���ν��μ����и�����Ӧ��

在无托槽隐形矫治技术临床应用中,附件是辅助矫活力施加到牙齿、实现精确控制牙齿移动不可缺少的辅助装置本文从附件的定义、种类以及使用方法等方面进行了详细介绍,并回顾了无托槽隐形矫治器附件的研究现状,对当前国内最新的附件研究成果进行了介绍附件通过增强隐形矫治器的固位从而提高隐形矫治技术的矫治效率和矫治效果     

3种无托槽隐形矫治器附件粘接方法的比较研究

目的 比较全酸蚀粘接剂、自酸蚀粘接剂和树脂加强型玻璃离子水门汀3种材料粘接无托槽隐形矫治器附件的操作时间和临床效果。方法 将采用无托槽隐形矫治器矫治的30例错牙合畸形患者（附件156个）随机分为3组,每组10例。A组采用3M Adper Single Bond 2全酸蚀粘接剂和3M Z350纳米充填树脂粘接附件,B组采用3M Adper Easy One自酸蚀粘接剂和3M Z350纳米充填树脂粘接附件,C组直接采用GC Fuji Ortho LC树脂加强型玻璃离子水门汀粘接附件。记录每个附件的操作时间,评价粘接时、治疗1个月和6个月时3组附件的失败情况。结果 C组附件的操作时间较A、B组短（P<0.01）。3组附件之间的粘接失败率无统计学差异（P>0.05）,同一组内不同时间的粘接失败率也无统计学差异（P>0.05）。结论 3种材料粘接附件的稳定性均能达到满意的效果,但树脂加强型玻璃离子水门汀操作简便,更适宜临床推广。     

�ִ����в����ν��μ�������

本文主要介绍了无托槽隐形矫治器的生产工艺流程及现代无托槽隐形矫治技术的临床应用流程。无托槽隐形矫治器的生产工艺流程主要步骤为：扫描硅橡胶印模或石膏模型,从而获得数字化牙列模型,运用计算机辅助设计与制造（CAD／CAM）系统模拟治疗计划并生产加工母模,采用热压成型技术加工隐形矫治器。现代无托槽隐形矫治技术临床应用主要流程有：临床接诊、病例提交、确认模拟矫治方案、生产矫治器、临床配戴矫治器、精细调整,最终完成治疗并保持。     

比较传统树脂和流体树脂在无托槽隐形矫治中的应用

目的 比较传统树脂和流体树脂这两种树脂材料制作的附件在无托槽隐形矫治中的应用.方法 选取连云港市口腔医院2019年至2020年无托槽隐形矫治患者22例,共232个附件,比较传统树脂和流体树脂这两种树脂材料制作附件的操作时间差异,并比较粘结当时和粘结一年后附件缺损、附件脱落方面的差异及不同附件形态和不同牙位间脱落率间的差异.结果 流体树脂制作的附件在操作时间方面短于传统树脂,差异有统计学意义(P<0.05).粘结当时及粘结一年后,优化附件的脱落率低于传统附件,差异有统计学意义(P<0.05).粘结当时,前牙附件脱落率低于后牙,差异有统计学意义(P<0.05).结论 在无托槽隐形矫治中,使用流体树脂制作的附件较适用于临床;临床选择附件时尽量选择优化附件;在粘结附件时,后牙区模板可以剪断以减少后牙附件脱落.     

无托槽隐形矫治对非拔牙病例矫治疗效的临床研究

目的：应用美国正畸专科医师委员会OGS（Objective Grading System）客观评分系统,对无托槽隐形矫治器临床矫正效果进行评价。方法：选择60例20～25岁非拔牙矫治的错颌畸形患者,随机分成两组,实验组采用无托槽隐形矫治器,对照组采用自锁托槽矫治器。用ABO测量尺对矫治完成后的石膏牙模型和全景片分别进行测量,测量参数包括：牙齿排列整齐程度、邻牙边缘嵴高度差值、颊舌向倾斜度差值、矢状向咬合关系差值、咬合接触紧密度、覆盖异常程度、邻面接触紧密度及牙根成角。评分结果输入SPSS13．0统计软件包进行分析。结果：除上下后牙颊舌向倾斜角及咬合接触两项有统计学差异外,其余指标均无统计学差异。结论：无托槽隐形矫治器对错殆畸形非拔牙矫治病例临床矫治效果可达到自锁托槽矫治器矫治的效果。     

国产无托槽隐形矫治技术的临床应用初探

目的 将我国自主研发的无托槽隐形矫治技术应用于口腔正畸临床,探讨该矫治器的临床应用情况、存在的问题以及应用前景.方法 选取41例较简单的错(牙合)畸形患者,主要包括牙列间隙、牙列拥挤以及牙周病止畸治疗,应用国产无托槽隐形矫治技术进行正畸治疗.通过层析扫描建立数字化三维牙颌模型,通过激光快速成形技术加工无托槽隐形矫治器,根据治疗方案,为每例患者设计10～40副矫治器.患者每2～3周更换一副矫治器,矫治后评估疗效.结果 所有病例均完成矫治并取得良好的矫治效果,矫治后牙列排齐、无间隙、前牙覆(牙合)覆盖正常,矫治疗程6～25个月,平均18个月.结论 目前,国产无托槽隐形矫治技术仅町矫治相对简单的错(牙合)畸形,并以其透明、美观、舒适、卫生等优点,而具有良好的临床应用前景.     

无托槽隐形矫治技术附件的临床粘结技巧

无托槽隐形矫治技术是近年来随着计算机技术、三维重建技术与工程制造技术的发展而出现的一种新型正畸矫治技术,为正畸医生提供了一种新的正畸理念和治疗手段[1-2]。在隐形矫治技术的临床应用中,附件的粘结是非常重要的环节和步骤,它直接影响到牙齿移动的效率和矫治目标的实现[3]。目前无托槽矫治技术的临床研究不断丰富,但有关粘结附件的临床操作技术未见文献报道。     

无托槽隐形矫治技术拔除前磨牙的支抗设计与临床控制

无托槽隐形矫治技术的诞生满足了人们对于牙齿正畸美观、舒适的需求,成为了成人和青少年很好的正畸治疗手段。在最初使用无托槽隐形矫治器时,它只能被用于排齐牙列等简单正畸治疗。随着无托槽隐形矫治器生产商和临床医生对完成病例不断回顾和研究,当前无托槽隐形矫治技术体系不断完善并逐渐精准化,其中对于拔除前磨牙的无托槽隐形矫治也趋于成熟。本文将对无托槽隐形矫治技术拔除前磨牙的支抗设计和临床控制进行综述。     

无托槽隐形矫治技术与固定矫治技术尖牙远中移动的有限元对比分析

目的通过对无托槽隐形矫治技术与固定矫治技术中远中移动尖牙过程的生物力学特点进行比较分析,深入探讨无托槽隐形矫治技术中牙齿移动的生物力学规律。方法建立下颌双侧第一前磨牙拔除的三维有限元模型,模拟无托槽隐形矫治器载荷和固定矫治器载荷,比较两种载荷作用下牙齿及牙周膜的平均主应力和Von Mises应力的变化,以及牙齿旋转中心的变化。结果模拟无托槽隐形矫治器载荷时下牙齿及牙周膜的平均主应力和Von Mises应力均小于固定矫治器载荷,同时,牙齿旋转中心更接近根尖。结论两种矫治技术均使尖牙产生倾斜移动,但使用无托槽隐形矫治技术尖牙的旋转中心更接近根尖,且应力分布更为合理。     

无托槽隐形矫治器拔除四个前磨牙矫治拥挤一例报告

我国的无托槽隐形矫治系统（Angelalign TM System）自问世以来,在正畸临床的应用日益广泛,也得到越来越多临床医生的认可。2007年,田杰等首次发表了用国产EAB型无托槽隐形矫治器矫治牙列间隙的病例报道。之后相关的报道越来越多,史真,白玉兴,田杰等报道了拔除下切牙矫治病例。白玉兴等报道了无托槽隐形矫治器在牙周病正畸中的应用。李丽岩报道了一例固定矫治后严重复发病例的隐形矫治与固定矫治联合矫治。     

柠檬精油对牙周致病菌抑制作用及其安全性初步研究

目的:探讨柠檬精油对牙周致病菌的体外抗菌活性及对细胞增殖的影响。方法:采用微量液体稀释法测定柠檬精油对Pg、Fn、Aa、Pi的最小抑菌浓度(minimal inhibitory concentration,MIC)及最小杀菌浓度(minimum bactericidal concentration,MBC);以较低浓度的MIC为标准稀释LEO作为实验组,采用MTT法测定柠檬精油对HUVECs的毒性作用,明确抑菌浓度下LEO的安全性。结果:柠檬精油对牙周主要致病菌均有抑菌作用,Pg、Fn、Aa、Pi的MIC分别是9.0 g/L、4.5 g/L、4.5 g/L、9.0 g/L,Aa、Fn的 MBC是9.0 g/L,Pg、Pi的MBC未测得。1/2MIC、1/20MIC浓度的LEO能够抑制人脐静脉内皮细胞的生长,而低于1/200MIC浓度的LEO则对人脐静脉内皮细胞的生长没有影响,其中1/200MIC浓度的LEO作用明显优于0.02%的CHX。结论:体外环境中,柠檬精油对牙周致病菌Pg、Fn、Aa、Pi具有抗菌活性,低浓度应用对机体相对安全。     

Computer-assisted planning for maxillofacial prosthodontic rehabilitation

Computerized tomography (CT) planning and the use of CT derived surgical templates for implant placement have shown promise for restoring function within months after surgical reconstruction of acquired post-oncologic defects.     

Effect of Pingyangmycin on human venous malformation endothelial cells

Purpose: Venous malformations are common vascular anomalies with a propensity of the head and neck. Intralesional injection of Pingyangmycin (PYM, bleomycin A5 hydrochloride) is a widely used sclerotherapy method for the treatment of venous malformation.     

Clinical and pathological aspects on some odontogenic tumors

Odontogenic tumors constitute a very diverse group of lesions that reflects the complex processes of odontogenesis. Controversies over their classification/subtyping, terminology and diagnosis have been persisted, which has direct bearings on therapeutic and/or prognostic implications.     

Can you be too old for oral implants? An update on ageing and plasticity in the oro‐facial sensorimotor system

This review focuses on the capacity of the brain for plasticity and the utility and efficacy of oral implants in helping to restore oro‐facial sensorimotor functions, especially in elderly patients. The review first outlines the components of the oro‐facial sensorimotor system which encompasses both oro‐facial tissues and a number of brain regions. One such region is the sensorimotor cortex that controls the activity of the numerous oro‐facial skeletal muscles. These muscles are involved in a number of functions including reflexes and the more complex sensorimotor functions of mastication, swallowing and speech. The review outlines the use by the brain of sensory inputs from oro‐facial receptors in order to provide for exquisite sensorimotor control of the activity of the oro‐facial muscles. It highlights the role in this sensorimotor control played by periodontal mechanoreceptors and their sensory inputs to the brain, and how oral implants in concert with the plastic capacity of the brain may, at least in part, compensate for reduced sensorimotor functioning when teeth are lost. It outlines findings of ageing‐related decrements in oro‐facial sensorimotor functions and control. The changes in oro‐facial tissues and the brain that underlie these ageing‐related functional alterations are also considered, along with adaptive and compensatory processes that utilise the brain's capacity for plasticity. The review also notes the evidence t hat rehabilitation that incorporates adjunctive approaches such as sensorimotor training paradigms in addition to oral prostheses such as implants may enhance these processes and help maintain or facilitate recovery of sensorimotor functioning in the elderly.     

Tumor microenvironment in oral cancer: novel approaches for immunotherapy

Squamous cell carcinoma of the head and neck (SCCHN), which arises from the squamous mucosal epithelium of the oral cavity, pharynx and larynx, is a major health problem in the US and other parts of the world, especially in developing countries.     

Oropharyngeal dysphagia in amyotrophic lateral sclerosis alters quality of life

Dysphagia is one of the most important complications encountered in amyotrophic lateral sclerosis (ALS). Our aim was to determine whether oropharyngeal dysphagia impacted the quality of life (QoL) of patients with ALS. Thirty consecutive patients were recruited (31–82 years, 18 men). Swallowing function was evaluated using a standardised videofluoroscopic barium swallow. All the patients completed a specific questionnaire on quality of life in dysphagia (SWAL‐QoL) immediately after the videofluoroscopy. The results of dysphagia outcome severity scale separated 14 patients with oropharyngeal dysphagia and 16 with normal swallowing function. There was no difference in the average age, weight and body mass index of the two groups (dysphagic patients: 68 ± 11 kg versus non‐dysphagic patients: 69 ± 14 kg). Most of the dysphagic patients had a bulbar affection based on their Norris scores which determine the importance of cranial nerves illness (20 ± 8), significantly lower than those of the non‐dysphagic patients (35 ± 5) (P < 0·0001). There was no difference in the neurological peripheral symptoms evaluated by Amyotrophic Lateral Sclerosis Functional Rating Scale scores (dysphagic patients: 26 ± 7 versus non‐dysphagic patients: 27 ± 8) (ns). The swallowing quality of life questionnaire revealed that the dysphagic patients had significant burden (P < 0·001). They were affected by the necessity to applied a food selection (P < 0·01), by the increase in eating duration (P < 0·05) and described a decrease in eating desire (P < 0·05). They complained of fear regarding the risk of dysphagia (P < 0·05). They also described difficulties with oral communication (P < 0·001). All of those complained about dysphagia which impacted directly mental health (P < 0·05) and social life (P < 0·05). In conclusion, oropharyngeal dysphagia is a common symptom accompanying ALS, which alters the patient's QoL, especially social health.     

Interventional neuroradiologic procedures in the head and neck

Interventional radiology and interventional neuroradiology are evolving specialties which can aid the head and neck surgeons in the clinical management of patients with complex vascular lesions.     

Functional palatomaxillary reconstruction using free tissue transfer

The use of bone containing vascularized flaps has become the gold standard in the reconstruction of composite, post ablative palato-maxillary defects.