牙龈探诊出血与探诊压力相关性的评价

目的：评价牙龈探诊出血（ＢＯＰ）与探诊压力之间的关系．方法：应用自行研制的压力探针对１０名牙龈健康的测试对象共２８０颗牙齿进行探测．结果：随着探诊压力的增大,ＢＯＰ％均值有明显增高趋势,ＢＯＰ％与探诊压力之间呈高度正相关．结论：临床上探诊压力最好控制在０．２Ｎ,探诊压力过大会使ＢＯＰ假阳性数增多．同时表明该压力探针为临床研究提供了一种简便的、较为客观及可定量的检测方法     

重度广泛型侵袭性牙周炎患者牙周序列治疗的临床研究

目的：观察重度广泛型侵袭性牙周炎（generalized aggressive periodontitis, GAgP）患者牙周序列治疗后临床指标的变化,并评价其治疗效果。方法：15例GAgP患者在龈上洁治后1个月内完成龈下刮治、根面平整及光动力治疗,刮治后4周再评估,行翻瓣及翻瓣植骨术,每3个月进行1次牙周维护,序列治疗后纵向观察12个月。在基线和维护期各时间点记录全口探诊深度（probing depth,PD）、探诊出血（bleeding on probing, BOP）和牙齿松动度,磨牙记录根分叉病变的程度。结果：在基线时患者平均PD（3．96±2．21）mm,BOP阳性位点占88．1％。序列治疗后12个月平均PD（2．36±1．28）mm,BOP阳性位点减少至8．7％,其中轻、中、重度位点治疗后PD值与治疗前比较差异有统计学意义（P〈0．05）。结论：GAgP患者经牙周序列治疗和定期牙周维护能取得良好的治疗效果。     

口腔医学本科实习医师牙周探诊检查的准确性及影响因素分析

目的 评估口腔医学本科实习医师牙周邻面探诊的准确性并分析可能的影响因素,以期为牙周临床教学提供参考.方法 按照临床带教常规,选取北京大学口腔医学院38名初次进入牙周临床实习的本科生,每名实习医师均使用Williams刻度探针检查并记录1～2例(共58例)慢性牙周炎患者的探诊深度,教师进行重复探诊并加以核对,记录Ramfjord代表牙(6|14/41|6)邻面探诊深度的复核结果作为本项研究的结果数据.根据实习医师与教师探诊深度的差异,将所有位点分为完全一致位点(实习医师与教师探诊深度相同的位点)、基本一致位点(实习医师与教师探诊深度差异为1 mm的位点)和不一致位点(实习医师与教师探诊深度差异≥2 mm的位点).结果 随着牙周袋加深,学生的探诊准确性下降.完全一致位点百分比磨牙[58.8％ (261/444)]显著低于切牙[73.1％(339/464)],P＜0.01.实习医师邻面探诊不准确的最主要原因是不能探入龈谷,此项因素占70.7％ (87/123).结论 邻面探诊角度的培训应成为牙周临床前期探诊教学的重点,临床实习时教师需重点核查实习医师对深牙周袋和磨牙的邻面探诊.     

北京东城区高三学生牙周健康状况调查

目的 调查北京东城区高三学生的牙周健康状况.方法 对参加高考前体检的750名北京东城区高三学生进行牙周检查,检测牙石、探诊出血、探诊深度以及附着丧失情况,评价牙龈炎和牙周炎的发病率.结果牙龈炎的总体检出率为73.5%,男女学生发病率分别为76.7%和69.2%,差异有统计学意义(P=0.027).牙周炎的总检出率为10.9%,其中男生为11.8%,女生为9.8%,性别差异没有统计学意义(P=0.474).结论 北京东城区高三学生的牙龈炎检出率较高,男生高于女生.牙周炎检出率相对较低,男女生间没有明显差异.     

牙周袋内硫化物水平与牙周临床指数的关系

目的分析慢性牙周炎患者治疗前、后牙周袋内硫化物水平的变化及与牙周临床指数的关系。方法对35名慢性牙周炎患者,分别在牙周基础治疗前、治疗后2、6周、3个月时进行硫化物的检测和牙周探诊深度（probing depth,PD）和出血指数（bleeding index,BI）的检查。对所得数据进行分析。结果治疗前在PD≥4mm或BI≥2的位点,牙周袋内硫化物检出率和浓度明显高于PD〈4mm或BI〈2的位点（P〈0.05）;治疗后,硫化物水平和PD、BI均明显下降（P〈0.05）;治疗后3个月硫化物水平有上升趋势,但无统计学意义。牙周袋内硫化物水平与牙周炎严重程度之间有相关关系。在深牙周袋、出血的位点硫化物水平增高,治疗后牙周袋内硫化物水平与探诊深度、出血指数变化一致。结论牙周袋内硫化物水平的检测可反映牙周炎症的严重程度,并可作为判断牙周疗效的指标。     

牙齿的邻面状态与牙周探诊深度关系的研究

本实验对508例后牙牙周组织的健康状态进行临床检查,测量牙周探诊深度及附着丧失水平,并记录相应的牙齿邻面状态.结果得出:牙齿邻面有充填体悬突和充填体合并继发龋的牙周探诊深度比对照组明显增加(P<0.01);牙齿的邻面有龋病和不良固位体牙周探诊深度较对照组有增加(P0.05).牙齿邻面充填体悬突和充填体合并继发龋的牙周探诊深度及附着水平大于3mm所占百分比值明显高于对照组.本研究结果表明:牙齿的邻面状态与牙周探诊深度及附着丧失有关.牙齿邻面充填体悬突、邻面龋是影响牙周组织健康的重要因素.     

牙周探针及探诊技术的进展及临床应用

牙周病的正确诊断和治疗依赖规范化的牙周检查,在诸多的牙周检查中牙周探诊是最重要的检查方法之一。牙周探诊不仅可以探测牙龈出血、牙周袋深度、牙周附着水平,还可以探查袋内是否有牙石、是否出现根分叉病变等情况。文章就目前牙周探针及探诊技术的进展及临床应用做一介绍,以期牙周探诊技术在临床诊疗中发挥更大的作用。     

探龈缘出血法的临床应用评价

目的：研究探龈缘出血法（BOMP法）的临床应用价值.方法： 实验一是对31名受检者的5100个位点分别用Williams刻度牙周探针探龈缘法和压力恒定的Florida探针探袋底法（BOPP法）检查出血指数;实验二是对另31名受检者的4 974个位点用Williams刻度牙周探针分别用BOMP法、BOPP法检查出血指数.结果：在PD＜4 mm时,BOMP法与其他两种方法的一致率、相关程度最高,而且有较高的阴性预测值.BOMP法与其他两种方法在位点水平、牙位水平、区段水平和个体水平上的相关性呈逐渐增加的趋势.结论：BOMP法较适用于评价牙龈炎和种植体周围早期炎症,适用于人群的流行病学调查.     

牙周炎伴糖尿病患者对牙周非手术治疗的疗效观察

目的：观察慢性牙周炎伴糖尿病患者对牙周非手术治疗的疗效。方法：观察36例中、重度牙周炎伴糖尿病患者(DM组)，其中20例血糖较高或高低波动(DM-H组)，16例血糖相对较低或较稳定(DM-L组)。以28例非糖尿病慢性牙周炎患者作为对照(Non-DM组)。所有患者每个牙分6个位点，分别观察牙周治疗前及治疗后（口腔卫生指导、洁治、根面平整)1、3、6个月的菌斑指数(P1I)、牙龈指数(GI)、探针出血(BOP)、探针深度（PD)和临床附着丧失（AL)的变化。结果：牙周非手术治疗后，所有患者的牙龈炎症显著改善，牙周袋深度显著下降且牙周附着再获得。伴糖尿病及非糖尿病牙周炎患者对牙周非手术治疗的反应类似。结论：牙周炎伴糖尿病患者对牙周非手术治疗具有良好的治疗反应，糖尿病患者血糖的不同水平并不影响短期治疗反应。     

内窥镜辅助下微创牙周基础治疗的临床疗效评价

目的 探讨牙周内窥镜辅助下超声龈下刮治及根面平整(subgingival scaling and root planning,SRP)对重度牙周炎治疗的临床疗效.方法 选取2017年6月至2019年1月于南京大学医学院附属口腔医院就诊的Ⅲ-Ⅳ期牙周炎患者19例,随机分为内窥镜组及对照组.内窥镜组在龈上洁治术1周后,牙周...     

牙周炎患者的血脂、血糖水平分析

目的分析牙周炎对患者血糖和血脂水平的影响。方法对117例侵袭性牙周炎(AgP)患者、40例慢性牙周炎(CP)患者及37名牙周健康者,空腹抽取静脉血,检测血脂、血糖水平,比较3组之间的差异。结果AgP患者平均甘油三酯水平[(1．09±0．79)mmol／L]显著高于健康对照者[(0．94±0．28)mmol／L,P<0．05];CP和AgP患者的血糖水平[分别为(5．40±1．01)mmol／L和(5．07±0．66)mmoL／L]均高于健康对照者(4．62±0．64 mmol／L),P< 0．01;CP组的总胆固醇高于健康对照组,P<0．05;AgP组的重度位点百分比与总胆固醇呈正相关(r=0．25,P<0．01)。结论牙周炎可能会影响血糖和血脂的水平。     

糖尿病患者唾液葡萄糖含量分析

目的 :研究糖尿病患者唾液中葡萄糖含量的改变 ,并观察高血糖状态下唾液糖与血糖的关系。方法 :实验组为 6 0例糖尿病患者 ,对照组为 6 0例正常人。收集实验组及对照组清晨非刺激状态下自然分泌的全唾液 ,进行葡萄糖含量分析 ,同时行空腹血糖分析。结果 :糖尿病组的唾液葡萄糖含量为 ( 1.95 0±0 .179)mmol/L ,高于对照组的 ( 0 .95 3± 0 .12 4)mmol/L ,二者有显著性差异 (P <0 .0 1)。糖尿病组的唾液葡萄糖含量与血糖浓度有显著直线相关性 (P <0 .0 5 )。结论 :糖尿病患者唾液腺分泌功能发生改变 ,这可能是机体在长期高血糖状态下对唾液腺的损害 ,可视为糖尿病这一全身性代谢疾病的口腔局部表现     

Gingival blood glucose estimation with reagent test strips: a method to detect diabetes in a periodontal population

Background: Periodontal disease is considered the sixth complication of diabetes. Therefore, as a foremost responsibility of the periodontist, the present study was carried out to screen an unsuspecting periodontal population for the presence of diabetes with the help of gingival blood glucose and reagent test strips. Methods: A total of 356 patients with no known medical history of diabetes visiting the outpatient Department of Periodontics, at the Government Dental College and Hospital, Nagpur, Maharashtra, India, were divided into 3 groups: group 1 included patients with a healthy periodontium; group 2, patients with gingivitis; and group 3, patients with periodontitis. Gingival blood, formed by puncturing the interdental papilla of the upper anterior teeth with a lancet, was allowed to fall onto a test reagent strip, where the color change was noted, and corresponding glucose values recorded. Patients with glucose values >120 gm% (per manufacturer provided chart) were sent for glucose tolerance tests to confirm their glycemic status. Patients with abnormal glucose tolerance values were further referred to a physician for the confirmation of diabetes. Results: Diabetes was detected in 19.1% of the survey population, of which 3.9% of patients belonged to group 1, 7.8% of patients belonged to group 2, and 7.3% of patients belonged to group 3. Diabetes was detected in 40.8% of patients with hyperglycemia, of which 8.4% of patients belonged to group 1, 16.8% of patients belonged to group 2, and 15.6% of patients belonged to group 3. A total of 10.11% of the survey population who tested positive for diabetes were females and 8.99% were males. Conclusions: The use of reagent strips for the estimation of gingival blood glucose seemed to be a suitable option for the screening of an unsuspecting periodontal population for the presence of diabetes; however, additional studies in a larger population are needed to confirm their suitability.     

Elevated blood glucose levels in patients with severe periodontal disease

Background, aims: The rôle of diabetes mellitus in various forms of periodontal disease was investigated intensively in the past; some studies have also indicated an impact of periodontal inflammation on diabetic balance. The purpose of this study was to evaluate the reciprocal relationship between abnormal serum glucose levels and elevated CPITN scores in non‐diabetic patients. Material and Methods: 10,590 subjects were analyzed for normal and abnormal (higher than 120 mg/dl) serum glucose levels, their periodontal status reflected as CPITN was correlated with their glucose level category. Results: The results of the present study reflect a significant association between elevated blood glucose levels (higher than 120 mg/dl) and CPITN scores of 4.5 with an odds ratio of 2.46. Conclusion: A strong association exists between abnormal serum glucose level and periodontal disease as manifested by CPITN score.     

2型糖尿病伴牙周炎患者牙周炎症程度与血糖水平分析

目的:分析2型糖尿病伴牙周炎患者牙周炎症程度对血糖水平的影响。方法:将213例2型糖尿病伴慢性牙周炎患者,根据根据牙周探诊深度(Probing depth,PD)和牙周附着丧失(Attach ment Loss,AL)的程度分为2组:2型糖尿病伴轻度慢性牙周炎组、2型糖尿病伴中重度慢性牙周炎组,分别测定血清h s-CRP、FPG水平并比较。结果:2型糖尿病伴中重度慢性牙周炎组较2型糖尿病伴轻度慢性牙周炎组血清FPG、hs-CRP水平升高,两组间FPG(t=7.144,P0.001)、h s-CRP(t=13.493,P0.001)差异具有统计学意义,而两组间年龄(t=-0.369,P=0.712)、性别(P=0.819)、饮酒(P=0.697)、吸烟(P=0.223)差异无统计学意义,偏相关分析发现PD与FPG(P0.001)、h s-CRP(P0.001)呈正相关。结论:牙周炎症可能会使2型糖尿病患者FPG、h s-CRP水平升高。     

糖尿病患者胰岛素治疗前后唾液葡萄糖含量分析

目的:研究糖尿病患者胰岛素治疗前后唾液中葡萄糖含量的改变,并观察唾液糖与血糖的关系。方法:实验组为40例糖尿病患者。收集糖尿病患者胰岛素治疗前后清晨非刺激状态下自然分泌的全唾液,进行葡萄糖含量分析,同时行空腹血糖分析。结果:治疗前患者的唾液葡萄糖含量为(2.081±0.287)mmol/L,高于治疗后的(1.571±0.193)mmol/L,二者有显著性差异(P<0.01);治疗前患者的唾液葡萄糖含量与血糖浓度有显著直线相关性(P<0.05);治疗后患者的唾液葡萄糖含量与血糖浓度无显著直线相关性(P>0.05)。结论:糖尿病患者唾液中的葡萄糖含量明显增加,说明唾液腺分泌功能发生改变;良好的胰岛素治疗不仅可以达到良好的血糖控制,还可以控制减少唾液葡萄糖的分泌量。     

老年糖尿病患者拔牙术前血糖控制目标与预后相关性的初步分析

目的观察老年糖尿病患者在空腹血糖>8.88 mmol/L且≤10.00 mmol/L条件下行拔牙术的安全性。方法本研究为前瞻性队列研究,纳入2018年10月至2019年10月就诊于北京大学口腔医学院·口腔医院口腔颌面外科心电监护门诊的老年糖尿病拔牙患者100例,男性53例,女性47例,年龄(75.8±8.0)岁(65~95岁)。拔牙术前空腹血糖>8.88 mmol/L且≤10.00 mmol/L的50例患者为观察组;空腹血糖≤8.88 mmol/L的50例患者为对照组,两组糖化血红蛋白(glycosylated hemoglobin,HbA1c)均≤8.5%。分别观察拔牙术后24 h、1周拔牙窝处有无疼痛、肿胀、溢脓、瘘口及全身发热,观察术后1个月拔牙窝周围组织愈合情况。采用SPSS 25.0软件对拔牙术前血糖控制目标与预后的相关性进行统计学分析。结果观察组和对照组患者术前的空腹血糖分别为(6.92±0.99)和(9.88±0.68)mmol/L,HbAlc分别为(6.76±0.83)%和(7.69±0.75)%。两组患者的年龄、性别、糖尿病病史、拔牙牙位、牙龈指数、牙齿松动度等差异均无统计学意义(P>0.05)。术后24 h,对照组与观察组拔牙窝愈合良好的患者均占94%(47/50),两组均有3例患者拔牙窝局部疼痛,但可耐受,周围组织均无红肿表现。术后1周检查创口愈合良好,术后1个月创口完全愈合。两组患者拔牙术后创口愈合状况差异无统计学意义(P>0.05)。结论拔牙术前空腹血糖≤10.00 mmol/L且HbA1c≤8.5%可作为老年糖尿病患者常规拔牙或口腔小手术的安全参考值。     

Plasma lipid and blood glucose levels in patients with destructive periodontal disease

Hyperlipidaemia and hyperglycaemia are major risk factors for cardiovascular disease. In recent years, some evidence has been presented that periodontal disease is associated with an increased risk of cardiovascular disease. To further elucidate this association, we have studied standard blood chemistry variables known as risk markers for cardiovascular disease in periodontally diseased and healthy subjects. We have measured levels of plasma lipids and fasting blood glucose in 39 subjects with moderate periodontal disease (age 50-60 years) and compared the results with those obtained in 40 age- and sex-matched controls. Both groups were systemically healthy according to their medical history. Total cholesterol, low density lipoprotein cholesterol and triglycerides were significantly higher in periodontally diseased subjects by about 8% (p<0.03), 13% (p<0.003) and 39% (p<0.001), respectively, when compared to controls. Although subjects with diabetes were excluded from the study, we found significantly higher blood glucose levels in the patient than in the control group (85 +/- 25 versus 73 +/- 17 mg/dl; p<0.02). There was also a significantly higher frequency of pathological plasma lipid profiles in the patient than in the control group. The results indicate that hyperlipaemia and pre-diabetes may be associated with periodontal disease in systemically healthy subjects. These data do not allow us to decide, whether periodontal disease causes an increase in hyperlipaemia and in a prediabetic state or whether periodontal disease and cardiovascular disease share hyperlipidaemia and the prediabetic state as common risk factors.     

口腔扁平苔藓患者空腹血糖测定及评价

对１０２例口腔扁平苔藓进行空腹血糖测定，发现９例糖尿病，患病率８．８％，显著高于年龄、性别配对的正常组（３．１％）（Ｐ＜０．０１）；进一步的分析表明，扁平苔藓患者血糖偏高者（ｎ＝２３）的口腔念珠菌感染率（７３．９％）高于血糖正常者（４６．８％），差别具有显著性（Ｐ＜０．０５）。对９例伴发糖尿病的扁平苔藓患者予以糠尿病治疗与口腔抗真菌治疗，７例口腔损害消失或改善。结果揭示，高糖血症、糖尿病在扁平苔藓致病中具有一定作用。