牙周健康对2型糖尿病伴牙周炎患者口腔健康相关生活质量影响分析

目的 采用老年口腔健康评价指数(GOHAI)量表评估2型糖尿病伴牙周炎患者口腔健康相关生活质量状况.方法 对有2型糖尿病病史的患者进行牙周临床检查,将符合慢性牙周炎诊断、全口余留牙数在16颗以上,同时最近一年内未接受牙周治疗的个体,共80人作为研究对象.牙周临床检查包括采用Williams刻度探针检查全牙列菌斑指数、改...     

牙周-正畸-种植综合治疗改善重度牙周炎伴错牙合畸形的临床效果（附1例8年随访报告）

牙周病是影响口腔健康和生活质量的常见口腔疾病之一,重度牙周炎常伴发牙齿松动、移位甚或牙齿脱落导致牙列缺损等问题,若同时合并错牙合畸形,其治疗将是一个长期、复杂的过程,需要口腔多专业的联合治疗。随着患者对美观和生活质量要求的不断提高,针对伴有错牙合畸形和牙列缺损的重度牙周炎,其治疗目标已不仅局限于恢复健康,还包括在此基础之上重建完整牙列及其所具有的咬合功能和美观。文章展示了1例广泛型Ⅲ期C级牙周炎患者通过包括牙周基础治疗、正畸治疗、种植修复治疗在内的多学科联合治疗,获得满意的、口腔功能和美观改善的诊疗效果,以期为临床复杂病例的多学科综合诊疗积累一定的经验。     

Oral health-related quality of life of periodontal patients

BACKGROUND AND OBJECTIVE: The purpose of this study was to assess the oral health-related quality of life of patients presenting to a periodontal specialist by means of six questions, and to assess the perceived oral health by means of one question. Self-assessments of oral health were associated with clinical characteristics. MATERIAL AND METHODS: Logistic regression models were used to associate self-assessments with clinical characteristics in a cross-sectional study. RESULTS: On the six-item questionnaire, close to 20% (295/1480) of the patients reported that teeth, gums or dentures had an impact fairly often or very often on one or more items (eating, relaxing, avoiding going out, feeling self-conscious, pain or discomfort). On the single question requesting a self-assessment of oral health, 42% (628/1468) rated their oral health as fair or poor. Both common oral health-related quality of life problems and worse perceived oral health were associated with having more than eight teeth with>5 mm periodontal pockets (odds ratio=1.45, 95% confidence interval=1.01-2.08; and odds ratio=2.83, 95% confidence interval=2.08-3.84, respectively), compared with patients who had fewer than three teeth with>5 mm periodontal pockets. CONCLUSION: Oral health-related problems in patients presenting to a periodontal specialist office negatively affect their quality of life. If some of the findings of this study can be confirmed in other studies, it could change the perception of chronic periodontitis as a silent disease.     

牙周炎对老年糖尿病患者口腔健康相关生活质量的影响

目的:探索牙周炎对老年糖尿病患者口腔健康相关生活质量的影响,为提高老年糖尿病患者口腔健康相关生活质量提供理论依据。方法:采用OHIP-14中文版对第四军医大学口腔医院老年病科149名60岁以上2型老年糖尿病患者进行问卷调查,并采用CPI牙周探针进行牙周健康检查,利用FoxPro6.0软件建立数据库,SPSS19.0软件进行统计分析。结果:糖尿病牙周炎组老年人OHIP量表总得分的中位数和四分位数为P₂₅=13,P₅₀=16,P₇₅=18;糖尿病非牙周炎组老年人分别为P₂₅=7,P₅₀=9,P₇₅=11;糖尿病牙周炎组高于糖尿病非牙周炎组,差异有统计学意义(P<0.05)。两组老年人在功能限制、生理性疼痛领域得分最高。除生理障碍领域外,在其他领域糖尿病牙周炎组得分均高于糖尿病非牙周炎组(P<0.05)。结论:牙周炎影响老年糖尿病患者口腔健康相关生活质量,尤其在功能限制和生理性疼痛领域。医生应当重视老年糖尿病患者的牙周状况,改善其口腔健康相关生活质量。     

口腔扁平苔藓与牙周炎关系的研究进展

牙周炎为发生在牙周组织的慢性感染性疾病,同时口腔扁平苔藓也是口腔粘膜的常见疾病。临床上大多数口腔扁平苔藓患者牙周状态差,并且牙周基础治疗对其有一定疗效;在发病机制上二者都与免疫、遗传及心理精神因素等有关。牙周炎与口腔扁平苔藓这两种慢性炎症疾病可同时存在或伴随患者终身,维护好牙周健康已成为口腔医学必须面对的现实。本文对近年来牙周炎与口腔扁平苔藓的关系进行回顾总结,为牙周病和口腔扁平苔藓的进一步研究奠定基础。     

Oral health-related quality of life, sense of coherence and dental anxiety: an epidemiological cross-sectional study of middle-aged women

ABSTRACT: BACKGROUND: Few publications report on the relationship between salutogenesis, as measured by the concept of sense of coherence, and oral health-related quality of life. Even less information is to be found when the behavioural aspect of dental anxiety is added. The aim of the present study was to evaluate how oral health-related quality of life is related to sense of coherence and dental anxiety. METHOD: The study had a cross-sectional design and included 500 randomly selected women in Gothenburg, Sweden, 38 and 50 years of age, from health examinations in 2004-05. The survey included questionnaires covering global questions concerning socio-economic status, oral health/function and dental care behaviour, and tests of oral health-related quality of life, sense of coherence, and dental anxiety. RESULTS: High dental anxiety and low sense of coherence predicted low oral health-related quality of life. In addition, socioeconomic status as measured by income, perceived oral functional status as captured by chewing ability and self-reported susceptibility to periodontal disease were also important predictors of oral health-related quality of life. CONCLUSION: Dental anxiety and sense of coherence had an inverse relationship with regard to oral health-related quality of life. These associations were stronger than other risk factors for low oral health-related quality of life.     

Effects of two different methods of non-surgical periodontal therapy on patient perception of pain and quality of life: a randomized controlled clinical trial

BACKGROUND: The purpose of this study was to investigate the effect of two modes of delivery of non-surgical periodontal therapy on patient experience of pain and oral health-related quality of life (OHQoL). METHODS: Fifty-nine patients with mild to moderate periodontitis received non-surgical therapy using a piezo-ceramic device (n = 30) or curets (n = 29). Periodontal examinations were carried out at baseline and 8 weeks following therapy. Subjects completed the short-form McGill pain questionnaire, visual analog scales regarding sensitivity and satisfaction, and the United Kingdom OHQoL questionnaire (OHQoL-UK) at baseline, treatment, and 1, 4, and 8 weeks. RESULTS: Both groups showed improvements in clinical parameters with no significant differences between the groups. Pain scores and OHQoL-UK showed no significant differences between the groups. After treatment, OHQoL-UK scores improved from an initially negative effect on quality of life to a level of no effect. Differences in sensitivity scores between the groups were statistically significant at 1 week (P = 0.011), 4 weeks (P = 0.005), and 8 weeks (P = 0.025), favoring the use of the piezo-ceramic device. CONCLUSIONS: In mild to moderate periodontitis, therapy had a small positive impact on pain and OHQoL-UK scores. These data support the concept that periodontitis may negatively affect a patient's quality of life and that treatment may improve it.     

Clinical trial of oral malodor treatment in patients with periodontal diseases

Pham TAV, Ueno M, Zaitsu T, Takehara S, Shinada K, Lam PH, Kawaguchi Y. Clinical trial of oral malodor treatment in patients with periodontal diseases. J Periodont Res 2011; 46: 722–729. © 2011 John Wiley & Sons A/S Background and Objective: Only a few clinical research studies have assessed different therapeutic approaches to oral malodor in subjects affected by periodontal diseases. The aim of this study was to evaluate the effects of periodontal treatment and tongue cleaning on oral malodor parameters in periodontitis and gingivitis patients. Material and Methods: The subjects were 102 periodontitis and 116 gingivitis patients with oral malodor. Oral malodor was measured by organoleptic test and Oral Chroma™. Oral health status, including tooth conditions, periodontal health, tongue coating and proteolytic activity of the BANA test in tongue coating were assessed. Subjects in each periodontal disease group were randomly assigned into two subgroups depending on the sequence of treatment: periodontal treatment and tongue cleaning. Oral malodor and oral health parameters were compared by groups and sequence of treatment. Results: For subjects in the periodontitis group, there were statistically significant reductions in oral malodor after periodontitis treatment or tongue cleaning; however, major reductions were found after periodontitis treatment. For those in the gingivitis group, there were also statistically significant reductions in oral malodor after gingivitis treatment or tongue cleaning, but the most marked reductions were observed after tongue cleaning. At the completion of treatment, all oral malodor parameters fell below the threshold levels in all subgroups. Conclusion: The present study indicated that periodontal treatment played an important role and tongue cleaning contributed to a lesser extent to reduction in oral malodor in periodontitis patients. In contrast, tongue cleaning alone can be the primary approach to reduce oral malodor in gingivitis patients.     

Childhood caries in the state of Kentucky,USA: a cross-sectional study

Background

Few publications report on the relationship between salutogenesis, as measured by the concept of sense of coherence, and oral health-related quality of life. Even less information is to be found when the behavioural aspect of dental anxiety is added. The aim of the present study was to evaluate how oral health-related quality of life is related to sense of coherence and dental anxiety.

Method

The study had a cross-sectional design and included 500 randomly selected women in Gothenburg, Sweden, 38 and 50 years of age, from health examinations in 2004–05. The survey included questionnaires covering global questions concerning socio-economic status, oral health/function and dental care behaviour, and tests of oral health-related quality of life, sense of coherence, and dental anxiety.

Results

High dental anxiety and low sense of coherence predicted low oral health-related quality of life. In addition, socioeconomic status as measured by income, perceived oral functional status as captured by chewing ability and self-reported susceptibility to periodontal disease were also important predictors of oral health-related quality of life.

Conclusion

Dental anxiety and sense of coherence had an inverse relationship with regard to oral health-related quality of life. These associations were stronger than other risk factors for low oral health-related quality of life.

     

Controlled clinical and psychometric studies on the relation between periodontitis and depressive mood

BACKGROUND: Depressive mood is considered a risk factor for the development of periodontitis. OBJECTIVES: Investigation of the relationship between periodontitis and psychopathology utilizing psychometry (both observer- and self-rating scales). METHODS: Forty periodontitis patients were compared with 41 age- and sex-matched controls. The percentage of smokers was similar in both groups (30% versus 24.4%). Dental variables included probing depth, clinical attachment loss (CAL), radiographic loss of attachment, papillary bleeding index (PBI) and approximal plaque index (API). Psychometry comprised the Hamilton Depression Scale, the Zung Self-Rating Depression and Anxiety Scales, the von Zerssen Well-being and Complaint Scales, the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the Quality-of-Life Index, crystallized intelligence and the Freiburg Personality Inventory (FPI). RESULTS: Multifactorial analysis of variance demonstrated increased depression and anxiety scores, reduced well-being, increased somatic complaints, deteriorated quality of life and introversion in periodontitis. Partial correlation analyses between psychometric measures and dental variables revealed positive correlations of periodontal disease severity/CAL with the depression/anxiety, subjective well-being and complaints scores, and a negative correlation with quality of life. The API was negatively correlated with social orientation, and the CAL was positively correlated with somatic complaints and introversion in the FPI. CONCLUSION: Our clinical-psychometric studies confirm depressive mood as a relevant pathogenetic factor for periodontitis.     

Relationship between the oral cavity and cardiovascular diseases and metabolic syndrome

The components of the human body are closely interdependent; as a result, disease conditions in some organs or components can influence the development of disease in other body locations. The effect of oral health upon health in general has been investigated for decades by many epidemiological studies. In this context, there appears to be a clear relationship between deficient oral hygiene and different systemic disorders such as cardiovascular disease and metabolic syndrome. The precise relationship between them is the subject of ongoing research, and a variety of theories have been proposed, though most of them postulate the mediation of an inflammatory response. This association between the oral cavity and disease in general requires further study, and health professionals should be made aware of the importance of adopting measures destined to promote correct oral health. The present study conducts a Medline search with the purpose of offering an update on the relationship between oral diseases and cardiovascular diseases, together with an evaluation of the bidirectional relationship between metabolic syndrome and periodontal disease. Most authors effectively describe a moderate association between the oral cavity and cardiovascular diseases, though they also report a lack of scientific evidence that oral alterations constitute an independent cause of cardiovascular diseases, or that their adequate treatment can contribute to prevent such diseases. In the case of metabolic syndrome, obesity and particularly diabetes mellitus may be associated to an increased susceptibility to periodontitis. However, it is not clear whether periodontal treatment is able to improve the systemic conditions of these patients. Key words:Cardiovascular diseases, periodontitis, metabolic syndrome, obesity, diabetes mellitus.     

慢性牙周炎与慢性肾病相关性研究进展

慢性牙周炎是发生在牙周支持组织的一种慢性炎症性破坏性疾病,牙周炎不仅影响口腔健康,也与全身健康密切相关。慢性肾病被认为是一种严重危害生命健康的非传染性慢性疾病。近年来有研究发现慢性牙周炎与慢性肾病之间有密切联系。本文就慢性牙周炎与慢性肾病相关性研究进展作一综述。     

Impact of oral health on the life quality of periodontal patients

OBJECTIVES: To assess the impact of oral health on the life quality of a periodontal patient group. MATERIALS AND METHODS: Two hundred and five patients attending a private periodontal clinic completed a questionnaire incorporating the 16-item UK oral health-related quality-of-life measure (OHQoL-UK), a check list of questions about their periodontal health over the past year and a comprehensive periodontal examination. RESULTS: The effect of oral health on quality of life was considerable, with many individuals experiencing negative impacts across a broad range of physical, social and psychological aspects of life quality. OHQoL-UK(Copyright ) scores was associated with patient's self-reported periodontal health in the past year: experiences of "swollen gums" (p<0.01), "sore gums" (p<0.01), "receding gums" (p<0.01), "loose teeth" (p<0.01), "drifting teeth" (p<0.01), "bad breath" (p<0.01) and "toothache" (p<0.01). In addition, OHQoL-UK scores were correlated with the number of teeth with pocket depths of 5 mm or more (r(s)-0.42, p<0.01). New patients had poorer oral health-related quality of life compared with the treated maintenance group (p<0.01). CONCLUSIONS: Periodontal status impacts on life quality. This has implications in understanding the consequences of periodontal health and in the use of patient-centred outcomes in periodontal research.     

维、汉患者牙周病知识和口腔保健行为的比较

目的：通过对口腔科维吾尔族和汉族患者的牙周病知识水平和口腔保健行为的调查，了解两民族对牙周病认知程度和保健行为的差异及二者之间的关系。方法：以问卷方式调查了161例维吾尔族患者和339例汉族患者牙周病相关知识，并记录其牙周状况。结果：维吾尔族患者对牙周病的病因和早期症状以及防治知识认知率低于汉族患者，差异有统计学意义，维吾尔族患者中能够使用正确的刷牙方法和经历过洁治术的人数少于汉族患者。了解牙周保健知识以及接受过牙周治疗是影响患者牙周保健行为的因素之一。结论：提示维吾尔族患者的牙周病知识水平和牙周保健行为能力低于汉族患者，必须加强健康教育，应该以改变其口腔保健行为作为重点，并充分发挥少数民族护士的作用。     

The relationship between normative orthodontic treatment need and oral health-related quality of life

OBJECTIVES: The first objective was to assess whether having had orthodontic treatment affected the levels of oral health-related quality of life impacts in Brazilian adolescents. A second objective was to assess the relationship between a normative clinical measure of orthodontic treatment need and two measures of oral health-related quality of life. METHODS: A cross-sectional study was conducted in Bauru, SP, Brazil, on 1675 randomly selected adolescents aged between 15 and 16 years. Adolescents were clinically examined using the Index of Orthodontic Treatment Need (IOTN). Two oral health-related quality of life measures, namely the Oral Impacts on Daily Performance (OIDP) and the shortened version of the Oral Health Impacts Profile (OHIP-14) were used to assess the adolescents' oral health-related impacts. Multiple logistic regression was used in the data analysis. RESULTS: Adolescents who had completed orthodontic treatment reported less oral health impacts on their daily life activities than those currently under treatment or those who never had any treatment. Combining the IOTN index with either of the two oral health-related quality of life measures used in this study provided more information about the adolescents' perceived satisfaction with their appearance than the IOTN on its own. CONCLUSION: Current methods of assessing orthodontic need should be complemented by oral health-related quality of life measures with valid psychometric properties, and measures of perceived need.     

Does dental disease hurt your heart?

Recent research has yielded conflicting data regarding the relationship between dental disease, particularly periodontitis, and cardiovascular disease. A causative relationship would have major ramifications for health care. There is a plausible theoretical basis for such a link, as increased levels of inflammatory mediators may increase the risk of atherosclerotic plaque formation. Nevertheless, a clinical confirmation of a causative relationship has been difficult, in part because cardiovascular disease and periodontal disease share common risk factors such as increasing age and tobacco use, and because cardiovascular medications may increase the risk of periodontitis. Patients should be encouraged to control documented risk factors for cardiovascular disease and to maintain oral health for its well-known health benefits.     

Detection and diagnosis of periodontal conditions amenable to prevention

Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory diseases. Gingivitis affects the majority of people, and advanced periodontitis is estimated to affect 5-15% of adults. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. All patients should undergo periodontal assessment as part of routine oral examination. Periodontal screening using methods such as the Basic Periodontal Examination/Community Periodontal Index or Periodontal Screening Record should be performed for all new patients, and also on a regular basis as part of ongoing oral health care. If periodontitis is identified, full periodontal assessment is required, involving recording of full mouth probing and bleeding data, together with assessment of other relevant parameters such as plaque levels, furcation involvement, recession and tooth mobility. Radiographic assessment of alveolar bone levels is driven by the clinical situation, and is required to assess bone destruction in patients with periodontitis. Risk assessment (such as assessing diabetes status and smoking) and risk management (such as promoting smoking cessation) should form a central component of periodontal therapy. This article provides guidance to the oral health care team regarding methods and frequencies of appropriate clinical and radiographic examinations to assess periodontal status, to enable appropriate detection and diagnosis of periodontal conditions.     

OI：10.19538/j.kq.2020.09.003 牙周-正畸-种植修复多学科综合治疗重度牙周炎的临床效果观察（附1例5年随访报告）

 牙周炎作为一种发生于牙周支持组织的炎症性破坏性疾病，发展到晚期可引起牙齿松动、移位甚或脱落，对患者口腔功能和美观造成不同程度的损害，影响患者的全身健康及口腔健康相关的生活质量。针对合并错畸形、牙列缺损的重度牙周炎病例，需要在全面完善的口腔检查基础之上制定周密完善的系统治疗计划，积极实施包括牙周、正畸、修复等在内的多学科综合治疗，从而达到控制炎症、恢复健康、重建功能和改善美观的治疗目标。文章展示了1例牙周炎Ⅳ期C级病例的多学科综合诊治过程，通过对患者实施规范有序的牙周系统治疗，包括完善的牙周基础治疗和恰当的牙周手术治疗，控制牙周炎症、保留预后较差患牙，获得了健康稳定的牙周状况。在此前提下，通过正畸治疗，纠正不良咬合关系及因牙周炎导致的牙齿移位，消除咬合创伤，建立有利于牙周健康稳定的咬合关系，同时结合种植修复治疗重建完整牙列，最终达到了恢复健康、重建功能及改善美观的治疗目标。基于该病例，文章重点探讨了重度牙周炎的多学科诊疗策略，从一定程度上总结本病例在临床处理中的关键点，以期为重度牙周炎的临床诊治提供一定的经验。     

Evaluation of oral health-related quality-of-life in patients with generalized aggressive periodontitis

Abstract

Objective. This study aimed to assess the association between the quality-of-life and clinical parameters in patients with generalized aggressive periodontitis. Materials and methods. The examination included assessing the number of missing teeth; the number of mobile teeth; and periodontal measures such as bleeding on probing (BoP), probing depth (PD), gingival recession (REC) and plaque index (PI). Patients were asked to rate the impact of their oral health on 16 key areas of oral health-related quality-of-life (OHQoL-UK^©). Results. In this study, most of the subjects' complaints were missing teeth (85%) and REC (75%), following by bleeding gums (62%), bad breath odor (58%), pain/sensitivity (53%) and mobility (53%). On the other hand all clinical parameters affected the OHQoL-UK^© (p < 0.05) and the most affected parameters of QoL were missing teeth, BoP, mobility and REC (p < 0.05). Conclusions. The findings of the current study showed that aggresive periodontitis has a deep impact on patients' oral health-related quality-of-life. When setting a treatment plan in aggressive periodontitis patients, clinicians must evaluate the patient perceptions and the effect of treatment options on a patient's entire life.     

Effect of Nd: YAG laser irradiation on the treatment of oral malodour associated with chronic periodontitis

AIM: To investigate, using a randomised-controlled, single clinical trial whether treating periodontitis with non-surgical periodontal treatment procedures and laser applications can decrease the effect of oral malodour and compare the effectiveness of the different therapies. METHODS: Sixty patients suffering from chronic periodontitis and complaining of oral malodour were included in the study. The parameters measured included organoleptic scoring, volatile sulphur compound (VSC) levels, gingival index, plaque index, probing depth and clinical attachment levels before and after the different treatment procedures (oral hygiene instructions, scaling-root planing-SRP and subgingival Nd: YAG laser irradiation). RESULTS: There were significant relationships between oral malodour and the specific periodontal parameters. For all patients, there were statistically significant (p < 0.05) decreases in the clinical index scores and VSC values after all treatments. Although the VSC values decreased in all groups after treatment, laser treatment alone did not cause as large decreases as that achieved by SRP and SRP + laser irradiation. CONCLUSION: The results confirmed that in the population studied, oral malodour levels were significantly reduced after treating chronic periodontitis. The data indicated a possible adjunctive role for Nd: YAG lasers in periodontal therapy and treatment of oral malodour.