Comparison of Glycated Hemoglobin Levels in Individuals Without Diabetes and With and Without Periodontitis Before and After Non‐Surgical Periodontal Therapy

Background: Only a few studies have examined the association between periodontitis and glycated hemoglobin (HbA1c) levels in individuals without diabetes. The aim of this study is to compare HbA1c levels in individuals without diabetes and with and without periodontitis before and after non‐surgical periodontal therapy. Methods: This comparative study was done on individuals without diabetes who were 35 to 65 years old. Group A consisted of 30 individuals without periodontitis, and group B consisted of 30 individuals with periodontitis. Body mass indices and clinical parameters, including oral hygiene index‐simplified (OHI‐S) score, gingival index (GI), probing depth (PD), clinical attachment level (CAL), and HbA1c level, of all participants were recorded. All participants received non‐surgical periodontal therapy (scaling and root planing). After 3 months, all participants were reexamined, and clinical parameters and HbA1c levels were evaluated and compared to baseline values. Results: There were significant differences between group A and group B in regard to baseline OHI‐S, GI, PD, and HbA1c (P <0.05). There was no clinical attachment loss in group A, either at baseline or after 3 months. At the end of 3 months, group B showed improvement in all clinical parameters (P <0.05) and their HbA1c levels also significantly decreased (P <0.05), although the values never reached those of group A. Conclusion: The HbA1c levels of individuals without diabetes and with periodontitis (group B) were significantly reduced 3 months after non‐surgical periodontal therapy, although they never reached the same levels as those of the individuals without diabetes or periodontitis (group A).     

Evaluation of periodontal status and effectiveness of non-surgical treatment in patients with type 2 diabetes mellitus in Taiwan for a 1-year period

Background: The periodontal status and effects of non‐surgical periodontal treatment in patients with type 2 diabetes mellitus and periodontal disease are assessed. Methods: One‐hundred patients with type 2 diabetes (mean ± SD hemoglobin (Hb)A1c level: 7.3% ± 0.94%) and periodontal disease were recruited for this study. The group with moderate‐to‐severe periodontal disease included patients with >1 tooth with a probing depth (PD) ≥5 mm and >2 teeth with a clinical attachment loss (AL) ≥6mm, and the group with mild periodontal disease included patients with <1 affected tooth, and >2 affected with a clinical AL ≥6mm. Patients (28 patients in the mild group and 72 patients in the moderate‐to‐severe group) underwent non‐surgical periodontal treatments. We analyzed differences in serum concentrations of metabolic parameters (glycated hemoglobin and low‐density lipoprotein), inflammatory parameters (interleukin [IL]‐1β and C‐reactive protein [CRP]), and periodontal parameters between the two groups before treatment and at 3, 6, 9, and 12 months post‐therapy. Results: Seventy‐five patients with diabetes (21 patients in the mild group and 54 patients in the moderate‐to‐severe group) completed the study. Significant differences in the plaque index (PI), gingival index (GI), PD, and clinical AL at examination times were observed in the whole cohort (P <0.05). We observed significant differences in the PI, GI, and PD in the moderate‐to‐severe group (P <0.05), whereas there was only a significant difference in PD in the mild group (P <0.05) between baseline and 12 months post‐treatment. Both groups experienced improved glycemic control, but the difference was insignificant. CRP and IL‐1β levels were significantly different at examination times for the whole cohort (P <0.05). No significant positive association among metabolic and inflammatory parameters at 12 months post‐therapy were found. Conclusion: Non‐surgical periodontal treatment improved and maintained the periodontal health of patients with well‐controlled diabetes, but no significant reduction of metabolic parameters was observed over a 1‐year period.     

Gingival crevicular fluid levels of interleukin-1beta and glycemic control in patients with chronic periodontitis and type 2 diabetes

BACKGROUND: Patients with diabetes have increased incidence and severity of periodontal disease not accounted for by differences in the subgingival microbial infection. Poor glycemic control has been consistently associated with periodontal disease severity. Also, recent evidence suggests that hyperglycemia may induce inflammatory cytokine production. Few studies, however, have examined local biochemical measures of periodontal inflammation in patients with type 2 diabetes. The aim of this study was to determine whether glycemic control was related to gingival crevicular fluid (GCF) levels of interleukin-1beta (IL-1beta). METHODs: GCF samples were collected from 45 patients with type 2 diabetes and untreated chronic periodontitis. Plaque index (PI), bleeding on probing (BOP), probing depth (PD), and attachment level (AL) were recorded at six sites per tooth. IL-1beta levels were determined from individual GCF samples by enzyme-linked immunoabsorbent assay (ELISA). Individual site and mean patient values were calculated. Glycated hemoglobin (HbA1c) levels were measured from anticoagulated whole blood using an automated affinity chromatography system. Serum glucose was also determined. RESULTS: Clinical periodontal measures (PD, AL, BOP) and measures of glycemic control (HbA1c, random glucose) were significantly correlated with GCF IL-1beta. Patients with greater than 8% HbA1c had significantly higher mean GCF IL-1beta levels than patients with less than 8% HbA1c. In a multivariate model adjusting for age, gender, PD, AL, BOP, and PI, HbA1c and random glucose were independent predictors of high GCF IL-1beta. CONCLUSIONS: Poor glycemic control is associated with elevated GCF IL-1beta. These data are consistent with the hypothesis that hyperglycemia contributes to an heightened inflammatory response, and suggests a mechanism to account for the association between poor glycemic control and periodontal destruction.     

牙周基础治疗对2型糖尿病患者血清瘦素含量影响研究

目的:观察牙周基础治疗对2型糖尿病伴牙周炎(DMCP)患者血清中瘦素(leptin)的浓度、临床牙周状态、血糖控制的影响。方法:选取DMCP患者和不伴有全身系统性疾病的慢性牙周炎(CP)患者各30例进行牙周基础治疗。分别在治疗前、治疗后1个月和3个月记录所有患者牙周临床指数:探诊深度(PD),附着丧失(AL)及菌斑指数(PLI),并检测血清中糖化血红蛋白(HbA1c)及leptin的含量。结果:DMCP组中PD、PLI和血清leptin含量在治疗后1个月和3个月时均显著降低(P<0.05),AL和血清HbAlc含量仅在治疗后3个月显著降低(P<0.05)。CP组中PD和PLI在治疗后1个月和3个月时均显著降低(P<0.05),AL和血清leptin含量仅在治疗后3个月显著降低(P<0.05)。2组治疗前血清leptin含量与牙周临床指数呈正相关。结论:牙周基础治疗有助于DMCP患者的血糖控制、牙周状态改善和血清中leptin含量下降。     

Effect of Fluoxetine on Periodontal Status in Patients With Depression: A Cross‐Sectional Observational Study

Background: Fluoxetine, a selective serotonin reuptake inhibitor, has been reported to reduce periodontal disease severity in a rat ligature‐induced periodontitis model. The objective of the present study is to investigate the influence of fluoxetine intake on periodontal parameters in patients with periodontitis with clinical depression. Methods: A sample of 236 patients with chronic periodontitis and clinical depression were assessed for clinical parameters of periodontal disease. Of these, 115 patients were taking fluoxetine (20 mg/day) for ≥2 months, and 121 patients were not. Participants taking fluoxetine were further analyzed for correlation between duration of drug intake and periodontal parameters. Results: All periodontal parameters, except plaque index, were significantly lower in participants taking fluoxetine (P <0.01). Partial correlation analysis, adjusted for confounders, revealed a significant and negative correlation between duration of fluoxetine intake and attachment loss (AL) (R² = ?0.321, P <0.05). Logistic regression analysis revealed that fluoxetine intake was associated with a lower risk of having AL ≥3 (odds ratio [OR] = 0.55, 95% confidence interval [CI] = 0.31 to 0.96) and lower odds of increased bleeding on probing (BOP) percentage values (OR = 0.62, 95% CI = 0.34 to 0.97). Conclusion: In this observational study, use of fluoxetine was associated with lower BOP percentages and reduced AL.     

Fluid dynamics of gingiva in diabetic and systemically healthy periodontitis patients

OBJECTIVES: The influence of diabetes mellitus (DM) on the fluid dynamics of periodontium has not been reported in periodontal disease. The objectives of this study were (i) to investigate the alterations in the fluid dynamics of periodontium in diabetic periodontitis patients, and present the association of this phenomenon with the metabolic control of DM; (ii) to reveal any correlation between the fluid dynamics of periodontium and clinical signs of periodontal disease in DM and periodontitis. DESIGN: Fifteen well-controlled diabetic chronic periodontitis patients (Group 1), 14 systemically healthy chronic periodontitis patients (Group 2), and 14 systemically and periodontally healthy individuals were included in the study. Gingival crevicular fluid volume (GCF-V) and gingival tissue osmotic pressure (GOP) were used as the parameters of periodontal fluid dynamics. GCF-V was measured by a Periotron device, while GOP was measured by a digital osmometer. Silness-L?e plaque index (PI), L?e-Silness gingival index (GI) and clinical attachment loss (AL) levels were recorded to determine the periodontal health status. RESULTS: PI, GI and AL were higher in Groups 1 and 2 than in Group 3 (P<0.05), but similar between Groups 1 and 2 (P>0.05). Increased GCF-V and GOP were observed in Groups 1 and 2 compared with Group 3 (P<0.01), and the increase in Group 1 was greater than that in Group 2 (P<0.01). There were strong positive correlations between GCF-V and GOP in all three groups: between GI and GCF-V and GI and GOP in Groups 1 and 2; and between AL and GCF-V and AL and GOP in Groups 2 and 3. CONCLUSION: The results suggest that (i) DM may have an additive influence on the fluid dynamics of periodontium in the presence of periodontal disease; (ii) this phenomenon may not be prevented by the metabolic control of DM; (iii) the clinical signs of periodontal disease may be affected by the fluid dynamics of periodontium in both DM and periodontitis.     

牙周炎伴糖尿病患者全唾液中Pro-CT含量的检测及其意义

目的:比较糖尿病合并牙周炎患者、单纯糖尿病患者、单纯牙周炎患者以及健康者全唾液中降钙素原(Pro-CT)水平,及其与血糖控制情况及牙周病炎严重程度之间的关系。方法:采用病例对照研究,纳入糖尿病合并牙周炎患者(DM+CP组)24例,单纯糖尿病患者(DM组)、单纯牙周炎患者(CP组)以及健康人群各30例,收集受检者静息全唾液,采用酶联免疫吸附试验(ELISA)检测全唾液中Pro-CT水平。结果:DM+CP组全唾液中Pro-CT水平显著高于其他3组,差异极具统计学意义(P<0.01);全唾液中Pro-CT水平随牙周炎严重程度加重而增高,随血糖控制情况的不理想而增高,差异有统计学意义;全唾液中Pro-CT水平与探诊深度(PD)、探诊出血指数(BI)、附着丧失(AL)、缺失牙数均呈正相关,且相关程度由高到低依次为PD、BI、AL、缺失牙数,差异有统计学意义(P<0.05)。结论:糖尿病患者体内的微炎症状态可能与牙周炎症有关,全唾液中Pro-CT水平既受牙周炎症影响也受全身因素的调控。     

牙周炎与认知功能障碍的相关性研究

目的 通过评估认知功能正常和认知功能障碍中老年人的牙周状况,来研究牙周炎与认知功能障碍之间的关系。 方法 选取认知功能障碍患者40例及认知功能正常的健康对照的中老年人35例,使用简易精神状态量表（MMSE）评估认知功能,并检查和评估其牙周健康状况,包括牙周炎的严重程度、余留牙齿数量、探诊出血阳性率、探诊深度（PD）以及附着水平（AL）。比较两组患者的牙周状况,分析牙周检查指标和认知功能的相关性。使用SPSS 26.0软件进行统计学分析。 结果 认知功能障碍组与健康对照组在牙周炎严重程度的分布情况有明显差异（χ²=13.309,P=0.001）,认知功能障碍组的重度牙周炎比例显著高于健康对照组（P<0.05）。认知障碍组PD≥6 mm、AL≥5 mm的位点百分比显著高于对照组,PD=1~3 mm、AL=0~2 mm的位点百分比明显少于对照组（P<0.05）。两组的探诊出血阳性率无明显差别（P>0.05）,认知功能障碍组的余留牙齿数量明显少于对照组（P<0.05）。认知功能的MMSE评分与牙齿数量、AL=0~2 mm的位点百分比呈正相关,与AL≥5 mm的位点百分比呈负相关（P<0.05）。 结论 牙周炎与认知功能障碍之间存在相关性,二者之间的具体关系及相关机制值得进一步探究。     

Association between interleukin-1 genotype and periodontal disease in a diabetic population

BACKGROUND: Recently, it has become evident that for many common chronic diseases, modifying factors amplify disease mechanisms to make the clinical condition more severe. The aims of this report were 1) to investigate the prevalence of periodontitis in a diabetic population, 2) to evaluate the association of periodontitis with metabolic control, and 3) to evaluate periodontitis in diabetics with different interleukin (IL)-1 genotypes. METHODS: One hundred diabetic patients were screened. Type and duration of diabetes, level of control (glycosylated hemoglobin), and demographic data were recorded. Periodontal disease was defined as two or more teeth with clinical attachment loss (CAL) > or = 5 mm. Poorly controlled diabetes was defined as glycosylated hemoglobin values > 8%. Finger-stick blood samples were collected and analyzed for genotyping of IL-1A (+4845), IL-1B (+3954), IL-1B (-511), and IL-1RN (+2018) polymorphisms. RESULTS: Among the diabetic patients in the study, 66% showed periodontal destruction, and 43% of those could be characterized as severe. The prevalence of severe attachment loss increased with decreasing control of diabetes. Only the IL-1B (-511) genotype was found to be associated with periodontal disease in the African American patients (P<0.05). The frequency of allele 1 was 0.77 in periodontitis affected versus 0.33 in healthy African American diabetics. A borderline significant association between IL-1B (+3954) and periodontal disease also was noted in Caribbean periodontal patients (P=0.06); however, the allele 2 frequency in this population was only 10%. CONCLUSIONS: These data confirm the high prevalence and severity of periodontitis in the diabetic population, and support the association between poor glycemic control and periodontal disease. The low prevalence of some of the IL-1 gene polymorphisms in the ethnic groups included in this study limits the validity of conclusions on genotype associations with clinical findings, but there was a trend suggesting that allele 1 at IL-1B (-511) and IL-1B (+3954) was overrepresented among diabetics with periodontal disease.     

Periodontal complications of hyperglycemia/diabetes mellitus: Epidemiologic complexity and clinical challenge

This report provides a comprehensive overview of the adverse effects of hyperglycemia on the periodontium. It combines data from literature reviews of original data from two large, population‐based epidemiologic studies with comprehensive periodontal health assessment. Emphasis is placed on the exploration of hitherto sparsely reported effects of prediabetes and poorly controlled (uncontrolled) diabetes, in contrast to the umbrella term “diabetes.” This stems from the realization that it is not simply having a diagnosis of diabetes that may adversely affect periodontal health. Rather, it is the level (severity) of hyperglycemia that is the determining factor, not the case definition of the diagnosis of diabetes or the type of diabetes in question. Importantly, based on existing evidence this paper also attempts to estimate the improvements in periodontal probing depth and clinical attachment level that can be expected upon successful nonsurgical periodontal treatment in people with chronic periodontitis, with and without diabetes, respectively. This exploration includes the implentation of new systematic reviews and meta‐analyses that allow comparison of such intervention outcomes between hyperglycemic and normoglycemic subjects. Based on both existing literature and original analyses of population‐based studies, we try to answer questions such as: Is there a glycated hemoglobin concentration threshold for periodontitis risk? Does short‐term periodontal probing depth reduction and clinical attachment level gain after scaling and root planing depend on glycemic control in type 2 diabetes? Are short‐term scaling and root planing outcomes in people with hyperglycemia/diabetes inferior to those in people without diabetes? Do periodontitis patients with diabetes benefit more from the use of adjuvant antibiotics with nonsurgical periodontal treatment than people without diabetes? Does hyperglycemia lead to greater tooth loss in patients in long‐term post‐periodontal treatment maintenance programs? Throughout this review, we compare our new findings with previous data and report whether the results of these new analyses corroborate, or are in discord with, similar scientific reports in the literature. We also explore the potential role of dental health‐care professionals in helping patients control the risk factors that are identical for periodontitis and diabetes. Finally, we suggest various topics that still need exploration in future research.     

Relationship of serum advanced glycation end products with deterioration of periodontitis in type 2 diabetes patients

BACKGROUND: A close relationship between diabetes and chronic periodontitis has been demonstrated. We previously found that Porphyromonas gingivalis with the type II fimA gene is an infectious factor closely associated with the deterioration seen in diabetic periodontitis patients. In the present study, we examined whether other biomarkers are related to the development and deterioration of periodontitis often seen in type 2 diabetic individuals. METHODS: A total of 97 type 2 diabetes patients with and without periodontitis were recruited, and their periodontal and diabetic conditions were analyzed. The ratio (%) of teeth with an attachment loss >5 mm among all teeth in each subject was used as an index of periodontal deterioration. Peripheral blood was tested for levels of glycated hemoglobin (HbA1c), advanced glycation end products (AGEs), C-reactive protein (CRP), and cytokines (tumor necrosis factor [TNF]-alpha and interleukin [IL]-1beta). Subgingival plaque samples were also examined for the occurrences of Actinobacillus actinomycetemcomitans, Tannerella forsythensis, Treponema denticola, and Prevotella intermedia. RESULTS: Serum AGEs were significantly associated with deterioration of periodontitis, whereas no other serum biochemical marker or bacterial occurrence showed a clear relationship with that condition. CONCLUSION: AGEs may be factors associated with diabetic periodontitis and may be useful as biomarkers that reflect such deterioration.     

2型糖尿病家系成员牙周状况调查

目的调查2型糖尿病家系成员的牙周状况。方法共收集43个家系[167人，男性71人，女性96人，平均年龄为（49.2±12.2）岁]，分别抽取静脉血，并选取每位受检者的6颗代表牙，记录每颗牙的6个位点的菌斑指数（plaque index，PLI）、牙龈出血指数（bleeding index，BI）、牙周探诊深度（probing depth，PD）、附着丧失（attachment loss，AL）并记录总牙数及失牙数。结果43个家系中共有糖尿病患者101例，其中4例全口牙缺失，经牙周病问卷调查显示，均为牙齿松动自行脱落或拔除。97例糖尿病患者均患牙周炎，其中轻度牙周炎50例，中度牙周炎24例，重度牙周炎23例。48例非糖尿病者中牙龈炎5例，轻度牙周炎30例，中度牙周炎11例，重度牙周炎2例。糖尿病患者和非糖尿病者龈炎和轻、中、重度牙周炎患病率差异有统计学意义（X^2=17.96，P〈0.005），糖尿病患者的PD、AL及缺失牙数均高于非糖尿病者，差异有统计学意义（P〈0.05）。血糖控制不良的糖尿病患者BI、AL均显著高于血糖控制良好的糖尿病患者（P〈0.05）。血糖控制良好的糖尿病患者PLI、BI、PD及AL略高于非糖尿病者，但差异无统计学意义。结论在糖尿病家系成员中糖尿病患者的牙周炎患病率明显高于非糖尿病者，牙周破坏程度亦明显重于非糖尿病者；血糖控制良好患者的牙周状况与非糖尿病者相似。     

Clinical diagnosis of trauma from occlusion and its relation with severity of periodontitis

The purpose of the present study was to determine the reliability of several selected signs of trauma from occlusion and their relations with severity of periodontitis. 32 moderate to advanced chronic periodontitis patients participated in the study. All teeth present were evaluated for various abnormal occlusal contacts, signs of trauma from occlusion, and the severity of periodontitis. Standardized periapical radiographs were also taken for each tooth. The results demonstrated that: (1) no significant difference occurred in probing pocket depth (PD), clinical attachment loss (AL), or percentage of alveolar bone height (BH) between teeth with and without various abnormal occlusal contacts, i.e., premature contacts in centric relation occlusion, non-working contacts in lateral excursions, premature contacts of anterior teeth or posterior protrusive tooth contacts; (2) teeth with either significant mobility, functional mobility, or radiographically widened periodontal ligament space (PDLS) had deeper PD, more AL and lower BH than teeth without these signs, while teeth with pronounced wear or radiographically thickened lamina dura had less AL than teeth without these findings; (3) 2 combined indices, i.e., the trauma from occlusion index (TOI) and the adaptability index (AI), were proposed for the identification of occlusal trauma and the response of periodontium to excessive biting forces in heavy function, respectively; TOI-positive teeth exhibit deeper PD, more AL and less osseous support than TOI-negative teeth; however, AI-positive teeth had less AL and more osseous support than AI-negative teeth; (4) with identical attachment level, TOI-positive teeth had less osseous support than TOI-negative teeth while the magnitude of difference became greater with an increase of attachment loss.     

Inverse association between periodontitis and respiratory allergies in patients with type 1 diabetes mellitus

Aim: In a general adult population, we have demonstrated an inverse association between periodontitis and respiratory allergies that is in line with the hygiene hypothesis suggesting a protective effect of infections against the development of allergies. The objective of the present study was to investigate the association between periodontitis and respiratory allergies in a type 1 diabetes mellitus population. Material and Methods: The study population comprised 170 patients with type 1 diabetes mellitus aged 17–80 years. Respiratory allergies were present in 22 subjects. The attachment loss (AL) was measured. Periodontitis was defined according to the percentage of surfaces that exceeded 3 mm AL (healthy, mild, moderate, severe periodontal conditions). Results: Our adjusted analyses revealed an inverse association between periodontitis and respiratory allergies. For increasing AL, a trend towards a decreasing risk was present for respiratory allergies (p_trend<0.05). Compared with subjects with healthy periodontal conditions, individuals with severe periodontal conditions had the lowest risk of respiratory allergies [odds ratios (OR) 0.06 (95% confidence interval (CI) 0.01–0.39)], followed by subjects with moderate AL [OR 0.14 (95% CI 0.03–0.63)] and mild AL [OR 0.32 (95% CI 0.09–1.08)]. Conclusion: There is a strong inverse association between periodontitis and respiratory allergies in patients with type 1 diabetes mellitus. These findings further support the hygiene hypothesis.     

利用Florida探针评价牙周炎非手术治疗的疗效

目的利用Florida探针评价牙周炎的非手术治疗的疗效。方法选择100例牙周炎患者为研究对象,进行牙周非手术治疗,采用Florida探针检测患者在治疗前和治疗结束后1个月时的探诊深度（PD）和附着丧失（AL）。检测位点为患者所有天然牙的近中颊、颊正中、远中颊和舌正中4个位点。将全口牙分成前牙组、前磨牙组、后牙组和所有牙组4组,比较4组间、4个位点间以及PD<5 mm和PD≥5 mm的位点间治疗前后PD和AL的变化。结果前牙组、前磨牙组、后牙组和所有牙组治疗后PD和AL与治疗前相比均有明显改善（P<0.05）,PD明显下降,且有牙周附着再获得;其中前牙的改善较磨牙和前磨牙更明显。PD<5mm和PD≥5mm的牙周位点间PD的恢复有统计学差异（P<0.05）,治疗后明显好转;而AL在治疗前后无统计学差异（P>0.05）。4个位点间改善程度的比较无统计学差异（P>0.05）。结论Florida探针能够较准确、客观地评价牙周状况。牙周非手术治疗对牙周炎具有良好的治疗效果,前牙疗效更为明显,同一牙齿不同位点的疗效基本一致。     

参加社区慢性病管理的糖尿病患者牙周健康状况调查及相关因素分析

目的了解社区糖尿病患者的牙周状况及相关因素。方法对参加慢性病管理的90例2型糖尿病患者进行牙周、血糖检查及问卷调查。结果本组研究对象牙周炎患病率为100％，轻、中、重度牙周炎分别为37．1％、24．4％、38．9％。附着丧失男性高于女性。牙周状况与糖化血红蛋白水平高度相关，受社会行为因素影响。结论糖尿病患者的牙周附着丧失与糖化血红蛋白水平关系更为密切，应将二者作为定期监测的指标，积极控制牙周炎症，优先针对低收入、牙周保健知识水平低的人群开展行为干预。     

应激性唾液标志物与牙周炎临床参数的相关性分析

目的：探讨应激性唾液标志物嗜铬粒蛋白A（chromogranin A,CgA）、皮质醇、α淀粉酶、β内啡肽与牙周炎临床参数龈沟出血指数（sulcus bleeding index,SBI）、牙周探诊深度（periodontal probing depth,PD）、附着丧失（attachment loss,AL）的相关性。方法：选择2017年12月-2018年12月江西省中西医结合医院口腔科收治的慢性牙周炎患者105例为牙周炎组,同期在院健康体检者105例为对照组,检测2组唾液中CgA、皮质醇、α淀粉酶、β内啡肽水平及SBI、PD、AL。采用SPSS 22.0软件包分析应激性唾液标志物与牙周炎临床参数的相关性,利用多因素Logistic回归分析明确牙周炎有关的危险因素。结果：牙周炎组唾液中CgA、皮质醇、α淀粉酶、β内啡肽水平显著高于对照组(P<0.05),牙周炎组SBI、PD、AL显著高于对照组(P<0.05),唾液中CgA、皮质醇、α淀粉酶、β内啡肽水平与SBI均呈正相关 (P<0.05）,唾液中CgA、皮质醇、α淀粉酶、β内啡肽水平与PD均呈正相关 (P<0.05）,唾液中CgA、皮质醇、α淀粉酶、β内啡肽水平与AL均呈正相关 (P<0.05）,CgA、皮质醇、α淀粉酶、β内啡肽是牙周炎的独立危险因素(P<0.05)。结论：应激性唾液标志物CgA、皮质醇、α淀粉酶、β内啡肽与牙周炎临床参数显著相关,提示应激性唾液标志物能在一定程度上反映牙周炎的病情进展,为牙周炎诊断和疗效监测提供有益参考。     

难治性牙周炎患者血清中瘦素(LEP)水平及其与牙周临床指数关系分析

目的: 探讨难治性牙周炎患者的血清瘦素水平以及其与牙周临床指数之间的关系。方法: 本文随机选取健康组、慢性牙周炎组以及难治性牙周炎组患者各40例,记录所有接受检测者的牙周炎临床指标牙周袋探诊深度(PD)、菌斑指数(PLI)、牙周附着水平(AL)以及探诊出血(BOP)的相关变化情况;然后采用高效液相关层析法检测所有接受检查患者的糖化血红蛋白(HBALC)以及空腹血糖(FPG)指标变化情况,并且同时使用酶联免疫吸附法(ELISA)检测患者血清中瘦素(LEP)表达水平变化情况。结果: 难治性牙周炎组中患者的血清中HBALC(10.902±2.129)%、FPG(9.783±2.109) mmoL/L、LEP(1.347±0.658) μg/L的浓度明显高于慢性牙周炎组和健康组HBALC(5.601±0.375)%、(5.142±0.319)%、FPG(5.689±0.712)、(5.432±0.467) mmoL/L、LEP(0.912±0.256)、(0.462±0.119) ng/mL(P<0.05);所有受试者的血清瘦素指标与PD、AL、PLI以及BOP指标值都呈正相关,R值依次分别为0.497、0.534、0.509和0.571(P<0.05)。结论: 难治性牙周炎患者血清中瘦素水平会逐渐升高,血清瘦素水平与PD、AL、PLI以及BOP指标呈正相关的关系。     

牙周基础治疗对Ⅱ型糖尿病伴牙周炎病人糖基化终产物的影响

目的:观察牙周基础治疗对Ⅱ型糖尿病伴慢性牙周炎病人牙周组织和血清中糖基化终产物(advanced glycation end of products,AGEs)变化的长期影响。方法:诊断为Ⅱ型糖尿病并伴有中等程度以上牙周炎的病人30例,分为进行牙周基础治疗的干预组15例(DM1组),未进行牙周基础治疗的未干预组15例(DM2组);分别在初诊和每次复诊治疗前记录2组的探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、空腹血精、AGEs指标。结果:经牙周基础治疗后,DM1组牙周临床指标均有明显改善;2组AGEs水平有不同程度升高(P<0.05);DM1组第21个月AGFs水平显著低于DM2组,有统计学意义(P<0.05)。结论:牙周基础治疗对Ⅱ型糖尿病伴慢性牙周炎病人的PD、AL、血糖水平、AGEs水平有显著的改善(P<0.05),并且有助于长期稳定。     

Periodontal Status Affects C‐Reactive Protein and Lipids in Patients With Stable Heart Disease From a Tertiary Care Cardiovascular Clinic

Background: There are scarce data on the impact of the periodontal condition in the control of biomarkers in patients with cardiovascular disease (CVD). The aim of this study is to assess whether periodontal inflammation and tissue breakdown are associated with C‐reactive protein (CRP) and lipids in patients with stable heart disease. Methods: This cross‐sectional study included 93 patients with stable coronary artery disease (57 males; mean age: 63.5 ± 9.8 years) who were in outpatient care for at least 6 months. After applying a structured questionnaire, periodontal examinations were performed by two calibrated periodontists in six sites per tooth at all teeth. Blood samples were collected from patients on the day of periodontal examination to determine levels of CRP, lipids, and glycated hemoglobin. Multiple linear regression models were fitted to evaluate the association among different periodontal and blood parameters controlling for sex, body mass index, glycated hemoglobin, use of oral hypoglycemic drugs, and smoking. Results: Overall, the sample presented high levels of periodontal inflammation and tissue breakdown. Unadjusted mean concentrations of triglycerides (TGs), very‐low‐density lipoprotein cholesterol, and glucose were significantly higher in individuals with severe periodontitis. When multiple linear regression models were applied, number of teeth with clinical attachment loss ≥6 mm and presence of severe periodontitis were significantly associated with higher CRP concentrations. Bleeding on probing was significantly associated with TGs, total cholesterol, and non‐high‐density lipoprotein cholesterol. Conclusion: In this sample of patients with stable CVD, current periodontal inflammation and tissue breakdown are associated with cardiovascular inflammatory markers, such as CRP and lipid profile.