医学院学生牙周健康维护3年随访调查

目的:观察评估青年人群的牙周病状况,以及干预措施对控制牙周病发展的作用.方法:纳入153名医学院学生,随机分为A组(接受干预措施)和B组(未接受干预措施),随访3a.A组受试者纳入后进行口腔卫生宣教,详细讲解牙刷的选择、刷牙方式,牙线、牙缝刷的使用,同时根据纳入者实际情况给予牙周基础治疗,每隔半年再次进行口腔卫生宣教、牙周维护治疗,加强菌斑控制.比较随访前、后指数牙的菌斑软垢指数(debris index,DI)、牙石指数(calculus index,CI)、探诊深度(probing depth,PD)、临床附着丧失(clinical attachment loss,CAL)、探诊出血(bleeding on probing,BOP)和牙龈指数(gingival index,GI)的变化.采用SAS6.12软件包对数据进行统计学分析.结果:3年后,实验组的CI、DI评分和基线相比显著下降(P＜0.01),对照组和基线相比无显著差异(P＞0.05).实验组和对照组之间PD、BOP、GI变化有显著差异(P＜0.01),CAL的变化也有显著差异(P＜0.05),对照组CAL的增加显著高于实验组.结论:定期牙周健康维护及口腔卫生教育对人群牙周健康水平有积极影响.     

椅旁健康教育对慢性牙周炎患者维护期口腔卫生状况的影响

目的探讨椅旁健康教育对慢性牙周炎患者维护期口腔卫生状况的影响。方法 120例慢性牙周炎患者随机分为实验组和对照组,均给予洁治、龈下刮治和根面平整,实验组同时给予全面的口腔健康教育。于基线、基线后1、3、6个月检查Quigley-Hein菌斑指数。采用两组完全随机化设计资料均数的t检验分析所得数据。结果基线、基线后1个月时,两组间菌斑指数差异无统计学意义（t0=1.543,P0=0.1227;t1=1.925,P1=0.063）;基线后3、6个月时,实验组菌斑指数显著低于对照组（t3=19.153,P3=0.001;t6=25.265,P6=0.001）。结论实施全面的口腔健康教育可以显著改善牙周炎患者的口腔卫生状况。     

Diagnostic potential and future directions of biomarkers in gingival crevicular fluid and saliva of periodontal diseases: Review of the current evidence

ObjectivesThe holy grail of biomarker research in periodontology is to develop a high impact diagnostics which have a significant impact on clinical decision-making, patient outcomes and healthcare providers. In the field of periodontal diagnostics, oral fluid-based biomarkers have been studied mainly in the gingival crevicular fluid (GCF) and saliva.MethodsA literature search was performed using the Cochrane library and PubMed databases from 2000 to January 2017.ResultsCurrently, there are more than 90 different components in the GCF that have been investigated as diagnostic and prognostic markers of periodontal disease progression involving; inflammatory mediators, markers of oxidative stress, host-derived enzymes, tissue-breakdown products and mediators of bone homeostasis. Furthermore, various biomarkers in saliva have been proposed which reveal a promising outlook for saliva as a key diagnostic medium for periodontal disease. Recent systematic reviews with high value of evidence have shown that potential salivary biomarkers can provide important complimentary diagnostic information and can be used as tests for screening diagnosis, prognosis and predicting periodontal disease progression.ConclusionFuture developments in proteomic analysis and personalized medicine will pave the way allowing novel diagnostic tools. Still, the application into the field of dentistry will depend on how practitioners will apply this into their daily clinical practice.Clinical relevanceStill, the application into the field of dentistry will depend on how practitioners will apply this into their daily clinical practice.     

冲牙器辅助对口腔正畸患者牙龈龈沟液炎性因子及牙周健康状况的影响

目的 观察冲牙器辅助对口腔正畸患者牙龈龈沟液炎性因子及牙周健康状况的影响。方法选取2020年01月至2021年12月于我院口腔科就诊的口腔正畸患者80例。随机数字表法分为对照组和观察组，每组40例；对照组采用声波震动牙刷早、中、晚饭后清洁口腔3 min，观察组采用声波震动牙刷联合冲牙器清洁口腔，冲牙器使用时间3 min；分别于清洁前后检测两组牙周情况[出血指数（BI）、菌斑指数（PLI）、牙龈指数（GI）、菌斑百分率、探诊深度（PD）]和龈沟液炎性因子[检测龈沟液中白细胞介素-6(IL-6)、高敏C反应蛋白（hs-CRP）、白细胞介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-α)]。结果 清洁后观察组BI、PLI、GI、菌斑百分率低于对照组（P<0.05），观察组牙齿邻面（颊侧近中、颊侧远中、舌侧近中、舌侧远中）和光滑面（颊侧正中、舌侧正中）的BI低于对照组（P<0.05），观察组IL-6、hs-CRP、IL-1β及TNF-α均低于对照组（P<0.05）。结论 冲牙器辅助能有效减少口腔正畸患者的牙龈龈沟液炎性因子水平，改善牙周健康状况。     

Relationship between lactate dehydrogenase activity in saliva and oral health status

OBJECTIVE: Lactate dehydrogenase (LDH) activity in serum increases as a marker of cellular necrosis. LDH activity in saliva could constitute a specific indicator of oral mucosal lesions with tissue breakdown including periodontal disease. The aim of this study was to determine LDH activity in saliva, assessing inter-individual variations with regard to the oral health status. MATERIALS AND METHODS: An oral and perioral examination was performed on a study group of 175 volunteers, to assess the number of missing teeth, caries, fillings, dental prosthesis, periodontal status and temporomandibular joint condition. LDH activity was determined from stimulated whole saliva. RESULTS: After adjustment by age, gender, smoking habits, missing teeth and use of removable prosthesis, the multivariate analysis showed that increased LDH activity was associated with periodontal disease, specifically with the presence of calculus and pockets greater than 5mm. CONCLUSION: LDH activity in whole saliva could be useful as a biochemical marker of periodontal status.     

唇腭裂患者口腔卫生及牙周健康状况的调查研究

目的 调查我国各年龄段唇腭裂患者口腔卫生及牙周健康的现状、特点及与普通正畸患者之间的差异。方法 对唇腭裂患者及年龄匹配的普通正畸患者各80例，其中6～11岁30例、12～15岁27例、16～25岁23例，进行口腔卫生及牙周健康的检查及口腔卫生保健的问卷调查。结果 各年龄阶段的唇腭裂患者全口的牙周状况与对照相比均无统计学差异，但12～15岁、16～25岁组的唇腭裂患者全口的口腔卫生差于对照，12～15岁组的唇腭裂患者的口腔保健行为差于对照组；裂侧附近的牙齿的茵斑指数高于非裂侧及对照组，且在16～25岁组表现出探诊深度大于非裂侧及对照组。结论 不同的年龄阶段有不同的口腔卫生及牙周状况的特点。应该根据其特点，进行不同的口腔卫生指导及保健；应加强唇腭裂患者口腔健康的教育，强调裂侧附近牙齿的清洁及定期牙周栓查的必要性。     

造血干细胞移植引起的慢性移植物抗宿主病口腔黏膜及牙周状况的调查分析

目的: 观察造血干细胞移植（hematopoietic stem cell transplantation,HSCT）后有慢性移植物抗宿主病患者的早、晚期口腔黏膜及牙周改变的临床表现,探讨慢性移植物抗宿主病对口腔状况的影响。方法: 收集108例造血干细胞移植后患者,按移植后治疗时间不同分为移植时间小于1年(n=32)和超过1年(n=43) 2组。采用问卷调查、临床检查,收集临床资料,确定罹患口腔慢性移植物抗宿主病患者的基本信息,记录口腔黏膜及牙周病损及严重程度,采用SPSS21.0软件包进行统计学分析。结果: HSCT后出现口腔表征发生率为78.95%,HSCT小于1年组与HSCT超过1年组的轻度症状发生率分别为59.38%和18.60%,差异显著（ χ²=11.525,P=0.001）;HSCT超过1年的苔藓样反应与HSCT小于1年的发生率分别为60.47%和31.25%,差异有统计学意义（χ²=6.274,P=0.012）;浅、中度牙周袋患者检出率分别为49.38%和40.74%;可视牙菌斑、牙结石、牙龈出血检出率分别为62.96%、64.20%和50.62%。结论: HSCT后黏膜及牙周改变的发生率较高,早期口腔黏膜慢性移植物抗宿主病轻度症状明显,晚期口腔表现则以苔藓样反应为主。     

Bacterial profiles of oral streptococcal and periodontal bacterial species in saliva specimens from Japanese subjects

Objective

Recent developments in molecular biological techniques have increased understanding of the distribution of oral bacterial species in clinical specimens, though few investigations have been conducted to simultaneously detect oral streptococcal and periodontal species in the same specimens. The purpose of the present study was to investigate the distribution and correlation of 6 oral streptococcal and 6 periodontal species in saliva specimens taken from children and their mothers.

Design

Seventy-four pairs of children and their mothers were approved to participate in this study. Saliva specimens were collected and bacterial DNA extracted, which was subjected to PCR analyses using species-specific sets of primers. The combinations of species able to be detected simultaneously were determined by statistical analyses.

Results

Streptococcus sobrinus and Porphyromonas gingivalis were detected more often in the mothers than the children. Streptococcus mutans, Streptococcus sanguinis, and Streptococcus oralis were detected simultaneously in a significant number of specimens, while the presence of Campylobacter rectus was correlated with the presence of at least one of the red complex species (P. gingivalis, Treponema denticola and Tannerella forsythensis). On the other hand, no correlation was shown between the rates of detection of oral streptococcal and periodontal species.

Conclusions

Our results indicate that among streptococcal and periodontal species, several are able to coexist in saliva, while the presence of both does not have an influence on each other.     

A review of the oral health status in Syria

AIM: To estimate the prevalence and severity of dental caries and periodontal diseases in Syria and to determine possible secular changes in the last two decades. METHODS: Epidemiological studies performed between 1980-1999, using the WHO criteria for dental caries and the CPITN criteria for periodontal diseases in Syria were retrieved and reviewed. RESULTS: The caries experience of 5-year-old children was high (dmft of 4.7-5.2). The estimated DMFT score of 12-year-old Syrian children was 1.9-2.3. A secular change of the caries experience in the last two decades was not apparent. The amount of untreated caries lesions was high and had not changed substantially in the last two decades. The D component comprised 72-90% of the DMFT of 12-15-year-old children and 26-30% of the DMFT of 35-44-year-old Syrians. The majority of 15-24-year-olds, and more than 80% of the 35-44-year-olds had calculus. Despite the widespread and chronic existence of calculus, only 3-11% of the 35-44-year-old persons had one or more deep periodontal pockets. CONCLUSION: The caries experience in Syria is moderately low and does not seem to have changed in the last two decades. The increased output of graduate dentists in the last decade has not changed the large amount of untreated caries lesions. In Syria, where the prevalence of unmet (caries) treatment needs is high, regular removal of calculus (scaling) for the sake of preventing periodontal pockets should not have a high priority in the oral health services.     

Levels of gingival tissue platelet activating factor after conventional and regenerative periodontal surgery

The hypothesis, a relationship between gingival tissue platelet activating factor (PAF) levels and healing after periodontal surgery, was tested by measuring PAF levels in gingival tissues collected from sites that had undergone flap surgery and guided tissue regeneration (GTR) or flap surgery alone. Using a split-mouth design, 20 intrabony defects were randomly assigned to treatment with flap surgery and GTR (group 1) or with flap surgery alone (group 2). Gingival tissue samples were obtained at surgery (baseline) and at 6-month follow-up evaluation visit. One half of each sample was used for analysis of PAF levels by high-performance liquid chromatography, and the other half of the sample was used for histomorphometric analysis that included measurements of number and diameter of blood vessels. PAF levels and diameter of blood vessels were significantly decreased (p < 0.01), and the number of blood vessels was significantly increased (p < 0.05) in both groups after 6 months compared to the baseline values. Postoperative number of blood vessels were significantly higher in group 1 (p < 0.05), whereas there was no significant difference in postoperative PAF levels between the two groups (p > 0.05). Based on the reported results, it is suggested that a decrease in gingival PAF levels might be found after conventional and regenerative periodontal surgery.     

Effect of iatrogenic factors on periodontal health: An epidemiological study

IntroductionPeriodontitis is a multifactorial disease. Among conglomerate etiological factors, overhanging interproximal restorations are viewed as contributing factors causing gingival inflammation due to their retentive capacity for bacterial plaque leading to periodontal destruction. Hence this study is intended to determine the prevalence of overhanging restorations and its effect on periodontal status of the teeth and to assess the iatrogenic effects of overhanging margins on periodontal health.Materials and methodsA total of 100 subjects of 15–65 years of age were recruited for this study. Dental restorations which affect periodontal health like amalgams, composite or glass ionomer restorations (overhanging margins proximally), fixed prosthesis, cervical abrasions, class V restorations extending sub-gingivally were included in the study. Patients with known systemic diseases, smokers, and on any medication in past 6 months were excluded from the study. Various parameters like bleeding on probing, probing depth, clinical attachment loss, biological width, gingival recession, duration of restoration were assessed according to the site of the restorations.Statistical analysisA commercially available SPSS version 20.0 Software, was used to perform the statistical analysis. The data were distributed normally and it was investigated using paired t-test. The prevalence of overhanging restorations was done through percentages comparison between restorative sites with non-restorative sites.ResultsThe presence of sub-gingival restorations was greater in males than in females. This can be attributed to the oral hygiene maintenance of the subjects. The prevalence of sub-gingival restorations was more prevalent in the age groups between 35 and 45 years of age.ConclusionThis study clearly identified a higher prevalence, 50.8% of sub-gingival restorations causing gingivitis and has shown significant influence on periodontal status of the tooth.     

852名大学生口腔健康知识、态度、行为及其与患龋情况关系的调查

目的调焱潍坊地区大学生口腔健康知识、态度、行为及其与患龋情况的关系,为促进大学生口腔健康干预提供参考。方法以分层整群抽样法抽取潍坊地区某高校3个专业852名大学生进行问卷调奄及口腔榆查。自行设计调查问卷,问卷内容包括口腔健康知识、态度、行为等;同时进行患龋情况检查。对结果进行统计学分析。结果总体患龋率为43．19％,其中龋齿数大于4颗的占14．12％;问卷调查平均得分：健康知识（54．52±14．95）分,态度（75．79±19．78）分．行为（58．89±17．88）分;线性回归分析显示口腔健康行为与态度有关（P〈0．01）,但与健康知识没有明显的线性关系;龋失补牙数与口腔健康行为有明显关系（P〈0．05）．与口腔健康知识及态度没有明显关系（P〉0．05）。结论具有积极的态度以及良好的口腔卫生行为才能拥有较好的口腔健康。被调查的大学生总体口腔健康状况不佳,对口腔健康知识知晓率较低,需加强大学生的口腔健康宣教。     

Investigating oral health among individuals with depression: NHANES 2015–2016

ObjectivesDepression is highly prevalent across populations, yet studies on its contribution to oral health are lacking. Therefore, our goal is to examine the association of depression and oral health problems (preventative care, access to dental care, and oral condition in relation to quality of life) controlling for sociodemographic and chronic disease indicators (CDI).Methods5,992 respondents’ data 18+ years old were analyzed from the 2015–2016 National Health and Nutrition Examination Survey (NHANES). The independent variable of interest was depression symptoms status. Oral health outcomes were the dependent variables. We used the Patient Health Questionnaire-9 (PHQ-9) for depression and the Oral Health Questionnaire (OHQ) to measure oral health outcomes. Covariates included sociodemographics (age, education, sex, race/ethnicity, and income) and CDI included current smoking, diabetes, and body mass index. All data were weighted using 2 years sample weight.ResultsThe mean age of respondents was 47.22 years (45.97–48.46) and 46% were males. Participants with depression present 6.93%, and females 63.85% were higher than males 36.15%.Participants with depression have significantly low income 43.10% than others p value < 0.0001. After adjusting for sociodemographics and CDI, participants who have depression were more prone to report fair/poor oral condition [aOR = 1.91 (1.29–2.84)], oral pain [aOR = 2.66 (1.91–3.71)], and difficulty accessing needed dental care [aOR = 2.52 (1.96–3.24)] than others. Having depression was associated with poor oral health perceptions [aOR = 2.10 (1.41–3.13)], and having difficulty at job/school because of their oral health [aOR = 2.85 (1.90–4.26)].ConclusionBased on the empirical evidence provided by our study, there is an association between depression and oral health outcomes and oral health-related quality of life.     

"摩梭人"牙周疾病及其相关知识的现状

目的：“摩梭人”是至今世界上唯一存在的“母系家庭”，本研究旨在了解该人群牙周疾病的现状及其对该疾病相关知识的认识。方法：采用WHO（1997）口腔健康调查标准，抽样调查方法采用捷径调查，选择“摩梭人”886人，男389人，女497人。根据性别和年龄（18－24岁，25－34岁，35－44岁，65－74岁）进行分组，用社区牙周指数（community periodontal index,CPI)来评价该群体的牙周健康状况，并做一致性检验，Kappa值为0．86。结果：四个年龄组中社区牙周指数被记录为“健康”（即CPI为0）者分别占受检人数的14．7％，1．45％，（35－44岁，65－74岁组均为0）；“牙龈出血”（CPI为1）分别为5．6％，0．55％，1．51％，0；“牙洁石积聚”分别为79．3％，92．8％，88．5％，84．4％；“浅牙周带”分别为0．5％，3．33％，9．85％，13．4％；“深牙周带”分别为0．03％，1．05％，1．15％，2．2％；以其牙周状况和对牙周疾病及其相关知识的认识无性别差异，对牙周疾病病因及如何预防知识的认识欠缺，仅5－13％的人群知道刷牙是主要的口腔卫生措施。结论：“牙石积聚”为最高CPI分值者普遍存在，该人群缺乏对牙周疾病病因以及如何预防知识的认识，迫切需要口腔健康保健，在该地区积极开展牙周疾病的防治工作。     

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。     

Effects of adhesive flash-free brackets on enamel demineralization and periodontal status

ObjectivesTo evaluate the effects of adhesive precoated (APC) flash-free brackets on enamel demineralization and periodontal status in patients during fixed orthodontic treatment.Materials and MethodsThirty patients, age 12 to 18 years, who had Angle Class I or Class II malocclusion with mild to moderate crowding in the permanent dentition were selected for this study. APC flash-free and conventional ceramic brackets were bonded for a split-mouth study design. The quadrant allocation was randomized. Demineralization records were obtained immediately after bonding (T0), 1 month after bonding (T1), and 6 months after bonding (T2). Clinical periodontal measurements, including gingival index, plaque index, and bleeding upon probing, were obtained before bonding (T0) and at the same time points (T1 and T2). Data were analyzed using Mann-Whitney U and Friedman tests to compare parameters between groups and times.ResultsDemineralization values decreased on most sides of the brackets for both groups between T0 and T1. In the conventional group, there was significantly higher demineralization on more sides compared with flash-free brackets between T1 and T2. With one exception, the decreased values were found in the incisal/occlusal sides of all brackets at T2. All periodontal parameters showed significant increases after 6 months of treatment in both groups. Intergroup comparison showed no significant differences in demineralization or periodontal measurements at any of the time points.ConclusionsThe effects of APC flash-free and conventional brackets on enamel demineralization and periodontal health did not differ from each other.     

无托槽隐形矫治器与固定矫治器对牙周影响的研究

目的 本研究通过临床评估使用无托槽隐形矫治器与传统固定矫治器患者的牙周指数变化,比较两种矫治器对牙周健康的影响,判断隐形矫治器是否更有利于口腔卫生和牙周健康维护.方法 临床选取40名成人患者,分为隐形矫治组(Ⅰ组)和固定矫治组(F组),通过测量在其矫治前及佩戴后1、3、6个月中菌斑指数(Plaque Index,PLI)、牙龈指数(Gingiva-Index,GI)及龈沟出血指数(Sulcus Bleeding Index,SBI)等牙周指数变化,对比两种矫治器对牙周健康的影响.结果 隐形矫治组的PLI在治疗中明显低于固定矫治组,但GI及SBI除第一个月有差异外,后期无明显差别.佩戴矫治器后两组的各项指数均高于矫治前.结论 无托槽隐形矫治器在一定程度上仍有碍口腔卫生的维护,但优于传统的固定矫治器,在矫治过程中短期内仍会对牙周组织健康造成一定影响,与传统固定矫治器并无明显差别.     

Subgingival microbiota levels and their associations with periodontal status at the sampled sites in an adult Sudanese population using miswak or toothbrush regularly

Little information is available on the effect of miswak use on gingival microbiota. We assessed levels of 28 oral bacteria in subgingival plaque of adult Sudanese miswak (n = 38) and toothbrush users (n = 36) age range 20–53 years (mean 34.6 years) to study associations between these bacteria, oral hygiene method, and periodontal status at the sampled sites. A pooled subgingival plaque sample from 6 probing sites of 1 selected tooth in each jaw was obtained from each subject. Whole genomic DNA probes and the checkerboard DNA-DNA hybridization were used in assessing 74 pooled samples. Using 10⁵ bacterial cells threshold, between 2.6% and 47.4% of miswak users and between 2.8% and 36.1% of toothbrush users harbored the investigated species. The percentages of subjects with the investigated species at 10⁶ bacterial cells varied between 2.6% and 39.5% in miswak and between 2.8% and 36.1% in toothbrush users. Miswak users harbored significantly higher Streptococcus intermedius, Actinobacillus actinomycetemcomitans, Veillonella parvula, Actinomyces israelii, and Capnocytophaga gingivalis, and significantly lower Selenomonas sputigena, Streptococcus salivarius, Actinomyces naeslundii, and Streptococcus oralis than did toothbrush users. Probing pocket depth ≥ 6 mm showed significantly (P < 0.05) higher levels of Porphyromonas gingivalis, Treponema denticola, Bacteroides forsythus, Fusobacterium nucleatum, and V. parvula than those 4–5 mm. Our results indicate that the type of oral hygiene had a significant effect on levels of 11 out of 28 bacterial species, and that the type of effect was also dependent on type of bacteria and probing pocket depth.     

自锁托槽与传统托槽相比对牙周状况影响的Meta分析

目的：通过Meta分析评价自锁托槽与传统托槽相比对牙周状况的影响。方法：计算机检索Pubmed、EMbase、Cochrane Library、CNKI、CBM、WangFang Data等数据库,查找从建库至2013年12月国内外公开发表的有关固定正畸治疗中自锁托槽与传统托槽相比对牙周状况影响的文献。由2名评价员按照纳入和排除标准独立进行文献筛选、资料提取和质量评价后,应用revman5．0统计软件进行Meta分析。结果：共纳入文献9篇,结果发现除探诊深度（PD）外,自锁托槽组的牙菌斑指数（PLI）、牙龈指数（GI）、龈沟出血指数（SBI）在观察时间为3个月和6个月的合并效应值均低于传统托槽组。结论：在固定正畸治疗中,自锁托槽较传统托槽更有利于牙周健康。