自制单齿拉钩治疗单纯颧弓骨折20例报告

单纯性颧弓骨折的发生率占颧骨复合体骨折的 10 %。作者采用自制单齿拉钩经皮肤穿刺的闭合复位方法 ,进行单纯性颧弓骨折复位 ,取得良好的效果。1.自制拉钩　使用 4mm直径的克氏针弯制 (见图 1)。2 .临床资料　本组共 2 0例 ,男 14例 ,女 6例 ,年龄 2 0 -5 5岁 ,均经X线摄片或C     

自制美容整形拉钩

整形拉钩是美容整形手术中常用、且不能缺少的一种器械,若无可给许多美容整形手术带来许多不便,我们从一九九一年以来自制了美容整形拉钩用于临床,解决了急需之急,并且从术中感觉到自制拉钩具备了许多优点。一材料与制作方法我们选用自制美容整形拉钩的材料为口腔科使用的双头探针。制作时先将弯曲二头探针扳直或锤直,     

介绍一种颌面颈部手术简易皮瓣拉钩

二、使用方法:颌面颈部手术切开皮肤全层后,用皮瓣拉钩从切口皮下钩起皮瓣边缘。根据皮瓣大小,可用左手食指、中指和无名指同时并排提起1～3个皮瓣拉钩,将预定分离部位的皮肤拉紧、展平。右手持手术刀分离皮瓣。随着皮瓣的游离可改变拉钩的牵拉部位。 皮瓣拉钩细而尖锐,易刺入皮瓣边缘真皮层,不造成边缘皮肤损伤,牵拉牢靠,不易滑脱。左手可同时提起3个皮瓣拉钩,使6个位点同时钩起皮瓣边缘,均匀用力拉紧、展平皮瓣,为平整地剥离颈瓣创造了条件。用于上颌骨切除术、腮腺手术及皮淋巴清扫术等需剥离较大皮瓣时尤为适宜。     

“S”形切口在20例髁突颈骨折切开复位内固定术中的应用

目的:研究“S”形切口应用于髁突颈骨折切开复位内固定术的临床效果。方法：对20例采用“S”形切口行髁突颈骨折切开复位内固定术患者的临床资料进行回顾性分析。结果：经过1～4a的术后随访，20例均获得了良好的咬合关系，19例达到正常的张口度，无一例出现面神经受损和腮腺涎瘘等并发症。结论：相对于临床上常用的传统手术切口，“S”形切口具有切口隐蔽、术野暴露好、利于面神经保护、髁突颈复位充分牢靠等优点，值得临床推广。     

超声辅助腮腺导管深部结石翻瓣取石术5例报道

目的 :探讨超声辅助腮腺翻瓣取石术治疗腮腺导管深部结石的临床应用价值。方法 :收治2019年1月—2020年6月就诊于上海交通大学医学院附属第九人民医院口腔外科的5例腮腺深部导管结石患者,术前CT平扫明确结石位于咬肌前缘后方的腺内段导管。患者于全麻下行腮腺翻瓣取石术,术中B超辅助定点后,设计耳后S形小切口。术中通过解剖面神经下颌缘支,暴露结石所在腺内导管,切开管壁,取出结石,严密缝合导管。术后1周、3个月、12个月随访。结果:所有患者均成功取出结石,术后1例患者出现腮腺导管阻塞症状,冲洗、扩张治疗后好转。未出现面神经损伤、涎瘘、感染等并发症。随访12个月,术前症状完全得到缓解,疗效满意。结论:超声辅助腮腺翻瓣取石术治疗腮腺导管深部结石成功率高,疗效好,可在临床推广应用。     

陈旧性下颌脱位

作者报导一例79岁的双侧颞下颌关节前脱位2月的女性患者,10年前曾经发生过一次脱位作过手法复位。本次脱位后,手法复位失败,用Fink 氏法复位。手术在安定静脉注射加1%赛洛卡因局麻下进行。在下颌切迹表面皮肤上作稍斜向前上的2厘米长切口(如图)。钝解剖纵行分开嚼肌纤维,暴露出下颌切迹。用一个拉钩钩住下颌切迹向前下牵引,使髁状突复位。这个操作在双侧进行。通过检查此病人全口托牙的咬(牙合)和术后X 线片,证实下颌已复位。术后经过顺利,无并发症。为防止再脱位,用弹性绷带限制张口一周,然后用颏托4月。     

“分侧复位法”在颞下颌关节脱位中的应用与评价

对50例各类颞下颌关节脱位的患者使用"分侧复位法"进行颞下颌关节复位,1次成功49例、失败1例,无任何并发症发生,与传统的颞下颌关节复位术对比有操作简单、复位迅速、效果可靠、患者痛苦小等优点。     

“T”形劈冠法在下颌中位近中水平阻生智牙拔除术中的应用

目的:探讨"T"形劈冠法在下颌中位近中水平阻生智牙拔除术中的可行性及效果。方法:选择2008年10月至2009年12月在中山大学孙逸仙纪念医院口腔颌面外科门诊就诊的患者中,符合中位近中水平阻生的下颌第三磨牙患者62例,采用"T"形劈冠法拔出智牙。结果:62例患者手术时间8～35min,5例患者在挺出牙根时造成舌侧骨板折裂,复位后予以保留。术后24～48h内,6例患者出现明显的颊部肿胀,5例患者主诉术区轻微疼痛,轻度开口受限者2例,轻度干槽症1例,1例患者术后出现暂时性下唇麻木,未发生皮下气肿及颌骨骨折。结论:"T"形劈冠法在下颌中位近中水平阻生智牙拔除术中创伤小,并发症少,值得推广。     

自制单齿钩治疗单纯颧弓“M”型骨折的临床观察

[摘要] 目的 探讨自制单齿钩复位单纯颧弓"M"型骨折的临床疗效。方法 对36例患者应用自制单齿钩经皮穿刺复位,术后影像学随访。结果 36例患者均治愈,面部外形满意,无张口受限,面部无明显瘢痕及神经损伤等症状。结论 该方法复位创伤小,并能有效恢复颧弓外形及开口功能,临床疗效佳。     

37例全面部骨折救治体会

目的:探讨全面部骨折的急诊处理和治疗方法。方法:对37例全面部骨折患者实施切开复位钛板坚强内固定+颌间或颅颌牵引,复位次序遵循"从固定到活动,从简单到复杂"的原则。结果:34例患者经治疗后均取得满意效果,咬合关系恢复良好,功能恢复正常,面形基本恢复正常。结论:全面部骨折通过面部小切口切开,按从固定到活动,从简单到复杂的复位固定顺序,辅以颌间结扎牵引进行固定,方便、可行,可取得良好效果。     

Influence of transient salivary flora on assessment of mutans streptococci level by the "Strip mutans" method

The Dentocult SM ("Strip mutans") method occasionally shows decoloration of broth and of colonies of mulans streptococci on the plastic strip, thereby making interpretation difficult. In an attempt to explain the phenomenon and to investigate the influence of the salivary flora on the "Strip mutans" method, a total of 46 subjects were sampled. Saliva was analyzed using the "Strip mutans" method and conventional plating techniques to identify mutans streptococci, enterococci, staphylococci, enteric bacteria, and yeasts. Approximately 85% of the "Strip mutans" scores coincided with the conventional MSB-plating method. Two samples showed decolored mutans streptococci colonies on the "Strip mutans" strip. Enterococcus spp. were present in the saliva of these test subjects and could grow in the "Strip mutans" broth. Enterococcus faecalis was able to induce the same type of decoloration under experimental pure culture conditions. Three "Strip mutans" samples showed small colonies of mutans streptococci, visible only under magnification (× 10–20). Staphylococcus epidermidis was present in these saliva samples and showed heavy growth in the broth. Under experimental pure culture conditions S. epidermidis also inhibited the growth of mutans streptococci to some extent.     

口腔鳞癌手术后中药治疗远期疗效观察

作者曾对２３８例口腔鳞癌术后应用中药“参阳”方的疗效进行前瞻性的研究,本文继续对已生存４～８年的５６例病员门诊随访结果进行分析．结果是生存情况：７年生存期原治疗组高于原对照组１２．５％,原治疗组３０例均健在,而原对照组中的２６例,２例带瘤生存,１例死亡;Ｔ细胞亚群测定中,复发死亡者的ＣＤ８值均升高,ＣＤ４／ＣＤ８比值均下降;中医辨证中,正常者及肾气虚者的例数以治疗组为多,而阴虚与气阴两虚者,治疗组低于对照组;由上提示：经“参阳”方治疗者有较好的远期疗效．     

Immunochemical characterization of the carbohydrate antigens of serotype c/Lancefield group C "Streptococcus milleri"

Carbohydrate antigens of the serotype c/Lanceficld group C " Streptococcus milleri " were extracted by autoclaving whole cells of the type c reference strain K51Y. The type c and group C antigen molecules were separated and partially purified by a DEAE-Sephadex A-25 column chromatography followed by Sephad-ex G-100 gel filtration. The purified type c antigen and group C antigen were homogeneous in the double diffusion and in the immunoelectrophoresis. The type c antigen was composed principally of glycerol, rhamnose, glucose and N-acetylglucosamine in a molar ratio of 0.22:0.27:1.00:0.48. The quantitative precipitin inhibition test indicated that N-acetylglucosamine played a major role in immunodeterminant structure. Thus, the type c antigen of " S. milleri " is a new carbohydrate type antigen and is immunochemically different from the Oltens-type antigen III found occasionally in group C streptococci. In contrast, the group C antigen preparation contained a high proportion of N-acetylgalactosamine in addition to glycerol, rhamnose, glucose and N-acelylglucosamine, and the N-acetylgalactosamine residue was involved in the immunodominant epitope, being in good agreement with the previously proposed chemical structure of the group antigen. N-acetylgalaclosamine was detected in the autoclaved extracts of a nontypeable/group C strain but not of a type c/ungroupable strain.     

Clinical and microbiological changes associated with the use of combined antimicrobial therapies to treat "refractory" periodontitis

BACKGROUND: The present investigation examined clinical and microbial changes after a combined aggressive antimicrobial therapy in subjects identified as "refractory" to conventional periodontal therapy. METHOD: Fourteen subjects were identified as "refractory" based on full-mouth mean attachment loss and/or >3 sites with attachment loss > or =3 mm following scaling and root planing (SRP), periodontal surgery and systemic antibiotics. After baseline monitoring, subjects received SRP, locally delivered tetracycline at pockets > or =4 mm, systemically administered amoxicillin (500 mg, t.i.d. for 14 days)+metronidazole (250 mg, t.i.d. for 14 days) and professional removal of supragingival plaque weekly for 3 months. Subjects were monitored clinically every 3 months post-therapy for 2 years. Subgingival plaque samples were taken at the same time points from the mesial aspect of each tooth and the levels of 40 subgingival taxa were determined using checkerboard DNA-DNA hybridization. Mean levels of each species were averaged within a subject at each visit. Significance of changes in clinical and microbiological parameters over time were evaluated using the Friedman or Wilcoxon signed ranks test. RESULTS: On average, subjects showed significant improvements in all clinical parameters after therapy. Mean (+/-SEM) full-mouth pocket depth reduction was 0.83+/-0.13 mm and mean attachment level "gain" was 0.44+/-0.12 at 24 months. Clinical improvement was accompanied by major reductions in multiple subgingival species during the first 3 months of active therapy that were maintained for most species to the last monitoring visit. Reductions occurred for three Actinomyces species, "orange complex" species including Campylobacter showae, Eubacterium nodatum, three Fusobacterium nucleatum subspecies, Peptostreptococcus micros, Prevotella intermedia as well as the "Streptococcus milleri" group, Streptococcus anginosus, Streptococcus constellatus and Streptococcus intermedus. Subjects differed in their response to therapy; six modest response subjects exhibited less attachment level gain and were characterized by reductions in the microbiota from baseline to 3 months, but re-growth of many species thereafter. CONCLUSIONS: The combined antibacterial therapy was successful in controlling disease progression in 14 "refractory" periodontitis subjects for 2 years.     

Immunochemical characterization of the carbohydrate antigens of serotype k and Lancefield group G "Streptococcus milleri"

Carbohydrate antigens of the serotype k/Lancefield group G " Streptococcus milleri " were extracted by autoclaving whole cells of the type k reference strain Streptococcus anginosus K214-2K. The type k and group G antigen molecules are separated from each other and partially purified by a DEAE-Sephadex A-25 column chromatography followed by a Sephadex G-100 gel filtration. In the double diffusion and the immunoelectrophoresis, the type k and group G antigen preparations obtained yielded single bands with their homologous antisera respectively. The type k antigen preparation contained principally glycerol, rhamnose, ribitol, galactose and glucose in a molar ratio of 0.54:1.20:0.43:0.33:1.00. The quantitative precipitin inhibition test indicated that β(l-6)glucosyl-glucose (gentiobiose) sequence played a major role in immunodeterminant structure. Thus, the type k antigen of "S. milleri" appears to be a new carbohydrate type antigen that is chemically different from any Ottens type antigen. In contrast, the group G antigen preparation contained high proportion of rhamnose in addition to glucose, N -acetylglucosamine and N -acetylgalactosamine in a molar ratio of 6.45:1.00:0.24:1.15, and the rhamnose residue was involved in the immunodominant epitope, being in good agreement with the previously proposed chemical structure of the group antigen.     

"All-on-Four" immediate function concept and clinical report of treatment of an edentulous mandible with a fixed complete denture and milled titanium framework.

The "All-on-Four" concept-tilting the distal implants in the edentulous arches improves the prosthetic support-increases the inter-implant distance and provides better implant anchorage in the bone by using longer implants. Computer milling of a solid block of titanium also provides frameworks with improved fit and fewer technical challenges than conventional cast or noncast approaches. This clinical report describes a method of restoring an edentulous mandible with the "All-on-Four" immediate function concept and a milled titanium framework. The patient in our clinical report has reported for follow-up visits for 1 year and is satisfied with the outcome of the treatment. No discernable clinical and radiographic changes were noted around the dental implants. To date, there have been no prosthetic complications. The patient is scheduled for quarterly follow-ups to determine the effectiveness of home care.     

预加载“L”形曲力学行为的有限元分析

目的　研究不同预加载情况下“L”形曲的力学特性。方法　采用 3D梁单元建立不同预加载情况下“L”形曲的三维有限元模型 ,在模型两端添加节点约束和节点位移 ,用ANSYS软件模拟临床应用并计算。结果　FX和FY的力值都随预加载“L”形曲近中臂长度的增加而逐渐减小 ,合力方向与X轴的最大夹角出现在近远中臂等长时 ,FY随远中后倾弯的增加增大 ,而FX则随近中后倾弯的增加增大。结论　掌握不同预加载情况下“L”形曲的力学特性有助于在临床上选择性应用     

Influence of "time of day", pocket depth and scaling on gingival fluid flow

Gingival fluid was sampled from the orifices of the gingival crevices in five male subjects with clinically healthy gingiva. The sampling was performed at 0915 h, 1215 h and 1515 h of the same day. Variation in "time of day" did not seem to influence the rate of gingival fluid flow. A total of 144 pockets (2-11 mm) in 19 patients were sampled for gingival fluid at the orifices. The adjacent gingiva was evaluated accordingly to the Gingival Index (GI). Gingival fluid flow was much more influenced by the degree of gingival inflammation than by pocket depth. Scaling with curettes was performed in five patients. Gingival fluid was sampled at the orifices immediately before scaling and on days 1, 14 and 28 after scaling. The flow rate decreased to a minimum on day 14 after scaling for all pocket depths and remained at almost the same level until day 28. Pockets less than 5 mm deep were more frequently without measurable amounts of fluid than pockets deeper than 5 mm on days 14 and 28.     

Is change in probing depth a reliable predictor of change in clinical attachment loss?

Background

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Clinicians and researchers need a measure for monitoring the periodontal condition of their patients or study participants. The authors explored the utility of change in probing depth (PD) for predicting change in clinical attachment loss (CAL).MethodsThe authors used clinical trial data from 363 participants who had received nonsurgical treatment to describe associations between PD and CAL changes. They computed the association between PD and CAL changes—correlation, sensitivity, specificity, and positive and negative predictive values—according to tooth type, tooth site and initial PD.ResultsDepending on the subset of tooth sites, sensitivity of PD change to predict CAL change ranged from 18 to 74 percent; the highest sensitivity was at initially deep sites. Specificity and negative predictive value were higher than sensitivity and positive predictive value. Correlations between person-level mean PD and CAL changes ranged from 0.60 to 0.79 and were highest at initially deep sites.ConclusionsExcept at initially deep sites, PD change did not reliably predict CAL change. Clinicians and researchers who measure only PD may fail to identify teeth that lose or gain attachment.Clinical ImplicationsClinicians should consider monitoring CAL to detect changes in periodontal status more reliably. It is unknown if these findings apply to patients treated surgically or to prediction of tooth loss.     

Rubber dam use during root canal treatment: Findings from The Dental Practice-Based Research Network

Background

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The Dental Practice-Based Research Network (DPBRN) provided a means to investigate whether certain procedures were performed routinely. The authors conducted a study to quantify rubber dam use during root canal treatment (RCT) among general dentists and to test the hypothesis that certain dentist or practice characteristics were associated with rubber dam use.MethodsDPBRN practitioner-investigators (P-Is) answered a questionnaire that included items about rubber dam use and other forms of isolation during RCT. DPBRN enrollment questionnaire data provided information regarding practitioner and practice characteristics.ResultsA total of 729 (74 percent) of 991 P-Is responded; 524 were general dentists who reported providing at least some RCTs and reported the percentage of RCTs for which they used a rubber dam. Of these 524 P-Is, 44 percent used a rubber dam for all RCTs, 24 percent used it for 51 to 99 percent of RCTs, 17 percent used it for 1 to 50 percent of RCTs, and 15 percent never used it during RCT. Usage varied significantly by geographic region and practice type. The use of cotton rolls and other forms of isolation also was reported.ConclusionsSimilar to other reports in the literature, not all DPBRN general dentists used a rubber dam during RCT.Clinical ImplicationsBecause the clinical reference standard is to use a rubber dam during RCT, increasing its use may be important.