其他

4221件口腔修复体的临床分析，牙科畏惧症的构成因子及其在牙病治疗前后的差异，Heliprobe^TM与鼻闻法测量氨性口臭的相关性，口腔医学学科与医学美学的关系初探，口腔修复学临床及教学三维互动预览平台的初步建立，动态消毒在口腔门诊手术室空气消毒中的效果观察     

Halimeter与嗅觉测量口臭的相关研究

目的　比较Halimeter与感官分析测量口臭的相关性。方法　用Halimeter测量 68名受试者 ,与嗅觉测量的结果作相关分析。结果　二者有显著相关 ,r =0 .80 7(P <0 .0 1)。结论　二者用于口臭测量有显著相关。提示Halimeter可作为用于口臭临床研究的一种简便工具 ,可更准确地表达口臭的程度     

终末期肾脏病患者鼻测口臭相关影响因素的Logistic回归分析

目的探讨终末期肾脏病(ESRD)患者口臭与相关影响因素的关系。方法分别用茚三酮分光光度法和鼻测法检测ESRD患者口气中氨的浓度值和感官口气值(OS),并统计性别、年龄、学历、透析时间、抽烟史、氨值、肌酐、尿素氮、唾液pH值、舌苔面积、舌苔厚度等因素,分析鼻测法与这些检测指标之间的Logistic回归关系。结果在α=0.05水平,单因素Logistic回归分析显示氨值、尿素氮、舌苔厚度、唾液pH值等4个因素为ESRD患者口臭的危险因素,进一步作多因素Logistic回归分析表明,氨值是ESRD患者口臭最可能的危险因素。结论 SRD患者体内不能完全代谢的氨是产生氨性口臭最可能的危险因素。     

口臭与主要产臭菌的相关性分析

目的分析口臭与主要产臭菌的相关性.方法选择口臭患者29名,用鼻闻法确定口臭的来源和部位,使用口气测量仪测量口腔中挥发性硫化物(volatile sulfur compounds,VSCs)的浓度;分别从产臭牙周袋、舌苔和唾液中采集标本,进行厌氧培养,并进行菌落计数.结果VSCs水平与龈下菌斑中的厌氧菌总数明显正相关(P＜0.01),与龈下菌斑中产黑菌数(black-pigment bacteria,BPB)和具核梭杆菌数(Fusobacterium nucleatum,FN)也相关(P＜0.05),舌苔上的厌氧菌总数、产黑菌和具核梭杆菌与VSCs水平呈正相关(P＜0.05).结论牙周病和大量舌苔可能是引起口臭的主要原因,而细菌(主要包括产黑菌和具核梭杆菌)在口臭的形成中起重要作用.     

口臭与牙周炎及舌苔的相关性研究

目的　探讨口臭及口气中挥发性硫化物 (volatilesulphurcompounds ,VSCs)与牙周炎及舌苔的相关性 ,舌在口臭及VSCs产生中的作用。方法　选择 6 0例全身健康、有口臭的牙周炎患者 ,鼻闻法检查口臭程度 ,使用便携式口臭测量仪分别测量清除舌苔前后的VSCs量。记录牙周袋探诊深度(probingdepth ,PD)及PD≥ 4mm位点比例 ,出血指数 (bleedingindex ,BI) ,菌斑指数 (plaqueindex ,PLI)及舌苔厚度与面积。结果　Spearman相关分析法显示 ,口臭值、VSCs量与BI、PLI、舌苔厚度存在明显的正相关性 (P <0 0 1) ,与舌苔面积也有关系 (P <0 0 5 )。口臭值与PD及PD≥ 4mm位点比例无关 ,VSCs量与PD及PD≥ 4mm位点比例存在一定的相关性 (r=0 2 6 ,P <0 0 5 )。清除舌苔可以明显降低VSCs量 (t=10 15 ,P <0 0 1) ,其减少量与舌苔厚度及面积均有明显相关性 (P <0 0 1)。结论　口臭值、VSCs量与BI、PLI及舌苔均有关系 ,而牙周袋PD只与VSCs量有关系 ;虽然清除舌苔可以明显降低VSCs量 (降低 36 7% ) ,但由于存在如何完全彻底清除舌苔的问题 ,所以舌与牙周炎在口臭及VSCs形成中的作用尚需进一步研究。     

唾液中尸胺水平与口源性口臭的相关研究

目的:建立高效液相色谱测定唾液尸胺含量的方法,探讨唾液尸胺水平与口臭鼻测法结果的相关性。方法:56例实验对象的唾液经纯化,以DiamonsilC18柱为反相色谱柱,用1,6-己二胺为内标,流动相由A液(甲醇)和B液(水∶磷酸∶三乙胺=360∶9∶6)组成,检测波长为231nm,流速1ml/min。口臭鼻测法使用0～5级评分标准,由2位嗅辨员独立完成,以鼻测法均值为应变量,唾液尸胺浓度为自变量,使用SPSS11.0软件包进行Pearson相关分析。结果:尸胺在5～80nmol/ml范围内线性关系良好(r=0.9985),本法回收率为91.5%,精密度为6.93%;唾液尸胺浓度与鼻测法结果呈正相关(P<0.01)。结论:唾液中尸胺的形成和口臭有一定联系,高效液相色谱法测定唾液尸胺浓度在口臭临床诊断方面具有实用价值。     

Halimeter与嗅觉测量口嗅的相关研究

目的：比较Halimeter与感官分析测量口臭的相关性。方法：用Halimeter测量68名受试者，与嗅觉测量的结果作相关分析。结果：二乾有显著相关，r＝0．807（P＜0．01）。结论：二者用于口臭测量有显著相关。提示Halimeter可作为用于口臭研究的一种简便工具，可更准确地表达口臭的程度。     

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     

硫性口臭与氨性口臭的定性方法探讨

病理性口臭除代谢性疾病及口腔恶性肿瘤引起外,主要有细菌感染口鼻咽及胃而造成,口鼻咽主要由革兰氏阴性厌氧杆菌分解蛋白质底物产生挥发性硫化物(volatile sulfur com-pounds,VSCs)而引起[1]。胃内主要由幽门螺杆菌感染分解尿素产生氨而造成[2,3]。目前常用鼻闻法来诊断口臭[4     

牙周治疗改善口臭的作用

目的 :探讨牙周基础治疗 (龈上洁治、龈下刮治和根面平整 )对于改善口臭及降低口气中挥发性硫化物 (VSCs)水平的作用 ;牙周治疗配合清除舌苔、单纯牙周治疗和单纯清除舌苔降低VSCs的比较。方法 :全身健康牙周炎患者 117例 ,鼻闻法评价口臭程度 (OR)后分成两组 ,口臭组 85例 ,无口臭组 32例。口臭测量仪 (halimeter)测量清除舌苔前后口气中VSCs水平。检查菌斑指数 (PLI)、牙周袋探诊深度 (PD)和出血指数(BI)。口臭组 46例完成牙周基础治疗后重复以上检查。结果 :清除舌苔可明显降低口气中VSCs(口臭组37% ,无口臭组 2 9% ) (P <0 .0 1) ;牙周治疗前OR为 3.1,VSCs为 462 .3μg/L ,治疗后则分别为 1.0和184.3μg/L ,两者均明显降低 (P <0 .0 1) ,其中VSCs下降了约 5 5 % ;牙周治疗后再清除舌苔VSCs为 116.4μg/L ,降低了约 72 %。方差分析显示三种方法降低口气中VSCs水平有明显差异 (P <0 .0 1) ,其中牙周治疗配合清除舌苔最显著 ,单纯牙周治疗次之 ,单纯清除舌苔最小。结论 :牙周炎和舌苔是口臭和口气中VSCs的重要来源 ,尤其是牙周炎。牙周治疗和清除舌苔是改善口臭的有效方法 ,两者结合效果更好     

Periodontal diseases as a source of halitosis: a review of the evidence and treatment approaches for dentists and dental hygienists

Bad breath (halitosis) is an important social complaint. In most cases (≥90%), the cause of halitosis can be found within the oral cavity. Under this circumstance, the term oral malodor applies. It affects both healthy and periodontally diseased individuals. Oral malodor is mainly caused by a microbial degradation of both sulfur‐containing and nonsulfur‐containing amino acids into volatile, bad‐smelling gases. Anaerobic gram‐negative bacteria, the same species that have been linked to periodontal diseases, are especially involved in this process, explaining why clinicians often associate oral malodor with periodontitis. Some volatile organic compounds render patients more susceptible to periodontitis and this supports the malodor–periodontitis link. This review investigates the interaction between oral malodor and periodontal diseases. Pro and con arguments regarding the mechanisms of halitosis and clinical implications will be presented. In general, however, the impact of tongue coatings has been found to be the dominant factor, besides gingivitis and periodontitis. The last part of this review discusses the treatment of bad breath, with different options.     

幽门螺杆菌感染与口臭的相关性探讨

目的：探讨幽门螺杆菌感染与口臭的相关性。方法：采用鼻嗅法对27例消化科已证实幽门螺杆菌感染者进行口臭值的检测及用^14C尿素呼吸试验仪对口腔科30例口臭者进行有无幽门螺杆菌感染的检测。被检者牙体、牙周基本健康，无鼻咽部疾病及严重肝功能不全、无糖尿病。结果：27例幽门螺杆菌感染者的口臭检测率为93％。30例口臭者的幽门螺杆菌感染率为90％。结论：幽门螺杆菌感染与口臭可能有较大的相关性，是引起顽固性口臭的一大原因。     

口臭研究模型的建立及其对口腔致臭菌的确定

目的建立一个可模拟口臭代谢过程的唾液沉淀物系统,同时分析几种细菌对口臭产生的影响,为致臭菌的确定提供依据。方法收集10名牙周健康个体的刺激性全唾液10份。调整离心全唾液的上清液和沉淀物的比例,建立口臭研究模型,在37 ℃兼性厌氧条件下孵育使其产生臭味,7 h内每隔1 h分别用鼻闻法检测气相和液相的臭味指数,用Halimeter测量挥发性硫化合物（VSCs）水平,用玻璃电极测量pH值。在经过1 h孵育后的口臭模型内,分别加入可疑致臭菌（牙龈卟啉单胞菌、具核梭杆菌、中间普氏菌）菌悬液以及作为对照的非致臭菌（伴放线放线杆菌）菌悬液和蒸馏水,继续在37 ℃兼性厌氧条件下孵育,在余下的6 h内每隔1 h测量1次各组的臭味指数、VSCs水平及pH值。结果调整离心全唾液比例后的口臭模型能模拟口臭代谢过程,产生明显的臭味。在孵育1 h后的口臭模型内,加入可疑致臭菌菌悬液后,臭味产生相对于伴放线放线杆菌组和蒸馏水组高,牙龈卟啉单胞菌组相对显著。结论孵育离心全唾液为研究口臭产生的有用模型。通过改变致臭细菌的数目来改变微生物负载,对细菌代谢的活性会产生影响,从而影响臭味的形成,可以此来确定致臭菌。     

Oral malodor-related parameters in the Chinese general population

OBJECTIVES: To estimate the prevalence of halitosis in the Chinese population and to assess the relationships between halitosis and oral health, social and behavioural factors. METHODS: The correlation between the incidence of oral malodor and oral health was surveyed in a sample of 2000 individuals (1000 males and 1000 females) aged 15-64 years residing in urban and rural areas. Malodor was measured with both organoleptic measurements and with a portable sulphide monitor. Assessment of oral health included decayed, missing and filled teeth (DMFT), periodontal status, dental plaque, and tongue coating. Behavioural and social factors related with oral health or halitosis were also investigated. RESULTS: The prevalence of halitosis was 27.5% according to the organoleptic score. The level of volatile sulphur compounds (VSCs) in mouth air was significantly lower in males and in some of the age groups after lunch. Age and location of residence (rural or urban areas) did not influence the VSCs concentration in mouth air. The amount of tongue coating played the most important role in increasing VSCs concentration in mouth air, followed by periodontal status and plaque index values. DMFT, social, and behavioural factors did not contribute to halitosis. CONCLUSIONS: Tongue coating score, modified sulcus bleeding index and calculus index were factors significantly related to oral malodor in this study.     

Clinical examination of subjects with halitosis

OBJECTIVE: To develop and apply a detailed clinical protocol for screening and assessing subjects with a complaint of halitosis. DESIGN: Cross-sectional. SUBJECTS AND METHODS: Several methods were used to recruit subjects with a complaint of halitosis, including a newspaper advertisement. A definition of halitosis arising from within the oral cavity, which is not related to generalized chronic gingivitis, chronic periodontitis or pathology of the oral mucosa was used. An extensive list of exclusion criteria was applied at the initial visit. Eligible subjects were asked to follow strict instructions and complete a questionnaire prior to their second visit for data collection. The clinical examination consisted of an organoleptic assessment, Halimeter reading and periodontal examination. RESULTS: The best method of recruiting subjects was advertising. Of 66 individuals recruited, four failed to attend the screening visit and 25 were excluded. The main reasons for exclusion were poor oral hygiene and existing periodontal disease. Thirty-seven completed the full protocol, resulting in identification of 18 with halitosis and 19 controls. CONCLUSIONS: Application of the exclusion criteria resulted in significant attrition of eligible participants. Our results suggest that organoleptic assessment should be regarded as a useful standard for defining subjects with halitosis.     

Microbiological culture analysis of the tongue anaerobic microflora in subjects with and without halitosis

Objective:  Determination of the microflora present on the tongue dorsum of subjects with and without halitosis using conventional microbiological culture methods.
Methods:  Twenty-one halitosis and 20 control patients were recruited using a strict clinical protocol. Samples were collected from the posterior dorsum of the tongue using a sterile brush. Each sample was vortex mixed for 30 s and serial 10-fold dilutions to 10⁻⁷ were carried out. Samples were plated onto fastidious anaerobe agar (FAA) and FAA enriched with vancomycin. These were incubated under anaerobic conditions for 10 days at 37°C. Strict anaerobes were identified by metronidazole sensitivity and bacteria were identified to genus level by a combination of colony morphology, Gram staining and biochemical and enzymatic tests (rapid ID 32 A).
Results:  The predominant species in test and control groups were Veillonella sp. and Prevotella sp. Greater species diversity was found in the halitosis samples compared with controls. The halitosis samples contained an increased incidence of unidentifiable Gram-negative rods, Gram-positive rods and Gram-negative coccobacilli.
Conclusions:  There was no obvious association between halitosis and any specific bacterial genus. The increased species diversity found in halitosis samples suggests that halitosis may be the result of complex interactions between several bacterial species. The role of uncultivable bacteria may also be important in contributing to this process.     

体检人群口臭与代谢指标的相关性分析

目的 比较健康体检者口臭程度与代谢指标的相关性。方法 选取体检者2 885例,纳入分析的体检指标有体质量、身高、血压、血糖、胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白以及尿酸。由口腔医师检查患者口气情况,比较非口臭者和口臭患者的代谢指标,并对口臭组的口臭程度与代谢指标之间的关系进行深入分析。结果 男性出现口臭的比例较高（P<0.01）;两组代谢指标的比较,体质指数、收缩压、舒张压、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白和尿酸的平均水平口臭组均高于非口臭组,高密度脂蛋白口臭组低于非口臭组;口臭值较高的患者,其代谢指标的平均水平（除高密度脂蛋白低）均高于口臭组中口臭值较轻者。结论 口臭与代谢指标异常之间存在同质关系,两者之间有相关性。     

Identification of oral bacterial species associated with halitosis

BACKGROUND: The authors examined the tongue bacteria associated with oral halitosis (bad breath originating from the oral cavity), focusing on noncultivable bacteria-bacteria that cannot be identified by bacterial culture techniques. METHODS: The authors took samples from the dorsal tongue surface of eight adult subjects with halitosis and five control subjects who did not have halitosis. They identified the bacteria in these samples by using both anaerobic culture and direct amplification of 16S ribosomal DNA, a method that can identify both cultivable and noncultivable microorganisms. They analyzed the resulting microbiological data using chi(2) and correlation coefficient tests. RESULTS: Clinical measures of halitosis were correlated highly with each other and with tongue coating scores. Of 4,088 isolates and phylotypes identified from the 13 subjects, 32 species including 13 noncultivable species were found only in subjects with halitosis. Solobacterium moorei was present in all subjects with halitosis but not in any control subjects. CONCLUSIONS: Subjects with halitosis harbor some bacterial species on their dorsal tongue surfaces that are distinct from bacterial species found in control subjects. This finding is consistent with the hypothesis that halitosis has a microbial etiology. CLINICAL IMPLICATIONS: Like other oral diseases with microbial etiology, halitosis may be amenable to specific and nonspecific antimicrobial therapy targeted toward the bacteria associated with it.     

Relationship between the SF-36 questionnaire and patient's satisfaction following halitosis therapy

Objective:  To assess the health-related quality of life (HRQOL) of patients complaining of halitosis at their first visit and at a later time when their complaint had diminished following therapy, using a self-administered questionnaire, the Medical Outcome Study Short Form-36 (SF-36). The aim of this study was to examine the relationship between HRQOL of patients before and after self-reported disappearance of their complaint following oral hygiene improvements for halitosis.
Subjects and methods:  Seventy patients of our special clinic for halitosis served as subjects. At the first visit, each completed the SF-36 before determination of volatile sulfur compound (VSC) concentration in mouth air. After excluding dropouts, the same measurements were performed for subjects whose self-reported complaint had disappeared following oral hygiene therapy.
Results and discussion:  At the initial visit, SF-36 scale scores for general health, vitality, social functioning, role-emotion, and mental health were significantly lower when compared with the national averages in Japan. For subjects with self-reported disappearance of complaint, only social functioning rose significantly among SF-36 scores at the end of the study. These results suggest that an awareness of improvement in social life could be related to patient's satisfaction with halitosis oral hygiene therapy.