唑来膦酸系统治疗对骨质疏松时人工骨植骨愈合及种植体骨结合的影响

目的：研究唑来膦酸系统治疗对骨质疏松时人工骨植骨愈合及其内种植体骨结合的影响。方法：30只雌性SD大鼠随机分成3组：假手术组（A）、骨质疏松组（B）和唑来膦酸治疗组（C）。A组接受假手术,B、C组行双侧卵巢切除术。术后12周在大鼠右侧胫骨近中干骺端植入羟基磷灰石涂层种植体,并于种植体旁制备骨缺损,行Bio-oss骨粉同期植入术;C组给予唑来磷酸钠0.2mg/kg/3周肌注,A、B组注射生理盐水。种植术后第4周、12周分2批处死动物,标本制作不脱钙切片检测。结果：种植术后4周时,B组皮质骨厚度（TCB）、种植体骨结合率（IBCR）、新生骨量（NBV）、Bio-oss骨粉包被率（ERBP）均显著低于A组和C组（P〈0.01）;而C组除TCB外,其它参数则均显著高于A组（P〈0.01）。12周时,B组各项参数均显著低于A组和C组（P〈0.01）,C组除TCB略低于A组外（P〈0.05）,其它参数与A组相似（P〉0.05）。结论：实验性骨质疏松可延迟人工骨植骨愈合,降低种植体骨结合率;唑来膦酸系统应用则可拮抗骨质疏松的负面影响,促进植骨愈合,使种植体骨结合率增加。     

天然牙-种植体联合桥上部结构应力分布的三维有限元分析

目的 揭示天然牙—种植体联合桥在咀嚼过程中上部结构应力的分布规律，为临床设计该种类固定桥提供理论参考依据。方法 借助于CT扫描和计算机辅助设计手段，用三维有限元方法对天然牙一种植体联合固定桥在不同载荷下，上部结构的应力分布差异以及位移变化进行生物学分析。结果 种植体基台在斜向载荷下的最大应力值是垂直载荷下的4～6倍，且应力分布不均，有应力集中现象，以压应力为主。桥体He面的应力峰值在集中载荷下是分散载荷下的数倍，He面中1／3出现力点高度集中的压应力区，但载荷方向对其无影响。种植体基台在近远中向的最大位移明显大于天然牙颈部，固定桥整体移动方向是朝着天然牙运动。结论 天然牙—种植体联合桥可通过减少斜向力和集中力或提高基台的结构强度及桥体材料的抗挠曲强度，防止上部结构机械并发症的发生。这种固定桥是可行的。     

钛表面掺镓羟基磷灰石涂层的合成和性能表征

目的:钛表面制备含镓羟基磷灰石(Ga-HA)涂层并研究其理化性能。方法:溶胶-凝胶法制备Ga-HA,浸润-提拉法制备涂层并煅烧。SEM检测涂层表面形貌,FTIR、XRD分析其基团结构,拉伸试验检测其结合强度,AAS检测镓、钙离子释放浓度。结果:Ga-HA的结晶度高于HA。体外释放实验结果显示煅烧后涂层钙、镓离子释放量减少。讨论:镓的掺入使HA结晶度增强但未改变其主要晶相结构;镓的掺入有助于减缓涂层的降解,为Ga-HA涂层在骨质疏松患者的临床应用提供了基础。     

雌激素对骨质疏松时种植体骨愈合的影响:Ⅱ骨计量学和电镜观察

目的 :研究雌激素替代治疗对骨质疏松时种植体骨愈合的影响。方法 :选用32周龄雌性SD大鼠36只 ,并随机分为假手术组、卵巢切除组及雌激素组。卵巢切除12周后于大鼠胫骨近中干骺端植入纯钛螺纹状种植体 ,雌激素组同时肌注苯甲酸雌二醇。种植术后4周及12周分两批处死大鼠 ,摘取胫骨 ;标本分别进行扫描电镜观察和骨计量学测量。结果 :在种植后4周及12周时 ,雌激素组除12周时皮质骨结合率与卵巢切除组无显著差异外 ,其它各项骨计量学参数均显著高于卵巢切除组 (P<0.05或P<0.01) ;而与假手术组比较 ,除骨矿化速度及4周时单位骨量外 ,其他各项指标均无显著差异 (P>0.05)。电镜观察种植体—骨界面愈合雌激素组和假手术组均优于卵巢切除组。结论 :雌激素替代治疗可促进实验性骨质疏松大鼠种植体骨愈合 ;该方法有助于增加临床绝经性骨质疏松患者牙种植体骨整合率     

The Benefit of the Smartphone in Oral and Maxillofacial Surgery: Smartphone Use Among Maxillofacial Surgery Trainees and iPhone Apps for the Maxillofacial Surgeon

The use of smartphones has soared among healthcare professionals in recent years, with estimated figures reporting that the majority of clinicians own and use smartphones in the workplace. Smartphones allow the clinician to carry textbooks in their pocket, write documents on the move and use email and internet to enhance productivity and clinical decision making. These advances in smartphone technology have enabled access to healthcare information for the clinician and transfer of data between team members, giving rise to the phenomenon of telemedicine. With the ability to instantly transfer clinical data to the off-site surgeon, combined with purpose-built medical apps, the smartphone is rapidly becoming an invaluable tool for the modern surgeon. Many studies have linked the benefits of smartphones and apps in other surgical specialities, but no article to date has highlighted the merits and full scope of this technology to the Oral and Maxillofacial Surgeon. We report that 94 % of British maxillofacial surgery trainees own a smartphone, with 61 % owning an iPhone. 89 % of trainees questioned had downloaded medical apps and used them regularly during clinical activities. We discuss the clinical application of the smartphone in the field of oral and maxillofacial surgery and review a list of useful and relevant apps for the modern maxillofacial surgeon using the iPhone as an example platform.