病人?患者?病员?

作为一名口腔科医生,天天都离不开口腔科病人,但对"病人"这一名词,常用的称呼或写作有:"病人"、"患者"、"病员"等,有时也见到在一篇文章中,这几个名词都出现,比较紊乱.     

Platelet preparations in dentistry: How? Why? Where? When?

The aim of this article is to review the outcomes of platelet preparations in dentistry. A structured electronic search discovered 348 articles, which described the use of autologous platelet concentrates with a relevance to clinical dentistry. Among these articles, 220 articles investigated platelet rich plasma, 99 investigated platelet rich fibrin, 22 investigated plasma rich in growth factors and 7 investigated the use of concentrated growth factors. Several studies reported beneficial treament outcomes in terms of enhanced bone and soft tissue regeneration.     

Human histological research: is it necessary? Humane? Ethical?

A review of the dental literature in the United States over the past 60 years is replete with studies utilizing human histological evidence for research. The first reference found for the use of human tissue for histological study was published in 1941 in the Journal of Dental Research.(1) Much of this literature focuses on the use of block sections, in which teeth scheduled for extraction are removed along with portions of the surrounding soft tissue and bone in order to study the effects of various interventions. The tissue removed in no way facilitates the surgical extraction of the tooth. It is removed to establish the type of healing, repair, or regeneration by histological evidence. There is no compensating benefit to the patient who, in fact, is put at risk--the removal of the extra tissue may compromise the fit of a subsequent prosthetic restoration.     

Defensive behavior? Also in dentistry?

The objective of this pilot-study was to investigate if defensive behaviour of dental practitioners occurs just as in the general practice of family physicians. On the basis of a survey, developed in the Department of General Practice of the University of Amsterdam, 38 dentists (mainly general-practitioners with an average of 20.9 years in practice), were interviewed. The dentists mention defensive practices, but the reasons are unrelated to fear of law-suits. They recommend unnecessary treatments, based on the wishes of their patients. The financial situation of the patient and defensive behaviour are closely related. The respondents avoid to give treatments because of dentally unmotivated patients or deviant behaviour of their visitors. Unnecessary referrals to specialists are also cited. Defensive behaviour was found to play a role in 3.5% of all patient encounters.     

Excess?ve fluor?de ?ntake alters the MMP-2, TIMP-1 and TGF-β levels of per?odontal soft t?ssues: an exper?mental study ?n rabb?ts

Objectives

This study evaluated the influence of fluoride on periodontal soft tissues by investigating any alterations in their MMP-2, TIMP-1 and TGF-β profiles secondary to excessive fluoride intake.

Material and methods

Fluorosis was induced in 18 rabbits (test group) through consumption of fluoride added to drinking water, whereas 10 rabbits consumed regular tap water as daily supply (control group). Following fluorosis verification, animals were sacrificed and their 1st mandibular molar teeth were utilized in the assessments. MMP-2, TIMP-1 and TGF-β were separately investigated for gingival epithelium (GE), gingival connective tissue (GC) and periodontal ligament (PL) to evaluate periodontal soft tissues. Histological sections were prepared from the groups, the parameters were determined by immunohistochemistry, and their levels were calculated by quantification of the immunostainings.

Results

Staining intensity of MMP-2 in GC and PL (p?<?0.01); TIMP-1 and TGF-β of GE, GC and PL (p?<?0.01) were higher in the test group compared to those of the control group. Intra-group staining of TIMP-1 was higher than MMP-2 in all test group compartments (p?<?0.01) and in the control group GE (p?<?0.01). TIMP-1 was also higher than TGF-β in the GE and PL of the test group (p?<?0.05) and in the GE of the control group (p?<?0.01).

Conclusion

These results suggest that excessive fluoride intake may affect periodontal soft tissues by increasing MMP-2, TIMP-1 and TGF-β, and thereby altering the MMP-2/TIMP-1 and TIMP-1/TGF-β ratios.

Clinical relevance

Excessive fluoride consumption may alter the periodontal tissue homeostasis which may be detrimental in the maintenance of periodontal health.     

Fractures of mandible: is spontaneous healing possible? Why? When?

Closed and open reduction of fractures of the mandible constitutes an endless debate, and it is interesting that modern times have not brought a conclusion to this controversy. From 1995 to 1997 in the Plastic Surgery Department of Argerich Hospital in Buenos Aires, Argentina, 23 patients were evaluated with different fractures of the mandible in which neither closed nor open reduction was performed. Seventeen patients (74%) presented associated fractures in different areas of the mandible and 6 (26%) only had one fracture; 2 of them (9%) were edentulous. Three (13%) of the 23 patients had more than two fractures in different areas. Condylar fractures were the only lesion in 8 patients (35%), and they were associated with body fractures in another 6 patients (26%). Spontaneous healing of the fractures occurred in all 23 patients. No complications were found in any of them. All fractures presented the following characteristics: 1) Fractured fragments were aligned without displacement (or light displacement), 2) Occlusion was normal (or pretraumatic occlusion), 3) Facial symmetry was maintained, 4) Radiography demonstrated fractures without displacement, 5) Minor edema and hematoma were present in the area of the fracture, and 6) There was only pain during masticatory movements. The treatment was as follows: 1) Soft food and liquid diet (solid food was avoided 30 days after trauma), 2) Opening of the mouth was not permitted, 3) Oral antibacterial cleaning, and 4) Analgesic therapy. Spontaneous healing was produced by secondary bone repair mechanism as a "natural" process.     

TGF-?TGF-?TGF-?蛋白在人牙胚表达的免疫组化研究

目的：探讨TGF-β1、TGF-β2、TGF-β3在人牙齿发育过程中的作用。方法：采用SP免疫组化方法,检测正常引产的胎龄为4～7个月的胎儿颌骨组织切片中TGF-β1、TGF-β2、TGF-β3在牙胚中的分布。结果：TGF-β1、TGF-β3主要在成釉细胞及成牙本质细胞表达,TGF-β2主要在内釉细胞及成釉细胞表达;TGF-β1、TGF-β2、TGF-β3在釉结均呈阳性表达。结论：TGF-β1、TGF-β2、TGF-β3是人牙齿发育过程中重要的调节因子,参与牙胚细胞分化、基质形成及牙齿形态形成。     

Why fluoride?

Fluoride has been used in dentistry for over 100 years for the purpose of preventing dental caries. During this time there has been great debate over the mode of action, the optimum method of delivery, and the potential risks associated with its use. This, the first of three papers, will provide a summary of the history of the use of fluoride, the mode of action, benefits and different methods of delivery. It will also discuss the potential risk of dental fluorosis. CLINICAL RELEVANCE: This article aims to provide a background for general practitioners for the appropriate use of fluorides in dentistry, enable them to understand the wider significance of fluoride in dentistry and to be able to answer non-clinical questions raised by patients.