纤维桩桩道预备时机对根尖微渗漏影响的体外对比研究

目的：对比纤维桩桩道不同预备时机对根尖微渗漏的影响。方法收集30颗离体下颌单根管前磨牙,采用ProTaper冠向下法预备根管,热牙胶垂直加压充填技术充填根管后,将样本随机平分成3组, A组为即刻桩道预备组,B组为2d后桩道预备组,C组为7d后桩道预备组。染料渗入法及透明牙技术处理后,在显微镜下记录各组根尖微渗漏长度,并进行t检验统计学分析。结果 A组根尖微渗漏长度为（0.96±0.15）mm ,B组根尖微渗漏长度为（0.97±0.11）mm ,C组根尖微渗漏长度为（1.01±0.12）mm ,3组样本根尖微渗漏值均较小,且3组结果之间差异均无统计学意义（P＞0.05）。结论纤维桩桩道预备时机对根尖微渗漏无明显影响。     

2种锥形束CT诊断牙根纵裂准确性的研究

目的 比较2种锥形束CT(CBCT)诊断牙根纵裂的准确性,评估根充物、观察面、牙根观察位置对CBCT诊断的影响.方法 纳入20例单根恒下颌前磨牙作为研究对象,牙根置于人下颌骨标本第一前磨牙牙槽窝内,根据先后不同处理步骤依次拍摄4次大视野及小视野CBCT,记录下列4种情况:无根纵裂+无根充物、无根纵裂+热牙胶根充、有根纵裂+无根充物、有根纵裂+热牙胶根充.2名牙体牙髓科主治医师对结果进行判读.结果 1)无论根管内是否存在根充物,小视野CBCT诊断牙根纵裂的灵敏度均明显高于大视野CBCT(P＜0.05).2)根管内存在根充物时,小视野CBCT及大视野CBCT正确诊断根纵裂的部位均是在轴位根尖1/3区.结论 不论根管内是否存在根充物,小视野CBCT均是诊断牙根纵裂的最佳选择.根管内存在根充物时,CBCT根尖1/3受伪影影响最小,诊断牙根纵裂的灵敏度最高.     

Restoration of the Occlusal Vertical Dimension with an Overlay Removable Partial Denture: A Clinical Report

The process of tooth loss throughout life associated with severe occlusal wear may pose a challenge in the rehabilitation of partially edentulous arches. In these cases, many therapeutic procedures are necessary because each tooth must be restored to obtain the correct anatomical contour and recover the occlusal vertical dimension (OVD). A removable partial denture (RPD) with occlusal/incisal coverage, also known as an overlay RPD, is an alternative treatment option with fewer interventions, and, consequently, lower cost. This clinical report reviews the principles involved in the clinical indication for an overlay RPD, as well as the necessary planning and execution, to discuss the feasibility and clinical effectiveness of this treatment, identifying the indications, advantages, and disadvantages of this procedure through the presentation of a clinical case. The overlay RPD can be an alternative treatment for special situations involving partially edentulous arches in patients who need reestablishment of the OVD and/or realignment of the occlusal plane, and it can be used as a temporary or definitive treatment. The main advantages of this type of treatment are its simplicity, reversibility, and relatively low cost; however, further studies are needed to ensure the efficacy of this treatment option.     

GB virus C coinfection and vertical transmission in HIV-infected mothers before the introduction of antiretroviral prophylaxis

OBJECTIVES: To investigate the prevalence of GB virus C (GBV-C) viraemia and GBV-C antibodies in a cohort of HIV-infected mothers and their infants between 1987 and 1994. METHODS: GBV-C viraemia and antibodies were determined by polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) in 52 HIV-infected mothers and their 53 infants, who were born before antiretroviral prophylaxis for reduction of HIV transmission was introduced at the end of 1994. Ten of these children acquired HIV. RESULTS: Mothers of three children had GBV-C viraemia and mothers of another 14 children carried antibodies against GBV-C. No mother had GBV-C antibodies and GBV-C viraemia simultaneously. GBV-C viraemia was detected in only one infant. This child was delivered by the vaginal route to a mother with GBV-C viraemia, and was not HIV-infected. No vertical transmission of GBV-C occurred from mothers with GBV-C antibodies. However, four of 10 children who were infected with HIV had a mother with past or ongoing GBV-C infection. CONCLUSION: Our findings suggest that the risk of vertical transmission of GBV-C is not elevated in HIV-infected mothers. Furthermore, although the number of HIV-1-infected children was low, we saw no evidence that the presence of ongoing or past GBV-C infection influenced the probability of vertical HIV transmission.     

The different effects of intraoral vertical ramus osteotomy (IVRO) and sagittal split ramus osteotomy (SSRO) on mandibular border movement

Objectives: This study investigated the different effects of intraoral vertical ramus osteotomy (IVRO) and sagittal split ramus osteotomy (SSRO) on mandibular border movement.

Methods: The participants included 22 patients receiving IVRO and 22 patients receiving SSRO who were treated at Okayama University Hospital. Their mandibular border movement was evaluated in three dimensions with 6° of freedom using an optical recording system.

Results: A strong correlation between condylar and lower incisor movement was observed during maximum jaw protrusion and laterotrusion. Significant improvements in condylar and lower incisor movement were detected after orthognathic surgery during maximum jaw protrusion and laterotrusion in the IVRO group and during maximum jaw protrusion in the SSRO group.

Discussion: IVRO likely achieves greater improvement in jaw movement than SSRO. Therefore, the application of IVRO could be considered in the treatment of patients with jaw deformities featuring temporomandibular joint problems.     

Full-mouth rehabilitation of a patient with severely worn dentition and uneven occlusal plane: a clinical report

Severe tooth wear is frequently multifactorial and variable. Successful management is a subject of interest in dentistry. A critical aspect is to determine the occlusal vertical dimension (OVD) and a systematic approach that can lead to a predictable and favorable treatment prognosis. Management of patients with worn dentition is complex and difficult. Accurate clinical and radiographic examinations, a diagnostic wax-up, and determining OVD are crucial. Using mini-implants as orthodontic anchorage may facilitate orthodontic movement of teeth to improve their position, which is necessary for favorable prosthetic treatment. A 46-year-old man was referred for restoration of his worn and missing teeth. After diagnostic work-up, provisional removable prostheses were fabricated for both jaws, evaluated clinically, and adjusted according to esthetic, phonetic, and vertical dimension criteria. Clinical crown lengthening and free gingival graft procedures were performed in appropriate areas. Drifting of the left posterior mandibular teeth was corrected using mini-implants as orthodontic anchorage. Two conventional implants were inserted in the right mandibular edentulous area. After endodontic therapy of worn teeth, custom-cast gold dowels and cores were fabricated, and provisional removable prostheses were replaced with fixed provisional restorations. Metal-ceramic restorations were fabricated, and a removable partial denture with attachments was fabricated for maxillary edentulous areas. An occlusal splint was used to protect the restorations. Full-mouth rehabilitation of the patient with severely worn dentition and an uneven occlusal plane was found to be successful after 3 years of follow-up. This result can encourage clinicians to seek accurate diagnosis and treatment planning to treat such patients.     

Cribado de Chagas en mujeres gestantes latinoamericanas. Experiencia en el Poniente Almeriense

Introduction

The transmission of Chagas disease is a public health problem in non-endemic countries.

Methods

Chagas screening was performed by two serological tests in pregnant women from endemic areas for 4 years.

Results

We studied 261 pregnant women from 13 Latin American countries, making a confirmatory diagnosis (two positive tests) in 4 cases. There was no case of vertical transmission.

Conclusion

Although Chagas disease has a low prevalence in the province of Almeria, the screening is necessary for the detection and treatment of infants with the disease.     

对比数字化X线牙片与CBCT对牙根纵裂诊断价值分析

目的：对比数字化X线牙片与CBCT对牙根纵裂的诊断价值。方法：以济南市口腔医院口腔内科的50例牙根纵裂患者为研究对象。将患者分别定义为观察组和对照组。对照组行数字化X线牙片检查,观察组行CBCT检查。分别根据x线片诊断标准和CT诊断标准对影像学检查结果做出独立判断。再根据牙根纵裂临床诊断金标准分别对x线根尖片的诊断结果和CBCT检查的诊断结果进行比较,得出两组真阳性（TP）、假阳性（FP）、真阴性（TN）、假阴性（FN）,计算敏感性、特异性、阳性预测值、阴性预测值。结果：牙根纵裂临床诊断金标准判断结果显示：本组50例患者中,牙齿纵裂确定46例,排除4例。X线根尖片检查诊断牙根纵裂的敏感度为77％,特异性为75％,阳性检出率为96．88％,阴性检出率为16．67％;CBCT诊断牙根纵裂的敏感度为95．65％,特异性为100％,阳性检出率为100％,阴性检出率为66．67％。CBCT扫描诊断牙根纵裂的敏感度、特异性、阳性检出率明显大于X线根尖检查（P〈0．01）。CBCT扫描诊断牙根纵裂的阳性检出率大于x线根尖片检查（P〈0．05）。结论：在牙根纵裂的临床诊断中,CBCT诊断的敏感度、特异性、阳性检出率、阴性检出率均高于x线牙片,具有更高的临床应用价值。     

上海地区不同垂直骨面型成人临床冠中心高度的比较研究

目的比较上海地区不同垂直骨面型成人各牙临床冠中心高度差异,得出临床冠中心高度平均值。方法选择符合纳入标准的高角、均角、低角上海地区成人各50例,测量3组人群各同名牙临床冠中心高度并对3组间差异进行统计学分析。结果高角组各同名牙临床冠中心高度大于均角组但无统计学差异(P>0.05),高角组及均角组各同名牙临床冠中心高度均大于低角组并有统计学差异(P<0.05)。结论直丝弓托槽应粘结在临床冠的中心位置,高角及均角患者粘结高度大于低角患者,正畸医师需根据患者的垂直骨面型对托槽粘结高度做适当调整。     

112例根纵裂下颌磨牙半切术后不同修复方式的疗效比较

目的:比较观察根纵裂下颌磨牙半切术后不同修复方式的远期临床疗效.方法:按纳入标准治疗发生根纵裂的下颌磨牙112个,对拟保留的牙根经完善的根管治疗术后,行半切除术.分别采用单端固定桥和双端固定桥修复.术后12、24、36个月随访,评价其临床疗效.结果:术后12个月时双端固定桥和单端固定桥修复成功分别为100％和95.83％ (P ＞0.05);术后24个月时分别为89.66％和71.74％ (P ＜0.05);术后36个月时,成功率分别为88.37和35.48％ (P ＜0.05).结论::发生根纵裂的下颌磨牙行半切术后,双端固定桥修复能够取得较好的远期疗效.