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目的    探讨利用三维图像处理软件（Mimics 软件）实现埋伏牙完全可视化的新手段。方法    对2008年3—12月于山东省口腔医院正畸科就诊的埋伏牙患者10例,常规摄取口腔全景片和数字牙片。采用螺旋CT对患者头面部扫描后,放射科医生将CT数据转化成DICOM格式保存。正畸科医生将数据输入到Mimics软件中,在个人计算机上建立数字牙颌模型。结果    10例患者CT数据经Mimics软件处理后,均重建出所需牙颌三维数字图像,显示出埋伏牙的位置、牙体形态、发育情况以及与邻牙、窦腔和颌骨的关系,实现了埋伏牙充分可视化。结论    Mimics软件可将CT信息转化成三维数字模型,是一种快速、简便的实现埋伏牙可视化的手段,可应用于埋伏牙的诊断和指导正畸治疗计划的制订。     

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??Objective??To propose a new panoramic tomographic predictor of maxillary impact canines by the analysis of the sector of crown and root??the inclination of the dental axis and the teeth length of the maxillary impacted canines on panoramic tomographs and by comparing the position of maxillary impact canines with that on cone-beam computed tomographys??CBCT??. Methods??Collect the general datas of 135 patients who had unilateral impacted maxillary canines. A total of 135 maxillary impacted canines were included as the experimental group??the 135 non-impacted canines on the opposite side in the same patients were as the control group. ??1??The NNT Viewer software and Planmeca Dimaxis Pro software were used to measure the cone-beam computed tomographys and panoramic tomographs respectively. The mesial and distal position of the maxillary impacted canine in the panoramic tomographs was divided into 5 sectors???? ~ ?? sector????the position of labiopalatal side was determined by CBCT??and the relationship between them was analyzed. ??2??The difference between the mesial and distal position distribution of crown and root??the inclination of the dental axis and the teeth length of the teeth of the experimental group and the control group was measured and analyzed in the panoramic tomographs. Results????1??The labiopalatal distribution of the maxillary impacted canines was significantly different between sexes??χ2 = 13.542??P = 0.001??. A statistically significant association was observed between the labiopalatal positions in the cone-beam computed tomographys and the root sectors in panoramic tomographs of the impacted canines ??r = 0. 225??P = 0.009????but not the crown sectors??r = 0.001??P = 0.991??.??2??There are differences in the distribution of the mesial and distal positions of the crown and root between the two groups??χ2 = 219.263??68.447??both P < 0.001??. The maxillary impacted canine of the experimental group was shorter than that of the control group??and the dental axis was more inclined??P < 0.05??. Conclusion??The labiopalatal position can be predicted by the location of the mesial and distal position of the maxillary impacted canine root in the panoramic tomographs. The sector of root and the tooth length can be used to predict the probability of maxillary impacted canines.     

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牙周炎(periodontitis)是由细菌感染引起并侵犯牙周组织的慢性破坏性疾病,其主要特征是牙龈出血、牙周袋的形成、牙槽骨的吸收和牙齿松动等。以往,临床医生通过传统的检查,如视诊、探诊和普通X线片等方法诊断牙周病,但精确度不高,预测性低,不利于发现牙周病高危人群     

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目的 探讨髁状突位置与错(殆)畸形的关系.方法 选择2009年3月至2010年12月厦门市口腔医院正畸科收治的各类错(殆)患者60例(各15例),通过锥形束CT(CBCT)获取影像资料,应用Dolphin 11.0软件在垂直于髁状突长轴的斜位测得颞下领关节前、上、后间隙值,运用Pullinger分析法判断髁状突在关节窝的位置.结果 安氏Ⅱ1、Ⅲ类错(殆)患者的髁状突在关节窝内大部分为前移位,安氏Ⅰ类错(牙合)患者的髁状突在关节窝内居中位,安氏Ⅱ2患者的髁状突在关节窝大部分居后位.结论 (1)不同类型的错(殆)畸形髁状突位置存在差异;(2)CBCT结合Dolphin 11.0软件可作为研究颞下颌关节的有效手段.     

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目的    探讨快速脱敏疗法在牙科畏惧症儿童中的应用。方法    选取2008年7—10月到青岛市口腔医院儿童牙科门诊就诊的3～7岁牙科畏惧症患儿100例,随机分为两组（每组各50例）,干预组使用快速脱敏疗法,对照组不使用快速脱敏疗法,比较两组儿童在牙科治疗中的配合程度。结果    使用快速脱敏疗法的儿童在诊疗中的配合程度明显高于未使用快速脱敏疗法的儿童,差异具有统计学意义（P < 0.01）。结论    快速脱敏疗法能有效降低牙科畏惧症儿童在牙科治疗中的恐惧程度。     

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??Objective    To investigate the influence of Porphyromonas gingivalis??Pg?? and Treponema denticola??Td?? in gingival crevicular fluid ??GCF?? of patients with aggressive periodantitis??AgP?? on organic acid. Methods    Forty cases of AgP and 40 healthy volunteers in our hospital were selected and GCF was collected. GCF in booth of same quadrant of patients was collected??and plaque index ??PLI????sampling location??probing depth??PD????sulcus beeding index??SBI?? and attachment loss??AL?? were recorded. CE was used to detect the concentration of organic acid??PCR was used to detect Pg and Td. The gray value of amplification entry stripe??which was detected positive??was given quantitative analysis??amplification target bars and brightness ratio showed the relative volune of target gene??which was PCR product quantity. Results    PLI??PD??AL??concentration of acid??Pg/Td detection rate and Pg/Td product quantity of AgP group were higher than those of healthy group ??P??0.05????Pg butyric acid concentration at positive detection point of AgP group was higher than that at negative detection point??P??0.05????organic acid concentration at Td positive detection point was higher than that at negative group??P??0.05??. Conclusion    Organic acid concentration in GCF of AgP patients shows product quantity of Pg and Td??which plays a certain guiding role in organic acid concentration of AgP.     

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??Objective    To study the effect of arecoline on the permeability of Hacat cell epithelia model in vitro and the adjustment of Ca2+ on it. Methods    Establish  the Hacat cell epithelia monolayer model in vitro by culturing Hacat cell. The models were divided into control group ??group A????arecoline treatment group ??group B?? and “calcium+ arecoline” treatment group ??group C??. The values of Lucifer Yellow Papp were used to estimate the permeability changes of models after treatment with arecoline and calcium. Results    In group B??the Lucifer Yellow Papp of each subgroup was higher than that of group A ??P < 0.05?? and the Lucifer Yellow Papp increased as the arecoline concentration and treatment time were increased ??P < 0.05??. In group C??after pretreatment with calcium??the Lucifer Yellow Papp of each subgroup were lower than that of group B at corresponding concentration and time points ??P < 0.05????while the Pappof each subgroup was higher than that of group A??P < 0.05??. Besides??the Lucifer Yellow Papp increased as the arecoline concentration and treating time were increased ??P < 0.05??. Conclusion      The increase of permeability of oral epithelia model by arecoline may play an important role in the pathogenesis and development of oral submucous fibrosis. The pretreatment with calcium??to some extent??can weaken the effect of arecoline on the permeability of Hacat cell monolayer model.     

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??Sialic acid is a nine-carbon sugar acid??which is located at the terminal residue of glycoconjugations. The sialic acid-containing glycoconjugates are widely distributed on the surface of eukaryotic and prokaryotic cells and in serum and saliva. The sialic acid plays an important role in bacteria survival and pathogenesis. Some pathogenic bacteria coat themselves in sialic acid??providing resistance to components of host’s immune response??and some can use it as a nutrition. In this paper??the role of sialic acid and sialidase in bacteria survival and pathogen was reviewed.     

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本文着重介绍应用复合树脂对临床不同类型牙体美容缺陷进行美学修复的临床设计方案、洞斜面设计、牙体美学分层修复颜色设计理念与方法,并结合临床病例对修复过程中重要环节如口腔微笑分析、牙体比色、牙体预备、酸蚀、粘接、牙体修复、抛光修整等操作步骤及临床要点进行归纳、总结。旨在为临床医生合理应用复合树脂进行牙体修复,获得良好美学效果提供借鉴和帮助,以期共同努力提高复合树脂牙体美学修复水平。     

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??Confident and charming smiles may bring us the impressions of beauty. And having complete and beautiful dentitions is an essential condition for attractive smiles. Common dental diseases such as hard tissue injury??discoloration??as well as occlusal deformity??dentition defect??edentulous jaw and so on??can not only damage the oral health of patients??but also have a negative impact on the smile. In order to accomplish a series of aesthetic treatment for the health and beauty of the teeth??dental professionals should not only have exquisite skills??but also have a profound understanding of dental anatomy??morphology and disease diagnostics. This article will summarize the common indicators??aesthetic problems and countermeasures of dental aesthetics based on the previous studies.     

牙槽突裂骨移植治疗进展

牙槽突裂骨移植是口腔颌面部裂隙畸形重建的重要步骤。初期肋骨移植能使上颌骨连续,消除口鼻腔瘘,不影响面中部发育,有助于防止双侧唇裂上颌骨节段性塌陷。二期髂骨移植成功率高,能稳定地产生小梁骨,恢复上颌骨连续性,提供正畸支持。牙槽突植骨能否产生足够的牙槽骨支持后期的正畸治疗,尚需进一步研究。本文就牙槽突裂骨移植治疗的进展作一综述。     

牙槽突裂植骨术后植入骨的定位分析

目的应用牙CT对牙槽突裂植骨术后的骨桥位置进行定位分析。方法选取18名单侧完全性牙槽突裂患者,在牙槽突裂植骨术后3个月对植骨部位进行牙三维CT扫描,将牙槽突裂隙分割后对植入骨进行定位。结果牙槽突裂植骨术后,近远中向上骨桥的数量没有统计学差异（P>0.05）;唇腭向上唇侧的骨桥数多于腭侧骨桥数（P<0.001）;垂直向上,植入骨的骨桥主要存在于裂隙侧中切牙的根中和根尖1/3,而鼻底及近牙槽嵴顶的骨桥数量较少（P<0.05）。结论牙槽突裂植骨术后骨桥的位置主要位于裂隙侧中切牙的根中和根尖1/3处,且唇侧的骨量明显多于腭侧的骨量。     

髂骨块状骨植骨术修复恒牙列牙槽突裂的短期临床观察

目的探讨牙槽突裂髂骨块状骨植骨术的临床可行性和可靠性。方法回顾分析15例行"牙槽突裂髂骨块状骨植骨术"的恒牙列牙槽突裂患者,随访6个月以上,收集临床资料,并进行影像学分析。结果所有患者均能定期复诊,术后13例患者创口愈合良好,2例因创口裂开导致植骨失败。影像学资料显示术后6个月植骨区间隙消失,骨桥形成,且植骨区无明显吸收。已有2例患者完成正畸及种植治疗。术后3个月所有患者均可正常行走,无明显行动障碍。结论牙槽突裂髂骨块状骨植骨术短期临床效果满意,移植骨吸收少,长期效果还需进一步研究。     

三维CT技术在牙槽突裂整复中的应用

在牙槽突裂治疗中,影像学评估至关重要,在植骨术前术后常规都会对牙槽突裂患者拍摄X线头颅全景片进行评估,但二维影像存在着影像重叠及模糊等问题。近年来,随着三维CT技术的不断发展,螺旋CT、锥形束CT等技术在121腔医学领域开始广泛应用。在牙槽突裂整复中,三维CT可用于评估术前裂隙大小、植骨术后的效果观察、计算术后植入骨吸收量等,并能以三维重建的方式较为直观地展示裂隙区域。除此之外,与常规螺旋CT相比,锥形束CT还具有价格便宜、辐射量小、清晰度高等优点。     

三维CT技术在牙槽突裂整复中的应用

在牙槽突裂治疗中,影像学评估至关重要,在植骨术前术后常规都会对牙槽突裂患者拍摄X线头颅全景片进行评估,但二维影像存在着影像重叠及模糊等问题.近年来,随着三维CT技术的不断发展,螺旋CT、锥形束CT等技术在口腔医学领域开始广泛应用.在牙槽突裂整复中,三维CT可用于评估术前裂隙大小、植骨术后的效果观察、计算术后植入骨吸收量等,并能以三维重建的方式较为直观地展示裂隙区域.除此之外,与常规螺旋CT相比,锥形束CT还具有价格便宜、辐射量小、清晰度高等优点.     

牙槽突裂的裂隙特点及正畸治疗对唇腭裂患者牙槽突植骨术的影响

牙槽突裂是位于唇腭裂患者上颌牙弓处的骨缺损,常发生于侧切牙与尖牙之间。由于先天性裂隙、早期手术治疗所致瘢痕挛缩及唇肌压迫等原因,患者多并发严重的上颌骨横向发育障碍。牙槽突植骨术作为唇腭裂序列治疗中的重要步骤,是修补上颌骨裂隙和矫正上颌横向发育不足的有效手段。众多临床实践及研究发现,正畸治疗的时机选择与牙槽突植骨术的成功率及预后效果密不可分,同时,牙槽突裂的裂隙特点对牙槽突植骨术产生的影响也不可忽视。本文就牙槽突裂的裂隙特点与正畸治疗时机对牙槽突植骨术成功率及预后的影响两方面进行综述,以期为唇腭裂患者临床治疗方案的选择及实验研究的设计提供一定的依据。     

唇腭裂二期牙槽突植骨临床常用评价方法的分析

目的随机选择52例单侧完全性唇腭裂患者,其中男性31人,女性21人,牙槽突植骨手术进行时,病人的年龄范围9至26岁,平均年龄15.2岁。方法在牙槽突植骨手术后对病人定期随访并拍摄上颌前部咬合片和上颌体腔片。分析上述两种X线片在评价牙槽裂隙部位牙槽骨高度的作用时,使用同一天拍摄的上颌体腔片和上颌前部咬合片。拍摄所分析的X线片时,裂隙侧尖牙已经萌出。评价标准采用1986年Bergland等所提出的临床分级方法进行。每种X线片分别进行两次评价,两次评价间间隔一周。结果上颌前部咬合片和上颌体腔片在评价牙槽突植骨部位的牙槽骨高度上没有本质的区别。结论正畸治疗前判断牙槽突高度时,既可以选择上颌体腔片也可以选择上颌前部咬合片。     

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唇腭裂患者常伴有的牙槽突裂不仅影响患者的面容,而且影响患者牙齿正常萌出及颌骨发育。自体髂骨松质骨移植是牙槽突裂修复的首选方法。本文从骨移植愈合机制、正常牙槽骨的生物学特性、手术时机、手术操作、骨诱导因子等几个方面内容结合作者临床体会,试图对术后移植骨吸收的原因及对策进行分析,以期对临床治疗有所裨益,提高手术修复效果。     

CT在唇腭裂二期牙槽突植骨疗效评价中的应用

目的 探讨唇腭裂二期牙槽突植骨后牙槽骨三维结构,以确保唇腭裂牙槽突植骨术后正畸 治疗的顺利进行。方法 选择唇腭裂二期牙槽突植骨术后半年以上的唇腭裂患者７名,病人的唇腭类型 分别为：单侧完全性唇腭裂６人,双侧完全性唇腭裂１人,牙槽突裂隙为８侧。病人的平均年龄为１５岁, 年龄范围 １１岁至 ２６岁。ＣＴ扫描平面与　面平行,从眶下缘至牙冠的根 １／３,每 ２毫米扫一层并进行三维 重建。结果ＣＴ可以真正反映唇腭裂牙槽突植骨部位的三维结构,能够发现唇腭侧存在的骨骼缺陷,有 利于唇腭裂序列治疗的顺利进行。结论 唇腭裂牙槽突植骨后,正畸治疗前采用ＣＴ这一先进手段进行 裂隙部位牙槽骨高度的三维评价,对于牙槽突植骨后正畸治疗及唇腭裂序列治疗具有十分重要的意义, 使牙槽突植骨的评价进入了三维时代。