应用超声骨刀拔除下颌第三磨牙临床效果的Meta分析

目的:采用Meta分析评价应用超声骨刀拔除下颌第三磨牙的临床效果。方法:计算机检索CBM、CNKI、VIP数据库和万方数据库,同时对检索结果的参考文献进行检索,检索时间为建库至2019-03-01,搜集应用超声骨刀与单纯涡轮钻法拔除下颌阻生第三磨牙临床效果的随机对照试验文献,对检索结果进行独立质量评估和数据提取,采用RevMan 5.3软件进行Meta分析。结果:9篇文献纳入研究分析,包括实验组534例,对照组529例。Meta分析表明应用或者联合应用超声骨刀与单纯涡轮钻法拔除下颌阻生第三磨牙相比,手术时间缩短(P<0.01),术后疼痛程度减轻(P<0.01),肿胀和张口受限的发生率降低(P<0.01)。结论:应用或联合应用超声骨刀法拔除下颌阻生第三磨牙的临床效果优于单纯涡轮钻方法。     

牙冠延长术中使用超声骨刀的护理要点

总结在牙冠延长术中,使用超声骨刀进行牙槽骨修整及成形的护理要点和注意事项,以期为相关临床护理指南提供理论依据.回顾四川大学华西口腔医院牙周科在牙冠延长术中采用超声骨刀进行牙槽骨修整的20例患者资料,结合临床护理经验,对超声骨刀在牙槽骨修整及成形的应用优势、临床护理配合要点、超声骨刀器械维护进行总结.超声骨刀应用于牙冠延长术能为手术安全性提供有力保障,有利于医生精准、高效的操作,有利于降低患者不适反应.术前、术中、术后全方位的护理配合以及正确的器械维护能够为手术的成功开展提供有力的支持.有效、全面地护理能为超声骨刀在牙冠延长术中的成功开展提供有力支持.     

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目的总结超声骨刀在真性颞下颌关节强直手术中的临床应用经验,评价其临床效果。方法 2007—2010年在深圳市人民医院口腔医学中心对11例真性颞下颌关节强直病例,应用超声骨刀进行截骨,形成间隙,完成裂隙关节成形术9例以及间置物关节成形术2例。观察超声骨刀的临床使用特点和临床效果。结果 11例真性颞下颌关节强直患者均顺利完成关节成形术,无损伤关节内侧面动脉而引起大出血和颅底损伤,伤口均一期愈合。结论应用超声骨刀实施真性颞下颌关节强直手术,手术安全,精确度高,损伤小。     

压电超声骨刀在颌骨囊肿摘除术中的临床应用

目的：总结压电超声骨刀在颌骨囊肿摘除术中的临床应用特点,并评价其临床效果。方法：对4l例颌骨囊肿病例,应用压电超声骨刀进行骨开窗,其中8例配合使用电钻,摘除囊肿,6例囊腔用钛板将游离的自体骨块复位固定,关闭骨腔。观察超声骨刀的临床使用特点及临床效果。结果：4l例均完整摘除颌骨囊肿,其中1例因术中操作不当致鼻底黏膜损伤,其余病例无软组织损伤。伤口一期愈合。8例配合使用电钻者,骨切割效率明显提高。结论：颌骨囊肿摘除术中应用压电超声骨刀,手术精确度高,安全,方便。     

超声骨刀在口腔颌面外科领域的研究进展

超声骨刀是基于压电效应的原理设计出的一种新型骨切割设备,具有选择性切割矿化硬组织、创伤及产热小、精确性高、减少术中出血、操控性好等诸多优点,目前被广泛应用于口腔颌面外科。大部分学者认为超声骨刀可促进骨愈合、保护软组织。本文就超声骨刀对软硬组织影响的基础研究、口腔颌面外科中的临床应用进展作一综述。     

超声骨刀在根尖囊肿刮治术中的应用效果观察

目的：评价超声骨刀在根尖囊肿刮治术中的应用效果。方法：应用超声骨刀对29例根尖囊肿行囊肿刮治术,术后观察病变区的变化。结果：29例在观察期内预后均良好。结论：超声骨刀应用于根尖囊肿刮治术可获得很好的疗效。     

自制超声骨刀专用吸引器头在阻生第三磨牙拔除术中的应用

目的介绍自制超声骨刀专用吸引器头的制作及应用于阻生第三磨牙拔除术中的效果观察。方法选择拔牙难度判断为＂较难＂的下颌阻生第三磨牙114例,将自制超声骨刀专用吸引器头配合超声骨刀应用于阻生第三磨牙拔除术中。结果该吸引器头能及时吸走超声骨刀操作中产生的唾液、碎屑和气雾,提高术野清晰度和骨切割效率,同时能牵拉黏骨膜瓣,提高手术效率。结论自制吸引器头简单实用,值得临床应用。     

超声骨刀在上颌窦底提升牙种植术中的应用

在上颌磨牙区牙槽骨高度不足的情况下,种植牙修复上颌后牙,常常需要提升上颌窦底黏膜。相比于传统的提升器械,超声骨刀在上颌窦底提升技术上,显示出明显的优势。超声骨刀刀头特有的切割方式可使其在切割过程中不损伤软组织,可调节的超声震动频率和骨切割时超声水流的冲击作用,也可显著降低上颌窦黏膜穿孔的发生率。本文就超声骨刀的工作原理、及在上颌窦底提升技术中的临床应用等作一介绍。     

超声骨刀在上颌磨牙分根术及半切术中的应用

目的探讨上颌磨牙使用超声骨刀行分根术及半切术后行桩核冠修复的临床疗效。方法临床选择符合条件的18颗存在严重牙体缺损的上颌磨牙,完善根管治疗后应用超声骨刀行分根术或半切术,必要时做牙冠延长术,根分叉有炎症先行牙周治疗,而后行桩核联冠或腭侧单冠修复。随访2年。结果 1例患者于1年后失访,其余17颗患牙均能保持良好的咀嚼功能,患者无明显不适,X线片示牙槽骨无明显吸收。结论应用超声骨刀行分根术及半切术联合桩冠修复对治疗严重缺损上颌磨牙有良好的临床效果。     

超声骨刀在下颌磨牙分根术及半切术中的应用

目的:评价应用超声骨刀进行分根术及半切术后行桩核冠桥修复的临床疗效。方法:临床选择符合条件的27颗下颌磨牙进行完善的根管治疗后应用超声骨刀行分根术或半切术,必要时做冠延长术,根分叉有炎症先行牙周治疗,而后做桩核联冠或固定桥修复。随访2年。结果:除一颗患牙牙周炎进展导致牙周脓肿松动拔除外,其余26颗患牙均能保持良好的咀嚼功能,患者主观感受无明显不适,X片示牙槽骨无明显吸收或少量增生。结论:应用超声骨刀行牙分根术及半切术联合冠桥修复对治疗严重缺损下颌磨牙具有良好的临床效果。     

Piezosurgery in oral and maxillofacial surgery

This review summarizes current knowledge and experience with piezosurgery, a promising, meticulous and soft tissue-sparing system for bone cutting, based on ultrasonic microvibrations. The main advantages of piezosurgery include soft tissue protection, optimal visibility in the surgical field, decreased blood loss, less vibration and noise, increased comfort for the patient and protection of tooth structure. To date it has been indicationed for use in oral and maxillofacial surgery, otorhinolaryngology, neurosurgery, ophthalmology, traumatology and orthopaedics. The main indications in oral surgery are sinus lift, bone graft harvesting, osteogenic distraction, ridge expansion, endodontic surgery, periodontal surgery, inferior alveolar nerve decompression, cyst removal, dental extraction and impacted tooth removal. In conclusion, piezosurgery is a promising technical modality for different aspects of bone surgery with a rapidly increasing number of indications throughout the whole field of surgery.     

Technological advances in extraction techniques and outpatient oral surgery

There have been several exciting technological advances in extraction techniques and outpatient oral surgery within the last decade. A variety of new instruments and techniques are revolutionizing the fields of oral and maxillofacial surgery and dentistry. This article reviews the newer innovations in dentistry including the powered periotome, piezosurgery, the Physics Forceps, laser therapy, orthodontic techniques, and use of polyurethane foam.     

Applications of Piezoelectric Surgery in Endodontic Surgery: A Literature Review

Introduction

Piezosurgery (piezoelectric bone surgery) devices were developed to cut bone atraumatically using ultrasonic vibrations and to provide an alternative to the mechanical and electrical instruments used in conventional oral surgery. Indications for piezosurgery are increasing in oral and maxillofacial surgery, as in other disciplines, such as endodontic surgery. Key features of piezosurgery instruments include their ability to selectively cut bone without damaging adjacent soft tissue, to provide a clear operative field, and to cut without generating heat. Although piezosurgery instruments can be used at most stages of endodontic surgery (osteotomy, root-end resection, and root-end preparation), no published data are available on the effect of piezosurgery on the outcomes of endodontic surgery. To our knowledge, no study has evaluated the effect of piezosurgery on root-end resection, and only 1 has investigated root-end morphology after retrograde cavity preparation using piezosurgery.

Methods

We conducted a search of the PubMed and Cochrane databases using appropriate terms and keywords related to the use and applications of piezoelectric surgery in endodontic surgery. A hand search also was conducted of issues published in the preceding 2 years of several journals. Two independent reviewers obtained and analyzed the full texts of the selected articles.

Results

A total of 121 articles published between January 2000 and December 2013 were identified. This review summarizes the operating principles of piezoelectric devices and outlines the applications of piezosurgery in endodontic surgery using clinical examples.

Conclusions

Piezosurgery is a promising technical modality with applications in several aspects of endodontic surgery, but further studies are necessary to determine the influence of piezosurgery on root-end resection and root-end preparation.     

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超声骨刀手术系统是指利用压电超声频率微振荡刀进行切骨术与骨整形术的一种创新性的骨外科手术设备,具有软硬组织识别功能,同时采用冷切割模式,可确保手术过程中最大的精确性与安全性.目前,它在口腔手术中已有较多应用,主要用于各种复杂的切割手术,比如口腔外科手术中的骨开窗、骨开裂、矫正等.     

超声骨刀在口腔领域中的应用

超声骨刀手术系统是指使用压电超声频率微振荡刀进行切骨术与骨整形手术的一种创新性的骨外科手术设备,具有软硬组织识别功能,同时采用冷切割模式,可确保手术过程中最大的精确性与安全性。目前,它在口腔骨外科手术中已有较多应用。本文就超声骨刀的工作原理、技术特点及其在口腔领域中的应用等方面作一综述。     

华西口腔医院口腔颌面创伤专科医师规范化培训的实践探索

专科医师规范化培训是我国毕业后医学教育的重要组成部分,已经从局部试点转入了全面实施阶段。口腔颌面创伤是口腔颌面外科重要亚专业,目前我国口腔颌面创伤外科专科医师数量较少,主要集中在大城市的少数专科医院中,尚缺乏全面系统的规范化培训。文章通过分析我国口腔颌面创伤专科医师规范化培训现状,介绍华西口腔医院口腔颌面创伤专科医师规范化培训体系方面的经验,为培养能够独立规范地承担口腔颌面创伤专科常见多发疾病、疑难重症诊疗工作且具备良好执业道德的高素质口腔颌面创伤专科人才提供参考。     

Perioral soft-tissue rejuvenation techniques to enhance esthetic restorative dentistry

Every practitioner has the obligation to offer his or her patients the latest advances in their profession. Dentistry has made a shift over the past 50 years from caries restoration and prosthetic replacement to preventative and esthetic rejuvenation. Related dental specialties have also blossomed with new procedures and an expanded scope of practice. This shift has also included more comprehensive care and treatment of the oral and maxillofacial region. Modern esthetic dentists realize the facial soft tissues serve as a frame for their restorative artwork. Contemporary oral and maxillofacial surgery includes cosmetic facial surgery. Procedures for such surgery are taught in oral and maxillofacial surgery residency programs, are part of the oral and maxillofacial surgery board exams, and are covered by oral and maxillofacial surgery malpractice companies. Esthetic dentists should understand facial aging, as well as the basic procedures available for facial rejuvenation by the oral and maxillofacial surgeon. Contemporary esthetic dentistry goes beyond the oral cavity, and the smile is truly enhanced by simultaneous facial rejuvenation. This article discusses the process of perioral facial aging and various cosmetic facial surgery options.     

Cosmetic oral and maxillofacial surgery options

BACKGROUND: Dentistry and its related specialties have made exponential increases in the functional and cosmetic treatment of the maxillofacial region. Oral and maxillofacial surgeons historically have been involved in functional and cosmetic rejuvenation of the face, and newer technologies have enhanced the ability to make patients look and feel better. METHODS: Cosmetic oral and maxillofacial surgery is being taught in residency programs, is included in the oral and maxillofacial surgery board examinations and represents a part of contemporary oral and maxillofacial surgery. The author discusses common facial rejuvenation procedures with an emphasis on newer treatment technologies. RESULTS: Many oral and maxillofacial surgeons have the ability to improve the esthetics of the maxillofacial area and related structures. The large number of aging baby boomers and technological advances in cosmetic facial surgery have made these procedures easier to perform and more popular than ever. CONCLUSION: A global diagnosis and treatment plan to include facial esthetics can enhance cosmetic dentistry and serve to frame the work of the restorative dentist. The oral and maxillofacial surgeon can help the dentist and patient pursue both functional and cosmetic improvement with safe and effective procedures. CLINICAL IMPORTANCE: All dentists should be aware and abreast of advances in all areas of dentistry and have a basic understanding of available procedures that can benefit their patients. Cosmetic oral and maxillofacial surgery can enhance the work of the restorative dentist and improve facial esthetics, as well as enhance the well-being of the patient.     

Tracheostomy-dependent child with temporomandibular ankylosis and severe micrognathia treated by piezosurgery and distraction osteogenesis: case report

Ankylosis of the temporomandibular joint in children is one the most difficult and complex conditions managed by oral and maxillofacial surgeons, and often leads to some facial deformity. Distraction osteogenesis of the mandible provides an excellent treatment for mandibular airway obstruction in children who do not respond to conservative measures, and allows for early removal of the tracheostomy. We report the case of a 1-year-old boy with severe micrognathia and temporomandibular ankylosis who was dependent on a tracheostomy; he was treated with piezosurgery and mandibular advancement by distraction osteogenesis.     

持续发展,与时俱进——我国口腔颌面外科发展之前瞻

2006年伊始,传来阵阵喜讯：2006是“十一五”规划起始之年：是强调以自主创新为主的第6次全国科技大会胜利召开之年；也是《国家中长期科学和技术发展规划纲要(2006～2020年)》正式公布之年……,这一切一切,给我国科技界、生命科学和医学界,给我国口腔颌面外科事业的发展带来了新的挑战和新的机遇。1当前生命科学及医学的发展趋势1．1生命科学的内涵和在科技领域中的地位