超声和手工龈下刮治对龈下微生物影响的研究

目的 :比较Perioproline超声龈下刮治和手工龈下刮治对龈下微生物的影响 ,评价Periopro line超声龈下刮治系统的临床疗效和工作效率。方法 :选取慢性成人牙周炎患者 7名 ,共 2 0个左右基本对称牙被纳入研究 ,随机分入实验组 (超声组 )和对照组 (手工组 )。记录治疗时间和治疗前、治疗后 0d、7d和 14d的PD ,BOP值 ,及采集龈下菌斑样本培养鉴定 ,观察比较总菌落形成单位 (CFU)和牙周可疑致病菌检出率及检出量的变化。结果 :两组在治疗后PD、BOP值及龈下菌斑总量 (CFU)和牙周可疑致病菌数量及检出率均显著下降 (P <0 .0 5) ;治疗前后各时段组间均无明显差别 ;超声组的治疗时间明显少于手工组 (P <0 .0 5)。结论 :Perioproline超声龈下刮治和手工龈下刮治均可有效减少龈下微生物的量 ,改善患牙的牙周临床状况 ,且两者间无差异 ,但Perioproline超声龈下刮治明显较手工刮治节省时间     

超声龈下刮治同步药物冲洗对牙周炎的治疗作用

目的探讨超声龈下刮治同步药物冲洗对牙周炎的治疗效果。方法选取中、重度慢性牙周炎患牙34颗,随机分为三组：A组（蒸馏水组）超声龈下刮治同步无菌蒸馏水冲洗（11颗牙）;B组（消炎痛组）超声龈下刮治同步0.1%消炎痛药物冲洗（13颗牙）;C组（甲硝唑组）超声龈下刮治同步0.2%甲硝唑药物冲洗（10颗牙）。比较龈上洁治、龈下刮治前后28日临床检查指标,及治疗后7、28日龈沟液的量和龈沟液中IL-6的水平变化。结果三组治疗后菌斑指数（PLI）、探诊深度（PD）、龈沟出血指数（SB I）、龈沟液的量及龈沟液中IL-6水平明显降低,有显著性差异;附着丧失（AL）降低不明显;消炎痛组和甲硝唑组治疗后龈沟液中IL-6水平降低程度大于蒸馏水组,有显著性差异。结论超声龈下刮治同步药物冲洗能够明显提高牙周炎的治疗效果。     

全口一次龈下刮治与分区段龈下刮治的疗效分析

目的：比较一次全口龈下刮治与分区段龈下刮治的临床疗效。方法：选择需进行牙周洁治的慢性牙周炎患者50例,分为实验组25例和对照组25例,实验组一次全口龈下刮治,对照组分四个区段进行龈下刮治,观察3个月内治疗前后PD、BI、PI的变化,并记录患者对治疗的主观感觉和治疗后是否有发热症状。结果：实验组和对照组龈下刮治后3个月,PD、BI均显著降低,两组间无统计学差异（P〈0.05）;与对照组相比,实验组1个月时P（I1.09±0.57）和VAS值（0.37±0.26）显著降低,差异有统计学意义（P〈0.05）。两组患者均无治疗后发热症状。结论：全口一次龈下刮治与分区段龈下刮治都可获得良好的治疗效果,全口一次龈下刮治更利于菌斑控制和短期消除治疗不适。     

单独龈下超声刮治与结合人工刮治两种方法的临床效果比较

目的 比较单独应用龈下超声刮治与结合人工刮治两种治疗方式的临床效果.方法 选取36例慢性牙周病患者,采用半口对照的方法将患牙分为对照组(左半口)和实验组(右半口),先对所有患牙进行龈上洁治术,一周后对照组实行龈下超声刮治术,实验组实行龈下超声刮治结合人工刮治术.治疗前后1个月、3个月分别检查受试牙,并记录各项临床指标( BOP、PD、CAL).结果 在治疗结束后1个月和3个月,两组各项牙周临床指标均有明显改善(P＜0.05),实验组的改善优于对照组,且有显著性差异(P＜0.05).结论 龈下超声刮治后使用人工刮治,可以获得一个更加平整的根面,取得良好的临床效果.     

0.5%PVP-I龈下冲洗对龈下微生物的作用

目的　观察０．５ ％ 聚维酮碘（ＰＶＰ－Ｉ）龈下冲洗后龈下微生物组成的变化,并与０．５％ 洗必太进行对比研究。方法　选取临床诊断为中、重度牙周炎的患者１１ 例,共计４５ 颗患牙,牙周袋深≥４ｍ ｍ 。将含有患牙的不同象限随机分组,分别采用：（１）０．５ ％ ＰＶＰ－Ｉ;（２）０．５％ 洗必太（ＣＨ） ;（３）０．９ ％ 生理盐水５ｍｌ 进行一次性龈下冲洗。冲洗前及冲冼后２４ 小时分别采集龈下菌斑行刚果红染色涂片,高倍视野下（×１００） 观察龈下微生物组成的变化。结果　０ ．５％ ＰＶＰ－Ｉ龈下冲洗２４ 小时后龈下菌细胞密度降低,球菌比率升高,杆菌比率降低（ Ｐ＜ ０．０１）,螺旋体比率未见明显改变,与ＣＨ 组间比较无统计学上差异。效果均明显优于生理盐水组。结论　０．５％ ＰＶＰ－Ｉ龈下冲洗短期即可减少龈下微生物的量,并使微生物组成发生有益的转化,与０．５ ％ 洗必太可达到相同的效果。     

超声龈下刮治应用于慢性牙周炎的临床体会

治疗牙周炎的龈上洁治及龈下刮治有明确疗效及重要意义。但由于手工龈下刮治对于操作者的技术要求较高且费时、费力，故在广大基层医院并未得到有效开展。随着超声技术的发展，超声龈下刮治技术逐渐成为牙周治疗的主流。关于超声龈下刮治的应用已有报道，笔者于1999年7月～2002年7月，对91例慢性牙周炎患者采用超声波或手工龈下刮治术，取得了较好疗效。     

超声龈下刮治术与替硝唑液局部冲洗在牙周治疗中的临床分析

目的观察超声龈下刮治术后替硝唑液局部冲洗在牙周基础治疗中的临床效果。方法选取慢性牙周炎患者80例,随机分成两组,每组40例,作超声龈下刮治术后实验组给予替硝唑液局部冲洗,对照组给予过氧化氢液局部冲洗,一周后进行对比观察。结果术后一周复诊,探针出血、牙周袋深度、口腔异味、牙龈肿痛、咀嚼疼痛等牙周病常见症状两组均有显著性好转,两组差异无显著性。结论超声龈下刮治术配合龈下冲洗是行之有效的牙周基础治疗方法,替硝唑液作为冲洗液有明显效果。     

超声龈下刮治的临床疗效

超声龈下刮治的应用已有报道。我们将超声龈下刮治与手工刮治法进行疗效比较 ,报告如下 :从门诊选择成人牙周炎患者 32例 ,男 18例 ,女 14例 ,年龄 2 4～ 5 8岁。所选病例均无与牙周炎有关的全身性疾病 ,牙列完整 ,近 3个月未做任何牙周治疗 ,未服用抗生素。1　器械和方法1.1　器械超声治疗机和龈下超声工作头 1对 (丹麦产 )。手工刮治器 1套 7件及龈下锄形器、锉形器各 1对 (美国产 )。1.2　操作步骤纳入观察的病例在控制急性炎症后先行龈上洁治 ,指导患者掌握正确的刷牙方法 ,1周后再进行龈下刮治。每位患者均采用半口对照 ,即将每位患者…     

全口超声龈下刮治两次法对轻中度慢性牙周炎老年患者的近期疗效观察

目的:观察全口超声龈下刮治两次法对轻中度牙周炎的治疗效果。方法:按病例纳入标准选择年龄60岁以上、轻中度牙周炎患者42例,经口腔卫生宣教、超声龈上洁治术后,进行基线检查:牙龈出血指数(GBI),探针出血(BOP)阳性位点,牙周探诊深度(PD)及附着水平(AL),然后进行两次全口超声龈下刮治。术后1个月、3个月复查。所得数据进行配对t检验,统计学分析各临床指标治疗前后的变化。结果:术后1个月的PD由治疗前平均3.18 mm减少至平均2.45 mm(P<0.05),附着水平由平均4.51 mm提高至平均3.34mm(P<0.05),术后3个月的PD及AL分别为2.37 mm(P<0.05)及3.27 mm(P<0.05)。GBI术前平均为3.17,术后一个月及三个月分别减少至1.67(P<0.05)及1.82(P<0.05)。BOP阳性率由术前的37.2%,在术后一个月及三个月分别下降至13.2%(P<0.05)和16.8%(P<0.05)。结论:全口超声龈下刮治两次法短期可改善老年轻中度牙周炎患者的牙龈出血及附着水平,牙周袋探诊深度也有减少的趋势,同时相对于传统的分区龈下刮治及根面平整术,可减少患者复诊次数。     

0.5%PVP—Ⅰ龄下冲洗对龈下微生物的作用

目的 观察０．５％聚维酮碘龈下冲洗后龈下微生物组成的变化,并与０．５％洗 民太进行对比研究。方法 选取临床诊断为中,重度牙周炎的患者１１例,共计４５颗患牙,牙周袋深≥４ｍｍ。将含有患牙的下不同象限随机分组,分别采用：（１）０．５％ＰＶＰ－Ｉ;（２）０．５％洗必太（ＣＨ）;（３）０．９％生理盐水５ｍｌ进行一次性龈下冲洗。冲洗前及冲洗后２４小时分别采集龈下菌斑行刚果红染色涂片,高倍视野下观察龈下微生物     

Clinical effects of simultaneous ultrasonic scaling and subgingival irrigation with chlorhexidine

The clinical and microbial effects of a single episode of simultaneous ultrasonic scaling and subgingival irrigation with chlorhexidine (CHX) were studied as a function of clinical probing depth in patients with adult periodontitis. 60 patients were randomly assigned to receive subgingival irrigation under cavitation with either sterile water or 0.12% CHX delivered through the tip of an ultrasonically activated scaler as part of initial periodontal therapy in a double-blind study design. 3 periodontal sites were randomly selected for examination from each patient on the basis of clinical probing depth, with 1 site being selected within each of the following ranges: 1-3 mm, 4-6 mm, and 7-9 mm. Pretreatment and post-treatment (days 14 and 28) clinical assessments included a plaque index (PI), gingival index (GI), and clinical probing depth (CPD). Subgingival specimens also were collected from 1-3 mm and 4-6 mm sites on a random subset of patients (15 per group). Plaque counts of spirochetes and motile organisms were made by darkfield microscopy. Significant reductions in PI, GI, and CPD were observed among all sites within both treatment groups at 14 and 28 days post-treatment. CHX irrigation resulted in a significantly greater reduction in CPD than did water among sites initially probing 4-6 mm at both 14 and 28 days post-treatment (25% versus 13% and 31% versus 18%, respectively). Spirochete counts were modestly but nonsignificantly reduced at 14 days post-treatment among sites 4-6 mm within both treatment groups. These results suggest that subgingival irrigation with CHX during ultrasonic scaling provides differential clinical benefits that are site-dependent.     

The antimicrobial and clinical effects of a single subgingival irrigation of chlorhexidine in advanced periodontal lesions

The antimicrobial effects of subgingival chlorhexidine (CH) irrigations on the pathogenic flora in advanced periodontal lesions were assessed. Changes in the patterns of colonization within the subgingival sites were monitored by differential dark-field microscopy, in 16 patients, over a period of 10 weeks. In addition, changes in the clinical parameters of the diseased sites were also monitored. Initial base-line evaluations were made for both the clinical and microbiological parameters. 4 sites of moderate to advanced periodontal disease were selected in each patient. These were randomly irrigated with a single dose of either 0.2% CH gel, 0.2% CH solution, or physiological saline, while 1 site was left as a control. The patients were seen weekly, until the 5th week, then at the 7th and 10th weeks. At each appointment, a microbiological sample was taken from the subgingival region of each site, together with an assessment of the clinical indices. Results indicated that a single irrigation of an 0.2% solution of CH or 0.2% CH gel had a marked effect in decreasing the % of spirochaetes and, to some extent, motile bacteria. There was a concomitant shift in colonization to cocci, fusiform and filamentous organisms in pockets that were irrigated; this coincided with a reduction in the % of bleeding sites. Various patterns of colonization were observed which have been described and may assist in differential dark field (DDF) monitoring of lesions. Bleeding on blunt probing was found to be correlated with a flora dominated by spirochaetes. No other correlations were found over the 10-week period between the other parameters.(ABSTRACT TRUNCATED AT 250 WORDS)     

多根牙龈下超声和手工刮治临床疗效及离体牙图像分析

目的 比较超声细线器和传统手工法对多根牙龈下刮治的临床和离体牙的除石效果。方法 １２例中、重度牙周炎患者的２４颗磨牙,分别经两种方法智治后１个月,评价临床指标的改善。另外６例牙周炎患者的１２颗应拔的牙,智治后用图像分析仪,离体观察刮治后根面和根分叉区残留菌斑、牙石的百分比。结果 两种方法治疗后,临床指标均有改善（Ｐ〈０．０５）,当附着水平≥７ｍｍ时,细线器组优于手工组。在离体牙的根分叉区,细线器的     

超声龈下洁治和手工龈下刮治在慢性牙周炎治疗中疗效的比较

选取2014-01～2014-12慢性牙周炎患者80例,分2组,分别使用超声龈下洁治（超声组）和手工龈下刮治（手工组）的方法进行治疗,发现在牙周治疗术后4周和12周时2组患者的菌斑指数（PLI）、牙龈出血指数（GBI）、牙周袋深度（PD）和附着水平（CAL）等牙周指标较治疗前均显著下降（P ＜0．05）,超声组治疗后菌斑指数小于手工组（P ＜0．05）,余各项牙周指标在2组患者间均无统计学差异（P ＞0．05）。     

Depth of penetration in periodontal pockets with oral irrigation

The purpose of this study was to determine the effectiveness of the Water Pik oral irrigator as a vehicle for delivering an aqueous solution into periodontal pockets. Plaque-disclosing dye diluted with sterile saline solution was applied with the irrigator toward the gingival margins of teeth at 90 degrees and at 45 degrees prior to their extraction. The mean % penetration measured between a reference notch at the gingival crest and the periodontal ligament at the bottom of the pocket showed no statistical difference between the two angles of application. Penetration ranged from 44% to 71%, the lowest being into pockets 4-7 mm; higher mean penetration was noted in both subgroups 0-3 and greater than 7 mm. No statistical difference was found between proximal and facial or lingual surfaces, maxilla and mandible, existence of tooth contact, and proximal tissue contour or consistency. The mean % penetration was independent of pocket depth (chi 2 analysis). Correlation between pocket depth and mean penetration was low for all but one subgroup (90 degrees application and pockets greater than 7 mm). The results suggest that the oral irrigator will deliver an aqueous solution into periodontal pockets and will penetrate on average to approximately half the depth of the pockets.     

2种超声器械龈下刮治的效果评价及扫描电镜观察

目的：比较0dontogain和Prophy Max超声治疗仪在牙周龈下刮治治疗中的效果,并对刮治后的牙根进行扫描电镜观察.方法：选取20例慢性牙周病患者,采用半口对照,随机分为A组（0dontogain组）和B组（Prophy Max组）,每组6个患牙.按照分组,分别对受试牙进行超声龈下刮治术.在龈下刮治术前,术后1个月、2个月分别检查观察牙的各项临床指标（BOP、PD、CAL）,同时记录2组的操作时间.选择10个离体单根牙,随机分为A组和B组,分别用Odontogain和Prophv Max超声仪进行刮治,记录每颗牙的操作时间,并对刮治后的离体牙根作扫描电镜观察.实验结果采用SAS6.12软件包进行分析.结果：A组和B组在龈下刮治术后1个月和2个月,各项牙周临床指标均有明显改善（P＜0.01）,A组的改善稍优于B组,但无显著性差异（P＞0.05）.在临床及离体牙的操作时间上,A组明显优于B组（P＜0.01）.扫描电镜显示,离体牙经刮治后,2组的牙根邻面均较光滑,且A组残留的牙石较少.结论：2种超声治疗仪在牙周治疗中都能达到较好的治疗效果,Odontogain超声治疗仪更快捷、高效.     

Clinical effects of pulsed oral irrigation with 0.2% chlorehexidine digluconate in patients with adult periodontitis

The aim of this study was to investigate the effects of using 0.2% Chlorhexidine digluconate in an pulsated jet irrigator by patients as part of their daily dental home-care measures. After initial assessment, 16 patients diagnosed as having adult periodontitis received scaling and polishing together with advice on the subgingival use of a pulsated jet oral irrigator with which they were supplied. 8 patients having 293 active sites with probing depths equal to or in excess of 4 mm used 0.2% chlorhexidine digluconate (CHX) in the oral irrigator, 2 x daily for 56 days. The other group of 8 patients with 253 active sites over 4 mm used a placebo as the irrigating solution. A modified dichotomous plaque index (MPI), gingival bleeding index (GBI) and probing pocket depths (PPD) were assessed on days 0, 28 and 56. Within-group comparisons showed that the CHX regime reduced MPI, GBI and PPD significantly but that the placebo group (PG) only achieved a significant reduction in the PPD. Between-group comparisons showed that the use of 0.2% CHX as an irrigant was significantly more effective than the placebo solution at reducing all the clinical parameters studied. The patients found the oral irrigator easy and pleasant to use, although all the CHX group developed staining to a varying extent. This double blind study demonstrated that 0.2% CHX used 2 x daily in an oral irrigator was effective at reducing plaque deposition, periodontal inflammation and probing pocket depths. The effects of using lower concentrations of chlorhexidine digluconate in this regime need to be investigated.