随着口腔技术的发展,种植牙已逐渐成为牙列缺损和牙列缺失患者首选的修复方式,但吸烟、糖尿病、细菌感染等相关危险因素可能导致种植体感染,发展为种植体周围病,直至发展到种植体失败.种植体周围病是指发生在已形成骨结合并行使功能的种植体周围组织的炎症性过程,是类似于慢性成人牙周炎的特异性感染,其发病率为5％～8％[1],包括种植体周围黏膜炎及种植体周围炎.

口腔颌面部感染来源为牙源性、腺源性、血源性、损伤性和医源性,其中以前2者为主,后3者感染途径较少见.口底蜂窝织炎主要有化脓性和腐败坏死性2种类型,腐败坏死性蜂窝织炎也称为路德维希咽峡炎(Ludewig's angi-na),脓液一般颜色较深,黏稠,有明显硫化物臭味,该区域出现感染后,发展速度较快,甚至向下感染可能引起纵隔病变,另外容易压迫呼吸道,需密切关注患者通气情况[1].

目的:分析综合护理干预在社区3～6岁学龄前儿童口腔健康中的应用效果.方法:选取2021年1月—2022年1月在和平街社区进行儿童口腔健康检查的98例学龄前儿童,采用随机数字表法分为观察组与对照组各49例.对照组实施常规护理干预,观察组实施综合护理干预,比较两组口腔健康行为改变情况、家长对儿童口腔健康知识掌握的优良率、儿童龋齿率、菌斑指数.结果:观察组口腔健康行为优于对照组;观察组家长对儿童口腔健康知识掌握的优良率(73.47％)高于对照组(46.94％),差异有统计学意义(P＜0.05);观察组龋齿率(1

传统的人工种植牙技术虽然相对较成熟,但受医生的主观因素影响较大.种植体在颌骨内放置的位置、角度、深度等的准确性会影响其长期种植的成功率[1,2].种植牙机器人综合应用机器视觉、力学传感和微型模块化等技术设计研制,将其引入到口腔种植手术中,可以判读重现手术区域的解剖结构、精准规划种植方案、及时导航校准等,具有精准、高效、安全等优点.2020年3月～10月我科对42例牙列缺损采用瑞医博口腔种植机器人(机械臂:Uni-versal Robots,丹麦;光学跟踪定位仪:Claron Technology,加拿大;主机:华北工控,中国;搭配RemeDen手术导航软件),行口腔种植手术,由于人工智能的引入,在传统护理配合基础上,要求更精准的护理配合操作,现报道如下.

临床中上颌后牙拔除时偶会出现与上颌窦穿通,这与上颌后牙和上颌窦底的解剖密切相关.2013年以来我科采用带蒂颊脂垫瓣修复拔牙术后口腔-上颌窦瘘患者11例,效果良好,现将护理体会报告如下. 1 资料与方法 1.1 临床资料 本组患者11例,其中男7例、女4例;年龄21～66岁.上颌后牙拔除术后出现口腔-上颌窦瘘,2周或更长时间复查仍未愈合,无明显急性炎症,排除明确手术禁忌.

上颌前牙区属于重要美学区域,该区域的种植具有对功能及美学的双重高要求.目前,种植体的骨结合已经不是临床追求的目标,而更多的倾向于软组织边缘、色泽、丰满度与周围组织协调,即红色美学;修复牙冠颜色形态与邻牙协调,即白色美学.锥形束CT(conebeam CT,CBCT)、计算机辅助技术的应用,可保证种植体植入准确理想的三维位置,从而为后期的红白美学效果奠定基础[1,2].应用数字化导板完成上前牙种植义齿修复过程涉及知识点多、步骤复杂,护士需要专业的理论知识、熟练规范的护理配合,现将相关的护理配合要点总结如下.

目的 对预防口腔科交叉感染的消毒护理措施展开分析和探究.方法 选择2018年2月—2019年2月间接受口腔科交叉感染的患者共42人为对象进行分析研究.分成两组,对照组实施传统消毒的操作,研究组采取消毒护理措施,对比两组患者的护理效果.结果 通过数据统计分析可得,研究组患者口腔交叉感染率和对照组相比较更低,且研究组的护理满意度也比对照组的优越.结论 对于口腔科患者进行治疗时,首先要考虑好怎样预防交叉感染的出现,因此,相关医务人员要积极做好健康宣教,并且消毒护理工作认真履行义务,保障护理治疗的效果.

Objective:To observe and compare the dynamic changes of contamination of high-frequency contact surfaces near dental chairs in outpatient department of stomatology, so as to provide reference for the disinfection management of the surface contamination near dental chairs in outpatient department of stomatology.Methods:The chair-side operating tables and treatment vehicle tables in the Department of periodontology, general stomatology and orthodontics of Stomatology center of our hospital were selected as the subjects of investigation. Biofluorescence detector was used to smear and sample the designated areas immediately after disinfection and 1 hour, 2 hours and 3 hours after disinfection respectively. Each site was collected and observed for 5 working days.Results:The qualified rate of sample was 100% immediately after disinfection, and the contamination exceeded the standard one hour, two hours and three hours the qualified rate of sampling was 26.7% (8/30) , 23.3% (7/30) and 13.3% (4/30) after disinfection. There was a significant difference in the qualified rate of sample at each time point ( χ2 value was 59.155, P<0.05). One hour, two hours and three hours after disinfection, the contamination of chair-side tables the qualified rate of sampling was 26.7% (4/15) , 20.0% (3/15) and 13.3% (2/15) and treatment vehicles the qualified rate of sampling was 26.7% (4/15) , 26.7% (4/15) and 13.3% (2/15) exceeded the standard and there was no significant difference in the qualified rate of sample at each point ( χ2 value was 0.034, P>0.05). Conclusion:The outpatient department of stomatology should pay attention to the disinfection management of high-frequency contact surfaces near dental chairs, and adjust the disinfection frequency reasonably according to the change of pollution to ensure the surface hygiene and meets the standard requirements.

目的 分析探讨A型肉毒毒素注射治疗良性咬肌肥大的优质护理效果.方法 选取我院口腔医学中心单纯良性咬肌肥大患者45例(2017年1月～2019年1月),经A型肉毒毒素注射治疗,全过程实施优质护理配合,随访观察效果及并发症.结果 术后三天,43例(95.56％)患者出现咬肌酸胀、咀嚼力量下降,但均可耐受并在2周后逐渐缓解.25例(55.5％)患者在注射10天后出现轻微面部不对称,经过追加剂量补打后效果满意.45例(100％)患者感觉6个月时逐渐失去效果,咬肌体积减小的程度已经不足以达到理想的面部轮廓,但与注射前相比仍有明显改善.45例(100％)患者在治疗期间均未出现双侧面部严重不对称、面神经损伤、感染、过敏、中毒等严重不良反应.43例(95.56％)患者表示非常满意,2例(4.44％)患者表示满意,无不满意例数.结论 优质护理措施能有效改善患者不良情绪,提高患者满意度,减少并发症,值得临床广泛推广和应用.

口腔印模是用可塑性印模材料取得的上、下颌牙列和周围软硬组织的阴模,临床常见的印模材料有藻酸盐、硅橡胶、聚醚橡胶等.口腔科技师根据牙模制作出义齿后,再由口腔科医师放入患者口腔中.口腔印模的制取是口腔修复、正畸工作中的重要工序,但在制取过程中口腔印模的表面和内部往往直接沾染、吸附患者的唾液和血液而携带致病微生物.若不对口腔牙模进行合格的消毒处理,极易造成致病微生物在医生、护士、技师、患者之间的交叉感染和传播.

PDCA循环又称戴明循环,是美国质量管理专家戴明博士提出的一种程序化、标准化、科学化的基本管理方法 ,是全面质量管理所应遵循的科学程序[1].口腔诊疗器械的消毒管理是口腔科管理的重要内容,是保证日常诊疗顺利进行、控制院内交叉感染的重要环节[2].我院口腔医学中心引入PD-CA循环,对诊疗器械的消毒管理进行了深入分析与持续改进,取得了较好的效果,现报道如下.

Objective To evaluate the effect of individualized nursing on the failure rates of bracket in adolescents treated by fixed appliances.Methods 120 adolescents treated by fixed appliances were randomly assigned to 4 groups (A,B,C and D).30 females in group A and 30 males in group B were treated by individualized nursing (that is,nurses using language,illustration and texts to help patients in recognition,mentality,behavior) ; 30 females in group C and 30 males in group D were treated by routine nursing.The failure rates of bracket of the four groups were calculated after one month.And it was compared between group A and B,group C and D,group A and C,and group B and D.Results After one month,the failure rates of bracket were 0.20％,0.40％,1.57％ and 1.76％,respectively.Significant differences were not found between group A and B and group C and D (P＞0.05),but were found between group A and C and group B and D (P＜0.05).Conclusions During the orthodontic treatment of adolescents,gender has little effect on the failure rates of bracket.Individualized nursing could improve compliance,thus reduce the failure rates of bracket.

Objective:To evaluate the effect of two different types of adhesive and four-handed operation in clinic bracket bonding. Method:Forty patients needed bonding brackets were randomly and equally divided into 4 groups(n=10).A group:184 brackets were boned with four-handed operation and light curing adhesive. B group:180 brackets were boned with non four-handed operation and light curing adhesive. C group:188 brackets were boned with four-handed operation and chemical curing adhesive. D group:192 brackets were boned with non four-handed operation and chemical curing adhesive. Result:The average time of bonding one bracket:of A group was 2.65 min;of B group was 3.52 min;of C group was 1.95 min;of D group was 2.18 min. There was statistical difference between A group and B group;C group and D group;A group and C group;B group and D group(P 0.05). When it is time to check after one month,the number of adhesive failure bracket was 5 in A group,7 in B group,4 in C group and 8 in D group. The failure rate was 2.72 % of A group;3.89 % of B group;2.13 % of C group;4.16 % of D group. There was no statistical difference between four groups.Conclusion:The chemical curing adhesive and four-handed operation could improve the efficiency in clinic bracket bonding. Both of them had no effect on the bonding results.

<正>麻疹是由麻疹病毒引起的急性呼吸道传染病,该病主要在6个月～5岁小儿间流行。随着麻疹疫苗的计划免疫接种,儿童发病率显著下降,但近年来发现成人麻疹发病率有所增加。现将我科2007年1月～2009年12月间麻疹患者发病情况进行分析,并总结成人麻疹流行病学特点及临床特点,为今后预防工作提供帮助。

病例介绍 患者男性,87岁.诊断为慢性肺源性心脏病、慢性阻塞性肺气肿、慢性喘息型支气管炎20余a.近5 a活动后胸闷、气短逐渐加重,曾2次因自发性气胸入院.2002年10月6日受凉后,咳嗽、咳痰、喘息加重.10月10日晚8时喘息剧烈不能平卧,端坐位,言语断续,伴大汗,吸氧不能缓解.