心血管病患者261例拔牙安全性分析

目的:为心肌梗塞后和冠状动脉植入人工支架的患者拔牙安全提供临床参考依据.方法:通过对261 例患心肌梗塞后和冠状动脉植入人工支架因牙疾拔牙的患者,进行术前、术中、术后连续心电图、血压、心律(率)监测.结果:261 例患者共拔牙465 颗,人均拔除1.78 颗,均顺利完成治疗,无一例发生并发症,治疗效果满意.结论:心肌梗塞后和冠状动脉植入人工支架患者在心电监护下拔牙,术中将收缩压波动控制在30 mmHg内,舒张压波动控制在20 mmHg内,心率波动控制在20 次/min内,且无明显心律失常者拔牙是安全的.     

312例经皮冠状动脉介入治疗的冠心病患者的心电监护拔牙的临床回顾研究

目的:观察分析经皮冠状动脉介入治疗(PCI)的冠心病患者局部麻醉和拔牙过程中的血压、心率、心电图的变化以及并发症的处理,为此类患者安全施行拔牙手术提供参考。方法:全程心电监护312例PCI术后的冠心病患者的拔牙,术前、术中根据心率、血压、心电图等情况给予相关的治疗,记录麻醉术前、中、后和拔牙术前、中、后的血压、心率的变化,进行对比分析。结果:303例患者完成手术,其中62例术中出现需要处置的心肌缺血、血压升高及心率失常等改变。9例因并发症停止拔牙治疗。麻醉前、中、后及拔牙前、中、后收缩压、舒张压和心率的变化有显著性差异,P<0.05;拔牙后10分钟的收缩压、舒张压和心率较麻醉前显著下降,P<0.01。结论:在术前积极准备及沟通、术中严密心电监护下,大多数经皮冠状动脉介入治疗的冠心病患者可以安全地完成牙齿拔除术。     

老年心血管病患者心电监护下拔牙306例临床分析

目的；对老年心血管病患者心电监护下拔牙问题进行分析研究。方法：对306例老年心血管病患者采取一系列安全措施：筛选病例，服用心血管病专科药，心理诱导，心电监护，麻醉，拔牙，详细记录术前、术中心率、血压变化。结果：拔牙顺利完成患者283例，占92．48％。因各种原因暂停手术拔牙患者23例，占7．52％。结论：老年心血管病患者拔牙具有一定危险性，但严格掌握其适应证禁忌证，安装心电监护，术前、术中采取必要的安全措施，其拔牙可以顺利完成。     

伴有牙科焦虑症心血管疾病患者拔牙护理116例分析

目的回顾分析伴有牙科焦虑症的心血管疾病患者心电监护拔牙术的护理配合的作用。方法对116伴有牙科焦虑症心血管疾病患者的心电监护拔牙护理情况进行回顾分析。结果全部患者均安全手术,术中、术后血压、心率均有升高但无明显异常波动。结论拔牙前对伴有牙科焦虑症心血管疾病患者行有效的心理指导和必要的口腔知识讲解能缓解患者紧张情绪,保证患者安全。这类患者在心电监护下拔牙是相对安全的。     

519例老年患者拔牙前后心率和血压变化

观察519例老年患者拔牙前、后心率和血压变化。方法对519例老年拔牙患者作术前问卷调查,检查患者拔牙前、后的心率和血压,将测量结果进行对照分析。结果老年拔牙患者术后心率和血压平均值均较术前有所增加。结论拔牙术可使老年患者的心率和血压升高,增加老年患者尤其是有心血管疾病患者的风险。     

心电监护拔牙患者血压变化分析

目的　探讨老年高血压、冠心病患者在心电监护下接受拔牙手术时血压变化。方法　对 135例高血压、冠心病患者手术过程中的血压变化进行统计分析。结果　 80 %患者血压变化在正负 1 5kPa范围以内。结论　医生在规范的心电监护拔牙门诊可以控制患者血压变化并安全地完成老年高血压、冠心病患者的拔牙手术。     

150例低危老年高血压患者拔牙安全性的临床分析

目的:通过监测低危高血压患者拔牙过程中各时间点的血压波动,分析高血压患者拔牙的安全性。方法:选择患有单纯性高血压(符合《中国高血压病防治指南》规定的低危标准),且需实施简单拔牙术的150例患者。其中100例手工测量术前10 min、麻醉后即刻、拔牙后即刻、拔牙后30 min共4个时间点的血压和心率,另50例在心电监护仪的监测下拔牙。分析高血压患者拔牙过程中的血压波动情况。结果:在严密监控下,150例研究对象中,有3例在麻醉后出现收缩压高于180 mmHg或舒张压高于100 mmHg,终止拔牙术,转内科治疗至血压稳定后择期拔除。其余病例术中、术后血压和心率波动均在正常范围,未发生心血管意外或创口出血、感染等并发症。结论:通过规范选择适应证,完善的术前检查,术中轻柔操作,并注意密切监测血压、心率变化,社区医院对大部分低危的高血压患者拔牙是安全的。     

房颤患者心电监护拔牙的临床研究

目的:对房颤患者不停用华法令、心电监护下拔牙问题进行分析研究,为其安全拔牙提供参考。方法:监测33例房颤患者拔牙前后及过程中血压、心率、心电图变化,进行对比分析,并观察术后出血情况。结果:32例患者完成手术。血压、心率在麻醉时及术中均明显升高(P<0.05),术后心率较术前显著降低(P<0.05)。3例术中出现室性早搏。所有患者术后拔牙创均无明显出血。结论:只要术前准备充分、术中严密监护、术后加强局部止血,长期口服华法令的房颤患者在不停药、不减量、局麻下施行拔牙术是安全可行的。     

咪达唑仑在老年高血压患者拔牙术中的应用观察

目的：评价低流量咪达唑仑静脉泵入技术，对于老年高血压患者拔牙过程中血压升高的控制。方法：单盲、随机、对照临床实验。对照组和试验组各50例，分别给予心理疗法和咪达唑仑泵入控制血压，比较基础值、就诊后、拔牙前、拔牙中和拔牙后的血压变化。血压的数值变化采用均值t检验，拔牙过程中血压的波动比较，采用变异系数（CV）。结果：就诊后，2组患者血压都比基础值有明显升高，主要是收缩压的升高。采取心理疗法后血压降低不明显，整个拔牙过程维持在较高水平。采用咪达唑仑泵入技术后，血压对比基础值和对照组都有明显降低，但波动幅度较对照组大。结论：低流量咪达唑仑静脉泵入可以有效控制老年高血压病人拔牙时的血压升高。     

氧化亚氮/氧吸入舒适化技术在老年高血压患者心电监护拔牙中的应用

目的: 探讨氧化亚氮/氧吸入舒适化技术在老年高血压患者心电监护拔牙中的应用价值。方法: 根据纳入、排除标准,将60例年龄>65岁的老年高血压拔牙患者随机分为2组（n=30）：试验组（氧化亚氮/氧吸入心电监护组）和对照组（常规心电监护组）,记录T0（术前基础值）、T1（局部麻醉）、T2（手术操作）、T3(术后5 min）4个时间点的平均动脉压（MAP）和心率（HR）。采用SPSS 25.0软件包对数据进行统计学分析。结果: 试验组组内MAP、HR各时间点比较均无统计学差异(P>0.05);对照组组内T0与T3时间点MAP、HR比较无统计学差异(P>0.05),其余各两两时间点MAP、HR比较均有统计学差异(P<0.05);组间比较,2组T0、T3时间点MAP、HR比较无统计学差异(P>0.05),2组T1、T2时间点MAP、HR比较,试验组显著小于对照组 (P<0.05)。结论: 氧化亚氮/氧吸入舒适化技术在老年高血压心电监护拔牙中能稳定患者情绪,维持患者血压、心率平稳,从而提高患者拔牙的安全性。     

Oral cancer: molecular technologies for risk assessment and diagnosis

Purpose: The effective biomarkers related to diagnosis, metastasis, drug resistance and irradiation sensitivity of oral cancers will help the pathologist and oncologist to determine the molecular taxonomy diagnosis and design the individualization treatment for the patients with oral cancers.     

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。     

Stimulated whole saliva components in children with Down syndrome

The authors report on the components of stimulated whole saliva from children with Down syndrome—including pH, flow rate, sialic acid and protein concentrations, and amylase and peroxidase activity. Saliva samples were collected from 35 children aged 6–10 years. Of the participants, 17 had Down syndrome and 18 did not. To stimulate saliva production, the children chewed a piece of parafilm for 10 minutes before the sample was collected. Soon after collecting the saliva sample, the authors measured pH using a portable pH-meter. Sialic acid levels were determined with a thiobarbituric acid assay. Protein content was determined with Folin's phenol reagent. Amylase was assayed and the authors measured the maltose produced by the breakdown of starch and peroxidase using ortho-dianisidine.
No statistically significant difference was observed in levels of sialic acid (free and total) between the two groups. Protein concentration was about 36% higher in the group with Down syndrome. However, the salivary flow rate, pH, and amylase and peroxidase activities were lower among the children with Down syndrome.     

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.     

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.     

牙髓再生的研究现状

目前,根管治疗术在临床上已得到了广泛的应用并成功的保存了患牙,但其仍有许多术后并发症。随着组织工程技术在口腔领域的应用,构建一种组织工程化牙髓进行牙髓-牙本质复合体的再生治疗成为可能。近年来国内外已有很多关于牙髓再生的研究,并且已经取得了一定成果。本文将对目前国内外牙髓再生的研究进展现状作一综述。     

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.     

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.