低强度脉冲超声在牙周组织再生中的作用

牙周病、根面龋以及颌面先天畸形和创伤等都会不同程度地导致牙槽骨、牙龈和牙周膜等牙周支持组织缺损。低强度脉冲超声（LIPUS）的温热效应和机械刺激可促进成骨质细胞、成牙本质细胞和牙周膜细胞（PDLC）的生成和分化。PDLC可分化成中胚层细胞谱系,进而生成牙槽骨、牙骨质和牙周膜等牙周组织。碱性磷酸酶（AKP）和骨钙蛋白（OCN）为骨形成或骨分化的晚期标志物,经LIPUS刺激过的PDLC,其AKP活性和OCN的表达皆提高。经LIPUS刺激可减少正畸过程中牙根的吸收,促进修复牙根缺损的成牙骨质细胞的增殖分化和矿化,促进牙周组织伤口愈合和血管生成的结缔组织生长因子的表达,从而加速牙周软组织的愈合。LIPUS刺激在牙周支持组织再生中为一种安全无创的治疗手段,但其最佳刺激强度和治疗时间尚需继续探索。     

fibromodulin在牙周组织中的作用

摘要fibromodulin是富含亮氨酸的小蛋白多糖的成员之一,与其同家族的decorin和lumican一样,与胶原密切相关。fibromodulin在牙周组织中的特异性分布,以及粘结胶原和转化生长因子β的特性,使其有可能在牙周组织自身稳定、发育、损伤愈合中起着重要作用。本文就fibromodulin在牙周组织中的可能作用作一综述。     

低能量激光治疗牙本质过敏临床疗效观察

目的    评价低能量激光治疗牙本质过敏的近期临床疗效。方法    选取2009年1月至2011年8月大连医科大学附属第一医院口腔科收治的牙本质过敏患者27例（共54颗患牙）,采用低能量激光治疗,并用数字化疼痛评分法（VAS）检测治疗前及治疗后即刻、1 周、4周的牙本质敏感程度。结果    治疗前冷刺激VAS评分为64.6±30,在治疗后即刻、1周和4周时VAS评分分别为22±20.2、26.8±35.4、18.5±30.8,治疗前与治疗后各时间点比较差异均有统计学意义（P < 0.05）。结论    低能量激光治疗牙本质敏感具有良好的疗效。     

fibromodulin在牙周组织中的作用

fibromodulin是富含亮氨酸的小蛋白多糖的成员之一，与其同家族的decodn和lumican一样，与胶原密切相关。fibromodulin在牙周组织中的特异性分布，以及粘结胶原和转化生长因子13的特性，使其有可能在牙周组织自身稳定、发育、损伤愈合中起着重要作用。本文就fibromodulin在牙周组织中的可能作用作一综述。     

低能量微波照射对大鼠正畸牙移动及牙周组织改建的影响

目的： 探讨低能量微波照射对大鼠正畸牙移动及牙周组织改建的影响。方法： 将SD大鼠随机分为对照组和实验组。采用螺旋弹簧加力法,通过镍钛拉簧装置构建大鼠正畸模型。实验组每天1次,用微波治疗仪照射被移动的第一磨牙,每次30 min;对照组不施加任何干预措施。分别在造模当天、第7、14、21天处死大鼠,测量大鼠第一磨牙的移动距离。抗酒石酸酸性磷酸酶(TRAP)染色检测大鼠牙周组织中破骨细胞计数;免疫组织化学检测破骨细胞分化因子（ODF）的表达;实时荧光定量PCR（RT-PCR）检测白细胞介素6（IL-6）和肿瘤坏死因子α（TNF-α）mRNA的表达。采用SPSS 20.0软件包对实验数据进行统计学分析。结果： 第7、14、21天时,与对照组相比,实验组大鼠第一磨牙移动距离、牙周组织中破骨细胞计数、ODF表达显著升高（P<0.05）,牙周组织中IL-6和TNF-α的mRNA表达显著下降（P<0.05）。结论： 低能量微波照射能明显加快正畸牙移动速度,抑制炎性基因表达,促进牙周组织改建。     

一氧化氮在牙周组织中的生物学作用

一氧化氮 (ＮｉｔｒｉｃＯｘｉｄｅ ,ＮＯ)是一种毒性强、不稳定、易扩散 ,化学性质极其活泼 ,半衰期极短 (3～ 5ｓ)的自由基。它参与了循环、消化、神经、免疫等多种系统的生理及病理过程[1,2 ] 。 1993年Ｂｏｄｉｅｓ[3 ] 首次在唾液中检测出ＮＯ的存在 ,至此 ,揭开了口腔ＮＯ的生物学研究。当前 ,ＮＯ在口腔疾病中的作用研究正逐渐成为口腔新研究热点之一。现就ＮＯ在牙周组织中的生物学作用作一综述。1　ＮＯ的研究概况1.1　ＮＯ的生物合成及生物学作用ＮＯ由一氧化氮合酶 (ＮＯＳｙｎｔｈａｓｅ ,ＮＯＳ)由Ｌ—精氨酸和分子氧催化合成…     

低能量激光治疗牙本质过敏症的临床观察

目的 观察低能量激光治疗仪治疗牙本质过敏症的疗效。方法 观察患牙本质过敏症的患者７８例,９３颗患牙,用语言分级法（ＶＲＳ）对患者牙本质敏感程度进行分级。结果 低能量激光治疗本质过敏症的总有效率９３．５％。结论 低能量激光治疗牙本质过敏症疗效好、安全简便、易于操作,其作用机理值得探讨。     

The current status of low level laser therapy in dentistry, Part 1. Soft tissue applications

Despite more than 30 years of experience with low level laser therapy (LLLT) or 'biostimulation' in dentistry, concerns remain as to its effectiveness as a treatment modality. Controlled clinical studies have demonstrated that while LLLT is effective for some specific applications, it is not a panacea. This paper provides an outline of the biological basis of LLLT and summarizes the findings of controlled clinical studies of the use of LLLT for specific soft tissue applications in dentistry. Areas of controversy where there is a pressing need for further research are identified.     

An immunohistochemical study of matrix molecules associated with barrier membrane-mediated periodontal wound healing

Guided tissue regeneration (GTR) is a clinical procedure developed to facilitate periodontal regeneration by using barrier membranes to selectively promote the repopulation of a periodontal defect by periodontal ligament and bone cells at the expense of epithelial and gingival connective tissue cells. The aim of this study was to gain insight into the biological events occurring during membrane mediated periodontal wound healing by examining the immunohistochemical expression of a number of extracellular matrix components in tissues treated via the GTR technique. Experimental periodontal defects were created around the second premolar tooth in 4 dogs and wound closure was achieved by application of expanded polytetrafluoroethylene membranes around each tooth and flap positioning coronal to the cementoenamel junction. The dogs were sacrificed after a 4-wk healing period, block dissections of the part of the mandible containing the experimental tooth were obtained and paraffin sections were prepared. Using standard immunohistochemical techniques, the sections were stained with a monoclonal antibody against bone morphogenetic proteins 2 and 4 (BMP-2 and -4) and polyclonal antibodies against collagen I, collagen II, decorin, biglycan, bone sialoprotein, osteopontin and osteocalcin. Collagen I was predominantly localized within the regenerating bone, whereas collagen III staining was more abundant in the soft connective tissues of the defect. Decorin and biglycan staining was faint within the extracellular matrix of the regenerating defect, although both proteoglycans exhibited intense intracellular localization within some of the cells inhabiting the defect. The staining for BMP-2 and -4 was weak within the bone but strong within the extracellular matrix of the regenerating soft tissue. Osteopontin and bone sialoprotein were strongly localized in the regenerating bone and cementum found within the defect. Osteocalcin staining was present in both the regenerating and mature cementum and associated cementoblasts, and it was relatively weaker in the regenerating bone compared to the mature bone. The observed pattern of immunolocalization of the extracellular matrix macromolecules suggests that the heterogeneous cell population filling the GTR wound had created an environment that was conducive to periodontal regeneration.     

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遵循正确原则的自体牙移植术可获得较高成功率。更好地促进术后移植牙牙周组织的愈合则是提高成功率的关键。本文就自体牙移植术中牙周组织愈合机制及其预后做一介绍,希望通过对相应知识的深入理解,最终达到促进自体移植牙牙周组织愈合,提高自体牙移植术成功率的目的。     

纤维调节素在人类牙周细胞损伤愈合中的免疫组织化学表达

目的研究纤维调节素在牙周细胞损伤愈合中的表达,探讨纤维调节素在牙周损伤愈合中的作用。方法培养人类牙周细胞（牙龈成纤维细胞、牙周膜成纤维细胞和成骨细胞）;在培养了牙周细胞的载玻片上做损伤细胞的圆形创口,建立牙周细胞损伤模型,跟踪观察7 d;用免疫组织化学染色的方法,观察纤维调节素在牙周细胞损伤愈合过程中的表达。结果牙周细胞损伤后第1天,纤维调节素较强表达于损伤边缘新移行的细胞;随后,纤维调节素对损伤区新近移行的细胞的表达强于创口周围的细胞。结论纤维调节素强烈表达于损伤区新近移行的牙周细胞,可能参与牙周损伤愈合的早期活动。     

Relation between wound healing after surgery and susceptibility to periodontal disease

Abstract. In the present investigation wound healing was studied clinically in 8 younger (mean age 33.5 years) and 8 older patients (mean age 48 years), who were surgically treated for the same amount of severe periodontitis. This implies that the patients in the younger age group represented individuals with a higher degree of susceptibility to periodontal disease than the patients in the older age group. After surgery all patients were subjected to a carefully controlled oral hygiene program. Patients were recalled weekly until 8 weeks post surgery and again after 15 weeks for a final examination. At every recall session oral hygiene measurements were carried out and the bleeding tendency of the pockets was determined after probing with a standardized pressure. Bleeding on the basis of mechanical trauma after probing was considered to be a clinical parameter for wound healing in a plaque free environment.
Results indicate that the oral hygiene program resulted in equally low plaque scores in both age groups. However, in a period from 5–15 weeks after surgery younger patients showed significantly more bleeding pockets than older patients. Furthermore it was found in both groups that the more loss of attachment there was, the slower the rate of wound healing.
It was concluded that the time span for wound healing is longer in patients who are more susceptible to periodontal disease, than in those who are less susceptible.     

Potentials for root resorption during periodontal wound healing

The present study was undertaken to examine whether (1) the process of resorption, which invariably affects periodontitis involved reimplanted roots facing bone or gingival connective tissue during healing, is a transient phenomenon and, (2) root resorption can be prevented by permitting downgrowth of epithelium along the root surface. A total of 24 teeth in 2 monkeys (Macaca cynomolgus) was subjected to experimental periodontal tissue breakdown by the placement of elastic ligatures around the teeth. The ligatures were left in situ until about 50% of the supporting tissues had been lost. Following removal of the ligatures, the teeth were extracted and the denuded portions of the roots were scaled and planed. The crowns of the teeth were resected and the root canals filled with guttapercha. The roots were subsequently implanted into sockets prepared in the jaw bone in such a way that each root was embedded in bone except for a portion which was in contact with gingival connective tissue. 1 month prior to sacrifice of the animals, the cut surface of the coronal part of the roots was exposed by removal of the covering soft tissue. The epithelium was thereby allowed to migrate into the wound. Implantation of the roots was scheduled to provide healing periods of 1, 2, 3, 4, 8, 12, 16, 20 and 24 weeks before exposure of the roots. The histologic examination of the implant specimens disclosed that replacement resorption was a progressive process which eventually resulted in the elimination of the transplanted roots. It was possible to prevent root resorption in this model by permitting apical downgrowth of epithelium along the root surface during the initial phase of healing. The results are discussed in relation to procedures used in periodontal therapy.