复合树脂与聚合瓷在牙体缺损后修复术中的应用对比

目的 对比分析复合树脂与聚合瓷在牙体缺损修复术中对牙体抵抗力的影响.方法 选取48颗正畸拔除且无龋坏的单根上颌前磨牙,将所有样本按随机数法分为A、B、C、D四组,每组均为12颗.A组不给予处理,B组接受单纯复合树脂填充修复,C组接受复合树脂覆盖牙尖填充修复,D组接受聚合瓷嵌体覆盖牙尖修复.完成修复后测试不同组别的抵抗力,并根据牙体的劈裂情况对其进行分类.结果 ①抗折强度：A组（1010.31±292.81）N,B组（809.62±205.37）N,C组（1109.47±298.74）N,D组（1140.58±285.26）N,其中C组与D组的抗折能力均优于B组（q=3.802、4.197,P＜0.05）,C组与D组间的差异比较无统计学意义（q=0.394,P＞ 0.05）.②劈裂形式：A组Ⅰ型2颗,Ⅱ型10颗;B组Ⅰ型1颗,Ⅱ型11颗;C组Ⅰ型1颗,Ⅱ型11颗;D组Ⅰ型6颗,Ⅱ型6颗.D组的劈裂形式明显优于B、C组（x2=5.042,P=0.025）.结论 复合树脂与聚合瓷嵌体均有利于提高牙体缺损修复术中牙齿的抗折强度,而采用聚合瓷牙齿的劈裂形式要优于采用复合树脂.     

Aqueous hydrocortisone mouthwash solution: clinical evaluation

Patients often experience difficulties in applying topical steroids in orabase to the oral mucosa, particularly when large areas need to be covered. An aqueous hydrocortisone mouthwash solution has been developed, one that was anticipated to be more acceptable to patients. The solution contains hydrocortisone (0.3% w/v) in a 4.5% (w/v) 2-hydroxypropyl-β-cyclodextrin solution. Hydroxypropylmethylcellulose (0.5% w/v) was used to increase the viscosity of the solution and to promote the hydrocortisone±cyclodextrin complex. One hundred and two patients with aphthous ulceration, lichen planus, and other mucosal conditions used the mouthwash in an open clinical efficacy study. Most patients reported some or considerable improvement following a 2-week course of treatment with the mouthwash: 26 of 33 (78.8%) patients with aphthous ulceration were `much better', as were 26 of 54 (48.1%) patients with lichen planus and 5 of 16 (31.3%) patients with other mucosal lesions. No serious side effects were reported. Aqueous mouthwash solutions offer a potential vehicle for topical steroid therapy of oral mucosal lesions.     

口腔埋伏牙自体移植的临床研究

目的 探讨埋伏牙、易位牙再植的方法和临床疗效.方法 选择埋伏或易位的上前牙18颗,微创拔出错位牙,修整牙槽窝,立即植入牙槽窝内,结扎固定.术后1、2、3、4、5、6、12个月复查再植牙的松动度、牙髓活力、X线片.结果 18颗牙再植术后6个月各项指标正常,临床效果满意.结论 埋伏牙或易位牙可通过拔牙再植的方法恢复正常的咬合关系和咀嚼功能.     

改良微创贴面在前牙缺损的应用

目的：评价改良微创贴面在前牙缺损的临床应用效果。方法：对40例40颗前牙切端缺损要求修复的患者随机分为2组,分别用传统瓷贴面及改良微创贴面进行修复,修复1年后对颜色匹配、边缘、修复体完整度、牙龈健康及术后敏感度进行评价。结果：改良贴面在边缘、牙龈健康及术后敏感症状上优于传统贴面（P〈0.05）,在修复体完整性与颜色匹配上与传统贴面无显著性差异。结论：在严格选择好适应症的前提下,改良贴面在前牙切端缺损的修复临床效果良好。     

High-plasticity mesenchymal stem cells isolated from adult-retained primary teeth and autogenous adult tooth pulp—A potential source for regenerative therapies?

PurposeThe objective of this study was to compare the growth rate, morphology, immunohistology and plasticity of autogenous adult-retained SHEDs (arSHEDs) and adult dental pulp stem cells (DPSCs) obtained from the same donor.MethodsExpression of the mesenchymal stem cell markers CD44, CD90, CD105, caspase-3 and GAPDH were assessed using RT-PCR. Caspase-3 and CD44 were also evaluated at the protein level by western blotting of cell lysates. Plasticity of DPSCs and arSHEDs were tested by culture in adipogenic, chondrogenic, osteogenic and Schwann cells induction media.ResultsDPSCs and arSHEDs were isolated by explant culturing and were similarly positive for growth rate and all tested markers. Furthermore, DPSCs and arSHEDs could be driven to adipocyte, chondrocyte, osteocyte and Schwann cells lineages thus indicating similar plasticity as precursor cells.ConclusionThis study demonstrates the similarities between DPSCs and arSHEDs in a unique situation, where both stem cells (SC) types were obtained from a single patient and thus represent an alternative source of SC’s for tissue engineering and regeneration.     

Tactile Sensibility of Single‐Tooth Implants and Natural Teeth Under Local Anesthesia of the Natural Antagonistic Teeth

Introduction and Aim: The term osseoperception describes the capability of developing a subtle tactile sensibility over dental implants. The present clinical study aims at clarifying the question of how far tactile sensibility is to be attributed to the periodontium of the natural opposing tooth of the implant. Material and Method: Thirty‐two subjects with single‐tooth implants with natural opposing teeth were included in this clinical, single‐blind, split‐mouth study. The natural antagonistic tooth of the implant and the corresponding natural contralateral tooth were anesthetized with a locally infiltrated articaine anesthetic. In a computer‐assisted and randomized way, copper foils of varying thickness (0–100 µm) were placed interocclusally between the single‐tooth implant and the natural opposing tooth, and between the contralateral pair of natural opposing teeth in order to investigate the active tactile sensibility according to the psychophysical method of constant stimuli and evaluate it statistically by the Weibull distribution. Results: The average tactile sensibility of the implants with anesthetized antagonists at the 50% value calculated by means of the Weibull distribution was 20 ± 11 µm with a support area (90%–10% value) of 77 ± 89 µm. For the pair of natural teeth, the tactile sensibility at the 50% value was 16 ± 9 µm with a support area of 48.4 ± 93 µm. This resulted in an average intraindividual difference of 3.5 ± 7 µm at the 50% value and 29 ± 93 µm in the support area. The statistical calculations demonstrated an equivalent tactile sensibility (50% value) of the single‐tooth implant and the contralateral natural control tooth with the natural antagonists being anesthetized in each case (double t‐test, equivalence limit ± 8 µm, P < 0.01, power >80%). Conclusion: Apparently, the active tactile sensibility of single‐tooth implants with natural opposing teeth is not only to be attributed to the periodontium of the opposing tooth but also to a perception over the implant itself. This could support the hypothesis according to which the implant may have a tactile sensibility of its own.     

乳牙预成冠及树脂修复治疗乳磨牙大面积龋的临床效果观察

目的乳牙预成冠及树脂修复治疗乳磨牙大面积龋的临床效果观察。方法 2013年7月至2015年12月于本院就医的乳磨牙龋的患儿78例,所有患儿均通过入院前确诊,满足乳磨牙龋诊断标准,然后按照随机数字表法分为观察组与对照组,各组均为39例,其中观察组采用预成冠方法进行修复,而对照组以复合树脂进行修复,两组患儿均为同一位医生完成治疗,统计各组的总体治疗成功率。结果本研究半年内两组患儿随访临床治疗评估(每月1次)显示,观察组患儿在治疗后3个月、6个月的总有效率分别为97.43%、94.87%,均高于对照组的89.74%、84.61%,以上组间差异显著,具有统计学意义(P0.05);对于乳牙功能的行使保存,预成冠成功率要远远高于树脂修复成功率,预成冠保存乳牙继续行使咀嚼功能疗效较树脂修复显著,以上两组的组间数据对比存在明显差异,具有统计学意义(P0.05)。结论对于乳磨牙龋修复而言,运用预成冠修复方法无论在成功率、咀嚼功能疗效均高于树脂修复效果,具有临床推广意义。     

The influence of vertical dimension of occlusion changes on the electroencephalograms of complete denture wearers

PurposeThe present study was conducted to identify how changes in the vertical dimension of occlusion (VDO) affect the sensory perception and activity of the brain in complete denture wearers using an electroencephalogram (EEG).MethodsSubjects were 21 individuals wearing complete dentures who regularly visited the Division of Prosthodontics at Tsurumi University Dental Hospital for checkups (12 males and 9 females, average age: 76.6). Based on their original dentures, two duplicate dentures with different VDO (−3 mm and +5 mm) were fabricated. EEG activity and occlusal force were measured before and after gum chewing with each denture in all subjects. Negative indicator scores for psychological conditions and stable neuronal activity (Dα) were calculated using EEG data. Statistical analysis was performed using the Wilcoxon test to compare changes in the sensory perception, activity of the brain, and occlusal force (α = 0.05).ResultsAfter gum chewing with the +5-mm denture, a significant increase was observed in the negative indicator score (p < 0.05). No significant difference was found in the Dα values before and after gum chewing with any of the dentures (p > 0.05). A significant decrease was observed in the occlusal force between the original denture and the −3-mm denture (p < 0.05).ConclusionPsychological condition and occlusal force were influenced by immediate changes in the VDO of the complete denture.     

预成纤维桩应用于冠改向修复的初步研究

将80颗人离体牙模拟不同种倾斜角度（舌侧倾斜30°、15°，颊侧倾斜15°、30°，无倾斜）配伍分10组（n ＝8），实验组采用预成纤维桩修复，对照组采用钴铬合金铸造桩修复，各组均行铸造金属冠修复。电子万能试验机测试各组抗折载荷。结果显示修复倾斜牙时，纤维桩与铸造桩修复体之间抗折载荷无统计学差异。2种桩修复体受力过载时，主要为不可修复性折裂。根管桩种类与改向角度之间的交互作用没有统计学意义（P ＞0．05），即根管桩种类与改向角度均不会改变对方对抗折载荷的影响。     

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??Objective    To compare the short-term clinical effect of different degrees of wear in the posterior area of the implant denture. Methods    From January 2009 to December 2013??469 patients??the average age was 50.9??with partial loss of posterior teeth were followed up for 6 - 72 months. According to the degree of wear of natural teeth??they were divided into three groups??the non-wear group of 201 cases??457 implants????163 cases in mild-wear group??289 implants????105 cases in severe-wear group??235 implants??. The five-year cumulative survival rates of implants in the three groups were counted and the numerical values of bone resorption around the implants were measured. Results    Three groups of patients had no implant loss??the 5-year retention rate was 100%??there was no significant difference in bone resorption at the end of 3 months??6 months??1 year and 2 years after the repair??P > 0.05????there was no significant difference in the incidence of postoperative complications??P > 0.05??. Conclusion    In short time??the patients with mild wear and severe wear can have good clinical effect??whereas long-term effect need to be followed up.