�����껼��Spee����������ؽ����Ҳ�֢״�Ĺ�ϵ�о�

??Objective    To investigate the relationship between the depth of curve of Spee??COS?? and temporomandibular joint disorders??TMD?? in elderly patients. Methods    Eighty-nine elderly patients with TMD visiting the Hospital of Stomatology of China Medical University from January 2013 to June 2013 were recruited in the study by random number table. Muscle pain and temporomandibular joint??TMJ??sounds were examined according to Research Diagnostic Criteria for TMD??and the depth of COS were measured on the dental casts. The mean depth of COS of patients without muscle pain and patients with pain at all levels were compared??and the unilateral depth of COS of patients with and without TMJ sounds were compared. Related data were analyzed statistically with one-way analysis of variance and t-test. Results           The depth of ipsilateral COS of patients with TMJ sounds was significantly smaller than those of patients without TMJ sounds??left??P < 0.001??right??P = 0.008????while the depth of contralateral COS of patients with TMJ sounds had no significant differences with those of patients without TMJ sounds??left??P = 0.481??right??P = 0.905??. In addition??there were no significant differences between the mean depth of COS of patients without muscle pain and patients with pain at all levels??P = 0.327??. Conclusion    TMJ sounds are closely associated with COS??and the depth of ipsilateral COS of patients with TMJ sounds is smaller??and the COS is flatter. There is no significant association between the mean depth of COS and muscle pain.     

Spee����������ؽ����Ҳ��������

牙合因素在颞下颌关节紊乱病（temporomandibular disorders,TMD）的病因和病理中占有重要地位。Spee曲线是评价牙合这一生物力学三维结构中垂直向位置关系的关键指标,该曲线与TMD相关性的研究与分析一直是口腔医学中常做常新的课题。本文从Spee曲线的基本功能、形态特点以及各类影响因素等方面,对该曲线与TMD的相关性研究现状进行综述,并提出相关展望。     

Spee���߿�ǻ����ѧӦ���о���չ

错牙合畸形伴深覆牙合病例中经常伴随Spee曲线异常。深Spee曲线会造成咀嚼肌失衡,严重可导致咬合功能障碍。正确理解Spee曲线概念以及整平Spee曲线的方法对于每位正畸医生均相当重要,且临床治疗中存在一定难度。本文对Spee曲线的发生发展、整平Spee曲线的方法以及影响因素做一系统性梳理,以助于正畸临床的诊断与治疗。     

���ֲ�ͬ�ݷ���Ϲڲ����Ч���Ƚ��о�

目的比较并评价3种不同暂封材料的冠部封闭效果。方法收集2011年1月至2012年5月于佛山市禅城区向阳医院因正畸或牙周病拔除的完整成人单根前磨牙60颗,备洞开髓后随机分为3组,每组20颗,分别用Clip、CavitG、氧化锌丁香油酚黏固剂（ZOE）3种暂封材料充满窝洞,经封闭处理后浸入2％亚甲蓝溶液染色,在暂封7d和14d时取出每组各10颗牙齿,顺牙长轴近远中向纵向剖开,观察染料渗入最大长度,并以此来评估3种暂封材料的冠部封闭效果。结果7d时Clip组和CavitG组封闭效果均优于ZOE组（P〈0．05）,14d时Clip组封闭效果优于其他两组（P〈0．05）。结论Clip是一种较好的根管治疗髓腔暂封材料。     

����ҧ������������ؽ������ۺ�����ϵ�о�

??Objective    To identify differences in occlusal features between subjects with signs and symptoms of temporomandibular disorders and asymptomatic subjects. Methods    126 subjects who consented to participate in this research were examined for signs and symptoms of TMDs according to the guidelines of RDC-TMD. In addition??occlusal measurements were performed for all subjects on plaster models. The 126 patients were divided into the TMDs group and the no-TMDs group. Four occlusal features were recorded for each patient??overbite??overjet??posterior crossbite and the curve of Spee. All statistical analyses were performed with SPSS 13.0. Results    Significant associations were revealed between the curve of Spee and TMJ sounds. There were statistically significant differences between the TMDs group and the no-TMDs group in the overjet and overbite of inciors. No differences were found between subjects with and without a history of orthodontic treatment. The curve of Spee is not associated with pain of muscular origin or the posterior crossbite. Conclusion     The abnormal overjet and overbite could be occlusal risk factors for TMDs. Subjects with TMJ sounds tend to have a faltter curve of Spee compared to subjects without TMJ sounds.     

ǰ��ǣ�����ϴ������������ڹ��Ԣ���������ٴ���Ч�о�

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。     

Flexitime����ӡģ�����ٴ��������ܷ����о�

目的评价Flexitime硅橡胶印模材料的临床操作性能。方法对2011年11月至2012年1月于中国医科大学附属口腔医院就诊的60例上颌磨牙单冠修复患者,分别采用Flexitime硅橡胶印模材料（Flexitime组）、Express^TM硅橡胶印模材料(Express^TM组)和Impregum聚醚橡胶印模材料（Impregum组）单步取模法制取上颌印模,根据操作时间、口内凝固时间和从口内脱模难易程度对3种印模材料的临床操作性能进行综合分析比较。结果 Flexitime组、Express^TM组及Impregum组操作时间和口内凝固时间两两比较差异均有统计学意义（P<0.01）。Flexitime组口内凝固时间与操作时间无相关关系（P>0.05）;Express^TM组及Impregum组均呈负相关（P<0.01）。Flexitime组及Express^TM组与Impregum组口腔内脱模难易程度比较差异有统计学意义（P<0.01）。结论 Flexitime硅橡胶印模材料操作时间短,口内凝固快,且口内凝固时间不受操作时间影响,从口内脱模容易,临床操作性能优越。     

RGD�������ε�SLA��Ƭ������С����ǽ��Ӱ���о�

??Objective    To observe whether the modified sandblasted??large-grit and acid-etched??SLA??surface titanium discs by the immobilized Arg-Gly-Asp??RGD??peptide via chemical grafting methods would promote the osseointegration in diabetic Guangxi BA-MA mini-pig models. Methods    The experiment was carried out in the Comparative Laboratory of General Hospital of Nanjing Military Region from June 2014 to October 2015. Five Guangxi BA-MA mini-pigs were used for this research. Three of them were randomly induced into diabetes models by using streptozotocin??STZ??as diabetes model??DM??group??and the other two pigs were set as non-diabetes model??NDM??group. RGD peptite was grafted on the SLA surface of titanium implant discs with chemical coupling method. Each mini-pig was implanted separately three SLA titanium discs and three RGD-SLA titanium discs??discs diameter = 5 mm??in maxilla. All animals were sacrificed at one month. Samples were fixed by 4% formaldehyde and analyzed by MicroCT and undecalcified histology methods. Results    During the observation period??there were no significant differences in the parameters of bone mineral density??BMD????bone trabecular thickness??Th.Th????trabecular number??Th.N??and trabecular spacing??Th.Sp??between the groups. Resin embedded tissue histological analysis showed that the bone contact ratio of NDM-RGD-SLA group??64.8%±18.4%??are significant higher than DM-RGD-SLA group??33.9%±11.7%????NDM-SLA group??39.5%±20.9%?? and DM-SLA group??36.4%±15.9%??. No significant differences were found when compared within other groups. Conclusion    RGD peptide modified SLA titanium discs obviously promoted bone to implant contact. Whether animals have diabetes or not??there is no significant effect on the osseointegration between titanium discs and the jaw bones. However??when modified by RGD peptide?? the SLA discs can obviously improve bone formation around implants in NDM animals??not in DM animals. It implies that diabetes may inhibit the osseointegration effects of RGD peptide.     

���Դ̼��Դ���������������Ӱ���о�

目的探讨急性刺激对预先制备的大鼠受损牙齿牙髓的影响。方法本研究于2011年10-12月在大连大学附属新华医院实验中心进行。将24只sD大鼠的两侧上颌第一磨牙用涡轮机钻洞至牙本质深层,用氧化锌暂封,随机分为2组。应激组（12只）给予冷刺激,断食,断水;对照组（12只）正常饲养。在应激刺激第5、13、20、28天各组分别随机抽取3只大鼠,处死后取上颌双侧第一磨牙,检测牙髓炎症的变化72．P2X3受体表达情况。结果HE染色显示应激组大鼠牙髓充血水肿,有淋巴细胞、中性粒细胞等炎细胞浸润,后期出现牙髓细胞变性坏死。应激组牙髓中P2X3受体阳性表达在刺激第5、13天轻微增高,第20天明显增高,第28天逐渐下降;与对照组比较,差异有统计学意义（P〈0．05）。结论急性刺激可造成大鼠受损牙齿的牙髓炎症反应,从而导致大鼠出现牙髓来源的疼痛。     

��ӳ�������ò��������ָ�꼰���׼�о�

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。     

���ֲ�ͬ����Ԥ�����ܺ�Ը��ⲿ���̶ȵıȽ��о�

目的比较5种不同方法预备根管后对根尖1／3根管壁的清洁能力。方法将2007年12月至2008年3月在大连市口腔医院颌面外科门诊拔除的60颗离体牙随机分为6组,每组10颗。各组的牙齿先使用Protaper进行根管预备,然后使用不同的方法处理根管壁,分别为：A组H2O2和生理盐水（对照组）、B组EDTA凝胶和5．25％的NACLO,C组超声波荡洗根管、D组Nd：YAG激光、E组超声波（蒸馏水）＋EDTA、F组：超声波（5．25％NAcL0）＋EDTA。完成之后将样本纵向剖开,扫描电镜观察根管壁的界面,比较根尖1／3根管壁的清洁程度和牙本质小管的状态。结果对照组（A组）牙齿根尖部被玷污层全部覆盖,未见开放的牙本质小管;各实验组（B、C、D、E、F组）牙齿根尖部根管壁玷污层不同程度被去除。B、C、D、E、F组根尖1／3玷污层的评分与A组比较,差异有统计学意义（P〈0．05）;5个实验组间根尖1／3玷污层的评分比较,D组与E组差异无统计学意义（P〉0．05）,其余各组间差异均有统计学意义（P〈0．05）。结论5种不同的方法在一定程度上可去除根尖部的玷污层,以超声波（5．25％NACLO）＋EDTA处理根管壁的效果最佳。     

�������Ʒ��������ƴ���������Ч���о�

??Objective    To evaluate the effect of HMME-mediated adjunctive sonodynamic therapy??SDT??on periodontitis in rats??in order to provide theoretical and experimental evidence for the clinical application of SDT. Methods    Ligatures were placed on the subgingival regions of the first maxillary molar in 54 rats to induce the periodontitis models. Then the rats were randomly divided into three groups with 18 rats in each group.??1??The control group was treated by normal saline??NS?? to wash the periodontal pocket????2??the scaling and root planing??SRP??group received SRP and was washed with normal saline????3??the SRP plus SDT group was treated by SRP and washed with normal saline?? and then was treated through subcutaneous injection of HMME 1 mL??40 μg/mL??. After 90 min of incubation in the dark??the ultrasonic treatment at the frequency of 1 MHz and the intensity of 3W/cm2 was given for 10 minutes. SDT was performed every other day. Six rats from each group were sacrificed at 6??10??or 14 days postoperatively and periodontal tissue samples were taken for histological examination and immunohistochemical analysis. Results    SRP plus SDT group had reduced number of inflammatory cells. The expression of receptor activator of nuclear factor kappa-B ligand ??RANKL??was weakly positive??and the number of positive Tartrate-resistant acid phosphatase??TRAP?? was significantly reduced ??P < 0.05????compared to the SRP and the control group??P < 0.05??. Conclusion    SDT is an effective adjunctive therapy for periodontitis in rats.     

���ۺ����Դ����Ѹ�Σ�����뷢��Ԥ��ģ���о�

目的探讨非综合征性唇腭裂(nonsyndromic cleft lip and palate,NSCL/P)发病的主要危险因素;评估这些主要危险因素在NSCL/P发病中的相对重要性,最终确立NSCL/P发病概率的预测模型,为优生网络的构建奠定基础。方法采用1∶1配对病例对照研究,病例组来源于2006年9月至2007年9月在潍坊医学院附属医院、潍坊市人民医院、菏泽市立医院、烟台毓璜顶医院口腔科住院,年龄在12岁以下患有NSCL/P的儿童76例;对照组为来源于同一机构门诊或病房或同一居住区符合配对条件的非唇腭裂儿童76名。根据拟定的42项危险因素编制调查表,对病例组患儿与对照组儿童的父母进行调查,数据经审核后录入Excel 2003建立数据库。首先使用条件Logistic回归对资料进行单因素分析,再对单因素筛选的变量结合专业知识进行多因素分析,筛选主要危险因素并建立回归模型,根据危险因素分别建立分类树与LogitBoost算法的发病概率预测模型,采用受试者工作特征曲线(ROC曲线)对两模型进行评价,从而确立本研究中NSCL/P发病概率的预测模型。结果病例组与对照组作对比分析,进入条件Logistic回归模型的变量有:母亲孕期感染史(P=0.010)、家族遗传史(P=0.009)、母孕期饮食是否规律(P=0.007)、胎次(P=0.004)、母亲孕期异常情绪史(P<0.001)、父亲学历(P<0.001)。经ROC曲线评价,确立分类树模型可用来预测NSCL/P的发病概率。结论母亲孕期感染、家族遗传、母亲孕期饮食不规律、胎次、母亲孕期异常情绪是NSCL/P发病的促进因素,且其对NSCL/P发病的影响作用依次增强;父亲学历是该病的保护因素。经ROC曲线评价,最终确立分类树模型为NSCL/P发病概率的预测模型。     

���ǻ�����MG63ϸ����ֳ���ڼ�������ӱ��Ӱ���о�

目的研究高糖环境对具有人类成骨细胞表型特征的MG63细胞增殖周期以及相关因子（TRAIL、OPG、OPGL）表达的影响,以期确定高浓度的葡萄糖是否影响人类成骨细胞的生理功能,进一步探讨糖尿病伴慢性牙周炎的发病机制,并为临床正畸治疗提供一定的理论依据。方法本实验于2012年2—5月在药物基因与蛋白筛选国家工程实验室（东北师范大学）完成。采用含不同浓度葡萄糖（5.5、8、11、20、30 mmol/L）的培养基分别培养MG63细胞24 h后,四甲基偶氮唑盐（MTT）比色法测定细胞增殖,流式细胞仪检测细胞周期,逆转录聚合酶链式反应（RT-PCR）检测细胞中TRAIL、OPG、OPGL m RNA的表达。采用SPSS 16.0统计软件对数据进行分析。结果（1）低浓度的葡萄糖对MG63细胞增殖及其他生物学活性无显著影响;随着葡萄糖浓度的增高,其能够浓度依赖性抑制MG63细胞的增殖。（2）葡萄糖以浓度依赖方式影响细胞周期,高浓度葡萄糖可明显将细胞阻滞在G1期,S期细胞差异不显著,G2期细胞显著减少。（3）葡萄糖对MG63细胞中TRAIL和OPGL m RNA表达的作用随浓度增加依次递增（P〈0.05）,而对OPG m RNA表达的作用随浓度增加依次递减（P〈0.05）。结论高糖环境可抑制MG63细胞增殖,可能导致成骨细胞TRAIL和OPGL表达增多、OPG表达减少。     

���ʾֲ�ĥ������߷������в�ճ��Ч����ʵ���о�

本研究通过对比釉质磨除的氟斑牙与正常牙之间托槽抗剪切粘接破坏力的差异,探讨釉质局部磨除在提高氟斑牙患者托槽粘接的效果,为临床氟斑牙托槽粘接提供有效的方法。     

Er��YAG�������ϲ�ͬ�����Ӧ��������ֱ�Ӹ������ٴ������о�

??Objective    To compare clinical success rates of Er??YAG laser combined with different capping agents for direct pulp capping in primary teeth and evaluate the pain during treatment. Methods    A total of 60 teeth of 60 children between the age of 3 and 5 years were selected for this study. All the samples were randomly assigned to the following 4 groups??n=15???? Er??YAG laser+MTA??the exposed area was sealed with MTA after Er??YAG laser for caries removal and cavity preparation??Er??YAG laser+calcium hydroxide??CH????the treated area was sealed with CH paste after Er??YAG laser for caries removal??dental handpiece+MTA??the exposed pulp was sealed with MTA after dental handpiece for caries removal??dental handpiece+CH??CH was applied after dental handpiece for caries removal. The depth of cavity preparation was recorded while the child felt painful. At the 3-??6-??12-and 24-month recall examiations??the effect was observed by X-ray. Results    The proportion of the depth of cavity preparation??superficial dentin??middle dentin??deep dentin??by handpiece and Er??YAG laser was 50%??40%??10% and 0.67%??20%??79.33%??respectively. The two patterns of cavity preparation revealed significant difference??P < 0.05??. At the 3-??6-??12-month recall examiations??the success rates of the laser groups were higher than the handpiece groups??while they had no significant difference??P > 0.05??. At the 24 months??the success rates of the laser groups were 93.3%. They showed significantly higher success rates than the handpiece groups??P < 0.05??. The success rates of handpiece+MTA and handpiece+CH were 80%??12/15??and 73%??11/15????which did not reveal any significant difference. Conclusion        Er??YAG laser combined with pulp capping agents can be recommended for direct pulp therapy in primary teeth??and Er??YAG laser will result in a slight pain??thus the children will be inclined to accept and complete the treatment. The clinical effect of MTA shows no statistical difference compared with CH.     

������벣����ά����׮���ڲй��޸�Ч���Ƚ��о�

目的评价不锈钢根管桩与玻璃纤维桩用于残冠修复的临床效果。方法选择2009年6—8月柳州市人民医院口腔科门诊收治的残冠患者132例(160颗患牙),随机分成两组,每组80颗,分别采用Anthogyr不锈钢根管桩和玻璃纤维桩修复患牙,且均采用光固化瓷化树脂修补残冠并全冠修复,对其操作时间、同期成功率进行比较。结果经2年随访,两组成功率比较,差异无统计学意义(100%对93.8%;χ2=0.069,P>0.05)。结论 Anthogyr不锈钢根管桩与玻璃纤维桩的临床修复效果相近,前者设计独特、固位好、操作快捷、成本更低廉,值得推广应用。     

�������ɺϽ���о���չ

烤瓷熔附金属全冠(porcelain-fused-to-metal,PFM)也称金属烤瓷全冠,是一种由低熔烤瓷真空条件下熔附到铸造金属基底冠上的金一瓷复合结构的修复体.烤瓷熔附金属全冠兼具有金属全冠的机械强度好和全瓷冠美观的优点[1].     

��������ʴճ�Ӽ��޸�������Ш״ȱ���ٴ���Ч�Ƚ��о�

目的比较3MAdeper^TM EasyOne和ClearfilSEBond两种自酸蚀粘接剂修复牙颈部楔状缺损的疗效。方法选择2009年1月至2011年3月在安徽省阜阳市人民医院体检中心口腔科就诊的40例牙颈部楔状缺损患者,共有50对（100颗）左右对称同名患牙。将所有患牙按照随机同名牙配对方法分为两组,各50颗。一组惠牙采用3MAdeper^TM EasyOne粘接剂修复,另一组患牙采用ClearfilSEBond粘接剂修复。分别于修复后1年和2年对两组患牙进行随访,根据改良USPHS／Rygel临床评价标准评价修复效果。结果3MAdeper^TM EasyOne粘接剂修复楔状缺损1年和2年的固位率分别为96％和90％;ClearfilSEBond粘接剂修复楔状缺损1年和2年的固位率分别为94％和86％。经统计学检验,两种粘接剂在修复效果上差异无统计学意义（P〉0．05）。结论3MAdeper^TM EasyOne和ClearfilSEBond两种自酸蚀粘接剂修复牙颈部楔状缺损的临床效果相当,临床工作中可根据实际情况灵活选择使用。     

Spee曲线的整平与间隙

Spee曲线的整平需要占据间隙是正畸医生的共识,但是Spee曲线整平和间隙之间的量化关系存在诸多争议.整平Spee曲线与所需间隙的关系,影响着正畸治疗设计时的间隙分析,从而可能影响最终矫治方案的制定.本文就Spee曲线整平与间隙的关系进行综述.