下颌前磨牙变异根管的显微临床诊治一例

下颌前磨牙变异的根管解剖形态存在许多变异，传统方法对这些变异根管的诊治非常困难。显微根管技术在临床的广泛应用为根管变异的困难病例提供了先进的设备和方法。我们介绍1例下颌前磨牙变异根管的显微临床诊治病例。     

口腔手术显微镜联合锥形束CT辅助治疗上颌第一前磨牙遗漏远颊根管1例报告

遗漏根管是根管治疗失败的常见原因,避免根管遗漏对提高根管治疗成功率至关重要。上颌第一前磨牙根管解剖形态变异较大,多为颊腭双根管或单根管,极少存在三根管[1]。研究表明,汉族人上颌第一前磨牙三根管的发生率为0.2%~1.8%[2-4]。如何识别可能存在的遗漏第三根管是上颌第一前磨牙根管治疗过程中的难点。本文报道了1例口腔手术显微镜联合锥形束CT(CBCT)辅助治疗上颌第一前磨牙根管治疗中远颊根管遗漏的病例,以期为临床治疗提供参考。     

下颌前磨牙根管解剖形态的相关研究

下颌前磨牙根管解剖形态有多种变异，而对其根管解剖结构的了解是治疗成功的关键。本文简要介绍下颌前磨牙多种解剖结构的形成、形态特点、人种差异、分型和研究方法。     

下颌前磨牙的根管形态

牙医师充分了解牙齿根管的形态是牙髓治疗成功的先决条件。鉴于以往文献中报导的下颌第一、第二前磨牙两个或更多根管的发生率的变异很大,作者对400个下颌第一前磨牙和400个下颌第二前磨牙的根管解剖进行了详细的研究。拔下的牙齿经固定,脱钙,染色和透明后在解剖显微镜下进行检查。记录根管的数目和类型,侧支根管,根尖孔相交叉吻合的     

下颌前磨牙根管变异及其诊治策略

在全牙列中,下颌前磨牙根管变异极大[1],易导致临床操作困难或治疗不彻底,是较难治疗的牙位之一,如果临床无法进行完善的根管治疗,将最终导致根尖周炎甚至拔除.根管显微镜能提供良好的光源和放大视野,辅助完成复杂的根管治疗.在根管显微镜下探查下颌前磨牙变异根管的根管口、疏通变异根管,可顺利完成根管治疗,笔者将通过以下病例予以说明.     

下颌第一前磨牙的临床根管漏治

目的：提高临床医生对下颌第一前磨牙存在双根管的认识。方法：报道4例典型的下颌第一前磨牙根管漏治的病例，结合69个离体的下颌第一前磨牙的根管类型研究。结果：由于临床医生的疏忽和下颌第一前磨牙自身解剖特点，易发生下颌第一前磨牙根管漏治。结论：下颌第一前磨牙根管漏治是根管治疗术失败原因之一。     

下颌第二前磨牙罕见四根管治疗一例

下颌第二前磨牙经常表现出多变和复杂的根管形态,是最难进行根管治疗的患牙之一。对根管形态充分了解,对髓室底的恰当评估,以及对影像学检查的认真解读是根管治疗成功的先决条件。口腔手术显微镜及CBCT的应用为下颌第二前磨牙变异根管的寻找和治疗提供更可靠的保障。本病例就一例下颌第二前磨牙四根管治疗过程做一报告。     

下颌第一前磨牙双根管3例

近年研究表明下颌第一前磨牙的根管系统存在较大变异,使下颌第一前磨牙成为继下颌第二恒磨牙C形根管后的再一个根管治疗难度较高的牙齿。笔者报道3例下颌第一前磨牙双根管病例,为临床治疗提供参考。     

显微镜联合激光用于下颌第一前磨牙三根管治疗1例

<正>对牙齿根管系统解剖形态的准确认识和彻底地清除细菌是根管治疗成功的关键^[1]。下颌第一前磨牙常因楔状缺损和龋齿等因素引起牙髓炎或根尖周炎,通常需行根管治疗^[2]。然而,由于根管变异或遗漏导致治疗失败^[3,4]。本文报告l例罕见的下颌第一前磨牙三根管及侧支根管病例。病 例 报 告患者,女,34岁,主诉：左下后牙肿痛数日。现病史：数年前左下后牙于外院行根管治疗和冠修复,数日前左下后牙开始肿痛,咀嚼时加重,     

上颌前磨牙的根管系统解剖形态特点及研究方法的研究进展

通过回顾总结近年来多种研究方法对上颌前磨牙根管解剖形态的研究,了解上颌前磨牙根管解剖形态及其根管的变异情况,为临床研究治疗提供理论支持。     

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.