成人牙周炎治疗前后龈沟液蛋白质的电泳分析

目的通过分析成人牙周炎患者同一位点基础治疗前后１个月龈沟液（ｇｉｎｇｉｖａｌｃｒｅｖｉｃｕｌａｒｆｌｕｉｄ，ＧＣＦ）中蛋白成分的改变，以期发现能够反映牙周健康及疾病状况的特异蛋白。方法采用滤纸条法收集１２例成人牙周炎患者５６个位点ＧＣＦ样本，以十二烷基磺酸钠聚丙烯酰胺凝胶电泳（ＳＤＳＰＡＧＥ）法分离，ＩｍａｇｅＭａｓｔｅｒＴＭ电泳图象分析仪分析其中的蛋白质。结果治疗后蛋白区带数及非血清源低分子量１２０００，１００００蛋白的丰度及百分含量较治疗前显著减少（分别为Ｐ＜０００１和Ｐ＜００５），而３８０００蛋白百分含量呈增加趋势且与治疗前牙周探诊深度和ＧＣＦ量呈负相关（Ｐ＜００５）。结论分子量为１２０００，１００００的蛋白与牙周炎症有关；分子量３８０００的蛋白与疾病的好转有关     

三种牙周炎患者龈沟液中IL—8的检测

目的：探讨ＩＬ－８与不同种类牙周炎的关系，比较三种牙周炎，即青少年牙周炎（ｊｕｖｅｎｉｌｅｐｅｒｉ－ｏｄｏｎｔｉｔｉｓ，ＪＰ），快速进展型牙周炎（ｒａｐｉｄｐｒｏｇｒｅｓｓｉｖｅｐｅｒｉｏｄｏｎｔｉｔｉｓ，ＲＰＰ）和成人牙周炎（ａｄｕｌｔｐｅｒｉｏｄｏｎｔｉｔｉｓ，ＡＰ）龈沟液（ｇｉｎｇｉｖａｌｃｒｅｖｉｃｕｌａｒｆｌｕｉｄ，ＧＣＦ）中ＩＬ－８浓度和检出率。方法：采集ＪＰ、ＲＰＰ和ＡＰ患者ＧＣＦ，用ＥＬＩＳＡ法对ＧＣＦ中ＩＬ－８进行检测。结果：ＡＰ患者ＧＣＦ中ＩＬ－８检出率为６７．８５％，明显高于ＪＰ组、ＲＰＰ组的检出率（分别为３４．４８％、２５％）；ＧＣＦ中ＩＬ－８浓度无明显差别。结论：ＪＰ、ＲＰＰ患牙ＧＣＦ中ＩＬ－８检出率低可能是造成此种牙周炎局部中性粒细胞趋化异常的原因之一。     

牙周病患者龈组织中6－K－PGF_1a放免测定和免疫组化定位及定量分析

本实验采用放射免疫测定法（ＲＩＡ）测定了成人牙周炎（ＡＰ）、青少年牙周炎（ＪＰ）、龈炎（Ｇ）和健康人（Ｈ）（各１０例）龈组织中６－酮－前列腺素Ｆｉａ（６－Ｋ－ＰＧＦ＿１ａ）的含量，用免疫组织化学ＡＢＣ染色对同一标本中的６－Ｋ－ＰＧＦ＿１ａ定位，用显微分光光度计（ＭＳＰ）对染色标本定量，与ＲＩＡ结果比较，以探讨６－Ｋ－ＰＧＦ＿１ａ与牙周病的关系。ＲＩＡ结果表明：牙周病患者龈组织中６－Ｋ－ＰＧＦ１ａ含量从Ｈ、Ｇ、ＡＰ到ＪＰ呈递增趋势，各病变组与Ｈ皆有显著差异，ＪＰ与Ｇ组有显著差异，ＡＰ与Ｐ也有显著差异。ＡＢＣ染色表明龈组织中６－Ｋ－ＰＧＦ＿１ａ主要的分泌细胞为血管内皮细胞、巨噬细胞、浆细胞、多形核白细胞及个别的腺管内皮细胞等。对牙龈组织６－Ｋ－ＰＧＦ＿１ａ的ＭＳＰ定量结果与ＲＩＡ相似，两方法可相互补充。提示对６－Ｋ－ＰＧＦ＿１ａ与牙周病关系的研究有重要意义。     

牙周病患者治疗前后龈沟液中碱性磷酸酶水平的变化

选择牙周健康者（Ｈ）及边缘性龈炎（ＭＧ）、慢性成人牙周炎（ＣＡＰ），快速进展型牙周炎（ＲＰＰ）患者共３５人，２０４颗牙齿，测定其龈沟液（ＧＣＦ）中碱性磷酸酶（ＡＬＰ）的水平。发现牙周组织有破坏的患牙（ＣＡＰ和ＲＰＰ组），其龈沟液（ＧＣＦ）－碱性磷酸酶（ＡＬＰ）水平高于牙周无破坏者（Ｈ和ＭＧ组）ＧＣＦ－ＡＬＰ水平与牙周临床指标呈高度正相关，牙周治疗后临床指标及ＧＣＦ－ＡＬＰ水平均明显下降。提示ＧＣＦ     

龈沟液中TNFα的检测及其与IL—8的关系

目的：对牙周炎患者龈沟液（ＧＣＦ）中ＴＮＦα进行定量分析，初步探讨ＴＮＦα与牙周炎临床指标及ＧＣＦ中ＩＬ－８的关系。方法：采集２３例成人牙周炎患者ＧＣＦ，并记录临床指标：菌斑指数，牙龈指数，牙周袋深和附着水平。用Ｗｈａｔ－ｍａｎⅠ号滤纸条采集ＧＣＦ，通过ＥＬＩＳＡ法对ＧＣＦ中ＴＮＦα进行检测。结果：牙周炎ＧＣＦ中ＴＮＦα的检出率为４４．１２％，含量范围为０．００１～０．０２４ｍｇ／Ｌ，ＧＣＦ中ＴＮＦα含量与牙周附着水平，ＧＣＦ中ＩＬ－８水平相关显著；而健康组ＧＣＦ中ＴＮＦα检出率为０。结论：ＴＮＦα参与牙周炎症反应，并与细胞因子ＩＬ－８有一定的联系。     

细胞间粘附分子1及其受体在成人牙周炎袋上皮区的表达

目的 探讨成人牙周炎牙龈组织中白细胞通过上皮进入龈沟液的粘附机制。方法 采用碱性磷酸酶－抗碱性磷酸酶免疫组化方法，对细胞间粘附分子／白细胞功能相关抗原１在正常牙龈和成人牙周炎牙龈组织中的表达进行研究。结果 正常牙龈和成人牙周炎牙龈的结合上皮，沟内／袋上皮根部均表达ＩＣＡＭ－１，且染色强度呈方向变化；ＬＦＡ－１仅局限表达于白细胞表面，成人牙周炎袋上皮下方结缔组织及袋上皮细胞间隙中ＬＦＡ－１阳性白细胞     

龈沟液中天冬氨酸转氨酶及乳酸脱氢酶水平在牙周炎诊断中的作用

对３０例牙周炎患者的１２０颗牙及９例健康对照者的３６颗牙的龈沟液（Ｇｉｎｇｉｖａｌ Ｇｒｅｖｉｃｕｌａｒ ｆｌｕｉｄ，ＧＣＦ）中天冬氨酸转氨酶（Ａｓｐａｒｔａｔｅ ａｍｔｈｏｒａｎｓｆｅｒａｓｅ，ＡＳＴ）及乳酸脱氢酶（Ｌａｃｔａｔｅ ｄｅｈｙｄｒｏｇｅｎａｓｅ，ＬＤＨ）水平进行了测定，发现牙周炎患者ＧＣＦ－ＡＳＴ及ＧＣＦ－ＬＤＨ水平明显高于健康对照者。并且两种酶水平与牙周临床指标呈高度正相关。提示     

牙周炎患者龈沟液中IL—1活性检测

目的：通过对牙周炎龈沟液（ｇｉｎｇｉｖａｌｃｒｅｖｉｃｕｌａｒｆｌｕｉｄ，ＧＣＦ）中ＩＬ－１活性进行检测，初步探讨ＩＬ－１在牙周炎症中的作用。方法：以成人牙周炎为研究对象，通过细胞检测法对患牙ＧＣＦ中ＩＬ－１活性进行检测。结果：在患牙ＧＣＦ中可测到具有较高活性的ＩＬ－１，而在健康ＧＣＦ中未能测到。结论：牙周炎时局部有活性ＩＬ－１渗出，ＩＬ－１是参与牙周炎症反应的重要细胞因子。     

成人牙周炎患者治疗前后龈沟液中谷胱甘肽过氧化物酶水平的变化

目的：了解谷胱甘肽过氧化物酶（ＧＰｘ）在牙周病变过程中的变化及其临床意义。方法：选择２３例成人牙周炎（ＡＰ）患者的４４颗患牙,记录临床指标ＧＩ、ＰＤ、ＡＬ,并测定治疗前后ＧＣＦ－ＧＰｘ水平。结果：ＧＣＦ－ＧＰｘ与ＰＤ、ＡＬ负相关（Ｐ〈０．０５,Ｐ,０．００５）,与ＧＩ无明显相关性。牙周治疗后临床指标均明显下降（Ｐ〈０．００１）,ＧＣＦ－ＧＰｘ水平明显上升（Ｐ〈０．００１）,但ＧＣＦ－ＧＰＸ水平的上     

牙周病患者牙龈组织前列腺素E_2、血栓素B_2、6－酮－前列腺素F_（1α）水平的研究

采用ＲＩＡ对１１例健康牙龈组织（Ｈ）、１１名龈炎（Ｇ）患者的１７个牙、２６名成人牙周炎（ＡＰ）患者３６个牙和１４名青少年牙周炎（ＪＰ）患者的２０个牙的牙龈组织同时测定ＰＧＥ_２、ＴＸＢ_２、６－Ｋ－ＰＧＦ_（１α）的含量。结果以ＰＧＥ_２最多，ＴＸＢ_２次之，６－Ｋ－ＰＧＦ_（１α）最少；３种前列腺素（ＰＧｓ）均随病变严重程度而增加，除Ｇ组ＴＸＢ_２和６－Ｋ－ＰＧＦ_（１α）与Ｈ组相差显著（Ｐ＜０．０５）外，其余各病变组与Ｈ组比，３种ＰＧｓ均相差非常显著（Ｐ＜０．０１），ＡＰ组和ＪＰ组比Ｇ组也有非常显著升高（Ｐ＜０．００１），而ＡＰ和ＪＰ组间相差不显著（Ｐ＞０．０５），表明３种ＰＧｓ在牙周病发病中具有重要作用。     

不同牙周状态下龈沟液中瘦素水平的比较

目的:检测牙周健康者、慢性龈炎和慢性牙周炎患牙龈沟液中瘦素水平,为牙周炎的早期诊断提供客观指标。方法:选择牙周健康者、慢性龈炎和慢性牙周炎患者3组,治疗前记录牙周各项临床指标,并用Whatman^ 1号滤纸收集颊侧近远中牙周袋内GCF采用ELISA检测瘦素含量;同时收集血清进行瘦素水平的检测。结果:3组中慢性牙周炎组龈沟液中瘦素水平与牙周健康者龈沟液中瘦素水平比较有显著差异(P<0.05),慢性牙周炎组龈沟液中瘦素水平与慢性龈炎龈沟液中瘦素水平及慢性龈炎组龈沟液中瘦素水平与牙周健康者龈沟液中瘦素水平比较均无显著差异;牙周健康者、慢性龈炎和慢性牙周炎患者血液中瘦素水平比较均有显著差异(P<0.05)。血中的瘦素与临床指标PLI (P<0.01,r=0.593)、PD(P<0.05,r=0.920)、BI(P<0.05,r=0.862)、AL(P<0.05,r=0.846)均相关;龈沟液中的瘦素与临床指标PLI(P<0.01,r=0.813)、PD(P<0.05,r=0.962))、BI(P<0.05,r=0.720、AL(P<0.05,r=0.946)均相关。结论:龈沟液中瘦素水平可能是反映牙周组织状况的一项较为客观的指标。     

Effects of phase I periodontal treatment on gingival crevicular fluid levels of matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1

OBJECTIVES: The aim of this study was to evaluate the effects of phase I periodontal treatment on gingival crevicular fluid (GCF) levels of matrix metalloproteinase (MMP)-3 and tissue inhibitors of metalloproteinase (TIMP)-1. METHODS: Plaque index, gingival index, pocket depth and clinical attachment loss were recorded and GCF samples were collected from 20 chronic periodontitis (CP) patients and 20 periodontally healthy controls (C) before treatment. CP patients received phase I periodontal treatment and all clinical parameters were recorded and GCF samples were collected once more after treatment. Assays were performed by an enzyme-linked immunosorbent assay. RESULTS: All of the clinical parameters improved significantly after the therapy (p<0.05). Baseline GCF levels of MMP-3 were significantly higher than C and that level was reduced significantly by treatment compared with baseline levels (p<0.05). Baseline GCF levels of TIMP-1 were lower than post-treatment levels and C (p<0.05). GCF levels of TIMP-1 increased significantly by treatment compared with baseline levels (p<0.05). CONCLUSION: This study shows that the clinical improvements after phase I periodontal therapy are accompanied by reduction in MMP-3 and increasing in TIMP-1 GCF levels.     

Effects of periodontal therapy during pregnancy on periodontal status, biologic parameters, and pregnancy outcomes: a pilot study

BACKGROUND: Few studies have examined the potential effects of periodontal treatment during pregnancy on pregnancy outcomes, periodontal status, and inflammatory biomarkers. METHODS: A randomized, delayed-treatment, controlled pilot trial was conducted to evaluate the effects of second-trimester scaling and root planing and the use of a sonic toothbrush on the rate of preterm delivery (<37 weeks gestation). Secondary outcome measures included changes in periodontal status, levels of eight oral pathogens, levels of gingival crevicular fluid (GCF) interleukin-1beta (IL-1beta), prostaglandin E(2) (PGE(2)), 8-isoprostane (8-iso), and IL-6, and serum levels of IL-6, soluble intercellular adhesion molecule 1 (sICAM1), 8-isoprostane, soluble glycoprotein 130 (sGP130), IL-6 soluble receptor (IL-6sr), and C-reactive protein (CRP). Logistic regression models were used to test for effects of treatment on preterm delivery. Secondary outcomes were analyzed by analysis of covariance adjusting for subject baseline values. RESULTS: Periodontal intervention resulted in a significantly decreased incidence odds ratio (OR) for preterm delivery (OR = 0.26; 95% confidence interval = 0.08 to 0.85), adjusting for baseline periodontal status which was unbalanced after randomization. Pregnancy without periodontal treatment was associated with significant increases in probing depths, plaque scores, GCF IL-1beta, and GCF IL-6 levels. Intervention resulted in significant improvements in clinical status (attachment level, probing depth, plaque, gingivitis, and bleeding on probing scores) and significant decreases in levels of Prevotella nigrescens and Prevotella intermedia, serum IL-6sr, and GCF IL-1beta. CONCLUSIONS: Results from this pilot study (67 subjects) provide further evidence supporting the potential benefits of periodontal treatment on pregnancy outcomes. Treatment was safe, improved periodontal health, and prevented periodontal disease progression. Preliminary data show a 3.8-fold reduction in the rate of preterm delivery, a decrease in periodontal pathogen load, and a decrease in both GCF IL-1beta and serum markers of IL-6 response. However, further studies will be needed to substantiate these early findings.     

吸烟对牙周基础治疗前后龈沟液量和弹性蛋白酶水平的影响

目的　评价吸烟是否影响牙周炎基础治疗前、后龈沟液 (gingivalcrevicularfluid ,GCF)量和龈沟液中弹性蛋白酶 (elastase ,EA)的水平。方法　将 37例男性慢性牙周炎患者分为吸烟组 (2 2例 ,12 2个牙位点 ,每日吸烟≥ 2 0支 )和非吸烟组 (15例 ,90个牙位点 )。牙周炎基础治疗前、后用滤纸条法收集GCF ,用Periotron 6 0 0 0龈沟液测量仪测定GCF量。对吸烟组 92个位点和非吸烟组 6 0个位点GCF样本 ,用底物分解法检测EA水平。结果　治疗前吸烟组GCF量 (139 2± 33 4 )U和EA水平(0 6 34± 0 5 87)明显低于非吸烟组 [GCF量 :(15 5 4± 39 7)U ,EA水平 :0 835± 0 5 72 ],P <0 0 1。治疗后 ,两组GCF量和EA水平均显著降低 (P <0 0 0 1)。但吸烟组 91个位点 (74 6 % )GCF和 70个位点(76 1% )的EA水平治疗后有改善 ;而非吸烟组高达 88个位点 (97 8% )GCF和 5 6个位点 (93 3% )的EA水平有改善 (P <0 0 1)。结论　治疗前探诊深度相同的情况下 ,吸烟组GCF量和EA水平均低于非吸烟组 ,治疗后吸烟组的GCF和EA的减少程度不如非吸烟组明显。     

牙周治疗前后龈沟液中白细胞介素-6水平的变化

目的：探讨牙周洁利治对患牙龈沟液中IL-6水平的影响。方法：选取12例成人牙周炎患者的重度牙周炎换牙12颗,采集治疗前患牙的龈沟液并记录相关的临床指标。然后对患牙进行龈上洁治和龈下刮治,两周后,再次采集患牙的龈沟液并记录相关的临床指标。采用双抗体夹心ELISA法对牙周炎患牙龈沟液中IL-6水平进行检测。比较牙周洁刮治前后龈沟液中IL-6水平的差异。结果：经过牙周洁刮治,患牙龈沟中IL-6的水平明显降低,同时患牙的牙周临床指标也有明显的改善。结论：牙周基础治疗在缓解牙周炎患牙局部炎症的同时,也对患牙局部的IL-6水平产生明显影响。     

Expression of Protease Activated Receptor‐1 in Chronic Periodontitis

Background: Protease activated receptor‐1 (PAR₁) activation by thrombin may play a role in repair and homeostasis of periodontal tissues. The main objective of this study is to investigate PAR₁ expression in patients with periodontitis, before and after non‐surgical periodontal treatment, and to associate its expression with the presence of inflammatory biomarkers and PAR₂ expression. Methods: Gingival crevicular fluid (GCF) samples and clinical parameters, including probing depth, clinical attachment level, bleeding on probing, and gingival and plaque indices, were collected from periodontally healthy individuals and patients with moderate chronic periodontitis (CP) before and 6 weeks after periodontal non‐surgical treatment. PAR₁ and PAR₂ messenger RNA (mRNA) at the GCF were evaluated by quantitative polymerase chain reaction (qPCR). Flow cytometry analysis identified the GCF PAR₁‐expressing cells. GCF inflammatory biomarkers were also determined. Results: Clinical parameters were significantly improved after therapy (P <0.01). The qPCR analysis showed that, before therapy, PAR₁ mRNA levels in CP were similar to controls. Periodontal treatment led to increased PAR₁ expression in CP (P <0.05). PAR₁ expression was inversely correlated to PAR₂ expression and with interleukins 6 and 8, tumor necrosis factor‐α, interferon‐γ, and matrix metalloproteinase‐2 levels. Conclusions: Periodontal treatment results in PAR₁ overexpression in the GCF, and PAR₁ expression is associated with decreased expression of inflammatory biomarkers and inversely correlated to PAR₂ expression in the GCF. Therefore, the data suggest the importance of PAR₁ mediating the known anabolic actions of thrombin in the periodontium.     

Gingival crevicular fluid VEGF levels in periodontal health and disease

BACKGROUND: Vascular endothelial growth factor (VEGF), a glycoprotein, has attracted attention as a potential inducer of angiogenesis. It is detectable in periodontal tissues within endothelial cells, plasma cells, and macrophages and in junctional, sulcular, and gingival epithelium. In periodontitis patients, the volume of gingival crevicular fluid (GCF) and the total amount of VEGF collected from diseased sites were greater than from clinically healthy sites. The aim of the present study was to investigate the role of VEGF in periodontal disease progression and to investigate the effect of periodontal therapy on VEGF concentrations in GCF. METHODS: Forty-five subjects were divided into three groups based on gingival index, clinical attachment loss, and radiographic evidence of alveolar bone loss: healthy (group 1), gingivitis (group 2), and chronic periodontitis (group 3). A fourth group consisted of subjects from group 3, 8 weeks after treatment (scaling and root planing). GCF samples collected from each patient were quantified for VEGF levels using enzyme-linked immunosorbent assay. Further, the correlation between VEGF levels in situ and the clinical parameters was analyzed in all groups and was analyzed before and after treatment in the periodontitis group. RESULTS: The highest mean VEGF concentration (99.375 pg/ml) was observed in group 3, and the lowest was observed in group 1 (42.025 pg/ml). Its mean level in group 3 decreased to 54.60 pg/ml after treatment (group 4). Further, GCF VEGF levels showed a positive correlation with all of the clinical parameters. CONCLUSIONS: VEGF levels in GCF increased from health to periodontitis, and periodontal treatment resulted in a reduction in their concentrations. These data indicated that VEGF plays a key role in periodontal disease progression and can be considered a biomarker of periodontal disease progression.     

慢性牙周炎患者基础治疗前后龈沟液中瘦素水平变化的研究

目的：检测慢性牙周炎患者牙周基础治疗前后龈沟液中瘦素水平的变化。方法：选择轻、中、重度牙周炎患者共3组,每组11人,基础治疗前后收集龈沟液,采用酶联免疫法（Enzyme-Linked ImmunoSorbent Assay,ELISA）检测瘦素含量。结果：3组患者牙周基础治疗后龈沟液中瘦素水平均明显高于治疗前（P＜0.01）;瘦素与轻度牙周炎组治疗前的出血指数正相关（r=0.675）（P＜0.05）,与重度牙周炎组治疗前的探诊深度负相关（r=-0.799）（P＜0.01）;重度牙周炎组治疗后比治疗前的探诊深度减小（P＜0.01）,附着丧失减小（P＜0.05）。结论：龈沟液中瘦素含量变化与牙周炎的基础治疗密切相关,可以通过测定瘦素水平评估牙周炎治疗的临床疗效。     

牙周炎患者治疗前后龈沟液中谷胱甘肽过氧化物酶及超氧化物歧化酶变化的研究

目的　了解成人牙周炎患者治疗前后龈沟液 (GCF)中谷胱甘肽过氧化物酶 (GPx)和超氧化物歧化酶 (SOD)的变化。探讨其与牙周病的关系。方法　采用常规滤纸条法收集成人牙周炎患者治疗前后的GCF样本 ,用DTNB显色法测定GCF -GPx活性 ,用放免法测定SOD活性。结果　治疗后GCF -GPx活性和GCF -SOD活性分别为 (4 0 3 35± 12 1 2 3)U ,(7 6 0± 0 89)U ,GPx活性与探诊深度、附着丧失呈负相关 (r=0 30 6 ,P <0 0 5 ;r=0 4 2 5 ,P <0 0 5 )。结论　GCF中GPx和SOD活性高低可作为评价牙周炎症状的一项较为敏感和客观的实验指标。并提示牙周炎可能是局部自由基产生消除失衡的结果 ,牙周局部存在抗氧化能力下降。     

基础治疗对侵袭性牙周炎患者龈沟液骨钙素水平的影响

目的观察牙周基础治疗对侵袭性牙周炎患者的牙周临床指标及龈沟液骨钙素水平的影响。方法检测20例侵袭性牙周炎患者60颗牙齿牙周治疗前和治疗后4周的牙周临床指标,采用电化学发光法检测治疗前后龈沟液中的骨钙素水平。并与20例牙周健康对照组的60颗牙齿对照。结果实验组龈沟液骨钙素水平明显高于对照组;牙周治疗后实验组骨钙素较治疗前明显降低(P<0.05)。结论牙周基础治疗能明显改善侵袭性牙周炎的临床指数,降低龈沟液骨钙素含量。