PKP与“五点式”支撑复位综合疗法治疗新鲜骨质疏松性胸腰椎压缩骨折疗效比较

目的:观察经皮椎体后凸成形术(PKP)与"五点式"支撑复位综合疗法治疗新鲜骨质疏松性胸腰椎压缩骨折(OVCFs)在缓解疼痛、矫正脊柱后凸畸形、改善患者生活质量及邻近再骨折发生率、骨密度改善等方面的效果。方法:回顾性分析OVCFs患者74例,其中37例行PKP手术治疗(A组),37例行"五点式"支撑复位综合疗法治疗(B组),术后常规拍摄伤椎及其邻近阶段X线片,行骨密度检查,2组治疗后6、12、24个月进行随访,记录患者疼痛视觉模拟评分(VAS)、伤椎前缘高度、后凸Cobb角、Oswesty功能障碍指数(ODI)、邻近再骨折发生率、骨密度改善情况。结果:A组伤椎前缘高度恢复、后凸畸形矫正、疼痛缓解及功能活动、骨密度改善等方面均优于B组,差异有统计学意义(P0.05)。A组与B组邻近节段发生骨折率分别为8.1%和18.9%,差异有统计学意义(P0.05)。结论:PKP能使OVCFs患者的腰背疼痛得到有效缓解,能矫正后凸畸形,改善患者生活质量,降低邻近阶段骨折的再发生。     

运脾开胃散联合复方胃蛋白酶颗粒治疗小儿厌食症的临床疗效观察

目的观察和评价运脾开胃散联合复方胃蛋白酶治疗小儿厌食症的临床应用与疗效。方法从在我院就诊的符合中西医诊断标准的厌食症患儿选取90例,随机分为两组,治疗组给予运脾开胃散联合复方胃蛋白酶颗粒口服,对照组给予复方胃蛋白酶颗粒口服。结果两组患儿治疗后,食欲、食量均较前明显改善,但治疗组疗效更佳(P0.05)。治疗组痊愈15例,显效21例,有效4例,无效3例,总有效率为93.02%;治疗组痊愈10例,显效15例,有效7例,无效9例,总有效率为78.05%(P=0.0410.05)。结论运脾开胃散联合复方胃蛋白酶颗粒治疗小儿厌食症临床疗效显著,值得推广,同时为中西医结合治疗小儿厌食症提供了新思路。     

Assessing the quality of life in infants with deformational plagiocephaly

This was a parent-reported outcome study on the impact of helmet therapy on the quality of life of infants with deformational plagiocephaly and their caregivers. Using survey-based analysis, we compared the quality of life in infants with deformational plagiocephaly with a cohort of their healthy peers. In addition, we compared infant quality of life before and after helmet therapy to evaluate the impact of this mainstay therapy for deformational plagiocephaly.Our results demonstrated that infants with plagiocephaly and their caregivers had a significantly decreased quality of life compared with healthy controls. This reframes our understanding of deformational plagiocephaly and emphasizes the need for therapeutic intervention in these individuals. A common therapeutic option — helmet remolding therapy — was shown to have no negative impact on quality of life, underscoring this as an appropriate therapeutic option. These data will allow us to counsel our future parents more effectively regarding the impact of deformational plagiocephaly and helmet therapy.     

Willingness to pay for periodontal therapy: development and testing of an instrument

OBJECTIVES: The objective of this study was to develop and test the feasibility and validity of a willingness to pay (WTP) tool in a dental setting. METHODS: A questionnaire measured individuals' preferences among alternative treatments for periodontal disease and the maximum they would be willing to pay for their treatment of choice in terms of dental insurance premiums. The questionnaire provides detailed information, in probabilistic terms, of the risks and benefits of treatment choices for moderate to advanced adult periodontitis. It was pilot tested on 23 periodontal patients and 18 dental school faculty and staff. RESULTS: The majority (92.6%) felt the questionnaire was an accurate representation of treatments and outcomes, establishing face and content validity. In terms of construct validity, four hypotheses were tested: (1) manipulation of the outcomes of the preferred treatment led to a predictable shift in preferences for 38 subjects (92.7%); (2) although periodontal patients were not more likely to choose periodontal surgery than nonpatients (P = .14), those with a history of surgery were more likely to choose surgery again (P = .06); (3) WTP was positively related to income level (P = .05); and (4) subjects were willing to pay more for coverage for themselves than for others. Periodontal surgery was the preferred treatment for moderate to advanced periodontal disease, and was more strongly preferred than other choices (i.e., a higher WTP) for all income groups. The intraclass correlation coefficient for treatment preferences was 0.95 (P < .001) and the kappa for WTP was 0.78 (P < .001). CONCLUSION: This pilot study supports some of the criteria concerning validity of the WTP questionnaire to measure preferences for alternative periodontal therapies. Further testing on larger samples is required to confirm these results.     

The physical characterization of a thermoplastic polymer for endodontic obturation

OBJECTIVE: To analyze a new endodontic sealer material commercially known as Resilon and to describe in detail the experimental techniques employed that lead to the identification of the composite material. METHODS: An extensive structural, thermal, and physical characterization was used to identify a new endodontic sealer material using the following techniques: Fourier transform infrared (FTIR) spectroscopy, nuclear magnetic resonance (NMR) analysis, X-ray fluorescence spectrometry (XRF) technique, X-ray diffraction (XRD) measurement, thermo-gravimetric analysis (TGA) and a differential scanning calorimeter (DSC). The surface morphology was analyzed using a scanning electron microscope (SEM). RESULTS: The material was identified as a composite of polycaprolactone, which is a polymer of the polyester family and bioactive glass, which is radiopaque filler. CONCLUSIONS: The Resilon sealer material is a thermoplastic synthetic degradable polymer (polycaprolactone), it contains bioactive glass. Its properties, such as strength, modulus, shape-memory effect and biodegradability depend on the crystalline fraction, which is affected in turn by conditions of crystallization. Investigation of the crystallization kinetics of PCL is of practical significance. It is especially necessary to study its the dynamic and non-isothermal crystallization process.     

Safety of dental implant surgery in patients undergoing anticoagulation therapy: a prospective case-control study

Objectives: Several studies have described oral surgical procedures in patients receiving anticoagulant therapy, but no prospective studies on dental implant surgery during anticoagulant treatment are currently available, and only a limited number of case reports refer to endosseous dental implant treatment in these patients. In the setting of oral surgery, it has been suggested that anticoagulant treatment is not required when the International Normalized Ratio (INR) is <4 and local haemostatic measures are applied. The purpose of this preliminary study was to evaluate the incidence of bleeding complications following surgical implant therapy in a group of 50 consecutive patients receiving oral anticoagulant therapy (warfarin) without interruption or modifications to their therapy (group A). Materials and methods: One hundred and nine otherwise healthy patients comparable for age, sex, extent and site of the implant surgical procedure formed the control group (group B). In both groups, a standard protocol of local haemostasis, including non‐reabsorbable sutures and compressive gauzes soaked with tranexamic acid, was applied. Surgeons, blind to the group allocation, performed all the procedures in an outpatient setting. Results: Two and three late‐bleeding complications were reported in group A and group B, respectively, without significant difference in the bleeding risk (relative risk = 1.45; P= 0.65; 95% confidence interval 0.2506–8.4271). These complications were managed using a compressive gauze soaked with tranexamic acid at the site of the surgical wound. Conclusion: According to our preliminary results, local haemostasis in dental implant surgery is able to prevent bleeding complications in patients on oral anticoagulants, allowing these surgical procedures to be performed on an outpatient basis. To cite this article:
Bacci C, Berengo M, Favero L, Zanon E. Safety of dental implant surgery in patients undergoing anticoagulation therapy: a prospective case–control study.
Clin. Oral Impl. Res. 22 , 2011; 151–156.
doi: 10.1111/j.1600‐0501.2010.01963.x     

大锥度牙胶尖与两种镍钛机动根管预备锉的匹配性研究

目的评价大锥度牙胶尖与两种机动镍钛根管预备锉的匹配性。方法选择40只离体后牙根管,根据初尖锉的号码和近远中向根管弯曲度分为2组,分别以ProTaper和ProFile两种机动镍钛根管锉完成根管预备,插入大锥度牙胶尖进行试尖,比较两者的匹配性。结果ProTaper F1、F2、F3与0.06锥度/20、253、0号牙胶尖的匹配率分别为80%、88%、92%,均较同锥度大1号的牙胶尖匹配率高,差异有显著性(P<0.01)。ProFile 0.06锥度/30号和40号与0.04锥度同号牙胶尖的匹配率最高,分别为83%和96%,其次是0.06锥度小1号牙胶尖,而与0.06锥度同号牙胶尖匹配率最低,分别为35%和25%,3者间差异有显著性(P<0.01)。结论大锥度镍钛机动器械预备的根管,与主尖锉同号而锥度减小或锥度相同且小1号的大锥度牙胶尖有良好的匹配性。     

The effect of cleaning on blood contamination in the dental surgery following periodontal procedures

Blood contamination of 16 surfaces in the dental surgery was investigated using the Kastle-Meyer test for haemoglobin, after three types of periodontal procedures had been performed on a total of 30 patients. The effect of cleaning surfaces contaminated by blood was investigated using the same test. Cleaning materials used in the dental surgery were tested to rule out the possibility of false positive outcomes and the sensitivity of the test was determined prior to the study. The results show a marked variation in the degree of contamination and efficacy of cleaning following treatment. Overall, root planing was associated with the most widespread and frequent blood contamination and gingival surgery the least. The surgery work surface, edge of the spittoon, aspirator tube and ultrasonic scaler handpiece into which the ultrasonic insert fits, were the most frequently contaminated surfaces. The work surface, dentist's pen, light switch and handle were cleaned most effectively. The least effectively cleaned surfaces were the water dispenser switch, aspirator tube, bracket table and ultrasonic scaler handpiece. Methods for reducing this potential source of crossinfection are discussed.     

Clinical effects after subgingival polishing with a non-aggressive ultrasonic device in initial therapy

OBJECTIVES: The Vector ultrasonic system provides root debridement supported by different abrasive irrigation fluids. The aim of this study was to investigate the clinical outcome of initial therapy with subgingival low-abrasive debridement. MATERIAL AND METHODS: Twenty patients, who had at least two teeth with pocket depths >5 mm in each quadrant, took part in this prospective randomized clinical study. Patients were treated in a split-mouth design as one test quadrant (1) subgingivally with Vector fluid polish (VU-H) and as three control quadrants, (2) with only supragingival polishing (PO-H), (3) with hand instruments (HI-H) performed by a hygienist and (4) with hand instruments (HI-D) performed by a dentist. At baseline, 3 and 6 months after treatment, pocket depths and attachment levels (ALs) were measured and bleeding on probing (BOP) was recorded. RESULTS: At 6-month evaluation, all groups showed an improvement in clinical parameters. No statistically significant differences in any of the investigated parameters could be observed between the Vector group and the hand scaling groups, or when comparing the results of the two different operators. CONCLUSION: This study demonstrates that Vector treatment with polishing fluid was able to reduce pocket depths and the prevalence of BOP and improve clinical AL in a similar way as scaling with curettes.