外侧部分肋软骨移植修复唇裂术后鼻翼畸形

采用自行研制的部分肋软骨切取器,切取肋软骨外侧部分肋软骨,移植整复10例唇裂术后鼻翼畸形,经6~30个月的随访,10例患者唇裂术后鼻畸形均得到不同程度的改善;供区未发生并发症。     

腓骨重建及小钛板固定下颌骨体部缺损的三维有限元分析

背景：临床研究中进行腓骨重建修复下颌骨缺损的力学研究是不现实的,而有限元分析法为下颌骨缺损修复重建的生物力学研究提供了新的方法。目的：建立腓骨重建小钛板固定下颌骨体部缺损的三维有限元模型,对其进行生物力学分析。方法：建立下颌骨体部缺损腓骨重建三维模型及内固定模型,在前牙、健侧第一磨牙、健侧第二磨牙加载    100 N咬合力,观察下颌骨模型重建前后的最大应力值和最大位移值情况,前牙加载和后牙加载下重建模型钛板、钛钉孔周围骨质的应力情况,前牙加载和后牙加载下腓骨前后端的最大位移值情况。结果与结论：正常下颌骨的最大应力集中在髁突颈部。在重建模型中,最大应力集中在健侧髁突颈部,加载相同咬合力的情况下重建下颌骨的最大应力值均大于正常下颌骨的最大应力值,前牙加载最大应力值大于后牙加载。在每块钛板内侧的两钉孔之间应力值最大,下颌角部位的应力比较集中,加载侧近下颌骨缺损处前上方的第一颗钛钉为下颌骨残端钛钉的最大应力集中部位,近腓骨中段后下方钛钉为腓骨端钛钉的最大应力集中部位。下颌骨残端近缺损处以及腓骨中段上板处的钉孔周围皮质骨为最大应力集中部位,前牙加载时的最大应力大于后牙加载时的最大应力。腓骨在X轴上从上缘到下缘的位移值不断减少,在Y轴上从前下方及后端至中份的位移值逐渐减少,在Z轴上从前端到后端的位移值逐渐减少。腓骨前端的最大位移值在Z轴方向,后端的最大位移值在Y轴方向上,前牙加载时的最大位移值均较后牙加载时的最大位移值大。说明下颌角后上方钛板最易折断,应对其进行加固处理;钛钉尖端和颈部应力比较大,应选择双皮质钛钉;腓骨端和下颌骨残端钛钉和钛板的应力比较大,应重视其稳定性和固位性;前牙咬合时的应力大于后牙咬合时的应力,修复后应避免前牙咬合。 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

血清miR⁃199a⁃5p、miR⁃378a⁃3p水平与婴幼儿增殖期面部血管瘤普萘洛尔停药后复发的关系

目的探讨血清miR?199a?5p、miR?378a?3p水平与婴幼儿增殖期面部血管瘤普萘洛尔停药后复发的关系。方法增殖期面部血管瘤患儿93例,均接受普萘洛尔治疗,随访治疗后血管瘤复发情况,并将患儿分为复发组(23例)和无复发组(70例)。治疗前、后采集静脉血,qRT?PCR检测血清miR?199a?5p、miR?378a?3p表达,分析血清miR?199a?5p、miR?378a?3p表达与增殖期面部血管瘤婴幼儿普萘洛尔停药后复发的关系。结果无复发组治疗后血清miR?199a?5p、miR?378a?3p表达较治疗前增高(P<0.05),复发组治疗后血清miR?199a?5p、miR?378a?3p表达与治疗前比较差异无统计学意义(P>0.05)。复发组治疗后血清miR?199a?5p、miR?378a?3p表达低于无复发组(P<0.05)。治疗后瘤体分级Ⅲ~Ⅳ级患儿血清miR?199a?5p、miR?378a?3p表达高于Ⅰ~Ⅱ级患儿(P<0.05)。Logistic回归分析结果显示miR?199a?5p低表达、miR?378a?3p低表达、治疗后瘤体分级Ⅰ~Ⅱ级是增殖期面部血管瘤婴幼儿普萘洛尔停药后复发的危险因素(P<0.05)。结论血清miR?199a?5p、miR?378a?3p低表达与增殖期面部血管瘤婴幼儿普萘洛尔停药后血管瘤复发有关。     

钛板重建下颌骨体部缺损的生物力学变化

BACKGROUND:Three-dimensional finite element has been widely used in the oral cavity field, but little is reported on the three-dimensional finite element reconstruction of the mandibular body using titanium plate. OBJECTIVE:To study the biomechanical characteristics of reconstructing the mandibular body using titanium plate. METHODS:We established a three-dimensional finite element model of mandibular body defect undergoing reconstruction using bicortical titanium screws and titanium plate. Under the simulated normal occlusion state, a 200 N vertical load was added to the central fossa of the occlusal surface of the right mandible first molar. Then, stress distribution and maximum displacement of the mandible, titanium screw, and titanium plate were analyzed. RESULTS AND CONCLUSION:Under the simulated normal occlusion state, mandible stress was concentrated in the mandibular body and mandibular branch, especially in the anterior and posterior edges of the mandibular branch and the lower edge of the mandible. The stress in the posterior edge of the mandible was lower than that in the anterior edge of the mandible, and moreover, the contact site between the titanium plate and the mandible also presented a concentration of stress. The maximum stress of the bicortical titanium screws appeared near the screw cap, and the stress was also concentrated at the contact site between the titanium screw and the titanium plate. The maximum stress of the titanium screw at the ascending branch of the mandible was higher than that of the titanium screw at the anterior end of the defect. For the titanium plate, the stress was mainly concentrated at the fixed site of the titanium screws; the peak stress of the anterior and posterior edges of the titanium plate was found at the contact site between the anterior end of mandibular defect and the titanium stress as well as between the ascending branch of the mandible and the titanium screw. After mandibular body reconstruction using the titanium plate, a displacement was likely to occur at the contact site between the anterior end of mandibular defect and the titanium plate. In conclusion, these findings indicate that mandibular body reconstruction using bicortical titanium screws and titanium plate is relatively stable, but the titanium plate fixed at the anterior part of the mandibular angle is prone to breakage.     

下颌近中阻生第三磨牙和第二磨牙远中骨丧失情况的相关关系研究

目的 探讨近中阻生下颌第三磨牙(MTM)和第二磨牙远中牙槽骨丧失(MSMDBL)的相关关系.方法选取274例近中阻生MTM的CBCT资料,测量MTM与MSM牙长轴夹角、MTM近中釉牙骨质界至MSM远中釉牙骨质界距离(MTMMCEJ-MSMDCEJ)和MSMDBL,并统计年龄、性别,分析各因素对MSMDBL的影响及相关关...     

富血小板纤维蛋白联合诱导骨基质修复兔口腔种植体周围骨缺损

背景:富血小板纤维蛋白及人工骨材料已广泛应用于种植体周骨缺损的修复及再生,但二者以不同比例混合应用于种植体周围成骨方面的研究较少。目的:探讨富血小板纤维蛋白与医用诱导骨基质联合应用,对兔种植体周围骨缺损再生修复的效果。方法:12只大耳白兔建立口腔种植体周围骨缺损模型,沿右侧下颌骨下缘制备直径为5 mm、深为2 mm的圆柱形骨缺损区共3个,自近中至远中依次编号为1,2,3号,置入钛螺纹钉后,分别填入富血小板纤维蛋白与骨基质2∶1混合物、1∶1混合物、1∶2混合物;另一侧下颌骨相同操作制备3个骨缺损,自远中向近中编号依次为4,5,6号,分别置入钛螺纹钉,4号作为空白对照,5号填入富血小板纤维蛋白,6号填入骨基质。12只兔随机分为造模术后4,8,12周组,每组4只。各组分别随机选出1只兔,于处死前10 d注射盐酸四环素25 mg/kg,处死前3 d注射钙黄绿素5 mg/kg,进行荧光标记。分别于造模术后4,8,12周时处死动物,行大体观察、苏木精-伊红染色、荧光标记、甲苯胺蓝酸性品红染色,并对成骨效果进行统计学分析。结果与结论:(1)骨形成率大小依次为:富血小板纤维蛋白/医用诱导骨基质2∶1...