口腔门诊治疗并发晕厥106例回顾分析

目的：通过对1983年以来，孝感市中心医院口腔中心门诊治疗并发晕厥106例的回顾性分析，探讨口腔门诊治疗并发单纯性晕厥的原因及一些相关因素，增强医患双方的防治意识，安全顺利的进行口腔门诊治疗。方法：对106例单纯性晕厥反应，采取现场询问式调查的方法，对其一般情况，口腔门诊治疗经历，治疗时的心态，口腔门诊治疗的了解，以及不同口腔治疗晕厥发生情况等进行调查、归纳、分析。结果：1)晕厥的发生与患者的年龄有关，12～40岁口腔门诊治疗经历欠缺的患者是口腔门诊治疗并发晕厥的高危人群。2)口腔患者进行治疗前心理准备充足与否对并发晕厥反应的影响较大。3)晕厥在口腔门诊某些治疗中发生率较高，拔牙术最多，其次为脓肿切排。86％(92例)属因畏惧疼痛导致紧张而诱发的血管抑制性晕厥。4)晕厥多发生于治疗初期(93：13)。结论：口腔门诊治疗并发晕厥临床表现多不严重，但对患者就诊和医师的治疗影响明显，切实做好口腔治疗错误信息，消除和减轻他们的疑虑和畏惧的紧张心情，对保障口腔门诊治疗安全尤为重要。     

SEITO - Stockholm Eastman Index of Treatment Outcome

To obtain high quality in orthodontics; it is important to evaluate the treatment. There are many indices for evaluation of treatment outcome however all of them compare treatment outcome with ideal occlusion. Therefore Stockholm Eastman Index of Treatment Outcome (SEITO) was invented. This index relates the treatment outcome to the treatment goal. SEITO is a morphological index based on criteria from the records including study casts, and/or intra oral photos. METHOD: The outcome of treatment is related to the treatment goal as stated in the records. Pre-treatment goals are divided into subgroups; overjet, vertical relation anterior/lateral), anterior cross bite, transverse relations, impacted teeth and space crowding/ spacing. Each subgroup is scored; the points are 0, 1, 3 or 5 depending on the severity of the malocclusion. The points for each subgroup are added to give a total sum of treatment goal points. Each post-treatment subgroup above is evaluated. If the treatment goal is fulfilled, the treatment outcome points are equal to the treatment goal points. If not - there is a reduction in the outcome points. Finally the outcome points are expressed as a percentage of the treatment goal points and form a measure of the success of treatment. CONCLUSION: SEITO index is a simple and quick way to obtain a picture of the quality of treatment outcome, and the only orthodontic index that relates the treatment outcome to the treatment goal.     

根尖周炎引起的牙源性上颌窦炎的治疗

目的:探讨根管治疗/根管再治疗治疗根尖周炎引起的牙源性上颌窦炎的可行性.方法:临床确诊的根尖周炎引起的牙源性上颌窦炎病例5例,根管治疗/根管再治疗3个月、6个月和12个月复查CBCT.结果:根管治疗/根管再治疗后5例临床病例临床症状消失,3个月和6个月CBCT显示5例临床病例根尖周、上颌窦底和上颌窦内变化不明显,12个...     

Development of lingual-bracket technique. (Esthetic and hygienic approach to orthodontic treatment) (Part 2) Manufacture and treatment (author's transl)]

The present study relates to a development of the new technique and the new appliances, for the treatment of malocclusion and minor tooth movement. The primary purpose of the present study consists in to reduce mental burden of the patients receiving orthodontic treatment and to improve effect of the treatment further by making the appliance invsible when mouth is opened. The second purpose of the study is in orthodontic treatment carried out from lingual or palatal side, to control all teeth movement in oral cavity in three dimensions so that the normal occlusion may be operated. The third purpose of the present study is to make the exchange of wire readily when the wire with bigger elasticity is exchanged by turns buring the process of the treatment. The product of appliances and the outline of treatment for the lingual-bracket technique (lingual-bracket mushroom arch wire technique) is found out in this report.     

Treatment of dentine hypersensitivity by lasers: a review

BACKGROUND, AIMS: Since the development of the ruby laser by Maiman in 1960, a variety of papers on potential applications for lasers in dentistry have been published. The purpose of this paper is to summarise laser applications for the treatment of dentine hypersensitivity. The effects of laser on pulp tissue and problems on laser treatment are also reviewed. This article reviews the role of lasers for the treatment of dentine hypersensitivity since 1985, summarises many research reports from the last decade, and surmises what the future may hold for lasers in this treatment. METHOD: To date, 4 kinds of lasers have been used for the treatment of dentine hypersensitivity, and the effectiveness ranged from 5.2 to 100%, which was dependent on the laser type and parameters used. The mechanism involved in laser treatment of dentine hypersensitivity are relatively unknown. RESULTS: These require clarification to result in safely effective treatment optimization. In general, the efficiency for the treatment of dentine hypersensitivity using lasers is higher than other methods, but in severe cases, it is less effective. CONCLUSION: It is necessary to consider the severity of dentine hypersensitivity before laser use.     

颞下颌关节紊乱病的“梯度序列治疗”

颞下颌关节紊乱病是口腔科临床常见的疾病,好发于青年群体,女性多见,发病率在30%左右;其临床表现多为下颌运动异常、疼痛、弹响与杂音,部分患者伴有耳鸣、头痛等症状。颞下颌关节紊乱病的治疗目前主张采用"梯度序列治疗"模式,每个"层级"均有其严格的适应证。一般首选保守治疗或无创治疗,适用于功能障碍性或轻度器质性病变患者;次选微创治疗,适用于保守治疗无效患者或轻度器质性病变患者;最后才考虑选择开放手术治疗,适用于前两种治疗无效并伴有严重器质性病变的患者。"梯度序列治疗"方案的制定应该是个性化的,由医生主导,患者配合的情况下完成的。本文对颞下颌关节紊乱病的"梯度序列治疗"进行阐述。     

骨性安氏Ⅲ类错[牙合]伴偏颌及与颞下颌关节紊乱病的关联研究进展

骨性安氏Ⅲ类错[牙合]畸形伴偏颌会导致颅骨、下颌骨、上颌骨的旋转和移位,并常伴有口颌面部软组织的不对称改变,影响美观和功能,其常用治疗手段(正畸和正颌手术)存在美学效果的局限性,正确评估形态改变对治疗方案的选择意义重大。骨性安氏Ⅲ类错[牙合]伴偏颌与颞下颌关节形态、功能变化及颞下颌关节紊乱病(temporomandibular disorder,TMD)的发生相关,但因果关系尚存争议。本文就骨性安氏Ⅲ类错[牙合]畸形伴偏颌患者的病因、软硬组织的改变、治疗手段以及其与TMD的关联进行综述。目前研究结果表明,偏颌是一种病因不明确,涉及到颅底、上颌骨、下颌骨形态变化、软组织形态变化、咬合改变以及颌骨旋转移位的复杂疾病,对颞下颌关节及下颌功能运动也会产生影响。偏颌患者中常见骨性安氏Ⅲ类错[牙合]畸形,需要早期治疗;其治疗手段多样,正确评估导致面部不对称的软硬组织形态变化是治疗的前提。正畸?正颌联合治疗(必要时合并软组织的修整)是治疗骨性安氏Ⅲ类错[牙合]伴偏颌的有效手段。此外,偏颌与TMD之间也有紧密的联系,设计治疗方案时需要充分考虑。     

Orthodontic process and outcome: efficacy studies - Strategies for developing process and outcome measures: a new era in orthodontics

The development of process and outcome measures in orthodontics lends itself to retrospective clinical studies. Once valid and reliable measures have been tested, prospective studies may utilize these measures to assess the quality of orthodontic treatment outcome and the duration and process of treatment. The findings from two retrospective studies comparing the quality of outcome using the peer assessment rating (PAR) occlusal index and duration of treatment are reported. Class I and Class II treatment comparisons indicate the duration of treatment time is increased on average 5 months in Class II, division 1 patients. In the second study, the effect of extraction/non-extraction treatment in a sample that included all types of malocclusion indicates that, on average, treatment time is increased by approximately 5 months when extractions are included as part of the orthodontic treatment plan.     

The Herbst appliance--its biologic effects and clinical use

The purpose of this article is to survey the Herbst bite-jumping method. An outline of appliance design and appliance construction is given. The effects of the treatment method on the dentofacial complex and on the masticatory system have been analyzed with the aid of dental casts, cephalometric roentgenograms, and electromyographic registrations from the masticatory muscles. The use and effectiveness of the Herbst appliance in the treatment of Class II malocclusions are exemplified by clinical cases, some of which were followed for 5 years after treatment. The Herbst appliance is most effective in the treatment of Class II malocclusions, provided it is used as indicated. Thus, the appliance must be limited to growing persons only. The treatment method should not be looked upon as a last resort to be used only when other treatment approaches have failed. Treatment prognosis is best in subjects with a brachyfacial growth pattern. Unfavorable growth, unstable occlusal conditions, and persisting oral habits after treatment are potential risk factors for occlusal relapses. As treatment with the Herbst appliance is performed during a relatively short period, the hard and soft tissues (teeth, bone, and musculature) would need some time for adaptation to the new mandibular position after the appliance is removed. Posttreatment retention as a routine with a removable functional appliance is therefore recommended.     

The system and realization of orthodontic treatment in Sweden]

The need for treatment is subdivided into 4 degrees of severity. Nearly 12% of the 7-16-year-old children and adolescents are in urgent need of treatment. The mean duration of treatment (per patient and year) is 4.2 hours. From this it is calculated that 1 orthodontist will be required for 24,000 residents or for 3,500 children and adolescents aged between 7 and 16 years. In Sweden each province (24) has at least 1 orthodontic clinic that is responsible for treatment and advice. The free treatment of patients being in urgent need for treatment is realized by an orthodontist in cases with a high degree of severity, and otherwise by a general dental practitioner who works indepently or takes the advice of an orthodontist.     

牙中牙3例报告及文献复习

目的 探讨牙中牙的临床诊断和治疗方法。方法 针对3种不同类型、不同病变程度的牙中牙病例,分别采取预防性树脂充填术、根管治疗术、根尖屏障术和根尖诱导成形术进行治疗。术后定期随访,通过一般检查及影像学检查评价其疗效。结果 3种不同类型,不同病变程度的牙中牙病例,通过采用不同的治疗手段,均得到有效治疗。术后随访,预后良好。结论 牙中牙病情复杂,治疗难度大,临床医师应加强对牙中牙的认识,早发现、早诊断、早治疗。根据牙中牙的不同类型、不同病变程度,采取相应的治疗措施,尽可能保留患牙。     

Dental abnormalities of a long-term survivor of a childhood hematological malignancy: literature review and report of a case

The treatment of haematological malignancy is multimodal and involves chemotherapy, radiotherapy and/or bone marrow transplants. With the advancement in cancer therapy, there is an increase in the survival of many children with childhood haematological malignancy. In addition, the late effect of the oncology treatment to the orofacial and dental development becomes significant in terms of the potential clinical impact that may affect the quality of life of the survivor. The severity of the long-term effects is dependent on the age of the child at initiation of treatment and whether chemotherapy is combined with radiation or not. The dental treatment may become more complex if the patient requires advanced restorative dental care and the roots malformation may complicate orthodontic treatment. Therefore these patients may require a scheduled careful preventive programme, long-term follow up, with prophylactic treatment and intervention at appropriate time to minimize the consequences of the disease and the given therapy.     

Treatment planning the endodontic case

Following a definitive diagnosis of the need for root canal treatment, the treatment planning stage should be straightforward if a logical sequence of decision-making is followed. Very few contra-indications exist for providing root canal treatment, but the planning must include several aspects. Firstly, is root canal treatment best for the patient to maintain a functional dentition long term? Secondly, who should provide the treatment? Thirdly, what are the restorative options that will ensure the best long-term prognosis? The sequencing of root canal treatment generally occurs early in a typical treatment plan, and prompt restoration after treatment is crucial to long-term survival of the tooth.     

The role,efficacy and outcome measures for teriparatide use in the management of medication-related osteonecrosis of the jaw

Medication-related osteonecrosis of the jaw (MRONJ) is a complex disease which can be associated with multiple morbidities and is challenging to treat. This review evaluates the literature on the role and efficacy of teriparatide (TPTD) as a treatment for MRONJ. The clinical, radiological, histopathological and serological parameters used to assess treatment response have been described. Electronic databases were searched to retrieve articles (April 2005 and April 2020) based on strict inclusion criteria. Seventeen articles were included in this review. Of the 91 patients treated; only six received TPTD as a standalone treatment. There were significant variations in defining treatment outcomes and measuring treatment response. The longest follow-up period was 26 months, and 12 studies failed to report follow-up. The overall quality of evidence is weak with potential for a high risk of bias, making it difficult to determine the efficacy of TPTD and its long-term effects. However, TPTD may play a role in the treatment of intractable MRONJ in osteoporotic patients or those unfit for surgery. Therefore, randomized clinical trials on larger patient cohorts with long-term follow-up is required to confirm efficacy, safety and inform treatment indications for TPTD in the treatment of MRONJ.     

Diagnosis and treatment planning for the surgical-orthodontic patient

Contemporary orthognathic surgery has made it possible to reposition either or both jaws in one piece or as segmental osteotomies. This has provided the patient, who has a severe dentofacial problem, with the option of having all components of their malocclusion and facial aesthetic concerns addressed. The close collaboration between the orthodontist and the surgeon provides a comprehensive diagnosis and treatment plan to be generated. The goal of the presurgical phase of orthodontics is to remove the dental compensations and allow optimum surgical correction of the jaw discrepancy. A short phase of orthodontic treatment postoperatively is usually necessary to detail the final occlusion. A systematic approach to diagnosis and treatment planning is discussed in the context of the problem-oriented approach. The application of this approach is illustrated in a case report of the combined orthodontic-surgical treatment of a patient who benefited from a two-jaw surgical procedure with pre- and postoperative orthodontic treatment. The principles of presurgical orthodontic treatment are discussed and should avoid any counterproductive tooth movements that can be part of the surgical correction. Tooth movements done as part of the postoperative treatment should avoid compromising the surgical outcome. Illustrations of the cephalometric prediction tracing and its application to the diagnosis and treatment plan of the patient discussed in the case report is an important aspect in providing the dentofacial patient with a representation of the expected treatment outcome.     

Osseointegrated implants for single tooth replacement in general practice: A 1-year report from a multicentre prospective study

The single tooth implant is a treatment option for the replacement of missing single teeth and in many cases is the treatment of choice. It is, however, an expensive treatment requiring a co-ordinated approach to the surgical and restorative aspects of treatment. In this study, a group of dentists in general and restorative dental practice and with no previous experience in implant surgery underwent an intensive training course in all aspects of implant treatment for single teeth. Using a system of simplified instrumentation with a strict adherence to protocol, the group installed and restored single tooth implants ad modum Brånemark in a wide range of clinical situations. At the one year follow-up period following crown insertion, the success rate of treatment compared favourably with results reported from centres using the specialist team approach to treatment. The results of this study indicate that further consideration should be given to the training of general dentists so that improved delivery of dental health care can be provided at a more economic level.     

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提要：舌癌是口腔颌面部最常见的恶性肿瘤，治疗比较棘手。目前舌癌的治疗方案及治疗效果，在不同医疗单位之间，尚存在较大的差异。如何规范舌癌治疗方法，提高国内整体治疗水平，对于每一位口腔颌面－头颈肿瘤外科医生来说都是一项艰巨的任务。本文旨在通过对舌癌治疗方面的思考，抛砖引玉，希望为制定国内舌癌治疗规范打开一扇窗口，提高舌癌的治疗效果。     

Orthodontics in general practice. 4. Eruption guidance appliances in orthodontics

Eruption guidance appliances are recommended for early orthodontic treatment or prevention of malocclusions. The treatment effect of eruption guidance appliances and functional appliances is similar. In addition to dentoalveolar and skeletal effects, eruption guidance appliances would also have myofunctional effects for treating open mouth behaviour and swallowing problems. However, there is no solid evidence for the myofunctional effect claimed. The position of erution guidance appliances in the orthodontic treatment arsenal is limited: early treatment of Angle Class II malocclusion in 2 phases has no advantage over a 2 phase treatment. When eruption guidance is needed, preference is given to an individually produced appliance.     

Development of lingual brachet technique. (Esthetic and hygienic approach to orthodontic treatment) (Part 1) Background and design.

The present study relates to a development of the new technique and the new appliances, for the treatment of malocclusion and minor tooth movement. The primary purpose of the present study consists in to reduce mental burden of the patients receiving orthodontic treatment and to improve effect of the treatment further by making the appliance invisible when mouth is opened. The second purpose of the study is in orthodontic treatment carried out from lingual side, to control all teeth movement in oral cavity in three dimensions so that the normal occlusion may be operated. The third purpose of the present study is to make the exchange of wire readily when the wire with bigger elasticity is exchanged by turns during the process of the treatment. The background and the design of appliances for the lingual-bracker technique(lingual-bracket mushroom arch wire technique) is found out in this report.     

骨性安氏Ⅱ类错He的外科与正畸联合治疗

目的：探讨外科与正畸联合治疗骨性安氏Ⅱ类错Ｈｅ的方法和特点。方法：总结分析近年一经外科与正畸联合治疗的骨性安氏Ⅱ类错Ｈｅ病例２２例,介绍典型病例治疗过程,着重讨论拔牙时机,术前后正畸治疗特点及术式选择。结果：本研究２２例患者经联合治疗后,颌骨关系正常,牙弓形态衣Ｈｅ曲线正常,牙排列整齐,咬合关系好,面形及功能均获明显改善,疗效满意。