数字化技术评估上颌前牙区唇侧牙龈厚度与骨板厚度的相关性研究

目的 通过CBCT结合口腔扫描手段,分析青年人上颌前牙区唇侧牙龈厚度与骨板厚度相关性以及釉牙骨质界(CEJ)至牙槽嵴顶(ARC)的距离与牙龈生物型之间的相关性。方法 对30名受试者进行CBCT拍摄、口内数字化扫描,两组数据配准重建后测量釉牙骨质界至牙槽嵴顶的距离、唇侧CEJ下4 mm处牙龈厚度及对应骨板厚度。结果 厚中薄三种牙龈生物型对应釉牙骨质界至牙槽嵴顶的距离差异无统计学意义(F=1.886,P>0.05);CEJ下4 mm处牙龈厚度与骨板厚度在中切牙及侧切牙区存在负相关(r=-0.319;r=-0.292,P<0.01),在尖牙区无明显相关性(r=-0.197,P>0.05)。结论 牙龈生物型分型与釉牙骨质界-牙槽嵴顶的距离之间无显著相关性;上颌前牙区唇侧牙龈厚度及骨板厚度均较薄,两者之间相关性尚未明确。     

67名正常青年人上前牙区唇、腭侧骨厚度测量分析

目的:对汉族正常青年人上前牙区不同位点的唇、腭侧牙槽骨厚度进行测量,为术前评估、治疗方案制定及预后评估提供参考。方法:通过锥形束CT(CBCT)对67名符合条件的汉族青年志愿者进行上颌骨扫描。三维重建后,对前牙区唇、腭侧骨厚度进行测量。利用SPSS17.0软件包对测量数据进行配对t检验、独立样本t检验、方差分析及χ2检验。结果:1唇侧骨板除所有前牙L5处及上颌尖牙L1处厚度均数>1.00 mm外,其余测量位点唇侧骨板厚度均数均<1.00mm,而腭侧骨板厚度均数均>1.00 mm;2唇侧骨板厚度均小于腭侧骨板厚度(P<0.001);33种前牙唇侧骨板厚度在参考线L3与L4处厚度最小(P<0.001),腭侧骨板厚度自L1至L5逐渐增大(P<0.05);4仅在上颌尖牙L2处及所有前牙L5处唇侧骨板厚度<1.00 mm的频率<50%,男性上颌侧切牙L3、L4处及上颌尖牙L4处唇侧骨板缺如所占频率>50%;5男性切牙区唇侧骨板凹陷角度较尖牙小(P<0.05),唇侧骨板最凹点与根尖点之间的距离在男性上颌中切牙最大(P<0.05),女性牙位间无显著差异。结论:正常青年人上前牙牙槽骨骨板菲薄甚至缺如,且唇、腭侧骨厚度和形态存在差异。     

中国人上切牙牙冠厚度及宽厚比例的测量

目的 通过模型测量，了解具备理想前牙咬合者的上颌4个切牙牙冠厚度、宽度及宽厚比例值。方法 恒牙列初期矫治完成记存模型，男女各30例，测量4个上切牙的近远中宽度及咬合接触点水平处的唇舌向厚度，数据行统计学处理。结果和结论 中国汉族人上颌切牙呈典型的铲形结构，应以其近远中边缘嵴处的平均厚度来代表牙冠的厚度；得到了上颌4个切牙的平均宽度、厚度及宽厚比值。     

激光扫描法建立三维数字化牙颌模型的准确性和可靠性评价

目的 研究应用激光扫描法建立三维数字化牙颌模型的准确性和可靠性评价。方法 选择正畸治疗患者的石膏模型24 副,采用激光扫描法对石膏模型进行扫描,建立三维数字化牙颌模型,并对其牙冠宽度、牙冠高度、牙弓宽度和牙弓长度进行测量,与手工测得的结果进行比较分析。结果 石膏模型和数字化模型所有测量项目的一致性相关系数中,除双侧上颌第一前磨牙颊尖顶之间的距离(CCC=0.6307)和上颌中切牙近中接触点到右侧第一磨牙远中接触点的距离2 项测量指标结果(CCC=0.6571)良好外,其余指标的一致性都比较接近(CCC>0.7)。所有测量项目的均数差在0.017~0.862mm 之间,平均为0.104mm,D%﹤5%,部分指标存在统计学差异,但不具有临床意义。结论 基于激光扫描技术重建的三维数字化牙颌模型中,牙冠宽度和牙冠高度的准确性高,牙弓长度其次,牙弓宽度的准确性较低。     

上前牙矢状面牙根位置分类及唇侧骨板厚度的CBCT研究

目的 应用锥形束CT（CBCT）对上颌前牙矢状面牙根在牙槽骨中的解剖位置进行分类,并测量其唇侧骨板厚度,为上颌前牙即刻种植修复治疗提供影像学研究数据。方法 回顾性筛选出200名患者的CBCT影像,其中男性80名,女性120名。CBCT矢状面影像中,上前牙牙根在牙槽骨中的位置分为4类,并且测量其唇侧牙槽嵴顶下1.5 mm处唇侧骨板的厚度。结果 中切牙4种分类的发生率分别为I类80.5%、Ⅱ类7.5%、Ⅲ类1%以及Ⅳ类11%,侧切牙的发生率分别为I类72%、Ⅱ类11.5%、Ⅲ类1%以及Ⅳ类15.5%,尖牙的发生率分别为I类82%、Ⅱ类9.5%、Ⅲ类0%以及Ⅳ类8.5%。中切牙唇侧骨板平均厚度男性为（1.10±0.26）mm、女性为（0.98±0.19）mm,侧切牙唇侧骨板平均厚度男性为（0.87±0.20）mm、女性为（0.83±0.20）mm,尖牙唇侧骨板平均厚度男性为（1.18±0.35）mm、女性为（1.04±0.25）mm。除侧切牙外,中切牙和尖牙唇侧骨板厚度男性均大于女性,且差异具有统计学意义。结论 上前牙矢状面牙根位置的影像学分类研究对该区域患牙即刻种植修复治疗手术有导向性意义,并且上前牙牙槽嵴顶下1.5 mm处唇侧骨板菲薄,即刻种植修复前应结合以上两点进行详细评估。     

研究上前牙区角化龈宽度和牙龈组织厚度之间的关联

本研究的目的是为了评价角化龈的宽度和厚度之间是否为正相关。纳入了60位20-35岁的患者（30位男性,30位女性）,对其右上尖牙、侧切牙和中切牙的软组织进行检查。使用一个带有橡皮止动片的牙髓探针和一个分辨率为0.01mm的数字化卡尺进行数据测量。获得的数据包括角化龈的宽度和厚度。结果显示,侧切牙的平均角化龈宽度最宽（5.54±1.09mm）,中切牙次之（4.62±1.02mm）,尖牙最窄（4.32±1.33mm）。中切牙的平均牙龈厚度最厚（1.17±0.20mm）,侧切牙次之（1.04±0.24mm）,尖牙最薄（0.87±0.27mm）。男性与女性之间的角化龈宽度和厚度的差异没有统计学意义。上颌尖牙（Pearson r=0.398,P〈0.05）、侧切牙（Pearson r=0.369,P〈0.05）和中切牙（Pearson r=0.492,P〈0.05）区域的角化龈宽度和厚度之间为正相关。初步得出结论,对于20-35岁的患者,右上尖牙、侧切牙、中切牙的角化龈宽度和厚度之间为正相关。     

部分回族和蒙古族成人恒牙形态测量

目的:了解我国回族和蒙古族人群恒牙牙体形态特征,为牙体牙髓病的临床治疗提供解剖学资料.方法:分别收集新鲜拔除的348个回族和314个蒙古族成人恒牙,按照已建立的汉族成人恒牙测量的形态学测量标准,对牙齿的冠长、根长、全长、颈宽、近中远中径、颊舌径等进行测量并进行统计学分析.结果:回族成人上颌尖牙及下颌磨牙的冠长、上下颌尖牙及上颌第一磨牙的全长均大于蒙古族(P<0.05),回族成人下颌侧切牙的全长、上颌第一前磨牙的近中远中径和颊舌径、上颌第一磨牙的颈宽均小于蒙古族(P<0.05).回族成人较蒙古族成人下颌第二磨牙的根分叉位置更靠近根尖部(P<0.05).结论:回族、蒙古族与汉族成人恒牙牙齿形态存在差异.     

利用数字化印模和软件分析上中切牙全瓷冠牙体预备的精度

目的 利用数字化印模和设计软件对不同工作年限医师预备的上中切牙全瓷冠牙体预备的精度进行分析和评估。方法 在实验用标准牙模上,3组实验对象（上海第九人民医院口腔修复医师组、临床型研究生组和临床前本科生组）按照统一的牙体预备程序和标准,对右侧上颌中切牙进行全瓷冠牙体预备,利用Planscan口内扫描仪获取标准预备体和各实验组的样本数据,量化牙体预备各评价指标,并利用评分软件比较各组样本与标准预备体、各组样本之间的肩台宽度、聚合度以及轴壁高度。采用统计学单因素方差分析及最小显著性差异法（Least significant difference,LSD）多重比较的方法,分析不同分组之间的差异。结果 在肩台宽度与轴壁高度方面,临床经验不尽相同的3组在统计学上显示差异有显著性意义（P<0.05）。结论 在临床前牙体预备训练中应注意轴壁高度不过度预备,尤其应着重控制肩台宽度预备量的训练。     

上颌切牙的牙颈部形态测量及分析

目的 :本研究通过测量获得天然上颌切牙牙颈部宽度、厚度及牙颈曲度等数据,为切削制作个性化愈合基台提供依据。方法:采用电子游标卡尺对173颗离体上颌切牙(中切牙104颗、侧切牙69颗)的颈部近远中宽度、颊舌向厚度,近中牙颈部曲度、远中牙颈部曲度,釉牙骨质界(CEJ)根方1.5 mm颈部宽度、颈部厚度进行测量。每部位测量3次,数据以均数±标准差(x±s)表示,精确到0.01 mm。结果 :上颌中切牙及上颌侧切牙在颈部宽度、颈部厚度、CEJ根方1.5 mm颈部宽度与颈部厚度、近中颈曲度与远中颈曲度方面的差异均具有统计学意义(P<0.05)。上颌中切牙CEJ及CEJ根方1.5 mm颈部宽度大于颈部厚度;上颌侧切牙CEJ及CEJ根方1.5 mm颈部厚度大于颈部宽度。结论:上颌切牙基台顶端应设计为弧形,上颌中切牙、侧切牙基台近中颈部曲度应大于远中颈部曲度,近远中应为外形最高点,唇舌侧应为外形最低点。     

CBCT介导的渐进式教学在口腔专科生根管治疗术实习中的初步探讨

目的 探讨CBCT在口腔专科生根管治疗术实习过程中结合渐进式教学的效果。方法 选择62名口腔专科实习生,随机分为试验组（CBCT）和对照组（根尖片组）,实习初期和实习中期进行理论学习和观摩根管治疗流程,实习后期进行根管治疗术临床实践,对患者上颌中切牙、上颌第一前磨牙和下颌第一磨牙进行根管治疗,对比两组实习生读片准确性和根管治疗操作合格率,比较两组操作时间和治疗后疼痛。结果 两组学生对上颌中切牙读片、根管治疗操作合格率、操作时间和治疗后疼痛未见统计学差异（P>0.05）;而对上颌第一前磨牙和下颌第一磨牙,2组学生在所有评估指标上都存在差异（P<0.05）。结论 对于较复杂根管系统的牙位进行根管治疗时,CBCT可有效提高口腔专科生读片准确率和治疗成功率,缩短治疗操作时间,减轻治疗后疼痛。     

Diagnosis and management of hemangiomas and vascular malformations of the head and neck

Oral Diseases (2010) 16 , 405–418 Vascular anomalies are congenital errors in vascular development. They frequently involve the head, neck, and oral cavity. Subdivided into vascular tumors (hemangiomas) and vascular malformations, vascular anomalies remain poorly understood. However, growing interest and recent advances in the diagnosis, management, and molecular characterization of these lesions are improving treatment strategies. The role of the multidisciplinary team cannot be overstated. This review provides both basic and up‐to‐date knowledge on the most common vascular anomalies encountered by physicians and practitioners. Because treatment options for vascular anomalies are widely variable and often debated, this report aims to provide a comprehensive approach to these lesions based upon current concepts and practical clinical experience.     

口腔颌面-头颈部胚胎型横纹肌肉瘤临床诊治探讨

目的:探讨头颈部胚胎型横纹肌肉瘤的临床特点、诊断、治疗及预后.方法:回顾性分析上海交通大学医学院附属第九人民医院2000-09--2010-10收治的12例头颈部胚胎型横纹肌肉瘤患者的临床资料.结果:12例患者中9例获得随访.5例术前化疗患者中3例短期疗效达到PR,1例达到MR,化疗有效率达到60%;8例患者行手术治疗...     

Colour and translucency of opaque-shades and body-shades of resin composites

The purpose of this study was to evaluate the optical properties--not only the translucency but also the colours--of opaque-shade resin composites. The CIELAB parameters (L*, a* and b*) of disks of A2 and opaque A2 (OA2) shades of Charisma (Heraeus-Kulzer), Solare (GC) and Filtek Supreme (3M) were evaluated on backings of black, white and the material itself to calculate the translucency parameter (TP) and the colour differences (delta E*) between A2 and OA2. A two-way analysis of variance (anova) for the TP indicated a less statistically significant TP value in the OA2 shade than the A2 shade for all products. As for the products, Charisma showed a statistically greater TP value than the other two products. Regarding the delta E* between A2 and OA2, all the products revealed clinically perceptible colour differences (delta E* > 3.3). Hence, we must take the colour differences of opaque-shade resin composites into consideration, as well as the translucency of the materials, for a clinically acceptable colour match of the restoration.     

种植体周围炎与牙周炎的类比探究

种植体周围炎症是种植失败的主要原因之一,包括种植体周围黏膜炎和种植体周围炎。种植体周围炎的发生、发展及治疗和预防与牙周炎存在一定的相似性,本文将种植体周围炎和牙周炎的流行病学、组织病理表现、始动因素、危险因素、治疗和预防等方面进行类比,探讨如何更好地预防和治疗种植体周围炎。     

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牙拔除术是一种常见的外科手术,术后因机体对拔牙创伤的生理反应会不可避免地引起局部出现程度不一的疼痛、肿胀,这种由手术创伤引起的疼痛、肿胀虽然是正常手术的继发过程,但会导致患者术后生活质量下降,并可使很多由于恐惧而不敢拔牙的患者延误了最佳治疗时机。本文就拔牙术后疼痛和肿胀的发生原因、临床表现、治疗方法和预防措施进行阐述,为临床上如何避免或减轻拔牙术后的疼痛和肿胀提供帮助。     

Assessment and comparison of phagocytic function and viability of polymorphonuclear leukocytes in saliva of smokers and non-smokers

OBJECTIVES

Tobacco use is one of the most important public health problems worldwide. It is also linked to impairment of normal immunologic surveillance and defence mechanism of polymorphonuclear leukocytes. Tobacco smoke and its components have been seen to affect the phagocytic ability and viability of polymorphonuclear leukocytes suggesting the pathogenesis of tobacco induced oral diseases. Aim of this study was to assess and compare the phagocytic function and viability of polymorphonuclear leukocytes in saliva of smokers and non smokers.

DESIGN

The study comprised of 35 smokers and 35 non-smokers, age matched. Saliva was collected by rinsing method and the polymorphonuclear leukocytes were separated. Phagocytic activity was determined by using latex spheres as targets. Cell viability was measured using trypan blue stain.

RESULTS

Salivary polymorphonuclear leukocytes in smokers showed significant reduction in the phagocytic activity by ingesting few latex spheres when compared to the non-smokers. The viability of these cells in saliva of smokers was significantly reduced.

CONCLUSIONS

The present study revealed reduced phagocytic activity and viability of salivary polymorphonuclear leukocytes in smokers compared to non-smokers. These findings indicate that smokers are more prone to gingival, periodontal and other oral diseases. Thus indicating that the health care professionals should encourage smoking cessation as an aid in preventing oral diseases.     

Combined effects of NaF and SLS on acid- and polysaccharide-formation of biofilm and planktonic cells

Bacteria grow preferentially attached to surfaces embedded in an exopolysaccharide matrix to form biofilms. In this mode of growth, bacteria often show reduced susceptibility to antimicrobials. The aim of this study was to investigate whether the combination of NaF and the detergent sodium lauryl sulphate (SLS) could result in additive effects on acid formation by planktonic and biofilm cells, as well as on extracellular polysaccharide formation. An additive inhibitory effect on Streptococcus mutans acid formation was observed, both in planktonic and biofilm cells. In dental biofilms, SLS alone and in combination with NaF reduced acid formation. Extracellular polysaccharide formation by S. mutans and saliva was reduced by SLS alone and in combination with NaF. In dentifrices and mouthrinse solutions, NaF and SLS are often present in combination. It remains to be determined whether an additive effect on acid formation may also occur in dental biofilms under different concentrations from those used in the present study, and whether the effects may be selective for certain bacterial species.     

Effects of zinc and copper on adhesion and hemagglutination of Prevotella intermedia and Prevotella nigrescens

This study investigated the mechanism of protein attachment to the surface of the putative periodontal pathogens Prevotella intermedia and Prevotella nigrescens in artificial gingival crevicular fluid, and ways to increase protein attachment to the bacterial cells. The effects of cations on protein attachment, bacterial adhesion, and hemagglutination were examined, and cation-binding components on both bacterial species were identified. The presence of cations, especially zinc, copper and cerium, increased attachment of human serum proteins to both bacterial species. In contrast, the presence of hydrophobic inhibitors or sugars had little effect. Protein attachment was reduced by heat treatment of the bacterial cells. Pretreatment of bacteria with human serum proteins inhibited adhesion of both species to buccal epithelial cells and hemagglutination. These effects were enhanced by the presence of zinc and copper during pretreatment. Using a chelating column, specific zinc- and copper-binding proteins were identified on the surfaces of both bacterial species.     

Impact of moderate and severe hypodontia and amelogenesis imperfecta on quality of life and self-esteem of adult patients

ObjectivesThe objective of this study was to investigate the impact of moderate and severe hypodontia and amelogenesis imperfecta on the quality of life and self-esteem of affected adult patients.MethodsForty one adult patients (aged 18–45 years) with clinical and radiological diagnoses of moderate to severe hypodontia and twenty seven patients diagnosed with amelogenesis imperfecta were age and gender matched with a control group of patients attending for routine dental care. Subjects completed the Oral Health Impact Profile [OHIP-49] and Rosenberg Self Esteem Scale. A paired t-test was used to analyse data; the test alpha level was set at P ≤ 0.05.ResultsThe results for hypodontia patients were significantly different from controls in six out of the seven OHIP-49 domains, the exception being the Handicap domain. Total scores were also significantly different between the two groups (P = 0.003). Self-esteem was not significantly different between the two groups (P = 0.98).For amelogenesis imperfecta patients the results were significantly different from control patients in four out of the seven domains of the OHIP-49 and also in the total scores (P = 0.01). When self-esteem was investigated there was no significant differences between the two groups (P = 0.92).ConclusionsModerate to severe hypodontia and amelogenesis imperfecta have marked negative impacts on the Oral Health Related quality of life of this patient population relative to controls. However, self-esteem was not significantly affected.