2种固位方式对上颌前牙区种植的修复效果比较

目的 比较上颌前牙区螺丝固位（SR）和粘接固位（CR）的种植修复效果。方法 选择2015年7月至2016年10月于安徽医科大学附属口腔医院种植科修复的74例上颌前牙区缺牙患者（90颗种植体）,根据临床固位方式的不同,将患者分为SR组（51颗）与CR组（39颗）。比较两组修复后第1天和3、6、12个月边缘骨吸收、软组织指标和牙龈位置。结果 与SR组相比,CR组骨吸收量显著减少（F_组间=14.644,P<0.05）;改良出血指数（mSBI）显著增加（F_组间=7.536,P<0.05）;角化龈宽度（wKM）显著增加（F_组间=11.489,P<0.05）;牙龈边缘位置（GL）效果较好（F_组间=6.407,P<0.05）;两组改良菌斑指数（MPI）记分的差异无统计学意义（F_组间=1.525,P>0.05）。CR组美观满意度较高（t=-3.35,P<0.05）;刷牙出血满意度较低（t=3.022,P>0.05）;总体满意度差异无统计学意义（t=0.971,P>0.05）。结论 在边缘骨吸收、wKM、GL和美观满意度方面,CR效果较好;在mSBI和刷牙出血满意度方面,SR效果较好。CR与SR在上颌前牙区的种植修复效果上各有优劣,需临床进一步研究。     

The retained placenta

The incidence and importance of retained placenta (RP) varies greatly around the world. In less developed countries, it affects about 0.1% of deliveries but has up to 10% case fatality rate. In more developed countries, it is more common (about 3% of vaginal deliveries) but very rarely associated with mortality. There are three main types of retained placenta following the vagina delivery: placenta adherens (when there is failed contraction of the myometrium behind the placenta), trapped placenta (a detached placenta trapped behind a closed cervix) and partial accreta (when there is a small area of accreta preventing detachment). All can be treated by manual removal of placenta, which should be carried out at 30-60 minutes postpartum. Medical management is also an option for placenta adherens and trapped placenta. The need for manual removal can be reduced by 20% by the use of intraumbilical oxytocin (30 i.u. in 30 mL saline). A trapped placenta may respond to glyceryl trinitrate (500 mcg sublingually) or gentle, persistent, controlled cord traction.     

预充式导管冲洗器在急性颅脑损伤患者浅静脉留置针封管效果中的研究

目的：探讨预充式导管冲洗器在急性颅脑损伤患者中浅静脉留置针的封管效果。方法将56例采用外周浅静脉留置针输液的急性颅脑损伤的患者，随机分为观察组28例、对照组28例，观察组使用预充式导管冲洗器封管，对照组使用肝素钠稀释液封管，分别对留置针留置时间、导管堵塞、静脉炎等进行比较。结果两组患者静脉留置针的留置时间、堵管率、静脉炎发生率比较差异无统计学意义。但可以缩短操作时间减少护士工作量。结论预充式导管冲洗器用于外周浅静脉留置针安全有效，减少护士工作量。     

A Technique for Retrofitting a Metal Ceramic Crown to an Attachment‐Retained Removable Partial Denture: A Clinical Report

In dental applications, precision attachments have been used to retain removable partial dentures (RPDs) for several decades. Various types of extracoronal attachments are commonly used in combination with fixed partial dentures and RPDs to achieve retention and stability. Fracture of the framework, fracture of the roots or teeth, and irretrievable decrease of retention are common reasons for a failed attachment‐retained RPD. Another complication of metal ceramic crowns with precision attachment is decementation of the crowns. When fixed components of the attachment‐retained RPD fail, the traditional treatment approach requires remaking both the fixed and removable components of the attachment‐retained RPD. This technique describes retrofitting of a metal ceramic crown to a resilient attachment‐retained RPD.     

Maxillary Midline diastema closure after replacement of primary teeth with implant prosthesis

This case shows an excellent esthetic treatment outcome using implant‐retained crowns replacing maxillary laterals and canines in hypodontia patient with unusual incidence of spontaneous diastema closure after the placement of implants. To our knowledge, this is the first case report showing maxillary midline diastema closure after implant placement.     

乳牙滞留伴多颗多生牙及恒牙阻生1例报告

<正>多生牙也称额外牙,是一种牙齿数目的发育异常,可发生在牙弓的任何部位,其中以上颌前牙区多见。国内报道的恒牙列多生牙发生率为1%～3%[1],国外为1.04%～2.00%[2]。其中85.4%的患者只有1～2颗多生牙,3颗以上者少见[3]。本病例4颗多生牙伴乳牙滞留、恒牙阻生,导致恒牙远离牙槽骨正常位置,牙槽骨缺损失去保留价值,在临床上比较少见,总结报道如下。     

Complete mucostatic impression: a new attempt

Hypermobile ridges or flabby edentulous ridges are a common occurrence in edentulous patients. The literature reveals that the mucostatic impression technique is one of the treatment options in this scenario. Conventional mucostatic methods like employing a window tray technique, multiple relief holes, or double spacers can be employed when the flabby tissue is localized. But in cases of generalized flabbiness of the residual ridge, even the manual placement and manipulation of a custom tray may distort the tissues, violating the principle of mucostatics. This presentation is a clinical report of a patient with a generalized flabby maxillary edentulous ridge opposing a partially edentulous mandibular arch. A split two-part special tray using the principle of magnetic attraction for self retention was fabricated. This self retention ruled out finger pressure during impression making, helping to achieve mucostatics.     

Reference values of focused assessment with sonography for obstetrics (FASO) in low-risk population

Objective: Hemorrhagic shock is a relatively common occurrence in the postpartum period. In our hospital, we performed abdominal ultrasonography using the focused assessment with sonography for obstetrics (FASO) technique (a modified version of FAST). The aim of the present study was to determine the reference values for the ultrasonographic findings to establish the criteria for the diagnosis of a postpartum hemorrhage and severe shock using the FASO.

Methods: The present prospective cohort study included all postpartum women who vaginally delivered singleton infants. Abdominal ultrasonography was performed after delivery. The observation points of ultrasonography were as follows: (1) the diameter of the intrauterine cavity, (2) the pouch of Douglas, (3) Morison’s pouch, (4) between the spleen and kidney, and (5) the diameter of the inferior vena cava.

Results: One hundred and eighty-two postpartum women were included in this study. The mean uterine cavity was 9.8?±?7.3?mm. An echo-free space in the pouch of Douglas was observed in three cases, in one case in Morison’s pouch, and not observed between the spleen and kidney. A negative correlation was found between the volume of bleeding and IVCi (p?=?0.0008, r²=??0.061) and IVCe (p?<?0.0001, r²=??0.106).

Conclusions: The present study establishes criteria that can be used to diagnose a postpartum hemorrhage or severe shock using the FASO.