牙周病的流行病学研究进展

牙周病流行病学研究推动了牙周病病因学探讨以及防治、治疗措施的完善。本文就近年来国内外有关牙周病流行病学研究的方法(包括评价牙周组织的炎症状况、记录牙周探诊深度、临床附着丧失、X线片评价支持骨丧失的情况等几方面)以及牙周病自然发展的纵向观察两方面的研究进展进行综述。     

牙周病非手术治疗的研究进展

牙周病非手术治疗是牙周病治疗的基础,包括龈下刮治和根面平整术（SRP）和松牙固定术,适合于每一位牙周病患者,是牙周病治疗的第一步。药物治疗是牙周病治疗的辅助手段,针对致病原因分为抗生素类药物和免疫调节类药物治疗,抗生素类药物根据给药途径又可分为全身用药或局部用药。传统的SRP存在着一定的局限性,辅以牙周内镜、激光和光动力等新技术辅助治疗牙周病,其效果明显优于传统的SRP。本文就近年来牙周病非手术治疗的内容和研究进展作一综述。     

半导体激光在牙周病中应用及研究进展

近年来,牙周病已成为影响口腔健康甚至是全身健康的重要因素之一,半导体激光作为治疗牙周病的一种辅助手段已引起越来越多的关注。已有研究表明,半导体激光在牙周病治疗中可起到一定的杀菌消毒,促进愈合,减少出血等功效,日后在牙周领域中具有广泛的应用前景。以下就半导体激光在牙周病治疗中的应用进行综述。     

甲硝唑（灭滴灵）局部注射治疗牙周病的疗效观察

牙周病病因复杂，病变范围广泛，复诊率高。至晚期常导致全口牙齿脱落，因此，牙周病的防治至为重要，笔者用甲硝唑溶液做牙周组织局部注射治疗牙周病31例，与口服组30例的疗效作了比较，报告如下。     

1935名健康成人牙周病流行病学调查

为了解牙周病流行情况及牙周病的致病囡素,本文采用国际通用的指数计分法,对1935名健康成人进行了调查。牙周病流行病学特点是牙周病流行较普遍,但不甚严重。总罹患率为95.97%,患牙周炎者仅占5.89%而口腔卫生情况普遍很差,软垢及牙结石发现率均在93%以上。特别是牙周病指数及口腔卫生指数随年龄增加而升高,这提示牙周病是一种慢性进行性疾病。调查结果显示,软垢、牙结石、吸烟、牙齿排列不齐等因素与牙周病有一定关系。因此,本文提出加强口腔卫生宣传教育和施以必要的洁治术是防治牙周病的有力措施。对青年人的牙龈炎进行早期处置有重要意义,应大力提倡。     

中药丹参对牙周病防治的研究进展

牙周病主要是由微生物感染引起的牙齿支持组织疾病,中药丹参具有抗氧化、血管活性、改善微循环及抗菌消炎等药理作用,近年来在口腔医学方面的药理作用越来越受到关注,对于丹参防治牙周病的研究越来越深入,本文根据中药丹参近年来发现的一些药理作用结合牙周病产生的病理机制,就丹参对牙周病防治的研究现状进行综述。     

口腔内科患者对牙龈出血与洁治的认知情况调查

牙龈出血是牙周病最常见的症状,也是牙周病患者的主诉症状。许多患者不知道牙龈出血特别是刷牙时牙龈出血是一种疾病的早期信号,因而不能及时到医院诊治,延误了牙周病早期阶段的治疗。在为其进行洁治治疗时,有的患者错误认为那仅仅是为了美观,不能达到治疗牙周病的目的,还是服药治疗效果好。这反映出了人们对牙周病及其防治缺乏基本的认识。为此,笔者对600名牙病患者进行了牙龈出血与洁牙认知情况的问卷调查,为开展有针对性的卫生宣教工作提供依据。材料与方法1.调查对象1999年3～4月份来我院口腔内科就诊的患者600例。其中,男性260例,女性3…     

牙周病患者免疫状态的初步研究

<正> 免疫学的深入发展已渗透到医学的各个领域。牙周病与免疫学的关系在国外已有许多研究。虽然目前公认细菌是牙周病的始动因子,但宿主的应答反应可能是牙周病发生、发展的重要环节。因此,研究宿主的免疫状态,对牙周病的病因、转归和治疗的探索,具有一定意义。本文通过对32例牙周病患者的细胞和体液免疫     

中医对牙周病的一些认识

牙周病是威胁人们身体健康的主要口腔疾病之一。长期以来我国中医学在不断地探索它的病因，在其治疗及预防方面进行了大量的研究，了解中医对牙周病的认识，将对牙周病的发展具有一定的意义。牙周病是人类历史上最古老的疾病之一。在我国几十万年前的蓝田人下颌骨化石中就...     

牙周病的防治体会

作者对牙周病的防治进行了总结,谈了自己的临床体会。牙周病的防治体会@何立东$济南市解放军3520工厂医院!250022~~     

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牙菌斑是一种细菌性生物膜。菌斑控制是个人口腔卫生保健及龋病、牙周病防治的必要措施。菌斑控制的方法很多,其中有机械性措施和化学方法,然而每种方法又有其各自的局限性。近年来,光动力疗法在口腔抗菌方面的研究取得了一定进展,声动力疗法继光动力疗法在微生物领域的研究将具有重要的临床应用价值。本文就菌斑控制的方法做一综述。     

New directions in host modulation for the management of periodontal disease

Background: New strategies for periodontal disease management have been emerging as more is learned about the role of the host response. Our increasing understanding of inflammation and its resolution has opened the door to the study of new periodontal treatment strategies. This commentary examines periodontal disease in light of a new understanding of the role of inflammation in disease expression, thus setting the stage for the development of new prevention and treatment strategies of a widespread disease.
Methods: We examined current publications and focused on articles relating to anti-inflammatory and pro-resolution mechanisms in periodontal disease.
Results: Recent research has examined the inflammatory and resolution cascade in greater detail while looking at endogenous and exogenous mediators that can be utilized to achieve therapeutic end-points. The possible introduction of "resolution indices" for drug testing warrants a new look at pharmacologic agents that might have been overlooked for their beneficial effects in periodontal disease treatment.
Conclusion: The emerging awareness of inflammation and its control in periodontal disease management underscores the importance of exploring inflammatory pathways and mediators, thus exploring new ways to control inflammation. This direction of research promises a new era in drug discovery and therapeutics for periodontal disease treatment.     

Prevention of periodontal diseases

The ultimate goal of periodontal disease prevention is to maintain the dentition over a lifetime in a state of health, comfort, and function in an aesthetically pleasing presentation. This article focuses on primary and secondary periodontal disease prevention as they relate to gingivitis and periodontitis. Risk assessment, mechanical plaque control, chemical plaque control, current clinical recommendations for optimal prevention, and future preventive strategies are discussed.     

Host modulation for the treatment of periodontal disease

Until the 1970s, treatment strategies for periodontal diseases were primarily based on the understanding that plaque bacteria and their products mediated the tissue destruction in periodontal patients. This concept began to change, however, when investigators reported that host responses to the causative bacteria were a major contributor to disease pathogenesis. With a new understanding of host response and periodontal disease pathogenesis, it became apparent that inhibition of certain host response pathways might be an additional strategy, in addition to suppressing the causative bacteria, for treating periodontal diseases. The current understanding of periodontal disease etiology and pathogenesis emphasizes the role of the host in tissue destruction (Figure1).     

Understanding the pathogenesis of periodontitis: a century of discovery

The twentieth century was an especially notable time for research advances into the understanding of the aetiology and the pathogenesis of periodontitis. Beginning in 1900, using dark-field preparations, investigators began to implicate certain microorganisms, such as amoebae, as causing periodontitis. Today, using modern molecular techniques, we believe we have identified the primary causative agents of adult periodontitis. In 1900, histological sections of periodontal tissues at autopsy provided clues as to how periodontal pockets probably formed. Today there is a wealth of cellular and molecular data that suggest the actual pathways that the susceptible host uses to initiate periodontal tissue destruction. We now also appreciate that periodontitis may be a significant risk factor for systemic disease. A very exceptional 'century of discovery' into the nature of periodontal diseases should now lead to a new era of better diagnosis, prevention and treatment for this ubiquitous disease.     

兖州市6520名市民口腔健康状况调查报告

目的 以口腔医务工作者为调查对象之一,对其患龋率、牙周病及自我保健意识进行调查,并与普通人员作比较。方法 对6520名市民的患龋率、牙周病及自我保健意识进行分析研究。结果 目前医疗保健工作的重点偏于治疗,对广大群众的自我保健教育重视不够;新技术新项目的开展受传统意识的影响,口腔医疗工作也是治疗大于预防。结论 口腔医务工作者应清醒认识到,口腔医疗保健工作的重点应尽快侧重于预防。     

Incorrect nutrition as a risk factor for periodontal disease

Knowledge of the cause, prevention, and treatment of periodontal disease has increased rapidly during the past several decades; however, periodontal disease is still a prevalent infection, the treatment of which consumes vast amounts of financial and manpower resources. The intention of this article is to explore the role of nutrition in both the initiation and treatment of periodontal disease and to suggest that dental health professionals should consider nutritional guidance as a part of routine periodontal care.     

Prevention of infective endocarditis: a review of the medical and dental literature

This paper is a review of what is presently known about the cause and prevention of infective endocarditis. Systemic antibiotics alone are not always enough for an effective prevention of infective endocarditis. Non-streptococcus bacteria frequently found in the periodontal pocket are now reported as causing infective endocarditis; these bacteria are not uniformly susceptible to the antibiotics recommended for prophylaxis. Animal studies indicate that periodontal disease does increase the incidence of infective endocarditis and that the number of microbes entering the blood stream may not be as important in the production of infective endocarditis as other qualities, such as the microbe's ability to adhere. Antibiotics may affect the ability of a microorganism to adhere to tissues of the heart, but this association is yet unclear and may vary with the antibiotic and species of bacteria. Reduction of inflammation of the periodontal tissues is of the utmost importance in the prevention of infective endocarditis; however, mouthrinses have a very limited effect in a periodontal pocket of more than 3 mm in depth and irrigation of a periodontal pocket may create a dangerous bacteremia. Nevertheless, in addition to systemic antibiotics, local antimicrobial agents followed by routine dental treatment and maintenance show promise as an effective means for the prevention of infective endocarditis. Future research in the prevention of infective endocarditis should include placement of antimicrobials in the periodontal pocket and systemic agents that reduce platelet adhesion. The suggestions presented in this review are only recommendations for further research and are not to be construed as a substitute for the current guidelines.     

Current Concepts in the Management of Periodontitis

Periodontitis is a common disorder affecting >40% of adults in the United States. Globally, the severe form of the disease has a prevalence of 11%. In advanced cases, periodontitis leads to tooth loss and reduced quality of life. The aetiology of periodontitis is multifactorial. Subgingival dental biofilm elicits a host inflammatory and immune response, ultimately leading to irreversible destruction of the periodontium (i.e. alveolar bone and periodontal ligament) in a susceptible host. In order to successfully manage periodontitis, dental professionals must understand the pathogenesis, primary aetiology, risk factors, contributing factors and treatment protocols. Careful diagnosis, elimination of the causes and reduction of modifiable risk factors are paramount for successful prevention and treatment of periodontitis. Initial non-surgical periodontal therapy primarily consists of home care review and scaling and root planing. For residual sites with active periodontitis at periodontal re-evaluation, a contemporary regenerative or traditional resective surgical therapy can be utilised. Thereafter, periodontal maintenance therapy at a regular interval and long-term follow-ups are also crucial to the success of the treatment and long-term retention of teeth. The aim of this review is to provide current concepts of diagnosis, prevention and treatment of periodontitis. Both clinical and biological rationales will be discussed.     

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牙周疾病控制和防治是与群众健康密切相关的公共卫生领域的重要内容,控制和防治牙周疾病的基本医疗方法是洁牙术。本文认为洁牙术是经临床长期使用,被广泛公认的成熟、安全、有效的方法;洁牙术与基本医疗保险基金的支付能力相适应,是费用适宜的诊疗项目。作者提出将洁牙术列为国家基本医疗保险诊疗项目的建议。