替硝唑局部控释给药治疗牙周炎的应用研究

目的：观察替硝唑局部控释给药治疗牙周炎的临床疗效。方法：应用替硝唑棒缓释剂治疗45例成人牙周炎患者,并以口服替硝片剂为对照组,进行对比研究,检测了治疗前后牙周炎的各项指数以及病变部位厌氧菌的变化。结果：替硝唑棒治疗成人牙周炎的疗效显效率为93．33％,优于对照组73．33％。替硝唑局部给药对口腔厌氧菌的杀灭效果较口服替硝唑强,用药后无任何毒副作用。结论：替硝唑局部控释给药治疗牙周炎疗效显著,前景广阔。     

替硝唑治疗急性根尖周炎的疗效评价

应用替硝唑口服治疗５９例急性根炎周炎患者，以甲硝唑为对照，并检测了治疗前后根管内厌氧菌的变化。结果表明，替硝唑治疗急性尖周炎的疗效优于甲硝唑，替硝唑对根管内厌氧菌的杀灭效果较甲硝唑好，特别对根尖周炎根管中的优势菌－产黑色素杆菌和消化链球菌有很强的杀灭效果。     

替硝唑治疗牙周炎的临床疗效

牙周炎与口腔厌氧菌感染有密切关系。临床常用甲硝唑治疗，虽然疗效较好，但对Ｇ＋厌氧菌的抗菌活性较弱，且胃肠道不良反应较多。替硝唑（Ｔｉｎｉｄａｚｏｌｅ）为甲硝唑的同类药物，具有疗效高、抗菌谱广、作用时间长等特点［１］。本文报告替硝唑治疗成人牙周炎的临床...     

86例急性冠周炎抗厌氧菌药物治疗的临床评价

应用替硝唑片口服治疗４６例急性冠周炎患者，以甲硝唑片为对照组，检测了两组治疗前后盲袋内厌氧菌的变化及临床疗效。结果表明：替硝唑组和甲硝唑组对主要厌氧菌的杀菌率分别为９１．８％和６１．５％（Ｐ〈０．０１），对主要厌氧菌的抑菌率分别为９４．６％和６８．４％（Ｐ〈０．０１），替硝唑组治疗急性冠周炎的临床疗效（有效率为８０．４％）也优于甲硝唑组（有效率为３７．５％），因此，替硝唑应成为急性冠周炎患者全身给     

替硝唑治疗成人牙周炎的临床观察

替硝唑治疗成人牙周炎的临床观察贵州省人民医院（５５０００２）张光照岳朝晖替硝唑为新一代的硝基咪唑类衍生物，它是继甲硝唑后研制成的疗效高、疗程短、副作用小的抗厌氧菌新药。笔者从１９９５年３月至１９９６年３月，对３８例成人牙周炎患者进行治疗，并用甲硝唑为...     

替硝唑、根管糊剂治疗根尖周炎疗效观察

目的：探讨替硝唑治疗根尖周炎，观察其临床疗效。方法：对作根管治疗的患牙，应用替硝唑棉捻消毒根管，再将替硝唑粉加根充糊剂调状导入根管作根管充填；以４０例用甲硝唑粉加根充糊剂作根充的患牙为对照，经两年多时间连续观察，并检测根管消毒前后根管内压套菌的变化情况。结果：观察表明，替硝唑组和甲硝唑组对主要厌氧菌如消化链球菌、类杆菌、梭形菌、放线菌等的抑菌率分别为９４．５０％和７２％（Ｐ〈０．０１）。替硝唑治疗根尖周炎的临床疗效（有效率９４％）也优于甲硝唑组（有效率为６５％）。结论：替硝唑作根管消毒，并加入根充糊剂用以根管充填治疗根尖周炎是一种有效的方法。     

替硝唑甲硝唑对主要口腔致病厌氧菌株的MIC、MBC测定

替硝唑是继甲硝唑后研制成功的疗效高、疗程短、耐受性好的抗滴虫药物。对阴道滴虫、阿米巴等原生动物具有较高的省略,对厌氧菌群如产黑色素类杆菌群、脆弱类杆菌、梭形杆菌均有较强的抑菌杀菌作用。替硝唑用于牙周炎、冠周炎治疗总有效率高达97.1％,明显高于甲硝唑。本文实验测定替硝唑、甲硝唑对6株口腔重要厌氧菌的国际标准菌株的最低抑菌浓度(MIC)和最低杀菌浓度(MBC)。评价其对口腔优势厌氧菌的抑菌性能。     

替硝唑片治疗牙周炎的临床疗效观察

大量研究表明,牙周炎是以厌氧菌为主的混合性感染。已知甲硝唑对这些细菌有较好的抑菌和杀菌作用。但甲硝唑的消化道反应比较重,较难被患者所接受。替硝唑是新一代硝基咪唑类衍生物,是抗厌氧菌新药。我科牙周组近期应用珠海经济特区丽珠制药厂研制的替硝唑片剂,对30例成人牙周炎患者进行治疗,并以甲硝唑片为对照,进行短期临床使用观察,以比较确定其优缺点。观察结果表明,替硝唑治疗牙周炎的疗效优于甲硝唑。现将其临床疗效分析如下:     

替硝唑含片治疗冠周炎和牙周炎的疗效观察及其体外药效学研究

８０例冠周炎和８０例成年人牙周炎初诊标本中厌氧菌检出率分别为９１．３和８６．３％。应用替硝唑含片的试验组和应用甲硝唑粘附片的对照组治疗后原厌氧菌清除率分别为９２．４和８３．３％。试验组冠周炎和成年人牙周炎有效率分别为８２．０和８４．０％，对照组分别为５６．７和６０．Ｏ％。试验组患者用药后不良反应发生率为４．０％，对照组则为１０．０％。ＭＩＣ测定结果证实：替硝唑抗Ｇ－厌氧菌作用最强，抗Ｇ＋厌氧菌作用稍弱于克林霉素，但明显强于甲硝唑。应用纸片扩散法测得２５８株厌氧菌对替硝唑、甲硝唑和克林霉素的敏感率分别为８２．６，７４．４和７４．０％。研究结果表明：在同样剂量的条件下替硝唑含片较甲硝唑粘贴片具有临床疗效更好，抗厌氧菌作用更强和不良反应减少等优点。     

替硝唑治疗牙周炎和冠周炎的临床疗效观察和评价

采用替硝唑治疗牙周炎和冠周炎共６５例，进行了临床效果观察和评价，选用甲硝唑为对照，比较替硝唑的优缺点。结果表明，替硝唑治疗冠周炎、牙周炎具有显著效果，其疗效优于甲硝唑。     

三种营养状况评价法在口腔颌面恶性肿瘤患者中的比较

用营养状况综合评价法（ｃｏｍｂｉｎｅｄｓｕｂｊｅｃｔｉｖｅａｎｄｏｂｊｅｃｔｉｖｅｎｕｔｒｉｔｉｏｎａｌａｓｓｅｓｓｍｅｎｔ，ＳＮＡ）、营养状况简捷评价法（ｃｏｎｃｉｓｅｎｕｔｒｉｔｉｏｎａｌａｓｓｅｓｓｍｅｎｔ，ＣＮＡ）、营养状况综合评分法（ｇｅｎｅｒａｌｎｕｔｒｉｔｉｏｎａｌｓｔａｔｕｓｓｃｏｒｅ，ＧＮＳ）及营养状况主观评价法（ｓｕｂｊｅｃｔｉｖｅｇｌｏｂａｌａｓｓｅｓｓｍｅｎｔｏｆｎｕｔｒｉｔｉｏｎａｌｓｔａｔｕｓ，ＳＧＡ）分别对１２７例口腔颌面恶性肿瘤患者进行营养状况评价。以ＳＮＡ作为标准诊断方法，对ＣＮＡ、ＧＮＳ、ＳＧＡ进行比较研究。结果显示：①ＣＮＡ的总符合率（８８．２％）明显高于ＧＮＳ（７８．０％）与ＳＧＡ（７８．７％）；②ＣＮＡ的假阳性率（９．９％）和假阴性率（１５．２％）低于ＧＮＳ（１７．３％，３０．４％）与ＳＧＡ（１４．８％，３２．６％）；③ＣＮＡ的诊断指数（７４．９％）高于ＧＮＳ（５２．３％）与ＳＧＡ（５２．６％），这种差异具有显著性（Ｐ＜０．０５）；④ＣＮＡ的评价指标均由仪器测试，避免了人为误差。结论：ＣＮＡ是评价口腔颌面外科患者临床营养状况的最佳方法     

Techniques for dissection of the facial nerve in benign parotid surgery: a cross specialty survey of oral and maxillofacial and ear nose and throat surgeons in the UK

We investigated techniques of dissection of the facial nerve currently being used in parotid surgery for benign disease in oral and maxillofacial (OMF) and ear, nose and throat (ENT) surgery. A postal questionnaire was sent to 300 OMF and 300 ENT consultants and 49% were returned(171(57%) OMF and 123 (41%) ENT. The antegrade technique was used routinely by 209 surgeons (87%), the retrograde technique by 9 (4%), and both techniques combined by 21 surgeons (9%). The antegrade technique was used by 135 surgeons (56%) for revision parotidectomy, by 193 (81%) for limited superficial parotidectomy, by 173 (72%) for obese patients with large tumours and by 75 (31%) for injury to the facial nerve. The retrograde technique was used by 21 surgeons (9%) for revision parotidectomy, by 22 (9%) for limited superficial parotidectomy, by 15 (6%) for obese patients with large tumours and by 29 surgeons (12%) for injury to the facial nerve. A combination of techniques was chosen by 83 surgeons (35%) in revision parotidectomy, by 24 surgeons (10%) in limited superficial parotidectomy, by 51 surgeons (21%) in obese patients with large tumours and by (56%) surgeons 135 for injury to the facial nerve.     

Protection of short-time enamel erosion by different tetrafluoride compounds

OBJECTIVE: This in vitro study aimed to analyse the protective effect of differently concentrated titanium (TiF(4)), zirconium (ZrF(4)) and hafnium (HfF(4)) tetrafluoride on enamel erosion. METHODS: Polished enamel surfaces of 36 bovine crowns were covered with tape leaving 4 enamel windows each 3mm in diameter exposed. The crowns were randomly assigned to six groups (each n=6) and pretreated with 4% TiF(4), 10% TiF(4), 4% ZrF(4), 10% ZrF(4), 4% HfF(4) or 10% HfF(4) for 4 min (first window), 10 min (second window) or 15 min (third window). The fourth window of each crown was not pretreated and served as control. Erosion was performed stepwise with 1% HCl (pH 2) in five consecutive intervals of each 15 s (total 75 s). Enamel dissolution was quantified by colorimetric determination of phosphate release into the acid. For each tooth, cumulative phosphate loss of enamel pretreated with one of the tetrafluoride compounds was calculated as percentage of the respective control and statistically analysed using two-way ANOVA. RESULTS: Enamel erosion was significantly reduced by TiF(4), ZrF(4) and HfF(4) application. Cumulative phosphate loss (mean % of control, 75s erosion) after 4-15 min application was significantly lower for 4% ZrF(4) (7-11%), 10% ZrF(4) (2-6%), 4% HfF(4) (11-9%) and 10% HfF(4) (12-16%) compared to 4% TiF(4) (42-27%) and 10% TiF(4) (54-33%). Only for 4% and 10% TiF(4), phosphate loss decreased with increasing duration of application, but also increased with increasing acid intervals. CONCLUSION: TiF(4), ZrF(4) and HfF(4) might protect enamel against short-time erosion, but protection was more enhanced by ZrF(4) and HfF(4) compared to TiF(4) application overtime.     

Mandibular fractures in Townsville, Australia: incidence, aetiology and treatment using the 2.0 AO/ASIF miniplate system

In 1995 a total of 114 patients presented with 154 mandibular fractures at the Townsville General Hospital, Australia. Fifty-eight (51%) were white, 50 (44%) aboriginal, and six (5%) of other or unknown race. One-hundred-and-twenty-four of the fractures (81%) occurred in male and 30 (19%) in female patients. Most fractures (n= 128, 83%) resulted from fights. The rest being a result of road traffic accidents (10%), falls (3%), accidents caused by falling objects (3%) and sport accidents (2%). The mandibular angle (n= 66, 43%) and the symphyseal area (n= 40, 26%) were the most common fracture sites. Combined fractures were found in 30% patients (26%). Of all angle fractures, 97% were related to third molars. One-hundred-and-five patients had open reduction by an intraoral approach and stabilization by 2.0 AO/ASIF titanium miniplates and nine closed reduction. Complications included temporary sensory deficit of the mental nerve (3%), minor malocclusion (2%) and infection or dehiscence (5%). We conclude that osteosynthesis of mandibular fractures by the 2.0 AO/ASIF titanium miniplate system is reliable.     

Evaluation of different treatments for oroantral/oronasal communications: experience of 112 cases

This retrospective study analyzed the etiologic factors, location and treatments for patients with oroantral or oronasal communications (OAC or ONC). Data analysis extended to gender, age, etiology, location, type of treatment and short-term complications from January 1988 to May 2004. A total of 112 patients with 101 (90%) OAC and 11 (10%) ONC were included. The main etiology for OAC was tooth extraction (95%) with similar prevalence between right (49%) and left (51%) side. For ONC, pathological conditions (27%) and exodontia (27%) were the most prevalent. For the treatment of OAC, suture was the technique most frequently used (60%), followed by buccal fat pad (28%), buccal flap (9%), palatal flap (2%) and one dental transplant (1%). For ONC, the following treatments were used: suture (46%), buccal flap (36%) and palatal flap (18%). Failure to eliminate the communication occurred in six (6%) patients of the OAC group and three (27%) of the ONC group. The results confirm that tooth extraction was the most common etiologic factor for ONC and OAC. Suture, when the communication was small (3-5 mm), and the use of a buccal fat pad (100% successful), when a larger communication existed (>5 mm), seemed to be the two best choices for treatment.     

The Distribution of Internal Derangement in Patients with Temporomandibular Joint Dysfunction—Prevalence,Diagnosis, and Treatments

This study consisted of 355 patients referred to a surgical practice complaining of facial pain, temporomandibular joint (TMJ) sounds, and limited jaw opening. In 247 patients, 360 TMJs were evaluated by arthrography. While 72.2% of them had internal derangement, the remaining 27.8% had normal arthrograms (NID). Among the patients with internal derangement, meniscal displacement with reduction (MDR) was the largest group (47.3%), followed by meniscal displacement without reduction (MD) (32.3%), meniscal displacement without reduction associated with perforation (MDP) (15.4%), and perforation with normal disk position (P) (5.0%). The NID, MDR, and MD groups showed similar age distributions. The MDP and P groups showed a significantly older mean age. Gender distribution was biased toward females (82.0%). Of the total number of joints, 183 (50.8%) had a history of trauma, 69.9% of which had an internal derangement. In terms of treatment, 100% of the NID group was treated by splint therapy. The MDR group was mostly treated by partial meniscectomy (49.6%) and splint therapy (41.5%). The MD group was mostly treated by total meniscectomy (53.6%) followed by splint therapy (32.1 %). The MDP or P groups mostly underwent total meniscectomy (72.5% and 61.5%, respectively).     

3,095例口腔颌面部活检病理临床统计分析

作者对经活检病理诊断为口腔颌面部疾病3,095例进行了统计,肿瘤1,638例(52.93％),囊肿794例(25.66％),瘤样病变174例(5.62％),炎症343例(11.08％),口腔粘膜病114例(3.68％),其他:32例(1.03％)。在1,638例肿瘤中,牙源性肿瘤72例(4.40％),良性70例,恶性2例,发生于下颌骨58例(80.55％),上颌骨14例(19.45％);位于后牙区53例(73.61％),前牙区19例(26.39％)。涎腺肿瘤614例(37.48％),良性363例(59.12％),恶性251例(40.88％),最常见的是多形性腺瘤与粘液表皮样癌,发生于大涎腺的肿瘤良性多于恶性,而在小涎腺中,则恶性多于良性。其他肿瘤(指除牙源性和涎腺肿瘤外)952例(58.12％),其中良性525例(55.15％),恶性427例(44.85％),良性多于恶性,癌比肉瘤多,淋巴网状组织肉瘤比间叶组织肉瘤多。在794例囊肿中,以颌骨囊肿居多。在174例瘤样病变中,以牙龈瘤多见,多位于上颌前牙区。在343例炎症中,以结核和涎腺炎居多。在114例口腔粘膜病中,以白斑与扁平苔癣居多。     

A clinical, demographic and microbiologic study of ANUG patients in an urban dental school

35 ANUG patients were examined and compared clinically and demographically. Plaque removed from ulcerated sites in 20 patients was cultured using quantitative anaerobic procedures and examined by electron and darkfield microscopy. Patients were classified as having ANUG when presenting with ulceration and necrosis of interproximal papillae, pain and bleeding. The clinical symptoms of fetid odor, pseudomembrane formation, lymphadenopathy and elevated body temperature were present in 97%, 85%, 61% and 39% of the ANUG patients, respectively. 83% of the patients were smokers. The ANUG patients demonstrated a lower average age (24 years) than the general clinic population (32 years). There was a slightly higher % of male (54%) than female (46%) and the % of Caucasian (51%) and black (49%) ANUG patients were almost equal. Cultural studies revealed that gram-negative rods were the predominant cultivable micro-organisms present in the plaque, representing 78.2% of the total recoverable count. Of these, nearly half were strict anaerobes with Bacteroides gingivalis and Fusobacterium nucleatum accounting for 7.8% and 3.4%, respectively. Anaerobic and facultative gram-positive cocci (15.5%), gram-negative cocci (3.5%) and gram-positive rods (2.8%) were also isolated. Microscopic analysis of the morphologic composition of plaque revealed that rods (43%) constituted the greatest % of the total microorganisms observed followed by spirochetes (30%) and cocci (27%). 8 distinct types of spirochetal periplasmic flagellar arrangement were observed by electron microscopy, the "2-4-2" periplasmic flagellar arrangement being most numerous.     

The microbiology of periapical granulomas

Of the 16 periapical granulomas studied, 14 (88%) yielded a positive growth when homogenized and cultured. The concentration of colony-forming units per milliliter of the suspension ranged from 10(1.3) to 10(4.0) (mean 10(2.2)). A total of 47 isolates comprising 26 (55%) facultative anaerobes and 21 (45%) strict anaerobes were obtained. The organisms most commonly cultured were Veillonella species (15%), Streptococcus milleri (11%), Streptococcus sanguis (11%), Actinomyces naeslundii (11%), Propionibacterium acnes (11%), and Bacteroides species (10%). Most of the organisms (96%) were sensitive to either amoxicillin, clindamycin, or tetracycline, whereas only 45% were sensitive to metronidazole.     

黏膜下腭裂的腭咽闭合状态及语音表现分析

目的 通过分析黏膜下腭裂患者腭咽闭合模式、腭咽口各部分的收缩运动状况和语音表现,进一步探究黏膜下腭裂的病理特征规律。方法 回顾2008—2016年于四川大学华西口腔医院唇腭裂外科就诊的黏膜下腭裂患者的病历资料,分析其术前腭咽功能、辅音构音表现,采用鼻咽内镜观察腭咽闭合模式以及软腭、咽侧壁和咽后壁的运动情况。结果 共纳入353例黏膜下腭裂患者,其中术前腭咽闭合完全（VPC）者138例（39.09%）,腭咽闭合不全（VPI）者176例（49.86%）,边缘性腭咽闭合不全（MVPI）者39例（11.05%）; 268例患者接受了鼻咽内镜检查,167例（62.31%）为环状闭合,89例（33.21%）为冠状闭合,12例（4.48%）为矢状闭合;派氏嵴参与了45.51%（76/167）的环状闭合和13.48%（12/89）的冠状闭合。353例患者中137例（38.81%）构音正常,124例（35.13%）表现为辅音省略,51例（14.45%）有代偿性构音,36例（10.20%）有辅音弱化,25例（7.08%）有辅音替代,36例（10.20%）有2种以上的构音错误。结论 环状闭合是黏膜下腭裂患者最主要的腭咽闭合模式,压力辅音省略是最常见的构音障碍。随着腭咽闭合程度的降低,发生2种以上构音错误的患者明显增加。