磨牙铸瓷髓腔固位冠的临床效果

目的 观察IPS e.max press铸瓷髓腔固位冠在无髓磨牙保存修复中的临床效果.方法 选择45颗无髓磨牙,先经根管治疗及龈上洁治术,1～2周后预备剩余牙冠以及髓腔,硅橡胶印模、灌模,制作铸瓷髓腔固位冠,树脂粘结剂粘固.并于6个月、1年后复查.并将龈沟出血指数与对侧同名牙做配对比较.结果 1年内修复体保存率及临床可接受率为100%,髓腔固位冠无松动,边缘密合,可发挥正常咀嚼功能,美观效果良好.牙龈无明显红肿,其龈沟出血指数与对照牙之间的差异无统计学意义（P＞0.05）.结论 IPS e.max press铸瓷髓腔固位冠用于无髓磨牙保存修复可取得良好的效果,尤其对于短冠磨牙是一种很好的修复选择.     

修复磨牙大面积缺损的三种充填材料临床分析

目的,观察三种充填材料修复磨牙大面积缺损的临床疗效,目的:通过对250个磨牙大面积缺损的患牙进行根管治疗后置根桩与自攻螺纹钉行支架固位,分别用登土拍TPH复合树脂、银汞合金、玻璃离子水门汀充填,1年后复查.结果:1年后复查,TPH修复成功率97.81%,银汞合金修复成功率74.9%,玻璃离子水门汀充填成功率68.5%,结论:TPH树脂联合根管桩钉修复磨牙大面积缺损临床疗效明显优于银汞合金和玻璃离子水门汀.     

根管治疗术后树脂充填联合固位纤维冠外保护对上颌第一前磨牙牙齿抗折性能的影响

目的：探讨根管治疗术后树脂充填联合固位纤维冠外保护对上颌第一前磨牙牙齿抗折性能的影响。方法：选择2018年6月-2020年8月笔者医院因正畸拔除的60颗冠根完整的上颌第一前磨牙为研究对象，将60颗离体牙样本分为对照组（3M流体树脂填充），观察组（3M流体树脂填充联合固位纤维冠外保护），采用游标卡尺测量并比较两组第一前磨牙牙体标本解剖外形各项指标（牙全长、冠长、颈部颊舌径及近远中径），采用静态加载法和循环加载法对离体牙折裂载荷及离体牙折裂模式进行测定。结果：两组离体牙体标本解剖外形各项指标比较无统计学意义（P>0.05）。对照组平均折裂载荷为（627.96±91.42）N，观察组为（974.85±102.25）N，观察组折裂载荷值明显高于对照组；对照组可修复性牙折裂20颗（66.67%），观察组可修复性牙折裂27颗（90.00%），差异有统计学意义（P<0.05）。对照组中33.33%的离体牙样本表现为修复体和超过一半的牙体破坏或破坏涉及牙根，无法修补；观察组中10.00%的离体牙样本无法修补，差异有统计学意义（P<0.05）。结论：3M流体树脂充填辅以固位纤维冠外保护...     

下颌第二磨牙根管治疗失败病例（126例）原因分析

目的：分析126例患者下颌第二磨牙根管治疗失败的原因。方法：选取笔者医院2017年10月-2021年8月门诊接诊的下颌第二磨牙根管治疗失败的126例患者(共126颗患牙)为研究对象,回顾性分析患者的临床资料,总结下颌第二磨牙根管治疗失败的原因。结果：126颗患牙中,遗漏根管48颗,欠填26颗,根管超充21颗,根充不致密35颗,牙根纵裂2颗,冠部折裂9颗;冠渗漏15颗,根管内器械分离3颗,底穿2颗,髓腔入路欠佳13颗,根管内台阶、偏移、侧穿17颗。结论：下颌第二磨牙根管系统复杂,解剖位置操作不方便,造成治疗失败的原因较多,主要有解剖学因素和医源性因素,重在预防,对治疗失败患牙应综合考虑相关因素采取合理的治疗方案。     

二氧化锆髓腔固位冠在短冠磨牙应用中的疗效观察

目的:观察二氧化锆髓腔固位冠在短冠磨牙保存修复中的临床效果。方法:选择134颗短冠磨牙,先经根管治疗及龈上洁治术,1～2周后预备剩余牙冠以及髓腔,硅橡胶印模、灌模,经过计算机辅助设计(Computer Aided Design,CAD)和计算机辅助制作技术(Computer Aided Manufacturing,CAM)制备出二氧化锆髓腔固位冠,树脂粘结剂粘固,并于6个月、1年后复查。结果:132颗髓腔固位冠无松动,边缘密合,可发挥正常咀嚼功能,美观效果良好,牙龈无明显红肿,只有两颗牙齿修复失败。结论:二氧化锆髓腔固位冠用于短冠磨牙修复可取得良好的效果,是一种很好的修复选择。     

玻璃纤维桩联合双固化树脂水门汀修复前牙残根残冠

目的：评价玻璃纤维桩联合双固化树脂水门汀（RelyXunicem）修复前牙残根残冠的临床效果。方法：选择80颗已行根管治疗的前牙残根残冠,利用双固化树脂水门汀将Fibra-post玻璃纤维桩粘结于根管内,再在纤维桩上用复合树脂堆核,最后全冠修复。治疗完成后6、12个月复诊,观察临床效果。结果：6个月后复查,成功率为100%。12个月时,成功率98.7%,3颗患牙失访,1颗残根的纤维桩折断,其余76颗患牙无不适,桩核冠稳固无松动,均修复成功。结论：玻璃纤维桩联合双固化树脂水门汀修复残根残冠疗效好,可满足临床需要。     

130颗残冠残根修复的护理

牙的残冠残根以往只有拔去患牙,随着现代口腔医学的迅速发展,现在牙的残冠残根已能进行修复。我科１９９６～１９９７年修复残冠残根１３０颗,（１０４例）疗效满意。１　资料１０４例患者,男６０例,女４４例,年龄２０～５０岁。因龋病或外伤所致的前牙、双尖牙残冠残根１３０颗,病面在牙龈上２ｍｍ,Ｘ线摄片显示根尖无病变或范围＜０－５ｃｍ２,无牙周病。２　方法①植入桩钉。根据根管的粗细、长短,选择相应型号的根管钉,调拌磷酸锌粘固粉剂固位,准确旋入根管内。桩钉一般进入根管深度的１／２～２／３。②充填光固化树脂。③…     

玻璃纤维桩联合复合树脂修复青少年上前牙冠折

目的:观察玻璃纤维桩和复合树脂联合修复青少年上前牙冠折,随访2年并评价其临床效果。方法:对70例(88颗)青少年冠折上前牙行完善的根管治疗后,随机分成两组,35例患者45颗牙采用玻璃纤维桩和复合树脂联合修复,35例(43颗)采用螺纹钉和复合树脂联合修复。结果:随访期内玻璃纤维树脂桩冠修复组未见根折,1颗桩核松脱,螺纹钉树脂桩冠修复组3颗出现根折,1颗桩核松脱,2颗树脂边缘部分折裂,失访1例,两组修复效果差异有显著性(P0.01)。结论:对于根管治疗后青少年冠折上前牙,玻璃纤维树脂桩冠修复组成功率高于螺纹钉树脂桩冠组。     

隐裂磨牙根管治疗中保护方法的临床探讨

目的：临床对比观察3种方法对隐裂磨牙根管治疗中的保护效果。方法：选用正畸带环、临时树脂全冠、钢丝环扎3种方法对隐裂磨牙根管治疗前进行保护,并就患牙保留疗效、不良反应、保护装置外形进行临床对比。结果：正畸带环组、临时树脂全冠组在患牙保留有效率方面显著优于钢丝环扎组;临时树脂全冠组在不良反应、保护装置外形方面优于正畸带环组。结论：隐裂牙根管治疗前制作临时树脂全冠对保护患牙,防止冠折有良好的效果,同时不良反应更少。     

截根术治疗上颌第一磨牙近颊根严重病变疗效分析

目的:观察截根术治疗上颌第一磨牙近颊根严重病变的临床疗效。方法:选择2012年6月-2014年6月来笔者医院口腔门诊治疗的上颌第一磨牙病变且近颊根破坏最严重的32例患者(共32颗患牙),牙周基础治疗及根管治疗、咬合调整、翻瓣行截根术,术后3个月复查行全冠或联冠修复,1年、2年复查评价治疗效果。结果:术后2年复查,32颗患牙中29颗成功,1颗继发牙周病变致患牙松动拔除,1颗发生根折,1颗失访。结论:截根术治疗上颌第一磨牙近颊根严重病变,能保留牙冠和相对健康的余根继续行使咀嚼功能,疗效满意,是一种有效的治疗方法。     

Meta分析树脂充填、嵌体修复治疗后牙食物嵌塞的临床疗效

目的：根据国内外2010～2013年公开发表的随机对照性研究结果,评价树脂充填和嵌体治疗治疗后牙食物嵌塞的疗效.方法：检索2010 ～ 2013年国内外公开发表的中英文文献,关键词为“食物嵌塞、充填、嵌体”、“food impaction,fill,inlay”.对树脂充填或嵌体治疗后牙食物嵌塞的患者,进行治疗有效率的Meta分析,评价疗效.结果：共检索出的相关文献117篇,经筛选36篇文献符合本次Meta分析的纳入标准.共3607例研究对象被纳入治疗有效率评价,各研究方差齐性检验差异无统计学意义,采用Meta分析固定效应模型,评价树脂充填组和嵌体治疗组有效率0R值,合并均值及95％可信区间为3.60（2.91～ 4.47）.结论：树脂充填治疗后牙食物嵌塞较嵌体治疗的疗效好.     

Calcifying odontogenic cyst: radiologic findings in 11 cases.

OBJECTIVE: This retrospective study examines the relationship between histopathologically diagnosed cases of in calcifying odontogenic cysts (COCs) on the adjacent dentition. STUDY DESIGN: The records including diagnostic radiograph images of 11 patients treated for COCs from 1991 to 2004 were analyzed and correlations made between radiologic and histopathologic features. Special attention was applied to the associations between COCs and adjacent teeth. RESULTS: Radiologic and histopathologic features of the 11 lesions were variable, with some lesions being more solid and others more cystic. Calcifications varied from small flecks to solid calcified areas of frank odontoma. In 7 cases, the COC was associated with an impacted tooth and 5 of these cases involved COC-enveloping teeth. All cases excepting one in an edentulous jaw segment showed positional changes of adjacent teeth, including impaction. CONCLUSIONS: The radiographical features of COCs are varied but there is a high frequency of changes in adjacent teeth, including dental impaction. The presence of impaction or displacement of teeth for COCs occurring in the posterior segments of the jaw, and absence of this finding for anteriorly placed lesions may be indicative of the timing of COC development.     

纤维桩核修复后牙残冠临床疗效观察

目的:观察纤维桩核修复后牙残冠的疗效。方法:应用瑞士康特公司生产的Par a Pos t FI BER LUX玻璃纤维桩核材料成型后牙残冠桩核,辅以氧化锆全瓷冠修复外冠,86例(117颗)后牙于修复后6、12、18、24个月随访评估临床疗效。结果:117颗患牙在修复后随访观察期间,2颗修复体发生崩瓷现象,1颗修复牙并发牙龈炎,2颗患牙发生修复体外冠脱落,1颗修复体发生食物嵌塞;所有修复牙未发现根折、纤维桩核脱落、纤维桩折断及慢性根尖周炎等严重并发症。结论:应用纤维桩核修复后牙残冠能获得良好的近期临床效果。     

Impaction grafting improves the fit of uncemented humeral arthroplasty

This study tested the hypothesis that the excellence of the fit between a humeral prosthesis and the humerus can be optimized by impaction grafting with cancellous bone. Ten paired human humeri were prepared for insertion of a humeral implant by a standard surgical technique. One humerus from each pair was randomized to receive a 10-mm humeral component with cancellous impaction autografting, whereas the other was inserted without grafting. After insertion of a polymethylmethacrylate model of the prosthesis, computed tomography scans were obtained with 3-mm sections and the void areas of each section measured by use of NIH Image. The data demonstrate that cancellous impaction grafting significantly reduces the void between the prosthesis and the humerus (P <.001). The effect was most marked in the proximal and middle thirds of the implant. We conclude that cancellous impaction grafting is an effective method for improving the quality of fit between the humerus and the proximal two thirds of the humeral prosthesis.     

The “Steakhouse syndrome”

Summary Over a period of 5 years, 28 instances of acute food impaction of the esophagus were documented in 26 patients at our institution. In all patients the impacted bolus was successfully removed without complication using a flexible endoscope. Underlying diseases were identified during primary endoscopy in 31% of the cases. Further diagnostic workup was performed in all but 5 of the patients. After adequate evaluation pathologic findings were demonstrated in 90% of the cases (38% malignant and 52% benign diseases). Long-term therapy was deemed necessary in 17 of these 21 patients. Operative intervention was indicated in 4 cases, 2 of which were for malignant tumors. Acute food impaction should always be regarded as a symptom of esophageal disorders. In patients with esophageal cancer or other mediastinal tumors bolus impaction generally indicates an advanced tumor stage.     

Radiographic proximity of the mandibular third molar to the inferior alveolar canal.

OBJECTIVE: To determine the panoramic radiographic distance from the mandibular third molar tooth to the inferior alveolar canal. STUDY DESIGN: Five hundred sixty mandibular third molars were evaluated by panoramic radiography. The teeth were grouped into erupted vs unerupted and further subdivided by tooth angulation. The distance from the most inferior aspect of the mandibular third molar tooth to the superior border of the inferior alveolar canal was measured with digital calipers. A t test was performed to compare erupted and unerupted teeth, and ANOVA was used to determine if a significant difference exists based upon tooth angulation. A record review was performed to assess the incidence of inferior alveolar nerve paresthesia based upon measured distances. RESULTS: The mean distance from erupted mandibular third molar teeth to the inferior alveolar canal is 0.88 mm. This distance was significantly different from unerupted teeth (P=.002). The mean values for unerupted teeth indicated that the most inferior portion of all teeth measured was below the superior border of the canal (negative values) as follows: mesioangular (-0.97 mm), vertical (-0.61 mm), distoangular (-0.31 mm), and horizontal (-0.24 mm). The position of mesioangular impactions were significantly different than all other impaction groups (P=.0125). The incidence of inferior alveolar nerve paresthesia was 3.33% (18/541), most commonly associated with mesioangular impactions (-0.66 mm) in female patients. CONCLUSIONS: Unerupted mandibular third molar teeth are closer to the inferior alveolar canal than are erupted teeth. Mesioangular mandibular third molar impactions are most closely positioned to the inferior alveolar canal, and this may represent an independent risk factor for postoperative paresthesia.     

Upper lip shortening combined with Lefort 1 maxillary intrusion: a novel approach to correct the long face syndrome

Lip lengthening is a common characteristic of aging caused by the weakening of the fascial attachments and decrease of lip volume. We report a comprehensive combined plastic-orthognathic surgery of a long face syndrome uncharacteristically associated with a long upper lip in a 37-year-old Caucasian woman. The deformity comprised increased lower face height, vertical maxillary excess, and increased gingival display upon smiling. The long lip (30.7 mm; norm, 20.1?+?2 mm) constituted a limitation to the routine maxillary Lefort impaction because of the expected deficient display of maxillary teeth at rest and during smile. Lip shortening (5 mm) through a crescent flap was combined with maxillary impaction (6 mm), mandibular advancement (8 mm), and genioplasty (8 mm). Post-treatment results revealed normal relations between the upper lip and both the lower facial features and the dentition, at rest and during smile. Research should explore the predictability of the observed hard and soft tissue changes in similar dysmorphologies. Level of Evidence: Level V, therapeutic study.     

阻生下颌第三磨牙的正畸疗效观察

目的 探讨通过矫治阻生的下颌第三磨牙,代替因龋坏或矫治需要而拔除的第一或第二磨牙,恢复牙列完整性及咀嚼功能.方法 选择因各种原因拔除了下颌第一或第二磨牙且第三磨牙近中阻生的14例错牙 合畸形患者,应用固定矫治技术进行正畸治疗,对阻生的下颌第三磨牙进行直立并近中移动,关闭拔牙间隙.结果 所有患者均取得良好的矫治效果,阻生的下颌第三磨牙得到直立并近中移动,代替了缺失的磨牙,恢复了牙列的完整连续性,建立了良好的邻接关系及咬牙合关系.结论 阻生下颌第三磨牙通过矫治,可以代替缺失的磨牙,恢复其应有的功能.     

Articular disimpaction in acetabular fractures

Acetabular impaction fractures when not adequately addressed leads to early arthritis. Dome impaction injuries and marginal impaction injuries have to be properly planned pre-operatively with respect to surgical approach, disimpaction techniques and fixation strategies. CT scan is the best modality to analyse the site, extent of impaction and plan strategies to reduce. Emphasis of early mobilisation should not drive the surgeon towards the motive of rigid fixation of columns alone, as the inadequate reduction of acetabular impaction leads to loss of mechanical support on weight bearing and thereby cause loss of reduction. Bone grafting either by auto or allograft or graft substitutes in the void after disimpaction helps in reducing anatomically and provide mechanical support adequately. In cases of severe comminution, reconstruction of the wall defect with autologous graft is a better treatment option. In this article we reviewed the characteristics of impaction injuries of acetabulum exploring surgical procedures, approaches and techniques for achieving open reduction and internal fixation.     

Defining the impaction frequency and threshold force required for femoral impaction grafting in revision hip arthroplasty

Background and purpose The two most common complications of femoral impaction bone grafting are femoral fracture and massive implant subsidence. We investigated fracture forces and implant subsidence rates in embalmed human femurs undergoing impaction grafting. The study consisted of two arms, the first examining the force at which femoral fracture occurs in the embalmed human femur, and the second examining whether significant graft implant/subsidence occurs following impaction at a set force at two different impaction frequencies.

Methods Using a standardized impaction grafting technique with modifications, an initial group of 17 femurs underwent complete destructive impaction testing, allowing sequentially increased, controlled impaction forces to be applied until femoral fracture occurred. A second group of 8 femurs underwent impaction bone grafting at constant force, at an impaction frequency of 1 Hz or 10 Hz. An Exeter stem was cemented into the neomedullary canals. These constructs underwent subsidence testing simulating the first 2 months of postoperative weight bearing.

Results No femurs fractured below an impaction force of 0.5 kN. 15/17 of the femurs fractured at or above 1.6 kN of applied force. In the second group of 8 femurs, all of which underwent femoral impaction grafting at 1.6 kN, there was no correlation between implant subsidence and frequency of impaction. Average subsidence was 3.2 (1–9) mm.

Interpretation It is possible to calculate a force below which no fracture occurs in the embalmed human femur undergoing impaction grafting. Higher impaction frequency at constant force did not reduce rates of implant subsidence in this experiment.