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??Objective    To evaluate the clinical results of sinus floor elevation technique with simultaneous dental implantation in the posterior maxilla. Methods    A total of 79 patients underwent osteotome sinus floor elevation from 2009 to 2012. Bio-Oss and PRF were used as augmentation material??with simultaneous placement of implants. Results    The implant lengths ranged from 10 to 13 mm. The average height increase of the implant site was 3.8 ??2 to 5.7??. Sinus membrane perforation occurred in 3 cases and the dental implantation was abandoned. Totally 87 implants were placed. At second stage of surgery?? 3 failed implants were removed. Two implants were removed 18 months after prosthetic rehabilitation. One implant was lost due to progressive bone loss. The overall survival rate was 93.1%??81/87??. No clinical complications of the maxillary sinus area were observed during a follow-up period of 12 to 36 months. Conclusion    Osteotome sinus floor elevation with bone graft was a predictable and safe technique. It simplifies the surgical process and can be taken predictably for implant placement with surgical technique.     

下颌骨骨折79例治疗体会

下颌骨因其特殊位置 ,下颌骨骨折在颌面损伤中发生率较高 ,现将我院 1 989年～ 1 998年中 79例下颌骨骨折治疗介绍如下 :1　临床资料1 .1　一般资料 :79例中 ,男性 66例 ,女性 1 3例 ,男女比为 5.0 8∶ 1 ,年龄最大 69岁 ,最小 1 .5岁 ,平均年龄 33.1岁。1 .2　致伤因素 :交通事故 31例 ,跌伤 2 5例 ,打击伤1 5例 ,刀砍伤 7例 ,爆炸伤 1例。1 .3　骨折部位 ,79例下颌骨骨折患者中 ,骨折线共1 48处 ,其中下颌体骨折 90处 ,下颌角处 2 5处 ,髁状突颈部 2 4处 ,升支 8处 ,喙突 1处。本组病例中 ,闭合性骨折 45例 ( 57% ) ,开放性骨折 34例 ( 4 …     

腮腺Warthin瘤79例临床分析

目的:分析Warthin瘤(腺淋巴瘤)的发病原因,探讨Warthin瘤的治疗原则。方法:总结我院近10年住院病例中的Warthin瘤患者79例,从性别、年龄、部位、大小、病史、有无吸烟史、有无消长史及术式分类等方面进行分析统计。结果:在662例腮腺肿瘤患者中,Warthin瘤79例,占11.9%。其中男性67例,女性12例,男:女=5.6:1;年龄43～83岁,平均59.6岁。发病高峰年龄为60～70岁,共28例,占35.4%。部位在后下极占82%,耳前占12%,其他部位6%。病史从20 d～20年。肿瘤>3 cm者占82%,>6 cm者占18%。82%的患者有吸烟史,24.2%有消长史。行腮腺全叶或浅叶切除及腮腺区域性切除术,随访1～10年均未见复发。结论:本组病例资料与文献比较,Warthin瘤占腮腺肿瘤的比率有所提高(11.9%),女性患者增多(男女比例5.6:1),发病高峰年龄偏长(60～69岁)。治疗原则倡导包括肿瘤的腮腺区域性切除,以保留腮腺导管及大部分腺体功能。     

颌骨角化囊肿——79例临床病理研究

颌骨角化囊肿作为独立性疾病被认识约有20年的历史。以往曾称为胆脂瘤、表皮样囊肿、皮脂腺囊肿以及颌骨始基囊肿。1971年世界卫生组织在对颌骨囊肿的分类中将其称为始基囊肿,其同义名为“角化囊肿”。此分类强调的是组织学特微而不是推测它来自初期釉质器。     

上颌窦底提升同期种植体植入术79例临床分析

目的    观察采用经牙槽嵴入路提升上颌窦底同期植入种植体的临床效果。方法    对2009—2012年南京军区机关医院数字口腔中心接诊的79例上颌后牙缺失患者,行经牙槽嵴顶入路上颌窦底提升,选择性植入人工骨或富血小板纤维蛋白（PRF）,同时植入种植体。结果    79例患者平均提升上颌窦底高度3.8 mm（2.0～5.7 mm）。3例患者因上颌窦黏膜术中发生穿孔,遂关闭创口,未完成种植体植入。其余76例共植入87颗种植体,长度 10～13 mm。Ⅱ期手术时,3颗种植体松动拔除。义齿修复后追踪12～36个月,2颗种植牙松动拔除,1颗有进行性骨吸收,种植体存留率为93.1%（81/87）。所有病例均无上颌窦并发症。结论    经牙槽嵴顶入路上颌窦底提升术较开窗式上颌窦提升创伤小,操作简单,对窦底有适量剩余骨的上颌窦区种植是可行的;但由于窦底黏膜存在穿孔风险,技术要求较高,而且必须有专用的器械。     

79例外伤引起颌骨骨折的原因及研究

外力因素是造成颌面部骨组织损伤最常见的原因。我院口腔科从 1 996～ 2 0 0 0年共收治了 79例外伤引起的颌骨骨折病人。我们对这些病例作了分类统计 ,对病因和后果的关系作了一些研究分析。1　病例资料本组病例共 79例 ,男性 1 3例 ,女性 6例 ,最大67岁 ,最小 4岁 ,平均 30 .1 0岁。骨折发生部位 ,上颌骨 6例 ,下颌骨 77例 ,开放性骨折 36例 ,闭合性骨折 43例。2　资料统计2 .1　按外伤因素分类车祸 :颌骨骨折共 33例。发生在上颌骨 4例。下颌骨髁突 6例 ,升支 5例 ,体部 1 6例 ,角部 5例 ,颏部 8例。附表　颌面骨折年龄统计年龄 (岁 )例数…     

髁状突肿瘤及类肿瘤79例临床分析

本文对我院 1975～ 1999年间收治的经病理诊断的髁状突肿瘤及类肿瘤 79例进行了总结分析 ,现报告如下 :1　临床资料1.1　一般情况　 79例患者中 ,男性 41例 ,女性 38例 ,就诊年龄最小者 12岁 ,最大者 5 8岁 ,平均就诊年龄 31.2岁 ,病程最长者为 11年 ,最短者为 15ｄ ,平均病程为 4.3年。 79例术后标本行病理检查 ,良性肿瘤及类肿瘤 74例 ,占 93.6 7% ;恶性肿瘤 5例 ,占 6 .33%。病种分布情况见表 1。表 1　 79例髁状突肿瘤及类肿瘤病种分布病名例数 %髁突肥大 45 5 7.0髁突骨瘤 14 17.6髁突骨软骨瘤 9 11.3髁突软骨瘤 3 3 .8髁突滑膜骨瘤 11…     

自体肋软骨移植隆鼻术的体会(附79例报告)

我科自1981年8月至1989年10月采用自体肋软骨移植隆鼻术79例,现总结如下: 1 临床资料 79例中,男性24例,女性55例,年龄大多数为     

79例头颈部牙源性黏液瘤临床、病理及预后分析

目的: 研究头颈部牙源性黏液瘤的临床、病理及预后特点。方法: 回顾2001—2017年于上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科接受手术治疗的头颈部黏液瘤患者的临床、病理及预后信息,采用SPSS 17.0软件包对数据进行统计学分析。结果: 纳入患者79例,其中可随访71例。可随访患者中,男30例,女41例。年龄≤30岁27例,31~60岁39例。12例有吸烟史,3例有酗酒史。12例接受过手术治疗;42例发生于下颌骨,26例发生于上颌骨及颅底。肿瘤最大直径中位值为3.5 cm,36例肿瘤最大直径≤3.5 cm。60例接受肿瘤根治性切除,11例接受局部刮治术。52例瘤体组织以纤维成分为主,19例以黏液成分为主;随访期间4例出现局部复发。接受局部刮治术的患者,术后复发率（36.36%）显著高于接受肿瘤根治性切除的患者（P=0.001）。结论: 头颈部牙源性黏液瘤是一种较为罕见的良性肿瘤,具备局部侵袭性,下颌骨发病较常见,患者年龄以31~60岁为主。相对于局部刮治术,根治性切除可有效抑制肿瘤术后复发。     

保守治疗牙源性角化囊肿的初步探讨

目的:探讨保守治疗牙源性角化囊肿的可行性和临床意义。方法:对我院近几年收治的囊肿较大、多发或不愿作根治术的12名患者,行彻底刮治术加开窗术的保守治疗,术后佩带塞治器,观察其疗效和复发率。结果:术后0.5～1年X线显示9例原病变区有大量新生骨质沉积,3例无明显疗效,有效率为75%,随访1～3年,复发4例,复发率为33.3%。结论:牙源性角化囊肿保守治疗有一定临床疗效,但尚需降低复发率。     

Reclassification of odontogenic keratocyst as tumour. Impact on the odontogenic tumours prevalence

Oral Diseases (2010) 16 , 185–187 Aim: The aim of this study was to establish the impact of the redefinition and reclassification of odontogenic keratocyst (OKC) as a tumour on the prevalence of odontogenic tumours (OT). Methods: We revised 15 435 files of a teaching head and neck histopathology service in the time period from January 1981 to December 2008 and 478 cases of OT were selected. The 342 cases from 1981 to 2004 were classified according 1992 to the World Health Organization (WHO)‐classification (excluding keratocystic OT) while the 136 cases from 2005 onwards were classified according to the 2005 WHO‐classification (including keratocystic OT). Age and gender were obtained from medical records. The frequency distribution and prevalence of OT from each periods of time were compared. A chi‐square test was performed (P < 0.05 95% confidence interval). Results: The prevalence of OT increases 92% in the 2005–2008 period; from 2.6% (1981–2004 period) to 5% (2005–2008 period) (P 0.000).The most frequent OT in the 1981–2004 period was odontoma (45% of all OT) while in the 2005–2008 period was Keratocystic Odontogenicv Tumour (38.9%). Conclusions. The redefinition of OKC as a tumour produced an increase in the frequency and prevalence of OT.     

Solid variant of odontogenic keratocyst

A case of an unusual lesion from the maxilla is presented. Macroscopically, the lesion was solid and histologically consisted of 'multiple separate keratocysts' of varying size that infiltrated into the surrounding bone and soft tissues. Panoramic image and CT scans showed a multilocular honeycomb ill-defined radiolucency with infiltration into the maxillary sinus and floor of orbit. This lesion should be differentiated from similar odontogenic lesions, such as keratoameloblastoma and papilliferous keratoameloblastoma. As there was no evidence of follicles, islands of ameloblastoma, or papilliferous structures in the entire specimen, the lesion could not be diagnosed as either a keratoameloblastoma or a papilliferous keratoameloblastoma. The invasive and destructive growth behavior, the histopathological features, and the histochemical pattern of the collagen stroma imply that this solid lesion is a neoplasia. It is suggested that the proper term for this lesion is solid variant of odontogenic keratocyst.     

Odontogenic keratocyst clinically mimicking an eruption cyst: report of a case

This article describes a case of odontogenic keratocyst (OKC) in a 1 year and 7 month old girl who presented such a lesion mimicking an eruption cyst. To date, only one well-documented OKC occurring in a patient under 5 years old has been reported and it was thought to be associated with nevoid basal cell carcinoma syndrome (NBCCS). In our OKC case, the cyst was totally enucleated. No evidence of recurrence and NBCCS was found after a 4-year follow-up. The development of involving tooth in a growing child and the histogenesis of OKC are discussed in this article.     

The differential expression pattern of BMP-4 between the dentigerous cyst and the odontogenic keratocyst

BACKGROUND: Bone morphogenic protein-4 (BMP-4) is widely expressed in oral cavity and involved in tooth morphogenesis, cellular differentiation and proliferation. The purpose of this study was to compare the difference in expression pattern of BMP-4 in odontogenic keratocysts (OKC) and dentigerous cysts (DC). METHODS: We evaluated 77 cysts, OKC (n = 34) or DC (n = 43). The average age of patients with OKC was 29.5 +/- 14.4 and that of patients with DC was 36.1 +/- 19.4. The male to female ratio was 20:14 for OKC and 27:16 for DC. Ten cases of OKC were recurrences. Expression of BMP-4 was determined by immunohistochemistry and in situ hybridization. RESULTS: The intensity scales were (-) for invisible or trace staining, (+) for visible staining, and (++) for dense, strong staining. OKCs exhibited the following staining patterns: the epithelium in 15/34 specimens and the mesenchymal cells in 17/34 specimens showed (++) stain. In contrast, the staining pattern of DC was (-) for epithelium in 37/43 specimens. The mesenchymal cells showed (-) degree staining in 30/43 specimens. The difference between the groups studied was significant (P < 0.001 in epithelium and mesenchymal cells). When recurrent and non-recurrent OKC were compared BMP-4 was expressed more intensely in the recurrent cases (P = 0.036 in epithelium). The difference in BMP-4 expression in mesenchymal cells was not significant. In situ hybridization demonstrated positive mRNA probes to BMP-4 were localized in epithelium and mesenchymal cells of OKCs and DCs. CONCLUSIONS: BMP-4 was expressed more intensely in OKC when compared with DC, and was more intensely expressed in recurrent cases.     

Conservative management of recurrent keratocysts in Basal-cell naevus syndrome

Basal-cell naevus syndrome is characterized by multiple odontogenic keratocysts as well as skeletal, ophthalmologic and neurologic features. It is important that the dental practitioner be aware of this syndrome as it has important ramifications for the developing dentition. A case of Basal-cell naevus syndrome is presented along with a review of the literature regarding the management of this disorder. An argument for conservative surgical management of this syndrome is made.     

Cell proliferation markers in the odontogenic keratocyst: effect of inflammation

The immunohistochemical expression of PCNA and Ki-67 proteins and the histochemical expression of AgNORs were studied in 20 odontogenic keratocysts in order to assess the relationship between epithelial cell proliferation and inflammation within the capsule. Immunostained cells were quantified by conventional methods, and both quantitative and morphometric analyses of AgNORs were performed by TV image analysis. Non-inflamed odontogenic keratocysts showed a typical epithelial lining and inflamed odontogenic keratocysts were lined also by hyperplastic non-keratinized stratified squamous epithelium. A statistically significant increase of PCNA+ and Ki-67+ cells and of AgNOR numbers was detected in the linings of inflamed odontogenic keratocysts compared to non-inflamed lesions. The results suggest the existence of greater proliferative activity in the epithelial cells of inflamed odontogenic keratocysts, which may be associated with the disruption of the typical structure of odontogenic keratocyst linings.     

颞下窝软组织外周性角化囊肿1例报告

角化囊肿是口腔颌面部常见的牙源性肿物，多见于颌骨，特别是下颌支和下颌体，罕见在软组织中发生。本文报告1例发生在颞下窝软组织中的外周性角化囊肿，并结合文献，对外周性角化囊肿的组织来源及临床诊断进行了讨论。     

Survivin、bcl-2、caspase-3在牙源性角化囊肿中的表达及意义

目的检测凋亡相关蛋白survivin、bcl-2、caspase-3在角化囊肿中的表达,探讨其在角化囊肿发生发展中的意义。方法免疫组织化学方法检测20例角化囊肿(10例原发和10例复发)、10例含牙囊肿和10例根端囊肿中survivin、bcl-2、cas-pase-3的表达。结果Survivin、bcl-2、caspase-3阳性染色分别见于13(65%)、13(65%)、9(45%)例角化囊肿。Survivin、bcl-2在角化囊肿上皮基底层细胞中阳性表达,阳性率显著高于含牙囊肿和根端囊肿;caspase-3在角化囊肿上皮表层细胞表达。Survivin的表达与bcl-2正相关,与caspase-3无明显相关性。结论Survivin、bcl-2、caspase-3在角化囊肿形成和发展中起一定作用。     

Prognostic factors for keratocystic odontogenic tumor (odontogenic keratocyst): analysis of clinico-pathologic and immunohistochemical findings in cysts treated by enucleation

Background:  The purpose of this study was to determine prognostic factors for the recurrence of keratocystic odontogenic tumors (KCOTs) following simple enucleation by examining clinico-pathologic and immunohistochemical findings.
Methods:  Following enucleation, the frequency of recurrence among 32 subjects diagnosed with KCOT was analyzed for tumor site, radiographic and histologic features, and immunopositivity for Ki-67 and p53.
Results:  Keratocystic odontogenic tumors in four out of 32 subjects (12.5%) recurred during the follow-up period (median: 33 months, range: 7–114 months). Three out of four subjects (75.0%) among recurrent group showed high expression of Ki-67 (LI >10%) in basal layer and four (4/28; 14.3%) among non-recurrence group ( P  = 0.025). Expression of p53 among non-recurrent group was observed in 11 subjects (11/28; 39.3%), and in three subjects (3/4; 75.0%) among the recurrent group ( P  = 0.295). Hazard risk for the recurrence of KCOT was 4.02 (95% CI 1.42–18.14) for high Ki-67 expression in the basal layer by the Cox proportional hazard model ( P   =  0.009). In our study, none of the other clinico-pathologic variables were associated with the recurrence of KCOT.
Conclusion:  The results suggested that the evaluation of Ki-67 expression in KCOT at the time of pathological diagnosis might be helpful for consideration of appropriate adjunctive surgical procedures to avoid a recurrence and may serve as a prognostic marker.