目的 探究米诺环素治疗糖尿病患者种植体周围感染中疗效及对炎症反应的控制作用.方法 将医院2016年11月-2017年11月期间收治的72例糖尿病患者种植体周围感染患者作为研究对象,随机分为常规治疗组(36例)以及米诺环素治疗组(36例).常规治疗组患者实施常规治疗,米诺环素治疗组则在常规治疗的基础上使用盐酸米诺环素软膏.在经过4周的治疗后,比较两组患者临床治疗效果、治疗前后牙周指数以及龈沟液炎性指标.结果 米诺环素治疗组患者临床治疗总有效情况(100.00％)、治愈情况(91.67％)明显高于常规治疗组,差异具有统计学意义(P＜0.05).两组患者治疗后龈沟出血指数、软组织指数、菌斑指数、白细胞介素(IL)-1β、IL-6以及肿瘤坏死因子(TNF)-α均有显著改善(P＜0.05),且米诺环素治疗组患者治疗后的龈沟出血指数、软组织指数、菌斑指数、IL-1β、IL-6以及TNF-α明显低于常规治疗组(P＜0.05).结论 在临床种植体周围感染治疗中使用盐酸米诺环素软膏具有良好的临床效果,同时也能较好地控制炎症反应,有效促进牙周组织恢复.

目的 了解2型糖尿病牙种植术后患者种植体周围龈下微生物菌群的变化.方法 选择2015年1月~2017年12月来本院口腔科种植中心就诊的种植体(均为单颗种植体)患者,选取其中患有2型糖尿病者为观察组,非糖尿病者为对照组,各30例.应用DNA聚合酶链反应法(PCR)法检测种植体周围龈下1个月、3个月、6个月微生物,临床检查包括检测牙菌斑指数(Plaque Index,PLI)、龈沟出血指数(Sulcus bleeding Index,SBI).结果 术后1个月、3个月、6个月两组PLI、SBI临床指标的数值均有不同程度增加;观察组的PLI、SBI术后1个月、3个月、6个月数值均明显高于对照组,差异均有统计学意义(P＜0.05).细菌类型以球菌与杆菌为主;比较术后1个月、3个月、6个月两组种植 体周围龈下细菌分布情况,发现两组检出的球菌、杆菌所占的比例均逐渐增加,而检出的梭状菌、螺旋体所占的比例逐渐减少,两组细菌比较差异有统计学意义(P＜0.05);两组弯曲菌、丝状菌所占比例差异无统计学意义.结论 2型糖尿病会对牙种植术后种植体周围龈下微生物造成影响,随时间变化球菌、杆菌所占的比例逐渐增加;梭状菌、螺旋体所占的比例逐渐减少.

Objective To explore the effects of dexamethasone spray combined with dental pulp stem cells on bone resorption and inflammatory factors in the treatment of peri-implantitis of diabetic mellitus (DM) Beagle dogs.Methods The model of DM Beagle dog was established with alloxan in eight healthy adult Beagle dogs.The dental pulp stem cells were isolated,and the model of peri-implantitis with DM Beagle dog was established.The 8 peri-implantitis of DM Beagle dogs were randomly divided into the control group and test A,B,C groups with 2 dogs per group.Control group was treated with 0.9％ NaCl spray 2 mL per time,tid + Bio-Gide mixture fihn + Bio-Oss bone powder covering treatment.On the basis of the control group,test A,B,C groups were respectively treated with dexamethasone spray,dental pulp stem cell suspension and dexamethasone spray + dental pulp stem cell suspension to instead of 0.9％ NaCl,and the rest of treatments were the same.Four groups were treated for 24 weeks.The changes of bone height at the proximal,distal and middle edge at twelfth,twenty-fourth weeks after operation were measured by X-ray examination.The expressions of tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) in gingival crevicular fluid were detected by enzyme linked immunosorbent assay (ELISA).Results 24 weeks after operation,the main indexes in control group and test A,B,C groups were compared:the changes of mesial marginal height were (-0.42-±0.14),(-0.36 ±0.12),(-0.29 ±0.11) and (-0.17 ±0.07) mm,the changes of distal marginal height were (-0.30 ±0.12),(-0.26±0.14),(-0.21 ± 0.11) and (-0.12 ± 0.09) mm,TNF-α were (82.72 ± 19.31),(68.26±14.60),(54.78 ± 14.43) and (42.51 ± 12.95) ng · L-1,IL-6 were (36.20 ± 8.14),(31.32 ±9.36),(26.85 ± 6.61) and (20.48 ± 5.24) ng · L-1.There were statistically significant differences between test C group and control group (all P ＜ 0.05).Conclusion Dexamethasone spray combined with dental pulp stem cells can effectively reduce the bone resorption and the levels of inflammatory factors.

PURPOSE:To evaluate the clinical outcome of sonic endo-instruments in combination with Mtwo Ni-Ti files in root canal preparation of molars.METHODS:One hundred patients (118 first molars, 428 root canals) were included in this study, they were randomly assigned into 2 groups (n=50).Group 1 was shaped with sonic endo-instruments in combination with Mtwo Ni-Ti files,while group 2 was treated with stainless-steel files, both groups were obturated with lateral condensation technique. The time of root canal shaping, acute post-operative pain, the quality of the root canal filling and the success rate after 1 year were recorded and analyzed using SPSS 11.0 software package.RESULTS:The average preparation time in group 1 was (5.3±0.6)min/canal and (12.7±0.9) min/canal in group 2 (t=100.89,P<0.001). The rate of acute postoperative pain was significantly lower X(2)=4.87, P<0.05,in group 1 (8.20%) than in group 2 (22.81%); in group 1, 92.86% root canals were filled adequately while only 78.92% in group 2, the difference was significant (X(2)=17.45, P<0.05);higher success rate (X(2)=3.95, P<0.05) after 1 year was achieved in group 1 (91.80%) compared with group 2 (78.95%).CONCLUSIONS:Compared with stainless-steel files, sonic endo instruments in combination with Mtwo Ni-Ti files in root canal preparation of molars seem more effective, cause less postoperative pain and offer higher success rates.

目的评价联合应用声波根管器械与手用ProTaper镍钛锉对磨牙进行根管预备的临床疗效。方法选取符合纳入标准的患者160例(第一磨牙169颗,共564个根管),按就诊顺序抽签随机分为两组各80例。观察组联合应用声波根管器械与手用ProTaper镍钛锉进行根管预备,对照组采用手用ProTaper镍钛锉进行根管预备。两组均采用冷侧压充填根管,观察根管预备时间、根管预备术后急症反应发生率、根管充填的恰填率及根充后1年复查的治疗成功率。结果观察组根管预备时间为(4.35±0.65)min/根,对照组为(8.51±0.63)min/根(t=77.02,P<0.01);观察组根管预备术后急症反应发生率3.70%,低于对照组(12.50%),差异有统计学意义(χ2=4.30,P<0.05);观察组根管恰填率为93.20%,对照组为86.67%(χ2=6.71,P<0.01);根充后1年复查的痊愈率观察组为92.59%,对照组为81.82%(χ2=4.32,P<0.05)。结论联合应用声波根管器械与手用ProTaper镍钛锉预备根管高效省时、减少根管预备术后疼痛反应、提高了根充效果及根管治疗成功率,值得临床推广。

目的探讨微波热凝治疗牙本质过敏症的疗效。方法将我科2008年2月至2009年2月就诊的牙本质过敏症患者200例(560颗牙)随机分为观察组和对照组各100例,观察组采用微波热凝治疗,对照组采用极固宁脱敏剂治疗,对治疗后即刻及6个月的疗效进行评价。结果观察组治疗有效率显著高于对照组。结论应用微波热凝治疗牙本质过敏症操作简单、安全有效,是一种理想的治疗方法。

目的观察微波治疗难治性慢性根尖周炎的临床疗效。方法将符合纳入标准的难治性慢性根尖周炎患者160例按就诊顺序抽签随机分为两组各80例。观察组采用微波根管消毒后立即根管充填治疗,对照组采用氢氧化钙封药1周无症状后再行根管充填,观察两组1年后的远期疗效。结果观察组和对照组的成功率分别为96.3%和85%,差异有统计学意义(P<0.05)。结论采用微波治疗安全有效、操作简单、缩短就诊时间,是一种有效的治疗方法。

目的探讨高金合金、钴铬合金烤瓷冠对牙龈健康的影响。方法分别制作高金合金、钴铬合金烤瓷冠各48个(共96个)。在烤瓷冠完成时和复查时,临床检查烤瓷冠的边缘密合度、颈缘染色和患牙的菌斑指数(PLI)、牙龈指数(GI)、龈沟出血指数(SBI),观察时间2年。结果高金合金烤瓷冠无颈缘染色,在边缘密合度方面优于钴铬合金烤瓷冠(P<0.05);患牙的牙龈指数、龈沟出血指数均低于钴铬合金烤瓷冠(P<0.05);两组的菌斑指数无明显差异,均未见组织过敏反应发生。结论高金合金烤瓷冠对牙龈健康的影响低于钴铬合金烤瓷冠,具有更好的临床应用效果。

牙龈瘤是口腔科日常门诊比较多见的一种疾病,好发于青年人及中年人,女性明显多于男性.牙龈瘤来源于牙周膜及颌骨牙槽突的结缔组织,虽非真性肿瘤,不具备肿瘤的特有结构,但有肿瘤外形和易复发的生物学特征[1].