非骨化纤维瘤摘除术后下颌骨大范围缺损的种植修复

手术造成骨缺损的下颌骨采用种植体固定修复违背了下颌骨弯曲形态，冠根比和非轴向负荷的原则。个性化制作并连接于种植体的钩子显示该患者的下颌骨无任何弯曲弹性，但是无法避免冠根比高达39：12。该修复体14年没有进行维护。此病例的显著成功使得我们以前盲目应用的临床原则受到了质疑。     

口腔种植继续教育培训的实践与思考

为了提高和普及口腔临床医师的口腔种植知识和技能,使口腔临床医师的种植治疗规范化,北京口腔种植培训中心开展了各种形式的口腔种植继续教育培训课程,取得了良好的效果。本文系统回顾了我国口腔种植专业教育培训的特点及现状,总结分析了北京口腔种植培训中心继续教育培训的培训课程及实施方法等特点,并对今后的口腔种植教育培训进行了分析和思考。     

心理干预对大鼠颞下颌关节病防治作用的实验研究

目的 通过观察心理干预后心理应激状态下大鼠颞下颌关节的相关变化,探讨心理干预在颞下颌关节疾病防治过程中的作用.方法 应用交流箱心理应激动物模型对大鼠进行心理应激.分别在应激前后应用抗焦虑药物和去除应激源.用ELISA法和RT-PCR检测各组大鼠颞下颌关节髁突软骨细胞内白细胞介素-1(IL-1)和肿瘤坏死因子(TNF-α)的表达变化.结果 PCR结果显示:IL-1βmRNA在应激后第1周表达最强,第3周时减弱,第5周时达到正常水平;TNF-αmRNA在应激后第1周表达最强,第3周后逐渐达到正常水平.Elisa结果显示:抗焦虑药物组IL-1OD值(分别为0.107 ±0.024,0.101±0.005,0.088±0.010)、去除应激源恢复组IL-1OD值(分别为0.090±0.016,0.088±0.005,0.089 ±0.011)和肿瘤坏死因子的OD值(分别为0.095 ±0.006,0.077±0.007,0.069.±0.009;0.079±0.010,0.075±0.009.0.079 ±0.012)与对照组(分别为0.087±0.004,0.090±0.009,0.089±0.010;0.074±0.008.0.069±0.015.0.068±0.011)差异不显著(P>0.05);抗焦虑药物组、去除应激源恢复组IL-1和TNF-α的OD值与心理应激组(分别为0.282±0.045,0.226 ±0.021,0.092±0.002;0.164±0.009,0.123±0.013,0.091±0.006)有显著差异(P<0.05).结论 应用抗焦虑药物和去除应激源能有效降低心理应激对大鼠颞下颌关节的影响.

Abstract：

Objective To investigate the role of psychological intervention in the prevention of the temporomandibular joint disease (TMD) , through the observation of the relative changes in the rat TMJ under psychological stress after psychological intervention. Methods The rat model of communication box was built to exert the psychological stress. The antianxiety agent was applied before stress, and the stressor was removed after stress. The expression of the proinflammatory cytokines IL-1 and TNF-α in the mandibular condylar chondrocytes in rat TMJ was detected by ELISA and RT-PCR. Results The RT-PCR results showed that the expression of IL-1 mR-NA increased into the peak in the 1st week, weakened in the 3rd week, and returned to normal in the 5th week, while the TNF-αmRNA peaked in the 1st week, returned to normal in the 3rd week. The ELISA results showed that there was no significant difference of the OD value of the serum IL-1 and TNF-α(0. 095 ±0. 006,0. 077 ± 0.007,0.069 ±0.009 ;0.079 ±0.010,0.075 ±0. 009,0.079 ± 0.012) in the antianxiety agent group (0. 107 ± 0.024,0. 101 ±0.005,0.088 ±0.010)and the stressor removal group(0. 090 ±0.016,0. 088 ±0.005,0.089 ± 0.011) , compared with the control group(0.087 ±0.004,0.090 ±0.009,0.089 ±0.010;0.074 ±0.008,0.069 ±0.015,0.068 ±0.011) (P>0.05), while significant differences were observed when compared with the psychological stress group(0.282 ±0.045,0.226 ±0.021,0.092 ±0.002;0. 164 ±0.009,0.123 ±0.013,0.091 ± 0.006) (P<0.05 ). Conclusion Application of the antianxiety agent and stressor removal could effectively counter the influence of psychological stress to TMJ, which provides good experience for the clinical prevention of TMD.     

牙根吸收的临床分类

牙根吸收的临床分类尚缺乏统一认识,本文对乳牙牙根吸收分类、Andreasen分类法、Tronstad部位分类法以及Fuss病因分类法作一综述。     

全牙列即刻种植即刻修复数字化序列组合导板的设计、制作与临床应用

该文探讨对拟行全牙列即刻种植即刻修复患者进行精准种植及修复的方法.采用了数字化手段进行序列的组合导板及预成修复体设计,在导板引导下行拔牙后截骨,种植窝预备和种植体植入,并精确就位预成修复体.该方法能快速、高效、精准的完成种植外科及修复程序,是一种有效且值得推广的临床治疗技术.现将全牙列即刻种植即刻修复数字化序列组合导板...     

仿真头颅模型口内和手持牙颌模型条件下四种口内扫描仪全牙弓扫描时间和精度的对比研究

目的:通过比较仿真头颅模型口内和手持牙颌模型条件下4种口内扫描仪全牙弓扫描的扫描时间及扫描精度,评估不同扫描条件对数字化扫描的影响。方法:选择1个可固定于仿真头颅模型口内的上颌牙颌模型,使用光学扫描仪（ATOS Core）扫描全牙弓,获取“.stl”格式数据作为参考数据。将上颌模型固定于仿真头颅模型口内,3名研究者均使...     

口腔种植修复与口颌系统重建

口颌系统重建是口腔种植治疗的重要组成部分, 涉及多个学科和多种因素。本文着重关注种植修复口颌系统重建中颌位、垂直距离、和颞下颌关节等临床问题的重要性, 以期为口腔医师在临床诊疗中提供参考。     

心理应激后大鼠颞下颌关节内P物质降钙素基因相关肽的表达变化

目的 通过观察心理应激对大鼠颞下颌关节(TMJ)内P物质(SP)和降钙素基因相关肽(CGRP)表达的影响,探讨心理因素与颞颌关节病之间的关系.方法 SD大鼠90只,将动物编号,分为3组,每组30只,分别为心理应激组,足部电击组及空白对照组.采用交流箱心理应激动物模型,分别在1周,3周,5周时,取各组大鼠的颞下颌关节,在同一部位的切片,进行免疫组化(SABC法),图像分析;扫描电镜观察各组大鼠TMJ的变化.结果 心理应激1,3,5周SP(分别为为124.5±16.9,185.6±1.8,193.5±3.5)和CGRP(分别为185.9±5.3,112.5±5.2,174.3±5.3)的表达差异具有显著性(P＜0.05);扫描电镜显示心理应激后髁状突表面出现胶原纤维暴露且排列紊乱及宽窄不一等结构变化.结论 心理应激可使大鼠TMJ内的P物质、CGRP肽能神经纤维的表达发生变化,可能与颞下颌关节病密切相关.

Abstract：

Objective To observe the substance P(SP) and calcitonin gene-related peptide(CGRP) expressions in the temporomandibular joints(TM J) of the rats undergone emotional stress and explore the relationship between emotional stress and temporomandibular joint disorder(TMD). Methods Ninety SD rats were averagely randomly divided into emotional stress ( ES ) group( n = 30 ), electric foot-shocked (FS) group ( n = 30 ) and control (CON) group( n = 30). The emotional stress was induced by communication box. The TMJ tissues in ES and CON groups were removed after 1, 3 and 5 weeks of emotional stress for scanning electron microscope ( SEM ) test and immunohistochemistry test. The SP and CGRP expressions were examined with SABC immunohistochemistry and then analyzed by image analysis system. Results The expressions of SP and CGRP had significant difference after 1 ,3 and 5 weeks emotional stress ( SP: 124.5 ± 16.9,185.6 ± 1.8 and 193.5 ± 3.5, respectively; CGRP: 185.9 ±5.3, 112.5 ±5.2 and 174.3 ±5.3 ,respectively) (P＜0. 05 ). The SEM results showed that there was a series of structural change on the condylar surface after emotional stress. Conclusion The SP and CGRP energy nerve fibers take part in the TMJ pathological process undergone emotional stress.     

金基台烤瓷冠在种植修复中应用的临床研究

目的 在临床种植修复中,对于■龈距为3.5～5.0 mm的种植病例 ,临床上通过调改成品基台进行修复存在难度。为解决这一临床问题,本研究探讨金基台烤瓷冠修复,以期为解决这类临床问题提供参考。方法 临床收集从2013 年 ～2021 年间采用个性化的铸造金基台烤瓷冠修复■龈距（种植体平台到对颌牙的距离）3.5～5.0 mm的56 例病例,共计66 颗种植体单冠修复。功能负荷24～72 个月期间进行随访,通过观察根尖放射线片和临床检查,分析种植体的留存率、种植并发症的发生率、骨吸收情况以及软组织健康情况。结果 应用金基台烤瓷冠修复种植体的留存率为100%;种植工艺并发症的发生率为3%;种植生物学并发症的发生率为21%;种植体周牙槽骨吸收平均值为1.18 mm, 软组织状况良好。结论 本研究采用个性化铸造金基台烤瓷螺钉固位的一体冠修复,有效地解决了■龈距3.5～5.0 mm的单颗种植修复。     

全牙列种植即刻临时修复方案选择

该文探讨拟行全牙列种植术后即刻临时修复的方案选择,从其分类、适应证、具体步骤及优缺点方面对传统方式制取印模、利用活动义齿行pick-up、摄影测量技术口外扫描制取印模以及序列组合导板预成即刻修复体等4种方式进行阐述和比较,供种植医生借鉴参考,根据患者的术前情况进行诊断评估,为患者选择最适合的治疗方案。