螺旋体与牙龈卟啉单胞菌在口臭形成中的作用

目的　评价螺旋体和牙龈卟啉单胞菌各自在产生挥发性硫化物 (volatilesulfurcompounds,VSCs) ,形成口臭中的作用。 方法　对 117例牙周炎患者 ,用鼻闻法评价口臭值(organolepticrating ,OR)后分成口臭组 85例 ,无口臭组 32例 ,用口臭测量仪测量口气中VSCs水平 ,刚果红负性染色法检测舌苔和龈下菌斑中螺旋体的百分比 (S % ) ,间接免疫荧光法检测牙龈卟啉单胞菌 (Porphyromonusgingivalis ,Pg)。口臭组 4 6例在牙周基础治疗后重复以上检查。结果　口臭组探诊深度 (probingdepth ,PD) <4mm位点S %明显高于无口臭组 (P <0 0 1) ,而舌苔与PD≥ 4mm位点的S %、舌苔与龈下菌斑中的Pg均无差异。口臭组OR、VSCs水平与舌苔及PD <4mm位点S %正相关 ,与PD≥ 4mm位点的S %无关 ;OR值与PD≥ 4mm位点的Pg呈正相关 (P <0 0 5 ) ,与舌苔及PD <4mm位点的Pg无关 ,而VSCs与 3个部位的Pg均无关系 ;牙周治疗后OR和VSCs水平明显降低 ,舌苔中的S %、龈下菌斑中的S %及Pg均明显下降 (P <0 0 1)。结论　螺旋体是与VSCs及口臭的产生有关的口腔微生物之一 ,牙周治疗可以改善口臭     

The proportion of pseudo-halitosis patients in a multidisciplinary breath malodour consultation

AIM: To report the data from a multidisciplinary bad breath consultation in Germany. MATERIALS AND METHODS: In this cross sectional study, 407 patients attending a bad breath consultation were examined by a specially trained dentist, with an ENT-specialist, an internist, and a psychologist on call. RESULTS: All patients reported suffering from bad breath but only 72.1% showed detectable signs of breath malodour. Within this group, 92.7% revealed an oral cause, 7.3% revealed an extra-oral cause. Within the group without malodour, 76.3% had received prior diagnostics and treatments from other doctors, whereby 36% had received one or more gastroscopies and 14% had undergone an ENT operation. In only ten cases had an organoleptic evaluation of the putative malodour been performed. CONCLUSION: Our data reveal that breath malodour is mainly of oral origin and that patients with pseudo-halitosis are frequently not diagnosed correctly by doctors, resulting in a considerable amount of over-treatment.     

异常口气中挥发性硫化物的气相色谱分析研究

目的 对口臭患者口气中挥发性硫化物中的主要成分进行检测分析,并探讨与牙周病的关系。方法 根据相关标准筛选出口臭患者50例,采用气相色谱技术对挥发性硫化物中的主要成分:硫化氢(H2S)和甲硫醇(CH3SH),进行定性定量分析;同时检查记录患者口腔中牙周相关指标,将H2S和CH3SH与牙周相关指标作相关性分析。结果 H2S和CH3SH的浓度随着牙周袋深度和龈沟出血指数的增加而增加,同时CH3SH和H2S的比值也随之增加。结论 H2S和CH3SH的产生与牙周病的发生发展有较密切的联系,CH3SH与牙周病的相关性更大。     

Treatment of halitosis with photodynamic therapy in older adults with complete dentures: A randomized,controlled, clinical trial

BackgroundHalitosis of oral origin is mainly caused by the release of H₂S (hydrogen sulfide) by bacteria lodged on the tongue. Antimicrobial photodynamic therapy (aPDT) has been evaluated for the treatment of halitosis, but there are no previous reports of the use of this treatment modality in older people with dentures. The aim of the present study was to compare the effect of aPDT and tongue scraping (standard treatment) in older people with complete dentures diagnosed with halitosis (H2S gas concentration>112 ppb).MethodsThe participants were divided into two groups: G1- treatment with a tongue scraper (n = 20); G2- treatment with aPDT (n = 20). Halimeter testing was performed before and after treatments using gas chromatography and was repeated after seven days.ResultsAfter treatment, the group treated with aPDT had a lower mean concentration of H2S gas (18.5 ppb) than the tongue scraping group (185.3 ppb). After one week, the mean concentration of H2S increased to 218.2 ppb in the tongue scraping group and 39 ppb in the PDT group.ConclusionsBoth treatments were able to reduce the concentration of H2S but only treatment with aPDT was able to decrease halitosis to socially unnoticeable levels. Moreover, this normal breath condition remained for seven days only in the aPDT group.     

No association between halitosis and upper gastrointestinal endoscopic findings: a prospective study

Aim: Previous studies have focused on the relationship between halitosis, gastroesophageal reflux disease and Helicobacter pylori. In this study we aimed to investigate the interaction between halitosis and whole endoscopic findings. Materials and Methods: Patients who previously had dyspepsia and had undergone endoscopic examination were included in the study. Symptoms of dyspepsia were investigated by means of a questionnaire that investigated halitosis. Patients who suffered from objective halitosis (confirmed by questions both to the patient and their relatives) were further investigated. Patients with known local or systemic causes of halitosis or structural disorders at endoscopy were excluded. Results: The study included 358 patients (121 males and 237 females) with dyspeptic symptoms. The patients with and without halitosis had mean ages of 39.4±13.5 and 43.1±14.9 years, respectively. The group of patients without halitosis were significantly older than the halitosis group (p< 0.05). Patients in the halitosis group had significantly higher frequencies of regurgitation, bloating and nausea (p< 0.05) when compared to patients without halitosis. Endoscopic findings, including esophagitis, open cardia, hiatal hernia, gastritis and duodenitis, were comparable in the two groups. Conclusion: The frequency of halitosis was high in patients with dyspepsia who underwent upper gastrointestinal endoscopy. Halitosis had a close relationship with several upper gastrointestinal symptoms, including regurgitation, nausea and bloating. There was no association between upper gastrointestinal endoscopic findings and halitosis.     

Inhibition of methionine gamma lyase deaminase and the growth of Porphyromonas gingivalis: A therapeutic target for halitosis/periodontitis

Background and objectivesPathogenic infections caused by Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia can result in the production of volatile sulfur compounds (VSC’s) and other toxic compounds from methionine catabolism that can lead to halitosis and periodontitis. Our aim is to block the activity of methionine gammalyase-deaminase (Mgld) of methionine catabolism to prevent halitosis/periodontitis.DesignsCloned, expressed, Mgld protein was tested for purity by SDS-PAGE and western blotting. Mgld activity was tested by UV–vis spectroscopy and DTNB assay. Effects of Mgld inhibitor propargylglycine (PGLY) was tested on P. gingivalis growth by turbidity measurements. The effects of PGLY on oral epithelial and periodontal ligament cells in culture at different concentrations and time were tested for cell viability by MTT and Live-Dead assays. Amino acid comparisons of Mgld from different oral pathogens were done using standard bioinformatics program.ResultsPropargylglycine (PGLY) inhibited purified Mgld activity completely. In vivo, PGLY is a potent inhibitor on the growth of the P. gingivalis over 24 h, grown at 25 °C and 37 °C. Correspondingly in vivo Mgld activity was also affected by PGLY. Amino acid comparisons of oral pathogens showed 100% identity on the key residues of Mgld catalysis. Mammalian oral cell lines with PGLY, showed no difference in cell death over untreated controls assessed by MTT and Live-Dead assays.ConclusionsPGLY arrest’s VSC’s production by P. gingivalis. Since initial Mgld activity is inhibited subsequent enzymatic and nonenzymatic products formed will be prevented. PGLY showed no toxicity towards cultured mammalian oral cells. Thus, PGLY can serve as a mouthwash ingredient to prevent halitosis/periodontitis.     

牙周病患者口臭的因素分析及伦理诊治策略

口臭是牙周病患者的主要伴发症状之一,直接影响患者的就医和治疗。对牙周病患者口臭的心理状态进行分析,建议采取：解释和引导;尊重和理解;鼓励和治疗;宣教和预防等策略,以应对患者的心理困惑。     

甲壳胺抗口臭作用的实验研究

目的 通过观察甲壳胺凝集口腔细菌及其对产臭菌异味产物的影响，评价甲壳胺的抗口臭作用。方法 本研究选用了五种标准菌株，包括与菌斑形成密切相关的变形链球菌和粘性放线菌以及三种口腔主要产臭菌：牙龈卟啉单胞菌、中间普氏菌、具核梭杆菌。实验包括三个部分：运用厌氧培养观察甲壳胺对五种细菌的抑菌作用及凝集作用；利用气相色谱法分析甲壳胺对产臭菌硫化物及吲哚代谢产物的影响。结果0．002％～1％甲壳胺对五种细菌无明显抑菌作用，凝集实验结果通过肉眼观察及菌液涂片显示：0．125％～1％甲壳胺对这五种细菌产生了明显的凝集作用。色谱分析实验结果显示：在牙龈卟啉单胞菌、中间普氏菌、具核梭杆菌不加药物试管的顶空气体中，均能检测出二甲二硫醇、二甲三硫醇、二甲四硫醇和吲哚的存在，在这三种细菌加有1％甲壳胺的实验组试管的顶空气体中，未能检测出任何一种硫化物的存在，而且，除了中间普氏菌实验组仅检测出极少量的吲哚外(峰面积相当子不加药物试管的1／22)，牙龈卟啉单胞菌、具核梭杆菌实验组均没有检测到吲哚的生成。结论 甲壳胺能吸附凝集细菌，并减少产臭菌异味产物的释放。     

口源性口臭检测指标的初步研究

目的：探讨寻找鼻测法替代检测手段的可能性.方法：选取56例医学院在校学生作为研究对象,使用Spearman法和Pearson法,分析鼻测法与口腔可挥发性含硫化合物、唾液pH、舌背微生物培养、唾液尸胺等检测结果间的相关关系.结果：口腔可挥发性含硫化合物（rMax=0.537,P＜0.01;r稳定值=0.572,P＜0.01）、唾液pH（r=0.344,P＜0.01）、唾液尸胺浓度（r=0.352,P＜0.01）、口腔卫生指数的检测结果（r=0.323,P＜0.05）、唾液兼性厌氧培养菌落计数（r=0.398,P＜0.01）、舌背兼性厌氧培养菌落计数（r=0.293,P＜0.05）及舌背专性厌氧培养菌落计数结果（r=0.473,P＜0.01）均与鼻测法结果呈正相关,但相关性均较弱.结论：任一单一指标均不能替代鼻测法对口臭进行诊断.