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目的 探讨氧化锆全瓷冠桥修复体的修复效果,为临床应用提供参考.方法 对2008年1月至2009年6月佛山市禅城区口腔医院修复科收治的40例接受全瓷修复的患者,采用计算机辅助设计与计算机辅助制作(CAD/CAM)技术制作氧化锆全瓷冠桥修复体60件,其中上颌32件,下颌28件;前牙单冠24个,后牙单冠21个,前牙固定桥2个,后牙固定桥3个(均为3单位固定桥).分别在修复体黏结后1、3、6、12个月对患者进行随访观察,采用美国加利弗尼亚牙科学会的全瓷修复临床标准对修复体的临床效果进行评价,同时也对牙周健康状况进行评价,记录全瓷修复体牙冠的牙龈出血指数(BI)、牙周袋深度(PD)以及附着丧失(AL).结果 观察期间失访3例患者5件修复体,对剩余的37例患者55件修复体的临床观察结果显示,在黏结1个月后有2件修复体的边缘卡探针,有2颗氧化锆全瓷冠修复的牙齿出现牙龈炎.在黏结3个月后,有1个单冠出现裂纹,1例固定桥断裂,2颗牙齿出现牙龈红肿.在黏结6个月后,有1例桩核冠脱落,2颗牙齿出现牙髓炎或根尖周炎.所有复诊患者在12个月的临床观察中均未见边缘着色和继发龋,有5件修复体的颜色匹配稍差.在各时间点BI、PD和AL等指标与治疗前比较差异均无统计学意义(P＞0.05),各项指标比较差异亦无统计学意义(P＞0.05).结论 氧化锆全瓷修复体具有良好的稳定性和生物相容性,近期临床效果满意.     

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目的探讨外伤脱位牙即刻再植的临床疗效及其影响因素。方法选择1993年10月至2005年10月于江西省萍乡市人民医院和广东工业大学医院口腔科就诊的外伤脱位牙患者46例60颗牙进行即刻再植,术后随访观察5年。结果再植牙术后5年成功率为75%,累计有11例15颗再植牙失败,失败原因主要为术后牙根吸收大于根长1/3(占60%)、继发感染(占26.7%)、固定不牢靠(占13.3%)。离体时间<30 min再植牙的牙髓成活率和牙周膜愈合率均高于离体时间>30 min的再植牙,差异有统计学意义(P<0.01)。结论即刻再植外伤脱位牙经适当的临床治疗仍可保留多年,再植成功的关键是严格选择适应证、正确选择离体牙储存介质、尽快植入缩短牙离体时间、尽可能保存牙周膜活性、牢靠的固定结合功能运动和及时有效防治感染。     

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目的    评价LIFECORE种植系统的近期临床效果。方法    选择2005年8月至2009年2月就诊于中国医科大学口腔医学院种植中心,采用LIFECORE种植系统修复缺失牙的患者113例,共植入种植体221枚。其中有1例患者的1枚种植体于种植术后6个月时因松动取出,其余112例220枚种植体均于2009年6月前完成上部结构修复。行固定修复110例（215枚种植体）,活动修复2例（5枚种植体）。观察时间最长4年,最短3个月。结果    完成上部结构修复的112例患者中,108例对种植义齿修复后的效果表示满意,4例出现修复后并发症,给予相应处理后2例满意,2例表示可以接受。LIFECORE种植体修复后观察3个月至4年,累计存留率为97.1%。结论    LIFECORE种植系统修复缺失牙可获得良好的临床效果。     

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结合作者的临床经验、临床科研及相关文献,从矫治器的使用、矫治技术的实施等方面阐述如何在自锁托槽矫治器的使用过程中实现高效矫治。同时对自锁托槽矫治器的使用效果、矫治代价及主动自锁与被动自锁的特点等问题进行讨论。     

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??Objective    To analyze the clinical efficacy of 2D lingual brackets self-ligating technique in the treatment of malocclusion of adult patients. Methods    The clinical data of 30 adult patients with malocclusion treated in our hospital between December 2014 and December 2015 were reviewed. The plaster dental model?? profile and oral photograph??and the satisfaction rate of patients in this group were observed??and the cephalometric parameters of the patients before and after the treatment were compared. Results    The total effective rate of plaster dental model??profile and oral photograph in this group of patients after the treatment was up to 83.33%??and the satisfaction rate amounted to 96.67%. The changes of cephalometric parameters before and after treatment in Angle class??patients showed no significant difference??P??0.05??. Conclusion    The treatment with 2D lingual self-locking appliance technology for adult skeletal??malocclusion??bite??anomalies has good effect??and for skeletal Class?? non-extraction cases it has clinical value.     

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??Objective??To evaluate the effect of articular disc repositioning combined with orthodontic functional appliance in the treatment of juvenile bilateral temporomandibular joint ??TMJ??anterior disc displacement??ADD?? and  skeletal class ??malocclusion. Methods??Fourteen juvenile patients with bilateral TMJ ADD and skeletal class ?? malocclusion were selected from March 2016 to March 2018 in the Department of Oral Surgery??Ninth People’s Hospital??Shanghai Jiao Tong University School of Medicine. Magnetic resonance imaging ??MRI?? and cephalometric radiographs before surgery and  follow-ups were performed for all patients. Condylar height and relevant cephalometric radiographs were measured and compared by statistical analysis. Results??Compared with pre-surgery??MRI showed the condylar height increased ??1.74±0.98??mm during follow-ups after surgery ??P??0.001??. New generated bone was observed on all condyles. About 84.61% of the new bone formed at superior and posterior-anterior surface. Cephalometric radiographs showed that SNB increased ??1.83±1.56??°??P??0.001????pogonion position ??pog-G?? moved ??2.18±3.13??mm ??P = 0.028?? forward and incisor overjet decreased ??3.55 ± 1.86??mm ??P??0.001????whereas no significant changes were found in SNA??Sn - G Vert??Y-Axis??U1 - SN??IMPA ??L1-MP?? or U1-L1 ??P > 0.05??. Conclusion??Articular disc repositioning combined with postoperative orthodontic functional appliances can effectively promote condylar growth and reduce oral-maxillofacial deformities in juvenile patients with bilateral  TMJ ADD and skeletal class??malocclusion.     

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目的探讨复方苔藓散结合醋酸地塞米松贴膜治疗口腔糜烂型扁平苔藓的临床疗效。方法将2003—2006年大连大学附属中山医院口腔科92例糜烂型扁平苔藓患者随机分为中药组31例,西药组30例及中西医结合治疗组31例。前两组分别采用复方苔藓散(中药)或地塞米松贴膜(西药)进行治疗,中西医结合组则采用二者结合进行治疗。于治疗结束时及治疗后1年内追踪疗效。结果停药后临床疗效的总有效率比较显示,与中药组(51.61%)相比,西药组(86.67%)及中西医结合组(80.65%)的差异均有统计学意义(P均<0.01);治疗后1年内追踪观察西药组有效病例总复发率(61.53%)明显高于其余两组(P<0.05)。结论中西医结合治疗口腔糜烂型扁平苔藓短期及长期观察均可取得良好疗效。     

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??Temporomandibular joint anterior disc displacement??ADD?? is a common disease characterized by mouth opening limitation. It can result in degenerative changes of the condyle??when it happens in growing period. This study reviewed the relationship between juvenile ADD and dentofacial deformities??as well as disc repositioning surgery and related orthodontic and orthognathic surgery??in order to provide reference for developing and choosing a clinical treatment.     

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随着人们对生活质量的日益重视,强调美观的美学修复在口腔市场上迅速蓬勃发展。但现阶段国内的美学修复效果良莠不齐。究其原因,主要是由于缺乏合理的临床路径规范和实用的美学修复理论指导。本文建立了以最佳临床实践为目的的美学修复临床路径,用于规范化管理美学修复流程,保障美学修复的最终效果。     

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?? The purpose of vital pulp therapy for immature permanent tooth is to protect activity and function of the crown or root residual pulp tissue?? and promote the root physiological development. It has been recommended that vital pulp therapy should be performed only to preserve the healthy pulp tissue in teeth with normal pulp or teeth with reversible pulpitis or teeth without periapical lesions. But up to now?? there is no reliable means that can precisely reflect the pulp condition. Currently?? several studies have reported successful outcome of vital pulp therapy in vital teeth with cariously exposed pulp??or with signs and symptoms of irreversible pulpitis or with periapical lesions. In clinics?? we should make full use of the fact that pulp tissue in immature permanent teeth has strong ability of tissue repair and regeneration. So a more conservative pulp therapy should be taken for young permanent teeth in order to obtain a better prognosis.     

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目的研究超强纤维在替牙期儿童脱位牙固定中的临床效果。方法2005年5月至2008年3月采用超强纤维对辽宁医学院附属二院口腔修复科16例23颗替牙期儿童脱位牙进行固定,随访观察固定后患牙有无脱落、松动,牙龈、牙髓状况以及能否正常行使功能等。结果23颗再植牙于固定后0.5～2.5年期间观察效果良好,无脱落。X线片复查显示3颗于固定后1年时发现根侧有轻微吸收,4颗牙髓坏死。其余牙齿均无明显松动,牙龈附着正常,能正常行使功能。结论超强纤维作为一种新型材料,对脱位牙进行固定时具有美观、舒适、操作简单、有利于软硬组织愈合及对牙周健康无明显影响等优点,特别是对替牙期儿童术后护理及心理影响方面均具有良好的优势。     

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??Objective??To investigate condylar position before and after occlusal splint treatment in patients with temporomandibular disorders ??TMD?? and to study the treatment mechanism. Methods??Twenty patients with TMD were chosen from January to July 2016 in the Department of Orthodontics??Hospital of Stomatology??Fujian Medical University. The image of cone-beam computed tomography ??CBCT??was photographed before and after RW splint treatment. Measurements of  the spaces of  TMJ were made to compare the change of condular position.  Results??Anterior space  decreased but posterior space increased after treatment by occlusal splint??P??0.05????but there was no statistically significant chang in superior space??P??0.05??. Conclusion??After the occlusal splint treatment?? the condyle may move forwards to get centered in glenoid fossa.     

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目的比较修复临床常用的9种黏结材料与传统的磷酸锌水门汀对金属全冠固位力的影响。方法2008年1—12月在大连市口腔医院选用90颗完整的双尖牙经包埋固位后,用车床进行牙体预备。使预备后的牙体保持4mm的临床冠高度,20mm的临床冠周径。用失蜡铸造法完成金属全冠制作。用不同的黏结材料黏固金属全冠,用万能实验机检测金属全冠的固位力。经方差分析,比较不同黏结材料对金属全冠固位力的影响。结果本研究使用的黏结材料与传统的磷酸锌水门汀相比,对金属全冠固位力的影响存在显著的差异(P<0.01),不同黏结材料对金属全冠固位力的影响也有显著性差异(P<0.05)。结论不同种类的黏结材料对金属全冠固位力的影响存在差异,修复临床应根据不同的临床情况选择不同的黏结材料。     

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??Objective    To investigate the distribution and initial displacements of the maxillary first molar under various degree and location of tip back and Toe-in bends by the 3-D finite element method?? so as to clarify the biomechanism of those bends. Methods    ??1??The whole maxillar 3-D finit element model was successfully constructed. 0.018×0.025 wire was used in this study. Analyze the displacement of upper first molar when there were 15°?? 30° and 45° tip back bends in different location. When the forces were loaded in these situations on the model??observe the upper molar displacement on the Z directions. ??2??Analysze the displacement of upper first molar when there were 15°?? 30° and 45° Toe-in bends in different location. When the forces were loaded in these situations on the model??observe the upper molar displacement on the X and Y directions. Results    ??1??With the increase of the tip back bends angle?? the magnitude of the bending force increased. As bend location progressively moved toward the molar?? the magnitude of the intrusive moment at the molar also progressively increased. When the bend was close to the second premolar??the first molar showed an extensive movement.??2??With the angle of the Toe-in bends increaing?? the magnitude of force increased. When the bend was close to the upper first molar?? it showed the overall lingual displacement. When the Toe-in was near the second premolars?? the upper molar had a clockwise rotation. Conclusion    Tip back bend is critical in controlling vertical dimension of the first molar?? and is beneficial to anchorage control and bite opening when located in distal of the second premolar. Toe-in bend is in favour of rotation control of the first molar.     

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目的探讨局部缓冲对磁性附着体远中牙槽骨吸收后固位改善的情况。方法2007年4月至2008年2月于东北大学材料实验室建立犬磁性附着体牙槽骨吸收模拟模型,测量模拟不同吸收条件下,缓冲前后附着体义齿固位力变化,对缓冲前后义齿的固位力根据不同吸收条件进行方差分析。结果缓冲后前后牙区垂直方向及后牙区斜向前上方60°的固位力变化差异无统计学意义(P>0.05)。缓冲后前牙区斜向前上方60°的固位力变化差异有统计学意义(P<0.01)。未缓冲前牙区垂直方向及斜向前上方60°固位力随骨吸收总体呈下降趋势(P<0.01)。未缓冲后牙区垂直方向及斜向前上方60°的固位力变化差异无统计学意义(P>0.05)。结论对磁性附着体覆盖义齿进行局部缓冲可有效提高牙槽骨吸收后前牙区固位力。     

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目的评价Ceramage聚合瓷高嵌体和多面嵌体修复后牙牙体缺损的临床效果。方法选择2005年1月至2008年1月于中国医科大学口腔医学院修复科就诊的后牙牙体缺损患者129例(患牙200颗),行Ceramage聚合瓷高嵌体和多面嵌体修复各100颗牙,于患者戴用修复体后6个月、1年、2年、3年,检查其形态、边缘适合性、颜色、周围龋、修复体磨耗程度、接点及折裂情况。结果200颗患牙修复后中共出现5颗失败,其中高嵌体修复体破损1颗、松动1颗、食物嵌塞2颗;多面嵌体修复体未发现有破损,1颗出现基牙折裂。结论Ceramage聚合瓷是一种很好的后牙牙体缺损修复材料;与高嵌体相比,多面嵌体保留了更多牙体组织,更有利于修复体力学或生物学的使用周期。     

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目的    评价双重固化高强度复合树脂水门汀和树脂加强型玻璃离子水门汀黏固纤维桩的临床效果。方法     选择2007年在沈阳沈河金英武口腔诊所就诊,拟采用纤维桩修复的70例前磨牙或第一磨牙缺损患者的96颗患牙,随机分为2组,每组48颗,分别用不同的黏结剂（Ⅰ组：双重固化高强度复合树脂水门汀;Ⅱ组：树脂加强型玻璃离子水门汀）黏固纤维桩,制备树脂桩核,全冠修复。随访2年,观察修复效果。结果    Ⅰ组4颗失败,1颗为上颌第二前磨牙纤维桩折断,另3颗为上颌第一前磨牙纤维桩脱落,成功率为91.7%;Ⅱ组2颗失败, 1颗为上颌第一前磨牙,另1颗为下颌第一前磨牙,均为纤维桩折断,成功率为95.8%。两组治疗成功率比较差异无统计学意义（P＞0.05）。结论    2种黏结剂用于临床黏固纤维桩均表现出良好的临床效果。     

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目的评价康复新液治疗复发性阿弗他溃疡的临床疗效。方法2008年1月至2009年3月,在中国医科大学口腔医院综合急诊科选择复发性阿弗他溃疡患者80例,随机分成2组,A组采用康复新液治疗,B组采用口泰治疗,观察7d。对两组患者的治疗有效率、溃疡面积的变化、止痛时间进行对比分析。结果1周后,A组的治疗有效率(90.0%)明显的高于B组(65.0%),溃疡面积的变化A组(80±3.4)mm2明显的高于B组(53±1.6mm)2,止痛起效时间A组(2.8±0.5)min明显的低于B组(6.2±1.1)min,止痛维持时间A组(32±1.2min)明显的高于B组(10±0.3)min,差异均具有统计学意义(P<0.05)。结论康复新液治疗复发性阿弗他溃疡具有良好的临床疗效,可以广泛的用于临床。     

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??Objective    To evaluate the clinical aesthetic efficacy of ultra-thin veneers for anterior teeth. Methods    Totally 126 anterior teeth of 54 patients were chosen and restored in Department of Prosthodontics??Nanjing Stomatological Hospital between February 2012 and February 2013. Ultra-thin ceramic veneers were made from IPS e.max Press HT ??high translucency?? lithium disilicate glass ceramic ingots??and cemented with light-cured resin cement. Patients were interviewed and examined at 1 month??6 months??1 year??2 years??3 years??4 years and 5 years respectively. The clinical evaluation of ultra-thin ceramic veneers was carried out with reference to the criteria of USPHS from the aspects of secondary caries??marginal suitability??appearance??color match and integrity. Results    Totally 126 anterior teeth were restored with ultra-thin ceramic veneers made of IPS e.max Press. After 1 month??2 veneers ??1.6%?? were B class in color match??and the other indicators were A class. At 6 months??1year and 2 years after restoration??all veneers achieved A class in each evaluation indicator. After 3 years??gap was detected at the margin of 2 veneers ??1.6%????which were B class in marginal suitability. After 4 years??2 veneers ??1.6%?? were C class in integrity with 1mm incisal fracture. At 5 years after restoration??1 veneer ??0.8%?? was C class in integrity with disto-incisal fracture; slight discoloration was observed in 5 veneers ??4.0%????which were B class in color match??and one veneer was lost in follow-up. All the veneers were clinically effective with no sensitivity symptoms??no secondary caries or gingivitis. Conclusion    Ultra-thin ceramic veneers have the advantages of excellent translucency??natural appearance and acceptable marginal suitability??and have been an ideal choice for anterior aesthetic restoration.