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目的探讨偏侧咀嚼对颞下颌关节的影响。方法通过拍摄颞下颌关节X线侧位片,测量56例1999—2001年就诊于四川大学华西口腔医院颞下颌关节诊室的偏侧咀嚼患者的关节窝深度、宽度以及髁道斜度,了解其颞下颌关节形态变化。结果30例非习惯侧出现关节结节后斜面骨质粗糙、关节窝骨皮质吸收变薄、髁状突功能面骨质不光滑样骨质改变(53.6%),21例习惯侧出现骨质改变(37.5%),两者比较差异有统计学意义(P<0.05)。偏侧咀嚼患者习惯侧与非习惯侧的颞下颌关节窝深度和髁道斜度之间差异也有统计学意义(P均<0.05),而两者间关节窝宽度差异无统计学意义(P>0.05)。结论偏侧咀嚼影响颞下颌关节形态。     

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目的通过显微CT体外评价,比较3种不同直径羟磷灰石颗粒外部间隙分布情况,探讨材料外部间隙对临床运用的影响。方法 2014年3—4月于广州科学城显微CT实验室对颗粒直径分别为0.25~1 mm、0.4~1 mm、1~2 mm的3种人工骨材料进行体外固定,采用显微CT扫描,评价各自的间隙排列。结果 1~2 mm组羟基磷灰石颗粒压实堆积后显微CT下显示材料颗粒排列松散,颗粒团块间存在较大空隙,间隙率为61.75%;0.25~1 mm和0.4~1 mm组材料颗粒排列较为均匀,颗粒团块间存在间隙较小,间隙率分别为27.33%和42.44%。结论显微CT可用于颗粒移植材料的微观物理参数评估,0.25~1 mm组羟磷灰石颗粒压实后颗粒团块内部排列紧密,临床上有利于植骨后稳定成骨空间。     

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目的探讨关节腔注射透明质酸钠治疗间接性颞下颌关节(TMJ)损伤后并发关节功能紊乱患者的临床疗效。方法选择2009年5月至2011年5月甘肃省嘉峪关市第一人民医院口腔科收治的因间接性TMJ损伤并发关节功能紊乱且经保守治疗无效的患者40例,将其随机分为两组:治疗组20例,关节腔冲洗后注射透明质酸钠;对照组20例,单纯行关节腔冲洗。观察两组患者治疗前后关节疼痛、开口度和侧向活动度的变化。结果经过1个疗程(每周1次,3周为1个疗程)治疗后,两组患者的关节疼痛、开口度和侧向活动度均较治疗前改善;组间比较结果显示,治疗组关节疼痛、开口度和侧向活动度的改善程度均较对照组明显,差异有统计学意义(P<0.01)。结论关节腔注射透明质酸钠治疗间接性TMJ损伤后并发关节功能紊乱病的疗效优于单纯进行关节腔冲洗;透明质酸钠可以明显改善间接性TMJ损伤并发关节功能紊乱患者的疼痛症状、开口度和侧向活动度。     

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目的评价含生物活性玻璃成分的脱敏剂与氟保护漆联合应用对牙本质小管的堵塞效果及治疗牙本质过敏症(dentin hypersensitivity,DH)的临床疗效。方法选择2013年6月到2014年6月到中国医科大学口腔医学院干诊科就诊的59例DH患者的120颗患牙,随机分为A组(41颗)、B组(39颗)、C组(40颗),分别使用氟保护漆、奥敏清及氟保护漆与奥敏清联合涂布敏感处,应用视觉模拟评分(visual analogue scale,VAS)法评价其疗效。另选择因正畸需要拔除的完整无龋坏前磨牙20颗,制备成敏感模型后随机分为a、b、c、d四组,每组5颗,a、b、c三组处理方法同上述A、B、C组,d组为空白对照组,用蒸馏水进行处理,扫描电镜观察各组牙本质小管的堵塞情况。结果 A、B、C三组的VAS评分值在处理即刻均明显下降,且随时间推移均有增高趋势;有效率比较,A、C两组在1个月时差异有统计学意义(P<0.05),其他各组间在各时点差异均无统计学意义(P>0.05);各组内比较,A组即刻与1个月时差异具有统计学意义(P<0.05)。扫描电镜观察a、b、c三组牙本质小管均有不同程度堵塞,其中以联合应用组效果最佳。结论含生物活性玻璃成分的脱敏剂与氟保护漆联合应用堵塞牙本质小管的效果最佳,且具有较好的临床效果。     

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??Objective    To study the anatomic features of medial sural artery perforator flap and provide anatomic evidence for its clinical application. Methods    Totally 10 lower limbs preserved in formaldehyde from cadavers of adults were used to observe the anatomy of medial and lateral sural artery. Between April of 2010 and April of 2011?? 14 clinical cases were reconstructed by using medial sural artery perforator flap??perforator data were collected. Results    In all 10 specimens the mean number??median  of total perforators was 2.5??ranging 1 to 6??. All perforators were in an area between 5.0 cm and 19.0 cm from the popliteal crease and between 1.0 cm and 6.0 cm from the midline of the gastrocnemius muscles. In clinical study?? the mean number??median of total perforators was 2.0??ranging 0 to 4??. All perforators were in an area between 5.0 cm and 19.0 cm from the popliteal crease and between 0 cm and 5.8 cm from the midline of the gastrocnemius muscles. Most perforators entered the medial gastrocnemius muscle at a relative distance of one-fifth to one-third of the lower leg length measured from the popliteal crease. Conclusion    The medial sural artery perforator flap provides a constant anatomy with a long pedicle. It is a good alternative for oral and maxillofacial reconstruction of defects.     

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??Objective    To evaluate the sealing effect of a dentin adhesive in Class??restorations. Methods    Standardized mixed Class??cavities??2 mm × 2 mm × 2 mm??were prepared in 120 extracted premolars that were randomly assigned to 4 groups??n=30 for each group??. Three adhesive systems??All Bond Universal??total-etch and self-etch????Prime & Bond NT??and G bond and resin composite??were applied to each group following manufactures′ instructions. The teeth were immersed in 50 % ammoniacal silver nitrate and depth of penetration was evaluated under a microscope??and data were statistically analyzed by SPSS 20.0 software. Results    Microleakage was observed in all groups. All Bond Universal??total-etch??scores were lower than the other two groups??P??0.05??. There was no difference between total-etch and self-etch when All Bond Universal was used??P??0.05??. Higher microleakage scores were observed along the gingival margin than along the occlusal margin in all groups??P??0.05??. Conclusion    New universal adhesive ??All Bond Universal?? is a convenient and efficient adhesive. Total-etch and self-etch have no influence on marginal microleakage the long-term effect need further study.     

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目的    探讨重组人表皮生长因子（rhEGF）凝胶治疗复发性口腔溃疡的临床疗效。方法    采用随机平行对照试验方法,将2007-2009年辽宁省人民医院口腔科收治64例复发性口腔溃疡（ROU）患者随机分为试验组和对照组,试验组用rhEGF凝胶局部涂药,对照组给予2%碘甘油局部涂药,分组观察,2组均治疗至溃疡愈合或2周止。结果    试验组患者溃疡平均愈合时间为（3.52±1.29）d,对照组为（7.58±2.07）d,两组比较,差异有统计学意义（P < 0.05）。试验组总有效率（96.9%）明显高于对照组（62.5%）（P < 0.05）。结论    重组人表皮生长因子凝胶对口腔溃疡创面具有明显的促进愈合作用,应用方便、安全。     

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目的探讨透明质酸钠关节上腔和关节下腔注射在治疗颞下颌关节骨关节病中的疗效。方法选择2006年7月至2009年2月威海市立医院口腔门诊适合注射透明质酸钠的46例颞下颌关节骨关节病患者,随机分为试验组和对照组,试验组25例采用关节下腔注射透明质酸钠,对照组21例采用关节上腔注射,比较两组疗效的差异。结果张口度对照组平均增加(0.96±0.13)cm,试验组平均增加(1.28±0.09)cm,两组间差异有统计学意义(P<0.01);关节疼痛对照组平均缓解(23.43±9.62)mm,试验组平均缓解(29.08±10.51)mm,两组间差异有统计学意义(P<0.01)。治疗后3个月至6个月的症状改善进行比较,张口度对照组变化为(0.01±0.03)cm,试验组为(0.08±0.04)cm,差异无统计学意义;关节疼痛改善对照组为(1.64±0.56)mm,试验组为(4.24±0.79)mm,差异具有统计学意义(P<0.01)。结论透明质酸钠关节上、下腔注射对颞下颌关节骨关节病确有疗效,关节下腔注射较上腔注射对缓解患者的关节疼痛和改善张口度的效果更为明显,且对疼痛缓解的作用时间更持久。     

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目的    探讨可摘式局部义齿咬合重建修复对脑血流的影响。方法    选择2008年1月至2010年1月在山西医科大学口腔医院修复科就诊的需进行咬合重建修复的患者20例,在咬合重建前后分别应用经颅多普勒超声诊断仪探测患者大脑中动脉（MCA）的收缩期峰流速、舒张期末峰流速及平均峰流速,并进行比较分析。结果    20例患者进行咬合重建后,咀嚼前与咀嚼后MCA的收缩期峰流速、收缩期末峰流速及平均峰流速均比咬合重建前增加,且差异有统计学意义（P < 0.05）。结论    咬合重建修复可提高患者MCA的血流速度,增加相应脑区的供血量。     

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??Development of dentistry has entered into the digital era?? all kinds of digital equipment and technologies have sprung up. The use of these technologies makes the diagnosis and treatment results more predictable. As a useful tool in dentistry??cone beam CT??CBCT?? plays an important role in diagnosis and treatment. This article will focus on application of CBCT in endodontics.     

Signs and symptoms of temporomandibular disorders in Ecuadorian Indians

The purpose of this study was to determine the prevalence of signs and symptoms of temporomandibular disorders (TMD) in indigenous South American Indians. A total of 140 consecutive indigenous Indians (69 Quechua and 71 Colorado) attending a mobile dental health caravan in the Santo Domingo region of Ecuador were examined objectively and subjectively for signs and symptoms of TMD using a method similar to that used in previous studies. There was a prevalence of up to 41% of at least one symptom. The Quechua Indians reported a significantly higher prevalence of difficulty in opening of the mouth and pain in front of the ears than the Colorado Indians. There was a prevalence of up to 63% of at least one sign. The objective findings in the Colorado Indians were similar to those found to be present in a Scandinavian population and an Arab population in previous studies using similar methods. Signs and symptoms of TMD are common in Latin American Indians. Differences occur between different populations in the same geographical area.     

Prevalence of symptoms associated with temporomandibular disorders in a Turkish population

Despite numerous studies having been published, the epidemiology of temporomandibular disorders remains uncertain and controversial. The aim of this study was to estimate the prevalence and distribution of symptoms commonly associated with such disorders among a sample of adults in Istanbul, Turkey. A total of 1253 individuals aged 18 years were identified by using a random-digit dialing technique. They were asked standard questions about joint and jaw muscle pain, jaw opening, and joint sounds. Additional questions on tooth grinding and clenching, sleep patterns, and treatment-seeking behaviour were posed. Jaw pain was reported by 31% of the population. Women were more likely, than men, to respond positively to the questions concerning jaw pain. No gender- and age-related differences in prevalence of difficulty opening, clicking, tooth grinding/clenching and being poorly rested were found.     

The prevalence of signs and symptoms of temporomandibular disorders in very old subjects

Previous studies on the prevalence of signs of temporomandibular disorders (TMD) in elderly people have used non-standardized and invalidated examination protocols. The prevalence of the different signs of TMD in this group is therefore still unclear. The aim of this study was to evaluate the prevalence of signs of TMD in subjects of advanced aged, using a standardized and validated examination protocol. Additionally, young subjects were examined as a control group. Fifty-eight old peoples' home inhabitants and 44 young subjects were examined using a standardized and validated examination protocol. Differences between the groups were assessed using Mann-Whitney U-test or t-test. Geriatric subjects more often exhibited objective symptoms of TMD (38% exhibited joint sounds on opening), but rarely suffered from pain (pain at rest: 0%, joint pain: 0%, muscle pain: 12%). In contrast, young subjects rarely exhibited objective symptoms (joint sounds: 7%), but suffered more frequently from pain (facial: 7%, joint pain: 16%, muscle pain: 25%). The mandibular range of motion was higher in young subjects. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (joint sounds) of TMD, they rarely suffered from pain. In contrast, younger subjects rarely exhibited objective TMD signs but more frequently suffered from subjective signs (muscular pain on palpation) and facial pain.     

雌激素与颞下颌关节紊乱病

颞下颌关节紊乱病的流行病学调查发现女性患病率高于男性,且存在年龄分布,使得雌激素在其发病机制中的作用引起学者的注意。雌激素能够影响颞下颌关节组织结构如骨、软骨、关节盘等多种组织的生长、代谢、改建重建等,并能影响疼痛的调节机制,从而可能在颞下颌关节紊乱病的病理生理过程中起作用。     

Prevalence study of signs and symptoms of temporomandibular disorders in university students

The aim of this study was to evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD) in university students from 19 to 25 years old, male and female, through the distribution of frequency of the data obtained from a questionnaire and physical examination. The results showed that 68% of the subjects exhibited some degree of TMD, and the women were the most affected. Signs and symptoms such as articular sounds, pain to palpation of the masticatory, cervical and scapular girdle musculature, subjective sensation of emotional stress, and postural and occlusal changes were more evident in the group with TMD, although they were also present in subjects classified as TMD-free. Limitations in the mandibular movements were not found. The association of the obtained data allowed identifying a high prevalence of signs and symptoms of TMD in the Brazilian university population.     

Self-reported bruxism and temporomandibular disorders: findings from two specialised centres

The aims of this investigation were to report the frequency of temporomandibular disorders (TMD) diagnoses and the prevalence of self-reported awake and sleep bruxism as well as to describe the possible differences between findings of two specialised centres as a basis to suggest recommendations for future improvements in diagnostic homogeneity and accuracy. A standardised Research Diagnostic Criteria for TMD (RDC/TMD) assessment was performed on patients attending both TMD Clinics, viz., at the University of Padova, Italy (n=219; 74% women) and at the University of Tel Aviv, Israel (n=397; 79% women), to assign axis I physical diagnoses and to record data on self-reported awake and sleep bruxism. Significant differences were shown between the two clinic samples as for the frequency of TMD diagnoses (chi-square, P<0·001) and the prevalence of at least one positive response to bruxism items (chi-square, P<0·001). The more widespread use of TMJ imaging techniques in one clinic sample led to a higher prevalence of multiple diagnoses, and the higher prevalence of self-reported bruxism in patients with myofascial pain alone described in the other clinic sample was not replicated, suggesting that the different adoption of clinical and imaging criteria to diagnose TMD may influence also reports on their association with bruxism. From this investigation, it emerged that the features of the study samples as well as the different interpretation of the same diagnostic guidelines may have strong influence on epidemiological reports on bruxism and TMD prevalence and on the association between the two disorders.     

Nomenclature and classification of temporomandibular joint disorders

Currently, there are basically two approaches to classification, one based on structural and one on positional changes occurring within the joint. Despite the increase in knowledge of pathologic changes occurring within the temporomandibular joint (TMJ), the disc still seems to be a central issue in nomenclature and classifications of TMJ disorders. Basic pathologies of the TMJ involve inflammation and degeneration in arthritic disorders (irrespective of the presence or position of the disc) and structural aberrations in growth disorders. Some internal derangements may occur independent of underlying pathology, e.g. because of a traumatic event. In this position paper, a classification of TMJ disorders is proposed based on basic structural changes occurring in the joint.     

Diagnostic targeting of temporomandibular disorders

This article describes a diagnostic chart that is organized for a versatile representation of various conditions of temporomandibular disorders (TMD). It facilitates the grading of disorder severity and visualization of probable mutual effects between groups of disorders. It also enhances the clinician's awareness of potential systemic involvement in TMD by incorporating it into the chart. Comparison of charts completed at consecutive examinations is helpful for the assessment of disorder progression, regression or for the refining of diagnoses.     

Predictors for the development of temporomandibular disorders in scuba divers

The aim was to determine predictors for the development of complaints of temporomandibular disorders (TMD) in a large sample of Dutch scuba divers who were free of any TMD complaints before they started diving actively. Five‐hundred and thirty‐six scuba divers (mean ± SD age = 40·4 ± 11·9 years; 34·1% women) completed a specifically developed questionnaire, either online or on paper. Stepwise forward logistic regression analysis was performed to predict the presence of TMD pain, with several potential risk factors as predictors. Four hundred and eighty‐five of the 536 respondents were free of any TMD pain before they started diving actively. In this sample, TMD pain was present in 214 persons (44·1%). Four predictors contributed significantly to the presence of TMD pain, viz., clenching (OR = 2·466), warm water (OR = 1·685), biting on the mouthpiece (OR = 1·598), and the quality rating of the mouthpiece (OR = 0·887, that is, a higher rating means a smaller odds of having TMD pain). TMD pain is a common complaint among scuba divers who were free of such complaints before they started diving actively. Clenching, biting on the mouthpiece, and a low rating of the mouthpiece are predictors for the presence of TMD pain in scuba divers, while diving in cold water serves as a protective factor for TMD pain.     

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.