口腔健康宣教对种植牙患者牙科焦虑心理的影响

目的评价口腔健康宣教对种植牙患者牙科焦虑心理的影响。方法种植牙患者60例,试验组和对照组各30例,于术前30 min、术前2 min应用牙科焦虑量表测评焦虑程度,2次测评之间试验组患者接受口腔健康宣教。手术完成时,记录2组患者术中焦虑状态及疼痛程度。结果 2组术前30 min焦虑程度差异无统计学意义（P〉0.05）,试验组术前2 min的焦虑程度低于术前30 min（P〈0.05）,也显著低于对照组术前2 min（P〈0.01）,同时,试验组术中焦虑及疼痛程度与对照组相比均明显降低（P〈0.05）。结论口腔健康宣教能显著缓解种植牙患者术前的焦虑心理,减轻术中疼痛。     

系统化健康教育联合心理护理对老年种植牙患者的应用价值分析

目的 探讨老年患者在种植牙围手术期开展系统化健康教育联合心理护理的应用效果。方法 选取2019年1月至2021年12月山西医科大学口腔医院人工种植牙患者138例,随机平均分为对照组（n=69）和观察组（n=69）。对照组患者采用常规护理,而观察组患者采用系统化健康教育联合心理护理模式。对比两组心理状态、护理满意度、疼痛程度、口腔卫生情况及术后并发症的发生率。结果 观察组老年种植牙患者焦虑自评量表(SAS评分)、汉密顿抑郁量表(HAMD)及视觉模拟评分法(VAS)均低于对照组（P <0.05）;观察组护理满意度高于对照组（P <0.05）;在口腔卫生状况方面,观察组的效果显著好于对照组（P <0.05）;在种植牙术后并发症发生率上,观察组患者为2.9%,低于对照组11.6%(P <0.05)。结论 老年种植牙患者在围手术期实施全方位系统化健康教育联合心理护理,可有效的缓解老年种植牙患者的牙科焦虑症,减轻术后疼痛程度,提升患者护理满意度并降低术后并发症发生。     

综合防治对青少年正畸患者口腔卫生状况的影响

目的评价口腔综合防治对青少年正畸患者口腔卫生状况的影响。方法选择60例口腔正畸患者随机分为试验组和对照组,每组30例。试验组采用＂医院—家庭＂联合的健康教育模式：戴上固定矫治器后,医护人员采用菌斑显示液显示患者牙面菌斑,进行个体化的口腔卫生强化教育,请家长对患者刷牙进行监督,必要时针对性使用氟化物等综合干预。对照组在矫治前进行常规口腔卫生宣教。比较2组戴用固定矫治器前后的菌斑指数、牙龈指数及牙釉质脱矿情况。结果矫治6个月后,试验组和对照组菌斑指数分别为1.25±0.32和1.57±0.37,差异有统计学意义（t=4.137,P=0.000）;牙龈指数分别为1.07±0.23和1.20±0.19,差异有统计学意义（t=2.756,P=0.007）。治疗后对照组和试验组的牙釉质脱矿率分别为19.5%和4.2%,差异有统计学意义（χ2=48.451,P=0.000）。结论实施＂医院—家庭＂联合的健康教育模式,制定综合干预措施,可改善患者口腔卫生状况,有效控制菌斑,对减少牙龈炎和釉质脱矿等正畸并发症具有重要意义。     

优化教育模式提升口腔本科生口腔健康教育能力的实践探究

目的: 探索研究性学习提升口腔本科生口腔健康教育的效果,优化教学质量和人才培养模式。方法: 选取昆明医科大学口腔医学院本科四年级的同学（2016级和2017级）,随机分为试验组和对照组,对照组采用传统的现场口腔健康教育,试验组采用研究性学习结合模拟宣教,同时也进行现场口腔健康教育。通过比较学生的期末理论成绩和宣教实践成绩,综合考核学生的口腔健康教育能力。另外,采用问卷星了解试验组同学对本次教学改革的评价。结果: 159名口腔本科四年级的同学（试验组80人,对照组79人）参加了本项目。试验组和对照组的口腔预防医学考试的理论成绩差异无统计学意义（P>0.05）,但试验组的实践成绩显著高于对照组(t=4.897,P<0.01)。87.5%的学生认为研究性学习结合模拟口腔健康教育的教学形式新颖,80.0%的学生认为改革后的口腔健康教育形式相对于传统宣教更有利于激发学习兴趣,82.5%的学生认为应该在口腔健康教育实践课中增加模拟宣教。结论: 基于研究性学习的模拟宣教能有效提高口腔预防医学的教学质量,培养社会需要的实用型口腔卫生人才。     

术前口腔宣教对急性牙髓炎患者焦虑心理的影响

目的探讨术前口腔宣教对急性牙髓炎患者焦虑心理的影响。方法选择2011年7月—2013年6月间因急性牙髓炎就诊的154例患者,年龄19~64岁。将其随机分为试验组（78例）和对照组（76例）。试验组在治疗开始前接受口腔宣教,对照组接受常规治疗;在正式治疗开始前,对2组患者分别进行2次口腔焦虑评估问卷调查,采用SPSS12.0软件包,应用t检验和χ²检验对结果进行分析。结果试验组宣教后牙科焦虑（dental anxiety）分显著低于宣教前（t=4.1346,P<0.01）。试验组宣教后DA分显著低于对照组（t=6.2784,P<0.01）。试验组对首次治疗的可接受度高于对照组患者,完成后续治疗情况也显著好于对照组。结论对急性牙髓炎患者在开始治疗前进行相关疾病的口腔宣教,能够使患者增加对疾病的了解,在一定程度上减轻患者治疗过程中的压力和紧张、焦虑情绪,从而顺利完成首次治疗和后续治疗。     

舒适护理在口腔临床治疗中的应用

目的探讨舒适护理在口腔临床治疗中的应用。方法从2008年6-8月在四川大学华西口腔医院综合科随机选择103例初次就诊行口腔疾病治疗的患者作为对照组,实施口腔门诊临床常规护理模式;从2008年9-11月在同一科室随机选择105例初次就诊患者作为试验组,实施舒适护理模式。完成初次治疗和护理后,采用自行设计的患者对口腔临床护理工作的满意度调查问卷和患者对口腔健康知识的知晓度调查问卷,调查患者对护理工作的满意情况及对健康知识的知晓情况。结果试验组患者对口腔临床护理工作的满意度和对口腔健康知识的知晓度分别为98.095%和93.333%,对照组分别为72.816%和57.282％,2组差异有统计学意义,试验组的满意度和知晓度均高于对照组。结论将舒适护理应用于口腔临床治疗中,提高了患者对口腔护理工作的满意度和对口腔健康知识的知晓度,同时也提高了口腔临床护理人员的专业素质,有利于构建和谐的护患关系。     

改良Beck口腔评分量表在口腔颌面外科患者中的应用

目的:根据改良Beck口腔评分量表的评估分值,选取适合患者的口腔护理方案,为临床口腔护理工作提供理论依据及指导。方法:选取2022年1月～2023年12月黄石市中心医院收治的口腔颌面外科手术患者212例,采用随机数字表法将其分为对照组和实验组,各106例。对照组采用常规口腔护理方法。实验组采用改良Beck口腔评分量表进行评估,制定口腔护理方案、计划,护士实施护理措施。比较两组患者术后第1、3、5天口腔异味评分、口腔并发症发生率、口腔清洁度。结果:使用改良Beck口腔评分量表评估后进行相应的护理,实验组患者在术后口腔异味评分小于对照组;口腔总并发症发生率低于对照组;口腔清洁度优于对照组,差异均有统计学意义(P<0.05)。结论:在临床中应用改良Beck口腔评分量表对手术患者进行口腔卫生评估,基于评分结果制定口腔护理方案、计划,可改善口腔颌面外科手术患者术后口腔清洁度,降低术后伤口感染率、口腔异味。     

环孢素治疗糜烂型口腔扁平苔藓的随机对照试验

目的研究环孢素治疗糜烂型口腔扁平苔藓的疗效和安全性。方法采用随机对照试验设计,将60例糜烂型口腔扁平苔藓患者随机分为2组(随机数字表法),每组各30例,分别给予与环孢素(试验组)和氟轻松软膏(对照组)治疗6周,治疗结束后评价疗效和不良反应,并于3个月后复查。结果治疗结束后评价疗效:试验组有效率93.3%,对照组96.7%,试验组视觉量表值(VAS)为24.73±15.65,对照组为34.27±16.36。统计后2种药物在促进病损愈合方面疗效差异无统计学意义(χ2=0.351,P>0.05),环孢素在减轻患者疼痛方面优于氟轻松(P<0.05)。治疗过程中不良反应发生率环孢素比氟轻松低。3个月后复查:试验组有效率96.7%,对照组80.0%。试验组VAS值为26.63±17.01,对照组为37.37±18.43。统计结果显示环孢素在缩小病损面积(χ2=4.043,P<0.05)、减轻疼痛方面(P<0.05)均优于氟轻松。结论环孢素治疗糜烂型口腔扁平苔藓比氟轻松有着更肯定的疗效和安全性,值得临床进一步推广应用。     

种植义齿患者中应用健康教育处方的效果评价

目的探究健康教育处方在口腔种植义齿患者健康教育中的应用效果。方法将163例口腔门诊行种植义齿患者随机分为对照组（82例）与实验组（81例）,对照组给予常规健康教育,实验组在常规健康教育的基础上发放健康教育处方,通过宣教前后患者种植知识水平评分和复诊依从性对健康教育处方实施效果进行评价。结果宣教前,对照组和实验组患者口腔种植知识平均分分别为（16.83±13.06）、（18.00±14.04）分,差异无统计学意义（t=-0.551,P＞0.05）;两组患者宣教前后知识水平得分差值分别为（44.83±28.35）、（63.19±19.93）分,差异有统计学意义（t=-4.787,P〈0.05）;复诊平均次数分别为（2.26±0.605）、（3.27±0.707）次,差异有统计学意义（t=-9.856,P＜0.05）。结论应用健康教育处方对种植义齿患者进行个性化宣教,可提高患者的宣教效果和复诊依从性,值得在口腔专科门诊推广。     

老年口腔牙列缺损患者微创种植围手术期的护理

目的：探讨老年口腔牙列缺失患者微创种植牙的围手术期护理方法。方法：对2010年1月至2012年10月间在解放军总医院口腔种植科行微创种植手术的患者115例进行回顾性分析,总结老年微创种植牙的围手术护理方法。结果：全部患者在种植手术过程中生命体征平稳,种植体植入顺利患者感觉良好,种植体存活率达94.01％,术后未出现种植体周围炎等并发症,患者基本能按要求维护种植体。结论：口腔种植围手术期良好的护理是种植牙手术成功的关键因素之一,细致精心的口腔护理可提高种植体存活率,促进患者顺利康复。     

高龄老年患者人工牙种植术的围手术期护理

目的：探讨高龄患者人工牙种植术临床配合与护理要点,提高老年种植牙手术的成功率。方法：根据老年生理改变及心理变化的特点,在术前做好充分准备,术中采取相应的配合和术后正确的口腔护理措施。结果：本组50例老年种植牙患者种植后,经随访3个月～2年,均形成良好的骨结合,无种植体脱落及牙龈炎等并发症。结论：采用微创种植技术,对老年种植患者术前、术中、术后三个阶段实施精心护理,避免了切口感染,促进切口愈合,提高了老年种植牙手术的成功率。     

疼痛管理对口腔种植围术期患者的影响

目的:探讨口腔种植患者围术期疼痛管理方法,提高对口腔门诊种植手术患者的护理水平.方法:纳入100例口腔门诊种植手术患者,以随机抽签方式分为管理组和对照组,管理组采用疼痛管理干预手段进行护理,对照组仅采用传统常规护理,对2组患者的术后疼痛及满意度进行比较.采用SPSS 16.0软件包对评价结果进行x2检验.结果:在2组紧张程度相同的情况下,管理组患者的疼痛率降低,满意率高,与对照组之间差异显著(P＜0.05).结论:通过对口腔种植患者进行围术期疼痛管理,可有效减轻不适感,提高患者的满意度,有利于及早康复.     

Comparison Between Dexamethasone and Ibuprofen for Postoperative Pain Prevention and Control After Surgical Implant Placement: A Double‐Masked,Parallel‐Group,Placebo‐Controlled Randomized Clinical Trial

Background: Postoperative pain is a potential adverse side effect of oral surgeries, and attempts should be made to prevent or minimize it. This study compares efficacy of preemptive ibuprofen and dexamethasone protocols for pain prevention or control after surgical implant placement. Methods: This prospective, double‐masked, parallel‐group, placebo‐controlled, randomized clinical trial included 117 patients with planned dental implant placement. Patients were assigned to receive one of three different protocols: 1) 600 mg ibuprofen 1 hour before surgery and another 600 mg 6 hours after the first dose; 2) 4 mg dexamethasone 1 hour before surgery and another 4 mg 6 hours after the first dose; or 3) placebo. Rescue medication (1,000 mg acetaminophen) was made available to each patient, and they were instructed to take it as necessary. Pain intensity was evaluated via a 101‐point numeric rating scale and a visual analog scale, and discomfort was evaluated using a four‐point verbal rating scale hourly for the first 8 hours after surgery and three times daily for the following 3 days. Results: Ibuprofen and dexamethasone significantly reduced pain (Kruskal–Wallis; P <0.05) up to 3 days after surgery and discomfort (P <0.05) up to 2 days after surgery compared with placebo treatment. Both treatments reduced the number of painkillers taken and increased time before the first painkiller was taken (P <0.01). Conclusion: Steroidal dexamethasone is as effective as non‐steroidal ibuprofen for preventing or controlling postoperative pain and discomfort after surgical implant placement.     

Carisolv(伢典)微创化学机械去龋法治疗老年人龋齿的临床研究

目的:评价伢典微创化学机械去龋法治疗老年人龋齿的有效性和安全性.方法:门诊老年龋齿病人48例,随机分为伢典治疗组30例和对照组18例,分别采用伢典凝胶去龋和常规磨牙去龋,比较两组病人的感受,治疗所用时间,治疗效果.结果:伢典治疗组病人痛苦小,安全,但所用时间长于对照组.结论:伢典化学机械去龋法治疗老年人龋齿安全、有效、无痛.     

种植义齿冠修复后失败病例的临床报告

目的:分析影响种植义齿修复成功率的原因。方法:收集临床上的10例种植修复前各项检查无异常,但恢复上部机构后发生种植体炎症或冠折裂等问题的病例,对其原因进行综合分析。结果:2例患者原因为咬合过紧,且后牙未及时修复导致种植体周围炎;3例患者未能成功控制牙周问题;1例患者夜磨牙;其余原因无法确定。结论:种植治疗前的咬合判断及治疗后的维护对种植成功率至关重要。     

Evaluation of the implementation of an 'oral hygiene protocol' in nursing homes: a 5-year longitudinal study

De Visschere L, de Baat C, Schols JMGA, Deschepper E, Vanobbergen J. Evaluation of the implementation of an ‘oral hygiene protocol’ in nursing homes: a 5‐year longitudinal study. Community Dent Oral Epidemiol 2011; 39: 416–425. © 2011 John Wiley & Sons A/S Abstract – Objectives: To explore the long‐term effects of the implementation of an oral hygiene protocol in nursing homes. Methods: Out of 14 nursing homes (Flanders) seven nursing homes were randomly allocated to the intervention group and confirmed to implement an ‘oral hygiene protocol’. The remaining nursing homes (the control group) continued to perform oral hygiene as usual. Oral hygiene levels were scored and factors related to plaque levels were recorded. Mixed model analysis with random institution effect, were performed to explore differences in oral hygiene levels owing to the intervention, and the predictive value of explanatory variables. Results: At baseline, no significant differences were found between plaque levels in both study groups. In an unadjusted analysis, different effects were observed on denture and dental plaque. The lowest denture plaque levels were found 2 years after the start of the study, while the lowest dental plaque levels were found at the end of the study. The effect of the intervention could not be confirmed in an adjusted mixed model, where significant indicators for dental plaque were resident’s dependency (P < 0.01) and presence of mouth rinse (P < 0.01). Capacity of the nursing home (P < 0.05) and the presence of toothpaste (P < 0.01) were dominant influencing factors for denture plaque. Conclusions: After 5 years of implementation obtained plaque levels were unsatisfactory. A lot of uncertainties remained on the impact of characteristics of individual nursing homes. Obtaining adequate oral hygiene levels in nursing homes remain an important ongoing challenge and needs further research.     

Electromyographic analysis of masticatory and neck muscles in subjects with natural dentition, teeth-supported and implant-supported prostheses

Objectives: To compare the electromyographic (EMG) characteristics of masticatory and neck muscles in patients with natural dentition, teeth‐supported prostheses and implant‐supported prostheses. Materials and methods: Twenty‐five subjects aged 40–80 years were examined. Five patients had maxillary and mandibular implant‐supported fixed prostheses; five patients had mandibular implant‐supported fixed prosthesis and maxillary removable complete denture; seven patients had implant‐supported fixed prosthesis (one arch) and natural dentition or full‐arch tooth‐fixed prosthesis (one arch); and eight control subjects had natural dentition or single tooth‐fixed prostheses. Surface EMG of masseter, temporal and sternocleidomastoid muscles was performed during maximum teeth clenching and unilateral gum chewing. Interarch dental contacts were assessed with shim stocks. Results: All groups had similar interarch dental contacts (P>0.05). During clenching, patients with maxillary and mandibular implant‐supported fixed prostheses had unbalanced standardized masseter and temporalis anterior activities (74%), with significantly larger values found in the other patients and control subjects (all mean values larger than 86%, P=0.017). All patients chewed with significantly larger muscular potentials than control subjects (on average, 1434–2100 μV s vs. 980 μV s, P=0.04), and had altered muscular patterns (left side, P=0.021). The patients with one arch with natural dentition/tooth fixed prostheses had chewing muscular patterns similar to the control subjects. Conclusions: Clenching with the analyzed prostheses was performed with a relative increment of temporalis activity. Neuromuscular coordination during chewing was larger in patients who maintained their teeth or dental roots, independently from the number of dental contacts.     

Titanium allergy in dental implant patients: a clinical study on 1500 consecutive patients

Background: In dentistry, allergic reactions to Ti implants have not been studied, nor considered by professionals. Placing permanent metal dental implants in allergic patients can provoke type IV or I reactions. Several symptoms have been described, from skin rashes and implant failure, to non-specific immune suppression.
Objective: Our objective was to evaluate the presence of titanium allergy by the anamnesis and examination of patients, together with the selective use of cutaneous and epicutaneous testing, in patients treated with or intending to receive dental implants of such material.
Material and methods: Thirty-five subjects out of 1500 implant patients treated and/or examined (2002–2004) were selected for Ti allergy analysis. Sixteen presented allergic symptoms after implant placement or unexplained implant failures [allergy compatible response group (ACRG)], while 19 had a history of other allergies, or were heavily Ti exposed during implant surgeries or had explained implant failures [predisposing factors group (PFG)]. Thirty-five controls were randomly selected (CG) in the Allergy Centre. Cutaneous and epicutaneous tests were carried out.
Results: Nine out of the 1500 patients displayed positive (+) reactions to Ti allergy tests (0.6%): eight in the ACRG (50%), one in the PFG (5.3%)( P =0.009) and zero in the control group. Five positives were unexplained implant failures (five out of eight).
Conclusions: Ti allergy can be detected in dental implant patients, even though its estimated prevalence is low (0.6%). A significantly higher risk of positive allergic reaction was found in patients showing post-op allergy compatible response (ACRG), in which cases allergy tests could be recommended.     

无牙颌患者种植体支持不同修复方式的临床效果分析

目的 ：对比无牙颌患者行种植体支持整体桥架式修复及分段式修复的种植体成功率,并从咀嚼、发音、美观、舒适性、维护性方面对2种方式进行评价。方法：选择2016年1月1日—2019年12月31日于复旦大学附属中山医院及徐汇区中心医院就诊的无牙颌患者38例,将患者随机分配至研究组（n=19）和观察组（n=19）。研究组采用分段式修复,观察组采用整体桥架式修复。所有患者于修复后1个月、6个月、1年及2年时进行随访。结果：研究组及观察组种植体成功率分别为99.32%和98.68%,修复成功率为99.02%和98.64%。2组在咀嚼食物感受、发音方面未有明显差异（P>0.05）,但在义齿舒适度、维护性及美观效果方面,观察组患者评价明显高于研究组（P<0.01）。结论：无牙颌患者种植体支持无论是采用分段式还是整体桥架式修复,均可取得良好的效果,但在舒适度、美观效果及维护性方面,整体桥架式修复方式更好。     

Efficacy of two antibiotic regimens in the reduction of early dental implant failure: a pilot study

The purpose of this study was to compare the efficacy of two antibiotic regimens in reducing early dental implant failure. A preoperative single-dose regimen and a 3-day antibiotic course were compared. Eighty subjects needing dental implant placement were randomly allocated to one of the two antibiotic prophylaxis regimen groups. In the first group, dental implants were placed after the administration of a single preoperative dose of antibiotic (1 g of amoxicillin); no postoperative antibiotics were given. In the second group, dental implants were inserted in patients who received the same preoperative dose of antibiotic as the first group, but the antibiotic was then continued postoperatively for 3 days. Patients returned for postoperative evaluation at 3 days, 7 days, and 12 weeks. The surgical sites were assessed for pain, swelling, wound dehiscence, and pus formation. No statistically significant difference was observed between the two groups, probably because of the limited number of patients. Although minor complications were seen in a few patients, all implants were successfully osseointegrated. Until a study with a larger population rules definitively on the role of antibiotics in implant surgery, a single dose of antibiotic before implant placement may be sufficient.