口腔益生菌与口腔常见疾病的关系

人体口腔是一个存在多种微生物的复杂的微生态系统.正常的口腔中大约寄宿着上千种不同的细菌.口腔菌群一旦失调就会导致口腔疾病的出现,例如龋齿、牙周病长期困扰着患者和临床医生,而传统的预防治疗方法又存在种种弊端.乳酸杆菌是广泛应用的益生菌,在调节胃肠道生态平衡方面发挥重要作用,在口腔疾病的预防方面国内外学者也进行了大量的研究.此文对最近几年关于口腔乳酸杆菌的研究应用、作用机制以及应用前景做一概述.     

自锁托槽的临床应用及研究进展

自锁托槽是一种新的托槽类型,可以通过托槽槽沟唇侧的滑盖或弹簧夹固定弓丝,简便了结扎过程,节省了椅旁操作时间,还有助于减小滑动阻力,减少关闭间隙的阻力,使矫治效力增加。自锁托槽与传统托槽一样,能三维方向控制牙的移动。大部分学者认为,使用自锁托槽矫治可以减少总治疗时间,延长复诊间隔时间,减少复诊次数,并且自锁托槽的脱落率和意外打开率和传统托槽无显著差异。     

Prior intake of new oral anticoagulants adversely affects outcome following surgery for acute type A aortic dissection

Open in a separate window OBJECTIVESOral anticoagulation prior to emergency surgery is associated with an increased risk of perioperative bleeding, especially when this therapy cannot be discontinued or reversed in time. The goal of this study was to analyse the impact of different oral anticoagulants on the outcome of patients who underwent emergency surgery for acute type A aortic dissection (ATAAD).METHODSThis was a single-centre retrospective study of patients treated with oral anticoagulation at the time of surgery for ATAAD. Outcomes of patients on new oral anticoagulant (NOAC) therapy were compared to respective outcomes of patients on Coumadin. Additionally, a survival analysis was performed comparing these 2 groups with patients who were operated on with no prior anticoagulation.RESULTSBetween January 2013 and April 2020, a total of 437 patients (63.8 ± 11.8 years, 68.4% male) received emergency surgery for ATAAD; 35 (8%) were taking oral anticoagulation at the time of hospital admission: 20 received phenprocoumon; 14, rivaroxaban; and 1, dabigatran. Compared to Coumadin, NOAC was associated with a greater need for blood-product transfusions and haemodynamic compromise. Operative mortality was 53% in the NOAC group and 30% in the Coumadin group. A 5-year survival analysis showed no significant difference between the NOAC and the Coumadin group (P = 0.059). Compared to 402 patients treated during the study period without anticoagulation, patients taking NOAC had significantly worse survival (P = 0.001), whereas that effect was not observed in patients undergoing surgery who were taking Coumadin (P = 0.99).CONCLUSIONSEmergency surgery for ATAAD in patients taking NOAC is associated with high morbidity and mortality. NOAC are a major risk factor for uncontrollable bleeding and haemodynamic compromise. New treatment strategies must be defined to improve surgical outcomes in these high-risk patients.     

The upregulated intestinal folate transporters direct the uptake of ligand-modified nanoparticles for enhanced oral insulin delivery

Transporters are traditionally considered to transport small molecules rather than large-sized nanoparticles due to their small pores. In this study, we demonstrate that the upregulated intestinal transporter (PCFT), which reaches a maximum of 12.3-fold expression in the intestinal epithelial cells of diabetic rats, mediates the uptake of the folic acid-grafted nanoparticles (FNP). Specifically, the upregulated PCFT could exert its function to mediate the endocytosis of FNP and efficiently stimulate the traverse of FNP across enterocytes by the lysosome-evading pathway, Golgi-targeting pathway and basolateral exocytosis, featuring a high oral insulin bioavailability of 14.4% in the diabetic rats. Conversely, in cells with relatively low PCFT expression, the positive surface charge contributes to the cellular uptake of FNP, and FNP are mainly degraded in the lysosomes. Overall, we emphasize that the upregulated intestinal transporters could direct the uptake of ligand-modified nanoparticles by mediating the endocytosis and intracellular trafficking of ligand-modified nanoparticles via the transporter-mediated pathway. This study may also theoretically provide insightful guidelines for the rational design of transporter-targeted nanoparticles to achieve efficient drug delivery in diverse diseases.     

口腔修复技术治疗早期牙隐裂的临床效果

目的 分析口腔修复技术治疗早期牙隐裂的临床效果。方法 选取2021年11月-2022年11月于 我院口腔科治疗的102例早期牙隐裂患者为研究对象,采用随机数字表法分为对照组与观察组,每组 51例。对照组予以传统调磨填充治疗,观察组采用口腔修复技术治疗,比较两组修复效果、疼痛程度 （VAS评分）、并发症发生率、复发率、舒适度、满意度。结果 观察组修复治疗总有效率高于对照组 （P＜0.05）;观察组治疗后VAS评分低于对照组（P＜0.05）;观察组并发症发生率、复发率均低于对 照组（P＜0.05）;观察组舒适度、满意度均优于对照组（P＜0.05）。结论 对早期牙隐裂患者进行口腔 修复技术治疗能够达到良好的修复效果,可减轻患者咀嚼过程中的疼痛感,有利于预防并发症发生,减 少复发情况,提高患者舒适度和满意度,值得临床应用。     

牙周炎患者种植义齿修复后口腔自我维护的临床观察

目的：探讨菌斑显示剂在牙周炎患者种植义齿修复后口腔维护中的作用。方法整群选择2013年5月—2015年2月在医院进行义齿修复的62例患者共78颗种植体作为研究对象,随机分为观察组和对照组,每组31例39颗种植体。在修复后的口腔自我维护中,对照组给予一般维护,观察组在此基础上给予菌斑显示剂,比较两组患者的牙周参数和种植体周围黏膜炎发生率。结果种植体完成修复2周后,两组患者PLI、SBI、PD和菌斑指数与对照组相较差异无统计学意义(P>0.05);修复3个月后所有患者观察组PLI、SBI、PD和菌斑指数均优于对照组(P<0.05);种植修复后1年内,观察组种植体周围粘膜炎平均发生率为45.6%,对照组为59.4%,差异有统计学意义(P<0.05)。结论系统的口腔自我维护能够显著降低牙周炎患者种植体周围黏膜炎的发生率,使用菌斑显示剂让患者对菌斑有良好的自我控制效果显著。     

组织瓣修复口腔颌面部缺损的护理研究

口腔颌面部的外伤及恶性肿瘤等疾病会导致面部组织的缺损,对患者的美观度及功能等产生一定 的影响。组织瓣修复在改善患者口腔颌面部缺损以及外观上具有积极的临床效果,但其手术治疗效果与术 后护理具有密切的联系。本文对组织瓣移植进行概述,并对组织瓣修复口腔颌面部缺损的护理作一综述。     

37例口颊癌术后腮腺瘘的放疗效果评估

目的 评估放射治疗应用于口颊癌术后腮腺瘘的疗效以及不良反应.方法 回顾性分析2010年1月-2020年1月湖南省肿瘤医院头颈外科收治的因口颊癌术后出现腮腺瘘且接受放射治疗的患者37例,所有患者均采用6-MeV电子线照射,每次2 Gy,每天1次,每周5次,照射总剂量为8～18 Gy(平均剂量9.7 Gy),照射野包括整个...     

Hodgkin Lymphoma of the Oral Mucosa

In this report, we describe a rare case of relapsed nodular sclerosing Hodgkin lymphoma presenting as a lesion of the oral mucosa. Although this is an uncommon clinical scenario, health care professionals should be aware of this possibility. A brief differential diagnosis and review of Hodgkin lymphoma is discussed.