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[Oral health in young adults with a mild intellectual disability and multiple problems]. [有轻度智力障碍和多种问题的年轻人的口腔健康]。
Pub Date : 2024-07-01 DOI: 10.5177/ntvt.2024.07/08.24001
C M C Volgenant, R de Soet, Z Wang, J J de Soet

More than 1.1 million people in the Netherlands have a mild intellectual disability (MID). They are relatively more likely to have poor oral health. The aim of this study was to investigate the oral health of MID young adults with multiple problems (such as addiction). A questionnaire was administered orally to 76 inpatient clients of the Salvation Army in Amsterdam and intraoral examinations were also performed. The research group consisted of young adults with MID and additional multi-problems. The collected data was compared with a reference group (Dutch young adults with a low socio-economic status). The results suggest that oral hygiene is poor in this population, and that a more internal locus of control is associated with a higher caries index. The findings of this study emphasize the importance of professional oral care in young adults with MID given poor oral hygiene and treatment delays. A tailor-made approach with more flexibility in treatment is essential to provide young adults with MID the right oral care.

荷兰有 110 多万人患有轻度智力障碍 (MID)。他们的口腔健康状况相对较差。本研究旨在调查有多种问题(如成瘾)的轻度智障青壮年的口腔健康状况。研究人员对阿姆斯特丹救世军的 76 名住院病人进行了口头问卷调查,并进行了口腔内检查。研究小组由患有 MID 和其他多种问题的年轻人组成。收集到的数据与参照组(社会经济地位较低的荷兰年轻人)进行了比较。研究结果表明,该人群的口腔卫生状况较差,而更多的内部控制与更高的龋齿指数相关。这项研究的结果强调,鉴于口腔卫生状况不佳和治疗延误,专业口腔护理对患有混合髓鞘病的年轻人非常重要。要为患有 MID 的年轻人提供正确的口腔护理,必须采取量身定制的方法,并在治疗过程中增加灵活性。
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引用次数: 0
[Postoperative risk of bleeding after removal of third molars in healthy patients - a prospective observational clinical study]. [健康患者拔除第三磨牙术后出血风险--一项前瞻性观察临床研究]。
Pub Date : 2024-07-01 DOI: 10.5177/ntvt.2024.07/08.24028
W M H Rademacher, W Rooijers, M W Broekman, B J van der Slik, D E van Diermen, F R Rozema

Removal of third molars in healthy patients is considered a procedure with a low risk of bleeding. However, exactly how low the incidence of postoperative bleeding is remains unclear due to the heterogeneity of available studies. To determine the exact postoperative risk of bleeding after the removal of third molars in healthy patients, a prospective observational multicentre study was conducted. A total of 1,035 patients with complete follow-up was included. Of these, 329 patients reported subsequent bleeding, but did not consult their attending physician. A total of 15 patients visited the hospital, 8 of whom required minimally invasive (re)treatment. No hospitalizations were necessary. There was a large difference between the incidence of postoperative bleeding reported by patients and postoperative bleeding requiring clinical examination and/or treatment. To reduce this difference in future, patients should be given detailed information about what degree of postoperative bleeding is considered normal after removal of a third molar.

健康患者拔除第三磨牙被认为是一种出血风险较低的手术。然而,由于现有研究的异质性,术后出血发生率究竟有多低仍不清楚。为了确定健康患者拔除第三磨牙术后出血的确切风险,我们开展了一项前瞻性多中心观察研究。研究共纳入了 1,035 名接受过完整随访的患者。其中,329 名患者报告了后续出血情况,但并未咨询主治医生。共有 15 名患者到医院就诊,其中 8 人需要进行微创(再)治疗。没有人需要住院治疗。患者报告的术后出血发生率与需要临床检查和/或治疗的术后出血发生率之间存在很大差异。为了在今后减少这种差异,应向患者详细说明在拔除第三磨牙后,何种程度的术后出血属于正常现象。
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引用次数: 0
[Treatment of bruxism with botulinum toxin: think twice!] [用肉毒杆菌毒素治疗磨牙症:三思而后行!]
Pub Date : 2024-07-01 DOI: 10.5177/ntvt.2024.07/08.24017
F Lobbezoo, M C Verhoeff, R Helmers, J de Lange, M Koutris

A recent publication in the Nederlands Tijdschrift Voor Tandheelkunde (Dutch Journal of Dentistry) suggests botulinum toxin as a primary treatment for bruxism, especially for severe complaints of teeth grinding or jaw clenching. However, in the opinion of Lobbezoo et al., some outdated views on bruxism are used, and botulinum toxin is incorrectly classified as safe, according to them. In this Vision article, the authors describe the current insights into bruxism; they indicate how the presence of bruxism can be assessed in the clinic; when and how bruxism is treated; and finally, what the role of botulinum toxin is: an ultimum refugium. Therefore, regarding the use of botulinum toxin within the discipline of orofacial pain and dysfunction Lobbezoo et al. recommend: think twice!

荷兰牙科杂志》(Nederlands Tijdschrift Voor Tandheelkunde)最近发表了一篇文章,建议将肉毒杆菌毒素作为磨牙症的主要治疗方法,尤其是针对严重的磨牙或下颌紧握症状。然而,在 Lobbezoo 等人看来,他们使用了一些关于磨牙症的过时观点,并错误地将肉毒杆菌毒素归类为安全的。在这篇 "远见 "文章中,作者阐述了目前对磨牙症的认识;指出了在临床上如何评估磨牙症的存在;磨牙症何时以及如何治疗;最后,肉毒杆菌毒素的作用是什么:一种终极疗效。因此,对于在口面部疼痛和功能障碍学科中使用肉毒杆菌毒素,Lobbezoo 等人建议:三思而后行!
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引用次数: 0
[Follicular cyst steadily pushes tooth upwards, with all the consequences thereof]. [毛囊囊肿不断将牙齿推向上方,并由此产生各种后果]。
Pub Date : 2024-07-01 DOI: 10.5177/ntvt.2024.07/08.24033
S A Zijderveld, D R C Verkouteren

A 60-year-old man was referred to an oral and maxillofacial surgeon with discomfort caused by pressure on the left-hand side of the maxilla. Examination revealed a very elevated third molar in contact with the orbital floor and infundibulum, and, possibly, a follicular cyst. On account of the threat to the orbital floor, it was first decided to decompress the cyst and place an in situ drain. After 4 months, the tooth and cyst could be removed and the diagnosis of a follicular cyst was confirmed.Auteursinformatie.

一名 60 岁的男子因上颌骨左侧受压不适而被转诊至口腔颌面外科医生。检查发现,第三磨牙非常高,与眶底和眶内膜接触,可能还有一个滤泡囊肿。考虑到对眶底的威胁,首先决定对囊肿进行减压,并在原位放置引流管。4 个月后,牙齿和囊肿被移除,滤泡囊肿的诊断得到证实。
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引用次数: 0
[A PhD completed. More insight into the origin and composition of salivary stones]. [博士毕业。对唾液结石的来源和组成有了更深入的了解]。
Pub Date : 2024-06-01 DOI: 10.5177/ntvt.2024.06.24018
S Kraaij, J G A M de Visscher, F J Bikker, H S Brand

Salivary stones are hardened, stony calcifications that primarily develop in the drainage duct of a salivary gland. They can lead to obstruction of the saliva flow, resulting in swelling and pain. Since the aetiology of salivary stones remains largely unclear, this was further investigated in this PhD study. A case-control review of patient records showed that systemic diseases and lifestyle factors most likely do not play a role in their occurrence. The biochemical composition of salivary stones removed by oral-maxillofacial surgeons was examined, revealing that large salivary stones have a different inorganic composition than small salivary stones. Several salivary proteins were detected in submandibular salivary stones, including lysozyme, s-IgA, and -amylase. Clumping together of these proteins may play a role in the initial formation of salivary stones.

唾液腺结石是一种硬化的石质钙化物,主要发生在唾液腺的排泄管中。它们会导致唾液流动受阻,引起肿胀和疼痛。由于唾液腺结石的病因在很大程度上仍不清楚,本博士研究对此进行了进一步的调查。对患者病历进行的病例对照审查显示,全身性疾病和生活方式因素很可能与唾液结石的发生无关。对口腔颌面外科医生取出的唾液结石的生化成分进行了研究,结果显示,大唾液结石的无机成分与小唾液结石不同。在颌下腺唾液结石中检测到了几种唾液蛋白,包括溶菌酶、s-IgA 和淀粉酶。这些蛋白质聚集在一起可能是唾液结石最初形成的原因之一。
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引用次数: 0
[Diagnosing neuropathic orofacial pain in the general dental practice]. [普通牙科诊所中的神经性口面部疼痛诊断]。
Pub Date : 2024-06-01 DOI: 10.5177/ntvt.2024.06.23101
M Soffner, M Koutris, J Baggen, J de Lange, F Lobbezoo

Dental pain is a common reason for patients to visit the dentist. This type of pain is usually easy to diagnose and treat. However, diagnosing and treating other forms of orofacial pain remains complicated. One of the most challenging types of orofacial pain to diagnose and treat is neuropathic orofacial pain: pain resulting from damage to nerve tissue. Recognizing this type of pain in a timely manner can prevent unnecessary invasive dental treatments and disappointment for patients who seek help for this type of pain. There are relatively simple tools for dentists to distinguish neuropathic pain from other types of orofacial pain. The treatment of neuropathic pain is primarily focused on symptom relief through medication.

牙痛是患者看牙医的常见原因。这种疼痛通常很容易诊断和治疗。然而,诊断和治疗其他形式的口面部疼痛仍然很复杂。最难诊断和治疗的口面部疼痛类型之一是神经性口面部疼痛:神经组织受损导致的疼痛。及时发现这类疼痛可以避免不必要的侵入性牙科治疗,也不会让因这类疼痛寻求帮助的患者失望。牙医有一些相对简单的工具来区分神经性疼痛和其他类型的口面部疼痛。神经性疼痛的治疗主要侧重于通过药物缓解症状。
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引用次数: 0
[Suture techniques and materials used in oral surgery]. [口腔外科使用的缝合技术和材料]。
Pub Date : 2024-06-01 DOI: 10.5177/ntvt.2024.06.23090
J E Bergsma

This article highlights the importance of proper suturing of mucosa, gingiva, and skin after surgical procedures and trauma. Several factors play a role in promoting good healing, including optimal tension on the sutured wound, adequate blood flow, and careful selection of suture materials. The selected suture material depends on various factors, such as type of tissue, location of the wound, and healing time. Different suture techniques are discussed, including interrupted sutures, continuous sutures, horizontal and vertical mattress sutures, each with their own specific applications and benefits. Skillfulness in suture techniques and appropriate material selection contribute to effective wound healing and optimal outcomes.

本文强调了手术和外伤后正确缝合粘膜、牙龈和皮肤的重要性。促进伤口良好愈合的因素很多,包括缝合伤口的最佳张力、充足的血流量以及缝合材料的精心选择。所选缝合材料取决于多种因素,如组织类型、伤口位置和愈合时间。本文讨论了不同的缝合技术,包括间断缝合、连续缝合、水平和垂直褥式缝合,每种缝合技术都有其特定的应用和优点。娴熟的缝合技术和适当的材料选择有助于伤口的有效愈合和最佳疗效。
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引用次数: 0
[Haemophilia and dental procedures; a complex combination]. [血友病与牙科手术;复杂的组合]。
Pub Date : 2024-06-01 DOI: 10.5177/ntvt.2024.06.23098
G Mulders, J T van der Tas, M J H A Kruip, F S Kroon, A J G Jansen

A 28-year-old patient with severe haemophilia A presented to the emergency department with significant and painful swelling of the left cheek, an extensive haematoma extending from the left ear to the anterior thoracic region, an intraoral haematoma over the soft palate with deviation of the uvula to the right, and complaints of shortness of breath when lying down. Three days prior, his dentist had performed a restoration of the 36 molar under local anaesthesia. Due to pain, the general practitioner had administered an intramuscular injection of a non-steroidal anti-inflammatory drug (NSAID) two days post-procedure. The patient was admitted for treatment with coagulation factors and pain management. Dental procedures and local anaesthesia in patients with a severe coagulation disorder require specific preparatory measures, such as administration of coagulation factors. Collaboration and consultation with a patient's haematologist or haemophilia treatment centre are essential requirements for safe dental care.

一名 28 岁的重度血友病 A 患者因左脸颊明显肿胀且疼痛难忍、大面积血肿从左耳延伸至胸腔前部、软腭上有口腔内血肿且悬雍垂向右偏移而到急诊科就诊,并主诉躺下时呼吸急促。三天前,他的牙医在局部麻醉下为他修复了 36 颗臼齿。由于疼痛,全科医生在术后两天为其肌肉注射了非甾体抗炎药(NSAID)。患者入院后接受了凝血因子治疗和疼痛治疗。对患有严重凝血障碍的患者进行牙科手术和局部麻醉需要采取特殊的准备措施,如使用凝血因子。与患者的血液科医生或血友病治疗中心合作和协商是安全牙科护理的基本要求。
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引用次数: 0
[Temporomandibular joint disorder after dental treatment]. [牙科治疗后的颞下颌关节紊乱]。
Pub Date : 2024-05-01 DOI: 10.5177/ntvt.2024.05.23106
G B van Gessel, A J de Rijk

A 56-year-old woman presented with persistent unilateral gnathological complaints after replacing an amalgam restoration. The patient reported tension and pain in the right side of her jaw, along with crackling sounds in the temporomandibular joint. Physical examination revealed tenderness in the right masseter muscle and temporomandibular joint, as well as anterior disc replacement with reduction on both sides. The initial treatment focused on providing rest to the temporomandibular joint, the Yoda exercise, and later, wet-needling. Despite initially limited improvement, the symptoms persisted. This case underscores the complexity and various treatment options for temporomandibular joint issues following dental procedures.

一名 56 岁的女性在更换了汞合金修复体后,出现了持续性的单侧下颌疼痛。患者称右侧下颌紧张和疼痛,颞下颌关节有噼啪声。体格检查显示右侧颌面肌和颞下颌关节有压痛,前椎间盘置换术后两侧椎间盘缩小。最初的治疗主要是让颞下颌关节休息,进行尤达运动,后来又进行了湿针治疗。尽管最初的治疗效果有限,但症状依然存在。该病例强调了牙科手术后颞下颌关节问题的复杂性和各种治疗方案。
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引用次数: 0
[Fractures of the mandibular condyle]. [下颌骨髁状突骨折]。
Pub Date : 2024-05-01 DOI: 10.5177/ntvt.2024.05.23107
A V J Rozeboom

A fracture of the mandibular condyle is a common fracture of the mandible. After the diagnosis has been made, there are various treatment options: wait and see, conservative or surgical. Which of these treatment options is best depends on several different factors and is often the subject of debate. A common complication of a fracture of the mandibular condyle is malocclusion. Malocclusion can cause problems - even in the long term - for which the patient often requires secondary treatment.

下颌骨髁状突骨折是一种常见的下颌骨骨折。确诊后,有多种治疗方案可供选择:静观其变、保守治疗或手术治疗。哪种治疗方案最好取决于多种不同因素,通常也是争论的焦点。下颌髁状突骨折的常见并发症是咬合不正。错颌畸形会导致各种问题--即使是长期问题--患者往往需要二次治疗。
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引用次数: 0
期刊
Nederlands tijdschrift voor tandheelkunde
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