前牵引治疗不同时期上颌发育不足患者疗效评价

目的 应用头颅定位侧位片分析上颌发育不足患者在不同生长发育阶段进行前牵引治疗的临床效果。方法 选取2018年1月至2020年12月于上海交通大学附属第九人民医院口腔正畸科完成前牵引治疗的上颌发育不足患者36例,根据头颅定位侧位片颈椎骨龄分期（cervical vertebral maturation method,CVM）,分为生长发育高峰前期组（CVMⅠ～Ⅱ期）7例、生长发育高峰期组（CVMⅢ～Ⅳ期）17例以及生长发育后期组（CVMⅤ～Ⅵ期）12例。各组患者治疗前后分别拍摄头颅定位侧位片,对其软硬组织相关指标进行测量分析。结果 骨性矢状向指标上牙槽座角（SNA角）、上颌突距（A-Np）、前鼻嵴点至垂直参考轴的距离（VRL-ANS）、上牙槽座点至垂直参考轴的距离（VRL-A）、有效上颌长度（Co-A）、上下牙槽座点交角（ANB角）、Wits值在3组治疗前后的差异均有统计学意义（P <0.05）,其中治疗后生长发育高峰前期组A-Np改变值[（2.61±1.11）mm]与生长发育后期组[（1.00±0.82）mm]相比,差异有统计学意义（P=0.017）;骨性垂直向指标腭平面倾斜角（...     

通窍汤治疗慢性上颌窦炎40例

目的：观察中药治疗慢性上颌窦炎的临床疗效。方法：治疗组40例用中药,对照组40例用克拉霉素口服,治疗3个月。结果：总有效率治疗组87．50％,对照组57．50％。两组比较有极显著性差异（P〈O．05）。结论：中药治疗慢性上颌窦炎疗效较好,无明显副作用。     

3D Printed Customized Facemask for Maxillary Protraction in the Early Treatment of a Class III Malocclusion: Proof-of-Concept Clinical Case

In order to improve fit and comfort, a maxillary protraction facemask customized to the patient’s anatomy was produced by means of 3D face scanning, digital design and additive manufacturing. An 8-year-old patient in need of early treatment for the Class III malocclusion received a rapid palatal expander and a Petit-type facemask, whose components were digitally designed on a 3D scan of the patient’s face. For face scanning, the iPad Pro 2018 tablet (Apple, Cupertino, CA, USA) with the Bellus3D DentalPro application (Bellus3D, Campbell, CA, USA) was used. Facemask components were modelled with 3D Blender software. The rests were 3D printed in BioMed Clear biocompatible resin (Formlabs, Somerville, MA, USA), and the bar in stainless steel. For greater comfort, the internal surface of the rests was lined with a polymer gel pad (Silipos, Niagara Falls, NY, USA). The manufacturing procedure of the customized facemask is patented. The patient wore the facemask at night for a period of 9 months. The patient’s experience was evaluated with a questionnaire at 1 week, 3, 6, and 10 months of treatment. The customized facemask was well accepted by the patient and obtained the expected treatment outcome. Furthermore, 3D face scanning, 3D modelling and 3D printing allow for the manufacturing of customized facemasks with improved fit and comfort, favoring patient compliance and treatment success.     

Radiographic Analysis of Graft Dimensional Changes in Transcrestal Maxillary Sinus Augmentation: A Retrospective Study

Background. The maxillary sinus lift is a popular and predictable technique associated with implant-supported rehabilitation of the severely atrophic maxilla. The aim of the present retrospective study was to investigate the effectiveness of transcrestal maxillary sinus augmentation and the graft resorption pattern using different heterologous bone substitutes. Methods. A total of 75 sinus-grafting procedures were performed and 89 implants were placed in 66 patients, 24 males and 42 females, with mean age 67.9 ± 10.64 years (range 43–84 years). Nineteen subjects were smokers. The mean follow-up period was 93.33 ± 54.71 months (range 14–240 months). Clinical and radiographical evaluations were performed. Graft height and width were measured at baseline and at the latest follow-up. Results. Mesiodistal and vertical resorption averaged 9.3 ± 20.7% (standard deviation), and 5.04 ± 9.9% of the postoperative size, respectively, considering the graft as the unit. Linear regression analysis showed that graft resorption in both the vertical and the mesiodistal dimension is independent of the follow-up time. Conversely, there was a trend for greater resorption when increasing the postoperative graft size, in both vertical (p = 0.001) and horizontal (p = 0.007) dimensions. When grouping the dimensional changes by graft particle size (only small (<300 μm) particles, combination of small and medium (>500 μm)/large (>1000 μm) particles, and only medium/large particles), there was a trend for greater resorption associated with smaller particles, but it was not significant; neither in the mesiodistal nor in the vertical dimension (p = 0.17 and p = 0.25, respectively). No implant was lost during the observation period. In conclusion, the transcrestal technique for maxillary sinus augmentation documented a high level of predictability. The low clinical morbidity and the contextual dental implant positioning is clinically useful in relation to a significant reduction of the time required for implant restoration, a consistent decrease of the number of surgical phases, and a cost-effectiveness approach for the rehabilitation. The graft resorption pattern in all cases was compatible with persistent implant protection and support.     

口腔颌面部结核性病变(附174例报告)

本文报告174例口腔颔面部结核性病变,其中男性101例,女性73例。经病理学证实,94例为结核性淋巴结炎,76例为结核性溃疡,3例颌骨结核,1例腮腺结核。作者对口腔颌面部结核性病变的病因、临床表现、诊断及鉴别诊断、药物治疗与手术治疗等问题进行了讨论。     

颞下窝病变CT MRI诊断

本文报告了87例经病理证实颞下窝病变CT或MRI表现,发现该窝病变以继发肿瘤为主（79/87）,也可见于炎症（4/87）,原发肿瘤少见（4/87）。继发侵犯可来自窝壁各方向,但以鼻咽癌内侧壁、上颌窦癌前壁侵入为主。文内讨论了颞下窝解剖定位及继发侵犯的改变特点,指出横切CT和MRI对观察颞下窝病变具有基本等同诊断作用,并应为首选扫描方位。     

右上颌第二磨牙牙内陷1例报告及文献复习

目的：探讨上颌第二磨牙牙内陷患者的诊疗过程,分析罕见牙内陷患者临床表现、影像学特征和病理特点,制定合理的治疗方案。方法：收集1例牙内陷患者的临床资料、影像学表现和病理资料,分析磨牙区牙内陷患者的临床及影像学特征,结合相关文献,总结其临床诊断标准和治疗方法。结果：患者,女性,28岁,因发现右上后牙有洞6个月来本院就诊。专科检查可见17面平龈,牙冠巨大,面正中见凹陷及龋坏,未达髓腔,影像学检查可见17面类牙釉质密度影像向根方凹陷,深度约7.7mm,确诊为牙内陷。初诊时去除腐质,采用安抚治疗,复诊时发现患牙仍有自发痛,且未能解决食物嵌塞痛,考虑到术后恢复效果不佳,故患者同意拔除患牙。离体牙做病理磨片,显微镜下观察可见内陷处牙釉质及牙本质结构异常。结论：发生于磨牙区的牙内陷患者较为罕见,诊疗过程中应结合影像学检查明确疾病类型及治疗计划,建议治疗效果不佳的患牙应及时拔除。     

倾斜种植术在上颌后牙区骨量不足患者中的应用效果

目的 探究倾斜种植术在上颌后牙区骨量不足患者中的应用效果。方法 选取2020年3月-2022年3月于我院行种植牙手术治疗的86例上颌后牙区骨量不足患者为研究对象,按照随机数字表法分为对照组和研究组,每组43例。对照组采用常规种植术治疗,研究组采用倾斜种植术治疗,比较两组临床疗效、心理状况、牙周指标及治疗满意度。结果 研究组治疗总有效率为93.02%,高于对照组的86.05%（P＜0.05）;研究组SAS评分、SDS评分均低于对照组（P＜0.05）;研究组PD、GI、SBI、MD均优于对照组（P＜0.05）;研究组治疗满意度为95.35%,高于对照组的88.37%（P＜0.05）。结论 倾斜种植术在上颌后牙区骨量不足患者中的应用效果确切,可有效改善患者的牙周指标,减轻其焦虑、抑郁情绪,有利于提升治疗满意度。