牙周病诊断京方法研究进展

当前牙周病诊断朝着客观、准确、快速和患者易接受的方向发展，本文对近十多年来临床检查方法、牙周微生物及龈液辅助检查、基因诊断等方面的研究进展作一综述，旨在提高牙周病诊治水平。     

颞颌关节紊乱综合征专家系统的设计与实现

本文详细描述了作者将人工智能专家系统技术引入口腔医学领域的初步尝试,用当今最新人工智能语言Turbo prolog,医学专家系统外壳DEMES Shell基础上,开发的以诊断为核心的颞颌关节紊乱综合征(TMJDSES)专家系统的设计思想与实现方法。文中对系统的功能模块,推理流程及系统特点等进行了讨论。     

牙周病诊断方法研究进展

当前牙周病诊断朝着客观、准确、快速和患者易接受的方向发展,本文对近十多年来临床检查方法、牙周微生物及龈沟液辅助检查、基因诊断等方面的研究进展作一综述,旨在提高牙周病诊治水平。     

吸烟与牙周病关系的调查与分析

牙周病是发生在牙齿支持组织的一种慢性破坏性疾病。近年来研究表明：吸烟可以从多方面影响牙周病的发生发展及愈合。作者于2004．3—6月对在武汉大学人民医院进行体检的省直机关，大专院校4869名干部及教职员工牙周健康状况进行调查，了解吸烟与牙周病的关系，现报道如下：     

中西医结合治疗控制老年牙周病的疗效观察

目的：用中西医结合方法治疗控制老年牙周病,观察老年人的牙周病情况是否得到有效的控制和改善。方法：将240名老年牙周病患者分为实验组和对照组,进行系统的牙周治疗：牙周洁治、龈下刮治,实验组辅助使用新癀片、甲硝唑片,对照组只使用甲硝唑片,进行疗效观察。结果：辅助使用新癀片的实验组牙周炎症控制和症状改善情况好于对照组。结论：中西医结合方法治疗控制老年牙周病,其疗效好于常规的牙周病治疗方法。     

牙周病科门诊初诊情况调查与分析

牙周病是指发生于牙周组织的各种病理性改变，是口腔疾病中较为常见的一种疾病，包括牙龈炎和牙周炎。牙周病患者若未能及早发现，及时就诊，就可能造成牙齿的丧失，影响咀嚼功能及美观。为了了解牙周病患者的初诊情况及对牙周病的认识程度，笔者对牙周病科门诊３０３例病人的初诊情况进行了调查和分析。临床资料一、患者的性别、年龄、初诊原因情况（见表１）：从牙周病科门诊初诊病人中随机调查确诊为牙周疾病的患者３０３例，了解其初诊原因（主诉症状若有两种，以最主要症状为主）。男性１５５人，女性１４８人。所调查的３０３例患者年…     

螺旋霉素治疗牙周病

螺旋霉素虽然不是一种治疗牙周病的灵丹妙药,同时也不能代替传统的治疗方法,但作为牙周病局部治疗的辅助是有用的。牙周病的主要病源因素是牙菌斑,常规     

牙周病自然进程的研究现状

牙周病是人类最常见的疾病之一，也是导致成人牙齿丧失的最主要原因。牙周病自然进程中临床指标和微生物指标的改变具有一定特点，并可对疾病的进展速度和方式提供诊断及预测信息。     

牙周病与慢性阻塞性肺病的联系

牙周病作为一种慢性感染性疾病与许多全身性疾病有着密切的联系。对于慢性阻塞性肺病（chronic obstractive pulmonarg discases，COPD），牙周病作为局部病灶可以促进其发生与发展。本文就牙周病对COPD的影响途径、两者间的流行病学调查，以及一些细胞因子对两者的作用机制做一综述。     

纤维蛋白原与牙周病

牙周病是一种多因素疾病，其病因及发病机制尚不十分明确。急性期反应是感染、损伤等刺激后机体发生的一系列早期、复杂的反应，其反应产物可能参与牙周病的发生发展并与牙周状态相关。本文就急性期蛋白成分之一的纤维蛋白原与牙周微生物的粘附、定植，炎症反应的调节及其水平和基因多态性与牙周病关系的研究进展作一综述。     

Periodontal disease epidemiology – learned and unlearned?

The notion of periodontal disease being the major cause of tooth loss among adults was rooted in the focal infection paradigm that dominated the first half of the 20th century. This paradigm was established largely by personal opinions, and it was not until the development of periodontal indices in the mid‐1950s that periodontal epidemiology gained momentum. Unfortunately, the indices used suffered from a number of flaws, whereby the interpretation of the research results took the form of circular reasoning. It was under this paradigm that therapeutic and preventive intervention for periodontal diseases became entirely devoted to oral hygiene, as poor oral hygiene and older age were understood to explain nearly all the variation in disease occurrence. In the early 1980s, studies appeared that contradicted the concepts of poor oral hygiene as the inevitable trigger of periodontitis and of linear and ubiquitous periodontitis progression, whereby periodontal epidemiology was led into a relatively short‐lived high‐risk era. At this time, it became evident that old scourges continue to haunt periodontology: the inability to agree in operational clinical criteria for a periodontitis diagnosis and the inability to devise both a meaningful and a useful classification of periodontal diseases based on nominalist principles. The meager outcome of the high‐risk era led researchers to resurrect the focal infection paradigm, which is now dressed up as periodontal medicine. Unfortunately, these developments have left the core of periodontology somewhat disheveled and deserted.     

Development of an open case-based decision-support system for diagnosis in oral pathology

BACKGROUND: Making diagnoses in oral pathology are often difficult and confusing in dental practice, especially for the less-experienced dental student. One of the most promising areas in bioinformatics is computer-aided diagnosis, where a computer system is capable of imitating human reasoning ability and provides diagnoses with an accuracy approaching that of expert professionals. This type of system could be an alternative tool for assisting dental students to overcome the difficulties of the oral pathology learning process. This could allow students to define variables and information, important to improving the decision-making performance. However, no current open data management system has been integrated with an artificial intelligence system in a user-friendly environment. Such a system could also be used as an education tool to help students perform diagnoses. The aim of the present study was to develop and test an open case-based decision-support system. METHODS: An open decision-support system based on Bayes' theorem connected to a relational database was developed using the C++ programming language. The software was tested in the computerisation of a surgical pathology service and in simulating the diagnosis of 43 known cases of oral bone disease. The simulation was performed after the system was initially filled with data from 401 cases of oral bone disease. RESULTS: The system allowed the authors to construct and to manage a pathology database, and to simulate diagnoses using the variables from the database. CONCLUSION: Combining a relational database and an open decision-support system in the same user-friendly environment proved effective in simulating diagnoses based on information from an updated database.     

Analysis of saliva for periodontal diagnosis--a review

BACKGROUND: This review examines salivary constituents as potential diagnostic tests for periodontal disease. Saliva is a fluid that is readily available and contains locally-produced microbial and host response mediators, as well as systemic (serum) markers that may prove to be an aid in the diagnosis of periodontal disease. METHODS: A medline search was conducted and the relevant literature concerning the applications of saliva for periodontal diagnosis was reviewed. RESULTS: Based on the literature, salivary markers that have been studied as potential diagnostic tests for periodontal disease include proteins of host origin (i.e., enzymes, immunoglobulins), phenotypic markers, host cells, hormones (cortisol), bacteria and bacterial products, ions and volatile compounds. CONCLUSIONS: A number of markers show promise as sensitive measures of disease and the effectiveness of therapy. At this time, host-derived enzymes and other inflammatory mediators orginating from the gingival crevice appear to hold the greatest promise as salivary diagnostic tests for periodontal disease. Longer-term longitudinal studies, however, are required to establish the relationship between specific markers and progression of periodontal disease. Furthermore, analysis of saliva may offer a cost-effective approach to assessment of periodontal disease in large populations.     

Periodontal Diagnosis Affected by Variation in Terminology

Background: The randomized case presentation (RCP) study is designed to assess the degree of diagnostic accuracy for described periodontal cases. This is to lay the basis for practitioner calibration in the Practitioners Engaged in Applied Research and Learning (PEARL) Network for future clinical studies. Methods: The RCP consisted of 10 case scenarios ranging from periodontal health to gingivitis and mild, moderate, and severe periodontitis. Respondents were asked to diagnose the described cases. Survey diagnoses were compared to two existing classifications of periodontal disease status. The RCP was administered via a proprietary electronic data capture system maintained by the PEARL Data Coordinating Center. Standard analytic techniques, including frequency counts and cross‐tabulations, were used for categorical data with mean and standard deviation and median values reported for continuous data elements. Results: Demonstrable variations in periodontal assessment for health, gingivitis, and mild, moderate, and severe periodontitis were found among the 130 PEARL general practitioners who participated in the RCP survey. The highest agreement for diagnosis among dentists was for severe periodontitis (88%) and the lowest for gingivitis (55%). The highest percentage of variation was found in cases with health and gingivitis. Conclusions: There was variation among PEARL practitioners in periodontal diagnosis that may affect treatment outcomes. Our findings add clinical support to recent publications suggesting a need for standardization of terminology in periodontitis diagnosis.     

Accuracy of Self‐Reported Periodontal Disease in the Women's Health Initiative Observational Study

Background: This study examines the accuracy of self‐reported periodontal disease in a cohort of older females. Methods: The study comprised 972 postmenopausal females aged 53 to 83 years who completed baseline (1997 to 2001) and follow‐up (2002 to 2006) whole‐mouth oral examinations. Examinations included: 1) probing depth, 2) clinical attachment level, and 3) oral radiographs for alveolar crestal height in a study ancillary to the Women's Health Initiative Observational Study (WHI‐OS) conducted in Buffalo, New York, called the OsteoPerio study. Participants also self‐reported any history of diagnosis of periodontal/gum disease on a WHI‐OS study‐wide questionnaire administered during the time interval between the two OsteoPerio examinations. Results: Participants reporting diagnosis of periodontal/gum disease on the WHI‐OS questionnaire (n = 259; 26.6%) had worse oral hygiene habits, periodontal disease risk factors, and clinical periodontal measures compared with those not reporting periodontal/gum disease. Frequency of reported periodontal/gum disease was 13.5%, 24.7%, and 56.2% across OsteoPerio baseline examination categories of none/mild, moderate, and severe periodontal disease, respectively (trend: P <0.001), defined by criteria of the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP). Sensitivity, specificity, and positive and negative predictive values for reported periodontal disease status were 56.2%, 78.8%, 32.8%, and 90.7%, respectively, when CDC/AAP‐defined severe periodontal disease at baseline was the criterion measure (prevalence of 15%) and were 76.0%, 77.4%, 22.0%, and 97.4%, respectively, when tooth loss to periodontitis (prevalence of 7%) was the criterion. Conclusion: A simple question for self‐reported periodontal disease characterizes periodontal disease prevalence with moderate accuracy in postmenopausal females who regularly visit their dentist, particularly in those with more severe disease.     

A rapid diagnosis for periodontitis based on enzymatic activity of periodontopathic bacteria. Correlation between enzymatic activity, clinical periodontal parameters, and subgingival level of microorganisms

There have been various laboratory methods for the microbiological diagnosis of periodontal disease. However, there have been some disadvantages in these methods. In this study of the application of a chair-side test for microbiological diagnosis, the activity of peptidases in periodontal pockets of patients was examined by using the assay system SK-013. SK-013 consists of synthetic substrates and is capable of rapidly (in 15 min) evaluating the activity of specific peptidase from Treponema denticola and Bacteroides species. Using SK-013, we evaluate the correlation between the enzymatic activity, clinical periodontal parameters and subgingival level of microorganisms, including phase contrast microscopy. We calculated the sensitivity and efficacy of SK-013 as a diagnostic indicator in the presence of Spirochetes and in periodontitis. A positive correlation were demonstrated between enzymatic activity, clinical periodontal parameters, the numbers of total cell count, Spirochetes, and M & S ratio. SK-013 was highly sensitive and efficacious (sensitivity: 92%, efficacy: 96%). We concluded that the assay system SK-013 is a useful chair-side method for diagnosing periodontal disease.     

����̽�뼰̽�＼���Ľ�չ���ٴ�Ӧ��

??Treatment and diagnosis of periodontal disease should be based on the correct periodontal examination??and the periodontal probing is one of the most important periodontal examination. The periodontal probing not only reveals bleeding on probing??periodontal pocket depth??and periodontal attachment level??but also shows subgingival calculus and furcation involvement. This article attempts to make a brief  summary on the development of the periodontal probing technique and its clinical significance??in order for it to play a greater role in periodontal clinical diagnosis and therapy.     

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。     

Microbial interpretation of plaque relative to the diagnosis and treatment of periodontal disease

It has been suggested that monitoring microbial forms in plaque with the microscope may prove useful to the clinician in assessing periodontal status. In this regard, the microbial interpretation of plaque relative to the diagnosis and treatment of periodontal disease has recently received considerable attention. However, questions remain to be answered before the microscope is accepted for routine use in the diagnosis and treatment of periodontal disease. This report addresses a number of these questions surrounding the use of the microscope in evaluating plaque and its role in the diagnosis and treatment of periodontal disease.