目的:了解下颌第三磨牙阻生牙患者的流行病学分布特征及其对干槽症发病的影响.方法:分析1 777例下颌第三磨牙阻生牙拔出患者的年龄、性别、拔牙月份、牙位、阻生类型等流行病学特征的分布情况,并采用多因素Logistic回归分析探讨其与干槽症发病的关系.结果:1 777例患者平均年龄(33.69±11.57)岁,女性患者(60.33％)多于男性(39.67％),垂直阻生和近中阻生患者最多(37.76％和31.40％),颊侧阻生患者最少(0.79％).共有15例患者发生干槽症,发病率0.84％.多因素Logistic回归分析结果显示,5～ 10月拔除下颌第三磨牙阻生牙(OR =4.07,95％CI:1.08～15.42)、远中阻生(OR=12.19,95％CI:1.19～125.01)、舌侧阻生(OR=15.30,95％CI:2.59 ～90.36)与干槽症发病均呈正相关(P＜0.05).结论:下颌第三磨牙阻生牙拔除患者中女性较多,阻生类型以垂直阻生和近中阻生为主,较炎热季节行拔牙术、阻生类型是干槽症发病的危险因素.

目的 分析牙龈卟啉单胞菌致病岛rag基因在青少年正畸早期的的变化,探讨其与牙龈炎性反应的关系.方法 随机收集前来正畸的牙龈正常患者45例,分别取矫治器戴入前,矫治器戴入后1、2、3、6、12个月龈沟液标本,应用16S rDNA PCR技术及多重PCR技术检测各样本中的牙龈卟啉单胞菌及其致病岛rag基因.结果 矫治器戴入后1个月,牙龈卟啉单胞菌检出率较戴入前明显增加,差异有显著性(P＜0.05),到2个月时最高(P＜0.01);2个月后开始下降,戴入后6个月与12个月趋于稳定.致病岛rag基因在戴入矫治器后1个月明显增加,有显著性差异(P＜0.05),到2个月和3个月时最高(P＜0.01);3个月后开始下降,戴入后6个月与12个月趋于稳定,但仍高于矫治前.结论 牙龈卟啉单胞菌及致病岛rag基因与正畸牙龈炎性反应关系密切.

目的 研究牙周病导致的前牙移位患者实施治疗时采用口腔正畸的有效性.方法 选取本院2017年12月～2018年12月收治的75例牙周病导致的前牙移位患者,按照随机数字法分为研究组(38例)和常规组(37例).常规组采用常规牙周病治疗,研究组在常规组基础上进行口腔正畸治疗.观察两组治疗后的牙齿松动改善情况和前牙牙周改善状况.结果 正畸治疗后,研究组患者牙齿出血率为7.89％,常规组为32.43％,研究组低于常规组,差异有统计学意义(P<0.05).研究组患者牙齿松动程度优于常规组,差异有统计学意义(P<0.05).正畸治疗后,正畸治疗后,研究组患者的前牙覆盖、前牙覆、牙周袋深度等指标都比常规组低,差异有统计学意义(P<0.05).牙槽骨高度比较无显著差异(P>0.05).结论 在常规牙周病治疗的基础上,结合口腔正畸治疗,可以显著提高正畸效果,改善患者牙齿松动程度和前牙移位状况,值得在临床上进行应用和推广.

目的 比较舌向集中牙合全口义齿与非解剖式牙合全口义齿临床修复效果.方法 选取牙槽嵴重度吸收无牙颌患者22例,分别制作非解剖式牙合和舌向集中牙合两种全口义齿,各戴用2个月后进行满意度调查,比较二者的临床修复效果.结果 患者对2种牙合型义齿固位功能、语音功能的满意度差异没有统计学意义;而对舌向集中牙合义齿咀嚼效率、舒适性、美观性的满意度均较非解剖式牙合义齿高,二者差异有统计学意义.结论 对牙槽嵴重度吸收患者,应用舌向集中牙合全口义齿修复效果更好.

Objective To investigate the function of autogenous rib cartilage in renovating nasal deformity after cleft lip.Methods 30 patients need bone graft to rectify nasal deformity after cleft lip by moulding autogenous rib cartilage,and keep on holding nasal 6～12 months postoperation with nasal mode to be used specially for cleft lip.Results 30 patients are all issue I healing and evidently improved nasal wing collapse 、anasl septum skew 、flattened nasal tip and back of nose,and so on.Conclusion The result of restitution of nasal deformity after cleft lip is very good.It worth extending for its clinical application.

AIM:To explore the changes of Porphyromonas gingivalis (Pg) and its virulence factor FimA in the adolescent patients underwent ortIhodontic treatment.METHODS:61 orthodontic teenagers with healthy gingiva underwent orthodontic treatment.Givgival crevicular-fluid(GCF) of the subjects was collected before and 1,2,3 and 6 month after treatment respectively,simultaneously the gingival index (GI) of one-to-one correspondence was examined,Pg and its virulence factor FimA in GCF of each sample were detected by 16SrDNA PCR technique.SPSS 20.0 software package was used to analyze the data.RESULTS:3 months after treatment.Pg and FimA Genotype Ⅱ,Ⅳ and Ⅴ in GCF were increased (P ＜ 0.05).The positive growth of Pg and the 6 genotypes in the first 3 monthsafter treatment were increased,and the highest level appeared at the third month,then gradually decreased and returned to the prior treatment state in the sixth month.Significant positive correlation was observed between Pg and GI and FimA genotype Ⅰ,Ⅰb,Ⅱ,Ⅳ and Ⅴ respectively (P ＜ 0.05).CONCLUSION:During the orthodontic treatment in adolescents,the increase of Pg and FimA can be caused by the wearing the appliance in the early stage,that may induce gingival inflammation.

Objective: To analyze the stress of periodontal tissues in different conditions by establishing the three dimensional finite element mode l of an embedded tooth,and provide experimental reference to the orthodontictraction of embedded teeth.Methods: A patient with a canine completely embedded in the maxillary bone was chosen.The three dimensional finite element model of the canine and its surrounding tissues were established by means of the finite element method.On the basis of the stable dental cusp,the canine axis was changed to reach different angles of traction.Equivalent stress clouds of the periodontal membrane of the tooth were observed.Results: At 0°,there was a stress concentration area at the apex and cusp of the tooth.As the angle was bigger,there were stress concentration areas at the apex and the sides facing traction forces.Conclusion: When the traction direction is in line with the tooth axis,the embedded tooth moves integrally,and the periodontal stress distribution is homogeneous,which benefits the traction.

Objective To investigate the expression of vascular endothelial growth factor (VEGF)、matrix metalloproteinase-2(MMP-2) and matrix metalloproteinase-9 (MMP-9) in tongue squamous cell carcinoma and the clinical significance.Methods The expression of MMP-2,MMP-9 and VEGF in 60 cases of tongues quamous cell carcinoma tissues and in 20 cases of normal tongues tissues were examined by immunochemistry.Results The expression of MMP-2,MMP-9 and VEGF was higher in tongues quamous cell carcinoma than that in normal pancreatic parenchyma.In cases with lymph nodes metastasis and TNM stage Ⅲ + Ⅳ,the expression of two markers were significantly higher than those without lymph nodes metastasis and TNM stage Ⅰ + Ⅱ (P ＜ 0.05).A positive correlation was found between the expression of VEGF and MMP-2,MMP-9 in tongues quamous cell carcinoma ( P ＜ 0.05 ).Conclusion The expression of MMP-2,MMP-9 and VEGF was closely correlated with lymph nodes metastasis and TNM stage of tongues quamous cell carcinoma(P ＜ 0.05 ).VEGF and MMP-2,MMP-9 play an important role in the development of tongues quamous cell carcinoma,may cooperate with each other.

Objective To investigate the effects of different alloys on the periodontal tissue health and level of VEGF,IL-6,TNF-α in gingival crevicular fluid.Methods A total of 60 cases were divided into three groups:Ni-Cr alloy( group I ),Ti alloy( group Ⅱ ),Pd-Au alloy respectively( group Ⅲ ).The gingival cervicular fluid (GCF) of the pre-operation and six months after operation were collected and the concentration of VEGF,IL-6 and TNF-α were detected by ELISA.Results Before the operation,there was no significant difference in levels of VEGF,IL-6 and TNF-α between the three groups (P ＞ 0.05 ) ; After six months,the levels of VEGF,IL-6 and TNF-α increased in group I and group Ⅱ,but there was no significant difference in group Ⅲ.After operation,compared with group Ⅲ,VEGF,IL-6 and TNF-α in group I and group Ⅱ were significantly increased ( P ＜ 0.05).Conclusions Different dental alloys may affect the levels of VEGF,IL-6 and TNF-α in GCF.Pd-Au alloy is better for periodontal tissue than that of Ti alloy and Ni-Cr alloy.

目的 观察重度深覆(黯)正畸治疗中微型种植体支抗系统的应用效果.方法 8例成年前牙Ⅲ度深覆(牙)(合)、下颌前部牙槽发育过度的高角患者,均采用微型种植体作支抗,在两侧下侧切牙牙根和尖牙牙根间牙槽骨唇侧植人,每侧以50 g的牵引力压低下前牙.比较治疗前及覆(殆)正常时L6-MP距(下颌第一磨牙近中颊尖至MP平面的距离)、L1-MP距(下中切牙切缘点至MP平面的距离差)和转矩(L1-MP角).结果 本组患者治疗4～8个月.治疗过程中微型种植体稳定,无松动和脱落.治疗前L6-MP距、Li-MP距、L1 -MP角分别为(54.26±1.87)mm、(65.38±1.42)mm、92.57°±2.12°,治疗后分别为(54.47±1.48)mm、(60.13±1.25)mm、92.78°±2.03°,治疗前后Li-MP距相比,P＜0.05,L6-MP距、Li-MP角相比,P均＞0.05.结论 用微型种植体支抗系统压低高角深覆(黯)患者的下前牙,效果良好.

Objective To analyze the Bolton index ratios and Bolton's tooth size discrepancy frequency in different malocclusions in Shandong province. Methods Bolton indexes were measured and analyzed in randomly chosen 180 dental casts of three Angle's malocclusions by the method described by Bolton. Results The Bolton anterior and overall ratios for different malocclusions of Shandong province showed no signi?cant differences in anterior or overall ratios among different occlusal categories or between the different sexes,and no statistically signi?cant differences for every malocclusion when compared to the Chinese normal occlusion's Bolton index ratios. The anterior and overall tooth size discrepancies frequency outside two standard deviations from the Chinese normal occlusion's Bolton index ratios were 14.44% and 6.66% for all the malocclusions,respectively,and there were no signi?cant differences in anterior or overall tooth size discrepancies frequency among the three Angle's malocclusions. When more than 1.5 mm Bolton tooth size discrepancy(TSD)expressed in millimeters was used,the anterior and overall tooth size discrepancies frequency for all the malocclusions were 17.23% and 40.00%,respectively,and there were no signi?cant differences in anterior or overall tooth size discrepancies frequency among the three Angle's malocclusions,except the overall tooth size discrepancy between Class Ⅰ and Class Ⅲ malocclusions. Conclusion The Chinese normal occlusion's Bolton index ratios can be also used to malocclusions in Shandong province. The actual amount of discrepancy expressed in millimeters provides orthodontists with more useful information for clinically signi?cant tooth size discrepancy than the ratio in percentage terms.

目的 探讨高速涡轮钻用于下颌第三磨牙阻生齿拔除术的效果.方法 将210例(250颗)下颌第三磨牙阻生齿患者随机分为观察组110例(130颗)和对照组100例(120颗),观察组采用高速涡轮钻下行阻生齿拔出,对照组采用常规凿劈法拔除.观察两组手术时间,术后疼痛、张口受限程度及干槽症发病率.结果 观察组手术时间明显短于对照组,术后疼痛、张口受限、干槽症发生率明显低于对照组,P均＜0.05.结论 高速涡轮钻用于下颌第三磨牙阻生齿拔除可缩短手术时间,明显减轻术后疼痛、张口受限,避免干槽症.

BACKGROUND:As a new dermal substitute,acellular dermal matrix(ADM)has been extensively used in repair of tissue defects.But there are no reports about the expression of basic fibroblast growth factor(bFGF)during long-dated biological transition of ADM.OBJECTIVE:To discuss the rule of the bFGF expression in long-dated biological transition of collagen lattice in vivo.METHODS:A total of 21 Wistar rats were applied to prepare ADM.A wound at 2.5 cm×2.5 cm was made to deep fascia surface on left side of spine cord in 84 rats.ADM was transplanted to the back of Wistar rats,while contralateral normal skin served as the control.Samples were acquired at 3,5,7,10 days,2,3,4,6,8,10 weeks,4,6,8,10 months after operation.The bFGF expression was detected using immunohistochemical method.RESULTS AND CONCLUSION:Expression of bFGF came to appear in 3 days,and reached the peak in 10 days,then became stable in 4 weeks,after 8 weeks the expression of bFGF was the same with normal skin.In the course of long-dated biological transition of ADM,its rebuilding begins from the border of ADM gradually to the center;the rebuilding will become stable at 6-8 weeks after transplantation,then the ADM is considered to be autologous tissue and participates in the metabolic process of normal tissue.

颞颌关节陈旧性前脱位是指单侧或双侧下颌骨髁状突脱离关节凹迁移至关节结的前下方不能自行复位2周以上者,此病症状突出,但临床少见.近年来,我们采用颌间牵引治疗14例陈旧性双侧颞颌关节前脱位患者,取得良好治疗效果.现择2例报告如下.

许多就诊的拔牙患者总是把拔牙和疼痛联系在一起,我们在临床处理此类患者时除安慰、诱导外,使用了传统常规麻醉术加根尖部骨膜下麻醉法,收到了良好的效果.

多数学者认为,骨骼发育状况是分析青春生长突增期(又称青春生长进发期)较准确的评价指标,骨骼定性改变的估计是分析儿童生长发育成熟度最常用和最准确的方法.在正畸临床中,多采用拍摄X线手腕骨片作为青春生长突增指标,来帮助提高诊断的正确程度.而作为某些口腔专科医院和基层单位及口腔门诊部,受医院设备条件和病人经济承受能力等多方面原因限制,难以达到要求.笔者结合几年来正畸治疗体会,发现头颅侧位X线颈椎影像对判断青春生长突增期,评价患者骨龄有着重要的意义.