各种激光在牙周治疗中的应用

激光的应用几乎涉及口腔医学的所有领域，本文针对各种激光在牙周病治疗过程的临床应用和今后发展方向进行介绍。     

牙周冲洗与牙周健康维护

牙周冲洗与牙周健康维护韩璐①高翔①综述张世卫②史久成①审校①佛山市口腔医院（５２８０００）②北京医科大学口腔医学院（１０００８３）成功的牙周治疗，除医生认真的机械清创（手术或非手术）外，很大程度上有赖于患者自身的菌斑控制。Ａｄｒｉａｅｎｓ等指出：严格...     

激光在牙周治疗中的应用

[摘要]本文就目前牙周治疗中常见的几种激光作一介绍。文献回顾显示激光可以清除97%以上的牙周致病菌,能够有效去除病变牙骨质,并且对牙周组织和根面损伤较小,同时,激光可以减少治疗中的疼痛。在今后的牙周治疗具有广泛的应用前景。 [关键词]激光;牙周致病菌;牙周治疗;牙周手术     

全口牙周病伴缺牙的夹板式固定修复

1.资料和方法 1.1病例选择自2000年以来,门诊就诊患者中,牙周病伴有牙齿缺失及前牙前突稀疏,甚至伴有重度磨损或夜磨牙等症者58例,男性38例,女性20例;平均年龄67岁.全口(或半口)牙中多数松动为1～2度,并伴有2～6个牙齿缺失,X线片检查牙槽嵴吸收不超过根长2/3,全身健康状况良好.     

组织工程应用于牙周组织缺损修复

牙周组织工程用于修复牙周组织缺损给牙周病的治疗开辟了一条新路，本文概述了牙周组织再生技术的发展，阐明了牙周组织工程促进牙周再生相对于传统牙周再生方法的优势。并将组织工程用于修复牙周缺损的特点作一综述。     

牙周维护治疗的定义、时机和随访间隔

牙周基础治疗和牙周维护治疗是牙周序列治疗中必不可少的部分,牙周基础治疗目前已得到广泛关注,然而,人们对牙周维护治疗的重视尚待加强。鉴于牙周维护治疗是牙周治疗远期疗效的决定性因素,因此,我们需要明确牙周维护治疗的定义及时机。另外,牙周维护治疗需要定期实施,这其中"定期"一词则需要被深刻探讨。文章通过回顾国内外文献,进一步明确牙周维护治疗的定义和时机,同时对牙周维护的随访间隔进行探讨。     

牙周内科的兴起与展望

牙周内科是牙周病学一个新的分支，其基础是牙周疾病与系统性疾病之间存在很强的相关性，包括一些新的诊断和治疗策略。其中诊断应包括一些危险因素的评价；而治疗主要是树立整体治疗的观念，强调牙周病的非外科治疗，在刮治和根面平整的基础上进行抗菌治疗以及使用宿主调节剂治疗等方法。     

牙周韧带细胞的异质性

牙周韧带细胞是一群具有异质性的多能干细胞,在牙周再生中发挥着重要作用、本文从体内实验、体外实验及细胞移植学方面对牙周韧带细胞的异质性进行了综述。     

组织工程应用于牙周组织缺损修复

牙周组织工程用于修复牙周组织缺损给牙周病的治疗开辟了一条新路。本文概述了牙周组织再生技术的发展,阐明了牙周组织工程促进牙周再生相对于传统牙周再生方法的优势,并将组织工程用于修复牙周缺损的特点作一综述。     

牙周洁治与前列腺素的关系

目的 :探讨牙周洁治前后唾液中前列腺素 (PGs)变化 ,分析牙周洁治与PGs的关系。方法 :选慢性牙周炎(CP)患者 19例、青少年牙周炎 (JP)患者 11例 ,牙龈炎和健康人各 10例 ,用放射免疫测定法分析牙周洁治前后患者唾液中 6 -酮 -前列腺素F1a (6 -K -PGF1a)和前列腺素E2 (ProstaglandinE2 ,PGE2 )含量变化。结果 :洁治后牙周炎组患者唾液中 6 -K -PGF1a和PGE2 较治疗前明显降低 ,牙龈炎组患者唾液中 6 -k -PGF1a和PGE2 含量较洁治前降低最明显 ,健康人组唾液中 6 -K -PGF1a和PGE2 含量较治疗前轻度降低。洁治后CP组患者唾液中 6 -K-PGF1a和PGE2 较治疗前明显降低 ,而对JP患者降低程度较CP明显降低。结论 :牙周洁治对牙龈炎患者唾液中PGs降低程度最强 ,对牙周炎和健康人有一定降低作用 ,对JP患者降低程度最差。牙周洁治的作用机理可能与调节机体唾液中的PGs有密切关系。     

吸烟与牙周病关系的研究

为研究吸烟与牙周病的关系，调查４３２名中老年男性的口腔卫生状况、牙周状况及吸烟习惯。结果表明吸烟者软垢指数与不吸烟者相同，龈炎区段数两者差异无显著性，吸烟者牙周炎区段数高于不吸烟者。重度吸烟者牙周炎区段数高于轻、中度吸烟者及不吸烟者。调查结果提示吸烟可能是牙周病流行的高危因素之一。     

可摘式钛合金牙周夹板对慢性牙周炎松动牙的固定

目的 探讨可摘式钛合金牙周夹板对慢性牙周炎松动牙的临床固定效果。方法 将30例需做可摘式牙周夹板的慢性牙周炎患者随机分两组，每组15人。即实验组：制作钛舍金牙周夹板23件，固定松动牙115颗；对照组：制作钴铬合金牙周夹板2l件，固定松动牙106颗。戴用夹板前后均以LHLY型牙动度位移测量仪记录患者牙齿松动度数值的变化，用以比较两种牙周夹板的疗效。结果 两组患者分别在戴用牙周夹板1月、3月、半年、1年后进行复查，用测量仪所测牙齿松动度数值均较治疗前不同程度减小，临床有效率均为93％。但钛合金夹板和钴铬合金夹板对牙周病松动牙的固定疗效比较无差异。结论 可摘式钛合金牙周夹板对牙周病松动牙有良好的临床固定效果，是牙周病治疗理想的修复方法。但是钛合金夹板是否比钴铬舍金夹板对牙周病松动牙的固定疗效更好尚需要进一步研究。     

牙周基础治疗后维持期菌斑控制的效果观察

目的　评价菌斑控制预防牙周疾病的效果。方法　随机选择 4 0例牙周疾病患者 ,分为菌斑控制组 (2 3例 )及对照组 (17例 )。于全口洁治、刮治和根面平整 (SRP)后 2周 (基线 )、基线后 12、2 4、4 8周检测菌斑指数 (PLI)、龈沟出血指数 (SBI)、探诊深度 (PD)及临床附着丧失 (CAL)。结果　菌斑控制组基线后 12、2 4、4 8周时PLI、SBI、PD显著低于对照组 (P <0 .0 5 ) ,菌斑控制组基线后 4 8周时CAL显著低于对照组 (P <0 .0 5 )。结论　菌斑控制能够有效地预防牙周疾病的发生、发展。     

Nanocrystalline hydroxyapatite in periodontal bone regeneration: A systematic review

BackgroundPeriodontal diseases when persistent, results in periodontal pockets, attachment loss and progressive destruction of the alveolar bone. Grafting periodontal bone defects with bone substitute biomaterials has proven clinical success for accomplishing reconstruction of lost attachment apparatus, especially in deep intra-bony defects. Nanoparticles (NPs) have been considered indispensable in the future of health sciences and NP based alloplastic graft materials such as nanocrystalline hydroxyapatite (NCHA) hold great promise for regeneration of periodontal defects. Therefore the aim of this review is to evaluate the role of NCHA as an effective substitute for periodontal bone regeneration.Material & methodsPopular scientific databases such as PubMed (Medline), Cochrane database of clinical trials, Scopus (Elsevier), Web of science (Clarivate Analytics) and Google Scholar, were searched. The literature search was restricted to published reports in English, between January 2000 and December 2021. Database search returned 1227 results which were screened based on title, author names and publication dates.ResultsData from the 14 included studies were reviewed and tabulated. In the present review, all the studies reported using commercially available NCHA for periodontal bone regeneration.ConclusionNCHA is a suitable bone substitute material for periodontal bone regeneration, with outcomes comparable to that of conventionally used graft materials such as bovine xenograft and other synthetic alloplastic materials. While grafting with NCHA in intrabony periodontal defects, after any form of periodontal flap surgery or debridement, significantly improves bone regeneration by 6 months, addition of adjuncts like EMD and PRF further enhance the outcomes.     

EVALUATION OF CLINICAL PERIODONTAL CONDITIONS IN SMOKERS AND NON-SMOKERS

Given that tobacco smoking habit is a risk factor for periodontal diseases, the aim of this study was to compare clinical periodontal aspects between smokers and non-smokers. The clinical status were assessed in 55 patients, 29 smokers and 26 non-smokers, aged 30 to 50 years, with mean age of 40. The clinical parameters used were: probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), gingival recession (GR) and gingival bleeding index (GBI) for arches (upper and lower) and teeth (anterior and posterior). Tooth loss was also evaluated in both groups. Multiple regression analysis showed: tendency of greater probing depth and clinical attachment level means for smokers; greater amount of plaque in smokers in all regions; greater gingival index means for non-smokers with clinical significance (p<0.05) in all regions. Although, without statistical significance, the analysis showed greater gingival bleeding index means almost always for non-smokers; similar gingival recession means in both groups and tendency of upper tooth loss in smokers and lower tooth loss in non-smokers. The findings of this study showed that clinical periodontal parameters may be different in smokers when compared to non-smokers and that masking of some periodontal signs can be a result of nicotine''s vasoconstrictor effect.     

富血小板胶细胞基质在羊实验性牙周炎牙周缺损中的应用

目的：探讨羊富血小板胶-牙周膜成纤维细胞基质（PRgel-PDLFs）的合成,观察其促进羊中度牙周炎牙周再生的可能作用。方法：建立羊中度牙周炎模型;采用密度梯度离心法从羊新鲜全血中获取富血小板血浆（platelet-rich plasma,PRP）,并按一定比例加入牛凝血酶和氯化钙合成富血小板胶（platelet-rich gel,PRgel）,然后将其与成纤维细胞PDLFs培养合成PRgel-PDLFs基质,并将其植入动物模型牙周吸收缺损区,10周后处死动物,进行常规组织学检查及CT影像学分析。结果：组织学检查及CT影像学分析均显示,3组在牙根面均可见新生牙骨质样组织、牙周膜和牙槽骨样组织的形成,与空白组相比,PRgel-PDLFs组和PRgel组新生牙周组织明显增多,有统计学意义（P〈0.01）。PRgel-PDLFs组新生牙周组织量比PRgel组多,有统计学意义（P〈0.01）。结论：体外合成的PRgel-PDLFs基质可明显促进羊牙周炎吸收组织的再生。     

BMP复合材料修复骨下袋的临床应用研究

目的：探讨BMP复合材料修复牙周病骨下袋骨缺损的临床应用效果。方法：采用BMP复合材料（BMP和骨粉）植入有严重骨内缺损的牙周病患者的骨下袋内，分析包括术前术后（六个月一年）根尖片以及术后1周、2周、3周、4周、3个月和6个月、1年复查各项指标。结果：术后6个月及1年PD与AL与基线比均明显减少（P〈0．01）；术后6个月及1年X片显示原缺损区密度升高，植入区与周围组织问没有明显的界限。结论：BMP复合材料修复牙周病骨下袋骨缺损具有良好的临床应用效果。     

长春市138名7～12岁儿童口腔牙周健康状态调查

目的:了解长春市小学7～12岁儿童牙周疾病患病状态及4种牙周致病菌检出情况,为进一步大规模系统的儿童口腔疾病调查提供依据.方法:以上颌第一磨牙颊面为被检部位,记录探诊后出血(bleeding on probing,BOP)联邦、探诊深度(probing depth,PD)后,判断牙龈指数(gingival index,...     

Altered phenotype and function of dendritic cells in individuals with chronic periodontitis

Objective

To investigate the effects of periodontal bacterial lysates on maturation and function of mature monocyte-derived dendritic cells (m-MDDCs) derived from individuals with chronic periodontitis (CP) or healthy periodontal tissue (HP).

Design

m-MDDCs derived from peripheral blood monocytes, cultured for 7 days in presence of interleukin (IL)-4 and granulocyte-macrophage colony stimulating factor (GM-CSF), were stimulated with lysates of Streptococcus sanguinis, Prevotella intermedia, Porphyromonas gingivalis, or Treponema denticola on day 4, and were then phenotyped. IL-10, IL-12 and IFN-gamma concentration in the supernatant of cultures were measured.

Results

Expression of HLA-DR was lower in bacterial-unstimulated mature m-MDDC from CP compared to HP (p = 0.04), while expression of CD1a and CD123 were higher in CP. The expression pattern of HLA-DR, CD11c, CD123, and CD1a did not change on bacterial stimulation, regardless of the bacteria. Stimulation with P. intermedia upregulated CD80 and CD86 in CP cells (p ≤ 0.05). Production of IL-12p70 by bacterial-unstimulated m-MDDCs was 5.8-fold greater in CP compared to HP. Bacterial stimulation further increased IL-12p70 production while decreasing IL-10. Significantly more IFN-gamma was produced in co-cultures of CP m-MDDCs than with HP m-MDDCs when cells were stimulated with P. intermedia (p = 0.009).

Conclusions

Bacterial-unstimulated m-MDDC from CP exhibited a more immature phenotype but a cytokine profile biased towards proinflammatory response; this pattern was maintained/exacerbated after bacterial stimulation. P. intermedia upregulated co-stimulatory molecules and IFN-gamma expression in CP m-MDDC. These events might contribute to periodontitis pathogenesis.