TNF-α、sICAM-1在慢性间歇低氧条件下大鼠牙周炎发病机制中的作用

目的：探讨慢性间歇低氧和常氧条件下大鼠血清和牙龈组织中肿瘤坏死因子-α（TNF-α）、可溶性细胞间黏附分子-1（sICAM-1）在牙周炎发病机制中的作用。方法：将32只雄性 SD 大鼠随机分为4组（n ＝8）：常氧对照组（A 组）、常氧牙周炎组（B 组）、低氧对照组（C 组）、低氧牙周炎组（D 组）。采用正畸丝结扎双侧上颌第二磨牙和牙周炎食谱的方法建立牙周炎模型,常氧组和低氧组分别在常氧和模拟阻塞性呼吸暂停低通气综合征条件下饲养8周,检测各组动物牙周组织各项临床指标,用 ELISA 法检测动物血清和牙龈组织中 TNF-α、sICAM-1表达。结果：低氧牙周炎组中 TNF-α、sICAM-1浓度显著高于其余各组 P ＜0．05。血清和牙龈组织中 TNF-α、sICAM-1与附着丧失（AL）成正相关（P ＜0．05）。结论：慢性间歇低氧条件下 TNF-α、sICAM-1在牙周组织中的表达水平升高,加重了牙周炎症破坏程度,同时促使炎症反应向外周血管扩散。     

组胺及组胺受体1在大鼠牙周炎发病中表达差异的研究

目的：研究组胺及组胺受体1（HR1）在牙周炎发病机制中的作用。方法：将40只雄性SD大鼠随机分为实验组和对照组（每组20只）,其中实验组采用正畸丝结扎法建立牙周炎模型,对照组不作任何处理;建模8周后,分别采用ELISA法检测各组龈沟液中组胺含量,荧光定量PCR法检测各组牙龈组织中HR1 mRNA的表达水平。结果：牙周炎组龈沟液中的组胺浓度（35．47±3．908）μg／L 高于正常对照组（19．77± 3．832）μg／L（P＜0．05）;牙周炎组牙龈组织中的HR1－mRNA表达水平低于正常对照组（P＜0．05）。结论：组胺及HR1对牙周炎的发病均有一定调控作用。     

龈下菌斑中牙龈卟啉单胞菌牙龈素基因片段的检测

目的：检测慢性牙周炎患者龈下菌斑中牙龈卟啉单胞菌（Porphyromonas gingivalis,P.gingivalis）的2个基因片段kgp-cd和rgpB-cd,探讨2个基因片段的存在和缺失与牙周临床指标之间的关系.方法：选择慢性牙周炎患者龈下菌斑84个,对P.gingivalis阳性的龈下菌斑样本进行kgp-cd和rgpB-cd基因片段检测;根据2个基因片段的有无,将P.gingivalis分为A型和B型,采用SPSS11.5统计软件包,用t检验和x2检验分析不同基因型P.gingivalis与牙周临床指标的关系.结果：A型P.gingivalis在慢性牙周炎中的检出率高于B型（P＜0.05）,分别为85.29%和14.71%.不同基因型P.gingivalis引起的牙周袋探诊深度和牙龈出血倾向存在显著性差异（PD：t=2.85,P＜0.05;BOP：P＜0.05）.结论：kgp-cd和rgpB-cd基因与P.gingivalis的致病性有关.     

维吾尔族慢性牙周炎中牙龈卟啉单胞菌菌fimA毒力基因型的分布

目的：分析维吾尔族慢性牙周炎患者龈下菌斑中牙龈卟啉单胞菌菌毛fimA毒力基因型的分布情况。方法：收集52例维吾尔族慢性牙周炎患者的龈下菌斑，采用16SrRNA PCR法检测牙龈卟啉单胞菌，并根据菌毛fima毒力基因型的特异引物，用聚合酶链反应（PCR）检测Ⅱ型fimA和Ⅳ型fima菌株的分布。结果：16SrRNA PCR法检测牙龈卟啉单胞菌在龈下菌斑中阳性检出率是76．9％。牙周袋PPD〉6mm位点龈下菌斑标本的P．gingivalis检出率高于4〈PPD≤6mm采样的位点，2组差异有统计学意义（P〈0．05）。牙龈卟啉单胞菌菌毛．fimA毒力基因型在牙龈卟啉单胞菌感染者的检出率分别是：Ⅱ fimA型为37．5％，ⅣfimA型为22．5％。结论：维吾尔族慢性牙周炎患者龈下菌斑中牙龈卟啉单胞菌有较高的检出率。牙龈卟啉单胞菌存在fima毒力基因多态性。     

青春期龈炎龈下菌斑中牙龈卟啉单胞菌kgp基因型的研究

目的 研究青春期龈炎龈下菌斑中牙龈卟啉单胞菌（P.gingivalis）的特异kgp基因型，评估其与疾病严重程度之间的关系。方法检查并记录青春期龈炎组与牙龈健康组各36例的牙周临床指数，收集龈下菌斑样本，提取染色体DNA，采用聚合酶链反应（PCR）方法扩增编码牙龈蛋白酶K（KGP）催化域的序列片段。PCR产物用限制性内切酶Mse I消化。结果 P.gingivalis有毒株W83表现为kgp-A型，而无毒株ATCC33277表现为kgp-B型。所有P.gingivalis阳性个体的龈下菌斑中只检测到一种kgp基因型。kgp-A型在青春期龈炎组P．gingivalis阳性个体中的检出率为79．0％，在牙龈健康组为22．2％，两组kgp基因型的检出率差异有统计学意义（P=0．028）；青春期龈炎组有P.gingivalis定植的个体中，牙周临床指数与kgp的基因型无相关关系（P〉0．05）。结论青春期龈炎个体定植的Pgingivalis的kgp基因型多与有毒株P.gingivalis W83的表现相同，有必要监测kgp-A型阳性的个体，因其个体发展为牙周疾病的危险度可能会增高。     

黄芩苷抑制脂多糖诱导大鼠牙周炎的组织学观察

取10只正常大鼠作为对照组（A 组）,用40只大鼠右上颌第一、二磨牙间牙龈局部注射脂多糖建立大鼠牙周炎模型,随机分为4组：牙周炎组（B 组）、实验组（C1、C2、C3组）（n ＝10）,实验组实验牙的龈沟内每日注射黄芩苷溶液0．2 ml（浓度分别为0．01、0．1和1．0μg／ml）,牙周炎组注射等量生理盐水,连续3 d。用药后7 d 处死大鼠取样,光镜下观察组织学变化。牙周炎组牙周炎症明显重于实验组,各组破骨细胞数由多至少依次为：B 组、C1组、C2组、C3组、A 组,组间差异有统计学意义（P ＜0．05）。结果表明黄芩苷可以抑制脂多糖对大鼠牙周组织的损害。     

慢性牙周炎患者IL-17mRNA的表达及意义

目的：观察TL-17mRNA基因在慢性牙刷炎和健康牙龈组织中的表达水平变化,探讨TL-17在慢性牙周炎发生发展巾的作用。方法：选择慢性牙周炎患者23例,正常对照组15例,记录才周临床指标,采用Real—time PCR方法定量检测TL-17mRNA在牙龈组织中的表达。结果：慢性牙周炎组TL-17mRNA相对表达晕（0．00147＋0．00055）显著高于正常牙龈组（O．00047±0．00019）（P〈0．01）,并且慢性牙周炎组TL-17mRNA表达水平与牙龈指数（r=0．58,P〈0．01）、牙周袋探诊深度（r=0．57,P〈0．01）、附着丧失水平（r=0．49,P〈0．05）呈正相关。结论：Th17相关细胞凶子IL—17呵能住慢性牙周炎发病机制中发挥致炎作用。     

肿瘤坏死因子-α启动子区基因多态性与慢性牙周炎及冠心病的相关性研究

目的：研究肿瘤坏死因子-α（TNF-α）启动子区-308、-238位点单核苷酸多态性（SNP）改变对慢性牙周炎及冠心病的影响。方法：根据慢性牙周炎及冠心病的诊断及纳入标准收集73例单纯冠心病（CHD）患者、107例慢性牙周炎（CP）患者、114例CP合并CHD患者及138名健康对照者（HC）,检查这些患者的牙周状况,取颊黏膜拭子提取其基因组DNA,采用多聚酶链反应-限制性内切酶片段长度多态性的方法检测TNF-α-308位点G〉A及-238位点G〉A的基因型分布并分析其基因多态性与慢性牙周炎及冠心病易感性的关系．结果：TNF-α-238位点G〉A基因型频率在各组间无显著性差异（P〉0．05）,-308位点G〉A的基因型分布在冠心病患者较健康对照者之间有统计学差异（P〈0．05）,携带变异基因型GA或AA的个体较野生基因型GG个体冠心病发病风险增加2．87倍（95％ CI：1．316-6．250,P=-0．008）,但是-308位点基因变异与牙周炎发病无关（P〉0．05）．结论：TNF-α启动子区-308位点单核苷酸多态性与冠心病的易感性有关,与牙周炎的发病无关。     

大鼠牙龈炎局部血流及龈沟液天冬氨酸转氨酶水平的变化

目的：用大鼠牙龈炎动物模型对牙龈炎症程度的评定指标进行研究。方法：采用线线缝扎大鼠牙颈部，辅以高糖饮造成牙龈炎动物模型，7天后测定牙龈局部血流及龈沟液天冬氨酸转氨酶（AST）含量的变化。结果：模型动物牙龈充血红肿有溃疡和浅牙周袋形成。牙龈炎局部血流量和血流速度有一定程度的增加，且血细胞升高更加显著（P＜0．05），龈沟液对AST较对照组有所升高经统计学分析，有显著性差异。（P＜0．001）。结论：该模型为良好的牙龈炎动物模型，龈沟液AST及局部微血流的改变均是反映牙龈炎发病程度的客观评定指标。     

牙龈卟啉单胞菌菌体表面毒力因子及其致病性研究进展

牙周炎是以牙槽骨吸收和牙周袋形成为主要病理改变和临床体征的慢性感染性疾病,菌斑微生物是其主要的始动因子。大量研究证实,牙龈卟啉单胞菌（Porphyromonas gingivalis,P.gingivalis）是各种牙周炎,尤其是慢性牙周炎最主要的病原菌。本文主要对P.gingivalis外膜的致病结构及其理化特征做一综述,以期对牙周炎的治疗、防治及相关疫苗研发有所裨益。     

Etanercept作用下糖尿病Wistar大鼠牙周炎变化的实验研究

[摘要] 目的 观察肿瘤坏死因子α抑制剂Etanercept对实验性糖尿病Wistar大鼠牙周炎的影响。方法 12周龄Wistar大鼠45只,腹腔内一次性注射STZ诱导糖尿病。结扎糖尿病大鼠牙颈部建立牙周炎模型。将实验糖尿病大鼠分为糖尿病组,糖尿病牙周炎组和糖尿病牙周炎+Etanercept组。观察大鼠的牙龈指数、牙周袋深度、松动度。免疫组化观察IL-1β、IL-6在牙周组织中的表达。结果 糖尿病组大鼠牙龈指数、牙周袋深度、松动度与糖尿病牙周炎组和糖尿病牙周炎+Etanercept组有差别(P<0.05);糖尿病牙周炎组和糖尿病牙周炎+Etanercept组相比有差别(P<0.05)。糖尿病牙周炎组中IL-1β、IL-6表达高于糖尿病组(P<0.05),各时间段糖尿病牙周炎+Etanercept组牙周组织中IL-1β、IL-6表达低于糖尿病牙周炎组(P<0.05)。结论 肿瘤坏死因子α抑制剂Etanercept对实验性糖尿病Wistar大鼠牙周炎有抑制作用。     

Subgingival metronidazole in dialysis tubing and subgingival chlorhexidine irrigation in the control of chronic inflammatory periodontal disease

The present investigation compared subgingival metronidazole in dialysis tubing and subgingival chlorhexidine irrigation in the control of chronic inflammatory periodontal disease. 10 patients with 4 mm or deeper periodontal pockets were divided into 2 groups. Both received baseline scaling, root planing, subcontact area cleaning and instruction in the Bass technique of tooth brushing, but not in interdental cleaning. One group with 80 pockets received 0.2% chlorhexidine subgingival irrigation for 28 days and the other with 86 pockets received 0.5% metronidazole solution incorporated in subgingivally placed dialysis tubing. The tubings were replaced with freshly filled ones at days 7, 14 and 21. Active treatment ceased at day 28. Plaque Index, Sulcus Bleeding Index, pocket depth and gingival shrinkage were recorded at days 0, 7, 14, 21, 28, 56 and 84. Subgingival 0.5% metronidazole in dialysis tubing and 0.2% chlorhexidine irrigation were found to be equally effective in reducing chronic periodontitis. Metronidazole reduced Plaque Index less but pocket depth more than chlorhexidine. Improvements were maintained significantly below baseline levels for at least 8 weeks after the end of the 4-week treatment period.     

Treponema socranskii, Treponema denticola, and Porphyromonas gingivalis are associated with severity of periodontal tissue destruction.

BACKGROUND: The aim of the present study was to identify Treponema socranskii in addition to Treponema denticola and Porphyromonas gingivalis by polymerase chain reaction (PCR), and to clarify the relationship between the presence of these microorganisms and the severity of clinical periodontal parameters. METHODS: Saliva and subgingival plaque collected from 123 subjects (38 aggressive periodontitis patients, 65 chronic periodontitis patients, 20 healthy patients) were subjected to PCR to detect the aforementioned 3 microorganisms. RESULTS: Detection frequencies of T. socranskii, T. denticola, and P. gingivalis in plaque samples from aggressive periodontitis patients (71.1%, 73.7%, 84.2%, respectively) and chronic periodontitis patients (89.2%, 93.8%, 95.3%) were much higher than those from healthy subjects (30%, 5.0%, 10.0%). In aggressive and chronic periodontitis patients, these 3 species of bacteria were detected frequently at sites that showed deep periodontal pockets and severe attachment loss. The percentage of these bacteria-positive sites increased as the gingival index score of chronic periodontitis patients increased. T. socranskii was frequently detected together with T. denticola or P. gingivalis at the same sites, and coexistence of these microorganisms was frequently observed in deep periodontal pockets of aggressive periodontitis patients. CONCLUSIONS: T. socranskii, T. denticola, and P. gingivalis were frequently detected in periodontitis patients by PCR. The prevalence of these 3 microorganisms was correlated with various clinical parameters. Taken together, our findings suggest that T. socranskii, T. denticola, and P. gingivalis are associated with the severity of periodontal tissue destruction.     

Real-time polymerase chain reaction quantification of human cytomegalovirus and Epstein-Barr virus in periodontal pockets and the adjacent gingiva of periodontitis lesions

BACKGROUND: Genomic sequences of human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV), two herpesviruses, can frequently be detected in periodontal pockets of progressive periodontitis lesions, but the prevalence and load of the two viruses in gingival tissue are unknown. This study determined levels of HCMV and EBV DNA in the periodontal pocket and in the adjacent gingiva of periodontitis lesions using a real-time polymerase chain reaction (PCR) assay. MATERIAL AND METHODS: A total of 20 systemically healthy periodontitis patients participated in the study. Nine patients below 35 years of age were tentatively diagnosed as having aggressive (early onset) periodontitis, and 11 patients 36-56 years of age as having chronic (adult) periodontitis. Clinical parameters were evaluated using established methods. Using periodontal curettes, specimens were harvested from 6-10 mm periodontal pockets and from the adjacent inflamed periodontal pocket wall. A 5'-nuclease (TaqMan) real-time PCR assay was used to identify and quantify genomic copies of periodontal HCMV and EBV. RESULTS: HCMV DNA was detected in 78% of subgingival and 33% of gingival tissue samples from aggressive periodontitis lesions, but only in 46% of subgingival and 9% of gingival tissue samples from chronic periodontitis lesions. In aggressive periodontitis, HCMV subgingival and gingival tissue counts were positively correlated with periodontal pocket depth and probing attachment loss at sample sites (p6 mm, but none of 14 patients having mean pocket depth at sample teeth相似文献   

Porphyromonas gingivalis lipids and diseased dental tissues

BACKGROUND/AIM: Porphyromonas gingivalis synthesizes several classes of dihydroceramides and at least one of these lipid classes promotes proinflammatory secretory reactions in gingival fibroblasts as well as alters fibroblast morphology in culture. The purpose of this investigation was to determine whether the dihydroceramide lipids of P. gingivalis are recovered in lipid extracts of subgingival plaque, diseased teeth, and diseased gingival tissue samples. METHODS: Lipids were extracted from P. gingivalis, subgingival plaque, subgingival calculus, teeth laden with gross accumulations of subgingival calculus, and gingival tissue samples obtained from chronic severe periodontitis sites. Lipid samples were analyzed by gas chromatography-mass spectrometry as trimethylsilyl derivatives or by electrospray-mass spectrometry as underivatized products. High-performance liquid chromatography fractions of P. gingivalis lipids and gingival tissue lipids were also analyzed by electrospray-mass spectrometry analysis. RESULTS: P. gingivalis phosphorylated dihydroceramides were recovered in lipid extracts of subgingival plaque, subgingival calculus, calculus contaminated teeth, and diseased gingival tissue samples. However, the distribution of phosphorylated dihydroceramides varied between these samples. CONCLUSION: Subgingival plaque, subgingival calculus, diseased teeth, and gingival tissue are contaminated with phosphorylated dihydroceramides produced by P. gingivalis. The previously reported biological activity of these substances together with the recovery of these lipids at periodontal disease sites argues strongly for their classification as virulence factors in promoting chronic inflammatory periodontal disease.     

One stage full- versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset periodontitis. I. Long-term clinical observations.

BACKGROUND: A standard treatment strategy for periodontal infections often consists of 4 consecutive sessions of scaling and root planing (per quadrant, at 1- to 2-week intervals), without proper disinfection of the remaining intra-oral niches for periodontopathogens. This could theoretically lead to a reinfection of previously disinfected pockets by bacteria from an untreated region/niche. This study aimed to investigate, over an 8-month period, the clinical benefits of a one stage full-mouth disinfection in the control of severe periodontitis. METHODS: Sixteen patients with early-onset periodontitis and 24 patients with severe adult periodontitis were randomly assigned to test and control groups. The control group was scaled and root planed, per quadrant, at 2-week intervals and given standard oral hygiene instructions. A one stage full-mouth disinfection (test group) was sought by scaling and root planing the 4 quadrants within 24 hours in combination with the application of chlorhexidine to all intra-oral niches for periodontopathogens. Besides oral hygiene, the test group also rinsed twice daily with a 0.2% chlorhexidine solution and sprayed the tonsils with a 0.2% chlorhexidine spray, for 2 months. The plaque index, gingival index, probing depth, bleeding on probing, gingival recession, and clinical attachment level were recorded at baseline and at 1, 2, 4, and 8 months afterwards. RESULTS: The one stage full-mouth disinfection resulted, in comparison to the standard therapy, in a significant (P <0.001) additional probing depth reduction and gain in attachment up to 8 months. For initial pockets > or =7 mm, the "additional" probing depth reduction at the 8 month follow-up was 1.2 mm for single-rooted and 0.9 mm for multi-rooted teeth, with corresponding additional gains in attachment of 1.0 mm and 0.8 mm, respectively. The additional improvements were observed for all subgroups (adult periodontitis, generalized early-onset cases, smokers), with the largest differences in the non-smoking adult periodontitis patients. CONCLUSIONS: These findings suggest that a one stage full-mouth disinfection results in an improved clinical outcome for the treatment of chronic adult or early-onset periodontitis as compared to scaling and root planing per quadrant at 2-week intervals.     

An 8‐week,randomized, controlled,clinical study of the use of a 0.1% chlorhexidine mouthwash by chronic periodontitis patients

Aim: To evaluate the efficacy of a 2‐week administration of a 0.1% chlorhexidine mouthwash in the short‐term treatment of chronic periodontitis patients and the impact of this product when administered twice by pocket irrigation. Methods: Sixty patients were enrolled in a single‐centre, placebo‐controlled, randomized study with the blind allocation of product to two parallel groups. Clinical assessments were performed, and samples from six selected subgingival sites were collected for microbial analysis by culture at baseline, D15 and D56. Three of the six sites were randomly selected and were treated by subgingival irrigation with the same 0.1% chlorhexidine product at D0 and D7. A subsequent statistical analysis was performed using the paired Student’s t‐test and Wilcoxon rank sum test for within‐group analyses; analysis of variance and the Kruskall–Wallis test were used for between‐group analyses. Results: Two‐week treatment with a 0.1% chlorhexidine mouthwash slightly reduced the gingival inflammation associated with periodontitis. We observed a significant decrease in Gram‐negative, facultative anaerobes and micro‐aerophiles, and a significant increase in Gram‐positive cocci. No increase in the treatment effect was demonstrated by irrigation of the periodontal pockets. Conclusion: The 0.1% chlorhexidine mouthwash showed limited beneficial effects in the treatment of periodontitis patients.     

Genotypic characterization of Porphyromonas gingivalis isolated from Swedish patients with periodontitis and from periodontal abscesses

INTRODUCTION: A significant genetic polymorphism has been shown for Porphyromonas gingivalis isolates from different geographical areas. It is, however, possible that genetic similarities can be found among isolates obtained from a more specific population. The aim of the present study was to evaluate genetic heterogeneity among P. gingivalis isolates obtained from Swedish subjects with chronic periodontitis and from periodontal abscess lesions. METHODS: A total of 78 P. gingivalis strains, including 55 fresh clinical isolates obtained from 52 Swedish periodontitis subjects, eight isolates from eight Swedish periodontal abscess subjects and 15 reference strains, were subjected to amplified fragment length polymorphism (AFLP) and random amplified polymorphic DNA (RAPD) genotyping assays. RESULTS: A total of 62 AFLP genotypes and 70 RAPD genotypes were identified among the 78 P. gingivalis strains. Forty-six strains were clustered at 70% similarity level into 15 clusters. Six identical RAPD genotypes were identified among the strains. The AFLP/RAPD profiles were compared for identical genotypes. A total of 56 AFLP/RAPD genotypes were found. Four pairs of identical AFLP/RAPD genotypes were found for two strains obtained from two different periodontal pockets each of four subjects. Interestingly, two strains showed an RAPD/AFLP genotype, which was identical to the type strain W83. CONCLUSION: The present study demonstrated that Swedish P. gingivalis isolates exhibit a wide variety of genotypes with only a weak clustering pattern. No predominant genotype at the whole chromosomal DNA level was present among Swedish P. gingivalis strains.     

Langerhans' cell histiocytosis in a 5-year-old girl: evidence of periodontal pathogens

BACKGROUND: Langerhans' cell histiocytosis (LCH) is a rare disorder characterized by Langerhans' cell proliferation in various organs or tissues. When periodontal tissue is involved, clinical manifestations can vary from gingival recession and pocket formation to severe alveolar bone loss. This case report describes periodontal pathogens found in the pockets of involved primary teeth. METHODS: A 5-year-old girl with LCH presented with loose teeth. Intraoral examination and radiographs revealed deep pockets and severe bone loss around all primary molars. Bacterial samples were obtained from saliva and subgingival plaque and analyzed for the presence of five periodontopathic bacteria using a polymerase chain reaction (PCR) method. Due to severe periodontal destruction, all primary molars were extracted, and a gingival biopsy was taken from tooth T to confirm the diagnosis of LCH. RESULTS: The biopsy specimen revealed the histologic features of LCH. The patient was diagnosed as having periodontitis as a manifestation of LCH. PCR results of subgingival plaque from LCH-affected molars indicated the presence of Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, and Prevotella intermedia. However, Actinobacillus actinomycetemcomitans was absent from these teeth. No tested bacteria were found in the non-affected anterior teeth. CONCLUSIONS: The bacteria commonly associated with periodontal disease were detected in subgingival plaque samples from this LCH patient. More microbiological data are required to understand the role of these bacteria in LCH-associated periodontal destruction.