舒适护理在口腔临床治疗中的应用

目的探讨舒适护理在口腔临床治疗中的应用。方法从2008年6-8月在四川大学华西口腔医院综合科随机选择103例初次就诊行口腔疾病治疗的患者作为对照组,实施口腔门诊临床常规护理模式;从2008年9-11月在同一科室随机选择105例初次就诊患者作为试验组,实施舒适护理模式。完成初次治疗和护理后,采用自行设计的患者对口腔临床护理工作的满意度调查问卷和患者对口腔健康知识的知晓度调查问卷,调查患者对护理工作的满意情况及对健康知识的知晓情况。结果试验组患者对口腔临床护理工作的满意度和对口腔健康知识的知晓度分别为98.095%和93.333%,对照组分别为72.816%和57.282％,2组差异有统计学意义,试验组的满意度和知晓度均高于对照组。结论将舒适护理应用于口腔临床治疗中,提高了患者对口腔护理工作的满意度和对口腔健康知识的知晓度,同时也提高了口腔临床护理人员的专业素质,有利于构建和谐的护患关系。     

STA无痛麻醉仪在口腔治疗中的应用特点

口腔局部麻醉可以减轻患者口腔治疗带来的疼痛,降低不适感,缓解其对口腔治疗的恐惧感,已经在口腔临床中被广泛应用。随着牙科器械的不断革新,STA无痛麻醉仪得到了广泛应用。本文就STA无痛麻醉仪的构造、基本使用方法、注射技术以及口腔治疗中的优点和局限性进行综述,从而为临床工作者在口腔操作中如何使患者得到无痛、舒适、安全的治疗而提供帮助。     

《国际口腔种植学会(ITI)口腔种植临床指南》出版发行

《国际口腔种植学会(ITI)口腔种植临床指南》是由国际口腔种植学会(ITI)组织世界级口腔种植专家编写的旨在提高口腔种植医师临床水平的技术指导丛书。本书为第1卷,主要介绍了美学牙种植学的定义和原则、种植前的系统评估和修复治疗计划、临床治疗程序和如何获得最佳美学效果、     

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高血压是最常见的心血管疾病,也是老年口腔患者中的常见病。高血压及其心血管并发症可影响口腔治疗,显著增加治疗过程中出现意外的风险,从而影响临床治疗的安全性。不恰当的治疗时机、方式和强度也可诱发高血压危象、心肌梗死、急性心衰和脑卒中等并发症。本文着重介绍老年高血压患者在口腔治疗中的风险,阐述风险评估和规避方法,旨在帮助口腔临床医生提高对于老年高血压患者的治疗水平,避免治疗意外的发生。     

从手工制作到自动加工——数字化口腔修复治疗技术的发展

口腔修复学是一门集口腔医学、医学、美学、生物力学和材料学等现代自然科学为一体的实践性较强的学科.数百年以来,口腔修复科一直在沿用传统的修复治疗模式,即由临床医师为患者制定修复治疗方案、预备口腔软硬组织,通过制取印模的方法获取患者口腔或颜面部的解剖形态,再按常规制作步骤完成具有特定形态和功能的修复体,最终完成修复治疗.这种口腔修复临床治疗模式是以医师和技师的理论水平、临床经验和操作能力为基础,实现各类病例的临床修复治疗,因此对口腔修复医师和技师的临床经验和技能有较高的依赖性.数字化技术为口腔修复学开辟了崭新的修复治疗模式.     

妊娠期女性口腔急症的临床分析与医学干预

目的：探讨女性妊娠期常见口腔急症的病因、临床特点、治疗原则和预防措施。方法：通过对264例妊娠期口腔急症病例的病因、临床表现、治疗特点进行分类统计,分析其发病原因和临床特点,提出治疗原则。结果：妊娠期女性口腔急症的发生与其特殊时期有相关性。结论：女性妊娠前口腔基础疾病的存在;妊娠期肌体内环境和体型、体重及心理的变化是妊娠期口腔急症发作和治疗棘手的主要原因。     

妊娠期口腔急症的临床考量

妊娠期是口腔疾病患病和治疗的特殊时期,妊娠期发生的口腔急症需得到恰当的处置。一方面,孕妇生理环境、个人习惯的改变增加了部分口腔疾病的易患性;另一方面,为了保证孕妇和胎儿安全,临床治疗策略局限。孕妇应掌握口腔健康知识、增强口腔保健意识。口腔医生应在“孕前预防,孕期治标,孕后治本”的原则下,根据不同的妊娠时期制定合适的治疗方案,以最安全、简单、有效的手段控制急症、防止疾病进展,避免对孕妇和胎儿的不良影响。防治结合,让孕妇和口腔医生共同维护妊娠期口腔健康。本文围绕妊娠期治疗原则,对妊娠期口腔急症治疗的时机选择、临床管理和不同疾病的治疗策略等进行了总结。     

我国口腔材料性能评价标准的现况

口腔医学的进步离不开口腔材料的发展和技术的进步。口腔疾病的治疗大多需要借助口腔材料的应用来完成。当今新技术、新材料不断涌现,在推动口腔治疗技术的进步和发展的同时,也存在着可能的潜在危害。那么什么样的材料可以用于临床？如何评价这些新材料是否可用于临床？为更好地服务患者,更快地向市场推出更新更好的口腔材料产品,相关研究人员和口腔临床医生应了解我国相关的法律法规和有关口腔材料注册管理的相关知识。本文简述当前我国口腔材料的注册管理和标准方面的现状。     

近20年我国口腔扁平苔藓治疗性研究的文献评价

目的:了解近20年国内口腔扁平苔藓治疗性研究的现状,以及能否为临床治疗提供可靠的循证医学证据。方法:逐篇检索9种综合性口腔医学类统计源期刊,记录所有口腔扁平苔藓的治疗性研究,并分析其中的随机对照试验和非随机临床对照试验(RCT/CCT)。结果:共纳入临床治疗性文献108篇,包括非临床治疗性研究文献46篇,对其中60篇RCT/CCT文献进行了分析。结论:我国近20年口腔扁平苔藓治疗性文献质量不够理想,还有待进一步研究。     

微波热凝治疗口腔扁平苔藓近期临床研究

目的：观察微波热凝治疗口腔扁平苔藓近期临床效果。方法：应用微波治疗口腔扁平苔藓（OLP）27例。并追踪观察临床效果。结果：口腔平苔藓经微波热凝治疗。痊愈18例，有效7例，无效2例。结论：微波热凝治疗口腔扁平苔藓近期临床效果满意。     

成人和青少年在正畸矫治过程中口腔卫生情况的对比研究

目的：研究成人和青少年患者在固定正畸矫治过程中口腔护理的不同。方法：选取青少年患者、18～25岁成年患者各30名，记录患者口内上下殆两侧第一前磨牙的牙周情况。进行两样本等级资料的比较。结果：在近颊部位青少年的龈炎发病率为86．70%，成人的龈炎发病率为76．7％；在颊侧青少年的龈炎发病率为76．7％，成人的龈炎发病率为70．0％；在远颊部位青少年的龈炎发病率为90．0％，成人的龈炎发病率为80．0％。结论：在青少年和成人之间牙龈炎的发病情况有明显差异，青少年患者的牙龈炎比成人患者严重。     

Palatal implants in adolescents: a histological evaluation in beagle dogs

Objectives: Small osseointegrated implants inserted in the palate provide a reliable anchorage control during orthodontic treatment. When these implants are inserted in the median palatal suture in adolescents, there might be interference with normal transverse development of the maxilla. The aim of this study was to determine histometrically the influence of implants inserted in the median palatal suture in adolescent beagle dogs on transverse maxillary development and to determine the amount of osseointegration of unloaded palatal implants in the median palatal suture in adolescent beagle dogs.
Material and methods: Two palatal implants were inserted in the median palatal suture in four of five adolescent beagle dogs. The experimental period took 25 weeks, and the dogs were subjected to a scheme of sequential point labelling with vital stains every 6 weeks. Insertion sites were examined microscopically and histometric analysis was performed.
Results and discussion: Both anterior width and posterior width were wider in the control dog as compared with the average in the test dogs, 3.7% and 9.5%, respectively. After loss of a palatal implant, immediate repair of the bone in the suture area could be observed. In the posterior region, the repaired suture looked more like a suture in the infantile stage in humans, instead of having a sinusoidal course, as was observed in the control dog and in adolescent humans. The amount of osseointegration varied from 43% to 64.3%.
Conclusion: The results of this study support the idea that in adolescents, palatal implants should not be inserted in the median palatal suture because of possible growth impairment (transverse maxillary development). The amount of osseointegration of unloaded palatal implants in the median palatal suture in adolescent dogs is less as compared with dental implants in dogs and loaded palatal implants in adult humans.     

Localization of the neuropeptide galanin in nerve fibers and epithelial keratinocytes of the rat molar gingiva

Knowledge of the histochemical substrates of cellular and neurovascular connections in the gingiva is essential in order to understand the initial mechanisms of inflammation in the periodontium. Since the localization of the neuroendocrine peptide galanin in the gingiva is still unclear, we used immunohistochemical, in situ hybridization and immunoblot techniques to assess the localization of galanin in the gingiva of rat molars. Galanin-immunoreactive nerve fibers were located around blood vessels in the lamina propria, beneath the epithelium, in the epithelial-proprial junction and in the basal layer of the epithelium. Galanin was highly expressed in the suprabasal keratinocytes of the gingival epithelium. The localization of galanin in gingival nerve fibers and the expression of galanin in keratinocytes of the gingival epithelium indicate that galanin may be a possible regulator of different cellular functions in the gingiva.     

Oral health in 5-year-old Swedish children

ABSTRACT The purpose of the study was to investigate the oral health of a group of 5-year-old children who had previously been examined in this respect at 3 and 4 years of age. The results were compared with those in an aged-matched reference group. The study included examination of caries and gingivitis, occlusion, presence of lactobacilli and C. albicans in plaque samples, flow rate, pH and buffer effect of stimulated saliva, and certain data on past prophylaxis and oral habits. Caries was found in 76 % of the children in the study group (S-group) and in 78% in the reference group (R-group). No significant differences were found in caries or gingival indices, in oral habits or prophylactic measures between the two groups. Buffer effect and pH of stimulated saliva were negatively correlated with deft and deft. Lactobacilli were demonstrated in 37 % and C. albicans in 12 % of the plaque samples. Various sucking habits were still present in 25 % of the S-group and 22 % of the R-group. Forty-nine and 46 % respectively had been given a daily supply of fluoride tablets by their parents for at least 2 years.     

Compartmentalization of inflammatory cell phenotypes in normal gingiva and peri-implant keratinized mucosa

Abstract The interpretation of studies aimed at understanding the pathophysiology of periodontal breakdown has been hampered by an insufficient understanding of the physiology of host responses in clinically healthy gingiva. This investigation was aimed at the evaluation of the in situ phenotype and topographic distribution of the inflammatory cells in clinically normal gingiva and peri-implant keratinized mucosa (PIKM). Soft tissue biopsies were obtained from clinically healthy gingiva or PIKM in 14 patients. Acetone fixed, cryostat sections were stained with a panel of monoclonal antibodies with a three stage avidin-biotin immunoperoxidase technique. Numbers of positive cells/mm2 were determined with a calibrated image analysis system. The major findings of the study were: (i) the presence of significantly higher densities of phenotypically characterized mononuclear cells in the 1CT than in the JE in both gingiva and PIKM; (II) the absence of a significant difference in PMN densities between JE and ICT in both gingiva and PIKM; (iii) the absence of statistically significant differences in densities of phenotypically characterized leukocytes associated with gingiva and PIKM; (iv) the presence of regional differences in the relative proportions of immunocompetent cells in both the gingiva and PIKM. It is concluded that inflammatory cells are selectively distributed in gingiva and PIKM. Unique functional compartments could be identified. The observed compartmentalization requires selective regulatory mechanisms.     

Comparison of two transcutaneous approaches for the removal of impacted parotid stones

The aim of this study was to comparatively evaluate the indications and treatment outcomes of two transcutaneous approaches for the removal of impacted parotid stones. Sixty-eight consecutive patients with impacted parotid stones underwent endoscopy-assisted lithotomy via a direct mini-incision or a peri-auricular flap. Clinical safety and outcomes were evaluated. Complete stone extraction was achieved in all patients. In the mini-incision group (52 patients), the stones were in the middle third of the main duct in 31 patients, at the hilum in 16, and in the intraglandular duct in five. In the flap group (16 patients), they were in the middle third of the main duct in one patient, at the hilum in seven, and in the intraglandular duct in eight. Salivary fistula occurred in five mini-incision group patients (9.6%) and four flap group patients (25%). The clinical outcome in the mini-incision group (47 patients, median 25 months of follow-up) was good in 28 patients, fair in 13, and poor in six (12.8%). The clinical outcome in the flap group (16 patients, median 84 months of follow-up) was good in nine patients, fair in five, and poor in two (12.5%). The direct mini-incision approach was found to be safe and effective for impacted stones in the middle third, hilum, and proximal third of the main duct, while the peri-auricular approach would be best reserved for deeper intraglandular stones.     

Experimental peri-implant mucositis in man

OBJECTIVES: The purpose of this study was to examine reactions of gingiva and peri-implant mucosa (PiM) to de novo plaque accumulation in humans. MATERIAL AND METHODS: Prior to the start of the study, which included 12 partially edentulous subjects, a 3-week plaque control program was performed. Ethical approval was granted by the local ethics committee. On day 0, 2 soft tissue biopsies were harvested, 1 from a tooth and 1 from an implant site in every subject. After 3 weeks of undisturbed plaque accumulation (day 21), 2 additional biopsies were obtained from the gingiva and PiM in each subject. The tissue samples, each 4x4 mm in size, were snap frozen and prepared for immunohistochemical analysis. RESULTS: The size of the infiltrate (ICT) in the day 0 biopsies, was about 0.03 mm2 in both the gingiva and PiM. At the end of the plaque accumulation period, the size of the lesion had significantly increased in both groups and occupied an area of 0.26 mm2 in the gingiva and 0.14 mm2 in PiM. In the biopsies presenting day 0, the proportions of the various cell populations examined were similar in the gingiva and in PiM. The tissue fractions of almost all types of cells increased during the 3 weeks, but the mean change for each cell type was greater in the gingiva than in PiM. The CD3/CD19 ratio decreased in the gingiva between day 0 and 21, but increased in PiM. CONCLUSION: The results of the present study indicated that plaque accumulation induced an inflammatory response characterized by increased proportions of T- and B-cells in the ICT of both the gingiva and the PiM. Although not statistically significant, the host response in the gingiva tended to be more pronounced than in the peri-implant mucosa.     

凋亡抑制基因bcl-2在牙胚发育中的作用

目的：通过检测牙胚发育中ｂｃｌ－２基因、蛋白的表达及细胞凋亡的情况,探讨ｂｃｌ－２基因及细胞凋亡在牙齿发育中的作用。方法：利用原位末端标记法（ＴＵＮＥＬ）、原位杂交及免疫组织化学技术分别对ＳＤ大鼠牙胚发育不同时期ｂｃｌ－２ｍＲＮＡ、蛋白的表达及细胞凋亡进行研究。结果：在牙胚发育的各时期均有细胞凋亡现象及ｂｃｌ－２ｍＲＮＡ、蛋白的表达。ｂｃｌ－２ｍＲＮＡ早期在上皮性成釉器及周围的间充质细胞尤其是生长中心部位表达明显。牙体组织形成后各部位阳性表达逐渐减弱、消失;ｂｃｌ－２蛋白与ｍＲＮＡ的表达基本一致。早期凋亡细胞集中出现在细胞生长中心处。牙体组织形成后散在可见。结论：ｂｃｌ－２基因可能是牙齿发育中的细胞生长、增殖及凋亡的内在调控基因之一,参与了牙齿发育的重要塑形过程。     

Peripheral blood leukocyte populations in the elderly with and without periodontal disease

Abstract Periodontal disease in the elderly has not been characterized. Initial reports suggest that the disease is common and severe. Deficiencies in the immune response have also been reported to occur in the elderly. Consequently it was hypothesized that aging-related changes in the immune response may contribute to the severity and occurrence of periodontal disease in the elderly. To test that hypothesis, the % and number of leukocytes and leukocyte subsets in the peripheral blood of elderly (65–75 years) subjects were tested and used as indicators of the immune potential of those individuals. Age and gender effects on several of the parameters tested were identified. With the exception of increased number of leukocytes in the elderly group with severe periodontal disease, no other alteration in the leukocyte parameters tested were identified. These results suggest that periodontal disease in the elderly was not associated with obvious changes in the leukocyte and leukocyte subsets in the peripheral blood due to aging.     

Number of mutans streptococci or lactobacilli in a total dental plaque sample does not explain the variation in caries better than the numbers in stimulated whole saliva

Abstract For practical reasons the numbers of mutans streptococci (MS) and lactobacilli (LB) in plaque are commonly estimated from saliva samples. The saliva counts are considered to be a reasonable indicator of the entire dentition's total microbial load. However, the value of salivary counts for explaining and predicting caries have been found to be low. There was therefore reason to compare the relationships between caries on the one hand and, on the other, the number of MS or LB in plaque and in saliva, respectively, in order to assess their relative merits for explaining the variation in caries, both in a total material and in subgroups with less favourable oral hygiene. Sixty children aged 14–15 years participated in the study. Caries and plaque were registered and the number of MS and LB was estimated in total plaque and in stimulated saliva samples. The results showed that the number of MS or LB in plaque did not explain the variation in caries to a greater degree than did the salivary counts. For both bacteria the explanatory values increased, as expected, in subgroups with less favourable oral hygiene, but not even at this higher level of explanation was there any difference between plaque and saliva. The LB count was a stronger explanatory variable than the MS count. It was concluded that the number of MS and LB, estimated in total plaque as well as in saliva samples, is not a useful tool in prediction.