Severe dementia, including Alzheimer’s disease, is intractable and progressive. The purpose of this study was to document the improvement observed in two cases of severe dementia after denture placement. The subjects...Severe dementia, including Alzheimer’s disease, is intractable and progressive. The purpose of this study was to document the improvement observed in two cases of severe dementia after denture placement. The subjects, two women in their 70s with severe dementia, were diagnosed with Alzheimer’s disease by the medical doctors in charge of their cases. In the first case, the subject’s symptoms included severe disorientation, impaired communication, and a tendency to wander. Two weeks after a lower complete denture placement, she was able to greet others. Five weeks later, she was able to communicate and precisely read an analog clock. Her condition continued to improve for at least 3 months. In the second case, the subject’s mouth was always open. She was bedridden in a vegetative state and hardly moved, talked, or laughed;it was impossible to communicate with her. Only a few seconds after an upper complete denture placement, she started to talk, albeit unintelligibly. Two weeks after a lower complete denture placement, she could communicate normally, laugh, and walk without help. Although the underlying mechanism has not yet been clarified, the author hypothesizes that positive signals from the oral area are transferred to the brain as positive stimulation via the trigeminal nerve, the largest cranial nerve.展开更多
目的 探讨疼痛综合管理策略在儿童日间全麻下口腔治疗中的应用效果。方法 2020年1月至8月某院接受日间全身麻醉下口腔治疗儿童,年龄3~7周岁,按美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级为Ⅰ~Ⅱ级,治疗牙齿数≥1...目的 探讨疼痛综合管理策略在儿童日间全麻下口腔治疗中的应用效果。方法 2020年1月至8月某院接受日间全身麻醉下口腔治疗儿童,年龄3~7周岁,按美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级为Ⅰ~Ⅱ级,治疗牙齿数≥10颗。120名儿童被随机分配到2组,综合策略组(H组,n=60)采用疼痛综合管理策略,包括超前镇痛、疼痛管理指导、微信评估(在术后4、6、24 h通过扫描二维码进行疼痛评估)三项内容;对照组(C组,n=60)无超前镇痛及疼痛管理指导,仅进行微信评估疼痛。术后2 h采用表情、下肢、活动、哭闹、可安慰性(face,legs,activity,cry and consolability,FLACC)量表对2组进行疼痛评估。术后4、6、24 h采用父母疼痛测量量表(parents postoperative pain measure,PPPM)对2组进行疼痛评估。结果 与C组相比,H组术后2 h FLACC得分显著降低,差异有统计学意义(P <0.05)。H组在术后4、6、24 h三个时间点显著疼痛(PPPM≥6分)发生率均低于C组(P <0.05),且PPPM得分较C组显著降低(P <0.05)。H组91.7%的家长及时进行疼痛评估,而C组71.6%的家长及时评估疼痛,H组父母依从性更高(P <0.05)。结论 疼痛综合管理策略可降低儿童日间全麻下口腔治疗后疼痛的发生率,是安全有效的日间口腔治疗后疼痛管理方法。展开更多
文摘Severe dementia, including Alzheimer’s disease, is intractable and progressive. The purpose of this study was to document the improvement observed in two cases of severe dementia after denture placement. The subjects, two women in their 70s with severe dementia, were diagnosed with Alzheimer’s disease by the medical doctors in charge of their cases. In the first case, the subject’s symptoms included severe disorientation, impaired communication, and a tendency to wander. Two weeks after a lower complete denture placement, she was able to greet others. Five weeks later, she was able to communicate and precisely read an analog clock. Her condition continued to improve for at least 3 months. In the second case, the subject’s mouth was always open. She was bedridden in a vegetative state and hardly moved, talked, or laughed;it was impossible to communicate with her. Only a few seconds after an upper complete denture placement, she started to talk, albeit unintelligibly. Two weeks after a lower complete denture placement, she could communicate normally, laugh, and walk without help. Although the underlying mechanism has not yet been clarified, the author hypothesizes that positive signals from the oral area are transferred to the brain as positive stimulation via the trigeminal nerve, the largest cranial nerve.
