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??Objective    To evaluate the sealing effect of a dentin adhesive in Class??restorations. Methods    Standardized mixed Class??cavities??2 mm × 2 mm × 2 mm??were prepared in 120 extracted premolars that were randomly assigned to 4 groups??n=30 for each group??. Three adhesive systems??All Bond Universal??total-etch and self-etch????Prime & Bond NT??and G bond and resin composite??were applied to each group following manufactures′ instructions. The teeth were immersed in 50 % ammoniacal silver nitrate and depth of penetration was evaluated under a microscope??and data were statistically analyzed by SPSS 20.0 software. Results    Microleakage was observed in all groups. All Bond Universal??total-etch??scores were lower than the other two groups??P??0.05??. There was no difference between total-etch and self-etch when All Bond Universal was used??P??0.05??. Higher microleakage scores were observed along the gingival margin than along the occlusal margin in all groups??P??0.05??. Conclusion    New universal adhesive ??All Bond Universal?? is a convenient and efficient adhesive. Total-etch and self-etch have no influence on marginal microleakage the long-term effect need further study.     

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??Objective    To study the anatomic features of medial sural artery perforator flap and provide anatomic evidence for its clinical application. Methods    Totally 10 lower limbs preserved in formaldehyde from cadavers of adults were used to observe the anatomy of medial and lateral sural artery. Between April of 2010 and April of 2011?? 14 clinical cases were reconstructed by using medial sural artery perforator flap??perforator data were collected. Results    In all 10 specimens the mean number??median  of total perforators was 2.5??ranging 1 to 6??. All perforators were in an area between 5.0 cm and 19.0 cm from the popliteal crease and between 1.0 cm and 6.0 cm from the midline of the gastrocnemius muscles. In clinical study?? the mean number??median of total perforators was 2.0??ranging 0 to 4??. All perforators were in an area between 5.0 cm and 19.0 cm from the popliteal crease and between 0 cm and 5.8 cm from the midline of the gastrocnemius muscles. Most perforators entered the medial gastrocnemius muscle at a relative distance of one-fifth to one-third of the lower leg length measured from the popliteal crease. Conclusion    The medial sural artery perforator flap provides a constant anatomy with a long pedicle. It is a good alternative for oral and maxillofacial reconstruction of defects.     

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目的探讨透明质酸钠关节上腔和关节下腔注射在治疗颞下颌关节骨关节病中的疗效。方法选择2006年7月至2009年2月威海市立医院口腔门诊适合注射透明质酸钠的46例颞下颌关节骨关节病患者,随机分为试验组和对照组,试验组25例采用关节下腔注射透明质酸钠,对照组21例采用关节上腔注射,比较两组疗效的差异。结果张口度对照组平均增加(0.96±0.13)cm,试验组平均增加(1.28±0.09)cm,两组间差异有统计学意义(P<0.01);关节疼痛对照组平均缓解(23.43±9.62)mm,试验组平均缓解(29.08±10.51)mm,两组间差异有统计学意义(P<0.01)。治疗后3个月至6个月的症状改善进行比较,张口度对照组变化为(0.01±0.03)cm,试验组为(0.08±0.04)cm,差异无统计学意义;关节疼痛改善对照组为(1.64±0.56)mm,试验组为(4.24±0.79)mm,差异具有统计学意义(P<0.01)。结论透明质酸钠关节上、下腔注射对颞下颌关节骨关节病确有疗效,关节下腔注射较上腔注射对缓解患者的关节疼痛和改善张口度的效果更为明显,且对疼痛缓解的作用时间更持久。     

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目的    探讨重组人表皮生长因子（rhEGF）凝胶治疗复发性口腔溃疡的临床疗效。方法    采用随机平行对照试验方法,将2007-2009年辽宁省人民医院口腔科收治64例复发性口腔溃疡（ROU）患者随机分为试验组和对照组,试验组用rhEGF凝胶局部涂药,对照组给予2%碘甘油局部涂药,分组观察,2组均治疗至溃疡愈合或2周止。结果    试验组患者溃疡平均愈合时间为（3.52±1.29）d,对照组为（7.58±2.07）d,两组比较,差异有统计学意义（P < 0.05）。试验组总有效率（96.9%）明显高于对照组（62.5%）（P < 0.05）。结论    重组人表皮生长因子凝胶对口腔溃疡创面具有明显的促进愈合作用,应用方便、安全。     

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目的探讨偏侧咀嚼对颞下颌关节的影响。方法通过拍摄颞下颌关节X线侧位片,测量56例1999—2001年就诊于四川大学华西口腔医院颞下颌关节诊室的偏侧咀嚼患者的关节窝深度、宽度以及髁道斜度,了解其颞下颌关节形态变化。结果30例非习惯侧出现关节结节后斜面骨质粗糙、关节窝骨皮质吸收变薄、髁状突功能面骨质不光滑样骨质改变(53.6%),21例习惯侧出现骨质改变(37.5%),两者比较差异有统计学意义(P<0.05)。偏侧咀嚼患者习惯侧与非习惯侧的颞下颌关节窝深度和髁道斜度之间差异也有统计学意义(P均<0.05),而两者间关节窝宽度差异无统计学意义(P>0.05)。结论偏侧咀嚼影响颞下颌关节形态。     

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目的探讨关节腔注射透明质酸钠治疗间接性颞下颌关节(TMJ)损伤后并发关节功能紊乱患者的临床疗效。方法选择2009年5月至2011年5月甘肃省嘉峪关市第一人民医院口腔科收治的因间接性TMJ损伤并发关节功能紊乱且经保守治疗无效的患者40例,将其随机分为两组:治疗组20例,关节腔冲洗后注射透明质酸钠;对照组20例,单纯行关节腔冲洗。观察两组患者治疗前后关节疼痛、开口度和侧向活动度的变化。结果经过1个疗程(每周1次,3周为1个疗程)治疗后,两组患者的关节疼痛、开口度和侧向活动度均较治疗前改善;组间比较结果显示,治疗组关节疼痛、开口度和侧向活动度的改善程度均较对照组明显,差异有统计学意义(P<0.01)。结论关节腔注射透明质酸钠治疗间接性TMJ损伤后并发关节功能紊乱病的疗效优于单纯进行关节腔冲洗;透明质酸钠可以明显改善间接性TMJ损伤并发关节功能紊乱患者的疼痛症状、开口度和侧向活动度。     

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目的通过显微CT体外评价,比较3种不同直径羟磷灰石颗粒外部间隙分布情况,探讨材料外部间隙对临床运用的影响。方法 2014年3—4月于广州科学城显微CT实验室对颗粒直径分别为0.25~1 mm、0.4~1 mm、1~2 mm的3种人工骨材料进行体外固定,采用显微CT扫描,评价各自的间隙排列。结果 1~2 mm组羟基磷灰石颗粒压实堆积后显微CT下显示材料颗粒排列松散,颗粒团块间存在较大空隙,间隙率为61.75%;0.25~1 mm和0.4~1 mm组材料颗粒排列较为均匀,颗粒团块间存在间隙较小,间隙率分别为27.33%和42.44%。结论显微CT可用于颗粒移植材料的微观物理参数评估,0.25~1 mm组羟磷灰石颗粒压实后颗粒团块内部排列紧密,临床上有利于植骨后稳定成骨空间。     

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目的评价含生物活性玻璃成分的脱敏剂与氟保护漆联合应用对牙本质小管的堵塞效果及治疗牙本质过敏症(dentin hypersensitivity,DH)的临床疗效。方法选择2013年6月到2014年6月到中国医科大学口腔医学院干诊科就诊的59例DH患者的120颗患牙,随机分为A组(41颗)、B组(39颗)、C组(40颗),分别使用氟保护漆、奥敏清及氟保护漆与奥敏清联合涂布敏感处,应用视觉模拟评分(visual analogue scale,VAS)法评价其疗效。另选择因正畸需要拔除的完整无龋坏前磨牙20颗,制备成敏感模型后随机分为a、b、c、d四组,每组5颗,a、b、c三组处理方法同上述A、B、C组,d组为空白对照组,用蒸馏水进行处理,扫描电镜观察各组牙本质小管的堵塞情况。结果 A、B、C三组的VAS评分值在处理即刻均明显下降,且随时间推移均有增高趋势;有效率比较,A、C两组在1个月时差异有统计学意义(P<0.05),其他各组间在各时点差异均无统计学意义(P>0.05);各组内比较,A组即刻与1个月时差异具有统计学意义(P<0.05)。扫描电镜观察a、b、c三组牙本质小管均有不同程度堵塞,其中以联合应用组效果最佳。结论含生物活性玻璃成分的脱敏剂与氟保护漆联合应用堵塞牙本质小管的效果最佳,且具有较好的临床效果。     

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??Objective    To explore the responses of patients with all types of burning mouth syndrome to low-level laser therapy. Methods    Totally 90 BMS patients were randomly divided into 3 groups??30 cases in each group. Group A and B were treated with low-level laser?? and therapeutic regimens were one time a day for continuous irradiation of 20 days??group A???? and every other day for ten times??group B???? respectively. Group C was treated with non-irradiation light?? one time a day for continuous irradiation of 20 days. Group A?? B and C were all given routine medication. Before and after the treatment and in the one-month follow-up?? the pain ??VAS score?? and the total effective rates were measured. Results    Statistically significant difference ??P??0.05?? was found between group A and B in the change of VAS after treatment?? and the total effective rates of group A and B were significantly higher than that of group C. The total effective rate of type 2 BMS was significantly higher than that of type1 and 3. There was no significant difference among groups and types of BMS in the VAS scores and the total effective rates between one-month follow-up and after the treatment ??P??0.05??. Conclusion    Low-level laser is effective in the treatment of BMS?? especially for type 2. In a certain period of time?? there is no difference in the effect with different irradiation times under the same irradiation dose parameters.     

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??Objective??To assess the efficacy of oral propranolol combined with topical timolol maleate in the treatment of infantile parotid hemangiomas. Methods??Twenty-seven infants with parotid hemangiomas were hospitalized in Department of Oral and Maxillofacial Surgery?? Hospital of Stomatology?? China Medical University??from September 2013 to September 2015. The study group consisted of 9 males and 17 females?? aged between 2 months to 9 months?? with a median age of 4.8 months. The lesions were all located in the parotid region??and measured between 1.5 cm × 2.0 cm × 1.0 cm and 7.0 cm × 6.0 cm ×3.0 cm in size. Propranolol was administered orally at a dose of 1.0??1.5 mg/??kg·d???? 0.5% timolol maleate eye drop solution was applied topically with medical cotton swabs to the area of the lesion twice a day. The therapy duration was 12 to 32 weeks?? averaged 20.3 weeks. The follow-up duration was from 3 months to 12 months?? averaged 8.4 months. Record the colors?? volumes?? textures?? and ultrasonic results of hemangiomas before the treatments and at the end of treatments. Results??Of the 27 patients??21 demonstrated an excellent response ??77.8%????4 showed a good response ??14.8%????and 2 displayed a moderate response ??7.4%????cure rate was 77.8%??and effective rate was 100%. Conclusion??Overall??oral propranolol combined with topical timolol maleate is an effective treatment method for infantile parotid hemangioma??and is worth promoting.     

Microleakage of different cementation techniques in Class V ceramic inlays

Microleakage between the restorative materials and the cavity walls of teeth remains a problem. The purpose of this study was to evaluate the microleakage around Class V ceramic inlay restoration using three different cementation techniques. Class V preparations were made on the buccal surfaces of 45 freshly extracted premolar teeth. The teeth were randomly divided into three groups of 15. In the first group, dentine bonding agent (DBA) (Clearfil Liner Bond 2V) was applied immediately after the tooth preparation (D-DBA). In the second group, DBA was applied to the prepared cavities while luting ceramic inlays (I-DBA). In the third group, DBA was not applied at either stage (No-DBA). Impressions were made and ceramic inlays (Ceramco II) fabricated and cemented in the Class V cavities. The restorations were stored in water at room temperature for 24 h. All restorations were thermocycled and then subjected to a dye penetration test. After sectioning, leakage at cavity/restoration interface was scored. Statistical analysis was performed using Kruskal-Wallis, Mann-Whitney U and Wilcoxon's signed tests. Results showed no significant difference among three different cementation techniques (P > 0.05). Microleakage at the dentine margins was greater than that at the enamel margins (P < 0.05).     

4种嵌体制作材料边缘微渗漏的对比研究

目的 通过对4种材料嵌体粘结后边缘微渗漏及嵌体密合度的分析,为临床嵌体材料的应用提供有关依据。方法 选择40颗上颌第一前磨牙制备成远中嵌体,随机分为4组,每组10颗牙,分别制成树脂、水晶瓷、铸瓷和银钯嵌体,Pana-via F Kuraray树脂黏结剂黏结,体视显微镜观测微渗漏值,并行嵌体与牙体间间隙测量。结果 微渗漏值从低到高顺序为水晶瓷嵌体、复合树脂嵌体、银钯合金嵌体、铸瓷嵌体。水晶瓷嵌体和树脂嵌体间微渗漏结果无差异(P>0.05),两者与银钯合金及铸瓷嵌体间微渗漏值差异有统计学意义,银钯合金嵌体与铸瓷嵌体间微渗漏值差异亦有统计学意义。4组嵌体与牙体间间隙值顺序从低到高为水晶瓷嵌体、复合树脂嵌体、银钯合金嵌体、铸瓷嵌体。水晶瓷、树脂和银钯合金嵌体三组间密合度无差异,铸瓷组与前三组差异有统计学意义。结论 嵌体边缘微渗漏与嵌体材料有一定关系,嵌体与牙体间的密合度是影响嵌体边缘微渗漏的重要因素。     

5种黏结剂的微渗漏实验研究

目的:比较 5种牙齿黏结剂减少复合树脂充填物边缘微渗漏情况。方法:在新近拔除的 30个人磨牙的颊、舌侧颈部分别制洞,将牙齿分为 6组,每组 5个牙, 10个窝洞。在 5组牙齿窝洞上分别应用U-Bond、SingeBondAdhesive、DurafillBond、GlumaOneBond和SuperBondC&B5种黏结剂,另一组作为空白对照(不用黏结剂),然后充填光固化复合树脂, 光照固化。所有牙齿进行冷热循环 600次,之后放入墨水蓝水溶液中浸泡 48h,颊舌向剖开牙齿,在体视显微镜下观察复合树脂充填物边缘的染料渗漏情况,结果作统计学处理。结果: 5种黏结剂中牙合壁和颈壁U-Bond微渗漏最小,其它 4种黏结剂之间无差异, 5种黏结剂与对照组有明显差异。结论: 5种黏结剂中U-Bond效果较好,GlumaOneBond、SingeBondAdhesive、DurafillBond、SuperBond等其余 4种材料次之,对照组最差。     

四种常用牙本质粘结剂的边缘封闭性比较

目的对比研究四种临床常用牙本质粘结剂的边缘封闭性能.方法在20个离体人恒磨牙颊、舌侧牙颈部各制备3 mm×2 mm×2 mm的箱型V类洞.制备的窝洞随机分为4组,分别以全酸蚀粘结剂Prime&BondNT和Single Bond,自酸蚀粘结剂Adper Prompt和Clearfil SE Bond粘结,Charisma复合树脂充填.0.5%碱性品红溶液中染色24 h后,将充填体连续纵向剖开为四部分,体视显微镜下观察各剖面充填体边缘的微渗漏情况,并以扫描电镜观察树脂-牙本质界面的结合状态.结果各种粘结剂均存在微渗漏现象,龈方微漏程度显著高于冠方(P＜0.05).各种粘结剂之间的微漏程度无显著性差异(P＞0.05).电镜下各组界面均存在散在间隙,全酸蚀粘结剂形成的混合层较自酸蚀者厚,树脂突亦较长.结论多剖面评分法较常规正中剖面法能更全面地评价界面的微漏情况;各种粘结剂均不能完全消除充填体边缘微漏.     

自酸蚀黏结系统对窝沟封闭剂黏结强度的影响

目的:评价自酸蚀黏结系统对3种窝沟封闭剂剪切黏结强度的影响。方法:选取前磨牙36个,随机分为实验组与对照组,每组18个。实验组分为3小组,经自酸蚀黏结系统(XenoⅢ)处理后,分别与3种窝沟封闭剂(Estiseal F,Concise,Ionosit Seal)黏结。对照组分为3小组,用GLUMA牙釉质酸蚀凝胶酸蚀后分别与3种窝沟封闭剂黏结。37℃水浴保存24h,万能材料试验机检测剪切黏结强度,扫描电镜(SEM)观察断裂面形态。结果:实验组的剪切黏结强度(SBS)明显高于对照组(P<0.05);SEM观察结果表明,断裂形式取决于酸蚀系统的类型。结论:自酸蚀黏结系统可以提高窝沟封闭剂与釉质的剪切黏结强度。     

不同嵌体修复体的粘结微渗漏研究

目的：对比评价Panavia EX粘结IPS-Empress Ⅱ铸瓷嵌体、铸造镍铬合金嵌体、铸造金合金嵌体、复合树脂嵌体的边缘密合度和微渗漏情况。方法：选择近期拔除的20个完整下颌磨牙,制备成近中——远中嵌体洞型,随机分为4组,每实验组5个牙。4组嵌体使用Panavia EX粘结后,恒温保存,5g/L碱性品红染色24h,2次纵剖牙体后,体视显微镜观测嵌体密合度和微渗漏值。结果：在树脂类粘结剂粘结下,各组嵌体的微间隙和微渗漏的数值均存在显著性差异,按测量数值由小到大排序为：金合金嵌体〈间接树脂嵌体〈铸瓷嵌体〈镍铬合金嵌体。结论：在抗微渗漏方面,金合金性能最好;临床上应慎重选择镍铬合金嵌体。     

微瓷树脂嵌体和复合树脂嵌体微渗漏的对比研究

目的 对比研究1种微瓷聚合树脂嵌体和另外3种复合树脂嵌体的边缘微渗漏情况,为临床选择嵌体材料提供参考。方法 将80颗健康离体上颌前磨牙随机分为8组,每组10颗,嵌体窝洞制备后,分别用微瓷聚合树脂Ceramage（C）和复合树脂Brilliant new line(B)、Z350(Z)、P60(P)间接法制成嵌体,每种材料2组,使用即刻牙本质封闭(immediate dentin sealing,IDS)/延时牙本质封闭(delayed dentin sealing,DDS)技术粘结,冷热循环品红染色后,用金刚砂片将实验牙切开,体视镜下观察微渗漏。结果 4种树脂嵌体龈壁与轴壁微渗漏无显著性差异（P>0.05）,各IDS组与DDS组微渗漏亦无显著性差异（P>0.05）。无论龈壁还是轴壁,采用IDS或DDS粘结技术,4种材料之间皆有显著性差异（P<0.05）并且渗漏情况一致。微渗漏从小到大依次均为C、Z、P、B。结论 单从微渗漏方面评价,Ceramage和Z350均为制作树脂嵌体的良好选择。     

The nanoleakage phenomenon: influence of different dentin bonding agents, thermocycling and etching time

"Nanoleakage" takes place within the hybrid layer zone of the dentin-composite interface in spaces not occupied by polymerized resin. The purpose of this study was to quantify the amount of nanoleakage in specimens treated with one of six different bonding agents. For one agent, different etching times were used, and for two agents results after thermocycling were obtained. Standardized class V cavities were prepared in 165 extracted human molars with cervical margins located in dentin. After placement of the composite using bonding agents, the teeth were stored in a 1% rhodamin-B-isothiocyanate solution for 24 h at 20 degrees C, embedded in methacrylate, and sectioned parallel to the long axis of the tooth. A confocal laser scanning microscope was used to visualize a layer 10 microm below the prepared surface of the section. The lengths of the penetrated pathways were measured, representing the amount of nanoleakage. In all materials tested, penetration pathways appeared within the hybrid layer in absence of gap formation. Penetration lengths of the tested materials were in a range from 69 +/- 24 microm to 469 +/- 333 microm. Thermocycling had no statistically significant influence, and etching for 15 s resulted in statistically significantly shorter penetration compared to longer etching.     

Bonding of enamel-dentin crown fragments after crown fracture. An experimental study using bonding agents

Abstract Previous experimental studies into the use of dentin bonding agents for reattachment of enamel-dentin crown fragments have demonstrated fracture strength about 50–60% of that of intact teeth. In the clinic this has been reflected in the frequent need of repeated bonding of the treated incisors due to refracture. Recently newer bonding agents have been developed which can bond equally well with enamel and dentin. Employing the same experimental model, these bonding agents (All-Bond 2, Scotchbond MP) were used to reattach crown fragments to the remaining portion of sheep incisors. Loading of teeth bonded with these agents in an Instron testing machine at a speed of 1 mm/min demonstrated similar fracture strengths as those previously achieved with Gluma, Scotchbond 2 or Tenure. A second study was carried out whereby fragments were bonded with Scotchbond MP and loaded at various speeds. The results demonstrated that the fracture strength decreased exponentially with increased loading speed. By extrapolation, it was concluded that the strength was nil at a loading speed of approximately 2 m/min. It was concluded that the weak link in the bond between tooth fragment and remaining tooth structure is the bonding resin. Theoretically, a resin which is slightly elastic might act as a shock absorber to withstand functional stress. However, studies carried out with resins of varying moduli of elasticity gave disappointing results probably due to their low flexural strength. It is concluded on basis of previous and present results that reattachment with a bonding resin of the enamel dentin crown fragment after crown fracture is a realistic alternative to composite resin build-up although only half the strength of intact teeth is achieved.     

六种黏结剂黏固的铸造嵌体边缘的微渗漏研究

目的：用不同黏结剂，以嵌体为例，对边缘微渗漏进行分析比较和评价，为临床选择黏结剂提供参考依据。方法：选择24个近期拔除的磨牙制备成近中殆远中面嵌体洞型，随机分为6组，分别用磷酸锌水门汀，聚羧酸锌水门汀，3M ESPE Ketac（德国），3M ESPE RelyX^TM luting cement（美国），SHOFU CX-plus Glass polyalkenoqte（日本），3M ESPE RelyX^TM ARC（美国）树脂类黏结剂黏固，经恒温保存，染色，二次纵剖牙体，体视显微镜观测微渗漏。结果：磷酸锌水门汀黏固的铸造嵌体微渗漏最大，3M ESPE RelyX^TM ARC树脂类黏固的铸造嵌体微渗漏最小。结论：6种黏结剂黏固的嵌体边缘微渗漏差异有显著性并依次减小，6种黏结剂黏固的嵌体与牙体间的边缘密合度差异有显著性。