��ǻ�۰��ۺ����������ٴ��о�

目的    观察综合序列治疗口腔鳞癌临床疗效,探索治疗口腔鳞癌合理治疗方案。方法    对2000年8月至2005年8月在枣庄矿业集团中心医院及山东大学口腔医院确诊并住院的口腔鳞癌中晚期患者60例,经过采用平阳霉素新辅助化疗、手术、术后放疗等手段进行规范的综合序列治疗,观察5年存活率及复发转移情况。结果        60例患者1年后复发率20.0％,2年后复发率23.3％,5年后复发率30.0％,5年存活率75.0％。结论    规范合理的综合序列治疗方法是治疗口腔鳞癌比较有效的手段,能明显提高口腔癌患者的存活率。     

上颌倒置埋伏阻生中切牙的序列治疗

目的探讨上颌倒置埋伏阻生中切牙的综合序列治疗方案。方法 10例患者共11颗倒置埋伏阻生上颌中切牙为研究对象,经摄片定位、拓展间隙后,采用外科开窗、隧道牵引、选择性根管治疗及根尖切除术、修复等序列治疗。结果 11颗埋伏牙通过治疗后7颗成功牵引入牙列,排列整齐,牙周健康及牙髓活力正常;1颗唇侧出现1~2 mm的牙龈退缩;2颗需配合烤瓷冠修复;1颗进行了预防性根管治疗和根尖切除术,并进行烤瓷冠修复。结论上颌倒置埋伏阻生中切牙采用序列治疗可以取得良好的美观和功能效果。     

Prosthodontic Rehabilitation Using Surgical Space Modification

Treatment using a LeFort I osteotomy and sequential prosthodontic rehabilitation is presented. This treatment combination is a viable alternative therapy for the severe extrusion of posterior maxillary dento-osseous segments.     

伴口呼吸及错牙合畸形慢性牙周炎牙周序列治疗观察

目的:探讨前牙区牙龈增生伴张口呼吸、错牙合畸形的慢性牙周炎患者接受牙周序列治疗的临床疗效。方法:选择2007年9月~2008年9月在大连市口腔医院牙周黏膜科就诊的前牙区牙龈增生伴张口呼吸、错牙合畸形的慢性牙周炎患者10例,进行牙周序列治疗(基础治疗、牙周手术治疗、正畸治疗和牙周支持治疗),历时5年以上。在治疗前、正畸治疗后1~3年采用Florida探针检查记录前牙区探诊深度(PD)、附着丧失(CAL)、牙齿松动度(TM)、探诊出血(BOP)等临床指标,并进行统计分析。在治疗前和正畸治疗后1～3年拍摄曲面断层片。结果:正畸治疗后1～3年前牙区PD、CAL均较治疗前有明显降低,BOP阳性位点较治疗前明显减少,差异均有统计学意义(P<0.01);TM较治疗前无明显变化,差异无统计学意义。治疗后3年较治疗后1年和2年,PD、CAL下降,BOP阳性位点减少,但差异均无统计学意义。结论:前牙区牙龈增生伴张口呼吸、错牙合畸形的慢性牙周炎患者进行历时5年以上牙周序列治疗,临床疗效良好且稳定     

颌面头颈部骨肉瘤化学治疗的研究进展

骨肉瘤是颌面头颈部较为罕见的恶性肿瘤之一，包括局部切除手术及辅助放化学治疗在内的综合序列治疗是现阶段最有效的治疗方法。化学治疗是综合序列治疗的重要组成部分。在目前已有的化学治疗方案中，甲氨蝶呤、阿霉素和顺铂（MAP）等经典化学治疗方案在口腔颌面头颈部骨肉瘤的治疗中有重要的作用；此外，新辅助化学治疗和电化学疗法等方案也在近年诞生，然而其临床应用价值尚待考证。随着近年来对骨肉瘤分子生物学认知的逐步深入，在分子生物学水平上探讨针对肿瘤细胞的化学药物成为新的进展趋势。本文就化学治疗在颌面头颈部骨肉瘤治疗中应用的研究进展作一综述。     

Periodontal considerations and guidelines for therapy

This article presents a format of sequential periodontal therapy for the achievement of long-term periodontal health. The author discusses various periodontal considerations that are essential for successful precision restorative dentistry.     

Sequencing patients to implant-supported, full-mouth reconstructions: a case report.

Patients presenting with debilitated dentitions are often excellent candidates for implant-supported reconstructions. Their existing teeth, even if compromised structurally, help preserve the ridge anatomy and can be used to support fixed, interim prostheses. While the result is often a straightforward, treatment-planning decision, the diagnosis and interim stages of sequential extraction cases leave numerous decisions to be made. The authors' goal is to highlight some of the major treatment planning decisions that need to be made for the interim portion of sequential extraction treatment. LEARNING OBJECTIVES: This article describes several of the treatment-planning decisions that clinicians must consider when preparing to treat the partially edentulous patient with implant therapy. Upon reading this article, the reader should be able to: Understand the various transitional approaches used to convert a patient from a tooth- to an implant-supported restoration. Identify the steps involved in the sequential extraction of failing teeth.     

Effects of sequential administration of bleomycin in combination with mitomycin C on squamous cell carcinoma of oral regions

A sequential administration of bleomycin in combination with mitomycin C was evaluated clinically and histologically in ten patients with squamous cell carcinoma of the oral region. The therapy was effective against seven primary lesions and one metastatic lesion with an evident tendency to remission, but was completely ineffective against recurrent carcinomas. Myelosuppression seemed to be a more important toxic effect than the bleomycin-induced pneumonitis. The mechanism of action of the therapy and indications in clinical application are discussed.     

唇腭裂临床治疗准则初探

为探讨合理的唇腭裂临床治疗模式和方法，四川大学华西口腔医院唇腭裂外科在近年临床治疗方法比较的研究中，开发和引进了多种国内外临床治疗模式与方法。现以临床治疗效果评价为依据，按时间序列和技术方案序列对唇腭裂发生发展过程中各个阶段的治疗原则和方式方法进行总结，初步形成华西口腔医院唇腭裂临床治疗准则，希望以此来促进整体临床治疗和研究水平的提高。     

牙周维护治疗的定义、时机和随访间隔

牙周基础治疗和牙周维护治疗是牙周序列治疗中必不可少的部分,牙周基础治疗目前已得到广泛关注,然而,人们对牙周维护治疗的重视尚待加强。鉴于牙周维护治疗是牙周治疗远期疗效的决定性因素,因此,我们需要明确牙周维护治疗的定义及时机。另外,牙周维护治疗需要定期实施,这其中"定期"一词则需要被深刻探讨。文章通过回顾国内外文献,进一步明确牙周维护治疗的定义和时机,同时对牙周维护的随访间隔进行探讨。     

Systemic medications: clinical significance in periodontics

Systemic medications are of value as adjuncts to periodontal therapy. These medications can be divided into two major categories: antibiotics and agents for host modulation. Antibiotics have been shown to be valuable adjuncts in specialized types of periodontal disease, such as localized and generalized aggressive periodontitis, and of possible value in severe chronic periodontitis. Antibiotics have been studied individually, in combination and in sequential therapy. Host modulators include Periostat, non-steroidal anti-inflammatory agents, alendronate (Fosamax), hormone replacement therapy and anti-arthritic medications. These agents produce their beneficial effects by a variety of mechanisms of action, including inhibition of matrix metalloproteinases, inhibition of prostaglandin production, stimulation of osteoblasts, inhibition of osteoclasts, and other anti-inflammatory mechanisms of action.     

慢性牙周炎伴前牙病理性移位的多学科联合治疗1例

目的 本文通过报道Ⅲ期B级牙周炎伴前牙病理性移位（pathological tooth migration, PTM）的治疗过程1例,希望为PTM的临床诊治提供一定参考。诊治经过：患者女性,28岁,哺乳期;因孕期牙缝逐渐变大影响美观,分娩后就诊。对本病例采用牙周序列治疗+多学科联合治疗。结果 牙周序列治疗后,牙周恢复健康稳定,修复治疗后患者对美观和功能较为满意,且修复体设计利于牙周长期稳定。结论 PTM患牙应综合多因素进行病因分析,根据不同的病因制定诊疗方案。     

放疗对术后伤口愈合的影响

临床上越来越多的肿瘤患者以手术配合放疗等作为综合序列治疗，低剂量放疗对于未愈合伤口的微环境、愈合过程、局部组织细胞以及细胞因子具有一定的影响，但对临床常用的45-58Gy及以上的高剂量放疗对于伤口影响的研究较少。本文就放疗对伤口愈合的影响及促进放疗后的伤口愈合因素作一综述。     

口腔颌面部脉管性疾病的综合序列治疗

脉管性疾病(vascular anomalies)包括血管瘤和脉管畸形2大类,是婴幼儿期最常见的良性肿瘤或发育畸形,文献报道,血管瘤在新生儿的发病率为1.1%～2.6%,1岁时的发病率高达10%。其中,35%～60%发生在头颈部。虽然脉管性疾病属于良性病损,但发生在颌面部的病变,不仅导致严重的容貌毁损,还可能因为阻塞呼吸、消化道而有碍发音、进食,甚至导致出血、窒息并危及生命。20世纪80年代以前,国内外对于脉管性疾病的分类、诊断比较混乱,以至于在治疗上因“治疗过度”而带来许多后遗症或“治疗不足”而贻误时机。上述现象目前已经得到改善:首先国际上于1992…     

27例口腔颌面部恶性黑色素瘤临床分析

目的：探讨口腔颌面部恶性黑色素瘤的临床特点及治疗方法。方法：收集我科2009年1月~2013年7月收治的27例口腔颌面部恶性黑色素瘤患者,对临床病例资料、治疗方法及随访结果进行初步总结。结果：27例患者中,好发部位以上颌牙龈多见,其次为腭部、下颌牙龈、颊黏膜等。治疗方法主要采用手术治疗、手术＋化疗、手术＋生物免疫治疗、冷冻治疗＋手术、冷冻治疗＋切取活检等。随访观察1~54月,复发2例。结论：口腔颌面部恶性黑色素瘤应以综合序列治疗较为合理,且生物免疫治疗具有良好的发展前景。     

六亚甲基双乙酰胺联合5-FU对涎腺粘液表皮样癌的分化诱导作用

目的研究平面极性分化诱导剂六亚甲基双乙酰胺（ＨＭＢＡ）联合５ＦＵ对涎腺粘液表皮样癌的分化诱导作用。方法采用“５ＦＵ→ＨＭＢＡ”用药方案联合用药。结果ＨＭＢＡ对涎腺粘液表皮样癌有较强的分化诱导作用，当联合用药时ＨＭＢＡ的分化诱导作用被增强，另一方面，ＨＭＢＡ也明显增强了５ＦＵ的抗癌作用，两者显示出协同抗癌作用。结论将５ＦＵ与ＨＭＢＡ合用，对涎腺粘液表皮样癌的治疗可能具有一定应用价值     

Management of the implant periapical lesion: a case report

The implant periapical lesion (IPL), a possible cause for implant failure, may occur from the presence of pre-existing microbial pathology such as endodontic/periodontal lesions. This case report presents a case history related to IPL, which was caused by a pre-existing endodontic lesion. In addition, other possible causes such as surgical trauma and the management strategies of IPL are suggested. For the treatment of the infected form of IPL, a sequential surgical therapy can be utilized. This includes surgical removal of the implant or implant apical region, thorough debridement of the infected lesion, systemic antibiotics, and/or guided bone regeneration. The implant therapy should be directed to minimize the occurrence or consequences of IPL by careful diagnosis, systematic treatment planning, and appropriate treatment procedures.     

婴幼儿血管瘤口服普萘洛尔治疗后的进一步处理

目的 总结婴幼儿血管瘤患儿口服普萘洛尔停药后的进一步治疗经验,探讨其后期临床干预治疗与病变分型的关系。方法 回顾分析2010年1月—2014年5月接受口服普萘洛尔停药后序贯治疗的137例婴幼儿血管瘤患儿的临床资料。其中男41例,女96例;年龄14～25个月,中位年龄16个月。口服普萘洛尔停药后疗效评价Ⅰ级1例,Ⅱ级62 例,Ⅲ级74 例,Ⅳ级0例。丘疹型31例,毛细血管扩张型11例,肥厚型74例,复合型9例,深部型12例。位于头皮3例,面部49例,颈部14例,躯干33例,四肢38例。45例合并皮肤松弛,80例合并皮肤深部软组织肥厚。采用激光治疗38例,平阳霉素注射治疗63例,手术切除20例,联合治疗16例。仍按4级评分法对序贯治疗效果进行临床评价,并记录瘢痕增生、皮肤松弛和色素改变情况。采用SPSS18.0软件包进行统计学分析。结果 137例患儿中,后续治疗前各型皮肤松弛和软组织肥厚发生率有显著差异。后续治疗后随访6个月～4 a,疗效评定为Ⅰ级0例,Ⅱ级0例,Ⅲ级15 例,Ⅳ级122 例。5型患儿序贯治疗前、后远期治疗效果有显著差异（P均＜0.01）,2例肢体邻近关节患儿术后瘢痕增生,2例注射平阳霉素患儿注射区出现轻度色素改变。结论 肥厚型、深部型和复合型婴幼儿血管瘤口服普萘洛尔治疗后易遗留病变区不同程度的皮肤松弛或软组织肥厚。婴幼儿血管瘤患儿口服普萘洛尔停药后,需根据发病部位、临床分型和残留病变特点确定序贯治疗方案。毛细血管扩张型和丘疹型病变首选激光治疗,必要时联合平阳霉素局部注射;肥厚型病变和复合型病变首选平阳霉素注射治疗,深部型病变和部分增生明显的肥厚型病和复合型病变应考虑手术治疗;术后残余浅表病变,联合应用平阳霉素注射效果较好。     

Nature of periodontal diseases: Assessment and diagnosis

The assessment and diagnosis of periodontal diseases has become an active and controversial area of research which incorporates both new technologies and new concepts. Previous efforts have demonstrated the potential value of diagnostic testing in differentiating different diseases, in evaluating disease progression, and in monitoring the response to therapy. A few studies have even shown promise in predicting the response to therapy. Some of this work has incorporated proven diagnostic principles which allow a comparison between techniques. It is clear, however, that future work would benefit from an increased incorporation of these diagnostic principles and a recognition of the value of a sequential use of tests. Much work remains and many questions cannot be adequately answered at this time, but we should not lose sight of the great progress which has been made in the area of assessing and diagnosing periodontal diseases.     

Invisalign, an innovative invisible orthodontic appliance to correct malocclusions: advantages and limitations

Tooth movement may be achieved by the use of sequential positioners made by altering tooth positions on set-up models to simulate progress of treatment. The principle is based upon Kesling's positioner concept of 1945, though its subsequent application to splint therapy was labour intensive and did not result in precise tooth movement. Invisalign was developed by Align Technology, Inc (Santa Clara, CA, USA) in 1997 by applying 3-D imaging technology to overcome these problems, and permitting customization on a large scale. Their system offers significant advantages, but still suffers from limitations which are discussed in this article.