The repair of alveolar bone defects is a complex biological process that involves the interplay between implant materials, bone marrow mesenchymal stem cells (BMSCs), and the immune cells present in the surrounding area. Moreover, the polarization of macrophages induced by implant materials has been shown to play a crucial role in regulating bone regeneration. Recent studies have discovered that M2 macrophages promote the osteogenic differentiation of BMSCs by activating the TGF-beta/BMP signaling pathway. However, the molecular mechanisms underlying the regulation of bone regeneration in BMSCs by macrophages remain unclear. Our in vivo study demonstrated that a 10 % magnesium (Mg2+)-doped calcium sulfate hemihydrate -biphasic calcium phosphate (CSH/BCP) composite ceramic material was effective in repairing alveolar bone defects in rabbits. In our in vitro study, we observed that this ceramic material could induce M2 macrophage polarization and reduce inflammation. Moreover, the conditioned media obtained from M2 macrophages promoted the osteogenic differentiation of BMSCs. Additionally, our research showed that overexpression of miR-21-5p inhibited M2 macrophage polarization and reduced the osteogenic differentiation capacity of BMSCs. Co-overexpression of miR-21-5p and Smad2 in macrophages partially reversed the effects of miR-21-5p on the osteogenic differentiation of BMSCs and macrophage polarization. These findings suggested that Mg2+-doped CSH/BCP composite ceramic materials could enhance M2 macrophage polarization through the miR-21-5p/Smad2 axis, and the microenvironment of M2 macrophages could further promote the osteogenic differentiation of BMSCs. The findings presented in this work offer valuable insights into the molecular mechanisms that regulate bone regeneration in BMSCs and the role of macrophages in this process.

Objective: To clarify the course of vascular neural network system in the mandibular anterior teeth. Methods: The data of 104 cases of CBCT were retrospectively studied. The relationship between mandibular median lingual canal, mandibular accessory canal, mandibular buccal canal, and mandibular incisor neural tube was observed. Inclusion criteria were: when multiple cross-sectional images such as sagittal section, coronal section, horizontal section, arbitrary section, and curved section were read, the presence of mandibular incisor neural tube, mandibular median lingual canal, and mandibular accessory canal or mandibular buccal canal could be clearly observed. Results:（1） The median lingual canal of mandible communicated with the neural tube of mandibular incisors in 15 cases. Neural tube communication of bilateral mandibular incisors was observed in 22 cases. There were 104 cases of sublingual or buccal canal communicating with mandibular incisor neural tube, with a total of 184 branches. Conclusion:（1） The mandibular incisor nerve can send out several small branches on the buccalingual bone surface of the corresponding tooth position, such as premolars, canines, and incisors. The running channels of these small branches are the mandibular accessory canal and the mandibular buccalateral canal.（2） The median lingual canal of the mandible is a pipe from the lingual side of the mandible to the interior, which tends to disappear. It is not connected with the neural tube of the mandible incisor, and in some cases, it is anastomosed with the nerve of the mandible incisor or runs through the mandible.（3） The median lingual canal of the mandible is not a small branch from the mandible body to the bone surface issued by the neural tube of the mandible incisor, but a path from the soft tissue to the mandible body issued by the branch from the vascular and nerve bundle of the mouth floor.

目的 提高对CBCT图像金属耳饰伪影的认识,探讨其产生原因、表现特点及预防策略.方法 采用回顾性研究,收集2015年5月-2022年2月昆明市延安医院口腔科、丽江市人民医院口腔科拍摄的CBCT影像,对120例CBCT图像金属耳饰伪影进行分析.结果 线性伪影27例:表现为横贯面部的线性干扰影;声波样伪影83例:表现为横贯面部的声波状干扰影.结论 金属饰品伪影最为常见的是耳钉、耳坠、耳环,其中女性、少数民族患者多见;其发生率性别差异明显,女性明显高于男性,少数民族高于汉族;金属耳饰伪影会在CBCT图像的水平层面产生类似于波浪样干扰影像,建议拍摄时摘除耳饰,以避免金属伪影的产生.

目的 研究不同纤维桩表面处理方法对根管壁粘接固位力的影响.方法 收集 50 颗半年内因正畸拔出的完整离体单根管下颌双尖牙,随机分为 5 组.A组:空白组;B组:硅烷偶联剂处理组;C组:选择性酸蚀处理组;D组:过氧化氢溶液处理组;E组:喷砂处理组;按统一标准制作力学测试件进行力学测试,扫描电镜观察处理后的纤维桩表面相貌.结果 各组样本中拉力值最大值与最小值的比较:A组、B组、C组、D组、E组的最大值分别为 13.16 MPa、13.42 MPa、18.31 MPa、22.67 MPa、21.05 MPa,最小值分别为 8.9 MPa、8.94 MPa、12.98 MPa、17.69 MPa、14.39 MPa,D组、E组内的样本最大值及最小值均比A组大,且是 5 组实验样本中最大的.各实验组断裂模式的比较:通过卡方检验分析得出,断裂方式之间的差异具有统计学意义(α<0.05),大多为粘接剂与纤维桩之间的粘接界面破坏,其中D组和E组以混合破坏占主导地位,而A组、B组和C组是I型粘结破坏占主导地位;4 种不同的处理方法均不同程度的改变了玻璃纤维桩表面形貌,纤维束保存完整表面覆盖基质发生不同程度溶解.结论 综合评价 4 种纤维桩表面处理方法得出经过氧化氢溶液处理和喷砂处理的纤维桩的粘接强度在这 4 种方法中是最强的,临床值得推广运用.

目的:探讨心脏彩色多普勒超声在小儿先心病诊断中的应用价值.方法:选取济宁市兖州区人民医院2019年1月—2022年1月收治的90例疑似小儿先心病患儿为研究对象.90例患儿均进行心脏彩色多普勒超声检查、手术病理检查,记录两种检查方法的检查结果,并以手术病理检查结果为标准,分析心脏彩色多普勒超声的诊断准确度、特异度、敏感度以及一致性.结果:手术病理结果显示,90例疑似病例中,有79例(87.8％)患儿为先天性心脏病,其中房间隔缺损(atrioventricular septal defect,ASD)25例,室间隔缺损(ventricular septal defect,VSD)22例,心内膜垫缺损(endocardial cushion defect,ECD)2例,肺动脉狭窄(pulmonary stenosis,PS)4例,法洛四联症(tetralogy of Fallot,F4)10例,动脉导管未闭(patent ductus arteriosus,PDA)16例;剩下11例患儿为非先天性心脏病.心脏彩色多普勒超声检查显示有80例患儿为先天性心脏病,心脏彩色多普勒超声检查的准确度、特异度、敏感度与手术病理检查差异无统计学意义(P>0.05).心脏彩色多普勒超声的Kappa值为0.771,显示该检查方法与手术病理检查一致性较好.结论:采用心脏彩色多普勒超声对小儿先心病进行诊断,具有较高的准确度,且特异度、敏感度理想,临床应用价值显著.

目的 通过探讨CBCT对牙瘤的诊疗价值来总结牙瘤的影像学特点,从而提高对牙瘤的临床认识.方法 采用回顾性研究,收集2015年5月至2022年2月昆明市延安医院口腔科经CBCT(KavoiCAT 17-19,德国)诊断为牙瘤的19例门诊患者的影像资料,从牙瘤发生年龄、空间位置、牙位、类型等方面进行分析.结果 19例牙瘤患者发生年龄为8～23岁,其中男性6例,女性13例.牙瘤的发生区域为上颌10例,下颌9例,前牙区16例,前磨牙区2例,磨牙区1例;发生牙位为上颌中切牙位4例,上颌侧切牙位3例,上颌尖牙位3例;下颌侧切牙位1例,尖牙位2例,第一前磨牙位1例,其余5例均发生在相邻两牙位之间.牙瘤的发生类型为组合型14例,混合型5例(包括囊性牙瘤2例),其中牙瘤发生牙位牙埋伏阻生12例.结论 牙瘤多发现于青少年,女性患者多见;患者多为出现牙列不齐、牙齿迟萌、发病区域疼痛等临床症状时摄片检查发现,少部分患者常规影像检查时意外发现.牙瘤的发生位置多位于前牙区,其中尖牙位、切牙位居多,并常常伴有尖牙、切牙埋伏阻生;其中组合型牙瘤较多见,囊性牙瘤相对少见.CBCT的广泛应用对于全面了解牙瘤的发病情况、临床表现和鉴别诊断具有重要的临床价值.

OBJECTIVE:To identify the role of LGALS3BP/Gal-3 in the process of human periodontal ligament stem cells (hPDLSCs) differentiating into osteoblasts.METHODS:IP-WB experiments were carried out to examine the binding of LGALS3BP and Gal-3. Western blot was performed to detect the expressions of LGALS3BP and Gal-3 in hPDLSCs with or without osteogenic differentiation inducement. The expressions of differentiation-related Oct4, Sox2 and Runx2 were also detected by western blot. Alkaline Phosphatase (ALP) Assay Kit was used to measure ALP activity in hPDLSCs. The mineralization ability of hPDLSCs was observed by staining with Alizarin Red S solution.RESULTS:LGALS3BP bound with Gal-3 in hPDLSCs, and the expression of LGALS3BP and Gal-3 was improved after osteogenic differentiation of hPDLSCs. Recombinant GAL-3 promoted the expression of differentiation-related proteins Oct4 and Sox2 and Runx2 in osteogenic differentiation-induced hPDLSCs. Recombinant GAL-3 also promoted the differentiation of osteogenesis-induced hPDLSCs. Furthermore, LGALS3BP had a facilitating effect on differentiation-related protein expression, while it could be reversed by shGal-3. LGALS3BP also promoted osteogenic capacity of hPDLSCs, and shGal-3 could reverse this effect.CONCLUSION:LGALS3BP binds to Gal-3, producing a promoting effect on the osteogenic differentiation of human periodontal ligament stem cells.

目的:探讨3D手术导板配合CBCT三维影像用于种植牙的临床价值.方法:回顾性分析于2015年1月—2018年12月间行种植牙手术的38例患者临床资料,所有患者均完善术前检查,依据CBCT三维影像学结果设计模拟种植牙手术方案,在3D手术导板引导下实施种植牙手术,术后复查CBCT,将术前设计模拟手术方案与术后影像对比,测量角度误差.结果:术前应用CBCT三维影像学设计模拟手术方案,术中配合3D手术导板应用于种植牙手术,对比术后种植体角度同模拟手术种植体角度的误差,结果无统计学差异.结论:3D手术导板配合CBCT三维影像用于种植牙手术效果显著,操作简便,创伤小,患者不适感降低,值得临床推广应用.

为提高对下颌尖牙迁徙性阻生的临床认识,本文报告5例患者6颗下颌尖牙迁徙性阻生的CBCT影像学资料,对其影像学表现进行分析讨论.5例患者中男1例,女4例,年龄13～24岁.CBCT影像学资料显示多数尖牙呈水平状横卧于下颌骨体内,其中1例患者双侧下颌尖牙迁徙性阻生,其余4例患者单侧下颌尖牙迁徙性阻生.CBCT的应用对于全面了解下颌尖牙迁徙性阻生的发病情况、临床表现和鉴别诊断具有重要的临床价值.

目的 比较根管再治疗和水激光对乳牙非牙根稳定期根管治疗后复发处理的疗效.方法 对56例7～9.2岁(平均8.3岁)患者的60颗患牙进行过常规乳牙根管治疗,观察1个月后行预成冠修复后根尖再次出现肿胀,摄X线片未发现明显根管欠填和超填现象的第二乳磨牙,其中30颗患牙进行根管再治疗,另外30颗用水激光处理(随机),处理完1周和3年之内每3个月复查1次.结果 进行根管再治疗的30颗患牙有16颗肿胀在1周内完全消除,且在半年内未出现复发,用水激光处理的30颗患牙有28颗肿胀在1周内完全消除,且在3年内未出现复发.两组效果比较差异显著(P<0.05).结论 水激光技术对于处于非牙根稳定期的已行较完善乳牙根管治疗后复发的病例有很好的疗效.

目的 探讨他克莫司及丙酸氯倍他索治疗口腔扁平苔藓的短期疗效及安全性.方法 选取2015年6月～2016年3月就诊于昆明医学院附属延安医院口腔粘膜病专科门诊的口腔扁平苔藓患者30例作为研究对象,将其随机分为两组,分别采用0.1％他克莫司及0.05％丙酸氯倍他索乳膏进行治疗.利用口腔扁平苔藓REU评分系统及疼痛直观模拟标尺(VAS)对比各组治疗后第2周及第6周的疗效.结果 两组患者治疗后口腔扁平苔藓REU评分及疼痛值较治疗前均显著减少,差异有统计学意义(P＜0.05).两种药物对口腔扁平苔藓的治疗疗效比较,差异无统计学意义(P＞0.05).治疗期间丙酸氯倍他索组4例患者、他克莫司组1例患者出现了不良副反应.结论 丙酸氯倍他索及他克莫司对于减轻OLP患者病损区疼痛、减少粘膜病损数量及范围均拥有值得肯定的短期疗效.他克莫司长期治疗OLP的安全性,值得进一步深入研究.

探讨柳传志环(PDF环)结合"以病例为引导"的教学法(CBL教学法)在牙槽外科临床带教中的应用设计及其可行性,选择埋伏牙拔除术为经典案例,采用PDF环结合CBL教学法进行操作培训,分解PDF环能够应用于临床实习带教的所有步骤,两者的完美结合能够明显提高临床实习医师的自我学习能力,临床思维能力及实践操作能力.

This study aims to investigate the clinical features and treatment of mandibular impacted canines. From May 2013 to May 2018, 11 patients with mandibular impacted canines and complete imaging and records were recruited in the study. The 11 patients had a total of 14 impacted teeth. The study aimed to analyze the incidence, treatment methods, and results of mandibular impacted canines in both genders, as well as the occurrence of complications. Of the 11 patients, 3 were male and 8 were female. Among them, 3 patients had bilateral mandibular impacted canines. One patient had 4 impacted canines in the upper and lower mandibles. Among the 14 teeth, 7 were found to have migratory impacts, 3 were accompanied by dental cysts, and 1 was accompanied by cystic sarcoma. All the teeth were removed by bone expose. Mandibular impacted canines are more common in women. Generally, the position is deep, and some are horizontal. They are prone to migration and can be associated with various periodontal diseases.

目的 系统性评价芦荟治疗口腔黏膜病的有效性及安全性.方法 使用计算机文献检索确定所有以这为主题的已发表的文章.使用特定的关键字用PubMed、Cochrane、Database、Embase、Cbm、Cnki、万方和维普数据库,检索建库至2017年5月收录的关于芦荟治疗口腔黏膜病的随机对照实验(randomized controlled trials,RCT).由两名研究人员使用Cochrane Reviewer Hand booker 5.1系统分别独立进行文献筛选和质量评价.结果 25项研究符合纳入标准.临床诊断为口腔黏膜病变的研究样本患者人群从20例到120例.25项研究中包括5项口腔扁平苔藓(oral lichen planus,OLP)、6项口腔黏膜下纤维化(oral submucous fibrosis,OSMF)、8项口腔溃疡(oral ulcer)、3项放射性口腔黏膜炎(radioaction oral mucositis),其他研究为灼口综合征(burning mouth syndrome,BMS)、义齿性口炎(denture stomatitis)和口干(xerostomic).大多数研究表明,芦荟治疗口腔疾病的有效性具有显著的统计学意义,且未发现有任何不良反应.结论 芦荟治疗口腔黏膜病虽然有一定的效果,但仍需扩大临床对照试验来证明芦荟在口腔黏膜疾病治疗中的有效性及安全性.

目的 探讨并介绍高频电刀(high-frequency mono-polar electronic scalpel,HMES)在婴幼儿舌系带过短矫正术中的应用及效果评价.方法 2014年1月至2015年12月间,对246例1～36月龄舌系带过短患儿采用高频电刀行舌系带过短矫正术.结果 246例患儿均顺利完成手术,术后无1例感染及出血,切口均一期愈合良好.结论 高频电刀对对软组织具有良好的切割能力和止血效果,术中手术视野清晰、创伤小、止血快、出血少,手术精确度高,高频电刀在婴幼儿舌系带过短矫正术中可显著缩短手术时间,降低术后并发症,是安全、有效的手术方法,应用效果较好.

PURPOSE:To investigate the efficacy and mechanism of mandibular advancement device (MAD) treatment on obstructive sleep apnea syndrome (OSAS) patients.METHODS:Eighty OSAS patients treated with a mandibular protraction appliance were included in the study. Three-dimensional reconstruction technique was used as to measure the changes of upper airway structure and volume before and after MAD treatment. The data was analyzed using SPSS 17.0 software package.RESULTS:The anatomic structure and the reinforcement of soft tissue's collapse in the upper airway changed after application of MAD in OSAS patients; velopharyngeal and laryngopharynx configuration was significantly increased (P<0.01), while oropharyngeal configuration was significantly decreased (P<0.05).CONCLUSIONS:This study demonstrated that pathogeny of OSAS based on morphological characteristics may be removed by mandibular advancement device, the mechanism of efficacy of MAD treatment can be the reduction of airway internal fluctuation and vortex of air.

上颌尖牙埋伏阻生在临床上最为常见[1，2]，其临床表现为错颌畸形、恒牙迟萌、乳牙滞留、牙弓塌陷、邻牙倾斜，部分患牙甚至形成含牙囊肿、感染及邻牙牙根吸收等[3~5]，不仅对患者的美观和功能造成影响，甚至导致心理问题，所以应及时诊断和正确处理埋伏牙[6]。对一些需要拔除的骨埋伏阻生尖牙，其复杂多变的牙体发育畸形及毗邻解剖关系使得拔除手术存在着较大风险。现对我科2013年5月~2014年4月行微创拔除术的11例上颌骨埋伏阻生尖牙患者临床资料进行回顾性分析，旨在明确骨埋伏阻生尖牙的位置和毗邻关系，选择最佳手术路径，现报道如下。

双生牙属于双牙畸形的一种,临床上同融合牙不易区分, 其发病情况缺乏完整统计资料,我们较全面地检索了有关双生牙的国内中文文献,结合我科诊治的1例病例进行分析讨论,以提高对双生牙的发病情况、临床表现和鉴别诊断的认识.

目的 对比研究方丝弓托槽和金属牙弓夹板固定术对外伤性前牙松动脱位的临床疗效.方法 79例患者一共96颗患牙外伤性松动脱位,随机将患者分为两组,A组:用方丝弓托槽固定46颗牙;B组:金属牙弓夹板固定50颗牙.两组患者随访3个月,评估疗效.结果 两组牙周固定术的总有效率比较差异有统计学意义(P＜0.05).方丝弓托槽组治疗前、治疗后牙周指数比较差异无统计学意义(P＞0.05),牙弓夹板组治疗前、治疗后牙周指数比较差异有统计学意义(P＜0.05),两组治疗后牙周指数比较差异有统计学意义(P＜0.05).结论 方丝弓托槽固定法操作简单,固定更牢靠,易于清洁,对牙周组织损伤较小,获得非常好的临床疗效.

Objective To approach the type and differential diagnosis of neoplasms of lymphoid origin from parotid gland so as to guide clinical treatment. Methods The clinical data of 31 patients were studied retrospectively,and relevant literature review was taken. Results The 31 cases included 18 cases of benign tumor,5 cases of cystic lesions, 4 cases of lymphadenitis,4 cases of lymphoma. Conclusion Source of parotid neoplasms lymphatic disease varied in clinical manifestations ,a variety of preoperative imaging could be used for the diagnosis, intraoperative frozen for guide of surgery,and to choose the right surgical procedures.