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口腔颌面修复学杂志

口腔颌面修复学杂志

CSTPCD

Chinese Journal of Prosthodontics
本刊为首都医科大学附属北京口腔医院与解放军总医院联合主办的口腔修复专业学术期刊，为季刊，面向全国发行。是国内第一本关于口腔修复学的专业性杂志。栏目包括：颞下颌关节研究、口腔生物力学研究、种植义齿研究、烤瓷修复、固定义齿修复、总义齿修复、可摘局部义齿修复、修复前正畸、修复前外科、颌骨缺损修复、面部缺损修复、牙体缺损修复、修复技术、口腔修复心理、修复材料、专题讲座等栏目。
  • 发文量：2335
  • 被引量：637
  • H指数：1
  • 开始收录时间：2000,1(1)
  • CNKI综合因子：0.623
  • 维普期刊影响因子： 1.11
  • 万方期刊影响因子：1.16
  • 创刊时间：1999
  • 国内刊号/CN：11-4424/R
    国际刊号/ISSN：1009-3761
  • 发行周期：双月刊
    邮发代号：2-424
  • 主管单位：北京市卫生局
    主办单位：首都医科大学附属北京口腔医院 解放军总医院
口腔颌面修复学杂志-联系信息
  • 主编：刘洪臣
  • 电话：010-57099046
  • 邮箱：kqhmxfxzz@163.com
  • 地址：北京复兴路28号解放军总医院
  • 邮编：100853
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口腔颌面修复学杂志 >2024年第6期
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  • 摘要：miRNA是一种非编码小RNA.MiR-20a是miR-t7-92家族一员,位于13号染色体上,此家族的成员在组织和器官发育中具有重要作用,是脊椎动物发育所必须的.而miR-20a作为miR-17-92家族一员,其不仅是重要的癌基因,而且在干细胞增殖分化中也有重要作用,故本文主要对miR-20a对干细胞增殖,成骨分化及骨代谢的影响及机制做一综述.
  • 摘要：患者,女性,55岁。右下后牙部分牙组织劈裂两周,无疼痛。自述患牙多年前曾于外院行牙髓治疗。未曾进行修复治疗。现刷牙每日2次,每次2-3min,改良Bass刷牙法。使用牙线。患高血压病10余年,药物控制于120/80mm Hg;糖尿病10年,药物控制于空腹血糖6-7mmol/L。既往史、家族史无特殊。
  • 摘要：目前,基于计算机辅助设计与制造(computer-aided design/computer-aided manufacture,CAD/CAM)技术的数字化修复进入快速发展时期.多种口腔修复体已可通过数字化手段加工制作.随着种植技术和数字化技术的发展和进步,近年已有部分使用椅旁CAD/CAM数字化技术进行种植修复的报道.椅旁数字化修复系统以天然牙修复起步,至今已有30余年的历史.而将椅旁数字化技术用于种植修复则是近年来国际种植专业研究的热点,种植修复体的椅旁数字化实现同样是数字化加工技术的突破性进展.本文就椅旁数字化种植修复历史、应用现状及未来发展方向进行综述.
  • 摘要：釉珠的发生起因于一小团错位的成釉细胞或由于上皮根鞘的一小团上皮异常分化再度出现成釉功能而形成釉珠。在显微镜下观察,常见的釉珠完全为釉质所构成,釉珠基底直接附丽在牙本质上。有的釉珠包含牙本质,但含有牙髓者甚为罕见。
  • 摘要：目的:研究P物质对ST2细胞增殖和成骨分化的影响.方法:培养ST2细胞,加入1×10∧-10,1×10∧-8,1×10∧-6,1×10∧-5moL/L不同浓度的P物质,培养3d,分别在24、48、72h收获细胞,进行cck8检测,比较ST2细胞的增殖活性;成骨诱导培养ST2细胞,分实验组和对照组分别加入1×10∧-6moL/L浓度的P物质和未加P物质,在1、3、5、7d分别收获细胞,进行ALP的免疫荧光检测,ALP和Col I的ELISA检测,分析分化过程中的ALP和Col I蛋白表达.结果:CCK-8结果显示:P物质在24h时,除1×10∧-6及1×10∧-8浓度组外其他组与对照组之间对ST2细胞增殖作用无统计学差异;48h及72h不同浓度P物质对ST2细胞增殖活性均有促进作用,1×10∧-6及1×1 0∧-8浓度的促进作用与对照组相比有显著差异(P＜0.01),其中1×10∧-6的作用效果最强;随时间变化,增殖作用增强,且各时间组间具有统计学差异.ELISA及免疫荧光显示,ALP和Col I蛋白水平随时间递增,且实验组大于对照组(P＜0.05).结论:P物质能促进ST2细胞的增殖,并在一定条件下促进ST2的成骨分化,具有一定的浓度和时间的相关性.
  • 摘要：Er∶YAG激光作为一种有效切割牙体硬组织的新型激光,在口腔医学领域应用广泛,具有微创、舒适、安全等特点,研究较多的领域有:龋病、牙本质过敏症、硬组织表面处理、根管治疗、牙周病、牙齿漂白等,且有着较高应用前景.本文就Er∶ YAG激光在牙体组织中的硬组织部分的应用进展作一综述.
  • 摘要：目的:评估上颌窦内提升术(OSFE)联合短种植体修复上颌后牙区时植骨或不植骨的短期临床疗效.方法:上颌后牙缺失剩余骨高度不足(4-7mm)的患者30例,行上颌窦内提升术联合8mm长的种植体植入,同期植入无机牛骨(对照组)或不植骨(实验组),愈合3个月后完成修复.分别在术后当天、术后3、6、12个月进行随访,测量种植体稳定性及CBCT影像学检查种植体周围骨水平变化.结果:36枚种植体(实验组17,对照组19枚)植入平均剩余骨高度在实验组和对照组中分别为5.01±0.92和4.91±0.79mm(P＞0.05),术后平均提升高度为3.46±0.97(实验组)和5.13±1.25mm(对照组)(P＜0.01).1年后两组种植体的存留率分别为100％和94.7％(P＞0.05),窦底新骨形成高度在实验组与对照组分别为2.72±0.96和4.57±0.77mm(P＜0.01),所有种植体均获得了较好的稳定性且两组间差异无统计学意义(P＞0.05).义齿负载后的随访中,两组种植体周围骨吸收量差异均无统计学意义(P＞0.05).结论:通过短期随访观察,上颌窦内提升术联合短种植体植入时植骨或不植骨均可取得理想的修复效果.
  • 摘要：目的:介绍一种自配方二硅酸锂玻璃陶瓷的制备方法并测试其理化性能,为开发国产牙科二硅酸锂玻璃陶瓷建立基础.方法:选择锂铝硅酸盐(Li2O-Al2O3-SiO2)为玻璃的基质成分,通过熔融法制得玻璃样品,根据ISO6872标准对实验玻璃陶瓷进行晶相检测;通过三点弯曲法测定玻璃陶瓷的抗弯强度;通过失重法测试样品的乙酸溶解值;通过扫描电镜观察其显微结构.结果:本实验通过熔融法研制了以二硅酸锂(Li2Si2O5)为主晶相的玻璃陶瓷,其抗弯强度为181MPa,乙酸溶解值为41 μg· cm-2.SEM结果显示试样为以棒状晶体为主的多晶形形貌.晶形形貌不够理想,散在分布的球形晶体对抗弯强度有一定影响,但主要晶形仍为有互锁作用的棒状晶体.结论:实验玻璃陶瓷的抗弯强度满足ISO6872标准对牙科陶瓷的基本要求但不足以用于固定桥和后牙单冠的修复,乙酸溶解值可满足临床需求.
  • 摘要：目的:观察SDF-1在大鼠颞下颌关节骨关节炎中的表达以及其与MMP-13、IL-1 β和P38MAPK的相关性.方法:48只wistar大鼠随机分为对照组、模型组、高浓度抑制剂组和低浓度抑制剂组,采用关节腔注射碘乙酸钠溶液建立大鼠TMJOA模型.抑制剂组大鼠在建模后分别注射0.1μg/μL及1μg/μL SDF-1/CXCR4信号轴抑制剂AMD3100.后处死各组大鼠,取双侧颞下颌关节组织进行HE染色、番红固绿染色(S.O)以评价关节炎症水平;通过RT-PCR及免疫组化检测MMP-13、IL-1 β的表达量;通过免疫组化染色检测p38MAPK.结果:对照组、高浓度抑制剂组、低浓度抑制剂组及模型组组织评分为:0.75±0.43、5±0.71、8±0.71、11.5±0.5.p-p38表达量为:(14.3±2.2)％、(41.5±2.2)％、(60.0±3.8)％、(74.9±3.5)％.IL-1 β表达量为(12.8±1.0)％、(40.1±2.3)％、(64.2±4.4)％、(81.2±3.5)％;IL-1 β mRNA为0.97±0.11、3.38±0.48、5.03±0.23、6.35±0.35.MMP-13表达量为(13.2±1.2)％、(38.2±2.3)％、(62.1±3.3)％、(80.9±3.0)％;MMP-13mRNA为0.96±0.18、2.54±0.41、5.24±0.45、6.31±0.35.对照组及模型组中SDF-1表达量为(26.1±3.2)％、(75.2±4.5)％;SDF-lmRNA为1.02±0.14、6.26±0.45.结果表明,随抑制剂剂量增加,关节炎症水平明显降低,MMP-13、IL-1β、p38MAPK表达量显著下调(P＜0.05).结论:SDF-1在颞下颌关节骨关节病的作用与促进MMP-13及IL-1 β的表达和p38MAPK通路的激活相关.
  • 摘要：目的:研究在制取口腔印模前,多媒体辅助的医患信息交流方式对患者理解程度的影响.方法:将符合纳入标准的120名患者随机分为对照组、视频组、图片组三组:对照组采用统一录制的音频资料向患者讲解口腔印模的相关知识;视频组和图片组在同样音频资料的基础上,分别采用视频或图片向患者传递口腔印模相关知识.利用问卷作答及印模制取过程中患者的行为评估得分对实验效果进行定量分析,并通过电话随访对患者的认可度进行调查.结果采用SPSS 19.0软件对计量资料进行K-W检验,检验水准α=0.05.结果:视频和图片组中各有97.5％和87.5％的患者认为自己所接受的沟通方式良好,而对照组中只有42.5％的患者持同样看法.视频组的问卷及行为评估得分均显著高于其他两组(P＜0.05),图片组的问卷得分优于对照组(P＜0.05),但行为评估结果显示两组间差异无统计学意义(P＞0.05).结论:多媒体辅助的医患信息交流方式可促进患者对口腔印模的理解程度,增强信息传递的有效性,值得在临床工作中推广.
  • 摘要：目的:通过检测不同月龄大鼠相关成骨标志物及股骨Nfic因子的表达情况,探讨增龄对上述因子表达的影响.方法:分别选取6月龄,12月龄以及20月龄未交配SD大鼠雌雄各4只共计24只,采用双能骨密度测量法检测大鼠股骨远端骨密度;从心脏处取血并检测成骨标志物(AKP、BGP、SOD)指标;获取双侧后肢股骨行实时定量PCR(Q-PCR)获得Nfic、BGP、AKP基因mRNA的表达.结果:SD大鼠的骨密度在6月龄最高((x)=0.179g/cm2),12月龄期开始出现下降((x)=0.167g/cm2),20月龄大鼠的骨密度最低((x)=0.077g/cm2),6月龄年和12月龄大鼠差异无统计学意义,而两者和20月龄大鼠的统计学差异显著(P＜0.05);血清学检测显示,以BGP((x)=3.58ng/ul、(x)=2.30ng/ul、(x)=1.7 lng/ul)和AKP((x)=19.18金氏单位/100mL、(x)=14.58金氏单位/100mL、(x)=6.66金氏单位/100mL)以及SOD((x)=22.30U/ml、(x)=12.60U/ml、(x)=9.04U/ml)为代表的机体成骨细胞活性因子随着增龄的增加其活性逐渐降低(P＜0.05);Q-PCR结果显示,Nfic((x)=29.45、(x)=24.21、(x)=16.72)因子的表达趋势和成骨标志物表达趋势一致,随着增龄其表达逐渐降低(P＜0.05).结论:大鼠增龄性改变使得以AKP、BGP、SOD为代表的成骨活性标志物以及Nfic因子表达下降.
  • 摘要：经中国科协批准,由中国国际科技会议中心、解放军总医院口腔医学研究所等多家单位联合主承办的2016第八届中国国际美容医学大会,以及由中国整形美容协会口腔整形美容分会、中华口腔医学会口腔修复学专业委员会、中华口腔医学会口腔美学专业委员等共同举办的第一届北京国际口腔美容医学大会、
  • 摘要：Objective:To investigate the effects of the tilting angle and length of terminal implants of 6 implant-supported full dental arch by investigating the stress distribution on different implants,surrounding bone and framework with threedimensional finite element data.Methods:Six implants were employed to support a full-arch fixed prosthesis and five three-dimensional finite element models were established with CT images,based on the length (S and L) and distal tilt angle (0°,30° and 45°) of terminal implants for anedentulous mandible,which named:Tilt0-S,Tilt30-S,Tilt30-L,Tilt45-S and Tilt45-L.An oblique 240N was loaded at second molar.The VonMises Stresses were analyzed.The implants were consecutively named #1 to #6 from the loading point.Results:The stress of different implant sites had various changes.Compared with Tilt0-S group,#1 implant had the greatest stress on the implants,with the other groups exhibiting variable reductions;Tilt45-L demonstrated the greatest reduction in stress.#2 implant showed different degrees of increase.Tilt45-L had the least increase.#3 implant also had variable reductions.Tilt45-L demonstrated the greatest reduction.Tilt0-S had the greatest stress at bone around #1 implant neck,and Tilt45-L exhibited the least stress,which was a 36.3％ reduction compared to Tilt0-S.Compared withTilt0-S group,Tilt45-S and Tilt45-L exhibited the least stress in the framework.When the distal implant tilted 30°,Tilt30-S showed 1.7％ lower stress;Tilt30-L showed 8.5％ lower stress,which the greatest stress in the framework was found on the cantilevers distal to #1 implant.Conclusions:Matching different length and tilting angle of the terminal implants led to variable stress reductions on implants,bone and the superstructure.By optimizing implant configuration,the reduction of stress on implants and surrounding bone could be maximized.Under present conditions,If distal implant tilted 30 degrees,the same length with the front implant was better,If distal implant tilted 45 degrees,the longer implant was preferred configuration.More clinical test are needed.%目的:探讨6个种植体全牙弓固定修复时末端种植体倾斜角度和长度对种植体、周围骨界面及固定桥支架应力分布的影响.方法:用三维有限元方法建立五组下颌无牙颌修复设计模型.每组模型均为6个种植体,分别位于双侧侧切牙,第一前磨牙和第二前磨牙位置,前4个种植体相互平行,末端2个种植体根尖位于第二前磨牙位置,根据末端种植体远中倾斜角度及长度分为五组.将240N的力垂直加载于右侧第二前磨牙中央窝,分析记录每组模型各种植体和种植体周围骨界面的VonMises应力值.从加载侧起将种植体依次命名为1-6#.结果:1#末端种植体应力有不同程度降低,降幅依次为:Tilt45-L＞ Tilt30-S＞ Tilt30-L＞ Tilt45-S;2#种植体应力出现不同程度增加或维持不变;3#种植体应力出现不同程度降低.末端种植体倾斜后种植体周围骨组织应力发生不同程度的降低,降幅依次为Tilt45-L＞ Tilt30-S＞ Tilt45-S＞Tilt30-L.上部固定桥支架的应力,末端种植体倾斜45°时,种植体长度的影响不大;倾斜30°时,Tilt30-S组应力降低1.7％,Tilt30°-L组应力值降低8.5％.结论:从最大限度减小各部位应力角度考虑,末端种植体倾斜比平行更有利;倾斜角度和长度可能存在一个适合的匹配关系.本实验条件下,如果倾斜30°,应选择与前部相同长度的种植体;如果倾斜45°,加长种植体更有利.
  • 摘要：目的:评价铸瓷高嵌体修复根管治疗后牙的临床效果.方法:选择368例患者的397颗根管治疗后牙为观察对象,采用铸瓷高嵌体修复.由两位医师进行临床随访检查,根据改良美国公共卫生机构评价标准进行质量分级评估.结果:6-61个月的观察期内,3例修复体脱落,重新粘接后继续行使功能.6例修复体边缘嵴发生局部崩瓷,调磨抛光处理后,修复体未发生进一步的损坏.部分病例的修复体质量达到临床优良的等级,无临床不满意或差的病例.结论:铸瓷高嵌体可作为修复根管治疗后牙的一种可行的修复方式,并且在美学、生物学、功能学方面的性能优良.%Objective:To evaluate the clinical effect of all cast ceramic onlays on endodontically-treated posterior teeth.Methods:368 patients with 397 endodontically treated posterior teeth were restored with all cast ceramic onlays.Patients were recalled and examined by two clinicians.The quality of restoration was evaluated according to the modified US Public Health Service (USPHS) criteria.Results:The observation period ranged from 6 to 61 months.Three onlays debonded and were reinserted.six onlays chipping at the marginal ridge and were not further damaged.No cases of failure were observed at the end follow-up.For the most restorations,the quality rating was clinically excellent.No restoration was clinically unsatisfactory or poor.Conclusion:All cast ceramic onlay is a reliable method to restore endodontically-treated posterior teeth with good esthetic,biological,and functional performance.
  • 摘要：变形链球菌作为口腔中重要的致龋菌,主要通过识别细胞外的信号、调控自身基因表达以应对不断变化的口腔唾液环境.蛋白质组学揭示了群体感应系统及热休克蛋白系统在变链菌应对应激环境刺激中的重要作用.此外,应激条件下sRNA在转录后水平调控基因表达的作用也逐渐受到重视.%Streptococcus mutans (S.mutans) is the main clinical pathogen of dental caries that can adapt the change of oral saliva environment by gene expression regulated through extracellular signals.Under stress environment,the proteome studies reveal that quorum sensing and heat shock protein system play important roles.In addition,it was found that under the same situation,the regulation of gene expression by sRNA on the abnormal expression of the post transcription.This article reviews the several aspects mentioned above.
  • 摘要：微创医疗是随着医学模式的进步和转变产生的新兴医疗手段,通过先进的医疗设备与技能将手术等治疗的创伤最小化,在达到治疗目的的同时,减少治疗并发症,减轻患者痛苦.微创医疗是医学的基本理念,已渗透到各个学科专业.微创医学是研究微创医疗及其发生、发展规律以及新方法、新技术和新理论的新兴医学体系.本文在归纳总结介绍微创医疗与微创医学的的定义、专业概念、范畴、特点和发展的同时,重点介绍了口腔微创医疗,明确提出口腔微创医学的概念,分析了微创医学在口腔医学各个专科的应用,特别介绍了微创人工种植的应用,对微刨医学的各类手术和治疗手段在口腔医学领域的综合应用作了初步介绍,提出了口腔医师掌握微创医学理念和口腔微创医学理论及医疗手段的重要性.%Minimally invasive medical treatment was to minimize the trauma of surgery through advanced medical devices and methods.At the same time to achieve the purpose of treatment,it also reduced the treatment of complications and the pain of patients.Minimally invasive medical treatment was the basic concept of medicine.And penetrated into various disciplines.Minimally invasive medicine is a newly developing medical system for the research of minimally invasive medical treatment and its prospect,development rule and new method,new technology and new theory.In this paper,the definition,concept,category,characteristics and development of minimally invasive and minimally invasive medicine were summarized.Meanwhile,this paper focuses on the minimally invasive medical treatment was introduced emphatically introduced,and the concept of minimally invasive dentistry was explicitly proposed.The aim of this paper was to analyse preliminarily the application of minimally invasive medicine in stomatology.Specially,the application of minimally invasive dental implants was discussed.The paper presented the importance of the concept of minimally invasive medicine and minimally invasive medical theory and medical instruments for all kinds of operation and treatment methods of minimally invasive medicine,its importance was placed on dentists.At last,the comprehensive application of minimally invasive medicine in stomatology for all kinds of operation and treatment methods of minimally invasive medicine was preliminary introduced.
  • 摘要：Objective:To investigate the effects ofzoledronate on expression of Dlx-5 and Msx-1 in mandible and ilium of rats for a future study ofpathogenesis ofbisphosphonate-related osteonecrosis of the jaw.Methods:Twenty four 8 wk old female Sprague-Dawley rats were selected in this study.The rats of the experimental group (n=12) were injected intraperitoneally with zoledronic acid for 12 weeks,and those of the control group (n=12) were injected intraperitoneally with same amount of normal saline for 12 weeks.We use immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) to examine expression levels of Dlx-5 and Msx-1 in mandible and ilium samples.Results:The results of immunohistochemistry and RT-PCR showed that the expression of Dlx-5 at protein and gene level in mandible was increased in the experimental group compared with the control group (P＜ 0.01).The expression of Dlx-5 at protein and gene level in ilium was decreased compared with the control group (P＜0.05).The expression of Msx-1 at protein and gene level in mandible and ilium was decreased in the experimental group compared with the control group (P＜0.01).In the control group,expression level of Dlx-5 in mandible was decreased compared with ilium (P＜0.01).In the control group,expression level of Msx-1 in mandible was increased compared with ilium (P＜0.01).Conclusions:With treatment of zoledronate,there were site-specific differences of the altered tendency of Dlx-5 and Msx-1 expression in mandible and ilium of rats,indicating a certain restriction of bisphosphonate-related osteonecrosis to jaw bones.%目的:探讨唑来膦酸对远中缺失同源盒基因5(Distal-Less homeobox 5,Dlx-5)和肌节同源盒基因l(Msh homeobox 1,Msx-1)在大鼠下颌骨和髂骨表达水平的影响,以期为进一步研究双膦酸盐类药物导致颌骨骨坏死的致病机制提供理论基础.方法:选用24只8周龄雌性SD大鼠,实验组腹腔注射唑来膦酸持续12周,对照组腹腔注射等量生理盐水12周,采集下颌骨以及髂骨样本,应用免疫组化及RT-PCR检测大鼠上述两个部位Dlx-5和Msx-1在蛋白水平和基因水平的表达情况.结果:免疫组化及RT-PCR结果显示实验组中下颌骨Dlx-5的蛋白和基因表达水平均高于对照组(P＜0.01),髂骨Dlx-5的蛋白和基因表达水平低于对照组(P＜0.05),实验组中下颌骨和髂骨Msx-1的蛋白和基因表达水平均低于对照组(P＜0.01).对照组中与髂骨比较,下颌骨的Dlx-5基因表达水平降低(P＜0.01),下颌骨的Msx-1基因表达水平升高(P＜0.01).结论:在唑来膦酸作用下,大鼠下颌骨和髂骨Dlx-5和MSX-1的表达水平存在差异性变化.在一定程度上解释了双膦酸盐类药物导致颌骨骨坏死特异性发生于颌骨的原因.
  • 摘要：隧着计算机辅助设计与计算机辅助制作(CAD/CAM)的引入,口腔修复学正式跨入数字化时代.精良的印模是修复体制作的先决条件,因此精度是数字化印模成败的关键.本文综述了口腔数字化印模精度研究的进展,分析了影响精度的因素,证明了数字化印模技术在口腔修复领域的应用潜力.%With the introduction ofthe computer aided design and computer aided manufacture (CAD/CAM),prosthodontics enters into the digital era.Sophisticated impression is a prerequisite for the restoration of production.Therefore,the accuracy is the key to the success of digital impression.This article summarized accuracy of the oral digital impression and the influence factors,Proved the developmental potential of the digital impression technology in the field of dental prosthetics.
  • 摘要：目的:了解包头市患者戴用可摘局部义齿后的使用情况和基牙健康状况,为当地患者提供客观有效的口腔健康教育指导,为可摘局部义齿的制作、使用提供切实可行的人性化设计与建议.方法:选择内蒙古医科大学第四附属医院口腔科收治的198例可摘局部义齿修复患者,共228件义齿,戴用时间均满3年.失牙状况是根据kennedy牙列缺损分类法给予可摘局部义齿修复.其中肯氏Ⅰ类55例,肯氏Ⅱ类56例,肯氏Ⅲ类65例,肯氏Ⅳ类52例.对患者使用义齿3年后进行口腔检查,观察基牙的相关情况并对其进行分析研究.结果:所有牙列缺损患者均采用混合支持方式的义齿进行修复,三年后基牙患龋率10.82％,基牙牙周炎发生率为:肯氏Ⅰ类17.27％,肯氏Ⅱ类11.90％,肯氏Ⅲ类7.69％,肯氏Ⅳ类12.98％.结论:可摘义齿修复后基牙患龋率及牙周炎发生率均较高,从而影响了义齿的使用寿命及患者的生活质量.因此,应对其诱发的原因在修复初期就应采用相关预防和治疗的措施.从而延长可摘局部义齿使用寿命,改善患者生活质量.%Objective:To investigate the condition of abutment teeth of patients with removable partial dentures.Method:228 partial dentures from 198 patients during 2011 and 2013 in our hospital have been used for more than 3 years.55 patients are Kennedy Class Ⅰ,56 patients Kennedy Class Ⅱ,65 patients belong to Kennedy Class Ⅲ,and 52 patients Kennedy Class Ⅳ.We can inspect and analyze the relevant information of abutment after 3 years of use.Result:All the patients used a mixed re method,the abutment incidence of caries was 1 0.82％,the periodontitis was 17.27％ in ken's I,was 11.90％ in ken's]Ⅱ,was 7.69％ in ken's Ⅲ,was 12.98％ in ken's Ⅳ.Conclusion:The incidence of caries and periodontitis on abutment teeth increased after using removable partial denture.It is important to improve the removable partial denture in order to increase the quality of life.
  • 摘要：45-55岁围绝经期女性口干症的患病率在50％以上.口干症的发生与唾液腺功能障碍有关,唾液减少可造成口腔的自洁作用减弱,患龋风险随之升高,严重危害口腔健康.本文主要就围绝经期唾液腺的改变及口干的发生机制进行综述.%Oral dryness prevalence is more than 50％ in the 45 to 55-year-old perimenopausal women and often relates with the salivary dysfunction.Due to the dysfunction of the salivary glands,in perimenopausal women the immune function of oral cavity decreases and the risk of caries increases.It will threaten the oral health seriouly.This paper reviews the effect ofperimenopause in salivary glands and the mechanisms of oral dryness during perimenopause.
  • 摘要：目的:观察并评价牙周病患者前牙即刻种植的短期临床修复效果.方法:选择30例(32颗)因牙周病而拔除的前牙,在拔除后立即行即刻种植.分别于冠修复后的3个月、6个月、12个月对种植体的成功率、红色美学评分、牙龈乳头充盈指数、牙龈乳头近远中高度、种植体周骨吸收量进行比较并统计,评价其临床效果.结果:30位牙周炎患者共植入32枚种植体,冠修复后随访1年.共有2枚种植体松动脱落,成功率为93.75％.3个月、6个月、12个月时的美学评分差异无统计学意义(P＞0.05).牙龈乳头充盈指数3个月时(2.53±0.15)低于6个月时(2.97±0.21)和12个月时(2.88±0.72),差异有统计学意义(P＜0.05).冠修复3个月、6个月后,近远中龈乳头与修复体戴入即刻时相比,都略有增高,且前两者之间有统计学差异(P＜0.05).12个月时,牙龈乳头高度介于3个月与6个月前之间,差异有统计学意义(P＜0.05).冠修复3个月、6个月、12个月的骨吸收量无统计学差异(P＞0.05).结论:在完善系统的牙周治疗下,牙周病患者的即刻种植短期临床效果较理想,但长期效果尚待观察.%Objective:To evaluate the short-term clinical effects of immediate implant placement for anterior teeth of patients with periodontal disease.Methods:32 anterior teeth with periodontal disease were extracted,and then were performed implant immediately.Clinical parameters such as success rate,pink esthetic score,gingival papilla filling index,height of gingival papilla,and bone resorption around implants were evaluated in 3,6 and 12 months.Result:Success rate was 93.75％.There was no significant difference in pink esthetic score in 3,6 and 12months(P＞0.05).The gingival papilla filling index in 3 month was lower than that in 6 month and 12 month (P＜0.05).There was significant difference in height of gingival papilla in 3 month,6 month and 12 month(P＜0.05).There was no significant difference in bone resorption around implants in 3,6,12 month (P＞0.05).Conclusion:Immediate implant placement after complete periodontal therapy shows optimal outcomes in the short term studies,but further studies are needed for long-term effects.
  • 摘要：目的:探究直流微电场(DCEF)对炎症微环境下的大鼠骨髓间充质干细胞(rBMSCs)成骨分化作用的影响.方法:提取、培养及鉴定rBMSCs;以10mg/ml的TNF-α诱发细胞炎症反应,采用ELISA及实时定量PCR检测IL-1β及TNF-α的分泌量及基因表达;对正常rBMSCs(H-rBMSCs)组及炎症微环境下rBMSCs(H+cytokines)组加载DCEF,MTT法测生长曲线,茜素红染色及钙离子沉积量检测,实时定量PCR检测成骨基因BSP、OCN、Rumx2的表达,Western blot检测成骨蛋白ALP及Runx2的表达量.结果:H+cytokines组细胞IL-1β及TNF-α的分泌量均明显高于H-rBMSCs组(35.6±3.0比12.2±1.5;49.2±3.5比14.9±2.1,P＜0.05);H+cytokines组IL-1β及TNF-α基因表达水平分别是H-rBMSCs组2.5倍、2.2倍;H+cytokines+DCEF组及H-rBMSCs+DCEF组BSP、OCN、Runx2基因表达水平及ALP、Runx2蛋白表达水平分别高于H+cytokines组及H-rBMSCs(P＜0.05),H+cytokines+D CEF组部分成骨能力指标高于H-rBMSCs(ALP蛋白表达水平:0.95±0.08比0.43±0.04,Runx2蛋白表达水平:0.85±0.08比0.31±0.04;P＜0.05).结论:DCEF可促进炎症微环境下的rBMSCs增殖及成骨分化.%Objective:To investigate the effect of direct current electric field (DECF) on the osteogenic differentiation of rat bone marrow mesenchymal stem cells(rBMSCs) under inflammatory microenvironment.Methods:Rat tibia BMSCs were extracted,cultured and identified.The cell inflammatory response was induced by 10mg/ml TNF-α.Then,the secretions and the gene expression levels of IL-1β and TNF-α were measured by ELISA and real-time quantitative PCR.DCEF was loaded on healthy rBMSCs (H-rBMSCs) and rBMSCs under inflammatory microenvironment (H + cytokines),then the growth curves were measured by MTT method,the deposition amounts of calciumions were measured after alizarin red stained,the expressions of key osteogenic genes (BSP,OCN and Runx2) were detected by real-time quantitative PCR,the expressions of key osteogenic proteins (ALP and Runx2) were detected by Western blot.Results:The secretions of IL-1β and TNF-α in H+cytokines group were significantly higher than those in H-rBMSCs group.(35.6± 3.0 VS 12.2± 1.5,49.2± 3.5VS14.9± 2.1,P＜ 0.05) The expression levels of the two genes were 2.5 fold and 2.2 fold.(P＜ 0.05) The BSP,OCN,Runx2gene expression levels and ALP,Runx2 protein expression levels of H+cytokines+DCEF group and H-rBMSCs+DCEF group were significantly higher than those of H+cytokines group and H-rBMSCs group,respectively.(P＜0.05) Some of the osteogenic abilities of H+cytokines+DCEF group were stronger than those of H-rBMSCs.(ALP protein expression levels:0.95± 0.08 vs 0.43± 0.04,Runx2 protein expression levels:0.85± 0.08 vs 0.31± 0.04,P＜0.05) Conclusion:DCEF can promote proliferation and osteogenic differentiation of rBMSCs in inflammatory microenvironment.
  • 摘要：The development and formation of human tooth and bone tissue are derived from the differentiation of mesenchymal stem cells.Although their complexities are different,the tooth and bone are similar in the organizational structure and physical characteristics.The tooth and bone have some common characteristics on the basis of development.It has been demonstrated that nuclear factor I (nuclear factor I,NFI) family member C (Nfic),existing in the dental papilla mesenchymal cells,plays a critical role in the formation of the root dentin during the root development.Recent studies also have shown that Nfic plays an important role in the development of bone tissue,especially in the bone formation pathway,but its specific mechanism is still not completely clear.This article will preview the effect of Nfic on the regulation of root and bone development.%人体牙齿与骨组织的发育和形成均取决于间充质干细胞的分化,在众多信号通路的调控下形成最终的牙及骨.虽然二者的复杂程度不一,但牙齿和骨在组织结构和物理特性上都具有相似性,同时在发育基础上亦具有共通性.目前已证实,存在于牙乳头间充质细胞内的核因子I(nuclear factorI,NFI)家族成员C(Nfic),对牙根部牙本质形成起到关键的作用.而近些年的研究亦表明Nfic在骨组织发育的过程中同样起到非常重要的调控作用,尤其是在骨形成通路中发挥着不可替代的功能,但其具体机制仍不明确.本文就Nfic对牙根和骨发育调控作用的研究情况作一综述.
  • 摘要：Objective:To evaluate the effects of increased crown length on surrounding alveolar bone of implants when replacing missing teeth with severe bone loss and insufficient bone height,in order to restore optimal occlusal curve.Methods:After establishing a finite element model of the maxillary first molar,the clinical crown is obtained,and the models of four different kinds of crown models were simulated.The Straumann standard implants were created and simulated using Solidworks 12.0 software.The crown was restored and the stress analysis was performed using the Ansysl4.5 finite element analysis plug.The stress distribution in each condition was recorded with a vertical loading of 300N on the central pit of the crown or a oblique loading of 150N on the functional cusps of the crown.The statistical analysis was conducted on the difference crown length.Result:The stress peak of the cortical bone is mainly distributed on the implant cervical area,and the stress of the cancellous bone around the implant was in the implant cervical or root tip of the third of the area.The stress of the cortical bone under vertical or oblique loading was significantly higher than that of the cancellous bone,P＜0.05.Compared to the stress of the cortical bone under vertical or oblique loading,there were significant difference,P＜0.05,cancellous bone were no significant difference,P＞0.05.Compared to four kinds of crown length model,there were no significant difference,P＞0.05.Conclusion:The effect of oblique stress on bone is higher than that of vertical force when the implant is stressed.The increase of crown height shows no effect on the surrounding bone of the implant.%目的:临床上,在骨高度不足的缺牙区进行种植修复时,为保证正常的(牙合)曲线,冠高度增加明显,冠高度的增加是否会影响骨质吸收.方法:在建立上颌第一磨牙的有限元模型后,保留颈部以上部分,利用软件模拟出4种高度的牙冠模型.利用SolidWorks 12.0软件直接创建并模拟植入Straumann标准型种植体,完成牙冠修复,使用Ansysl4.5有限元分析插件对模型进行应力分析.针对这四种情况,分别在中央窝行垂直加载300N和功能尖斜向加载150N的力量,观察每种状态下种植体周围骨质的应力分布状况,同时利用统计学软件统计四组模型有无统计学差异.结果:各组种植体在垂直载荷下和斜向载荷下,种植体周围皮骨质应力峰值多集中在种植体颈部的区域,种植体周围松质骨的应力峰值多集中在种植体颈部或根尖1/3的区域.无论是垂直加载下还是斜向加载,皮质骨的应力峰值与松质骨的应力峰值对比,P＜0.05差异有统计学意义,斜向载荷下皮质骨的应力峰值与垂直载荷下皮质骨的Von-Mises应力峰值对比,P＜0.05差异有统计学意义,而松质骨之间P＞0.05差异无统计学意义.四种冠高度模型的骨质应力对比,P＞0.05,差异无统计学意义.结论:种植体受力时,斜向应力对骨质的影响高于垂直向力;冠高度的增加对种植体周围的骨质无影响.
  • 摘要：患者,男性,75岁。2016年10月因全口牙齿严重磨耗,咀嚼疼痛影响进食就诊。颌面部基本对称,颞下颌关节无疼痛,活动度对称,开口度开口型正常。咀嚼肌无压痛,牙龈质地颜色正常。前牙区覆盖正常,深覆牙合Ⅲ°（图1）,下前牙切端咬合于上颌腭侧牙龈。
  • 摘要：Objective:To evaluate deproteinized porcine bone mineral (DPBM,The Graft(@)) and deproteinized bovine bone mineral (DBBM,Bio-Oss(@)) in extraction socket preservation of bilateral mandibular wisdom teeth with the method of paired comparison,and observation to the osteogenesis with histological observation,providing reference for clinical application.Methods:17 cases were selected in this study,whose third molars required removal.Both sides were implanted the two xcnografts randomly.All the alveolar sockets were covered with barrier mambranes.After immediate surgery (T0),12 weeks (T12),24 weeks (T24),patients were taken CBCT respectively.Measured the thickness,height,width of both sides of the buccal and lingual alveolar bone wall.Compared the change amount of the above data during T0-T12,T12-T24 and T0-T24 using SPSS21.0 software with paired samples t-test and one-way ANOVA analysis with SNK;24 weeks after surgery,histological observation of osteogenesis with HE stain for partial the operative region.Results:Paired samples t-test showed that there were no significant difference on the change amount of buccal and lingual alveolar bone thickness,height and width on both sides during T0-T12,T12-T24 and T0-T2,One-way ANOVA analysis showed that during T0-T12 and T12-T24,there were significant difference on the change amount of lingual bone thickness,height at Graft side and only lingual bone height at Bio-Oss side.During T12-T24 and T0-T24,there were significant difference on the lingual bone thickness,height,width at Graft side and lingual bone thickness,height,width at Bio-Oss side,there were no significant difference on the other index.Histological observation showed that the Graft bone particulate material combine with new bone and fibrous connective tissue closely,which was similar to Bio-Oss.It was found no inflammatory reaction in all the specimens.Conclusions:The Graft（@） is similar to Bio-Oss（@） in the rate and extent of alveolar bone absorption after alveolar socket preservation for mandibular wisdom teeth.And the absorbtion of thinner lingual bone wall in vertical and horizontal amount is far more than the buccal,the absorption occur in the first 12 weeks mostly.Both of The Graft（@） and Bio-Oss（@） have favourable biocompatible and osteoconductive.%目的:脱蛋白猪骨矿物基质(DPBM,The Graft(@))与脱蛋白牛骨矿物基质(DBBM,Bio-Oss(@))在位点保存后配对比较并观察二者成骨情况,为临床应用提供参考.方法:选取17例双侧下颌智齿阻生患者,将二者随机植入左右两侧,均覆盖屏障膜.分别于本后即刻(T0)、12 周(T12)、24周(T24)拍摄锥形束CT,测量两组牙槽窝颊舌侧骨壁厚度及相应高度、宽度.利用SPSS21.0对两侧牙槽窝前12周(T0-T12)、后12周(T12-T24)、总24周(T0-T24)时各指标的改变值做配对t检验及单因素方差分析;24周时取部分患者植骨术区少量骨块,经HE染色,镜下观察两种异种骨成骨情况.结果:配对t检验显示双侧牙槽窝颊舌侧骨壁厚度、高度及宽度改变值在T0-T12、T12-T24T0-%T4时差异无统计学意义.单因素方差分析显示在T0-T12与T12-T24时,Graft侧舌侧厚度、高度改变值,Bio-Oss侧舌侧高度改变值差异有统计学意义;在T12-T24与T0-T24时,Graft侧舌与Bio-Oss侧舌侧厚度、舌侧高度、宽度改变值差异有统计学意义,其余差异均无统计学意义.组织学观察显示,24周时两种异种骨材料周围均有新形成的骨组织及纤维结缔组织紧密结合,受检区均未发现炎性反应.结论:The Graft(@)与Bio-Oss(@)用于下颌智齿健点保存后,在牙槽窝骨壁吸收速率及程度上表现相似;且较薄的舌侧骨壁垂直向、水平向吸收远多于颊侧骨壁,骨吸收多发生于前12周;The Graft(@)与Bio-Oss(@)均具有良好的生物相容性,骨引导性.
  • 摘要：The surface properties (surface topography,surface wettability,surface charge and surface chemistry) of implants significantly influence cell response and promote more rapid osseointegration.Surface hydrophilicity is known to play an important role in early bone response,and has received tremendous attention in the field of implants.The research progress in this paper is concerning different methods of modification to improve hydrophilicity of titanium dental implant and the effect of osseointegration.%钛种植材料的表面特性(表面形态、亲水性、表面电势能等)是影响种植体骨结合及临床疗效的关键因素.亲水性种植体由于其能加速种植体早期骨整合,缩短种植周期,成为研究热点.本文通过比较几种提升钛种植体亲水性的改性方法,对其成骨效果做一综述.
  • 摘要：目的:对比赝复体修复后上颌骨缺损患者和正常成年人对照组咀嚼运动时脑血流状况的差异.方法:选取因肿瘤手术切除导致上颌骨缺损的患者16例,手术恢复后采用中空式阻塞器型整体式赝复体修复,作为实验组;另选择16名完整牙列志愿者为对照组.应用经颅多普勒超声探测仪,测量两组在不咀嚼、空咀嚼5min、10min三个时段的大脑中动脉(MCA)收缩期峰流速(Vs)、舒张期末峰流速(Vd)、平均峰流速值(Vm).进行方差分析和样本均数两两比较的q检验.结果:病例组除在咀嚼5min和10min的Vs数值与对照组无显著性差异外(P＞0.05),其余各组均数的差异均具有统计学意义(P＜0.05).组间效应方差分析显示,分组因素对Vs、Vd无统计学意义(PO＞0.05),对Vm的影响有统计学意义(P＜0.05).在各时间段上,对照组的Vs、Vd、Vm高于病例组(P＜0.05).结论:咀嚼运动对赝复体修复后的上颌骨缺损患者及完整牙列受试者的大脑中动脉血管充盈度增加均有一定的促进作用.上颌骨缺损患者中空式阻塞器型赝复体修复后,在咀嚼运动时大脑中动脉Vs和Vd接近完整牙列受试者,Vm低于完整牙列受试者.%Objective:To study cerebral blood velocity during mastication in maxillary defect patients with prosthesis and complete dentition persons.Methods:After prosthesis repaired,16 patients with maxillary defect due to tumor resection and 16 complete dentition persons were selected.Shrink of peak velocity (Vs),end-diastolic peak velocity (Vd),average peak velocity values (Vm) of middle cerebral artery (MCA) were measured by transcranial Doppler ultrasound detector.Twogroups were measured including three periods respectively,i.e.0min,5min,10min after empty mastication.Variance analysis andq-test was analyzed.Results:Excepting Vs values of chewing 5min and 10min were not significantly different from those of the control group,there was significant difference in Vs,Vd and Vm between two groups (P＜ 0.05).Analysis of variance between groups showed that,grouping factor had no significant impact to Vs,Vd (P＞0.05) and had significant impact to Vm (P＜0.05).At the same point in mastication time,Vs,Vd,Vm values of control group were higher than that of case group.Conclusion:Mastication can promote the velocity of the middle cerebral artery in bothmaxillary defect patients with prosthesis repair and complete dentition persons.Comparing patients with prosthesis repair with complete dentition persons,There is no significant difference in Vs and Vd values,and significant difference in Vm values.
  • 摘要：目的:对比研究Ti2448合金和纯钛对大鼠原代成骨细胞粘附、增殖、形态及矿化的影响.方法:取对数生长期的SD大鼠原代成骨细胞,接种于纯钛及钛合金表面.培养1、3、5d后,检测细胞相对增殖率;培养24、72h后,免疫荧光染色观察细胞形态;矿化诱导液诱导矿化21d后,扫描电子显微镜观察细胞矿化情况.结果:原代培养的成骨细胞增殖能力正常,符合细胞的生长增殖曲线;Ti2448和纯钛表面的成骨细胞生长均符合细胞的生长曲线,但是接种于Ti2448表面的细胞增殖能力从接种第3、5d可观察到明显弱于纯钛组;免疫荧光染色观察可见,接种24h时成骨细胞均能正常粘附在Ti2448和纯钛表面,然而随着培养时间的延长至72h,Ti2448组表面细胞形态出现异常,不能正常伸展;经矿化诱导21d成骨细胞在Ti2448和纯钛表面均能正常生长且诱导出矿化结节.结论:原代成骨细胞均能在Ti2448合金和纯钛表面粘附、生长以及被诱导成骨矿化,但是纯钛组在细胞接种后的粘附伸展能力和增殖能力明显优于Ti2448组.%Objective:To study the effects of Ti2448 alloy and pure titanium on the adhesion,proliferation,morphology and mineralization of SD rat primary osteoblasts.Methods:growth phase of SD rat primary osteoblasts logarithmic were taken and inoculated on pure titanium and titanium alloy surface.Osteoblasts were cultured for 1 h,3 d and 5 d,and the relative proliferation rate was measured.After 24 h and 72 h,the morphology was observed by immunofluorescence staining.Mineralization was observed and evaluated by scanning electron microscope after induced mineralized for 21 d by Mineralized induced liquid.Results:The proliferation ability and cell growth curve of primary osteoblasts was within normal range.The growth curve on the surface of Ti2448 alloy and pure titanium was consistent with the primary osteoblasts,but the proliferation ability on the surface of Ti2448 alloy was significantly weaker than that of pure titanium group on the third and fifth day.Immunohistochemical staining showed that osteoblasts could adhere to the surface ofTi2448 alloy and pure titanium in the 24 hour normally.However,with the prolongation of culture time to the 72 hour,the cell morphology of Ti2448 alloy group was abnormal and could not stretch normally.The osteoblasts on the surface of both Ti2448 alloy and pure titanium growed normally and mineralized nodules could be induced successfully on the 21 day.Conclusion:Primary osteoblasts can adhere,grow and induce osteogenic mineralization on the surface of both Ti2448 alloy and pure titanium,The adhesion ability and proliferation ability of pure titanium group are better than that of Ti2448 group after cell inoculation.
  • 摘要：Objective:To investigate the effects of PM2.5 on the nasal and maxillary sinus mucosa of rats,and explore the gene expression level of muc5ac and muc5b.Methods:airbome PM2.5 with a four-inlets PM2.5 sampler were collected and made up the PM2.5 suspension with sterile saline were made.In experimental group,rats were dripped with the PM2.5 suspension through nasal passage,and in control group,they were dripped with equal dose of sterile saline.After dripping PM2.5 suspension for 7,14 and 30 days,the nasal and maxillary sinus mucosa were collected for morphology analysis and the gene expression of muc5ac and muc5b were evaluated.Results:After dripping the PM2.5 suspension by nasal passage for 30 days,significant morphologic alterations of the nasal mucosa were observed,including epithelial integrity destroyed,cilia disappeared,gland hyperplasia,inflammatory cell infiltration,and squamous metaplasia.The expression of muc5ac and muc5b in nasal mucosa was up-regulated significantly.There were no obvious changes of nasal mucosa neither at 7th day nor at 14th day.Nevertheless,there was only slight inflammation occurred in the maxillary sinus after PM2.5 instilled for 30 days,including epithelial integrity destroyed and inflammatory cell infiltration.The muc5ac expression was decreased,and there was no difference of muc5b expression between the two groups.Conclusions:PM2.5 suspension could induce pathological injury in nasal and maxillary sinus mucosa of rats,and the injury of nasal mucosa was more severe.%目的:研究大气中PM2.5对大鼠鼻黏膜及上颌窦黏膜的影响,并探究其中两种主要黏蛋白muc5ac和muc5b的基因表达情况.方法:使用四通道PM2.5采样器,采集大气中的PM2.5,用0.9％氯化钠注射液配制成混悬液,实验组大鼠每天鼻腔滴注500μl浓度为0.004μg/μl的PM2.5混悬液,对照组滴注等剂量0.9％氯化钠注射液,分别在7、14、30d取鼻黏膜及上颌窦黏膜.通过HE染色,光学显微镜下观察鼻黏膜及上颌窦黏膜的组织形态学,并通过荧光定量PCR检测muc5ac和muc5b的基因表达情况.结果:PM2.5混悬液滴注30d后,鼻黏膜上皮完整性被破坏,纤毛消失,黏膜下腺体增生,炎性细胞浸润,上皮层出现鳞状化生现象,同时其中两种主要的粘蛋白基因muc5ac和muc5b表达升高;滴注7、14d的鼻黏膜均未出现明显病变.而对于上颌窦黏膜,滴注30d后仅表现出轻微的炎症反应,上皮完整性受损,黏膜下少量炎细胞浸润,其中muc5ac表达降低,muc5b的表达未受影响;滴注7、14d同样未导致明显病变.结论:大气PM2.5混悬液达到一定浓度时,接触大鼠鼻黏膜及上颌窦黏膜会导致其受损,其中鼻黏膜损伤更加严重.

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