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目的评价上颌窦内、外提升术应用于上颌后牙区垂直骨量不足的种植义齿修复临床疗效。方法选择中国医科大学附属口腔医院种植中心2007年6月至2012年6月收治的上颌后牙缺失行种植义齿修复患者127例,植入种植体216颗。其中,上颌窦外提升术、内提升术及常规种植术的种植体数分别为40、61、115颗。于种植术后随访6~60个月,通过临床及影像学检查比较各组间种植体累计存留率、骨结合状况和种植体周围骨吸收状况。结果在随访期内,各组间种植体5年累计存留率及完成上部结构修复1年内种植体周围骨吸收差异均无统计学意义(P>0.05),且种植术后1年的骨吸收量平均每年小于0.2 mm。结论上颌窦内、外提升术与常规种植术种植义齿修复效果无明显差异,种植体成功与否关键在于手术适应证的选择及相关手术技巧的掌握。     

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目的评价改良型软压膜式口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)的临床疗效。方法选择2008年1月至2010年7月在阜阳市人民医院体检中心口腔科经改良型软压膜式口腔矫治器治疗的OSAHS患者12例,观察戴用矫治器前、后的临床表现,并将其戴用矫治器前、后的多导睡眠仪(PSG)监测数据及X线头影测量结果进行分析。结果 OSAHS患者戴用改良型软压膜式口腔矫治器3个月至1年后,呼吸紊乱指数(AHI)、呼吸暂停指数(AI)、低通气指数(HI)均较戴用前明显降低,而血氧饱和度(SaO2)则有明显升高;X线头影测量显示治疗后的上气道宽度增加;达到改善患者生存质量的目的。结论改良型软压膜式口腔矫治器治疗OSAHS具有广阔的临床应用价值,尤其以无创伤性、可逆性、经济实用、戴用舒适感较强、便于携带而日益受到重视。     

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提要：复合树脂直接修复技术在现阶段临床已广泛应用，有关其修复治疗后的临床疗效已有很多报道。本文介绍了有关复合树脂直接修复技术的临床疗效评估方法、标准及影响因素，为临床实际和疗效观察提供参考。     

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??Abstract: Objective To evaluate five years of clinical results of different crowns restoration for implant teeth in the posterior area. Methods From June 2006 to June 2011??603 patients with 1159 crowns after 1135 dental implants were followed up for 6??66 months. There were 135 zirconia all-ceramic??396 porcelain-fused-to-crown of gold alloy??363 porcelain-fused-to-crown of Ag-Pd??131 gold alloy based polymerization porcelain and 134 Ag-Pd based polymerization porcelain. Clinical examination??X-ray and patient satisfaction investigation were conducted??the software of SPSS 13.0 was used for restoration complications analysis and the cumulative success rate was evaluated with Davarpanah’s standard about failed crowns. Results There was no significant difference among different restoration(P = 0.299);the cumulative success rate was 97.2%;more than 95% of the patients were satisfied with the different restoration. Conclusion The different crowns restoration of implant in the posterior area can achieve good clinical results??whereas long-term effect need to be followed up.     

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目的 评价秋水仙碱治疗复发性阿弗他溃疡(RAU)的疗效.方法 选择2008年5月至2010年1月来江苏省苏北人民医院口腔科就诊的RAU患者112例,随机分成两组.对照组(56例)应用锡类散喷于溃疡表面,3～4次/d,至溃疡愈合;试验组(56例)在同对照组用药基础上给予秋水仙碱(5 mg/次)口服,疗程为12周,第1周1次/d,第2周2次/d,第3～ 12周3次/d.结果 治疗后1年,试验组总有效率为97.87％,对照组总有效率为46.67％,两组疗效比较,差异有统计学意义(P＜0.01).结论 秋水仙碱治疗RAU有较好的疗效.     

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目的评价Anthogyr种植系统7年内的临床应用情况及短期疗效。方法总结2007年5月至2013年12月于中国医科大学附属口腔医院种植中心接受Anthogyr系统种植修复的病例,共203例,随访1～7年,评价该系统手术及修复临床应用情况及疗效。结果7年种植320种植体,2颗种植体于术后9个月因无骨结合取出;随访观察1～7年,上部结构松动6例,崩瓷4例,食物嵌塞9例。种植体累积存留率达99．38％。结论Anthogyr种植系统临床操作简便,可获得稳定的修复效果。     

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结合作者的临床经验、临床科研及相关文献,从矫治器的使用、矫治技术的实施等方面阐述如何在自锁托槽矫治器的使用过程中实现高效矫治。同时对自锁托槽矫治器的使用效果、矫治代价及主动自锁与被动自锁的特点等问题进行讨论。     

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牙体缺损是一种常见牙体病,尤其牙颈部楔状缺损最多见,好发于老年人。用来充填修复的牙色材料较多,对其临床疗效评价不一。本研究选择可乐丽菲露树脂和氟化玻璃聚合体两种牙色材料充填398颗缺损患牙,于修复     

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目的 探讨氧化锆全瓷冠桥修复体的修复效果,为临床应用提供参考.方法 对2008年1月至2009年6月佛山市禅城区口腔医院修复科收治的40例接受全瓷修复的患者,采用计算机辅助设计与计算机辅助制作(CAD/CAM)技术制作氧化锆全瓷冠桥修复体60件,其中上颌32件,下颌28件;前牙单冠24个,后牙单冠21个,前牙固定桥2个,后牙固定桥3个(均为3单位固定桥).分别在修复体黏结后1、3、6、12个月对患者进行随访观察,采用美国加利弗尼亚牙科学会的全瓷修复临床标准对修复体的临床效果进行评价,同时也对牙周健康状况进行评价,记录全瓷修复体牙冠的牙龈出血指数(BI)、牙周袋深度(PD)以及附着丧失(AL).结果 观察期间失访3例患者5件修复体,对剩余的37例患者55件修复体的临床观察结果显示,在黏结1个月后有2件修复体的边缘卡探针,有2颗氧化锆全瓷冠修复的牙齿出现牙龈炎.在黏结3个月后,有1个单冠出现裂纹,1例固定桥断裂,2颗牙齿出现牙龈红肿.在黏结6个月后,有1例桩核冠脱落,2颗牙齿出现牙髓炎或根尖周炎.所有复诊患者在12个月的临床观察中均未见边缘着色和继发龋,有5件修复体的颜色匹配稍差.在各时间点BI、PD和AL等指标与治疗前比较差异均无统计学意义(P＞0.05),各项指标比较差异亦无统计学意义(P＞0.05).结论 氧化锆全瓷修复体具有良好的稳定性和生物相容性,近期临床效果满意.     

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目的    观察美松永久根管充填糊剂治疗慢性根尖周炎的临床疗效。方法    选择2006年１月至2008年12月濮阳市第三人民医院口腔病防治中心就诊的慢性根尖周炎患者368例（370颗患牙）,按就诊顺序随机分为2组。试验组186例（187颗患牙）应用美松永久根管充填糊剂进行根管充填;对照组182例（183颗患牙）应用常规根管充填糊剂与牙胶尖进行根管侧方加压充填。根管充填后1周和1年随访观察近期临床反应和远期疗效。结果    根管充填后1周复诊,试验组中163颗牙无不良反应,对照组142颗牙无不良反应,组间差异有统计学意义（P < 0.05）。根管充填后1年,试验组随访170例（170颗牙）,失访17颗牙;对照组随访163例（163颗牙）,失访20颗牙。试验组的成功率为98.82％,对照组的成功率为88.96％,试验组疗效优于对照组,且组间差异有统计学意义（P < 0.05）。结论    美松永久根管充填糊剂优于根管充填糊剂,是一种良好的根管充填材料。     

侵袭性牙周炎患者牙周基础治疗的疗效观察

目的评价侵袭性牙周炎牙周基础治疗的效果。方法选择2006年9月-2008年12月于中国医科大学口腔医院牙周科就诊的48例侵袭性牙周炎患者为研究对象,其中局限型侵袭性牙周炎（LAgP）20例,广泛型侵袭性牙周炎（GAgP）28例。所有患者均进行牙周基础治疗,分别在治疗前和治疗结束后1、3、6个月检测全口牙的探诊深度（PD）、临床附着丧失（CAL）、出血指数（BI）和牙齿松动度。结果LAgP和GAgP患者在治疗后1、3、6个月的PD、CAL、BI和牙齿松动度较治疗前均有明显改善（P<0.05）。LAgP患者的PD、CAL在治疗后3个月与治疗后1个月比较,GAgP患者的PD、CAL在治疗后6个月与治疗后3个月比较,其差异均有统计学意义（P<0.05）。所有患者第一恒磨牙治疗后1、3、6个月的CAL较同期中切牙的改善情况更明显。结论牙周基础治疗对侵袭性牙周炎具有良好的治疗效果,GAgP和LAgP患者牙周基础治疗后的中期效果有差异。     

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目的评价利用Florida探针对不同程度牙周炎的基础治疗疗效。方法随机选择2005年6月至2007年6月期间,中国医科大学口腔医学院牙周科轻度、中度和重度牙周炎患者各50例为研究对象,全部行牙周基础治疗。患者在治疗前和治疗结束后3个月时采用Florida探针检测患者的探诊深度(PD)和临床附着丧失(CAL),检测位点为患者全口天然牙(不包括第三磨牙)的近中颊、颊侧正中、远中颊和舌侧正中4个位点。轻度牙周炎共检测1370颗牙5480个位点,中度牙周炎1180颗牙4720个位点,重度牙周炎940颗牙3760个位点,比较治疗前后PD、CAL的变化。结果中、重度牙周炎的PD和CAL均有明显改善(P<0.05)。轻度牙周炎PD治疗前后的改变差异无统计学意义(P>0.05),附着丧失略微加重。结论牙周基础治疗对中、重度牙周炎具有良好的治疗效果。轻度牙周炎在治疗时应注意避免器械的过度使用,以免引起医源性损伤。Florida探针能够较准确、客观地评价牙周状况。     

Antimicrobials for the treatment of aggressive periodontitis

Aggressive periodontitis is characterized by a considerable attachment loss over a relatively short period of time. It may be the consequence of either the presence of highly aggressive pathogens or a highly susceptible host. In the first case, the use of antimicrobials should be beneficial in the treatment of those patients. However, due to the organization of the micro-organisms as a biofilm, the increasing incidence of allergies and resistance against antimicrobials and their side-effects, there is still controversy about their benefit in the treatment of periodontal disease. This paper discusses indications for the use of antimicrobials, the substances prescribed and the type of application under the conditions of aggressive periodontitis.     

甲硝唑凝胶在治疗侵袭性牙周炎中的临床观察

目的观察牙周袋内使用甲硝唑凝胶治疗侵袭性牙周炎的临床效果。方法侵袭性牙周炎患者56例（256颗牙）,随机分成2组,均采用龈上洁治、龈下刮治术,治疗组采用甲硝唑凝胶牙周袋内注射治疗（注满约10mg）,每周1次,共4次;对照组口服罗红霉素片（每日2次,每次1片0.15g）和甲硝唑片（每日3次,每次1片0.1g）,每周连续服用3日,共4周。记录并分析治疗前后2周、停药2周、停药4周后的出血指数（BI）、牙体松动度、牙周袋探诊深度（PD）和牙体附着水平（CAL）。结果治疗组和对照组在治疗前牙周水平基线一致,治疗后,治疗组BI、PD、CAL均较对照组明显改善（P〈0.05）。结论牙周袋内局部应用甲硝唑凝胶能提高侵袭性牙周炎的治疗效果,是值得临床广泛应用的局部治疗侵袭性牙周炎的药物。     

Periodontal regeneration in aggressive periodontitis patients: A systematic review of the literature

The aim of the present study was to systematically review the existing literature on periodontal regenerative procedures in individuals affected by aggressive periodontitis (AgP). An electronic and manual search was performed using an ad hoc prepared search string. All types of study designs were considered acceptable for inclusion. Data about treated patients, baseline clinical parameters, type of surgery, and outcomes were extracted and recorded. A narrative evaluation of the results was performed. After the article‐selection process, a total of 22 full‐texts were included in the qualitative synthesis. Twelve papers were case reports; one was a retrospective study; six were non‐randomized, comparative studies; and three papers were published on two randomized, controlled trials (RCT). Various biomaterials and surgical techniques were described in the included papers. Based on the existing literature, even considering the relatively low level of evidence, periodontal regenerative surgery could be successfully performed in patients affected by AgP. There is a substantial need of high‐quality RCT to support this.     

牙周基础治疗对Ⅱ型糖尿病伴牙周炎病人糖基化终产物的影响

目的:观察牙周基础治疗对Ⅱ型糖尿病伴慢性牙周炎病人牙周组织和血清中糖基化终产物(advanced glycation end of products,AGEs)变化的长期影响。方法:诊断为Ⅱ型糖尿病并伴有中等程度以上牙周炎的病人30例,分为进行牙周基础治疗的干预组15例(DM1组),未进行牙周基础治疗的未干预组15例(DM2组);分别在初诊和每次复诊治疗前记录2组的探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、空腹血精、AGEs指标。结果:经牙周基础治疗后,DM1组牙周临床指标均有明显改善;2组AGEs水平有不同程度升高(P<0.05);DM1组第21个月AGFs水平显著低于DM2组,有统计学意义(P<0.05)。结论:牙周基础治疗对Ⅱ型糖尿病伴慢性牙周炎病人的PD、AL、血糖水平、AGEs水平有显著的改善(P<0.05),并且有助于长期稳定。     

Herpesviral-bacterial interrelationships in aggressive periodontitis

BACKGROUND: Recent findings have begun to provide a basis for a causal link between herpesviruses and aggressive periodontitis. One theory is that herpesviruses cooperate with specific bacteria in the etiopathogenesis of the disease. This study examined whether the presence of herpesviruses [human cytomegalovirus (HCMV), Epstein-Barr virus (EBV) type 1, herpes simplex virus (HSV) type 1 and 2] is associated with the presence of putative pathogenic bacteria (Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Campylobacter rectus, Actinobacillus actinomycetemcomitans) in aggressive periodontitis lesions. METHODS: The study included 18 young adults with advanced periodontitis and 16 periodontally healthy subjects from Ankara, Turkey. Subgingival specimens pooled from two sites in each subject were collected by a periodontal curette. Qualitative polymerase chain reaction methodology was used to identify herpesviruses and bacteria. Chi-square tests were employed to determine statistical associations among herpesviruses, bacteria and periodontal disease. RESULTS: HCMV, EBV-1 and HSV-1 were each detected in 72-78% of the aggressive periodontitis patients. HSV-2 occurred in 17% of the periodontitis patients. EBV-1 was detected in one periodontally healthy subject. The study bacteria occurred in 78-83% (P. gingivalis, T. forsythia, C. rectus) and in 44% (P. intermedia, A. actinomycetemcomitans) of the periodontitis samples, and in 0-19% of the samples from healthy periodontal sites. HCMV, EBV-1 and HSV-1 were positively associated with P. gingivalis, P. intermedia, T. forsythia and C. rectus, but not with A. actinomycetemcomitans. HSV-2 was not associated with any test bacteria. CONCLUSIONS: These results support the notion that the clinical outcome of some types of severe periodontal infection depends on the presence of specific herpesviruses and bacterial pathogens. Our findings open the door to testing a variety of hypotheses regarding the deleterious aspects of combined herpesviral-bacterial infections in periodontal sites.