局部应用二磷酸盐对鼠正畸牙移动影响的研究

目的 探讨局部注射Zoledronate溶液对鼠正畸牙齿移动距离与牙周组织形态的影响。方法 选用42只雄性Wistar大鼠，牵引其上颌第一磨牙近中移动。实验中分别将Zoledronate溶液及生理盐水注射入实验组（左侧）及对照组大鼠（双侧）上颌第一磨牙腭侧的粘骨膜下。注射于实验前3d开始，共进行9次，每3d一次。分别在加力0、3、7、14、21d后记录上颌第一磨牙移动距离，组织HE染色后，观察牙周组织形态学的改变。结果 ①实验组大鼠牙齿移动距离明显低于对照组。②实验组大鼠压力侧破骨细胞数在实验全过程中均低于对照组，而根分叉区破牙骨质细胞数除加力14d外，2组差异无显著性。③实验过程中Zoledronate溶液对破骨细胞和破牙骨质细胞以外的细胞作用不明显。结论 Zoledronate能有效地抑制支抗牙移动，减少压力侧牙槽骨表面破骨细胞数。     

影响再植牙预后的相关因素分析

目的 分析再植牙根吸收的发生率、发生时间、牙齿在口腔内的保留时间及其影响因素。方法 对1988～2002年在北京大学口腔医院儿童口腔科就诊的59名患儿的68颗延期再植恒牙进行1～15年的临床回顾性分析。结果 再植牙根吸收的发生率为71％；根吸收最常发生在外伤后3～6个月；年龄越大，越早发生根吸收；钙离子导入能延长再植牙在口腔内的保留时间；延期再植牙的脱出时间对其在口腔内的保留时间长短影响较小。结论 延期再植牙经适当的临床治疗，仍可在口腔内保留数年。     

双重冠连接不同时期固定桥修复牙列缺损

目的探讨将不同时期固定桥连接成一体,共同受力,行使咀嚼功能的方法。方法选取临床病例2例,在新桥体的末端设计成1个双重冠,覆盖相邻原有固定桥上已开窗的基牙,黏接固位,使不同时期固定桥连接成一复合桥体共同受力。结果应用双重冠连接不同时期固定桥,能形成一个新的稳固的复合固定桥,临床初期效果良好。结论以双重冠将松动牙与相邻固定桥连接的方法简便易行,有一定临床应用需求和价值。     

Identification of a C-shaped canal system in mandibular second molars-part II: the effect of bone image superimposition and intraradicular contrast medium on radiograph interpretation

The purpose of this study was to investigate the effect of image superimposition from surrounding alveolar bone and intraradicular contrast medium on radiographic interpretation of a C-shaped canal system in mandibular second molars. Thirty mandibular second molars with fused roots were collected and stored in 10% formalin solution. After being scanned by microcomputed tomography and reconstructed, the buccal-lingual radiographs of each tooth were taken with or without intraradicular contrast medium and mandibular bony plates. The number of mesial and distal canals in the coronal-to-middle canal portion and the canal number in the apical 4-mm area were recorded. The buccal-lingual and three-dimensional view of reconstructed canal images were used to evaluate the accuracy of radiograph reading. The results were subjected to the Friedman and chi-square test. The results showed that without intraradicular contrast medium, the bone superimposition could decrease the accuracy of canal recognition significantly (p < 0.001), especially in the apical area. When contrast medium was in canals, the canal reading seemed not to be affected by the bone superimposition (p > 0.05). Based on these findings, the intraradicular contrast medium could increase the accuracy of canal recognition of a C-shaped canal system in mandibular second molars despite the bone image superimposition, especially in the detection of continuous C-shaped canals and the canals in the apical area.     

上颌斜面导板在增强支抗和调整咬合中的应用

目的探讨上颌斜面导板在加强下前牙支抗及治疗末期调整后牙尖窝关系中的作用。方法选择需下颌后牙前移而下前牙不能过多后移或治疗后期后牙尖窝关系不理想的患者62例,其中29例戴用上颌斜面导板加强下前牙支抗或治疗末期调整后牙尖窝关系,33例未戴用上颌斜面导板,对两组治疗前后的头颅侧位片进行测量并对组内和组间的差异进行统计学分析。结果上颌斜面导板能增强下前牙支抗,在关闭下前牙或下后牙间隙时,斜面导板阻挡下前牙,防止下前牙舌倾及后移,保证前牙覆牙合、覆盖正常。上颌斜面导板还可打开后牙咬合,使上下颌后牙脱离锁结,便于后牙前移及后牙尖窝关系的调整。结论上颌斜面导板能缩短治疗时间,使治疗效果更理想。     

不同的向会聚度对Finesse全瓷冠的适合性影响的研究

目的:评估不同的向会聚度对Finesse全瓷冠适合性的影响,为临床应用提供理论依据。方法:在向会聚度分别为5°、10°、15°的超硬人造石代型上分别制作全瓷冠各10个,粘结(玻璃离子3.5kg静止固位力)、包埋、片切。以体式显微镜测量边缘适合性AMO,边缘浮升量PMO,轴壁适合性AWA,面适合性OA,通过单因素方差和q检验,进行统计分析。结果:各组的边缘适合性均在临床要求范围内。5°组、10°组、15°组的AMO分别为109!m、66"m、69#m;5°组与10°组、15°组的AMO,PMO,OA相比较时存在显著性差异(P<0.05),10°组与15°组无显著性差异(P>0.05)。结论:Finesse热压铸型陶瓷冠具有良好的适合性,能满足临床应用要求。为保证较高的适合性,临床应采用10°到15°的牙体预备。     

不同金属基底不同瓷层厚度对金瓷修复体色彩的影响

目的:对比不同金属基底、不同瓷层厚度的金瓷修复体的色彩差异。方法:制作贵金属合金、金沉积与镍铬合金片,分别以其为基底制作0.1、0.3、0.5、0.7、0.9、1.1、1.3、1.5mm瓷层厚度的试件。用美能达CR-321色差计对试件测色,计算色差并进行统计分析。结果:同种金属基底的试件,随瓷层厚度的增加,色差值ΔE(前后瓷层厚度差值)均明显减小,当瓷层厚度≥1.1mm时,前后瓷层厚度组之间ΔE无统计学差异(P>0.05);不同金属基底相同瓷层厚度试件之间,贵金属与金沉积组之间无显著性差异(P>0.05),但二者与镍铬合金组有差异(P<0.05)。结论:不同的金属基底材料有不同的瓷层厚度要求;相同瓷层厚度时,高金合金为基底的修复体色彩,优于非贵金属合金基底;随瓷层厚度增加,修复体亮度均减小;色相由红向绿色相发展;彩度也随瓷层厚度的增加而下降,金沉积与贵金属合金瓷修复体颜色,较非贵金属合金颜色黄。     

Mechanical behavior of ProTaper universal F2 finishing file under various curvature conditions: a finite element analysis study

Introduction

The purpose of this study was to visualize the stresses and strain distribution patterns in ProTaper Universal F2 files (Dentsply Maillefer, Ballaigues, Switzerland) and to establish the stress- and strain-curvature relationship for this instrument under various conditions by using a dynamic, three-dimensional finite-element model.

Methods

An accurate geometric model of a ProTaper Universal F2 instrument was created. Two short, straight tubes were also modeled to represent the parts of root canal apical and coronal to the curvature. Then, the file was constrained to a curve of varying degree, curve length, and position. The maximum von Mises stress and strain on the tension side of the instrument was measured at 5-degree intervals in a numerical simulation package (LS-DYNA; Livermore Software Technology, Livermore, CA).

Results

The mechanical performance of the ProTaper F2 file under various conditions was simulated. A long curvature length produced lower values of stress and strain under the same angle of curvature. An increase in the curvature angle generally induces higher stress and strain. For the same degree and curve length, the stress and strain increased if the curved portion was situated further up the shaft of the instrument (ie, with a larger diameter).

Conclusions

The dynamic, numerical model may be used to evaluate and compare the effect of various root canal curvatures on the behavior of different designs of root canal instrument. The magnitude of stress and strain imposed on the instrument is influenced by the abruptness and degree of curvature as well as the location of the curved portion.