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目的利用锥形柬计算机断层扫描（CBCT）研究上颌第一磨牙近中颊根第二根管（MB2）发生率、根管解剖形态以及根管口位置分布。方法随机选取2011-2013年航天中心医院口腔科20～30岁患者CBCT影像160张（男80张、女80张）。平行近中颊根长轴平面观察其根管形态,并按照Vertucci分类统计。水平面观察根管口的位置,记录MB、MB2及腭根根管口间距离以及MB、MB2根管口分别到腭根根管口连线夹角,并比较不同性别间差异。结果本研究观察了279颗上颌第一磨牙,其中存在MB2牙齿233颗,检出率为83．5％,不同性别间差异无统计学意义（P〉0．05）。不同类型的根管出现概率不同,各类型出现率男女间无差异。MB与MB2根管口间距男性为（2．195±0．504）mm,女性为（1．966±0．419）mm,差异有统计学意义（P〈0．05）。结论上颌第一磨牙MB2发生率高,不同类型MB2发生概率不同,男性与女性之间无差异。MB与MB2根管口间距在两性之间存在统计学差异。     

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对缺损至龈下但尚有保留价值的残根可以采用多种治疗方法。目前,牙冠延长术和正畸牵引术的应用最为广泛。本文就牙冠延长术与正畸牵引术的特点及二者在保留残根治疗方面研究进展做一综述。     

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??Objective    To investigate the oral health status of 6??20-year old visually impaired students in Shenyang and analyze the risk factors of caries. Methods    Oral health status??oral health knowledge and related behavioral habits of 103 students were surveyed by questionaires. The risk factors of caries were analyzed through logistic regression analysis. Results    Caries prevalence rate was 78.64%??and the total mean DMFT was 2.43 ± 2.75. The rate of gingival bleeding and dental calculus was 44.66% and 67.96% respectively. Malocclusion rate was 49.51%. Female students had significantly higher dental caries experience than the male ones??P??0.05??. Logistic regression analysis indicated that caries experience was related to the education degree of their mothers and the experience of toothache. Brushing teeth properly with fluoride toothpaste could reduce the incidence of dental caries. Conclusion    Oral health of visually impaired students is poor. Oral health education and promotion measures should be emphasized among disabled students.     

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目的应用聚合酶链式反应-变形梯度凝胶电泳（PCR—DGGE）技术检测慢性根尖周炎患牙根管内中间普菌和链球菌定植情况,分析根管内细菌与患牙症状间关系。方法2011年12月至2013年5月于北京大学深圳医院口腔科就诊的27例慢性根尖周炎患牙根管内细菌样本,提取DNA,利用16SrDNA引物进行PCR—DGGE技术分析。结果27例共检出细菌菌属17种。中间普菌在17例有症状组中检测出16例（94．1％）,在10例无症状组中检测出6例（60．0％）,两组检出率差异有统计学意义（P〈0．05）。链球菌在17例有症状组中均未检测出,在10例无症状组中检测出4例（40．0％）,两组检出率差异有统计学意义（P〈0．05）。结论慢性根尖周炎患牙以厌氧菌感染为主,根管内中间普菌、链球菌与临床症状相关。     

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??To compare the amount of apically extruded debris from root canals when different nickel-titanium instruments were used. Methods    Sixty-eight healthy single-rooted premolar teeth extracted for orthodontic purpose were induded in the study. The teeth were randomly divided into the control group??hand ProTaper??and 3 experimental groups. Three kinds of nickel-titanium instruments were used??rotary ProTaper??Waveone and Mtwo??n = 17??. Debris extruded from the apical foramen after root canal preparation was collected into tubes and the amount of apically extruded debris was determined and analyzed. Results    The OD values of apically extruded debris??in the control group it was 68.65 ± 11.47??in rotary ProTaper group it was 62.66 ± 11.17?? in Waveone group it was 58.49 ± 12.96??in Mtwo group it was 47.70 ± 10.28. Waveone group and Mtwo group had less extruded debris??which was significantly different from the control group??P < 0.05??. Mtwo group had the least of extruded debris??which was significantly different from the other groups??P < 0.05??.  Conclusion    Mtwo nickel-titanium instruments produce obviously less apically extruded debris than ProTaper and Waveone.     

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颧骨位于面中部,参与面部宽度和突度的形成,是面部结构、功能和美观的关键标志。因其体表位置较突出,易受外力作用发生骨折。又因其参与眶外侧壁、眶底及颧弓的构成,故颧骨的骨折常波及上述邻近骨而引发颧骨复合体骨折。根据最小侵袭理论,采用合理的手术切口,应用恰当的内固定材料,在颧骨复合体骨折治疗中具有重要的临床意义。本文结合临床具体病例,运用循证医学证据分级和检索的方法对1例颧骨骨折患者的治疗进行探讨。     

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目的 评价钠钾镁钙葡萄糖注射液用于头颈部缺损游离皮瓣修复手术补液的有效性和安全性.方法 选择2009年1月至2011年12月中国医科大学口腔医学院口腔颌面外科收治的40例口腔颌面部恶性肿瘤晚期患者,均择期行颅颌面联合切除治疗,游离组织瓣修复缺损.随机分为A、B两组,每组20例.两组患者术中分别输入钠钾镁钙葡萄糖注射液和乳酸林格液进行补液.在麻醉诱导前(T1)、血管吻合前(T2)和血管吻合后即刻(T3)抽取桡动脉血检测血气分析[酸碱度(pH值)、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、碳酸氢根(HCO3-)、二氧化碳总含量(TCO2)、碱剩余(BE)、动脉血氧饱和度(SaO2)]、电解质(Na+、K+、Ca2+)、血糖和乳酸等指标,并进行各时点组间及组内比较.结果 与T1时点比较,两组患者术中BE均明显降低,PaO2均明显增高(P＜0.05);血糖浓度和乳酸浓度均明显升高(P＜0.05);其他血气分析和电解质指标均无明显变化.组间比较,在T3时点B组BE值比A组降低更明显(P＜0.05),A组血糖浓度比B组高(P＜ 0.05);在T2、T3时点B组乳酸浓度比A组高(P＜0.05).结论 在长时间的大手术中输入大量钠钾镁钙葡萄糖注射液是安全、有效的,且比乳酸林格液对乳酸的影响更低,更具有优势.     

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随着成人正畸需求的不断发展,舌侧隐形矫正技术已成为口腔正畸学的热点技术。舌侧隐形矫正能实现正畸治疗的＂全程美＂,同时也有生物力学上的一些优势。舌侧隐形矫正与唇侧正畸相比有很多不同之处,在临床应用中须充分注意其中的差异。本文讨论了舌侧隐形矫正技术的力学特点、优缺点、适应证和禁忌证、间接粘接技术和临床粘接、托槽选择、弓形特点、关闭间隙过程的临床特点等内容,包含了舌侧正畸技术的一些最新进展,并用典型临床病例展示舌侧隐形矫正的效果。     

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??Objective    To observe the clinical effect of inlay and post core crown restoration in the treatment of residual crowns with different degrees of defects. Methods    Totally 153 cases of patients with residual crown of the first molar in the Department of Stomatology?? Zhengzhou people's Hospital from January 2009 to December 2012 were selected. According to the type of dental defect?? the inlay?? fiber post resin core plus all ceramic crown?? silver and  palladium alloy post and core crown were used to repair a total of 176 teeth. Follow up regularly every year?? record the clinical check and evaluate the clinical effect. Results    Among the 176 teeth with residual crown of the first molar 153 were continuously followed up after 3 to 5 years??144 successful?? nine failure??with a success rate of 94.1%. In the failure cases??there was one case of broken tooth in inlay??class repair. Fiber post resin core was applied to repair 1 case of class??defects??and 4 cases of type ??defects had neck of the tooth broken. In silver palladium alloy post and core there was 1 case of root fracture??1 case of apical inflammation and 1 case of crown falling off. According to the different types of defects??there was no significant difference among the 3 methods??P > 0.05??. Conclusion    Residual crown of the first molar ????or ?? type of defects?? can be repaired by inlay. For type ??or ?? defects post core crown can be selected according to the amount of residual tissue in the neck.     

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??Objective    To evaluate the efficacy between low-level diode laser of 810 nm and topical tacrolimus in the treatment of erosive-atrophic oral lichen planus??OLP??. Methods    A total of 60 erosive-atrophic OLP patients were randomly divided into experimental and control groups??with 30 cases in each group. Experimental group received 810 nm diode laser as local irradiation therapy??the control group received drug treatmemt with tacrolimus gel??0.1%??. Evaluations were performed once a month during treatment and at the 3rd month and the 6th month. Results    Sign score??pain score ??and lesion severity were reduced in both groups. No significant differences were found between the two groups. But in the follow-up period after treatment??the recurrence rate of the experimental group was significantly lower than the control group??P < 0.05??. Meanwhile??nine patients of the control group reported side effects after the first one week of drug application. No side effects were found in the experimental group. Conclusion    Diode laser treatment is as effective as topical tacrolimus therapy without any adverse effects in the treatment of erosive -atrophic OLP. Diode laser therapy can reduce recurrence and its post efficacy is superior to tacrolimus. Diode laser therapy can be a promising alternative therapy in the treatment of erosive -atrophic OLP.     

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上颌骨、颧骨、鼻骨、筛骨和额骨的一部分共同构成框架样结构支撑面中部外形,组成面中部骨骼.面中部位于人体暴露的部位,极易造成骨折,交通事故为其主要致伤原因,其次是建筑工地高空坠落伤.因面中部上接颅脑,近年由于复合伤的增多,致使面中部陈旧性骨折的发生率增高.多数面中部骨折导致的面中部凹陷、鼻部扁平、眼球移位及复视、咬合关系紊乱和张口受限、错(牙合)及面部畸形等得不到及时治疗.增加了手术难度和并发症的发生,一直是临床治疗的难点.     

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??In the 1950s??studies had found that mechanical stress could rearrange the charges and produce electricity on the surface of the bone. This is called piezoelectric effect. Piezoelectric properties of the bone imply that adding a certain of active electric ingredients to transplant materials may increase the formation speed and the quality of the bone. With the development of science and technology??the piezoelectric materials in industry have been widely introduced into medical field as the bone substitute materials??generating charges on the surface of the bone to promote the bone healing. In this paper??we briefly introduce the piezoelectric effect of the bone, osteogenesis mechanism of piezoelectric materials??and review the progress of the research on piezoelectric materials for bone replacement.     

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目的评价Bioquick自锁矫治器矫治中度拥挤非拔牙病例临床应用效果。方法选取2009年7月至2013年2月于沈阳市口腔医院正畸科就诊的上颌牙列中度拥挤的非拔牙正畸患者28例,分为两组（每组14例）。分别应用Bioquick自锁托槽矫治器配合唇肌功能训练（Bioquick组）和MBT矫治器配合口外弓（MBT组）进行矫治,矫治前后拍摄患者头颅侧位x线片并进行头影测量分析,同时记录比较两组更换弓丝的时间。结果Bioquick组与MBT组矫治后的U6S-Y和U6-PP角测量值较矫治前均减小,差异有统计学意义（P〈0．05）;两组矫治前后各测量值差值比较,仅u6S-Y和u6-PP角的矫治前后差值具有统计学意义（P〈0．05）。Bioquick组更换弓丝时间为（49．72±10．34）S,MBT组为（238．5±25．29）s,两组差异有统计学意义（P〈0．05）。结论对于上颌牙列中度拥挤的非拔牙患者。Bioquick自锁托槽矫治器配合唇肌功能训练虽未能达到口外弓强支抗的作用效果,但仍能防止切牙的过度唇倾作用,可获得较好的面型。     

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随着人们对生活质量的日益重视,强调美观的美学修复在口腔市场上迅速蓬勃发展。但现阶段国内的美学修复效果良莠不齐。究其原因,主要是由于缺乏合理的临床路径规范和实用的美学修复理论指导。本文建立了以最佳临床实践为目的的美学修复临床路径,用于规范化管理美学修复流程,保障美学修复的最终效果。     

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目的探讨多重PCR技术用于检测牙龈卟啉单胞菌(Porphyromonasgingivalis,P.gingivalis)致病岛rag基因的可行性,并研究致病岛rag基因在毒力株和非毒力株中的分布情况。方法本研究于2011年1—6月在山东省口腔生物医学重点实验室进行,对P.gingivalis毒力株和非毒力株进行厌氧培养,采用普通PCR和多重PCR分别对他们的致病岛rag基因进行检测,对比检测结果,并对临床标本进行预实验研究。结果普通PCR和多重PCR均能对P.gingivalis致病岛rag基因进行检测,并且结果一致。多重PCR可用于临床标本的检测。致病岛rag基因不同基因型在毒力株和非毒力株中的分布不同,rag-1型存在于高毒力株P.gingivalisW83中,而rag-4型存在于低毒力株P.gingivalisATCC33277中。结论致病岛rag基因与细菌致病性密切相关;多重PCR技术省时省力、简单快速,为后续临床标本中rag基因的快速检测提供实验依据。     

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痣样基底细胞癌综合征(nevoid basal cell carcinomasyndrome,NBCCS)又称Gorlin综合征,是一种罕见的家族性常染色体显性遗传病。我院收治1例痣样基底细胞癌综合征病例,报道如下。1病例资料患者男,44岁,于2011年1月12日以     

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镍铬合金因其良好的机械性能、价格低廉优点,被广泛用于口腔修复中：方晓等于2005年报道,我国镍铬合会修复体的使用过量占50％～80％。镍离子具有明确的致敏性,临床上有镍引起过敏反应的报道。笔者现对镍铬合金修复引起广口腔粘膜白色损害1例报道如下。