上颌前牙埋伏阻生的正畸治疗探讨

目的探讨上颌前牙埋伏阻生的矫治方法。方法应用固定正畸技术结合牙槽外科手术助萌法和闭合式开窗导萌术,对18例上颌埋伏阻生前牙进行矫治。结果应用助萌法矫治8例,闭合式开窗导萌法矫治10例,埋伏阻生牙均牵引成功,牙髓活力测试正常,牙周组织附着良好。结论应用固定正畸技术结合牙槽外科手术助萌法和闭合式开窗导萌法治疗上颌埋伏阻生前牙,可取得良好的矫治效果。     

锥形束CT在诊断上颌埋伏牙冠根成角中的应用

目的：研究锥形束CT（CBCT）在诊断上颌埋伏牙冠根成角中的应用。方法：选择在曲面平展片、上牙咬合片上不能确切判断冠根是否成角以及成角大小的上颌埋伏牙患者13例,对其进行CBCT扫描,并进行三维重建,确定埋伏牙在上颌骨中的位置、冠根是否成角,并测量成角度数及冠根长度比。结果：13例上颌埋伏牙中,3例无冠根成角,10例确诊为冠根成角,其中6例冠根成角在120°~150°之间,另外４例冠根成角分别在150°~180°、90°~120°、60°~90°之间不等;7例冠根比在1∶1.5~1∶1之间,5例在1∶1~1∶0.5之间,另1例在1∶2~1∶1.5之间。结论：CBCT能够明确诊断上颌埋伏牙的冠根成角情况,对制定可行的治疗方案具有重要的指导意义。     

外科助荫与正畸联合治疗上颌埋伏尖牙17例分析

上颌尖牙埋伏阻生临床较为常见，常可导致相邻牙齿的拥挤、错位、甚至牙根吸收，还会引起埋伏牙周围骨质的囊性病变，给患者美观、功能、心理产生严重不良影响，我们通过对17例埋伏阻生尖牙进行外科助荫与正畸联合治疗，取得较好疗效。分析如下。     

上颌多生牙1例

1 病历摘要男,25岁.因发现左上前牙区有多生牙就诊,临床检查见(+)23间隙约1 mm,(+)23腭侧一多生牙,牙冠已部分萌出,无叩痛、松动等.X线示(+)23之间可见有4个多生牙影像.     

上颌埋伏牙的临床特点分析

我院2003-07～2005-08接诊了埋伏牙91例（102颗）,总结分析如下.     

上颌恒前牙缺失美容托牙修复探讨

上前牙是指3┼3计6个牙，其缺失的原因多为外伤撞击，其次是因牙周病松动、脱落或拔除。缺失牙的个数不同，修复的方法也不同。本文着重论述上前牙缺失较多，采用托牙修复的审美心理问题。     

锥形束CT在定位和拔除上颌埋伏阻生牙中应用的临床研究

目的探讨锥形束CT在上颌埋伏阻生牙定位和拔除中应用的价值。方法对在我院就诊经传统X线片确定有拟拔除的上颌埋伏阻生牙但不能具体定位的29例患者,术前采用锥形束CT扫描获得高分辨率影像,并对扫描信息进行三维重建和任意曲面观察来准确定位埋伏牙,指导选择合适的手术入路以拔除埋伏阻生牙。结果经锥形束CT扫描、三维重建后,所有共36颗埋伏牙被准确定位,根据CS 3D imaging software软件任意曲面观察埋伏牙后分析得出最佳手术入路,使得埋伏牙均顺利拔除,创口均Ⅰ期愈合,无感染及邻牙损伤等并发症发生。结论与传统的根尖片、咬合片、曲面断层全景片相比,锥形束CT能精确定位上颌埋伏阻生牙,在上颌埋伏阻生牙拔除方案的制订和拔牙操作中具有重要的指导意义。     

上颌前牙区多生牙一例

1病例介绍患儿男，11岁。因“上前牙区多生牙1个月”于2013年8月16日到包头市中心医院口腔科就诊。患儿健康状况良好，颌面部发育未见异常。检查：患儿上下牙列不齐，正处于替牙期。15、16、21、24、25、26、31、32、36、41、42、46正常萌出，26、74、75邻牙合面深龋洞已穿髓，74、75探痛明显，叩痛（～），松动（一）。21舌侧可见一多生牙，呈锥形，已部分萌出，11所在位置被另一多生牙占据，形似尖牙，已完全萌出。探诊两多生牙无牙周袋，叩痛（一），松动（一），冷热诊（一），牙髓活力测试（一）。曲面断层显示：两多生牙牙根已形成。11位置的多生牙恰阻挡11正常萌出。追问病史，患儿家属否认家族史及妊娠期异常情况。     

上颌双侧尖牙埋伏阻生正畸与颌面外科联合导萌1例

1病历摘要女,19岁,因牙列不齐要求矫正于2010-02-20就诊。检查:恒牙列,13、23缺如,12和14之间、22和24之间间隙约5mm,浅覆盖,下前牙中度拥挤。拍全颌曲面断层片及颌骨CT定位显示:13、23唇侧阻生,牙体发育正常,扭转,牙根均向远中倾斜约45°,对邻牙无压迫症状。诊断:(1)安氏一类错颌;(2)13、23埋伏阻生;(3)下前牙中度拥挤。治疗计划:(1)上颌局部扩展间隙;(2)外科开窗助萌;(3)正畸牵引导萌;(4)埋伏牙大部萌出后正畸排齐牙列。     

上颌前牙冠根折经冠延长术后修复的临床研究

对门诊60例非拔牙正畸患者，在第一恒磨牙近远中480个接触区分别放置3M分牙橡皮圈、分牙簧、铜丝分牙。结果上述三种分牙方法在48h内，牙齿分开率分别为92．5％、81％、45％。认为3M分牙橡皮圈具有分开效果好、分牙持续时间长、操作简单、不易脱落、不刺伤黏膜组织、安全舒适等优点，值得临床推广。     

Esthetic and functional rehabilitation of peg‐shaped maxillary lateral incisors: Practical recommendations

Peg‐shaped maxillary lateral incisors cause many functional and esthetic major consequences in affected patients. Their esthetic and functional rehabilitations are often multidisciplinary, involving different clinical procedures like periodontal, orthodontic, or prosthodontic procedures. No exhaustive protocol has been established to improve their comprehensive management by general dentists or specialists. The aim of this article is to elaborate a simplified clinical protocol of complete management of peg‐shaped maxillary lateral incisors by a multidisciplinary team (general practitioners, orthodontists, and prosthodontists). A clinical case of two peg‐shaped maxillary lateral incisors completely rehabilitated with multidisciplinary approaches including orthodontic treatment and restoration by veneers and direct composite resin, according to the established protocol. Extraoral, intraoral, and smile clinical analysis are crucial to ensure optimal rehabilitation. Treatment results previsualization via wax‐up and/or mock‐up play a key role in the communication between practitioner and patient to help the latter make decision. These options also facilitate the achievement of a multidisciplinary approach by accurately estimating the number of dental movements and the type of restorations that are most suitable to the presenting clinical situation.     

Radiological features of Adenomatoid odontogenic tumor: Report of a maxillary case and a mandibular one

We present two cases of AOT, the first case concerns a 23‐year‐old patient with an AOT located in the maxilla and the second case involves a 37‐year‐old patient presenting an AOT with mandibular localization.     

珊瑚羟基磷灰石保护拔牙位点的效应

背景：珊瑚羟基磷灰石作为骨移植物的优点主要有安全性、生物相容性和骨传导性,所以对于许多临床适应证它可以作为一个替代骨的生物材料。 目的：观察应用珊瑚羟基磷灰石于上颌切牙拔出后的牙槽窝后,对牙槽嵴的保持结果。 方法：将11例患者的17个因创伤不可保存的上颌切牙拔除,拔除后即刻将珊瑚羟基磷灰石植入拔牙窝。植入后3个月对患者进行临床观察和口腔全景X射线片检测。 结果与结论：所有患者均无不良反应和体征。X射线研究发现珊瑚羟基磷灰石植入后3,6个月后在植入区有新骨形成,与周围的骨组织无明显界限,且保持了牙槽骨的高度。说明珊瑚羟基磷灰石可以有效保持脊拔牙后牙槽骨的高度,并能促进新骨形成。     

Burkitt's lymphoma of maxillary gingiva: A case report

Burkitt's lymphoma(BL) is an aggressive form of nonHodgkin's B-cell lymphoma with three variants namely endemic, sporadic, and immunodeficiency-associated types. It is endemic in Africa and sporadic in other parts of the world. While the endemic form is widely reported to occur in early childhood and commonly involves the jaw bones, the sporadic form typically presents as an abdominal mass. This presentation reports a rare case of sporadic form of BL clinically manifesting as a generalized gingival enlargement in an immunocompetent adult male which demonstrated an aggressive behavior. The patient reported with a prominent anterior gingival swelling of 6 mo duration which slowly enlarged in size and associated with multiple lymph node involvement. Microscopic examination of the lesion using H, E and immunohistochemical diagnosis confirmed the diagnosis as BL. The patient succumbed to the disease before any therapy could be instituted. Since a wide array of causes can be attributed to gingival enlargements, it is necessary to consider malignancies as one of the important differential diagnosis so as to facilitate the need for appropriate diagnosis and prompt treatment.     

Comprehensive management of malocclusion in maxillary fibrous dysplasia: A case report

BACKGROUNDFibrous dysplasia (FD) is a developmental hamartomatous bone disease characterized by a blend of fibrous and osseous entities. Though rarely malignant, the tumor can vary from being small and asymptomatic, to a fairly large sized lesion, progressing gradually, compromising occlusion and facial esthetics. Treatment approach depends on the stage of skeletal maturity. It primarily involves surgical management for stabilizing the disease process. Post-surgical comprehensive dental treatment is necessary for restoring form and function of the jaws and teeth. This article describes comprehensive orthodontic management of severe malocclusion in a surgically operated case of FD maxilla.CASE SUMMARYA 19-year female presented with a chief complaint of excessive gingival display when smiling. Dental history included swelling of gums around the upper right front teeth, diagnosed at the age of 15 as FD of the right anterior maxillary segment and treated with surgical recontouring of the dysplastic bone. The clinical and radiological examinations showed adequate post-surgical healing. The surgically treated dysplastic area presented with right canting of the maxillary anterior occlusal plane. The maxillary teeth were torqued palatally, with the root of the right maxillary canine exposed clinically. We discuss sequential management of the associated malocclusion with comprehensive fixed orthodontics, along with special precautions taken to prevent reactivation of the quiescent and healed lesion.CONCLUSIONThe adequate healing of fibro-dysplastic bone post-surgery must be allowed before initiating orthodontic tooth movement in the dysplastic bone. Periodic follow-ups are needed to monitor stability of occlusion and any relapse of the lesion.     

纤维桩长度和牙槽骨高度对上颌中切牙抗折性能的影响

背景：纤维桩具有与天然牙本质接近的弹性模量,在受外力时能够与根管壁保持广泛面接触,与牙本质形成一同质的整体,使应力沿根管壁均匀传导,减少根折的发生。 目的：观察牙槽骨高度和纤维桩长度对上颌中切牙抗折性能的影响。 方法：将48颗离体上颌中切牙随机分为6组,每组8颗。A,B,C组牙槽骨距离釉质牙骨质界的距离为2 mm,纤维桩长度分别为5,7,9 mm;D,E,F组牙槽骨距离釉质牙骨质界的距离为5 mm,纤维桩长度分别为5,7,9 mm。截冠、根管治疗、纤维桩树脂核及铸造金属全冠修复后,将试样牙置于电子万能试验机上,与牙体长轴呈45？的加载方向,以1 mm/min的加载速度,持续加载至试样牙发生折裂。记录折裂时的加载强度和折裂模式。 结果与结论：牙槽骨高度对试样牙的抗折性能有显著影响（F=560.943,P＜0.05）;纤维桩长度对试样牙的抗折性能没有显著影响（P＞0.05）。牙槽骨高度正常各组试样牙断裂模式多为可修复性断裂模式,牙槽骨高度降低各组试样牙断裂模式多为不可修复性断裂模式,差异有显著性意义（χ2=5.689,P ＜0.05）。说明在牙槽骨高度降低的情况下,增加纤维桩的长度不能提高牙齿的抗折性能。     

511个乳磨牙Ⅱ类洞充填体状况的临床观察

[目的]了解银汞合金和玻璃离子水门汀(GIC)充填乳磨牙Ⅱ类洞的疗效情况.[方法]作者通过采取银汞合金和GIC充填Ⅱ类洞,并定期复诊的方法,对185名患儿的511个乳磨牙Ⅱ类洞充填体随时间脱落的情况进行临床观察.[结果]随着时间的延长,充填体的完好率逐步下降,而脱落率逐年上升.在充填后的1年内,银汞合金充填体与GIC充填体在完好、完全脱落、部分脱落的发生率上差异无显著性(P＞0.05);而在充填1年后,银汞合金充填体的完好率明显高于脱落率,而且其脱落率较GIC充填体明显偏低,且差异有显著性(P＜0.05).[结论]对于1年以后替换的乳磨牙的Ⅱ类洞的充填,推荐以银汞合金为好.     

Post‐COVID‐19 maxillary osteonecrosis and floating maxillary teeth due to mucormycosis in two uncontrolled diabetic patients

Mucormycosis is a rare, invasive, quickly progressing fungal infection that generally affects patients who are immunocompromised. If left untreated, the disease is characterized by progressive necrosis and is often fatal. We present two cases of post‐COVID‐19 mucormycosis with a history of several years of uncontrolled diabetic mellitus.