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摄影资料是口腔临床治疗的重要工具,能直观地反映患者口腔疾病状况和医生的治疗技术水平,在病历资料收集保存、医患交流、医技交流以及学术交流中发挥着不可替代的作用。传统的口腔摄影用的是负片相机,数码相机的出现为口腔医疗摄影提供了极大的方便,受到了口腔医生们的欢迎。十余年来,口腔临床摄影迅速发展,在摄影器材选择、摄影技术、照片质量方面有了极大的提高。本文回顾了国内外口腔临床摄影的发展历史和现状、与临床摄影相关的科研和教学情况。     

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1 发展概况 中国儿童口腔医学的部分内涵虽早已存在于我国口腔医学的范畴内,但作为一门独立的学科,主要是在20世纪80年代逐渐形成的,目前正不断发展、充实和提高,日趋成熟.     

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??Objective    To provide evidence for temporomandibular joint ??TMJ??prostheses design and size chosen via three-dimensional ??3D??measurements of CT data and cluster analysis of the Chinese. Methods    CT data from 448 adults from East China with normal TMJs were recruited and reconstructed by Proplan CMF 1.4 software. Thirteen parameters of the TMJ fossa and condyle-ramus units were performed by three-dimensional measurements. The data were analyzed statistically and hierarchical cluster analyses were performed to determine the size design. Results    The anatomical database of Chinese TMJ was established. There were significant differences in the 13 TMJ measurement parameters between the males and females. The glenoid fossa was grouped into 3 clusters?? and the condyle-ramus units were grouped into 4 clusters. Discriminant analyses were capable of correctly classifying 97.24% of the glenoid fossae and 94.98% of the condyle-ramus units. Conclusion    Three-dimensional measurements and cluster analysis of Chinese TMJ osseous morphology can provide an anatomical reference for prosthesis size design of Chinese TMJ replacement.     

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目的了解医学院校大学生口腔卫生相关知识与行为习惯,为制定大学生口腔健康教育方案提供依据。方法于2008年9月对中国医科大学199名在校大学生的口腔健康相关知识、行为等进行问卷调查。结果医学院校大学生的口腔保健知识欠缺,仅有25.1%的学生了解"牙菌斑"的概念,42.7%的学生能回答出"蔗糖致龋力最强";口腔保健意识较薄弱,如有龋坏牙齿,仅有68.3%的学生会去医院治疗;但口腔卫生习惯较好,有89.9%的学生每天刷牙≥2次,且口腔专业学生在口腔保健知识的知、信、行等方面显著好于非口腔专业学生。结论医学院校大学生口腔保健知识和保健意识缺乏,但愿意接受口腔健康知识教育,提示在医学院校开展口腔疾病健康教育是必要的。     

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??Objective??To compare the adaptive differences between two standard artificial temporomandibular joint replacement systems and Chinese bone structure. Methods    Totally 54 patients??63 joints?? treated by temporomandibular joint replacement from January 2010 to December 2016 were evaluated. Their CT data before operation were measured for the amount of bone trimming including fossa??ramus and bone graft in the fossa by ProPlan CMF 1.4 software. SPSS 17.0 software was used for statistical analysis. Results??The amount of fossa and ramus bone trimming and fossa bone graft in the self-designed prostheses was significantly less than that in the Biomet prostheses ???150.20 ± 125.86??mm3 vs??281.82 ± 188.26??mm3????103.86 ± 64.07??mm3 vs??229.45 ± 159.35??mm3 and ??95.88 ± 74.72??mm3 vs??263.03 ± 187.00??mm3??P??0.001??. Conclusion??Self-designed artificial joint replacement system is more suitable for Chinese bone structure than the Biomet system with less bone trimming and grafting.     

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弯曲细小根管预备是临床医生面临的一大挑战。本文结合笔者临床经验,就临床医生关心的一些问题,如弯曲细小根管的概念、预备器械和预备技术的选择、根管冠部预敞的应用、根尖1/3并发症及其预防、器械折断等进行述评。     

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《晋书》是贞观年间由房玄龄、褚遂良、许敬宗等诸大臣奉唐太宗诏命所修,共130卷,记载了自司马懿(西晋世祖武皇帝司马炎之祖),下至刘裕代东晋(公元317—420年)     

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残根残冠是牙体严重缺损的病变,对经过根管治疗的残根残冠进行保存修复治疗是十分有意义的,主要表现在简化治疗过程、减少修复损伤、提高修复效果、保存牙槽骨等方面。本文从保存修复的目的出发,针对不同的修复方法,探讨了残根残冠保存治疗的适应证,希望保存和微创的原则能在口腔修复临床中得到充分的重视和应用。     

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??Objective    To observe the clinical effect of inlay and post core crown restoration in the treatment of residual crowns with different degrees of defects. Methods    Totally 153 cases of patients with residual crown of the first molar in the Department of Stomatology?? Zhengzhou people's Hospital from January 2009 to December 2012 were selected. According to the type of dental defect?? the inlay?? fiber post resin core plus all ceramic crown?? silver and  palladium alloy post and core crown were used to repair a total of 176 teeth. Follow up regularly every year?? record the clinical check and evaluate the clinical effect. Results    Among the 176 teeth with residual crown of the first molar 153 were continuously followed up after 3 to 5 years??144 successful?? nine failure??with a success rate of 94.1%. In the failure cases??there was one case of broken tooth in inlay??class repair. Fiber post resin core was applied to repair 1 case of class??defects??and 4 cases of type ??defects had neck of the tooth broken. In silver palladium alloy post and core there was 1 case of root fracture??1 case of apical inflammation and 1 case of crown falling off. According to the different types of defects??there was no significant difference among the 3 methods??P > 0.05??. Conclusion    Residual crown of the first molar ????or ?? type of defects?? can be repaired by inlay. For type ??or ?? defects post core crown can be selected according to the amount of residual tissue in the neck.     

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??Objective    To observe the effect of different concentration of silicon on demineralized enamel??and investigate its effect on remineralization of enamel demineralization. Methods   The research was performed in laboratory of School of Stomatology??Jilin University from April to August 2014. Enamel specimens were placed in lactic acid gel for one week. Then all specimens were  randomly divided into 5 groups after we confirmed that artificial enamel caries were formed by SEM. Then the five groups of demineralized model were respectively placed in the remineralization solutions whose concentration of silicon was 0??0.5 × 10-6??1 × 10-6??8 × 10-6 and 16 × 10-6. All specimens were removed after three weeks. The remineralization effect of the enamel surface were evaluated by scanning electron microscopy??SEM??. Results    Different concentration of silicon had an effect on promoting remineralization of demineralized enamel??especially when the concentration of silicon was 8 × 10-6. With the increase of silicon concentration??the remineralization of enamel demineralization increased when the concentration of silicon was 0.5 × 10-6??1 × 10-6 and 8 × 10-6. When the concentration of silicon increased to 16 × 10-6??its remineralization decreased. Conclusion    Silicon has an effect on promoting remineralization of demineralized enamel, and the remineralization effect is the best when the concentration of silicon is 8 ×10-6.     

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目的评价插销式桩冠修复咬合过紧患者磨牙残根残冠的临床疗效。方法随机选择2006—2007年来佛山市禅城区口腔医院修复科就诊的22例咬合过紧患者的29颗磨牙残根、残冠,采用插销式桩冠修复后随访3年。随访内容包括桩冠是否松动脱落、是否折断、是否根折、牙龈状况、桩冠边缘密合度、食物嵌塞和继发根尖周炎等。结果观察期间失访1例患者,其余21例患者的28颗患牙中,有2颗患牙在修复后1年复诊时出现轻微牙龈炎症,余牙未见异常。在修复后2年复诊时所有患牙未见异常。在修复后3年复诊时有1颗患牙牙根折断,出现牙周脓肿,需要拔除;另有2颗患牙稍有食物嵌塞,出现轻微牙龈炎症,余牙未见异常,咀嚼功能良好。结论插销式桩冠在咬合过紧患者磨牙残根、残冠的修复方面具有独特优势,可在临床上推广应用。     

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目的评价不锈钢根管桩与玻璃纤维桩用于残冠修复的临床效果。方法选择2009年6—8月柳州市人民医院口腔科门诊收治的残冠患者132例(160颗患牙),随机分成两组,每组80颗,分别采用Anthogyr不锈钢根管桩和玻璃纤维桩修复患牙,且均采用光固化瓷化树脂修补残冠并全冠修复,对其操作时间、同期成功率进行比较。结果经2年随访,两组成功率比较,差异无统计学意义(100%对93.8%;χ2=0.069,P>0.05)。结论 Anthogyr不锈钢根管桩与玻璃纤维桩的临床修复效果相近,前者设计独特、固位好、操作快捷、成本更低廉,值得推广应用。     

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目的评价石英纤维增强树脂桩核修复残根、残冠的临床应用效果。方法选择2004年1月至2006年1月于济南市口腔医院修复科就诊的牙体缺损患者98例,共156颗患牙,均为经完善根管治疗的残根、残冠,随机分为石英纤维增强树脂桩核组(49例72颗患牙)和铸造金属桩核组(49例84颗患牙),金瓷冠修复后随诊3年。结果石英纤维增强树脂桩核组无一例根折裂发生,仅有1颗修复体发生桩折断;而铸造金属桩核组发生根折4颗、铸造金属桩核脱落3颗,出现牙龈色素沉着8颗。石英纤维增强树脂桩核组3年修复成功率(71/72,98.6%)明显高于铸造金属桩核组(69/84,82.1%),二者差异有统计学意义。结论石英纤维增强树脂桩核具有良好的美学效果,强度高,抗疲劳、抗腐蚀性及生物相容性好且不易造成根折,是残根、残冠修复的理想选择。     

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目的探讨辛伐他汀对糖尿病大鼠种植体周围骨组织中骨形态发生蛋白-2(BMP-2)表达的影响及临床意义。方法 2010年5—8月在山西医科大学取成年雄性SD大鼠36只,适应性喂养1周无异常后,随机分为A、B1、B23组,每组12只。A组予腹腔内注射柠檬酸盐缓冲液,B1、B2组按50mg/kg体重剂量予腹腔内注射链尿佐菌素(STZ),建立糖尿病大鼠模型。成模后,在3组大鼠胫骨近骺端种植纯钛种植体。B2组大鼠每日予辛伐他汀5mg/kg体重灌服,A、B1两组大鼠每只每日灌服生理盐水1.5mL。灌胃12周后,处死动物,采用免疫组化方法检测种植体周围骨组织中BMP-2的表达。结果 B2组BMP-2阳性细胞比例明显高于B1组,差异有统计学意义(P<0.01)。结论辛伐他汀能使糖尿病大鼠骨组织BMP-2表达增强,改善骨代谢,有促进种植体骨结合的作用。     

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目的探讨牙齿移动过程中骨形态发生蛋白（BMP）-1与Noggin在牙周组织中的表达及作用。方法2010年7月至2011年3月在大连医科大学附属第二医院分别建立以大鼠切牙及种植体为支抗的正畸牙齿移动模型,测量磨牙移动距离,用苏木精-伊红（HE）染色观察被移动磨牙牙周组织形态学变化,应用免疫组化方法检测BMP-1与Noggin在牙周组织改建过程中的表达情况。结果以种植体为支抗的正畸牙齿移动模型,其磨牙的移动距离和速度优于以切牙为支抗组。BMP-1与Noggin在牙周组织的分布及表达在空间和时间上具有明显的一致性：均表现为实验组表达明显强于对照组,张力侧表达强于压力侧;二者在牙周组织中的表达水平均在第7天组最强,到第28天组便基本接近对照组的水平。结论以种植体为支抗的正畸牙齿移动模型优于传统方法。BMP-1与Noggin均参与了牙周组织的改建过程,且可能在该过程中发挥重要的调节作用。     

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《外台秘要》是我国唐代王焘所著,成书于天宝十一载（公元752年）（图1）。本书汇集了初唐及唐以前的医学著作,对医学文献进行大量的整理,使前人的理论研究与治     

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全口义齿是大家都熟悉的一种修复体,用于对牙列缺失(无牙颌)患者的修复.由于全口义齿制作工艺相对简单,不需特殊的设备和材料,加之一些患者认为:只有牙全部缺失,才需要镶牙,因此全口义齿始终是常见的、普及的修复体.     

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目的    探讨重组人表皮生长因子（rhEGF）凝胶治疗复发性口腔溃疡的临床疗效。方法    采用随机平行对照试验方法,将2007-2009年辽宁省人民医院口腔科收治64例复发性口腔溃疡（ROU）患者随机分为试验组和对照组,试验组用rhEGF凝胶局部涂药,对照组给予2%碘甘油局部涂药,分组观察,2组均治疗至溃疡愈合或2周止。结果    试验组患者溃疡平均愈合时间为（3.52±1.29）d,对照组为（7.58±2.07）d,两组比较,差异有统计学意义（P < 0.05）。试验组总有效率（96.9%）明显高于对照组（62.5%）（P < 0.05）。结论    重组人表皮生长因子凝胶对口腔溃疡创面具有明显的促进愈合作用,应用方便、安全。     

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目的探讨透明质酸钠关节上腔和关节下腔注射在治疗颞下颌关节骨关节病中的疗效。方法选择2006年7月至2009年2月威海市立医院口腔门诊适合注射透明质酸钠的46例颞下颌关节骨关节病患者,随机分为试验组和对照组,试验组25例采用关节下腔注射透明质酸钠,对照组21例采用关节上腔注射,比较两组疗效的差异。结果张口度对照组平均增加(0.96±0.13)cm,试验组平均增加(1.28±0.09)cm,两组间差异有统计学意义(P<0.01);关节疼痛对照组平均缓解(23.43±9.62)mm,试验组平均缓解(29.08±10.51)mm,两组间差异有统计学意义(P<0.01)。治疗后3个月至6个月的症状改善进行比较,张口度对照组变化为(0.01±0.03)cm,试验组为(0.08±0.04)cm,差异无统计学意义;关节疼痛改善对照组为(1.64±0.56)mm,试验组为(4.24±0.79)mm,差异具有统计学意义(P<0.01)。结论透明质酸钠关节上、下腔注射对颞下颌关节骨关节病确有疗效,关节下腔注射较上腔注射对缓解患者的关节疼痛和改善张口度的效果更为明显,且对疼痛缓解的作用时间更持久。     

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??Objective    To evaluate the sealing effect of a dentin adhesive in Class??restorations. Methods    Standardized mixed Class??cavities??2 mm × 2 mm × 2 mm??were prepared in 120 extracted premolars that were randomly assigned to 4 groups??n=30 for each group??. Three adhesive systems??All Bond Universal??total-etch and self-etch????Prime & Bond NT??and G bond and resin composite??were applied to each group following manufactures′ instructions. The teeth were immersed in 50 % ammoniacal silver nitrate and depth of penetration was evaluated under a microscope??and data were statistically analyzed by SPSS 20.0 software. Results    Microleakage was observed in all groups. All Bond Universal??total-etch??scores were lower than the other two groups??P??0.05??. There was no difference between total-etch and self-etch when All Bond Universal was used??P??0.05??. Higher microleakage scores were observed along the gingival margin than along the occlusal margin in all groups??P??0.05??. Conclusion    New universal adhesive ??All Bond Universal?? is a convenient and efficient adhesive. Total-etch and self-etch have no influence on marginal microleakage the long-term effect need further study.