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??Abstract??Objective To discuss the effect of occlusal reduction on the postoperative pain level after one-visit endodontic treatment for acute pulpitis. Methods Totally 44 cases of acute pulpitis of mandibular molar were selected and divided into the experiment and control groups. The experiment group included 22 cases receiving total occlusal reduction in both centric and lateral occlusion after the root canal therapy. The control group included 22 cases without reduced occlusion. The rate of pain response and VAS ??Visual Analogue Scale/Score???? which was evaluated 7 days?? 1 time per day??were recorded after operation. A comparison of the pain response and VAS results was done between the two groups. Results There was no statistically significance between the groups regarding the rate of pain response after operation ??the experiment group 36.36%?? the control group 40.91%?? P > 0. 05??. The VAS of the experiment group was slightly lower than the control group?? the difference having statistical significance ??P < 0.05??. Conclusion Occlusal reduction has no effect on the rate of pain response?? whereas it might diminish the pain degree following acute pulpitis in one-visit root canal therapy.     

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目的微创拔牙法和传统凿骨劈冠法对下颌阻生智齿拔除效果的比较。方法对1999年6月至2011年5月在解放军第359医院口腔科须要拔除单侧下颌阻生齿的患者270例,随机分成A、B两组,每组135例,A组采用微创拔牙法,B组采用凿骨劈冠法,对拔牙时间及术中、术后并发症进行观察和统计分析。结果 A组(微创拔牙法)平均拔牙时间为(20.83±8.07)min,显著短于B组(凿骨劈冠法)平均拔牙时间(24.82±12.29)min(P<0.05),A组术中、术后的并发症显著少于B组。结论微创拔牙法拔除下颌阻生智齿,可以缩短拔牙时间,减轻手术创伤,减少术中、术后并发症的发生,值得临床推广使用。     

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目的    探讨慢性牙周炎与脑血栓形成的相关性。方法    选择2008年2月至2009年10月在辽宁省人民医院神经内科住院的脑血栓形成患者76例为脑血栓组,口腔科门诊以非牙周疾病就诊患者98例为对照组。两组均进行相同的病史及牙周检查。比较两组牙周炎患病率及牙周健康状况的差异。结果    脑血栓组患者探诊深度（PD）、附着丧失（CAL）均显著高于对照组,差异有统计学意义（P < 0.05）;脑血栓组牙周炎患病率显著高于对照组,差异有统计学意义（P < 0.05）;随着慢性牙周炎程度的加重,脑血栓形成的危险性递增。结论    慢性牙周炎与脑血栓形成之间可能存在一定的相关性。     

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提要：保存活髓是治疗龋病、齿科手术操作及外伤所致牙髓暴露的理想方法。理想的盖髓材料应具有诱导牙髓细胞分化、修复性牙本质形成和保存活髓的特性。目前,临床常用的盖髓材料均不理想。因此,国内外许多学者都在致力于寻找一种更好、更完美的盖髓材料。本文就近年来盖髓材料的研究进展做一介绍。     

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在牙体牙髓病治疗过程中,有效的局部麻醉技术是减轻患者疼痛的重要手段,也是确保治疗顺利进行的基本保障。本文对牙体牙髓治疗中局部麻醉的相关问题做一介绍,并针对牙髓治疗中局麻方法和局麻药物的选择给出建议。     

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乳牙牙髓病及根尖周病是儿童口腔科临床工作中的常见病、多发病,是引起牙体缺损、牙列缺失的主要原因,严重影响患儿的身心健康。乳牙牙髓病及根尖周病的治疗原则与其解剖生理特征及儿童心理特点密切相关。本文旨在结合笔者的临床经验及国内外文献,对乳牙牙髓病及根尖周病的治疗原则、方法及临床注意事项等进行评述,并强调根管治疗术在其中的重要性和必要性。     

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环孢素(cyclosporin)是有代表性的、能选择性抑制细胞免疫的免疫抑制剂,临床主要用于肝、肾等器官移植后的抗排异反应,也可用于治疗自身免疫性疾病,如类风湿性关节炎、系统性红斑狼疮等,均取得较好疗效。在口腔疾     

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??Objective    To compare the pain in adult female patients with the application of the invisalign® and Damon Q self-locking brackets during initial orthodontic treatment. Methods    Totally 81 orthodontic adult female patients were selected and randomly divided into 2 groups??44 patients in experimental group wore invisalign® aligners while 37 patients in control group wore Damon Q self-locking brackets appliances. VAS was used to evaluate the time of occurrence of pain and the degree of the pain at 2 h??4 h??8 h??24 h??2 d??3 d??4 d??5 d??6 d and 7 d after the orthodontic treatment. SF-MPQ was used to evaluate the nature of the pain and the incidence of ulcer. Results    Totally 76 effective questionnaires had been collected??and no significant differences were demonstrated in the overall rates of occurrence or the degree of the pain in both groups within the observation period??P > 0.05????but the nature of the pain was different. The incidence rate of ulcer in experimental group was lower than in control group. Conclusion    Basically there is pain in the patients who wear invisalign and Damon Q self-locking brackets for the first time?? but the nature of the pain and the occurrence of ulcer have significant difference.     

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??Temporomandibular joint disorders??TMD??are one of the most common and refractory diseases??and significantly influence living quality and physical and psychological health. The risk factors of TMD are more complex??and at present the pathogenesis has not been fully elucidated. In recent years??more people are concerned about the effect of psychological factors??but the effect and mechanism are complex. In foreign literature research of catechol-O-methyltransferase??COMT??as a gene associated with pain shows that before and after stress the COMT gene expression changes in masticatory muscle tissue of patients with TMD??so it can be concluded that there are correlation between the psychological state and COMT gene polymorphism. This article focuses on the effect and adjustment mechanism of COMT gene in TMD.     

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??With the development of digital technology??three-dimensional scanning??computer-aided design??and three dimensional printing??and so on??have penetrated into endodontic diagnosis??treatment??prognosis assessment and other aspects. The introduction of the digital technology and equipments makes the diagnosis and treatment of pulp disease more intuitive??accurate??and minimally invasive. This review summarizes the application of digital technology in the diagnosis and treatment of pulp diseases in recent years.     

正畸疼痛的研究进展

疼痛是组织损伤或潜在组织损伤所引起的不愉快感觉和情感体验。正畸疼痛会对患者的依从性造成负面影响,也使得许多患者抵制正畸治疗。该文总结了现有的研究中关于正畸疼痛的研究进展,并针对在临床工作中医生和患者可能会产生的疑问寻找可靠的答案。     

Appropriateness of orthodontic referrals: self-perceived and normative treatment needs of patients referred for orthodontic consultation

OBJECTIVES: The aims of this prospective study were to evaluate the self-perceived and normative orthodontic treatment needs of children referred for orthodontic consultation and to determine the proportion of children who were inappropriately referred. METHODS: The sample consisted of 257 children with a mean age of 12.0 years (SD = 2.4). An orthodontist assessed the children's normative treatment need using the dental health component (DHC) of the index of orthodontic treatment need (IOTN), and for patients in the mixed dentition the need for interceptive treatment was assessed. Questionnaires were answered by both the child and the parent to assess satisfaction with dental appearance and desire for treatment. RESULTS: The distribution of the IOTN grades showed that 73% of the children had definite need while 27% had borderline/no need for orthodontic treatment. Twenty-six per cent of children and 17% of parents did not express orthodontic concern, even though more than half of these children were in definite need of treatment as assessed by IOTN. The children's orthodontic concern was significantly related to the DHC scores. Out of the 103 children who were in the mixed dentition, only about 16% required interceptive treatment. CONCLUSIONS: The results indicated that a significant number of children were inappropriately referred for orthodontic treatment. Referring dentists need to assess the normative treatment needs of the children as well as the children's and parents' commitment and desire for orthodontic treatment before deciding on the need for referral.     

Normative and self-perceived orthodontic treatment need in Nigerian school children

Abstract

Objective. The aim of this study was to assess the normative and self-perceived need for orthodontic treatment in Nigerian children, and to evaluate distribution of orthodontic treatment need according to gender and age. Materials and methods. The sample consisted of 441 randomly selected school children, aged 11–18 years in Benin City, Nigeria. The subjects were further sub-grouped according to gender (229 males and 212 females) and age (246 11–13 years old and 195 14–18 years old). The Dental health Component (DHC) and Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN) were used to assess orthodontic treatment need normatively. Self-perceived need was evaluated by asking the subjects to rate their dental aesthetics on the Aesthetic Component scale of IOTN. Chi-square tests were used to evaluate gender and age differences in distribution of treatment need. Results. A definite need for orthodontic treatment was found among 21.5% (grades 4–5 of DHC) and 6.3% (grades 8–10 of AC) of the subjects; 3.9% of the subjects perceived a definite need for orthodontic treatment (grades 8–10 of AC). There were no statistically significant gender and age differences in distribution of orthodontic treatment need among the subjects (p > 0.05). Conclusion. The study revealed a need for orthodontic treatment in slightly more than one fifth (21.5%) of this sample of Nigerian children. The sample population has a lower need on aesthetic grounds and their normative and self-perceived orthodontic treatment needs were not influenced by gender and age.     

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口腔影像学是口腔正畸学诊断的重要依据。锥形束CT（CBCT）的临床应用使正畸诊断从二维时代走向了三维时代。CBCT对于正畸治疗方案设计、治疗后的预测以及治疗效果的评价等具有重要的作用。     

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目前对磨牙问题的关注和研究使得正畸医生对错机制的认识和矫治设计的理念正在发生某些改变。而针对主要由磨牙问题形成的错畸形进行的磨牙矫治,无论是在设计思想还是矫治手段上,都是一类棘手的难题。近年来,微型种植体支抗技术得到快速发展,有助于在解决这类难题时提供崭新的思路。本文概述种植支抗和磨牙矫治的结合带给正畸设计和治疗理念上的变化。     

正畸治疗疼痛的研究进展

疼痛是正畸治疗中最常见的问题之一,随着患者对治疗舒适度要求的增加,如何认识正畸治疗中的疼痛特点,如何减轻正畸治疗的疼痛程度,成为正畸医师关注的研究热点.本文就正畸治疗时疼痛的特点和减轻疼痛方法的研究进展作一综述.     

正畸治疗与颞下颌关节紊乱病关系的研究进展

颞下颌关节紊乱病是口腔临床常见病之一.一般认为颢下颌关节紊乱病是由多因素导致的咀嚼肌功能紊乱、颞下颌关节异常和退行性改变.近几十年来,正畸治疗与颢下颌关节紊乱病之间可能存在的关系一直是正畸医生研究和关注的焦点.本文就两者之间关系的研究作一.     

正畸疼痛的临床研究

疼痛是正畸牙移动过程中的最常见症状之一。许多研究表明疼痛已经成为患者中断正畸治疗最主要的原因之一,随着患者对治疗舒适度要求的增加,如何监测正畸疼痛,如何减轻正畸治疗过程中的疼痛成为正畸医生的研究热点。本文就正畸过程中产生的疼痛特点以及临床上正畸疼痛的控制方法以及研究进展做一综述。     

正畸治疗中的牙龈退缩

牙龈退缩作为正畸治疗中常见的并发症,不仅会引起牙根部牙本质敏感,牙颈和牙根部龋坏,牙周支持丧失,食物嵌塞,还会严重影响患者的容貌美观。牙龈退缩是多因素共同作用的结果,好发于前牙区和颌骨左侧,共分4度,50％以上的健康人群均可发病,退缩程度随着人的年龄增加而加重。其治疗首选非手术方法,即在正畸治疗过程中和治疗结束后注意炎症的控制,调殆,去除食物嵌塞发病因素;手术治疗主要有软组织移植术和引导组织再生术,前者通过皮瓣移植,后者促进牙周软硬组织的再生;若非手术和手术方法均不能有效地实现牙龈生理性重建,则可以采用修复方法对其进行掩饰性治疗,即人工龈修复。     

正畸治疗前后牙根吸收的临床研究

目的 调查正畸治疗前后牙根吸收的临床特征。方法 随机选择至少经过十二个月固定正畸治疗,有清晰可辨的矫治前后全口曲面断层片的病例９６例,用根吸收分级评估法记录每人矫治前后全口牙齿根吸收情况,并统计分析。结果 （１）正畸治疗前８．６％的牙齿存在根吸收,治疗后４１．６％的牙齿有程度不等的根吸收;（２）治疗前的根吸收绝大部分为轻度,治疗后仍以轻度吸收为主,但也有部分中重度吸收;（３）治疗前的根吸收主要在上颌前牙区;治疗后根吸收上下颌没有显著性差异,但前牙明显高于后牙。结论（１）正畸后的根吸收较为常见;（２）大部分正畸过程中的牙根吸收是可接受的;（３）正畸治疗后有一部分牙齿（１．３％）出现重度根吸收,主要分布于上前牙,成为危害患者颜面美观及功能的隐患,应引起足够的重视。