牙周炎患者腰椎和牙槽骨骨密度测量分析

牙周炎和骨质疏松症是影响中老年人健康的两大疾病，一些学者提出牙周炎可能与骨质疏松症有关。为了探讨两者的关系，作者选择了重度慢性牙周炎２１例，快速进展型牙周炎１１例，牙周组织正常者１４例，利用双能Ｘ线骨密度仪测量腰椎和牙槽骨骨密度。结果表明：两型牙周炎组的牙槽骨骨密度明显低于正常对照组，而腰椎骨密度与正常对照组无明显差别，两型牙周炎之间的牙槽骨和腰椎骨密度也无明显差别。表明牙槽骨骨密度与全身骨密度无明显相关关系，骨质疏松症在牙周炎的发生上不起主要作用。     

血清骨钙素与牙周炎的关系

目的：检测牙周炎患者血清中骨钙素含量，以期发现它与牙周炎牙槽骨病变的关系。方法：选择早发性牙周炎患者（early-onset periodontitis,EOP)31例，成人牙周炎患者（adult periodontitis,AP)21例，健康对照者35例，用放射免疫分析法测定血清骨钙素含量。结果：血清骨钙素含量EOP组（6．25ng/ml),AP组（5．89ng/ml)均显著高于健康组（3．74ng/ml)，但EOP组与AP组之间骨钙素含量无明显差异，结论：骨钙素可能作为牙周炎症病变代谢变化的标志。     

固齿丸对中、重度牙周炎患者血清骨代谢的影响

目的探讨固齿丸对中、重度牙周炎患者血清骨代谢指标的影响。方法纳入中、重度牙周炎患者共52例,随机分为固齿丸组35例、对照组17例。所有患者均进行牙周基础治疗,固齿丸组同时给予口服补肾固齿丸4gbid,连服3个月。测定所有患者治疗前后血清骨钙素(OC)、碱性磷酸酶(ALP)、Ca、P,记录指数牙位的龈沟出血指数(SBI)、探诊深度(PD)。并使用软件测定指数牙位牙槽骨平均灰度值(MGVs)。结果固齿丸组OC、ALP较治疗前升高,Ca、P较治疗前降低,指数牙位MGVs升高(均P<0.05);而对照组均无显著性差异(P>0.05)。固齿丸组在治疗后,SBI和PD均较治疗前有明显下降(P<0.01),对照组SBI治疗后有显著降低(P<0.01),但PD无明显改善(P>0.05)。结论固齿丸能显著改善牙周炎患者的骨代谢,促进新骨形成,并能一定程度改善临床症状,其机理可能与提高成骨细胞活性有关。     

龈沟液中骨钙素含量与牙周炎的关系

多年来 ,人们一直在寻找对牙周疾病状况进行更有效更准确判断的标志。骨钙素是矿化组织中最丰富的非胶原蛋白 ,一些研究结果表明骨钙素水平反映骨组织的转换 ,是代表骨代谢瞬间变化的一个灵敏的、特异的生化指标。牙槽骨病变是牙周炎的重要特征之一 ,特定位点龈沟液骨钙素的水平可能反映局部牙槽骨的变化。我们采用放射免疫分析法检测龈沟液中骨钙素的含量 ,以期发现它与牙周炎及牙槽骨病理变化的联系 ,并对不同类型牙周炎患者龈沟液中骨钙素的含量进行比较。1 材料和方法 :选择病变程度类似的快速进展性牙周炎 (ｒａｐｉｄｌｙｐｒｏｇｒ…     

牙周炎与血清骨钙素、钙、磷含量相关关系研究

目的 通过比较血清中钙、磷含量及与骨形成密切相关的骨钙素在牙周炎患者和牙周健康者之间的差异,探讨骨钙素、钙、磷与牙周炎之间的关系。方法 选择慢性牙周炎患者98例,侵袭性牙周炎患者31例,牙周健康者106例,于初诊时采集静脉血液并提取血清,测量血清中的骨钙素、钙及磷的含量,对比牙周炎组与牙周健康组之间的差异。结果 牙周健康组血清骨钙素明显高于牙周炎组,有统计学意义(P<0.05);牙周炎组血清钙含量略高于牙周健康组,但没有统计学意义;牙周炎组血清磷的含量与牙周健康组没有明显差异。结论 牙周炎组血清骨钙素的含量明显低于牙周健康组,提示血清骨钙素与牙周炎之间可能存在联系。     

应用锥形束CT浅析牙周基础治疗对慢性牙周炎牙槽骨骨量的影响

目的:应用锥形束CT及Simplant软件测量分析不同类型、不同年龄段的慢性牙周炎患者,经过牙周基础治疗后牙槽骨的骨量恢复情况,以期为进一步治疗计划的制定提供临床依据。方法:采用单纯随机抽样法选取2012年2月~2013年2月就诊于中国医科大学附属口腔医院的慢性牙周炎患者50例,其中轻度牙周炎患者15例,中度牙周炎患者18例,重度牙周炎患者17例。采用Simplant软件及t检验观测并比较基线及牙周基础治疗后6个月慢性牙周炎个体的牙槽骨缺损程度,是否进行了统计学分析,请简要补充统计方法及检验水准。结果:不同年龄、不同病损程度的慢性牙周炎患者治疗后6个月与治疗前相比, 牙槽骨高度和相对骨密度均有改善。<50岁的轻度、中度牙周炎患者治疗后6个月的牙槽骨密度均显著高于治疗前(P<0.05),牙槽骨距釉牙骨质界的缺损高度均有降低,但与治疗前相比差异均无统计学意义;重度牙周炎患者治疗前后牙槽骨密度和牙槽骨缺损高度均有改善但差异均无统计学意义。随着年龄的增长,牙槽骨缺损高度及相对骨密度的改善程度呈下降趋势且治疗前后差异无统计学意义;前磨牙及磨牙的近中、远中位点治疗后6个月牙槽骨缺损高度及相对骨密度较其他位点改善明显(P<0.05)。结论:牙周基础治疗在一定程度上可有效改善慢性牙周炎的牙槽骨缺损高度和相对骨密度;锥形束CT及Simplant软件的应用有助于评估治疗前后牙槽骨骨量的变化。     

2型糖尿病患者牙槽骨成骨细胞体外培养与生物学特性研究

目的:研究2型糖尿病患者牙槽骨成骨细胞生物学特异性。方法:采用组织块法进行体外培养2型糖尿病患者和正常人牙槽骨成骨细胞,倒置显微镜观察细胞的形态,用碱性磷酸酶(ALP)、茜素红(Alizarinred)染色法分别进行细胞成骨特性的检测,噻唑蓝(MTT)比色法检测细胞的增殖趋势,用酶动力学、放射免疫及酶联免疫分析(ELISA)方法分别进行碱性磷酸酶、骨钙素(BGP)和Ⅰ型胶原(COL-Ⅰ)浓度的检测,结果:在同等培养条件下,二者的形态无明显差异,但2型糖尿病患者成骨细胞较正常人成骨细胞生长慢、活性弱,矿化结节形成少;2型糖尿病成骨细胞上清液中ALP、BGP及COL-Ⅰ浓度均较正常人低(P<0.05)。结论:2型糖尿病患者牙槽骨成骨细胞增殖较缓慢,特征性分泌物含量较正常成骨细胞低。     

12例重度慢性牙周炎患者全颌种植义齿修复的临床观察

目的探讨对经牙周治疗的重度慢性牙周炎患者拔除剩余牙齿后同期植入种植体并采用全颌种植义齿修复的可行性。方法对12例重度慢性牙周炎患者行牙周治疗，控制病情后，拔除剩余牙齿并同期植入种植体，5～6个月后行全颌种植义齿修复。根据临床、X线检查和患者主诉评价修复效果。结果共计108枚种植体植入20个牙弓，其中37枚种植体即刻植入拔牙窝内。种植体平均承载3年，所有种植体均无松动。2枚种植体发生种植体周围炎，有进行性骨吸收，其中1枚为即刻植入拔牙窝内的种植体。除2枚有进行性骨吸收的种植体外，其余种植体周围的骨吸收高度平均为（1．33±0．10）mm。108枚种植体的存留率为98．1％，37枚即刻种植体的存留率为97．3％。结论对重度慢性牙周炎患者行牙周治疗后拔除剩余牙齿并同期植入种植体，采用全颌种植义齿修复，可减少牙槽骨的吸收、缩短种植修复疗程，在定期的口腔卫生维护下获得理想的修复效果。     

糖尿病大鼠牙槽骨骨密度的变化

为了评价糖尿病大鼠牙槽骨代谢情况，采用放射免疫分析检测其血清骨钙素浓度，以双能量Ｘ线骨密度测量仪测量牙槽骨骨密度并结合组织学观察。结果表明，糖尿病大鼠血清骨钙素浓度升高，股骨与上、下牙槽骨骨密度降低，牙槽骨骨小梁变细变疏、骨吸收活跃，新骨形成减少。本研究结果提示，糖尿病大鼠牙槽骨骨吸收活跃，骨形成缓慢，有骨质疏松倾向。     

慢性牙周炎基础治疗前后牙槽骨锥形束CT评价

目的 应用锥形束CT(CBCT)评价慢性牙周炎牙周基础治疗前后牙槽骨的改变.方法 选择重度慢性牙周炎患者30例,对牙周基础治疗前、后上颌前磨牙牙槽骨进行临床疗效观察及拍摄CBCT片,利用CBCT随机软件测量牙槽骨高度和相对骨密度变化.结果 重度慢性牙周炎基础治疗后,患者牙周袋探诊深度、附着丧失明显好转,较治疗前差异均有统计学意义(P＜0.05).牙槽骨密度升高差异有统计学意义(P＜0.05),牙槽骨吸收程度变化差异无统计学意义(P＞0.05).不同阅片者之间对牙槽骨密度及牙槽骨吸收状况的测量,一致性检测结果显示组内相关系数大于0.9,差异无统计学意义.结论 CBCT可用于重度慢性牙周炎牙周基础治疗前、后牙槽骨状态的评价,定点方法具有可行性和可重复性.     

Juvenile xanthogranuloma of the oral cavity in children: a clinicopathologic study

PURPOSE: This clinicopathologic study describes the histopathologic, immunocytochemical, and electron microscopic features of oral juvenile xanthogranuloma (JXG) in children. DESIGN: The study population consisted of 5 children (5 months to 10 years of age) with biopsy-proven JXGs obtained for consultation. RESULTS: Lesion sites were gingiva, buccal mucosa, and tongue and were described by the clinicians as (1). irritation fibroma; (2). granulation tissue; (3). pedunculated granular nodule; (4). papilloma-like lesion; and (5). brown-red umbilicated papule. Tissue was available for histopathologic (n = 5), immunocytochemical (n = 5), and ultrastructural (n = 3) studies. Three cases showed early JXG lesions possessing abundant histiocytes, but lacking Touton giant cells. The other 2 cases had classic JXG lesions with vacuolated histiocytes and Touton giant cells. Immunocytochemical findings were (1). CD68 (KP1, PGM1), moderate to diffuse; (2). fascin, moderate to diffuse; (3). factor XIIIa, focal to diffuse; (4). alpha-1-antitrypsin, moderate to diffuse; (5). S-100 protein, focal to diffuse; and (6). CD1a, negative in all cases. Ultrastructural examination displayed histiocytic and dendritic cells lacking pentalaminar structures (Birbeck granules). CONCLUSION: JXGs of the oral cavity vary in their clinical and histopathologic appearances and necessitate that Langerhans' cell disease (LCD) be excluded. JXG and Langerhans' cell disease may occur concurrently, before or after each other, in some children.     

三氧化矿物凝聚体对乳、恒牙牙髓细胞增殖和分化影响的比较

目的 对比三氧化矿物凝聚体（MTA）和氢氧化钙对人乳、恒牙牙髓细胞增殖和分化的影响。方法 采用甲基噻唑基四唑（MTT）法检测牙髓细胞生长增殖变化;实时荧光定量聚合酶链反应（PCR）检测碱性磷酸酶（ALP）、牙本质涎磷蛋白（DSPP）、骨保护因子（OPG）、核因子κB受体活化因子配体（RANKL）基因的表达。结果 氢氧化钙组乳、恒牙牙髓细胞增殖均显著低于对照组（P<0.01）,MTA组乳、恒牙牙髓细胞增殖均高于对照组（P<0.01）。实时荧光定量PCR检测结果显示,乳牙氢氧化钙组ALP、DSPP和OPG的表达显著低于对照组（P<0.01）,MTA组上述因子的表达显著高于对照组（P<0.01）;氢氧化钙组RANKL的表达显著高于对照组（P< 0.01）,MTA组RANKL的表达与对照组差异无统计学意义（P>0.05）。恒牙牙髓细胞氢氧化钙组ALP和DSPP的表达与对照组相比无显著差异（P>0.05）,MTA组ALP和DSPP的表达显著增加（P<0.01）;氢氧化钙组和MTA组OPG、RANKL的表达与对照组无显著差异（P>0.05）。结论 MTA比氢氧化钙更适合做乳牙和恒牙的盖髓剂,其优势在乳牙可能更为明显。     

Oral manifestations associated with human immunodeficiency virus infection in a Spanish population

A study was made of the oral manifestations in 396 patients with human immunodeficiency virus (HIV) infection. The following risk groups were established: intravenous drug users (79.5%), homosexuals (7.8%), homosexual intravenous drug users (3.3%). heterosexuals (8.1%) and hemophiliacs/transfusion patients (1.3%). The oral lesions, in decreasing order of frequency, were: periodontal disease (78.28%). candidiasis (65.65%). hairy leukoplakia (16.16%). herpes simplex virus lesions (5.30%), Kaposi's sarcoma (2.27%), recurrent aphthous ulceration (RAS) (1.01%), lichen planus (0.5%), non-Hodgkin's lymphoma (0.25%). tuberculous lesion of the tongue (0.25%) and ulcerations of uncertain etiology (0.25%). Attention is drawn to the greater predominance of these lesions in patients with CD4 values of less than 200/mm³, compared with those who have higher lymphocyte counts.     

重复取样测定龈沟液中天冬氨酸转氨酶水平

本研究目的是观察间隔１０分钟重复取样测定龈沟液中天冬氨酸转氨酶（ａｓｐａｒｔａｔｅａｍｉｎｏ－ｔｒａｎｓｆｅｒａｓｅ，ＡＳＴ）水平的变化情况。作者对１０名牙周健康者的４０个牙位点，及２０例牙周炎患者的８３个牙位点进行了龈沟液的第一次和１０分钟后重复取样，并测定分析了两次样本中ＡＳＴ的水平，及其与探诊深度（ｐｒｏｂｉｎｇｄｅｐｔｈ，ＰＤ）和牙龈出血指数（ｂｌｅｅｄｉｎｇｉｎｄｅｘ，ＢＩ）的关系。结果显示，牙周健康者间隔１０分钟两次取样ＡＳＴ水平差异有显著性（Ｐ＜０．０５），而牙周炎患者两次取样ＡＳＴ水平无明显改变（Ｐ＞０．０５），同时证实了ＡＳＴ与ＰＤ及ＢＩ有明显的相关性     

Jaw cysts at children and adolescence: a single-center retrospective study of 152 cases in southern Bulgaria

One hundred fifty two cysts of the upper and lower jaw were examined at patients up to 18 years old treated in the Clinics of Maxillo-Facial Surgery, University Hospital, Plovdiv, Bulgaria for the period 1998 - 2007. Patients were distributed in four age groups (up to 4 years old, from 5 to 9 years old, from 10 to 14 years old, from 15 to 18 years old). Both sexes were constantly affected (52% male, 48% female). The biggest number cystic lesions were found in the third age group (48.7%). The mandible was preferable localization of the lesions (69.7%). Dentigerous cysts predominated (61.8%) - more affected was third age group (31.6%). Radicular cysts were observed two times less (31.6%) - more affected were third (15.8%) and fourth (12.5%) age groups. The most frequently observed clinical symptom was presence of painless swelling (59.9%). The operative interventions were carried out predominantly under general anesthesia (81.6%) by intraoral approach (97.4%). The extraoral surgical approach was preferred in four cases only - three in third and one in fourth age groups.     

The hemolytic and cytotoxic properties of a zeolite-containing root filling material in vitro

OBJECTIVE: This in vitro study characterized the hemolysis and cytotoxicity of ZUT, an experimental glass ionomer cement (GIC) sealer with an added antimicrobial-containing zeolite (0.2% Zeomic w/w). STUDY DESIGN: ZUT, Ketac-Cem (GIC component of ZUT), Ketac-Endo, and two AH 26 sealer formulations were tested at various times after mixing. Hemolysis produced by standardized specimens was determined spectrophotometrically (n = 6/material). Cytotoxicity was assessed by using a Millipore Filter test with a HeLa cell monolayer (n = 10/material). Tests were repeated, and results were analyzed with a one-way analysis of variance (alpha = .05). RESULTS: Disks of AH 26 containing silver produced the most hemolysis of all test groups (P < .0001). Compared to controls, GICs and AH 26 formulations were noncytotoxic at 1 and 6 hours after mixing, respectively (P > .05). Addition of Zeomic did not increase the cytotoxic and hemolytic activity of Ketac-Cem (P > .05). CONCLUSION: Overall results suggest ZUT is less cytotoxic than AH 26 and possesses characteristics similar to the other GIC formulations tested.     

Effect of relining, water storage and cyclic loading on the flexural strength of a denture base acrylic resin

OBJECTIVES: This study investigated the effect of relining, water storage and cyclic loading on the ultimate flexural strength (FS(U)) and on the flexural strength at the proportional limit (FS(Pl)) of a denture base acrylic resin (Lucitone 550-L). METHODS: Rectangular bars of L were made (64 mm x 10 mm x 2 mm) and relined (1.3mm) with four relining resins (Kooliner-K, Ufi Gel Hard-UGH, Tokuso Rebase Fast-TR and New Truliner-NT). In addition, specimens relined with L and intact L specimens were made (64 mm x 10 mm x 3.3 mm). A three-point flexural test was applied on the specimens (n=10) after (1) polymerization; (2) water storage (30 days); (3) cyclic loading (10,000 cycles at 5 Hz) and (4) water storage (30 days)+cyclic loading. Data (MPa) were analyzed with three-way ANOVA and Tukey's HSD tests (alpha=0.05). To test for a possible correlation between FS(U) and FS(Pl), a linear regression coefficient "r" was calculated. RESULTS: After water storage, L-UGH and L-TR demonstrated an increased FS(U) (41.49-50.64 MPa and 49.95-57.36 MPa, respectively) (P<0.05). Only L-TR demonstrated an increased FS(Pl) (20.58-24.21 MPa) after water storage (P<0.05). L-L had the highest FS(U) (between 78.57 and 85.09 MPa) and FS(Pl) (between 31.30 and 34.17 MPa) (P<0.05). The cyclic loading decreased the FS(U) and FS(Pl) of all materials (P<0.05). Regression analysis showed a strong linear correlation between the two variables (r=0.941). CONCLUSIONS: Water storage improved the FS(U) of L-UGH and L-TR and the FS(Pl) of L-TR. L-L produced the highest FS(U) and FS(Pl). The FS(U) and FS(Pl) of all materials were detrimentally influenced by cyclic loading.     

Influence of additives on the properties of Bis-GMA/Bis-GMA analog comonomers and corresponding copolymers.

OBJECTIVES: The purpose of this study was to evaluate the effect of two additives: propionaldehyde (aldehyde) and 2,3-butanedione (diketone) on the properties of Bis-GMA diluted with TEGDMA and the synthesized Bis-GMA analogs, propoxylated Bis-GMA (CH(3)Bis-GMA) and propoxylated fluorinated Bis-GMA (CF(3)Bis-GMA). METHODS: Nine experimental comonomers were prepared combining Bis-GMA and TEGDMA, CH(3)Bis-GMA, CF(3)Bis-GMA, with aldehyde (32mol%) and diketone (32mol%). Photopolymerization was effected by using Camphorquinone (0.2wt%) and N,N-dimethyl-p-toluidine (0.2wt%). Experimental comonomer viscosity (Brookfield viscometer), polymerization shrinkage (gravimetrically), degree of conversion (FT-IR) and contact angles (contact angle goniometer) were determined. Comonomer and copolymer T(g)s (DSC and Fox equation) were also evaluated. Data were analyzed by one-way ANOVA and Tukey test (alpha=0.05). RESULTS: Bis-GMA/CH(3)Bis-GMA and Bis-GMA/CF(3)Bis-GMA with additives exhibited lower viscosities (p<0.01). Inclusion of additives into the comonomer systems did not produce significant increase in polymerization shrinkage (p>0.05). A significant increase in degree of conversion was shown for Bis-GMA/TEGDMA and Bis-GMA/CH(3)Bis-GMA with additives (p<0.01). Additives reduced contact angle and comonomer T(g) values, whereas the corresponding copolymers with additives showed an increase in T(g). SIGNIFICANCE: Use of novel comonomer systems with the addition of aldehyde and diketone functional groups would improve dental resin composite properties.     

Postgraduate training in Oral- and Maxillofacial Surgery: Results of a survey among 74 German interns

The aim of this study was to asses a survey of residents to obtain relevant information about their current situation in training in Oral and Maxillofacial Surgery in Germany. Special focus was given to the personal and clinical preferences of the residents, their main subjects of interest and plans after residency. Furthermore, the different principles of education at German teaching hospitals were evaluated.Overall, 74 questionnaires were completed on a voluntary and anonymous basis by German residents for Oral and Maxillofacial Surgery. Participants’ mean age was 32.74 years (68% male, 27% female). Most participants were in the fifth year of training (32%) and members of the German Association of Oral and Maxillofacial Surgery (70%). This rate increased with progress in residency (p = 0.006). Most residents (70%) were employed at university hospitals, followed by non-university hospitals (26%) and private practices (4%). Residents from university hospitals (3.06 ± 0.39 years) were less advanced in training compared to residents from non-university hospitals and private practices (4.10 ± 0.54 years; p = 0.005). Part-time employed residents were significantly younger (30.64 ± 2.37 years) than full-time employed residents (33.25 ± 0.64 years, p = 0.002).Structured concepts of training existed in 64% of the hospitals, while training depending on the current year of residency (42%) was most common. Most of the residents would prefer a systematic rotation system (59%). Main subjects of clinical interest were aesthetic (50%) and orthognathic surgery (46%). The interest in dento-alveolar surgery (34%) significantly increased with participants’ age (p = 0.008). Clefts and malformations were favoured by few residents (16%). Most participants planned to specialize in facial plastic surgery after residency (76%).The data collected might give evidence for an increasing importance of structured training concepts in Oral and Maxillofacial Surgery. It might be relevant to enhance the interest and the excitement of residents for oncology, traumatology, cleft and malformation surgery.     

Patterns of crowding of permanent mandibular incisors before eruption.

Observation of the radiographs taken of 37 mandibles from children ten months to seven years of age showed that the unerupted, permanent mandibular central incisors were rotated in 45 of 74 jaw halves (60.8%). The type of rotation in which the mesial aspect is directed lingually was most commonly seen (44.6%). The next most common observation was of jaw halves without any rotation of the central incisor (39.2%). The type of rotation in which the central incisor's distal aspect is turned lingually was the least common observation (16.2%). The rotation seemed symmetric in 25 jaws (67.6%).