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??Upper airway narrowing or collapse will not only result in snoring and obstructive sleep apnea hypopnea syndrome??but will also lead to compensatory oral breathing. Many years′  experience of oral breathing will induce a series of dentofacial anomalies. Orthodontists can either correct the dentofacial malocclusion of children or juveniles via various kinds of appliances??following adenoidectomy and tonsillectomy?? or enlarge upper airway through repositioning the jaw and tongue of an adult patient. To sum up??an orthodontist can play an independent or collaborative role in the upper airway management across one′ s life span.     

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??Root canal debridement and infection control are two of the main steps in root canal therapy. Bacteria will be present as biofilm colonies inside the root canal??and it will be well within fins??intercanal anastomoses??apical ramification??apical furcation or lateral accessory canal. Meanwhile??during the cleaning and shaping process??smear layer can be produced??which can be used for the viable bacteria inside the complex anatomical structure to sustain growth and activity. In addition??due to the complexity of the root canal system??the conventional irrigation and disinfection technology is superficial??then the smear layer and Enterococcus faecalis biofilms are difficult to remove. In recent years??lasers??as a novel adjuncting irrigation tool??are used clinically??such as Er??YAG laser and Er??Cr??YSGG laser. As is reported??laser-activated irrigations can effectively remove the smear layer and the infection and obtain better disinfection rates. So in this a review??we made a summary of the effect of laser-activated irrigations on endodontics.     

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??Nano antibacterial materials is a new kind of medical material?? because of its excellent antibacterial effect?? which was widely be used in the course of orthodontic treatment. So the purpose of this paper is to review the progress on the advantages of its antibacterial activity in orthodontic treatment process.     

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口腔全科医师是口腔医疗保健的主体,住院医师培训应以培养口腔全科医师为目的。综合医院口腔科在管理上应建立口腔全科诊疗思维,成为口腔全科医师的培养中心。开展住院医师规范化培训,对加强我国口腔医学人才的培养具有重大而深远的意义。     

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??Sialic acid is a nine-carbon sugar acid??which is located at the terminal residue of glycoconjugations. The sialic acid-containing glycoconjugates are widely distributed on the surface of eukaryotic and prokaryotic cells and in serum and saliva. The sialic acid plays an important role in bacteria survival and pathogenesis. Some pathogenic bacteria coat themselves in sialic acid??providing resistance to components of host’s immune response??and some can use it as a nutrition. In this paper??the role of sialic acid and sialidase in bacteria survival and pathogen was reviewed.     

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1项目简介近年来,我国地震、洪涝等灾害事故多发,安全生产、交通事故死亡人数居世界前列,来自临床的统计结果显示,我国14~40岁人群的最大死因是创伤。创伤现场迅速有效的救治也许能挽回其中许多人的生命,但长期以来,我国缺乏对突发自然灾害及意外事故中受伤人员救治的系统、规范、实用的培训。     

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内质网（endoplasmic reticulum,ER）是一种重要的真核细胞器,是蛋白质合成与分泌的重要场所。当细胞受到外界的某些刺激时,ER会产生一系列调节机制,形成内质网应i~（endoplasmic retieulum stress,ERS）。ERS使ER腔内错误折叠与未折叠蛋白聚集以及Ca。’平衡紊乱。可激活未折叠蛋白反应（unfolded protein response,UPR）,以保护由ERS所引起的细胞损伤,恢复细胞功能。但当应激反应过强或刺激时间过长时,则会诱导细胞凋亡,引起疾病的发生。氟瘫牙的形成是由于成釉细胞合成与水解蛋白质功能障碍,因此,推断ERS与氟斑牙的产生有关。现对ERS诱导细胞凋亡的机制和途径,以及这一机制在氟斑牙形成中的作用进行综述。     

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口腔黏膜病病因复杂、发病机制不清,给临床医生的诊治工作带来了很大的困难和挑战。舌诊在我国传统中医理论中具有独特的价值,是“整体观念、辨证论治”的代表和体现。本文通过对舌诊历史发展及其中医理论体系特点、舌生理解剖特点和近代实验研究进行概况,诠释了舌诊的科学依据、突出贡献和未来的发展方向;通过对口腔黏膜病诊断和治疗中诸多现实问题的探讨,阐明了舌诊在口腔黏膜病诊治中的作用和意义。同时,本文还描述了舌诊是中西医结合治疗的关键和基础以及如何正确掌握舌诊技能的重要性,提倡在口腔黏膜病治疗中对舌诊重视并应用。     

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激光在牙体牙髓病治疗方面的应用研究正不断深入,其中以治疗牙本质过敏、预防龋齿、盖髓术、牙髓切断术及根管治疗术的研究较多。在选择激光时,应根据牙体牙髓病的病变类型及程度来选择合适的方式,以达到治疗目的,同时避免和减少激光的副效应。本文就激光在牙体牙髓病治疗中的应用做一综述。     

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??Abstract??The condylar position should be taken into account in the diagnosis and treatment of condyle fracture??orthognathic surgery??occlusal reconstruction and temporomandibular disorders. The normal condylar position in the glenoid fossa and its clinical significance in the diagnosis and treatment of temporomandibular disorders??for example the disc displacement??will be discussed here through the literature review and the combination of our research findings. Many research data suggested a centric position of condyle in a normal joint??with individually variances. A posterior condylar position might be a risk factor of disc displacement??and on the other hand??the disc displacement might induce condyle to move posteriorly. With the use of anterior repositioning splint for treating anterior disc displacement with reduction??the condyle moved anteriorly and inferiorly??the condyle-disc relationship could be improved immediately. Besides??splint therapy may facilitate regenerative remodeling of condyles.     

下颌阻生第三磨牙的研究进展

第三磨牙是发育和萌出最晚的牙齿,临床上以第三磨牙的阻生最为常见,尤其是下颌第三磨牙。下颌第三磨牙的阻生容易引发冠周炎、龋齿、间隙感染和骨髓炎等病症,通常需要外科拔除或者进行正畸矫治。而在拔除或者保留第三磨牙的选择上,临床医生各持不同的看法。在正畸治疗中,常遇到需拔除下颌第二磨牙或第一磨牙。因此,保留第三磨牙以替代缺失的磨牙就有很重要的意义。本文通过对相关文献的分析,以期为临床上拔除或保留第三磨牙的选择提供参考。     

磨牙倾斜角度和萌出间隙对第三磨牙萌出的影响

目的研究影响第三磨牙阻生或萌出的一些客观因素。方法选择86例(男37例,女49例)平均年龄25.4岁,上下颌第三磨牙均存在的患者,将其分为萌出组和阻生组,利用曲面断层片对患者上下颌第三磨牙的近中倾斜角、牙冠近远中径、磨牙后间隙、磨牙后间隙和牙冠近远中径的比值进行测量分析。结果上颌萌出组萌出间隙较阻生组大1.95mm,第二磨牙和第三磨牙长轴交角相差12.53°,萌出组第三磨牙近远中径比阻生组小0.69mm,有统计学差异。下颌萌出组萌出间隙L-ES(R)较阻生组平均值大3.33mm;第三磨牙与牙合平面交角阻生组较萌出组大32.48°;萌出组与阻生组的磨牙后间隙/牙冠近远中径平均值分别为1.05、0.85,3项指标差异均有显著性(P<0.01)。下颌第三磨牙近远中径相差0.3mm,无统计学意义。结论第三磨牙萌出受萌出间隙和磨牙间交角的影响,对于上颌第三磨牙,磨牙交角影响更大,对于下颌第三磨牙无足够的间隙萌出,是导致下颌第三磨牙阻生的重要原因。     

正畸治疗中磨牙的拔除与保留(十六)——正畸拔除下颌第一磨牙后第三磨牙位置和倾斜度变化

目的：探讨正畸拔除下颌第一磨牙对下颌第三磨牙位置和倾斜度的影响.方法：选择34例拔除下颌第一磨牙正畸治疗和29例非拔除下颌第一磨牙正畸治疗,对两组病例治疗前后头颅侧位片进行测量分析.观察矫治前后下颌第三磨牙在垂直方向、水平方向及倾斜角度的改变,比较两组之间的差异.结果：拔牙组和非拔牙组间治疗前后下颌第三磨牙垂直位置和倾斜度变化的差异没有统计学意义（P＞0.05）;拔牙组和非拔牙组间治疗前后下颌第三磨牙水平位置变化的差异具有统计学意义（P＜0.05）.治疗后,拔牙组下颌第三磨牙比非拔牙组更靠近近中.结论：拔除下颌第一磨牙的正畸治疗加速了下颌第三磨牙向近中迁移.     

近中水平阻生下颌第三磨牙的矫治探索

目的探索保存和利用近中水平阻生下颌第三磨牙的矫治方法,以期保留更多的近中水平阻生的下颌第三磨牙。方法利用自行研制的磨牙胎面正轴装置及磨牙远中正轴装置,配合下颌固定矫治器,对近中水平阻生的下颌第三磨牙进行矫治。结果利用本研究方法对10例11颗近中水平阻生的下颌第三磨牙进行17．26个月矫治,均取得第三磨牙直立、稳定、覆胎覆盖关系正常的预期目标。结论利用磨牙殆面正轴装置及磨牙远中正轴装置,可快速、安全、高效地完成对近中水平阻生下颌第三磨牙的矫治。     

第三磨牙在口腔治疗中的作用

当第一或第二磨牙严重病损时,第三磨牙在口腔治疗中发挥重要作用。我们将严重病损的第一或第二磨牙拔除,再利用正畸矫治的方法将不同程度阻生的第三磨牙近中及直立移动,排入牙列,使之发挥磨牙咀嚼功能。阻生第三磨牙均成功排入牙列,建立咬合关系,最大限度地恢复了自体牙列完整与咬合功能。     

Independent predictors of satisfaction in impacted third molar surgery patients

Kim YK, Kim SM, Myoung H. Independent predictors of satisfaction in impacted third molar surgery patients. Community Dent Oral Epidemiol 2010; 38: 274–286. © 2010 John Wiley & Sons A/S Abstract – Objectives: Patient satisfaction and dissatisfaction are critical dimensions leading to favorable or unfavorable treatment outcomes. Although impacted third molar (ITM) surgery is one of the most common dental surgical procedures, it is a challenging operation because of numerous potential complications and patients generally suffer from severe psychosomatic symptoms as a result of severe perioperative anxiety. We hypothesize that multiple independent factors, including perioperative anxiety and various postoperative complications, affect satisfaction of the ITM surgery patients. Methods: Survey data from 219 participants encompassed basic patient demographic traits, difficulty of surgery, perioperative anxiety, pain sensation and common postoperative complications. The t‐test and one‐way anova with Duncan’s multiple‐range tests were applied to detect differences in mean values of perioperative anxiety, perioperative pain sensation and satisfaction based on basic demographic characteristics and postoperative complications. The significance of postoperative complications according to demographic data and difficulty of extraction was also analyzed. A paired t‐test was applied to detect the significance of anxiety level and pain sensation changes over time. Lastly, univariate and multiple stepwise regression analyses were used to analyze the relationships among perioperative anxiety, pain sensation and satisfaction to determine the predictive factor of patient satisfaction. Results: Basic demographic traits proved not to have a direct significant effect on satisfaction in ITM surgery patients, but some demographic factors and difficulty of surgery showed significant relationships with postoperative complications. Univariate analysis revealed that perioperative anxiety, pain sensation, postoperative infection, numbness/paresthesia and ecchymoses have a significant influence on patient satisfaction. In particular, preoperative anxiety level and numbness/paresthesia were independent predictive factors of patient satisfaction upon multivariate analysis. Conclusions: This study demonstrates that the patients who undergo ITM surgery often have severe anxiety that seriously impacts patient satisfaction and resultant treatment outcomes. In addition, patient satisfaction directly depends on the occurrence of some postoperative complications. Appreciation of these predictive factors and increasing patient satisfaction may help clinicians to provide optimal care for ITM surgery patients.     

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目的观察应用高速涡轮机拔牙法拔除下颌阻生智齿的临床疗效。方法对2004年8月至2008年4月大连大学附属中山医院口腔科收治的238例下颌阻生的智齿患者,随机分为试验组与对照组,分别采用高速涡轮机拔除法与骨凿法进行拔除。观察两组术后并发症发生情况,并进行统计学分析。结果高速涡轮机法与骨凿法拔牙术后各并发症的发生差异均有统计学意义(P<0.01或P<0.05),高速涡轮机拔牙法并发症的发生要明显低于骨凿法。结论应用高速涡轮机拔牙法拔除下颌阻生智齿,能降低患者术后并发症的发生率,认为高速涡轮机拔牙法的临床效果要优于传统骨凿法。     

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目的探讨拔除阻生智牙治疗大学生颞下颌关节紊乱病（temporomandibular disorders,TMD）的临床效果。方法选择2009年9月以来广东工业大学医院口腔科青年大学生TMD并智牙阻生患者136例,随机分为2组,每组68例,试验组采取心理＋药物＋局部理疗＋阻生牙拔除术等综合治疗,对照组仅采取心理＋药物＋局部理疗等保守治疗。两组完成治疗后随访观察1年,对比疗效差异。结果试验组总有效率为91.2%,对照组总有效率78.0%,两组疗效差异有统计学意义（P〈0.05）。结论拔除阻生智牙对治疗青年大学生TMD有较好的疗效,可列为青年大学生TMD系列治疗方法之一。     

正畸治疗中磨牙的拔除和保留(十九)——竖直近中阻生下颌第三磨牙牙槽骨改建分析

目的：观察近中阻生下颌第三磨牙竖直矫治后,其近中牙槽骨改建情况。方法：对16例共28个近中阻生下颌第三磨牙采用悬吊竖直法矫治病例进行观察,分析第三磨牙近中牙槽骨改建情况。结果：口腔全景X线片可见所有病例矫治后下颌第三磨牙近中牙槽骨均明显增高,未见深牙周袋形成。结论：在牵引矫治近中阻生下颌第三磨牙时,注意避免炎症,减小创面,开窗时少去骨,矫治后阻生牙周围骨质一般不会出现病理性吸收现象。     

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目的：探讨锥形束CT（ cone beam CT,CBCT）在下颌阻生第三磨牙（ impacted mandibular third molar,IMTM）拔除术前设计中的应用价值。方法选择2012年9月至2013年3月在沈阳医学院附属中心医院口腔科门诊就诊,根尖片或曲面平展片检查显示下颌管（MC）与IMTM根尖相邻或相重叠的病例55例（60颗牙）,行CBCT检查,根据CBCT所提供的影像资料,判断IMTM周围组织情况,采用涡轮钻分牙拔除IMTM。结果55例患者均未出现下牙槽神经损伤情况。结论 CBCT较传统影像学检查方法成像更清晰,定位更准确,尤其有利于颊舌向位置关系的显示。对于中低位的IMTM应行CBCT检查以避免拔牙过程中损伤相邻组织结构。