聚乳酸和无活性脱钙骨基质载体对rhBMP-2异位诱导骨形成的比较性研究

目的：为了研究聚乳酸和无活性脱钙骨基质载体对ｒｈＢＭＰ－２异位诱导的骨形成。方法：将重组人骨形态发生蛋白－２（ｒｈＢＭＰ－２）与无活性脱钙骨基质（ＤＢＭ）和聚乳酸（ＰＬＡ）复合,植入小鼠股部外侧肌肉陷窝比较ＰＬＡ和ＤＢＭ载体对ｒｈＢＭＰ－２诱导骨形成的影响。通过组织学检查、碱性磷酸酶（ＡＬＰ）和钙含量测定以及骨钙素（ＢＧＰ）放疫测定,进行对比观察。结果：术后２１天,实验组均可见新生软骨细胞和软骨岛,ｒｈＢＭＰ－２／ＰＬＡ和ＤＢＭ／ｒｈＢＭＰ－２组还可见部分骨组织形成,见骨小梁、板层结构和红骨髓,ｒｈＢＭＰ－２／ＰＬＡ组ＰＬＡ部分吸收,ＤＢＭ／ｒｈＢＭＰ－２组ＤＢＭ无吸收迹象。各实验组与对照组对比,ＡＬＰ、ＢＧＰ水平和Ｃａ量均有显著性差异（Ｐ＜０．０５）,ｒｈＢＭＰ－２／ＰＬＡ与ＤＢＭ／ｒｈＢＭＰ－２组在ＡＬＰ和ＢＧＰ水平上相比无显著差异（Ｐ＞０．０５）,但前组比后组的Ｃａ量为高（Ｐ＜０．０５）,这二组与单独植入ｒｈＢＭＰ－２组相比,定量检测指标均有显著性差异（Ｐ＜０．０５）。结论：（１）ＰＬＡ和ＤＢＭ均为ＢＭＰ的良好载体;（２）ｒｈＢＭＰ－２／ＰＬＡ是一种新的有价值的骨修复材料     

胰岛素样生长因子—Ⅰ对培养人牙周膜成纤维细胞生物学活性？…

胰岛素样生长因子（ＩＧＦ）可通过直接作用于成骨细胞或通过甲状腺素影响骨代谢过程而参与骨的改建。本文利用细胞增养技术观察了ＩＧＦ－Ｉ对培养人牙周膜成纤维细胞（ＰＤＬＦｓ）增殖、碱性磷酸酶（ＡＬＰ）活性变化以及蛋白质含量改变的影响。结果显示，ＩＧＦ－Ｉ对ＰＤＬＦｓ有明显的促增殖作用，对ＰＤＬＦｓ的ＡＰＬ活性、蛋白质合成也具有较强的促进作用，表明ＩＧＦ－Ｉ可能通过ＰＤＬＦｓ发挥其调节牙槽骨改建的作用，从     

聚乳酸和无活性脱钙骨基质载体对rhBMP—2异位诱导骨形成的比 …

目的：为了研究聚乳酸和无活性脱钙骨基质载体对ｒｈＢＭＰ－２异位诱导的骨形成。方法：将重组人骨形态发生蛋白－２（ｒｈＢＭＰ－２）与无活性脱钙骨基质（ＤＢＭ）和聚乳酸（ＰＬＡ）复合,植入小鼠股部外侧肌肉陷窝比较ＰＬＡ和ＤＢＭ载体对ｒｈＢＭＰ－２诱导骨形成的影响。通过组织学检查、碱性磷酸酶（ＡＬＰ）和钙含量测定以及骨钙素（ＢＧＰ）放疫测定,进行对比观察。结果：术后２１天,实验组均可见新生软骨细胞和软骨岛     

维生素D3衍生物对人成骨细胞生长和碱性磷酸酶活性的影响

目的：使用人胎成骨细胞（ＯＢ）为体外模型，观察了１，２５－双羟维生素Ｄ３〔１，２５（ＯＨ）２Ｄ３〕、２４，２５－双羟维生素Ｄ３［２４，２５（ＯＨ）２Ｄ３）］对ＯＢ生长和代谢的影响。方法：用ＡＬＰ测定法和Ｂｒａｄｆｏｒｄ蛋白含量法。结果：１，２５（ＯＨ）２Ｄ３在浓度为１０８ｍｏｌ／Ｌ时，刺激碱性磷酸酶（ＡＬＰ）的活性。但抑制ＯＢ的生长。２４，２５（ＯＨ）２Ｄ３在１０－８ｍｏｌ／Ｌ时无上述作用。结论：１，２５（ＯＨ）２Ｄ３对ＯＢ的ＡＬＰ有直接的促活作用，其作用与时间相关。２４，２５（ＯＨ）２Ｄ３对ＯＢ的ＡＬＰ活性无关。１，２５（ＯＨ）２Ｄ３对人胎ＯＢ生长有抑制作用。     

胰岛素样生长因子-Ⅰ和骨形态发生蛋白-2对人牙周膜细胞增殖的作用

目的：重组人胰岛素样生长因子－Ｉ（ｒｈＩＧＦ－Ｉ）、重组人骨形态发生蛋白－２（ｒｈＢＭＰ－２）分别或联合应用对人牙周膜（ＰＤＬ）细胞增殖的影响。方法：采用组织块法体外培养人ＰＤＬ细胞,ＭＴＴ法测定ＰＤＬ细胞在不同生长因子刺激下的增殖情况。结果：ｒｈＩＧＦ－Ｉ、ｒｈＢＭＰ－２都可促进人ＰＤＬ细胞的增殖,这种促增殖作用呈一定的浓度依赖性,ｒｈＩＧＦ－Ｉ与ｒｈＢＭＰ－２联合应用对人ＰＤＬ细胞的增殖有协同作用,且与单独应用相比相差显著。结论：ｒｈＩＧＦ－Ｉ、ｒｈＢＭＰ－２可望作为牙周再生的生物活性介质,ｒｈＩＧＦ－Ｉ与ｒｈＢＭＰ－２联合应用对ＰＤＬ细胞的促增殖作用更强。     

聚乳酸与重组人骨形成蛋白-2复合植入块修复兔下颌骨缺损的早期观察

采用冷冻干燥法，将聚乳酸（ＰＬＡ）制成多孔成形块状，并将ＰＬＡ与重组人骨形成蛋白－２（ｒｈＢＭＰ－２）有效的复合，植入兔下颌骨缺损动物模型，在术后２，４周通过Ｘ线片、组织学观察缺损部位的骨生成情况。结果表明：ＰＬＡ－ｒｈＢＭＰ－２植入组术后２周就有部分新骨形成，术后４周骨生成明显；而单独植入ＰＬＡ组术后４周仅有少量新骨生成。钙含量测定显示ＰＬＡ－ｒｈＢＭＰ－２组高于ＰＬＡ组。结果提示：ＰＬＡ为ＢＭＰ的有效传递系统，ＰＬＡ－ｒｈＢＭＰ－２复合植入块是一种有应用潜能的人工骨替代物。     

聚乳酸与重组人骨形成蛋白—2复合植入块修复兔下颌骨缺损…

采用冷冻干燥法，将聚乳酸（ＰＬＡ）制成多孔成形块状，并将ＰＬＡ与重组人骨形成蛋白－２（ｒｈＢＭＰ－２）有效的复合，植入兔下颌骨缺损动物模型，在术后２，４周通过Ｘ线片、组织学观察缺损部位的骨生成情况。结果表明：ＰＬＡ－ｒｈＢＭＰ－２植入组术后２周就有部分新骨形成，术后４周骨生成明显；而单独植入ＰＬＡ组术后４周仅有少量新骨生成。钙含量测定显示ＰＬＡ－ｒｈＢＭＰ－２组高于ＰＬＡ组。结果提示：ＰＬＡ为ＢＭ     

胰岛素样生长因子—I和骨形态发生蛋白—2对人牙周膜细胞增？…

目的：重组人胰岛素样生长因子－Ｉ（ｒｈＩＧＦ－Ｉ）、重组人骨形态发生蛋白－２（ｒｈＢＭＰ－２）分别或联合应用对人牙周膜（ＰＤＬ）细胞增殖的影响。方法：采用组织块法体外培养人ＰＤＬ细胞,ＭＴＴ法测定ＰＤＬ细胞在不同生长因子刺激下的增殖情况。结果：ｒｈＩＧＦ－Ｉ、ｒｈＢＭＰ－２都可促进人ＰＤＬ细胞的增殖,这种促增殖作用呈一定的浓度依赖性,ｒｈＩＧＦ－Ｉ与ｒｈＢＭＰ－２联合应用对人ＰＤＬ细胞的增殖有协同     

抗人血管内皮生长因子(VEGF)单克隆抗体重链可变区基因的克隆和序列分析

目的：克隆并分析人血管内皮生长因子（ＶＥＧＦ）单克隆抗体重链可变区基因。方法：从分泌抗人ＶＥＧＦ单抗的杂交瘤细胞株（Ｅｌ）中提取总ＲＮＡ,利用逆转录－ＰＣＲ方法,克隆抗人ＶＥＧＦ单克隆抗体（ＭＡＢ）重链可变区基因（ＶＨ）,将其重组入ｐＥＧＭＲ－ＴＶｅｃｔｏｒ测序载体测序。结果：ＶＨ基因序列全长３６９个碱基对,编码１２３个氨基酸,通过国际联机检索及Ｋａｂａｔ库扫描证实,该ＶＨ基因符合小鼠免疫球蛋白可变区基因特征,同源性最高达８７％。结论：ＶＨ基因全长３６９ｂｐ,根据Ｋａｂａｔ分类,归属小鼠重链可变区基因第Ⅱ（Ａ）亚组,由ＶＨ－Ｄ－ＪＨ４重排产生。     

口内进路硅橡胶块隆颏术的应用

口内进路硅橡胶块隆颏术的应用ＡＰＰＬＩＣＡＴＩＯＮＯＦＭＩＣＲＯＭＡＮＤＩＢＬＥＡＵＧＭＥＮＴＡＴＩＶＥ┐ＰＬＡＳＴＹＷＩＴＨＳＩＬＩＣＯＮＩＭＰＬＡＮＴＴＨＲＯＵＧＨＩＮＴＲＡ┐ＯＲＡＬＩＮＣＩＳＩＯＮ董帆作者单位：上海铁道大学附属甘泉医院口腔颌面...     

The quadrilateral analysis: a differential diagnosis for surgical orthodontics

The integration of the diagnostic and treatment skills of both the orthodontist and the maxillofacial surgeon has become a standard procedure in the treatment of severe dentofacial dysplasias. Orthognathic surgery, surgery without prior tooth movement, is being replaced by an interdisciplinary approach as the treatment of choice. When a proper tooth-to-denture-base relationship is obtained, an ideal maxillomandibular relationship can be achieved surgically. The quadrilateral analysis enables the practitioner to obtain an individualized skeletal, dental, and soft-tissue assessment of each patient requiring treatment. It determines the direction and extent of the skeletal dysplasia in millimeter measurements and allows the clinician to outline the appropriate surgical orthodontic procedures. The quadrilateral analysis indicates that in a balanced facial pattern a 1:1 ratio exists between the maxillary bony base length (Max.Lth.) and the mandibular bony base length (Mand.Lth.); also that the average of the anterior lower facial height (ALFH) and the posterior lower facial height (PLFH) equals these bony base lengths. Simply stated, the Max.Lth. = Mand.Lth. = (formula; see text) An accurate diagnosis locates the area and quantifies the magnitude of skeletal dysplasia. Then the correct placement of a dentition within the denture bases and the appropriate surgery in the area of dysplasia can produce an individualized, balanced facial pattern.     

Lower face cephalometry based on quadrilateral analysis with cone-beam computed tomography: a clinical pilot study

Objective

As most orthognathic surgeries focus on the lower face, the aim of this study was to transfer previously developed two-dimensional cephalometry—which is useful for surgeons in the orthognathic surgery of the lower face—to three-dimensional (3D) cephalometry by using cone-beam computed tomography (CBCT). We selected the quadrilateral lower face analysis developed by the surgeon Di Paolo, who focused only for the lower face and mentioned that data in millimeters are more easy to use than angles for surgeons. Additionally, we wanted to create a 3D lower face analysis approach based on quadrilateral analysis and establish a reference table for surgical planning.

Study design

Three investigators assigned 16 landmarks on CBCT images from 30 patients with normocclusion. Intra-class correlation coefficients (ICCs) and standard deviations (SDs) were calculated according to each landmark. The maxillary and mandibular lengths and widths and the anterior and posterior lower facial heights (ALFH and PLFH) are presented as means and SDs. The asymmetry of the face was calculated with paired t test, and the coherence of the lower face was assessed with correlation coefficients (r) and regression models.

Results

The ICCs were ≥0.90, and the SDs of the landmarks were lower than 1.00 mm, except for the J-point, which was located at the junction of the anterior border of the ramus and the corpus of the mandible. The SDs of linear measurements were 3.06–5.20 mm, and there was no significant facial asymmetry. The r among the structures was greater than 0.3 in 13 of 15 assessments. Based on these values, we could establish a floating norm of the lower face using the following five regressions: one linear regression for the mandibular length, two quadratic models for the ALFH and PLFH, and two multivariate regressions for the posterior widths of the maxillae and mandible.

Conclusion

The adaptation of quadrilateral analysis can provide accurate 3D characterization of the morphology of the lower face and the floating norm based on millimeter values, which is practical for surgeons. As the 3D extension of quadrilateral analysis could provide references of the lower face, which might be an accurate 3D approach for presurgical planning, the further investigation in bigger sample would be relevant in the practice.

     

Treatment and retention of a mandibular arch telescoped within the maxillary arch: case report

A patient in the early mixed dentition was experiencing "difficulty in eating." The right mandibular posterior teeth were telescoped within the maxillary arch. The mandibular midline deviated to the left of the maxillary midline. With the midlines aligned, posterior occlusion was minimal. By activating a lingual arch, the mandibular arch width was increased to establish a posterior occlusion. Also, the lingual arch was used as a retainer. The posterior occlusion remained stable throughout the mixed dentition. An unexpected second phase of treatment was indicated in the permanent dentition because the maxillary right first and second premolars and the maxillary right second molar were completely buccal to the mandibular teeth. Successful treatment was accomplished in spite of broken appliances and noncompliance.     

快速扩弓和固定矫治联合应用于高角病例的临床观察

目的 评价上颌快速扩弓和固定矫治器联合应用对牙弓、基骨矢状向和垂直向的影响。方法 对30例恒牙列轻中度拥挤病例以上颌快速扩弓和固定矫治器进行非拔牙治疗,分为两组：高角组(下颌平面角>32°;n=20)和均角组(下颌平面角≥22°且≤32°;n=10),分别在T1(治疗前)、T2(快速扩弓3个月后)和T3(固定矫治结束)进行头影测量分析。结果 高角均角患者经过快速扩弓联合固定矫治器治疗后在骨性垂直高度上的变化无差异。下颌平面角在3个时间点均有显著性变化。Y轴角、全面高、前上面高在T1-T2以及T1-T3间有明显增大。结论 快速扩弓虽然会导致上、下颌骨的向下旋转,但由于其变化量的绝对值小,无临床意义。高角不是快速扩弓治疗的禁忌证。     

唇挡对儿童面下部硬软组织侧貌影响的研究

目的　研究唇挡对替牙期及恒牙初期儿童面下部硬软组织侧貌形态的影响。方法　选择替牙期及恒牙初期下颌发育不良伴下牙列轻度或中度拥挤患儿 30例 (男 14例 ,女 16例 ) ,采用下颌唇挡治疗 6～ 10个月 ,进行治疗前后面部硬软组织X线头影测量分析。结果　唇挡治疗后下切牙唇倾 3.2 5°,呈以根尖为转动中心的倾斜移动 ,下颌第一磨牙远中倾斜 6 .13° ,呈以根分叉为转动中心的远中倾斜移动。下颌平面角增加 1.15° ,SNB角与面角无明显改变。颏唇沟厚度平均增加 1.2 3mm ,致使颏唇沟变浅 ,下唇角增大 (6 .0 5°) ,下唇及颏唇沟形态改善。结论　在儿童颌面部生长发育高峰期 ,唇挡可有效促进下颌牙弓生长发育 ,改善面下部硬软组织侧貌形态。     

Changes in the maxillary and mandibular tooth size-arch length relationship from early adolescence to early adulthood. A longitudinal study

The purpose of this study was to determine the association between the changes in maxillary and mandibular tooth size-arch length discrepancies (TSALD) and various dentofacial variables for 18 male and 14 female subjects with normal occlusion. All subjects were participants in the Iowa Longitudinal Growth Study and records were evaluated at two stages of dental development: stage I, when the permanent second molars initially erupted into occlusion (X age = 13.3 years); and stage II, at early adulthood (X age = 26.0 years). The following sets of variables were evaluated: mesiodistal crown diameters of single and groups of permanent teeth, dental arch widths and lengths, curve of Spee, maxillary and mandibular anterior and total crowding or spacing, anterior tooth rotations, and various cephalometric dentofacial parameters. Student's t test were used to compare subjects with the most and least changes. Regression analyses also were used to assess the relationships between these parameters and the changes in the maxillary and mandibular tooth size-arch length relationship. The most consistent finding from the t test comparisons is the significantly greater reduction in the available arch length in the group with the most TSALD at early adulthood. No other variables were found to be consistently different in the comparisons between the two groups. The results of the regression analysis indicated that a number of dentofacial variables are associated with the changes in the maxillary and mandibular TSALD--for example, the mesiodistal diameter of different teeth and the changes in anterior and posterior facial heights. The clinical implications of the present findings are discussed.     

A longitudinal study on growth and development of dental arches of primary, mixed and permanent dentitions

In dental clinic for children, criteria for growth and developmental changes related to increases in the width and length of the dental arch at the primary, mixed, and permanent dentition stages are essential. This study was carried out to measure the width and the length of normal dental arch and to make detailed observations of growth and developmental processes in the dental arch at each dentition stage. Materials were serial study casts of the maxilla and the mandible taken every 2 month from 127 children (74 boys and 54 girls). The casts were made from 6 months after birth until the age of 15. Measurements of the width of the dental arch were made between bilateral teeth of the same tooth type, both deciduous and permanent. The length of the dental arch was measured on the basis of the perpendicular distance from the contact point of mesial surfaces of central incisors to a line between bilateral teeth of the same tooth type. Measured values were categorized according to either chronological age or tooth age on the basis of the eruption of the central permanent incisors. The indices of the dental arch with relation to the width and the length at each dentition stage were calculated for the sake of partial and total observations of alterations in dental arch form. The results were as follows: 1) In terms of chronological age, until 1 year before the eruption of permanent replacements, the width of the dental arch gradually decreased in both the maxilla and the mandible in the regions of the deciduous central and lateral incisors. Increasing slightly from about the age of 6 years and the period of mixed dentition, the width of the dental arch remained stable until the permanent dentition stage. From the primary dentition stage, the width of the dental arch in the region of the maxillary and mandibular canines and first and second molars gradually increased. Therefore it remained stable until the eruption of permanent dentition. The width in the region of the permanent maxillary and mandibular first molars gradually increased and attained a stable condition at about 12 years of age. In males, the width in the area of the maxillary secondary molars decreased slightly and tended to decrease in the mandible. In females, on the other hand, the width showed a tendency to increase with advancing ages. With the exception of the second permanent molars, the width between the distance of bilateral teeth were consistently larger in males than in females.(ABSTRACT TRUNCATED AT 400 WORDS)     

恒牙列早期安氏Ⅲ类错患者下颌边缘运动轨迹的研究

目的　定量定性分析恒牙列早期安氏Ⅲ类错患者下颌边缘运动轨迹的特征及其与颅面形态的关系。 方法　选择恒牙列早期安氏Ⅲ类错患者21例作为试验组,20例恒牙列早期个别正常人作对照组,使用K6-I型 下颌运动描记仪描记两组研究对象的下颌边缘运动轨迹,同时拍摄X线头侧位片,分析二者的相关性。结果　试 验组下颌边缘运动范围与对照组无统计学意义。对照组ICP-最大张口线距与前下面高呈正相关,开口度与下颌支 高度及后面高呈正相关;试验组ICP-最大张口线距与前下面高及下前牙牙槽高度呈正相关,开口度与下颌体长度 及下前牙牙槽高度呈正相关。结论　安氏Ⅲ类错患者的下颌边缘运动与颅面形态的关系和个别正常人不同。     

Dentofacial changes after orthodontic intervention with eruption guidance appliance in the early mixed dentition

OBJECTIVE: To evaluate skeletal and dentoalveolar changes induced by the eruption guidance appliance in the early mixed dentition. MATERIALS AND METHODS: Pre- and posttreatment cephalometric radiographs of 115 consecutively treated children, 62 boys and 53 girls, were compared with those obtained from a control group of 104 children, 52 boys and 52 girls. Pretreatment radiographs were taken at the deciduous-mixed dentition interphase (T1) and after full eruption of all permanent incisors and first molars (T2). The mean age of the children in both groups was 5.1 years at T1 and 8.4 years at T2. RESULTS: A significant difference between the groups at T2 was found in the mandibular length, midfacial length, and maxillomandibular differential. The increase in mandibular length was 11.1 mm in the treatment group and 7.2 mm in the control group. No differences were found in measurements of maxillary position or size. There was a significant shift toward a Class I relationship in the treatment group. Labial tipping and linear protrusion of the mandibular incisors was evident in the treatment group at T2. There was no effect on the inclination or position of the maxillary incisors. CONCLUSIONS: Occlusal correction was achieved mainly through changes in the dentoalveolar region of the mandible. In addition, the appliance enhanced condylar growth resulting in a clinically significant increase in mandibular length. No effect was observed on maxillary position, maxillary size, inclination or protrusion of the maxillary incisors, or facial height.     

A case report of bilateral Brodie bite in early mixed dentition using bonded constriction quad-helix appliance

Brodie bite is a comparatively rare type of malocclusion found in primary and mixed dentition. It not only adversely affects chewing and muscle functions, but also impairs normal growth and development of the mandible. This report describes the therapeutic results of a patient with bilateral Brodie bite in early mixed dentition after using a bonded constriction quad-helix appliance. The patient, a boy aged 9 years and 2 months, first visited our hospital after occlusal abnormality in the molar region was detected at a local dental clinic. Case analysis resulted in a diagnosis of bilateral Brodie bite with slight mandibular retrognathism. Treatment objectives were to reduce the arch width of the maxillary dentition and expand the mandibular arch in order to establish and stabilize molar occlusion and to achieve a Class I molar relation and appropriate overbite and overjet. Treatment comprised covering the occlusal surface of the maxillary molars with resin and attaching a bonded constriction quad-helix appliance joined with a 0.040-inch quad-helix wire. A bi-helix appliance was also fixed to the mandibular dentition. Brodie bite visibly improved after 5 months. Cervical headgear was then fitted and the patient observed until eruption of the permanent dentition was complete. Class I molar relation was achieved after 2 years and 6 months, although spacing remained in the maxillary and mandibular dentitions. Treatment of bilateral Brodie bite in mixed dentition by means of a bonded constriction quad-helix appliance attached to the maxillary dentition enabled effective bite opening and reduction in the width of maxillary arch independent of the patient's cooperation, providing good therapeutic outcome in a short time period.