康复训练治疗鼻咽癌放疗后张口困难及咬肌痉挛

目的探讨康复训练对鼻咽癌患者放疗后张口困难及咬肌痉挛的防治效果。方法接受根治性放疗的鼻咽癌患者154例,根据放疗后问卷评分分为康复训练组和观察组,86例能完成指导训练内容80%的患者纳入康复训练组,其余68例患者纳入观察组。放疗后1年及2年分别测量2组患者的张口度,并评价有无咬肌痉挛性疼痛。结果康复训练组放疗后1年及2年的张口困难发生率分别为46.5%、52.2%,比观察组64.9%、83.8%低。康复训练组1年及2年的咬肌痉挛发生率分别为31.3%、36.0%,比观察组的66.2%、77.9%低。经分析,康复训练组张口困难各级患者的张口困难及咬肌痉挛发生率与观察组间差异均有统计学意义（P〈0.05）。结论早期康复训练可有效降低鼻咽癌患者放疗后张口困难及咬肌痉挛的发生率,有利于提高患者的生活质量。     

下颌阻生智齿涡轮钻法与锤凿法拔除的临床比较

目的　比较涡轮钻法与锤凿法在拔除下颌低位及埋伏阻生齿的临床效果 ,评价涡轮钻法的临床可行性和优越性。方法　对 2 70例下颌阻生智齿患者 ,随机采用锤凿法 (对照组 )或涡轮钻法 (实验组 )去除阻力后拔除 ,记录患者局部肿胀程度、张口受限程度、疼痛程度、干槽症、皮下淤血斑及皮下气肿的发生情况。结果　实验组手术时间比对照组明显缩短 (P <0 .0 1)。两组患者局部肿胀程度 ,疼痛程度和张口受限程度的构成比存在显著差异 (P <0 .0 1)。干槽症的发生率实验组明显低于对照组 (P <0 .0 5 )。淤血斑及皮下气肿发生率两组无显著差异。结论　涡轮钻法能显著缩短手术时间 ,减轻患者术后肿胀、疼痛、张口受限、干槽症等不良反应 ,值得临床推广     

丹参联合曲安奈德局部注射治疗口腔黏膜下纤维性变的临床研究

目的探讨丹参联合曲安奈德局部注射治疗口腔黏膜下纤维性变引起的口腔灼痛和张口受限的疗效。方法将丹参注射液和曲安奈德注射液混合均匀,局部注射到双侧病变颊黏膜下和翼颌韧带区,每周1次,连续10次为1个疗程。观察颊黏膜色泽、弹性变化,记录治疗前、治疗1个疗程后口腔灼痛症状和张口度。结果1个疗程后,35例患者病变区颊黏膜色泽均逐渐变红润、质地变软;自觉口腔灼痛症状均减轻或基本消退;其中29例患者张口受限得到改善,上下切牙切缘距离由治疗前的（17.05±4.31）mm,增加到（28.50±6.02）mm,治疗前后差异有统计学意义（t=6.55,P〈0.05）;其余6例上下切牙切缘间距增加小于或等于2mm,张口度变化不明显。结论丹参联合曲安奈德局部注射治疗口腔黏膜下纤维性变引起的口腔灼痛和张口受限有较确切的临床疗效。     

复方锌洁粘贴片治疗口腔粘膜炎症的临床疗效观察

目的 :观察复方锌洁粘贴片治疗口腔粘膜炎症的效果。方法 :用随机法将 63例门诊口腔粘膜炎症患者分成两组 ,用单盲法给药。实验组用复方锌洁粘贴片 ,对照组用安慰剂。结果 :实验组治疗有效率为 98 4 2 % ,对照组治疗有效率为68 2 5 %。两组比较差异有显著性 (p <0 0 1)。结论 :复方锌洁粘贴片有消炎、止痛及收敛的作用 ,临床观察疗效显著。     

畸形综合征併发颞下颌关节炎1例报告

<正> 患儿郭×,男性。生后4天,因不吃4天,于第3天发烧,抽搐1次,经积极抢救治疗烧退,仍不吃,张口受限,于1983年11月25日入院。其母有先兆流产,应用黄体酮保胎,妊娠5个月发烧,羊水过多,曾2次B超检查,过月18天行剖腹产。体检:外观正常新生几,体温36℃,啼哭时不能张大,牙关紧闭打不开,前囱较小,颈软,曾请外科会诊2次均排除破伤风。吮吸反射,拥抱反射均消失,双下肢肌张力增强,右侧口角处裂口1 cm,张口度0.3cm。实验室检查:血色素190g/l,白血球20×10~9/l,中性0.70,淋巴0.28,酸性0.02,出血时间1 min,凝血时间1min。入院治疗经过:患儿入院后,给予氨苄青霉素抗感染治疗,血培养无细菌生长,请外科医师会诊,排除新生几破伤风,经过抗感染治疗后,患儿张口度恢复正常,吃奶好,双下肢活动自如,于1983年12月5日出院。     

医用几丁糖治疗颞下颌关节不可复性盘前移位的临床研究

目的　观察医用几丁糖关节腔内注射对颞下颌关节不可复性盘前移位的临床治疗效果。方法　将30例颞下颌关节不可复性盘前移位患者 ,按就诊序号半随机分为试验组和对照组。试验组患者用几丁糖 1 0ml关节上腔注射治疗 ,对照组患者用强的松龙悬液 1 2 5mg关节上腔注射。注射治疗后 1d、1 4d复诊 ,测量最大张口度。结果　注射后 1 4d ,试验组患者平均张口度恢复到 (36 73± 4 6 9)mm ,比注射前增加 1 1 73mm ;对照组患者平均张口度为 (2 8 5 3± 5 81 )mm ,比注射前增加 3 86mm。试验组张口度增加值明显大于对照组 (P <0 0 5 )。结论　医用几丁糖是一种有效的治疗颞下颌关节不可复性盘前移位的生物材料。     

三种方法治疗颞下颌关节紊乱病的疗效比较

目的　比较关节灌洗、关节镜和关节开放手术 3种方法治疗颞下颌关节紊乱病的临床效果。方法　应用 3种方法治疗颞下颌关节紊乱病 :关节灌洗术治疗 35例 (42侧关节 ) ,关节镜术治疗 4 2例 (5 0侧关节 ) ,关节开放手术治疗 2 8例 (2 9侧关节 ) ,并对 3种方法的疗效进行比较。结果　关节灌洗组随访 2 4～ 5 2个月 ,术后张口度平均增加 (8.1± 3.9)mm ,健侧侧向运动增加 (3.8± 1.4 )mm ,85 .7%患者疼痛缓解 ,72 .2 %杂音消失 ,总有效率为 82 .9%。关节镜组随访 2 4～ 5 6个月 ,张口度平均增加 (7.5± 3.8)mm ,健侧侧向运动增加 (4.1± 1.8)mm ,88.1%患者疼痛缓解 ,79.2 %杂音消失 ,总有效率为 85 .7%。关节开放手术组 ,随访 2 4～ 5 5个月 ,术后张口度平均增加 (8.0± 5 .1)mm ,健侧侧向运动增加 (3.7± 2 .3)mm ,92 .9%患者疼痛缓解 ,总有效率为 89 3%。 3组比较 ,张口度、侧向运动改善及疼痛缓解率均无显著差异。结论　关节灌洗术、关节镜术和关节开放手术治疗颞下颌关节紊乱病均有效 ,但关节灌洗术方法简单、损伤小 ,易于推广应用。首先应选择手术创伤小的治疗方法 ,最后才选择开放手术。     

丹参复方双链酶药膜治疗复发性阿弗他溃疡的临床初步研究

目的:探讨丹参复方双链酶药膜治疗复发性阿弗他溃疡(RAU)的临床效果.方法:RAU 患者316 例(男147 例,女169 例)随机分为2 组:实验组157 例(男83 例,女74 例),对照组159 例(男64 例,女95 例).记录治疗前后疼痛指数,治疗有效率.结果: 2 组治疗后疼痛指数均明显低于治疗前(P<0.05),治疗前后疼痛强度差值及显效率2 组之间显著差异(P<0.05,P< 0.01).实验组总有效率为94.1%,对照组总有效率为45.6%,2 组之间有显著性差异(P<0.05).结论:丹参复方双链酶药膜治疗RAU镇痛效果好、缩短溃疡愈合时间;临床使用方便、安全.     

智齿冠周炎张口受限的一种疗法

采用甲硝唑、醋酸泼尼松龙、地卡因混合液 (简称“ＭＰＤ”液 )作为冠周炎局部治疗药物 ,并与 30例冠周炎常规冲洗上药的患者对比 ,取得了满意的效果。1　材料和方法随机抽取口腔门诊 6 5例诊断为冠周炎并有张口受限的患者 (冠周脓肿或伴有间隙感染者除外 )。男 2 4例 ,女 41例。治疗前先测量患者的最大张口度 (上中切牙切端与下中切牙切端的距离 )。取 5 0ｇ/Ｌ甲硝唑葡萄糖注射液、12 5ｍｇ的醋酸泼尼松龙注射液和 2 0ｇ/Ｌ地卡因 ,以 2 :1:1的体积比配制成“ＭＰＤ”液 ,置冰箱冷藏待用。ＭＰＤ组 35例用 30ｍｌ/Ｌ过氧化氢液清洗盲袋 ,…     

复方丹参对犬牙齿移植作用的免疫组织化学研究

目的:研究复方丹参在犬牙齿自体移植中的作用,对犬移植牙齿牙周组织的影响及可能的机制。方法:5只成年雄性杂种犬的移植牙齿分为实验组、对照组,对犬牙齿移植后1周、2周、3周、1个月共4个时间点的移植牙的牙体-牙周联合标本进行组织学HE染色;PV二步法检测TGF-β1和PCNA的表达情况。结果:实验组牙周组织改建活跃,TGF-β1和PCNA的阳性表达明显高于对照组,两组比较存在统计学差异(P<0.001)。结论:复方丹参可提高牙周组织中TGF-β1和PCNA的表达,这可能是其对犬移植牙作用的机制之一。     

Effect of dentifrice containing 5000 ppm fluoride on non-cavitated fissure carious lesions in vivo after 2 weeks

PURPOSE: This randomized clinical trial compared the ability of two dentifrices, one containing 5000 ppm fluoride (Duraphat) and the other 1450 ppm fluoride (Caries Protection, control) to reverse non-cavitated fissure carious lesions. METHODS: 30 adults having occlusal lesions with DIAGNOdent values between 10 and 20 were randomly assigned to two groups of 15 participants each. DIAGNOdent measurements were performed after cleaning the teeth with cleaning brushes and after additional cleaning using an airflow device. The participants were instructed to brush their teeth three times a day for 3 minutes after the meals with a 2 cm line of their assigned dentifrice. After a period of 2 weeks, the teeth were cleaned again with the airflow device and laser fluorescence measurement was performed. RESULTS: The group using the dentifrice containing 5000 ppm showed a significantly higher decrease in laser fluorescence (21%) over the test period than the control group (4%; P< 0.001; repeated measures ANOVA). The decrease in laser fluorescence in the test group was significant (P< 0.001; Wilcoxon signed-rank test). The difference between cleaning the teeth with cleaning brushes and additional cleaning with airflow before DIAGNOdent measurement was not statistically different (P> 0.05; Wilcoxon signed-rank test).     

The influence of text messages on the cooperation of Class II patients regarding the use of intermaxillary elastics

Objectives:To evaluate the influence of text messages on cooperation of Class II patients with the use of intermaxillary elastics.Materials and Methods:The sample consisted of 42 orthodontic patients (20 males and 22 females) aged between 14 and 34 years. They were randomly divided into one of the following two groups: a control group with 21 patients who did not receive messages and an experimental group with 21 patients who received motivational and reminder text messages. Messages were sent twice a week for a period of 3 months. The patients were instructed to wear the elastics all day, removing them only during meals and replacing them daily. All patients were instructed regarding the importance of cooperation. Measurements were performed with a digital caliper on plaster models at the beginning of elastics wear (T1) and 3 months later (T2). For intragroup and intergroup comparisons between T1 and T2, paired and unpaired t-tests, respectively, were used with a significance level of 5%.Results:Statistically significant differences were observed in the intra- and intergroup comparisons between T1 and T2. Both groups showed a decrease in the sagittal distance between upper and lower arches from T1 to T2, demonstrating the effective use of elastics. However, the experimental group showed a Class II correction that was 3.7 times greater than the control group (P = .001).Conclusions:Text messages had a positive influence on the cooperation of patients regarding the use of intermaxillary elastics in the orthodontic treatment of Class II malocclusion.     

"参阳"方辅助治疗口腔鳞状细胞癌的远期疗效评价

目的本研究旨在进一步评价综合序列治疗中加用中药“参阳”方对口腔鳞状细胞癌(简称鳞癌)患者的远期疗效。方法本组病例系初发口腔鳞癌患者,共238例。随机分为治疗组(参阳方)与对照组(安慰剂)。剔除术后未服满中药3个月患者17例,术后失访8例,实际研究病例数213例。其中治疗组104例,对照组109例。全组病例均经过5～10a以上随访(随访率为96.44%)。数据用Logrank法进行统计分析。结果“参阳”方组的3、5、8、10a生存率分别较对照组提高8.46%、9.26%、9.04%、8.57%,经统计学处理,P=0.1936,P>0.05,实际数据有延长生存率的趋势。结论术后服中药“参阳”方,有明显提高口腔鳞癌患者生存率的趋向,可作为综合序列治疗的辅助方法之一。     

应用颌间牵引改善数字化下颌骨缺损重建术后咬合不良

目的 评价应用颌间牵引改善数字化技术联合自体骨移植修复下颌骨缺损后仍然存在的上、下颌咬合关系不良的临床效果.方法 回顾分析中山大学附属口腔医院口腔颌面外科和桂林市第二人民医院口腔科2016年1月至2018年2月进行的18例利用数字化技术联合自体骨移植修复口腔下颌骨缺损的手术,术前均采用数字化辅助外科技术制作个体化树脂头...     

Convergence defects in patients with temporomandibular disorders

The aim of this study is to show the presence of a correlation between ocular convergence defects (OCD) and temporomandibular disorders (TMD) among a group of adult subjects. The group studied was made up of 48 subjects (12 males and 36 females). The average age was 35 with a range of 19-45 years of age. The subjects presented with TMD and muscular pain and/or dysfunction. Forty-eight subjects with TMD for the case study were matched by gender and age to 48 control subjects seeking routine dental care (control group). All the subjects were examined by the same orthoptist who classified the ocular convergence degree using two tests. The first test evaluated the distances (in centimeters) of the convergence near point (3-4 cm: normal; 5-7 cm: sufficient; > 7 cm: insufficient). The second test assessed the fusional convergence using a Berens prism test (> 25 diopters: normal; between 18-25: sufficient; < 18 diopters: insufficient). In the TMD group, 36 subjects (75%) showed a compromise of convergence: 13 (36%) were classified in the 5-7 degree range and 23 (48%) in the > 7 cm degree range. The Berens test showed ten subjects (28%) in the group < 18D and 26 (72%) in the group 18-25D. The control-group presented ten (21%) subjects with compromise of convergence: three classified in the group < 18D and seven in the group 18-25D. The TMD subjects presented a higher statistical percentage (p < 0.0001) of ocular convergence defects. The TMD patients also reported a strong association referred to specific signs and symptoms, i.e., limited maximal opening or myofascial pain. There were some subjective reports also of headaches and torcicollis (neck stiffness) which appeared significantly more frequently in subjects with a compromise of convergence. The study showed a much higher prevalence of ocular convergence defects in patients with head, neck, and shoulder pain.     

“新净界漱口水”对放射性口腔黏膜炎的防治效果观察

目的： 前瞻性随机双盲研究“新净界漱口水”对放射性口腔黏膜炎的防治效果。方法：60例拟行放疗的口腔癌患者随机分为试验组和对照组;试验组30例,自放疗第1天起,每天使用“新净界漱口水”含漱4次,每次5 mL,含漱 5 min,直至放疗结束。对照组30例使用生理盐水含漱,方法同试验组。按RTOG口腔黏膜炎分级标准评价2组患者的口腔黏膜炎严重程度,记录疼痛程度,并照相存档。3级口腔黏膜炎视为终止指标,发生者给予其他药物治疗。应用Stata 12.0软件包对数据进行统计分析。结果：2组患者的年龄、性别、放疗技术和剂量无显著差异（P>0.05）。试验组首次观察到黏膜炎的发生时间较对照组晚（照射11.0次∶9.1次,P<0.05）,且试验组在早期出现疼痛的比例较对照组低（36.7%∶70.0%,P<0.05）。另外,试验组3级口腔黏膜炎的出现时间较对照组晚（照射18.9次∶15.9次,P<0.05）,发生率较对照组低（63.3%∶90.0%,P<0.05）。结论：“新净界漱口水”能延缓放疗所致口腔黏膜炎的发生时间,减轻患者的疼痛症状,并能减少3级口腔黏膜炎的发生率,值得临床使用。     

口腔鳞癌手术后中药治疗远期疗效观察

作者曾对２３８例口腔鳞癌术后应用中药“参阳”方的疗效进行前瞻性的研究,本文继续对已生存４～８年的５６例病员门诊随访结果进行分析．结果是生存情况：７年生存期原治疗组高于原对照组１２．５％,原治疗组３０例均健在,而原对照组中的２６例,２例带瘤生存,１例死亡;Ｔ细胞亚群测定中,复发死亡者的ＣＤ８值均升高,ＣＤ４／ＣＤ８比值均下降;中医辨证中,正常者及肾气虚者的例数以治疗组为多,而阴虚与气阴两虚者,治疗组低于对照组;由上提示：经“参阳”方治疗者有较好的远期疗效．     

中药"参阳"方对人舌鳞癌细胞裸鼠移植瘤的抑瘤作用

目的:前瞻性研究表明,中药“参阳”方能够延长口腔癌患者的生存期并提高生存率,但其抗癌机制尚不十分明确。本研究的主要目的是观察中药“参阳”方对人舌鳞癌细胞裸鼠移植瘤的抑瘤作用,并探讨其可能的作用机制。方法:将体外培养的人舌鳞癌细胞系Tca8113细胞接种于裸鼠皮下,建立人舌鳞癌移植瘤模型,共48只,随机分为4组:“参阳”方A组、B组、阳性对照组和阴性对照组。采用灌胃方法进行药物干预,共30d,观察各组的抑瘤效果及对裸鼠一般状况、生存时间和脾脏指数的影响。结果:每只鼠每天喂养“参阳”方72.8mg,能轻度抑制Tca8113细胞移植瘤的生长,抑瘤率为22.04%;裸鼠的脾脏指数明显提高(t检验,P<0.05);生命延长率为18.9%。主要脏器的组织学检查未见病理改变,表明所用剂量药物无明显的毒副反应。结论:“参阳”方对荷瘤鼠的直接抗癌作用较弱,其对口腔鳞癌的治疗作用可能是通过调节机体的免疫功能而实现。     

Radiation-induced craniofacial bone growth inhibition: development of an animal model.

Craniofacial deformities caused by therapeutic radiation-induced bone growth inhibition can occur in up to 100% of survivors of childhood head and neck cancers. The mechanism of radiation-induced craniofacial bone growth inhibition is poorly understood. The objective of this study is to establish a model of radiation-induced craniofacial bone growth inhibition to study the pathophysiology of radiation on growing membranous bone. Seven-week-old male New Zealand white rabbits were randomized into 4 groups (n = 10/group) and received a single dose of orthovoltage radiation (0, 15, 25, or 35 Gy) to the right orbital-zygomatic complex. Serial radiographs and computed tomography scans were performed for cephalometric analysis, bone volume, and bone density measurements until skeletal maturity at 21 weeks. Statistically significant ( P < 0.05) reductions in orbital-zygomatic complex linear bone growth, bone volume, and bone density were found after radiation with 25 or 35 Gy compared with nonirradiated control animals. A significant ( P < 0.05) decrease in orbital-zygomatic complex volume was noted after 15-Gy radiation but there were no significant effects on linear bone growth as assessed by cephalometric analysis at this dose. This study establishes the rabbit orbital-zygomatic complex as a suitable model for the study of radiation-induced craniofacial bone growth inhibition and will permit investigation into the underlying cellular and molecular basis of this injury.