牙本质保护膜防治活髓基牙牙本质过敏的观察

目的 评价在全瓷固定桥修复治疗中牙本质保护膜防治活髓基牙牙本质过敏的效果.方法 选择118例患者,236颗进行全瓷固定桥修复治疗的活髓基牙,平均分为2组,试验组基牙采用牙本质保护膜处理,对照组基牙采用质量分数75％氟化钠甘油处理,暂时冠桥修复,7d后观察应用效果.结果 牙本质保护膜的有效率为96.61％,75％氟化钠甘油的有效率为66.10％,2组有效率差异具有统计学意义(X2=18.10,P＜0.05).结论 在全瓷固定桥修复中,牙本质保护膜对防治活髓基牙牙本质过敏有较好的临床效果.     

Follow-up study of periodontal tissues around the abutment teeth in Konus telescope denture

The purpose of this study was to evaluate the periodontal tissues around the 47 abutment teeth in patients with advanced periodontitis for 5 years maintenance periods. The periodontal and prosthetic treatment were carried out and 16 Konus telescope dentures were applied for 11 patients. During 5 years maintenance therapy, periodontal conditions were observed once a year assessing probing depth, attachment level, tooth mobility index, gingival index, marginal alveolar bone height, width of periodontal ligament and loss of lamina dura. The results showed that increase of probing depth in 0.61 mm and attachment loss in 0.78 mm were observed for 5 years. A slight gingival inflammation occurred and tooth mobility increased in some extent. Enlargement of periodontal ligament space and loss of lamina dura in 40% of abutment teeth were observed for 5 years. There were six decayed teeth, six teeth, from which a intracoronal crown was removed, and two extracted teeth in 47 abutment teeth. In conclusion, the periodontal tissues around abutment teeth in Konus telescope denture changed slightly at one year after denture placement, after which, the periodontal tissues were well maintained.     

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目的探讨可摘局部义齿的不同设计与基牙致龋的关系。方法选择2005年6月至2007年12月南阳市口腔医院修复科收治的需进行可摘局部义齿修复的患者156例,根据患者牙列缺损的情况,按照Kennedy分类法设计混合支持式义齿和黏膜支持式义齿2种不同形式的修复体,在患者戴入义齿前及戴入义齿后3年、5年分别对基牙牙体组织进行龋病检查及卫生状况检查。结果不同设计形式的修复体与基牙健康密切相关,同种支持形式的4类牙列缺损修复设计之间虽有差别,但差异无统计学意义(P>0.05);而黏膜支持式义齿引起基牙患龋率明显高于混合支持式义齿,差异有统计学意义(P<0.05)。可摘局部义齿修复患者,口腔卫生状况差者的患龋率明显高于口腔卫生状况优良者,差异有统计学意义(P<0.05)。结论可摘局部义齿的设计与制作不合理,患者戴于口内,如果口腔卫生又差,则会造成基牙和相邻牙龋坏,不仅影响口腔甚至影响全身健康。     

数字化技术在可摘局部义齿基牙全瓷冠崩瓷后再修复中的应用1例

数字化技术有助于提升可摘义齿基牙再修复的精准性及简便性,避免患者重行可摘义齿修复或利用旧活动义齿行手工堆塑基牙冠形态造成的误差,报告1例数字化技术在可摘局部义齿基牙全瓷冠崩瓷后再修复中的应用,取得了满意的治疗效果.     

Histologic evaluation of the periodontium of abutment teeth in combination implant/tooth fixed partial denture.

The histologic response of the periodontal tissues of teeth rigidly joined to implants with a fixed partial denture was evaluated using light microscopy. The fourth premolar of a dog was connected to implants placed in the first and second premolar position with a fixed partial denture. The restored teeth were under function for periods of 6, 12, 18, and 24 months, with unrestored fourth premolars as controls. The histology of the periodontal ligament on the fourth premolar was found to be similar in the control and the restored teeth. The periodontal tissues contained a minimal amount of inflammatory cell infiltrate. The crestal bone was cortical in nature, showing no periodontal breakdown. The orientation of the periodontal fibers was easily determined, indicating that minimal remodeling had taken place. The number and morphology of the blood vessels were also similar in the control and the treated teeth. The lack of inflammation and stability of the periodontal tissue suggested that the use of combination implant-to-natural-teeth restorations with rigid joints in this animal model does not result in deleterious effects on the periodontal tissues and that the forces placed on the tissues are within the remodeling capabilities of the teeth.     

套筒冠可摘义齿修复多数牙缺失体会

在临床工作中常遇到不愿拔除余留牙根的患者，此类患者由于口腔中多数牙缺失，牙槽嵴条件差，而患者本身又对义齿修复效果要求极高，对这类患者我们采用了套筒冠义齿修复，获得了较好的效果，现介绍如下。     

金属烤瓷全冠修复老年人活髓隐裂牙临床研究

目的:探讨金属烤瓷全冠修复老年人活髓隐裂牙适应证及临床疗效。方法:将134例老年人(60-68岁)134颗活髓隐裂牙按照疼痛性质随机分为:咬合痛组(A组)、咬合痛伴一过性冷热刺激痛组(B组)、咬合痛伴延续性冷热刺激痛组(C组),均直接进行金属烤瓷全冠修复,观察修复1周、6个月和1年后牙髓、根尖周病变的发生率。结果:A组和B组1周、6个月和1年的治愈率和有效率均高于C组;A、B组与C组间疗效差异显著(P<0.01)。结论:对于轻微咬合痛和伴一过性冷热刺激痛的患牙,可以直接金瓷全冠修复,对于伴延续性冷热刺激痛的患牙,则宜先行根管治疗术再行全冠修复。     

三种防龋药物对可摘局部义齿基牙患龋影响的对比研究

目的比较多乐氟氟化钠护齿剂、GC护牙素和Flariesse保护漆3种防龋药物在可摘局部义齿基牙中的防龋效果。 方法选择在揭阳市人民医院口腔科行可摘局部义齿修复的牙列缺损患者60例。根据世界牙科联盟临床牙位的记录法,样本为4个区均有天然牙存留者,使用简单随机抽样法随机选取每例患者4个区的基牙分别为多乐氟组、GC护牙素组、Flariesse保护漆组和对照组。试验组基牙半年重复1次涂布相应药物,对照组基牙不处理,2年后复诊检查基牙的龋坏情况。使用卡方检验比较4组基牙的患龋率,检验水准α = 0.05。 结果患龋率多乐氟组为14.75%、GC护牙素组为14.71%、Flariesse保护漆组为1.67%、对照组为35.21%。患龋率多乐氟组与GC护牙素组比较差异无统计学意义（χ² = 0.000,P = 0.994）,多乐氟组与Flariesse保护漆组（χ² = 6.971,P = 0.08）、对照组（χ² = 7.180,P = 0.08）,GC护牙素组与Flariesse保护漆组（χ² = 7.038,P = 0.008）、对照组（χ² = 7.752,P = 0.005）,以及Flariesse保护漆组与对照组（χ² = 23.380,P<0.001）间比较差异均有统计学意义。 结论可摘局部义齿基牙涂布药物可有效预防龋病,且Flariesse保护漆组防龋效果最佳。     

多乐氟预防可摘局部义齿基牙患龋的临床研究

目的 观察多乐氟对可摘局部义齿基牙的防龋效果. 方法 行可摘局部义齿修复的牙列缺损患者100例,采用自身对照的方法,患者修复义齿后,随机选择一侧基牙作为试验侧基牙组涂布多乐氟,半年重复1次,对照侧基牙组做空白对照,3年后复诊检查可摘局部义齿基牙的龋坏情况. 结果 试验侧基牙组患龋率为24. 7%(40/162),低于对照侧基牙组41. 9%(67/160),差异具有统计学意义(χ2 =10. 71,P<0. 01). 结论 可摘局部义齿基牙涂布多乐氟可有效预防龋病的发生.     

开髓洞型对全冠修复后隐裂牙抗力影响的 三维有限元研究

目的探讨在牙隐裂患牙根管治疗中采用传统开髓洞型和微创开髓洞型对烤瓷全冠修复后牙体抗力的影响。方法制作3种裂纹深度的牙隐裂三维虚拟模型,模拟微创开髓和传统开髓,并完成根管治疗和烤瓷全冠修复。在垂直加载和斜向加载条件下,记录牙体应力的分布情况和数值大小。结果在2种加载条件下,修复前牙齿应力集中于裂纹底部,局部应力集中随着隐裂深度的加深而增大,烤瓷全冠修复后基牙局部应力主要分布在肩台处,局部应力集中得到大幅缓解。不同开髓洞型对隐裂牙应力分布和大小的影响无明显差异。结论根管治疗后烤瓷全冠修复是治疗牙隐裂的有效措施;相比传统开髓洞型,微创开髓洞型并不能改善全冠修复后隐裂牙的应力分布。     

The effect of various clasping systems on the mobility of abutment teeth for distal-extension removable partial dentures.

Three clasping systems were placed in five patients, and measurements of abutment tooth mobility were made. These data were compared to previously established baselines and statistically analyzed. The findings of the study are: 1. There was no difference in abutment tooth mobility during the 4-week test period with each of the three clasping systems. The important factor may have been the fit of the distal-extension denture base over the residual ridge, which provides the stability to prevent increases in abutment mobility. 2. Any mobility increases were in a buccal direction only, or toward the flexible retentive clasp arm. There was never any change in lingual mobility. 3. All five patients chose the I-bar retainer as the design of choice due to its increased resistance to dislodgment. Periodic recall of distal-extension removable partial denture patients is mandatory to ensure proper stress distribution and prevent increases in abutment tooth mobility.     

弹性镶嵌技术在后牙游离端缺失修复中的应用

目的:针对后牙游离端缺失,以弹性义齿技术与合金铸造支架技术相结合制作可摘义齿,观察其临床疗效.方法:通过物理镶嵌原理使弹性义齿材料与金属网格支架相结合,前牙区以弹性义齿仿龈卡环代替以往的金属卡环,尽量减少金属基托的体积.结果:经过2年多的临床应用,患者普遍感觉较美观、轻便、舒适,功能良好;客观检查前牙区美观,基牙及义齿稳固,抗摆动性能强于金属卡环.结论:弹性镶嵌技术针对后牙游离端缺失而言,不失为一种适合国情的新技术,完全符合设计目的.     

Penetration of the pulp chamber by bleaching agents in teeth restored with various restorative materials

It is thought that externally applied bleaching agents may penetrate into the pulp chamber. This study was conducted to evaluate the diffusion of peroxide bleaching agents into the pulp chamber of teeth restored with various restorative materials. Sixty-five human extracted anterior maxillary teeth were separated into the 13 groups containing 5 teeth. Five teeth (control group) were not subjected to any cavity preparation and restoration. Standardized class V cavities were prepared in the other 60 teeth and restored using composite resin (Charisma), polyacid modified composite resin (Dyract), or resin-modified glass ionomer cement (Vitremer). All teeth were sectioned 3 mm apical to the cementoenamel junction to remove the intracoronal pulp tissue, and the pulp chamber was filled with acetate buffer to absorb and stabilize any peroxide that might penetrate. Vestibular crown surfaces of teeth in the experimental groups were subjected to four different bleaching agents for 30 min at 37 degrees C, whereas the teeth in the control groups were exposed only to distilled water. Then the acetate buffer solution in the pulp chamber of each tooth was removed, and the pulp chamber of each tooth was rinsed with 100 ml of distilled water twice. Leukocrystal violet and enzyme horseradish peroxidase were added to the mixture of the acetate buffer and rinse water. The optical density of the resulting blue solution was determined spectrophotometrically and converted into microgram equivalents of hydrogen peroxide. Higher hydrogen peroxide concentrations resulted in a higher pulpal peroxide penetration. The highest pulpal peroxide penetration was found in resin-modified glass ionomer cement groups, whereas composite resin groups showed the lowest pulpal peroxide penetration.     

正畸牙受力1天后的电活力测试观察

目的：观察正畸牙受力1d后的电活力测试值变化。方法：使用数字式全自动无痛牙髓活力测试仪对31名初戴矫治器患者进行受力前及受力1d后的电活力测试,并对受力前后的数值进行比较。结果：563个受检正畸牙中16．52％表现为敏感,各牙位间敏感牙的发生率不是均等的,其中前磨牙区敏感牙数所占比例最高。扭转15°以上的受检牙中48．28％表现为敏感,与其他牙齿相比有显著性差异。结论：正畸牙在受力的初始阶段部分牙齿的牙髓处于充血状态,电活力测试可以检测出牙髓充血严重的正畸牙,为临床判断正畸牙的受力情况提供参考。