颌骨肿瘤中骨形成蛋白-2基因扩增的RT-PCR研究

目的探讨颌骨肿瘤中骨形成蛋白(BMP)-2基因的扩增与颌骨肿瘤的发生、发展及生物学行为之间的关系。方法采用反转录-聚合酶链式反应(RT-PCR)技术检测9类87例新鲜颌骨肿瘤标本中BMP-2基因扩增结果。结果含肿瘤性硬组织的全部42例颌骨肿瘤(骨肉瘤、软骨肉瘤、牙源性纤维瘤、骨化性纤维瘤、化牙骨质纤维瘤)和部分颌骨成釉细胞瘤(27/31)均显示人BMP-2特异性扩增条带,而不含肿瘤性硬组织的其他颌骨肿瘤(牙源性钙化上皮瘤、纤维肉瘤、脂肪肉瘤)均未见特异性扩增条带。结论颌骨肿瘤中BMP-2基因扩增存在差异,BMP-2基因扩增与肿瘤性硬组织的形成有关,与某些颌骨肿瘤的发生、发展及生物学行为之间存在一定关系。     

Influence of preimplant surgical intervention and implant placement on bone wound healing

The aims of the present investigation were to study (1). the influence of preimplant (4 weeks) surgical intervention and (2). the influence of the implant placement per se on bone density and mineralized bone-implant contact (BIC) at implant sites in the rabbit jawbone. The experiment was performed in the edentulous area of the maxillas of 16 adult rabbits. In eight rabbits, the alveolar bone on the left side (test) was surgically exposed and a groove was prepared in the bone crest. Trabecular bone and marrow tissue were removed, and a bioabsorbable barrier membrane was placed to cover the groove. The right side underwent no treatment and served as the control. Four weeks later, a screw-shaped titanium implant was placed transversally through the maxilla, penetrating both the test and the control areas. After another 4 weeks of healing, the animals were killed to obtain ground sections for histomorphometry. Untreated jaws from eight rabbits served as reference specimens. In the rabbits subjected to surgery, the areas (mm2) of both mineralized bone and marrow tissue were similar for test and control (4.9 +/- 1.7 vs. 5.1 +/- 2.2 and 6.3 +/- 5.7 vs. 6.8 +/- 5.7 for bone and marrow, respectively). The BIC (%) for all threads was significantly lower on the test side than on the control side (32.1 +/- 27.7 vs. 47.7 +/- 20.3). The bone density (%) of the total experimental area was similar for test and control (48.5 +/- 12.1 vs. 46.5 +/- 9.3), as was the bone density in the area within the implant thread valleys and their mirror areas (43.0 +/- 13.9 vs. 41.3 +/- 13.5, and 40.2 +/- 11.0 vs. 40.3 +/- 7.2 for thread area and mirror area, respectively). The bone density of the total experimental area in the untreated rabbits was 35.9 +/- 5.2%. This value was significantly lower than the values in the total experimental areas (test and control) of the surgically treated rabbits. Similarly, the density of the reference area in the untreated rabbits was 25.4 +/- 5.3%, which was also significantly lower than the bone density of the periimplant area of the surgically treated rabbits. We conclude that the surgical trauma caused by the placement of implants in the maxilla of rabbits significantly enhanced the bone density of the implant sites. Surgical intervention in the implant sites 4 weeks prior to the implant placements, however, did not further enhance bone density or BIC.     

Assessing mineral density in small trephined jawbone biopsy specimens

This study reports the test of the hypothesis that mineral density can be precisely assessed in small trephined jawbone biopsy specimens. Mineral density was measured by dual-energy X-ray absorptiometry (DEXA) and peripheral quantitative computed tomography (pQCT). Ten fresh and ten histologically processed specimens, which were not the same, were measured. The coefficient of variations (CVs) for the alcohol stored and the histologic specimens by DEXA were respectively 1.60 and 1.71%. The CVs by pQCT for the total bone density in the alcohol stored and the histologic specimens were respectively 0.07 and 0.16%, for the trabecular bone density 0.69 and 1.04% and for the cortical bone density 0.07 and 0.12%. It was concluded that DEXA and pQCT are precise for mineral density assessment of small trephined jawbone biopsy specimens both alcohol stored and histologically processed.     

钛板坚强内固定在颌骨重建手术中的应用研究

目的 探讨坚强内固定技术在颌骨重建手术中的应用。方法 69例颌骨骨折和肿瘤切除术后及正颌手术骨连续性中断或骨缺损患采用坚强内固定技术重建。结果 术后外形基本对称，无明显功能障碍。1例创口近期发生感染，1例近期螺钉松动。结论 在颌骨骨折、颌骨肿瘤及正颌外科所致颌骨重建手术中采用坚强内固定技术，利于骨段间稳定加速其愈合，并恢复良好的功能和外观。     

阿霉素神经干注射结合骨腔刮治术治疗原发性三叉神经痛的临床研究

目的：寻找一种治疗原发性三叉神经痛的有效方法,达到治愈三叉神经痛,又不出现明显并发症的目的。方法：60例原发性三叉神经痛患者,随机均分为2组,治疗组以阿霉素行三叉神经干注射结合骨腔刮治术进行治疗。对照组口服卡马西平,对比两组疼痛积分、疼痛持续时间、发作频率及临床疗效等方面的差别,并进行统计学分析。结果：对30 d后的疗效进行观察,发现两组在疼痛积分、疼痛持续时间、发作频率上存在显著差异（P〈0.01）,具有统计学意义,治疗组总有效率93.3%,对照组总有效率70.0%,治疗组明显优于对照组（P〈0.01）。结论：阿霉素神经干注射结合骨腔刮治术治疗原发性三叉神经痛具有近期疗效确切、安全、微创等特点。     

Hamartomatous proliferations of odontogenic epithelium within the jaws: a potential histogenetic source of intraosseous epithelial odontogenic tumors

BACKGROUND: The jawbone is replete with a vestige of odontogenesis. The overall consensus is that intraosseous remnants of the enamel organ and dental lamina are the only histogenetic option for central epithelial odontogenic tumors. Curiously, incipient tumors or possible precursor conditions of residual odontogenic epithelium have rarely been reported in the literature. METHODS: We microscopically evaluated 39,660 biopsy samples to determine the presence of a tumor-like odontogenic epithelial nodule in the maxilla and mandible. RESULTS: Seven intraosseous specimens that associated with a focal proliferation of odontogenic epithelium were retrieved. Six hamartomatous processes showed four different morphologic patterns comparable with the tumor nests comprising ameloblastoma (n = 1), squamous odontogenic tumor (n=1), calcifying epithelial odontogenic tumor (n=2) and calcifying cystic odontogenic tumor (n=2). Among six lesions, four were the intrafollicular development. The remaining case of interest was multiple hyperplastic clear rests of Malassez in association with an impacted tooth. CONCLUSION: Although it is impossible to predict the fate of these microscopic structures of hamartomatous character, the present case series indicates that any of the dormant embryonic residues of odontogenic epithelium can return to an active state, capable of non-reactive, probably neoplastic proliferation of pathological significance.     

下颌骨骨折98例临床总结

目的:探讨下颌骨骨折的诊断和治疗方法。方法:全部下颌骨骨折病例术前拍下颌曲面体层片或下颌X线平片进一步确诊,然后行"颌骨坚固内固定术"加"间断颌间弹性牵引术"。结果:98例下颌骨骨折病例均得到了明确的诊断,获得了理想的复位固定和良好的咬合关系,无张口受限等并发症发生。结论:下颌曲面体层片或下颌骨X线平片仍然是目前诊断下颌骨骨折的最佳辅助检查手段,且经济、实用。"颌骨坚固内固定术"加"间断颌间弹性牵引术"是治疗下颌骨骨折的理想术式,值得基层医疗单位推广使用。