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复发性阿弗他溃疡(RAU)是发生于口腔黏膜最常见的溃疡类疾病,最早由Hippocrates在公元前400年提出[1]。调查显示,人群中RAU的患病率为10%～25%,在特定人群中,该病的患病率甚至可以达到50%,就性别差异而言,女性的患病率一般高于男性[2]。RAU最常见于10～30岁龄     

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灾难事件正对有限的医疗公共卫生资源提出严峻挑战,并日益对其提出更多的要求。在应对各种灾难或其他突发事件时,牙科医生的地位和作用正在发生改变,他们将在更大范围发挥更多的作用。笔者参考大量国外文献向大家介绍在大规模灾难事件中,牙科医生可以在允许的范围内提供救灾服务,同时强调有计划地教育培训牙科医生在灾难中发挥应有的作用,同时牙科医生在政府部门支持下形成一套完整的紧急预案是非常必要的。     

白细胞介素1受体拮抗剂基因型与糖尿患者群中牙周炎的关系

目的:探讨白细胞介素1受体拮抗剂(interleukin-1 receptor antagonist,IL-1ra)基因型与2型糖尿患者群中牙周炎(periodontitis of diabetes mellitus,DMP)易感性的关系。方法:收集2型糖尿病患者186例,分为糖尿病伴牙周炎组108名和糖尿病不伴牙周炎组78名,取血提取DNA,采用序列特异引物多聚酶链反应(sequence specific primers polymerase chain reaction,SSP-PCR)法测定IL-1RN内含子2/VNTR位点的基因型,比较各基因型检出率的差别。结果:IL-1RN内含子2/VNTR等位基因A2在2型糖尿病伴牙周炎组的检出率显著高于2型糖尿病不伴牙周炎组,分布差异有显著性(χ2=3.579,P=0.040)。结论:在2型糖尿病患者中,IL-1RN内含子2/VNTR等位基因A2可能与牙周炎的遗传易感性相关。     

偏侧咀嚼对紧咬牙运动时海马旁回激活影响的探索

目的探索偏侧咀嚼对紧咬牙运动时脑功能活动的影响。方法选取左、右侧偏侧咀嚼患者各7例，在紧咬牙运动时采集全脑血氧水平依赖对比的功能性磁共振成像（functional magnetic resonance imaging，fMRI）扫描数据。结果7例左侧偏侧咀嚼患者中有4例出现海马旁回的激活，而右侧偏侧咀嚼患者均未见海马旁回的激活。结论发现了左侧偏侧咀嚼患者紧咬牙运动可激活与人类学习记忆能力有重要关系的海马旁回的现象。     

唾液腺腺癌VEGF和NOS的表达与癌细胞增殖关系的研究

目的:研究唾液腺腺癌组织血管内皮生长因子(VEGF)、诱导型一氧化氮合酶(iNOS)、内皮型一氧化氮合酶(eNOS)的表达与癌细胞增殖的相关性。方法:应用免疫组化方法检测47例唾液腺腺癌手术切除标本VEGF、iNOS、eNOS和增殖细胞核抗原(PCNA)的分布及表达。结果:①30例(63.83%)唾液腺腺癌组织表达VEGF,31例(65.96%)表达iNOS;33例(70.21%)表达eNOS;②VEGF与iNOS的表达具有明显相关性,VEGF与eNOS的表达无明显相关性;③表达VEGF的唾液腺腺癌PCNA标记指数(PLI)明显高于不表达VEGF的唾液腺腺癌;表达iNOS的唾液腺腺癌PLI明显高于不表达iNOS的唾液腺腺癌。表达eNOS的唾液腺腺癌PLI与不表达eNOS的唾液腺腺癌无显著差异(P>O.05)。结论:①VEGF与iNOS的表达具有明显相关性,说明iNOS在VEGF的生成和发挥作用过程中起重要作用;②PLI随着VEGF和iNOS表达的增加而增加;说明两者对唾液腺腺癌细胞增殖具有促进作用。     

Risk factors for diagnostic subgroups of painful temporomandibular disorders (TMD)

Temporomandibular Disorders (TMD) encompass several entities, which may have differing etiologies. To test this hypothesis, we investigated risk factors for three diagnostic subgroups of painful TMD. Ninety-seven subjects with myofascial pain only, 20 with arthralgia only, 157 with both myofascial pain and arthralgia, and 195 controls without TMD pain met criteria for study eligibility. Investigated risk factors included both physical and psychological variables. Adjusted odds ratios were calculated by multiple logistic regression analyses. Myofascial pain occurring alone was significantly associated with trauma (Odds Ratio [OR] = 2.0), clenching (OR = 4.8), third molar removal (OR = 3.2), somatization (OR = 3.7), and female gender (OR = 4.2). Myofascial pain with arthralgia was significantly associated with trauma (OR = 2.1), clenching (OR = 3.3), third molar removal (OR = 4.0), somatization (OR = 5.1), and female gender (OR = 4.7). No significant associations were found for the small-arthralgia-only group.     

CVP动脉灌注联合手术治疗晚期上颌窦鳞癌的疗效(附39例分析)

目的 :探讨CVP方案行颞浅动脉灌注术前诱导化疗联合手术治疗 39例晚期上颌窦癌患者的可行性。方法 :39例T4患者采用卡铂、足叶乙甙、平阳霉素诱导化疗 ,然后施行上颌骨扩大切除加同侧根治性颈淋巴清扫术。结果 :所有患者均可耐受化疗 ,化疗疗效评价均为部分缓解。术后失访 5例 ,随访资料完整 34例 ,占87%。所有病例无原发灶复发。其中 4例死于远位转移 ,分别为术后第 5月、第 7月、第 8月和第 12月。 30例无瘤生存。 5年以上 17例 ,3年以上 6例 ,1年以上 4例 ,不足 1年 3例。结论 :CVP颞浅动脉灌注术前诱导化疗联合手术治疗晚期上颌窦癌 ,是提高远期疗效的有效方案。合理的术后化疗及免疫治疗是减少术后远位转移 ,提高远期生存率的重要因素。也是今后需要高度重视的问题     

Fluoride distribution in human dental calculus obtained from different sites on the tooth surface

We examined the site specificity of fluoride (F) distribution in human dental calculus. Teeth with supra- and subgingival calculus were obtained from patients who resided in non-fluoridated areas in Japan and China. Sequential layers of the dental calculus (30 μm thick) were abraded by an abrasive micro-sampling technique and fluoride and phosphorus in the powdered samples were analyzed. Fluoride concentrations were highest in the outer, lowest in the middle and intermediate in the inner layers of dental calculus in general. In the outermost layers fluoride concentrations were highest in calculus found near the tooth cervix both in supra- and subgingival calculus. Fluoride concentrations decreased markedly toward the apical region in subgingival calculus. while it did not change toward the incisal or occlusal region in supragingival calculus. In the inner layers, fluoride concentrations in both supra- and subgingival calculus were not affected by position on the teeth. Fluoride concentrations in subgingival calculus near the apex were lower than in supragingival calculus near the incisal or occlusal region. It was concluded that the fluoride concentrations differ in different regions of dental calculus, probably due to their different mechanisms of formation.     

Evaluation of X-Ray Projection Angulation for Successful Radix Entomolaris Diagnosis in Mandibular First Molars In Vitro

Introduction

The aim of this study was to evaluate the radiographic features of permanent three-rooted mandibular first molars with radix entomolaris (RE), investigate the correlation between anatomical classification and radiographic type of RE, and to determine the most effective horizontal beam angulation for the diagnosis of RE.

Methods

Twenty-five extracted mandibular first permanent molars with RE were selected for taking radiographs in 7 horizontal angulations. By using set criteria, 3 evaluators assessed morphologic and radiographic features of the RE and optimum beam angulation for RE diagnosis. Intraexaminer variability was analyzed with Cohen kappa test.

Results

Three types of curvature of RE presented with 3 distinct types of typical radiographic appearance on orthoradial radiographs. We classified the radiographic features of RE into 3 types, as follows: type i, type ii, and type iii. Seven teeth showed type i radiographic features. Zero-degree, 5-degree, 15-degree, and 25-degree radiographs were significantly better than the mesially angulated -15-degree and -25-degree images for detecting the type i RE images (P < .05). Fifteen-degree, 25-degree, and -25-degree horizontal beam angulations showed significantly more accurate diagnoses of RE in 8 type ii images (P < .05). Only 25-degree-angled radiographs were found to have a high diagnostic yield of type iii RE images (P < .05). A significant correlation was found between morphologic and radiographic types of RE (P < .05, contingency coefficient = 0.473). Intraexaminer variability was low, with kappa = 0.68 (P < .05).

Conclusions

RE presents 3 types of typical radiographic features on orthoradial radiographs. Additional 25-degree mesial horizontal-angled radiographs are essential for preoperative identification and evaluation of RE, especially types ii and iii.