蟾毒制剂与蟾酥制剂对狗牙髓组织的影响

目的：与砷剂作比较观察狗牙髓直接封蟾毒制剂、蟾酥制剂后的组织学变化。方法：实验动物采用狗,在光镜下观察标本。结果：封药１～４ｈ,砷剂与蟾酥制剂组牙齿牙髓血管扩张、充血明显;封药１ｄ,砷剂组牙齿冠髓坏死,根髓小血管破裂、出血,蟾毒制剂组牙齿冠髓组织严重水肿、细胞变性,但根髓出血较少;封药３～５ｄ,砷剂组牙齿牙髓呈出血性坏死,蟾毒制剂组牙齿牙髓以液化性坏死为主,而蟾酥制剂组牙齿兼有上述两种变化特征。结论：砷剂对牙髓的损伤以血管毒性为主,蟾毒制剂以原生质毒性为主,而蟾酥制剂兼有上述两种毒性作用。     

蟾毒对狗牙髓CGRP免疫阳性神经纤维的影响

目的：观察狗牙髓直接封蟾毒后牙髓内降钙素基因相关肽免疫反应阳性（简称ＣＧＲＰ－ＩＲ）神经纤维的动态变化。方法：采用冰冻切片和免疫组织化学方法（ＡＢＣ法）。结果：封药１ｈ，蟾毒组及可卡因组其牙髓内ＣＧＲＰ－ＩＲ神经纤维在形态、染色及数量上无显著差别；封药４ｈ，蟾毒组牙髓内ＣＧＲＰ－ＩＲ神经纤维明显断裂、数量减少、染色变浅，而可卡因组则无明显变化。结论：蟾毒快速麻痹牙髓神经的作用机理可能为一种神经毒性作用     

蟾毒制剂对狗牙切髓术影响的动物实验研究

目的：观察蟾毒制剂术前牙髓封药对切髓术后根髓组织自身愈合过程的影响。方法：使用狗的恒磨牙，光镜观察。结果：术前蟾毒制剂封药１ｈ组与生理盐水封药１ｈ组，切髓术后根髓组织变化以及牙本质桥形成时间和类型等均无显著差异。结论：蟾毒制剂冠髓封药１ｈ对根髓组织的自身修复功能无明显影响。     

蟾毒与蟾酥提取物牙髓镇痛效果的比较研究

目的：观察比较蟾毒与蟾酥不同提取物的牙髓镇痛效果。方法：采用以猫开口反射为疼痛指标的牙髓电刺激模型。结果：牙髓封药３０ｍｉｎ，蟾毒对牙痛阈值的增长率明显高于蟾酥乙醇提取物和氯仿提取物；封药１ｈ，蟾毒对牙痛阈值的增长率与蟾酥乙醇提取物无明显差别，但明显高于蟾酥氯仿提取物；封药２ｈ，对牙痛阈值的增长率，蟾毒与蟾酥乙醇提取物和氯仿提取物之间均无明显差异。结论：蟾毒的牙髓镇痛作用较强，起效快，其次为蟾酥乙醇提取物，蟾酥氯仿提取物作用较慢     

蟾毒对狗牙髓神经纤维超微结构的影响

蟾毒是加工制成蟾酥的主要原料,自1995年起我们将蟾毒用于临床快速无痛切髓,取得了较蟾酥制剂更理想的疗效[1]。为进一步探讨蟾毒快速去除牙髓疼痛的作用机理,我们观察了蟾毒封药后牙髓神经纤维超微结构的变化,现将结果报告如下。1材料与方法:(1)实验动物及其牙齿分组:选取2只成年狗的双根牙12个,按观察时间1ｈ、2ｈ、6ｈ和24ｈ,分成4组,每组3个牙。(2)实验药物:蟾毒糊剂:为中华大蟾蜍耳后腺分泌物冻干粉,加适量甘油、95%乙醇(1∶1)(ｍｌ/ｍｌ)混合液体调制成的丸膏状固体。(3)实验方法:将狗牙颌面穿髓,暂封约5#球钻大小的药物(对照牙封生理…     

蟾酥液体失活剂临床应用和组织学观察

蟾酥液体失活剂既能使牙髓失活又安全可靠。封药０．５～１ｈ可无痛去髓或切髓，１次完成治疗，也可以作为干髓术２次法的应用。本组治疗２１０个牙，优：１５５牙（７３．８１％），良：３９牙（１８．５７％），差：１６牙（７．６２％），有效率为９２．３８％。失活时间、颌别、牙别、洞别与切髓效果无显著性差异。封药后多数病人无明显的疼痛反应。组织学观察，封药２天，牙髓组织正常或血管轻度扩张充血，封药７天，牙髓血管明显扩张充血。蟾酥液体失活剂使用方便，毒副作用小，疗效满意     

无砷失活剂Antipulp的临床疗效观察

目的观察牙髓失活剂Antipulp的临床疗效。方法将280颗需行牙髓失活治疗的患牙随机分成2组,分别用无砷失活剂Antipulp和砷失活剂进行失活,观察并比较两者的临床使用效果。结果Antipulp的失活有效率为93.10%,与砷失活剂的失活效果无差异(P>0.05),但Antipulp组封药后的疼痛反应和对牙周组织的损伤程度低于砷失活剂组。结论Antipulp对牙髓的失活是安全有效的。     

防止砷失活剂泄漏的有效方法

防止砷失活剂泄漏的有效方法佛山市口腔医院桂和明含砷失活剂因作用快，价廉而广泛用于口腔科临床。但传统采用丁香油氧化锌糊剂（ＺＯＥ）封药常不能很好密封窝洞、造成失活剂地漏腐蚀邻近软组织、加重病员痛苦。笔者采用含碘仿的ＺＯＥ（氧化锌粉：碘仿粉＝５：１）封闭...     

牙髓损伤性刺激对牙髓组织中P物质等的影响

目的：比较和分析急性牙髓炎和牙齿开髓刺激后，牙髓组织中Ｐ物质（ＳＰ）、降钙素基因相关肽（ＣＧＲＰ）的变化。方法：利用免疫组织化学方法观察大鼠牙齿开髓后２ｈ、４ｈ和急性牙髓炎２ｈ、４ｈ组牙髓组织中ＳＰ、ＣＧＲＰ免疫阳性纤维的变化。结果：牙髓炎性及机械损伤性伤害刺激引起牙髓组织ＳＰ／ＣＧＲＰ免疫阳性纤维一致性变化。牙齿开髓及牙髓炎２ｈ、４ｈ组牙髓组织中ＳＰ、ＣＧＲＰ免疫阳性纤维减少。结论：两种刺激均引起牙髓组织内神经末梢释放ＳＰ、ＣＧＲＰ。     

YDM—1牙科电子麻醉仪引起Vc内SP,CGRP的变化

目的： 分析面部ＴＥＮＳ后,三叉神经脊束核尾侧亚核（Ｖｃ）内Ｐ物质（ＳＰ）、降钙素基因相关肽（ＣＧＲＰ）的变化。方法：利用免疫组织化学染色方法观察大鼠面部ＴＥＮＳ后１、２、４ｈ,Ｖｃ 内ＳＰ、ＣＧＲＰ免疫阳性纤维的变化。结果：面部ＴＥＮＳ后１ｈ 实验侧与对照侧相比,ＳＰ、ＣＧＲＰ免疫阳性纤维减少,甚至有脱失现象,２ｈ组呈恢复趋势,４ｈ 组与对照侧无显著差异。结论：面部ＴＥＮＳ引起Ｖｃ 内三叉神经末梢大量释放ＳＰ、ＣＧＲＰ。     

纤维蛋白粘接剂盖髓的动物实验研究

目的：观察纤维蛋白粘接剂（ＦＳ）对人工暴露的牙髓组织愈合的影响。方法：采用ＦＳ行狗牙直接盖髓术,常规制备牙－颌骨联合切片,光学显微镜观察牙髓创面的愈合及牙本质的修复。结果：ＦＳ盖髓后牙髓无出血,炎性反应轻。氢氧化钙盖髓后牙髓出血多,炎性反应较重。ＦＳ组术后４２ｄ出现骨样牙本质桥修复,氢氧化钙组术后２８ｄ出现骨样牙本质桥修复,术后６３ｄ,ＦＳ组６例中４例有牙本质桥形成,氢氧化钙组６例均有牙本质桥形成。结论：ＦＳ虽无牙本质诱导活性但因其良好的保护及促进牙髓组织创面愈合能力仍不失为一种较为理想的盖髓剂。     

Mineral trioxide aggregate vs. formocresol in pulpotomized primary molars: a preliminary report

PURPOSE: The aim of this study was to compare the effect of mineral trioxide aggregate (MTA) to that of formocresol (FC) as pulp dressing agents in pulpotomized primary molars with carious pulp exposure. METHODS: Forty-five primary molars of 26 children were treated by a conventional pulpotomy technique. The teeth were randomly assigned to the MTA (experimental) or FC (control) group by a toss of a coin. Following removal of the coronal pulp and hemostasis the pulp stumps were covered with an MTA paste in the experimental group. In the control group, FC was placed with a cotton pellet over the pulp stumps for 5 minutes and removed; the pulp stumps were then covered by zinc oxide-eugenol (ZOE) paste. The teeth of both groups were restored with stainless steel crowns. Eighteen children with 32 teeth arrived for clinical and radiographic follow-up evaluation ranging from 6 to 30 months. RESULTS: The follow-up evaluations revealed only one failure (internal resorption detected at a 17 months postoperative evaluation) in a molar treated with formocresol. None of the MTA-treated teeth showed any clinical or radiographic pathology. Pulp canal obliteration was observed in 9 of 32 (28%) evaluated molars. This finding was detected in 2 out of the 15 teeth treated with FC (13%) and in 7 out of the 17 treated with MTA (41%). CONCLUSION: MTA showed clinical and radiographic success as a dressing material following pulpotomy in primary teeth and seems to be a suitable replacement for formocresol in primary teeth.     

The effectiveness of mineral trioxide aggregate, calcium hydroxide and formocresol for pulpotomies in primary teeth

Aim To compare the effectiveness of mineral trioxide aggregate (MTA), calcium hydroxide (CH) and formocresol (FC) as pulp dressing agents in carious primary teeth. Methodology Forty‐five primary mandibular molars with dental caries in 23 children [AUTHOR QUERY: How many children?] between 5 and 9 years old were treated by a conventional pulpotomy technique. The teeth were randomly assigned to the experimental (CH or MTA) or control (FC) groups. After coronal pulp removal and haemostasis, remaining pulp tissue was covered with MTA paste or CH powder in the experimental groups. In the control group, diluted FC was placed with a cotton pellet over the pulp tissue for 5 min and removed; the pulp tissue was then covered with zinc oxide–eugenol (ZOE) paste. All teeth were restored with reinforced ZOE base and resin modified glass–ionomer cement. Clinical and radiographic successes and failures were recorded at 3, 6, 12, 18 and 24 month follow‐up. Results Forty‐three teeth were available for follow‐up. In the FC and MTA groups, 100% of the available teeth were clinically and radiographically successful at all follow‐up appointments; dentine bridge formation could be detected in 29% of the teeth treated with MTA. In the CH group, 64% of the teeth presented clinical and radiographic failures detected throughout the follow‐up period, and internal resorption was a frequent radiographic finding. Conclusions Mineral trioxide aggregate was superior to CH and equally as effective as FC as a pulpotomy dressing in primary mandibular molars. Internal resorption was the most common radiographic finding up to 24 month after pulpotomies performed with CH.     

289例牙颌面畸形正颌矫治的回顾性研究

目的:对正颌手术矫治牙颌面畸形的患者进行回顾性研究,探讨牙颌面畸形的分类、手术方式的选择与并发症的防治。方法:收集1985~2003年武汉大学口腔医学院口腔颌面外科收治的牙颌面畸形病例中,资料较完整的289例作回顾性分析,通过术前术后面型、咬合关系、颞下颌关节功能的临床检查、X线分析及下牙槽神经功能评测,对手术疗效进行评价。结果:289例患者共行手术449例次,282例(282/289)术后伤口I期愈合,其余7例延期愈合,面型与咬合恢复满意;最常见的并发症是下牙槽神经损伤(12/289),其次是咬合不理想(10/289),其他并发症较少。结论:牙颌面畸形患者的外科治疗,要根据个体畸形情况和要求,经过专科临床检查、头影测量分析和模型研究得出确切诊断和设计,拟定治疗方案作好术前预测,选择合适正颌手术,坚持术前术后正畸,方能重建牙颌面结构的关系和咬合功能的效果。     

Pulp response to collagen and glutaraldehyde in pulpotomized primary teeth of baboons

This investigation assessed histologically the pulp tissue reaction to glutaraldehyde (GA) and to a commercial collagen preparation in pulpotomized primary teeth of baboons. One hundred and eighty-eight primary teeth were pulpotomized; in half of them inflammation was induced prior to the treatment. The teeth were divided into five groups: in three of them GA was used as a pulp dressing and applied for 1 min (group 1), 5 min (group 2), or mixed into the paste (group 3); collagen was used in group 4 and in group 5 (control) IRM was placed directly over the pulp stumps. Follow-up times were two, eight, and 24 weeks. Total necrosis was observed only in the collagen group. Partial necrosis and severe inflammation also were seen mainly in this group, and when the GA was incorporated into the paste. Slight to moderate inflammation was evident in all groups two and eight weeks postoperatively; however, 78% of the teeth of group 2 (GA 5 min) were inflammation-free after 24 weeks. Partial dentin bridges were seen in 92% of the teeth of the control group, in 82% of group 2, and 50% each of groups 1 and 3 eight weeks postoperatively. Dentin bridges were present in only 4% of the collagen group. After 24 weeks, all the teeth in group 2 and 83% of group 1 had dentin bridges. We conclude that Zyderm (Colagen Corp. Palo Alto, CA) led to unacceptable results, 5 min application of GA presented the best healing response, and GA 1 min and IRM also were satisfactory.     

复方珊瑚糊剂治疗髓室底穿孔的临床观察

目的 :观察复方珊瑚糊剂修补髓室底穿孔的临床效果。方法 :髓室底穿孔患牙 62例 ,实验组采用复方珊瑚糊剂作髓室底穿孔修补 ,对照组采用玻璃离子水门汀作髓室底穿孔修补。一年后复查 ,观察疗效。结果 :实验组有效率 84.4% ,对照组有效率 63 .3 %。结论 :髓室底穿孔的患牙经用复方珊瑚糊剂作髓室底修补 ,可长期保存 ,其治疗效果明显优于玻璃离子水门汀作髓室底修补