It can get better effect to perform tooth demineralization for tough tissue in multitudinous oral disease during clinical therapy. Demineralization of tooth is needed in many simulated experiments in vitro. Demineralization is not only essential measure of tooth treatment, but also the progress of part of tooth diseases. This paper summarized the current methods of demineralization for tooth hard tissue.

目的:评价离体牙梯度浓度脱矿后的理化性能,为牙支架材料的临床应用提供依据.方法:收集健康正畸减数牙56颗及牙槽骨标本4例,将牙齿标本随机分为单一浓度脱矿A组(阴性对照组),梯度浓度脱矿B、C、D组(实验组),未脱矿E组(阴性对照组),牙槽骨F组(阳性对照组).脱矿完成后通过分析天平测量质量变化、扫描电子显微镜(scanning electron microscope,SEM)观察表面形貌变化、能谱仪(EDX)测量组成元素含量变化、显微硬度仪测量不同层厚硬度变化.结果:离体牙脱矿后质量变化率为30％ ～65％,无机物含量减少,范围为0.82％ ～38.05％;根据脱矿环境不同牙本质小管不同程度暴露,且显微硬度降低,与未脱矿牙差异明显(P<0.05),单一浓度脱矿后表面与中心硬度差异明显,梯度浓度脱矿后从表面到中心硬度呈梯度变化;C2、D3组与牙槽骨显微硬度及矿物质含量无明显差异.结论:梯度浓度脱矿法可制备出力学相容性优良、理化性能优化的牙槽嵴增高材料,但其临床疗效有待进一步研究.

目的 对预防腮腺肿瘤切除术后并发症的Meta分析进行汇总评价.方法 检索PubMed、Cochrane Library、CNKI和WanFang Data关于腮腺肿瘤切除术后并发症预防的Meta分析,检索时间为建库到2018年9月12日.按照纳入标准筛选文献、提取资料,采用AMSTAR量表评价纳入研究的质量.结果 共纳入24个研究,探讨13种干预措施对预防腮腺肿瘤切除术后并发症的效果.AMSTAR质量评价结果显示,3个高质量研究,16个中等质量研究,5个低质量研究.结论 本研究所涉及的干预措施对Frey综合征、涎瘘/积液、面部畸形预防有一定的效果,对术后复发、感染无明显效果,对面神经麻痹的疗效不确定;此外,仍然需实施严谨和规范的原始研究、直接比较Meta分析/系统评价或间接比较网状Meta分析,为临床提供更可靠、全面的证据.

Objective:To study the effect of gradient demineralized autogenous teeth combined with Bio-Oss bone powder in the repairing the alveolar bone defects.Methods:Animal models of mandible defectin rabbits were established,ti-tanium nail fixation with autogenous bone,autogenous teeth,and gradient demineralized autogenous teeth combined with Bio-Oss bone powder used to repair alveolar bone defects.After 12 weeks,animals were sacrificed for sampling,imaging and histo-logical observation.Results:Twelve weeks after operation,all grafts and bone tissue sealing were good,without loose and fall off.X-rays showed that the bone density and height around the titanium nail in different experimental groups have different degrees of change. Histology studies suggested that the interface between graft and bone tissue in different experimental groups have different degrees of vascularization and new bone formation.Conclusion:Internal fixation of autogenous teeth with titanium nails can be used to repair bone defect,and the effect of different degrees of demineralization autogenous teeth is different.

目的:探讨不同浓度盐酸处理的梯度脱矿自体牙作为牙槽嵴增高材料与牙槽骨的结合情况.方法:3月龄雄性新西兰家兔18只,随机分为梯度脱矿自体牙组(A组),未脱矿自体牙组(B组)及自体胫骨组(C组),分别取自体牙及自体胫骨,经预处理后用钛钉固定在兔牙槽骨上,增加牙槽嵴高度,12周后处死动物,进行X线检查与HE染色.结果:术后12周,梯度脱矿自体牙片发生血管化,原移植物被新骨取代;未脱矿自体牙组未出现明显再吸收现象,与骨组织之间存在清晰界限;自体胫骨与牙槽骨发生骨整合,结合紧密,但供骨区出现术后感染.结论:经梯度脱矿处理的自体牙增高牙槽嵴具有自体骨组织移植相似效果.

目的 比较脱矿自体牙和脱矿自体牙联合Bio-oss骨粉修复兔下颌骨缺损的临床疗效.方法 建立兔下颌骨缺损动物模型,利用脱矿自体牙(A组)和脱矿自体牙配合Bio-oss骨粉(B组)分别对牙槽骨缺损进行钛钉内固定法修复,于植入修复材料12周后处死动物,取材,进行组织学观察和扫描电镜观察.结果 术后12周,所有实验动物移植体均与骨组织密合良好,无松动脱落.HE染色提示不同实验组移植体和骨组织界面有不同程度血管化及新骨形成.扫描电镜结果显示两组均有新骨形成,矿化程度有不同,A组骨质较为疏松,表面呈多孔状,骨皮质有缺损,B组移植区表面较为平整,但是骨皮质表面仍然不够光滑致密.结论 脱矿自体牙和脱矿自体牙联合Bio-oss骨粉用钛钉做坚固内固定均可以修复下颌骨缺损,二者修复骨缺损效果有差异,使用Bio-oss骨粉组新骨形成质量优于单纯使用脱矿牙片组,形成新骨更为成熟.

以武汉大学医学部2005级八年制，2006、2007七年制临床医学专业共计72名学生作为教学研究对象，分别进行双语临床模拟接诊训练和双语临床见习一次，课后按照评估标准打分，并对学生进行问卷调查，以评价教学效果。对口腔科学实践技能课的双语模拟接诊的教学模式，高达97%的学生表示赞同。同时，评估结果显示：学生的接诊技巧和口腔常用检查器械的选择和检查得分率较高，分别为85.7%和80%。在临床医学生的口腔实践技能教学中引入双语模拟接诊和见习课程，不仅有助于双语教学的延续性，同时增强了专业英语的实用性。

目的 评价左奥硝唑氯化钠注射液治疗口腔厌氧菌感染的临床疗效与安全性.方法 采用随机、双盲、平行对照研究.入组60例口腔厌氧菌感染患者均分为两组,分别静脉滴注左奥硝唑-氯化钠注射液(试验组)或奥硝唑-氯化钠注射液(对照组),剂量均为0.5 g,每日2次,3～5 d为1个疗程.评价药物疗效及安全性.结果 试验组患者用药后痊愈率96.67%,对照组为90·00%(P>0.05).试验组细菌清除率为100.00%,对照组为83.33%(P>0.05).试验组不良反应发生率为0,明显低于对照组的23.33%(P<0.01).结论 左奥硝唑治疗口腔厌氧菌感染安全有效.

Objective:Observing clinical effect of traditional decoction Wubeizi joint Amlexanax paste local treatment of the major aphthous ulcer.Method:Selected 30 patients with o major aphthous ulcer were randomly divided into experimental and control groups.Decoction 50 g was given wet dressing joint 5 g:250 mg of Amlexanox paste or Amlexanox paste only 4 times/d,ulcer surface coating 3 d continuously.Before and after treatment in patients with oral ulcers,the average ulcer stage,ulcer pain index and the largest difference between the diameter of evaluation as a therapeutic index of drug efficacy.Result:Experimental group,significantly higher than the control groups in maximum ulcer diameter difference(P <0.05).The clinical trial in the experimental group was 100 % effective,better than the control group 66 %(P <0.05).Conclusion:Gall decoction Wubeizi combined Amlexanox paste can effectively reduce severe recurrent oral ulcer pain,ulcer healing was significantly shorter period.

目的 观察vitapex糊剂用于乳牙牙髓炎的临床疗效.方法 将80例乳牙牙髓炎随机分为2组,每组40例.观察组用vitapex糊剂充填,对照组用氧化锌丁香油糊剂充填;观察1周内疼痛发生情况及6个月后的疗效.结果 观察组疼痛发生率为7.5%,低于对照组20.0%(P＜0.05).术后6个月复查,观察组成功率达95.0%,优于对照组82.5%(P＜0.05).结论 vitapex糊剂治疗乳牙牙髓炎疗效比较理想,临床操作方便,是理想的乳牙根充材料.

Objective:To explore the skills of clinic disposal and therapeutic effect on crown fracture of young permanent teeth.Method:according to different symptoms and history,give different treatments such as indirect pulp capping,pulpotomy,apexification and root canal therapy to 26 cases(32 teeth)traumatic crown fracture of permanent teeth of 8 to 15 years old patients,and were followed up for 1 week,3 weeks,6 weeks and 6 months.Result:there are one case in indirect pulp capping group and two cases in pulpotomy suffering from pain during the first week after treatment.Fllowing-up(six months)showed that seven cases of success and one case of failure in indirect pulp capping group,10 cases of success and 2 cases of failure in pulpotomy group,five cases of success and two cases of failure in apexification group;5 cases of success,0 cases of failure in root canal therapy group.Conclusion:Crown fracture of young permanent teeth whose pulp is not exposed should be treated in time,to prevent infection of pulp from bacteria through the dentinal tubules.The treatment of young permanent teeth whose pulp is exposed should be based on the case of root of the teeth.Regular follow-up should be done after the treatment.If the situation of the pulp turn bad,it is necessary to adjust the treatment in time.This is conducive to the continued development and post-repair of young permanent teeth.

The perfect health care and the social welfare system is the important safeguard of constructing harmonious society.As a better function of market economy,social security is relatively mature in western industrialized countries.Canada's medical security system in the establishment and implementation has some useful experience for China medical reform.Being senior visitors,the authors have carried on half an year inspection to Canada and analyzed the function of the social welfare and the health care system which displays in the peaceful country.Meanwhile,the authors also point out the accumulated malpractice and the improvement in the future.

Objective: To study the effects of selenium on oral mucosal cell and hepatocyte DNA damage induced by fluorosis in rats. Methods: Three groups of male SD rats were provided with deionized drinking water containing 0 (control group), 150 mg · L -1 sodium fluoride (fluorosis group), 2 mg · L -1 sodium selenite and 150 mg · L -1 sodium fluoride(combinative action group of selenium and fluoride) respectively for 4 weeks. Single cell gel-electrophoresis assay was used to detect the DNA damage rate in rat oral mucosal cells and hepatocytes. Results: The DNA damage rates of fluorosis group were 50.20% in oral mucosal cells and 44.80% in liver cells and were higher than those of the control group significantly. The results also showed that selenium had antagonistic effect on DNA damage induced by fluorosis and could decrease the rates of DNA damage to 14.60% in oral mucosal cells and 12.60% in liver cells respectively. Conclusion: It suggests that selenium at certain concentration relieves DNA damage induced by fluorosis in rat oral mucosal cells and hepatocytes in vivo.

为研究塞克硝唑在临床治疗口腔厌氧菌感染的疗效,以替硝唑为阳性对照药,对50名牙周炎患者、50名冠周炎患者采用随机的方法进行治疗.结果显示,试验药和对照药抗口腔厌氧菌的痊愈率分别为25%和15%,有效率均为60%,两组无显著性差异(P＞0.05).

Objective To explore effects of excessive fluoride on oral mucosal cell DNA synthesis and cell cycle changes in rats. Methods Two groups of male SD rats were provided with deionized drinking water containing 0(control group) and fluoride(150 mg/L sodium fluoride) respectively for 4 weeks. Oral mucosal cell DNA damage was measured with single cell gel electrophoresis(or comet assay), DNA relative content(DNA RC ) and cell cycle were detected with flow cytometry. Results Excessive fluoride could reduce the cell number of G 2/M period in cell cycle and decrease DNA relative content significantly in rat oral mucosa. In addition, excessive fluoride could induce rat oral mucosal oxidative stress. The DNA damage rates of excessive fluoride group were 50.20% in oral mucosal cells and were higher than that of the control group significantly. Conclusions It was suggested that excessive fluoride could induce cell cycle changes, decrease DNA relative content and result in oxidative stress and DNA damage in rat oral mucosal cells in vivo.

目的:观察更昔洛韦治疗复发性阿弗它溃疡(RAU)临床疗效及对患者细胞免疫功能的影响.方法:对13例巨细胞病毒抗体(CMV-IgG)阳性的RAU患者,在溃疡期给予更昔洛韦静脉滴注,进行治疗前后的对比研究,根据RAU疗效评价标准给予临床评价;用流式细胞仪检测外周血T淋巴细胞亚群;用ELISA法测定巨细胞病毒抗体(CMV-IgM CMV-IgG).结果:治疗2周后溃疡期明显缩短,疼痛指数减少;血CD8+T细胞在治疗开始后半年比例降低,CD4+/CD8+比值明显升高;CMV-IgG的效价治疗前后亦有差异.结论:更昔洛韦(GCV)对机体的免疫功能有明显促进作用,且能有效缓解临床症状,具有较好的临床综合疗效.

为了观察曲安奈德与维生素B12联合局部注射治疗口腔扁平苔藓(OLP)的疗效,将OLP患者30例分为A、B两组,A组注射曲安奈德和维生素B12;B组仅注射曲安奈德,分别于治疗1周、6周后综合判定疗效.结果显示,曲安奈德与维生素B12联合治疗和对照组相比,治疗1周后疼痛指数、6周后综合疗效指标均明显降低,两组疗效经统计学分析有显著性差异.

目的:探讨心理恐惧与局麻拔牙镇痛不全和晕厥之间的关系.方法:局麻拔牙时根据患者的症状、表现,作出判断标准并进行分析.结果:在4018例成人局麻拔牙病例中,因心理恐惧出现痛觉过敏20例(占0.5%),假性疼痛80例(占2%).发生情绪性晕厥28例(占0.7%).结论:心理恐惧与局麻拔牙镇痛不全和晕厥有直接关系,发生率女性多于男性.情绪性晕厥在每次拔牙中均发生的患者常有家庭史.