绝经后骨质疏松症与牙周炎

绝经后卵巢功能衰退，引起体内雌激素缺乏，妇女对骨质疏松症的易感性增加。绝经后骨质疏松症可造成妇女全身骨量减少，骨折危险性增加。它对牙周炎的发生、发展是否有影响，尚未定论。本文回顾了近些年来国内外所做的相关研究，提供了绝经后骨质疏松症和雌激素缺乏作为牙周炎的危险因素的依据及可能存在的机制。     

雌激素缺乏对大鼠实验性牙周炎骨吸收的影响

目的评价雌激素缺乏及雌激素替代治疗(ERT),对大鼠实验性牙周炎牙槽骨吸收的影响。方法选取Wistar雌性大鼠24只,随机分成三组,Ⅰ组假手术组(n=8)、Ⅱ组卵巢摘除(OVX)组(n=8),Ⅲ组OVX 雌激素给药组(n=8)。21天后,将大鼠一侧上颌第一磨牙的牙周结扎,60天后,处死动物,取材,测得双侧磨牙的骨吸收量。结果结扎侧Ⅱ组的骨吸收量显著高于Ⅰ、Ⅲ组,有统计学意义,P<0.05;Ⅰ、Ⅲ组相比无统计学差别,P>0.05。结论ERT可能有效地防止雌激素缺乏状态下的牙槽骨吸收,但对于伴有菌斑刺激引起的牙周炎,ERT尚不能有效地阻止牙槽骨的吸收。     

绝经后骨质疏松大鼠实验性牙周炎动物模型研究

目的:通过卵巢切除术及钢丝结扎法建立绝经后骨质疏松大鼠实验性牙周炎动物模型。方法:选用3~4月龄雌性SD大鼠16只,随机分为假手术组(SHAM)、卵巢切除组(OVX),每组8只,卵巢切除术1周后进行钢丝结扎,于实验第8周处死大鼠,通过体重、骨密度测量、血清生化检测及组织学观察对动物模型进行评价。结果:与SHAM组相比,OVX组大鼠术后体重明显增加,血清碱性磷酸酶水平显著增高,而雌二醇水平及全身骨密度值明显降低(P<0.01)。股骨骨小梁数量减少,较为稀疏不连续。钢丝结扎侧磨牙牙龈乳头炎症明显,上皮钉突增生,牙槽嵴顶高度降低,OVX组牙槽骨呈疏松性改变,骨吸收明显高于SHAM组。结论:采用卵巢切除术及钢丝结扎法可建立绝经后骨质疏松大鼠实验性牙周炎动物模型,为探讨绝经后骨质疏松与牙周炎的相互作用及其机制提供了有效的手段。     

雌激素对去卵巢大鼠牙槽骨组织结构和MT1-MMP表达的影响

目的:研究雌激素对去卵巢大鼠牙槽骨组织结构、MT1-MMP表达的影响.方法:对大鼠牙槽骨组织石蜡切片进行HE染色和MT1-MMP免疫组化染色,观察不同时期的正常大鼠、去卵巢大鼠和去卵巢后补充雌激素大鼠的牙槽骨组织结构情况和牙槽骨中MT1-MMP的表达及其分布特征.结果:雌激素缺乏会导致大鼠牙槽骨的骨代谢失衡,牙槽嵴与固有牙槽骨吸收、破坏;成骨细胞和骨细胞MT1-MMP表达降低,而破骨细胞MT1-MMP表达升高.结论:雌激素缺乏引起牙槽骨吸收,MT1-MMP表达水平和分布部位变化可能对其有调节作用.     

卵泡刺激素在女性绝经后骨质疏松及口腔骨吸收疾病中的研究

卵泡刺激素是(Follicle stimulating hormone,FSH)是由动物脑垂体前叶嗜碱性细胞合成与分泌的一种糖蛋白类促性腺激素。近年来,研究发现FSH可独立于雌激素调节骨量,影响绝经后骨质疏松。绝经后骨质疏松可影响牙槽骨骨量,在口腔骨吸收疾病中,起到一定作用。本文就FSH的研究背景及其对骨质疏松和口腔骨吸收疾病的影响作一综述。     

雌激素通过信号通路对成骨细胞分化、成熟与凋亡的调控

绝经后骨质疏松（postmenstrual osteoporosis,PMOP）是由于妇女绝经后雌激素水平下降导致以骨量减少、骨微观结构退化为主要特征的骨形成与骨吸收失衡的骨转换型骨病,目前已证实雌激素可通过多个环节影响骨骼的生长和重构,如成骨细胞和破骨细胞的增殖、分化、钙化、骨基质沉积、凋亡等,骨质疏松改变可使大鼠种植体一骨界面骨融合指数降低、新骨生成量减少,本文针对雌激素对成骨细胞分化、成熟与凋亡的调控机理研究进展作一综述。     

雷洛昔芬防治骨质疏松大鼠牙周炎牙槽骨吸收的实验研究

目的:探讨雷诺昔芬对骨质疏松大鼠实验性牙周炎牙槽骨吸收的防治作用.方法:选用3~4 月龄雌性SD大鼠,随机分为假手术组(SHAM)、卵巢切除组(OVX)、雷诺昔芬治疗组(RAL)及雌激素治疗组(EST),每组8 只.采用卵巢切除术及钢丝结扎法建立骨质疏松大鼠实验性牙周炎动物模型,灌胃给药7 周后处死,通过体重、骨密度测量、血清生化检测及组织学观察对药效进行评价.结果: RAL 组大鼠骨密度值明显高于OVX 组,血清碱性磷酸酶及骨钙素水平下降,而血清雌二醇水平显著增加.股骨骨小梁排列整齐,皮质骨致密,与EST 组及SHAM 组比较无明显差别.OVX 组牙周炎牙槽骨吸收(0.33±0.02) mm2,明显大于RAL、EST 组及SHAM 组[(0.18±0.02) mm2、(0.19±0.02) mm2、(0.20±0.01) mm2](P<0.01).结论: 雷诺昔芬可在一定程度上抑制骨质疏松大鼠实验性牙周炎所致病理性牙槽骨吸收.     

雌性激素对牙槽骨骨量的影响

本实验采取切除大鼠双侧卵巢制造人工绝经模型,观察雌激素缺乏对股骨与牙槽骨骨质疏松产生的影响。采用骨密度测定,骨小梁参数测定,包括骨小梁体密度(TBV),骨小梁板厚度(MTPT)和平均骨小梁板间隙(MTPS),同时检测骨Ca、Mg含量,血清Ca、Me、P、ALP及空腹尿Ca/cr值。结果表明,雌激素水平低下与股骨、牙槽骨骨密度降低有正相关性,骨小梁参数亦表现相应的改变。给予去势动物雌激素治疗后骨密度有所增加。以上结果并得到组织学证实,说明雌激素缺乏是引起牙槽骨骨质疏松的原因之一。     

大豆异黄酮预防绝经后牙槽骨骨质疏松的动物实验

目的:探讨大豆异黄酮对绝经后牙槽骨骨质疏松的防治作用。方法:将32只3月龄雌性SD大鼠随机分为4组,适应性喂养1周后,A组为假手术组,B、C、D组均摘除双侧卵巢。C组大鼠于术后1周开始肌肉注射苯甲酸雌二醇(0.1mg/kg),每周1次。而A、B和D组肌肉注射等量橄榄油。D组大鼠于术后1周开始每天给予大豆异黄酮混悬液灌胃(100mg/kg)。其余3组用等量生理盐水灌胃。各组动物在同等条件下饲养,自由进食、饮水。实验结束后处死动物,收集大鼠下颌骨标本。对组织HE染色切片进行骨形态及计量学分析。结果:去卵巢后,大鼠牙槽骨呈疏松样改变。大豆异黄酮治疗后的D组.骨小梁面积、骨小梁周长、骨小梁面积比、骨小梁数量及分离度与去卵巢的B组有显著性差异,而与雌激素治疗的C组无显著性差异。结论:雌激素缺乏可引起牙槽骨骨质疏松。大豆异黄酮与雌激素一样。可以抑制破骨细胞性骨吸收.并对骨形成有刺激作用。     

雌激素对骨质疏松大鼠牙槽骨改建过程中IL-1表达的影响

目的:研究雌激素对骨质疏松牙槽骨改建过程中白细胞介素-1(IL-1)的分布及表达的影响,探讨雌激素对骨质疏松牙槽骨改建影响的机制。方法:利用大鼠卵巢切除术制成骨质疏松模型,并运用免疫组化染色方法及半定量分析,观察IL-1在骨质疏松及雌激素治疗后的牙槽骨中的表达变化。结果:IL-1在骨质疏松牙槽骨中的表达明显增强,阳性反应主要分布于破骨细胞、部分成骨细胞中,而经雌激素治疗后,IL-1的阳性表达明显下降。结论:雌激素对骨质疏松大鼠牙槽骨中IL-1的表达有明显的抑制作用。     

Mood and malignancy: head and neck cancer and depression

Head and neck cancer patients have been reported to show high rates of depression. However, it is important to differentiate between depressive symptoms and a depressive disorder. This review critically examines the relationship between head and neck cancer and depression. There appears to be little evidence for depression leading to an increased risk of developing cancer and although depressive symptoms in head and neck cancer patients are common, very few studies have investigated depressive disorders. The studies that investigated the incidence of a comorbid depressive disorder report a prevalence very close to that of the general population, implying that major depression is not a normal response to cancer. Finally, the evidence suggests that comorbidity of depression with cancer has a negative impact on morbidity and mortality. Both psychosocial and biological factors could account for this. Dysregulation of the stress hormone axis and increased inflammation are common in depressive disorders and have been suggested as underlying pathological mechanisms and are both markers of poor prognosis in cancer. This evidence suggests that a relatively small number of patients develop a depressive disorder following a diagnosis of cancer, but for those that do it may have a substantial impact on their prognosis.     

低氧和自噬与肿瘤的发生发展

自噬作为真核生物的一种应激调控机制,既可以促进肿瘤的发生发展,又可以抑制肿瘤的增殖。在肿瘤局部低氧的微环境下,低氧诱导因子-1α、哺乳动物雷帕霉素靶蛋白信号转导通路抑制、内质网应激均可促进自噬的发生。在肿瘤快速地发生发展过程中,肿瘤的糖代谢功能增强、活性氧族增多、窖蛋白1下调以及上皮间质转化的激活均诱导了自噬的发生并促进肿瘤的局部浸润、侵袭转移和耐药,因此,抑制自噬可能为肿瘤治疗提供一种新的策略。     

Survey of Australian and New Zealand Oral and Maxillofacial Surgery trainees and recent specialists--education and experience

This study examined the demographic characteristics, educational background and attitudes toward training of all recent OMS specialists and all current trainees in Australia and New Zealand in 1996. The early nineties is a key period as it marks the transition from an essentially dentally based speciality (85% dental degree in 1990); to recent specialists with an increasing number with both medical and dental degrees (33% dual degree 1990-1996); to predominantly dual degree training (84.4% dual in 1996). Current trainees had more extensive experience in pathology, preprosthetic and reconstructive surgery. They were also strongly critical of the length and cost of training.     

Open bite and and therapeutic strategy

Anterior open bites can be divided into two categories: skeletal and dento-alveolar. The etiology, basically affecting dento-alveolar structures, is functional or mechanical such as the rotation of the first higher molars, the exaggerated curve of Spee and the incisor supraclusion and the simple orthodontic treatment can bring a therapeutic success but functional rehabilitation remains the guaranty of such a stability of our treatment. The purpose of this work is to make a teaching article which puts the point on the interest of the elements of the diagnosis and the orthodontic treatment indicated in certain clinical situations of anterior open-bite; this by detailing biomechanics of correction of this anomaly requiring various therapeutic strategies. Functional rehabilitation remains always the guaranty of such a therapeutic stability. For the teaching aspect, we want to attach stereotypic forms and also to present clinical cases treated in the service of consultation and dental treatment in order to answer such a request.