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骨代谢过程中,锌是不可缺少的重要微量元素之一,适量的锌对成骨细胞增殖、分化、凋亡等生理过程有重要的作用。本文就锌对成骨细胞生物学作用方面的影响、作用机制及研究现状做一综述。     

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??Zinc is a necessary trace element for organism??which important to the physiological regulation of organs and tissues. Zinc has an important biological effect in the process of apoptosis??it can inhibit apoptosis and induce apoptosis??both depending on intracellular concentration of zinc. The mechanism of zinc in influencing apoptosis is complex??which is the result of joint action of a variety of factors. Appropriate concentration of zinc coating on the surface of dental implants??which are made of pure titanium??modified by micro-arc oxidation??can promote the proliferation and differentiation of osteoblasts and the formation of bone matrix??also??different concentrations of zinc can affect the apoptosis of osteoblastic cells??probably through a mitochondria-mediated pathway.     

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目的    探讨全面部骨折各种手术复位径路的可行性及优缺点。方法    对2002—2009年在宿州市立医院口腔颌面外科救治的资料完整的69例全面部骨折手术病例复位手术径路进行回顾性分析。结果    69例患者中,有47例采用了头皮冠状切口+小切口,22例单纯采取局部小切口。术后随访平均6个月,患者在功能上皆取得了良好的治疗效果,并发症表现各有不同。结论    冠状切口+小切口和单纯局部小切口在不同适应证中均可获得满意的治疗效果,应进一步研究如何减少冠状切口的并发症和如何应用微创切口对全面部骨折进行良好复位。     

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目的探讨颧弓上缘微型切口在颧弓骨折治疗中的运用。方法采用颧弓上缘微型切口联合颌面部局部微型切口,并以微型钛板坚强内固定治疗2006年1月至2008年1月在山西医科大学口腔医学院收治的颧骨颧弓复合体骨折的患者48例。结果所有患者切口均Ⅰ期愈合,3个月、半年复诊,绝大多数外形和功能恢复良好,取得了满意的治疗效果。结论选择在颧弓上缘面神经走行的"危险区"以外的区域做平行面神经分支的微型皮肤切口,联合颌面部局部微型切口,并以微型钛板坚强内固定治疗颧骨颧弓复合体骨折,对患者手术创伤小,路径短,避免头皮冠状切口所遗留的副反应,并能有效恢复颧弓外形及开口功能,符合微创手术原则。     

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目的探讨扇形切口在重唇手术中的应用。方法选择2009年5月至2010年5月郑州大学口腔医学院口腔颌面外科收治的重唇患者6例,采用扇形切口行重唇手术,观察临床疗效。结果术后6例患者的唇部形态及功能均良好。结论扇形切口是重唇整复术的可行性切口。     

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目的评价颌骨骨折口内切口坚强内固定的治疗效果。方法对内蒙古包头中心医院口腔科2002—2007年间收治的186例新鲜颌骨骨折患者采用口内进路暴露颌骨骨折部位(除外下颌升支及髁状突骨折),以钛板坚强内固定配合颌间弹力牵引使骨折段复位固定。结果186例患者182例软组织Ⅰ期愈合,口内咬合关系恢复良好,颌面部外形和咀嚼功能、开口度正常。结论口内切口坚强内固定是治疗颌骨骨折的一种适用手术进路。     

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??Abstract??Objective To compare the clinical effect of different treatments for relaxation incision in palatoplasty??postoperative reaction and incision healing. Methods Totally 113 patients with cleft palate were divided into three groups randomly??who underwent palatoplasty. Iodoform gauze ??nothing or absorbable hemostatic gauze was used on both sides of the relaxation incision. After surgery??the diet??temperature changes??wound healing and bleeding??postoperative cleft or perforation were observed and analyzed. Results In Iodoform gauze group??2 cases of postoperative infection were found in all cases??12 patients had fever on the 3ird day??16 patients developed bleeding and one patient had postoperative cleft perforation. There were 4 and 5 patients with fever on the 3rd day of postoperation in the other two groups. Conclusion Nothing and filling into relaxation incision with absorbable hemostatic gauze are more helpful for wound healing and postoperative recovery in palatoplasty.     

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成人患者多伴有牙周、关节等问题,正畸治疗机制复杂、疗程较长,患者不仅对疗效要求高,对正畸治疗的疗程也颇为关注。骨皮质切开术,通过切开牙齿周围的骨皮质,辅助加速牙齿移动,缩短疗程,为成人正畸提供了一种新的治疗理念与思路。术中辅助植骨,可减轻治疗风险,同时可改善患者的牙周状况。骨皮质切开术日趋成熟,作为一种牙周辅助快速正畸技术在国外已应用于临床。本文将对骨皮质切开术在正畸牙齿垂直向控制中的临床应用、发展、优缺点以及一般临床程序等做一综述。     

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??Periodontally accelerated osteogenic orthodontics??PAOO??was developed from corticotomy??which was based on the regional acceleratory phenomenon??RAP??. This technique has been known as a reasonable and safe option for the growing demand for shortened treatment time of adult teeth movement. The paper provides the history of PAOO development??its related experimental studies??surgical technique??indications??contraindications??clinical treatment outcomes??risks and complications.     

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??Objective    To evaluate the advancement of zinc for bone repair with osteoporosis. Methods    The osteoporosis model have been established by ovariectomy??OVX??in female rats  for 12 weeks. Then??critical defects??5 mm??were prepared in bilateral mandible with a trephine and the rats were divided into three groups as the repair methods??in which experimental group were restored with zinc-releasing calcium phosphate ceramic/hydroxyapatite??Zn-TCP/HA????control group with β-TCP and blank control group were sutured directly. After 12 weeks??improved bone repair and shorten healing time in the OVX rats would be tested through biomechanical tests??radiographic and histological examination. Results    Osteoporosis in mandibular of female rats had been confirmed by bone density testified. Then??12 weeks after implantation??experimental group showed better bone repair than control group and blank control group through biomechanical tests??radiographic and histological examination. Conlusion    Zn-releassing scaffolds would obviously improved bone regeneration of the critical-sized defect in OVX rats model and provides valuable information for the therapy of osteoporosis related diseases by tissue engineering approach.     

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目的    研究腭裂术后松弛切口两种不同处理方法的患者术后反应及愈合情况。方法    将2007年8月至2009年7月在安徽省蚌埠医学院第一附属医院口腔科住院治疗的腭裂患者185例随机分为治疗组（93例）和对照组（92例），治疗组患者术后松弛切口内置入明胶海绵并进行对位缝合；对照组按照传统方法填塞碘仿纱条。比较两组患者术后体温、出血、进食、创口愈合等情况。结果    治疗组患者术后1例感染，12例发热，8例继发性出血；对照组术后12例感染，35例发热，25例继发性出血；两组间比较差异有统计学意义。治疗组1例术后穿孔，而对照组术后5例穿孔，两组术后均无复裂患者；两组间差异无统计学意义。结论    松弛切口内置入明胶海绵并进行对位缝合有利于腭裂术后恢复，是比较好的一种方法。     

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口腔颌面部是人体的暴露部位,容易受到各种外力打击发生外伤性骨折,给患者的面部容貌和功能带来很大的损害。近年来,随着交通事故的逐渐增加,由其所致的颌     

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上颌骨、颧骨、鼻骨、筛骨和额骨的一部分共同构成框架样结构支撑面中部外形,组成面中部骨骼.面中部位于人体暴露的部位,极易造成骨折,交通事故为其主要致伤原因,其次是建筑工地高空坠落伤.因面中部上接颅脑,近年由于复合伤的增多,致使面中部陈旧性骨折的发生率增高.多数面中部骨折导致的面中部凹陷、鼻部扁平、眼球移位及复视、咬合关系紊乱和张口受限、错(牙合)及面部畸形等得不到及时治疗.增加了手术难度和并发症的发生,一直是临床治疗的难点.     

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目的采用微弧氧化(micro-arc oxidation,MAO)技术,在纯钛表面制备含锌(Zn)活性涂层,并评价其对成骨细胞活性的影响。方法本实验于2009年10月至2010年10月在中国医科大学附属口腔医院中心实验室进行。以机械抛光纯钛试样作为对照组(CP组);经MAO技术处理的纯钛涂层试样根据钙(Ca)含量不同分为高钙组(H-Ca组)、低钙组(L-Ca组),以及在低钙组的涂层中加入锌元素的低钙加锌组(L-Ca-Zn组)。每组32个试件。将4组试样材料与MG63细胞复合培养,利用扫描电子显微镜(SEM)观察、噻唑蓝(MTT)比色试验、碱性磷酸酶(ALP)活性测定及酶联免疫吸附试验(ELISA)等方法,评价材料对成骨细胞黏附、增殖、分化及矿化的影响。所得数据采用SPSS13.0软件进行单因素方差分析(α=0.05)。结果在实验检测期间,H-Ca组试样对成骨细胞的生长增殖、分化、矿化作用均优于L-Ca组,差异有统计学意义(P<0.05)。比较L-Ca-Zn组与H-Ca组可以看出,在实验检测初期H-Ca组试样对成骨细胞的生长增殖、分化、矿化作用优于L-Ca-Zn组;随着观察时间的延长,L-Ca-Zn组试样细胞的增殖水平和ALP活性与H-Ca组间差异无统计学意义(P>0.05)。比较L-Ca-Zn组和L-Ca组可以看出,在实验检测初期L-Ca-Zn组试样对成骨细胞的作用与L-Ca组差异无统计学意义(P>0.05);随着观察时间的延长,L-Ca-Zn组试样显示出较L-Ca组试样具有更好的提高成骨细胞活性的作用(P<0.05)。结论采用MAO技术制备的含锌活性涂层纯钛可在一定程度上促进成骨细胞黏附、增殖、分化及矿化,具有良好的生物相容性。     

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??Objective    To evaluate the effect of zinc oxide?? iRoot BP and mineral trioxide aggregate??MTA?? as root-end filling materials during periapical microsurgery in animals by comparing X-ray and pathological biopsy after surgery. Methods    The study was completed in Tianjin Stomatological Hospital Laboratory between April 2011 and March 2015.The mandibular premolars of 4 Beagle dogs were selected for study. Periapical lesions in teeth of dogs were induced in the experiment?? root canal therapy and micro-surgery were made. Totally 48 canals were divided into three groups??each group having 16 canals.Zinc oxide?? MTA or iRoot BP was randomly used as root-end filling materials. After one year??periapical radiography was taken and the animals were sacrificed?? then serial sections from the roots were prepared for histopathological observation. The success rates of 12 months post-operatively were statistically analyzed according to imageology and histopathology. Results    According to the X-ray film?? the success rate of zinc oxide?? MTA and iRoot BP 1 year after operation was 81.2%?? 93.8% and 93.8%??respectively. There was no significant difference among the three kinds of materials. Pathological results of tissue showed that the degree of inflammation of MTA and iRoot BP was lower than zinc oxide?? the difference being statistically significant. There was no significant difference between iRoot BP and MTA in the number of inflammatory cells. The bone deposition rate of MTA[??80.2±26.4?? %] and iRoot BP[??78.6±30.4??%] was higher than that of zinc oxide[??50.2±16.5??%]. The MTA was the only one on which direct deposit of hard tissues could be observed directly on. Conclusion    As retrograde root-end filling materials?? zinc oxide?? iRoot BP and MTA produce similar healing effect??and hard tissue can be promoted to regenerate by all of them. BP and the MTA produce less severe inflammation on the periapical tissues. MTA has the best biological compatibility.     

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目的比较4种根管充填材料在一次性根管治疗中的临床疗效。方法选择2003年7月至2005年10月张掖市人民医院口腔科门诊首诊病例中,因牙病需作根管治疗的患者752例共752颗牙,随机分为4组,分别采用AHplus糊剂加牙胶尖、Cortisomol糊剂加牙胶尖、Vitapex糊剂加牙胶尖、氧化锌糊剂加牙胶尖充填根管。观察术后1周内疼痛发生情况及1年后的疗效。结果各组在根管充填后1～7d出现急性反应的例数和反应发生率比较,AHplus组充填后急性反应发生率与其它组间比较差异均有统计学意义(P<0.05),Cortisomol组、Vi-tapex组充填后急性反应发生率与氧化锌组比较差异亦都有统计学意义(P<0.05),氧化锌组术后疼痛发生率高于其它各组,且差异有统计学意义(P<0.05)。术后1年复查,AHplus组总有效率最高,且与其他各组比较差异有统计学意义(P<0.05),Cortisomol组和Vitapex组总有效率相差不大,但高于氧化锌组,且差异有统计学意义(P<0.05)。结论能有效减少一次性根管治疗后急性反应的发生的根充材料效率由高到底的是:AHplus糊剂、Cortisomol糊剂、Vitapex糊剂和氧化锌糊剂。