冷光美白技术漂白活髓着色牙的临床疗效分析

目的：评价应用Beyond冷光美白技术漂白活髓着色牙的临床疗效。方法：选择牙齿变色病人117例,其中外源性染色牙18例,氟牙症16例,四环素染色牙47例,增龄性变色牙36例,该组病例的前牙及第一前磨牙均为活髓牙,采用Beyond冷光漂白法治疗,关白效果用Vita比色板进行前后比较。结果：外源性着色牙与增龄性变色牙关白疗效较好,平均提高6．09个色阶。对氟牙症疗效也较明显,但颜色分布不均匀,仍会有条纹或斑块状白斑。对轻、中度的四环素牙平均可提高3．46个色阶,重度四环素牙疗效欠佳。结论：Beyond冷光美白技术是目前治疗活髓变色牙特别简捷、安全和有效的方法之一。     

诺丹顿增白胶治疗牙色泽异常临床初步观察

采用软托盘加诺丹顿增白胶对３０例牙色泽异常患者进行漂白治疗,其有效率达１００％。其中,对于外源性色斑牙,轻度,中度四环素牙,采用该方法治疗效果最佳。笔者认为在目前众多的牙色泽异常方法中,该方法操作简便,应用安全,疗效可靠,建议推广。     

人氟斑牙釉质表面结构及漂白后改变的电镜观察

目的:目前国内外对氟斑牙的研究主要集中在流行病学调查和临床疗效分析,对其漂白后釉质表面脱矿程度的研究却鲜有报道.观察不同程度人氟斑牙电镜下微观结构的特点,了解冷光美白对不同程度人氟斑牙釉质表面的影响,探讨冷光美白对重度氟斑牙的安全性.方法:选择因牙周病拔除的完整无龋坏的正常牙10颗,人各型氟斑牙50颗,选取颊侧典型区域制备标本.氟斑牙标本按Dean氏分类法分为轻、中、重度3组,正常牙标本作为对照组.各组标本随机分为4个亚组,A组:不做任何处理;B组:釉质表面蚀刻;C组:釉质剖面蚀刻;D组:釉质表面冷光美白,扫描电镜下观察标本的表面形貌.结果:轻度氟斑牙釉柱间隙增宽,少量晶体排列紊乱,晶间隙增宽.重度氟斑牙釉质表面凹凸不平,呈弹坑状或蜂窝状,釉柱轮廓不清,晶体排列紊乱甚至消失.中度氟斑牙居于二者之间.冷光美白后,正常牙和氟斑牙釉质表面低倍镜下均未见明显改变,高倍镜下散在浅碟状凹坑;中重度氟斑牙还伴有大量粟粒状小孔.结论:随着氟斑牙严重程度的加重,釉质表层损害程度加重.冷光美白造成釉质表层的轻微脱矿,氟斑牙稍重于正常牙.从结构和漂白后釉质表面脱矿程度方面进一步探讨氟斑牙的表面结构特点,从而为氟斑牙的临床治疗提供基础数据.     

喷粉洁牙和外漂白法在外源性染色牙面上的应用

本实验借用Sharif的方法,用我国常见的、汤色较重的祁门红茶作色素原,与洗必泰液交替浸泡人类离体上切牙,建立牙齿外源性染色模型。选用气流喷砂法和过氧化氢凝胶外漂白法去色后拍摄数码照片,通过计算机对外源性染色牙处理前、后白色度值变化的分析,比较它们的去色效果;并用扫描电镜观察两种方法对牙面的损伤情况。     

用奥普申斯漂白剂对着色牙作内漂白的研究

着色牙在临床较为常见,其原因是多方面的,严重者不仅影响美观,而且还影响患者心理健康。因此,我们在92年引进美国产奥普申斯牙用漂白剂,对62颗单个着色前牙作内漂白的脱色治疗,效果满意,现报告如下。 一、临床资料 1.牙体、牙周情况基本良好的单个着色前牙62例。     

聚合瓷嵌体修复活髓后牙大面积牙体缺损中的临床研究

目的:研究聚合瓷嵌体修复活髓后牙大面积牙体缺损(Big dentin defect,BDD)中的临床疗效。方法:从2009年6月到2011年6月,于我院牙科就诊病患中,后牙的牙体缺损大于1个牙尖者有80例,共87颗牙齿。以数字法随机分成治疗组(41例,46颗)及对照组(39例,43颗)。对照组以高嵌体方案治疗,治疗组以聚合瓷嵌体方案治疗。对比两组一周以及一年后修复体评价情况。结果:治疗一周后,治疗组在美观方面显著优于对照组,差异有统计学意义(u=2.038,P0.05)。而两组对比术后敏感以及牙周状况等数据,差异均无统计学意义(u=1.132,1.389,均P0.05)。治疗一年后,治疗组在修复体折裂以及美观等方面显著优于对照组。差异有统计学意义(u=3.138,2.874,均P0.05)。两组在继发龋和边缘着色,邻接以及肩台适合和牙周状况等方面对比,差异均无统计学意义(u=1.132,1.374,1.454,1.268,1.366,均P0.05)。结论:聚合瓷嵌体对于活髓后牙BDD的修复效果较为显著,可较大程度恢复病患牙体功能,减少继发龋的发生率。不易折裂又更加美观,值得临床推荐。     

放射直视影像在口腔固定修复中的临床应用评价

目的：探讨放射直视影像（radiovisiography,RVG）在口腔固定修复中的应用价值。方法：对拟行口腔固定修复中的全冠及桩核冠修复的患牙术前进行RVG投照,对RVG图像进行分析,分别测量牙冠各部位的厚度以及牙根的长度、角度、根管各部位的直径,从而对活髓牙牙体预备中并发症的预测和预防以及桩间隙制备时器械的选择和桩的设计。结果：67颗活髓牙中7例前牙需要术前进行根管治疗,1例术中发生针尖大小的穿髓点,予dycal垫底后保留活髓。因为术前及早的预测穿髓事件的发生,病人均满意及理解。拟行桩核冠修复的21颗患牙无一例发生根管侧穿,观察3月未发现有一例根折。结论：RVG能快速,经济,直观的给临床口腔修复医师提供牙体全面的信息,有利于并发症的预防及治疗方案的选择。     

扩髓更换髓内钉治疗髓内钉固定后股骨干肥大性骨不连

目的:评价扩髓更换髓内钉治疗髓内钉固定后股骨干肥大性骨不连的临床疗效及手术适应症。方法:自1998年4月至2009年6月采用扩髓更换髓内钉治疗11例髓内钉固定后股骨干肥大性骨不连,其中男9例,女2例,年龄23-61岁。平均36.2岁,骨折部位在股骨上1/3者2例;中1/3者6例;下1/3者3例,原始骨折Winquist-Hansen分型:I型2例,II型3例,III型4例,IV型2例。结果:11例患者均获随访,时间:11～56个月,平均27.4个月,2例患肢短缩1 cm。另4例未获得骨性愈合,3例再次采用附加钢板合并自体髂骨植骨,1例远端锁钉动力化,再次干预后获得骨性愈合,愈合时间6～16个月,平均8.3个月。结论:扩髓更换髓内钉是治疗髓内钉固定后股骨肥大性骨不连的传统方法,基于力学稳定和临床观察,更适用于股骨中段骨不连。     

成年人个别牙早失伴错(牙合)畸形修复前正畸治疗的临床观察

目的:探讨成年人个别牙缺失伴错牙合患者,通过正畸治疗校正错牙合后,修复治疗的疗效情况。方法:对16例成年人个别牙缺失致前牙散在间隙或伴有反牙合患者,采用直丝弓矫治技术进行修复前正畸治疗。结果:16例成年人个别牙缺失伴错牙合畸形的患者经过修复前正畸治疗后,再进行牙列缺损修复治疗,获得了令患者较为满意的疗效,外貌也得到了改善。结论:通过正畸、修复相结合的口腔综合治疗,可以有效地使便利体获得更加完善的口腔功能及美观效果。     

开窗减压对颔骨牙源性囊性病变治疗作用研究

目的:探讨开窗减压对颌骨牙源性囊性病变的治疗作用.方法:102例牙源性颌骨囊性病变按囊肿大小分成两组,直径大于3.5cm且颌面部畸形明显的37例为甲组,全部采用开窗减压术;直径小于3.5cm的65例为乙组,其中27例(乙组A)采用开窗减压或开髓引流术,38例(乙组B)采用一次性手术切除.定期复查观察囊肿及颌骨变化情况,记录曲面断层片上囊腔影像面积变化,术后6月视情况采取Ⅱ期手术治疗.结果:甲组开窗减压术后囊肿逐步缩小,骨质再生情况良好,颌面部外形改善,未出现神经及周围重要结构损伤症状,6月后囊肿面积平均缩小75.03%,与术前囊腔面积比较有显著差异(P＜0.01),有效率100%,Ⅱ期手术完成治疗;乙组A开窗减压或开髓引流组6月后有效率70.37%,大多采用二次手术治疗;乙组B一次手术切除治疗组囊腔愈合良好,6月后颌骨形态结构基本恢复正常,有效率100%,与乙组A有显著差异(P＜0.05).全部病例观察3至6年未见复发.结论:开窗减压术对大型颌骨囊性病变有很好的治疗作用;小型牙源性囊性病变最好选择一次性手术治疗.     

金属烤瓷全冠修复老年人活髓隐裂牙适应证及临床疗效

目的：探讨老年人活髓隐裂牙应用金属烤瓷全冠修复临床效果及适应症。方法：选取本院2006年1月至2011年1月期间收治的356例老年活髓隐裂牙合计621颗为研究对象,根据患牙疼痛程度随机将患者分为咬合疼痛组（A组）104例合计215颗患牙,咬合伴过敏性冷热刺激痛组（B组）122例合计232颗患牙,咬合伴延续性冷热刺激疼痛组（C组）130例合计174颗患牙,所有患者均接受金属烤瓷全冠修复,观察患者在治疗后1个月、6个月、12个月、18个月、24个月治愈情况以及牙髓及根尖周病变及牙髓发生情况。结果：与C组相比,A组、B组术后1个月、6个月、12个月、18个月、24个月治愈率以及总有效率较高,差异有统计学意义（P〈0．05）。结论：金属烤瓷全冠修复适合于轻微咬合疼痛以及咬合伴过敏性冷热刺激痛的患者,而对于咬舍伴延续性冷热刺激疼痛的患者则宜先行根管治疗术再进行全冠修复。     

Cytokine gene expression--part of host defence in pulpitis

Analyses of cytokines mediating inflammatory reactions are key to understanding the etiopathology of various diseases. This study investigated differences in cytokine gene expression between pulps from healthy virgin teeth and from symptomatic vital teeth with severe caries lesions in a group of young, healthy individuals. The mRNA levels of IL-1alpha, IL-1beta, IL-6, IL-8, and IL-18 were measured concomitantly by quantitative real-time RT-PCR. IL-1alpha and IL-1beta were not expressed at significantly higher levels in symptomatic versus clinically healthy pulps, while the difference was significant for the other cytokines (log-rank test, P<0.05). A concordance test for independence revealed significant correlation between IL-1alpha and IL-1beta, and between IL-6, IL-8, and IL-18 mRNA levels (P<0.05). The cytokine-specific differences revealed a differential significance of gene expression in cytokine regulation. The hypothesis that increase of cytokine mRNA expression is part of host reaction in pulpitis was corroborated by our observation.     

年轻恒牙与成熟恒牙牙髓中ConA的表达

目的　研究刀豆素A (ConcanavalinA ,ConA)在人的年轻恒牙与成熟恒牙牙髓中的表达特征 ,以进一步了解牙髓发育成熟过程。方法　采用ABC法 ,对年轻恒牙和成熟恒牙牙髓标本进行ConA的免疫组化染色 ,并做图像定量分析。结果　ConA主要在牙髓成纤维细胞和成牙本质细胞的胞浆染色 ,同时在细胞外基质中可见阳性染色。年轻恒牙组呈强阳性染色 ,成熟恒牙组呈弱阳性染色。图像分析表明两组间灰度值有显著性差异 (P <0 0 1)。结论　年轻恒牙和成熟恒牙的牙髓组织中ConA的表达不同 ,提示可利用凝集素在组织细胞的表达情况来研究牙髓的分化、成熟状态。     

龋坏引起的慢性牙髓炎牙髓组织中的细菌超微观察

对１０例龋坏引起的慢性牙髓炎、未穿髓的新鲜离体患牙,进行分段定位、半薄切片、革兰氏染色,光镜观察定位后,再行超薄切片,醋酸铀－柠檬酸铅复染,电镜进行超微结构观察。结果：（１）患牙牙髓组织中有５例观察到多种类型微生物存在,为球杆菌、球菌、杆菌。（２）牙髓组织中的细菌位于细胞内及细胞外,并处于各种状态,有生长繁殖阶段的也有固缩溶解阶段的。（３）深龋引起的长期有症状的慢性牙髓炎牙髓组织中有大量活细菌存在,细菌均存在于冠髓内,接近龋坏部位,周围及深层组织中未见菌体。并观察到组织细胞吞噬大量细菌后,细胞变性,出现核固缩、核仁消失,细胞膜不清楚。细胞周围有大量溶酶体出现。结果提示：深龋引起的长期有症状的慢性牙髓炎,尽管未穿髓,牙髓组织中,仍可有大量活细菌长期存在。     

Nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) histochemistry detecting NOS in healthy and chronically inflamed pulp

The aim of this study was to examine the expression of nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) activity in human dental pulps and determine whether there are changes of the activity in chronically inflamed pulp tissue. Nineteen pulps with clinical diagnosis of chronic pulpitis were collected during endodontic treatment. The healthy controls were obtained from teeth extracted for orthodontic therapy. The clinical diagnosis was confirmed by histological analysis. Healthy pulps showed stratified odontoblasts in peripheral parts, while in central area there was normal connective tissue. Chronically inflamed pulps showed less expressed stratification of odontoblasts and infiltration of lymphocytes, polymorphonuclear leukocytes, plasma cells and mastocytes. NADPH-d granular reactivity was assessed semi quantitatively under the light microscope by a single observer and scored on an intensity scale from negative reaction to very strong reaction. In healthy human pulps, NADPH-d activity was strong to very strong in odontoblastic layer. Endothelial cells and Schwann cells showed strong NADPH-d reactivity, while the other parts of central area were weakly positive. Similar distribution of reactivity was expressed also in chronically inflamed pulp; moderate to strong reaction was observed in stromal area as result of positive reaction in inflammatory cells and endothelial cells of abundant newly formed capillaries.     

The intercellular substance of the pulp of human, fully erupted, permanent premolar teeth

The intercellular substance of the pulp of fully erupted, healthy, human permanent premolar teeth was studied by light microscopy. Histological and histochemical methods were applied to sections from whole, decalcified teeth and isolated, undecalcified pulps, fixed with phosphate-buffered formalin and embedded in paraplast. Fibres were mainly collagen; they formed a meshwork progressively more dense from the crown to the root apex; in the crown the fibre meshwork was denser at the periphery than in the center of the pulp. Coarse bundles of collagen fibres were found in the apical part of the pulp of about one every third teeth. Glycoproteins, recognized thanks to their P.A.S. positivity, were abundant in the basal membranes of vessels and nerve fibres and between odontoblasts, but scarce in the remaining pulp tissue. Glycosaminoglycans, recognized thanks to their alcianophilia, were more abundant in the vessel wall and in the areas with coarse bundles of collagen fibres than elsewhere in the pulp; also, they were more abundant at the periphery than in the center of the pulp. As judged by staining with alcian blue at critical electrolyte concentration, glycosaminoglycans were mostly hyaluronate, with low amounts of condroitinsulphate and dermatansulphate; some heparansulphate or keratansulphate was present only in the regions with coarse bundles of collagen fibres. The morphological and histochemical differences found among different regions of each pulp and among different pulps as well provide a basis to recognize and interpret inter-regional and inter-individual variations in the pulp response to physiological and pathological modifications affecting the hard tissues of the teeth.     

LED光质对茄子果实品质及抗氧化能力的影响

采用发光二极管(LED)精量调制光质和光强,以白光为对照,研究红光、蓝光和红蓝组合光对‘布利塔’长茄果实品质、抗氧化能力及产量的影响.结果表明: 蓝光处理下,茄子果肉中可溶性蛋白、游离氨基酸和茄皮中花青素含量显著高于其他处理,分别比对照高15.1%、27.2%和73.6%,但果肉中类黄酮、总酚含量及产量显著低于其他处理;红光处理下,茄皮中类黄酮含量显著高于其他处理,但果肉中维生素C(Vc)和可溶性蛋白含量显著低于其他处理;红蓝组合光处理下,果肉中可溶性糖及茄皮中总酚、红色素、黄色素含量、总抗氧化能力以及产量均显著高于其他处理,其中茄皮中总抗氧化能力及产量分别比对照高43.5%和43.4%;而白光处理下,果肉中Vc、类黄酮和总酚含量及总抗氧化能力最高.茄皮中总酚及果肉中Vc含量与其总抗氧化能力呈显著正相关.设施栽培条件下,适当补充蓝光或红光均有利于改善茄子部分品质,红蓝组合光更有利于改善茄皮品质与产量形成.     

Picrosirius Red Staining of Dental Structures

Histologic sections of dog mandibles and teeth were stained with picrosirius red and Mayer's hematoxylin. Collagenous structures of the mandible stained brilliant red. Dentinal tubules, Sharpey's fibers and other structures not easily seen in sections stained with hematoxylin and eosin alone were seen clearly after this procedure. Under polarized light collagen fibers could be specifically identified and their orientation determined. Picrosirius red-hematoxylin is recommended for examination of normal or pathologic dental specimens.     

Picrosirius red staining of dental structures

Histologic sections of dog mandibles and teeth were stained with picrosirius red and Mayer's hematoxylin. Collagenous structures of the mandible stained brilliant red. Dentinal tubules, Sharpey's fibers and other structures not easily seen in sections stained with hematoxylin and eosin alone were seen clearly after this procedure. Under polarized light collagen fibers could be specifically identified and their orientation determined. Picrosirius red-hematoxylin is recommended for examination of normal or pathologic dental specimens.