目的:评价伴错畸形的侵袭性牙周炎(aggressive periodontitis,Ag P)患者行牙周-正畸联合治疗的临床疗效及安全性。方法:纳入25名就诊于北京大学口腔医院牙周科并完成牙周-正畸治疗的Ag P患者,回顾性评价初诊(T0)、正畸治疗前(T1)、正...目的:评价伴错畸形的侵袭性牙周炎(aggressive periodontitis,Ag P)患者行牙周-正畸联合治疗的临床疗效及安全性。方法:纳入25名就诊于北京大学口腔医院牙周科并完成牙周-正畸治疗的Ag P患者,回顾性评价初诊(T0)、正畸治疗前(T1)、正畸治疗完成后(T2)的探诊深度(probing depth,PD)、出血指数(bleeding index,BI)、探诊后出血比率(percentage of sites with bleeding on probing,BOP%),通过根尖片评价正畸前后剩余牙槽骨高度(residual alveolar bone height,RBH)的变化及牙根吸收发生状况。结果:(1)在牙周治疗后、正畸治疗前(T1)及正畸治疗完成后(T2),PD、BI、BOP%以及PD>3 mm位点的百分比均有显著降低(P<0.001)。(2)T0时全口RBH均值为68.37%±15.60%,牙周-正畸治疗后RBH为70.27%±14.23%,差异有统计学意义,其中上切牙[T0为58.79%±16.71%,T2为65.54%(55.74%,78.13%)]、上尖牙[T0为77.62%(66.06%,87.17%),T2为79.57%(69.75%,86.52%)]及上磨牙[T0为74.30%(61.69%,84.45%),T2为76.76%(68.12%,85.09%)]在正畸治疗后RBH增高明显(P<0.05)。(3)正畸治疗后人均有23.94%±13.45%的牙发生牙根吸收,其中以下切牙及上切牙的发生率最高,总发生率分别为68.48%和65.31%。结论:伴错畸形的Ag P患者,在规范的牙周治疗后,正畸治疗不会引起牙周炎症加重或牙槽骨吸收;约2/3的上、下切牙可发生轻度的牙根吸收。展开更多
Keratocystic odontogenic tumors(KCOTs,previously known as odontogenic keratocysts) are aggressive,noninflammatory jaw lesions with a putative high growth potential and a propensity for recurrence.This article puts tog...Keratocystic odontogenic tumors(KCOTs,previously known as odontogenic keratocysts) are aggressive,noninflammatory jaw lesions with a putative high growth potential and a propensity for recurrence.This article puts together a summary of the serial studies related to KCOTs undertaken by the author’s research group in recent years.Intraosseous jaw cysts with a solely orthokeratinized lining epithe-lium have been suggested to differ from the typical KCOTs.We report 20 cases of such cyst type under the term of ’orthokeratinized odontogenic cyst(OOC)’.Apart from the presence of a keratinizing epithelial lining,the OOC lacks the other histological features of KCOT,exhibits little if any tendency to recur,has no apparent association with NBCCS,may be cured by simple enucleation,and may thus constitute its own clinical entity.Mutations in PTCH1 gene are responsible for NBCCS and are related in tumors associated with this syndrome.We have so far detected 26 PTCH1 mutations(2 mutations occurred twice) in 10 out of 34(29.4%) sporadic and 14 out of 16(87.5%) NBCCS-associated KCOTs.The 26 mutations consisted of 10 frameshift,2 nonsense,3 aberrant splicing,4 in-frame insertion/deletion/ duplication and 7 missense mutations.Two missense mutations in PTCH2 were also detected in 2 out of 15 NBCCS related KCOT patients.By contrast,no pathogenic mutation was detected in SMO.Thus,our data,together with reports from ther groups,indicate that defects of PTCH1 are involved in the pathogenesis of syndromic as well as sporadic KCOTs.The pathogenic role of PTCH2 requires further investigation.A series of in vitro studies on bone resorption of KCOTs and ameloblastomas were undertaken by this group.The results indicate that odontogenic lesions could promote bone resorption in vitro and it is likely to be related to some of the cytokines secreted by the lesions.展开更多
目的:建立犬拔牙窝模型,采用影像学分析方法评价拔牙窝内植入去蛋白牛骨基质骨粉颗粒Bio-Oss®(简称Bio-Oss骨粉)并覆盖复层猪小肠黏膜下层膜(multilaminated small intestinal submucosa membrane,mSIS)或可吸收胶原膜Bio-Gide...目的:建立犬拔牙窝模型,采用影像学分析方法评价拔牙窝内植入去蛋白牛骨基质骨粉颗粒Bio-Oss®(简称Bio-Oss骨粉)并覆盖复层猪小肠黏膜下层膜(multilaminated small intestinal submucosa membrane,mSIS)或可吸收胶原膜Bio-Gide®(简称Bio-Gide膜),愈合4周和12周后的牙槽窝内成骨效果。方法:拔除3只比格犬双侧上下颌共计18颗前磨牙的远中根,得到18个拔牙窝,随机平均分为3大组,并分别对各拔牙窝组进行以下操作:(1)植入Bio-Oss骨粉并覆盖mSIS膜(mSIS组),(2)植入Bio-Oss骨粉并覆盖Bio-Gide膜(BG组),(3)自然愈合(空白对照组)。每大组各随机平均分为2个小组,分别于手术后4周和12周取样进行微计算机体层扫描(micro-computed tomograph,Micro-CT),检测评价各组牙槽窝内新骨的生长情况,比较mSIS膜和Bio-Gide膜对拔牙窝内骨再生的影响。结果:Micro-CT分析显示,mSIS组和BG组在术后4周和12周的新生骨容积比均显著高于空白对照组(P<0.05),其中mSIS组略高于BG组,但两组间差异无统计学意义(P>0.05)。术后4周mSIS组和BG组的牙槽窝冠1/3区域新生骨容积比例显著高于中1/3及根1/3区域(P<0.05)。术后4周各组的新生骨密度值相近(P>0.05),术后12周时mSIS组和BG组的新生骨密度值均显著高于对照组(P<0.05)。术后4周和12周mSIS组和BG组的新生骨小梁的数量以及排列紧凑程度明显优于空白对照组(P<0.05),而mSIS略优于BG组,但两组间差异无统计学意义(P>0.05)。各组间骨小梁厚度的差异无统计学意义(P>0.05)。结论:两种屏障膜联合去蛋白牛骨基质植入拔牙窝内有利于新骨再生,mSIS膜与Bio-Gide膜的应用效果相似。展开更多
目的:在颊侧袋形瓣引导性骨再生手术基础上,探讨放置可吸收胶原膜是否有利于维持术后牙槽嵴轮廓稳定。方法:收集2019年6月至2023年6月因单颗后牙缺失采用种植体植入同期进行颊侧袋形瓣引导性骨再生手术患者,根据骨粉表面是否覆盖胶原膜...目的:在颊侧袋形瓣引导性骨再生手术基础上,探讨放置可吸收胶原膜是否有利于维持术后牙槽嵴轮廓稳定。方法:收集2019年6月至2023年6月因单颗后牙缺失采用种植体植入同期进行颊侧袋形瓣引导性骨再生手术患者,根据骨粉表面是否覆盖胶原膜分为胶原膜覆盖组和无覆盖组。术前(T0)、术后即刻(T1)和术后3~7个月(T2)拍摄锥形束CT,利用Mimics软件测量种植体光滑-粗糙交界面下不同水平(0、2、4和6 mm)处颊侧骨板厚度(thickness of the buccal bone plate,BBT,分别表示为BBT-0、-2、-4、-6)。结果:收集胶原膜覆盖组15例,无胶原膜覆盖组14例,共计29例患者进行统计分析。在T0、T1和T2三个时间点,不同水平的BBT在两组间差异均无统计学意义(P>0.05)。T2时,BBT-0在胶原膜覆盖组和无覆盖组分别为(1.22±0.55)mm和(1.70±0.97)mm,相应的BBT-2分别为(2.32±0.94)mm和(2.57±1.26)mm。T1~T2愈合阶段不同水平处颊侧骨板吸收的绝对值[(0.47±0.54)~(1.33±0.75)mm]和百分数[(10.04%±24.81%)~(48.43%±18.32%)],以及T0~T2阶段颊侧骨板新骨形成厚度[(1.27±1.09)~(2.75±2.15)mm]在两组间差异均无统计学意义。结论:颊侧袋形瓣引导骨再生手术无论是否使用胶原膜均可有效修复种植体颈部颊侧骨缺损。与无胶原膜覆盖相比,胶原膜覆盖植骨材料不能提高术后牙槽嵴轮廓的稳定性。展开更多
文摘目的:评价伴错畸形的侵袭性牙周炎(aggressive periodontitis,Ag P)患者行牙周-正畸联合治疗的临床疗效及安全性。方法:纳入25名就诊于北京大学口腔医院牙周科并完成牙周-正畸治疗的Ag P患者,回顾性评价初诊(T0)、正畸治疗前(T1)、正畸治疗完成后(T2)的探诊深度(probing depth,PD)、出血指数(bleeding index,BI)、探诊后出血比率(percentage of sites with bleeding on probing,BOP%),通过根尖片评价正畸前后剩余牙槽骨高度(residual alveolar bone height,RBH)的变化及牙根吸收发生状况。结果:(1)在牙周治疗后、正畸治疗前(T1)及正畸治疗完成后(T2),PD、BI、BOP%以及PD>3 mm位点的百分比均有显著降低(P<0.001)。(2)T0时全口RBH均值为68.37%±15.60%,牙周-正畸治疗后RBH为70.27%±14.23%,差异有统计学意义,其中上切牙[T0为58.79%±16.71%,T2为65.54%(55.74%,78.13%)]、上尖牙[T0为77.62%(66.06%,87.17%),T2为79.57%(69.75%,86.52%)]及上磨牙[T0为74.30%(61.69%,84.45%),T2为76.76%(68.12%,85.09%)]在正畸治疗后RBH增高明显(P<0.05)。(3)正畸治疗后人均有23.94%±13.45%的牙发生牙根吸收,其中以下切牙及上切牙的发生率最高,总发生率分别为68.48%和65.31%。结论:伴错畸形的Ag P患者,在规范的牙周治疗后,正畸治疗不会引起牙周炎症加重或牙槽骨吸收;约2/3的上、下切牙可发生轻度的牙根吸收。
文摘Keratocystic odontogenic tumors(KCOTs,previously known as odontogenic keratocysts) are aggressive,noninflammatory jaw lesions with a putative high growth potential and a propensity for recurrence.This article puts together a summary of the serial studies related to KCOTs undertaken by the author’s research group in recent years.Intraosseous jaw cysts with a solely orthokeratinized lining epithe-lium have been suggested to differ from the typical KCOTs.We report 20 cases of such cyst type under the term of ’orthokeratinized odontogenic cyst(OOC)’.Apart from the presence of a keratinizing epithelial lining,the OOC lacks the other histological features of KCOT,exhibits little if any tendency to recur,has no apparent association with NBCCS,may be cured by simple enucleation,and may thus constitute its own clinical entity.Mutations in PTCH1 gene are responsible for NBCCS and are related in tumors associated with this syndrome.We have so far detected 26 PTCH1 mutations(2 mutations occurred twice) in 10 out of 34(29.4%) sporadic and 14 out of 16(87.5%) NBCCS-associated KCOTs.The 26 mutations consisted of 10 frameshift,2 nonsense,3 aberrant splicing,4 in-frame insertion/deletion/ duplication and 7 missense mutations.Two missense mutations in PTCH2 were also detected in 2 out of 15 NBCCS related KCOT patients.By contrast,no pathogenic mutation was detected in SMO.Thus,our data,together with reports from ther groups,indicate that defects of PTCH1 are involved in the pathogenesis of syndromic as well as sporadic KCOTs.The pathogenic role of PTCH2 requires further investigation.A series of in vitro studies on bone resorption of KCOTs and ameloblastomas were undertaken by this group.The results indicate that odontogenic lesions could promote bone resorption in vitro and it is likely to be related to some of the cytokines secreted by the lesions.
文摘目的:在颊侧袋形瓣引导性骨再生手术基础上,探讨放置可吸收胶原膜是否有利于维持术后牙槽嵴轮廓稳定。方法:收集2019年6月至2023年6月因单颗后牙缺失采用种植体植入同期进行颊侧袋形瓣引导性骨再生手术患者,根据骨粉表面是否覆盖胶原膜分为胶原膜覆盖组和无覆盖组。术前(T0)、术后即刻(T1)和术后3~7个月(T2)拍摄锥形束CT,利用Mimics软件测量种植体光滑-粗糙交界面下不同水平(0、2、4和6 mm)处颊侧骨板厚度(thickness of the buccal bone plate,BBT,分别表示为BBT-0、-2、-4、-6)。结果:收集胶原膜覆盖组15例,无胶原膜覆盖组14例,共计29例患者进行统计分析。在T0、T1和T2三个时间点,不同水平的BBT在两组间差异均无统计学意义(P>0.05)。T2时,BBT-0在胶原膜覆盖组和无覆盖组分别为(1.22±0.55)mm和(1.70±0.97)mm,相应的BBT-2分别为(2.32±0.94)mm和(2.57±1.26)mm。T1~T2愈合阶段不同水平处颊侧骨板吸收的绝对值[(0.47±0.54)~(1.33±0.75)mm]和百分数[(10.04%±24.81%)~(48.43%±18.32%)],以及T0~T2阶段颊侧骨板新骨形成厚度[(1.27±1.09)~(2.75±2.15)mm]在两组间差异均无统计学意义。结论:颊侧袋形瓣引导骨再生手术无论是否使用胶原膜均可有效修复种植体颈部颊侧骨缺损。与无胶原膜覆盖相比,胶原膜覆盖植骨材料不能提高术后牙槽嵴轮廓的稳定性。
