青少年正畸患者的牙周健康教育

目的 建立基于青少年社会行为发育特点的正畸牙周健康教育体系,并评估其临床应用价值.方法 将80例正畸患者随机分为干预组(n=40)和对照组(n=40),两组分别接受系统的牙周健康教育和常规口腔卫生宣教,治疗前、治疗后1个月、3个月和6个月时,对患者口腔菌斑指数和牙龈指数进行检查和记录.结果治疗前两组牙周情况差异无统计学意义(P＞0.05).治疗开始后1个月、3个月和6个月时,干预组患者的菌斑指教和牙龈指数均低于对照组,差异有统计学意义(P＜0.01).结论 该正畸牙周健康教育方法 符合青少年发育特点,其效果优于传统卫生宣教方法 .     

成人牙周创伤致切牙移位伴牙槽骨吸收的正畸治疗

[目的]探讨正畸治疗成人牙周创伤致切牙移位伴牙槽骨吸收患者的临床疗效.[方法]选择成人牙周创伤致切牙移位伴牙槽骨吸收患者51例,比较正畸矫治前后的牙周袋深度(PPD)、临床牙冠的长度(CCL)、根尖到牙槽骨最低水平线的距离(MBL)、牙根长度(RL)的变化.[结果]PPD、CCL明显减低,MBL明显增加,RL无明显变化...     

Peri-implant keratinized gingiva augmentation using xenogeneic collagen matrix and platelet-rich fibrin: A case report

BACKGROUNDKeratinized gingival insufficiency is a disease attributed to long-term tooth loss, can severely jeopardizes the long-term health of implants. A simple and effective augmentation surgery method should be urgently developed.CASE SUMMARYA healthy female patient, 45-year-old, requested implant restoration of the her left mandibular first molar and second molar. Before considering a stage II, as suggested from the probing depth measurements, the widths of the mesial, medial, and distal buccal keratinized gingiva of second molar (tooth #37) were measured and found to be 0.5 mm, 0.5 mm, and 0 mm, respectively. This suggested that the gingiva was insufficient to resist damage from bacterial and mechanical stimulation. Accordingly, modified apically repositioned flap (ARF) surgery combined with xenogeneic collagen matrix (XCM) and platelet-rich fibrin (PRF) was employed to increase the width of gingival tissue. After 1 mo of healing, the widths of mesial, medial, and distal buccal keratinized gingiva reached 4 mm, 4 mm, and 3 mm, respectively, and the thickness of the augmented mucosa was 4.5 mm. Subsequently, through the second-stage operation, the patient obtained an ideal soft tissue shape around the implant.CONCLUSIONFor cases with keratinized gingiva widths around implants less than 2mm，the soft tissue width and thickness could be increased by modified ARF surgery combined with XCM and PRF. Moreover, this surgery significantly alleviated patients’ pain and ameliorated oral functional comfort.     

冲牙器洗牙改善牙齿固定矫治期间的牙周组织

目的:探讨冲牙器洗牙对成人固定矫治患者牙周组织的改善作用。方法:将32例应用固定矫治器治疗的成人患者分为研究组和对照组,每组各16例。研究组患者的口腔卫生措施为牙刷刷牙联合冲牙器洗牙;对照组患者仅使用牙刷刷牙。分别于研究开始时以及3个月时检测牙周菌斑指数(plaque index,PLI)和牙龈指数(gingival index,GI),比较两组间的差异。结果:应用冲牙器洗牙3个月后,研究组GI变化的幅度显著大于对照组(P<0.05)。结论:冲牙器洗牙是牙刷刷牙的有效补充,应用冲牙器可以有效改善固定矫治器患者牙周的不良症状。     

低强度脉冲超声波对Beagle犬Ⅱ度根分叉病变的辅助效应

背景：低强度脉冲超声波主要用于促进骨折愈合及提高新生骨组织密度,尚未见其对Ⅱ度根分叉病变组织学修复效应的报道。目的：观察低强度脉冲超声波对Ⅱ度根分叉病变的组织学修复效应。方法：5只Beagle犬各取2颗下颌第4前磨牙颊侧作为实验区,建立Ⅱ度根分叉病变模型,分别分为超声组和对照组并在颊侧缺损龈方根面制备切迹作为参照点,高糖饲养8周。超声组行根面平整术,术后1周行低强度脉冲超声波（90mW/cm21.5MHz,200μs,1kHz）处理20min/d,对照组行根面平整术和假处理。6周后取实验区域组织制备脱钙切片,苏木精伊红染色、Masson染色行根分叉区域组织测量分析。结果与结论：超声组根分叉区新生牙槽骨沿根面生长,根分叉区可见牙龈上皮;对照组根分叉区以结缔组织生长为主,可见大量牙龈上皮和少量新生骨组织。超声组新生牙槽骨胶原呈＂红-蓝＂相间,以红染为主;对照组呈现蓝染,即超声组的新生牙槽骨胶原较对照组成熟。超声组牙槽骨、牙骨质、牙周膜新生量均大于对照组（P〈0.05）。提示90mW/cm2低强度脉冲超声波可促进根分叉病变新生牙槽骨胶原成熟和改建。     

正畸治疗导致上颌第二磨牙颊侧倾斜萌出的危险因素分析

目的探讨正畸治疗发生第二磨牙颊侧倾斜萌出的危险因素。方法回顾性分析正畸治疗患者173例,详细总结患者病历,将年龄、性别、有无拔牙治疗史、治疗前后牙弓后段拥挤度、第一磨牙前移量、第三磨牙有无异常及下颌平面角度等8项指标纳入单因素分析范围,分析导致上颌第二磨牙颊侧倾斜萌出的危险因素;有统计学意义指标进一步纳入Logistic回归分析范围,寻找独立危险因素。结果 173例正畸治疗患者中,共发生第二磨牙颊侧倾斜萌出37例,患病率达21.4%。单因素考察结果显示,治疗后牙弓后段拥挤、第三磨牙牙胚缺失及第一磨牙前移量为第二磨牙颊侧倾斜萌出的重要影响因素(P0.05);Logistic回归分析结果显示,治疗后牙弓后段拥挤为第二磨牙颊侧倾斜萌出的独立危险因素(OR=3.168,P0.05)。结论正畸治疗中第二磨牙颊侧倾斜萌出的患病率较高,与治疗后牙弓后段拥挤、第三磨牙牙胚缺失及第一磨牙前移量密切相关,尤以治疗后牙弓后段拥挤为重,当重点注意。     

Periodontal changes in children and adolescents with diabetes: a case-control study

OBJECTIVE: To evaluate the level of oral disease in children and adolescents with diabetes. RESEARCH DESIGN AND METHODS: Dental caries and periodontal disease were clinically assessed in 182 children and adolescents (6-18 years of age) with diabetes and 160 nondiabetic control subjects. RESULTS: There were no differences between case and control subjects with respect to dental caries. Children with diabetes had significantly higher plaque and gingival inflammation levels compared with control subjects. The number of teeth with evidence of attachment loss (the hallmark of periodontal disease) was significantly greater in children with diabetes (5.79 +/- 5.34 vs. 1.53 +/- 3.05 in control subjects, unadjusted P < 0.001). When controlling for age, sex, ethnicity, gingival bleeding, and frequency of dental visits, diabetes remained a highly significant correlate of periodontitis, especially in the 12- to 18-year-old subgroup. In the case group, BMI was significantly correlated with destruction of connective tissue attachment and bone, but duration of diabetes and mean HbA(1c) were not. CONCLUSIONS: Our findings suggest that periodontal destruction can start very early in life in diabetes and becomes more prominent as children become adolescents. Programs designed to promote periodontal disease prevention and treatment should be provided to young patients with diabetes.     

The effects of combination treatment with a long-acting beta2-agonist and a corticosteroid on salivary flow rate, secretory immunoglobulin A, and oral health in children and adolescents with moderate asthma: a 1-month, single-blind clinical study

BACKGROUND: Asthma is a common chronic disorder of childhood, and it is frequently accompanied by dental and other oral abnormalities. As such, oral and dental effects of asthma medications have been investigated in several studies. However, the effect of combination therapy with a long-acting beta(2)-agonist and a corticosteroid on oral health in children and adolescents has not been reported in the literature. OBJECTIVE: The aim of this study was to examine whether combination treatment with a long-acting beta(2)-agonist (salmeterol) and a corticosteroid (fluticasone propionate) administered by dry powder inhaler (DPI) affects oral health in children and adolescents with moderate asthma. METHODS: This 1-month, single-blind clinical study was conducted at the Department of Periodontology, Ondokuz Mayis University Faculty of Dentistry, Samsun, Turkey. Male and female children and adolescents aged 7 to 17 years with moderate persistent asthma, as classified by the Global Initiative for Asthma guidelines, were studied before and after 1 month of treatment with combination salmeterol 50 microg and fluticasone propionate 100 mug administered by DPI BID. Salivary flow rate and secretory immunoglobulin A (sIgA) level were measured, and periodontal health was assessed by gingival and dental plaque indices for buccal surfaces and periodontal pocket depth. RESULTS: The study enrolled 15 children and adolescents (8 girls, 7 boys; mean [SD] age, 11 years [45 months]; median age, 13 years; [range, 7-17 years]). At 1 month, mean sIgA, gingival index, buccal surface index, gingival index, dental plaque index, and periodontal pocket depth were not changed significantly from baseline, whereas mean (SD) salivary flow rate was significantly decreased (from 153.21 [39.29] to 113.16 [46.99] microL/5 s; P = 0.015) and dental plaque index on the buccal surface was significantly increased (from 1.43 [0.63] to 1.61 [0.67]; P = 0.01). CONCLUSIONS: In this small study, combination treatment with salmeterol 50 microg and fluticasone propionate 100 microg inhaled twice daily was associated with changes in oral health among these children and adolescents with moderate asthma. Regular follow-up of oral health status may be warranted in children and adolescents during long-term use of a long-acting beta2-agonist and a corticosteroid.     

膜诱导组织再生技术治疗牙种植体周围炎

目的：在动物实验的基础上，研究临床应用膜诱导组织再生技术治疗牙种植体周围炎，以观察治疗的临床效果。方法：选择符合牙种植体周围炎诊断标准的患者作为研究对象，在牙种植体周翻瓣刮治的同时运用胶原膜覆盖种植暴露面和骨面，观察种植体周骨组织再生情况和种植体的稳固性。结果：经过一年的放射学和临床观察，发现炎症未复发，种植体稳固性提高，种植体周骨组织有不同程度的再生。结论：膜诱导组织再生技术可用于牙种植体周围炎的治疗。     

正畸联合烤瓷修复成人前牙龈下冠折的临床疗效观察

目的探究正畸联合烤瓷修复对成人前牙龈下冠折的效果及美容度的影响.方法选取2017年8月1日-2019年7月31日我院收治的50例成人前牙龈下冠折患者,采用随机数字表法将这些患者均分为研究组与对照组,研究组患者采用正畸联合烤瓷修复,对照组患者采用牙龈切除联合烤瓷治疗,比较两组患者临床治疗效果;比较两组患者美观度、咬合度以及治疗满意度.结果研究组患者显效11人、有效12人、无效2人,总有效率为92%,对照组患者显效6人、有效14人、无效5人,总有效率为80%.研究组患者美观度(96.26±12.16),咬合度(95.52±12.58),治疗满意度88%,对照组患者美观度(81.26±10.26),咬合度(89.53±12.16),满意度72%.研究组上述指标优于对照组,差异具有统计学意义(P<0.05).结论对成人前牙龈下冠折患者采用正畸联合烤瓷修复治疗,有助于保存牙根、牙周组织,且具有较好保留前牙美观的效果,较牙龈切除联合烤瓷治疗效果更好,值得在临床中推广应用.     

Phase IIa clinical trial of complement C3 inhibitor AMY-101 in adults with periodontal inflammation

BackgroundGingivitis and periodontitis are prevalent inflammatory diseases of the periodontal tissues. Current treatments are often ineffective or do not prevent disease recurrence. Uncontrolled complement activation and the resulting chronic gingival inflammation are hallmarks of periodontal diseases. We determined the efficacy and safety of a complement 3–targeted therapeutic, AMY-101, which was locally administered to adult patients with periodontal inflammation.MethodsThirty-two patients with gingival inflammation were enrolled in a randomized, placebo-controlled, double-blind, split-mouth phase IIa trial that followed a dose escalation study to select a safe and effective dose in an additional 8 patients. Half of the patient’s mouth was randomly assigned to AMY-101 (0.1 mg/site) or placebo injections at sites of inflammation, administered on days 0, 7, and 14, and then evaluated for safety and efficacy outcomes on days 28, 60, and 90. The primary efficacy outcome was a change in gingival inflammation, measured by a modified gingival index (MGI), and secondary outcomes included changes in bleeding on probing (BOP), the amount of plaque, pocket depth, clinical attachment level, and gingival crevicular fluid levels of matrix metalloproteinases (MMPs) over 90 days.ResultsA once-weekly intragingival injection of AMY-101 for 3 weeks was safe and well tolerated in all participants and resulted in significant (P < 0.001) reductions in clinical indices measuring gingival inflammation (MGI and BOP). AMY-101 significantly (P < 0.05) reduced MMP-8 and MMP-9 levels, indicators of inflammatory tissue destruction. These therapeutic effects persisted for at least 3 months after treatment.ConclusionAMY-101 treatment resulted in a significant and sustainable reduction in gingival inflammation without adverse events and, we believe, merits further investigation for the treatment of periodontitis and other oral or peri-implant inflammatory conditions.Trial registrationClinicalTrials.gov identifier {"type":"clinical-trial","attrs":{"text":"NCT03694444","term_id":"NCT03694444"}}NCT03694444.FundingAmyndas Pharmaceuticals.     

Fibrin glue mixed with platelet-rich fibrin as a scaffold seeded with dental bud cells for tooth regeneration

Odontogenesis is a complex process with a series of epithelial‐mesenchymal interactions and odontogenic molecular cascades. In tissue engineering of teeth from stem cells, platelet‐rich fibrin (PRF), which is rich in growth factors and cytokines, may improve regeneration. Accordingly, PRF was added into fibrin glue to enrich the microenvironment with growth factors. Unerupted second molar tooth buds were harvested from miniature swine and cultured in vitro for 3 weeks to obtain dental bud cells (DBCs). Whole blood was collected for the preparation of PRF and fibrin glue before surgery. DBCs were suspended in fibrin glue and then enclosed with PRF, and the DBC‐fibrin glue‐PRF composite was autografted back into the original alveolar sockets. Radiographic and histological examinations were used to identify the regenerated tooth structure 36 weeks after implantation. Immunohistochemical staining was used to detect proteins specific to tooth regeneration. One pig developed a complete tooth with crown, root, pulp, enamel, dentin, odontoblast, cementum, blood vessels, and periodontal ligaments in indiscriminate shape. Another animal had an unerupted tooth that expressed cytokeratin 14, dentin matrix protein‐1, vascular endothelial growth factor, and osteopontin. This study demonstrated, using autogenic cell transplantation in a porcine model, that DBCs seeded into fibrin glue‐PRF could regenerate a complete tooth. Copyright © 2011 John Wiley & Sons, Ltd.     

Fixed multibracket dental therapy has challenges but can be successfully performed in young persons with Down syndrome

Purpose The objective of this study was to analyze the feasibility of orthodontic treatment with fixed multibracket dental appliances (FMAs) in patients with Down syndrome (DS). Methods The study sample was formed of 25 patients with DS who underwent orthodontic treatment with FMAs. Dental and skeletal characteristics, aspects of FMA treatment, retainer use and recurrences were analyzed. Results were compared with a control group of healthy, age-, sex- and PAR index-matched individuals. Results All the controls underwent a single desensitization session, whereas 2–3 sessions were necessary in 11 patients with DS (p?p?p?=?0.004). Complications were more common in patients with DS than in controls (p?=?0.003), due particularly to traumatic ulcers development. There were more failures during the maintenance phase in patients with DS than in controls (p?=?0.001). The mean duration of treatment was 37 months in patients with DS and 23 months in controls. More cemented retainers were used in the controls than in patients with DS (p?=?0.050). Conclusions It is possible to perform orthodontic treatment with FMAs in patients with DS, although treatment may take longer than usual and the frequency of complications is higher than in controls.

• Implications for Rehabilitation

• Certain dental characteristics of Down syndrome (DS) make these children firm candidates for orthodontic intervention.

• There is little literature available on orthodontic treatment in patients with DS, particularly with regard to the use of fixed appliances.

• This case–control study shows that it is possible to perform orthodontic treatment with fixed appliances in adequately selected patients with DS.

• However, in patients with DS orthodontic treatment may take longer than usual and the frequency of complications is higher than in the general population.

     

正畸牙移动过程中牙周组织白细胞介素8的表达

背景:白细胞介素8作为一种与骨改建相关的炎性细胞因子,参与牙周组织的改建,促进牙槽骨的吸收,是骨吸收的标志物之一.目的:观察正畸力对牙周组织改建过程中白细胞介素8表达的影响.方法:将10周龄雄性SD大鼠上颌一侧第一磨牙与上颌切牙之间安置正畸装置,并施加0.49 N近中向正畸力,在加力后1,3,5,7,14 d取材,进行组织形态分析法、免疫组化染色检测白细胞介素8在牙周组织中表达的阳性细胞的面密度值.结果与结论:正常大鼠牙周组织内白细胞介素8的表达呈弱阳性;随加力时间的延长大鼠牙周组织牙周膜细胞白细胞介素8表达增强,加力后5 d达到高峰,之后开始下降.实验提示正畸力可引起局部牙周组织炎症及白细胞介素8的释放.正畸牙移动早期,白细胞介素8的释放可能是牙周组织早期炎症反应和牙槽骨改建的触发因素之一.     

牙周病患者正畸治疗的研究进展

牙周病是口腔科常见疾病,发展到一定程度,常引起牙齿的松动、移位、伸长甚至脱落,影响美观及功能,这使牙周病患者的正畸治疗日益引起关注。文中就固定矫治器对牙周组织的影响,牙周病患者正畸治疗进展及正畸矫治前后的牙周状况分析作一综述。     

Bio-oss/富血小板纤维蛋白复合物修复牙槽骨缺损区后牙移动的效果及可行性

目的探讨Bio-oss/富血小板纤维蛋白(PRF)复合物修复牙槽骨缺损区后牙移动的效果和可行性。方法前瞻性将2016年1月至2018年6月收治的牙槽骨缺损区行正畸矫治的患者38例(65颗牙)采用随机数字表法分为对照组(19例34颗牙)和观察组(19例31颗牙),对照组于牙槽骨缺损区植入Bio-Oss骨粉,观察组于牙槽骨缺损区植入PRF/Bio-Oss复合物。记录两组正畸治疗前创面愈合情况;根据锥形束CT(CBCT)计算正畸牙齿术前-术后6个月、术前-术后12个月(正畸治疗6个月)平均垂直骨吸收量、骨密度值;术后6个月、12个月计算正畸牙齿各部位唇侧骨厚度及月平均移动距离。结果观察组创面愈合时间短于对照组,2周创面愈合率大于对照组(P <0. 05);观察组术前-术后6个月、术前-术后12个月垂直骨吸收量低于对照组,骨密度平均值高于对照组(P <0. 05);观察组术后12个月正畸牙齿颈部、中间、根尖的唇侧骨低于对照组(P <0. 05);观察组术后12个月正畸牙齿月平均移动距离小于对照组(P <0. 05)。结论 PRF/Bio-Oss复合物修复牙槽骨缺损区可减少缺损区骨吸收量,提高骨密度值,进一步减小术后正畸牙齿移动距离。     

Comprehensive management of malocclusion in maxillary fibrous dysplasia: A case report

BACKGROUNDFibrous dysplasia (FD) is a developmental hamartomatous bone disease characterized by a blend of fibrous and osseous entities. Though rarely malignant, the tumor can vary from being small and asymptomatic, to a fairly large sized lesion, progressing gradually, compromising occlusion and facial esthetics. Treatment approach depends on the stage of skeletal maturity. It primarily involves surgical management for stabilizing the disease process. Post-surgical comprehensive dental treatment is necessary for restoring form and function of the jaws and teeth. This article describes comprehensive orthodontic management of severe malocclusion in a surgically operated case of FD maxilla.CASE SUMMARYA 19-year female presented with a chief complaint of excessive gingival display when smiling. Dental history included swelling of gums around the upper right front teeth, diagnosed at the age of 15 as FD of the right anterior maxillary segment and treated with surgical recontouring of the dysplastic bone. The clinical and radiological examinations showed adequate post-surgical healing. The surgically treated dysplastic area presented with right canting of the maxillary anterior occlusal plane. The maxillary teeth were torqued palatally, with the root of the right maxillary canine exposed clinically. We discuss sequential management of the associated malocclusion with comprehensive fixed orthodontics, along with special precautions taken to prevent reactivation of the quiescent and healed lesion.CONCLUSIONThe adequate healing of fibro-dysplastic bone post-surgery must be allowed before initiating orthodontic tooth movement in the dysplastic bone. Periodic follow-ups are needed to monitor stability of occlusion and any relapse of the lesion.     

低强度脉冲超声波对Beagle犬Ⅱ度根分叉病变的辅助效应

背景:低强度脉冲超声波主要用于促进骨折愈合及提高新生骨组织密度,尚未见其对Ⅱ度根分叉病变组织学修复效应的报道。目的:观察低强度脉冲超声波对Ⅱ度根分叉病变的组织学修复效应。方法:5只Beagle犬各取2颗下颌第4前磨牙颊侧作为实验区,建立Ⅱ度根分叉病变模型,分别分为超声组和对照组并在颊侧缺损龈方根面制备切迹作为参照点,高糖饲养8周。超声组行根面平整术,术后1周行低强度脉冲超声波(90mW/cm21.5MHz,200μs,1kHz)处理20min/d,对照组行根面平整术和假处理。6周后取实验区域组织制备脱钙切片,苏木精伊红染色、Masson染色行根分叉区域组织测量分析。结果与结论:超声组根分叉区新生牙槽骨沿根面生长,根分叉区可见牙龈上皮;对照组根分叉区以结缔组织生长为主,可见大量牙龈上皮和少量新生骨组织。超声组新生牙槽骨胶原呈"红-蓝"相间,以红染为主;对照组呈现蓝染,即超声组的新生牙槽骨胶原较对照组成熟。超声组牙槽骨、牙骨质、牙周膜新生量均大于对照组(P<0.05)。提示90mW/cm2低强度脉冲超声波可促进根分叉病变新生牙槽骨胶原成熟和改建。     

上颌第一磨牙弯曲牙根生物组织应力的三维有限元分析

背景：根据弯根牙牙周膜应力分布为口腔临床工作者提供正畸施力的方式和大小,以此来优化正畸力系统设计。目的：探讨上颌第一磨牙弯曲牙根受到正畸力作用下牙根及牙周膜的应力分布情况。方法：选用正常形态和牙根弯曲的上颌第一磨牙作为建模素材,应用 CT 机扫描,ANSYS Workbench 11.0 有限元分析软件建立上颌第一磨牙及其牙周膜的有限元模型,应用 6 种不同载荷方式对模型进行加载,分析其应力分布情况。结果与结论：弯根牙应力集中区主要在牙颈部,其次是根尖部,牙齿在做整体移动时其牙根、牙周膜、牙槽骨应力最小。对于弯根牙的矫治需要更准确的定位以及更合理的牵引力。     

Effect of Periodontal Treatment in Renal Transplant Recipients

Objective

To evaluate the effect of periodontal treatment on gingival overgrowth in a group of renal transplant patients.

Subjects and Methods

Twenty-five renal transplant recipients receiving immunosuppressive therapy with cyclosporine A (CsA) were randomly assigned to 2 groups. Group 1 (n = 15) included patients who had been specifically referred to a dental clinic to prevent gingival overgrowth and were given full periodontal therapy. Group 2 (n = 10) was comprised of patients who did not receive any professional periodontal cleaning. Patients from both groups were examined to determine their periodontal status before and after 3, 6 and 12 months in terms of their plaque index, gingival index and gingival overgrowth. During the examination, their overall health was stable.

Results

For group 1, the scores were 1.89 (baseline), 0.98 (6 months) and 0.56 (12 months), and hence there were significant reductions (p = 0.0001). The gingival indices were 1.71 (baseline), 0.76 (6 months) and 0.35 (12 months), and the reductions were also significant (p = 0.0001). A significant association was observed between poor oral hygiene and the degree of gingival overgrowth. The 1-year post-treatment follow-up showed that patients in group 1 did not develop gingival overgrowth due to the use of CsA as group 2 did without prior periodontal therapy.

Conclusion

Oral hygiene status was the most important variable related to the development and degree of gingival overgrowth due to the use of CsA.Key Words: Gingival overgrowth, Periodontal treatment, Cyclosporine