口腔颌面部损伤136例分析

本文对136例口腔颌面部损伤的伤因,颌骨骨折、牙损伤及软组织损伤等情况进行了分析。讨论了口腔颌面外伤的特点、急救处理、及骨折线上牙齿的处理等问题。强调对颌面外伤的处理必须注重整体观念。     

Histological evaluation of dog permanent teeth after traumatic intrusion of their primary predecessors

Abstract –  The aims of this study were to analyze the histomorphology of developing permanent teeth whose primary teeth had suffered traumatic intrusion, as well as to compare the influence of immediate extraction of the intruded tooth to passive re-eruption. Nine dogs from 45 to 50 days old were submitted to the intrusion of the maxillary central and lateral primary incisors using a force applicator adapted to the teeth incisal cuspids. The right side intruded teeth were kept in their sockets and the ones on the left side were extracted 30 min later. After a postoperatory periods of 30 and 60 days, four (group 1) and five (group 2) dogs, respectively, were killed by perfusion. The histological evaluations showed that, in group 1, alterations had occurred in the odontoblastic layer and deposition of the enamel matrix had taken place in some specimens while in group 2, a portion of non-mineralized matrix was observed. We concluded that the morphological changes were because of the immediate trauma of intrusion. No differences were found between the groups where the primary tooth was immediately extracted or left to passively re-erupt.     

Concomitant intrusive luxation and root fracture of a central incisor - report of a case

Abstract A case of a 9-year-old boy who presented with intruded maxillary central incisors, one of which had also sustained a middle third root fracture, is reported. The root fracture was diagnosed after orthodontic extrusion was started, which resulted in separation of the apical and coronal fragments. The hypermobile coronal fragment was stabilised by passing a K file through a palatal access cavity into the root canal of the apical fragment. Orthodontic alignment was completed and the fractured incisors were restored with the file left in situ. At a 10-year follow-up, the incisors were clinically healthy and continued to satisfy aesthetic and functional demands.     

Orbital Decompression for the Treatment of Spontaneous Globe Luxations

Aims: To describe the results of orbital decompression in patients with spontaneous globe luxations and to evaluate predisposing factors for this condition.

Methods: The clinical records of patients who underwent orbital decompression for the treatment of spontaneous globe luxations between 2010 and 2013 were reviewed. Data collected were age, gender, predisposing factors, preoperative and postoperative exophthalmometry, duration of follow-up, presence of diplopia before and after surgery and intra- and postoperative complications.

Results: Seven patients underwent orbital decompression after spontaneous globe luxation during the study period. Six patients underwent bilateral decompression. Two patients underwent a three-wall decompression, four of them medial and lateral decompression and one patient medial decompression. The predisposing factors for globe luxation were Graves’ orbitopathy, malar hypoplasia, high myopia, floppy eyelid syndrome and orbital fat hypertrophy in the context of obesity. After orbital decompression, none of the patients reported new globe luxations. No intraoperative complications were observed. None of the patients developed de novo diplopia.

Discussion: Orbital decompression is an effective method for the prevention of new episodes in patients with spontaneous globe luxations. It has good aesthetic and functional results and addresses the exophthalmos present in most cases.     

Canine cruciate ligament ruptures: Implications for financial costs and human health

The cranial cruciate ligament (CCL) in dogs is homologous to the anterior cruciate ligament (ACL) in humans. Factors that place an individual at-risk for noncontact ruptures are not clearly defined in humans or dogs. Cyclic variation in human females as well as early spay/neuter in canines has frequently implicated hormonal variation, however these factors do not fully explain the human dimorphic or canine breed rupture rates. The present study examined dogs as a proxy model for humans to better understand the covariance. A random clinical data sample from the Oklahoma State University Veterinary Hospital was obtained on (n = 29) CCL surgical cases and nonsurgical (n = 28) controls. A statistical test for association of spay/neuter with CCL rupture was significant (chi-square = 21.7, p < .01). Sex balance between the groups was not significantly (p > .01) different. Data on other variables related to morphometric variability such as the tibial plateau angle was not available on the nonsurgical sample and comparisons could only be made to values from the literature. Though there may have been sample bias, this preliminary study found that more large than small dogs were represented in the surgical sample. Our results also support the claim that spayed/neutered dogs are more likely to rupture their CCL than intact dogs. Given the high costs of surgical repair, both for canines and humans, we argue for multivariate studies that investigate the interaction of variables in a larger subject sample which can provide comparable data on all parameters.     

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth

Avulsion of permanent teeth is one of the most serious dental injuries. Prompt and correct emergency management is essential for attaining the best outcome after this injury. The International Association of Dental Traumatology (IADT) has developed these Guidelines as a consensus statement after a comprehensive review of the dental literature and working group discussions. It represents the current best evidence and practice based on that literature search and expert opinions. Experienced researchers and clinicians from various specialties and the general dentistry community were included in the working group. In cases where the published data did not appear conclusive, recommendations were based on consensus opinions or majority decisions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. The purpose of these Guidelines is to provide clinicians with the most widely accepted and scientifically plausible approaches for the immediate or urgent care of avulsed permanent teeth. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines. However, the IADT believes that their application can maximize the probability of favorable outcomes.     

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction

Traumatic dental injuries (TDIs) occur most frequently in children and young adults. Older adults also suffer TDIs but at significantly lower rates than individuals in the younger cohorts. Luxation injuries are the most common TDIs in the primary dentition, whereas crown fractures are more commonly reported for the permanent teeth. Proper diagnosis, treatment planning and follow up are very important to assure a favorable outcome. These updates of the International Association of Dental Traumatology's (IADT) Guidelines include a comprehensive review of the current dental literature using EMBASE, MEDLINE, PUBMED, Scopus, and Cochrane Databases for Systematic Reviews searches from 1996 to 2019 and a search of the journal Dental Traumatology from 2000 to 2019. The goal of these guidelines is to provide information for the immediate or urgent care of TDIs. It is understood that some follow‐up treatment may require secondary and tertiary interventions involving dental and medical specialists with experience in dental trauma. As with previous guidelines, the current working group included experienced investigators and clinicians from various dental specialties and general practice. The current revision represents the best evidence based on the available literature and expert opinions. In cases where the published data were not conclusive, recommendations were based on the consensus opinions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. It is understood that guidelines are to be applied using careful evaluation of the specific clinical circumstances, the clinician's judgment, and the patient's characteristics, including the probability of compliance, finances and a clear understanding of the immediate and long‐term outcomes of the various treatment options vs non‐treatment. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines. However, the IADT believes that their application can maximize the probability of favorable outcomes.     

年轻恒牙嵌入性脱位的X线追踪观察分析

目的:通过对年轻恒牙嵌入性脱位的X线片进行回顾性研究,观察患牙复位、牙根发育和牙根吸收情况,并分析其影响因素。方法:收集2013年1月~2019年3月发生嵌入性脱位的年轻恒牙病例,分析其X线片,了解患牙复位、牙根发育及牙根吸收情况。结果:所有患牙基本复位,牙根继续发育占66.7%,发生替代性吸收占25%;嵌入程度较轻的患牙利于牙髓存活(P=0.008);自然再萌的患牙可减少替代性吸收(P=0.005);牙髓存活的患牙牙根可发育,且无替代性吸收(P<0.001)。结论:嵌入性脱位的年轻恒牙牙髓可存活,且牙根可继续发育。牙髓存活的患牙利于牙根发育、减少替代性吸收。重度嵌入的年轻恒牙可有萌出潜力。     

Multidisciplinary treatment for a patient with traumatically intruded permanent canine and premolar

When selecting treatment for traumatically intruded teeth, various factors should be evaluated including the degree of intrusion, pulp vitality, patient's age and maturity of the tooth. Treatment options consist of surgical repositioning, orthodontic extrusion and spontaneous re‐eruption. This study describes a case of a 22‐year‐old male with traumatically intruded maxillary canine and first premolar that was treated comprehensively by an orthodontist, endodontist and prosthodontist two months after injury.