海奥骨粉复合CGF用于拔牙位点保存的临床观察

目的将海奥骨粉结合CGF填充拔牙创行拔牙位点保存,观察其临床效果,为临床应用提供参考。方法选择残根残冠欲拔出后行延期种植修复的患者46例58颗牙,年龄25～64岁,平均(41±1.0)岁,其中男25例,女21例58颗牙随机分为观察组和对照组,每组29颗牙。观察拔牙后在拔牙创内填入海奥骨粉,表面覆盖CGF膜;对照组拔牙创内未填入任何材料,单纯关闭创窝。术后一周观察局部术后反应及创口愈合情况;术后分别在3个月和6个月观察拔牙部位压床丰满度和局部牙槽骨的密度及高度变化。结果术后一周所有病例均未发生拔牙创未愈,创口裂开或者填充材料溢出等情况。3个月X线片显示拔牙区域虽然可见拔牙窝形状,但观察组密度明显较对照组高(P0.001);6个月观察组其牙槽骨高度平齐牙槽嵴顶,骨质密度与周围牙槽骨呈均匀一致,对照组拔牙(P0.001)。结论拔牙创内填入海奥骨粉和CGF行位点保存能够避免拔牙后牙槽骨吸收的效果,值得推广。     

应用羟基磷灰石生物陶瓷及口腔膜引导骨再生修复牙周骨缺损

背景：羟基磷灰石生物陶瓷以天然优质海洋珊瑚为原料,在珊瑚骨架上形成羟基磷灰石薄层,保留珊瑚天然孔孔相同的支架结构,为组织生长提供了良好空间。目的：观察羟基磷灰石生物陶瓷膜引导骨再生修复牙刷骨缺损的临床效果。方法：将42例下颌第一磨牙牙周病致骨缺损患者随机分组：实验组采用羟基磷灰石生物陶瓷结合u腔修复膜充填修复骨缺损,对照组采用单独羟基磷灰石生物陶瓷充填修复。结果与结论：临床随访观察12个月,两组牙周组织附着丧失、牙剧探诊深度较治疗前明显改善（P〈0．05）,且实验组牙周组织附着丧失、牙周探诊深度改善优于对照组（P〈0．05）;实验组骨缺损区新骨形成密度和骨量均优于对照组（P〈0．05）。表明采用羟基磷灰石生物陶瓷充填骨缺损区同时覆盖生物膜的引导骨再生技术可获得良好的骨引导再生效果,修复骨缺损。     

应用羟基磷灰石生物陶瓷及口腔膜引导骨再生修复牙周骨缺损

背景：羟基磷灰石生物陶瓷以天然优质海洋珊瑚为原料,在珊瑚骨架上形成羟基磷灰石薄层,保留珊瑚天然孔孔相同的支架结构,为组织生长提供了良好空间。 目的：观察羟基磷灰石生物陶瓷膜引导骨再生修复牙周骨缺损的临床效果。 方法：将42例下颌第一磨牙牙周病致骨缺损患者随机分组：实验组采用羟基磷灰石生物陶瓷结合口腔修复膜充填修复骨缺损,对照组采用单独羟基磷灰石生物陶瓷充填修复。 结果与结论：临床随访观察12个月,两组牙周组织附着丧失、牙周探诊深度较治疗前明显改善(P < 0.05),且实验组牙周组织附着丧失、牙周探诊深度改善优于对照组(P < 0.05);实验组骨缺损区新骨形成密度和骨量均优于对照组(P < 0.05)。表明采用羟基磷灰石生物陶瓷充填骨缺损区同时覆盖生物膜的引导骨再生技术可获得良好的骨引导再生效果,修复骨缺损。     

高频电刀结合高速涡轮牙钻拔除下颌近中阻生智齿的临床应用

目的探讨高频电刀结合高速涡轮牙钻拔牙法拔除下颌近中阻生智齿的临床疗效。方法选择双侧下颌第三磨牙近中阻生且需拔除的患者52例,一侧用高频电刀结合高速涡轮牙钻拔牙法去冠去骨拔除患牙(治疗组),2w后另一侧用传统锤凿法拔除患牙(对照组),比较两组间手术时间、术后局部肿胀程度、疼痛和张口度受限程度。结果治疗组手术时间、肿胀程度、疼痛以及张口受限度均明显优于对照组,差异有统计学意义(P<0.05)。结论高频电刀结合高速涡轮牙钻拔牙法可缩短手术时间,减轻术后并发症。     

自体骨髓间充质干细胞复合富血小板纤维蛋白促进拔牙窝骨愈合

BACKGROUND: Alveolar bone deficiency will not meet aesthetic and functional requirements for dental implants.OBJECTIVE: To observe the repair effect of passage 3 autologous bone marrow mesenchymal stem cells (BMSCs) and platelet-rich fibrin (PRF) on alveolar bone defects in rabbits.METHODS: Twenty-seven New Zealand rabbits were randomly divided into BMSCs/PRF group, PRF group and model group (n=9 per group). The left mandible incisors were extracted in all the rabbits under general anesthesia. BMSCs/PRF group was immediately implanted BMSCs/PRF composite into the alveolar socket, PRF group only implanted PRF, and model group implanted nothing.RESULTS AND CONCLUSION: In the model group, the alveolar crest and alveolar mucosa become sunken notably and narrowed. In the BMSCs/PRF and PRF groups, the thickness of alveolar bone wall, alveolar bone width, alveolar bone height difference, and bone mineral density were all increased, especially in the former group. In addition, the trabecular arrangement was better in the BMSCs/PRF groups than the model and PRF group. Our findings indicate that alveolar socket filling with composite of BMSCs and PRF can achieve preservation of alveolar bone width and height after tooth extraction in rabbits.   中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

种植体不同基台连接方式对上颌单个前牙种植修复美学的影响

BACKGROUND: Implant-abutment connection has become a key factor in the success of implant restoration, but  the effects of different implant-abutment connections on peri-implant tissues is unclear. OBJECTIVE: To compare the effects of three different implant-abutment connections on the alveolar bone and peri-implant soft tissues at the maxillary esthetic zone. METHODS: Sixty patients undergoing aesthetic restoration of single maxillary anterior tooth were enrolled randomly, including 20 cases of Bego Replace system, 20 of Osstem Replace system, and 20 cases of ITI Replace system. All the patients had a follow-up of 3 to 6 months after the surgery, and then received the two-stage surgery. Radiographic and clinical examinations were made at the same time. Peri-implant bone height measured was used as the reference line. The final crowns were made after 2 weeks, and the peri-implant bone resorption and pink esthetic scores were evaluated after 12 months shown through X-ray films. RESULTS AND CONCLUSION: There were significant differences in peri-implant marginal bone loss and pink esthetic scores among different groups after implant restoration. The amount of marginal bone loss around implants using platform switching was significantly less than that using platform butt-joint (P < 0.0.5), and the pink esthetic scores of the former group was higher than the later one (P < 0.05). These findings indicate that aesthetic restoration of a single maxillary tooth implant using platform switching is able to preserve better marginal bone and acquire better aesthetic effects.       

种植体周围炎动物模型的研究进展

种植体周围炎是口腔种植修复的常见并发症,发病率较高。依据与人类牙周组织结构和疾病发展过程的相似程度选择合适的动物,使用不同方法建立动物模型进行实验研究,可以进一步掌握疾病的发病机制、病程发展、病理特点,为临床更准确地评估和诊断疾病,制定合理的治疗方案,提供理论依据。本文就实验动物模型的选材、建模方法以及相关科学研究进展等进行了系统综述。     

不同浓度γ-分泌酶抑制剂对人牙周膜干细胞骨向分化的影响

目的研究不同浓度的γ-分泌酶抑制剂（DAPT）对人牙周膜干细胞（hPDLSC）骨向分化的影响。 方法将体外培养的hPDLSC随机分为5组：（1）2个对照组,即hPDLSC组和二甲基亚砜（DMSO）组（加入0.173 25 μL/L DMSO）;（2）3个实验组,分别加入25、50和75 μmol/L的DAPT,即DAPT25组、DAPT50组及DAPT75组。通过细胞计数试剂盒（CCK-8）法检测不同浓度DAPT对hPDLSC的增殖情况的影响;通过茜素红染色、实时荧光定量聚合酶链反应（PCR）以及蛋白免疫印记法（Western blot）检测不同浓度DAPT对hPDLSC的Notch信号抑制能力及成骨能力的影响。使用SPSS 21.0软件对数据进行统计分析,以P<0.05为差异具有统计学意义。 结果CCK-8结果显示,DMSO浓度为0.173 25 μL/L时对hPDLSC的增殖没有明显影响,同时不同浓度的DAPT均会抑制hPDLSC增殖,且DAPT浓度为50 μmol/L时对细胞的抑制能力最强（P<0.001）;茜素红染色结果显示,hPDLSC组及DMSO组染色明显,矿化结节面积大且颜色深,两组间无明显差异,而3个实验组形成的矿化结节均有所减少,其中DAPT浓度为50 μmol/L时较浓度为25及75 μmol/L时形成的矿化结节数量更少且矿化结节面积更小;实时荧光定量PCR结果显示,DAPT浓度为50 μmol/L时,其成骨标志基因牙骨质附着蛋白（CAP,0.574 ± 0.182）、骨钙蛋白（OCN,0.269 ± 0.100）、Runt相关转录因子2（Runx2,0.470 ± 0.080）的表达量均明显减少,Notch信号通路相关分子Notch1及Hes-1的表达水平分别为0.467 ± 0.118及0.318 ± 0.015,较其余组也有所减少,且DAPT浓度为50 μmol/L时的相关成骨标志基因表达量最低（P<0.05）,Notch信号通路相关分子Notch1及Hes-1的表达水平也最低（P<0.05）;Western blot结果显示,与对照组相比3个实验组Notch、Hes-1及Runx2的蛋白表达量均有减少,其中50 μmol/L的DAPT组Runx2的蛋白表达量（0.116 ± 0.006）明显比其它组少,差异有统计学意义（P<0.001）。 结论DMSO浓度为0.173 25 μL/L时对hPDLSC增殖及骨向分化没有明显影响;DAPT可抑制Notch信号通路的传递,从而抑制hPDLSC增殖及骨向分化,同时DAPT浓度为50 μmol/L时抑制能力最强。