上颌全口义齿固位与稳定性的三维有限元分析

目的研究牙尖斜度、腭穹隆形状、人工牙排列位置对上颌全口义齿固位与稳定性的影响。方法应用三维有限元方法研究牙尖斜度、腭穹隆形状和人工牙排列位置对上颌全口义齿基托位移状况的影响。结果颊侧基托边缘区垂直向位移均为压向粘膜方向,使基托下沉的移位;后牙从牙槽嵴顶向颊侧移动,前牙唇向偏离牙槽嵴时,唇、颊侧基托边缘区位移增大;牙尖斜度为0°和10°时,基托后缘区垂直向位移、唇侧基托的垂直向和纵向位移均为背离粘膜方向,牙尖斜度大于等于20°时,基托后缘区和唇侧基托边缘区的垂直向位移变为压向粘膜方向。腭穹隆低平和腭穹隆高者位移较腭穹隆适中者大。结论牙尖斜度、腭穹隆形状、人工牙排列位置对上颌全口义齿的固位与稳定有明显的影响作用。选用牙尖斜度为22°～24°的人工牙有利于义齿的固位与稳定。     

不同牙尖斜度对下颌全口义齿软衬后稳定性影响的研究

目的：比较下颌全口义齿软衬后不同牙尖斜度条件下义齿基托组织面位移情况,分析牙尖斜度对软衬后义齿稳定性的影响.方法：采用三维有限元方法,选择标准无牙下颌牙槽嵴模型为实验对象,建立无牙下颌和软衬全口义齿有限元模型,采用双侧后牙垂直加载,牙尖斜度选取0°、10°、15°、20°、25°、30°,对义齿基托组织面位移结果进行分析.结果：（1）0°-30°不同牙尖斜度各组间垂直向位移差异无显著性;（2）不同牙尖斜度水平向位移各组间具有显著性差异（P＜0.01）,以0°与10°最小;（3）加载后不同牙尖斜度软衬模型义齿软衬层组织面与黏膜表面始终贴合.结论：全口义齿牙尖斜度在0°-30°之间时,软衬材料可以较好的适应不同牙尖斜度,水平向动度以0°与10°最小.     

舌向集中[牙合]全口义齿在牙槽嵴重度吸收患者的临床修复效果观察

牙槽嵴低平患者进行全口义齿修复是临床上常见又困难的病例。低平的牙槽嵴因表面黏膜薄弱,易产生压痛,而且固位不良、义齿不稳定,直接影响到修复的效果。对于这类患者我们在义齿制作时,常采用传统的非解剖式人工牙,义齿在功能运动时所受侧向力减少,有益于义齿稳定,但因为无牙尖斜度,咀嚼效率较差。近年来,越来越多的学者开始倾向于应用改良殆型人工牙制作全口义齿,希望提高咀嚼效能。     

三种品牌人工牙在全口义齿修复中的性能比较

目的 观察三种品牌人工牙制作全口义齿修复7－8年后的磨耗及He关系变化。方法 选择103例全口义齿修复患者，让其自选三种品牌人工牙之一作全口义齿修复，7－8年后复查人工牙He面磨耗程度，颌位和He关系的变化，义齿固位情况及咀嚼效能的自我评价。结果 三种品牌人工牙所作全口义齿7－8年后的He磨耗，义齿固位经秩和统计分析，Ivoclar牌人工牙与ODI和Bayer两种品牌相比差异有显著性（P＜0.05)，ODI与Bayer比较差异无显著性（P＞0.05)。结论 使用 优质的塑脂人工牙作全口义齿修复，能延长全口义齿发挥最佳咀嚼效能时间。     

计及牙尖斜度的上颌全口义齿基托应力及其分布状况

目的 :研究牙尖斜度对上颌全口义齿基托应力分布状况的影响 ,为预防上颌全口义齿基托折裂和全口义齿修复时人工牙牙尖斜度的选择提供理论依据。方法 :应用三维有限元应力分析法研究不同牙尖斜度时上颌全口义齿基托应力及其分布状况。结果 :随着牙尖斜度的增加 ,基托的应力集中状况明显加剧 ,牙尖斜度为 10°时 ,基托应力集中状况相对较缓 ,2 0°时次之 ;拉应力集中区由基托前腭部、前牙腭侧移动到唇系带切迹区 ;综合应力集中区由基托前腭部、前牙腭侧移动至后牙牙列的部位。结论 :牙尖斜度对上颌全口义齿基托的应力集中状况有明显的影响作用。临床行全口义齿修复时 ,宜选用牙尖斜度为 10°或 2 0°的人工牙 ,以便达到减缓基托应力集中之目的。提示如何使基托内集中的应力重新分布或减缓应力集中应是解决基托折裂的关键性问题。     

缩小义齿牙尖斜度和加大牙冠体积在防止基托纵折中的应用

目的 通过缩小上颌总义齿牙尖斜度和增大牙冠体积防止上颌义齿基托纵折。方法 对18例行上颌总义齿修复病例,排牙时选用牙尖斜度为10°～20°人工牙,同时在上颌后段义齿腭侧堆加基托材料,增大义齿牙冠体积,扩大其与下颌天然基牙舌尖的接触面积,形成尖窝关系。结果 经过0.5～2.5年随访,除1例义齿意外摔断外,成功16例,失败1例。结论 减小牙尖斜度和加大牙冠体积防止单纯上颌总义齿基托纵折可收到良好的效果。     

104例佩戴全口义齿患者满意度与义齿质量间关系的研究

目的 研究患者对全口义齿满意度与义齿质量间是否存在联系.方法 对104例佩戴全口义齿3-10个月的患者进行满意度问卷调查,同时进行义齿质量相关检查,包括义齿基托边缘伸展、人工牙排列、义齿稳定状况、义齿的固位、咬合关系和息止(牙合)间隙.结果 影响全口义齿患者满意度的主要因素为义齿基托边缘伸展、人工牙排列、咬合关系和息止(牙合)间隙.结论 患者对全口义齿外观、咀嚼能力、义齿稳固性、舒适性方面的满意度受义齿质量临床评价相关参数的影响.     

全口义齿

不同牙尖斜度对下颌全口义齿软衬后稳定性影响的研究;改良（牙合）型单颌总义齿咀嚼效能的研究;下颌全口覆盖义齿的加强结构对基托下黏膜应力分布影响的三维有限元分析;计算机辅助设计与快速成形技术辅助制作全口义齿的探讨;     

长正中牙合全口义齿修复无牙颌再诊患者咀嚼效能研究

目的评价长正中牙合全口义齿修复无牙颌再诊患者的咀嚼效能。方法选择2011年1月—2013年8月口腔科全口义齿修复无牙颌再诊患者20例,为每位患者制作1副长正中牙合全口义齿,以该义齿为模板,采用义齿复制技术再制作1副解剖牙合全口义齿,每例患者交替戴用长正中牙合全口义齿和解剖牙合全口义齿3个月以上,采用UV-2450型分光光度计,集中进行咀嚼效能测定。结果 2种牙合型30 s咀嚼效率吸光度值:长正中牙合全口义齿(0.898)明显高于解剖牙合全口义齿(0.657),t=8.581,P<0.001,2种牙合型咀嚼效率有高度显著性差异。结论 20例长正中牙合全口义齿修复无牙颌再诊患者的咀嚼效能高于解剖牙合全口义齿。     

双侧游离端义齿咀嚼效能的测定和分析

本文采用吸光度法测定了62例肯氏Ⅰ类牙列缺损者戴用双侧游离端义齿前后的咀嚼效能。结果表明:1.肯氏Ⅰ类牙列缺损患者戴用双侧游离端义齿后咀嚼效能随戴义齿时间延长而逐步提高,至戴义齿3个月趋于稳定。2.影响双侧游离端义齿咀嚼效能的主要因素,按其相关程度排列依次为缺失(牙合)单位数、(牙合)力、年龄、人工牙种类、牙槽嵴吸收程度和义齿所在颌位,其中(牙合)力与咀嚼效能呈正相关,其它因素与其呈负相关。性别、咀嚼习惯、戴义齿经验与咀嚼效能无相关。     

Evidence of the validity of a model of determinants of quality of restorative dental care

A model describing the relationship between self-reported quality of restorative dentistry and dentist characteristics for 119 Montana general dentists is presented. The best predictors formed a significant model explaining 22% of the variance of the quality measure. Results are contrasted with a previous estimation of the model for 102 Washington general practitioners. Evidence for the external validity of the model is presented.     

Experimental evidence of formation of imines in the course of reduction of hydrazones

The reduction of hydrazones is generally suggested to proceed through a reductive cleavage of the nitrogen–nitrogen bond followed by a reduction of the carbon–nitrogen bond. This sequence of reduction processes is here supported for fluorenone (V) and benzophenone (VI) hydrazones as well as by a comparison of the reduction of fluorenone and benzophenone hydrazonium ions (I,III) with corresponding imines (II,IV). Another proof of the presence of imines as intermediates is the splitting of four-electron waves of hydrazones V and VI and hydrazonium ions I and VIII into two waves at pH < 2. This has been interpreted as due to differences in slopes dE_1/2/dpH and pK_a-values of protonated hydrazine derivatives on one side and corresponding imines on the other. In this pH-range imines formed in reductions of VI and VIII are reduced in a single two-electron wave, those of I and V in two one-electron steps. Fluorenone imine (II) is sufficiently stable to allow recording of time-independent current–voltage curves between pH 6 and 11. In this pH-range the imine (II) is reduced in two one-electron steps. Benzophenone imine (IV) has been found stable between pH 4.6 and 12. At pH 4.6–8 the reduction of the imine IV takes place in a single two-electron step, at pH 8–12 in two one-electron steps. Final proof of the initial cleavage of the N–N bond is presented by comparison with the reduction of nitrones.     

不同剂型玻璃离子水门汀溶解性比较研究

目的:研究、比较不同剂型玻璃离子水门汀的溶解性和表面微观形态改变,为临床使用提供依据.方法:将3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)及GC玻璃离子水门汀(双糊剂型)分别在人工唾液中浸泡30 d,冷热循环15000次,烘干测重,比较前后质量变化,计算溶解率,并用扫描电镜观察表面微观改变.结果:不同剂型的玻璃离子水门汀溶解率由高到低分别为3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(双糊剂型).3种玻璃离子水门汀经浸泡溶解后,SEM扫描表面微观形态可观察到GE玻璃离子水门汀(双糊剂型)表面形态改变较少,其他2组玻璃离子水门汀表面微观改变较多.结论:双糊剂型玻璃离子水门汀理化性能及溶解率均低于传统水粉剂型,是未来临床修复治疗的的良好选择.     

Evaluation of efficacy of chemiluminescence for diagnosis of leukoplakia

ObjectiveLeukoplakia is the most common potentially malignant disorder preceding oral cancer. Chemiluminescence has been developed as an adjunct to conventional examination for the diagnosis of these potentially malignant disorders. This study was conducted to assess the efficacy of chemiluminescence in the diagnosis of leukoplakia and to compare the results with histopathological examination.Study designA total of 50 patients with leukoplakia were included from the outpatients attending the Department of Oral Medicine and Radiology, Dental Hospital, Bengaluru, Karnataka, India. These patients were subjected to conventional oral examination followed by chemiluminescent examination with Vizilite (Zila, Fort Collins, CO, USA) and biopsy for histopathological confirmation.ResultsThe sensitivity, specificity, positive predictive value, and negative predictive value of chemiluminescence were 93.75%, 55.56%, 78.95%, and 83.3%, respectively. The overall accuracy of chemiluminescence was 80%. A statistically significant association was observed between histopathology results and chemiluminescence results.ConclusionAlthough it is an easy, safe, minimal time consuming, and noninvasive technique, it has only adjunctive utility and it does not replace biopsy for the diagnosis of leukoplakia.     

颌骨动静脉畸形的栓塞治疗

目的：总结直接穿刺结合经血管内介入栓塞治疗颌骨动静脉静脉畸形的经验。方法：收治凳骨动静脉畸形患者6例,均进行了介入栓塞治疗。采用的栓塞材料为附凝血棉纤毛的螺圈,聚乙烯醇泡沫微粒和二氰基丙烯酸对丁酯。数字减影颈动脉造影在PHILIPSV300下完成。结果6例颌骨动静脉畸形患者中4,例急性出血得到了快速、有效控制,1例慢性渗血的右下 骨动静脉畸形患者,介入栓塞治疗,拔除松动的右下凳第一磨牙,有效地控制了出血,另1例伴局部软组织搏动性膨隆的上凳骨动静脉畸形患者,介入治疗后膨隆的搏动性得到明显改善,栓塞治疗后分别随访3－24个月,均未发现有口腔内渗血或出血。随访的X线片上,病灶区可见新骨形成。结论：局部穿刺结合经血管内介入栓塞治疗颌骨动静畸形是一种安全、有效的治疗方法。     

正畸患者切牙影像失真发生情况分析

目的研究正畸患者曲面体层片上的切牙影像失真发生情况，并分析其原因。 方法从中山大学附属口腔医院放射科影像数据库中选取500例正畸患者的曲面体层片和头影测量侧位片，所有曲面体层片均采用咬合杆投照，分别从切牙牙体影像放大、缩小、牙根变短、根尖模糊等评价指标分析上下颌切牙影像失真的发生情况，在头影测量侧位片上测量中切牙根尖-对颌切牙切缘的距离，探讨切牙影像失真发生的原因。采用SPSS 19.0统计软件对所得数据进行统计学检验。 结果500例患者中，切牙牙体影像正常者共417例，切牙牙体影像失真者共83例，影像失真发生率16.6%，其中切牙牙体影像放大17例、牙体影像缩小0例、牙根变短30例，牙根影像变短伴模糊36例。影像失真患者的根尖-切缘距离大于影像正常的患者，差异有统计学意义（F = 5 187.18，P = 0）；影像失真患者的覆盖值大于影像正常的患者，差异有统计学意义（F>477，P = 0）。 结论严重牙颌面畸形如反 、深覆盖是导致曲面体层片的切牙影像失真的主要原因之一。     

Design of clinical trials of traditional therapies of periodontitis

The present paper on the design of clinical trials of periodontal therapy first addresses the issue of the etiology of periodontal disease. It is suggested that most if not all forms of destructive periodontal disease are caused by microorganisms and that there are different forms of disease with different microbial etiologies. The progressive nature of destructive periodontal disease is subsequently discussed and it is emphasized that, in a given patient, periodontal sites which show signs of inflammation and attachment loss may not over a period of several months and years show further sign of attachment loss. The present methods of assessing periodontal disease do not allow us to discriminate between potentially active and inactive sites in untreated patients. The significance and variability of indicators of periodontal disease such as bleeding on probing, probing pocket depth and probing attachment level measurements are discussed. The errors inherent in the various measurements are analyzed and suggestions are presented describing how alterations in any of the above parameters could be identified and presented in a clinical trial. Of concern for the statistical analysis of clinical data of periodontal disease is the definition of the "experimental unit". For a number of years, the "experimental unit" in periodontal trials was the patient. It is clear, however, that different sites within the same individual show different patterns of disease progression and lesion morphology and often respond differently to periodontal therapy. Statistical analyses must consequently be designed which recognize differences in site-to-site infection and lesion morphology within a common host. Until such analyses are available, the investigator should be wary of pooling data within the same individual, since such pooling may obscure meaningful alternatives which may take place in individual periodontal sites. Some goals of periodontal therapy are subsequently identified. 4 goals are discussed more in detail, namely: to establish conditions which will allow the patient to maintain a dentition without further breakdown of the periodontium; to reduce pocket depth to establish an anatomy in the dentogingival region which with proper maintainance care will prevent the re-establishment of the subgingival infection; to gain attachment as a result of treatment; to assess the effect of a certain chemotherapeutic agent on periodontal disease.     

正常青年Monson球面半径的测量研究

目的测量正常青年Monson球面半径。方法选择60名(男30名,女30名)正常青年制取全口印模,应用立体摄影成像的原理与方法对Monson球面半径进行测量和统计学处理。结果Monson球面的半径平均为10.173 cm,大于理论值10.160 cm,差异有显著性(P<0.01);男、女性球面半径差异无显著性。结论本实验所得到的数据可作为全口义齿修复中记录颌位关系的一个参量。     

鼻测量法的进展

唇裂术后继发畸形是指唇裂修复术后,仍遗留或继发于手术操作和生长发育变化而表现出来的一类畸形[1]。包括唇畸形、鼻畸形和颌骨畸形。其修复较原发性唇裂修复更复杂,更灵活多变。而导致其修复复杂性的一个重要原因即是局部组织结构复杂变异和缺乏可靠的三维测量手段[2],鼻畸形     

口底癌34例临床分析

目的探讨口底癌的临床特性、治疗方法及预后。方法对我院自1992—2002年住院治疗的34例口底癌患者进行回顾性分析。结果34例口底癌患者中,男28例(82.4%),女6例(17.6%),男女比为4.7∶1,平均发病年龄58岁。发病部位:前口底22例(64.7%),后口底12例(35.3%)。淋巴结转移率41.2%。单纯手术组、化疗加手术组、放疗加手术组、化疗加手术加放疗组的5年生存率分别为45.5%、60.0%、50.0%、62.5%。结论口底癌以中老年患者好发,男性居多。易发生淋巴结转移,综合疗法疗效较好。