颞颌关节功能紊乱的牙合垫式义齿治疗

目的 观察(牙合)垫式义齿在老年牙列缺损伴(牙合)磨耗引起TMD的修复效果。方法 87例TMD病例,男54例,女33例,年龄58～75岁。面下1/3变短,深覆(牙合)且伴有TMD症状,经升高咬合后采用(牙合)垫式义齿修复,并对治疗前后关节间隙变化进行统计学分析。结果 用(牙合)垫式义齿修复能使TMJ,(牙合),肌肉协调一致,治疗TMD效果好。结论 部分牙列缺损伴有重度(牙合)磨耗的TMD患者,(牙合)垫式义齿修复是一种有效的治疗方法。     

牙列重度磨耗老年患者咬合重建的疗效观察

目的评价对牙列重度磨耗导致咬合垂直距离降低的老年患者进行咬合重建的疗效。方法老年牙列重度磨耗患者65例按有无牙列缺损和颞下颌关节紊乱（tempommandihulardisorders,TMD）分为3组。A组42例,牙列重度磨耗伴牙列缺损,不伴TMD。B组15例,牙列重度磨耗伴牙列缺损,且有功能性TMD。C组8例,牙列重度磨耗伴有功能性TMD,但无牙列缺损。A组和B组采用胎垫式可摘义齿,C组采用可摘式验垫重建咬合。65例患者随访45d～9年,根据咀嚼功能和颞下颌关节（temporomandibularjoint,TMJ）功能进行疗效评价。结果咀嚼功能方面,A组42例中40例达到优良,B组15例中14例达到优良,C组8例中7例达到优良。TMJ功能方面,A组仍无TMD病例,B组15例中14例TMJ功能恢复正常,C组8例中7例TMJ功能恢复正常。结论老年患者由于牙列重度磨耗导致的咬合垂直距离降低,有必要进行咬合重建修复,在正中耠位行验重建修复效果满意,可为其后固定修复提供参考。     

老年患者牙列缺损伴重度磨耗的可摘局部义齿修复的临床分析

目的:探讨老年患者牙列缺损伴重度磨耗用不同治疗方法后的临床疗效。方法:将牙列缺损伴重度磨耗的老年患者36人随机等量分为2组,分别采用牙合垫式可摘局部义齿修复(A组)、普通可摘局部义齿修复(B组),观察2年后的疗效。结果:A组满意率为88.9%,B组满意率为55.6%。2组满意率比较有统计学意义(χ2=4.985,P=0.026),A组与B间的疗效存在显著性差异(P<0.05)。结论:使用牙合垫式可摘局部义齿修复老年患者牙列缺损伴重度磨耗,能获较佳疗效。     

牙列缺损伴重度(牙合)面磨损(牙合)重建修复的临床研究

目的 通过对不同类型牙列缺损并伴重度(牙合)面磨损的患者进行修复治疗,探讨(牙合)重建的有关问题.方法 选取牙列缺损并伴重度(牙合)面磨损患者69例,制取修复前研究模型,根据不同的缺损类型进行(牙合)垫式可摘局部义齿、固定义齿或固定-可摘义齿联合修复,随访3个月～4年,观察修复治疗效果.结果 患者的咀嚼功能明显改善,有颞下颌关节症状者,症状得到了缓解,无颞下颌关节症状者在咬合升高后未出现新的颞下颌关节症状.结论 对于牙列缺损伴重度(牙合)面磨损患者,(牙合)垫式可摘义齿及固定义齿修复均是(牙合)重建修复的有效方法.     

颞颌关节功能紊乱的He垫式义齿治疗

目的：观察He垫式义齿在老年牙列缺损伴He磨耗引起TMD的修复效果。方法：87例TMD病例，男54例，女33例，年龄58—75岁。面下1／3变短，深覆He且伴有TMD症状，经升高咬合后采用He垫式义齿修复，并对治疗前后关节间隙变化进行统计学分析。结果：用He垫式义齿修复能使MJ，He，肌肉协调一致，治疗TMD效果好。结论：部分牙列缺损伴有重度He磨耗的TMD患者，He垫式义齿修复是一种有效的治疗方法。     

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目的 评价SD球帽式附着体义齿在伴重度磨耗的肯氏Ⅰ类牙列缺损修复中的临床效果。方法 对2005年5月至2007年2月山西省人民医院就诊的16例下颌双侧末端游离牙列缺损患者采用SD球帽式附着体义齿修复，对重度磨耗的余牙行金属烤瓷全冠修复，重建患者丧失的咬合功能，此前患者均经牙合垫式可摘义齿修复并获得最佳咬合高度。采用过筛法进行咀嚼效率检测，比较二者的临床效果和咀嚼效率。结果 经过6个月观察，16例患者均认为附着体义齿美观、稳固性好，对修复效果满意，基牙未发现龋坏及松动，无颞下颌关节明显不适。统计学分析显示，各观察期球帽式附着体咀嚼效率高于传统的牙合垫式可摘义齿（P < 0.05）。结论 SD球帽式附着体用于伴磨耗的肯氏Ⅰ类牙列缺损的修复效果理想。     

牙列重度磨耗伴缺损老年患者两种咬合重建治疗的效果比较

目的:观察牙列重度磨耗伴缺损的老年患者分别采用垫式可摘局部义齿与固定义齿进行咬合重建治疗的效果,并进行对比研究。方法:24例牙列重度磨耗伴缺损的老年男性患者,分别采用垫式可摘局部义齿与固定义齿进行咬合重建治疗,其中垫式可摘局部义齿咬合重建组15例,固定义齿咬合重建组9例,并分别对患者治疗前后的自我感觉(美观、舒适)、临床表现、咀嚼效率、颞下颌关节紊乱病临床症状的变化等指标进行评估及分析。结果:垫式可摘局部义齿与固定义齿咬合重建治疗后,患者均主观感觉良好、临床症状改善、咀嚼效率增加,差异显著(P<0.01)。固定义齿咬合重建组患者较垫式可摘局部义齿咬合重建组患者主观感觉更好,咀嚼效率增加更多(P<0.05)。有颞下颌关节病症状的患者咬合重建后症状均有改善,两种咬合重建方法间未见明显差异。结论:垫式可摘局部义齿与固定义齿咬合重建治疗均能一定程度恢复牙列重度磨耗伴缺损老年患者的口颌功能,改善颞下颌关节病症状。采用固定义齿进行咬合重建治疗更具有美观、舒适、提高咀嚼效率的作用。     

牙列重度磨耗伴缺损的可摘局部义齿重建修复

目的：探讨应用可摘局部义齿一次性咬合重建修复牙列重度磨耗伴缺损的可行性.方法：对17例牙列重度磨耗伴缺损的患者采用（耠）垫式可摘局部义齿行一次性咬合重建,治疗后1个月、3个月和6个月复诊,调查患者主观感觉、咀嚼效果、义齿稳定性;以及是否有颞颌关节不适.结果：患者咬合升高1.5mm-2.5mm.随访6个月,患者无不适,咀嚼功能改善明显,对义齿的美观和功能都满意.结论：对于牙列重度磨耗伴缺损的病例可以尝试应用可摘局部义齿进行一次性咬合重建修复.     

垫式可摘局部义齿修复TMD患者牙列缺损的探讨

目的:观察牙列缺损伴有颞下颌关节症状的老年患者采用垫式可摘局部义齿修复的临床效果。方法:对79例牙列缺损、余留牙重度磨耗、低位咬合同时伴有颞下颌关节症状的老年患者,采用垫式可摘局部义齿修复,并作半年、1 年、3年追踪复查。检查项目为咀嚼功能与颞下颌关节改善情况。结果:有效率分别为98.73%、100%、93.67%,修复效果令人满意。结论:采用垫式可摘局部义齿在恢复缺失牙功能的同时,能有效缓解颞下颌关节症状,改善面容,提高咀嚼功能,固定松动牙,防止食物嵌塞。     

垫式可摘局部义齿的临床疗效观察

目的:观察垫式可摘局部义齿对牙齿重度磨耗伴缺牙的患者的修复效果。方法:对25例缺牙伴重度深覆患者进行取模型、用蜡堤确定颌位关系并升高咬合1mm-2mm,在上颌制作铸造支架式活动义齿,并在余留牙上制作铸造金属垫。于治疗后1、2周,1、2、3个月进行定期观察。结果:戴用义齿2周内有3例不愿继续使用义齿,其余的22例均适应了义齿并正常行使咀嚼功能,这其中有4例患者出现过牙周病加重。结论:牙合垫式可摘局部义齿能修复缺损的牙列,减小深覆,加大面下1/3的高度,是修复牙齿重度磨耗伴缺牙的一个可行修复方法。     

Evidence of the validity of a model of determinants of quality of restorative dental care

A model describing the relationship between self-reported quality of restorative dentistry and dentist characteristics for 119 Montana general dentists is presented. The best predictors formed a significant model explaining 22% of the variance of the quality measure. Results are contrasted with a previous estimation of the model for 102 Washington general practitioners. Evidence for the external validity of the model is presented.     

Experimental evidence of formation of imines in the course of reduction of hydrazones

The reduction of hydrazones is generally suggested to proceed through a reductive cleavage of the nitrogen–nitrogen bond followed by a reduction of the carbon–nitrogen bond. This sequence of reduction processes is here supported for fluorenone (V) and benzophenone (VI) hydrazones as well as by a comparison of the reduction of fluorenone and benzophenone hydrazonium ions (I,III) with corresponding imines (II,IV). Another proof of the presence of imines as intermediates is the splitting of four-electron waves of hydrazones V and VI and hydrazonium ions I and VIII into two waves at pH < 2. This has been interpreted as due to differences in slopes dE_1/2/dpH and pK_a-values of protonated hydrazine derivatives on one side and corresponding imines on the other. In this pH-range imines formed in reductions of VI and VIII are reduced in a single two-electron wave, those of I and V in two one-electron steps. Fluorenone imine (II) is sufficiently stable to allow recording of time-independent current–voltage curves between pH 6 and 11. In this pH-range the imine (II) is reduced in two one-electron steps. Benzophenone imine (IV) has been found stable between pH 4.6 and 12. At pH 4.6–8 the reduction of the imine IV takes place in a single two-electron step, at pH 8–12 in two one-electron steps. Final proof of the initial cleavage of the N–N bond is presented by comparison with the reduction of nitrones.     

不同剂型玻璃离子水门汀溶解性比较研究

目的:研究、比较不同剂型玻璃离子水门汀的溶解性和表面微观形态改变,为临床使用提供依据.方法:将3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)及GC玻璃离子水门汀(双糊剂型)分别在人工唾液中浸泡30 d,冷热循环15000次,烘干测重,比较前后质量变化,计算溶解率,并用扫描电镜观察表面微观改变.结果:不同剂型的玻璃离子水门汀溶解率由高到低分别为3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(双糊剂型).3种玻璃离子水门汀经浸泡溶解后,SEM扫描表面微观形态可观察到GE玻璃离子水门汀(双糊剂型)表面形态改变较少,其他2组玻璃离子水门汀表面微观改变较多.结论:双糊剂型玻璃离子水门汀理化性能及溶解率均低于传统水粉剂型,是未来临床修复治疗的的良好选择.     

Design of clinical trials of traditional therapies of periodontitis

The present paper on the design of clinical trials of periodontal therapy first addresses the issue of the etiology of periodontal disease. It is suggested that most if not all forms of destructive periodontal disease are caused by microorganisms and that there are different forms of disease with different microbial etiologies. The progressive nature of destructive periodontal disease is subsequently discussed and it is emphasized that, in a given patient, periodontal sites which show signs of inflammation and attachment loss may not over a period of several months and years show further sign of attachment loss. The present methods of assessing periodontal disease do not allow us to discriminate between potentially active and inactive sites in untreated patients. The significance and variability of indicators of periodontal disease such as bleeding on probing, probing pocket depth and probing attachment level measurements are discussed. The errors inherent in the various measurements are analyzed and suggestions are presented describing how alterations in any of the above parameters could be identified and presented in a clinical trial. Of concern for the statistical analysis of clinical data of periodontal disease is the definition of the "experimental unit". For a number of years, the "experimental unit" in periodontal trials was the patient. It is clear, however, that different sites within the same individual show different patterns of disease progression and lesion morphology and often respond differently to periodontal therapy. Statistical analyses must consequently be designed which recognize differences in site-to-site infection and lesion morphology within a common host. Until such analyses are available, the investigator should be wary of pooling data within the same individual, since such pooling may obscure meaningful alternatives which may take place in individual periodontal sites. Some goals of periodontal therapy are subsequently identified. 4 goals are discussed more in detail, namely: to establish conditions which will allow the patient to maintain a dentition without further breakdown of the periodontium; to reduce pocket depth to establish an anatomy in the dentogingival region which with proper maintainance care will prevent the re-establishment of the subgingival infection; to gain attachment as a result of treatment; to assess the effect of a certain chemotherapeutic agent on periodontal disease.     

Evaluation of efficacy of chemiluminescence for diagnosis of leukoplakia

ObjectiveLeukoplakia is the most common potentially malignant disorder preceding oral cancer. Chemiluminescence has been developed as an adjunct to conventional examination for the diagnosis of these potentially malignant disorders. This study was conducted to assess the efficacy of chemiluminescence in the diagnosis of leukoplakia and to compare the results with histopathological examination.Study designA total of 50 patients with leukoplakia were included from the outpatients attending the Department of Oral Medicine and Radiology, Dental Hospital, Bengaluru, Karnataka, India. These patients were subjected to conventional oral examination followed by chemiluminescent examination with Vizilite (Zila, Fort Collins, CO, USA) and biopsy for histopathological confirmation.ResultsThe sensitivity, specificity, positive predictive value, and negative predictive value of chemiluminescence were 93.75%, 55.56%, 78.95%, and 83.3%, respectively. The overall accuracy of chemiluminescence was 80%. A statistically significant association was observed between histopathology results and chemiluminescence results.ConclusionAlthough it is an easy, safe, minimal time consuming, and noninvasive technique, it has only adjunctive utility and it does not replace biopsy for the diagnosis of leukoplakia.     

颌骨动静脉畸形的栓塞治疗

目的：总结直接穿刺结合经血管内介入栓塞治疗颌骨动静脉静脉畸形的经验。方法：收治凳骨动静脉畸形患者6例,均进行了介入栓塞治疗。采用的栓塞材料为附凝血棉纤毛的螺圈,聚乙烯醇泡沫微粒和二氰基丙烯酸对丁酯。数字减影颈动脉造影在PHILIPSV300下完成。结果6例颌骨动静脉畸形患者中4,例急性出血得到了快速、有效控制,1例慢性渗血的右下 骨动静脉畸形患者,介入栓塞治疗,拔除松动的右下凳第一磨牙,有效地控制了出血,另1例伴局部软组织搏动性膨隆的上凳骨动静脉畸形患者,介入治疗后膨隆的搏动性得到明显改善,栓塞治疗后分别随访3－24个月,均未发现有口腔内渗血或出血。随访的X线片上,病灶区可见新骨形成。结论：局部穿刺结合经血管内介入栓塞治疗颌骨动静畸形是一种安全、有效的治疗方法。     

正畸患者切牙影像失真发生情况分析

目的研究正畸患者曲面体层片上的切牙影像失真发生情况，并分析其原因。 方法从中山大学附属口腔医院放射科影像数据库中选取500例正畸患者的曲面体层片和头影测量侧位片，所有曲面体层片均采用咬合杆投照，分别从切牙牙体影像放大、缩小、牙根变短、根尖模糊等评价指标分析上下颌切牙影像失真的发生情况，在头影测量侧位片上测量中切牙根尖-对颌切牙切缘的距离，探讨切牙影像失真发生的原因。采用SPSS 19.0统计软件对所得数据进行统计学检验。 结果500例患者中，切牙牙体影像正常者共417例，切牙牙体影像失真者共83例，影像失真发生率16.6%，其中切牙牙体影像放大17例、牙体影像缩小0例、牙根变短30例，牙根影像变短伴模糊36例。影像失真患者的根尖-切缘距离大于影像正常的患者，差异有统计学意义（F = 5 187.18，P = 0）；影像失真患者的覆盖值大于影像正常的患者，差异有统计学意义（F>477，P = 0）。 结论严重牙颌面畸形如反 、深覆盖是导致曲面体层片的切牙影像失真的主要原因之一。     

正常青年Monson球面半径的测量研究

目的测量正常青年Monson球面半径。方法选择60名(男30名,女30名)正常青年制取全口印模,应用立体摄影成像的原理与方法对Monson球面半径进行测量和统计学处理。结果Monson球面的半径平均为10.173 cm,大于理论值10.160 cm,差异有显著性(P<0.01);男、女性球面半径差异无显著性。结论本实验所得到的数据可作为全口义齿修复中记录颌位关系的一个参量。     

鼻测量法的进展

唇裂术后继发畸形是指唇裂修复术后,仍遗留或继发于手术操作和生长发育变化而表现出来的一类畸形[1]。包括唇畸形、鼻畸形和颌骨畸形。其修复较原发性唇裂修复更复杂,更灵活多变。而导致其修复复杂性的一个重要原因即是局部组织结构复杂变异和缺乏可靠的三维测量手段[2],鼻畸形