两种手术切口治疗腮腺肿瘤的对比研究

目的介绍一种腮腺肿瘤切除的改良式手术切口,并与传统方法进行临床对比。方法改良的腮腺切除术采用耳屏前面部除皱切口及耳后延续入发髻内切口,在嚼肌筋膜(SMAS)下翻瓣,减少了术后Frey综合征的发生;先解剖面神经总干减少了周围支的损伤,暴露面神经总干后,根据肿瘤的位置,选择性解剖面神经颈面干行腮腺部分切除术,保护腮腺的部分功能;采用蒂在上方的胸锁乳突肌填塞局部减少了术后畸形。结果应用传统术式的36例患者,38.8%出现面神经功能损害,16.2%出现涎瘘,8.3%出现Frey综合征;应用改良术式的6例患者中,无1例出现涎瘘及面神经损伤,随访3～6个月无1例出现Frey综合征,并且局部凹陷轻微,面容美观。结论改良式手术方法切口隐蔽,容易操作,不易损伤面神经周围支,术后并发症少。     

Flap technique for periodontal bone implants. Papilla preservation technique

A new flap design for placement of implants into osseous defects has been described. The flap design can be used in anterior and posterior areas of human subjects. Photographs of representative cases are presented. Wound healing always occurred by primary intention and without evidence of immediate graft exfoliation. Interdental soft tissue craters did not develop, making it easier for patients to maintain optimal oral hygiene. This type of flap design can also be used without grafts in order to improve postoperative soft tissue contour.     

Indirect bonding technique

Accurate bracket placement is the key for the successful treatment of an orthodontic case. With indirect bonding, not only is the bracket placement more accurate but this technique also significantly reduces chairtime. In this article, the author explains use of thermal glue in an indirect bonding technique. In cases of constricted arches, a modified rapid maxillary expander can be used along with indirect bonding to reduce overall treatment time.