当代口腔种植修复技术新进展

口腔种植修复技术的发展与成熟极大地改变了口腔医学面貌,已成为当今修复牙齿缺失最常规、最有效的临床方法之一。该文旨在相关种植外科技术、种植修复技术、种植体材料、数字化口腔种植四个方面的新进展与新问题进行讨论。     

舍格伦综合征动物模型的研究进展

<正>舍格伦综合征(Sjgren Syndrome,SS)是一种自身免疫性疾病[1],在人群中的发病率大约是0.1%⁰.6%,多见于中年女性,女性与男性的发病比例大约是9∶1,这提示性激素可能与疾病的发病有关[2]。该疾病表现为外分泌腺的进行性破坏,从而引起眼干、口干[3]、唾液腺及泪腺肿大、类风湿性关节炎等结缔组织疾病。该疾病也可以累及其他器官,如胸腺、肺、肝脏、肾脏等器官的损伤[4],并且伴随着许多     

影响口腔种植及修复成功的因素分析

种植修复已被越来越多的人接受,种植体直径和长度、种植体的植入位置、种植体的受力分析和角度基台的设计、种植体龈缘美学效应的设计以及修复体的牙尖斜度等是影响种植与修复成功的重要因素.本文就影响种植及修复成功的因素作一综述.     

外胚层发育不全综合征患者的口腔种植修复策略

外胚层发育不全综合征（ectodermal dysplasia,ED）是一类由胚胎外胚层发育而来的组织和结构发生的一种遗传性系统性疾病的统称,口腔疾病主要表现为牙齿发育不全或者是先天性牙齿缺失、牙齿形态异常、颌面部发育畸形等。近年来,由于能提供更好的稳定性和舒适度,口腔种植修复逐渐成为ED患者的理想选择。但患者年龄小、骨量缺失和骨性Ⅲ类错牙合畸形给种植修复带来很大的困难。文章就ED患者种植修复的难点做一综述,旨在为临床中的决策做参考。     

口腔种植修复中附着龈重建的回顾性分析

目的: 分析附着龈重建应用于口腔种植修复中的临床效果。方法: 选取2011年3月~2015年3月在我院接受口腔种植修复的患者70例,随机分为观察组和对照组,各35例,对照组患者接受常规的牙龈缝合修复,观察组患者则采用附着龈重建处理,分析比较两组患者修复治疗后附着龈宽度的改善情况。结果: 治疗后,观察组患者附着龈宽度的恢复情况、炎症发生情况、出血指数等方面均显著优于对照组(P<0.05)。结论: 附着龈重建方式在口腔种植修复中具有良好的临床效果,有利于患者附着龈宽度的恢复,值得在临床上推广和应用。     

miR-146a在相关自身免疫性疾病中的研究进展

<正>自身免疫性疾病是一类发病原因复杂,临床表现多样,严重危害人类健康的疾病,包括类风湿性关节炎[1-2]、系统性红斑狼疮[3]、舍格伦综合征[4-6]以及多发性硬化症[7]等。近年来,microRNA(miRNA)在调节免疫系统方面的作用逐渐受到研究人员重视。2007年Dai等[8]首次发现自身免疫性疾病红斑狼疮     

五年制口腔医学生口腔种植修复临床前教学实践探索

经历了几十年的快速发展,口腔种植修复技术已然成熟,口腔种植的概念也已深入人心,尤其在大、中城市。然而,经过专门培训的口腔种植专业医生数量有限,口腔医学本科专业的医学生应该掌握这门技术,为今后快速步入口腔种植修复领域提供保障。本文针对五年制口腔医学专业口腔种植学科人才培养现状,对口腔种植修复临床前教学改革进行思考,使口腔医学专业毕业生在未来口腔种植修复领域有所建树。     

附着龈重建在口腔种植修复中的临床分析

目的:探讨并分析附着龈重建在口腔种植修复中临床应用价值。方法:研究对象为2017年10月-2019年10月在我院就诊的72例口腔种植修复患者作为本实验的研究对象,按着随机的原则将72例口腔种植修复患者分为两组(即对照组以及实验组),每组总共有36例患者,其中对照组采用常规牙龈缝合;实验组采用附着龈重建,之后对两组患者的临床疗效进行对比分析。结果:实验组患者临床治疗总有效率(97.12%)明显优于对照组患者(52.78%);两组患者在术前,其平均宽度经统计学分析,未见统计学意义(P>0.05),实验组术后1、6个月平均宽度与对照相比,经统计学分析,其差异具有统计学意义(P<0.05);实验组患者BI(0.71±0.54)、PLI(0.61±0.10)、PD(1.69±0.38)明显优于对照组患者BI(0.86±0.48)、PLI(0.78±0.22)、PD(2.91±0.44);实验组患者生理功能以及心理功能评分明显优于对照组评分。结论:AG重建应用于口腔种植修复中,可明显提高临床修复疗效,改善患者的生活质量,具有较高的临床应用价值,值得临床推广及应用。     

无牙颌患者种植修复的研究进展

<正>伴随社会老龄化的日益加重,全口无牙颌患者越来越普遍。范卫华等[1]采用多阶段分层等容量随机抽样的方法,抽取广东省城乡35⁴4岁、6544岁、65⁷4岁常住人口各720人,男女各半,按照《第三次全国口腔健康流行病学调查方案》检查余留牙和无牙颌,结果显示3574岁常住人口各720人,男女各半,按照《第三次全国口腔健康流行病学调查方案》检查余留牙和无牙颌,结果显示35⁴4岁组人均有29.41颗牙,无单颌牙     

口腔种植患者的口腔护理行为调查分析

目的：了解口腔种植患者的口腔护理行为,为口腔种植患者的口腔护理健康教育提供依据。方法：对在福建省级机关医院口腔科完成口腔种植义齿修复半年以上的患者进行问卷调查。结果：3.2%患者每天刷牙3次;34.8%患者刷牙时间大于3分钟;50.2%左右患者经常使用牙线和牙缝刷;30.3%患者经常使用冲牙器;仅6.7%患者做到戒烟;49.4%患者不按医嘱定期复查;65.2%患者未能进行牙周洁治。结论：口腔种植患者在口腔专业维护方面存在偏差,应加强健康教育,同时应特别注意文化程度较低的人群。     

Hypersensitivity reactions to dental materials in patients with lichenoid oral mucosal lesions and in patients with burning mouth syndrome

Abstract— Epicutaneous patch testing of a battery of 35 dental test substances was carried out in 24 patients with visible lichenoid oral mucosal lesions and in 24 patients with burning mouth syndrome (BMS) without any visible lesions. Reactions to mercury ammonium chloride were found in 33% (8/24) of the patients with visible lesions compared to 0% (0/24) of the patients with BMS. The difference was statistically significant. In 7 of the 8 patients who reacted to mercury, total or partial regression of the lesions was observed after removal of dental amalgam. Reactions to nickel sulfate were found in 21% (5/24) of the patients with BMS compared to 3% (1/24) of the patients with lichenoid lesions. This difference was also statistically significant. Nickel is a rare component in dental restorations, but the oral mucosa is daily exposed to nickel through food and water intake. Removal of nickel from the environment of the patient can therefore be hard to accomplish.     

慢病管理在口腔常见疾病中的应用

随着生活质量的提高,口腔疾病正逐渐受到大家的重视,近年来关于慢性口腔疾病的相关性研究越来越多。慢病管理分为生物医学管理方法、认知行为干预及心理干预手法,其已作为一种科学的管理模式,广泛应用于高血压、糖尿病、肾脏疾病和其他慢性疾病的管理中。现已有研究应用认知行为干预及心理干预等方法对牙周病、龋齿、扁平苔藓等慢性口腔疾病患者的心理及行为进行管理干预,改善了患者的口腔健康情况,提高了患者的生活质量。该文就近年来慢病管理在口腔疾病中的应用现状做一简要综述。     

Off‐label use of biologicals in the management of inflammatory oral mucosal disease

The recent development of novel biologic immunomodulators effective in the treatment of immune‐mediated inflammatory conditions has led to their widespread use in rheumatology and dermatology. These include the tumour necrosis factor‐α antagonists, infliximab, etanercept and adalimumab and the T‐cell modulator modifiers efalizumab and alefacept. In dermatology, although these agents are licensed only for psoriasis, increasingly off‐label use has extended to a number of conditions in which oral mucosal disease is a significant component. These include Behçet’s disease, recurrent apthous stomatitis, benign mucous membrane pemphigoid and lichen planus. This article provides a review of the current literature on such off‐label use in oral mucosal disease.     

Short dental implants in patients with oral lichen planus: a long-term follow-up

Oral lichen planus is associated with the Koebner phenomenon, and trauma may exacerbate oral lesions. Short dental implants, as alternatives to bony augmentation, would reduce the number of interventions and their morbidity. However, we know of no studies that have analysed the long-term outcomes of short implants in patients with oral lichen planus. We have therefore designed a retrospective study of such patients treated with short implants (≤ 8.5 mm long), with survival of implants as the main outcome. The secondary outcomes were marginal bone loss and the development of complications. We calculated the implants’ survival and compared the outcomes statistically between erosive and reticular oral lichen planus. Sixty-six short implants were placed in 23 patients with a mean (SD) age of 58 (7)?years. The mean (SD) peri-implant bone loss was 0.96 (0.89)?mm mesially and 0.99 (1.1)?mm distally. Sixty-five of the 66 implants survived with a mean (SD) follow-up of 68 (32) months, and there were no significant differences between erosive and reticular disease. Stable long-term outcomes can be expected for short implants placed in patients with oral lichen planus, and graftless rehabilitation of missing teeth could be possible in these patients if short implants were used.     

辅助性T细胞17与白细胞介素17在口腔黏膜疾病中的研究进展

辅助性T细胞17(T helper cells 17,Th17)细胞是一种新的CD4+T辅助细胞,其通过分泌特有的白细胞介素17(interleukin 17,IL-17)参与机体免疫及炎性反应.在口腔黏膜疾病中,口腔扁平苔藓(oral lichen pla-nus,OLP)、复发性阿弗他溃疡(recurrent ap...     

Regression of oral lichenoid lesions after replacement of dental restorations

The aim of the study was to determine the prognosis and to evaluate the regression of lichenoid contact reactions (LCR) and oral lichen planus (OLP) after replacement of dental restorative materials suspected as causing the lesions. Forty‐four referred patients with oral lesions participated in a follow‐up study that was initiated an average of 6 years after the first examination at the Department of Odontology, i.e. the baseline examination. The patients underwent odontological clinical examination and answered a questionnaire with questions regarding dental health, medical and psychological health, and treatments undertaken from baseline to follow‐up. After exchange of dental materials, regression of oral lesions was significantly higher among patients with LCR than with OLP. As no cases with OLP regressed after an exchange of materials, a proper diagnosis has to be made to avoid unnecessary exchanges of intact restorations on patients with OLP.     

口腔扁平苔藓相关microRNAs的研究进展

口腔扁平苔藓(oral lichen planus,OLP)是一种常见的病因不明的慢性炎症性疾病,细胞介导的局部免疫应答紊乱在其中发挥着重要作用。目前发现microRNAs(miRNAs)在炎性反应、自身免疫性疾病的发生发展中起到重要作用,已有大量研究报道显示miRNAs可能与OLP相关。文献复习结果表明,miRNA?19a高表达和miRNA?122、miRNA?199、miRNA?138、miRNA?635、miRNA?578低表达可能通过调控白介素、干扰素、肿瘤坏死因子等细胞因子而与OLP的发生相关;miRNA?125a低表达和miRNA?132、miRNA?146a、miRNA?155高表达可能通过影响CD4^+T细胞在Th1/Th2亚群上的分化过程而与OLP的严重程度相关;miRNA?26a、miRNA?29a、miRNA?31高表达和miRNA?27b、miRNA?200a、miRNA?137低表达可能通过具有功能关系的相关基因组、转录因子和miRNA协同调控网络等与OLP癌变风险相关。目前研究仍存在不足之处,许多利用基因芯片筛选差异表达miRNA的研究并没有根据OLP类型或癌变风险进一步的分组探究。     

牙周病患者种植治疗的相关风险因素

牙周病是导致牙齿缺失的主要疾病之一。随着口腔种植技术的发展,越来越多的牙周病患者选择种植治疗修复缺失牙。牙周病与种植牙在诸多方面存在关联,且牙周病患者发生种植牙失败的风险较高,在对牙周病患者进行种植治疗之前,应对口腔局部条件、全身状况、生活习惯等进行评估,以利于种植方案的选择和风险规避。本文就牙周病患者种植治疗相关风险因素的研究进展作一综述。     

慢性肾脏病患者的口腔种植治疗

慢性肾脏病是威胁人类健康的全球公共卫生问题,影响全身多器官系统功能.随着疾病的进展,患者的口腔健康常受影响.种植牙已成为牙缺失的最佳修复方式,为慢性肾病患者提供安全可靠的牙种植治疗,是需要,也是挑战.口腔种植医师应从全局出发,综合评估患者的健康情况,充分了解患者既往及当前接受的治疗与药物使用情况;完善患者术前血液生化、...     

Dental implants in patients with oral mucosal diseases – a systematic review

To reveal dental implants survival rates in patients with oral mucosal diseases: oral lichen planus (OLP), Sjögren's syndrome (SjS), epidermolysis bullosa (EB) and systemic sclerosis (SSc). A systematic literature search using PubMed/Medline and Embase databases, utilising MeSH and search term combinations identified publications on clinical use implant‐prosthetic rehabilitation in patients with OLP, SjS, EB, SSc reporting on study design, number, gender and age of patients, follow‐up period exceeding 12 months, implant survival rate, published in English between 1980 and May 2015. After a mean observation period (mOP) of 53·9 months (standard deviation [SD] ±18·3), 191 implants in 57 patients with OLP showed a survival rate (SR) of 95·3% (SD ±21·2). For 17 patients with SjS (121 implants, mOP 48·6 ± 28·7 months), 28 patients with EB (165 implants, mOP 38·3 ± 16·9 months) and five patients with SSc (38 implants, mOP 38·3 ± 16·9 months), the respective SR was 91·7 ± 5·97% (SjS), 98·5 ± 2·7% (EB) and 97·4 ± 4·8% (SSc). Heterogeneity of data structure and quality of reporting outcomes did not allow for further comparative data analysis. For implant‐prosthetic rehabilitation of patients suffering from OLP, SjS, EB and SSc, no evidence‐based treatment guidelines are presently available. However, no strict contraindication for the placement of implants seems to be justified in patients with OLP, SjS, EB nor SSc. Implant survival rates are comparable to those of patients without oral mucosal diseases. Treatment guidelines as for dental implantation in patients with healthy oral mucosa should be followed.