Lingual

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  • 文章类型: Journal Article
    康复训练需要精确的运动协调和目标准确性,以获得最佳效果。本文探讨了舌头力量练习(TSE)表现准确性对运动结果的影响,坚持,以及参与者的信心和动力。一项为期8周的随机临床试验包括84名典型的衰老参与者,分为四组,这些参与者在家庭锻炼计划(HEP)期间通过获得生物反馈(存在/不存在)和TSE强度剂量(最大/次最大)来定义。保留,培训,对于使用生物反馈装置的参与者,在每两周一次的访视和HEP期间跟踪HEP的准确性。与舌头力量结果的关联,参与者因素,生物反馈,和强度给药进行了分析。在8周结束时,运动准确性测量对舌头强度结果没有贡献。训练准确性的提高(获得能力所需的练习较少)与更高的参与者信心和更好的对HEP的依从性有关。生物反馈的存在与粘附性降低相关,但保留准确性更高,而与次最大强度运动相比,最大强度与所有准确性指标的改善有关。在典型的衰老参与者中的这些发现表明,在吞咽相关的锻炼计划中需要量身定制的方法,考虑到生物反馈和运动强度对运动学习和运动保留的影响。准确性表现及其对临床结果的影响值得在吞咽困难和各种康复方法的临床人群中进行研究。试验注册Clincialtrials.gov:NCT04809558。
    Rehabilitative exercises require precise movement coordination and target accuracy for optimal effectiveness. This paper explores the impact of tongue strength exercises (TSE) performance accuracy on exercise outcomes, adherence, and participant confidence and motivation. An 8-week randomized clinical trial included 84 typically aging participants divided into four groups defined by access to biofeedback (present/absent) and TSE intensity dosing (maximal/submaximal) during a home exercise program (HEP). Retention, training, and HEP accuracy were tracked at biweekly visits and during HEP for participants with access to a biofeedback device. Associations with tongue strength outcomes, participant factors, biofeedback, and intensity dosing were analyzed. Exercise accuracy measures did not contribute to tongue strength outcomes at the end of 8 weeks. Increased training accuracy (less practice required to achieve competency) was associated with higher participant confidence and better adherence to the HEP. The presence of biofeedback was associated with reduced adherence but better retention accuracy, while maximal intensity was associated with improvements in all accuracy measures compared to submaximal intensity exercise. These findings in typically aging participants suggest the need for tailored approaches in swallowing-related exercise programs, given the effects of biofeedback and exercise intensity on motor learning and exercise retention. Accuracy performance and its effect on clinical outcomes warrants study in clinical populations with dysphagia and with various rehabilitative approaches.Trial Registration Clincialtrials.gov: NCT04809558.
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  • 文章类型: Journal Article
    纤维脂肪瘤定义为典型的脂肪瘤,由不同数量的少质细胞和胶原纤维成分横断。口腔和舌纤维脂肪瘤是人类医学中公认的组织学实体,在女性中更为普遍。最常见于第四个十年之后,来自颊粘膜。兽医学中缺乏口腔中这种肿瘤的文献。通过对提交诊断病理学服务的病例进行多机构回顾性汇编,在这里,我们描述了犬口腔纤维脂肪瘤的临床和病理特征。共检索到112例犬口腔纤维脂肪瘤。平均年龄为10.1岁(范围2-16岁,±2.63年标准偏差),平均肿瘤大小为1.7厘米(范围为0.2-8厘米,±1.1cm标准偏差)。最常见的位置是舌头(57.1%,64/112),其次是颊粘膜(15.2%,16/112),舌下面积(8.0%,9/112),牙龈和嘴唇(4.5%,每个5/112),上颚(1例)。口腔纤维脂肪瘤的解剖位置仅在犬种之间存在显着差异(P<0.001),但在性别之间没有差异。年龄,回忆,或提交的理由。肿瘤最常见于男性(69.7%,78/112),在62.5%(70/112)的病例中,肿瘤是偶然发现的.在考虑犬的良性舌部和其他口腔软组织肿块时,应将纤维脂肪瘤视为鉴别诊断。
    Fibrolipoma is defined as a typical lipoma transected by variable amounts of paucicellular and collagenous fibrous components. Oral and lingual fibrolipomas are well-recognized histological entities in human medicine that are slightly more prevalent in females, occur most commonly after the fourth decade, and arise from the buccal mucosa. The documentation of this neoplasm in the oral cavity is lacking in veterinary medicine. Through a multi-institutional retrospective compilation of cases submitted to diagnostic pathology services, here we describe the clinical and pathologic features of oral fibrolipomas in dogs. A total of 112 cases of oral fibrolipomas in dogs were retrieved. The mean age was 10.1 years (range 2-16 years, ±2.63 years standard deviation), with an average tumor size of 1.7 cm (range 0.2-8 cm, ±1.1 cm standard deviation). The most common location was the tongue (57.1%, 64/112), followed by the buccal mucosa (15.2%, 16/112), sublingual area (8.0%, 9/112), gingiva and lip (4.5%, 5/112 each), and palate (1 case). The anatomical location of oral fibrolipomas only differed significantly among the dog breeds (P < .001) but not among sex, age, anamnesis, or reason for submission. The tumor was most commonly reported in males (69.7%, 78/112), and in 62.5% (70/112) of the cases, the tumor was an incidental finding. Fibrolipoma should be considered a differential diagnosis when considering benign lingual and other oral soft tissue masses in dogs.
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  • 文章类型: Journal Article
    目的:使用多参数监测仪评估有创血压(IBP)和舌部示波血压(OBPton)之间的一致性。
    方法:非致盲,prospective,实验研究。
    方法:共12头雌性大白杂交猪。
    方法:招募进行需要动脉插管放置的实验程序的猪。将宽度最接近舌头周长40%的血压袖带置于舌系带的前端。收缩压,同时测量平均和舒张期IBP和OBPton,间隔5分钟.使用Bland-Altman分析检查配对测量之间的一致性。平均偏差,精度(平均偏差的标准偏差),95%的协议限制,计算了10和20mmHgIBP内的相关系数和测量值百分比.
    结果:收缩压记录的配对测量总数为124、126和124,平均和舒张压,分别。平均偏差,收缩期OBPton的精度和95%一致界限为11.5、11.5(-11.1至34.2),平均OBPton5.6,5.7(-5.7至16.8)和舒张OBPton7.6,10.1(-12.1至27.4)mmHg。仅平均OBPton的相关系数大于0.9。仅对于平均和舒张OBP,超过50%的测量值在IBP的10mmHg内,并且80%的测量值在IBP的20mmHg内。
    结论:作为示波血压测量的袖带部位的舌头是测量平均动脉的有用部位,但不是收缩压或舒张压麻醉的大型白色杂交猪。该技术符合美国兽医内科学院的标准,用于测量平均动脉压,而不是收缩压或舒张压。
    OBJECTIVE: To evaluate the agreement between measurements of invasive blood pressure (IBP) and oscillometric blood pressure from the tongue (OBPton) using a multiparameter monitor.
    METHODS: Unblinded, prospective, experimental study.
    METHODS: A total of 12 female Large White crossbreed pigs.
    METHODS: Pigs undergoing experimental procedures that required arterial cannula placement were recruited. A blood pressure cuff with the closest width to 40% of the circumference of the tongue was placed rostral to the lingual frenulum. Systolic, mean and diastolic IBP and OBPton were measured simultaneously at 5 minute intervals. Agreement between paired measurements was examined using Bland-Altman analysis. Mean bias, precision (standard deviation of mean bias), 95% limits of agreement, correlation coefficients and percentage of measurements within 10 and 20 mmHg of IBP were calculated.
    RESULTS: The total numbers of paired measurements recorded were 124, 126 and 124 for systolic, mean and diastolic blood pressures, respectively. The mean bias, precision and 95% limits of agreement for systolic OBPton were 11.5, 11.5 (-11.1 to 34.2), for mean OBPton 5.6, 5.7 (-5.7 to 16.8) and for diastolic OBPton 7.6, 10.1 (-12.1 to 27.4) mmHg. Correlation coefficients were greater than 0.9 for mean OBPton only. More than 50% of measurements were within 10 mmHg of IBP and 80% of measurements were within 20 mmHg of IBP for mean and diastolic OBPton only.
    CONCLUSIONS: The tongue as a cuff site for oscillometric blood pressure measurement is a useful site for measuring mean arterial, but not systolic or diastolic blood pressure in anaesthetized Large White crossbreed pigs. This technique fulfils the American College of Veterinary Internal Medicine criteria for measuring mean arterial pressure but not systolic or diastolic arterial pressure.
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  • 文章类型: Journal Article
    这项研究调查了红眼鸽子的舌头和喉部结构的形态,并将其与摄食习惯相关联。使用大体解剖学检查样本,扫描电子显微镜(SEM),和组织学技术。舌头符合下喙的形状,顶点有一个尖的尖端,身体,和根是杰出的。中间的树林很明显,带有尖头三角形乳头的乳头状c将身体与根部分开。舌头的长度,其宽度(主体),舌头占下颌长度的百分比是,平均而言,12.5mm,2.3mm,57.3%,分别。SEM显示背上皮高度脱皮,具有尖状乳头状突起。乳头状峰呈现约20-22的尖乳头。唾液开口在根部很明显,被粘膜褶皱和钝乳头包围。喉部突起呈不规则三角形状,升高。声门的边缘显示腺状的精确标记。典型的角化多层粘膜上皮存在于先端,并在尾端减少。体部和先端均存在鼻舌骨软骨和毗邻的结缔组织。在身体和根部可见许多肾小管肺泡腺。声门边缘显示粘液上皮内腺。鼻端和尾端舌腺对中性和酸性粘蛋白呈阳性反应。这项研究证明了红眼鸽子的舌头与其饮食的形态功能关系。
    This study investigated the morphology of tongue and laryngeal structures in red-eyed dove and related it to feeding habits. Samples were examined using gross anatomy, scanning electron microscopy (SEM), and histological techniques. The tongue conformed to the shape of the lower beak, and the apex with a pointed tip, body, and root were distinguished. A median grove was apparent, and a papillary crest with pointed triangular papillae separated the body from the root. The length of the tongue, its width (body), and the percentage of the length of the lower jaw occupied by the tongue were, on average, 12.5 mm, 2.3 mm, and 57.3%, respectively. SEM showed highly desquamated dorsal epithelium with pointed papillae-like projections. The papillary crest presented pointed papillae of about 20-22. Salivary openings were apparent in the root, surrounded by mucosal folds and blunt papillae. Laryngeal prominence was irregularly triangular shaped and elevated. The rim of the glottis showed glandular pinpointed marks. Typical cornified multilayered mucosal epithelium was present in the apex and decreased caudally. Hyaline entoglossal cartilage and adjoining connective tissue were present in the body and apex. Numerous tubuloalveolar glands were seen in the body and root. The rim of the glottis showed mucous intraepithelial glands. The rostral and caudal lingual glands indicated positive reaction to neutral and acidic mucins. This study demonstrated a morphofunctional relationship of the tongue of a red-eyed dove to its diet.
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  • 文章类型: Journal Article
    背景:阻塞性睡眠呼吸暂停/低通气综合征(OSAHS)是一种普遍存在的疾病,影响了全球相当大一部分人口,在过去的20年里,它的患病率越来越高。OSAHS的特点是睡眠期间反复上呼吸道(UA)闭合,导致对生活质量产生重大影响,并增加心血管和代谢发病率。尽管持续气道正压通气(CPAP)是治疗的金标准,由于各种因素,患者的依从性仍然欠佳,如不适,副作用,和治疗不可接受。
    目的:考虑到与CPAP依从性相关的挑战,我们探索了一种通过肌功能疗法靶向UA肌肉的替代方法.这种非侵入性干预涉及嘴唇的锻炼,舌头,或两者都可以改善口咽功能并减轻OSAHS的严重程度。为了开发用于基于家庭的肌功能治疗的便携式设备,并连续监测运动表现和依从性,本研究的主要结局是完成和坚持4周训练的程度.
    方法:这项概念验证研究的重点是一种便携式设备,该设备旨在促进舌头和嘴唇的肌功能治疗,并能够精确监测运动表现和依从性。进行了一项临床研究,以评估该计划在改善睡眠呼吸障碍方面的有效性。参与者被指示进行舌头突出,唇压,控制呼吸作为各种任务的一部分,每周6次,持续4周,每节持续约35分钟。
    结果:10名参与者被纳入研究(n=8名男性;平均年龄48岁,SD22岁;平均BMI29.3,SD3.5kg/m2;平均呼吸暂停低通气指数[AHI]20.7,SD17.8/小时)。在完成为期4周的计划的8名参与者中,总体依从率为91%(175/192次).对于舌头运动,成功率从第一天的66%(211/320练习;SD18%)增加到最后一天的85%(272/320练习;SD17%)(P=0.05)。训练结束后AHI没有明显变化,但成功的嘴唇运动改善与仰卧位AHI降低之间存在显著相关性(Rs=-0.76;P=0.03)。这些发现证明了该设备在肌功能治疗期间准确监测参与者在嘴唇和舌头压力练习中的表现的潜力。训练计划的多样性(it混合练习混合训练游戏),它能够为每个练习向参与者提供直接反馈,和治疗依从性的容易测量是我们的培训计划的主要优势。
    结论:该研究的便携式家用肌功能疗法设备有望作为降低OSAHS严重程度的非侵入性替代方法,成功的嘴唇锻炼改善与AHI减少之间存在显着相关性,保证进一步的发展和调查。
    BACKGROUND: Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a prevalent condition affecting a substantial portion of the global population, with its prevalence increasing over the past 2 decades. OSAHS is characterized by recurrent upper airway (UA) closure during sleep, leading to significant impacts on quality of life and heightened cardiovascular and metabolic morbidity. Despite continuous positive airway pressure (CPAP) being the gold standard treatment, patient adherence remains suboptimal due to various factors, such as discomfort, side effects, and treatment unacceptability.
    OBJECTIVE: Considering the challenges associated with CPAP adherence, an alternative approach targeting the UA muscles through myofunctional therapy was explored. This noninvasive intervention involves exercises of the lips, tongue, or both to improve oropharyngeal functions and mitigate the severity of OSAHS. With the goal of developing a portable device for home-based myofunctional therapy with continuous monitoring of exercise performance and adherence, the primary outcome of this study was the degree of completion and adherence to a 4-week training session.
    METHODS: This proof-of-concept study focused on a portable device that was designed to facilitate tongue and lip myofunctional therapy and enable precise monitoring of exercise performance and adherence. A clinical study was conducted to assess the effectiveness of this program in improving sleep-disordered breathing. Participants were instructed to perform tongue protrusion, lip pressure, and controlled breathing as part of various tasks 6 times a week for 4 weeks, with each session lasting approximately 35 minutes.
    RESULTS: Ten participants were enrolled in the study (n=8 male; mean age 48, SD 22 years; mean BMI 29.3, SD 3.5 kg/m2; mean apnea-hypopnea index [AHI] 20.7, SD 17.8/hour). Among the 8 participants who completed the 4-week program, the overall compliance rate was 91% (175/192 sessions). For the tongue exercise, the success rate increased from 66% (211/320 exercises; SD 18%) on the first day to 85% (272/320 exercises; SD 17%) on the last day (P=.05). AHI did not change significantly after completion of training but a noteworthy correlation between successful lip exercise improvement and AHI reduction in the supine position was observed (Rs=-0.76; P=.03). These findings demonstrate the potential of the device for accurately monitoring participants\' performance in lip and tongue pressure exercises during myofunctional therapy. The diversity of the training program (it mixed exercises mixed training games), its ability to provide direct feedback for each exercise to the participants, and the easy measurement of treatment adherence are major strengths of our training program.
    CONCLUSIONS: The study\'s portable device for home-based myofunctional therapy shows promise as a noninvasive alternative for reducing the severity of OSAHS, with a notable correlation between successful lip exercise improvement and AHI reduction, warranting further development and investigation.
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  • 文章类型: Case Reports
    舌骨瘤,一种罕见的,主要影响后舌的良性骨肿瘤,很难诊断。这项研究旨在报告一例17岁女性的骨瘤影响舌头。患者有异物感和逐渐增长的病变3年,并接受了临床检查和诊断程序。一个定义明确的,表面光滑,在舌后三分之一处发现白色肿块。在局部麻醉下完全切除1.5×1×0.4cm肿块,经组织病理学证实为良性舌骨瘤。术后2个月的结果是平稳的。舌骨瘤的稀有性,以及它通常是无症状的事实,使诊断变得困难。诊断需要适当的临床检查,影像学检查,和组织病理学分析。手术干预,主要目的是完全切除,同时保持舌功能,仍然是主要的治疗选择。成功的切除需要对医疗保健专业人员进行有关这种罕见的良性骨肿瘤的教育,以确保最佳的患者预后。
    Lingual osteoma, a rare, benign bone tumor that primarily affects the posterior tongue, can be difficult to diagnose. This study aims to report a case of osteoma affecting the tongue in a 17-year-old female. The patient had a foreign body sensation and a progressively growing lesion for 3 years and underwent clinical examination and diagnostic procedures. A well-defined, smooth-surfaced, white mass was discovered in the posterior third of the tongue. The 1.5 × 1 × 0.4 cm mass was completely excised under local anesthesia and histopathologically confirmed as a benign lingual osteoma. The 2-month post-operative outcome was uneventful. The rarity of lingual osteoma, as well as the fact that it is often asymptomatic, makes diagnosis difficult. The diagnosis entails a proper clinical examination, imaging studies, and histopathological analysis. Surgical intervention, primarily aimed at complete excision while preserving tongue function, remains the primary treatment option. Successful excision entails educating healthcare professionals about this rare benign bony tumor to ensure the best possible patient outcomes.
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  • 文章类型: Case Reports
    此病例报告描述了一名年轻成年患者的复杂的完整步骤II类病例,该患者接受了舌侧直丝矫治器和上第一磨牙拔除术。由于病人拒绝手术治疗,她被提供了最好的伪装,双重目的是获得理想的咬合关系和保持轮廓;适当的生物力学策略,包括空间闭合过程中的提取选择和锚固控制,需要实现计划的结果。该病例报告表明,通过完全不可见的非依从性技术,无需手术治疗即可成功解决成年患者的严重矢状差异的可能性。拔除最受损的牙齿。这份报告还强调了在诊断和治疗阶段都需要仔细规划,以获得最佳效果。
    This case report describes a complex full-step class II case in a young adult patient treated with lingual straight-wire appliance and upper first molar extraction. As the patient refused a surgical treatment, she was offered the best possible camouflage with the double aim of obtaining an ideal occlusal relationship and maintaining the profile; appropriate biomechanical strategies, including extraction choice and anchorage control during space closure, were needed to achieve the planned results. This case report demonstrates the possibility of successfully resolving severe sagittal discrepancies in an adult patient without surgical treatment by means of a completely invisible non-compliance technique, with the extraction of the most compromised teeth. This report also underlines the need for careful planning during both diagnostic and treatment phases, in order to obtain the best results.
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  • 文章类型: Journal Article
    我们对口面部疼痛的理解存在一些知识空白。其中一些包括特定组织中的外周感觉神经支配类型,性别间神经支配的差异和高等物种啮齿动物研究的验证。当前的研究通过验证非人类灵长类动物中舌组织感觉神经支配的小鼠研究以及评估性别特异性差异来解决这些差距。舌和三叉神经节是从原始的雄性和雌性mar猴收集的,并通过免疫组织化学和定量的纤维数量使用特定标记物测试神经纤维。我们还测试了神经纤维的特定亚组是否属于髓鞘化或非髓鞘化轴突。我们观察到类似于小鼠的发现,小鼠舌受表达CGRP和TRPV1等伤害性感受器标记物以及TrkB等非伤害性感受器标记物的神经丝支配,小白蛋白(PV)和酪氨酸羟化酶(TH)。此外,我们发现虽然TrkB和PV的一部分可能是感觉纤维,TH阳性纤维主要是交感神经纤维。此外,CGRP的数量,两种性别的TrkB和TH阳性神经纤维相似。然而,我们观察到女性有髓鞘TRPV1阳性纤维的比例高于男性,女性的PV+纤维数量也增加.一起来看,这项研究首次描述了非人灵长类动物的感觉神经支配,并评估了舌头组织神经支配的性别差异,从而为未来的口面疼痛研究奠定了基础,新的世界较小的NHP,如普通的marmoset。
    Several gaps in knowledge exists in our understanding of orofacial pain. Some of these include type of peripheral sensory innervation in specific tissues, differences in innervation between sexes and validation of rodent studies in higher order species. The current study addresses these gaps by validating mouse studies for sensory innervation of tongue tissue in non-human primates as well as assesses sex-specific differences. Tongue and trigeminal ganglia were collected from naïve male and female marmosets and tested for nerve fibers using specific markers by immunohistochemistry and number of fibers quantified. We also tested whether specific subgroups of nerve fibers belonged to myelinating or non-myelinating axons. We observed that similar to findings in mice, marmoset tongue was innervated with nerve filaments expressing nociceptor markers like CGRP and TRPV1 as well as non-nociceptor markers like TrkB, parvalbumin (PV) and tyrosine hydroxylase (TH). Furthermore, we found that while portion of TrkB and PV may be sensory fibers, TH-positive fibers were primarily sympathetic nerve fibers. Moreover, number of CGRP, TrkB and TH-positive nerve fibers were similar in both sexes. However, we observed a higher proportion of myelinated TRPV1 positive fibers in females than in males as well as increased number of PV + fibers in females. Taken together, the study for the first time characterizes sensory innervation in non-human primates as well as evaluates sex-differences in innervation of tongue tissue, thereby laying the foundation for future orofacial pain research with new world smaller NHPs like the common marmoset.
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  • 文章类型: Case Reports
    舌前肠重复囊肿是罕见的发育异常,症状多样,和腺癌可能由它们发展。放射学评估,包括计算机断层扫描和磁共振成像,可以帮助诊断这些病变并确定其范围。异常增强应引起对舌前肠重复囊肿恶性的怀疑。早期发现和完全手术切除舌前肠重复囊肿对于防止恶性转化是必要的。建议采用辅助放疗或放化疗的完整肿瘤切除。教学要点是粘液腺癌可以从舌前肠重复囊肿发展而来,放射学研究可能有助于诊断。
    腺癌可以从舌前肠重复囊肿发展而来,这是罕见的发育异常,放射学研究可能有助于诊断。
    Lingual foregut duplication cysts are rare developmental anomalies with varied symptoms, and adenocarcinomas may develop from them. Radiological evaluations, including computed tomography and magnetic resonance imaging, can help diagnose these lesions and determine their extent. Abnormal enhancement should raise the suspicion of malignancy of a lingual foregut duplication cyst. Early detection and complete surgical resection of lingual foregut duplication cysts are necessary to prevent malignant transformations. Complete tumor resection with adjuvant radiotherapy or radiochemotherapy is recommended. The teaching point is that mucinous adenocarcinoma can develop from a lingual foregut duplication cyst, and radiological studies may aid in the diagnosis.
    UNASSIGNED: Adenocarcinomas can develop from lingual foregut duplication cysts, which are rare developmental anomalies, and radiologic studies may aid in the diagnosis.
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  • 文章类型: Journal Article
    背景:在下颌侧切牙中发现4%阿替卡因与1:100,000肾上腺素的组合唇浸润(1.8mL)加舌浸润(1.8mL)优于1.8mL相同溶液的唇浸润。然而,不知道音量或位置是否有最大的影响。因此,这个前景的目的,随机交叉研究旨在确定在下颌侧切牙中,与使用1:100,000肾上腺素的4%阿替卡因的阴唇浸润(1.8mL)加舌侧浸润(1.8mL)相比,使用1:100,000肾上腺素的4%阿替卡因的阴唇浸润(1.8mL)的麻醉效果.
    方法:一百名受试者随机接受两组注射,使用4%阿替卡因和1:100,000肾上腺素,在两个单独的预约中,包括1.8mL(总共3.6mL)的唇和舌浸润和1.8mL(总共3.6mL)的下颌侧切牙的两个唇浸润。使用电浆测试来确定麻醉成功(最高80/80读数)。对数据进行统计学分析。
    结果:与两种唇浸润(74%)相比,唇和舌组合显示出明显更高的麻醉成功率(97%),并且从1分钟到58分钟具有明显更高的80/80s读数。
    结论:在本临床研究的局限性内,与使用3.6mL阿替卡因的唇浸润相比,使用3.6mL体积的4%阿替卡因和1:100,000肾上腺素的组合唇+舌浸润显着增加了下颌侧切牙的牙髓麻醉成功率。因此,渗透的位置比体积更重要。
    BACKGROUND: A combination labial infiltration (1.8 mL) plus lingual infiltration (1.8 mL) of 4% articaine with 1:100,000 epinephrine in the mandibular lateral incisor was found superior to a labial infiltration of 1.8 mL of the same solution. However, it is not known whether the volume or the location had the greatest effect. Therefore, the purpose of this prospective, randomized crossover study was to determine the anesthetic efficacy of a labial infiltration of a 3.6 mL volume of 4% articaine with 1:100,000 epinephrine compared with labial infiltration (1.8 mL) plus lingual infiltration (1.8 mL) of 4% articaine with 1:100,000 epinephrine in the mandibular lateral incisor.
    METHODS: One hundred subjects randomly received 2 sets of injections, using 4% articaine with 1:100,000 epinephrine, consisting of labial and lingual infiltrations of 1.8 mL (3.6 mL total) and 2 labial infiltrations of 1.8 mL (3.6 mL total) of the mandibular lateral incisor in 2 separate appointments. Electric pulp testing was used to determine anesthetic success (highest 80/80 reading). The data were analyzed statistically.
    RESULTS: The labial and lingual combination exhibited a significantly higher anesthetic success rate (97%) when compared with the 2 labial infiltrations (74%) and had significantly higher 80/80s readings from 1 minute to 58 minutes.
    CONCLUSIONS: Within the limitations of this clinical study, a combination labial plus lingual infiltration using a 3.6-mL volume of 4% articaine with 1:100,000 epinephrine significantly increased pulpal anesthetic success for the mandibular lateral incisor when compared with a labial infiltration using a 3.6-mL volume of articaine. Therefore, location of the infiltrations was more important than volume.
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