根管治疗失败病例根管内微生物检测及药敏试验

目的通过对根管治疗失败病例根管内微生物进行培养检测，了解失败病例根管内菌群特征，同时对检测出的细菌进行药敏试验，为临床根管治疗提供参考。方法选择86例根管治疗失败病例共86颗惠牙，去除根管内充填物后，对根管内细菌取样，进行培养和鉴定，用琼脂稀释法对根管内分离的优势菌进行药敏试验。结果根管治疗失败病例根管中微生物菌群组成以兼性厌氧菌为优势菌，主要以1-2种革兰阳性菌为主，肠球菌是最常检出的细菌。失败病例根管内检出的兼性及专性厌氧菌对青霉素G、甲醛甲酚、甲硝唑敏感。结论细菌与根管治疗失败密切相关，根管治疗失败病例根管内微生物组成有其独特性。临床应选择敏感性药物进行治疗。     

显微根尖手术治疗39例慢性根尖周炎病例的临床疗效

目的评价显微根尖手术治疗39例慢性根尖周炎病例的临床疗效。方法对39例慢性根尖周炎病例进行显微根尖手术治疗．包括在牙科手术显微镜下借助显微外科器械对患牙进行根尖刮治、根尖切除、根尖倒预备和MTA倒充填。术后每3个月复诊．通过临床和X线片检查评价术后1年的疗效，分为愈合、好转和无效病例。结果39例慢性根尖周炎病例1年后随访的治疗成功率为94．9％，其中治愈病例为82．1％．好转病例为12．8％。结论显微根尖手术对治疗慢性根尖周炎病损具有良好疗效。     

Tweed—Merrifield定向力矫治技术在前突高角病例治疗中的应用

目的 探讨Tweed-Merrifield定向力矫治技术对前突高角病例的矫治效果.方法 根据Tweed-Merrifield定向力技术原理对20例前突高角患者进行正畸治疗,并对矫治结果进行观察和分析.结果 无论是生长发育期患者还是成人患者,通过Tweed-Merrifield定向力矫治技术,20例前突高角病例均得到显著的改善.结论 Tweed-Merrifield定向力矫治技术特别适合前突高角病例矫治,其良好效果源于其对垂直方向的有效控制,实现下颌骨的逆时针旋转,从而使前突高角病例的面型得到极大改善.     

预成钛合金螺纹桩保留残根的临床修复观察

目的观察钛合金螺纹桩对残根残冠的修复效果。方法对2002年~2009年5月份期间采用钛合金螺纹桩加双固化树脂核修复的病例进行复诊观察并用预定标准评价修复效果。根据患牙的牙位、余留牙体组织量、桩与牙根的直径比及桩在根管内的密合程度对复诊的病例进行分组比较。结果复诊病例共40例,有49颗修复牙,门诊复诊病例23例共25颗修复牙。失败病例中桩折断两例,桩脱落三例。失败病例均发生在余留牙体组织量不理想组。结论螺纹桩在余留牙体组织量理想的情况下可以获得满意修复效果,在牙体缺损较多的情况下修复效果欠佳。     

颈部淋巴结肿大90例临床分析

目的：探讨颈部淋巴结肿大的病因,以指导临床治疗。方法：对90例颈部淋巴结肿大病例进行淋巴结切取活检,明确病理诊断。结果：90例颈部淋巴结肿大病例淋巴结反应性增生41例,淋巴结炎19例,淋巴结结核13例,结节病4例,恶性淋巴瘤9例,转移癌4例。结论：对颈部淋巴结肿大病例,需行淋巴结切取活检方能明确诊断,从而进行临床治疗。     

基于人工神经网络的错牙合畸形减数矫治的辅助鉴别

目的:借助人工神经网络方法建立错牙合畸形病例正畸治疗减数与否决策建议的专家系统。方法:选取错牙合畸形病例230例,其中减数病例138例及未减数者92例,每个病例用28个指标反映。在上述230个病例中选取207个病例的集合,利用MATLAB语言,构成28-25-1BP人工神经网络模型的训练集,另23个病例作为测试集。结果:建立了230例错牙合畸形患者资料数据库;对学习训练过的207例数据进行测试,结果其正确率为100%,然后再用未经学习训练过的23个测试集样本进行测试,结果有19例预测成功,正确率为82.6%(4个病例预测失败)。结论:所建立的人工神经网络能够对错牙合畸形病例正畸治疗是否减数做出82.6%正确的结果。     

北京部分医疗机构口腔正畸矫治疗效评价与分析

目的    对北京地区开展口腔正畸矫治的三级综合医院、区域医疗中心和民营口腔医院进行正畸矫治疗效评价工作,以便进一步改进口腔正畸医疗工作,提高正畸矫治质量。方法    2014年8月至12月,北京口腔医疗质量控制与改进中心组织相关专家制定出北京地区口腔正畸矫治疗效的评价标准,即采用专家主观评价和治疗标准（peer assessment rating,PAR）指数客观测量相结合的方法,对北京地区77家开展口腔正畸诊疗项目的三级综合医院、区域医疗中心和民营口腔医院的正畸病例矫治疗效进行综合评价,对各个医疗机构提交的正畸矫治前后的病例资料进行编号,主、客观评价均采用盲法。用SPSS19.0统计软件对评分结果进行分析。之后将此次正畸矫治疗效评价结果、改进意见和总结反馈给各医疗机构及卫生行政部门。结果    在通知的77家医疗机构中,41家医疗机构提交了正畸病例资料,提交率53.2%。此次疗效评价工作共收到122份正畸病例,其中资料完整的病例共50份（占41%）。进行主客观评价的114份病例资料的评价总分均值为87.1分,表明绝大多数的提交病例正畸矫治疗效良好。在评价的40家医疗机构中,37家（92.5%）医疗机构的评价总分为80分以上。结论    北京地区医疗机构对正畸病例资料的收集工作有待进一步加强。此次疗效评价工作中,绝大部分提交的正畸病例矫治效果良好,参与此次疗效评价工作的医疗机构的正畸矫治水平较高。     

腮腺肿块B超诊断意义临床分析

我科对1989年以来的腮腺肿块病例进行复习,对其中24例术前作过B超检查和腮腺造影检查,术后经病理分型的病例作一临床分析,就B超对腮腺肿块诊断意义进行分析,现报道如下:     

前牙转矩辅弓在临床初步应用体会

目的：探讨前牙转矩辅弓的应用效果。方法：选择用方丝弓矫治器进行治疗的病例29例,男10例,女19例,平均年龄20.5岁。其中非拔牙病例17例,拔牙病例12例,在＂精细调整＂阶段选用前牙转矩辅弓对上、下颌前牙进行转矩控制。结果：前牙转矩辅弓可以有效地对上下颌前牙进行转矩控制,前牙轴倾度趋于正常,明显缩短疗程。结论：在＂精细调整＂阶段应用前牙转矩辅弓调整前牙关系效果显著。     

CNO舌鳞癌颈部淋巴结隐匿性微转移与预后的研究

目的:研究CNO舌鳞癌病例中颈淋巴结隐匿性转移(PN1)、隐匿性微转移(简称微转移,PNm+)病例与确无淋巴结转移(PNO)的病例三者问预后的关系,以确定PNm+叶病例是否如PN1病例一样需在术后补充放射治疗.方法:①.搜集福建省肿瘤医院自1993.8～2002.11间的CNO舌鳞癌病例54例.②.对PNO病例用免疫组化染色(IHC)法结合连续切片查找PNm+病例.③.分别统计PN1、PNm+、PNO组的死亡率及生存期.④.对采集的数据用SPSS 10.0软件进行统计学处理.结果:至研究结束时止,所有复发病例均已死亡,PN1组与PNm+组间的死亡率没有显著性差异:PN1组与PNO组间以及PNm+组与PNO组间存在显著性差异.PN1组与PNm+组的生存期没有显著性差异;PN1组与PNO组以及PNm+组与PNO组间生存期存在显著性差异.结论:PN1组与PNm+组病例的预后相似,均较PNO组预后差,从而证明了PNm+病例和PN1病例一样,需要在手术后进行辅助放疗.     

The impact of case reports in oral and maxillofacial surgery

This review examines the effect of publishing case reports on journal impact factor and future research. All case reports published in the four major English language oral and maxillofacial surgery journals in the two year period, 2007-2008, were searched manually. The citation data of each case report were retrieved from the ISI online database. The number, percentage and mean citations received by case reports and their relation to the 2009 journal impact factor were analysed. Case reports which received more than 5 citations were also identified and all of the citing articles retrieved and analysed. Thirty-one percent of all articles published in major oral and maxillofacial journals in 2007-2008 were case reports. Case reports had a low citation rate with a mean citation of less than 1. There were 38 (7.2%) case reports with more than 5 citations and 30% of the citing articles were also case reports. The publication of case reports negatively affected journal impact factor which correlated directly with the percentage of case reports published within a journal. Case reports reporting recent topics, describing new treatment/diagnosis method and with a literature review were more likely to receive citations.     

相邻后牙邻面龋损相关性的临床研究

目的临床研究相邻恒磨牙2个邻面的龋损程度是否具有相关性。方法随机视诊检查临床初次治疗的患牙的邻牙。患牙因邻面龋坏去腐后形成邻洞形,按照龋损程度将该邻窝洞分为3级。邻窝洞修复之前对其相邻牙面进行清洁、视诊,记录结果,并对该相邻牙面的视诊分级与邻窝洞的分级的相关性进行分析。结果临床共收集190例,其中邻窝洞1级71例（37.4%）,2级65例（34.2%）,3级54例（28.4%）;相邻牙面视诊的结果为,视诊0级8例（4.2%）,1级12例（6.3%）,2级67例（35.3%）,3级52（27.4%）,4级51例（26.8%）。统计分析显示邻窝洞的相邻牙面的龋坏程度与其牙位、邻窝洞的位置和患者的年龄、性别无相关性,与邻窝洞的分级存在正相关关系,即邻窝洞范围增大,其相邻牙面患龋的几率增大,程度加重。结论恒磨牙相邻两牙邻面龋损程度具有相关性。     

可摘式弹性隐形食物防嵌器疗效观察

目的探讨可摘式弹性隐形食物防嵌器治疗食物嵌塞的临床效果。方法82例食物嵌塞患者,应用可摘式弹性隐形食物防嵌器治疗,经6～12个月随访,进行疗效评价。结果疗效Ⅰ级65例,Ⅱ级11例,Ⅲ级0例,Ⅳ级6例。76例疗效满意,6例失败,失败的主要原因为治疗前牙周病严重,牙齿脱落。结论可摘式弹性隐形食物防嵌器能有效治疗食物嵌塞,且异物感小,对发音、美观几乎无影响。     

Comparing student-generated learning needs with faculty objectives in PBL cases in dental education

The purpose of this study was to compare learning need reports generated by students during their investigation of a problem-based learning (PBL) case with the faculty-identified learning objectives established for it. Four PBL cases facilitated by four group tutors were selected for comparison. The student-generated learning needs were collected for each and were compared to the faculty-specified learning outcomes. The results were analyzed by individual case and compared among the four student groups. Over 96 percent of the faculty-specified objectives across all four cases and across all four groups of students were covered by the student-generated learning need reports. Only one of the four cases demonstrated a statistically significant difference between small groups with regard to percent coverage of the stated case objectives. Our data agree with previous research findings. Although there was some variability in the learning objectives investigated by student small groups studying the same case, the faculty-specified case objectives were included in the student-generated learning needs. First-trimester dental students were capable of generating learning needs that produced an excellent match with the faculty objectives for the cases studied.     

Direct-to-consumer orthodontics: Exploring laypeople’s perception of orthodontic treatment complexity

BackgroundThe authors aimed to explore the treatment preferences of laypeople regarding direct-to-consumer (DTC) orthodontics and to identify whether case complexity, as perceived by laypeople, is one of the factors influencing interest in DTC orthodontics.MethodsAn online cross-sectional survey was conducted. Data analysis was performed using logistic regression models.ResultsA total of 1,362 surveys were completed. A significant inverse association was identified between the complexity of an orthodontic case, as measured using the American Board of Orthodontics’ discrepancy index (DI) score, and the likelihood of choosing DTC treatment over an orthodontist. Participants were 3.53 times as likely to choose DTC treatment for a mild case (DI score, 0-10) compared with a complex case (DI score, > 20), although the likelihood of choosing DTC treatment for a moderate case (DI score, 11-20) was only 1.79 times higher than for a complex case.ConclusionsWhen laypeople were asked to consider each case as if it were their own dentition, there was a significant inverse association between the complexity of an orthodontic case, as measured using the DI score, and the likelihood of choosing DTC treatment over an orthodontist. Laypeople were seemingly more likely to choose DTC orthodontics for dentitions that did not appear crowded and were well aligned within the arches. Laypeople seemed to have an understanding that there are some limitations to DTC orthodontics.Practical ImplicationsOrthodontists should better understand the factors influencing consumers’ decisions to select DTC orthodontics and dental organizations should focus their educational campaigns on these factors.     

Root resorption of replanted teeth: an SEM study

Abstract— Two replanted and subsequently expelled upper central incisors were observed under a scanning electron microscope to study the changes brought about by root resorption The severity of resorption and the distribution of the affected areas were different in the two specimens. In the first case, large, deep excavations were found along a continuous bone defect which exposed the opposite root canal wall. Bacteria-like elements were found on the bottom of the eroded areas both on the outer and on the inner root surfaces. In the second case, resorption denuded the apical portion of the metal post. Erosive lacunae were visible in some areas while tubiform excavations were present close to the apical margin exposing the collagen network. The roots in the first case likely underwent inflammatory resorption while replacement resorption was thought to have occurred in the second case.     

基质金属蛋白酶及其组织抑制剂在牙本质生成性影细胞瘤和牙源性影细胞癌中的表达

目的 对牙本质生成性影细胞瘤(dentinogenic ghost cell tumor,DGCT)和牙源性影细胞癌(ghost cell odontogenic carcinoma,GCOC)中基质金属蛋白酶(matrix metallopmteinases,MMP)和金属蛋白酶组织抑制剂(tissue inhibitors of metalloproteinase,TIMP)的表达特点进行研究.方法 免疫组织化学分析15例DGCT和9例GCOC中MMP-2、MMP-9、MMP-14、TIMP-1和TIMP-2的表达.对DGCT和GCOC各一例分析MMP-2、MMP-9、MMP-14、TIMP-1和TIMP-2 mRNA的表达;明胶酶谱分析MMP-2和MMP-9酶原和活化蛋白的表达.结果 MMP-9和TIMP-1在GCOC中高表达(7/9,8/9);TIMP-1在GCOC中的高表达,与在DGCT中相比差异具有统计学意义(P＜0.05).对一例DGCT和一例GCOC病例研究发现,MMP-9酶原和活酶在GCOC中高表达,并且MMP-9和TIMP-1 mRNA在GCOC中高表达.结论 MMP-9和TIMP-1可能与GCOC的性质和生物学行为有关.     

Oral amyloidosis: two unusual case presentations

Two cases of oral amyloidosis are reported. In each case there were unusual oral manifestations. In the first case the patient's only complaints were of recurrent swelling of the submandibular glands and xerostomia. The diagnosis of amyloidosis was determined from a labial salivary gland biopsy. In the second case an enlarged tongue had produced displacement of the teeth, causing malocclusion. The resulting difficulty in chewing stimulated the patient to seek advice. In each case the diagnosis was confirmed by electron microscopy, Congo red staining, and serum and urine electrophoresis.     

下颌前磨牙扭转与颞下颌关节应力分布的有限元分析

目的:用有限元方法分析当牙发生扭转后,在咬合载荷的作用下,双侧髁突应力的变化。方法:利用在ANSYS中建立左侧下颌第二前磨牙与颞下颌关节的三维有限元模型,设计下颌第二前磨牙ICO加载和下颌第二前磨牙逆时针方向水平扭转30°后,进行相同上颌牙列情况下的咬合加载的工况,通过软件运算后,研究髁突处应力分布变化的规律。结果:在下颌第二前磨牙水平扭转30°后,在加载侧髁突上产生了异常的应力效应,应力分布趋势变得规律性较差。其中,最大主应力和VonMises应力由正常加载的从内侧向外侧过渡增大,变成由内向外呈先减小后增大再减小的趋势。扭转加载时,双侧髁突应力水平较正常牙位加载工况下髁突的应力低,尤以加载对侧髁突应力减小明显。结论:单侧前磨牙扭转,可致加载侧髁突拉应力分布规律明显变差。