金属烤瓷桥在修复牙周病伴牙列缺损中的临床应用

目的探讨牙周病伴牙列缺损最佳修复疗效。方法牙周病维护治疗后对牙周病伴牙列缺损选择基牙进行烤瓷修复。结果烤瓷桥可用于修复牙周病而致的牙缺失,基牙有松动的牙周病患者。结论烤瓷桥用于修复牙周病伴牙列缺损时,既恢复了缺失牙的功能,同时使松动的牙得到了固定,为一种可选择的异物感比较小、疗效较肯定的修复方法。     

下颌牙周病渐进缺牙致无牙颌的种植方案设计

目的：牙周病致牙列缺失的义齿修复是非常困难的,尤其是下颌骨低平条件较差的下颌牙列缺失修复。患者常抱怨义齿的压疼、固位稳定及咀嚼效率差。虽然牙种植体应用较好地解决了上述问题,但在临床中患者由于下颌后牙区骨高度不足且距下颌神经管较近,医疗风险及手术难度加大,使得种植覆盖义齿修复效果不如预期。本文目的是用种植体最佳分布结果指导临床牙周病渐进性拔牙病例设计种植修复方案。方法：通过分析牙周病致无缺牙行种植覆盖义齿修复的临床效果并对下颌无种植覆盖义齿三维有限元分析。结果：牙周病致无缺牙行种植覆盖义齿常规在两侧颏孔区之间种植2-4枚种植体,由于后牙区没有种植体支撑,从义齿修复受力原则及防止磨牙区及种植体周骨质吸收来讲不是最佳方案,最佳应在后牙区种植种植体。结论：牙周病治疗过程中在下颌缺牙的磨牙区植入1-2枚种植体,即便最后下颌自然牙全部缺失,可以常规在两侧颏孔区之间种植2-4枚种植体,结合前期植入的种植体共有6-8枚,可以考虑种植固定或者套桶冠固位进行下颌牙列缺失的种植修复,使种植修复效果达到最佳。     

下颌牙周病患者的种植治疗方案选择与效果

牙周病是人类口腔中最常见的疾病和多发病,也是口腔缺牙的最主要原因之一.临床中由于牙周病导致的牙齿缺失常常伴随着牙槽骨的缺失,以及口腔中余留牙的松动和倾斜,这又给义齿的修复带来极大的困难,最终的结果就是全口牙的缺失.而因牙周病致全口缺牙的义齿修复又是非常困难的,常出现义齿的压疼、固位不稳定及咀嚼效率差等主诉,给医患关系带来紧张,尤其是下颌牙列缺失修复.     

修复治疗中松动牙的保留

牙周病患者伴有缺失牙时,固定后用作基牙的松动牙和对松动牙列患者进行的各种固定形式是不同的。本文介绍了松动牙作基牙修复前的处置方法和各种修复设计,提出了修复后应注意的问题。这种通过固定和可摘修复方式来达到松动牙的动态固定,是牙周病患者用松动牙作基牙时固定松牙和修复缺失牙相结合的形式。     

牙列缺失伴牙周病患者综合治疗的疗效观察

目的:评价牙列缺失伴牙周病患者采用综合治疗的临床效果。方法:随机选择来门诊进行牙列修复治疗的180例伴不同程度牙周病患者,在修复牙列缺失的同时,配以中西药联合等措施综合治疗牙周病,并经1~4年随访观察。结果: 180例中疗效良好162例( 90% ),明显改善12例( 6. 7% ),无效6例(3. 3% )。结论:牙列缺失伴牙周病患者通过以上治疗方法,不仅修复了牙列缺失,而且使牙周病得到了有效治疗。修复治疗配合中西药物等综合治疗,提高了疗效。随访观察证明,早期治疗和综合治疗是治疗牙周病的科学有效途径,只要坚持治疗,均可获得满意效果。     

套筒冠义齿修复重度牙周病患者牙列缺损的临床研究

目的研究牙列缺损而基牙有严重牙周病时，套筒冠义齿修复的临床应用。方法对8例因重度牙周病所致牙列缺损患者进行修复，并观察该修复体对重度牙周病经牙周综合治疗后患牙的疗效巩固。结果余留牙松动度较修复前明显降低。X线片显示牙槽骨吸收得到控制并有新骨形成。结论套简冠义齿不仅可以修复缺失牙，恢复咀嚼功能，还有利于基牙牙周组织的恢复与重建，对松动牙产生良好的夹板固定作用。     

套筒冠义齿修复牙周病伴牙列缺损的临床应用研究

目的探讨套筒冠义齿修复牙周病伴牙列缺损的临床疗效。方法20例牙周病患者经牙周综合治疗病情稳定后进行套筒冠义齿修复,共制作套筒冠义齿24件,基牙共计146颗,其中松动牙81颗;比较分析牙周病伴牙列缺损患者修复前,修复后3、6、12个月基牙松动度、牙龈指数、牙周袋、牙槽骨高度、牙周膜宽度和硬骨板的丧失,并进行问卷调查。结果20例牙周病患者经修复治疗后,随着时间的推移,牙松动度减低,牙龈指数改善,牙周袋变浅,X线片显示基牙的牙周膜和骨硬板清晰完整,牙槽骨边缘高度未再见降低,骨密度明显增加,随访问答结果显示,患者的咀嚼功能显著提高,患者对义齿比较满意。结论套筒冠义齿修复牙周病伴牙列缺损具有良好的临床疗效。     

2013 年北京综合医院口腔学术年会论文摘要

牙周病广泛流行,是导致牙齿缺失的主要原因。老年人的患病率在75％以上,且严重程度较重。中重度牙周病治疗中,我科采用口腔多学科协作应用修复学和种植学方法得到了满意疗效。牙周病治疗的总体目标：基本H标是消除炎症、破坏停止;恢复牙周组织的形态;恢复牙龈及骨的生理外形;恢复牙的边缘嵴及邻面接触点,消除食物嵌塞;恢复牙周组织的功能：修复缺牙、调狳、松动牙固定等;维持疗效,防止复发：自我控制菌斑,定期复查。在牙周病治疗中保存牙槽骨骨量至关重要。导致颌骨丧失三因素：炎症、咬合创伤和牙列缺失后废用性颌骨萎缩。中重度牙周病治疗中通过牙周治疗消除炎症,通过牙周夹板消除咬合创伤,不能保留的牙及早拔除并种植义齿修复。牙周病修复治疗的内容：咬合调整,松动牙固定,缺失牙修复。牙周夹板的作用：稳定牙列,预防牙齿移位;改变力的传递方向,避免或减少咬合力对牙周组织的创伤;控制牙齿的异常动度,为受损牙周组织愈合创造有利的条件;形成多根巨牙,分散咀嚼压力,减轻单个牙牙周组织的负担;恢复牙列完整性,改善咀嚼效能和美感。牙周夹板有半永久的粘结式夹板和永久的粘固式夹板两种。牙列缺失后颌骨废用性萎缩应进行种植义齿修复。前牙区牙槽骨解剖学上有倾斜角度且牙槽骨伴有凹陷性缺损,一般需植骨治疗。前牙美学要素多,前牙区种植手术较疑难,因而前牙区牙周病患者在完善的牙周治疗基础上可选择牙周病修复治疗;后牙区要求有咬合功能,美学要求低,中重度牙周病患牙应选择种植义齿修复治疗。     

跨牙弓桥在牙周-修复联合治疗中的应用进展

严重的牙周病经常会导致牙列缺损或牙列缺失,在牙周基础治疗后,需修复重建来恢复患者口颌的美观和功能。牙周病患者剩余的牙齿基本松动,患牙的牙周支持力严重下降。当牙周病控制良好,通过牙周夹板将松牙固定在一起,剩余的牙能在相当长的时间内行使功能,特别是跨牙弓弧形设计时[1]。本文针对这种修复方式在牙周-修复联合治疗中的应用进行探讨。     

圆锥型套筒冠修复体对牙周病修复治疗的临床研究

目的对圆锥型套筒冠修复体修复治疗中重度牙周病的疗效作临床研究。方法对14例中重度牙周病与牙周病伴牙列缺损患者经牙周病综合治疗后采用圆锥型套简冠可摘义齿作修复治疗,在修复前和修复后3月、1a、2a进行定期检查.测定菌斑指数、牙龈指数、牙松动度和咀嚼效能,进行对比分析。结果该治疗方法能有效控制牙周菌斑附着,消除对牙周组织的创伤,有效防止牙周病复发,且降低牙齿松动度,咀嚼效能随修复后时间推延不断提高。结论圆锥型套简冠可摘义齿是中重度牙周病的有效修复治疗方法。     

JNK抑制剂对鼠实验性牙周病后基质金属蛋白酶-2mRNA影响的研究

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JNK抑制剂对鼠实验性牙周病后基质金属蛋白酶影响的研究

目的 研究JNK特异性抑制剂SP600125对大鼠实验性牙周病后基质金属蛋白酶的影响。方法 18只雄性SD大鼠随机分为对照组、生理盐水组(腹腔注射生理盐水)和SP600125组(腹腔注射SP600125),每组6只。每只大鼠右侧下颌第一磨牙牙颈部结扎钢丝,4周后去除钢丝,对照组在全麻下切取牙龈组织。此后生理盐水组每天腹腔注射生理盐水,SP600125组每天腹腔注射SP600125稀释液,连续7d后分别在全麻下切取牙龈组织。利用明胶酶谱法,分别检测对照组、生理盐水组和SP600125组牙龈组织中MMP-2的酶活性。结果 SP600125组牙龈组织中MMP-2酶活性较对照组和生理盐水组明显降低,差异有统计学意义。结论 JNK特异性抑制剂SP600125能够降低实验性鼠牙周病牙龈组织中的MMP-2酶活性,进一步证实JNK传导通路在牙周病的形成和发展中起到重要作用,本研究可为牙周病的治疗提供一条新的途径。?     

How we got from there to here and back

Edward H. Angle dominated orthodontic armamentarium, diagnosis and treatment planning for almost a half century until Charles Tweed successfully challenged his mentor's nonextraction mantra. The ensuing diagnostic regimen used by Tweed, however, proved to have serious limitations and clearly resulted in the extraction of too many teeth. This caused a subsequent deterioration of soft tissue appearances of patients that neither they nor their doctors liked. This article will describe and illustrate how new expansion techniques differ qualitatively from those of Angle, and how these techniques offer patients and doctors less invasive and more comfortable therapies which do not jeopardize facial appearances.     

How we got from there to here and back

Edward H. Angle dominated orthodontic armamentarium, diagnosis and treatment planning for almost a half century until Charles Tweed successfully challenged his mentor's nonextraction mantra. The ensuing diagnostic regimen used by Tweed, however, proved to have serious limnitations and clearly resulted in the extraction of too many teeth. This caused a subsequent deterioration of soft tissue appearances of patients that neither they nor their doctors liked. This article will describe and illustrate how new expansion techniques differ qualitatively from those of Angle, and how these techniques offer patients and doctors less invasive and more comfortable therapies which do not jeopardize facial appearances.     

Use of mobile electronic devices as educational tool in pediatric community outreach

The introduction of mobile electronic devices, as opposed to paper forms, in pediatric outreach programs of the New York University College of Dentistry is discussed. Since 2007, students have been receiving training on how to operate a personal digital assistant (PDA) and use it in community outreach for non-invasive oral-facial screenings and patient education. The shift from using paper forms to electronic media had a positive impact among the academic community, as it resulted in saving time and reducing the possibility of data collection errors. It may represent a significant improvement in data collection and patient education; and it provides an opportunity to enhance research and quality assessment.     

The management of occupational exposures to blood and saliva in dental practice

Accidental injuries when handling sharp or rotating instruments can allow inoculation of a dental team member by the patient's blood or saliva. The risk of transmission of HIV from occupational exposure among dental workers is low and to date no occupational exposure has resulted in HIV transmission. However, hepatitis B and C have a high morbidity and mortality and are more infectious than HIV. This paper demonstrates how occupational exposures to blood and saliva could be managed in general dental practice and outlines the legal responsibilities of a dentist in the management of these exposures.     

Representativeness of the "Ramfjord teeth" for epidemiologic studies of gingivitis and periodontitis

Data from the Veterans Administration Dental Longitudinal Study of 736 men each examined four times were analyzed to determine how representative the six "Ramfjord Teeth" (RT) were of the rest of the dentition for epidemiologic studies of gingivitis and periodontitis. Correlation coefficients were calculated between scores for gingival inflammation generated by the RT and scores for the teeth in the rest of the mouth; the correlation coefficients between the two scores tended to be high. Sensitivity, specificity and predictive values were calculated for periodontal pathology classified on the basis of the pocket depths of the six RT. Reliance on the RT resulted in systematic underestimation of the prevalence and incidence of deep periodontal pockets. The RT are more than adequately representative of the rest of the dentition for epidemiologic studies of gingivitis, but are inadequate surrogates of the rest of the mouth for epidemiologic studies of periodontitis.     

Full-body impression technique for conjoined twins: A clinical report

This clinical report describes a unique impression technique devised for fabrication of a full-body cast of conjoined twins. The authors describe how the cast was used by the medical team to plan the surgical flap design for effective abdominal wall closure during the 27-hour operation sequence that resulted in the twins' separation. The cast, in turn, proved invaluable in planning the complicated surgical procedures necessary to separate them.