兔颞下颌关节骨病的作用

目的通过制动兔的颞下颌关节,制造骨关节病动物模型,采用组织病理学和组织化学方法研究透明质酸钠对制动的颞下颌关节的作用。方法普通家兔18只,分为2个实验组和1个对照组。实验组动物颞下颌关节制动后,左侧关节腔内注射0.06ml透明质酸钠,右侧关节腔内注射同等量的生理盐水,分别观察2周和4周后处死,完整取出双侧颞下颌关节(TMJ)作组织学及组织化学染色,评价关节软骨的改变及软骨中糖胺多糖含量的变化。结果与注射透明质酸钠的左侧关节相比,注射生理盐水的右侧TMJ出现了明显的退行性骨关节病的改变,两者具有显著性差异(P<0.01)。结论透明质酸钠对制动后TMJ的退行性变可起到明显的抑制作用。     

透明质酸钠治疗颞下颌关节不可复性盘前移位的临床观察

目的 探讨透明质酸钠治疗颞下颌关节不可复性盘前移位的临床疗效.方法 34例颞下颌关节不可复性盘前移位患者随机分为试验组和对照组,各17例.试验组关节上腔内注射透明质酸钠注射液1 mL,对照组关节上腔内注射强的松龙注射液12.5 mg.术后0.5 h、1个月观察患者开口度和疼痛情况.结果 张口度和疗效,术后0.5 h,试验组和对照组差异无统计学意义;术后1个月,试验组和对照组差异有统计学意义.结论 透明质酸钠和强的松龙治疗颞下颌关节不可复性盘前移位短期疗效均较好,但长期疗效,透明质酸钠明显优于强的松龙.     

翼外肌在创伤性颞下颌关节骨强直中的病理性作用

目的:创伤性颞下颌关节强直病理学机制仍不清楚,本研究目的是验证翼外肌在创伤性颞下颌关节骨性强直病理学机制中的作用.方法:7只6个月大的雄性绵羊,双侧颞下颌关节模拟髁突矢状骨折,关节盘外侧1/3切除建立创伤性颞下颌关节骨强直绵羊动物模型.左侧颞下颌关节作为实验组,切断左侧翼外肌;右侧关节作为对照组,保留右侧翼外肌.所有绵羊均在术后12周实施安乐死.所有颞下颌关节复合体通过大体解剖、螺旋CT、显微CT、组织病理学等检查进行评估.结果:大体解剖发现,对照组颞下颌关节发生了骨强直,而实验组颞下颌关节只发生纤维粘连;螺旋CT和显微CT检查发现,与实验组比较,对照组颞下颌关节间隙可见钙化影像,上下关节面可见新骨长入关节间隙的不规则钙化影像,对照组的髁突最大内外径及最大前后径明显大于实验组;显微CT显示,两组所有显微结构参数均有统计学差异(P<0.05),对照组髁突新生骨小梁总体表达方向与翼外肌的牵拉方向一致,而实验组髁突骨折区新生骨小梁的主要方向与翼外肌的牵拉方向不一致;组织病理学检查发现,对照组关节发生了骨强直,但实验组无骨强直发生.结论:当髁突发生矢状骨折时,翼外肌对骨折块有牵拉(类似牵张成骨)的病理性作用是创伤性颞下颌关节骨强直发生的重要因素.     

颞下颌关节骨关节病动物模型的构建研究

目的建立能够很好地反映颞下颌关节骨关节病(temporomandibular joints osteoarthritis,TMJOA)的发病情况并为治疗打下良好基础的动物模型。方法选择37只新西兰白兔,分为实验组、阴性对照组和健康对照组,通过颞下颌关节(TMJ)内注射Ⅱ型胶原酶来诱导兔产生TMJOA,并动态全程观察4、8、12、16、20、24周兔颞下颌关节大体和组织病理学的发生、发展过程。结果随时间的延长,病变先是表现为逐渐加重,以后出现缓解趋势,实验组中均于4周后出现较明显的骨关节病损,其中12周组达到病变高峰,20、24周组出现局部修复现象。结论胶原酶注射后的兔颞下颌关节大体和组织病理学改变与人TMJOA的基本病理改变一致,具有良好的可比性和相似性,成功地构建了一种TMJOA的动物模型。     

颞下颌关节盘摘除术关节区组织病理学变化的实验研究

目的 建立兔颞下颌关节盘摘除术实验动物模型,研究关节盘摘除术早期,关节区组织形态学变化.方法 用10只新西兰大白兔,实验组8只行双侧关节盘摘除术;2只为正常对照组.术后1周、2周、4周、10周各处死2只,切取关节组织,进行组织病理学观察.结果 髁突及关节结节关节软骨连续性破坏,功能区关节软骨下骨组织直接暴露于关节腔内,非功能区则软骨细胞各层增生明显,表面纤维层增生变厚,呈现出纤维性粘连样改变.暴露在关节腔部分的骨组织表面致密,髓腔内的骨小梁吸收,伴微小囊肿形成.髁突关节软骨、骨组织及滑膜出现早期骨关节炎样改变.结论 兔关节盘摘除术后早期,关节区组织表现为骨关节炎样改变,不是适应性改变.     

颞下颌关节骨关节病关节下腔透明质酸钠治疗对滑液一氧化氮的影响

目的 :研究一氧化氮与颞下颌关节骨关节病的关系以及评价关节下腔透明质酸钠治疗骨关节病的疗效。方法 :采用硝酸还原酶法测定 2 0例颞下颌关节骨关节病造影前、透明质酸钠下腔治疗后滑液一氧化氮水平。临床指标选择开口度和疼痛程度。结果 :无症状志愿者关节滑液未能检测出一氧化氮 ,骨关节病疼痛组滑液一氧化氮水平显著高于无疼痛组 (t =2 .118,P <0 .0 5 )。颞下颌关节下腔透明质酸钠治疗后关节功能得到了改善 ,无疼痛组、疼痛组滑液一氧化氮水平显著下降 (t=2 .839,P <0 .0 5 ;t =3.132 ,P <0 .0 5 )。结论 :一氧化氮可能参与了颞下颌关节骨关节病的病理过程 ,关节下腔透明质酸钠治疗颞下颌关节骨关节病疗效明显     

透明质酸钠治疗颞下颌关节骨关节病的动物实验研究

目的:评价透明质酸钠对山羊颞下颌关节骨关节病的治疗效果。方法:对8只山羊的双侧颞下颌关节上腔一次性注射胶原酶而诱导骨关节病病变。分2组,4只/组。治疗组,透明质酸钠关节上腔封闭;对照组,关节上腔注射生理盐水。3月后处死,对髁突应用光镜和扫描电镜观察。结果:在光镜和扫描电镜下观察,对照组的髁突、关节盘、关节凹表现为骨关节病变化,治疗组骨关节病表现不明显。结论:通过3个月的观察和研究,证明透明质酸钠关节上腔封闭对颞下颌关节骨关节病具有显著疗效。     

髁状突骨折后颞下颌关节内粘连的治疗及组织病理学观察

目的初步探讨髁状突骨折继发颞下颌关节内粘连的治疗及其病理组织学特点.方法髁状突骨折后持续开口受限病例6例,对其行开放及关节镜手术治疗.术中发现关节内粘连、手术切除粘连组织并取部分粘连组织行组织病理学检查.结果所有病例手术后开口度明显改善.早期粘连组织表现为血运丰富的疏松结缔组织,后期为致密结缔组织,其中可见软骨成分.结论髁状突骨折后关节内粘连组织早期为疏松结缔组织构成的纤维条索,后期为致密的纤维结缔组织,可有软骨化改变.手术是治疗此类病例的较佳选择.关节镜手术对部分病例有一定的应用价值.     

Evidence of the validity of a model of determinants of quality of restorative dental care

A model describing the relationship between self-reported quality of restorative dentistry and dentist characteristics for 119 Montana general dentists is presented. The best predictors formed a significant model explaining 22% of the variance of the quality measure. Results are contrasted with a previous estimation of the model for 102 Washington general practitioners. Evidence for the external validity of the model is presented.     

Experimental evidence of formation of imines in the course of reduction of hydrazones

The reduction of hydrazones is generally suggested to proceed through a reductive cleavage of the nitrogen–nitrogen bond followed by a reduction of the carbon–nitrogen bond. This sequence of reduction processes is here supported for fluorenone (V) and benzophenone (VI) hydrazones as well as by a comparison of the reduction of fluorenone and benzophenone hydrazonium ions (I,III) with corresponding imines (II,IV). Another proof of the presence of imines as intermediates is the splitting of four-electron waves of hydrazones V and VI and hydrazonium ions I and VIII into two waves at pH < 2. This has been interpreted as due to differences in slopes dE_1/2/dpH and pK_a-values of protonated hydrazine derivatives on one side and corresponding imines on the other. In this pH-range imines formed in reductions of VI and VIII are reduced in a single two-electron wave, those of I and V in two one-electron steps. Fluorenone imine (II) is sufficiently stable to allow recording of time-independent current–voltage curves between pH 6 and 11. In this pH-range the imine (II) is reduced in two one-electron steps. Benzophenone imine (IV) has been found stable between pH 4.6 and 12. At pH 4.6–8 the reduction of the imine IV takes place in a single two-electron step, at pH 8–12 in two one-electron steps. Final proof of the initial cleavage of the N–N bond is presented by comparison with the reduction of nitrones.     

不同剂型玻璃离子水门汀溶解性比较研究

目的:研究、比较不同剂型玻璃离子水门汀的溶解性和表面微观形态改变,为临床使用提供依据.方法:将3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)及GC玻璃离子水门汀(双糊剂型)分别在人工唾液中浸泡30 d,冷热循环15000次,烘干测重,比较前后质量变化,计算溶解率,并用扫描电镜观察表面微观改变.结果:不同剂型的玻璃离子水门汀溶解率由高到低分别为3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(双糊剂型).3种玻璃离子水门汀经浸泡溶解后,SEM扫描表面微观形态可观察到GE玻璃离子水门汀(双糊剂型)表面形态改变较少,其他2组玻璃离子水门汀表面微观改变较多.结论:双糊剂型玻璃离子水门汀理化性能及溶解率均低于传统水粉剂型,是未来临床修复治疗的的良好选择.     

Design of clinical trials of traditional therapies of periodontitis

The present paper on the design of clinical trials of periodontal therapy first addresses the issue of the etiology of periodontal disease. It is suggested that most if not all forms of destructive periodontal disease are caused by microorganisms and that there are different forms of disease with different microbial etiologies. The progressive nature of destructive periodontal disease is subsequently discussed and it is emphasized that, in a given patient, periodontal sites which show signs of inflammation and attachment loss may not over a period of several months and years show further sign of attachment loss. The present methods of assessing periodontal disease do not allow us to discriminate between potentially active and inactive sites in untreated patients. The significance and variability of indicators of periodontal disease such as bleeding on probing, probing pocket depth and probing attachment level measurements are discussed. The errors inherent in the various measurements are analyzed and suggestions are presented describing how alterations in any of the above parameters could be identified and presented in a clinical trial. Of concern for the statistical analysis of clinical data of periodontal disease is the definition of the "experimental unit". For a number of years, the "experimental unit" in periodontal trials was the patient. It is clear, however, that different sites within the same individual show different patterns of disease progression and lesion morphology and often respond differently to periodontal therapy. Statistical analyses must consequently be designed which recognize differences in site-to-site infection and lesion morphology within a common host. Until such analyses are available, the investigator should be wary of pooling data within the same individual, since such pooling may obscure meaningful alternatives which may take place in individual periodontal sites. Some goals of periodontal therapy are subsequently identified. 4 goals are discussed more in detail, namely: to establish conditions which will allow the patient to maintain a dentition without further breakdown of the periodontium; to reduce pocket depth to establish an anatomy in the dentogingival region which with proper maintainance care will prevent the re-establishment of the subgingival infection; to gain attachment as a result of treatment; to assess the effect of a certain chemotherapeutic agent on periodontal disease.     

Evaluation of efficacy of chemiluminescence for diagnosis of leukoplakia

ObjectiveLeukoplakia is the most common potentially malignant disorder preceding oral cancer. Chemiluminescence has been developed as an adjunct to conventional examination for the diagnosis of these potentially malignant disorders. This study was conducted to assess the efficacy of chemiluminescence in the diagnosis of leukoplakia and to compare the results with histopathological examination.Study designA total of 50 patients with leukoplakia were included from the outpatients attending the Department of Oral Medicine and Radiology, Dental Hospital, Bengaluru, Karnataka, India. These patients were subjected to conventional oral examination followed by chemiluminescent examination with Vizilite (Zila, Fort Collins, CO, USA) and biopsy for histopathological confirmation.ResultsThe sensitivity, specificity, positive predictive value, and negative predictive value of chemiluminescence were 93.75%, 55.56%, 78.95%, and 83.3%, respectively. The overall accuracy of chemiluminescence was 80%. A statistically significant association was observed between histopathology results and chemiluminescence results.ConclusionAlthough it is an easy, safe, minimal time consuming, and noninvasive technique, it has only adjunctive utility and it does not replace biopsy for the diagnosis of leukoplakia.     

颌骨动静脉畸形的栓塞治疗

目的：总结直接穿刺结合经血管内介入栓塞治疗颌骨动静脉静脉畸形的经验。方法：收治凳骨动静脉畸形患者6例,均进行了介入栓塞治疗。采用的栓塞材料为附凝血棉纤毛的螺圈,聚乙烯醇泡沫微粒和二氰基丙烯酸对丁酯。数字减影颈动脉造影在PHILIPSV300下完成。结果6例颌骨动静脉畸形患者中4,例急性出血得到了快速、有效控制,1例慢性渗血的右下 骨动静脉畸形患者,介入栓塞治疗,拔除松动的右下凳第一磨牙,有效地控制了出血,另1例伴局部软组织搏动性膨隆的上凳骨动静脉畸形患者,介入治疗后膨隆的搏动性得到明显改善,栓塞治疗后分别随访3－24个月,均未发现有口腔内渗血或出血。随访的X线片上,病灶区可见新骨形成。结论：局部穿刺结合经血管内介入栓塞治疗颌骨动静畸形是一种安全、有效的治疗方法。     

正畸患者切牙影像失真发生情况分析

目的研究正畸患者曲面体层片上的切牙影像失真发生情况，并分析其原因。 方法从中山大学附属口腔医院放射科影像数据库中选取500例正畸患者的曲面体层片和头影测量侧位片，所有曲面体层片均采用咬合杆投照，分别从切牙牙体影像放大、缩小、牙根变短、根尖模糊等评价指标分析上下颌切牙影像失真的发生情况，在头影测量侧位片上测量中切牙根尖-对颌切牙切缘的距离，探讨切牙影像失真发生的原因。采用SPSS 19.0统计软件对所得数据进行统计学检验。 结果500例患者中，切牙牙体影像正常者共417例，切牙牙体影像失真者共83例，影像失真发生率16.6%，其中切牙牙体影像放大17例、牙体影像缩小0例、牙根变短30例，牙根影像变短伴模糊36例。影像失真患者的根尖-切缘距离大于影像正常的患者，差异有统计学意义（F = 5 187.18，P = 0）；影像失真患者的覆盖值大于影像正常的患者，差异有统计学意义（F>477，P = 0）。 结论严重牙颌面畸形如反 、深覆盖是导致曲面体层片的切牙影像失真的主要原因之一。     

正常青年Monson球面半径的测量研究

目的测量正常青年Monson球面半径。方法选择60名(男30名,女30名)正常青年制取全口印模,应用立体摄影成像的原理与方法对Monson球面半径进行测量和统计学处理。结果Monson球面的半径平均为10.173 cm,大于理论值10.160 cm,差异有显著性(P<0.01);男、女性球面半径差异无显著性。结论本实验所得到的数据可作为全口义齿修复中记录颌位关系的一个参量。     

鼻测量法的进展

唇裂术后继发畸形是指唇裂修复术后,仍遗留或继发于手术操作和生长发育变化而表现出来的一类畸形[1]。包括唇畸形、鼻畸形和颌骨畸形。其修复较原发性唇裂修复更复杂,更灵活多变。而导致其修复复杂性的一个重要原因即是局部组织结构复杂变异和缺乏可靠的三维测量手段[2],鼻畸形