乳前牙脱位手法复位163颗疗效观察

幼儿牙齿脱位因年龄小 ,其检查和治疗受到限制。自 1993～ 2 0 0 2年 ,我们采用手法复位 ,取得较好效果 ,现报告如下。1　临床资料1.1　一般资料均为门诊病人。患儿 10个月～ 3岁 ,男 70例 ,10 8颗牙 ;女 35例 ,5 5颗牙。乳上中切牙 138颗 ,占 84 % ;乳侧切牙及其他 2 5颗 ,占 16 %。乳前牙直接碰伤 39颗 ,外力击伤 18颗 ,摔倒致颌面外伤伴牙外伤 10 6颗。侧向脱位 118颗 ,嵌入 2 7颗 ,部分脱位 18颗。1.2　治疗伴颌面部外伤者行清创缝合术后 ,脱位牙用手法复位至牙槽窝内 ,对牙齿嵌入不严重者不做处理。下颌有对牙合牙者尽量不与患牙接触 ,…     

硬质透明牙托在脱位牙固定中的应用

笔者于2000～2005年采用硬质透明牙托固定脱位牙21例,27颗牙,收到理想效果。1临床资料本组病例21例共27颗牙,其中外伤脱落20例26颗牙,错位扭转牙(右上侧切牙外伤一月余)1例1颗牙。男14例,女7例。年龄8～51岁。脱位牙牙位:上中切牙22颗,上侧切牙3颗,上尖牙2颗。牙槽骨骨折1例、2     

下颌侧切牙双根管的临床研究

目的:观察临床治疗中下颌侧切牙双根管的发生几率。方法:临床需要根管治疗的下颌侧切牙102颗,拍X线片,术中配合使用牙科手术显微镜及小号K锉探查并扩通根管,确定根管是否为双根管。用Pro Taper镍钛锉进行根管预备,垂直加压技术充填根管。结果:102颗下颌侧切牙中双根管牙26颗。结论:下颌侧切牙双根管发生几率较高,临床治疗中应引起注意,必要时应拍摄偏位X线牙片及CBCT检查。     

第二前磨牙及下颌侧切牙先天性缺失一例

先天性牙缺失是临床上见到的一种先天性的一颗或多颗牙缺失的牙发育异常性疾病。最多见者为第三磨牙缺失,其次为上颌侧切牙或下颌第二前磨牙缺失。本文报告一例第二前磨牙及下颌侧切牙先天性缺失病例。     

上前牙冠折一次性桩冠修复体会

上前牙外伤性冠折,尤其是损及冠1/2时直接影响到患者的美观,对于一些有特殊工作要求美观者是一个急需解决的问题。传统的方法是先行根管治疗,观察后再行桩冠修复。鉴于患者迫切要求修复患牙,我们先后对14例上前牙外伤性冠折牙患者试用了一次性根管治疗即时桩冠修复,均收到满意效果。 适应症:上前牙外伤性冠折1/2以上,牙折线尚未到龈下,不影响桩冠固位,X线未见根折者。 临床资料:本组中,男9例,女5例,最大年龄44岁,最小19岁。其中上中切牙11颗,侧切牙3颗,受伤时间8例不超过24小时,6例未达48小时。全部病例无明显全身症状及颌面外伤。     

牙外伤463例急诊临床分析

目的研究急诊牙外伤的流行病学特征和临床特点,为牙外伤的防护和应急处理提供参考。方法回顾2008年1～12月于北京大学口腔医院急诊科就诊的463例牙外伤患者的临床资料,分析患者的性别和时间分布、外伤原因和类型、外伤牙部位和数目、伤后就诊时间等。结果463例患者中,男女比例为1.84∶1。外伤时间春季较少,冬季较多;周末较平时增加。成人在室外受伤人数占93.1%（268/288）,5岁以上的儿童有83.6%（92/110）在室外受伤;5岁及5岁以下的儿童有69.2%（45/65）在室内受伤。外伤牙1023颗,其中乳牙112颗,恒牙911颗。受伤牙位左右基本对称,上中切牙最易受累。各类型牙外伤中,冠折为最多见。63.7%的患者累及2颗及2颗以上患牙;71.1%的患者合并不同程度颌面部软组织损伤;大部分患者在牙外伤后24h内到急诊就诊。结论急诊牙外伤常累及多颗牙齿,并伴发不同程度的颌面部软组织损伤,临床应注意避免漏诊;根据牙外伤的发病情况,对不同人群,在不同时间、地点可采用针对性防护措施。     

乳磨牙含牙囊肿致前磨牙埋伏且牙根吸收1例报告

1病例报告 患者,女,16岁,于2009年1月18日因“牙齿排列不齐,下颌缺牙”来我院正畸科就诊。口内检查：前牙闭锁殆,1l、2l舌倾,切端咬至下颌唇侧黏膜上,13、22、23唇向低位,下颌缺失两颗切牙,45缺失,46、47均正常萌出,右下后牙列散在间隙,摄曲面断层片（图1）和根尖片可见下颌先天缺失两颗切牙,分别于44、46之间根中1／3及根尖处见形似前磨牙和磨牙的上下两颗埋伏牙,磨牙冠部已形成含牙囊肿,牙根很短,形态似乳磨牙,前磨牙牙冠旋转,牙根不清晰,追问病史患者在乳牙时曾缺失1颗乳磨牙。     

487颗下颌前牙根管的弯曲情况研究

目的:了解下颌前牙根管弯曲情况。方法:采用间接数字化X线成像技术拍摄487颗下颌前牙的近远中 向和颊舌向X线影像,分析根管的弯曲情况。结果:下颌前牙根管以Ⅰ型为主。26.22%的下颌切牙和31.45%的 下颌尖牙出现近远中向弯曲,7.01%的下颌切牙和18.87%的下颌尖牙出现颊舌向弯曲。下颌切牙Ⅰ型弯曲根管 颊舌向弯曲度(M=15.8°)最大;其弯曲半径(M=4.7mm)和弯曲长度(M=2.6mm)最小。结论:下颌前牙根管的 弯曲情况较复杂,以下颌切牙为甚。     

12例外伤后牙颈部外吸收患者临床特点分析

目的:分析外伤后牙颈部外吸收的临床特点,探讨其治疗策略。方法:收集2020年2月～2023年2月来南华大学附属长沙中心医院就诊的牙外伤后出现牙颈部外吸收的病例,收集患者的基本信息、患牙位置、吸收程度、初诊时主要症状、采取的治疗措施、牙齿存留以及治疗后恢复情况等,并对收集的数据进行分析和讨论。结果:共收集到12例牙颈部外吸收病例,发现患牙21颗,其中上颌中切牙9颗,上颌侧切牙3颗,下颌中切牙7颗,下颌侧切牙2颗,吸收程度为Ⅰ级0颗,Ⅱ级7颗,Ⅲ级5颗,Ⅳ级9颗,根据患牙情况我们进行了根管治疗、龈下刮治、局部充填以及拔除中一种或者两种以上的治疗,在随访期内,有8例共11颗患牙因吸收严重最终拔除,其余4例中2例共4颗患牙经过根管治疗联合龈下刮治以及缺损局部充填后原有根尖瘘管消失,牙颈部透射影未见扩大,1例共4颗患牙经过根管治疗后牙颈部透射影消失,无临床阳性症状发生,1例共2颗患牙经过根管治疗联合局部充填后牙颈部透射影未见扩大,无临床阳性症状发生。结论:外伤后牙颈部外吸收早期发现较为困难,致病机制尚不清楚,但是外伤后的定期随访有助于及时发现,并采取适当的治疗可以有效终止外伤后牙颈部外吸收对牙齿...     

壮族人群恒前牙根管弯曲度测定

目的了解壮族人群恒前牙的根管弯曲情况。方法收集新鲜拔除的壮族人群恒前牙245颗,采用间接影像学手段观察其根管类型和弯曲形状,在Schneider法和Sch覿fer法的基础上,结合电子测量尺软件测量分析218颗Ⅰ型根管牙齿的弯曲度、弯曲半径和弯曲长度。结果壮族人群恒前牙以Ⅰ型根管为主,有13颗下颌中切牙和12颗下颌侧切牙为Ⅱ、Ⅲ、Ⅳ型根管。上颌中切牙、侧切牙、尖牙以及下颌中切牙、侧切牙、尖牙Ⅰ型根管近远中向弯曲发生率分别为40%、80%、77%、65%、66%、73%,唇舌（腭）向弯曲发生率分别为62%、69%、70%、62%、41%、61%。弯曲部位多在根尖1/3,多为中度弯曲;上颌尖牙在近远中向上的根管弯曲度最大,下颌尖牙在唇舌（腭）向上的根管弯曲度最大;上颌侧切牙在近远中和唇舌（腭）2个方向上的根管弯曲半径及弯曲长度均较小。结论壮族人群恒前牙根管弯曲情况较复杂,其下颌切牙Ⅱ、Ⅲ、Ⅳ型根管发生率较高。     

Age and order of eruption of primary teeth in Spanish children

Abstract – A longitudinal study on primary tooth eruption was performed in 114 Spanish children in two Primary Care Centers over 3 yr. Data from periodic observations and data collected by previously instructed parents was studied. Ages of tooth eruption were calculated for both sexes. Comparison between the two sides of the jaws showed a nonsignificant tendency towards earlier left side eruption. Comparison between maxillary and mandibular showed a significant earlier mandibular eruption for central incisors and second molars and a significant earlier maxillary eruption for lateral incisors. Comparison between sexes showed a tendency towards earlier eruption in boys for all teeth, significant only for mandibular central incisors, maxillary and mandibular lateral incisors and mandibular canines. Order of tooth eruption and its most frequent changes were also studied. When these findings were compared to studies performed in other populations it was concluded that ages and order of primary tooth eruption in Spanish children are similar to those found in other populations.     

Bilateral dens invaginatus in the mandibular incisor region.

A case of bilateral dens invaginatus in the mandibular incisor regions has been reported. Radiographs demonstrated invaginations in both of the incisors in the mandibular incisor region and also demonstrated a periapical radiolucency. Clinical examination revealed two anomalous incisors and apparently there was congenital absence of two mandibular incisors. Dens invaginatus in the mandibular incisors would appear to be a most unusual occurrence.     

前牙色度学指标与视感色差关系的研究

目的研究前牙色度学指标与视感色差关系,指导临床对牙齿比色与配色。方法选择2篇研究报告的前牙和比色板的CIE1976L*a*b*表色系统的L*、a*、b*数据,计算各自的△E9*4和△Ca*b。结果男性上下颌同名前牙的△E9*4为1.03~3.24,中切牙与尖牙的△E9*4为1.71~3.74。女性上下颌同名前牙的△E9*4为2.77~3.68,中切牙与尖牙的△E9*4为3.11~4.69。Vita 3D相邻一级彩度比色片的△E9*4为2.15~3.82,相邻二级彩度比色片的△E9*4为4.62~5.81。Vita C相邻一级彩度比色片的△E9*4为2.03~5.75,相邻二级彩度比色片的△E9*4为4.20~8.86。结论从比色和配色考虑,男性上下颌切牙的彩度宜同级或下颌切牙比上颌切牙低半级,女性下颌切牙比上颌切牙低一级彩度,尖牙高于中切牙一级彩度配色为宜。     

Endodontic treatment of mandibular incisors with two root canals: report of two cases

The root canal anatomy of mandibular incisors can present a number of variations, including multiple canals. Two case reports are presented to illustrate the serendipitous discovery and successful non-surgical endodontic management of complex canal systems in mandibular incisors. In both cases, all four mandibular incisors had two canals each.     

Craniofacial pattern of Class III deciduous dentition.

The purpose of this study was to investigate the morphological characteristics of the cranio-dento-facial complex of children with deciduous dentition and Class III malocclusion. Forty Chinese children in Taiwan with normal occlusion and 40 with Class III malocclusion in deciduous dentition were selected for cephalometric analysis. Mandibular length was significantly greater and the mandible was situated farther forward in the Class III group. The maxilla was also slightly backward in this group, perhaps in association with the shorter maxillary length. The mandibular incisors were tipped lingually to compensate for the intermaxillary skeletal dysplasia and the maxillary incisors were tipped lingually by the retroinclined mandibular incisors.     

A controlled study of the morphometric changes in the primary dentition of pre-term, very-low-birthweight children

The aim of the present investigation was to compare the dimensions of the primary incisors from pre-term children and full-term controls. One hundred and eleven pre-term children, consisting of 86 very-low-birthweight (< 1,500 g), 25 low-birthweight (from 1,500 to 2,500 g), and 169 full-term, normal-birthweight (> 2,500 g) children, donated a total of 572 maxillary and mandibular primary central and lateral incisors for study. The teeth were measured by means of a digital micrometer. The results showed that there was a dose-response effect of birthweight on tooth size. The very-low-birthweight teeth showed the smallest dimensions, the normal-birthweight controls the largest, and the low-birthweight teeth intermediate dimensions (p < 0.001). In the maxillary primary central and lateral incisors, and the mandibular primary central incisors, very-low-birthweight teeth were from 6 to 11% smaller in both mesiodistal and faciolingual dimensions compared with normal-birthweight teeth (p < 0.001). The largest differences were observed in the maxillary lateral incisors, where mean decreases of 0.58 +/- 0.45 mm in mesiodistal and 0.50 +/- 0.40 mm in faciolingual dimensions (11% reduction in both measurements) were observed. In addition, in the mandibular and maxillary lateral incisors of very-low-birthweight children, the left-sided teeth were significantly smaller than those on the right side in both mesiodistal and faciolingual dimensions (p < 0.03).     

The use of regression constants in estimating tooth size in a Negro population.

A study of a sample of 105 Negro children and adolescents, residents of Connecticut, was undertaken to determine the degree of correlation between mandibular tooth size and the size of the canines and premolars. The correlation between the total mesiodistal width of the mandibular permanent incisors and that of the maxillary or mandibular canine and first and second premolars was found to be 0.63 and 0.71, respectively. Further, regression constants were determined in an attempt to estimate the buccal segments from the mandibular incisors.     

The prevalence and pattern of nursing caries in preschool children of Tehran

This cross sectional study was carried out to determine the prevalence and pattern of nursing caries and its relevant factors in preschool children of Tehrari. 620 children aged 2-6 yrs were selected randomly from 22 kindergartens in Tehran. They were examined for dental caries. The criteria used for nursing caries was presence of caries on buccal or palatal surfaces of at least two maxillary incisors with absence of caries in mandibular incisors. A questionaire was used for evaluation of related factors.     

Factors contributing to mandibular anterior crowding in the early mixed dentition

The aim of this study was to uncover the possible factors contributing to mandibular anterior crowding in the early mixed dentition. Mandibular dental casts of 60 children in the early mixed dentition were divided into two groups according to the severity of mandibular anterior crowding. The space available for the mandibular permanent incisors, total incisor width, deciduous intercanine width, deciduous intermolar widths, permanent intermolar width, interalveolar width, and total arch length were compared between the crowded group (CG) and noncrowded group (NCG), and correlations with crowding were investigated. The mandibular deciduous intercanine width, mandibular deciduous intermolar widths, mandibular permanent intermolar width, mandibular interalveolar width, space available for the mandibular permanent incisors, and total arch length were significantly larger in the NCG. The total width of the four mandibular incisors did not differ significantly between CG and NCG. Significant inverse correlations were found between crowding and available space, deciduous intercanine width, deciduous intermolar widths, permanent intermolar width, and interalveolar width. Total incisor width was directly correlated with crowding. No significant correlation was found between crowding and total arch length. The results of this study suggested that individual variations play an important role in treatment planning. However, one must not overlook arch length discrepancies and transverse discrepancies in patients with mandibular anterior crowding.     

下颌切牙根管解剖特点的锥形束CT影像学研究

目的采用锥形束CT研究下颌切牙根管解剖特点,及其与性别、年龄、牙位的关系。方法使用锥形束CT观察316例共1148颗下颌切牙,获得其断层图像后进行三维重建,通过计算机图像观察其根管数目及根管类型。记录被检查者的性别、年龄和牙位。计算下颌切牙双根管检出率,统计根管类型,分析根管解剖特点与性别、年龄、牙位的关系。结果下颌切牙双根管检出率为27．5％,其双根管类型以Vertucci分类的Ⅲ型最多,占14．1％。双根管在各年龄段间的分布差异有统计学意义（P〈0．05）,20～29岁和30～39岁两个年龄段的双根管检出率较高,分别为36．8％和36．5％。下颌切牙双根管的检出率女性高于男性。侧切牙双根管的检出率高于中切牙,结论下颌切牙双根管检出率较高,锥形束CT在诊断双根管方面具有重要作用。