前方牵引治疗唇腭裂上颌后缩畸形的研究进展

唇腭裂是口腔颌面部最常见的先天性发育畸形,替牙期唇腭裂患者常表现出上颌发育不足、上牙弓狭窄、前后牙反胎、牙齿缺失等颅颌面异常.以往的研究显示,上颌发育不足是唇腭裂患者最常见的畸形之一,由于先天发育异常及多次唇腭裂修复术的影响（手术创伤、术后瘢痕挛缩、异常的肌张力等）,25％～44.3％替牙期唇腭裂患者具有不同程度的上颌后缩畸形.     

自锁托槽对唇腭裂腭扩展短期效果的研究

目的：探讨自锁托槽对单侧完全性唇腭裂患者上颌腭扩展的短期治疗效果。方法选取5例恒牙期单侧完全性唇腭裂（UCLP）患者,未行牙槽突裂骨移植手术,上颌牙齿粘贴自锁托槽（AO, Time2）,放置高弹性镍钛弓丝,采集患者治疗前和腭扩展6~17个月后的牙颌模型、头颅定位后前位片进行测量,分析上颌腭扩展前后患者的牙弓、牙槽骨、腭穹窿以及颌骨的形态变化。结果牙颌模型测量结果提示：第一前磨牙区牙弓宽度明显增大,其次为尖牙区牙弓宽度,第一磨牙区牙弓宽度增加最少,第二磨牙区宽度减小。牙弓长度变化不明显。第一磨牙近中颊向扭转。腭部宽度增加,深度减小。头影测量结果提示：鼻腔宽度、上颌基骨宽度和上颌磨牙宽度稍有增加。结论唇腭裂自锁托槽腭扩展后上颌牙颌形态在横向宽度的变化较矢状向的变化明显。短期腭扩展治疗效果以牙齿移动和牙槽改建为主。     

钕铁硼永磁体扩大唇腭裂患者上颌狭窄的应用研究

本实验采用第三代稀土永磁体钕铁硼产生的力，对上颌发育不足、牙弓狭窄的唇腭裂患者进行扩大上颌治疗，并与机械力扩大上颌进行比较。结果表明，磁力扩大唇腭裂患者上颌是可行的；与机械力相比，磁力扩大上颌患者的牙弓长度明显增大，ＳＮＡ角也均增大，说明磁力扩大上颌对改善唇腭裂患者上颌发育不足有利。治疗前后静脉血血气分析结果表明了磁力扩大上颌的生物安全性。     

成人腭裂患者牙弓形态的比较研究

目的 探讨腭裂畸形本身及修复术对牙弓形态发育的影响.方法 应用牙颌模型CT扫描测量系统,对比分析正常(牙合)成人、单侧完全性唇腭裂(UCLP)均已修复组以及腭裂未修复组成人患者牙弓形态特征.结果 腭裂术后组上颌牙弓各段宽度、牙弓前段长度均显著小于未手术组(P ＜ 0.01);未手术组上颌牙弓前段宽度、上下颌牙弓长度均显著小于正常组(P ＜ 0.01),而上下颌牙弓后段宽度大于正常组(P ＜ 0.001).结论 腭部裂隙对上颌牙弓发育的影响仅仅局限于牙弓前部裂隙邻近的区域,腭裂手术是造成上颌牙弓宽度缩窄的主要原因,同时也抑制了上颌牙弓前段长度发育.     

慢速腭扩展临床研究进展

腭扩展是正畸常用的矫治上颌横向发育不足及上颌牙弓狭窄的固定矫治技术。腭扩展分为快速腭扩展和慢速腭扩展,由于快速腭扩展矫治力较大,存在副作用,而慢速腭扩展可提供更接近生理性的力,严格掌握适应证,可取得较好的临床效果。本文就慢速腭扩展的矫治器类型、骨性和牙性改变以及与快速腭扩展的比较作一综述。     

单侧完全性唇腭裂术后牙弓间横向关系的不调及正畸矫治后变化的探讨

目的 :探讨单侧完全性唇腭裂术后患者上下颌牙弓间横向关系以及正畸治疗对上颌牙弓的影响。方法 :对 84名单侧完全性唇腭裂术后患者的错畸形和上下颌颌间关系进行研究 ;并对 36名唇腭裂术后患者进行正畸治疗前后的牙模型进行测量分析上颌牙弓宽度的变化。结果 :(1)单侧完全性唇腭裂术后 6 0 .7%的患者出现牙弓间横向关系的不协调 ,双尖牙区较易受累。 (2 )在出现牙弓间横向关系不调的患者中 ,双侧后牙反者为 6 0 %。 (3)正畸治疗后上颌牙弓的尖牙、第一、第二双尖牙间各自的宽度均有显著增加 ,第一磨牙间宽度变化不显著。上颌第一、第二双尖牙间各自宽度较尖牙间、第一磨牙间宽度增加显著。结论 :单侧完全性唇腭裂术后患者上颌宽度的发育受到明显的限制 ,牙弓间横向关系不协调的比率较高 ,以双尖牙区为主 ;正畸矫治扩弓的重点应在双尖牙区。     

单侧完全性唇腭裂术后牙弓问横向关系的不调及正畸矫治后变化的探讨

目的 探讨单侧完全性唇腭裂术后患者上下颌牙弓间横向关系以及正畸治疗对上颌牙弓的影响。方法 对84名单侧完全性唇腭裂术后患者的错(牙合)畸形和上下颌颌间关系进行研究;并对36名唇腭裂术后患者进行正畸治疗前后的牙(牙合)模型进行测量分析上颌牙弓宽度的变化。结果 (1)单侧完全性唇腭裂术后60.7％的患者出现牙弓间横向关系的不协调,双尖牙区较易受累。(2)在出现牙弓间横向关系不调的患者中,双侧后牙反(牙合)者为60％。(3)正畸治疗后上颌牙弓的尖牙、第一、第二双尖牙间各自的宽度均有显著增加,第一磨牙间宽度变化不显著。上颌第一、第二双尖牙间各自宽度较尖牙间、第一磨牙间宽度增加显著。结论 单侧完全性唇腭裂术后患者上颌宽度的发育受到明显的限制,牙弓间横向关系不协调的比率较高,以双尖牙区为主;正畸矫治扩弓的重点应在双尖牙区。     

恒牙列早期单侧完全性唇腭裂术后患者牙特征的研究

作者对332名恒牙早期间侧完全性唇腭裂术后患者和同龄正常青少年的牙模型进行测量分析，结果表明：①上颌牙弓、基骨的生长发育受到明显影响，其中腭盖高度发育受限最为明显。②上颌牙弓前段宽度发育受限程度明显大于牙弓后段，上颌结节区宽度缩窄不明显。③上颌与下颌牙弓、基骨关系不协调。     

唇腭裂患者错畸形综合治疗的疗效分析

唇腭裂患者往往同时存在全牙弓反牙合、牙列不齐、缺失牙、阻生牙、牙槽裂隙、颌骨发育异常等多种畸形 ,因此治疗难度大 ,疗程较长[1] 。现将我们治疗并在治疗后观察至 12岁～ 15岁以上的 16例唇腭裂患者的方法及结果进行总结 ,分析各年龄段唇腭裂畸形治疗的疗效。一、材料和方法16例 7～ 16岁唇腭裂修复术后患者 ,均伴有不同程度的全牙弓反牙合、颌骨发育异常及其它畸形。①采用螺旋扩弓器或磁力扩弓矫治器进行扩弓治疗 ,解除后牙反牙合 ,上牙弓狭窄等畸形 ,以促进上颌发育。②对存在下颌发育过度的患者 ,戴用头帽颏兜抑制下颌的过度发育。…     

单侧完全性唇腭裂术后患者牙弓间宽度不调的矫治

目的　通过对单侧完全性唇腭裂术后患者上下颌间牙弓宽度不调的研究及对患者正畸治疗的临床观察 ,总结该类患者正畸治疗的特点。方法　对 4 8例单侧完全性唇腭裂术后患者进行临床检查 ,记录其上下牙弓间的宽度关系 ;根据患者错情况制定不同的治疗方案进行临床治疗。结果　 (1)单侧完全性唇腭裂术后患者中出现上下颌牙弓宽度不调的比率为 6 0 .4 % ,双侧后牙反为 33.3% ,单侧后牙反为 16 .7%。男女之间差异无显著性。 (2 )宽度不调以双尖牙区为重 ,上尖牙区是扩弓治疗的重点。 (3)磨牙区牙弓宽度的不协调常较轻微 ,一些患者甚至上颌最后磨牙区略宽 ,对 5例患者 (占 10 4 % )进行了上颌磨牙的腭向移动。结论　单侧完全性唇腭裂患者正畸治疗中上颌多需扩弓 ,且扩弓潜力较大。对于严重拥挤的患者 ,拔牙决定应在扩弓后作出。扩弓治疗应在牙槽突植骨前进行 ,扩弓后需延长保持时间     

Diagnosis and management of hemangiomas and vascular malformations of the head and neck

Oral Diseases (2010) 16 , 405–418 Vascular anomalies are congenital errors in vascular development. They frequently involve the head, neck, and oral cavity. Subdivided into vascular tumors (hemangiomas) and vascular malformations, vascular anomalies remain poorly understood. However, growing interest and recent advances in the diagnosis, management, and molecular characterization of these lesions are improving treatment strategies. The role of the multidisciplinary team cannot be overstated. This review provides both basic and up‐to‐date knowledge on the most common vascular anomalies encountered by physicians and practitioners. Because treatment options for vascular anomalies are widely variable and often debated, this report aims to provide a comprehensive approach to these lesions based upon current concepts and practical clinical experience.     

口腔颌面-头颈部胚胎型横纹肌肉瘤临床诊治探讨

目的:探讨头颈部胚胎型横纹肌肉瘤的临床特点、诊断、治疗及预后.方法:回顾性分析上海交通大学医学院附属第九人民医院2000-09--2010-10收治的12例头颈部胚胎型横纹肌肉瘤患者的临床资料.结果:12例患者中9例获得随访.5例术前化疗患者中3例短期疗效达到PR,1例达到MR,化疗有效率达到60%;8例患者行手术治疗...     

Assessment and comparison of phagocytic function and viability of polymorphonuclear leukocytes in saliva of smokers and non-smokers

OBJECTIVES

Tobacco use is one of the most important public health problems worldwide. It is also linked to impairment of normal immunologic surveillance and defence mechanism of polymorphonuclear leukocytes. Tobacco smoke and its components have been seen to affect the phagocytic ability and viability of polymorphonuclear leukocytes suggesting the pathogenesis of tobacco induced oral diseases. Aim of this study was to assess and compare the phagocytic function and viability of polymorphonuclear leukocytes in saliva of smokers and non smokers.

DESIGN

The study comprised of 35 smokers and 35 non-smokers, age matched. Saliva was collected by rinsing method and the polymorphonuclear leukocytes were separated. Phagocytic activity was determined by using latex spheres as targets. Cell viability was measured using trypan blue stain.

RESULTS

Salivary polymorphonuclear leukocytes in smokers showed significant reduction in the phagocytic activity by ingesting few latex spheres when compared to the non-smokers. The viability of these cells in saliva of smokers was significantly reduced.

CONCLUSIONS

The present study revealed reduced phagocytic activity and viability of salivary polymorphonuclear leukocytes in smokers compared to non-smokers. These findings indicate that smokers are more prone to gingival, periodontal and other oral diseases. Thus indicating that the health care professionals should encourage smoking cessation as an aid in preventing oral diseases.     

Comparison of antimicrobial and cytotoxic effects of glutaraldehyde and formocresol

The in vitro antimicrobial and cytotoxic concentrations of glutaraldehyde and formocresol were determined. Minimal antimicrobial concentrations of these two agents against selected microbial flora reported in carious primary teeth were 3.125% for glutaraldehyde and 0.75% for formocresol. At a doubling of these concentrations, most organisms, except Candida albicans, Staphylococcus epidermidis, and Streptococcus mutans, were killed by both substances in 30 seconds. Cytotoxicity was evaluated on tissue cultures of pulp fibroblasts and HeLa cells at minimal cidal concentrations and at 10- and 100-fold dilutions. Exposure of pulp fibroblasts and HeLa cells to formocresol and indirect exposure to vapors caused the cells to become atrophic and to form a less dense tissue pattern. Cells directly exposed to glutaraldehyde retained their normal cell shape and tissue pattern, whereas cells indirectly exposed to vapors continued to proliferate. These data showed effective antimicrobial activity at concentrations of 3.125% glutaraldehyde and 0.75% formocresol and suggested that glutaraldehyde may exert a less cytotoxic effect on the immediate and surrounding tissues when used as a pulpotomy agent.     

Comparison of etidocaine and lidocaine for control of intra- and post-operative bleeding and pain

Etidocaine hydrochloride, an amide-type of local anesthetic with prolonged duration of action, was evaluated and compared with the standard local anesthetic lidocaine to determine its efficacy of action and its effect on bleeding during and following the removal of impacted mandibular third molar teeth. The findings indicate that 1.5% etidocaine hydrochloride with 1:200,000 epinephrine, in comparison with 2% lidocaine with 1:100,000 epinephrine, produces anesthesia comparable to that obtained with lidocaine but results in greater measured intraoperative blood loss.