下颌骨缺损自体骨移植术后种植床软组织条件的评估与准备

目的：对下颌骨缺损自体骨移植术后种植床软组织进行评估并外科修整。方法：对11例非血管髂骨移植和12例血管化腓骨瓣移植患者进行植骨床牙槽突软组织评估。其中4／23例Ⅱ期植入种植体，并于植入术后4-6月行腭粘膜移植术。结果：自体骨移植术后牙槽突软组织均活动游离，厚度不一，前庭沟和颌舌沟变浅。4例腭粘膜移植术后形成适宜厚度的理想附着龈。结论：下颌骨缺损自体骨移植术后种植床坎组织均需行外科修整。腭粘膜移植术是一种理想方法。     

牙槽突裂骨移植稳定性的研究进展

牙槽突裂自体骨移植术是目前常用的修复唇腭裂患者牙槽突骨缺损的手术方法，但术后常存在植入骨再吸收现象。植骨时机、植入骨骨源、裂隙的结构、牙周健康状况和术后并发症等多种因素对手术成功率均有影响，通过加入生长因子和牵引成骨等方法，可增加移植骨的稳定性。作者就有关影响植入骨稳定性的因素及增加移植骨稳定性方法的研究进展作一综述。     

局部牙槽骨缺损自体下颌块状骨onlay植骨重建种植技术

种植体的成功存活需要三维空间中足够的骨组织覆盖,而拔牙的手术创伤、长期的无牙状态、不合适的局部义齿、根尖周感染、其他手术创伤、先天缺牙或者外伤致牙列缺损,都有可能导致牙槽骨的高度或（和）宽度不足,限制了种植体在颌骨中的植入。重建缺损牙槽突的方法主要有自体骨移植、引导性骨组织再生、牵引成骨等。自体骨移植由于其具有骨再生作用和良好的生物相容性已经成为颌骨缺损重建的金标准,而块状自体骨onlay植骨合并种植体植入技术因其适应证广泛、手术相对容易、预后可靠、并发症少等优点已经广泛应用于临床。     

血管化腓骨游离移植重建下颌骨缺损及同期种植体植入

目的：介绍血管化腓骨游离移植即刻重建下颌骨缺损并同期植入牙种植体的方法。方法：对2例下颌骨造釉细胞瘤骨缺损行血管化腓骨游离移植重建，于术中同期植入Frialit-2台阶柱状牙种植体，术后进行临床和影像学追踪观察。结果：2例患者面部外形恢复满意，咬合关系正常，X线与CT检查骨愈合良好，骨重建形态与种植体位置满意．结论：血管化腓骨游离移植与同期牙种植体植入重建下颌骨缺损可有效地恢复面部外形和口腔生理功能。     

即刻植骨同期种植体植入修复下颌骨缺损

目的：探讨下颌骨缺损即刻植骨同期种植的可行性。方法：对6例下颌骨部分切除的患者，行下颌骨缺损即刻植骨同期种植术。其中2例行血管化腓骨双层折叠移植，另4例为非血管化髂骨移植。同期植入种植体共19颗。结果：6例术后均一期愈合，X线显示种植体周围骨结合正常。结论：下颌骨缺损血管化和非血管化骨移植同期种植术是可行的，但由于同期种植的复杂性，要求在适应症的选择及手术操作上应更加严格。     

在移植骨上延期种植的实验研究

目的论证冷冻自体下颌骨复合髂骨移植后延期种植的可行性。方法16只成年雄性杂种狗，制备下颌骨双侧骨缺损，左侧行冷冻自体下颌骨骨块的原位再植并结合髂骨松质骨移植，即复合移植组（composite transplantation group，CTG），右侧缺损行自体髂骨块移植即髂骨移植组（iliac transplantation group，ITG），术后3个月分别在两类骨块上植入IMZ TPS种植体，种植体植入后3、6、9、12周分别处死4只动物取材，采用数字化X线片对种植体与颌骨结合界面进行灰度定量分析，组织学观察种植体．骨结合情况。结果各期种植体周围均未见吸收性骨质密度减低影像。骨一种植体界面灰度定量分析显示，种植体植入两类移植骨3、6和9周时，其界面骨质密度改变差别明显，复合移植组明显优于髂骨移植组；种植体植入12周时，两组界面骨质已无明显差别，两类移植骨均与种植体有良好的骨结合，其骨愈合方式基本相同。结论冷冻自体下颌骨复合移植修复下颌骨缺损并延期植入牙种植体后，二者可形成良好的骨结合。     

自体骨游离移植修复牙槽骨缺损Ⅱ期种植修复临床报告

目的：利用自体骨游离移植以增加牙槽骨骨量,Ⅱ期种植体植入。方法：对19例牙槽嵴萎缩患者进行自体下颌正中部、髂骨取骨植骨术,Ⅱ期植入36枚种植体。结果：全部患者植骨区切口一期愈合,移植骨完全成活,植骨术后9个月进行种植体植入,种植体与移植骨结合良好。义齿修复后,随访6个月～3年,平均14月,种植体无松动、脱落。结论：该方法对于牙槽骨缺损要求种植修复的患者疗效可靠。     

自体髂骨游离移植加同期种植修复牙槽缺损初步观察

目的：利用自体髂骨游离移植同期种植修复牙槽缺损。方法：13例牙槽嵴萎缩患者行自体髂骨游离移植同期植入29枚种植体。结果：移植骨存活，植入的29枚种植体与移植骨结合良好，义齿修复一年后种植体无松动、脱落。结论：采用该方法可早期修复牙槽缺损，但仍需进一步观察长期效果。     

即刻植骨同期种植体植入修复下颌骨缺损

目的 :探讨下颌骨缺损即刻植骨同期种植的可行性。方法 :对 6例下颌骨部分切除的患者 ,行下颌骨缺损即刻植骨同期种植术。其中 2例行血管化腓骨双层折叠移植 ,另 4例为非血管化髂骨移植。同期植入种植体共 19颗。结果 :6例术后均一期愈合 ,X线显示种植体周围骨结合正常。结论 :下颌骨缺损血管化和非血管化骨移植同期种植术是可行的 ,但由于同期种植的复杂性 ,要求在适应症的选择及手术操作上应更加严格     

全厚皮片结合骨移植同期植入种植体:1例报告

目的:前臂全厚皮片结合骨移植同期植入种植体行重建下颌的功能恢复.方法:下颌骨部分切除同期髂骨重建患者1例,术后6个月检查瘢痕组织严重,X片示重建下颌骨愈合良好,前牙区成V型骨缺损.术中植入4颗Tiunite种植体,植Rio-oss块状骨、骨粉与自体骨混合物于骨缺损区,同期于前臂内侧切8cm*5cm全厚皮片修复瘢痕粘膜,术后10个月行义齿修复.随访观察.结果:皮片移植成功,种植体与移植骨结合良好.修复后咬合恢复正常,咀嚼功能良好,患者满意.术后随访4年,成釉细胞瘤未复发,种植体周围未见明显骨吸收.结论:全厚皮片结合骨移植同期植入种植体可作为下颌重建伴瘢痕严重患者修复的可靠方法之一.     

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.     

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.     

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.     

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.     

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。     

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.     

替牙期骨性Ⅲ类错牙合患者颞下颌关节特征的锥形束CT研究

目的:采用锥形束CT(CBCT)研究替牙期骨性Ⅲ类错牙合患者颞下颌关节的影像学特征,探讨Ⅲ类功能状态下,颞下颌关节的生长、改建机制。方法:从就诊于昆明医科大学附属口腔医院正畸科的患者中选取符合纳入标准的替牙期骨性Ⅲ类错牙合患者及骨性Ⅰ类错牙合患者各20名,使用NNT viewer 5.3图像处理软件进行三维重建及线距和角度的测量,并进行统计学分析。结果:替牙期骨性Ⅲ类错牙合患者组和替牙期骨性Ⅰ类错牙合患者组对比结果为:矢状面双侧关节前间隙偏小、双侧关节上间隙偏小、双侧关节结节斜度偏小;冠状面双侧关节内间隙偏小,双侧关节上间隙偏小,双侧关节外间隙偏小,右侧髁状突角度偏小;横截面右侧髁状突前后径偏小。结论:替牙期骨性Ⅲ类错牙合患者颞下颌关节发育不充分,呈现髁状突,关节窝深度,关节结节斜度;冠状面关节内、外间隙均较小的特征。骨性Ⅲ类错牙合患者髁状突在关节窝中处于前置近关节窝顶位置。骨性Ⅲ类错牙合患者颞下颌关节影像学特征与其功能状态相适应。     

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。