无牙颌种植固定修复的并发症及风险防控

随着医学技术和社会经济的发展,无牙颌种植即刻固定修复已在临床上广泛应用。这一技术尽管存在着许多优点,然而同样也存在着广泛的机械、生物、美学及外科并发症。文章就无牙颌种植固定修复的并发症及相关因素进行探讨,并提出有效的风险防控措施,为无牙颌患者种植即刻固定修复及最终永久修复的合理设计、安全实施提供参考。     

口腔种植专题研讨会学术回顾与展望

此次研讨会有国内15所大学的23位种植学专家就上颌窦底提升术、上颌后区骨量不足及无牙颌种植修复三个重点进行典型病例研讨。针对上颌窦底提升、onlay植骨、种植体长度直径及冠根比、种植导航、上颌后牙骨量不足种植的风险、即刻负载、不翻瓣种植、all-on-4种植及附着龈等9个问题进行了专家与听众互动式提问、解答及争论。通过研讨认为应该强调循证医学,临床创新,处理好常规与尝试、安全与风险、一般和特需及需要与可能的关系。专家共同的体会是:口腔种植的发展已进入"自由王国"阶段,快速的学科发展是不断创新的结果,如何迎接种植大潮,遵守自然规律防止进入误区是至关重要的。     

中华口腔医学会口腔颌面外科专业委员会2015年口腔颌面-头颈肿瘤学术研讨会第一轮通知

由中华口腔医学会口腔颌面外科专业委员会主办,青岛大学医学院附属医院承办的"中华口腔医学会口腔颌面外科专业委员会2015年口腔颌面-头颈肿瘤学术研讨会"将于2015年9月18日-20日在青岛举行。会议将邀请国内著名口腔颌面外科及头颈肿瘤专家作特邀演讲,将针对下颌骨恶性肿瘤外科处理、口咽癌与舌根癌临床研究与治疗进展、口腔癌生存率研究进行专题讨论。同时,本次会议将设置青年医师学术报告比     

Biological complications with dental implants: their prevention, diagnosis and treatment

Biofilms form on all hard non-shedding surfaces in a fluid system, i.e. both on teeth and oral implants. As a result of the bacterial challenge, the host responds by mounting a defence mechanism leading to inflammation of the soft tissues. In the dento-gingival unit, this results in the well-described lesion of gingivitis. In the implanto-mucosal unit, this inflammation is termed "mucositis". If plaque is allowed to accumulate for prolonged periods of time, experimental research has demonstrated that "mucositis" may develop into "periimplantitis" affecting the periimplant supporting bone circumferentially. Although the bony support may be lost coronally, the implant still remains osseointegrated and hence, clinically stable. This is the reason why mobility represents an insensitive, but specific diagnostic feature of "periimplantitis". More sensitive and more reliable parameters of developing and existing periimplant infections are "bleeding on probing", "probing depths" and radiographic interpretation of conventional or subtraction radiographs. Depending on the diagnosis made continuously during recall visits, a maintenance system termed Cumulative Interceptive Supportive Therapy (CIST) has been proposed.     

Tobacco prevention and control in dental practice: the future

Tobacco use adversely affects oral health and dental care. Globally, the health consequences of tobacco use are worsening, particularly those caused by cigarette smoking. Concerned government and nongovernmental organizations are attempting to contain the transnational tobacco companies' promotion of tobacco use and its disregard for the serious health consequences. Dependence prevents most tobacco users from easily breaking free from their high-risk behavior. Evidence-based clinical treatment methods that substantially increase quit rates are available in the Public Health Service clinical practice guideline, Treating Tobacco Use and Dependence. Guideline recommendations are as useful to dental clinicians as to other health care disciplines. Dental educators have a strategic role in ensuring that clinicians are well informed and are skilled in and committed to providing tobacco prevention and cessation services to their patients. Dental organizations must identify and overcome perceived and real clinician and practice barriers to adopting essential cessation services. The dental profession is in an excellent position to play a major role in several emerging issues, such as helping the public and policymakers understand the chronic nature of tobacco dependence and supporting cessation services for all people, particularly pregnant women and youths. Such messages should be presented in terms that resonate with the public because tobacco industry activities and products continue to undermine well-being, the health economy, and individual self-directed behavior of choice.     

Incidence and primary prevention of complications related to the placement of dental implants

Despite high success rate with endosseous titanium implants, failures inevitably occur. At an early stage, lack of primary stability, surgical trauma, peroperative contamination and occlusal overload seem to be the most important causes of implant failure. Many authors have reported that implant failures after primary healing and osseointegration are mainly due to peri-implant infection and/or excessive occlusal stress. Like periodontal disease, peri-implant inflammatory lesions develop as a result of plaque accumulation and exhibit similar clinical and microbiological signs as encountered for periodontitis. Clinicians should therefore enforce preventive measures to decrease the prevalence of such causative agents. Therapeutic attempts should have their rationale in the restoration of a biomechanical and/or host-bacterial equilibrium. The major limitation at this point seems to be the detection of a pathological process. Aside from clinical evaluation, the interpretation of radiographic images is one of the most frequently applied diagnostic procedures in patients with osseointegrated implants. Post-therapeutic maintenance care is an integral part of the entire implant treatment approach.     

Control of cross-infection risks in the dental operatory: prevention of water retraction by bur cooling spray systems

A new dental unit control system was found to overcome the possibility of mechanically retracting bacteria from the mouth into the water line used to provide a spray of water to cool high-speed burs during treatments. This was demonstrated by results obtained after clinical use and after use in simulated, worst case test conditions using a red tempera indicator solution and indicator bacteria.     

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牙齿酸蚀症是一种常见的口腔疾病,随着人们生活水平的提高,其发病率在逐年增长.牙釉质在酸性环境下会发生羟基磷灰石溶解反应,磷酸钙盐被溶出,并扩散至牙齿表面,这个过程称之为脱矿.釉质脱矿一旦发生,大部分不可逆转,常会影响到牙齿的健康和美观.防治牙齿酸蚀成为近几年国内外学者研究的热点,而氟化亚锡对牙齿的保护作用也受到学者们的重视.本文对氟化亚锡防治牙齿酸蚀的机制,应用的局限性和安全性,以及验证其防酸蚀效应的实验影响因素进行综述.     

对口腔诊室中飞沫和气溶胶的认知与感染防控措施

口腔操作因喷溅可产生大量飞沫,进而转化为飞沫核以气溶胶的形式悬浮留存于诊室空气中。飞沫和气溶胶均可能携微生物造成院内的污染,对临床医护人员及患者健康造成潜在威胁。本文通过对生物气溶胶研究领域涉及的一些概念和口腔诊室飞沫和气溶胶的干预措施进行文献回顾和梳理,以明晰现有文献资料中是否有气溶胶携菌的试验证据,为传染病疫情期间口腔临床工作的防控策略制定提供指导,也为日常口腔诊疗工作的院感管理和防控措施的实施提供参考。     

Increased risks of dental caries and periodontal disease in Chinese patients with inflammatory bowel disease

Objectives: Inflammatory bowel disease (IBD) may be associated with oral diseases, but few relevant studies have been reported in China. This study aimed to compare the prevalence, severity and extent of dental caries and periodontal disease in Chinese IBD patients and healthy controls. Materials and methods: In this cross-sectional study, questionnaires and oral examinations were completed for 389 IBD patients [265 with Crohn’s disease (CD) and 124 with ulcerative colitis (UC)] and 265 healthy controls based on the established criteria of the World Health Organization. Tobit regression, multiple linear regression and logistic regression were performed to analyse the data. Results: After adjusting for confounders, the decayed, missing and filled surfaces indices were significantly increased in the CD and UC patients compared with those in the controls (P < 0.001). Patients with CD [odds ratio (OR) = 4.27, 95% confidence interval (95% CI): 2.63–6.95, P < 0.001] and UC (OR = 2.21, 95% CI: 1.24–3.94, P = 0.007) had significantly higher risks of dental caries than controls. Significantly higher percentages of sites with probing pocket depth ≥ 5 mm and clinical attachment loss ≥ 4 mm were observed in CD and UC patients compared with controls (P < 0.001). A fully adjusted model revealed that CD and UC were risk indicators for periodontitis (OR = 4.46, 95% CI: 2.50–7.95, P < 0.001; OR = 4.66, 95% CI: 2.49–8.71, P < 0.001, respectively). No significant differences in dental caries and periodontal disease were observed between the CD and UC patients. Conclusions: Chinese IBD patients have a higher prevalence, severity and extent of dental caries and/or periodontal disease than controls, and require oral health education and multidisciplinary treatment.Key words: Dental caries, periodontal disease, inflammatory bowel disease, Crohn’s disease, ulcerative colitis