弹性包绕式（牙合）垫加前方牵引矫治替牙期骨性反

目的探讨弹性包绕式（牙合）垫加前方牵引矫治替牙期骨性反（牙合）的适用性及治疗前后的牙颌结构变化。方法选择替牙期骨性Ⅲ类错患者9例,平均年龄8.1±1.5岁,患者前牙反,上颌相对于下颌后缩,应用弹性树脂材料制作包绕上颌全部牙齿及部分牙槽骨的包绕式（牙合）垫,中部连接螺旋扩弓器快速扩弓,加前方牵引矫治反（牙合）。在头颅侧位片上测量矫治前后牙、牙槽骨及颌骨的变化。结果弹性包绕式垫固位良好,腭中缝在2～3周内打开,前牙反在6～11个月内解除;上颌骨前移,下颌骨轻度向下后旋转,SNA平均增大1.9°,ANB角平均增大2.8°;治疗后上切牙唇倾,下切牙舌倾。结论在替牙期采用弹性包绕式垫加前方牵引能够促进上颌骨生长,简便、有效地治疗替牙期骨性反（牙合）。     

弹性包绕式(牙合)垫加螺旋扩弓器矫治替牙期后牙反(牙合)

目的:探讨弹性包绕式垫加螺旋扩弓器矫治替牙期后牙反的适用性及治疗前后的牙颌结构变化。方法:选择替牙期反病例11例,平均年龄9.1±1.6岁,后牙反,上颌缩窄,发育不足。应用弹性树脂材料制作包绕上颌全部牙齿及部分牙槽骨的包绕式垫,中部连接螺旋扩弓器;快速扩弓法解除后牙反。在头颅正位定位片上测量矫治前后牙弓、基骨宽度的变化。结果:弹性包绕式垫固位良好,后牙反在2～3周内解除,腭中缝打开。在牙弓宽度的增加中,骨改变所占的比例接近50%。结论:弹性包绕式垫加螺旋扩弓器能简便、有效地治疗替牙期后牙反,促进上颌横向发育。     

前方牵引器矫治替牙期重度骨性前牙反畸形

目的：探讨替牙期重度骨性前牙反前方牵引治疗前后软硬组织的变化。方法：选择40例替牙期轻中度和重度骨性前牙反患者,单纯使用前方牵引器进行矫治。每例患者在矫治前后分别拍摄头颅定位侧位片,采用传统头影测量方法和Pancherz头颅参照系统对治疗前后的软硬组织变化进行分析比较。结果：前方牵引治疗结束后,两组患者前牙反解除,建立了正常的覆覆盖关系,磨牙关系基本中性,Ⅲ类骨面型明显改善。结论：①同时伴有上颌骨后缩和下颌骨前突的重度骨性前牙反病例,应早期进行前方牵引。②重度骨性前牙反前方牵引后,骨性变化（26%）明显小于轻中度组骨性变化（42%）。③单纯采用前方牵引治疗替牙期重度骨性前牙反病例,其软组织侧貌及骨骼改形均有显著性变化。     

弹性包绕式(牙合)垫加螺旋扩弓器矫治替牙期后牙反(牙合)

目的：探讨弹性包绕式[牙合]垫加螺旋扩弓器矫治替牙期后牙反[牙合]的适用性及治疗前后的牙颌结构变化。方法：选择替牙期反[牙合]病例11例，平均年龄9.1±1．6岁，后牙反[牙合]，上颌缩窄，发育不足。应用弹性树脂材料制作包绕上颌全部牙齿及部分牙槽骨的包绕式殆[牙合]，中部连接螺旋扩弓器；快速扩弓法解除后牙反[牙合]。在头颅正位定位片上测量矫治前后牙弓、基骨宽度的变化。结果：弹性包绕[牙合]殆垫固位良好，后牙反[牙合]在2-3周内解除，腭中缝打开。在牙弓宽度的增加中，骨改变所占的比例接近50％。结论：弹性包绕式[牙合]垫加螺旋扩弓器能简便、有效地治疗替牙期后牙反[牙合]，促进上颌横向发育。     

快速扩弓结合前方牵引对牙颌作用的三维测量研究

目的探讨应用快速扩弓结合前方牵引矫治替牙期骨性Ⅲ类反在三维方向上的作用。方法选取30例替牙期骨性Ⅲ类反患者,应用快速扩弓结合前方牵引的方法进行治疗。分别对矫治前、后的X线头颅侧位片和石膏模型进行测量分析,并运用SPSS12.0软件进行统计学处理。结果快速扩弓结合前方牵引治疗替牙期骨性Ⅲ类反作用为:①水平方向上增加上颌牙弓宽度;②矢状方向上上颌突度的增加是上前牙唇倾,上颌骨向前生长的结果;下颌突度的减小是下颌后下旋转和髁突在关节窝内移位共同作用的结果;③垂直方向的变化与水平和矢状方向的变化密切相关,面下高度增加,下颌平面角增大。结论快速扩弓结合前方牵引治疗可有效矫正替牙期骨性Ⅲ类反,但使牙颌结构在三维方向上都产生极其复杂的不同的变化,应根据错的特点调整相应的治疗措施以使在各个方向上增加有利的变化,避免或减少不利的变化。     

26例替牙期骨性反前方牵引治疗前、后X线片头影测量的变化

目的 采用前方牵引矫治替牙期骨性Ⅲ类错畸形并分析治疗前、后头影测量变化。方法 对26例替牙期骨性安氏Ⅲ类错患儿,使用口内垫活动矫治器配合双杆式可调式前方牵引进行治疗。治疗前、后头影测量并进行对比分析,通过观察颌面部软硬组织的变化,判断前方牵引的疗效。结果 所有患者均解除前牙反,上颌骨均有不同程度向前下向生长;下颌骨前部向前生长受到抑制并顺时针旋转,上、下颌骨间不调改善;软组织侧貌改变明显,面下1/3前后关系协调。结论 前方牵引矫治替牙骨性安氏Ⅲ类错的效果显著。?     

前方牵引加舌刺早期矫治伴舌习惯的骨性Ⅲ类高角患者的临床疗效分析

目的研究上颌前方牵引加舌刺矫治替牙期伴舌习惯的高角骨性Ⅲ类错的临床疗效。方法 7例适应证患者接受前牵引加舌刺的矫形治疗,采用X线头影测量技术分析软硬组织矫治前后的改变。结果所有患者前牙建立正常的覆盖,正常或稍浅的覆。上颌骨向前发育,下颌骨后退,下颌平面角无明显增大,上下颌骨间不调改善,鼻唇角减小,面型明显改善。结论使用上颌前方牵引加舌刺能有效治疗替牙期的伴舌习惯的高角骨性Ⅲ类错。     

弹性夹板式垫加前方牵引矫治替牙期骨性反的研究

骨性Ⅲ类错是正畸治疗中难度最大的错畸形之一,随着个体的生长,畸形有逐渐加重的趋势。在替牙期采用前方牵引是一种较为有效的治疗手段,但在替牙早期,由于牙冠萌出不足及牙齿处于替换的不稳定状态,使牵引的口内矫治器部分制作较为困难,固位效果不佳,针对这一问题,我科采用新型的弹性材料,制作包绕上颌全部牙齿及牙槽骨的夹板式垫,取得较好的临床效果,现报道如下。1材料和方法1.1临床资料2004-09—2005-02到我院就诊的替牙期骨性Ⅲ类错病人7例,其中男4人,女3人,年龄6～10.2岁,均为前牙反,上颌相对下颌后缩,无明显的功能性前移位。1…     

前方牵引矫治骨性Ⅲ类错20例临床体会

目的应用上颌前方牵引矫治器矫治骨性Ⅲ错。方法应用上颌前方牵引矫治器对替牙期16例,恒牙早期4例的骨性Ⅲ类错进行矫治。结果上颌前方牵引矫治器具有促进上颌骨向前发育,抑制下颌骨向前发育的作用。患者矫治前后的侧貌得到明显改善,并且建立了基本正常的前牙覆、覆盖关系。结论上颌前方牵引矫治器对矫治上颌发育不足的骨性Ⅲ类错有明显效果。     

“2×4”技术配合前方牵引矫治替牙期轻度骨性反

目的探讨"2×4"技术配合前方牵引矫治替牙期轻度骨性反。方法选择10例替牙期轻度骨性反病例,上颌用"2×4"技术配合前方牵引进行矫治。矫治前后拍摄X线头颅侧位定位片进行分析比较。结果 10例替牙期轻度骨性反病例均取得满意疗效。矫治前后X线头影测量指标显示有显著性差异。结论 "2×4"技术配合前方牵引是矫治替牙期轻度骨性反的有效方法。     

Clinical experiences with patients with facial bone deformities associated with hemifacial microsomia.

Eighteen adult patients with hemifacial microsomia were treated with a combination of skeletal and augmentation surgery. Three typical cases are presented. In principle, skeletal and augmentation surgery have recently been performed in combination in a single stage. Groin flaps and scapular or scapular ostocutaneous flaps have mainly been employed for augmentation surgery.     

Vasovagal syncope with asystole associated with intravenous access

Two cases of vasovagal syncope (VVS) during venous access are reported. Both patients had a history of fainting episodes and experienced bradycardia with asystole, hypotension, and fainting. Pain and phobic stress during venous access triggered an increase in parasympathetic tone, resulting in bradycardia with asystole and hypotension in both cases. Hypotension and bradycardia likely caused cerebral hypoperfusion, leading to fainting. The intense parasympathetic tone triggered by somatic or emotional stress was likely responsible for directly depressing the sinus node, leading to asystole and bradycardia. Bradycardia with asystole progressing to syncope is a potentially fatal dysrhythmia in patients with cardiovascular disease or older patients with decreased cardiac function. Appropriate treatment for VVS includes the administration of intravenous fluids, vagolytics, ephedrine, and the rapid use of the Trendelenburg position. Intravenous fluids and atropine were used to treat the present patients.     

Inflammation associated with implants with different surface types

OBJECTIVES: The aim of this study was to determine the nature of the inflammatory infiltrate associated with different transmucosal implant surfaces in dogs. METHODS: Three experimental and one control single-stage implants were randomly placed on each side of the jaw in eight dogs. The transmucosal portion of the test implants consisted of an acid-etched surface (type A), a machined surface with a circumferential groove (type C) and a surface prepared by mild anodic oxidation (type D). The control was a standard machined surface (type B). In order to determine the response to the different surfaces, plaque control was carried out twice weekly following placement of the implants for the entire period of the experiment. At 6 months, gingival biopsies and plaque samples were obtained. The area of inflammatory infiltrate and the nature of the infiltrating cell types were determined using immunohistology. Real-time polymerase chain reaction was used to identify putative periodontal pathogens. RESULTS: Inflammatory infiltrates were associated with all implant surfaces and were commonly found subepithelially and perivascularly. T cells were the predominant infiltrating cell type in all lesions, associated with the different surfaces. In all lesions the CD4 : CD8 ratio was approximately 2 : 1. Statistical analysis showed that the type C surface (machined surface with a groove) had significantly larger inflammatory infiltrates than the type B surface (machined surface without a groove; P<0.05). No statistically significant differences were found with respect to the size of the inflammatory infiltrates or in terms of the nature of infiltrating cells. However, despite the intensive plaque control regime, plaque was present on all implant surfaces at the time of biopsy 6 months after placement. All implants had similar numbers of Tannerella forsythia, Fusobacterium nucleatum and Porphyromonas gingivalis. Actinobacillus actinomycetemcomitans, was not detected in any sample. CONCLUSIONS: These results suggest that the development of inflammation associated with implants is independent of surface type, but is nevertheless associated with the presence of plaque. The different surfaces had no influence on the nature of the infiltrate, with T cells being the predominant cell type in all lesions. Finally, the different implant surface types seemed not to influence the peri-implant microbiota. However, the presence of the circumferential groove tended to be associated with larger infiltrates. Whether this is due to increased plaque accumulation remains to be determined.     

Recurrent intraoral pyogenic granuloma with satellitosis treated with corticosteroids

The development of recurrent pyogenic granulomas as multiple satellite lesions has not been reported in the oral cavity. This report describes an unusual case of intraoral pyogenic granuloma recurring multiple times after surgical excisions with the formation of satellite lesions. Due to failure of surgical management, an alternative approach was taken. We illustrate how the lesions were successfully treated with a series of intralesional corticosteroid injections.