Objective To evaluate the efficacy of mechanical nickel-titanium(NiTi)rotary instruments compared with conventional manual treatments in root canal treatment of deciduous teeth.Methods A systematicsearch was conducted in MEDLINE,PubMed,EMBASE,Google Scholar,Cochrane Library up to August 2024.Randomized controlled trials comparing NiTi rotary and manual instruments in primary teeth were included.The primary outcome was root preparation time,while secondary outcomes include root filling time,obturation quality,and clinical or radiographic success rates.Statistical software RevMan 5.4 was used for data analysis.Results Compared with manual instruments,NiTi rotary systems significantly reduced both canal preparation time[SMD=2.72 min,95%CI:2.06-3.39,P<0.000 01]and filling time[SMD=0.72 min,95%CI:0.39-1.05,P<0.000 1].Rotary instrumentation also achieved a higher proportion of optimal obturations[OR=0.46(95%CI:0.29-0.71),P=0.000 6].No significant differences were observed in clinical or radiographic success rates between the two techniques.Conclusion Mechanical NiTi rotary instruments markedly shorten canal preparation and filling times and improve obturation quality compared with manual instrumentation,though long-term clinical and radiographic outcomes appear comparable.
Objective: To explore the operational accuracy and operative time of oral surgery robot-assisted endodontic microsurgery on a head-simulator for clinical reference. Methods: Three pairs of surgical simulation models were set up on head-simulator. Each model included 10 positions anteriorly and posteriorly, 20 teeth for each technique, for a total of 60 teeth. An attending physician with more than 3 years clinical experience in endodontic microsurgery completed fixed-point osteotomy and apicoectomy in three groups of endodontic microsurgery under freehand (FH), static navigation (SN), and surgery robot (SR). The duration of each operation was recorded. Cone-beam CT was taken before the operation and the surgical path was planned in the software; after surgery, a plug gauge (precision gauge for measuring hole dimensions) was inserted into the surgical path for intraoral scanning. Surgical accuracy (starting point, end point, and angular deviation) was assessed in all 3 groups, and surgery time was compared. Results: The deviation at the starting point and the end point, and angular deviation was (0.37±0.11), (0.37±0.10) mm, and 0.71°±0.17°in the SR group. The deviations in the SR group were significantly lower than those in the SN group [(0.59±0.14), (0.65±0.18) mm, and 2.64°±0.75°] (P<0.05), and both groups were significantly lower than the FH group [(1.37±0.31), (1.10±0.21) mm, and 9.84°±3.15°] (P<0.05). The operative time in the SN group [(1.20±0.03) min] was significantly less than that in the SR group [(2.18±0.03) min] (P<0.05), and both groups were significantly less than that in the FH group [(8.70±3.15) min] (P<0.05). Starting point deviation, end point deviation, and angular deviation [(1.09±0.10), (0.90±0.07) mm, 7.22°±1.13°] in anterior teeth using the FH was significantly lower than the starting deviation, endpoint deviation, and angular deviation [(1.65±0.14), (1.30±0.06) mm, 12.46°±2.10°] in the posterior teeth using FH (P<0.05), and the operative time in the anterior teeth using the FH [(5.75±0.57) min] was significantly less than that in the posterior teeth using [(11.65±1.14) min] (P<0.05). The difference in accuracy and operative time between using SN and SR on anterior and posterior teeth was not statistically significant (P>0.05). Conclusions: Oral surgery robot-assisted endodontic microsurgery helps improving the accuracy of clinicians' operations and shorten the operation time.
AIM: To sift the optimal ratio of artemisia capillaris thunb(ACT, X1), chrysanthemum(CHR, X2),honeysuckle(HDN,X3),angelica dahurica and asarum sieboldii(AD and AS, X4)by uniform design. METH-ODS:According to the uniform design and the U8(85) uniform design table,ACT,CHR,HON,AD and AS were used as the factors and 8 concentrations of each medicine as the levels. By evaluating the antibacterial activity against Porphy-romonas gingivalis(P.gingivalis),the inhibition rate of biofilm formation and the toxicity on human gingival fibroblasts were explored,the optimal ratio of the 5 drugs was sieved. RESULTS: The above-mentioned compounds all showed inhibitory effects on the growth and biofilm formation of P.gingivalis. Binomial regression was applied to obtain the opti-mal ratio of the 5 drugs and the equation was Y = -0.9918 -0.0044X2-0.0002X1X2-0.0005X1X3+ 0.0004X1X4+0.0017X2X3. In addition,the optimal ratio was 55 mg/mL ACT,45 mg/mL for,40 mg/mL HON,40 mg/mL for AD and AS(33:17). CONCLUSION:In the compound of honeysuckle traditional chinese medicine mouthwash the optimal ratio is 55 mg/mL for ACT,45 mg/mL for CHR,40 mg/mL for HON,40 mg/mL for AD and AS(33:17).
目的:了解新疆地区维吾尔族第一前磨牙的牙体解剖形态.方法:收集新疆维吾尔族青少年因正畸减数而拔除的第一前磨牙306个,其中上颌156个,下颌150个.用数显游标卡尺测量离体牙的全牙长、冠长、根长、冠近远中径、冠唇(颊)舌径等指标;肉眼观察离体牙根数目,测量牙根弯曲度;显微镜下观察根尖孔的位置,并计算根尖孔变异率.结果:获得维吾尔族人第一前磨牙全长、冠长、根长等牙体解剖形态数据.上颌第一前磨牙,单根率42.95％,双根率57.05％(P>0.05);根尖孔开口位置变异率为64.49％;牙根弯曲发生率42.95％,直根管率57.05％(P>0.05).下颌第一前磨牙,单根率94.67％,双根率5.33％(P<0.05);根尖孔开口位置变异率51.90％;牙根弯曲率28.00％,直根率72.00％(P<0.05).结论:获得新疆地区维吾尔族第一前磨牙牙体解剖形态具体数据.
目的:分析新疆喀什地区个别正常牙合维吾尔族青年微笑特征.方法:用数码相机采集150名新疆喀什地区15~20岁个别正常牙合维吾尔族青年动态微笑视频,获取姿势性微笑图像,用计算机软件分析笑线类型和微笑指数、微笑对称率、颊隙率、牙龈暴露指数、牙齿暴露数目等微笑特征指标.结果:个别正常牙合的维吾尔族青年微笑时,男性高位、中位、低位笑线分别为21.4%、55.7%、22.9%,女性分别为26.2%、56.3%、17.5%(χ2=44.899,P<0.05),除微笑指数男(6.426 ± 2.634)、女(7.392 ± 2.296)间有显著差异性(P<0.05)外,其余各微笑指标在性别间均无显著差异(P>0.05).结论:新疆喀什地区维吾尔族青年以中位笑线居多,微笑指数、微笑对称率等微笑指标性别间均无显著差异.
AIM:To investigate the proliferation and mineralization of osteoblasts from rabbit periosteal cells (PCs) and bone marrow mesenchymal stem cells(BMSCs) treated by cyclic mechanical centrifugal stress. METH-ODS:Rabbit skull periosteum cells,and femoral BMSCs were in vitro culture,spread to the third passages,and then divided into experimental and control groups. Low-speed centrifuge was used for loading centrifugal force of 170 g, 210 g, and 250 g respectively given to the experimental cells for 10 min/d stress stimulation. The control group cells was placed in the clean bench 10 min/d without centrifugal treatment. All the cells were conventionally cultured for 1, 3,5,7 and 9 d respectively. The cell proliferation and,ALP activity and,mineralization were examined,and the rela-tive expression levels of OCN and RUNX2 mRNA were measured by qRT-PCR. RESULTS:Cyclic mechanical cen-trifugal stimulation incveased the proliferation activity,ALP activity and the number of mineralized nodules of PCs and BMSCs,and the number of mineralized nodules in 2 weeks after loading was significantly increased. The relative ex-pression of osteocalcin OCN and RUNX2 mRNA was significantly increased. The growth of PCs in 250 g group was the most significant(P<0.05). CONCLUSION: Periodic mechanical centrifugal stimulation can promote the prolifera-tion and of rabbit PCs and BMSCs in vitro.
AIM:To analyze the distribution range of W angle in normal adults and in those with different sagittal malocclusion of Han nationality. METHODS:W angle was measured on lateral cephalometric X-ray films of 120 subjects with normal occlusion (60 male and female) and 180 with ClassⅠ,ⅡandⅢmalocclusion respectively (n=30), the difference of W angle value of the sujects with different sagittal malocclusion was nalyzed. RESULTS:The mean value of the W angle(°) in Han male and female adults with normal occlusion was 59. 94 ± 4. 21 and 58. 03 ± 2. 90 respectively (P>0. 05). The mean value for the W angle in the subjects with ClassⅠ,ⅡandⅢmal-occlusion was 58. 07 ± 2. 96, 55. 12 ± 3. 48 and 64. 85 ± 4. 84 respectively(P<0. 05). CONCLUSION:The normal value of W angle can be used to evaluate the relationship between anterior-posterior direction of maxilla and mandi-ble. Skeletal class I malocclusion:56. 46°≤W≤61. 28°;Skeletal classⅡmalocclusion:W<56. 46°;Skeletal classⅢ malocclusion:W>61. 28°.
根尖牙乳头干细胞是从尚未发育完成的牙根尖乳头组织中分离出的,具备间充质干细胞特性的一类牙源性干细胞. 2006年由施松涛团队首次报道并命名[1] ,其英文全称是Stem Cells From Apical Papilla,研究团队同时定义了该名称的缩写:SCAP. 2006年以后,国内针对SCAP的研究逐渐增加,但各研究团队发布研究成果时,尽管细胞来源一致,英文全称一致,但是对英文全称的缩写并不一致. 较多研究者均认同并使用"Stem Cells From Apical Papilla"这个英文定义及全称,但在对该名称的英文缩写却是"SCAPs";有的研究者引用了施松涛团队的文章,但是英文缩写却是"SCAPs". 此类情况导致各种专业杂志,甚至研究生论文中,关于SCAP和SCAPs的写法混杂,容易产生文献认知歧义.
上颌第一磨牙由于萌出早,患龋及牙髓炎、根尖周炎的几率较高,但由于其根管解剖形态复杂多样,根管治疗失败率也较高[1]. 因此,充分了解上颌第一磨牙的根管解剖形态十分必要. 上颌第一磨牙通常有3个独立的牙根,即近中颊根、远中颊根和腭根,形成"三足鼎";通常有3～4个根管(即近中颊根1 ～2 个根管,远中颊根、腭根各1个根管). 上颌第一磨牙近颊根3个根管比较少见. 我们接诊1 例右侧上颌第一磨牙近颊根为3根管的患者,现报告如下.
Epidemiology of traumatic dental injuries ( TDIs) indicates that these injuries are more prevalent in child. TDIs have significant negative influence on the esthetic, speech and psychology of children. Different types of tooth fracture should be treated with different measures and may have different prognosis. Although tooth fracture is not the most severe form of TDIs with respect to other types of traumatic injuries, the delayed care following a traumatic in-jury and the suboptimal management may compromise long-term outcomes. It is important to take timely and appropri-ate treatment for tooth fracture. This article mainly reviews the classification, management and prognosis of tooth frac-ture in primary and permanent teeth in light of the recent literature.
目的:探讨肿瘤坏死因子-α(TNFα)基因多态性与糖尿病性牙周炎(DP)易感性的相关性.方法:电子检索MEDLINE、Web of Science、CNKI、万方以及中国生物医学文摘数据库自建库至2016-04收录的所有文献,从中收集TNFα-(308G/A)位点基因多态性与DP易感性的相关研究并进行meta分析.同时采用病例对照研究进行验证:分别收集慢性牙周炎(CP)患者(60例)、健康对照者(N)(56例)、2型糖尿病(T2DM)患者(58例)、DP患者(60例)的血液样本并采用DNA测序法检测其TNFα-(308G/A)位点的基因型.随后采用χ2检验分析基因型和等位基因频率在各组间分布的差异,并应用非条件Logistic回归分析计算风险比(OR)及95％可信区间(95％CI),以评估各基因型与DP发病风险的相关性.结果:meta分析结果显示,TNFα-(308G/A)位点多态性可能是汉族人群DP易感性的相关因素.病例对照研究结果显示,TNFα-(308G/A)位点的3种基因型(GG、GA、AA)及等位基因(G、A)频率在各组间的分布均有统计学差异(P<0.05);携带A等位基因的人群患DP的风险明显增加(OR=5.074,95％CI:1.857～13.868,P=0.002),而且携带GA基因型的人群患DP的风险显著高于携带GG基因型的人群(OR=5.637,95％CI:1.949～16.301,P=0.001).结论:汉族人群中TNFα-(308G/A)位点基因多态性可能是DP易感性的相关因素.
目的:比较牙本质树脂(UD1)、自固化树脂水门汀(Super-Bond C&B)、光固化树脂水门汀(Variolink N)和双固化树脂水门汀(PULPDENT Embrace)粘结聚合瓷嵌体后,剪切粘结强度和微渗漏情况.方法:微渗漏实验:选择44个前磨牙,在颊面制备长、宽、深分别为5、3、2 mm的洞型后,随机分为A1、B1、C1、D14组(n=11),分别用牙本质树脂UD1(A1)、Super-Bond C&B(B1)、Variolink N(C1),PULPDENT Embrace(D1)4种材料与Ceramage聚合瓷嵌体进行粘结.经过500次冷热水浴循环后,体视显微镜观测甲基蓝渗透深度.剪切粘结强度实验:另选择40个前磨牙,暴露牙本质面后随机分为A2、B2、C2、D24组(n=10),分别用A1、B1、C1、D1相同的粘结材料与高3 mm、直径3 mm聚合瓷试件粘结后,测试剪切粘结强度.结果:4组粘结材料牙合方微渗漏值由大到小依次为C1>B1、A1>D1,其中D1组、C1组与其他各组两两比较均有显著差异(P<0.05),而A1组与B1组间无统计学差异(P>0.05);龈方微渗漏值D1<A1、B1、C1组(P<0.05),其中A1、B1、C1组间两两比较均无统计学差异(P>0.05).剪切粘结强度比较D2组最大,其余3组组间两两比较均无统计学差异(P>0.05).结论:牙本质树脂UD1、Super-Bond C&B、Variolink N和PULPDENT Embrace均具有较好的粘结强度,其中双固化树脂水门汀粘结材料PULPDENT Embrace的边缘封闭性和剪切粘结强度均高于其他3种.
AIM:To investigate the effects of maxillary sinus elevation with bone graft in the treatment of the rear vertical bone deficiency in maxillary edentulous area. METHODS:40 patients underwent maxillary sinus ele-vation were included,20 were treated with bone graft and 20 without. The patients were followed up at 6,12,24 and 36 months after operation.Clinical and radiographic examinations were performed to evaluate the rate of implant retention, marginal bone resorption and new bone formation. The effects were compared between the 2 groups. RESULTS: The cumulative implant retention rate of the 2 groups was 100% 3 years after operation.The average marginal bone resorp-tion at 36 months after operation was(1.08 ± 0.77)mm in bone graft group and(1.06+0.10)mm in non-bone graft group(P>0.05),there was no significant difference between the 2 groups in each follow-up visit (P>0.05).36 months after operation,the new bone formation in bone graft group and non-bone graft group was (3.01 ± 0.83)mm and (2.76 ± 0.68)mm respectively (P>0.05). CONCLUSION: There is no significant difference of long-term clinical effect of maxillary sinus elevation with bone graft compared with that without bone graft.
1 病例报告 患者女,59岁.2017 -06因右上后牙冷热刺激痛,自发痛1周来我院就诊.检查:15、16颊侧楔状缺损,探( -),叩( -),冷诊疼痛并持续数10 s,未见穿髓孔;17近中邻面大面积龋损,探( +),叩( -),冷诊疼痛并持续数10 s.诊断:15、16楔状缺损伴慢性牙髓炎;17龋病伴慢性牙髓炎.治疗计划:15、16、17行根管治疗术.治疗:局麻下17揭髓室顶,发现近颊、远颊、腭根3个根管口,腭侧根管口位置偏远中,在髓室底腭侧近中疑似有第2根管口,#10 K 锉探查后发现为近中腭侧根管;4个根管口呈梯形分布,腭侧2个根管口间距离大于颊侧2个根管口间距离.#10、#15 K锉疏通根管,测定根管长度,机用镍钛器械预备根管至#25/0.8;#25/0.4锥度牙胶尖试尖,热融牙胶充填根管(图1~2).15、16常规根管预备,热融牙胶充填根管(图1~2).根管治疗完成后,15、16行全冠修复,17行嵌体修复.
Chronic periodontitis(CP)is an oral chronic infection/inflammatory condition,identified as a source of mediators of inflammation into the blood circulation,which may contribute to exacerbation of several diseases. Alzheimer's disease (AD)is a neurodegenerative disease characterized by progressive cognitive decline and memory loss,inevitably leading to complete loss of mental faculties and death. There is increasing evidence that inflammation plays a key role in the pathophysiology of AD.The relationship between CP and AD has been confirmed. In this paper, the research progress on the association between CP and AD is overviewed.
目的:研究层状纳米粒颗粒Laponite对成牙本质细胞(OLCs)的矿化促进作用.方法:采用透射电镜(TEM)和动态光散射法(DLS)对Laponite进行形态表征观察;通过CCK-8和活/死细胞染色法检测不同浓度的Laponite对OLCs增殖和活力的影响,并分别通过划痕实验比较各组细胞的迁移能力,q-PCR检测各组细胞成牙本质相关基因的表达水平,茜素红染色和半定量分析比较各组细胞的钙化结节形成情况.结果:Laponite在水溶液中可分散形成纳米圆盘状颗粒,其平均粒径为(30.9±7.4)nm;当Laponite浓度小于100μg/mL时,对OLCs的增殖和活力无显著影响(P>0.05);而10μg/mL和100μg/mL的Laponite均能明显增强OLCs的迁移能力,并显著提高其成牙本质相关基因的表达水平以及钙化结节的形成量(P<0.05).结论:10μg/mL和100μg/mL的Laponite能够促进OLCs的生物矿化.
目的:比较4种第七代自酸蚀粘结剂粘结老化后玻璃纤维增强树脂(GFRC)的剪切粘结强度(SBS).方法:制作GFRC试件160个,随机分为实验组和对照组(n=80),每组再分为4个亚组(n=20).实验组以5℃/55℃冷热循环方式进行老化,对照组则不进行老化处理.两大组的4个亚组分别使用Ad-perEasy One(AEO)、S3BOND(S3B)、Tetric N-Bond Self-Etch(TNB)、G-BOND(GB)4种自酸蚀粘结剂,在GFRC表面粘结Z350复合树脂后,测量各组SBS;用扫描电镜(SEM)观察其断面形态,并对各组数据进行统计分析.结果:与对照组相应亚组相比,实验组AEO、S3B亚组的SBS显著升高(P<0.05),TNB亚组的SBS则无显著差异(P>0.05),GB亚组的SBS显著下降(P<0.05);实验组中各亚组的SBS两两相比则无显著差异(P>0.05).20倍SEM下,与对照组相应亚组相比,实验组AEO、S3 B亚组的Z350断面附着厚层玻璃纤维的样本数增多;GB亚组Z350断面附着厚薄相间/薄层玻璃纤维的样本数增多.1200倍SEM下,实验组AEO、S3 B亚组断面纤维包埋面更密集,且呈横向的嵴状和凹槽断层状结构.结论:与TNB、GB相比,AEO和S3 B能显著提高老化后GFRC的SBS,是用4种第七代自酸蚀粘结剂粘结GFRC中较好的选择.
AIM:To investigate the effects of tumor necrosis factor-α(TNF-α) with different concentra-tions on the proliferation and osteogenic differentiation of human periodontal ligament stem cells(hPDLSCs) in vitro. METHODS:hPDLSCs were isolated and cultured by limited dilution method. Surface antigens of hPDLSCs were de-tected by flow cytometer.hPDLSCs were treated with TNF-α at 0 ng/ mL(the control group),0.1 ng/ mL,1 ng/ mL, 10 ng/ mL and 50 ng/ mL respectively. Cell proliferation was evaluated using CCK8 assay. hPDLSCs were induced by osteogenic induction medium with 0 ng/ mL,0.1 ng/ mL and 10 ng/ mL TNF-α respectively for consecutive 7 d and 21 d. By means of real-time PCR,the expression Runx2,Osterix,OPN and Bone BSP were measured. Mineral nod-ule formation was evaluated by alizarin red S staining. RESULTS: The cultured hPDLSCs were positive for CD105(96.6%),CD90 (97.1%) and negative for CD34 (1.89%),CD45 (1.65%). TNF-α at 0.1~10 ng/ mL had no influence on cell proliferation, whereas 50 ng/ mL TNF-α inhibited cell proliferation. After osteogenic induction for 7 d,the expression of Runx2 and Osterix in 0.1 ng/ mL TNF-α group was higher than that in control group,whereas in 10 ng/ mL TNF-α group was lower. After osteogenic induction for 21 d,the Mrna levels of Runx2,Osterix,OPN and BSP were increased in 0.1 ng/ mL TNF-α group and decreased in 10 ng/ mL group. Moreover, mineral nodule in 0.1 ng/ mL TNF-α group was more than that in control group and 10 ng/ mL TNF-α group. CONCLUSION:TNF-α at high concentration my inhibit the proliferation at low concentration may promote osteogenic differentiation of Hp-DLSCs.
AIM:To determine the critical range of onlay or fiber post-and-core crown in the treatment of mandibular first premolar with large defect using three-dimensional finite element stress analysis. METHODS:Three-dimensional finite element models of mandibular first premolar with different defects(residual dentin is located at 2mm a-bove the gingival margin)were respectively established: crown with 2 axial wall defects(group A); crown with 3 axial wall defects( group B);crown with all axial wall defects( group A) . Simulations of pile fiber post-and-core crown and onlay restorations were respectively performed for each group, then stress intensity and stress distribution were analyzed following loading by using the software ANSYS. RESULTS:The maximum Von-Mises stress for residual dental tissues is displayed in all onlay groups, that in onlay group A, B and C was 81. 475 MPa, 79. 808 MPa and 78. 658 MPa respec-tively, between each 2 groups, P>0. 05, between onlay and fiber post-and-core crown groups, P>0. 05. CONCLU-SION:The 3 kinds of tooth defect can be restored by onlay or fiber post-and-core crown, however, the onlay method is the better way to restore the crown with 2 axial wall defect and the crown with 3 axial wall defect, and the fiber post-and-core crown method is the better way to restore the crown with all axial wall defect.
Er,Cr:YSGG激光作为新一代水动力生物激光系统,可降低激光热量对牙体、牙髓及牙槽骨的损伤,在口腔领域具有广泛的应用前景.Er,Cr:YSGG激光在牙周治疗中具有根面清洁、杀菌消毒、促进创面愈合、减少出血等作用,近年来,其广泛应用于牙周领域.本文就Er,Cr:YSGG激光的工作原理及其在牙周治疗中的应用作一综述.
