"Fatigue on rest" and associated symptoms (headache, vertigo, blurred vision, nausea, tension and irritability) due to locally asymptomatic, unerupted, impacted teeth.

"Fatigue on Rest", headache, vertigo and the feeling of loss of balance, blurred vision, nausea, tension and irritability, were found to be prevalent amongst patients who had locally asymptomatic, unerupted impacted teeth. A comparative pressure sign was developed, which, when positive, confirmed the relationship between the impacted teeth and the medical symptoms. Removal of the impactions resulted in the alleviation of the symptoms. Stress and psychogenic factors are considered as trigger mechanisms, rather than as basic causes of the symptoms.     

不同微创手术方法治疗输尿管上段嵌顿性结石的疗效对比

目的对比3种微创术式治疗输尿管上段嵌顿性结石的临床疗效,为临床手术方式的选择提供理论依据。方法选取我院收治的141例输尿管上段嵌顿性结石患者,采用随机数字表法将其随机分为A、B、C 3组,每组各47例。A组患者接受经尿道输尿管镜碎石术（URSL）,B组患者接受微创经皮肾穿刺取石术（MPCNL）,C组患者接受后腹腔镜输尿管切开取石术（RLU）。对比3组患者的手术时间、术后住院天数、术后体外冲击波碎石治疗情况、术后结石清除率以及并发症的发生情况等。结果 A组的手术时间为（51.59±17.13）min,显著短于C组（P〈0.05）;A组的术后住院天数为（5.62±1.17）d,显著长于C组而短于B组（P〈0.05）;A组有36.17%的患者术后需要接受体外冲击波碎石治疗,显著高于B组和C组（P〈0.05）;A组术后3 d和1个月的结石清除率分别为51.06%和82.98%,均显著低于B组和C组（P〈0.05）。A组术后并发症的发生率为14.89%,B组术后并发症的发生率为8.51%,C组术后并发症的发生率为6.38%;3组患者术后并发症发生率的差异没有统计学意义（P〉0.05）。结论对于结石位置较低、体积较小,可采用URSL进行治疗;结石靠近肾盏或者合并有重度肾积水的患者,可采用MPCNL进行治疗;对于穿刺风险大或者URSL、MPCNL治疗失败的患者,可采用RLU进行治疗。     

Orthodontic traction of a transmigrated mandibular canine using mini-implant: a case report and review

The patient in this case is an 11-year-old girl, whose mandibular left canine was transmigrated. The traction to the arch was assisted by using a temporary skeletal anchorage device. After 5 months of poor response to traction, the biomechanics were re-adjusted, obtaining effective traction in to the arch in 12 months. After this period, the treatment was completed with fixed orthodontic appliances.     

Efficacy of adjuvant ozone therapy in reducing postsurgical complications following impacted mandibular third-molar surgery: A systematic review and meta-analysis

BackgroundResults from several randomized controlled trials have shown a beneficial effect of ozone in reducing postsurgical complications after impacted mandibular third-molar surgery, but the literature is lacking a systematic review and meta-analysis.MethodsThe authors conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines after exclusion and inclusion criteria were applied and the following outcome parameters were evaluated: pain, swelling, trismus, quality of life, number of analgesics consumed, and adverse events. RevMan Cochrane Collaboration software, Version 5.3, was used to perform meta-analysis and the Grading of Recommendation Assessment, Development and Evaluation approach was used to rate the certainty of evidence.ResultsPatients who underwent adjuvant ozone application reported lower pain scores than patients in the control group at 24 hours after surgery (95% CI, –3.94 to –1.56) and at 7 days (95% CI, –1.67 to –0.78). Pooled analysis of all 4 included trials revealed a standardized mean difference (SMD) in swelling of –0.44 at 24 hours, 0.63 at 72 hours, and –0.87 at 7 days after surgery in the experimental group. Higher mean estimates in mouth opening were experienced by patients who received ozone at 24 hours (SMD, 2.74; 95% CI, –1.93 to 7.41; 4 studies, 133 patients), 72 hours (SMD, 2.77; 95% CI, –0.63 to 6.17; 4 studies, 133 patients), and 7 days after surgery (SMD, 1.42 SMD; 95% CI, –1.34 to 4.18; 4 studies, 133 patients).Practical ImplicationsEvidence suggests that adjuvant ozone application can offer some benefit for reducing pain, improving quality of life, and decreasing mean intake of analgesics after impacted mandibular third-molar surgery, but it is not effective in reducing facial swelling and trismus, which paves the way for future research.     

加长型鞘在MPCNL治疗嵌顿性输尿管上段结石中的应用

目的：探讨加长型鞘在MPCNL术治疗嵌顿性输尿管上段结石中的应用效果。方法：回顾性分析本院2010年1月-2013年12月经MPCNL治疗嵌顿性输尿管上段结石112例患者的临床资料，其中2010年1月-2012年2月的60例作为对照组，术中仅用普通peel-away鞘，2012年3月-2013年12月的52例作为加长型鞘组，在普通peel-away鞘基础加用加长型鞘，观察比较两组患者的手术时间、术中出血量、术后并发症发生情况。结果：加长型鞘组的手术时间、术中出血量均明显少于对照组，术后并发症发生率明显低于对照组，差异均有统计学意义（P〈0.05）。结论：应用加长型鞘能明显提高MPCNL治疗嵌顿性输尿管上段结石的有效率，且安全性更高，值得临床推广应用。     

Comparison of Ho:YAG laser and pneumatic lithotripsy in the treatment of impacted ureteral stones: An analysis of risk factors

The aim was to compare pneumatic and holmium:yttrium-aluminum-garnet laser in the treatment of impacted ureteral stones with different locations and to identify the risk factors for complications. Between March 2005 and November 2012, a total of 230 patients underwent ureteroscopic lithotripsy for impacted stones. Of the patients, 117 had pneumatic and 113 had laser lithotripsy for the fragmentation of the stones. Treatment outcomes based on evidence of being stone free were evaluated. Preoperative, operative, and postoperative follow-up findings were analyzed and compared. There was a difference between the two groups according to overall stone clearance rate (93.8% vs. 80.3%, p = 0.002). There was no statistically significant difference for distal location between the laser and pneumatic groups (96.8% vs. 91.7%, p = 0.288). For 10 patients with intrarenally migrated stones who were managed with flexible ureterorenoscopy in the same session, laser lithotripsy was more successful than pneumatic for proximal ureteral stone (94.4% vs. 67.9%, p = 0.007). The overall complication rate was 26.1%. There was no statistically significant difference between the two groups (29% vs. 23%, p = 0.296). Multivariate logistic regression analysis revealed that the proximal location was a statistically significant parameter for the occurrence of complications in both groups (p = 0.001 for PL, p = 0.004 for laser). The pneumatic and holmium:yttrium-aluminum-garnet laser lithotripsy are effective in the treatment of distal impacted stones. Both treatments with semirigid ureteroscopy are acceptable for proximal impacted ureteral stones, but holmium laser lithotripsy has an advantage of use with flexible ureteroscope for intrarenally migrated stone.     

下颌第三阻生牙拔除术并发症回顾性分析

目的探讨下颌第三阻生智齿拔除术术中和术后并发症的原因和防治方法。方法对2008年1月到2012年3月拔除的482例下颌第三阻生齿临床资料进行回顾性分析,对术中并发症和术中并发症进行分析,寻找阻生齿拔除术并发症的有效防治手段。结果术中发生断根25例,舌侧牙槽骨板折裂30例,牙龈撕裂16例,邻牙损伤5例。术后早期并发症425例,其中同时具备疼痛、肿胀和张口受限症状的患者253例,单纯疼痛者22例,疼痛伴张口受限者80例,疼痛伴肿胀者70例,后期并发症中出血20例,干槽症30例。局部感觉异常12例,间隙感染10例。结论阻生牙术前应拍曲面断层片,正确评估拔牙难度和阻力分析,选用涡轮钻法,动作轻柔,缩短拔牙时间,减少创伤,能预防并发症的发生。     

锥形束CT在阻生齿拔除术中的应用

目的:应用锥形束CT(CBCT)观测及分析阻生齿与邻近解剖结构的关系,为临床手术提供参考依据.方法:在第三磨牙拔除术前摄曲面断层X线片检查,对于与下牙槽神经管接触或部分重叠的病例35例,进行锥形束CT检查.结果:锥形束CT对阻生齿拔除术能更好的进行阻力分析.结论:锥形束CT检查对于第三磨牙拔除术手术方案的选定具有一定的指导意义.