渗透性树脂对树脂修复体微渗漏影响的实验观察

目的:观察使用渗透性树脂ICON对修复体边缘进行处理后的微渗漏变化。方法:20颗健康离体牙随机分为2组,颊面制备深度2mm的窝洞,Z350树脂充填,A组使用渗透性树脂ICON处理树脂修复体边缘处的牙体组织及树脂牙体结合处,B组为对照组。37℃水浴条件下分别置于0.1%罗丹明B荧光染料浸染,24h后激光扫描共聚焦显微镜测量染液渗入深度,定量评价微渗漏程度,对检测结果进行统计学分析。结果:A、B组微渗漏差异有统计学意义(P<0.05)。结论:渗透性树脂对改善树脂修复体微渗漏状况有明显效果。     

口腔医学本科实习医师牙周探诊检查的准确性及影响因素分析

目的 评估口腔医学本科实习医师牙周邻面探诊的准确性并分析可能的影响因素,以期为牙周临床教学提供参考.方法 按照临床带教常规,选取北京大学口腔医学院38名初次进入牙周临床实习的本科生,每名实习医师均使用Williams刻度探针检查并记录1～2例(共58例)慢性牙周炎患者的探诊深度,教师进行重复探诊并加以核对,记录Ramfjord代表牙(6|14/41|6)邻面探诊深度的复核结果作为本项研究的结果数据.根据实习医师与教师探诊深度的差异,将所有位点分为完全一致位点(实习医师与教师探诊深度相同的位点)、基本一致位点(实习医师与教师探诊深度差异为1 mm的位点)和不一致位点(实习医师与教师探诊深度差异≥2 mm的位点).结果 随着牙周袋加深,学生的探诊准确性下降.完全一致位点百分比磨牙[58.8％ (261/444)]显著低于切牙[73.1％(339/464)],P＜0.01.实习医师邻面探诊不准确的最主要原因是不能探入龈谷,此项因素占70.7％ (87/123).结论 邻面探诊角度的培训应成为牙周临床前期探诊教学的重点,临床实习时教师需重点核查实习医师对深牙周袋和磨牙的邻面探诊.     

连续视程与三焦点人工晶状体植入术后视觉质量的比较

目的：比较Tecnis Symfony连续视程人工晶状体与Zeiss三焦点人工晶状体(At Lisa tri 839MP)植入术后患者视觉质量的差异。

方法：选取2019-01/2020-12于我院行白内障超声乳化吸除联合人工晶状体植入术的患者42例53眼,其中A组22例29眼植入Tecnis Symfony连续视程人工晶状体,B组20例24眼植入Zeiss三焦点人工晶状体。观察两组患者术后3mo时远中近视力,绘制离焦曲线,并评估生活质量,记录并发症发生情况。

结果：术后3mo,两组患者视力均明显改善,两组患者裸眼远(5m)、中(80cm)距离视力及最佳矫正远距离视力(5m)无差异(均P>0.05),但B组患者裸眼中(60cm)、近(40cm)距离视力优于A组(均P<0.05)。术后3mo绘制离焦曲线示A组在+1.0～-2.0D段跨度平稳形成平台期; B组在0、-2.5D处形成两个波峰; 0D处两组远视力无显著差异(P>0.05),-2.5、-3.5D处B组近视力显著优于A组(均P<0.01)。两组患者术后脱镜率均在90%以上,均出现不同程度眩光、光晕等光学现象,但生活质量总体满意度较高,A组阅读速度明显高于B组,且夜间视物满意度较高(均P<0.05)。

结论：两种类型人工晶状体植入术后脱镜率均在90%以上,可为患者提供兼顾远、中、近的全程视力,Symfony连续视程人工晶状体植入术后流畅阅读及夜间视物满意度较高; Zeiss三焦点人工晶状体植入术后近距离视力更好,更适合近距离工作者。     

Infiltration peropératoire de lévobupivacaïne après césariennes : étude randomisée en double insu contre placebo

Objectives

The efficacy of single-dose intraincisional infiltration with levobupivacaine in postoperative analgesia and chronic pain after caesarean sections is unknown.

Study

A placebo-controlled double-blind randomized trial.

Patients and methods

After ethical approval, and written inform consent, 140 women scheduled for a caesarean section were randomly assigned and received 30 mL of levobupivacaine 0.5% (L group) or saline (placebo-P group) into their wound. The primary endpoint was morphine consumption (using intravenous morphine patient-controlled analgesia) for the first 24 h after surgery. At 1 h to 48 h, side effects, pain at rest and pain 2 months later were recorded.

Results

All included patients had similar demographic and surgical characteristics. The morphine consumption was significantly lower in the L group at h6, h8 and h12 (considering both total intake and each request). At h4, the mean total morphine consumption was 25 (12) mg in the L group versus 31 (14) mg in the P group (P = 0.05). Time until discharge and side effects including nausea-vomiting (14 vs 20%), wound scar complications (6 vs 8%) and chronic pain after 2 months (25% in both groups complained of small pain, and 75% no pain) were similar between the two groups (P > 0.05).

Conclusion

Single-dose local infiltration of levobupivacaine 0.5% reduced opioid requirement at 12 h, with no difference after 24 h. www.clinicaltrials.com, number: NCT00621907.     

Is self interdental cleaning associated with dental plaque levels,dental calculus,gingivitis and periodontal disease?

Crocombe LA, Brennan DS, Slade GD, Loc DO. Is self interdental cleaning associated with dental plaque levels, dental calculus, gingivitis and periodontal disease? J Periodont Res 2012; 47: 188–197. © 2011 John Wiley & Sons A/S Background and Objective: To ascertain whether interdental cleaning behaviours of Australian adults were associated with lower levels of plaque, gingivitis and periodontal disease. Material and Methods: Data were obtained from the National Survey of Adult Oral Health 2004–06. Outcome variables were three indicators of oral hygiene outcomes (the presence or not of dental plaque, dental calculus and gingivitis) and two of periodontal disease (the presence or not of at least one tooth with a periodontal pocket or clinical attachment loss of ≥ 4 mm). The independent variable was classified into the following three groups: regularly clean interproximally ‘at least daily’ (daily+); ‘less than daily’ (< daily); and ‘do not regularly clean interproximally’ (reference group). Poisson regression with robust variance estimation was used to calculate prevalence ratios (PRs) and 95% confidence intervals (95% CIs) relative to the reference group, adjusted for covariates. Results: Regular self interdental cleaning was associated with less dental plaque (< daily, PR = 0.89, 95% CI = 0.84, 0.95; and daily+, PR = 0.89, 95% CI = 0.82, 0.96), less dental calculus (< daily, PR = 0.88, 95% CI = 0.80, 0.97; and daily+, PR = 0.79, 95% CI = 0.70, 0.89) and lower levels of moderate/severe gingivitis (daily+, PR = 0.85, 95% CI = 0.77, 0.94). Periodontal pocketing was less likely for the < daily group (PR = 0.61, 95% CI = 0.46, 0.82), but was not associated with daily+ cleaning (PR = 0.99, 95% CI = 0.663, 1.49). There was not a significant association between interdental cleaning and clinical attachment loss (< daily, PR = 0.90, 95% CI = 0.77, 1.05; and daily+, PR = 1.17, 95% CI = 0.95, 1.44). Conclusion: Regular interdental cleaning was associated with better oral hygiene outcomes, such as dental plaque and gingivitis, although there was no significant association between regular interdental cleaning and clinical attachment loss.     

Infectious keratitis after transepithelial photorefractive keratectomy: A case report

Transepithelial photorefractive keratectomy (tPRK) promotes faster re-epithelialization which in turn can reduce the risk of infectious keratitis in the postoperative period. We present a case of a 22-year-old man with infectious keratitis in his left eye 8 days after an uneventful bilateral tPRK. A 2 mm × 5 mm anterior stromal area of corneal infiltration with a same sized overlying epithelial defect was noted at the time of presentation. His uncorrected distance visual acuity was 20/63 in his left eye. Corneal scrapings showed Bordetella bronchiseptica. The infection responded to intensive treatment with topical levofloxacin 0.5% eye drops. The final visual acuity was 20/20 in the left eye.     

针药复合麻醉应用于胃镜无痛检查的临床观察

目的:观察电针在无痛胃镜检查时对血压、心率、血氧饱和度、不良发应及麻醉深度的影响。方法:140例胃镜检查患者随机分成电针组和对照组,每组70例。记录胃镜插入时所引起的应激反应以及胃镜检查前、中、后患者的血压、心率、血氧饱和度及镇静程度的变化。结果:电针组胃镜插入时应激反应发生率低,电针组检查中和检查后血压、心率平稳,与检查前比较无明显变化(P0.05)。对照组患者血流动力学波动较大,检查中与检查前比较,差异有统计学意义(P 0.05)。电针组镇静程度检查中和检查后与对照组比较,电针组镇静程度明显低于对照组,差异有统计学意义(P 0.05)。结论:电针应用于无痛胃镜检查可有效抑制胃镜插入时所引起的应激反应,维持血压和心率的稳定,且可以使患者在镇静程度较低的情况下完成检查。