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??Objective    To analyze the principle and evaluate clinical effect of correction on skeletal mandibular deviation by multiloop edgewise arch wire ??MEAW??technique in permanent dentition. Methods    MEAW technique was applied to treat 16 cases of skeletal mandibular deviation with 0.56 mm × 0.71 mm MBT bracket system. Panoramics and cephalometric radiographs were taken and compared before and after treatment. Results    After average treatment time of 20 months??totally 16 cases gained perfect therapeutic effect with molar distal tipping and movement??mean value??tipping 7.63°??movement 3.38 mm????lingual inclination in lower anterior teeth with the change 3.31 mm during treatment??but mandible bone remained asymmetric before and after treatment and there was little change happened on jaws. Conclusion    Skeletal mandibular deviation in permanent dentition can be treated successfully by multiloop edgewise arch wire technique??that is so-called “compensatory treatment”.     

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目的探讨单冠修复体牙尖斜度的不同对冠修复后近远中邻接关系的影响。方法选择2004年1月至2010年5月在广州医学院荔湾医院口腔科因食物嵌塞而行上颌第一磨牙单冠修复的患者214例,按制作牙尖斜度的不同分为3组,即15～25°牙尖斜度组(68例)、>25～35°牙尖斜度组(70例)以及>35～40°牙尖斜度组(76例)。冠修复体制备完成后,检查修复体与邻牙的邻接关系,并于修复后第6、12和24个月每组各抽取40例进行临床随访,调查患者再次发生食物嵌塞的情况。结果修复后第6个月,3组患者之间食物嵌塞的发生率差异无统计学意义(P>0.05)。修复后第12、24个月,前2组患者之间食物嵌塞的发生率差异无统计学意义(P>0.05),而前2组和第3组患者之间食物嵌塞的发生率差异有统计学意义(P<0.05)。结论为了减少上颌第一磨牙单冠修复后再次出现食物嵌塞,建议降低牙尖斜度并和邻牙牙尖斜度协调。     

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正畸治疗的目的是通过改变牙齿整体的三维位置从而获得相对正常的咬合关系,因而正常是诊断和治疗错畸形的基础与标准。牙齿近远中倾斜度是正常重要组成因素之一,目前测量牙齿近远中倾斜度的方法各有千秋。本文就各种测量牙齿近远中倾斜度的方法做一综述。     

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??Objective    To observe and measure the mandibular alveolar bone morphology at the area of mental foramen in the patients with mandibular deviation by CBCT to provide reference for genioplasty in orthognathic surgery??so as to reduce the complications such as the injury to nerves and blood vessels. Methods    In this study??84 adults with mandible deviation were selected??CBCT scans were conducted and InVivo 5 software was used to reconstruct the mandible??locate the markers??observe and measure and analyze the position of the mental foramen and the morphology of the mental canal. All the measurements were analyzed with SSPS 17.0 package. Results    The mental foramen was mostly below the second premolar at the mandibular??39.29%????and below the first premolar is the least??11.90%??. There was no significant difference between the oblique side and the contralateral side on all measurement values??in addition to the angle of the mental canal??the gender difference is significant??and it's much greater in males. Conclusion    There are some differences in the position of the mental foramen between the individuals of mandibular deviation deformity and the normal??and also are somewhat different between males and females. The CBCT imaging can clearly display the three-dimensional structure??the trend and the relationship with adjacent structures of the mental canal??which can effectively reduce or avoid the surgical complications.     

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摘要：目的 探讨斜向载荷下采用不同基牙数目时下颌后牙双侧游离缺损冠外附着体义齿支持组织的应力分布情况。方法 2005年选取一成年健康男性志愿者的头部CT（取下颌牙槽骨部分）和离体尖牙、第一双尖牙、第二双尖牙、第一磨牙、第二磨牙的CT扫描图片。建立下颌KennedyⅠ类牙列缺损冠外附着体义齿修复的三维有限元模型,分析在斜向载荷作用下采用不同基牙数目时,基牙牙周组织及缺牙区牙槽嵴的Von Mises应力分布。结果 斜向载荷下,末端基牙牙周膜应力集中区主要位于颊舌侧的牙颈部,随着基牙数目的增加,基牙牙周组织及缺牙区牙嵴的最大应力值都呈下降趋势,基牙由1颗增加至2颗时,应力明显下降,当基牙增加至3颗时,应力的下降量明显减少。结论 在下颌游离缺损修复中,斜向载荷下冠外附着体义齿支持组织应力的减少与基牙数目的增加不完全成比例,在临床上应根据具体的情况确定联合基牙的数目。     

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目的    研究不同正畸治疗方法对阻生下颌第三磨牙的影响。方法    选择2005年1月至2008年5月青岛大学医学院附属医院口腔正畸科治疗的第三磨牙阻生青少年患者79例（154颗患牙）,按治疗前下颌第三磨牙倾斜角及矫治是否拔牙分为4组：未拔牙A组（非拔牙矫治且倾斜角≤30°）,未拔牙B组（非拔牙矫治且倾斜角＞30°）,拔牙A组（拔牙矫治且倾斜角≤30°）,拔牙B组（拔牙矫治且倾斜角＞30°）。拍摄正畸治疗前后口腔曲面断层片,测量并计算矫治前后下颌第三磨牙倾斜角及萌出间隙的变化。结果    矫治后拔牙A组第三磨牙倾斜角比矫治前平均减小3.36°,且差异有统计学意义（P < 0. 05）;其余各组矫治前后差异均无统计学意义。矫治后各组下颌第三磨牙的萌出间隙均高于矫治前,且差异有统计学意义（P < 0. 05）,其中拔牙组矫治前后萌出间隙变化尤为明显。结论    对于原倾斜角较小的下颌第三磨牙,拔牙有利于改善第三磨牙的萌出角度;与非拔牙矫治相比,拔牙矫治更多地增加了下颌第三磨牙的萌出间隙,有利于下颌第三磨牙的萌出。     

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先天性双侧面斜裂临床上较为罕见,是一种少见的颅颌面先天性畸形,其发病机制尚不清楚,通常需要多次手术才能改善畸形状态,在所有面斜裂中占0.075%～0.54%[1-2]。     

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目的探讨成釉细胞瘤(AB)的发病和复发机制。方法对2004—2006年中国医科大学口腔医学院和沈阳市口腔医院病理科存档的34例病理诊断为AB的蜡块标本(滤泡型AB18例,丛状型AB10例,壁性AB6例)及口腔正常黏膜蜡块标本14例,采用SABC法免疫组化检测BMP-2的表达。胞浆出现棕黄色颗粒为阳性着色。用改良打分法半定量分析BMP-2表达。采用秩和检验比较。结果AB与正常口腔黏膜的BMP-2表达差异具有统计学意义。滤泡型AB组、丛状型AB组和壁性AB组间差异无统计学意义。结论BMP-2在AB中有阳性表达。在不同病理类型的AB中,BMP-2的表达差异无统计学意义。BMP-2在AB的发生、发展中起重要作用。     

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??Objective The location features of adult skeletal class ?? malocclusion mandibular deviation patients with mandibular condyle using Mimics software for 3D measurement. Methods    Fifty patients with skeletal class ?? malocclusion and mandibular deviation??deviation group??28 patients??nondeviation group??22 patients??received spiral computed tomography??DICOM data were collected. Maxillary and mandibular three-dimensional reconstruction was performed using Mimics 17.0. The upper and lower jaws were separated and the condylar morphology was revealed completely. To make sure measurements and analyze statistically. Results    There was no statistical difference in nondeviation group. In deviation group??the angle of coronal and horizontal plane in deviated condyle with coronal plane in skull was larger than the other side??the angle of horizontal plane in condyle with FH plane was smaller than the other side. The distance of sigmoid notch to FH plane and coronal plane was smaller than the other side. The distance of sigmoid notch to midsagittal plane is larger than the other side. The other measurements had no satistical difference. Conclusion    Mandibular condyle position of adults with skeletal class ?? malocclusion and mandibular deviation is asymmetric. The lateral condyle is more laterally and inferiorly positioned on the contralateral side than on the deviated side. The sigmoid notch is more laterally??superiorly??and posteriorly positioned on the deviated side. There is no obvious change in the TMJ space.     

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??Objective    To measure the anatomic buccolingual angulation values of the maxillary alveolar process based on CBCT images in order to form a basis for the implant treatment planning?? including the design of implant position and angulation. Methods    A random sample of 51 CBCT images were selected and analyzed. The NewTom 5G CBCT data sets were reformatted at a 0.5-mm spacing?? with the inferior border of the region of interest parallel to the occlusion plane of maxillary teeth. Twenty-four buccolingual cross-sectional images of the maxillary alveolar process were obtained for buccolingual angulation measurements. Results    Mean or median values of the buccolingual angulation of maxillary alveolar process ranged from about 0 degree to more than 40 degrees. Cross-sections distal to the premolar region showed a statistically higher proportion of vertical process ??angulation equals to 0 degree???? compared to cross-sections corresponding to maxillary premolars and anterior teeth region ??P < 0.05??. There were no statistical differences between the angulation of alveolar process both from the right side and left side and from males and females patients ??P > 0.05??. Conclusion    The buccolingual angulation of maxillary alveolar process decreases from anterior teeth region through the premolars region to the molars region?? with the lateral incisor and canine region being the most inclined bucally and a high proportion of the molars region being nearly vertical. Knowing average values of buccolingual angulation of maxillary alveolar process before dental implantation may help the clinician plan the position and orientation of implants?? especially when an implant surgical template is not available.     

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??Objective    To measure the anatomic buccolingual angulation values of the mandibular alveolar process based on CBCT images in order to help determine the implant angulation at the implant treatment-planning phase. Methods    A random sample of 51 CBCT images were selected and analyzed. The NewTom 5G CBCT data sets were reformatted at a 5-mm spacing??with the inferior border of the region of interest parallel to the base of the mandible. Twenty-four buccolingual cross-sectional images of the mandibular alveolar process of each CBCT scan were obtained for angulation measurements by NNT5.6 software. Results    The mean or median values of the buccolingual angulation of the mandibular alveolar process??ranging from 1.8 degrees to 28.5 degrees??were obtained. There were no statistically significant differences on the angulation values of the alveolar process between the right side and left side or between male and female patients??P??0.05??. The number of buccally-inclined alveolar process cross-sections increased from cross-section NO.8 to NO.11??and decreased from cross-section NO.14 to NO.17??which were statistically significant??P??0.05??. Conclusion    The mean or median values of the buccolingual angulation of mandibular alveolar process increase gradually from the anterior tooth region via the premolar region to the second molar region. Most of the mandibular alveolar process cross-sections at the anterior teeth region incline buccally??while most of those at the premolar region and all of those at the molar region incline lingually. Knowing buccolingual angulation values of the mandibular alveolar process before dental implantation may help the clinician plan the orientation of implants.     

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??Objective    To discuss the influence of glycogen synthase kinase-3β??GSK-3β??on osteogenesis of jaw bone marrow mesenchymal stem cells??JBMMSCs?? in inflammatory microenvironment. Methods    Use shRNA to knock down the expression of GSK-3β in JBMMSCs. IL-1β and TNF-α were used to mimic inflammatory microenvironment. After osteogenesis??Western Blot was used to detect osteogenesis-related protein expression and Alizarin Staining was used to detect the efficiency of osteogenesis in different groups. Results    Expression of osteogenesis-related protein and efficiency of osteogenesis was highly up-regulated after knocking-down of GSK-3β in JBMMSCs. Inflammatory microenvironment could significantly down-regulate the expression of osteogenesis-related protein and efficiency of osteogenesis in ordinary JBMMSCs??while knocking-down GSK-3β could attenuate this effect. Conclusion    Knocking-down of GSK-3β in JBMMSCs can both increase the efficiency of osteogenesis and resist the adverse effect of inflammatory microenvironment on osteogenesis??thus GSK-3β is a potential target for improving the regeneration in inflammatory microenvironment.     

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目的 探讨多曲方丝弓技术(MEAW)矫治恒牙列单侧后牙反(殆),改善功能性下颌偏斜的疗效.方法 选取2007-2010年就诊于山西医科大学口腔医院正畸科门诊的安氏Ⅲ类错(殆)伴下颌偏斜患者10例,排齐整平牙列,采用MEAW技术调整后牙在三维方向上的位置,配合双侧不对称的短Ⅱ美和短Ⅲ类牵引,调整上下中线.拍摄矫治前后X线片并进行头影测量分析.结果 10例患者均取得良好矫治效果,矫治后磨牙为中性关系,覆(殆)覆盖正常.结论 轻度恒牙列单侧后牙反(殆)患者通过MEAW技术可有效纠正磨牙关系及下颌偏斜.     

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??Objective??To clarify the role of recipient T lymphocytes in stem cells from exfoliated deciduous teeth??SHED??-based bone regeneration and further explore the underlying mechanisms??and provide the experimental evidence for revealing the mechanisms of host immune microenvironment in tissue regeneration. Methods??Human SHED and mouse CD4+ T lymphocytes were isolated and cultured respectively. SHED mixed with HA/TCP were implanted into immunocompromised mice subcutaneously??and CD4+ T cells were infused intravenously via tail vein 2 days before operation. The mice with PBS infusion were used as control. The samples were harvested 2 days??5 days and 14 days??and the levels of pro-inflammatory cytokines in implantations were examined by ELISA analysis??the samples were collected 8 weeks after operation??and new bone formation were evaluated by HE staining. SPSS 20.0 was used to perform the statistical analysis. Results??SHED showed spindle-like morphology??expressed markers of mesenchymal stem cells ??CD73??CD90??CD105 and CD146????and possessed multilineage differentiation potential. The purity of CD4+ T cells was up to 95.7%. Compared with the control group??the levels of IFN-γ??TNF-α and IL-17 in the implantation were significantly increased in experiment group ??P < 0.05??. Furthermore??the IFN-γ level was dramatically increased and reached the peak 5 days after operation. At 8 weeks after operation??the area of new bone formation of the implantation was remarkably decreased in experiment group ??P < 0.05??. Conclusion??T lymphocytes inhibit SHED-based bone regeneration??which is related to the secretion of proinflammatory factor??and IFN-γ plays an important role in this process.     

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根分叉病变因其解剖结构复杂成为牙周医生治疗的一大难题,近年来随着牙周手术的开展,很多过去需要拔除的根分叉病变患牙现可以长期保存并行使功能。但是很多口腔医生对根分叉病变的认识和根分叉区牙周手术的开展还远远不够。本文根据国内外研究结果及笔者临床经验,就根分叉病变的诊断、治疗做一介绍。     

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基因芯片技术作为一门新兴的分子生物技术,在生命科学的许多领域得到广泛应用,并且扮演着重要角色。本文对近年来该技术在口腔医学领域的应用做一综述。     

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目的对Ⅱ度根分叉病变的下颌磨牙超声洁治后和牙龈翻瓣术后疗效进行对比,探讨非手术方法超声洁治对根分叉病变治疗的效果。方法选取2010年9月至2012年9月在锦州市口腔医院门诊就诊的下颌磨牙Ⅱ度根分叉病变患者48例,随机分为2组,每组24例,分别采用超声洁治和牙龈翻瓣术进行治疗,对比两组治疗前及治疗3个月后患牙的牙周袋探诊深度（PD）、牙龈出血指数（BI）、附着水平（AL）。结果超声洁治和牙龈翻瓣术两种方法都能够在Ⅱ度根分叉病变患牙中取得满意疗效,但牙龈翻瓣术组PD和BI值略低于超声治疗组。结论对于大多数Ⅱ度根分叉病变的患者,非手术方法超声洁治也能取得满意的治疗效果,特别是对不能进行手术治疗患者患牙的保存具有重要临床意义。     

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影响牙再植的因素众多,牙再植的成功率并不高。如何改善牙再植的预后一直是儿童牙科临床面临的一大挑战。牙再植的过程一般包括患牙及牙槽窝的处理、惠牙再植和固定。辅助治疗则包括全身性抗生素的应用、局部抗菌措施、破伤风疫苗的强化等。由于牙根发育程度的不同以及惠牙根面牙周膜细胞活性状态的差异等原因,患牙的根面处理及再植后的固定措施有所差异。此外,还需根据患牙牙根发育是否完全、患牙根面是否有活性牙周膜细胞覆盖等对患牙牙髓进行相应的观察或处理。本文拟就这些方面进行简要的介绍。     

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软件模拟设计的审核和修改是无托槽隐形矫治技术非常重要的环节,也是其区别于传统正畸技术的重要特点,本文以iOrtho 6．0软件为例,对无托槽隐形矫治技术客户端软件的原理以及常用功能进行详细介绍。     

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目的研究孕妇牙周炎与早产儿、小于胎龄儿之间的相关性。方法将2009年1-4月来湖北省妇幼保健院口腔科进行孕期常规口腔检查的3251名妊娠中期孕妇的资料输入数据库,牙周检查项目包括软垢指数、龈沟出血指数、牙周袋探诊深度及临床附着丧失水平等,随访妊娠结局（新生儿体重、分娩时孕周）。运用χ2检验及logistic回归分析数据。结果3251名孕妇中最终符合调查要求2702名,妊娠中期诊断为牙周炎301例,其中重度牙周炎61例;早产儿、小于胎龄儿的发生率,在重度牙周炎孕妇分别为11。5％和9．8％,在牙周健康孕妇分别为6．0％和6．6％,差异均有统计学意义（P〈0．001）;重度牙周炎孕妇终止妊娠的孕周平均为35．2周、新生儿体重平均2478g,而牙周健康孕妇平均为39.3周和3512g,差异均有统计学意义（P〈0．001）;重度牙周炎孕妇发生早产儿和小于胎龄儿的OR值分别为2．45和3.47。结论孕妇重度牙周炎是引起早产儿、小于胎龄儿等不良妊娠的主要危险因素之一。