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[A PhD completed. Developments in diagnosis and treatment of obstructive sleep apnea]. 博士学位完成。阻塞性睡眠呼吸暂停的诊断和治疗进展[j]。
Pub Date : 2023-06-01 DOI: 10.5177/ntvt.2023.06.23018
P F N Bosschieter

Identification of phenotypes and endotypes contributes to a better understanding of the complex pathophysiology and heterogeneous clinical presentation of obstructive sleep apnea. The general goal of this dissertation was to determine the added value of the identification and use of potential predictors; risk factors associated with obstructive sleep apnea and factors influencing treatment outcome. By identifying predictors, the specificity and sensitivity of diagnostic tools can be increased. In addition, these predictors can provide guidance in choosing from the treatment options, which could subsequently lead to an increase in treatment success. The phenotypes studied in this dissertation are: snoring sound, dental parameters and positional dependency. The predictive value of specific manoeuvres and tools during sleep endoscopy for treatment success with a mandibular repositioning device was also studied. Finally, the innovative treatment for obstructive sleep apnea, hypoglossal nerve stimulation was investigated.

表型和内型的鉴定有助于更好地理解阻塞性睡眠呼吸暂停的复杂病理生理和异质性临床表现。本文的总体目标是确定潜在预测因子的识别和使用的附加价值;阻塞性睡眠呼吸暂停的相关危险因素和影响治疗结果的因素。通过识别预测因子,可以提高诊断工具的特异性和敏感性。此外,这些预测因子可以为选择治疗方案提供指导,从而提高治疗成功率。本论文研究的表型有:鼾声、牙参数和位置依赖性。我们还研究了睡眠内镜下特定操作和工具对下颌复位装置治疗成功的预测价值。最后,探讨了舌下神经刺激治疗阻塞性睡眠呼吸暂停的新方法。
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引用次数: 0
[The Stark family, dentists for 75 years]. [斯塔克家族,75年的牙医]。
Pub Date : 2023-06-01 DOI: 10.5177/ntvt.2023.06.23010
D J Schutte

In the Netherlands there are a few families that have been active from generation to generation in the profession of dentist. Although this is not the case with the Stark family, as many as 12 members of the family have been in the dental profession over a period of 75 years. In addition, a few were also very active outside dentistry, with the greatest example being the painter and toothpaste manufacturer Elias Stark (1849-1933).

在荷兰,有几个家族世代活跃在牙医行业。尽管斯塔克家族并非如此,但在75年的时间里,该家族多达12名成员从事牙科行业。此外,一些人在牙科之外也非常活跃,最伟大的例子是画家和牙膏制造商Elias Stark(1849-1933)。
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引用次数: 0
Dental materials and oral care products that can cause contact allergies 可引起接触性过敏的牙科材料和口腔护理产品
Pub Date : 2023-05-09 DOI: 10.5177/ntvt.2023.05.23023
S.M. Franken, A.J. Feilzer, N.A. Ipenburg, T. Rustemeyer
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引用次数: 0
[What is known about the diagnosis and treatment of herpes labialis?] 关于唇疱疹的诊断和治疗,我们知道些什么?]
Pub Date : 2023-05-01 DOI: 10.5177/ntvt.2023.05.22089
M V Starink

Herpes labialis is one of the most common skin infections. In most people it is asymptomatic or mildly symptomatic, but very severe cases do occur. Herpes remains latent and can recur. Herpes labialis is a clinical diagnosis. If in doubt, additional testing can be carried out, usually polymerase chain reaction. There are no treatments that can eliminate the virus. In case of more severe symptoms and frequent recurrences, there may be an indication for treatment. In case of mild complaints, topical zinc sulphate/zinc oxide and analgesics (systemic or topical lidocaine) will suffice. More severe complaints and frequent recurrences can be treated with antiviral creams (Aciclovir) or with systemic antiviral medication (Valaciclovir). In frequent recurrences, prophylactic Valaciclovir can also be given for a period of many months. Treatment should be started as soon as possible and will slightly shorten the duration of the disease.

唇疱疹是最常见的皮肤感染之一。大多数人无症状或症状轻微,但也会发生非常严重的病例。疱疹是潜伏的,可以复发。唇疱疹是一种临床诊断。如果有疑问,可以进行额外的检测,通常是聚合酶链反应。目前还没有可以消除这种病毒的治疗方法。如果症状更严重且经常复发,可能需要治疗。在轻微的情况下,局部硫酸锌/氧化锌和止痛药(全身或局部利多卡因)就足够了。更严重的症状和频繁复发可以用抗病毒药膏(阿昔洛韦)或全身抗病毒药物(瓦昔洛韦)治疗。在频繁复发的情况下,预防性的伐昔洛韦也可以服用数月。治疗应尽快开始,并将稍微缩短病程。
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引用次数: 0
[White lesions of the oral mucosa: leukoplakia]. 【口腔黏膜白色病变:白斑】。
Pub Date : 2023-05-01 DOI: 10.5177/ntvt.2023.05.23016
J G A M de Visscher, E H van der Meij

White lesions of the oral mucosa may be caused by various disorders. In most instances of white lesions, diagnoses can be made solely on clinical grounds. When the clinical diagnosis is not compatible with a known disease, the term leukoplakia is used. This is of importance since the yearly malignant transformation rate of oral leukoplakia into a squamous cell carcinoma is 2-4%. The presence and degree of epithelial dysplasia is the most important predictor for malignant transformation.

口腔黏膜的白色病变可能是由各种疾病引起的。在大多数白色病变的情况下,诊断可以完全根据临床依据。当临床诊断与已知疾病不相容时,使用术语白斑。这一点很重要,因为口腔白斑每年向鳞状细胞癌的恶性转化率为2-4%。上皮异常增生的存在和程度是恶性转化最重要的预测因子。
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引用次数: 0
[Basal cell nevus syndrome: the interface between dentistry and dermatology]. 基底细胞痣综合征:牙科和皮肤病学之间的界面。
Pub Date : 2023-05-01 DOI: 10.5177/ntvt.2023.05.22095
B Cosgun, B J A Verkouteren, P A W H Kessler, K Mosterd

Basal cell nevus syndrome is a rare, autosomal dominant disorder, predominantly caused by a mutation in the PTCH1 gene. As basal cell carcinomas and keratocysts are the most common abnormalities, dermatologists, orofacial maxillary surgeons, and dentists play a key role in patient care. From the age of 8, screening for odontogenic keratocysts with an orthopantomogram or MRI is recommended every other year. The intensity increases to annual screening after the development of the first odontogenic keratocyst. If BCNS is caused by an underlying SUFU mutation, screening is not indicated since there are no reports of odontogenic keratocyst in these patients to date. Radiation exposure by, for example, computed tomography, should be minimized as it induces new BCCs. Regular follow-up by a dermatologist for early diagnosis and treatment of (multiple) BCC's is recommended for life.

基底细胞痣综合征是一种罕见的常染色体显性遗传病,主要由PTCH1基因突变引起。由于基底细胞癌和角化囊肿是最常见的异常,皮肤科医生、口腔颌面外科医生和牙医在患者护理中起着关键作用。从8岁开始,建议每隔一年进行一次骨断层扫描或核磁共振检查,以检查牙源性角化囊肿。在首次出现牙源性角化囊肿后,强度增加到每年筛查一次。如果BCNS是由潜在的SUFU突变引起的,则不需要筛查,因为迄今为止没有这些患者中牙源性角化囊肿的报道。应尽量减少计算机断层扫描等放射暴露,因为它会诱发新的基底细胞癌。建议终生由皮肤科医生定期随访,进行早期诊断和治疗(多发)BCC。
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引用次数: 0
[Dental materials and oral care products that can cause contact allergies]. [可引起接触性过敏的牙科材料和口腔护理产品]。
Pub Date : 2023-05-01 DOI: 10.5171/ntvt.2023.05.23023
S M Franken, A J Feilzer, N A Ipenburg, T Rustemeyer

Various restorative and prosthetic materials, dental implants, medicines and cosmetic materials, such as toothpaste and denture cleaning products, are used in oral care. In principle, these materials can cause contact allergies, which can manifest as lichenoid reaction, cheilitis and angioedema. It is usually a local reaction of the oral mucosa and surrounding tissues, but a systemic reaction can also occur elsewhere in the body. If a patient develops complaints from dental materials that could be due to an allergy, it makes sense to investigate this allergologically, although these do not yet show full specificity or sensitivity. After a positive allergological examination, it is possible to examine more specifically whether the patient's complaints match the test result and it can be decided whether it is sensible to replace the dental material and, if so, which material could be an alternative. After removal of the causative allergens, the complaints should disappear completely.

各种修复和修复材料,牙种植体,药物和化妆品材料,如牙膏和假牙清洁产品,用于口腔护理。原则上,这些物质可引起接触性过敏,可表现为类地衣反应、唇炎和血管性水肿。它通常是口腔黏膜和周围组织的局部反应,但全身反应也可发生在身体的其他部位。如果患者对可能是由于过敏引起的牙科材料产生不适,那么对这种过敏症进行调查是有意义的,尽管这些还没有显示出完全的特异性或敏感性。在过敏检查呈阳性后,可以更具体地检查患者的抱怨是否与测试结果相符,并可以决定是否更换牙科材料,如果是,哪种材料可以替代。去除致敏原后,症状应完全消失。
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引用次数: 0
[Lichen planus]. [地衣化planus]。
Pub Date : 2023-05-01 DOI: 10.5177/ntvt.2023.05.23021
C L M van Hees, E H van der Meij

Lichen planus is an inflammatory disorder of the skin and/or mucosa. Immune dysregulation, infections, environmental and genetic factors play a role in its pathogenesis. Clinically, there are 6 important distinctive manifestations. The mucosal subtypes manifest inside the mouth, oesophagus, genitalia and - although less often - the nose, ear canal, tear duct and conjuctiva. The non-mucosal subtypes occur on the skin, scalp (hair follicles) and nails. Patients may suffer from several subtypes of lichen planus. Unfamiliarity with the different manifestations may lead to a delay in diagnosis and thus to insecurity and distress in patients. The advice to all healthcare providers is to ask patients with lichen planus about symptoms of all subtypes and clinically inspect the skin and mucosa, or to refer the patient to a dermatologist.

扁平苔藓是一种皮肤和/或粘膜的炎症性疾病。免疫失调、感染、环境和遗传因素在其发病机制中起作用。临床上有6个重要的独特表现。粘膜亚型出现在口腔、食道、生殖器和鼻、耳道、泪道和结膜内,尽管较少出现。非粘膜亚型发生在皮肤、头皮(毛囊)和指甲上。患者可能患有几种亚型的扁平苔藓。对不同表现的不熟悉可能导致诊断的延误,从而导致患者的不安全感和痛苦。对所有医疗保健提供者的建议是向患有扁平苔藓的患者询问所有亚型的症状,并临床检查皮肤和粘膜,或将患者转诊给皮肤科医生。
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引用次数: 0
[Mucosal anomalies in autoimmune bullous diseases]. 自身免疫性大疱性疾病的粘膜异常。
Pub Date : 2023-05-01 DOI: 10.5177/ntvt.2023.05.22090
J M Meijer, A Vissink

Mucosal anomalies are frequently seen in autoimmune bullous diseases, particularly in pemphigus vulgaris and mucous membrane pemphigoid. The blistering, erosions, ulceration or erythema may present anywhere on the oral mucosa, but also on other mucosal sites. A differential diagnosis is needed of (erosive) oral lichen planus, systemic autoimmune disease, inflammatory bowel diseases, chronic graft-versus-host disease, infectious causes, Behçet's syndrome and recurrent aphthous stomatitis. A quick diagnosis and initiation of adequate treatment are important because of the potential severity of the disease and to prevent complications due to cicatrization. Besides a biopsy for histopathological analysis, a perilesional biopsy for direct immunofluorescence microscopy and immunoserological tests are needed for diagnosis of pemphigus or pemphigoid. In addition to a mucosal biopsy, a biopsy for direct immunofluorescence of the skin can contribute to a diagnosis of a bullous disease. Besides topical corticosteroids, immunosuppressive treatment is often required for treating autoimmune bullous diseases, such as treatment with rituximab in patients with pemphigus.

黏膜异常常见于自身免疫性大疱性疾病,特别是寻常型天疱疮和粘膜类天疱疮。起泡、糜烂、溃疡或红斑可出现在口腔粘膜的任何部位,也可出现在其他粘膜部位。需要鉴别诊断(糜烂性)口腔扁平苔藓、全身自身免疫性疾病、炎症性肠病、慢性移植物抗宿主病、感染性原因、behet综合征和复发性口疮性口炎。由于该疾病的潜在严重性和防止因愈合引起的并发症,快速诊断和开始适当治疗非常重要。诊断天疱疮或类天疱疮,除了进行组织病理学分析的活检外,还需要进行直接免疫荧光显微镜和免疫血清学检查的病灶周围活检。除了粘膜活检外,皮肤直接免疫荧光活检也有助于大疱性疾病的诊断。除了局部皮质类固醇外,免疫抑制治疗通常需要用于治疗自身免疫性大疱性疾病,例如天疱疮患者的利妥昔单抗治疗。
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引用次数: 0
[Ulcerations of the oral mucosa]. [口腔黏膜溃疡]
Pub Date : 2023-05-01 DOI: 10.5177/ntvt.2023.05.22084
E H van der Meij, J G A M de Visscher

Ulceration is a common presenting sign of a wide spectrum of diseases of the oral cavity involving many etiologic factors, such as trauma, infection, neoplasms, medication, and immune related disorders, ranging from self-limited lesions to life-threatening diseases. In most cases, a proper diagnosis can be established based on medical history and clinical features only. Early diagnosis is important as oral ulcerations might be a manifestation of a systemic disease or sometimes even due to a malignant process.

溃疡是多种口腔疾病的常见表现,涉及多种病因,如创伤、感染、肿瘤、药物和免疫相关疾病,范围从自限性病变到危及生命的疾病。在大多数情况下,仅根据病史和临床特征即可作出正确的诊断。早期诊断很重要,因为口腔溃疡可能是全身性疾病的表现,有时甚至是恶性过程的表现。
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引用次数: 0
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Nederlands tijdschrift voor tandheelkunde
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