后牙D型改良粘结桥的临床应用初探

目的评价后牙D型改良粘结桥临床效果。方法收集口腔门诊28例缺失1颗后牙患者,应用D型改良粘结桥修复。修复体粘结后即刻、粘结后6个月和1年观察,对修复体边缘适合性、菌斑指数、牙龈指数等方面进行评价。结果后牙D型改良粘结桥半年后临床复查,基牙2的牙龈指数高于对照牙2(P<0.05)。1年后复查1例(3%)在使用中脱粘,1例(3%)修复体折断,基牙的菌斑指数、牙龈指数与对照牙比较,差异均有统计学意义(P<0.05)。结论后牙D型改良粘结桥作为一种微创伤的固定修复方式,短期临床效果令人满意,长期的牙周维护是必要的。     

树脂粘结式与带环焊接式Nance弓临床脱落率的比较分析

目的:研究树脂粘结式Nance弓替代带环焊接式Nance弓的可行性。方法:选取临床上拔除上颌双侧第一双尖牙需要使用Nance弓加强支抗的病例30例,分别制作戴入树脂粘结式Nance弓和带环焊接式Nance弓,观察6个月内的松脱情况,分析造成脱落的原因。结果:树脂粘结式Nance弓双侧松脱1例,单侧松脱3例,带环焊接式Nance弓单侧松脱3例,两种Nance弓脱落率无统计学差异。结论:树脂粘结式Nance弓制作粘固过程简捷,脱落率与带环焊接式Nance弓无明显差异,适合在临床上推广使用。     

正畸粘结树脂改良型玻璃离子粘固剂的研究进展

直接粘结技术已在口腔正畸临床得到广泛的应用，成功地矫治了各种牙颌畸形，改变了过去多带环技术所无法克服的操作复杂等缺点，且各种正畸粘合剂也不断地研制成功，推动着固定矫治技术的不断发展。一种粘接材料能否应用于临床，关键要考察其粘接强度。以往的研究证实，传统型玻璃离子粘固剂的粘接强度明显低于复合树脂釉质粘接剂的粘接强度，正畸治疗中托槽脱落率较高，不能满足临床要求。20世纪90年代以后出现的树脂改良型玻璃离子粘固剂在材料成分上有了改变，使材料性能得以改进，尤其在粘接强度上较传统型玻璃离子粘固剂有了明显提高，使其有可能应用于正畸临床中。近年来的研究集中在应用树脂改良型玻璃离子粘固剂粘接正畸托槽方面，并已成为正畸研究领域的热点之一。本文对近年来改良型玻璃离子粘固剂的研究发展状况进行回顾，关于树脂改良型玻璃离子粘固剂具有以下几个方面的特性.     

改良式子宫捆绑术在剖宫产宫缩乏力出血中的应用

目的探讨改良式子宫捆绑术在剖宫产宫缩乏力出血中的应用。方法选取剖宫产宫缩乏力出血患者98例,随机分为改良组和常规组,分别采用改良式子宫捆绑术和传统子宫捆绑术,观察两组疗效。结果治疗前,两组血常规指标比较差异无统计学意义(P0.05)。治疗后,改良组血常规优于常规组,差异有统计学意义(P0.05)。改良组总有效率高于常规组,出血量低于常规组,差异有统计学意义(P0.05)。结论改良式子宫捆绑式可有效提高临床治疗效果,可在临床推广和应用。     

改良式原位缝合在末节断指中的临床应用

末节再植也有较高的成活率。但是仍有一部分病人因找不到可吻合的血管，而无法再植。对讲究美观的年轻人，特别是年轻女性，要求更为迫切。为此我们在搞好断指再植的同时，研究末节断指的解剖和修复方法，提出改良式原位缝合法并临床应用13例，成活10例，成活率77．8％，成活指功能良好。报告如下。     

改良式Palomo手术治疗精索静脉曲张体会

目的观察改良式Palomo手术治疗精索静脉曲张的效果。方法应用小切口经腹膜后精索静脉高位结扎术(改良Palomo术式)治疗精索静脉曲张不育症300例,观察术后精液参数的变化及配偶的受孕情况。结果本组300例均顺利完成改良Palomo手术,术中未发生输尿管或输精管损伤。其中双侧手术平均时间(27.32±4.12)min,单侧(18.28±3.32)min。患者术后均获3个月~2年随访,临床症状明显改善,48例不育症者中随访2年内39例(81.25%)配偶成功受孕。结论改良Palomo术治疗精索静脉曲张简便有效,并发症少。     

改良袢式吻合在全胃切除术后消化道重建中的应用

全胃切除术后的手术并发症和术后生活质量与消化道的重建方式密切相关.理论上,理想的消化道重建方式应满足操作简单、并发症发生率低、能够维持营养吸收和具有储存食物的功能、缓解术后消化道症状、最大限度地减少反流性食管炎并具有较高的生活质量等需求[1].我们对76例胃癌患者应用改良袢式吻合行全胃切除术后消化道重建,疗效满意,现报告如下.     

改良马迈式挤奶法在剖宫产后乳房疏通中的应用

目的疏通乳房,提高母乳喂养率。方法将160例产妇随机分为观察组和对照组各80例,对照组产妇剖宫产后采用传统的挤奶方法疏通乳房;观察组采用改良马迈式挤奶法进行乳房疏通。结果观察组产后乳房舒适度评分、乳房肿胀程度与对照组比较,组间效应、时间效应、交互效应均P0.05。观察组术后5d和6个月纯母乳喂养率显著高于对照组(均P0.01)。结论对剖宫产产妇应用改良马迈式挤奶法可有效疏通乳房,从而降低产后乳房胀痛度,提高纯母乳喂养率。     

改良垂直褥式缝合在胫骨手术中的应用

2005年2月～2009年1月,我院将改良的垂直褥式缝合法等软组织保护技巧应用于胫骨骨折的复位手术,疗效满意,现报道如下。     

改良式腹部横切口在子宫全切术中的临床研究

目的:研究改良式腹部横切口用于宫全切术的临床疗效。方法:对子宫小于孕4个月大小的良性病变患者100例,采用改良式腹部横切口子宫切除术,与同期传统腹式纵切口子宫切除术进行比较。结果:改良式腹部横切口子 宫切除术具有手术时间短、术中出血少、术后病率低、排气时间早、拆线时间短、切口愈合好、疤痕小等优点。结论:改良式腹部横切口用于良性病变的子宫切除术是可行的。     

Super-Bond C&B粘结剂固定牙周松动前牙的临床观察

目的:观察牙周炎松动前牙用Super-Bond C&B粘结剂固定治疗后6个月的临床效果。方法:牙周基础治疗后的16例牙周炎患者共计18颗Ⅱ～Ⅲ°松动前牙,采用Super-Bond C&B粘结剂在牙齿邻面将松动牙直接粘结固定,治疗后6个月时对粘结固定治疗效果进行评价。观察粘结有无松脱,患牙动度、探诊深度、附着丧失等的变化。结果:18颗牙在6个月内有1例治疗失败,1例松脱,已行再固定。治疗后6个月患牙的探诊深度、附着丧失较固定前有所改善(均值分别减少0.81mm、0.42mm,P<0.05);咀嚼功能明显改善,患者自觉舒适无异物感。结论:采用Super-Bond C&B粘结剂直接粘结法固定牙周炎所致松动前牙,具有美观、舒适的特点,粘结效果稳定,牙周状况改善,有助于改善牙齿的咀嚼功能。     

冠延长术在前牙固定义齿修复中的应用

目的:探讨冠延长术在前牙固定义齿修复中的作用。方法:选取28例患者34颗前牙进行了冠延长术,最少于6周后行固定义齿修复。于修复后6个月、1年,2年随访复诊。检查内容包括边缘密合性,牙龈健康状况以及咀嚼功能。结果:研究表明,在:2年的随访过程中,97%的修复体边缘密合性、牙龈健康状况及咀嚼功能良好。1颗牙因根折被拔除。结论:冠延长术在修复前牙牙体缺损至龈下的患者效果理想,可广泛应用于前牙的保存修复。     

应用附着体固位在可摘义齿临床应用效果观察

目的:观察不同类型附着体固位可摘义齿的临床效果.方法:采取冠外精密附着体、磁性附着体、套筒冠作为固位装置制作可摘义齿,对游离端缺失下颌义齿和多牙缺失病例32例进行修复.随访6个月-3年,对义齿美观舒适性、固位力、咀嚼功能、摘戴适应情况及基牙松动、义齿下沉加衬情况进行观察.结果:所有兵力对义齿美观舒适、固位力、咀嚼功能均感满意.30例对义齿摘戴适应(93.75％),2例感到义齿摘戴不便(按扣式、套筒冠义齿各1例).结论:附着体固位可摘义齿兼有固定、活动一尺的优点,能达到良好的临床效果.     

瑞士硅胶印模材在固定义齿修复中的应用

目的：总结、探讨硅橡胶印模法在固定义齿修复应用中的技法及临床注意事项,为临床工作提供参考。方法：常规备牙后,选择合适托盘或个别托盘,将硅橡胶粗泥按比例混合后置入托盘,上覆塑料薄膜后取模而作为一次阴模,去除阴模牙齿龈向倒凹,再将细泥硅橡胶注入一次阴模后取模,获取二次阴模,灌注石膏阳模。结果：可见全部病例的牙齿不论是阴模还是阳模,其组织面均平整细腻、颈缘线清晰连续、无气泡,制作出的基底冠颈缘与阳模肩台及口内基牙肩台均精密贴合。结论：应用硅橡胶制取1次、2次阴模的精确度高,利于所制作的义齿与肩台精密贴合,提高了义齿的精密度,增强了义齿颈缘区域牙周组织的健康。     

Ingestion of a fixed partial denture during general anesthesia

Dental trauma during anesthesia is a common occurrence. Many patients have had extensive dental work, which is more fragile than the natural dentition. This work may include crowns, fixed partial dentures (bridges), and porcelain veneers. We report for the first time, a case in which a fixed partial denture became dislodged and was ingested, and was recovered postoperatively with endoscopy.     

正畸治疗在连续多牙位缺失固定义齿修复中的应用

目的:探讨中草药牙得安牙粉在正畸治疗中对牙周维护的临床效果.方法:选择50例错合畸形患者,随机分成两组,实验组:基础治疗、口腔卫生宣教加中草药牙得安草粉.对照组:基础治疗、口腔卫生宣教加普通牙膏.分别在矫治前、矫治三个月,矫治六个月时对其进行临床牙周指标检测.结果:矫治前两组临床牙周指标差异无显著性,P＞0.05.矫治三个月、六个月时,两组临床牙周指标差异均有显著性,P＜0.05.结论:中草药牙得安牙粉能减少牙菌斑形成,有效改善牙龈健康.     

Removable partial denture in special clinical conditions

Controversies concerning the prosthetic treatment through removable or fixed dentures until the age of 18 existed and continue to exist due to the structural instability of the stomatognathic system. In this communication we present a special experience, acquired about the treatment of some clinical situations in which the removable partial denture has been found appropriate with respect to certain features as bone substance loss as a consequence of traumatisms or tumor extirpations, oligodontia, cleft lip and palate. The clinical situations that will be presented refer to a group of 29 patients treated during a period of 10 years in the Department of Prosthetic Dentistry within the Faculty of Stomatology of Ia?i, Romania. Our conclusion is that the children and teenager patients prosthetic therapy differs with respect to the type and etiology of the teeth loss, the affected zone, the stage of the growth and development process of the stomatognathic system, the technological conditions, the patient social conditions, and last but not least, by his affective attitude regarding the teeth loss and the denture type. The removable partial denture for children and teenagers represents, with some exceptions, an emergency or transitory solution until the necessary conditions for other therapeutic stages are fulfilled. Taking into consideration the tissues lability on which it is applied, the removable partial denture requires a rigorous postprosthetic therapy.     

The influence of the loading mode on the stress distribution on the connector region of metal-ceramic and all-ceramic fixed partial denture

Abstract:  Studies pertaining to the mechanical behavior of fixed partial dentures (FPDs) frequently found the highest tensile stress values at the connector region when load is applied at the pontic central region. The connector region is considered the weakest point of the prosthesis with the greatest potential of fractures, regardless of the material used. This 2D finite element study compared the stress distribution on three-element all-ceramic and metal-ceramic FPDs with different loading conditions. Three FPD models were designed: (i) metal-ceramic FPD; (ii) all-ceramic FPD with the veneering porcelain only on the occlusal face; and (iii) all-ceramic FPD with the veneering porcelain on the occlusal and cervical face of the pontic. Loads of 100 N were applied following these simulations: (i) distributed on all working cusps; (ii) only on the abutment teeth; and (iii) only on the pontic. There is a significant change on the stress distribution and on the tensile stress values when the load configuration is changed. The stress distribution from the load applied on the abutments was significantly better compared with the other two load simulations. When the loads were applied on the pontic and distributed on all working cusps, the highest tensile stress values appeared on the cervical region of the connectors between the abutments and the pontic. However, when the load was applied on the abutment teeth, the maximum tensile stress value significantly decreased and was located on the occlusal region of the connectors. In fact, the load applied on the pontic region does not simulate the clinical situation. Studies using this load configuration have overestimated the connector regions as having the highest probability of failures.     

铸造桩核冠在可摘局部义齿残根残冠基牙再修复中的应用

目的：观察桩核冠修复可摘局部义齿基牙的临床效果。方法：选择可摘义齿基牙出现残根、残冠的患者12例,利用桩核冠进行修复,追踪随访,从主观感觉、口腔检查和X线检查观察其修复效果。结果：临床追踪1～3年,患者自觉舒适,修复体使用情况良好,基牙和牙周组织健康。结论：桩核冠修复可摘局部义齿基牙的临床效果良好,值得临床应用。