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稀土元素是一组金属元素的简称,包括镧系元素及化学性质与其相近的钪和钇2种元素。稀土元素具有拮抗内毒素、抑制炎症因子分泌、防龋、干预和调控骨的形成与再造、抗凝血、抑癌等生物学作用,已广泛应用于生物医学领域。本文主要对稀土元素在口腔医学领域内的应用研究进展做一综述。     

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目前,普萘洛尔已成为复杂严重婴幼儿血管瘤的一线治疗选择,但其究竟是通过何种机制治疗婴幼儿血管瘤仍然没有一个普遍接受的观点。本文对目前国内外关于普萘洛尔治疗血管瘤的分子生物学机制及其临床研究做一综述,以期为临床使用普萘洛尔治疗婴幼儿血管瘤提供有价值的线索和启示。     

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牙齿酸蚀症是一种常见的口腔疾病,随着人们生活水平的提高,其发病率在逐年增长.牙釉质在酸性环境下会发生羟基磷灰石溶解反应,磷酸钙盐被溶出,并扩散至牙齿表面,这个过程称之为脱矿.釉质脱矿一旦发生,大部分不可逆转,常会影响到牙齿的健康和美观.防治牙齿酸蚀成为近几年国内外学者研究的热点,而氟化亚锡对牙齿的保护作用也受到学者们的重视.本文对氟化亚锡防治牙齿酸蚀的机制,应用的局限性和安全性,以及验证其防酸蚀效应的实验影响因素进行综述.     

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牙源性干细胞具有自我更新、多向分化和免疫调节的潜能。近年来研究表明,牙源性干细胞在组织再生、免疫和炎症相关疾病的治疗方面发挥了重要作用。牙源性干细胞与炎症之间存在着一定的相互作用:一方面,炎症状态下免疫细胞和细胞因子影响牙源性干细胞的增殖分化能力;另一方面,牙源性干细胞能够调节免疫和炎症应答。本文对牙源性干细胞与炎症相互作用的研究进展做一综述。     

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变色牙的美容修复是临床中经常遇到的问题。对变色牙的治疗主要包括漂白、釉质微打磨技术、贴面和全冠修复等方式。牙漂白术作为一种最保守的治疗方法常成为变色牙治疗的首选。有研究表明,高浓度的漂白药物对牙体组织的表面形态、化学组成、微硬度及釉质抗折性等都有影响;漂白药物甚至还可透过牙本质对牙髓造成刺激。本文着重以漂白药物对牙体硬组织的影响做一综述,以探讨漂白药物对牙体结构的影响。     

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吸烟是牙周病的危险因素,可以从多个方面影响牙周病的发生、发展和预后。本文仅从吸烟对牙周菌群、炎症介质、牙周成纤维细胞、牙周感染进程、牙周治疗效果及预后等方面的影响以及被动吸烟与牙周病的关系方面进行综述。     

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??Bone implant repair for missing teeth has become one of the treatments with plenty of evidence to support. The theoretical basis of planting technology is osseointegration??the direct connection of the implant surface with the surrounding living bone. Surface characteristics of the implant material are an important factor which affects osseointegration. In recent years??researchers have modified surface properties of the implant by various methods??such as the change of the surface morphology??structure??chemical properties and/or hydrophilicity??to promote osseointegration speed. For now??promoting osseointegration by increasing the hydrophilic properties of titanium implant surfaces has become one of the main research focuses. This review focuses on improving the surface properties of titanium implants??especially the hydrophilic properties .     

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?? Tissue engineering is a technology that uses the biological materials to repair the damaged tissue??and is widely used in tissue regeneration?? it also provides a new approach to the periodontal ligament regeneration. In this paper?? we highlight recent research and application progress in periodontal ligament regeneration. Scaffolds?? growth factors and seeding cells as tissue engineering techniques are reviewed.     

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Ⅱ类错在上下颌骨位置、形态、大小上有多种表现形式。功能性矫治器治疗Ⅱ类错能取得良好效果,但部分病例治疗后有复发。因此,探究其复发原因与不同表现形式的Ⅱ类错的关系,从而更进一步理解功能性矫治器的适应证范围,对临床有重要意义。本文对Ⅱ类错的颌骨特征、Ⅱ类错与颞下颌关节的关系及功能性矫治器的针对性治疗方面内容做一综述,为临床提供参考。     

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牙菌斑是一种细菌性生物膜。菌斑控制是个人口腔卫生保健及龋病、牙周病防治的必要措施。菌斑控制的方法很多,其中有机械性措施和化学方法,然而每种方法又有其各自的局限性。近年来,光动力疗法在口腔抗菌方面的研究取得了一定进展,声动力疗法继光动力疗法在微生物领域的研究将具有重要的临床应用价值。本文就菌斑控制的方法做一综述。     

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颞下颌关节紊乱病(TMD)病因复杂,目前尚不很清楚。最初提出、且目前仍认为比较正确的是因素学说。20世纪60年代初提出精神心理因素学说,被很多学者认可,但却无法被完全认同。后来又提出创伤因素学说、自身免疫因素学说、解剖因素学说等,这些学说都有不足之处。现在一般认为是多种因素引起TMD。     

Prevalence of temporomandibular disorders (TMD) among Finnish prisoners: cross-sectional clinical study

Objective: The aim of the present study was to evaluate the prevalence of self-reported temporomandibular disorders (TMD) symptoms and clinically diagnosed TMD among Finnish prisoners.

Material and methods: Altogether 100 prisoners from the Pelso Prison, Vaala, Finland, underwent dental and TMD clinical examinations performed by a calibrated and well-trained dentist. Symptom Questionnaire and clinical examination according to a Finnish pre-final version of the DC/TMD (Diagnostic Criteria for Temporomandibular Disorders) Axis I protocol were used to evaluate the prevalence of TMD sub-diagnoses.

Results: The most common TMD symptoms were facial pain (54.0%), temporomandibular joint noises (43.0%) and headache (37.0%). The prevalence of joint-related TMD diagnoses was four and a half times higher than diagnoses attributed with pain (76.0% vs. 17.0%). The most common TMD diagnoses were degenerative joint disease (33.0%) and disc displacement with reduction (33.0%).

Conclusions: The prevalence of self-reported TMD symptoms and clinical assessed TMD, especially join-related TMD diagnoses, is high among Finnish prisoners. Examination and treatment of TMD should become a common practice also in prison dental care.     

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提要：颞下颌关节紊乱病（TMD）是口腔临床常见病之一,其治疗方法众多。咬合板作为一种保守、可逆的治疗方法被广泛应用在TMD的治疗上。然而,各类咬合板治疗TMD的疗效尚不完全明确,本文结合近年来国内外文献对其进行综述。     

Association of tightly locked occlusion with temporomandibular disorders

The association between teeth loss and temporomandibular disorders (TMD) is still inconclusive. A kind of secondary changes of the occlusion after teeth lose called the tightly locked occlusion (TLO), defined as the occluding contact that delivers angled occlusal force on the drifted neighbour and/or the tipped antagonists of the lost posterior teeth, was hypothesized to be association with TMD. The study aimed at investigating the association between the TLO and TMD. A total of 113 posterior-teeth losing patients, 64 with TMD symptoms (group of TMD) and 49 without (group of TMD-Free) were included. Study casts and joint radiographs were made to diagnose the TLO and joint morphological changes. The simultaneous contribution of the potential variables of gender, age, tooth losing number, the TLO, joint symmetry and signs of osteoarthrosis shown on radiographs were tested through binary logistic regression analysis. In women, the TLO entered into logistic model, and had an effect on the incidence of TMD (P = 0.008). The odds ratio of with-TLO versus without-TLO is 2.6 (95% CI: 1.2, 5.8) after controlling for the effect of gender. Age, tooth lose number, joint asymmetry or osseous changes had no effect on the incidence of TMD. The tightly locked occlusion is associated with some signs and symptoms of TMD. Randomized controlled trials will be needed in further studies to test the hypothesis that treatment of a TLO, as defined in the present study, will have a beneficial effect on the signs and symptoms of TMD.     

利用咬合力计指导调治疗颞下颌关节紊乱病

目的：用咬合力计指导调[牙合]并评价调[牙合]对治疗TMD的疗效。方法：随机选取10例因TMD来我院就诊的患者,取观测模型,分析其咬合,并进行调[牙合]。根据调[牙合]治疗前后其临床症状改善情况,进行疗效分析。结果：3个月后多数患者的颌面部肌肉酸痛、无力、关节弹响、开口型异常等症状缓解或消失。结论：（1）调[牙合]是治疗TMD的一种有效的治疗方法。（2）咬合力计能够客观、真实、准确地反应出咬合接触点的详细情况。     

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随着锥形束CT在口腔颌面部应用的开展,锥形束CT也逐渐应用于颞下颌关节疾病的影像诊断中。本文介绍锥形束CT在颞下颌关节疾病中的应用现状,包括颞下颌关节紊乱病、颞下颌关节发育畸形、关节创伤、关节强直以及关节肿瘤等,结果表明锥形束CT作为一种有价值、有前途的影像检查方法,可以用于颞下颌关节疾病特别是关节骨性改变的评估中。     

The role of orthodontics in temporomandibular disorders

Summary Temporomandibular Disorder (TMD) is the main cause of pain of non‐dental origin in the oro‐facial region including head, face and related structures. The aetiology and the pathophysiology of TMD is poorly understood. It is generally accepted that the aetiology is multifactorial, involving a large number of direct and indirect causal factors. Among such factors, occlusion is frequently cited as one of the major aetiological factors causing TMD. It is well known from epidemiologic studies that TMD‐related signs and symptoms, particularly temporomandibular joint (TMJ) sounds, are frequently found in children and adolescents and show increased prevalence among subjects between 15 and 45 years old. Aesthetic awareness, the development of new aesthetic orthodontic techniques and the possibility of improving prosthetic rehabilitation has increased the number of adults seeking orthodontic treatment. The shift in patient age also has increased the likelihood of patients presenting with signs and symptoms of TMD. Because orthodontic treatment lasts around 2 years, orthodontic patients may complain about TMD during or after treatment and orthodontists may be blamed for causing TMD by unsatisfied patients. This hypothesis of causality has led to legal problems for dentists and orthodontists. For these reasons, the interest in the relationship between occlusal factors, orthodontic treatment and TMD has grown and many studies have been conducted. Indeed, claims that orthodontic treatment may cause or cure TMD should be supported by good evidence. Hence, the aim of this article is to critically review evidence for a possible association between malocclusion, orthodontic treatment and TMD.     

1835名军事飞行人员颞下颌关节紊乱病的流行病学调查

目的：研究颞下颌关节紊乱病在我军飞行人员中的患病情况,探讨我军飞行人员颞下颌关节紊乱病的发病因素.方法：对1835名飞行人员进行口腔检查和颞下颌关节检查,筛选出颞下颌关节紊乱病患者,评估飞行人员颞下颌关节紊乱病与年龄、飞行时间、机种、咬合关系、不良习惯之间的关系.结果：歼击机飞行人员颞下颌关节紊乱病发病率最高（33.43％）,运输机飞行人员发病率最低（23.45％）,P＜0.05;颞下颌关节紊乱病发病率与飞行人员年龄、飞行时间无显著关系;心理因素、睡眠质量、夜磨牙、偏侧咀嚼习惯、第三磨牙伸长与飞行人员颞下颌关节紊乱病发病高度相关.错骀畸形是飞行人员TMD的重要发病因素,其中锁滁、开赡患者TMD发病率较高,其次是深覆盖、深覆骀及反骀患者.结论：飞行人员颞下颌关节紊乱病发病的重要因素是心理素质差、睡眠障碍、夜磨牙、偏侧咀嚼习惯及错（牙合）畸形.     

Prevalence among adolescents in Bergen,Western Norway,of temporomandibular disorders according to the DC/TMD criteria and examination protocol

Objective: The aims of this study were to assess the prevalence of temporomandibular disorders (TMD) among adolescents and to contrast the prevalence of TMD according to the DC/TMD clinical examination protocol versus the prevalence of pain related to TMD according to two screening questions.

Material and methods: Two hundred and ten adolescents living in the county of Bergen, Norway, were offered an additional examination for TMD in connection with their regular dental check-up appointment. Five dental clinics were selected with differing socio-economic patient populations, as reflected by stratification of average levels of DMFT, and an equal number of girls and boys were invited to participate. The participants answered two screening questions for pain related to TMD followed by a clinical examination according to the DC/TMD protocol by five calibrated examiners.

Results: Acceptable calibration results were obtained. Approximately 80% of eligible participants consented to partake. According to the criteria of DC/TMD, the prevalence of TMD among the study participants was 11.9%, with a peak at 16 years of age. According to the self-reported screening questions for pain related to TMD, 7.2% responded positively. Only seven participants with a TMD diagnosis established according to the DC/TMD clinical examination protocol reported also pain related to TMD based on answering the two screening questions.

Conclusion: The prevalence of TMD is higher for girls than for boys and the prevalence of TMD established according to the DC/TMD criteria was higher than the prevalence of pain related to TMD estimated by use of two screening questions for self-reported pain.