锥形束CT诊断上颌前牙区多生牙价值研究

目的回顾性分析锥形束CT（CBCT）在上颌前牙区多生牙诊断及定位中的价值。方法以经CBCT确诊为上颌前牙区多生牙的146例患者的195颗多生牙为研究对象,分析多生牙的数目、形态、大小、空间位置、生长方向及其与邻近组织的关系。结果146例患者年龄5~39岁,男女比例为2.95∶1, 其中102例（69.9%）为单颗多生牙。195
颗多生牙的长度平均为（11.97±2.40）mm,其中,126颗（64.6%）位于中线区,131颗（67.2%）为圆锥形,51颗（26.2%）牙根弯曲,98颗（50.3%）牙冠生长方向倒置,133颗（68.2%）与邻近恒牙或恒牙胚有接触,恒牙牙列常伴有各种异常。结论多生牙空间位置变异大,可引起恒牙列病变。CBCT检查能精确直观地显示上颌前牙区多生牙及其与周围组织关系,对多生牙的诊断及定位具有重要的指导意义。     

Effects of Choukroun’s platelet-rich fibrin on bone regeneration in combination with deproteinized bovine bone mineral in maxillary sinus augmentation: A histological and histomorphometric study

PurposeThe potential effect of Choukroun’s platelet-rich fibrin (PRF) in combination with allograft on promoting bone regeneration has been discussed in previous publications. This study aims to evaluate an influence of PRF on bone regeneration in sinus augmentation in combination with a xenograft, deproteinised bovine bone.Materials and methodsEleven sinuses from 10 patients with posterior maxillary bone atrophy were selected for the study. As a test group, six sinus floor elevations were grafted with a Bio-Oss and PRF mixture, and as control group, five sinuses were treated with Bio-Oss alone. Clinical and radiographic examinations were performed pre- and postoperatively. After 6 months of sinus augmentation, bone biopsies were obtained from the grafted posterior maxilla, and un-decalcified ground sections were prepared. Bone characteristics were evaluated using histological observation and histomorphometric analyses.ResultsNo adverse effect was observed in any case within the follow-up period of 6 months after sinus augmentation. Histological observation showed similar morphological characteristics for both the PRF and control groups. The percentage of new bone formation in the PRF group was about 1.4 times of that in control (18.35% ± 5.62% vs. 12.95% ± 5.33%), while the percentage of residual bone substitute in the control group was about 1.5 times higher as that in the PRF group (28.54% ± 12.01% vs. 19.16% ± 6.89%). The percentage of contact length between newly formed bone and bone substitute in the PRF group was 21.45% ± 14.57% vs. 18.57% ± 5.39% in the control. No significant statistical differences between the two groups were found in these observed parameters.ConclusionsOur preliminary result demonstrated neither an advantage nor disadvantage of the application of PRF in combination with deproteinised bovine bone mineral in sinus augmentation after a healing period of 6 months.     

多效生长因子在牙周炎治疗前后的表达情况

目的研究多效生长因子(pleiotropin,PTN)在牙周炎治疗前后的表达情况。方法应用RT-PCR、原位杂交方法,利用雄性Wistar大鼠50只分为炎症组、恢复组和对照组分别检测PTN的表达情况。结果 RT-PCR半定量分析PTNmRNA在炎症组和恢复组两组中的表达P<0.01,有统计学意义的。PTNmRNA的阳性产物位于牙龈上皮、龈沟内上皮和结合上皮细胞胞浆中,呈棕黄色颗粒。炎症组中PTNmRNA的表达主要集中于棘细胞层和颗粒细胞层,表达量为弱阳性和中强阳性。恢复组中PTNmRNA的表达主要集中于棘细胞层和基底细胞层,表达量为强阳性和中强阳性。对照组中PTNmRNA的表达较少。RT-PCR与原位杂交检测结果基本一致(P<0.05)。结论 PTN同时具有致炎和促进组织修复的功能,但促进组织修复的作用更明显。     

儿童前牙区牙槽骨和基骨骨密度的锥形束CT测量

目的评估儿童前牙区上下颌牙槽骨和基骨的骨密度。方法选择138例患者的锥形束CT扫描图像,以亨斯菲尔德单位(X线衰减单位Hu)来测定其上下颌切牙区、尖牙区牙槽嵴和基骨骨密质及骨松质的骨密度。结果上颌切牙区左右两侧相同部位间的骨密度值相比较,差异没有统计学意义(P>0.05);下颌切牙区左右两侧相同部位的骨密度值相比较,基骨区舌侧骨密质的骨密度值差异有统计学意义(P=0.012);上颌尖牙区左右两侧相同部位的骨密度值相比较,差异没有统计学意义(P>0.05);下颌尖牙区左右两侧相同部位的骨密度值相比较,牙槽骨和基骨区骨松质的骨密度值差异有统计学意义,P值分别为0.046和0.002。结论本研究可为前牙区微螺旋种植体植入位置和方法提供一定的数据。     

下颌第三磨牙近中阻生相关因素的头影测量分析

目的探讨成人下颌第三磨牙(M3)近中向阻生或萌出的机制及其与颌骨发育的关系。方法选取72例正畸患者为研究对象,术前拍摄全景X线片和头颅定位侧位片。通过全景X线片观察下颌M3阻生或萌出的情况,将其分为阻生组和萌出组,并对其X线头颅侧位片进行头影测量分析。结果阻生组与萌出组的下颌体长度(Go-Po’)、下颌支宽度(W)、下颌平面角(MP-FH)、前下面高(ANS-Me)、下颌支长度与下颌骨长度的比值(Co-Go/Co-Po)的差异有统计学意义(P<0.05),阻生组的W、Co-Go/Co-Po大于萌出组,而Go-Po’、ANS-Me、MP-FH小于萌出组。两组间的Co-Po、Co-Go、上下中切牙角、上牙槽座点-鼻根点-下牙槽座点角的差异无统计学意义(P>0.05)。结论下颌M3的近中向阻生和萌出可能与下颌的旋转生长及面部生长型有关,下颌向前旋转和短面型患者的下颌M3更易发生近中向阻生。     

成都地区12岁青少年第三磨牙发育的X线分析

目的通过全景片分析成都地区12岁青少年第三磨牙(M3)的发育情况。方法随机抽取四川大学华西口腔医院影像资料库12岁青少年的全景片449张,根据观察的结果将M3的发育状况进行分级统计,分析不同性别以及上下颌骨和两侧颌骨M3的发育情况。结果 12岁青少年M3的发育情况为:大部分牙冠已钙化,牙冠呈帽状,而且男性与女性的发育情况差别不明显。大部分下颌M3较上颌M3发育得更早,左右两侧M3分别占60.69%和64.25%。上颌M3以垂直向生长为主,下颌M3以近中向生长为主。结论 12岁青少年M3牙冠大部分已经钙化,下颌发育早于上颌。     

Olmesartan improves coronary flow reserve of hypertensive patients using coronary magnetic resonance imaging compared with amlodipine

Objectives: Hypertension impairs coronary endothelial cell function, coronary microvascular function and the coronary flow (CF) reserve (CFR). Angiotensin II receptor blockers (ARBs) have been reported to possibly improve coronary endothelial function and coronary microvascular function. The purpose of this study was to determine whether treatment with the ARB olmesartan was more effective for improving CFR than the calcium channel blocker amlodipine. Methods: Twenty patients with untreated essential hypertension (M/F = 13/7, aged 55.6 ± 11.6 years) were randomly assigned to treatment with either olmesartan (n = 10) or amlodipine (n = 10) for 6 months. CF was measured in the proximal left anterior descending artery by magnetic resonance imaging before and during intravenous infusion of adenosine. CFR was calculated as the ratio of the hyperemic to baseline diastolic peak flow before and after 6 months of treatment. Results: The extent of systolic blood pressure reduction was similar in both groups (-40.0 ± 19.1 vs. -48.8 ± 14.7 mm Hg, p = 0.26). The olmesartan group showed significant improvement of CFR (from 1.9 ± 1.0 to 3.1 ± 1.1, p = 0.005), but this did not occur in the amlodipine group. Conclusion: Olmesartan, but not amlodipine, improves CFR in hypertensive patients.