口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

双膦酸盐颌骨坏死及双膦酸盐对种植体骨结合影响的研究进展

<正>随着我国人口老龄化日益严重,维持口腔健康尤其是恢复已丧失牙齿功能是临床医生亟需解决的问题。种植技术基于骨结合理论是目前临床重建已丧失牙齿功能的重要手段,然而种植临床受众往往以中老年人为主,此类患者由于骨密度和骨质量下降伴有不同程度的骨质疏松,而骨质疏松极大地影响种植成功率,导致预后不良。     

改进的连续波热牙胶根充法应用于老年人根管充填的临床评价

目的：评价老年人根管充填应用改进的连续波热牙胶根充法的充填质量和效率。方法：213名需要根管治疗的老年口腔患者,共计238颗患牙,按照根管充填方法的不同分为热牙胶组和冷侧压组,并对两组间根管充填恰填率、侧支根管充填情况、根充所用时间、术中疼痛四方面进行对比分析。结果：改进的连续波热牙胶组根管恰填率高达89．92％,而冷侧压组仅为79．82％,热牙胶组优势明显;另外在侧支根管充填情况和根充所用时间的对比中,热牙胶组依然强于冷牙胶组（P〈0．05）;两组术中疼痛并没有差别（胗0．05）。结论：改进的连续波热牙胶根管充填法应用于老年口腔患者优点突出,易于接受,能有效提高老年人根管治疗的质量和效率。     

抗凝血与抗血小板治疗老年患者拔牙的临床研究

目的：观察抗凝血治疗和抗血小板治疗的老年患者拔牙术后出血及拔牙创的愈合,评价拔牙术后明胶海绵加缝合创口的止血效果。方法：老年患者分为抗凝血治疗需要拔牙组、抗血小板治疗需要拔牙组和随机选择需要拔牙的老年患者作正常对照。抗凝血治疗组拔牙前均进行凝血酶原时间国际标准化率检测。三组均采用局部纱布压迫止衄,比较拔牙术后出血情况,拔牙术后出血的病人采用局部明胶海绵加缝合创口处理。结果：抗凝血治疗与其他2组出血有显著性差异,3组均未出现局部不可控制的出血;3组创口愈合没有明显差别。结论：接受抗凝血治疗和抗血小板治疗的老年病人,在不停药和不减少药物剂量的情况下可以行拔牙术,明胶海绵加上局部缝合可达到止血目的。     

颌面外科门诊临床教学的质量提高和医疗安全策略分析

为了改善颌面外科门诊临床教学的质量和医疗安全,作者根据口腔颌面外科门诊临床教学的特点,分析了现阶段颌面外科门诊实习存在的问题,从实习医生基础理论知识的加强,颌面外科思维能力的培养,沟通技巧的训练,加强其法律和伦理意识,利用问题式教学模式和PDCA理论,改善口腔颌面外科临床教学模式,建立合理的临床实习教学评价体系,提升口腔颌面外科门诊教学质量和医疗安全。     

神经生长因子对口腔种植体早期骨结合影响的实验研究

目的 观察外源性神经生长因子(nerve growth factor,NGF)对口腔种植体骨愈合的影响,以期缩短口腔种植体骨愈合时间.方法 在12只新西兰大白兔下颌骨双侧各植入种植体1枚,右侧为实验组:种植体边缘骨膜下注射1.0μgNGF;左侧为对照组:同样部位注射相同剂量的生理盐水.注射1次/d,连续7 d.术后2、4、8周分别处死动物各4只,获取下颌骨,制作种植体骨磨片甲苯胺蓝染色标本,行大体、放射学和组织学观察以及骨计量学分析.结果 术后2、4周各组下颌骨种植体周围新生骨密度低于正常骨组织,种植体骨结合率对照组2周(26.67±3.88)%、4周(52.59±5.07)%;实验组2周(42.24±6.67)%、4周(72.25±6.30)%;术后8周两组骨密度与正常骨组织相近,实验组新生骨小梁出现哈弗系统,种植体骨结合率两组相比,差异无统计学意义.结论 口腔种植术后早期加入外源性NGF能够加速种植体周围骨小梁的形成和成熟,增加骨结合面积,提高种植体骨结合率,缩短口腔种植体骨愈合时间.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

目的 了解唾液硝酸根和、亚硝酸根在口腔感染防御上的作用.方法 收集33例口腔念珠菌病患者及34名无口腔念珠菌病对照者的唾液,高效液相色谱法测定硝酸根、亚硝酸根含量,对其中10例患者治疗前后的唾液硝酸根、亚硝酸根含量进行比较,结果 分别采用独立样本t检验或配对样本t检验(α=0.05).结果 腮腺液硝酸根的浓度和分泌速度:患者组为(49.70±0.50)ms/L和(27.71±0.50)μ/min,对照组为(21.51±0.60)ms/L和(12.55±0.60)μg/min;混合唾液硝酸根的浓度和分泌速度:患者组为(6.46±0.94)ms/L和(10.57±0.91)μg/min,对照组为(1.11±0.70)mg/L和(2.10±0.74)μg/min;混合唾液亚硝酸根的浓度和分泌速度:患者组为(8.48±0.58)mg/L和(13.91±0.55)μg/min,对照组为(3.39±0.53)mg/L和(6.42±0.58)μg/min.以上检测项目患者组与对照组比较差异均有统计学意义(t值分别为2.692、2.554、3.792、3.464、2.888、2.397.P值均<0.05).念珠菌病患者治愈后,其腮腺液及混合唾液硝酸根、亚硝酸根水平均下降,其中腮腺液硝酸根的分泌速度治疗前后分别为(37.50±0.50)μg/min和(14.34±0.64)μg/min,混合唾液硝酸根的浓度和分泌速度治疗前后分别为(14.29±1.01)mg/L和(2.59±1.03)mg/L、(25.97±0.93)μg/min和(4.12±1.00)μg/min,以上三者治疗前后的改变差异有统计学意义(t值分别为3.142、3.475、3.922,P值均<0.05).结论 口腔念珠菌病患者的唾液硝酸根和亚硝酸根水平均有明显升高,治疗后下降,这种变化可能与机体的防御性反应有关.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

口腔临床实习医师职业暴露防护现状和教育策略

职业暴露是指医务人员从事诊疗、护理等工作过程中意外被乙肝、丙肝、艾滋病病毒等感染者或者病人的血液、体液污染皮肤或者黏膜,或者被含有病毒的血液、体液污染的针头及其他锐器刺破皮肤,有可能被病毒感染的情况。近年来,医院感染的发生率逐年增加,已成为我国乃至全球的公共卫生问题。特别是口腔医护人员,他们需要频繁使用锐器[1],各种医疗器械均会与患者的血液、唾液直接接触。在医务人员职业暴露后,沾有患者血液、唾液的医疗器械便会传播[2],口腔医护人员感染的机会大大增加。口腔医务人员的乙肝感染率是一般人群的3~6 倍,在医疗行业中口腔医务人员乙肝感染率也是最高的[3]。