固定修复重建咬合5年临床观察

目的 临床分析咬合失调患者的病因，采用固定修复术重建咬合，测定治疗前后的咀嚼效能及观察颞下颌关节紊乱病的临床变化。方法 65例经临床诊断为咬合失调病例，采用固定修复的方法施行咬合重建，并分别于修复前，修复后3个月和5年，采用过筛法进行咀嚼效率的测试，检查颞下颌关节紊乱病临床症状的变化。结果 统计学分析显示固定修复前后咀嚼效率有显著性差异（P＜0．01）；颞下颌关节紊乱病的临床症状得到缓解。结论 固定修复方法对恢复咬合关系是有效的，重建咬合后颞下颌关节紊乱病得到缓解，这种不可逆性咬合重建尚需长期的，大量的临床观察。     

正畸治疗应如何规避颞下颌关节紊乱病的风险

颞下颌关节紊乱病是导致口颌面非牙源性疼痛的常见原因之一,但其病因机制尚未完全阐明.传统的牙合学理念认为咬合是其病因之一,改变患者咬合的正畸治疗也就被认为可能会导致颞下颌关节紊乱病.而由于正畸治疗持续2年左右,一旦患者在治疗中出现颞下颌关节病症状,就可能产生医患纠纷.因此,正畸医生如何在越来越多患者寻求正畸治疗的情况下,...     

第九次全国颞下颌关节病学及学研讨会征文通知

中华口腔医学会颞下颌关节病学及学专业委员会拟定于2012年9月21日-24日在杭州举办第九次全国颞下颌关节病学及合学研讨会暨国家级继续教育项目《颞下颌关节紊乱病及口颌面疼痛的基础与临床进展》学习班,同时将进行颞下颌关节紊乱病和口颌面疼痛等学组成立大会。大会将就本领域的热点问题进行专题讨论,如颞下颌关节紊乱病的治疗规范、正畸和修复治疗中颞下颌关节问题的应对策略、临床咬合问题的诊断和治疗、     

微调适应证探讨

微调是精细的咬合治疗技术,在口腔临床已有较为广泛的应用.微调要达到有效的治疗效果,既要掌握其基本技能,更要准确掌握其适应证.本文结合作者应用微调咬合治疗的临床经验,重点探讨微调的适应证.微调技术主要适用于咬合创伤、咬合干扰等咬合病、咬合的相关疾病、咬合创伤口颌面痛、龋病及牙体缺损窝洞充填术后的咬合调整、牙周病的辅助治疗、固定义齿及可摘义齿修复后的咬合精细调整、人工种植牙修复完成后以及错颌畸形正畸后的精确咬合调整等.文章对每一类适应证的特点做了介绍,对颞下颌紊乱及颞下颌关节紊乱病能否应用微调治疗也做了分析,特别强调了规范化微调的重要性.     

上颌咬合板治疗颞下颌关节紊乱病

为寻找治疗颞下颌关节紊乱病的有效方法。方法 对３４例颞下颌关节紊乱病伴前牙深覆 Ｈｅ患者给予上颌Ｈｅ板治疗。结果 上颌咬合板对颞下凳关节疼痛，弹响以及张口受限等临床症状有明显缓解作用。结论上颌咬合板可作为治疗颞下颌关节乱紊乱病的方法之一。     

咬合板对颞下颌关节紊乱病相关颌面部疼痛的影响

颞下颌关节紊乱病（temporomandibular disorders, TMD）是口颌面部慢性痛的主要来源,严重干扰日常活动。咬合板是颞下颌关节紊乱病的最常用的治疗方法之一,但其疗效尚未完全明了。学者们多年来致力于对咬合板的作用机制、疗效的研究,但至今尚未得出统一的结果。该文将对咬合板的作用机制、咬合板的分类、TMD相关疼痛的种类与咬合板的选择、TMD的其他保守治疗与咬合板的关系四个方面对于咬合板治疗颞下颌关节紊乱病相关颌面部疼痛的疗效进行进行综述。     

上颌咬合板治疗颞下颌关节紊乱病

目的为寻找治疗颞下颌关节紊乱病的有效方法。方法对34例颞下颌关节紊乱病伴前牙深覆患者给予上颌板治疗。结果上颌咬合板对颞下颌关节疼痛、弹响以及张口受限等临床症状有明显的缓解作用。结论上颌咬合板可作为治疗颞下颌关节紊乱病的方法之一。     

正颌外科手术对颞下颌关节的影响

正颌外科手术改变了原有颌骨位置和咬合关系, 也影响颞下颌关节的原有结构和功能。随着正颌外科手术的广泛开展, 正颌术后对颞下颌关节结构和功能的影响日益受到重视, 颞下颌关节在正颌外科治疗中的重要性也逐渐得到认识。正确理解和把握正颌外科手术与颞下颌关节的关系, 不仅有助于从理论上阐明正颌外科手术对髁突的影响和产生颞下颌关节紊乱病的原因, 而且对如何预防和治疗正颌外科患者的颞下颌关节紊乱病有重要临床意义。本文基于正颌外科与颞下颌关节之间的相互关系, 阐释二者的相互影响与相关诊疗, 以期促进学科发展, 提高临床诊疗水平。     

流体静力牙合垫在TMD诊断和治疗中的应用

目的观察流体静力牙合垫治疗颞下颌关节紊乱病的效果.方法选择5例常规方法治疗效果不明显的颞下颌关节紊乱病患者,先用流体静力牙合垫辅助建立下颌肌位,再制作硬树脂牙合垫保持该位置.结果患者戴流体静力牙合垫一周,大多数症状缓解或消失,治疗后随访1年,疗效稳定.结论流体静力牙合垫可能是一种诊断与治疗颞下颌关节紊乱病的有效辅助装置,有进一步研究的价值.     

复杂修复的咬合设计理念及关键临床步骤

复杂修复由于涉及牙位多、对咬合关系影响大等一直是口腔修复的疑难之一。对这类修复临床问题的解决首先是建立正确的修复理念，文章对修复治疗中如何客观认识咬合与颞下颌关节紊乱病之间的关系进行了梳理，并对复杂修复中如何基于患者口颌系统的功能特点设计个性化咬合的临床步骤进行了阐述。     

Mood and malignancy: head and neck cancer and depression

Head and neck cancer patients have been reported to show high rates of depression. However, it is important to differentiate between depressive symptoms and a depressive disorder. This review critically examines the relationship between head and neck cancer and depression. There appears to be little evidence for depression leading to an increased risk of developing cancer and although depressive symptoms in head and neck cancer patients are common, very few studies have investigated depressive disorders. The studies that investigated the incidence of a comorbid depressive disorder report a prevalence very close to that of the general population, implying that major depression is not a normal response to cancer. Finally, the evidence suggests that comorbidity of depression with cancer has a negative impact on morbidity and mortality. Both psychosocial and biological factors could account for this. Dysregulation of the stress hormone axis and increased inflammation are common in depressive disorders and have been suggested as underlying pathological mechanisms and are both markers of poor prognosis in cancer. This evidence suggests that a relatively small number of patients develop a depressive disorder following a diagnosis of cancer, but for those that do it may have a substantial impact on their prognosis.     

低氧和自噬与肿瘤的发生发展

自噬作为真核生物的一种应激调控机制,既可以促进肿瘤的发生发展,又可以抑制肿瘤的增殖。在肿瘤局部低氧的微环境下,低氧诱导因子-1α、哺乳动物雷帕霉素靶蛋白信号转导通路抑制、内质网应激均可促进自噬的发生。在肿瘤快速地发生发展过程中,肿瘤的糖代谢功能增强、活性氧族增多、窖蛋白1下调以及上皮间质转化的激活均诱导了自噬的发生并促进肿瘤的局部浸润、侵袭转移和耐药,因此,抑制自噬可能为肿瘤治疗提供一种新的策略。     

Survey of Australian and New Zealand Oral and Maxillofacial Surgery trainees and recent specialists--education and experience

This study examined the demographic characteristics, educational background and attitudes toward training of all recent OMS specialists and all current trainees in Australia and New Zealand in 1996. The early nineties is a key period as it marks the transition from an essentially dentally based speciality (85% dental degree in 1990); to recent specialists with an increasing number with both medical and dental degrees (33% dual degree 1990-1996); to predominantly dual degree training (84.4% dual in 1996). Current trainees had more extensive experience in pathology, preprosthetic and reconstructive surgery. They were also strongly critical of the length and cost of training.     

Open bite and and therapeutic strategy

Anterior open bites can be divided into two categories: skeletal and dento-alveolar. The etiology, basically affecting dento-alveolar structures, is functional or mechanical such as the rotation of the first higher molars, the exaggerated curve of Spee and the incisor supraclusion and the simple orthodontic treatment can bring a therapeutic success but functional rehabilitation remains the guaranty of such a stability of our treatment. The purpose of this work is to make a teaching article which puts the point on the interest of the elements of the diagnosis and the orthodontic treatment indicated in certain clinical situations of anterior open-bite; this by detailing biomechanics of correction of this anomaly requiring various therapeutic strategies. Functional rehabilitation remains always the guaranty of such a therapeutic stability. For the teaching aspect, we want to attach stereotypic forms and also to present clinical cases treated in the service of consultation and dental treatment in order to answer such a request.