几丁质/rhBMP2/胶原复合物修复骨缺损的实验研究

目的：研究几丁质作为骨缺损充填材料和rhBMP2载体的可行性。方法：制备多孔几丁质及几丁质/rhBMP2/胶原复合物，进行了几丁质，几丁质/rhBMP2/胶原复合物修复兔颅骨缺损的实验研究。通过X线片，组织学检查评价其骨缺损修复能力。结果：实验结果表明几丁质具有一定的骨引导活性，与rhBMP2复合后，成为既具有骨引导活性，又具有骨诱导活性的复合植骨材料，具有较强的骨缺损修复能力。结论：几丁质适于作为骨替代材料及BMP的载体，但在材料的强度和表面活性上还需要改进。     

Coupling electrical and mechanical outputs of human jaw muscles undertaking multidirectional bite-force tasks

Previous studies have identified both linear and curvilinear relations between increasing bite-force magnitude and the integrated electromyogram (EMG) of jaw-closing muscles. In an attempt to explain the discrepancy, bite forces of incrementally increasing magnitude were produced on the right-hand side in five specified directions by eight humans. Linear regression lines were fitted to normalized EMG activities of the left and right masseter and temporalis muscles against increasing bite-force magnitude in each direction. The grand mean of linear correlation coefficients was 0.79 (±0.11 SD), suggesting an overall linear relation. Each set of individual data was fitted with polynomial lines up to the third order. The ‘best’ fit was selected by statistical significance of coefficients and the least-square analysis of the sum of residues for each fitted line; 62% of individual data-sets were best fitted with linear regression lines, 31% with quadratic lines and the remaining 7% with cubic lines. Repeated analysis of residue variance of the pooled data showed that either a linear or quadratic line fitted every data set except one, for which a cubic line had the best fit. Working-side muscles had significantly larger linear correlation coefficients than corresponding balancing-side muscles for most bite-force directions. Analysis of variance of linear correlation coefficients revealed that the degree of linearity often depended upon the roles played by a muscle in producing forces in different directions. It appears that linearity or non-linearity of the EMG-force relation is a determinant, among other variables, of the direction of the resultant force.     

Tobacco and alcohol related to the anatomical site of oral squamous cell carcinoma

The aim of the present study was to evaluate the possible relationship between tobacco smoking and alcohol drinking and the anatomical sites of squamous cell carcinoma (SCC) of the lip and oral cavity. For this purpose, a case-case study has been performed in 690 patients. The study was focused on the relative risk (RR) or developing SCC at various (sub)sites, for smokers and drinkers of alcohol (divided into moderate and heavy users) relative to non-smokers and non-drinkers. Estimates of ratios of these relative risks were obtained. The relative risk associated with tobacco smoking, adjusted for the use of alcohol, appeared to be highest for SCC in the retromolar area, followed by the floor of mouth, whereas the lowest RR was found in the cheek mucosa. For alcohol drinking, adjusted for tobacco smoking, RR of SCC of the floor of mouth was significantly higher than for the tongue, whereas the RR of SCC of the cheek appeared to be lowest. Furthermore, this study suggests that the contrasts between relative risks, observed by anatomical site of oral SCC, are more pronounced for tobacco smoking than for the use of alcohol. The possible local and systemic factors responsible for these variations of susceptibility for tobacco and alcohol within the oral cavity are discussed.     

Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials

OBJECTIVES: To determine whether parachutes are effective in preventing major trauma related to gravitational challenge. Design Systematic review of randomised controlled trials. DATA SOURCES: Medline, Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists. STUDY SELECTION: Studies showing the effects of using a parachute during free fall. MAIN OUTCOME MEASURE: Death or major trauma, defined as an injury severity score > 15. RESULTS: We were unable to identify any randomised controlled trials of parachute intervention. CONCLUSIONS: As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.     

Is occlusion becoming more confusing? A plea for simplicity

It is not difficult to observe and record patient occlusal characteristics before starting simple or complex occlusal rehabilitations. If this is done, and if the subsequently placed crowns and fixed prostheses are constructed in observation of similar characteristics, clinical success usually is the result. Deviations from the suggestion to duplicate the "normal" occlusion should be made when the original natural occlusion had caused overt pathosis, or when all teeth or one arch of the teeth is being restored at one time. If this is the case, centric relation occlusion is more reproducible and easier to develop than occlusion with a shift from centric relation to centric occlusion. Peculiar requests of patients relative to occlusal positioning, or routine dependence on various devices to predetermine occlusal characteristics for rehabilitation (as is currently popular in some groups), should be considered, but they should be tempered with careful observation of preoperative occlusal characteristics.     

Necrotizing stomatitis: report of 3 Pseudomonas aeruginosa-positive patients

Necrotizing oral lesions have been described in immunosuppressed patients, usually in association with gingival and periodontal pathoses. The etiology of these lesions has not been completely elucidated. We present 3 patients with a type of necrotizing stomatitis in which clinical patterns appear distinct from the periodontal forms of the disease. The lesions yielded bacterial cultures positive for Pseudomonas aeruginosa and reverted to no growth in 2 patients after proper antibiotic therapy. We propose that P aeruginosa may be responsible for selected necrotizing oral lesions with a clinical presentation lacking typical necrotizing periodontal disease and that this condition may represent the intraoral counterpart of ecthyma gangrenosum. In such cases, bacterial culture of the lesion becomes imperative because the disease does not respond to typical periodontal and antimicrobial therapy.     

Transmission of bone strain in the craniofacial bones of edentulous human skulls upon dental implant loading

STATEMENT OF PROBLEM: Little is known about how craniofacial bones that are distant from dental implants are loaded. Whether bone experiences different strain when implants of different diameters are loaded is unknown. PURPOSE: This study was designed to (1) characterize bone strain both adjacent to and distant from dental implants and (2) compare bone strain in response to the same loads on small-diameter and large-diameter implants. MATERIAL AND METHODS: On 4 edentulous, dry adult human skulls, the buccopalatal midpoint of the edentulous occlusal surface was marked unilaterally in the maxillary first molar area with a round bur. A hole for implant placement was prepared, and 2 self-tapping titanium implants (3.75 x 7 mm and 4 x 7 mm) were placed in the same location and at the same orientation, one after the other. A 4-mm-long titanium abutment was connected to the implant. Each implant was loaded 10 degrees lateral to its longitudinal axis, simulating a lateral occlusal force in 3 of the skulls. In skull 2, loading was along the longitudinal axis of the implant and simulated a vertical occlusal force. The magnitude of the ramp forces was 0 to 100 N. Uniaxial strain gages and/or 3-element strain rosettes were implanted in the supramolar cortical bone, the supraincisor cortical bone, the zygomaticomaxillary suture, and the zygomaticotemporal suture. All strain gages/rosettes were excited with 500 mV DC, and the output signals were recorded with a strain conditioner. Tensile strain was expressed as positive values and compressive strain as negative values. Student t tests were used to test for normal distribution of bone strain within each skull; Wilcoxon tests were applied for skewed distribution between small- and large-diameter implants and between 50-N and 100-N loads (P相似文献   

New technology: mandatory, elective, or hype?

If you were to buy all of the technologies that are currently advertised as being important, it would be financially stressful. In addition, you may not find that you would use all of them with equal enthusiasm. In our opinion, some new technologies are mandatory for current practice, while others are primarily elective. Only you can decide which technology is desirable to better treat your patients and make dentistry more enjoyable for you and your staff. Incorporation of the right new technology into your practice will excite you, your staff, and your patients, stimulate your interest in dentistry, and potentially provide higher quality dentistry. The money you spend on the technology of your choice will be well spent if you evaluate each concept carefully and thoroughly before buying it.