Intra Oral Approach for Complex &Compound Odontomas (Large or Small)

Odontoma by definition alone refers to any tumour of odontogenic origion. These are considered to be hamartomatous malformation rather than true neoplasm and are generally asymptomatic. World Health Organization defines a lesion as the complex odontoma: when the calcified dental tissues are simply arranged in an irregular mass bearing no morphologic similarity to rudimentary teeth. Compound odontomas: composed of all odontogenic tissues in an orderly pattern, which result in many teeth-like structures, but without morphologic resemblance to normal teeth. The goal of this article is to report two cases of the complex odontomas erupted in oral cavity and compound odotome with impacted teeth. The article also aims to report that intra oral approach for removal of odontomas complex or compound small or large is better than extra oral approach.

Evaluation of the Accuracy of Digital Models Obtained Using Intraoral and Extraoral Scanners versus Gold Standard Plaster Model (Diagnostic Accuracy Study)

Introduction: Digital models showed promising results for orthodontic diagnosis and treatment planning. Digital models can be obtained from alginate impressions as well as direct intra-oral scanners. Studies assessing the accuracy of digital models have shown digital models to be valid, clinically acceptable, and more quickly obtainable. With the advent of new scanners with better scanning technology researches are necessary to evaluate their accuracy and reliability. Aim of Study: To evaluate the diagnostic accuracy of 3D digital models obtained through intraoral and extraoral scanning modalities to the reference gold standard plaster model. Material & Methods: Twenty-four adult male and female subjects were randomly selected for this study. The intraoral scanners evaluated in this study were Sirona (CEREC Omnicam) and 3 shape (TRIOS 3), while the laboratory scanners used were Sirona (inEos X5), and 3 shape (D850). Intra-oral scanning of the subjects and extra-oral scanning of their alginate impressions, plaster models of the alginate impression, rubber base impression, and plaster model of their rubber base impression were done. Linear dental measurements included intermolar width, interpremolar width, intercanine width, mesiodistal width of the 1st permanent molar, 1st premolar, canine and central incisor and arch width. All data were collected, tabulated and subjected to statistical analysis. Results: Small differences between the plaster and digital models were observed. Intra-observer reliability analysis for 14 out of the 16 measurements showed that all variables exhibited good to excellent reliability. Conclusions: There was no difference between the digitization using the intraoral scanner or the laboratory scanner. The most accurate digitization technique was the 3 Shape laboratory scanner of the cast of the alginate impression. The inEos X5 showed the highest error of digitization of the alginate and rubber base impressions.

Successful Treatment of Intra-Arterial Peplomycin Infusion for Recurrent Oral Florid Papillomatosis

A 56-year-old woman had noticed the erosion of oral mucosa and tongue 8 years ago. The mucosal lesions had been initially diagnosed as oral lichen planus and resistant to various treatments with prednisolone, etretinate and mizoribine and so on. One year ago, rapidly growing verrucous lesion occurred on her upper lip. Although we administered intralesional radiation therapy, the tumor recurred and new whitish lesions on the buccal mucosa and hard palate occurred 9 months after treatment. We confirmed an anatomical blood supply to the tumors by a fluorescent real-time imaging system and subsequently administered the intra-arterial infusion of peplomycin through retrograde catheters from bilateral superficial temporal arteries under the final diagnosis as oral florid papillomatosis (OFP). The tumors were dramatically shrunk and did not recur 16 months after treatment. OFP is known as clinically multiple whitish and verrucous lesions over the oral cavity and lip and a subtype of SCC with high differentiation. We suppose that an intra-arterial infusion therapy of peplomycin should be considered as the curative treatment for OFP.

激光应用于口源性口腔异味治疗的研究进展

口腔异味是继龋病、牙周病之后最常见的口腔科就诊问题,临床上80%~90%的病理性口腔异味由口源性因素引起,称为口源性口腔异味(IOH)。IOH的临床治疗包括定期洁牙、日常保健和使用抗菌药物,然而这些方式无法根除IOH,疗效短且患者不适感强,导致患者依从性差,无法达到理想的控制效果。激光在治疗时通常无需麻醉且几乎无疼痛感,因此适合用于多种口腔疾病的临床治疗。文章简要介绍IOH的病因和诊疗方式,重点总结近年来激光治疗IOH的疗效,为未来治疗IOH提供更多新的选择。

不同体积分数乙醇对白酒中典型酯类物质在口腔中吸附和释放过程的影响

风味物质在口腔中的释放过程对食品的最终风味感知有重要影响。该研究以溶解于10%、30%、50%、70%(体积分数)乙醇水溶液中的20种白酒典型酯类物质为研究对象,通过分析经品评员品评后吐出混标酒样中酯类物质的回收率,考察乙醇对酯类物质口腔吸附率的影响;并应用口腔顶空固相微萃取技术结合气相色谱-质谱联用仪,考察乙醇对酯类物质口腔释放过程的影响。实验结果显示,a)随着乙醇体积分数的增加(10%~70%),17种酯类物质在30%乙醇水溶液中的口腔吸附率显著高于溶于10%乙醇水溶液中的酯类(P<0.05),它们的口腔驻留量也会相应增加;b)在酯类物质的口腔释放过程中(30 s、2 min、4 min),乙醇体积分数的增加,会降低log P值(油水分配系数)较低酯类物质的瞬时口腔释放量(30 s),增加log P值较高物质的瞬时口腔释放量,推测其原因是高体积分数乙醇对log P值不同酯类物质的口腔释放抑制效果存在差异和酯类物质在口腔中驻留量的增加两者竞争性作用的结果;c)随着释放时间延长,在释放时间为2 min时,体积分数为70%的乙醇能够促进酯类物在口腔中的释放;释放时间为4 min时,30%和50%的乙醇能够增加酯类物质的口腔滞留度。该研究结果有助于进一步认知香气物质的口腔释放机制。

口内数字印模与选择性压力印模下颌牙列缺损游离端黏膜形态差异分析

目的:比较口内数字印模与选择性压力印模技术制取的下颌牙列缺损模型游离端黏膜组织形态的差异。方法:纳入下颌Kennedy第一、二类牙列缺损患者17例,共23个游离端,分别使用口内数字印模和选择性压力印模为同一患者制取2个下颌模型。使用模型扫描仪获取选择性压力印模石膏模型的三维图像,作为参照模型。在Geomagic Control 2014软件中将同一患者的口内数字印模与选择性压力印模进行三维偏差分析,得到均方根误差,测量游离端牙槽嵴顶距末端基牙5、10、15 mm处的2.5 mm半径圆形区域形态差异。采用SPSS 20.0软件包对偏差进行统计学分析。结果:口内数字印模与选择性压力印模技术制取的游离端黏膜平均形态差异为(0.37±0.12)mm,最小形态差异为0.26 mm,最大形态差异为0.55 mm。区域形态差异与末端基牙距离呈正相关(P<0.05),其中,距末端基牙5 mm处区域形态差异为(0.14±0.11)mm,距末端基牙10 mm处区域形态差异为(0.22±0.13)mm,距末端基牙15 mm处区域形态差异为(0.39±0.16)mm。结论:在本研究条件下,口内数字印模与选择性压力印模对下颌游离端缺牙区黏膜组织形态差异整体为0.26~0.55 mm,形态差异大小与距离末端基牙的距离呈正相关趋势。

数字化辅助一体化纤维桩核及树脂基陶瓷冠修复冠折年轻恒牙1例

桩核修复是临床常见的牙体缺损修复方式,临床常用桩核主要有玻璃纤维预成桩树脂核和个性化一体式桩核。在个性化桩核的材料选择上,由于金属的美观缺陷及氧化锆的弹性模量限制,兼具个性化、机械性能及美学优势的一体化玻璃纤维桩核作为一种新型桩核形式被临床所应用。本文报告1例CAD/CAM一体化纤维树脂桩核及树脂基陶瓷冠修复年轻恒牙冠折的临床病例。

双黄连口服液质量一致性评价研究

目的:探索建立双黄连口服液(SHLO)质量一致性评价方法,并对常见市售8个厂家的产品进行质量分级。方法:建立SHLO中6个指标成分的高效液相色谱含量测定方法,从同厂家不同批次、不同厂家角度分析样品含量均一性;用3个质量一致性参数[批内一致性差异(PA)、批间一致性差异(PB)、指纹图谱相似率(PC)]表征不同厂家产品质量一致性水平;运用主成分分析(PCA)模型提取一致性区分因子(P),实现对8个厂家样品质量一致性分级。结果:建立的高效液相色谱含量测定方法简便且方法学验证合格;40批样品中绿原酸、黄芩苷、连翘苷的质量浓度分别为0.66~1.25、12.71~21.89、0.39~0.66 mg·mL^(–1),均符合《中华人民共和国药典》(以下简称《中国药典》)2020年版对该制剂的限度要求,非《中国药典》2020年版指标成分新绿原酸、连翘酯苷A、汉黄芩苷的质量浓度分别为0.75~1.44、0.07~0.94、0.001 3~1.930 0 mg·mL^(–1),且同厂家样品均一性较好、不同厂家样品存在一定差异;8个厂家样品PA为1.2%~7.7%、PB为16.6%~39.1%、PC为99.3%~99.9%,依据P可将8个生产厂家样品分为3类,其中厂家F、R产品的一致性较好。结论:建立了简便的SHLO多成分定量方法,结合3个一致性评价参数和PCA模型可对不同生产厂家样品质量进行区分,数据结果可为各生产厂家质量标准提升提供参考。

Exploring the practice of common oral diseases among the patients visiting in the selected dental college and hospital in Bangladesh

Background:Having the ability to identify potential health risk factors such as lifestyle,ethnicity,health status,and social determinants associated with oral health status risk,health care providers can take an active role in health screening to discover any need for clinical preventive services,including dental preventive services,and can detect health problems.Methods:A descriptive type of cross-sectional study was conducted to explore the practice of common oral diseases among the patients visiting in the selected dental college and hospital in Bangladesh from October 2019 to December 2019.About 100 patients were interviewed through a semi-structured questionnaire,followed by an oral examination through a checklist and a face-to-face interview.A systematically random sampling technique was employed to select the study population.Results:Among them,the(21-30)year age group shows a maximum 20%,whereas the(71-80)year age group represents the minority with only 2%.Among them,56%were male and 44%were female.Students represent the majority of 26%,whereas others(day laborers)represent only 4%.Decayed teeth remained in 72%of cases,teeth were missing in 31%of cases,and filled teeth were present in 24%of cases.A majority of 71%clean teeth once daily,whereas only 29%clean teeth twice daily.Again,only 30%brush teeth at night and a maximum of 95%brush teeth in the morning.Moreover,a maximum of 68%use toothpaste and brushes,while only 4%use meswak for cleaning their teeth.About 4%of cases with no debris,51%of cases with less than 1/3rd of the tooth with debris,32%of cases with 1/3rd-2/3rd of the tooth with debris,and 13%of cases with more than 2/3rd of the tooth with debris were present.Again,about 30%had no calculus,52%less than 1/3rd of tooth,16%in between 1/3rd and 2/3rd of tooth,and 2%more than 2/3rd of the calculus was present.About 47%of mild,22%of moderate,6%of severe and 25%had no inflammation.Furthermore,for treatment purposes,20.69%was advised for scaling,19.66%for filling,16.90%for root canal treatment,17.59%for extraction,17.24%for prosthodontic treatment,1.03%for orthodontic treatment,2.07%for pulpotomy,2.41%for pulpectomy,and 2.41%for minor surgery.Overall,about 72%of the respondents,mostly the students,are suffering from decayed teeth,which may be due to a lack of frequency of brushing,indicating 95%that it is once daily.In addition,the most alarming situation among them is about 20.69%required scaling,which may be due to improper and inadequate brushing maintenance.Conclusion:to some extent,the above scenario may reflect the negative hallmark for our country’s younger generation in terms of oral health practice.Therefore,the establishment of a preventive oral health policy by our policymakers for the general population,mostly school-going students,on an emergency basis.

Advanced Primary Lymphoma of Oral Cavity: Report of a Case

Usually the oral manifestations of NHL are secondary to a more widespread involvement throughout the body, however, it can rarely present as a primary lesion in the oral cavity, having 0.1% - 0.2% prevalence. In this paper we report a case of highly proliferative oral non-Hodgkin lymphoma which presented with very mild symptoms, but had a sudden and significant progression in less than two weeks with involvement of all four quadrants of the oral cavity.

用于口舌驱动系统的双频植入式天线设计

口舌驱动系统是一种能够为丧失自主生活能力的患者提供帮助的辅助技术.为了满足该系统工作需求并为其提供良好的无线通信能力,提出了一种具有双频、柔性、宽频和小型化特性的植入式天线设计方案.考虑计算时间及设计方案的可行性,天线的设计在单层人体肌肉模型中完成,为了探究天线在口舌驱动系统中的性能表现,提出了多层人体口腔模型.借助曲流结构和缺陷地结构实现了天线的小型化设计,通过调整天线的馈电点位置,实现了天线的双频和宽带特性,通过在天线上下表面涂覆与介质基板相同材料的保护层,避免了天线与人体的直接接触从而提高了生物安全性.通过仿真确定了天线的最佳几何结构,并在新鲜猪肉和皮肤仿真液中进行测量,结果表明,该天线能够稳定工作在0.433 GHz和2.45 GHz频段.天线在两个频段的阻抗带宽分别达到了78.2%和34.2%,而整体尺寸仅为10 mm×10 mm×0.35 mm,同时天线表现出较低的比吸收率值.在此基础上,进行了远场数据传输测试,结果表明天线具有良好的远场传输能力,能够满足口舌驱动系统的应用需求.

应用代谢组学方法分析口臭患者与健康人舌苔代谢物的差异性

目的:利用非靶向代谢组学方法,分析口源性口臭患者和健康人舌苔代谢物差异,寻找口源性口臭差异显著代谢物作为生物标志物。方法:采用液相色谱质谱技术结合主成分分析法和正交偏最小二乘法-判别分析法,分别对12例口源性口臭患者和12名健康人舌苔样本进行非靶向代谢组学研究,以正交偏最小二乘法-判别分析法模型中变量投影重要性值>1和t检验P<0.05为标准筛选并确定差异性代谢物。结果:口源性口臭患者和健康人舌苔代谢物存在差异,鉴定到11个差异代谢物,谷氨酸、甘氨酸-苯丙氨酸、色氨酰-脯氨酸、脱氧腺苷、4,5-二氢白色向日葵素、N-乙酰-DL-色氨酸、帕拉米松乙酸酯、环戊醇、(2-己基环戊亚基)肼硫代甲酰胺、L-哌可酸和牛磺酸。其中口源性口臭组中的甘氨酸-苯丙氨酸和N-乙酰-DL-色氨酸表达显著上调,而牛磺酸表达显著下调。结论:口源性口臭患者和健康人的舌苔代谢物存在差异,具有诊断价值的差异代谢物或可作为口源性口臭的诊断标志物。

一种由口腔菌群失衡引起的大鼠口臭模型的构建及其评价

目的:利用口源性口臭(Intra-oral halitosis,IOH)患者唾液整体微生物群定植构建大鼠口臭模型,通过检测大鼠口腔相关微生物、相关代谢和口气值变化对该模型的可行性进行评价。方法:将健康的6~8周龄雄性Wistar大鼠随机分为两组,模型组(H组)和对照组(C组)。均适应性饲养1周后麻醉下进行口腔菌群采样并检测口气值,使用蘸有生理盐水的棉签机械清洗两组大鼠的牙齿和黏膜。再常规饲养1周后重复清洗并使用0.1%NaoCl冲洗口腔黏膜和牙齿5 min,随后用23μmol/L缓冲抗坏血酸钠冲洗10 min。使用加入保护液的IOH患者唾液整体微生物群涂抹H组大鼠牙齿和口腔黏膜,每日1次,涂抹后禁食水1 h,后持续给予10%高糖水,6周后麻醉下口腔菌群采样。同时常规饲养C组并采样。采用16SrRNA测序技术检测大鼠口腔微生物变化,使用PICRUSt进行菌群代谢功能预测,利用Halimeter口气检测仪每2周检测大鼠口气值。结果:与C组相比,H组口腔菌群中卟啉单胞菌属(Porphyromonas)、梭杆菌属(Fusobacterium)、孪生球菌属(Gemella)、纤毛菌属(Leptotrichia)和消化链球菌属(Peptostreptococcus)等与IOH相关的物种比例明显升高。PICRUSt代谢预测分析表明,与C组相比,H组口臭相关代谢途径明显增强。同时口气检测值也出现显著升高。结论:该造模方法可使IOH相关微生物定植大鼠口腔并发挥其产臭功能,很好的模拟了临床患者口腔菌群和口气特征,可用于未来IOH新的治疗方式和疾病发生发展的研究中。

口源性口臭患者口腔不同生态位菌群及代谢分析

目的研究口源性口臭患者与健康受试者口腔不同生态位菌群组成和代谢差异,探讨口源性口臭与口腔菌群的关系。方法随机选择7例以口臭为主诉就诊的口源性口臭患者(halitosis组)以及3例健康受试者(normal组)。分别记录两组口气值,收集两组唾液、舌苔、颊黏膜和颚黏膜菌群样本。采用16S rRNA方法对样本进行物种组成和多样性分析,并采用PICRUSt方法对样本进行代谢预测分析,组间差异显著性检验采用Adonis分析。结果两组4个生态位菌群丰度和多样性均无明显差异(均P>0.05)。Adonis分析表明,两组间唾液菌群差异显著(P=0.011),两组间舌苔(P=0.25)、颊黏膜(P=0.128)和颚黏膜(P=0.178)菌群结构相似。门水平上,halitosis组唾液中螺旋体门、颊黏膜中螺旋体门和拟杆菌门、颚黏膜中放线菌门比例均明显升高(均P<0.05)。属水平上,halitosis组弯曲杆菌属和巨球型菌属在唾液、舌苔和颊黏膜中均表现出高比例,密螺旋体属在唾液和颊黏膜中比例明显升高,纤毛菌属在舌苔和颊黏膜中比例升高(均P<0.05)。此外,halitosis组唾液中小杆菌属、舌苔中棒状杆菌属、颊黏膜中普雷沃菌属和毛绒厌氧杆菌属也表现出高比例(均P<0.05),而颚黏膜中仅巨球型菌属比例增高(P=0.017)。代谢方面,两组口腔4个生态位在硫及含硫氨基酸代谢未表现出显著差异(均P>0.05),但halitosis组唾液中泛酸盐和CoA生物合成途径明显增强,颊黏膜中糖胺聚糖降解途径及烟酸和烟酰胺代谢途径明显增强,颚黏膜中糖酵解/糖异生途径明显增强(均P<0.05)。结论口腔不同生态位致臭菌的高丰度定植、微生物失衡和代谢变化与口源性口臭的发生密切相关。

两种取模方法制作全瓷高嵌体的临床效果比较

目的:比较两种取模方法制作全瓷高嵌体的临床效果。方法:将80例根管治疗后需做高嵌体的患者随机采用数字印模法或弹性材料印模法获取印模制作高嵌体,分别记录取模时间、患者舒适度。1周后试戴嵌体记录修复体适合度及调改时间,进行临床效果比较。采用SPSS 18.0统计学软件进行数据处理。结果:数字印模组取模时间明显短于弹性印模材料组(P<0.05);取模时患者舒适度亦有明显差异(P<0.05);制作的修复体适合度及调改时间两组没有明显差异(P>0.05)。结论:数字印模具有取模速度快、方便、临床体验好、精确度高的优点,能较好地满足制作修复体对印模的要求,值得临床推广。

面下部轮廓整形术的术式选择

目的:探讨面下部轮廓整形术的手术方法。方法:对95例要求手术重塑面下部轮廓患者进行分类。根据分类,采用口内入路,以双侧下颌角整形术为主,结合面部吸脂术、颊脂垫部分摘除术、部分咬肌去除术、颏成形术等对患者下面部轮廓进行综合整形。结果:所有患者面下部轮廓均得到明显改善,术后随访6个月～1年,效果满意。其中术中大出血2例,术后血肿2例,一侧颏神经损伤2例,口角拉伤3例。结论:以双侧下颌角整形术为主,结合其他手术方式重塑面下部轮廓,临床效果满意。

口内入路面部轮廓复合改形术的临床应用

目的:探讨口内入路面部轮廓复合改形术的治疗效果。方法:采用口内切口,对患者下颌角肥大及颧骨过高等情况进行下颌角和颧骨等多部位的面部轮廓复合改形。结果:自2001年以来完成手术23例,出现术中出血和术后早期感染并发症各1例,经治疗痊愈。随访1年,患者面部轮廓均得到明显改善。结论:口内入路面部轮廓复合改形术能安全有效地矫治下颌角和颧骨肥大等症,效果良好。

3Shape Trios口内扫描仪在E.max铸瓷高嵌体临床应用中的效果评价

目的:评价3Shape Trios口内扫描仪在E.max铸瓷高嵌体临床应用中的早期临床效果。方法:选择2016年10月-2017年10月在西安交通大学口腔医院综合科行E.max铸瓷高嵌体修复的37例患者为研究对象,参照标准程序制作全瓷高嵌体,并采用3Shape Trios口内扫描仪采集数字化模型。修复完成后1周患者复诊并填写修复体满意度调查表,修复完成后2个月采用改良的美国公共卫生署(USPHS)标准对修复体进行评价。结果:共制作E.max铸瓷高嵌体40个,患者总体满意度为94.6%,根据改良的USPHS标准,各检查项目均达到B类以上标准,其中87.5%的修复体所有检查结果均符合A类标准。结论:3Shape Trios口内扫描仪在E.max铸瓷高嵌体临床应用中可获得较好的早期临床效果,患者满意度高,值得临床推广。

口内单侧纵切口e-PTFE隆颏术疗效观察

目的：阐述口内单侧纵切口e—PTFE隆颏术，观察其临床疗效。方法：对23例轻中度小颏畸形的患者，采用口内单侧纵切口，配合自制改良剥离子行e-PTFE隆颏术。结果：所有就医者随访6个月～2年，术后切口均一期愈合，无感染、假体排异、变形、移位等不良后果产生，外形满意。结论：口内单侧纵切口e—PTFE隆颏术是一种安全、有效、简便的纠治小颏畸形的手术方法。

数字化技术在口腔种植修复中的应用

随着计算机技术的飞速发展及其在口腔医学领域的广泛应用,当代口腔种植诊疗模式发生了前所未有的改变。数字化技术已真正渗透到种植修复治疗中的每一个环节,实现了精准、高效、舒适的个性化口腔种植诊疗新模式。该文旨在详细介绍口腔种植学中数字化技术的临床应用现状,阐述分析其优势与局限,并对其未来的发展方向进行探讨与展望。