氟泡沫对小儿龋齿的预防保健效果

目的 分析对龋齿患儿采用氟泡沫预防保健的效果和临床价值。方法 选择2020年1月-12月于本院行口腔检查的80例龋齿患儿为研究对象,采用随机数字表法分为参考组和试验组,各30例。参考组使用安慰剂处理,试验组使用氟泡沫处理。随访1年,比较两组新发龋齿率、再矿化率、龋齿值、生活质量评分及不良反应发生率。结果 试验组新发龋齿率低于参考组,矿化率高于参考组,差异有统计学意义（P ＜0.05）;两组保健后龋齿值均低于保健前,且试验组低于参考组,差异有统计学意义（P ＜0.05）;试验组心理状态、生活环境、生理职能及社会关系评分均高于参考组,差异有统计学意义（P ＜0.05）;两组不良反应发生率比较,差异无统计学意义（P ＞0.05）。结论 氟泡沫在龋齿患儿中的预防保健效果确切,能够有效控制龋齿进展并促进牙釉质再矿化,有利于预防新发龋齿,从而提升患儿的生活质量,且安全性理想,值得临床应用。     

三维数字化技术在口腔正畸教学中的应用

口腔正畸教学中三维数字化的应用,对提升口腔正畸教学效率提供了技术保障。三维数字化教学对比常规教学更能满足国内正畸医疗所需。在具体的教学实践中,从三维数字化分析软件、锥形束CT、数字化牙颌模型、三维颜面成像技术着手,可以在口腔正畸教学中全面提升教学质量,为口腔正畸教学提供可行性借鉴。     

下颌后缩与前突青少年患者牙龄差异性分析

目的:通过对下颌后缩与下颌前突两类青少年患者牙齿发育进程的差异性分析,探讨生长发育期儿童牙齿发育早晚对下颌矢状向骨型的影响.方法:随机选择错(牙合)患者143(男80例,女63)例,年龄9～12.9(平均11.5)岁,依据头颅侧位片上SNB角、SNA角以及ANB角的测量结果,分为下颌后缩组(SNA正常,SNB＜77.6,ANB≥5)与下颌前突组(SNA正常,ANB＜0).在全口曲面断层片上应用Demirjian评价牙龄方法评定样本牙齿成熟度并转化为牙龄,比较两组间牙龄的差异性.结果:下颌后缩组患者的平均牙龄为11.9岁,牙龄年龄差为0.3岁;下颌前突组患者的平均牙龄为11.5岁,牙龄年龄差为0.1岁.两组牙龄之间未发现明显的差异性;下颌后缩患者的牙齿发育相对于下颌前突患者有轻微提前的趋势.结论:下颌后缩与下颌前突两类青少年患者的牙龄没有显著性差异,提示牙齿发育的早晚对下颌矢状向骨型不存在明显的相关性.     

Quality of recovery from two types of general anesthesia for ambulatory dental surgery in children: a double-blind, randomized trial

Background:  Pediatric dental procedures are increasingly performed under general anesthesia because of the inability to cooperate, situational anxiety, or other behavioral problems. Volatile anesthetics have been associated with emergence delirium in children, whereas the use of propofol for anesthetic maintenance has been shown to reduce the incidence of emergence delirium after other types of surgeries. The aim of this study is to compare a sevoflurane-based anesthetic with a propofol-based technique as it relates to the incidence of emergence delirium and the quality of recovery after pediatric dental surgery, in patients who present with risk factors for perioperative behavioral issues.
Methods:  We prospectively collected data of 179 pediatric patients scheduled for ambulatory dental surgery using a double-blind and randomized trial design. Subjects were anesthetized following standardized protocols for either a sevoflurane- or a propofol-based technique. The incidence of emergency delirium, as measured by the Pediatric Anesthesia Emergence Delirium score, was the primary outcome. Secondary outcomes included the incidence of postoperative nausea and vomiting (PONV), number of nursing interventions in the recovery room, time to discharge readiness, and parental satisfaction.
Results:  We found no difference in the incidence of emergence delirium after both types of anesthesia. However, use of sevoflurane significantly increased both the risk of PONV and the number of postoperative nursing interventions. Discharge criteria were met about 10 min earlier in patients anesthetized with sevoflurane. Parental satisfaction was equally high with both anesthesia regimens.
Conclusions:  A propofol-based anesthetic technique did not lead to a lower incidence of emergence delirium after dental surgery in children but did result in significantly less PONV and fewer postoperative nursing interventions.     

Discrepancy between chronological age and evaluated dental age using the Demirjian system in Western Australian children

The aims of this work were to assess dental age using the Demirjian system and to evaluate the discrepancy between chronological and dental age among children residing in Western Australia. Forty panoramic radiographs of 5- to 11-year-old children taken at the paediatric clinic of a dental hospital in Western Australia were selected. The developmental stage of each left permanent mandibular tooth excluding the third molar was assessed by three trained examiners. Estimated dental age using the Demirjian system was compared with the chronological age of each child. The accuracy of the Demirjian system in this group of children was 42.5%. The difference between chronological age and dental age was significant (t = 4.066, df = 39, p < 0.001). Dental age estimation for Caucasian children had greater accuracy (χ² = 5.013, df = 1, p = 0.025). Gender and orthodontic concerns were not related to the accuracy of the Demirjian system (p ≥ 0.481). The discrepancy between chronological and dental age using the Demirjian system was significant when assessing the Western Australian population although it was more accurate for Caucasian children. The accuracy was similar between subjects with and without orthodontic concerns.     

我军医疗机构口腔卫生服务经济和军事效益评价

目的进行我军不同类型医疗机构口腔科经济和军事效益的评价,为有关部门制定政策卫生提供参考。方法利用通信调查问卷了解我军医疗机构口腔科资源现况和服务现况,采用比率分析法来分析我军医疗机构口腔科提供口腔卫生服务的经济效益和军事效益。结果共获取我军不同类型的医疗机构口腔科有效问卷43个,我军各类医院口腔科以师医院平均每口腔医师和每卫技人员(人)业务年病人(人)最多,每牙科椅年收入(万元)则以军区总医院和驻军医院为高。军事效益以师医院最高,军区总医院最低。结论我军各类医院口腔科必须以军事效益为目标,因此,应采取措施调整结构,加强师医院口腔科建设,提高我军口腔卫生服务的军事效益。     

颌骨囊肿开窗减压术后应用囊肿塞治器患者的牙科焦虑症调查分析

目的：对颌骨囊肿开窗减压术后行囊肿塞治器患者的牙科焦虑症患病情况进行调查,并探讨与患者发生牙科焦虑症可能相关的因素。方法：选取2012年3月—2014年12月来我院修复科就诊的 198 例颌骨囊肿开窗减压术后行囊肿塞治器治疗的成人患者进行调查,采用改良牙科焦虑量表(MDAS)评估牙科焦虑症的发生情况,采用SPSS 22.0软件包对所得数据进行统计学分析。结果：颌骨囊肿开窗减压术后行囊肿塞治器患者的牙科焦虑症患病率为63.6%;χ₂检验结果显示,各因素组(性别、年龄、婚姻状况、视觉模拟量表(VAS)等级、是否初次来口腔门诊,不包括文化程度)的牙科焦虑症(DA)患病率的差异是具有统计学意义的(P<0.05);采用Logistic回归分析显示,本次调查的因素组中对牙科焦虑症的危险性较大的因素是性别、年龄、VAS等级、是否初次来口腔门诊因素;Spearman等级相关分析显示,VAS等级与MDAS分级为低度正相关,总体相关系数有统计学意义。结论：颌骨囊肿开窗减压术后行囊肿塞治器患者的牙科焦虑症患病率较高。患者的性别、年龄、婚姻状态、VAS等级、是否初次来口腔门诊对牙科焦虑症的发生有密切关系,患者经历囊肿开窗术疼痛程度与患牙科焦虑症焦虑水平呈正相关。     

儿童龋病与唾液CCL28 和sIgA 抗体的相关性

目的：探讨儿童唾液中趋化性细胞因子CCL28含量和sIgA 抗体分泌与儿童患龋状况之间的联系。方法： 抽取长沙市两所幼儿园3~5岁108名幼儿进行龋齿检查,根据检查结果分为无龋组[龋失补指数(dynamical mean-field theory,DMFT)=0];低龋组(DMFT=1~4);高龋组(DMFT≥5),收集非刺激性全唾液样本,用酶联免疫吸附试验 (ELISA) 定量检测唾液中 CCL28及sIgA的含量,并对结果进行统计学分析。结果：108名儿童唾液中CCL28的浓度为 (121.22±32.63) pg/mL,sIgA 的浓度为(16.49±8.02) μg/mL,两者之间存在线性正相关关系(r=0.734),且儿童唾液样本中 CCL28和sIgA含量随儿童患龋程度而增加(P<0.05)。结论：儿童龋患能够促进CCL28和sIgA分泌,且CCL28和sIgA的分 泌量与龋患程度呈正相关;CCL28对唾液中sIgA 的分泌起促进作用。     

髓腔内压对树脂水门汀与牙本质粘接强度的影响

目的: 评价髓腔内压条件对树脂水门汀与牙本质微拉伸粘接强度的影响。方法: 选择新拔除的人无龋第三磨牙30颗分成2组,去除咬合面釉质制备牙本质平面,选取剩余牙本质厚度为0.5~2.5 mm的牙本质试样,在有染料的髓腔内压条件下,观察牙本质表面与牙面处理剂Single Bond Universal(SBU)固化后表面在即刻、5 min、30 min、2 h的染料渗透情况。保持最小剩余牙本质厚度为(1.0±0.1) mm,分别在有或无髓腔内压条件(15或0 cmH₂O,1 cmH₂O=0.098 kPa)下维持30 min,使用SBU并光照固化,然后使用模具在牙本质表面堆塑RelyX Ultimate(RLX)树脂水门汀(直径10 mm,高4 mm),制备牙本质-树脂水门汀粘接试样。试样在37 ℃蒸馏水中储存24 h后,将牙本质-树脂水门汀试样垂直于粘接界面切割形成横截面积为0.9 mm×0.9 mm条状试样,使用微拉伸测试仪测试计算其粘接强度(两独立样本t检验,双侧检验水平α=0.05),用扫描电镜观察统计试样断裂类型(Fisher精确检验,双侧检验水平α=0.05)。将牙本质-树脂水门汀试样垂直粘接界面做切片,厚度0.8 mm,扫描电镜下观察粘接界面形貌。结果: 在髓腔内压条件下,随时间延长,粘接表面染料渗出增加。有髓腔内压时和无髓腔内压时RLX与牙本质微拉伸粘接强度分别为:(26.26±9.78) MPa和(28.70±9.09) MPa,两者差异无统计学意义(P>0.05)。两组试样断裂类型无明显差异(P>0.05),都以混合断裂为主。两组试样粘接界面可见4~8 μm指状树脂突,分布及长短较均匀,形貌无明显差异。结论: SBU预处理牙本质后,髓腔内压不影响树脂水门汀RLX的即刻牙本质粘接强度。     

The Callender modification of the Macintosh laryngoscope blade reduces the risk of tooth-blade contact in children

Background: Dental injury is well recognized as a potential complication of laryngoscopy and tracheal intubation. The flange of the Macintosh blade may contact teeth during laryngoscopy causing damage. The Callander modification of the Macintosh blade (Callander blade) with a shortened heel at the proximal end has been shown to increase the blade–tooth distance and reduce contact rates in adults. Aim: This study was designed to evaluate the effectiveness of the Callander blade on reducing dental contact in children. Methods: One hundred children, aged 4–14 years, scheduled for general anesthesia requiring endotracheal intubation were studied prospectively. The children were preoperatively evaluated for Mallampati score and dental defects, looseness, and avulsions. Following induction of anesthesia, laryngoscopy was performed twice on each child in succession, once with a standard Macintosh blade and once with a Callander blade of the same size in a random order. The blade–tooth distance and contact rate were compared between the two blades. Results: With the Callander blade, the blade–tooth distance was greater than with the Macintosh (1.78 ± 1.77 vs 0.28 ± 0.76 mm, P = 0.001). The frequency of direct contact was less with the Callander blade than it was with the Macintosh blade (33% vs 86%, respectively, P = 0.008). However, difficult laryngoscopy rate did not differ between the blades. Tracheal intubation was successful in all children and there was no dental injury. Conclusion: Our findings suggest that the Callander blade decreases the risk for dental injury and provides tracheal intubating conditions in children with normal airways similar to those obtained with a traditional Macintosh blade.