上前牙倒置阻生拔除后再植的临床体会

为探讨上前牙倒置阻生拔除后再植的可行性，选择上前牙倒置阻生病例15例，经正畸治疗扩展间隙，再经口腔外科手术拔除后再植。结果，86．7％的病例获得良好的治疗效果，无明显松动。认为用拔除后再植术治疗上前牙倒置阻生，能明显改善面形和咀嚼功能，避免了拔牙后再修复。     

上颌阻生尖牙的临床诊断与治疗

目的：对阻生上颌尖牙的病因、临床检查、诊断及其相应的治疗进行了临床研究。方法：选取57例上颌尖牙阻生患者，通过病史询问、临床检查、X线片和模型测量的综合分析，从临床角度对阻生牙进行了诊断分类，采用不同的方法进行了矫治，并对矫治效果进行了评估。结果：采取适宜有效的治疗办法，均取得了满意的治疗效果，牙周膜愈合成功率达100％，活髓牙成功率达93．6％，牙龈形态良好者达89．4％。结论：尖牙阻生情况各异，治疗方法多样，根据临床分类选择合适的治疗方法，是矫治成功的关键。     

A clinical and radiologic study of autotransplanted impacted canines

The aim of the present study was to evaluate the clinical and radiologic results of 20 autotransplantations of impacted canines performed in the Orthodontic and Pedodontic Department of the University of Geneva between 1979 and 1988. The sample, divided into two different age groups (group A: 13–20 years; group B: 20–48 years), demonstrated persistence of pulp vitality in 80% of the cases in group A, whereas routine endodontic treatment was instituted in all cases of group B. Periodontal healing was noted in 90% of the cases in group A, and in 70% of the cases in group B. The present clinical and radiologic data indicate that impacted canines can be transplanted at any age with good prognosis and are an alternative to orthodontic repositioning in selected cases of canine impaction.     

"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.     

Management of maxillary impacted canines: A prospective study of orthodontists' preferences

BackgroundMaxillary canines are considered the most commonly impacted teeth, after the third molars. Orthodontists have different preferences on how to approach maxillary impacted canines (MIC). The objective of this article was to investigate orthodontists’ approach to managing MIC.Material and methodsA cross-sectional study comprising a comprehensive survey with 22 questions was sent to practicing orthodontists. This study explored the preferred diagnostic measures, surgical techniques, materials, and mechanics utilized to manage MIC;104 responses were returned.ResultsPalatal impaction was reported to be encountered more often than labial impaction by 60% of the respondents. In 62% of the respondents, an oral and maxillofacial surgeon was the specialist preferred to perform the surgical exposure. In 66%, the choice of required surgical techniques was reported as a joint decision between orthodontists and other specialists who perform the surgery. Cone-beam computed tomography (CBCT) was reported to be the diagnostic x-ray of choice. The gold button with a chain was the preferred bonded attachment in 86% of cases. Less than half of the respondents bonded the attachments themselves during surgical exposure. A clear plastic retainer was the preferred retainer in 61% of the respondents, and 43% of the respondents tended to use a closed exposure technique. Coe-pak^TM was the preferred surgical pack for orthodontists who prefer an open exposure technique. Piggyback (double wire) was the preferable mechanic to move a palatally impacted canine.ConclusionOur findings indicate that there are variations among orthodontists on how to manage MICs in terms of diagnostic methods, surgical management, materials, and mechanics.     

Failure of eruption of first permanent molar teeth: a diagnostic challenge

Ankylosis, mechanical and primary failure of eruption of molar teeth are rare and often difficult to distinguish between. All may have significant repercussions on the occlusion and successful management may involve invasive procedures. We present a case where an initial presentation characteristic of mechanical failure of eruption (ankylosis) of a first permanent molar tooth was excluded following a period of monitoring. Subsequent relief of crowding using a removable and then sectional fixed orthodontic appliance allowed spontaneous eruption of the tooth obviating the need for surgical intervention. This case highlights the utilisation of conservative treatment options until a diagnosis was confirmed to minimise the risk of iatrogenic damage and unnecessary treatment.     

复方氯己定含漱液预防干槽症临床观察

目的:评价复方氯己定含漱液预防下颌阻生智齿拔除术后干槽症的临床效果。方法:临床搜集需拔除下颌阻生智齿的342例患者,共342颗牙,随机分为复方氯己定含漱液组(A组)、口服抗生素组(B组)和消炎抗菌可溶止血纱布组(C组),比较3组术后干槽症的发病率。结果:A组干槽症发病率显著低于C组(P<0.05);A组与B组、B组与C组间比较,干槽症发病率均无显著性差异(均P>0.05)。结论:下颌阻生智齿拔除后,口腔应用复方氯己定含漱液可有效预防术后干槽症的发生。     

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??Objective    To evaluate the efficacy of ropivacaine in extraction of mandibular impacted third molar. Methods    In this study 150 healthy patients who need to extract one mandibular impacted third molar were randomly divided into two groups. The experimental group was given 0.75% ropivacaine to get anesthesia??while the control group received 2% lidocaine. The time to onset and duration of action were noted. The visual analogue score??VAS??was recorded 30 min and 4 h after extraction. The rate of taking pain relieving drugs was noted. Blood pressure and pulse were monitored during the operation. Monitor the anesthetic complications and compare the anesthetic effect of the two drugs. Results               Ropivacaine had a significantly shorter onset and longer duration of oral anesthesia than lidocaine??P??0.05??. The experimental group had lower VAS 30 min and 4 h after operation??P??0.05??and fewer patients needed pain relieving drugs than the control group??P??0.05??. There was a slight decrease of the pulse in the experimental group 30 min postoperatively??P??0.05??. The pulse and blood pressure in the control group and the blood pressure in the experimental group had no obvious change. There was no complications in both groups. Conclusion    Ropivacaine may be suitable for time-consuming oral procedures because of its short onset??long duation??prolonged postoperative analgesia and minimal cardiovascular risk.     

Two‐year‐old girl with impacted ureteral stone successfully treated with a single session of combined percutaneous nephrostomy and ureteroscopy

Impacted stones frequently cause changes in the ureter, including edema of the ureteral wall, stone embedding in the ureteral mucosa or ureteral bending, which often preclude spontaneous passing of the stone and increase the risk of complications during surgery. When stone impaction is suspected preoperatively, management should be adapted accordingly. However, surgical treatment strategies remain controversial in pediatric patients because of the scarcity of cases reported. We describe the case of a 2‐year‐old girl with a right impacted ureteral stone who presented with gross hematuria and pyuria, but no metabolic risk factors or hematological abnormalities. Ureteroscopy was carried out in the presence of a percutaneous nephrostomy catheter. At the 7‐month follow up, hydronephrosis had improved from grade 3 to grade 1, and the ureter was free from residual or recurrent stones. No complications were noted. We believe that percutaneous nephrostomy before the lithotripsy facilitates treatment for impacted stones in pediatric patients.