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目的探讨金栀洁龈含漱液对中重度牙周炎患者的临床治疗效果。方法选择2009年10月至2010年10月在辽宁省人民医院口腔科就诊的中重度牙周炎患者60例,牙周基础治疗后,随机分为2组,试验组选取中药金栀洁龈含漱液对牙周袋进行冲洗维护,对照组常规选取双氧水进行牙周袋冲洗维护,两组治疗前后均进行牙周病相关临床指标菌斑指数(PLI)、出血指数(BI)、探诊深度(PD)、附着丧失(AL)的记录及龈沟液中炎性因子白细胞介素-6(IL-6)质量浓度的测定。结果经过5周的牙周系统治疗和金栀洁龈含漱液、双氧水的牙周袋冲洗治疗后,试验组和对照组牙周炎患者的BI、PD、AL及龈沟液中IL-6质量浓度均比治疗前有改善,但试验组比对照组改善更加明显,差异有统计学意义(P<0.05)。试验组和对照组PLI的组间对比差异无统计学意义(P>0.05)。结论金栀洁龈含漱液在治疗中重度牙周炎患者时疗效显著,值得在临床上推广使用。     

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目的探讨中药离子导入治疗颞下颌关节紊乱病(TMD)的临床疗效。方法将2000年11月至2007年11月大连大学附属中山医院确诊的TMD患者212例,随机分为试验组(中药离子导入组)109例,采用中药溶液湿热敷配合电脑中频药物导入治疗仪治疗;对照组(药物治疗组)103例,采用传统口服药治疗。治疗2周后对比观察临床疗效。结果试验组及对照组的治疗有效率分别为90.83%和78.64%,两组差异具有统计学意义,(χ2=6.13,P<0.05),试验组有效率明显高于对照组。结论中药离子导入治疗TMD是一种具有较好应用前景的治疗方法,为中药治疗TMD提供了一种新的给药途径。     

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目的探讨偏侧咀嚼对颞下颌关节的影响。方法通过拍摄颞下颌关节X线侧位片,测量56例1999—2001年就诊于四川大学华西口腔医院颞下颌关节诊室的偏侧咀嚼患者的关节窝深度、宽度以及髁道斜度,了解其颞下颌关节形态变化。结果30例非习惯侧出现关节结节后斜面骨质粗糙、关节窝骨皮质吸收变薄、髁状突功能面骨质不光滑样骨质改变(53.6%),21例习惯侧出现骨质改变(37.5%),两者比较差异有统计学意义(P<0.05)。偏侧咀嚼患者习惯侧与非习惯侧的颞下颌关节窝深度和髁道斜度之间差异也有统计学意义(P均<0.05),而两者间关节窝宽度差异无统计学意义(P>0.05)。结论偏侧咀嚼影响颞下颌关节形态。     

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目的通过显微CT体外评价,比较3种不同直径羟磷灰石颗粒外部间隙分布情况,探讨材料外部间隙对临床运用的影响。方法 2014年3—4月于广州科学城显微CT实验室对颗粒直径分别为0.25~1 mm、0.4~1 mm、1~2 mm的3种人工骨材料进行体外固定,采用显微CT扫描,评价各自的间隙排列。结果 1~2 mm组羟基磷灰石颗粒压实堆积后显微CT下显示材料颗粒排列松散,颗粒团块间存在较大空隙,间隙率为61.75%;0.25~1 mm和0.4~1 mm组材料颗粒排列较为均匀,颗粒团块间存在间隙较小,间隙率分别为27.33%和42.44%。结论显微CT可用于颗粒移植材料的微观物理参数评估,0.25~1 mm组羟磷灰石颗粒压实后颗粒团块内部排列紧密,临床上有利于植骨后稳定成骨空间。     

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目的探讨关节腔注射透明质酸钠治疗间接性颞下颌关节(TMJ)损伤后并发关节功能紊乱患者的临床疗效。方法选择2009年5月至2011年5月甘肃省嘉峪关市第一人民医院口腔科收治的因间接性TMJ损伤并发关节功能紊乱且经保守治疗无效的患者40例,将其随机分为两组:治疗组20例,关节腔冲洗后注射透明质酸钠;对照组20例,单纯行关节腔冲洗。观察两组患者治疗前后关节疼痛、开口度和侧向活动度的变化。结果经过1个疗程(每周1次,3周为1个疗程)治疗后,两组患者的关节疼痛、开口度和侧向活动度均较治疗前改善;组间比较结果显示,治疗组关节疼痛、开口度和侧向活动度的改善程度均较对照组明显,差异有统计学意义(P<0.01)。结论关节腔注射透明质酸钠治疗间接性TMJ损伤后并发关节功能紊乱病的疗效优于单纯进行关节腔冲洗;透明质酸钠可以明显改善间接性TMJ损伤并发关节功能紊乱患者的疼痛症状、开口度和侧向活动度。     

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目的评价含生物活性玻璃成分的脱敏剂与氟保护漆联合应用对牙本质小管的堵塞效果及治疗牙本质过敏症(dentin hypersensitivity,DH)的临床疗效。方法选择2013年6月到2014年6月到中国医科大学口腔医学院干诊科就诊的59例DH患者的120颗患牙,随机分为A组(41颗)、B组(39颗)、C组(40颗),分别使用氟保护漆、奥敏清及氟保护漆与奥敏清联合涂布敏感处,应用视觉模拟评分(visual analogue scale,VAS)法评价其疗效。另选择因正畸需要拔除的完整无龋坏前磨牙20颗,制备成敏感模型后随机分为a、b、c、d四组,每组5颗,a、b、c三组处理方法同上述A、B、C组,d组为空白对照组,用蒸馏水进行处理,扫描电镜观察各组牙本质小管的堵塞情况。结果 A、B、C三组的VAS评分值在处理即刻均明显下降,且随时间推移均有增高趋势;有效率比较,A、C两组在1个月时差异有统计学意义(P<0.05),其他各组间在各时点差异均无统计学意义(P>0.05);各组内比较,A组即刻与1个月时差异具有统计学意义(P<0.05)。扫描电镜观察a、b、c三组牙本质小管均有不同程度堵塞,其中以联合应用组效果最佳。结论含生物活性玻璃成分的脱敏剂与氟保护漆联合应用堵塞牙本质小管的效果最佳,且具有较好的临床效果。     

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??Objective    To explore the responses of patients with all types of burning mouth syndrome to low-level laser therapy. Methods    Totally 90 BMS patients were randomly divided into 3 groups??30 cases in each group. Group A and B were treated with low-level laser?? and therapeutic regimens were one time a day for continuous irradiation of 20 days??group A???? and every other day for ten times??group B???? respectively. Group C was treated with non-irradiation light?? one time a day for continuous irradiation of 20 days. Group A?? B and C were all given routine medication. Before and after the treatment and in the one-month follow-up?? the pain ??VAS score?? and the total effective rates were measured. Results    Statistically significant difference ??P??0.05?? was found between group A and B in the change of VAS after treatment?? and the total effective rates of group A and B were significantly higher than that of group C. The total effective rate of type 2 BMS was significantly higher than that of type1 and 3. There was no significant difference among groups and types of BMS in the VAS scores and the total effective rates between one-month follow-up and after the treatment ??P??0.05??. Conclusion    Low-level laser is effective in the treatment of BMS?? especially for type 2. In a certain period of time?? there is no difference in the effect with different irradiation times under the same irradiation dose parameters.     

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目的    探讨可吸收性胶原生物膜应用于齿槽裂植骨修复的临床效果。方法    选择2006—2009年在广东省口腔医院口腔颌面外科就诊的单侧齿槽裂患者108例,年龄9 ~ 13岁,随机分为2组。对照组60例单纯应用髂骨松质骨行植骨修复,试验组48例应用髂骨松质骨加可吸收胶原生物膜覆盖行植骨修复。术后1周及3、6、12个月行X线检查。结果    试验组植骨成活率和临床成功率（97.9%、79.2%）高于对照组（86.7%、58.3%）,差异有统计学意义（P < 0.05）。结论    自体髂骨加可吸收胶原生物膜联合应用于齿槽裂植骨修复中,可有效提高植骨成功率,为后续治疗提供更好保障,值得临床推广。     

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??Objective??To assess the efficacy of oral propranolol combined with topical timolol maleate in the treatment of infantile parotid hemangiomas. Methods??Twenty-seven infants with parotid hemangiomas were hospitalized in Department of Oral and Maxillofacial Surgery?? Hospital of Stomatology?? China Medical University??from September 2013 to September 2015. The study group consisted of 9 males and 17 females?? aged between 2 months to 9 months?? with a median age of 4.8 months. The lesions were all located in the parotid region??and measured between 1.5 cm × 2.0 cm × 1.0 cm and 7.0 cm × 6.0 cm ×3.0 cm in size. Propranolol was administered orally at a dose of 1.0??1.5 mg/??kg·d???? 0.5% timolol maleate eye drop solution was applied topically with medical cotton swabs to the area of the lesion twice a day. The therapy duration was 12 to 32 weeks?? averaged 20.3 weeks. The follow-up duration was from 3 months to 12 months?? averaged 8.4 months. Record the colors?? volumes?? textures?? and ultrasonic results of hemangiomas before the treatments and at the end of treatments. Results??Of the 27 patients??21 demonstrated an excellent response ??77.8%????4 showed a good response ??14.8%????and 2 displayed a moderate response ??7.4%????cure rate was 77.8%??and effective rate was 100%. Conclusion??Overall??oral propranolol combined with topical timolol maleate is an effective treatment method for infantile parotid hemangioma??and is worth promoting.     

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目的研究前方牵引联合唇挡矫治替牙期骨性Ⅲ类错的临床疗效。方法选择2010—2011年大庆油田总医院集团五官医院口腔正畸科门诊就诊的替牙期上颌发育不足的骨性Ⅲ类错患者30例。随机分为试验组和对照组,各15例。试验组使用前方牵引联合唇挡进行矫治;对照组则仅使用前方牵引矫治。在治疗前后对所有患者进行X线头影测量分析并比较组间差异。结果试验组治疗前后变化差值与对照组比较,X线头影测量分析结果显示,SNA、ANB、U1-SN、U1-NA角、U1-NA距、Ptm-U6差异均有统计学意义(P<0.01);模型测量结果显示,TAL、AD、拥挤度差异亦均有统计学意义(P<0.01)。结论采用前方牵引和唇挡联合矫治替牙期骨性Ⅲ类错,可有效消除单一采用前方牵引矫治带来的负面影响,是一种切实可行的办法。     

心理干预对青少年正畸患者心理及疗效影响研究

目的 探讨心理干预对于青少年正畸患者心理及疗效的影响。方法 选择2008年7月至2010年7月江苏省连云港市第二人民医院口腔科就诊的错牙合畸形患者62例,随机分为干预组及对照组,每组各31例,均采用标准直丝弓固定矫治。干预组予以正畸治疗同时辅以心理干预,对照组则仅进行常规正畸治疗。治疗前后根据抑郁自评量表（SDS）与焦虑自评量表（SAS）评分以及疗效标准进行评定。结果 青少年错牙合畸形患者正畸治疗前均有不同程度的焦虑或抑郁心理。干预组心理状况改善明显,两组SAS、SDS评分差异均有统计学意义（均P＜0.05）。两组治疗后疗效差异有统计学意义（P＜0.05）。结论 心理干预可明显降低青少年错牙合畸形患者焦虑抑郁心理,进而影响正畸治疗效果。     

认知行为干预疗法对青少年正畸疗效的影响

目的探讨认知行为干预疗法对青少年正畸治疗的临床意义。方法选取青少年正畸患者120例,随机分成试验组和对照组,试验组进行正畸治疗联合认知行为干预疗法心理辅导,对照组进行单纯的正畸治疗。结果试验组与对照组相比较,试验组更加积极地配合治疗,治疗效果更好,复发率较低,总体满意度较高。两组患者比较,差异有统计学意义。结论认知行为干预在青少年正畸治疗中有着积极的作用,值得推广。     

Appropriateness of orthodontic referrals: self-perceived and normative treatment needs of patients referred for orthodontic consultation

OBJECTIVES: The aims of this prospective study were to evaluate the self-perceived and normative orthodontic treatment needs of children referred for orthodontic consultation and to determine the proportion of children who were inappropriately referred. METHODS: The sample consisted of 257 children with a mean age of 12.0 years (SD = 2.4). An orthodontist assessed the children's normative treatment need using the dental health component (DHC) of the index of orthodontic treatment need (IOTN), and for patients in the mixed dentition the need for interceptive treatment was assessed. Questionnaires were answered by both the child and the parent to assess satisfaction with dental appearance and desire for treatment. RESULTS: The distribution of the IOTN grades showed that 73% of the children had definite need while 27% had borderline/no need for orthodontic treatment. Twenty-six per cent of children and 17% of parents did not express orthodontic concern, even though more than half of these children were in definite need of treatment as assessed by IOTN. The children's orthodontic concern was significantly related to the DHC scores. Out of the 103 children who were in the mixed dentition, only about 16% required interceptive treatment. CONCLUSIONS: The results indicated that a significant number of children were inappropriately referred for orthodontic treatment. Referring dentists need to assess the normative treatment needs of the children as well as the children's and parents' commitment and desire for orthodontic treatment before deciding on the need for referral.     

兰州地区青少年正畸患者正畸治疗意识的调查分析

目的 调查兰州地区青少年对错牙合畸形的认识及正畸治疗意识。方法 对兰州地区4个城区4 981名在校中学生进行错牙合畸形调查,并向其发放问卷了解治疗动机和正畸意识。结果 4 981名学生中错牙合患者3 168名（65.61%）,其中有452名正在矫治治疗（14.27%）。对2 716名尚未正畸治疗患者调查其未作治疗原因,有21.54%认为没有觉得不齐,20.00%的认为学习紧张。结论 兰州地区青少年错牙合患病率较高,矫治率低,对正畸治疗认识不足。     

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目前,口腔种植已经成为临床常用的修复方式,但在有种植要求的人群中会有许多复杂情况,如伴有不同程度的咬合问题,单纯的种植修复难以达到理想治疗目的,需要正畸等专科医生的参与等。反之,正畸治疗中常遇到的磨牙早失、恒牙先天缺失等难题,也需要通过种植获得满意的治疗效果。口腔多专业联合治疗目前已成为一种发展趋势。对某些牙列缺损患者进行以后期种植修复为导向的正畸治疗正在成为共识,而正畸治疗中应用种植技术辅助完成矫治的情况也不罕见。本文将就种植-正畸联合治疗的特点和优越性等方面进行阐述,为部分复杂病例的临床治疗提供参考经验。     

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目的    探讨心理辅导对青少年口腔正畸患者疗效的影响。方法    收集2006年3月至2010年3月在溧阳市中医院正畸门诊就诊的不同类型错牙合畸形青少年患者128例,随机分为辅导组和对照组,每组64例,均采用标准方丝弓技术进行矫治,其中对辅导组在矫治计划制定之后,施以正畸认知宣教、心理辅导、鼓励疗法、暗示疗法和与家长交流等方法。观察记录各组患者复诊情况、口腔卫生情况、配合积极人数、矫治器损坏情况、疗程≤18个月的人数和复发病例等。结果    在正畸治疗的整个过程中,辅导组基本都取得令人满意的疗效,无中途放弃治疗患者,口腔卫生状况、积极配合、矫治器损坏、治疗时间、复发等方面均明显优于对照组（P < 0.05 ）。结论    心理辅导可明显提高青少年正畸治疗的效果。     

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目的研究能够敏感反映患者侧貌美观程度的头影测量指标及其标准。方法中国医科大学口腔医学院正畸科2002—2005年117例矫治后患者侧貌剪影图,经16名正畸医师、63名大学生进行美观程度评分,按评分分为高分组和低分组,测量两组患者10项头影测量指标,分析组间各项指标的差异,通过Logistic回归分析,筛选与颜面侧貌美观程度密切相关的指标。结果高分组U1-AP(6.80±1.87)mm,L1-NB(3.29±2.30)mm,FMIA(56.56±6.70)°;低分组U1-AP(8.7±2.17)mm,L1-NB(4.20±3.88)mm,FMIA(49.50±10.28)°,3项指标在两组间均有统计学差异(P均<0.05),其余7项指标组间均无统计学差异(P均>0.05)。Logistic回归分析结果显示,U1-AP值与侧貌美观程度有显著相关性。结论上牙突度是影响侧貌美观的关键因素,治疗目标应以U1-AP突距(6.80±1.87)mm为参考标准。     

牙列中存在修复体的错(牙合)畸形的矫治

本文通过对31例牙列中存在修复体的错(牙合)畸形进行固定矫治,观察托槽在修复体上的粘结强度,总结此类畸形的矫治特点。结果表明,此类畸形的矫治设计有其特殊性。修复体表面的托槽较对侧同名牙上的托槽易于脱落,光固化复合树脂覆盖牙及塑料义齿上托槽的粘结强度高于金属义齿,托槽脱落次数较少。应采取有效措施提高托槽在修复体表面的粘结强度。在适当的正畸力作用下,正畸治疗不会影响修复体的牙周健康和牙齿的稳定性。     

Normative and self-perceived orthodontic treatment need in Nigerian school children

Abstract

Objective. The aim of this study was to assess the normative and self-perceived need for orthodontic treatment in Nigerian children, and to evaluate distribution of orthodontic treatment need according to gender and age. Materials and methods. The sample consisted of 441 randomly selected school children, aged 11–18 years in Benin City, Nigeria. The subjects were further sub-grouped according to gender (229 males and 212 females) and age (246 11–13 years old and 195 14–18 years old). The Dental health Component (DHC) and Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN) were used to assess orthodontic treatment need normatively. Self-perceived need was evaluated by asking the subjects to rate their dental aesthetics on the Aesthetic Component scale of IOTN. Chi-square tests were used to evaluate gender and age differences in distribution of treatment need. Results. A definite need for orthodontic treatment was found among 21.5% (grades 4–5 of DHC) and 6.3% (grades 8–10 of AC) of the subjects; 3.9% of the subjects perceived a definite need for orthodontic treatment (grades 8–10 of AC). There were no statistically significant gender and age differences in distribution of orthodontic treatment need among the subjects (p > 0.05). Conclusion. The study revealed a need for orthodontic treatment in slightly more than one fifth (21.5%) of this sample of Nigerian children. The sample population has a lower need on aesthetic grounds and their normative and self-perceived orthodontic treatment needs were not influenced by gender and age.     

正畸治疗与颞下颌关节紊乱病关系的研究进展

颞下颌关节紊乱病是口腔临床常见病之一.一般认为颢下颌关节紊乱病是由多因素导致的咀嚼肌功能紊乱、颞下颌关节异常和退行性改变.近几十年来,正畸治疗与颢下颌关节紊乱病之间可能存在的关系一直是正畸医生研究和关注的焦点.本文就两者之间关系的研究作一.