56例合并系统性疾病的口腔癌患者的治疗效果评价

目的: 总结56例合并系统性疾病的口腔癌患者的诊疗经验。方法: 回顾56例口腔癌患者的临床资料,根据口腔癌的特征,分析和制订局部及全身治疗方案,评价治疗效果。结果: 56例患者分别接受手术、放化疗、免疫治疗等。对34例（60.71%）合并高血压患者、11例（19.64%）合并冠心病患者、1例（1.79%）合并严重心律失常的患者提出心血管治疗意见;对23例（41.07%）糖尿病患者提供了合理化控制血糖的方案;对19例（33.93%）合并呼吸系统疾病的患者提出了相应的肺功能检测及术后并发症的治疗方案。结论: 多学科协作对合并系统性疾病的口腔癌患者的诊疗合理、有效,值得完善和推广。     

The influence of systemic diseases on the diagnosis of oral diseases: a problem-based approach

Although all dentists are taught about the importance of oral health to general health and that systemic disease can manifest in the oral cavity, the 4-year dental school curriculum does not allow time to gain competency in these relationships. Nevertheless, all dentists must have skills in taking a medical history and an appreciation of oral findings that might have a systemic origin. This article focuses on the identification of abnormal signs and symptoms in the oral cavity and the determination of those that have a systemic origin. It is imperative that clinicians are mindful of the possible oral-systemic associations, because these could potentially have a huge impact on patient care.     

Radiographic diagnosis of systemic diseases in dentistry

Symptoms of systemic diseases, regardless of whether the soft tissue or the skeletal system is affected, develop in the oral and maxillary regions. It is believed that the number of diseases affecting the oral and maxillary regions exceeds 350. Because the incidence of systemic diseases is relatively low and their symptom constellations are complex, it is not easy to understand, memorize, and diagnose these diseases. Therefore, I organized the radiographic findings of systemic disease according to the 5 oral and maxillofacial sites (teeth, jaws, palate, salivary glands and malar, bone) and attempted to classify the radiographic findings of systemic diseases that become manifest in the dental, oral and maxillary regions.     

以口腔表征为首发的血液系统疾病500例临床分析

目的： 探讨以口腔表征为首发症状的血液系统疾病的临床特点,为早期诊断,防止漏诊误诊提供依据。方法： 回顾近5年因口腔症状首诊于上海交通大学医学院附属第九人民医院口腔相关科室（口腔黏膜病科、牙周病科、牙体牙髓病科和口腔颌面-头颈肿瘤科）的500例血液系统疾病患者的临床资料,分析其口腔表征的多样性及分布情况。结果： 500例首诊于口腔各科的血液系统疾病患者的口腔表征有口腔黏膜和牙龈出血、牙龈增生、口腔黏膜溃疡、口腔黏膜感染及口腔颌面部肿块。其中以口腔颌面部肿块症状首诊者数量居首,占19.8%。血常规、凝血机制和口腔病理活检对血液系统疾病的初步筛查与确诊至关重要。结论： 多种血液系统疾病都可能在疾病初期就出现口腔表征,正确认识血液系统疾病多样性的口腔表征,结合血常规和凝血机制检查以初步筛选血液系统疾病;对表现为口腔颌面部肿块的患者进行肿块活检,可在临床上更早地对血液系统疾病进行诊断和鉴别诊断,从而避免误诊和漏诊。口腔表征的治疗以针对血液系统疾病为主,口腔局部对症治疗为辅。     

口腔罕见病与遗传病生物样本库的建立与完善

目的：：建立口腔罕见病与遗传病生物样本库,实现样本信息系统化管理。方法：以第四军医大学口腔医院为依托,与符合或疑似口腔罕见病与遗传病病症的患者或家属签订知情同意书,采用相关技术提取各类样本,完善样本的临床、遗传及分子生物学信息,录入生物样本库管理系统,通过系统产生的二维条码实施样本入库。定期对样本进行质量控制。结果：自2010年起筹建口腔罕见病与遗传病生物样本库,于2011年开始录入样本,目前已经实现了对7000余份口腔罕见病与遗传病样本的系统信息化管理,这些样本包括血液、组织、细胞、DNA、RNA、蛋白、引物等多种类型;在样本库建立和维护的过程中,从样本入库、保存、出库等多个环节实现了对样本的质量控制,同时还制定了近10种规章制度完善生物样本库的建设。结论：口腔罕见病与遗传病生物样本库的建立使疾病样本的储存系统化和规范化,为保留珍贵的疾病样本资源提供了保证,也为科研课题的实施和科研单位之间的合作提供了便利。     

加强全身疾病治疗中的龋病防治

龋病的发展受多种因素影响,患者的全身健康状况可影响患龋病的风险,主要表现为全身疾病的治疗可以改变口腔微生态环境,影响唾液腺功能和唾液成分,直接或间接破坏牙体组织结构,导致龋易感性增加.与全身疾病相关的龋病具有特殊的临床特征,其防治方法也有所不同。本文回顾和分析全身疾病治疗过程中龋病易感的原因和机制,系统介绍全身疾病治疗中的龋病防治和龋病管理的现代理念。     

Demographic Study of Prevalence of Systemic Diseases in Oral Maxillofacial Surgery Patients of Central India

Summary

An evaluation and consideration of health status of patient prior to any surgical treatment forms an essential part of comprehensive health care. Apparently well but in fact medically compromised patients usually present with unacceptable possibility of complications; whereas adequate pretreatment utilization of many techniques available to diagnose and treat underlying systemic disease significantly decreases morbidity and mortality associated with it.

Aims and Objectives

Purpose of this study was to evaluate, prospectively, prevalence of various systemic diseases in oral surgery patients.

Materials and Methods

For analyzing prevalence of systemic diseases in oral surgery patients, the patients reporting to oral surgery department for various treatments were prospectively evaluated for a period of 6 months and were grouped according to a system involved and findings analyzed to get prevalence in central India.

Result

Of the 12,487 patients who reported to the department 506 (4.055 %) were medically compromised with a highest prevalence of cardiovascular diseases (35.57 %), and least prevalence of infectious diseases (3.55 %). These results are statistically significant (by Chi-square test) at p < 0.01 (χ² = 342.752).

Conclusion

The aim of study was to evaluate prevalence of systemic disease in oral surgery patients of central India which is 4.055 % with highest population showing involvement of cardiovascular disease and minimum population undergoing oral surgical procedures are compromised by various infectious diseases.     

Ultrasonographic study of cystic diseases in the oral and maxillofacial region

Fourteen cases of oral and maxillofacial cysts were evaluated by means of ultrasonography. The pathologic diagnoses were as follows; 5 epidermoid or dermoid cysts, 5 branchial cysts, 3 mucoceles and 1 thyroglossal duct cyst. Epidermoid or dermoid cysts were detected as the solid patterns in the ultrasonographic images. In the cases located submentally, the boundary echoes were not so clear and smooth as those of the branchial cysts, because of the difficulties to differentiate the cyst wall and the surrounding muscle layers. In many cases, strong homogeneous internal echoes were detected, whose echo levels were the same as that of the submandibular gland. All branchial cysts were detected as solid patterns, and in 4 cases homogeneous internal echoes were found, whose echo levels were less than that of the submandibular gland. Mucoceles showed a cystic pattern. For the ultrasonographic diagnosis of the cervical region, the submandibular gland and the mylohyoid muscle play an important role for comparing their echogenecities with the lesions.     

外泌体miRNA在口腔疾病中的研究进展

外泌体是活细胞分泌至细胞外基质的纳米级囊泡,在细胞之间的物质交换和信号转导方面发挥重要作用,能将其携带的脂质、蛋白质、核酸传递至受体细胞,调节受体细胞的生理、病理过程。微小RNA(microRNA、miRNA)作为外泌体中重要的"货物"被转运至受体细胞,调控受体细胞信号通路,从而对疾病的进展起着调节的作用。近年来,外泌体miRNA在牙周疾病、黏膜相关疾病、口腔癌等疾病中的研究日益增多。本文就外泌体miRNA在口腔疾病中的调控机制进行综述,并讨论外泌体miRNA作为生物标志物在口腔疾病诊断中的潜在前景。     

口腔颌面部结核52例临床分析

目的探讨口腔颌面部结核的发病趋势与临床变化,以提高临床诊治水平.方法回顾分析我院1995年1月～2004年12月间52例口腔颌面部结核的临床资料.结果口腔颌面部结核以单一病灶包块型为主,占38例,主要侵犯淋巴结;溃疡型5例,主要累及口腔粘膜;其它9例.52例中仅4例有结核病史(7.69%).手术加系统性药物治疗40例,以药物治疗为主12例,全部病例痊愈,无并发症,经6个月～2年随访无复发.结论口腔结核的既往典型特征已不明显,临床表现与局部病变密切相关,活检能明确诊断.冶疗以手术加药物治疗相结合;多部位结核、粘膜结核、骨结核以药物治疗为主.     

Granulomatous diseases: Oral manifestations and recommendations

Granulomatous diseases may present with oral manifestations that are detectable by dental care providers. In certain cases, oral manifestations may precede systemic signs and symptoms. Dentists managing patients with these conditions may modify the dental treatment plan and possibly retain the support of other health professionals. This review gives an update on granulomatous diseases that can be faced by the dental practitioner.     

194例口腔颌面部错构瘤临床分析

目的:对口腔颌面部错构瘤的临床特点、不同手术方法及效果作回顾性分析.方法:对我院1993年1月至2009年12月收治的194例口腔颌面部错构瘤患者的临床资料进行回顾性分析.各临床因素之间采用t检验和X<'2>检验.采用Kaplan-Meier法绘制生存曲线,生存函数比较采用Log rank检验.结果:人组病例男107例...     

常见口腔黏膜病动物模型研究进展

口腔黏膜病作为口腔医学的一部分,其中大部分疾病的病因仍不明确,这给临床治疗带来困难。黏膜病动物模型作为临床研究工作的一种必要方法,因此在口腔医学的研究中占有重要地位。国内外对于一些具体黏膜病,如口腔溃疡,口腔白斑,口腔癌等的模型建立有着详细介绍,但对口腔黏膜病的动物模型的总结性文章文献较少见,因此本文对口腔黏膜疾病较为成熟的动物模型做以阐述。     

唾液蛋白质糖基化及其与全身和口腔疾病关系的研究进展

蛋白质糖基化是重要的蛋白质翻译后修饰方式之一,通过赋予蛋白质各种结构和功能特征而在生命活动中扮演重要角色。唾液作为一种获取简单且无创的生理物质,包含有来自血清、龈沟液、口咽黏膜分泌物的成分。近年来随着相关研究的深入,人们对唾液的认识被不断更新。研究发现,唾液蛋白质可以作为一些疾病的诊断指标,唾液中蛋白质糖基化修饰也与多种疾病状态密切相关。本文就唾液蛋白质糖基化及其与全身和口腔疾病关系的研究进展作一综述。     

口腔颌面部错构瘤(附7例报告)

目的 研究口腔颌面部错构瘤的病理特征及鉴别诊断。方法 分析了7例错构瘤病例的临床资料和组织学表现。结果 口腔颌面部错构瘤有其自身的组织学和临床特征。结论 通过组织学检查和其临床表现特征,可以正确地诊断错构瘤。     

口腔颌面部结节病14例临床分析

目的：总结分析14例口腔颌面部结节病的诊治经验。方法：回顾分析1993年至2005年期间收治的14例结节病患者的病例资料，所有患者均行手术治疗，术后经病理诊断证实。8例口腔及颌面部单发病变行完整切除，术后予以随访观察。4例病变位于腮腺者，行肿块及腮腺浅叶切除术，保留面神经，术后随访观察。2例多发病变者，先予试验性激素治疗，病变缩小后再行大部切除，术后继续接受激素治疗。随访1个月～10a。结果：14例患者中，男5例．女9例：年龄30～66岁，中位年龄49岁、病变位于唇部5例，腮腺4例（1例双侧腮腺受累），颏部1例，下颌下1例，舌1例，颧部及下颌下1例．同时累及腮腺、下颌下、颏部1例．手术治疗效果良好，1例有上唇结节病患者．术后1年复发，再次手术治疗；1例舌结节病行部分切除，病变持续存在（8a），仍感不适。2例病变广泛者，术后辅以激素治疗．预后良好，无病变复发或进展。结论：口腔颌面部结节病临床少见，多属局部性病变，手术治疗可获良好疗效。对病变广泛者．术后需配合正规激素治疗，并严密随访观察。     

Clinical and public health implications of periodontal and systemic diseases: An overview

Severe periodontitis is defined by extensive loss of the tooth attachment apparatus. It is the sixth most common human disease and is estimated to affect 11.2% of the global adult population, hence representing a significant healthcare, social, and economic burden. Since the 1990s, multiple epidemiologic, experimental, and interventional studies have evidenced how periodontitis may also impact systemic health and it has been independently associated with the majority of chronic noncommunicable diseases. The evidence supporting these associations, mainly focusing on diabetes, pregnancy complications, and cardiovascular disease, was thoroughly reviewed in 2012 by an international consensus workshop. In the last 5 years, however, important advances have been made, not only in our understanding of the etiopathogenesis of periodontitis, or concerning the mounting evidence regarding the independent associations between periodontitis, diabetes, and cardiovascular disease, but also with many other systemic diseases including metabolic disease and obesity, rheumatoid arthritis, certain cancers, respiratory diseases, and cognitive disorders including Alzheimer's disease. This review describes these scientific advances by gathering together the existing evidence on the importance and relevance of the associations between periodontitis and many systemic diseases.     

口腔颌面部多原发癌8例报道

复习8例多原发癌(MPC)病例,并探讨其临床特点、诊断及治疗。除1例第一原发癌为鼻咽癌外,其余均发生于口腔颌面部。多中心起源的MPC2例,相同器官、不同组织来源1例,不同器官、相同组织来源3例,不同器官、不同组织来源2例;同时性癌2例,异时性癌6例。口腔颌面部MPC可分为4种类型,应注意与复发癌、转移癌相鉴别。