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EVALUATION OF ORAL MIDAZOLAM AS CONSCIOUS SEDATION FOR PEDIATRIC PATIENTS IN ORAL RESTORATION

Chinese Medical Sciences Journal 2006年第3期21卷 163-166页

作者： kuo wan Quan Jing Ji-zhi Zhao Department of Endodontics Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730

Objective To evaluate the effect of midazolam alone on sedation in young children for dental restorative care. Methods Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twenty-one patients were assigned to intervention group received 0. 5 mg/kg of oral midazolam 20 minutes prior to the beginning of dental treatment, and 19 patients in control group received placebo liquid 20 minutes before treatment. All patients received painless local anesthetic injection and were restrained with children＇s board and bands. Blood pressure （ BP）, heart rate （HR）, oxygen saturation, treatment compliance scores of the Ramsay scale, the Briekopf and Butmer scale, Frankl scale, and the Houpt scale were recorded. Each procedure was taped and all the data were evaluated every 5 minutes by an anesthetist or experienced dentist who was unaware of the drug given to the child. Results HR in intervention group （82. 5 ± 5.1 bpm） was much lower than that in control group （95.2 ± 8.9 bpm; F=31.20, P 〈0. 001 ）. Intervention group had a significantly lower systolic BP level （94.8±5.6 mmHg） than control group （98.5±5.5 mm Hg; F=4. 34, P =0. 04）, but the diastolic BP （63.0 ± 3.5 mm Hg） was not significantly lower than control group （ 65.5 ± 4. 8 mm Hg; F = 3.31, P = 0. 07 ）. Children in intervention group showed more compliance. The patients＇ scores of the Ramsay scale, Briekopf and Buttner scale, Frankl scale, and Houpt scale in intervention group （ 1.37 ± 0. 96, 1.37 ± 0. 83, 1.32 ± 0. 67, and 2. 32 ± 1.49, respectively） were significantly lower than those in control group （3.71 ± 1.23, 2.71 ± 0. 96, 2.71 ± 0. 90, and 4.71 ± 1.19 ; F = 44. 66, 22. 36, 30.39,and 31.88,respectively,all P〈0.001） Conclusions Oral midazolam alone is safe and produces effective sedation for the dental treatment of young children. Oral midazolam application should be generally preferred because it is more easily accepted by pediatric patients.

关键词： midazolam oral administration dental anxiety dental restoration

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Double Roots of Mandibular Premolar in Full-mouth Periapical Films

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Chinese Medical Sciences Journal 2015年第3期30卷 174-178页

作者： Ling-jia Kong kuo wan Deng-gao Liu Department of Stomatology Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical College Department of Radiology Peking University School of Stomatology

Objective To evaluate the incidence of two-rooted mandibular premolar morphology using full-mouth periapical film series in a Chinese population,with particular emphasis on bilateral incidence,so as to provide a clinical anatomical basis for root canal treatment in mandibular *** A total of 2015 patients who underwent dental treatment and had full mouth periapical radiographs at the Peking University School of Stomatology from April 2011 to April 2012 were enrolled in this *** experienced dentists reviewed the patients' periapical films and classified the root morphology of mandibular premolars *** incidence of unilateral and bilateral double roots were recorded and calculated,including confirmed and suspected bucco-lingual root *** In terms of the morphology of two-rooted mandibular first premolars,of the 2015 cases with complete root formation,two-rooted first premolars were detected in 120 cases,with a total number of 159 *** to the number of teeth,the overall incidence of double roots was 4.03%(159/3972).In terms of the morphology of two-rooted mandibular second premolars,of the 2015 cases with complete root formation,two-rooted second premolars were detected in 24 cases,with a total number of 33 *** to the number of teeth,the overall incidence of double roots was 0.85%(33/3880).Conclusions The roots of mandibular premolars display specific morphological *** on a large sample,we observed and calculated not only the occurrence rate of bucco-lingual and mesio-distal double roots in first and second mandibular premolars,but also the incidence of unilateral or bilateral double roots within the same *** findings could provide useful information on the anatomical structure of mandibular premolars for endodontic,prosthodontic and surgical procedures,and could improve the quality of treatment and reduce complications.

关键词： first mandibular premolar second mandibular premolar double roots full-mouth periapical film

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BLOOD PRESSURE CHANGES OF ELDERLY HYPERTENSIVE PATIENTS DURING DENTAL EXTRACTION UNDER SEDATION WITH CONTINUOUS INTRAVENOUS INFUSION OF MIDAZOLAM

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Chinese Medical Sciences Journal 2007年第2期22卷 132-135页

作者： Ji-zhi Zhao kuo wan Quan Jing Xi Chen Department of Stomatology Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730

Objective To evaluate the changes in blood pressure (BP) of elderly hypertensive patients having dental extraction under sedation with continuous intravenous infusion of midazolam. Methods One hundred elderly hypertensive patients undergoing dental extraction were recruited for this single-blind, randomized, controlled study. Patients in intervention group (n=50) were given midazolam dissolved in glucose solution and patients in control group (n=50) were given glucose solution only with communication technique. Systolic BP (SBP) and diastolic BP (DBP) were recorded in five time points. Results Under basal conditions, intervention group did not show significant difference in BP compared with control group. Before sedation, mean values of SBP and DBP (especially SBP) significantly increased compared with basal conditions in both groups (P<0.05). During dental extraction sessions, mean values of BP in intervention group significantly decreased than control group (P<0.05), but coefficient of variation did show significant difference in both groups. Conclusion Continuous intravenous infusion of midazolam has been proved to be very successful in controlling BP of elderly patients having dental extraction.

关键词： midazolam intravenous infusion hypertension dental extraction aged

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Effectiveness and Safety of Computer-controlled Periodontal Ligament Injection System in Endodontic Access to the Mandibular Posterior Teeth

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Chinese Medical Sciences Journal 2014年第1期29卷 23-27页

作者： Quan Jing kuo wan Xiao-jun wang Lin Ma Department of Dentistry Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical College Department of Plastic Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical College

Objective To evaluate the effectiveness and safety of a computer-controlled periodontal ligament （PDL） injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis. Methods A total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth： the premolar group （PM, z2=38）, first molar group （FM, n=66）, and second molar group （SM, n=58）. All the patients received computer-controlled PDL injection with 4% articaine and 1 ＇ 100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure. Results The overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups （92.1%, 53.0%, 93.1%, respectively; 2 X =34.3, P〈0.01）. Both the PM and SM groups showed higher success rates than that of the FM group （v=l, f=16.73, P〈0.01, v=l, Z = 4.5, X2 2 P〈0.01）. No irreversible adverse effects on the periodontal soft tissues at the injection sites were observed in the follow-up visits in any of the groups. Conclusion The computer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.

关键词： periodontal ligament injection endodontic access irreversible pulpitis

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Multiple Coatings can Improve the Bond Durability of One-step Self-etching Adhesive to Primary Dentin

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Chinese Medical Sciences Journal 2012年第2期27卷 106-111页

作者： Lin Ma Jian-feng Zhou Quan Jing Ji-zhi Zhao kuo wan Department of Stomatology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Prosthodontics Peking University School&Hospital of StomatologyBeijing 100081China

Objective To investigate whether multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin. Methods Twelve caries-free human primary molars were randomly divided into 2 groups. In group 1, each tooth was hemisected into 2 halves. One half was assigned to the control subgroup 1, which was bonded with a commercially available one-step self-etching adhesive according to the manufacturer＇s instruc- tions; the other half was assigned to experimental subgroup 1, in which the adhesive was applied three times before light curing. In group 2, one split half tooth was bonded with a commercially available one-step self-etching adhesive according to the manufacturer＇s instructions; for the other half, three layers of adhesive were applied with each successive layer of light curing. Specimens were stored in 0.9% NaC1 containing 0.02% sodium azide at 37℃ for 18 months and then were subjected to microtensile bond strength test and the fracture mode analysis. Results When the adhesive was applied three times before light curing, the bond strength of the ex- perimental subgroup 1 was significantly higher than that of the control subgroup 1 （47.46__＋13.91 vs. 38.12＋11.21 MPa, P〈O.05）. When using the technique of applying multiple layers of adhesive with each successive layer of light curing, no difference was observed in bond strength between the control subgroup and the experimental subgroup （39.40＋8.87 vs. 40.87-＋9.33 MPa, P〉O.05）. Conclusion Multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin when using the technique of light-curing after applying 3 layers of adhesive.

关键词： self-etching adhesive microtensile bond strength test primary dentin multiple coatings

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Effect of Multiple Coatings of One-step Self-etching Adhesive on Microtensile Bond Strength to Primary Dentin

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Chinese Medical Sciences Journal 2011年第3期26卷 146-151页

作者： Lin Ma Jian-feng Zhou Jian-guo Tan Quan Jing Ji-zhi Zhao kuo wan Department of Stomatology Peking Union Medical College HospitalChinese Academy of Medical Sciences ＆ Peking Union Medical CollegeBeijing 100730China Department of Prosthodontics Peking University School and Hospital of StomatologyBeijing 100081China

Objective To investigate the effect of multiple coatings of the one-step self-etching adhesive on immediate microtensile bond strength to primary *** Twelve caries-free human primary molars were randomly divided into 2 groups with 6 teeth *** group 1,each tooth was hemisected into two *** half was assigned to control subgroup 1,which was bonded with a single-step self-etching adhesive according to the manufacturer's instructions;the other half was assigned to experimental subgroup 1 in which the adhesive was applied three times before light *** group 2,the teeth were also hemisected into two *** half was assigned to control subgroup 2,which was bonded with the single-step self-etching adhesive according to the manufacturer's instructions;the other half was assigned to experimental subgroup 2 in which three layers of adhesive were applied with light curing each successive *** bond strength was immediately tested after specimen *** When the adhesive was applied three times before light curing,the bond strength of the experimental subgroup 1(n=33,57.49±11.61 MPa) was higher than that of the control subgroup 1(n=31,49.71±11.43 MPa,P0.05).Conclusion Multiple coatings of one-step self-etching adhesive can increase the immediate bond strength to primary dentin when using the technique of light-curing after applying three layers of adhesive.

关键词： self-etching adhesive microtensile bond test primary dentin multiple coatings

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Clinical Treatment and Anatomy Study of Maxillary First Molars with Five Root Canals

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Chinese Medical Sciences Journal 2011年第2期26卷 129-131页

作者： kuo wan Shun-yun Luo Ji-zhi Zhao Hai-yun wang Lin Ma Wen-dong Yang Department of Stomatology Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China

THE purpose of root canal treatment is to thoroughly clean the root canal system and fill it in all its dimensions.I To achieve this goal, the entire root canal system must be adequately debrided and completely filled. In clinical practice, variations in the canal morphology pose a constant challenge to endodontists in deciding on accurate diagnosis and appropriate management. Knowledge of these variations is crucial for a successful endodontic treatment, especially in absence of an operating microscope or cone-beam computered tomography （CBCT）.

关键词： endodontics maxillary first molar root canal system

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Medical Emergencies in Dental Clinics: A Survey of 2013 Dentists in China

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Chinese Medical Sciences Journal 2020年第4期35卷 342-349页

作者： Quan Jing kuo wan Lin Ma Jizhi Zhao Department of Dentistry Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

Objective To investigate the feature and frequency of medical emergencies in dental clinics in China and the Methods A survey study was conducted among 2408 dentists who attended continuing educational courses held by Society of Sedation and Analgesia of Chinese Stomatological Association in 18 cities from December 2015 to December *** information of the dentists and the characteristics of medical emergencies they encountered were collected and *** associated demographic features for dentist experiencing medical emergencies were analyzed by logistic regression *** A total of 2013 dentists provided valid responses and reported 2923 events of medical emergencies in dental *** them,85.0%reported that they had encountered medical emergencies,and 35.5%had encountered at least ***(35.9%)and hypoglycemia(30.3%)were the most common reported medical *** emergencies were most likely to occur during local anesthesia(49.9%),out-patient oral surgery(25.9%),and root canal treatment(11.3%).There were 6 patients(0.2%)died in emergencies.84.0%dentists reported that they had never received training courses about medical emergency management in dentistry other than Basic Life *** practicing time(10-15 years)(OR=0.59,95%CI:0.41-0.85,P=0.004),working in private dental facilities(OR=1.69,95%CI:1.20-2.38,P=0.003)were associated with an increased risk of experiencing medical *** More efforts are needed in prevention,early identification,and timely management of medical emergencies in dental clinics in order to prevent fatal *** results of this survey are useful information for re-designing emergency training courses for Chinese dentists.

关键词： dental clinics dentists medical emergency frequency survey

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口腔治疗中笑气应用的医源性污染危害与防控

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中华口腔医学杂志 2019年第4期54卷 282-285页

作者：王莹万阔中国医学科学院北京协和医学院北京协和医院口腔科 100730

氧化亚氮(nitrous oxide,N2O)又称笑气,作为常见吸入镇静镇痛气体在口腔诊室被广泛使用,以减少治疗过程中的焦虑和疼痛。研究表明长期暴露在较高浓度的笑气环境中可能对医务人员的健康造成一定影响,但目前有关口腔治疗中笑气应用的医源... 详细信息

氧化亚氮(nitrous oxide,N2O)又称笑气,作为常见吸入镇静镇痛气体在口腔诊室被广泛使用,以减少治疗过程中的焦虑和疼痛。研究表明长期暴露在较高浓度的笑气环境中可能对医务人员的健康造成一定影响,但目前有关口腔治疗中笑气应用的医源性污染研究并不充分。美国和欧洲国家对笑气的应用较成熟,制定了关于笑气医源性污染的相关规定和防控措施,但目前在这些国家笑气的临床使用仍存在医源性污染并缺乏统一的检测手段。国内关于笑气对医务人员的健康影响鲜有研究,对如何检测和防控笑气污染了解较少。现主要针对口腔诊室内笑气污染的危害、检测与防控进行综述。

关键词：牙科诊室职业暴露笑气环境检测

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哮喘患者牙科清醒镇静技术的应用

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中国医学科学院学报 2010年第3期32卷 357-360页

作者：马林万阔中国医学科学院北京协和医学院北京协和医院口腔科北京100730

哮喘多在儿童时期发病,可影响口腔健康,而牙科治疗和牙科焦虑也容易诱发哮喘发作。本文介绍了哮喘对牙科治疗和牙科用药的影响及哮喘患者牙科清醒镇静方式选择等问题。

关键词：哮喘清醒镇静牙科治疗

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