107例牙周-牙髓联合病变患牙的临床治疗体会

目的：观察牙周-牙髓联合病变患牙的联合治疗效果。方法：对107例牙周-牙髓联合病变的139个牙的临床资料进行分析,采取牙周牙髓联合治疗,观察临床疗效。结果：经过1年的随访,联合治疗总有效率82.73%,其中根尖周病变引起的牙周病变治疗效果好,且前牙好于后牙。结论：临床上对牙周-牙髓联合病变患牙及时采用系统的综合治疗可以最大限度保存患牙,取得良好的临床疗效。     

老年人牙周牙髓联合病变135牙治疗体会

笔者收集了 132位 6 0岁以上老人患牙周牙髓联合病变的病例 ,共 135个患牙 ,针对患者的具体情况 ,采取根管治疗与牙周治疗相结合 ,经术后一年的追踪观察 ,报告如下 :1　临床资料1.1　诊治对象均被诊断为牙周牙髓联合病变 ,男 70例 ,女 6 2例 ,前牙 2 1个 ,双尖牙 30个 ,磨牙 84个。1.2　治疗方法1.2 .1　根管治疗术前拍Ｘ线片 ,了解牙周病变及根管情况 ,常规开髓 ,牙髓失活或拔髓 ,常规根管清理、扩大、封药。症状完全消失后 ,作完善的根管充填治疗。术后配合全身用药。并对患牙进行调磨降牙合、减径等处理。1.2 .2　牙周治疗同时根据牙周病…     

牙髓牙周联合病变综合治疗的临床疗效

目的探讨牙髓牙周联合病变综合治疗的临床疗效。方法选择牙髓牙周联合病变120例182颗患牙,采用牙髓牙周综合治疗,观察疗效。结果经2年随访,182颗患牙综合治疗的有效率为84．62％。结论对牙髓牙周联合病变采用综合治疗,可以取得良好的临床疗效。     

牙周牙髓联合病变治疗探讨

目的:探讨慢性牙周炎及其引起的牙髓根尖周病变治疗方法.方法:将118位病人的166个患牙进行牙髓活力测试、评价.根据临床症状进行牙周基础治疗和根管治疗术,随访6个月,观察疗效.结果:前磨牙冷诊阳性率77.55%,电活力阳性率85.71%,开髓后发现有67.34%牙髓部分或全部坏死;磨牙冷诊阳性率75.22%,电活力阳性率72.57%,开髓后发现有56.63%牙髓部分或全部坏死.根管治疗术6个月后复查所有患牙症状明显改善,咬合功能基本恢复正常,松动度、探诊深度都有明显改善(P<0.05).结论:牙髓状态应根据病史和症状进行综合判断.慢性牙周炎引起的牙髓刺激症状经过牙周基础治疗以及脱敏或楔形缺损充填治疗症状明显减轻者,可不做牙髓处理.经上述治疗后症状仍未消失,应行根管治疗术.如有牙髓坏死,并由此加重骨破坏者,应尽早进行根管治疗术.     

根管治疗联合不同时机牙周治疗对牙周源性牙周牙髓联合病变患牙疗效的影响

目的探讨根管治疗联合不同时期牙周治疗对牙周源性牙周牙髓联合病变患牙疗效的影响。方法选取我院2016年7月～2019年1月收治的牙周源性牙周牙髓联合病变患者80例,均行根管治疗术,并于术后给予牙周治疗。根据患者的牙周治疗时机,将其分成早期组(n=42)、延期组(n=38)。早期组在根管治疗术后1周行牙周治疗,延期组在根管治疗术后1个月行牙周治疗。比较两组临床疗效,分别于术前、术后1个月记录两组牙周探诊深度(PD)、附着丧失水平(AL)、牙龈退缩(RG)、菌斑指数(PLI)。于同时段采集血清、龈沟液检测白介素-8(IL-8)、白介素-1β(IL-1β)、白介素-6(IL-6)水平,分析炎症改善效果。结果早期组总有效率为92.86%,显著高于延期组的89.47%(P<0.05)。两组术后PD、AL、RG、PLI显著低于术前,且早期组术后PD、AL、PLI显著低于延期组(P<0.05)。两组术后龈沟液内IL-8、IL-1β、IL-6水平显著低于术前,且早期组术后各指标显著低于延期组(P<0.05)。两组术后血清IL-8、IL-1β、IL-6水平显著低于术前,且早期组术后各指标...     

牙周牙髓联合病变的诊治研究进展

牙周牙髓联合病变是临床上常见的疾病.由于多因素相互作用,临床上对该病的诊断和治疗存在多种观点.因此,对牙周牙髓联合病变的治疗原则和治疗方法的研究由来已久,本文就牙周牙髓联合病变的诊治研究进展进行综述.     

影响牙周-牙髓联合病变预后的相关因素研究进展

牙周-牙髓联合病变是牙周炎的伴发病变之一,因其治疗方法复杂,疗程相对较长,预后难以确定,给口腔科医生的临床诊治带来了巨大的挑战。该文对影响牙周-牙髓联合病变预后的相关因素研究进展作一综述。     

306颗牙周-牙髓联合病变的治疗观察

目的 探讨治疗牙周-牙髓联合病变的有效方法 。方法 对306颗牙周-牙髓联合病变患牙采用牙周病-牙髓病联合治疗的方式进行治疗;行洁治术、刮治术,牙周袋内放入碘甘油甲硝唑棒、盐酸米诺环素软膏进行牙周给药,及牙体牙髓治疗。结果 牙周-牙髓联合病变患牙306颗,经2年随访,痊愈207颗,好转90,失败9颗。总有效率达90.8%。结论 对牙周-牙髓联合病变患牙进行牙周牙髓联合治疗,效果良好。?     

牙周牙髓联合病变牙周治疗时机选择研究

目的:探索牙周牙髓联合病变牙周治疗的时机。方法:收集2013年10月~2015年10月就诊于我院的138例牙周牙髓联合病变患牙,随机分为对照组(A组)和实验组(B组),A组于根管治疗完成后1周行全口龈下刮治及根面平整术,B组于根管治疗完成后4~6周行全口龈下刮治及根面平整术。分别记录2组患者在牙髓治疗前、牙周治疗前、牙周治疗后2个月、维护期3、6、12个月的SBI、PD、AL、PLI,TM并进行统计学分析。结果:牙髓治疗前,A组与B组各观察指标的组间比较,差异无统计学意义。牙周治疗前2组SBI、PD、TM值相比(P<0.05),差异有统计学意义。牙周治疗后2个月,2组分别与治疗前基线相比,各项指标比较差异有统计学意义。2组维护期3、6、12个月时各项指标与治疗后2个月相比差异无统计学意义。牙周治疗后各时间点,2组各项指标组间比较,差异无统计学意义。结论:对于牙周源性的牙周牙髓联合病变及"真正"的联合病变,根管治疗后1周即可行根面平整。     

中老年牙周牙髓联合病变16例的治疗体会

牙周牙髓联合病变是中老年人较常见的口腔疾病。过去多认为此种患牙不能保留须拔牙。 1990年以来 ,我们对 16例中老年牙周牙髓联合病变采用综合治疗方法 ,保留患牙 ,疗效满意。现报告如下。1　临床资料16例患者 ,男 12例 ,女 4例 ;年龄 5 0～ 76岁 ,无严重全身性疾病 (高血压、冠心病、糖尿病、恶性肿瘤等 )。牙位 :16为 4例 ,17为 3例 ,2 6为 2例 ,2 7为 5例 ,46为 2例 ,均为单个牙发病 ,Ⅱ度龋 3例 ,楔形缺损 2例 ,创伤牙合 1例。本组病例均出现不同程度的自发性牙痛 ,阵发性加剧 ,遇冷热刺激时可诱发难以忍受的疼痛 ;牙龈红、肿、痛 ,牙…     

牙周牙髓联合病变伴畸形根面沟治疗的临床疗效研究

目的:评价显微根管外科手术联合牙周治疗牙周牙髓联合病变伴畸形根面沟的治疗效果。方法:选择畸形根面沟致牙周牙髓联合病变的患牙11例,经显微根管治疗后,采用显微根管外科手术联合牙周治疗,分别记录患牙术前、术后6个月及术后1年牙周探诊深度(PD)、龈沟出血指数(SBI)、牙齿松动度(TM),并进行统计分析。所有患牙术后6个月及1年复查,通过临床检查和X线片评定根尖周病损愈合结果。结果:术后6月及术后1年分别与术前相比,PD、SBI及TM均明显降低(P<0.05);术后6月成功率为81.82%;术后1年成功率为90.91%。结论:显微根管外科手术联合牙周治疗是畸形根面沟致牙周牙髓联合病变的可行治疗方法。     

牙髓源性牙周牙髓联合病变6年疗效观察1例

本文报告1例牙髓源性牙周牙髓联合病变,通过反复多次根管冲洗和封药,未经牙周基础治疗最终控制感染,观察期6年,预后良好.     

牙周牙髓联合病变激光与药物辅助治疗观察及菌群分析

目的:探讨双波长激光对比盐酸米诺环素治疗牙周牙髓联合病变的差别及牙周袋菌群分析。方法:收集牙周牙髓联合病变患者60颗患牙,随机分为2组:实验组Nd:YAG消毒根管一次性充填根管+Er: YAG处理牙周袋;对照组碘伏消毒根管一次性根管充填+盐酸米诺环素牙周袋上药。按视觉模拟评分法(visual analogue scale,VAS)观察两组治疗后1 d疼痛差异,对比两组治疗1周、2周、3周、3月、6月、1年的牙周袋深度(the depth of periodontal pocket,PD)、牙周附着水平(clinical periodontal attachment level,CAL),探诊出血指数(bleeding on probing,BOP),评价疗效。抽取两组病例各4例,并定期采集患牙牙周袋菌斑行高通量测序。结果:实验组与对照组治疗1 d疼痛有差异;不同时间点间PD、CAL静息状态下VAS评分有差别;BOP阳性位点发生率有差别。2组牙周袋菌斑多样性差异不大,以韦荣氏菌、变性链球菌、卟啉单胞菌、消化链球菌为主。结论:双波长激光联合辅助治疗牙周牙髓联合病变的效果优于盐酸米诺环素,具有较好的临床应用前景。     

Management and Treatment Outcomes of Maxillofacial Fibro-osseous Lesions: A Retrospective Study

Introduction

Fibro-osseous lesions are a diverse group of bone disorders and include developmental, reactive or dysplastic diseases and neoplasms. They share overlapping clinical, radiographic and histopathologic features and demonstrate a wide range of biological behaviour.

Aim

To evaluate the characteristics, treatment and outcome of benign fibro-osseous lesions of the jaws.

Patients and Method

All patients with fibro-osseous lesions of the jaws treated at the department of Oral and Maxillofacial Surgery of the Kamineni Institute of Dental Sciences from 2007 to 2013 were included in this study.

Results

Six males and four females were treated. Juvenile ossifying fibroma was most often encountered (40 %), and the mandible was the most frequent location (70 %). Main clinical feature in most of the cases was a painless expansile swelling with facial asymmetry, and radiologically mixed (radiolucent and radiopaque lesions) were seen in majority of cases. All cases were surgically treated and histopathologically confirmed. Segmental ostectomy was performed in six cases; maxillectomy was done in one case and excision along with margin in three cases. Mean follow-up was of 3.3 years with no recurrence.

Conclusions

Fibro-osseous lesions, although sharing similar microscopic features, exhibit a variety of clinical behavior rendering their treatment highly individualized. Radical treatment is the choice to achieve an outcome without recurrence.     

重度牙周炎病例牙周牙髓联合治疗与单纯牙周治疗的临床对比研究

目的：本研究比较了重度牙周炎病例牙周牙髓联合治疗法与单纯牙周治疗法治疗效果的差异，旨在探讨牙髓状态对牙周治疗效果的影响。方法：半年随访重度牙周炎病例14例，共计试验牙20颗，随机进入实验组(牙周牙髓联合治疗组)12颗，对照组(单纯牙周治疗组)8颗。于治疗后3个月、6个月通过牙周袋探诊深度(probing pocket depth，PDD)、相对附着水平(relative attachment level，RAL)，影像学指标釉牙骨质界到骨缺陷底的距离(cementum enamal junction to bottom of born，defects，CEJ-BD)，釉牙骨质界到牙槽嵴顶的距离(cementum enamal junctioa to alveolar crest，CEJ-AC)及计算机辅助骨密度影像分析值(computer assisted densitometric image analysis，CADIA)对比两组治疗效果的差异。结果：观察期内临床指标PPD、RAL及CEI-AC未出现显著性差异，而CEJ-BD及CADIA于治疗后3个月，6个月出现显著性差异。结论：重度牙周炎病例选择牙周牙髓联合治疗法较单纯牙周治疗法更有利于牙周骨组织的再生。     

A Retrospective Brazilian Multicenter Study of Biopsies at the Periapical Area: Identification of Cases of Nonendodontic Periapical Lesions

IntroductionThe purpose of this study was to analyze the features of lesions obtained from biopsies at the periapical area of teeth with a radiographic or clinical initial diagnosis of apical periodontitis.MethodsA retrospective study was conducted on biopsies obtained from 1953–2018 at 3 Brazilian oral and maxillofacial pathology centers. Cases of endodontic and nonendodontic periapical lesions (NPLs) with a clinical diagnosis of endodontic pathoses were retrieved. Data regarding patient age, sex, and anatomic location were obtained from patients’ records. The frequency and percentage of cases with clinical diagnoses of a periapical cyst, periapical granuloma, or dentoalveolar abscess were recorded, and the final histopathologic diagnosis was documented.ResultsAmong 66,179 oral biopsies, 7246 (10.94%) were clinically diagnosed as periapical disease, 306 (4.22%) of which were histopathologically diagnosed as NPLs. The most frequent NPLs were odontogenic keratocysts (n = 107, 34.96%) followed by dentigerous cysts (n = 48, 15.68%). The mean age at diagnosis was 39.68 years with a range of 6–80 years. A total of 159 (51.96%) cases occurred in females and 147 (48.03%) in males (female to male ratio = 1.08:1). Most lesions (137, 44.77%) were located in the posterior mandible.ConclusionsA wide variety of histopathologic diagnoses, including benign odontogenic and nonodontogenic cystic and tumorous lesions, infectious diseases, and malignant neoplasms, was reported in the present survey. The features presented in this study were consistent with previous findings reported in the literature.     

A Retrospective Clinical and Radiographic Study on Healing of Periradicular Lesions in Patients Taking Oral Bisphosphonates

IntroductionBisphosphonates have been related to impaired bone remodeling. The impact of oral bisphosphonates on periradicular healing has not been studied. The purpose of this study was to evaluate the healing of periradicular lesions in patients taking oral bisphosphonates after root canal therapy.MethodsThirty-four teeth with preoperative periradicular radiolucencies were identified in patients undergoing oral bisphosphonate therapy. These cases were examined clinically and radiographically to determine treatment outcome. Thirty-eight control teeth were selected from a pool of patients not taking bisphosphonates. Nonsurgical root canal treatment and retreatment was performed by endodontic residents and undergraduate dental students at Baylor College of Dentistry using nonstandardized protocols.ResultsIn the bisphosphonate group, 73.5% of the lesions healed, whereas the control cases had a healing rate of 81.6%. There was no statistically significant difference between the groups (p > 0.05).ConclusionThe results of this preliminary short-term study suggest that patients taking long-term oral bisphosphonates can expect a satisfactory outcome with evidence of periradicular healing after conventional root canal treatment. Thus, root canal treatment may be considered a safe and realistic alternative to extraction in patients on bisphosphonate therapy.