柠檬精油对牙周致病菌抑制作用及其安全性初步研究

目的:探讨柠檬精油对牙周致病菌的体外抗菌活性及对细胞增殖的影响。方法:采用微量液体稀释法测定柠檬精油对Pg、Fn、Aa、Pi的最小抑菌浓度(minimal inhibitory concentration,MIC)及最小杀菌浓度(minimum bactericidal concentration,MBC);以较低浓度的MIC为标准稀释LEO作为实验组,采用MTT法测定柠檬精油对HUVECs的毒性作用,明确抑菌浓度下LEO的安全性。结果:柠檬精油对牙周主要致病菌均有抑菌作用,Pg、Fn、Aa、Pi的MIC分别是9.0 g/L、4.5 g/L、4.5 g/L、9.0 g/L,Aa、Fn的 MBC是9.0 g/L,Pg、Pi的MBC未测得。1/2MIC、1/20MIC浓度的LEO能够抑制人脐静脉内皮细胞的生长,而低于1/200MIC浓度的LEO则对人脐静脉内皮细胞的生长没有影响,其中1/200MIC浓度的LEO作用明显优于0.02%的CHX。结论:体外环境中,柠檬精油对牙周致病菌Pg、Fn、Aa、Pi具有抗菌活性,低浓度应用对机体相对安全。     

Computer-assisted planning for maxillofacial prosthodontic rehabilitation

Computerized tomography (CT) planning and the use of CT derived surgical templates for implant placement have shown promise for restoring function within months after surgical reconstruction of acquired post-oncologic defects.     

Effect of Pingyangmycin on human venous malformation endothelial cells

Purpose: Venous malformations are common vascular anomalies with a propensity of the head and neck. Intralesional injection of Pingyangmycin (PYM, bleomycin A5 hydrochloride) is a widely used sclerotherapy method for the treatment of venous malformation.     

Oropharyngeal dysphagia in amyotrophic lateral sclerosis alters quality of life

Dysphagia is one of the most important complications encountered in amyotrophic lateral sclerosis (ALS). Our aim was to determine whether oropharyngeal dysphagia impacted the quality of life (QoL) of patients with ALS. Thirty consecutive patients were recruited (31–82 years, 18 men). Swallowing function was evaluated using a standardised videofluoroscopic barium swallow. All the patients completed a specific questionnaire on quality of life in dysphagia (SWAL‐QoL) immediately after the videofluoroscopy. The results of dysphagia outcome severity scale separated 14 patients with oropharyngeal dysphagia and 16 with normal swallowing function. There was no difference in the average age, weight and body mass index of the two groups (dysphagic patients: 68 ± 11 kg versus non‐dysphagic patients: 69 ± 14 kg). Most of the dysphagic patients had a bulbar affection based on their Norris scores which determine the importance of cranial nerves illness (20 ± 8), significantly lower than those of the non‐dysphagic patients (35 ± 5) (P < 0·0001). There was no difference in the neurological peripheral symptoms evaluated by Amyotrophic Lateral Sclerosis Functional Rating Scale scores (dysphagic patients: 26 ± 7 versus non‐dysphagic patients: 27 ± 8) (ns). The swallowing quality of life questionnaire revealed that the dysphagic patients had significant burden (P < 0·001). They were affected by the necessity to applied a food selection (P < 0·01), by the increase in eating duration (P < 0·05) and described a decrease in eating desire (P < 0·05). They complained of fear regarding the risk of dysphagia (P < 0·05). They also described difficulties with oral communication (P < 0·001). All of those complained about dysphagia which impacted directly mental health (P < 0·05) and social life (P < 0·05). In conclusion, oropharyngeal dysphagia is a common symptom accompanying ALS, which alters the patient's QoL, especially social health.     

替牙期骨性Ⅲ类错牙合患者颞下颌关节特征的锥形束CT研究

目的:采用锥形束CT(CBCT)研究替牙期骨性Ⅲ类错牙合患者颞下颌关节的影像学特征,探讨Ⅲ类功能状态下,颞下颌关节的生长、改建机制。方法:从就诊于昆明医科大学附属口腔医院正畸科的患者中选取符合纳入标准的替牙期骨性Ⅲ类错牙合患者及骨性Ⅰ类错牙合患者各20名,使用NNT viewer 5.3图像处理软件进行三维重建及线距和角度的测量,并进行统计学分析。结果:替牙期骨性Ⅲ类错牙合患者组和替牙期骨性Ⅰ类错牙合患者组对比结果为:矢状面双侧关节前间隙偏小、双侧关节上间隙偏小、双侧关节结节斜度偏小;冠状面双侧关节内间隙偏小,双侧关节上间隙偏小,双侧关节外间隙偏小,右侧髁状突角度偏小;横截面右侧髁状突前后径偏小。结论:替牙期骨性Ⅲ类错牙合患者颞下颌关节发育不充分,呈现髁状突,关节窝深度,关节结节斜度;冠状面关节内、外间隙均较小的特征。骨性Ⅲ类错牙合患者髁状突在关节窝中处于前置近关节窝顶位置。骨性Ⅲ类错牙合患者颞下颌关节影像学特征与其功能状态相适应。     

Interventional neuroradiologic procedures in the head and neck

Interventional radiology and interventional neuroradiology are evolving specialties which can aid the head and neck surgeons in the clinical management of patients with complex vascular lesions.     

Functional palatomaxillary reconstruction using free tissue transfer

The use of bone containing vascularized flaps has become the gold standard in the reconstruction of composite, post ablative palato-maxillary defects.     

小剂量短疗程泼尼松治疗顽固性复发性阿弗他溃疡的疗效及免疫改变

目的:探讨小剂量短疗程泼尼松治疗顽固性复发性阿弗他溃疡(顽固性RAU)的临床疗效及对免疫指标调节的作用。方法:选择37例顽固性RAU的患者,小剂量短疗程口服泼尼松治疗1个月,前20 d 10 mg/d,之后5 d减量为7.5 mg/d,最后5 d减量为5 mg/d,治疗前后检查血常规、肝肾功能、外周血体液和细胞相关免疫指标,观察治疗1个月、停药2个月后临床疗效及不良反应,治疗1个月后免疫指标改变。结果:小剂量短疗程口服泼尼松治疗顽固性RAU的治疗1个月后总有效率为100%,停药2个月后总有效率为91.4%,治疗1个月后外周血免疫球蛋白及补体(IgG、IgA、IgM、IgE和C4)水平降低(P<0.05),免疫细胞(B、T淋巴细胞及NK细胞)比例未出现明显差异。结论:采用小剂量短疗程泼尼松治疗顽固性RAU有较好的疗效,可延长溃疡发作间歇期,降低溃疡发作的数目、面积及疼痛程度,未见不良反应的发生。调节体液免疫可能是泼尼松治疗顽固性RAU的途径之一。     

Researches on optimizing treatment of Chinese cleft lip and/or palate

We all know that the development of the sequential therapy ameliorates the clefts treatment. Modes and methods of the sequential therapy differ among different countries and places because of the differences of economy, medical system and sanitary status.     

Osteotomy versus unicompartmental arthroplasty: an algorithm for anteromedial knee osteoarthritis

Knee arthritis occupies a significant proportion of the musculoskeletal burden in the UK. Total knee arthroplasty currently comprises the mainstay of treatment. There has been a shift towards treating isolated unicompartmental osteoarthritis with bone-preserving surgical techniques, in the form of realignment osteotomy or unicompartmental arthroplasty. There are significant data regarding the survivorship of unicompartmental knee arthroplasty from the National Joint Registry data. Similar registry data are not available for osteotomy surgery yet, but the evidence suggests that unicompartmental knee arthroplasty has greater survivorship. Osteotomies can, however, deliver higher functional return. For both techniques to succeed, it is imperative that rigorous surgical decision-making, with regards to patient selection, should be followed. This paper discusses the basis for these principles and their importance in delivering optimal care. Often, these two surgical techniques are promoted as being mutually exclusive; this paper argues that, in fact, they are part of a complementary algorithm that can deliver the best outcome to the appropriately selected patient.     

Antioxidants as a novel dental resin-composite component: Effect on elution and degree of conversion

Objective

Ascorbic acid (Asc) and N-acetylcysteine (NAC) were reported to reduce genotoxicity induced by dental (co)monomers and their epoxy metabolites. The aim of the present study was to investigate Asc or NAC as novel components in light-curable methacrylate based dental composites regarding their effects on degree of conversion (DC) and elution of composite components. Additionally, the release of Asc or NAC was determined.

Alloplastic total temporomandibular joint replacement in skeletally immature patients: a pilot survey

The aim of this study was to survey an international group of temporomandibular joint surgeons regarding their outcomes with alloplastic total joint replacement in skeletally immature patients and to review the literature linked to autogenous reconstruction and alloplastic replacement of the temporomandibular joint (TMJR) in this population. A total of 24 custom/patient-specific TMJ Concepts devices were implanted into 14 patients (eight male and six female). Their mean age was 14 years (range 7–17 years). Nine (64.3%) had bilateral devices and five (35.7%) had unilateral devices. The most prevalent diagnosis was idiopathic condylar resorption (33.3%), followed by ankylosis (16.7%). Concurrent orthognathic surgery was performed in four patients (28.6%). The TMJR was completed as a one-stage procedure in 11 patients (78.6%) and in two stages in three patients (21.4%). All surgeons reported improvements in maximum incisal opening with good function. The respondents reported no asymmetric mandibular growth or retrognathia after either bilateral or unilateral TMJR implantation. This pilot study indicates that the use of TMJR in the growing patient may be a useful modality in select cases. The encouraging results of experienced surgeons demonstrate and support the need for further studies on the utilization of TMJR in this patient population.     

Reliability and failure modes of implant-supported zirconium-oxide fixed dental prostheses related to veneering techniques

Objectives

To compare fatigue failure modes and reliability of hand-veneered and over-pressed implant-supported three-unit zirconium-oxide fixed-dental-prostheses(FDPs).

Methods

Sixty-four custom-made zirconium-oxide abutments (n = 32/group) and thirty-two zirconium-oxide FDP-frameworks were CAD/CAM manufactured. Frameworks were veneered with hand-built up or over-pressed porcelain (n = 16/group). Step-stress-accelerated-life-testing (SSALT) was performed in water applying a distributed contact load at the buccal cusp-pontic-area. Post failure examinations were carried out using optical (polarized-reflected-light) and scanning electron microscopy (SEM) to visualize crack propagation and failure modes. Reliability was compared using cumulative-damage step-stress analysis (Alta-7-Pro, Reliasoft).

Results

Crack propagation was observed in the veneering porcelain during fatigue. The majority of zirconium-oxide FDPs demonstrated porcelain chipping as the dominant failure mode. Nevertheless, fracture of the zirconium-oxide frameworks was also observed. Over-pressed FDPs failed earlier at a mean failure load of 696 ± 149 N relative to hand-veneered at 882 ± 61 N (profile I). Weibull-stress-number of cycles-unreliability-curves were generated. The reliability (2-sided at 90% confidence bounds) for a 400 N load at 100 K cycles indicated values of 0.84 (0.98-0.24) for the hand-veneered FDPs and 0.50 (0.82-0.09) for their over-pressed counterparts.

Conclusions

Both zirconium-oxide FDP systems were resistant under accelerated-life-time-testing. Over-pressed specimens were more susceptible to fatigue loading with earlier veneer chipping.     

Ghlorhexidine as a root canal medicament for treating inflammatory lesions in the periodontal space

Abstract— The purpose of the present study was to investigate the therapeutic effect of intra-canal application of chlorhexidine on inflammatory root resorption. Dental pulps from monkey incisors were infected and resealed prior to extraction of the teeth. Root dentin was mechanically exposed and the teeth were replanted under aseptic conditions. After 4 weeks, the experimental teeth were dressed with chlorhexidine gel and resealed. Animals were sacrificed 4 weeks later, and their jaws prepared for histologic examination. Results showed that both marginal and apical periodontal inflammation and resorption were reduced in the chlorhexidine-treated teeth. It was concluded that the use of intra-canal chlorhexidine may be a useful adjunct in the treatment of inflammatory root resorption, but further human trials need to be undertaken before its clinical use can be recommended.     

小鼠牙髓干细胞同种异体移植后体内免疫反应初探

目的:初步探究小鼠牙髓干细胞同种异体移植后的全身免疫反应。方法:牙髓干细胞分离获得自C57BL/6 小鼠牙髓组织,培养至第3 代,与纳米羟基磷灰石(n-HA)复合培养形成复合物,扫描电镜观察其生长黏附情况。40只4周龄的C57BL/6 小鼠随机分成两组。实验组将复合物移植入上背部皮下,对照组将纳米羟基磷灰石植入上背部皮下,术后均使用外科方法严密缝合创口。两组动物术后均观察4周、6周处死,分离脾脏,制成脾淋巴细胞悬液,流式细胞仪测定CD4⁺、CD8⁺的值。结果:牙髓干细胞在体外与纳米羟基磷灰石结合良好;免疫组化染色实验组4周、6周均可见牙本质涎蛋白(dentin sialoprotein,DSP)阳性表达;实验组与对照组相比,术后4周、6周CD4⁺/CD8⁺值均无明显差异。结论:牙髓干细胞同种异体移植后,尚不能够引起机体的免疫排斥反应,其在体内仍具有低免疫原性,有望成为组织工程同种异体种子细胞来源。     

显微CT法研究中国人下颌切牙根管系统解剖形态

目的:使用显微CT扫描技术研究中国人离体下颌切牙根管系统解剖形态。方法:收集108颗中国人下颌切牙,使用显微CT进行扫描后构建根管系统三维可视化模型。对主根管形态进行分型,记录第二根管分出位置,分支根管的发生率和位置。结果:下颌切牙根管最常见的形态为VertucciⅠ型和Ⅲ型,发生率分别为78.70%和14.81%,分支根管发生率为24.07%。第二根管发出位置在釉质牙骨质界根方(6.07±3.42) mm。结论:下颌切牙根管系统解剖形态复杂,了解其主根管及分支根管的发生规律对于提高根管治疗成功率具有重要意义。     

Oral maxillofacial reconstruction: 25 years'''' experience

Purpose: To make a retrospective analysis of the reconstructive cases with oral maxillofacial defects of 25 years in the department.