不同口腔卫生干预措施对心脏移植患者牙周健康状况的影响

目的:探讨口腔卫生宣教和牙周洁治对原位心脏移植患者牙周健康的影响。方法:56例原位心脏移植并中度以下牙周病患者,随机分为:口腔卫生宣教组、治疗组、对照组。口腔卫生宣教组采用口腔卫生宣教措施,治疗组用牙周洁治联合口腔卫生宣教。在实施口腔干预措施前(基线水平)、治疗后3、6个月分别检测菌斑指数(plaqueindex,PLI),龈沟出血指数(sulcus bleeding index,SBI),探诊出血百分率(blooding on probing rate,BOPR),牙石指数(calculus index,CI),龈沟探诊深度(probing depth,PD),进行统计学分析。结果:治疗前3组间各项指数差异无统计学意义,治疗后3个月口腔卫生宣教组的PLI(1.68±0.45),BOPR(37%)与对照组间差异均有统计学意义(P<0.05);治疗组PLI(1.08±0.93),SBI(0.97±0.12),BOPR(25%),CI(0.67±0.49),PD(2.01±0.34)与口腔宣教组和对照组间差异均有统计学意义(P<0.05)。治疗后6个月口腔卫生宣教组PLI(1.57±0.67),SBI(1.68±0.76),BOPR(34%)与对照组间差异有统计学意义(P<0.05);治疗组PLI(1.13±0.37),SBI(1.31±0.62),BOPR(24%)CI(0.87±0.58),PD(2.24±0.27)与口腔卫生宣教组和对照组之间差异均具有统计学意义(P<0.05)。结论:对原位心脏移植患者进行口腔卫生宣教联合定期牙周洁治能有效降低牙周疾病的发生和发展。     

认知行为干预改善牙周炎患者依从性的临床研究

目的 研究认知行为干预能否改善牙周炎患者对治疗的依从性.方法 将62例慢性牙周炎患者随机分为2组,对照组牙周基础治疗前行常规口腔卫生指导,包括刷牙方法和时间、牙线的使用等;试验组牙周基础治疗前通过口腔健康教育进行认知行为干预,教育内容包括牙周炎的症状、病因、发展过程、结果和治疗方法等. 2组均在治疗前和治疗后3个月分别测量并记录所有牙的菌斑指数(plaque index,PI)、牙龈指数(gingival index,GI)和牙周袋深度(probing depth,PD).结果 治疗后3个月2组的PI、GI、PD较基线水平均有改善,差异有统计学意义(P＜0.05).试验组和对照组的PI是0.24±0.17和0.84±0.22,GI是0.87±0.26和1.15±0.34, 2组差异有统计学意义(P＜0.01).PD分别是(4.12±0.49) mm和(4.25±0.51) mm,差异无统计学意义(P＞0.05).结论 与单纯的口腔卫生宣教相比,认知行为干预能够更好改善牙周炎患者依从性,从而更有效提高患者的口腔卫生维护水平.     

Diode激光辅助治疗对老年人牙周炎的疗效观察

目的:比较Diode激光辅助牙周基础治疗(实验组)与单纯的牙周基础治疗(对照组)对老年人牙周炎的治疗效果.方法:选择20位老年牙周炎患者共70颗牙,左右对称,随机确定一侧为实验组,对侧牙为对照组.口腔卫生宣教和龈上洁治后2周为基线,治疗2周、4周、8周后记录龈沟出血指数(SBI)、牙周袋深度(PD)和附着水平(CAL),并进行统计分析比较.结果:实验组和对照组的SBI在2周、4周、8周后与基线比较均有明显改善(P＜0.05).PD改善方面,仅实验组在4周后较基线有明显降低(P＜0.05).不管实验组还是对照组,CAL治疗后与基线比较均没有明显改善(P＞0.05).两组之间比较,SBI、PD和CAL的改善均没有明显差异(P＞0.05).结论:Diode激光辅助牙周基础治疗和单纯的牙周基础治疗均对改善老年患者的龈沟出血指数和牙周袋深度有效,但Diode激光辅助牙周基础治疗与单纯的牙周基础治疗相比没有显著提高治疗效果.     

上海市在职成年人口腔保健与牙周健康状况的调查

目的:调查上海市不同职业在职成年人口腔卫生习惯和牙周健康状况,初步探讨口腔卫生习惯对牙周病流行情况的影响程度.方法:采取分层、整群、随机的抽样方法,通过问卷调查了解400名上海市不同职业在职成年人的口腔卫生习惯,检测简化口腔卫生指数(OHI-S)、牙龈指数(GI)、探诊出血(BOP)、牙周袋探诊深度(PD)、临床附着丧失(CAL)、松动度(Mobility,M)及余留牙数等指标以评价牙周健康状况.结果:上海市不同职业在职成年人口腔卫生习惯、口腔卫生状况及牙周健康状况有极显著差异;上海市成年人人群简化口腔卫生指数OHI-S=2.16±0.99,牙龈炎为中度流行(GI=1.23±0.50),牙周健康者比率为5.75%,牙周炎的患病率为71.5%.结论:上海市在职成年人口腔卫生习惯和口腔卫生状况与职业存在相关性;其牙周健康状况与职业也存在相关性;调查结果证实口腔卫生习惯是影响口腔卫生状况以及牙周病流行的一个至关重要的因素.     

认知行为干预辅助治疗固定矫治儿童牙龈炎

目的:观察认知行为干预(cognitive behavioral therapy,CBT)能否提高固定矫治儿童牙龈炎的治疗效果.方法:将60例患儿随机分为两组,对照组在行牙周基础治疗前只进行常规口腔卫生宣教,干预组除常规口腔卫生宣教外,通过口腔健康教育进行认知行为干预.比较两组在基线,治疗后1个月、治疗后3个月和治疗后6个月的菌斑指数(PLI)、牙龈指数(GI)和探诊出血(BOP)等指标.结果:基础治疗后两组各项指标均有明显改善(与治疗前比较P＜0.01),且干预组各项指标的改善能维持相对较长的时间,明显好于对照组(P＜0.01).结论:认知行为干预能明显提高病人口腔健康维护的主观能动性,提高牙周基础治疗的效果.     

慢性牙周炎患者牙周维护期间依从性不同对临床疗效的影响分析

目的:观察慢性牙周炎患者牙周维护期间依从性不同对临床疗效的影响。方法:临床纳入慢性牙周炎患者70例,根据患者依从性差异分为完全依从性组以及不完全依从性组,每组35例。所有患者均首先进行为期4周的基础治疗,对于无手术指征者给予牙周维护治疗,并进行定期复查。观察治疗前与治疗12个月后患者菌斑指数(Plaque index,PI)、牙龈指数(Gingival index,GI)以及牙周袋深度(Probing depth,PD)、探针出血(BOP)阳性率、临床附着水平(CAL)等指标。结果:治疗前,两组患者PI、GI、PD、BOP阳性率、CAL水平等差异无显著性;完全依从性组患者治疗6个月、12个月的PI、GI、PD评分、BOP阳性率、CAL水平均明显优于不完全依从性组(P＜0.05),具有统计差异。结论:依从性较好的慢性牙周炎患者在接受临床治疗后,疗效要明显优于依从性较差的患者。因此,临床医师需要对慢性牙周炎患者进行定期随访,以提高患者的依从性。     

儿童超重及肥胖与牙周健康状况的相关性调查

［摘要］目的 探究10～11岁儿童超重及肥胖与牙周状况之间的关系。方法 纳入成都市198名10～11岁儿童,其中男106名,女92名。检查受试者身高、体重、腰围,计算体质指数(BMI)、记录刷牙习惯和牙周状况。以BMI作为标准纳入超重肥胖组（实验组）98人、正常组（对照组）100人,以腰围为标准纳入超重肥胖组（实验组）94人、正常组（对照组）104人。牙周检查内容包括探诊出血指数(BOP)、可见菌斑指数(VPI)、牙石指数(CI)和探诊深度(PD)。采用χ2检验、t检验、单因素及多因素Logistic回归模型进行分析。 结果BMI和腰围标准分组下,实验组的口腔卫生习惯均差于对照组（P＜0.01）,BOP、VPI＞0.25人数、CI高于对照组（P＜0.01）,出现PD＞3 mm的人数无统计学差异。控制VPI＞0.25、口腔卫生习惯不良作为混杂因素,BMI标准的超重/肥胖是BOP>0.25的危险因素(OR=1.911,95% CI 1.02~3.58),腰围标准的超重/肥胖是BOP>0.25（OR=1.78,95% CI 1.28~3.39）和出现牙石（OR=1.88,95% CI 1.03~3.58）的危险因素。 结论 10～11岁儿童中全身性肥胖与BOP相关,腹型肥胖与BOP和出现牙石均存在关联。     

牙周基础治疗对龈沟液白细胞介素-35水平的影响

目的 探讨牙周基础治疗对牙周炎患牙龈沟液(gingival crevicular fluid,GCF)中白细胞介素(interleukin,IL)-35水平的影响.方法 选取30例慢性重度牙周炎患者的患牙30颗,收集龈上洁治和龈下刮治治疗前后患牙的GCF并记录相关的临床指标.酶联免疫吸附测定法检测GCF中IL-35含量,Pearson相关分析GCF中IL-35与牙龈指数(gingival index,GI)、平均探诊深度(probing depth,PD)、附着丧失(clinical attachment loss,CAL)平均值的相关性.结果 牙周洁、刮治后患牙牙龈GCF中IL-35含量显著低于治疗前,两组比较差异有统计学意义(t=4.043,P＜0.01).牙周洁、刮治后患牙GI值和PD值均低于治疗前,治疗前后比较差异有统计学意义(P＜0.05).治疗前GCF中IL-35含量与GI值呈正相关(r=0.557,P＜0.01),而与患牙牙周袋的PD值和CAL值均无相关性(P＞0.05).结论 牙周基础治疗可明显影响患牙GCF中IL-35水平,IL-35可能在牙周炎的发生发展过程中具有重要作用.     

基础治疗对慢性牙周炎临床疗效和龈下牙周致病菌的影响

目的:评价牙周基础治疗对慢性牙周炎临床疗效及龈下牙周致病菌的影响.方法:纳入慢性牙周炎患者 120例,在牙周基础治疗前和治疗后1个月时检查牙周探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、菌斑指数(plaque index,PLI)和牙龈指数(gingival index,GI).采用实时荧光定量聚合酶链反应法(real-time PCR)检测基础治疗前和治疗后6周时龈下菌斑中牙龈卟啉单胞菌(P.g)和伴放线放线杆菌(A.a)比例的变化.采用SAS6.12软件包对所得数据进行t检验.结果:各项指数在治疗前、后比较差异有统计学意义(P＜0.05).治疗后P.g占总菌的比例与基线相比有显著性差异(P＜0.05),治疗后A.a占总菌的比例与基线相比,无显著差异(P＞0.05).结论:基础治疗可以有效治疗慢性牙周炎,并能降低致病菌P.g的比例.     

半导体激光辅助重度慢性牙周炎牙周非手术治疗的临床研究

目的: 评估半导体激光在辅助重度慢性牙周炎的牙周非手术治疗中发挥的作用。方法: 20例重度慢性牙周炎患者基线时进行牙周各项检查,包括探诊深度(probing depth, PD)、临床附着水平(Clinical attachment level, CAL)、出血指数(bleeding index, BI)、松动度(tooth mobility, MOB)。将患者的牙列分为左右两侧,右侧患牙为对照组,仅采用牙周非手术治疗;左侧患牙为实验组,先行牙周非手术治疗,再选取检查时重度慢性牙周炎的患牙,进行半导体激光的牙周袋消毒。治疗后8周对患者进行同样的牙周检查,比较牙周指标恢复情况。结果: 8周复查时两组的PD、CAL及BI均较基线时明显降低(P＜0.05);实验组PD和CAL的改善程度比对照组更明显(P＜0.05),治疗后的MOB无明显改善(P＞0.05)。结论: 半导体激光在辅助重度慢性牙周炎牙周非手术治疗时可以增加其疗效,能有效增加附着水平,它可能是对当前牙周非手术治疗方案的有效补充。     

口腔健康促进项目对养老院老年人牙周健康和生活质量的影响

目的： 评价口腔健康促进项目对养老院老年人牙周健康及生活质量的影响。方法： 以武汉市2个城区的5所养老院老年人为研究对象,随机整群分为干预组和对照组,在干预组开展为期6个月的口腔健康促进项目,内容包括面对面口腔健康教育和发放牙具等。采用SPSS 21.0软件包,利用t检验和重复测量方差分析比较2组在干预前、后的老年口腔健康评价指数（GOHAI）和临床检查指标的变化,包括简化口腔卫生指数（OHI-S）、牙龈指数（GI）、探诊出血指数（BOP）和牙周袋深度（PD）。结果： 共322人完成随访,其中干预组144人,对照组178人。干预前,2组的社会人口学特征、GOHAI总分和临床检查指标均无显著差异（P>0.05）。干预后,与对照组相比,干预组的GOHAI总分,OHI-S、GI、BOP均显著改善（P<0.05）。结论： 健康教育与行为干预相结合的健康促进项目能够改善养老院老年人的口腔健康相关生活质量及牙周健康状况,是养老机构改善老年人牙周健康的有效措施。     

Effect of eucalyptus extract chewing gum on periodontal health: a double-masked, randomized trial

BACKGROUND: Studies in vitro showed that eucalyptus extracts possess antibacterial activity against cariogenic and periodontopathic bacteria; however, the clinical effects with respect to periodontal health in humans remain unproven. The objective of this study was to evaluate the effect of chewing gum containing eucalyptus extract on periodontal health in a double-masked, randomized, controlled trial. METHODS: Healthy humans with gingivitis but not deep periodontal pockets were randomly assigned to the following groups: high-concentration group (n=32): use of 0.6% eucalyptus extract chewing gum for 12 weeks (90 mg/day); low-concentration group (n=32): use of 0.4% eucalyptus extract chewing gum for 12 weeks (60 mg/day); and placebo group (n=33): use of chewing gum without eucalyptus extract for 12 weeks. Plaque accumulation (PLA), gingival index (GI), bleeding on probing (BOP), periodontal probing depth (PD), and clinical attachment level (CAL) were measured at weeks 0, 4, 8, 12, and 14. Significance was analyzed with repeated-measures two-way analysis of variance followed by the Games-Howell pairwise comparison test. RESULTS: The interaction between the effects of eucalyptus extract chewing gum and the intake period was statistically significant for PLA, GI, BOP, and PD but not for CAL. The low- and high-concentration groups exhibited statistically significant (P <0.05) improvements compared to the placebo group for PLA, GI, BOP, and PD. CONCLUSIONS: Eucalyptus extract chewing gum had a significant effect on PLA, GI, BOP, and PD. The use of eucalyptus extract chewing gum may promote periodontal health.     

Clinical evaluation of periodontal surgical treatment with an Er:YAG laser: 5-year results

BACKGROUND: The aim of the present study was to evaluate and compare the long-term clinical outcomes of erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser-assisted periodontal flap surgery versus conventional treatment with the modified Widman flap procedure. METHODS: A total of 146 single-rooted periodontally involved teeth from 25 patients were included in this study. In each patient, left or right maxillary single-rooted teeth were assigned randomly to one of two groups: group A (Er:YAG laser) and group B (modified Widman flap surgery). Er:YAG laser was used to debride the bone pockets, scale the root surface, and trim the periodontal flap. Recession, probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and bleeding on probing (BOP) scores were recorded at baseline and at 3, 6, 12, 24, 36, 48, and 60 months. RESULTS: Both treatments resulted in decreases in PD, PI, GI, and BOP, increases in gingival recession, and gains in CAL. PD reduction in group A versus group B was statistically significant at 6, 12, 24, and 36 months (P < 0.05). Gains in CAL were significantly greater in group A versus group B at 6, 12, 24, and 36 months. BOP scores were significantly lower in group A versus group B at 3 and 6 months (P < 0.05). All other differences between treatment groups were not statistically significant. CONCLUSIONS: Surgical treatment of single-rooted teeth with chronic periodontitis using the Er:YAG laser yields greater PD reduction and gains in CAL for up to 3 years compared to conventional Widman flap surgery. The short-term results obtained with both treatments can be maintained over 5 years.     

The effect of different cigarette smoking levels on gingival crevicular fluid volume and periodontal clinical parameters in Saudi Arabia

IntroductionPeriodontal disease is a chronic inflammatory condition of the periodontium. It is the main cause of tooth loss and is considered one of the biggest threats to the oral cavity. Tobacco smoking has long been associated with increased risk for periodontal, peri-implant, and other medical diseases.ObjectiveTo evaluate the effect of smoking and its level on periodontal clinical parameters (probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), bleeding on probing (BOP), and the volume of gingival crevicular fluid (GCF)) in healthy and chronic periodontitis individuals.Material and MethodA total of 160 participants were recruited in the present study, who were equally divided into the following five groups: healthy controls (C), healthy smokers (HS), nonsmokers with periodontitis (PNS), light smokers with periodontitis (PLS), and heavy smokers with periodontitis (PHS). GCF volume and periodontal clinical parameters (PD, PI, GI, CAL, and BOP) were assessed for each participant and compared between the study groups.ResultThere was a statistically significant difference in PD, PI, GI, CAL, and BOP between healthy and periodontitis patients (p < 0.001). The mean PI, PD, and CAL were considerably higher in heavy smokers than light smokers and non-smokers (P < 0.001). In contrast, the mean GI and BOP were significantly lower in heavy smokers than in light smokers and non-smokers. There was a statistically significant difference in GCF between healthy and periodontitis patients (p < 0.001). The mean GCF readings were higher in heavy smokers than light smokers or non-smokers (P < 0.001).ConclusionThe present study confirms the influence of smoking on periodontal clinical parameters. Smoking was associated with increased PD, PI, CAL, and GCF readings; however, GI and BOP were decreased in smokers. The number of cigarettes played a key role in the volume of GCF and periodontal clinical parameters.     

糖尿病前期患者糖代谢状态与牙周炎症的相关性

目的:研究糖尿病前期患者其糖代谢水平与牙周炎症的相关性。方法:对171名糖尿病前期患者(30~65岁)进行牙周检查,根据探诊出血结果分为高探诊出血(H-BOP)和低探诊出血(L-BOP)比例组,检测2组糖代谢指标(空腹血糖、糖耐量、胰岛素抵抗及糖化血红蛋白)及牙周检查指标(菌斑指数、牙周袋深度、附着丧失、探诊出血比例),对混杂因素(年龄、性别等)等校正后用多因素回归分析方法研究糖代谢指标与牙周探诊出血的相关性。结果:与L-BOP组相比,H-BOP组患者的牙周袋深度、附着丧失水平、空腹血糖水平及糖耐量水平均明显增加(P<0.05);进行多因素回归分析后,随着空腹血糖水平、糖耐量水平的升高,患者为H-BOP的几率显著增加(OR=1.33,1.45),随着胰岛素抵抗水平(HOMA-IR)升高时,患者为H-BOP的几率也有增加(OR=1.20)。而糖化血红蛋白与空腹胰岛素升高时,患者为H-BOP的几率有减小,但相关差异无显著性。结论:糖尿病前期患者其糖代谢水平与牙周炎症有相关性。     

无锡市老年人牙周健康状况调查分析

目的:了解无锡市老年人牙周健康状况,为牙周疾病防治提供参考.方法:选择无锡市1156名65～74岁的老年人为调查对象,应用简化口腔卫生指数、牙龈指数、探诊出血、牙周袋探诊深度、临床牙周附着丧失、松动牙数及牙缺失数等,评价牙周健康状况.应用SPSS12.0软件包对数据进行t检验和x2检验.结果:无锡市老年人简化口腔卫生指数(OHI-S)为3.16±1.48,牙龈指数(GI)为1.33+0.54;牙龈探诊出血、牙周袋深度及牙周附着丧失等牙周健康状况未表现出显著的城乡差异.结论:无锡市老年人牙周健康状况不佳,应注重牙周病预防,普及和加强口腔健康教育.     

上海妊娠期女性牙周健康状况的多因素分析

目的:了解上海市妊娠期女性的牙周健康状况,探讨妊娠期女性牙周健康的影响因素,为以后进行有针对性的口腔健康教育、制订公共卫生策略提供依据。方法:采用横断面研究, 随机抽取各区县妇幼保健院建卡的妊娠期女性(0~40周)进行调查。调查方法包括问卷调查和临床牙周检查, 牙周检查项目包括可视菌斑指数、探诊出血指数、牙周袋深度、临床附着丧失。采用SPSS18.0软件包对数据进行χ2检验和logistic多因素回归分析。结果:共调查561名妊娠期女性,平均年龄(27.5±4.0)岁,孕周5~40周,平均孕周(18.9±8.1)周。牙周病患病率49.6%,其中牙周炎患病率为6.8%,牙龈炎为42.8%。Logistic回归分析显示,处于妊娠中、晚期的女性比妊娠早期更容易患牙周病;居住在郊区的妊娠期女性比居住在市区者患牙周病的危险性高。结论:上海市妊娠期女性牙周病的患病率与妊娠周期、居住地有关,应该加强对相应高危人群的口腔健康教育。     

Clinical outcome observed in subjects with recurrent periodontal disease following local treatment with 25% metronidazole gel

BACKGROUND: The aim of this study was to evaluate the clinical outcome in patients with recurrent periodontal disease following treatment with 25% metronidazole gel. METHODS: Twenty subjects in a maintenance care program but with recurrent periodontal disease participated. Three months after scaling and root planing, a total of 40 sites, 2 in each patient, with probing depth > or = 5 mm were selected. One site randomly selected was treated with metronidazole gel (test) and the other site with a placebo gel (control). Baseline and follow-up measurements included plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). RESULTS: There were no statistically significant differences in PI, GI, BOP, PD, or CAL between test and control sites. CONCLUSION: This study showed that local treatment with 25% metronidazole gel did not seem to influence the clinical healing in this group of subjects with recurrent periodontal disease.     

Effects of xylitol impregnated toothbrushes on periodontal status and microbial flora in orthodontic patients

ObjectivesTo investigate whether the use of xylitol-impregnated toothbrushes affects periodontal condition and microbial flora in orthodontic patients with poor oral hygiene.Materials and MethodsForty-four patients with baseline mean Turesky plaque index scores ≥1.5 were randomly divided into two groups. Half received xylitol-containing toothbrushes and the other half, xylitol-free toothbrushes. The periodontal measurements and saliva samples were taken at baseline (T0), 1 month later (T1), and 3 months after brushing (T2) to evaluate periodontal health and microflora changes. Periodontal status was assessed with plaque index (PI), gingival index (GI), and bleeding on probing (BOP) scores. Data were statistically analyzed with Mann-Whitney U and Friedman tests.ResultsAll periodontal parameters significantly decreased from T0 to T1 and from T0 to T2 in both groups. The PI and GI scores reduced significantly in the control group, while BOP scores reduced in both groups between T1 and T2. Intergroup comparisons showed significant differences for BOP, PI, and GI at T0, T1, and T2 times, respectively. For microbial parameters, there were no statistically significant differences within groups from T0 to T1. Total bacterial counts significantly decreased in the xylitol group between T1 and T2. Decreases in Streptococcus mutans and total bacteria were significant in both groups from T0 to T2. No significant differences were found between the groups in microbial flora at any time.ConclusionsA 3-month use of xylitol-containing toothbrushes showed almost the same changes and provided no positive effects on periodontal and microbial parameters compared to the control group.