不完全性腭裂修复术后患者替牙期的颅面特征初探

目的比较不完全性腭裂患者修复术后与健康儿童替牙期颅面形态的差别，进一步了解不完全性腭裂患者的颅面特征。方法选择20例不完全性腭裂修复术后，处于替牙期的患者作为腭裂组，年龄7～11岁；选择年龄、性别匹配的非腭裂健康儿童35名作为对照组。对两组研究对象的头颅侧位X线片进行X线头影测量对比分析。结果腭裂组全颅底长、上颌长、下颌有效长度分别为86．48mm、44．79mm、65．45mm，对照组分别为91．27mm、48．84mm、70．49mm，差异均有统计学意义（P〈0．001）。结论不完全性腭裂患者颅面部发育不足，呈Ⅲ类骨面型。     

“2×4”技术矫治替牙期前牙反的软硬组织变化

目的　评价“2× 4”矫治技术对替牙期前牙反牙合的矫治作用。方法　 18例替牙期前牙反牙合患者采用“2× 4”矫治技术合并Ⅲ类牵引矫治 ,对治疗开始和完成时的头颅侧位定位片进行头影测量及配对样本t检验比较其软硬组织变化。结果　治疗前后上下颌相对于颅底未见显著变化。下颌相对于上颌的矢状位置 (ANB角、Wits值 )发生显著改善 ,下前面高 (ANS Me)增大。治疗后上切牙唇倾、下切牙舌倾明显。软组织面凸角 (Ns Sn Pos)明显变小、上唇基角 (S N′ Sn)明显变大、H角变大 ,软组织凹面形改善。结论　早期采用“2× 4”技术合并Ⅲ类牵引可以有效矫治替牙期前牙反牙合 ,改善下颌相对于上颌的矢状位置关系及凹面形。     

"2×4"技术矫治替牙期前牙反(牙合)的软硬组织变化

目的评价"2×4"矫治技术对替牙期前牙反(牙合)的矫治作用.方法 18例替牙期前牙反(牙合)患者采用"2×4"矫治技术合并Ⅲ类牵引矫治,对治疗开始和完成时的头颅侧位定位片进行头影测量及配对样本t检验比较其软硬组织变化.结果治疗前后上下颌相对于颅底未见显著变化.下颌相对于上颌的矢状位置(ANB角、Wits值)发生显著改善,下前面高(ANS-Me)增大.治疗后上切牙唇倾、下切牙舌倾明显.软组织面凸角(Ns-Sn-Pos)明显变小、上唇基角(S-N'-Sn)明显变大、H角变大,软组织凹面形改善.结论早期采用"2×4"技术合并Ⅲ类牵引可以有效矫治替牙期前牙反(牙合),改善下颌相对于上颌的矢状位置关系及凹面形.     

儿童和成人深覆牙合牙合颅颌形态的横断面研究

目的对儿童和成人深覆牙合患者的颅颌面形态进行横断面研究,分析其生长发育中颅颌形态变化的趋势,探讨成人深覆牙合患者的颅颌面形态特征。方法随机抽取Ⅲ度儿童深覆牙合患者159例（平均年龄12.47岁）,成人深覆牙合患者81例（平均年龄21.76岁）,个别正常对照组51例（平均年龄18.41岁）。采用Winceph 7.0软件对3组X线头影测量项目进行测量,采用SPSS 12.0软件进行统计学分析。结果儿童深覆牙合患者在上前面高、下前面高、上颌第一磨牙相对于上颌前部的位置、上颌骨长度、上下颌骨-平面距、上颌磨牙-腭平面距、下颌切牙-下颌平面距、上下齿槽座点平面-下颌平面角、下颌角、下颌切牙距、覆盖、下颌平面-前颅底平面角、下颌磨牙-下颌平面距、后面高、上颌切牙距、下颌体长度、下颌升支高度、平面-前颅底平面角、上颌中切牙-前颅底平面角与成人深覆牙合患者间差异有统计学意义。成人深覆牙合患者在下颌-前颅底平面角、上下颌骨-前颅底平面角、颌凸角、上下颌骨矢状向不调指数、上下颌骨垂直向不调指数、上下颌骨-平面距、上下齿槽座点平面-下颌平面角、下颌角、覆盖、下颌平面-前颅底平面角、上颌后部位置、下颌磨牙-下颌平面距、上颌中切牙-前颅底平面角、下颌体长度、下颌升支高度、后颅底长度、平面-前颅底平面角、后面高与正常个体间差异有统计学意义。结论深覆牙合患者随着年龄的增长,颅、颌、、面部仍表现有一定的生长潜力,但是患者颌骨矢状关系并无改善。成人深覆牙合患者颌面部特征表现为垂直向、矢状向关系显著不调。     

FR3矫治乳牙期,替牙期前牙反He的头影测量对比研究

目的 为观察ＦＲ３矫治前牙反Ｈｅ的效果，尤其是矫治疗后颅面形态的改变。方法 采用ＦＲ３对１７例乳牙期和１０例替牙期前牙反Ｈｅ患者进行矫治，通过头影响测量分析其矫治前后的变化及矫治后与正常值的差异。结果 ＦＲ３能促进上颌生长发育，唇倾上切牙；使下颌后退，有效地改善异常的Ｈｅ间关系，乳牙期反Ｈｅ矫治后，除下切牙舌倾、颏角尖锐外、基本恢复Ⅰ类骨面型，矫治效果好。替牙期反Ｈｅ由于骨骼异常较严重，因而矫治后     

西北地区替牙期骨性Ⅲ类错[牙合]构成分析

目的：分析西北地区替牙期骨性Ⅲ类错[牙合]的构成。方法：采用计算机辅助X线头影测量技术,对第四军医大学口腔医院正畸科03～08五年间替牙期骨性Ⅲ类错[牙合]的回顾性研究,分析骨性Ⅲ类患者在矢状向与垂直向的构成。结果：矢状向主要表现为上颌正常,下颌发育过度;其次为下颌正常,上颌发育不足。其它类型占比例较低。垂直向主要表现为高角或均角,低角较为少见。结论：替牙期骨性Ⅲ类错[牙合]的表现形式存在差异,研究其构成有利于我们进一步认识此类错[牙合]的成因,并对其防治提供一定的参考。     

“2×4”技术矫治替牙期前牙反软硬组织变化

目的 :评价简单固定矫治器 (“2× 4”矫治技术 )对替牙期前牙反的矫治作用。方法 :样本为 18例替牙期前牙反 ,恒磨牙呈中性或轻度近中关系 ,下颌可退至切对切 ,轻、中度凹面形。采用“2× 4”矫治技术合并Ⅲ类牵引 ,平均治疗时间为 6个月 ,治疗开始和完成时的头颅侧位定位片进行头影测量及配对样本t检验比较其软硬组织变化。结果:治疗前后上下颌相对于颅底未见显著变化;;下颌相对于上颌的矢状位置(ANB角、wits值)发生显著改善;;下前面高(ANSMe)增大。治疗后上切牙唇倾、下切牙舌倾明显;;矫正了前牙的覆、覆盖;;同时;;软组织面凸角(NsSnPos)明显变小、上唇基角(SN’Sn)明显变大、H角变大;;软组织凹面形改善。结论:早期采用“2×4”技术合并Ⅲ类牵引可以有效矫治替牙期前牙反;;改善下颌相对于上颌的矢状位置关系及凹面形。     

单侧完全性唇腭裂术后反(牙合)患者替牙期颅面生长发育的分析研究

目的探讨单侧完全性唇腭裂前牙反(牙合)患者手术后替牙期的纵向颅面生长发育特征.方法对14名男性单侧完全性唇腭裂术后前牙反(牙合)患者的头颅定位侧位片进行回顾性分析,前后两次拍片的间隔时间平均24.2个月,第二张X光片处于生长发育高峰前期,测量分析牙颌面的变化,应用SAS8.0统计软件作配对t检验.结果反映上颌的后部位置和大小的指标Ptm-S(FH)、Ptm'-A'(FH),Ptm'-A'(PP)的变化没有统计学意义;下颌的长度增加明显;反映上下颌矢向关系的ANB、A-NPg减小;上下颌长度的差值增大.两年间U1-SN增大,L1-MP保持不变,覆盖保持不变.鼻唇角明显减小.结论单侧完全性唇腭裂前牙反(牙合)患者手术后替牙期两年间上颌生长不明显,上下颌骨关系和面型有Ⅲ类倾向,上颌切牙有代偿性唇向倾斜的趋势,以维持原有的覆盖关系.     

乳牙期骨性Ⅱ类与Ⅲ类（牙合）颅底形态差异的研究

目的：研究乳牙期骨性Ⅱ类与Ⅲ类错（牙合）畸形患者颅底形态的差异。方法：选取乳牙期骨性Ⅱ类及Ⅲ类错（牙合）畸形患儿各20例，通过头影测量分析，比较两种骨面型患者颅底形态的差异。应用SPSSl3．0统计软件，对测量数据进行独立样本t检验及相关分析。结果：骨性Ⅱ、Ⅲ类错（牙合）患者全颅底长及后颅底倾角减小且有显著差异，后颅底长、前颅底长及颅底角减小，但变化无统计学差异。SNA角与前颅底长（S-N）、后颅底长（S-Ba）及全颅底长（N-Ba）呈显著正相关：SNB与侧颅底长（S-Ar，N-Ar）、全颅底长（N-Ba）及颅底角（NSAr，NSBa）呈显著负相关，与后颅底倾角（SBa-FH）显著正相关。结论：乳牙期不同类型错（牙合）畸形与颅底形态有关，后颅底对颅面形态影响较大。     

西安地区Ⅲ类错(牙合)颅面类型矢状向构成分析

目的分析西安地区Ⅲ类错颅面类型矢状向的构成,对临床制定合理的矫治方案提供一定的依据。方法采用计算机辅助X线头影测量技术,对第四军医大学口腔医院正畸科2003～2008年间就诊的1177例Ⅲ类错患者的颅面类型进行回顾性研究,统计分析Ⅲ类错矢状向的构成。结果Ⅲ类错患者替牙期分类构成中,矢状向主要表现为上颌正常,下颌发育过度;其次为下颌正常,上颌发育不足。其它类型占比例较低。恒牙早期患者矢状向主要表现形式为双颌发育基本正常或上颌正常,下颌发育过度。恒牙期Ⅲ类错的主要表现形式为上颌正常,下颌发育过度。其次为上颌发育不足伴下颌发育过度。结论西安地区Ⅲ类错矢状向颅面类型在不同年龄段的构成存在一定差异,但总的来说下颌前突仍是Ⅲ类错的主要表现形式。     

Plaque and gingivitis in the deciduous and permanent dentition

Abstract The aim of the present investigation was to monitor de novo plaque formation and associated alterations of the gingival conditions in the deciduous, mixed and permanent dentition in man. 31 volunteers, divided into 3 study groups participated in the trial. Group 1 was made up of 11 subjects, 4–6 years of age (deciduous dentition), group 2 comprised of 10 subjects, 8–9 years of age (mixed dentition) and group 3 included 10 subjects, 14–16 years of age (permanent dentition). After a screening examination, each participant received detailed instruction in a proper oral hygiene technique and was subjected to professional tooth cleaning. The professional debridement and the oral hygiene instruction were repeated after 1 week. After another week, a given day was termed Day 0 and a baseline examination was performed. This examination included assessments of plaque and gingivitis. Each subject received an additional, comprehensive professional tooth cleaning and was asked to abstain from all mechanical oral hygiene measures. Re-examinations were performed after 3 and 7 days. The findings demonstrated that: (i) during a 7-day period of no active oral hygiene, subjects with a mixed or a permanent dentition formed visible amounts of plaque and developed modest signs of gingivitis; (ii) during the 7 days of the trial, young subjects with a fully erupted deciduous dentition formed less plaque than the older subjects, and failed to respond to de novo plaque formation with enhanced signs of gingivitis; (iii) in subjects with a mixed dentition, the amount of plaque formed during the 7 days of experiment and the matching gingivitis development were similar in the deciduous and permanent tooth segments of the dentition.     

儿童牙列缺损的分类和修复原则

本研究根据临床儿童牙列缺损病例，考虑乳牙缺失；恒牙根尖孔形成与否；缺失合并牙列畸形；先天性缺牙等因素，将儿童牙列缺损分成六类及相应的亚类，并提出临床方案及治疗原则。     

Pragmatic care for an aging compromised dentition

As our population ages, dentists face challenges in maintaining compromised teeth in aging patients. For the most part, elderly patients (i.e., over 65 years of age) prefer to keep their natural teeth and in some cases, avoid removable dentures altogether. Ideally, patients should not be rendered edentate late in life, as they are unlikely to successfully adapt to the limitations of complete replacement dentures. However, this is not always possible and care should ideally be planned to avoid edentulism, or at least, to carefully manage the transition to the edentate state. In the course of planning care, the dentist needs to recognise the need for age appropriate care, factoring in the impact of the elderly patient's health status and social circumstances. For elderly patients with a compromised dentition, the dentist should try to provide care which is minimally invasive and with as low a burden of maintenance as possible. In this paper, principles of pragmatic care for elderly patients with a compromised dentition will be outlined using clinical cases. Three pathways will be outlined: (i) maintenance of a functional natural dentition using adhesive restorative techniques; (ii) use of overlay prostheses and complete replacement overdentures to manage toothwear and toothloss, complete replacement overdentures, and; (iii) staging a transition to the edentate state using transitional removable partial dentures.     

圆锥型套筒冠义齿修复牙列缺损的疗效观察

对29件圆锥型套筒冠义齿(108颗基牙)修复牙列缺损后6、12、18个月的基牙牙体牙周状况、义齿固位力情况、咀嚼效能进行检查。1颗基牙折断,3颗基牙内冠脱落,10颗基牙出现牙龈炎,其余义齿使用固位及咀嚼效能良好,牙周无异常。因此,圆锥型套筒冠义齿是修复牙列游离端缺损较理想的方法,但制作中应严格掌握适应证,严格按照制作要求进行加工,才能取得良好的疗效。     

Black pigmentation in primary dentition: Case report and literature review

Black tooth staining is an extrinsic discoloration found in both primary and permanent dentition, and seen as dark pigmented lines extending to the gingival margin or an incomplete coalescence of dark dots that rarely extend beyond the cervical third of the crown. An association between black tooth staining and Actinomyces bacterial strains has been reported, while black-pigmented bacteria associated with such staining are known to be harbored in the oral cavity. Prevotella intermedia and Prevotella nigrescens are black-pigmented bacteria known to be dependent on the heme portion of hemoglobin as an iron source required for their growth. Recently, developments in molecular biological techniques have enabled rapid and easy detection of periodontopathic bacterial species using bacterial DNA extracted from oral specimens, such as plaque and saliva. Here, we report a case of black pigmentary deposition identified on all teeth of a 2-year-old girl, as well as the results of analysis of the distribution of oral bacteria in saliva and plaque specimens obtained from the patient using a molecular biological technique. In addition, a literature search found a case of disease related to the oral bacteria detected in our patient. We concluded that the bacteria detected in this case may have a strong relationship with black pigmentation, although the route of bacterial infection and cause of staining remain to be elucidated.     

Hypophosphatasia affecting the permanent dentition

Reports on dental abnormalities in connection with hypophosphatasia almost exclusively describe changes in primary teeth. A 23-year-old man with hypophosphatasia, first diagnosed at the age of 8 months, is described; histologically and radiographically verified signs of the condition were present in the permanent dentition. The findings included a reduced level of the marginal alveolar bone supporting the upper central incisors, which had to be extracted. The molars displayed large coronal pulp chambers. Histologically, the upper incisors demonstrated abnormal root cementum, with areas of dentin resorption, as well as disturbances of the mineralization of the coronal dentin. The patient also had signs of abnormal root resorption of molars. The potential involvement of permanent teeth puts children with hypophosphatasia at risk of developing oral complications during adolescent and adult life.     

Root exposure in the primary dentition studied in human skulls

The aims of the present study were to examine, on the primary dentition of 75 human dried skulls, the distance from the cemento-enamel junction (CEJ) to the alveolar bone crest, and to evaluate its relation to developmental age, bone morphology and attrition. The measurements from the CEJ to the alveolar crest were longer for the maxillary teeth, the second molars showed the shortest measurements, while the cuspids showed the longest. Significant positive partial correlations were found between age and the distance from the CEJ to the alveolar crest when controlling for attrition (r = 0.64), and between age and attrition when controlling for the distance from the CEJ to the alveolar bone crest (r = 0.54). The partial correlation between migration and attrition when controlling for age proved to be not significant (r = 0.13). Significant correlations were found between age and the distances from the mental foramen to: the alveolar crest (r = 0.90), and to the lower border of the mandible (r = 0.97). These findings suggest that root exposure takes place in the primary dentition, as the result of continuous eruption at a faster rate than formation of alveolar bone, presumably to compensate for facial growth.     

替牙期假性安氏Ⅲ类错（牙合）的牙颌特征

目的　研究替牙期假性安氏III类错的牙颌特征 ,为早期诊断提供依据。方法　假性安氏III类错组包括替牙期拍摄的 36张头颅侧位片。该组为追踪观察至生长发育期后确定为假性安氏III类错的患者 (女 1 5名 ,男 2 1名 ) ,替牙期拍摄头颅侧位片时的平均年龄为 1 0 7± 2 0岁。选择标准为 :①安氏Ⅰ类磨牙关系 ,前牙反 ;②功能性下颌前移位。真性安氏III类错组包括替牙期拍摄的 40张头颅侧位片。该组为追踪观察至生长发育期后确定为真性安氏III类错并接受正颌手术治疗的患者 (女 2 1名 ,男 1 9名 ) ,替牙期拍摄头颅侧位片时的平均年龄为 9 7± 2 2岁。选择标准为 :安氏III类磨牙关系 ,前牙反。安氏Ⅰ类错组包括 31名安氏Ⅰ类错患者 (女 1 7名 ,男 1 4名 ) ,平均年龄为 1 1 2± 1 4岁。选择标准为 :①安氏Ⅰ类骨面型 ,②覆覆盖正常 ,③轻度或中度牙列拥挤 ,④正中位时为直面型。结果　假性安氏III类错组中 ,女性“A”点到Nperp的距离平均值为 - 1 63mm ,与安氏Ⅰ类错女性平均值 0 52mm相比 ,差异有显著性 (P <0 0 5)。假性安氏III类错组上切牙较直立。结论　替牙期假性安氏III类错组的牙颌特征为 :①面中部长度 (Co A)稍短 ,②下颌功能性前移位 ,但下颌长度正常 ,③上前     

Gingivitis in the human deciduous dentition

This study examined the relationship between clinical and histomorphometric parameters in the human deciduous dentition. Clinical parameters including plaque index, gingival swelling, gingival color, tooth mobility and degree of root resorption were determined prior to the extraction of teeth. The teeth were extracted with their surrounding gingiva in order to preserve the in situ relationship between the hard and soft tissues. Histomorphometric analysis was carried out on 55 sites, using block surface light microscopy (BSLM). Apical migration of the junctional epithelium was found at 53% (29) of the sites. The gingival sulcus was shallow (0.3 +/- 0.19 mm) and coronal to the cemento-enamel junction at 84% (46) of the sites. Junctional epithelium with retepegs was present at 89% (49) of the sites, whilst an inflammatory cell infiltrate (ICI) was present at all sites examined. The ICI was located opposite to the junctional epithelium and cementum at 80% (44) of the sites. The extent of ICI correlated positively with the patients' age and was significantly increased when clinical evidence of gingival swelling or redness was present.     

The relationship between alveolar bone height and age in the primary dentition

Abstract The natural history of changes in attachment level in the primary dentition should be determined before considering diagnostic criteria for periodontal diseases in children. The present study was designed to describe longitudinal changes in the distance between the alveolar bone crest and the cementoenamel junction (ABC-CEJ) determined radiographically. Bite-wing radiographs were obtained from 33 children as part of a routine annual dental examination in a rural community. The ABC-CEJ distance of 1500 sites located at the mesial and distal aspects of primary molars and distal aspect of primary cuspids were measured. An analysis of variance model was used to assess the effect of age, sex, tooth, side of the mouth, jaw, site and patient on the ABC-CEJ measurements. The side of the mouth (left, right) and the site (mesial, distal) had no significant effect on the ABC-CEJ distance. ABC-CEJ distances in the upper jaw were greater than in the lower jaw, and different teeth exhibited different ABC-CEJ distances. Canines had the greatest distance and second molars the smallest. The most interesting relationship was between alveolar bone height and age. The overall ABC-CEJ distance seemed to increase with age; however, this was not a linear relationship but followed the pattern of facial growth, with two spurts separated by a period of minimal increase. The results indicate that different levels of ABC-CEJ distance might be considered as a cut-off value for radiographic diagnosis of alveolar bone loss at different ages, for different primary teeth and for different jaws.