拔除阻生智齿患者牙科焦虑的调查及分析

目的：了解综合医院口腔科拔除阻生智齿患者牙科焦虑的患病情况并进行相关因素分析。方法：采用牙科焦虑一般因素调查表、改良牙科焦虑量表（MDAS）及状态焦虑量表（S-AI）对300例口腔颌面外科门诊的拔除阻生智齿患者进行调查及评定,同时对引起牙科焦虑的相关因素进行分析。结果：拔除阻生智齿患者牙科焦虑的发生率为56.00%,有6项因素对牙科焦虑症的患病率有影响,差异有统计学意义（P〈0.05）,其中5项因素对MDAS得分影响较大。结论：牙科焦虑在拔除阻生智齿的患者中较普遍,有多种因素影响患者牙科焦虑的程度。     

牙列缺损种植修复患者焦虑状况的影响因素分析

探讨牙列缺损种植修复患者发生焦虑状况的可能影响因素。2016年3月至2017年12月期间,选择我院收治的牙列缺损行种植义齿修复患者150例作为研究对象。评价患者的状态和特质焦虑量表(STAI)、修正版牙科焦虑量表(MDAS)和VAS疼痛评分之间的相关性,Logistic回归分析确定患者焦虑的影响因素。根据术前的SAI和TAI评分将牙列缺损患者分为低焦虑组、中焦虑组和高焦虑组,高焦虑组的VAS评分和MDAS评分均显著高于其他两组(p<0.05)。SAI、TAI和MDAS评分分别与VAS评分显著正相关(r=0.664,r=0.758,r=0.437,p<0.05)。性别(女)、年龄(<25岁)、付费方式(自费)、居住地(农村)和收入(<4 000元)为牙列缺损患者产生焦虑情绪的独立危险因素。牙列缺损患者行种植修复手术前的焦虑水平与术后的疼痛正相关。性别、年龄、付费方式、居住地和收入是牙列缺损患者焦虑水平升高的独立危险因素。     

阻生智齿拔除术患者前后龈沟液中炎症因子和应激因子水平变化及临床意义

目的:探讨阻生智齿拔除术患者前后龈沟液中炎症因子和应激因子水平变化及临床意义。方法:选择我院2017年1月至2019年1月192例行阻生智齿拔除术的患者为研究对象(观察组),并选择100例口腔健康志愿者作为对照组,检测观察组阻生智齿拔除术术前、术后2d、术后5d及对照组龈沟液中白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)、活性氧(ROS)水平,并在术后2d记录观察组患者牙龈指数(GI),探讨各指标与患者预后的关系。结果:观察组术前龈沟液IL-8、TNF-α、MDA及ROS水平与对照组无显著差异(P0.05),术后2d、术后5d龈沟液IL-8、TNF-α、MDA及ROS水平均高于对照组(P0.05);观察组术后2d龈沟液IL-8、TNF-α、MDA及ROS水平高于术前和术后5d(P0.05),术后5d龈沟液IL-8、TNF-α、MDA及ROS水平高于术前(P0.05);GI分级3级患者龈沟液IL-8、TNF-α、MDA及ROS水平高于GI分级2级患者,GI分级2级患者龈沟液IL-8、TNF-α、MDA及ROS水平高于GI分级1级患者(P0.05);龈沟液IL-8、TNF-α、MDA及ROS水平与术后GI分级均呈正相关(P0.05)。结论:阻生智齿拔除术患者手术前后龈沟液IL-8、TNF-α、MDA及ROS水平会出现波动,且术后各指标水平可反映患者预后情况。     

高速气涡轮切割手机联合专用加长裂钻对拔除下颌阻生第三磨牙的效果分析

目的:探讨牙科高速气涡轮切割手机配合阻生牙专用加长裂钻拔牙对口腔外科门诊需要拔除下颌阻生第三磨牙患者的影响。方法:选取我院收治的59例需要拔除下颌阻生第三磨牙患者,按照随机数字表法将所有患者随机分为试验组和对照组两组。其中试验组患者采用牙科高速气涡轮切割手机辅助阻生牙专用加长裂钻进行拔牙,而对照组患者则采取传统的劈骨分牙法,通过两组患者的术后复诊对患者的下唇麻木、断根等发生率以及张口受限、疼痛、肿胀等情况进行评价。结果:根据我院对两组患者的术中情况及术后并发症情况进行统计分析,结果显示试验组患者的手术时间为(25.68±6.83)min,明显低于对照组患者[(35.23±14.23)min,t=3.962,P=0.000]。试验组患者中仅有1例术后出现断根情况,无其他并发症出现;而对照组患者术后则有3例断根情况和1例下唇麻木患者(后逐渐缓解)、1例下颌关节疼痛以及1例舌侧骨板骨折患者。根据我院对两组患者术后1d的临床资料进行统计分析,结果显示试验组患者术后1d面部肿胀程度明显比对照组患者轻(P0.05);试验组患者的疼痛情况明显优于对照组患者(P0.05);试验组患者的张口受限程度明显比对照组患者轻(P0.05)。结论:牙科高速气涡轮切割手机配合阻生牙专用加长裂钻拔牙对口腔外科门诊需要拔除下颌阻生第三磨牙患者具有较好的临床治疗效果,值得在临床上加以广泛推广和运用。     

冠心病介入术前患者睡眠质量及相关因素研究

目的:探讨冠心病介入治疗患者术前睡眠质量及其影响因素。方法:采用一般状况调查表、匹兹堡睡眠质量指数(PSQI)量表、焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSRS)对2013年7月至2014年1月在某院心内科接受介入治疗的392例冠心病患者进行问卷调查。结果:发放问卷410份,回收有效问卷392份,有效率为95.6%。392例患者中287例存在睡眠质量问题,总发生率为73.2%,PSQI总分为9.88±3.63。相关因素分析显示年龄、性别、婚姻状况、焦虑、抑郁和社会支持6项是冠心病介入治疗术前患者睡眠质量的预测因素。结论:冠心病介入治疗患者术前睡眠质量较差,并受多种因素影响。     

阻生智齿拔除的配合与护理体会

萌出不全的智齿叫阻生智齿,多发生在18～30岁的青壮年,以下颌智齿多见。主要因下颔与第二磨牙之间的位置不够,以致智齿萌出受阻,其牙冠常向前倾斜或仅部分萌出。因牙面远中部有龈瓣覆盖与牙冠之间形成一盲袋,袋内易存食物残渣,其中的温度与湿度是细菌繁殖的良好场所。机体抵抗力降低,细菌乘虚而入,容易发生慢性或急性智齿冠周炎,因此应拔除。目前,拔除阻生智齿是预防和治疗冠周炎最彻底的方法。我科自2005年1月至12月,拔除阻生智齿共456颗,术后无1例出现并发症,为配合拔牙术的颐利进行,减少并发症的发生,护士需做好门诊手术的配合和护理工作。现将手术配台及护理体会报告如下。     

类风湿关节炎患者焦虑水平的调查研究及护理

目的:探讨类风湿关节炎(RA)患者焦虑水平、焦虑发生的状况及其主要相关影响因素,进而为临床护理、心理护理工作提供有效依据及方向。方法:本研究属于描述性研究,抽样方法为方便抽样,通过焦虑自评量表(SAS)及自拟焦虑相关因素的调查问卷,对2010年4月至2010年8月58例住院RA患者进行调查研究。结果:住院患者SAS得分较国内常模高,焦虑水平明显增加;RA患者焦虑和性别、年龄、婚姻、文化程度、职业有相关性;影响患者焦虑症状的发生的主要原因为疾病带来的痛苦,对药物毒副作用的担心,对经济状况的担心,给家人带来的负担,对治疗缺乏信心,性格。结论:RA住院患者存在明显的焦虑情绪,RA患者焦虑发生与多种因素有关,应实施有针对性的个体护理措施。     

心理护理对恶性肿瘤患者抑郁焦虑的影响

目的:探讨恶性肿瘤住院患者焦虑抑郁情绪的相关因素及心理护理干预对其的影响。方法:对158例恶性肿瘤住院患者(肿瘤组)及170例良性疾病住院患者(良性组)进行焦虑、抑郁自评(应用焦虑自评量表(SAS)、抑郁自评量表(SDS))及他评(应用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评分调查及统计分析;将肿瘤组患者随机分为常规护理组(对照组)、常规护理 心理护理组(护理组),通过心理护理干预,观察两组SAS、SDS、HAMD、HAMA评分变化。结果恶性肿瘤住院患者焦虑、抑郁程度明显高于良性疾病患者,差异有显著性(P<0.01)。在接受心理护理干预后,患者的焦虑抑郁评分及发生率较干预前明显下降,差异有显著性(P<0.05或0.01)。结论:恶性肿瘤患者焦虑和抑郁情绪程度及发生率高于良性疾病患者;心理护理干预可改善恶性肿瘤住院患者焦虑、抑郁情绪,有利于提高患者的生活质量及康复。     

化疗期乳腺癌患者情绪状态及其影响因素的调查研究

目的:调查化疗期乳腺癌患者的抑郁及焦虑情绪状态,探讨情绪状态的影响因素,促使医护人员更好的了解化疗期乳腺癌患者的情绪状态,以便更好的提供相应的护理与治疗。方法:采用自行设计的调查问卷,对2012年7~12月住院的97名化疗期乳腺癌患者进行调查,内容包括一般人口学资料、医院焦虑抑郁量表及状态-特质焦虑问卷。结果:化疗期乳腺癌患者的抑郁得分为(4.79±4.23)分,特质焦虑得分为(41.70±11.81)分,状态焦虑得分为(40.61±12.11)分,其影响因素包括教育水平和家庭人均月收入,Pearson相关分析得出特质焦虑、状态焦虑与抑郁之间存在正相关。结论:化疗期乳腺癌患者焦虑与抑郁处于较高水平,教育水平越高、家庭人均月收入越高的患者其焦虑、抑郁程度越低。医护人员可以通过对化疗期乳腺癌患者进行相应的心理疏导以减轻负性情绪的产生,以促进和保持治疗的顺利进行与疾病的转归。     

慢性持续期哮喘患者自我效能水平及相关因素分析

目的:探讨慢性持续期哮喘患者的自我效能水平及其相关因素。方法:采用一般资料调查表、自我效能量表、社会支持量表(SSRS)、综合性医院焦虑抑郁量表(HADS)等,对我院2009年3月至2011年6月呼吸科门诊随诊的79例慢性持续期哮喘患者进行调查。结果:所有患者的平均自我效能总分为(57.15±9.03)分。患者自我效能水平与病程、经济状况、吸烟情况、发作次数及发作程度呈负相关(P<0.05)。结论:慢性持续期哮喘患者自我效能水平有不同程度的降低,哮喘发作次数、焦虑抑郁情绪以及社会支持水平是影响患者自我效能水平的主要因素。     

Dental treatment strategies in a 40-year-old patient with cleidocranial dysplasia

Oral anomalies and dental treatment in a patient with cleidocranial dysplasia (referred to the dental clinic at the age of 40 years) are presented. Five supernumerary teeth were found in the patient: three in the maxilla in the area of molars and two in the mandibula in the area of premolars. Therapy included surgical exposure of impacted teeth in combination with removal of supernumerary teeth.     

Factors affecting the motivation for dental check‐ups and anxiety in the elderly in Tokyo

Objectives: The purpose of this study was to identify factors influencing the motivation for regular dental check‐ups and anxiety about future dental problems in the elderly. Background: Regular dental check‐ups are important to maintain oral health. Anxiety affects the quality of life of the elderly. However, few studies have investigated the factors influencing the motivation for regular dental check‐ups and anxiety in the elderly. Materials and methods: Among 452 elderly persons, 215 participants provided useful answers to our questionnaire. The questionnaire consisted of items concerning oral and living conditions of the subjects. Logistic regression analysis was conducted. Results: The mean age of the study sample was 75.7 ± 5.8 years. The percentage of edentulous subjects was 12.1%. The motivation for regular dental check‐ups was significantly positively correlated with the number of teeth present (p < 0.01), using inter‐dental brushes (p < 0.01), being on regular prescribed medication (p < 0.05), and having experience of providing oral care for the bedridden (p < 0.05). Anxiety about future oral problems was significantly associated with self‐rated health status (p < 0.01) and the presence of dentists who could be counted on to provide domiciliary visits (p < 0.05). Conclusion: The participants of this study had a high motivation for regular dental check‐ups, but were concerned about the future, particularly if they became bedridden.     

Dental anxiety among middle-aged and elderly women in Sweden. A study of oral state,utilisation of dental services and concomitant factors

The aim of this project was to investigate dental anxiety and its expression in utilisation of dental services, oral health and oral symptoms. In a cross-sectional study of women's health in Göteborg (population 432,000), Sweden, 1016 women aged 38 to 84 years participated. This randomly selected population took part in a series of investigative procedures including medical and dental clinical examinations, interviews and questionnaires. Levels of dental anxiety were measured on the Corah Dental Anxiety Scale (DAS). The average DAS score obtained was 7.2. The study showed that older women were significantly less anxious than younger ones. Severe dental anxiety (DAS 15) was experienced by 3.9% of the participants. This frequency corresponds well with findings by Hällström and Halling in their analysis of data from the first Göteborg study of women's health 24 years ago. High levels of dental anxiety were correlated with longer intervals between dental visits, poorer oral function and aesthetics and a higher frequency of oral symptoms. Headaches were more prevalent in the younger age groups and a correlation with dental anxiety was revealed. Our previous studies have shown that symptoms such as tension headaches are prevalent among dental phobic patients and that they are reported to be reduced by therapy for dental fear. The clinical and radiographical examinations revealed a generally poorer oral status, with a statistically significant higher number of decayed teeth among women with high dental anxiety.     

不同去龋技术在乳牙龋病治疗中的应用疗效分析

目的:比较传统机械切割法、非创伤性充填法(atraumatic restorative treatment,ART)和Carisolv化学法在临床乳牙龋病治疗中的应用效果差异。方法:选取2011年1月-2012年6月来我科就诊的5-8岁儿牙患者96名,患牙180颗,随机分为3个不同的治疗组:传统机械去龋组、ART组和Carisolv化学去龋组进行相应牙体充填治疗,通过去龋效果、去龋时间、术中疼痛发生率和术后长期疗效等方面比较不同去龋技术之间的差异。结果:常规机械去龋组和Carisolv组的去龋效果明显优于ART组(P0.05),二者之间无明显差异(P0.05);3种去龋方法的去龋操作时间无明显差异(P0.05);Carisolv组和ART组去龋治疗中患儿术中疼痛发生例数明显低于常规机械去龋组(P0.05),二者之间无明显差异(P0.05);治疗1年后的复诊发现,常规机械去龋组和Carisolv组中患牙继发龋发生率明显低于ART组(P0.05),二者之间无明显差异(P0.05);三种方法治疗后患牙充填物折断/脱落发生率无明显差异(P0.05)。结论:Carisolv化学去龋法能有效减轻术中疼痛和术后复发率,值得在临床乳牙治疗中推广应用;ART的去龋效果和远期疗效可能限制其广泛应用。     

Factors associated with dental anxiety among older people in Britain

Objective: This paper reports on a study of denial anxiety among adults aged 60 years living independently in Britain. Design: A national cross‐sectional study carried out with the assistance of the Office for National Statistics' Omnibus Surveys in 1999. Setting: Data was collected by face to face interviews with older people in their homes Measurements : Data on dental anxiety were collected from 973 subjects by means of face to face interviews and was measured by the Dental Anxiety Scale (DAS) (Corah, 1969). In addition, data on dental service use and oral health status (self‐reported) was collected. Results: The mean DAS score was 8.4 (sd 3.5), and 13% (129) of subjects were classified as dentally anxious (DAS ≥ 13). DAS scores were associated with numerous socio‐demographic factors (P<0.01), self‐reported oral health status (P<0.01) and dental service (P<0.01) factors. A series of regression analyses revealed that dental anxiety was a significant predictor of a number of behavioural and oral health outcomes. Conclusion: One in eight older people in Britain are dentally anxious and this is associated with their use of services and oral health status (self‐reported).     

A cross-sectional analysis of the prevalence of dental anxiety and its relation to the oral health-related quality of life in patients with dental treatment needs at a university clinic in Switzerland

doi: 10.1111/j.1741‐2358.2011.00465.x A cross‐sectional analysis of the prevalence of dental anxiety and its relation to the oral health‐related quality of life in patients with dental treatment needs at a university clinic in Switzerland Objectives: The aim of this observational, cross‐sectional study was to analyse the relationship between dental anxiety (DA) and health‐related quality of life aspects associated with oral conditions of a population with dental treatment needs in Switzerland. Methods: The measurements of DA were collected by means of two questionnaires, the Dental Anxiety Scale (DAS) and a Visual Analogue Scale (VAS). Oral health‐related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP). The sample included 223 patients enrolled at a university clinic which specialises in oral prosthetic rehabilitation and temporomandibular disorders. Of them, 78.9% were at or above the age of 50. Results: No gender or age dependencies were observed. A comparison of answers regarding OHRQoL and DA revealed a significant interdependence (p = 0.0118); highly anxious patients were 3.55 times more likely to suffer from poor quality of life compared with less anxious ones. Conclusion: This cross‐sectional study of mostly elderly patients seeking dental treatment in Switzerland found that increased DA was associated with an impaired OHRQoL. The average DA was slightly higher than the results of other industrialised countries and the average OHRQoL was reduced.     

正畸患者埋伏牙患病情况的流行病学研究

目的:调查分析正畸患者埋伏牙的基本患病情况。方法:第四军医大学口腔正畸科2008.1.1-2011.4.23就诊的6876例患者中,以确诊的589例埋伏牙患者为研究对象,对其性别,年龄,部位和数量等基本情况进行流行病学研究。结果:埋伏牙在第四军医大学口腔正畸患者中患病率为8.56%,以上颌好发,上颌尖牙患病率最高,其次为埋伏多生牙;以单发为主;女性较男性多发。结论:埋伏牙在正畸门诊患者中患病率较高,尤其是上颌尖牙,提示正畸医生在患者就诊时要注意埋伏牙的早发现及早治疗。     

Unnoticed swallowing of a unilateral removable partial denture

doi: 10.1111/j.1741‐2358.2011.00621.x Unnoticed swallowing of a unilateral removable partial denture Objective: This paper presents a case report about an unnoticed swallowing of a partial denture impacted in the esophagus in a 74‐year old man without serious complications. Background data: Dental prostheses (removable/fixed dental prostheses or fragments of dentures) appear to constitute a significant proportion of swallowed of impacted foreign bodies in the orolaryngopharynx. Conclusion: This case emphazises that is advisable to contraindicate this type of unilateral removable partial denture to replace teeth as temporary or definitive dental prosthesis.     

Comparison and Optimisation of Transfection of Human Dental Follicle Cells,a Novel Source of Stem Cells,with Different Chemical Methods and Electro-poration

Introduction Human dental follicle cells (HDFCs) derived from human impacted third molars (wisdom teeth) have been shown to be a significant source of adult stem cells. Generation of mesenchymal stem cell-like cells from dental follicles causes minimal surgical stress. In vitro and in vivo reports showed that HDFCs can be utilized in gene and cell therapy applications which make them an attractive alternative source for different gene-cell therapy applications. However, there are currently no systematic comparative studies on transfection potential of HDFC cells using different chemical and electro-poration techniques. Methods Stem cells from impacted third tooth molars were isolated, and analyzed for expression of surface markers. Transfection efficiencies of four commercially available transfection reagents (Transfast, Escort V, Superfect and FuGene HD) and electro-poration on isolated stem cells were compared. Results Isolated HDFCs were stained positive for CD105, CD90, CD73, CD166, and negative for CD34, CD45, and CD133. Among the chemical transfection reagents used in this study, FuGene HD was the most efficient in transfecting HDFCs, even in the presence of 10% serum. Conclusion Electro-poration of HDFCs yield relatively high transfection rates and cell viability when compared to chemical transfection techniques. Our observations might be useful for developing gene and cell therapy applications using dental follicle stem cells.