潜艇艇员固定义齿修复五年临床观察

潜艇艇员因潜海作业的环境 ,牙列缺损后要求制作固定义齿。本文追踪观察我科 1 991～ 1 994年为艇员制作的不同类型固定义齿的使用情况 ,为今后艇员的义齿修复和修复后的义齿维护提供参考。一、对象和方法1 .对象 :在我科做后牙固定修复并有条件复查的艇员6 9名 ,均男性 ,年龄 1 8～ 2 5岁 ,共 72付义齿。其中 ,7付固定桥在观察期间因基牙疼痛 (2付 ) ,连结体折断 (3付 )及瓷崩(2付 )拆除 ,剩余的 6 5付固定桥作为观察对象。6 5付固定桥的类型有锤造桥 31付 ,铸造桥 1 9付和烤瓷桥 1 5付。2 .方法 :根据病历记录 ,在镶牙后 5年至函患者到我…     

两种烤瓷后牙固定桥修复的远期疗效对比分析

目的对钛合金和镍铬合金两种烤瓷后牙固定桥修复的远期疗效对比分析。方法选取2011年12月。2012年12月曾在我院进行烤瓷牙固定修复患者123例、142颗修复牙，随机分为两组患者，甲组患者62例患者、70颗修复牙，采用镍铬合金烤瓷固定桥修复；乙组患者61例、72颗修复牙，采用钛合金烤瓷固定桥修复，对比两组患者的远期治疗效果。结果对两组患者进行5年的随访，乙组患者修复体完整情况对比甲组患者无显著性差异，无统计学意义（P〉0．05）。乙组患者修复体边缘的颜色改变、牙龈颜色改变、边缘舒适情况、牙龈反应均显著优于甲组患者，差异性显著，具有统计学意义（P〈0．05）。结论采用钛舍金烤瓷固定桥修复远期完整度较好，同时能够显著提高边缘舒适情况，减少边缘的颜色改变、牙龈颜色改变、牙龈反应等，有效提高患者的生活质量，适宜依据患者情况应用。     

外伤前牙缺失中玻璃纤维增强树脂黏结桥的临床应用

目的评价玻璃纤维增强树脂黏结桥修复外伤前牙缺失的临床疗效。方法收集20例因训练和运动导致上前牙根折拔除的门诊军人,其中缺失1颗牙者18例,缺失两颗牙者2例。采用玻璃纤维增强树脂黏结桥(FRC-FDP)进行修复。临床进行定期检查,全面评价使用效果。结果经6～60个月的临床观察,20例患者的黏结桥均完好,无松动、折断、破损,修复体边缘完整,无明显染色,无继发龋。基牙牙龈探诊无出血。修复治疗成功率达100%。结论玻璃纤维增强树脂黏结桥为因外伤前牙缺失的患者提供了一种较好的修复方法。     

变异式烤瓷冠矫正前牙反(牙合)临床观察

目的:探讨运用变异式烤瓷冠修复个别上前牙重度反NFDD9的临床设计、牙体预备及修复效果.方法:对上前牙反NFDD927例(38颗)采用变异式烤瓷冠进行修复,烤瓷冠设计按照临床要求进行调整,修复后经2～3年随访,观察修复前后牙周情况和患者满意度.结果:修复2年后,变异式烤瓷冠修复后基牙牙龈无明显炎症,无崩瓷、瓷裂发生,前牙美观程度明显改善,患者无不适,效果满意.结论:变异式烤瓷冠可以有效纠正个别前牙反NFDD9,改善美观,可作为正畸治疗的替代手段.     

改良式固定型马里兰桥修复老年前牙缺失的临床效果观察

目的 探讨运用改良式固定型马里兰桥修复老年患者前牙缺失的可行性,并对修复的方法设计、修复体制作过程及适应证进行总结.方法 选择个别前牙缺失,存在不同程度邻牙松动、牙龈萎缩、牙根暴露等体征的老年患者24例,运用改良式固定型马里兰桥修复缺失牙,并对完成修复的病例随访3～5年.结果 修复成功率为87.5%.24例患者有3例修复体脱落,需重新粘接;其余修复体未见明显松动.基牙无松动,桥体下方牙龈无明显红肿,患者对修复体的使用与外观效果均感满意.12例患者存在不同程度牙结石;2例患者存在舌侧轻度异物感,经过对症处理后效果满意.结论 改良式固定型马里兰桥修复老年前牙缺失具有磨牙少、效果美观,并能同时固定松动牙邻牙等优点,修复效果可靠.但其远期效果有待进一步观察.     

63例老年人牙体牙列缺损烤瓷修复的疗效观察

目的 观察并了解老年人牙体牙列缺失后的烤瓷修复特点.方法 对解放军总医院口腔科收治的63例老年患者共138个牙单位进行烤瓷修复,并进行3个月～1年的随访观察,以总结烤瓷修复的条件和注意要点.结果 烤瓷修复体与牙体密合,无松动脱落,牙周组织无刺激和炎性反应,患者使用情况良好,有3例出现瓷裂.烤瓷修复的条件和注意要点包括:牙列具有6～7个分布在不同部位的牙齿或牙根,牙槽吸收达根的1/2;咬合垂直距离恢复要准确;调整整体颌关系;清除牙合早接触点,以免出现瓷裂现象;需根据材料性能选择烤瓷温度,严格操作.结论 烤瓷修复体是修复老年人牙体牙列缺损的一种良好的方法 .     

悬锁卡环义齿的临床应用效果观察

目的观察悬锁卡环局部可摘义齿的临床应用效果。方法对2004年1月～2011年6月为14例双侧后牙缺失患者制作的悬锁卡环义齿进行随访观察1～7年,评价其临床效果。结果义齿有效修复13件,占总数的92.9%;无效修复1件,占总数的7.1%。结论悬锁卡环义齿对双侧后牙缺失有良好的修复效果,可以较好地改善咀嚼功能。     

两种临时修复粘接桥在前牙种植术后即刻修复中的比较

目的 比较树脂制作的粘接桥与烤瓷熔附金属制作的粘接桥在口腔前牙种植术后即刻修复中的临床效果,分析评估两种粘接固定义齿在口腔前牙种植术后即刻修复的应用价值.方法 选择单颗前牙行种植术后要求即刻修复的患者55例,其中树脂粘接固定义齿修复40例,烤瓷熔附金属粘接固定义齿修复15例,分别在即刻修复后1、2、3个月观测两种义齿的松动、咬裂及染色情况,分析其临床应用价值以及存在的问题.结果 40件树脂粘接固定义齿松动率为7.50%,咬裂率为22.50%,染色率为100%,成功率为70.00%;15件烤瓷熔附金属粘接固定义齿松动率为6.67%,咬裂率为0,染色率为6.67%,成功率为93.33%.两种修复体发生松动情况的差异无统计学意义（P＞0.05）,被咬裂和染色情况的差异有统计学意义（P＜0.05或P＜0.01）.全部患者对两种修复体的美学修复效果均满意,观察期内未发生伤口裂开及感染等并发症.结论 两种临时修复体在口腔前牙种植术后均可保持缺牙间隙,且能较好地恢复美观效果及发音功能.咬合关系正常时,烤瓷熔附金属粘接固定义齿较树脂粘接固定义齿强度大,不易着色,可满足前牙种植术后临时修复的要求.     

变异式烤瓷冠矫正前牙反临床观察

目的:探讨运用变异式烤瓷冠修复个别上前牙重度反的临床设计、牙体预备及修复效果。方法:对上前牙反27例(38颗)采用变异式烤瓷冠进行修复,烤瓷冠设计按照临床要求进行调整,修复后经2～3年随访,观察修复前后牙周情况和患者满意度。结果:修复2年后,变异式烤瓷冠修复后基牙牙龈无明显炎症,无崩瓷、瓷裂发生,前牙美观程度明显改善,患者无不适,效果满意。结论:变异式烤瓷冠可以有效纠正个别前牙反,改善美观,可作为正畸治疗的替代手段。     

选择性激光熔覆钴铬合金烤瓷冠对牙周组织的影响

目的探讨选择性激光熔覆(selective laser melting,SLM)烤瓷冠对牙周组织的影响。方法选择钴铬合金烤瓷冠修复患者62例,烤瓷冠86颗,依据修复体分为两组,A组为选择性激光熔覆(Selective Laser Melting,SLM)钴铬合金烤瓷冠44颗,B组选用常规钴铬合金烤瓷冠42颗。修复后3和6个月观察两组基牙牙周指标变化、龈沟液中白细胞介素8(Interleukin-8,IL-8)、白细胞介素10(Interleukin-10,IL-10)变化。结果修复后3个月,两组在牙周指标和炎症因子方面较修复前无明显变化(P0.05)。修复后6个月,A组各指标较修复前无统计学差异(P0.05)。B组牙周指标较修复前显著增加,IL-10较修复前显著减少(P 0.05)。结论 SLM钴铬合金烤瓷冠较常规钴铬合金烤瓷冠对牙周组织影响更小。     

社区老年人的牙齿缺失情况调查

目的 :调查老年人牙齿缺失情况 ,为社区保健有关措施提供依据。方法 :对成都市武侯区 3个居民点老年人牙列缺失和牙列缺损情况进行调查。结果 :牙列完整者有 10 .98% ,牙列缺失者有 13.33% ,平均每人失牙 10 .5 2颗 ,且随年龄增长失牙者逐渐增多 ;牙齿缺失率上颌 >下颌 ,磨牙 >双尖牙 >切牙 >尖牙。结论 :本组资料具有一定的代表性 ,对比我们 10年前的调查结果发现了较为乐观的变化 ,这与我们采取的的社会干预措施密切相关     

手术治疗复杂桡骨远端骨折

目的 探讨治疗复杂桡骨远端骨折(AO分型的B型和C型)的方法. 方法 2005年6月-2007年6月手术治疗78例(83侧)复杂桡骨远端骨折,男51例,女27例;平均年龄34.6岁.按AO分型:B1型12侧,B2、B3型22侧,C1型21侧,C2型16侧,C3型12侧.手术采用切开直视下关节面复位、撬拨复位植骨支撑矫止桡骨远端掌倾角和尺偏角、应用外固定支架固定等方法. 结果 全部患者得到随访,平均随访时间10.5个月.术后关节面塌陷、移位均＜2 mm,掌倾角平均10.6°,尺偏角学均20.3°全部骨性愈合,以Garland and Werley评分方法评定腕关节功能:优33侧,良41侧,可7侧,差2侧,优良率89%. 结论 手术治疗可使关节而复位、可矫止掌倾角和尺偏角,应用外固定支架消除了前臂的轴向短缩应力,足治疗桡骨远端复杂骨折的有效疗法.     

两种附着体义齿支持组织的应力比较分析

目的比较球帽附着体和栓道式附着体义齿支持组织的Von Mises等效应力分布。方法分别建立基牙牙周组织正常、吸收1/4、吸收1/3、吸收1/2的两种附着体义齿的三维有限元模型,采用垂直向加载力300N,模拟单侧后牙咬合状态,分析支持组织的Von Mises等效应力。结果基牙牙周组织不同状况下,栓道式附着体义齿的基牙和牙周膜最大Von Mises等效应力值小于球帽附着体义齿,缺牙区牙槽嵴最大Von Mises等效应力值大于球帽附着体义齿,但其分布相对较均匀。结论基牙不同牙周状况下,栓道式附着体义齿与球帽附着体义齿相比,其支持组织应力分布相对较均匀,应力集中范围小,可见栓道式附着体舌侧对抗臂的设计可以使支持组织受力更均匀,更有利于基牙健康。     

Bondsteel fixed partial denture: a provisional indirect technique for in-the-field dental emergencies

This article presents a modified resin-bonded fixed partial denture technique of replacing a single missing anterior tooth under limitation of material and time. This technique involved a small section of an oral surgery arch bar that was bent and fitted passively into the grooves that were prepared in the lingual of the abutment teeth. A polycarbonate crown was fitted passively on the arch bar by a thin layer of Vaseline. The polycarbonate crown was then filled with acrylic resin to bond the polycarbonate crown and the arch bar together. The result provides an esthetic appearance and a 4-month clinical success without complication. Thus, this technique is a short-term solution for clinics that have limited resources for a definitive treatment.     

Enamel and dentin mineralization in familial hypophosphatemic rickets: a micro-CT study

Objectives:

The aim of the present study was to analyse the mineralization pattern of enamel and dentin in patients affected by X-linked hypophosphatemic rickets (XLHR) using micro-CT (µCT), and to associate enamel and dentin mineralization in primary and permanent teeth with tooth position, gender and the presence/absence of this disease.

Methods:

19 teeth were collected from 5 individuals from the same family, 1 non-affected by XLHR and 4 affected by XLHR. Gender, age, tooth position (anterior/posterior) and tooth type (deciduous/permanent) were recorded for each patient. Following collection, teeth were placed in 0.1% thymol solution until µCT scan. Projection images were reconstructed and analysed. A plot profile describing the greyscale distance relationship in µCT images was achieved through a line bisecting each tooth in a region with the presence of enamel and dentin. The enamel and dentin mineralization densities were measured and compared. Univariate ANOVA and post hoc Tukey tests were used for all comparisons.

Results:

Teeth of all affected patients presented dentin with a different mineralization pattern compared with the teeth of healthy patients with dentin defects observed next to the pulp chambers. Highly significant differences were found for gray values between anterior and posterior teeth (p < 0.05), affected and non-affected (p < 0.05), as well as when position and disease status were considered (p < 0.05).

Conclusions:

In conclusion, the mineralization patterns of dentin differed when comparing teeth from patients with and without FHR, mainly next to pulp chambers where areas with porosity and consequently lower mineral density and dentin defects were found.     

妊娠对大鼠正畸牙移动的影响实验研究

目的观察妊娠对大鼠正畸牙移动的影响。方法选取48只体重为(250±25)g的Wistar大鼠,并将其分为对照组(非妊娠期)与实验组(妊娠期)。大鼠的上颌中切牙分别用弹簧以30g的力推向远中,在第2d、第7d、第14d观察并记录两个上颌中切牙近中向的距离。随后再利用显微镜观察组织学切片记录破骨细胞的数量,最后对这些数据进行样本t检验。结果两组在第2d、第7d、第14d正畸牙移动的距离相比较没有明显的差异(P>0.05),但是两组的破骨细胞数目存在明显差异(P<0.05),实验(妊娠)组的破骨细胞数目显著降低。结论妊娠期大鼠正畸牙的移动呈轻度减缓,并无统计学意义,但牙体受压侧破骨细胞的变化却有显著的统计学差异。     

骨内牙种植体在牙缺失修复中的应用

目的回顾分析骨内牙种植体的适应证及临床应用效果。方法对94例患者的157个骨内牙种植体进行4个月～8年的临床观察,根据种植体的分布情况了解种植牙适应证的变化。通过对种植体周软组织状况、种植体动度、种植体周骨吸收情况及抗旋转扭力的检查,评价其骨整合成功率和修复成功率。结果有7.6%和25.5%的骨内牙种植体分别用于修复全颌缺失和游离端缺失,66.9%用于修复非游离端缺失。种植后初期骨整合成功率达98.1%,修复后5年种植成功率为93.8%。种植体初期稳定性<10N.cm者与≥10N.cm者相比种植成功率明显降低(P<0.05)。结论骨内牙种植体是临床上修复各种类型缺牙的理想手段之一,成功率高,初期稳定性对于提高种植成功率有重要意义。     

Endovascular parent artery occlusion in large-giant or fusiform distal posterior cerebral artery aneurysms

Posterior cerebral artery aneurysms are amenable to deconstructive surgical treatment because of the rich collateral supply of the distal posterior cerebral artery. This report retrospectively analyses the outcome of endovascular parent artery occlusion for large or fusiform distal posterior cerebral artery aneurysms. Medical records and cerebral angiograms from two endovascular centres were analysed retrospectively. Eight patients with large or fusiform distal posterior cerebral artery (PCA) aneurysms were treated by endovascular occlusion of the segment of the PCA at the site of the aneurysm. Three of those were treated urgently after acute subarachnoid haemorrhage, the remainder had elective treatment. The clinical and angiographic outcomes in seven patients were assessed at 6 to 12 months. A single case of occipital infarction resulting in permanent homonymous hemianopia was the only permanent complication. Of the remaining patients, six made excellent recoveries and one was lost to follow-up. No recurrence or re-bleeding was noted. Endovascular parent artery occlusion may be an alternative to surgical parent artery occlusion in distal PCA aneurysms which are not convenient for selective endovascular treatment or surgical clipping.     

Percutaneous transluminal angioplasty of the distal abdominal aorta and its bifurcation

Percutaneous transluminal angioplasty (PTA) of stenotic lesions in the distal abdominal aorta and its bifurcation was performed in 14 patients, 6 of whom were women. The stenotic segment in the aorta or aortic bifurcation was usually the only significant lesion. The double-balloon technique was used in 12 patients via bilateral femoral artery catheterizations. In 2 other patients with aortic lesions, a single large balloon sufficed. Good results were achieved in all but 1 patient, with minor complications occurring in 3 instances. The follow-up period varied from 6 months to 5 years. We believe that PTA is the procedure of choice in treating localized lesions of the distal abdominal aorta and its bifurcation, especially when distal vessels are relatively uninvolved.