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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。     

钌红电镜组织化学技术应用

目的 采用钌红电镜组织化学技术对涎腺多形性腺瘤，肌上皮瘤，腺样囊性癌和基底细胞瘤进行研究以示踪肿瘤中蛋白多糖的形成和分布。方法 新鲜标本分切后固定于2.5%戊二醛中24小时，其中含0.2%的钌红；0.1M二甲肿酸钠缓冲液冲洗过夜；1%OsO4后固定1小时；丙酮逐级脱水，Epon812包埋，在半薄切片上定位，超薄切片用Opton109型电镜观察，结果 在多形性腺瘤和肌上皮瘤中，粘液样区域内充满了蛋白多糖，这种蛋白多糖是由NMCs分泌产生的，腺样囊性癌的NMCs也分泌产生蛋白多糖，该瘤中筛状结构形成是由于NMCs分泌蛋白多糖所致，这种分泌功能的出现是肌上皮细胞向肿瘤性细胞转变的一个标志。结论 钌红电镜组织化学技术方法可检涎腺肿瘤中蛋白多糖形成和分布，是一种简便，易行的方法。     

下颌骨骨折动力加压固定断面应力分析

实验采用反射光弹模拟应力分析法,通过受力模型等差线条纹图观测、分析、量化换算,对下颌骨骨折轴向和偏心动力加压固定作断面压应力比较研究.结果显示两种固定状态下骨折断面均表现为挤压应力,沿骨折线应力分布不均匀,板周区和牙槽区呈压应力高峰带,最大应力分量在轴向和偏心加压分别为1.8MPa和2.3MPa(板周区),以及0.5MPa和1.0MPa(牙槽区),中间区受力较弱.轴向动力加压总压力为100N,偏心动力加压总压力为140N,后者比前者断面应力分布稍趋合理.     

Microleakage Evaluation in Amalgam Restorations Used with Bases

Marginal leakage in amalgam restorations often precedes the development of secondary caries. One potential way to improve the marginal seal of such restorations, and thus minimize the risk of carles development, is to apply a glassionomer base prior to amalgam placement.
This study compared microleakage resistance among amalgam restorations placed with and without light-cured glass-ionomer base materials. Preparations were made in extracted human molar teeth. Four groups were studied, including copal varnish, which was used as a control. All specimens were restored with amalgam. Results indicated significantly greater leakage at the cavity wall/base interface for restorations with a copal varnish cavity liner than for those with a glass-ionomer base. Leakage differences among bases were also found at the amalgam/base interface. Best results were obtained with a dual-cure resin-based system. These samples showed minimal leakage at both the cavity wall/base and the base/amalgam interfaces. These findings suggest that light-cured glass-ionomer bases can be effective in the prevention of microleakage in amalgam restorations.     

流动复合树脂衬洞在楔状缺损修复中的疗效评价

目的:评价流动复合树脂作为洞衬材料在楔状缺损修复中的价值。方法:选择85例患者的360颗楔状缺损患牙为研究对象,采用自身对照设计,随机选择每例患者一侧患牙为实验组,采用流动树脂衬洞后再以复合树脂充填;对侧同名牙为对照组,直接采用复合树脂充填。以改良的USPHS/Ryge临床修复体质量评估系统评价修复后1年和3年的疗效。应用SPSS12.0软件包对数据进行统计学处理。结果:实验组在边缘完整性和术后敏感方面优于对照组,有显著性差异。在边缘完整性方面,1年复查时实验组满意率为100%,高于对照组的95.65%(P<0.01);3年复查时实验组满意率为98.56%,高于对照组的92.42%(P<0.01),均有统计学差异。术后1年复查时,实验组未出现敏感病例,而对照组6颗患牙出现中度敏感,需要更换修复体。实验组优于对照组,差异有统计学意义(P<0.05)。结论:流动复合树脂洞衬用于楔状缺损修复可提高边缘完整性和降低术后敏感发生率。     

安氏Ⅲ类错的遗传流行病学研究

目的本文通过对安氏Ⅲ类错的家庭聚集性、遗传度及遗传方式的研究,探讨遗传因素在安氏Ⅲ类错发生中的地位和作用。方法采用遗传流行病学病例对照的研究方法,对195个安氏Ⅲ类错先证家系和208个对照家系进行调查,比较其一级亲属患病率,以二项分布(p+q)n的数学模型及χ2检验判定家庭聚集性。以Falconer回归法进行遗传度的估算。结果安氏Ⅲ类错先证组一级亲属患病率为27.83%,与对照组8.09%相比,统计学上差异具有显著性。二项分布显示,先证组实际频数大于二项分布的理论频数,说明其具有家庭聚集性。一级亲属遗传度为80.85%,其中男性遗传度为90.79%,高于女性遗传度(71.08%)。结论安氏Ⅲ类错的发生具有明显的家庭聚集性,属于多基因遗传模式。其一级亲属遗传度为80.85%,遗传倾向有明显的性别差异。遗传因素在其发病中起重要作用,尤其对男性作用更为明显。     

Intraoral multistage mandibular angle ostectomy: 10 years' experience in mandibular contouring in Asians

In Asia, a round face rather is more acceptable than a square face. Intraoral mandibular angle ostectomy is a common aesthetic procedure for correcting a prominent mandibular angle. However, an operation of sheer straight-lined prominent mandibular angle resection would sometimes create extramandibular angles or palpable bone steps in the margin of mandibular body and produce unnatural lower one-third facial appearance, especially for a square and disproportional mandibular angle even extending to the middle mandibular body. This article describes the method of multistage mandibular angle ostectomy to produce a natural lower one-third facial contour. This method mainly focused on the posterior area of mandibular ostectomy by intraoral approach, although it has modifications. Mandibular contouring is realized first through bone cutting from antegonial notch posteriorly upperward, reaching to the middle ramus of the mandible near the earlobe; second ostectomy followed along mandible lower part is to get rid of extramandibular angle according to the preoperative design; sometimes necessarily, third ostectomy creates a smooth mandibular contour. From January 2000 to January 2010, 379 patients were operated on, and satisfactory results were achieved. Thus, this procedure could avoid excessive bone cutting, extramandibular angles, unnatural appearance, and palpable bone steps.     

建立下颌前牙牙槽骨吸收和联冠修复的三维有限元模型

目的：建立下颌前牙不同程度牙槽骨吸收后的釉质、牙本质、牙骨质、牙周膜、松质骨、皮质骨等组织的三维有限元模型。方法：利用薄层CT扫描技术与Ansys软件相结合，对层厚为1mm的CT断层影像进行分析处理。结果：模型具有良好的几何相似性，共有单元约13万个，节点约19万个，数据量约130MB，可以根据要求任意旋转、缩放、透视、剖开，进行多种方式观察；并可以按照不同研究目的和要求，对模型进行简单的修改和调整，模拟牙槽骨吸收、联冠修复等临床治疗所需的几何形态，考查各种约束和加载条件下前牙的力学反应；讨论了约束的处理和载荷的施加方式。结论：薄层CT扫描技术与Ansys软件相结合建立的三维有限元模型，能较精确地模拟实际情况，为进一步研究下颌前牙牙槽骨吸收和联冠修复奠定了良好的基础。     

正畸钢丝冠内固定治疗磨牙纵折的应用

目的:改进磨牙纵折保留治疗的固定方法.方法:对56颗磨牙纵折采用正畸钢丝冠内固定、牙体牙髓治疗加全冠修复的综合治疗,保留患牙.结果:56颗磨牙纵折成功49颗,失败7颗,有效率为87.5%.结论:在磨牙纵折的保留治疗中,正畸钢丝冠内固定是一种较佳的固定方法.