Oral manifestations of patients with hypophosphatasia

Hypophosphatasia is a rare inherited disorder characterized by defective bone mineralization and deficiency of tissue non-specific alkaline phosphatase (TNSALP) activity. The disease is caused by mutations in the liver/bone/kidney alkaline phosphatase gene (ALPL) encoding TNSALP. As for dental manifestations, premature loss of deciduous teeth due to disturbed cementum formation is well known. However, few reports of multiple cases have been presented. The oral manifestations of patients diagnosed with hypophosphatasia were analyzed by collecting clinical records of cases from a nationwide survey of pediatric dentistry clinics affiliated with 29 university dental hospitals in Japan. We inquired regarding the number of cases and clinical findings of diagnosed patients. We obtained information for 9 children diagnosed with hypophosphatasia from our university and 10 from 6 other universities. The main oral manifestation was early exfoliation of deciduous teeth, which was found in 15 of the 19 cases. Early exfoliation of mandibular deciduous anterior teeth was recognized in 14, whereas there were no cases of early exfoliation of a permanent tooth. The main oral finding of hypophosphatasia was early exfoliation of deciduous teeth, predominantly in the mandibular anterior region of children aged 1 to 4 years old.     

低磷酸酯酶症乳牙的光镜和扫描电镜研究

目的 观察低磷酸酯酶症在乳牙结构上的表现。方法 应用光学显微镜和扫描电子显微镜研究,对胝磷酸酯酶症患儿的下颌第二乳磨牙、上颌乳中切牙和下颌乳尖牙进行观察。结果 大部分牙根表面无确定的牙骨持结构或公在局部偶风小岛状的牙骨质;牙根表面普遍存在牙本质吸收现象,吸收以根尖部为重;牙根表面未风确定的细菌构成膜性结构。结论 认为牙根牙骨质形成不全或发育不良是该病患儿乳牙过早脱落的根本原因。     

Hypoplasia in crown of primary mandibular left lateral incisor identified in infant Japanese girl

A girl aged 0 years 11 months was referred to our clinic by a local pediatrician for examination of a missing tooth crown of a primary mandibular left lateral incisor. Our intraoral examination showed that seven primary incisors had emerged into the oral cavity, while no tooth crown was noted in the region of the primary mandibular left lateral incisor. A calcified structure was identified close to the gingival margin, which had a bone-like appearance and color, with no inflammation seen in the gingiva around the structure. Furthermore, the pulp space could be seen through the layer of hard tissue located close to the gingival region. A periapical radiograph taken at the first visit demonstrated a root-like structure with dentin and pulp, whereas enamel was not detected. The structure was speculated to be the root of the primary mandibular left lateral incisor, which was in the developmental stage. As there were no abnormal signs or symptoms, we decided to perform periodical examinations at 3-month intervals. Periapical radiographs taken at 1Y0M and 1Y7M showed root formation with no unusual conditions observed around the affected tooth.     

骨保护素在犬乳恒牙替换期的表达

目的：观察犬乳恒牙替换中骨保护素（osteoprotegerin，OPG）在组织中的表达情况，探讨其在此过程中存在的作用。方法：分别对乳牙期、替牙期、恒牙期杂种犬取上、下颌骨，制备石蜡切片，进行HE染色和破骨细胞内OPG的免疫组化染色，用彩色病理图像分析系统分析各组染色强度灰度值（OD）。结果：OPG在乳牙根吸收面、恒牙胚牙囊周围和接近恒牙胚的牙槽骨陷窝中的破骨细胞、乳牙牙周膜细胞、成骨细胞、恒牙胚的成釉细胞、成牙本质细胞表达阳性。结论：OPG可能参与了犬乳恒牙替换过程中乳牙根吸收、恒牙胚的发育。     

大连开发区3岁儿童乳牙龋病患病状况及相关因素分析

目的:了解大连开发区3岁儿童乳牙龋病患病状况及影响因素.方法:采用多阶段、整群随机抽样方法,抽取15所幼儿园里全部3岁儿童进行口腔健康检查和儿童家长的问卷调查.参照世界卫生组织推荐龋病诊断标准,问卷内容包括儿童的基本信息、口腔卫生习惯、饮食习惯,家长的口腔健康知识及口腔健康态度以及社会经济因素.使用SPSS 16.0对数据进行统计分析,计算乳牙龋患病率和龋均.采用卡方检验,独立样本t检验和单因素方差分析以及Logistic回归分析比较组间差异及龋病的影响因素.结果:共有1220名3岁儿童完成口腔健康检查,其中964名儿童家长(79.8％)完成问卷调查.3岁儿童乳牙龋病患病率为62.8％,龋均3.40,龋面均7.34,男女间差异均无统计学意义(P＞0.05).Logistic回归分析显示儿童摄入甜食和含糖饮料的频率(P＜0.05),父母的最高学历水平(P＜0.05)与儿童是否患龋相关.结论:大连开发区3岁儿童乳牙龋病患病状况较严重,患龋与进食含糖食物和饮料的频率及家长的教育水平有相关性.     

TheraCal LC和Dycal两种盖髓剂用于乳牙和恒牙直接盖髓的疗效比较

目的 比较TheraCal LC和Dycal两种盖髓剂用于乳、恒牙直接盖髓术的临床疗效。方法 选择深龋意外露髓的乳牙180颗和恒牙243颗做直接盖髓术,乳、恒牙均按单双数就诊顺序采用半随机方法分为两组,乳牙TheraCal LC组81例患者（90颗牙）;乳牙Dycal组76例患者（90颗牙）。恒牙TheraCal LC组102例患者（122颗牙）;恒牙Dycal组109例患者（121颗牙）。术后12个月,比较两种材料的治疗成功率。结果 治疗12个月后,恒牙TheraCal LC组成功率为95.1%,恒牙Dycal组成功率为93.3%,两组之间差异无统计学意义（P>0.05）。乳牙TheraCal LC组成功率为87.7%,乳牙Dycal组成功率为46.9%,两组之间有显著差异（P<0.05）。结论 TheraCal LC盖髓剂更适合乳、恒牙的盖髓剂,乳牙的优势可能更为明显。     

激素替代疗法治疗女性灼口综合征的临床观察

目的 :观察尼尔雌醇治疗女性灼口综合征的临床效果。方法 :采用尼尔雌醇辅以孕激素的雌激素替代疗法治疗已停经的女性灼口综合征患者。结果 :激素治疗组与维生素治疗组相比有显著性差异 (P <0 .0 1)。结论 :舌感觉异常多发生在妇女更年期 ,内分泌紊乱起着重要作用 ,激素替代疗法可以明显缓解症状     

短期激素替代疗法治疗绝经期舌痛症的临床观察

目的:评价短期激素替代疗法对绝经期舌痛症患者心理健康的影响和临床疗效。方法:87例绝经期舌痛症患者随机分为两组,治疗组42例给予利维爱治疗,治疗对照组45例给予谷维素加维生素E治疗,另随机选择同期42例作为空白对照组。于治疗前后分别检测血清雌二醇(E2 )、卵泡刺激素(FSH) ,焦虑自评量表(SAS)与抑郁自评量表(SDS)进行分析,用自行设计的调查表对舌痛症患者的全身不适症状进行调查,并观察口腔症状改善情况。结果:①治疗前两个治疗组的血清E2水平均低于空白对照组、FSH水平高于空白对照组(P <0 .0 5 ) ,SDS、SAS标准分高于空白对照组(P <0 .0 5 ) ,绝经期舌痛症患者具有多项全身不适症状。②治疗3个月后,治疗组较治疗前血清E2水平升高、FSH水平下降(P <0 .0 5 ) ,SDS、SAS标准分下降(P <0 .0 5 ) ,治疗组各项全身症状较同期治疗对照组有明显改善(P <0 .0 5 ) ,临床总有效率80 .95 % ,明显优于治疗对照组(P <0 .0 5 )。结论:短期激素替代疗法可获得口腔局部不适症状的改善,可以改善绝经期女性的心理健康。     

氢氧化钙糊剂用于乳牙根管充填的疗效观察

目的 :观察氢氧化钙碘仿糊剂作为乳牙根管充填材料的临床疗效。方法 :用两种根管充填材料对乳磨牙进行根管充填 ,实验组用氢氧化钙碘仿糊剂根管充填 ,对照组用氧化锌碘仿糊剂根管充填 ,观察一年后的疗效。结果 :实验组平均有效率为 84.1% ,对照组有效率为 81.4% ,实验组与对照组无显著差异(P >0 .0 5 )。结论 :氢氧化钙碘仿糊剂用于乳牙根管充填的疗效比较理想。     

Assessment of root dentin pH changes in primary and permanent molars with different types of calcium hydroxide intracanal medication

Purpose

To evaluate root dentin pH changes using different calcium hydroxide medications in primary and permanent molar root canals.

Accuracy of two different apex locators in primary teeth with and without root resorption

The objective of this study was to assess the accuracy of two frequency apex locators, Root ZX (Morita, Kyoto, Japan) and Endex (Osada, Tokyo, Japan) in primary teeth with and without root resorption in vitro. For this study, 90 sound extracted primary teeth (60 molars and 30 incisors; 93 roots with visible resorption and 51 roots without) were selected. A total of 144 root canals were included. After access preparation, root canal lengths were measured visually. The teeth were embedded in an alginate model developed specifically for testing apex locators. Electronic length was determined with two different frequency apex locators, Root ZX (Morita, Kyoto, Japan) and Endex (Osada, Tokyo, Japan). Statistical evaluation was performed using Mann–Whitney U and Wilcoxon W tests (p < 0.05). Results revealed that both apex locator devices did not show similar values to visual length measurements with statistically significant differences in primary teeth with root resorption (p < 0.05). For the teeth without root resorption, Endex showed similar values to visual length measurements with no statistically significant differences (p > 0.05), but Root ZX values were different than visual length and the differences were statistically significant (p < 0.05). There were no significant differences between the two apex locators considering the presence of root resorption. The two frequency apex locators can be recommended for use in root canal therapy for primary teeth with and without root resorption, only if electrical determination of root canal length is supported with other diagnostic measures.     

氟化钠-壳聚糖凝胶对乳牙釉质早期龋再矿化实验观察

目的:探讨氟化钠壳聚糖凝胶促进乳牙釉质早期龋模型再矿化的可行性.方法:乳前牙试件使用乳酸羧甲基纤维素凝胶预处理,制备早期龋模型;早期龋的乳前牙试件随机分成4组(n=6),3组分别进行氟化钠壳聚糖凝胶、壳聚糖空白凝胶、多乐氟处理,1组作为空白对照,处理完成后进行pH循环,SEM、EDS检测循环完成后的试件表面.结果:SEM观察,氟化钠壳聚糖凝胶能更好的保护釉质表层结构不受破坏,而多乐氟和空白对照组,则表现出釉质表层的崩解.同时氟化钠壳聚糖凝胶有更多的矿化物结晶在釉质表面形成.EDS检测钙离子的沉积比例,氟化钠壳聚糖凝胶组明显多于其余各组(P＜0.05).结论:氟化钠壳聚糖凝胶可以提高乳前牙早期龋的再矿化水平.     

白血病患儿乳牙根尖周炎根管治疗的临床观察

目的:探讨白血病患儿乳牙根尖周炎进行根管治疗的可行性与安全性。方法:29例白血病患儿30个患根尖周炎的乳牙,掌握适当的治疗时机进行根管治疗;限定血象标准,白细胞计数3.0×109/L～10×109/L;血小板计数>50×109/L;制定根管治疗操作原则并进行术后定期随访。结果:29例均未发生任何牙源性白血病并发症。29个患牙根尖病变受到控制,根尖部或根分叉部骨质吸收都有不同程度的好转,仅1例失败。结论:只要掌握好治疗时机,达到限定的血象标准,按照操作原则治疗,白血病患儿乳牙根尖周炎的根管治疗是可行的、安全的。     

STA髓腔麻醉法在乳磨牙牙髓摘除术中的应用

目的:探讨STA髓腔麻醉法在乳磨牙牙髓炎无痛治疗中的可行性.方法:将就诊的3～9岁儿童中,同颌对称同名乳磨牙明确诊断为乳磨牙牙髓炎的患儿22名(4～7岁),共44颗患牙.每个患儿的2颗乳磨牙中,选取1颗采用STA髓腔麻醉,作为第1组(n=22);另1颗采用STA常规麻醉,其中上颌采用颊侧骨膜上浸润麻醉,下颌采用牙周膜(PDL)麻醉作为第2组(n=22).结果:髓腔麻醉注射时患儿的疼痛程度明显低于常规麻醉(P＜0.05);1 min内开髓揭顶时的麻醉效果较高于常规麻醉.髓腔麻醉下治疗结束后均无软组织麻木感及无自伤性溃疡的发生,患儿对髓腔麻醉更易接受.结论:乳磨牙STA髓腔麻醉法镇痛效果优于传统浸润麻醉.     

牙本质磷蛋白在犬乳恒牙替换期表达的原位杂交研究

目的：观察牙本质磷蛋白（DPP）mRNA在犬乳恒牙替换期的表达，寻找研究牙本质形成与损伤修复的良好模型。方法：采用原位杂交的方法，检测犬牙替换期恒牙胚、发育中的恒牙和乳牙DPP mRNA的表达。结果：犬恒牙胚、发育中的恒牙和乳牙均检测到DPP mRNA的表达，DPP mRNA存在强弱变化。结论：DPP在犬牙存在表达，并具有时空特异性。     

阿霉素神经干内注射治疗原发性三叉神经痛285例临床分析

目的:总结作者13年中采用阿霉素神经干内注射治疗原发性三叉神经痛患者285例(339支神经)的经验.方法:对因颌面部出现阵发性剧痛的门诊患者,通过询问病史及临床检查,确诊为原发性三叉神经痛并确定罹患的神经分支后,即行手术,显露其神经束,于束内注入0.5％阿霉素.术后随访观察6个月～13 a,评价疗效.结果:285例患者均于门诊一次完成诊疗,整个过程约lh,所有病例于24～48 h内疼痛停止发作.随访中,有73支分布区出现疼痛复发,复发率约21％,89例出现其他分支疼痛.结论:本组病例证实,阿霉素神经干内注射治疗原发性三叉神经痛疗效确切,无严重并发症.     

Recovery of INS-R and ER-alpha expression in the salivary glands of diabetic mice submitted to hormone replacement therapy

The interaction between proteins and cell receptors is related to tissue homeostasis such as in salivary glands. In this respect, alterations in hormone levels caused by hyperglycaemic conditions may interfere with this interaction, intensifying the damage caused by diabetes mellitus. Hormone replacement therapy is an option to reverse this damage, but doubts still exist regarding the efficacy of this procedure. The objective of this study was to evaluate the effect of oestrogen replacement therapy combined with insulin treatment on the expression of oestrogen (ER-alpha) and insulin receptors (INS-R) in the salivary glands of spontaneously diabetic mice. Twenty-five mice were divided into five group of 5 animals each: group I (NOD diabetic), group II (NOD diabetic treated with insulin), group III (NOD diabetic treated with oestrogen), group IV (NOD diabetic treated with insulin and oestrogen), and group V (control BALB/c mice). Group II received insulin, group III received oestrogen, and group IV received insulin plus oestrogen administered daily for 20 days. Groups I and V received saline for the same period of time to simulate treatment. Glucose and oestrogen levels were monitored during the experimental period and salivary gland samples were collected at the end of the experiment for fluorescence microscopy analysis of ER-alpha and INS-R. Animals receiving oestrogen replacement therapy plus insulin showed regulation of the expression of oestrogen and insulin receptors. Oestrogen treatment alone contributed to the recovery of these cell receptors. These results indicate that oestrogen replacement therapy alone, and especially when combined with insulin, is important for the recovery of the interaction between functional proteins and their receptors, thus contributing to the reestablishment of tissues damaged by the hyperglycaemic condition.     

两种镍钛锉在儿童乳磨牙根管治疗中的临床效果

目的 比较M3乳牙专用镍钛锉和M2镍钛锉在乳磨牙根管治疗中的应用效果。方法 选择3 ～ 8岁儿童90例,分成实验组2组和对照组1组,每组30例,实验组分别在乳牙根管治疗中使用 M3乳牙镍钛锉和M2镍钛锉,对照组使用不锈钢K 锉。分别记录3组的根管预备时间以及疼痛评估值、以及术后X线片检查充填效果。所有的根管治疗操作均为同一医生进行。结果 实验组中的两组平均每根根管预备时间均比对照组短,X线片显示恰充根管数量均高于对照组,患儿术后第1天和第3天的疼痛反应评分值均低于对照组,差异均有统计学意义(P<0.05),而实验组中的M3组和M2组比较,根管预备时间、充填效果、术后第1天和第3天的疼痛反应评分值差异没有统计学意义(P>0.05)。术后第7天3组间疼痛评分值差异无统计学意义(P>0.05)。结论 M3乳牙专用镍钛锉和M2镍钛锉在乳牙根管治疗时操作时间短、术后疼痛反应低,充填效果佳,均可用于乳牙根管治疗,但是M3乳牙镍钛器械更适用于儿童。