Root fractures often occur in immature maxillary permanent central incisors and can be combined with other injuries, making treating more difficult and prognosis uncertain. A 10-year-old girl sustaining a second dental trauma came to our hospital. Teeth 11 and 21 experienced root fracture following the first injury 15 months earlier. The second injury resulted in lateral luxation of the coronal fragment of Tooth 11 from the original fracture site and subluxation of Tooth 21. Tooth 11 was repositioned, and both Teeth 11 and 21 were splinted for 3 months. An apical plug was applied to Tooth 21 at 52 months. After 8 years of follow-up, complete resorption was observed in the apical fragment of Tooth 11, and both teeth exhibited a favourable prognosis. It illustrates that complex root fractures sustaining two separate traumatic incidents can have a positive long-term outcome through accurately judging and grasping the timing of sequential treatment.

Ectopic eruption of the first permanent molars is a local eruption disturbance. The frequency of ectopically erupted first permanent molars is predominant in boys and primarily affects the maxilla. Interceptive treatment for irreversible ectopic eruptions should be initiated early to prevent space loss and the impaction of the second premolars. Herein, we report the case of a six-year-old girl with irreversible ectopic eruption of the bilateral mandibular first permanent molarstreated with a modified lingual arch. The mandibular first permanent molars were successfully distalised after six months of treatment, and one year of follow-up showed a satisfactory outcome. The modified lingual arch satisfies not only the clinical aspects of treatment but also the patient's well-being. However, the lingual arch may disturb tooth eruption in the mixed dentition stage.

目的:上颌乳磨牙形态较复杂且不易获得完整标本,本研究通过锥束CT研究上颌乳磨牙牙冠、髓腔、牙根的形态,为临床儿童牙体牙髓病的诊疗提供参考.材料和方法:共测量217颗上颌乳磨牙,包括104颗上颌第一乳磨牙,113颗上颌第二乳磨牙.所有CBCT图像,在轴向、矢状和冠状平面进行了分析.记录乳磨牙从牙冠到牙根的各种参数,如髓顶的厚度、髓底的厚度、牙根根数及根数对根管类型进行了研究.结果:上颌乳磨牙腭根最长,上颌乳磨牙一根一根管的发生率多于一根多根管.讨论:上颌乳磨牙并不是简单上颌恒磨牙的缩小版,在牙体牙髓病治疗时需仔细探查.

第四次全国口腔健康流行病学调查显示,5 岁儿童患龋率达 70.9％,充填率仅4.1％,我国儿童龋病情况较为严峻而且儿童患龋情况呈现上升趋势,2016 年浙江省口腔健康现况调查结果显示3-5 岁儿童患龋率为70.81％,但是我国儿童口腔医生非常缺乏.

BACKGROUND Several previous studies have reported an unusual root formation in which a fractured apical fragment of an immature root continued to develop independent of the main root after trauma to an immature tooth. To date, there have been only rare reports of the continuing apical formation of the fractured root associated with dens evaginatus (DE). This paper presents a case of a separated root tip formation associated with a fractured tubercle of DE. CASE SUMMARY An 11-year-old boy was referred for gingival sinus on the buccal side of the right mandibular second premolar (tooth # 45). Clinically, tooth # 45 was free of caries, but there was a sign of a fractured tubercle of DE on the occlusal surface. Radiography showed that the root canal of tooth # 45 was widely radiolucent. A separated root apex was found apically under the main root and was nearly completely formed with an apical orifice at the apical tip. Tooth # 45 was diagnosed as tubular fracture of DE with chronic apical periodontitis. A revascularization technique was recommended to treat the tooth. At 3-mo and 1-yr follow-up, the patient remained asymptomatic. Periapical radiography revealed that the separated root tip distally drifted with closure of the apex. However, the root length and thickness of the main root did not increased. CONCLUSION Clinicians should be aware that even if tubercle of DE is fractured in an immature tooth, the root tip may be separated from the main root and completely formed.

口腔黏膜科是口腔全科住院医师规范化培训的亚专科之一,黏膜病病种繁多且多病因不明、临床表现复杂、病损形态多样易混淆,且诸多黏膜病与全身状况及心理社会因素相关,治疗上往往也具有同病异治、异病同治、缺乏特效药、病情易反复且难以治愈等特点,这些特点无一不增加了临床教学的难度.采用多元化教学模式,综合多种教学方式的优点应用于口腔黏膜病学住院医师规范化培训中,充分调动住院医师自主学习的积极性,不仅提高了临床技能,同时提高了住院医师的临床思维辨识能力及教学能力.

目的:评价思维导图教学法在儿童口腔临床带教的应用效果.方法:选择2018年1月-12月入我院儿童口腔科轮转的40名学员,随机分为实验组(n=20)和对照组(n=20),对照组采用传统带教方法,实验组采用思维导图辅助教学.两组学员轮转前后均进行考试,轮转结束后对学员进行访谈.结果:两组学员在轮转前的成绩无显著性差异.轮转结束后,两组学员的成绩均有提高,实验组学员成绩提高相对较多,但无显著性差异.访谈结果表明,实验组学员对学习展现更高的积极性,并对教学方式更加认可.结论:思维导图能提高学员对教学内容的记忆与掌握,提高学习积极性,为临床带教提供新的教学思路与方法.

Objective To compare the clinical effect and patient satisfaction between reattachment of permanent anterior teeth using dual-cured resin and esthetic light-cured resin in crown fracture permanent anterior teeth.Methods180 crown fracture permanent anterior teeth of 148 patients were divided into two groups. In experimental group, 82 permanent anterior teeth, which had intact incisal edge segments, were reattached by dual-cured resin. In control group, 98 permanent anterior teeth, which segment were lost, were restored with esthetic light-cured resin. Cases were assessed clinically by two year's followed up.Results The success rate was 64.86% in experimental group and 54.54% in control group after two year's follow up(P<0.05) .The patient satisfaction was 8.65±1.31 in experimental group and 6.98±1.45 in control group after two year's follow up(P<0.05).Conclusion The clinical effect of reattachment with dual-cured resin to treat anterior crown fracture is superior to restore with esthetic light-cured resin.

目的:对氟保护漆预防低龄幼儿龋齿的临床效果进行评价.方法:选取2014年1月至12月至儿童口腔科就诊的220名3岁儿童为研究对象,随机分成试验组和对照组,其中试验组115名儿童接受口腔健康教育及半年一次涂0.1%氟保护漆,对照组105名儿童仅接受口腔健康教育,试验前及1年后均进行口腔检查,记录患龋率、龋均,对防龋效果进行比较分析.结果:试验前,两组的患龋率和龋均无显著性差异(P>0.05).1年后复查,试验组的患龋率和龋均均显著低于对照组(P<0.05).结论:氟保护漆具有明显的预防低龄幼儿龋齿的作用,值得推广.

目的：解决口腔窝沟封闭管理信息化业务问题，实现卫生部门和教育部门信息联动，提高口腔医生工作效率和医疗质量水平。方法通过对口腔窝沟封闭业务需求分析，编写设计方案，采用面向对象、基于开源Spring 2．0框架和MVC模式等设计思想和技术原理，开发适龄儿童窝沟封闭管理信息系统。结果适龄儿童窝沟封闭管理信息系统的设计与开发，实现了窝沟封闭业务的信息化管理，优化了业务流程，提高了工作效率。结论适龄儿童窝沟封闭管理信息系统操作简单，具有人性化和智能化特点，在浙江省推广应用，可极大地提高窝沟封闭业务管理水平。

目的：评价MRC矫治器对治疗儿童口腔不良习惯的临床效果。方法：采用MRC矫治器对30例儿童口腔不良习惯患者进行治疗，每月复查记录MRC戴用情况，观察其疗效，半年后评价治疗结果。结果：30例患者中，有效25例（83．3％），患者纠正不良习惯，咬合关系改善；无效3例（10．0％），患者未纠正口腔不良习惯；2例失访（6．7％），患者未及时复诊，无法评价效果。结论：MRC矫治器治疗儿童口腔不良习惯有效率高，值得推广。

畸形中央尖是一种牙体形态发育畸形,口腔中表现为牙齿(牙合)面颊舌尖中间或接近中央窝的颊尖三角嵴上突出一圆锥状的额外牙尖,最多出现于下颌第二前磨牙,偶发于上颌前磨牙或上颌第二磨牙[1],多呈对称性分布,50％中央尖有髓角伸入[2].畸形中央尖的发生是由于在牙胚发育期间牙乳头在中央窝处向成釉器突起而形成牙尖畸形,影响因素包括牙胚生长发育时期的遗传因素和外来因素等.其发生率为1％～5％[3],女性高于男性.

上颌第一恒磨牙位于牙弓后段,髓腔解剖结构复杂,根管治疗难度大,其根管治疗的失败往往由于近中颊根第二根管(MB2)的漏治引起[1].因此,了解上颌第一磨牙近中颊根根管系统的复杂性是根管治疗成功的关键[2-4].目前国内外已有许多关于上颌第一磨牙近中颊侧根管根管形态学的体内外研究[5-9],本文就其研究进展综述如下.

口腔环境中寄居了大量的微生物,目前常规采用一次性器械、高效消毒和无菌技术等方法来减少和预防口腔治疗过程中病原体传播.口腔修复科的牙体预备过程,往往费时较久,长时间压缩水气对患者口腔的喷射,更易对诊室空气造成污染.目前,牙体预备前通常采用饮用水漱口来清洁口腔,而碘伏是口腔消毒的常规杀菌剂.为此,我们在牙体预备前采用饮用水漱口组、含漱液漱口及碘伏消毒3种方法进行口腔预防性清洁,观察诊室空气中细菌含量的变化,以期找出有效控制诊室空气污染的方法,为控制医源性交叉感染提供参考意见.