应用激光多普勒技术检测牙髓血流的初步研究

目的　探索利用激光多普勒血流仪研究牙髓血流的可行性。方法　使用JI 2 0 0型微循环激光动态分析仪 ,检测 80颗正常上颌切牙、15颗死髓牙的牙髓血流状况 ,并对另 16颗深龋患牙治疗前、后的牙髓血流状况进行对比观察。结果　正常上颌切牙左右侧及男女性别间无差异 ,上中切牙牙髓血流量略大于上侧切牙。由死髓牙测得的流量值显著小于正常对照。 16颗深龋患牙治疗前牙髓血流量皆高于正常对照组 ,治疗后有 15颗患牙的血流量很快降至正常 ,有 1颗患牙在治疗后血流量无明显变化 ,最终发生牙髓坏死。结论　利用激光多普勒血流仪研究牙髓血流是可行的     

激光多普勒在牙龈及牙髓血流测量中的应用

激光多普勒流量计（ＬＤＦ）是一种可连续地，无创伤地监测组织微循环变化的重要工具，本文着重介绍了ＬＤＦ的工作原理，以及它在牙龈和牙髓血流研究应用中所取得的进展，结果表明在牙龈，牙髓血流的基础研究和疾病诊断方面，ＬＤＦ具有独特的优点，同时对ＬＤＦ的优点和不足作了客观地评述。     

牙髓活力检测的新进展

牙髓状态的判定对牙体修复和牙髓治疗方案的选择十分重要,目前临床上牙髓状态的检测大致分为牙髓感觉测试和牙髓活力测试.牙髓感觉测试通过刺激牙髓神经观察患者的主观感受来判断,主观性较强,不一定能反映牙髓的真正状态,而牙髓活力检测可以通过检测牙髓血流量的变化从而体现牙髓的活力,客观、无创,在临床应用上有一定的优势.本文就牙髓感觉测试与牙髓活力检测的区别,以及目前牙髓活力检测的研究新进展作一综述.     

激光多普勒在牙龈及牙髓血流测量中的应用

激光多普勒流量计(LDF)是一种可连续地、无创伤地监测组织微循环变化的重要工具。本文着重介绍了LDF的工作原理,以及它在牙龈和牙髓血流研究应用中所取得的进展,结果表明在牙龈、牙髓血流的基础研究和疾病诊断方面,LDF具有独特的优点,同时对LDF的优点和不足作了客观的评述。     

对牙髓活力测试方法的介绍与评价

牙髓活力判断是牙体牙髓疾病诊疗的基础.目前冷测试、热测试和电活力测试已被广泛应用于临床的诊疗过程中,它们统称为牙髓感觉测试.但目前口腔医师发现感觉测试存在诸多不足,尤其在年轻恒牙上表现出极高的误诊率.为了提升诊断精度,牙髓血流测试应运而生,大幅减小了漏诊率和误诊率,但由于技术尚兴起不久,并没有在临床上得到广泛应用.除此...     

经颅多普勒仪检测磁性附着体对脑血流状态的影响

目的:分析戴用磁性附着体受试者脑血流的变化趋势。方法:应用经颅多普勒(3D-TCD)血流分析技术,测定24例正常人戴用3种不同类型的磁性附着体前后大脑中动脉的平均血流速度。应用SPSS10.0软件对各组数据进行两两比较。结果:戴用磁性附着体前后,大脑中动脉的平均血流速度无明显改变(P>0.05),同时戴用不同类型的磁性附着体后大脑中动脉的血流速度在统计学上差别无显著意义(P>0.05)。结论:戴用磁性附着体的患者脑血流状态无明显改变。     

上颌成组切牙三维有限元模型的建立

目的建立上颌成组切牙的三维有限元模型。方法利用Micro-CT扫描技术扫描上颌成组切牙,结合Geomagic Studio及Unigraphics NX4平台建立上颌成组切牙的三维几何模型,导入有限元分析软件Ansys Work-bench 11.0中,建立起实体模型。结果建立的有限元模型共有单位35 873个,节点62 359个;模型形态逼真,具有较高的几何相似性,能够任意旋转、放大或者缩小,通过对模型施加不同大小的力,能以单独或者成组的方式观察和分析各个牙的受力情况。结论实验成功建立上颌成组切牙的三维有限元模型,该模型结构完整,能够较准确模拟上颌切牙的力学反应情况。     

LDF检测正常成人第一恒磨牙牙髓血流量的研究

目的 探讨正常成人的上下颌第一恒磨牙的牙髓血流量(pulpal blood flow,PBF)在生理状态下的“临床正常参考值范围”,为临床诊疗工作提供参考依据。方法 按照激光多普勒血流检测仪的工作原理及操作注意事项,对正常成人上下颌健康第一恒磨牙采用激光多普勒血流检测仪检测其PBF值,分析计算其生理状态下的临床正常参考值范围。统计分析PBF值在不同性别、不同牙位和上下颌间的差异性。结果 招募正常成人志愿者共200人,其中平均年龄(22.76±3.26)岁,男性95人,女性105人,第一恒磨牙总数800颗。无论是男性还是女性,第一恒磨牙左侧和右侧PBF检测值差异无统计学意义(P>0.05),上、下颌第一恒磨牙PBF检测值差异无统计学意义(P>0.05)。第一恒磨牙PBF值的性别差异具有统计学意义(P<0.05),女性第一恒磨牙PBF值较男性高,男性PBF临床正常参考值范围为(8.56±3.25)PU,女性PBF临床正常参考值范围为(9.51±3.47)PU。结论 LDF检测正常成人第一恒磨牙PBF值女性较男性高,同性别的左右侧、上下颌第一恒磨牙PBF值无差异,其均可作为...     

上颌尖牙埋伏阻生患者上颌切牙牙齿宽度改变的研究

目的探讨中国人上颌切牙宽度与尖牙阻生是否存在内在的联系.方法选择103名上颌尖牙埋伏阻生患者,分为46名腭侧阻生组和57名唇侧阻生组.选择年龄、性别匹配,上颌尖牙正常萌出的患者60名,作为对照组.测量这些患者的上颌切牙近远中宽度,并进行统计学分析.结果尖牙阻生患者的左右侧中切牙及侧切牙的近远中宽度基本一致,无统计学差异.尖牙唇侧阻生患者的侧切牙宽度大于对照组,腭侧阻生患者的侧切牙宽度小于对照组,均有统计学差异.唇腭侧阻生患者的侧切牙宽度有显著性差异.结论尖牙埋伏阻生患者的上颌切牙宽度变化和尖牙阻生的位置有着高度的相关性.     

上颌侧切牙年轻恒牙牙中牙伴根尖周炎的牙髓血运重建治疗1例

牙内陷是由牙发育时期成釉器过度卷叠或局部过度增殖,深入到牙乳头中而导致的牙齿形态异常,因其复杂的解剖结构,给常规的牙髓治疗带来困难和挑战。牙中牙的牙髓治疗为牙内陷最复杂的一种情况,本文报道1例上颌侧切牙年轻恒牙牙中牙伴根尖周炎的牙髓血运重建治疗的病例,结合锥形束CT的辅助诊断,对其治疗及预后进行评估。随访2年,牙根继续发育,根尖周炎症消失。本病例为年轻恒牙牙中牙的牙髓病及根尖周病提供了新的治疗策略。     

Effect of luxation type on pulpal blood flow measurements: a long-term follow-up of luxated permanent maxillary incisors

Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood-flow (PBF). Dental injury has been associated with significant PBF reduction. The purpose of this study was to assess whether (i) the type of luxation trauma may affect PBF measurements and (ii) whether luxation type-related measurements may show short- and long-term changes of PBF values. In 41 trauma patients, 69 maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous tooth were investigated by LDF to assess local PBF values. Perfusion units were recorded in four sessions, on the day of splint removal, and 12, 24 and 36 weeks after splint removal. Statistical analysis consisted of univariate analysis of variance for repeated measurements. For the LDF measurements, the main effect of the variable 'session' was not significant (P = 0.119). However, there was a significant 'session'/'luxation type' interaction (P = 0.000). Analysis of simple session-within-luxation type effects revealed intrusive luxations to be associated with a significant decrease in PBF values (P = 0.000), while subluxations (P = 0.568), lateral luxations (P = 0.980), extrusive luxations (P = 0.910), and avulsions (P = 0.996) showed no significant difference between session-related values. The PBF measurements did not change over time for the contralateral incisors (P = 0.996). The LDF may become useful in the detection of pulpal ischaemic episodes in luxated maxillary incisors after repositioning and splinting. Further studies are warranted to assess the validity of the diagnosis of post-traumatic 'ischaemic episodes' by comparing it with histological tooth pulp changes, and by determining how well it may predict course and response to treatments in clinical trials.     

Laser Doppler flow investigation of fractured permanent maxillary incisors

Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood-flow (PBF). Dental injury has been associated with losses of pulpal sensibility. The purpose of this study was to assess the outcome of splint therapy on tooth fracture type-related PBF values. In 15 trauma patients, a single maxillary incisor treated by repositioning and splinting was investigated by LDF to assess local PBF values. Perfusion units were taken in four sessions, on the day of splint removel, and 12, 24 and 36 weeks after splint removal. Analysis of the tooth fracture type-related PBF measurements revealed root fractures to be associated with a significant decrease (P < 0.05) and uncomplicated crown fractures to be associated with a significant increase in PBF values (P < 0.05), while complicated crown fractures showed no significant difference between the session-related values (P > 0.05). The main findings of this study suggest splint therapy of root fractures of the central maxillary incisor to be associated with a short- and long-term decrease in PBF values. The LDF may become useful in the detection of transient ischaemic episodes and the identification of teeth at risk for adverse sequelae such as avascular necrosis and tissue loss.     

Evaluation of pulpal blood flow after tooth splinting of luxated permanent maxillary incisors

Abstract –  Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood flow (PBF). Dental injury has been associated with losses of pulpal sensibility. The purpose of this study was to assess whether LDF could be used to detect short- and long-term changes of PBF values of luxated permanent maxillary central incisors after repositioning and splinting. In 18 trauma patients, a single maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous tooth were investigated by LDF to assess local PBF values. Perfusion units (PU) were taken in four sessions: on the day of splint removal, and 12, 24, and 36 weeks after splint removal. Analysis of the luxation type-related PBF measurements revealed intrusion type-related PBF values to be associated with a significant decrease in PBF values ( P  < 0.05), while lateral luxation and extrusion type-related PBF values showed no significant difference between the session-related values ( P  > 0.05). PBF measurements did not change over time for the contralateral incisors ( P  > 0.05). Teeth affected by an intrusion-type luxation injury remained unresponsive to sensitivity testing at follow up, while 3 (60%) developed grey discoloration of the crown. LDF may become useful in the detection of ischemic episodes of luxated maxillary central incisors after repositioning and splinting. Further studies are warranted to assess the validity of post-traumatic 'ischemic episodes' by comparing it to histological tooth pulp changes.     

Age-related changes in the human pulpal blood flow measured by laser Doppler flowmetry

Abstract  – The purpose of this study was to examine the age-related changes in human pulpal blood flow (PBF). Recordings were taken from 22 clinically healthy upper central incisors in 22 healthy participants (age: 8–75 years). A Moor blood flow monitor (type MBF3D) was used to measure PBF; and subjects' electrocardiogram (ECG), mean blood pressure (BP) and heart rate (HR) were also recorded. The resting PBF was significantly decreased with the increased age of the participants (Pearson's correlation coefficient, P  < 0.001). The examined tooth crown was briefly(1 s) cooled using a dental coolant, and significant reductions in PBF were induced (one-way repeated measures anova , P  < 0.05). The magnitude of the reduction (%) was significantly decreased with the increased age of the participants (Pearson's correlation coefficient, P  < 0.05). The findings indicate that the hemodynamics in the human pulp is reduced with age.     

Diagnostic characteristics of pulpal blood flow levels associated with adverse outcomes of luxated permanent maxillary incisors

Abstract – Laser Doppler flowmetry (LDF) is a non‐invasive method to assess pulpal blood flow (PBF). Dental injury has been associated with significant PBF reduction. The purpose of this study was (i) to describe PBF characteristics of teeth with specific clinical outcomes, and (ii) to demonstrate diagnostic characteristics for different threshold PBF values for detection of specific multiple adverse outcomes. In 80 trauma patients, a single maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous control tooth were investigated by LDF to assess local PBF values. Perfusion units (PU) were taken in two sessions, on the day of splint removal (session I), and 12 weeks after splint removal (session II). The ability of session II‐related PBF measurements at 2.9, 6.4 and 9.9 PU levels to identify adverse outcomes occurring 36 weeks after splint removal was investigated. Adverse outcomes were classified as type I (loss of sensitivity), type II (periapical radiolucency), type III (grey discolouration), type IV (loss of sensitivity and periapical radiolucency), and type V (loss of sensitivity, periapical radiolucency and grey discolouration of crown). Receiver–operator characteristic (ROC) curves were used to evaluate the sensitivity and specificity of PBF assessments. There was a significant increase in PBF values from session I to session II (P = 0.0001) for teeth without an adverse outcome, while teeth affected by a type II–V outcome showed a significant decrease in PBF values (P < 0.05). PBF measurements did not change over time for the contralateral incisors (P > 0.05). A type IV and V outcome occurred in 21 and 24% of the instances, respectively. The PBF of 2.9 PU demonstrated a sensitivity of 70% and a specificity of 93% for type V outcomes. The best likelihood ratio was found for the PBF 2.9 PU level and incisors associated with a type V outcome. The data suggest that the LDF test to be a valuable diagnostic adjunct for luxated teeth showing signs of adverse outcomes including grey discolouration or a combination of other signs. However, it may also become necessary to apply clinical decision‐making methods in order to correctly evaluate the value of information gathered. The clinical implication is that LDF may become useful in the prediction of adverse outcomes at a much earlier time period than may be accomplished by standard sensitivity tests.     

Laser Doppler flowmetry of luxated permanent incisors: a receiver operator characteristic analysis

Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood-flow (PBF). Dental luxation injuries have been associated with significant PBF reduction. The purpose of this study was to describe diagnostic characteristics for different session-related threshold PBF values for detection of specific adverse outcomes. In 61 trauma patients, a single maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous control tooth were investigated by LDF to assess local PBF values. Perfusion units (PU) were taken 12 weeks (session I) and 24 weeks (session II) after splint removal. The ability of session I-related PBF measurements at 2.8, 6.4 and 10.1 PU levels, and of session II-related ameasurements at 2.4, 6.3 and 10.2 PU levels to identify adverse outcomes occurring 36 weeks after splint removal was investigated. Adverse outcomes were classified as type I (periapical radiolucency), type II (grey discoloration), and type III (periapical radiolucency and grey discoloration of crown). Receiver operator characteristic curves were used to evaluate the sensitivity and specificity of PBF assessments. There was no significant difference in PBF values between session I and session II (P > 0.05) for teeth without an adverse outcome, and those with a type I, II or III outcome (P > 0.05). The PBF measurements did not change over time for the contralateral incisors (P > 0.05). A type I, II and III outcome occurred in 36, 21 and 12% of the incisors, respectively. The best likelihood ratio was found for the PBF 6.4 PU level at session I and incisors associated with a type I (20.8) and type II outcome (15.2). The PBV of 6.4 PU demonstrated a sensitivity of 96% and a specificity of 59% for type I outcomes, and a sensitivity of 100% and a specificity of 50% for type II outcomes. The data suggest the LDF test to be a valuable diagnostic adjunct for luxated teeth showing signs of adverse outcomes.     

Laser Doppler flow measurements of pulpal blood flow and severity of dental injury

AIM: To evaluate laser Doppler flowmetry (LDF) measurements of pulpal blood flow (PBF) and severity of dental injury. METHODOLOGY: The relationship between adverse outcomes and PBF measurements was analysed in 94 permanent maxillary incisors of 71 consecutive dental trauma patients. The diagnostic adverse outcome group was comprised of 72 incisors in 52 patients with a type I (loss of sensitivity), type II (loss of sensitivity and periapical radiolucency), or type III (loss of sensitivity, periapical radiolucency and grey discoloration of crown) diagnosis. The nonadverse outcome group consisted of 22 incisors in 19 patients with the finding of an absence of an adverse outcome. At each session, when an injured permanent maxillary incisor was recorded, a contralateral homologous tooth was used as a control. An ordinal stepwise regression was completed to assess the degree of association between PBF measurements and adverse outcomes RESULTS: Using chi-square analysis for pairwise comparison, a significant relationship between PBF measurements and types of adverse outcomes (chi(2) =119.635, d.f. = 12, P = 0.000) was observed. PBF measurements that were significantly associated with more severe outcome were PBF levels of 3 PU and 相似文献   

The lamp effect of laser Doppler flowmetry on teeth

The aim of this study is to analyse the intra and extracoronal scattering of laser light. Twelve vital teeth from 12 volunteer individuals (aged 22-29 years) were used. The camera removing the charge coupled device's infrared cut filter was used for imaging the laser Doppler flowmetry light during pulpal blood flow measurement. When the obtained photos were analysed, it was seen that the laser beam caused the tooth to shine like a lamp and it also illuminated the tissues inside the mouth (tongue, lips, adjacent teeth, etc.). As a result, it was shown that when the necessary cautions were not taken, the laser could scatter all around the tissues surrounding the tooth. Because of the conductive characteristic of the fibre and the optical characteristics of the tooth, we think that the beam is inevitably scattered onto the tissues outside the pulp and together with the isolation of the gingiva, crown should be isolated, as well.     

Comparison of two laser Doppler systems on the measurement of blood flow of premolar teeth under different pulpal conditions

An in vivo investigation was conducted to assess the ability of two laser Doppler flowmeters (DRT4, Moor Instruments Ltd; Laserflo BPM2, Vasamedics) to differentiate between vital pulp, ischaemically necrosed pulp, and an empty pulp chamber in premolar teeth in children. Sixteen intact, vital teeth in need of extraction for orthodontic purposes were identified. Laser Doppler blood flow readings were taken prior to (T1) and after the administration of adrenaline-free local anaesthetic (T2), after extraction and replantation of the teeth (T3), and after broaching the pulp tissue and replanting the teeth (T4). The data collected (flux values) for both instruments were analysed using a repeated measures ANOVA. Significant differences were found for vital pulp (T1, T2) versus ischaemically necrosed pulp (T3), and for vital pulp (T1, T2) versus an empty pulp chamber (T4), with the Moor DRT4 instrument. This instrument also detected a significant difference in pulpal blood flow to the vital pulp, before and after the administration of local anaesthetic. No other significant differences were found.     

Effect of wavelength and bandwidth on the clinical reliability of laser Doppler recordings

Abstract The aim of this study was to investigate the effect of wavelength and bandwidth on laser Doppler flower meter signals from vital and root-filled teeth. and to establish their sensitivity and specificity. Twenty human subjects were recruited, each with a vital root and the contralateral tooth root filled but not restored apart from the palatal access cavity. Readings were taken these teeth for 3 min at 20 HZ, For each of 3.I kHZ, 14.9 kHZ and 22.1 kHZ Bandwidth using a modified laser Doppler Mood flow monitor which permitted simultaneous recording using 810 nm and 633 nm light sources with a probe of four optical libres with 0.25 mm separation. Ten traces from each combination of variables was examined by 10 trained observers who indicated if the traces came from vital or root-filled teeth judged by the amplitude and regularity of pulsatility of the trace. From die accuracy of their replies, sensitivity and specificity were calculated. Median flux values were higher for vital teeth than for root-filled teeth and for the 810 nm wavelength than for die 633 nm wavelength. Flux values increased with wider bandwidth using the 810 nm light source. with the 633 nm light source, the highest flux values were recorded using the 3.1 kHz bandwidth. using the Mann-Whitney U test. there was a highly significant difference between readings from vital and root-filled teeth for the 3.1 kHz/810 nm wave-length combination (p<0.003) and significant difference for the 3.KHZ/810 nm length group (p<0.02). Comparison Of other groups showed no significant difference (p<0.05)).The 810 nm wavelenght showed good sensitivity but poor specificity at 14.9 and 22.KHZ bandwidth. The 3.1 KHZ wavelength showed good specificity, but poor sensitivity, at 14 9 and 22.1 kHZ bandwidth. The 3.1 kHz bandwidth showed the best sensitivity and specificity for both wavelengths. Sensitivity and specificity were increased if die results of last Fourier analyses were considered in addition to observations of flux values and pulsatility of traces. The 810 nm/3.1 kHZ combination offered die greatest sensitivity and specificity as a test to distinguish between root-filled and vital teeth. This combination was best when the results of Fourier analysis were considered in addition to visual observations.