老年人原发性三叉神经痛改进撕脱术治疗的临床疗效观察

目的:探讨改进的三叉神经周围支撕脱术治疗老年人原发性三叉神经痛的临床疗效.方法:在三叉神经周围支撕脱术的基础上,采用局部骨碎块填塞神经孔治疗32例老年原发性三叉神经痛患者,其中第Ⅱ支17例,第Ⅲ支10例,第Ⅱ、Ⅲ支5例,均为单侧病变.结果:本组术后随访观察最长6年,最短5个月,显效12例,有效16例,无效4例,有效率87.5%.术后患者撕脱神经所支配区域的面部遗有不同程度的感觉麻木,无其它并发症.结论:改进撕脱术是一种治疗老年人原发性三叉神经痛简单、安全而有效的方法.     

Direct and indirect time spent on care of dental trauma: a 2-year prospective study of children and adolescents

Abstract – The aim was to account for the total time spent by professional care‐givers (direct time) and by patients and companions engaged as support and help (indirect time) to treat and otherwise attend to children and adolescents with dental trauma to primary and permanent teeth. The study was based on a random sample of 192 children and adolescents with dental traumas reported to an insurance company and prospectively followed up by telephone interviews over a period of 2 years after the trauma episode. On average, direct time represented 16% of total time for all visits for dental trauma to permanent teeth and 11% for trauma to primary teeth. The most extensive type of indirect time was transport time, which took up 30% of the total time spent on injuries to permanent teeth and 36% for injuries to primary teeth. Multiple regression analysis of the impact of dental and demographic injury variables on the time variables showed that complicated trauma was associated with extended time, direct as well as indirect, for permanent and primary teeth injuries. Our estimate of the average relative increase in total time spent by patients and companions in cases of complicated injury to permanent teeth was 117% (95% confidence interval [CI], 52–211) for patients and 112% (95% CI, 42–217) for companions. For transport time a strong predictor was access to a dental clinic near the place of residence. Lack of access could extend the average transport time by 180% (95% CI, 80–335) for patients and 163% (95% CI, 67–317) for their companions in cases of injuries to primary teeth.     

Federal University of Santa Catarina follow-up management routine for traumatized primary teeth – part 1

Abstract –  The objective of this study was to verify if the follow-up management routine of traumatized primary teeth set up by Federal University of Santa Catarina, which performs clinical and radiographic assessments (15 and 45 days; 4, 8 and 12 months) after the oral trauma, enabled an early diagnosis of sequelae which would indicate the need for endodontic intervention, as well as the influence a type of trauma and the child's age could have in the severity of the sequelae. In this study 52 sets of records were used of patients being seen in the last 6 months, with a total of 70 teeth that were receiving follow-up treatment. Patients returned for regular visits set up by the management routine, where clinical and radiographic examinations were performed to check for sequelae, which justified endodontic intervention. Mobility (51.2%) and crown discoloration (25.6%) were the most common sequelae found in the patient's first appointment. In the follow-up visits, replacement root resorption (22.5%) was the second most common sequela found, suggesting endodontic intervention. No significant association was found between severe sequelae, types of trauma and a child's age ( χ ² = 0.3, P  = 0,8613). During the intervals of the follow-up visits, it was noticed that between 46 days and 8 months a higher number of sequelae were diagnosed ( P  < 0.05). The diagnosis of sequelae such inflammatory and replacement root resorption, which can lead to an early loss of a primary tooth, are frequent and that the interval between the follow-up visits has to be changed, suggesting the setting up of management routine 2. The study also concluded that the type of trauma and the child's age are not fundamental factors in the diagnosis of severe sequelae.     

Epidermoid carcinoma arising in Warthin's tumour: a case study

We present a case of epidermoid carcinoma arising in Warthin's tumour of parotid gland in an 80–year-old woman. Light microscopy revealed small foci typical of benign Warthin's tumour with transition to epidermoid carcinoma. Immunohistochemical and ultrastructural observations confirmed the epidermoid features of the malignant cells. The differential diagnosis of a metastasis from an epidermoid carcinoma to the stroma of Warthin's tumour and also of the so-called metaplastic variant of Warthin's tumour is discussed.     

Mandibular metastasis of angiosarcoma. A case report

A case of mandibular metastasis of angiosarcoma is described, along with its clinical manifestations and histopathological features. This is the 5th case ever reported of metastasis of angiosarcoma to the mandible.     

Effect on the incidence of oral submucous fibrosis of intervention in the areca nut chewing habit

Incidence of oral submucous fibrosis was calculated from a 10-yr prospective intervention study of 12,212 individuals with a strong component of health education on tobacco and area nut chewing. Based on 11 new cases among 6341 chewers, the annual incidence was 8.0 per 100,000 among men and 29.0 for women. An earlier 10-yr follow-up study, with no intervention component, served as control. Based on 11 new cases among 3,809 chewers, the annual incidence was 21.3 per 100,000 for men and 45.7 for women controls. Although the decrease in the incidence in the intervention cohort was not statistically significant due to small number of cases, the results underscored the causal role of areca nut chewing and indicated the potential for primary prevention of oral submucous fibrosis.     

Juvenile ossifying fibroma. An analysis of 33 cases with emphasis on histopathological aspects

Juvenile ossifying fibroma (JOF) is a maxillofacial fibro-osseous lesion that may show cell-rich osteoid strands or psammoma-like ossicles. Whether both types are variants of a single entity or different lesions under the same diagnostic label is a subject of debate. This problem was investigated by analyzing a series of 33 patients with lesions having one or both of the above histological appearances. It was concluded that osteoid strands define a unique fibro-osseous lesion but that lesions with psammoma-like ossicles fall within the morphological spectrum of cemento-ossifying fibroma. Therefore the term juvenile ossifying fibroma should be reserved for the lesion with the osteoid strands.     

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。     

Progression of approximal caries in primary molars and the effect of Duraphat treatment

The progression of caries lesions over a 2-yr period was studied in 3–6-yr-olds. All 468 children included in the study lived in an area during 1977–85 (Malmö, Sweden) with a low fluoride concentration (0.2 ppm) in the drinking water. Radiographs were taken with a standardized periodic identical technique. Caries lesions were scored on the distal surface of the first and on the mesial surface of the second primary molars (maximum 8 per child) according to G röndahl et al . Half of the children were treated semiannually with a fluoride varnish (Duraphat). In all, 421 surfaces with caries at baseline were available at the 1-yr examination and 369 at the 2-yr examination. After 1 yr, 34.1% of the shallow enamel lesions remained unchanged, while a progression was seen in 60.9%. 5.1% had been restored. The corresponding figures after 2 yr were 20.6, 52.1 and 27.3%. Of the deeper enamel lesions at baseline, 28.8% remained unchanged after 1 yr and 13.7% after 2 yr. Of the lesions extending into the dentin, 81.5% had been restored after 1 yr and all after 2 yr. When evaluating the effect of Duraphat, only the percentage of individuals with one or more superficial enamel lesions showing progression was determined. After 1 yr, 51.2% in the Duraphat ( n = 41) and 82.8% in the control group ( n = 29) showed progression (restored surfaces included). The corresponding figures after 2 yr were 66.7 ( n = 42) and 91.2% ( n = 34). The differences after both 1 yr and 2 yr were statistically significant. The main conclusions from this study are that the progression rate of approximal caries lesions in primary molars is comparatively high and that semiannual application of a fluoride varnish has a certain cariostatic effect on the progression.     

VP糊剂根管充填或空管疗法治疗乳磨牙尖周脓肿的疗效比较

目的 对患尖周脓肿的乳磨牙采用VP糊剂进行根管充填或空管疗法的疗效观察。方法 将182例190颗患牙随机分为VP糊剂根管充填组和空管疗法组,1年后回访。结果 根管充填组治疗有效率为93.75％,空管疗法组为91.49％,经卡方检验两者疗效无显著性差异(x~2=0.38,P>0.05)。结论 空管疗法疗效好,操作简便,临床应用前景广阔。