牙冠轴面突度的变化对牙周组织健康的影响

目的　研究不同程度增加牙冠轴面突度对牙周龈沟液量 (GCF)、龈沟液中天冬氨酸转氨酶 (GCF AST)、碱性磷酸酶 (GCF ALP)水平及软垢堆积水平的影响。方法　将牙冠颊面分别增加0 2mm、0 5mm和 0 8mm ,于 1、4和 8周时测量龈沟液量 ,检测GCF AST、GCF ALP水平 ,记录软垢堆积水平。结果　牙冠轴面突度增加 0 2mm ,各指标没有明显变化 ;增加 0 5mm ,GCF AST水平明显增加 ;增加 0 8mm ,GCF AST、GCF ALP水平增加显著。结论　牙冠轴面突度增加不利牙周健康 ,增加越大 ,牙周健康受到的损害越大     

激光联用洁治改善固定正畸患者牙周状况的临床研究

目的:评价Nd:YAG激光辅助改善固定正畸患者牙周状况的效果.方法:选择60例接受固定正畸治疗的男性患者,以右下颌第一磨牙为实验牙,左下颌第一磨牙为对照牙,分别比较它们在正畸治疗开始前、激光、超声洁牙和两者联用治疗前以及3种治疗1周和6个月后的龈沟液(GCF)量、天门冬氨酸氨基转移酶(AST)与碱性磷酸酶(ALP)水平的变化.结果:激光治疗、超声洁治术以及两者联用均能在短期内降低GCF量、ALP及AST水平(P＜0.05),但激光治疗和两者联用后局部GCF量、AST及AL P水平较超声洁牙后降幅更大(P＜0.05);3组6个月后GCF量、ALP及AST水平均有所提高(P＜0.05),但联用组提高较少(P＜0.05).结论:Nd:YAG激光可应用于固定正畸患者以改善其牙周状况,若能配合超声洁治,效果更理想.     

3种全冠修复体对基牙龈沟液中酶水平的影响

目的:探讨3 种不同材料的全冠修复体对基牙龈沟液(GCF)中的天冬氨酸转氨酶(AST)和碱性磷酸酶(ALP)水平的影响.方法:选择临床病例30 例,分为3 组,分别采用钴铬合金烤瓷冠、纯钛烤瓷冠、全瓷冠修复.在修复前、修复后1、 3、 6 个月分别进行GCF量和AST、ALP总量的测定及分析.结果:修复前及修复后1 个月时, 3 组之间各检测指标无明显差异;修复后3、6 个月时钴铬合金烤瓷冠组的GCF、AST、ALP值均高于纯钛烤瓷冠和全瓷冠组;而纯钛烤瓷冠组与全瓷组的GCF、AST、ALP值无显著变化且2 组之间各项指标无明显差异.结论:临床合格的钴铬合金烤瓷冠可导致GCF量及其成分变化,对牙周组织有一定的不利影响,而纯钛烤瓷冠和全瓷冠对牙周组织健康的影响相对较小.     

取样方法的比较及其对龈沟液酶水平的影响

目的观察重复取样后两次样本的碱性磷酸酶（ａｌｋａｌｉｎｅｐｈｏｓｐｈａｔａｓｅ，ＡＬＰ）水平的变化，比较袋口和袋内两种取样方法。方法分别用袋口和袋内法间隔２０ｍｉｎ重复取龈沟液（ｇｉｎｇｉｖａｌｃｒｅｖｉｃｕ－ｌａｒｆｌｕｉｄ，ＧＣＦ）样本，并测定其中的ＡＬＰ水平。结果两种方法取样示，２０ｍｉｎ后的ＡＬＰ水平与第１次相比差异无显著性（Ｐ＞０．０５）；袋内法获得的ＡＬＰ水平明显高于袋口法（Ｐ＜０．００１）；重复取样后，多数位点ＡＬＰ水平不能完全恢复，但袋内法略优于袋口法，用酶总量表达略优于用浓度表达。结论重复取样的间隔期宜超过２０ｍｉｎ；建议用袋内法取样测定ＡＬＰ水平并以酶总量表示为佳。     

微种植体支抗压低伸长磨牙对患者龈沟液中AST及ALP活性水平的影响

目的:探讨应用种植体支抗压低磨牙,对龈沟液(GCF)内天冬氨酸转氨酶(AST)及碱性磷酸酶(ALP)活性水平的影响.方法:纳入我院口腔正畸科就诊的需要压低伸长磨牙26颗(患者26例)分成2组:一组采用德国非凡公司的mandica微螺钉(13例),另一组采用中国陕西中邦微螺钉(13例).压低力值为1.47 ～1.96 N.压入量为3～5 mm.每名患者一侧第一或第二磨牙为压低组,以对侧同名牙为对照组,以对颌同名牙为空白对照组.分别收集全部样本在加力前、加力后24 h、48 h、7d、14 d和28 d、3月、6月时磨牙近远中龈沟内GCF,用全自动生化分析仪测定GCF中ALP和AST的水平,应用方差分析对数据进行统计学处理.结果:不同阶段时龈沟液内ALP的水平相比治疗前明显升高,28 d时达到高峰,3、6个月后也有所增加,但是与28 d无统计差别.龈沟液内AST的水平相比治疗前明显升高,3个月达到高峰.各时间段两组种植钉间龈沟液中AST及ALP活性水平改变无明显差异.结论:压低磨牙可引起受力牙龈沟液AST、ALP水平改变.     

固定矫治器对错患者龈沟液量和酶水平的影响

本研究的目的是明确在没有正畸力的条件下固定矫治器是否影响牙周健康。采用“滤纸条”法 ,观察 16例错患者在除外正畸力的前提下 ,固定矫治器放置前后龈沟液 (gingival crevicular fluid,GCF)量、GCF中天冬氨酸转氨酶 (aspartate aminortransferase,AST)、碱性磷酸酶 (alkaine phosphatate,ALP)水平的变化。结果显示固定矫治器的放置可引起 GCF量的显著性增加 (P<0 .0 0 1)和 GCF中 AST、ALP水平的显著性增加 (P<0 .0 0 1)。从而得出结论固定矫治器的放置可通过影响口腔卫生而对牙周健康产生不利影响 ,因此对接受正畸治疗的人群进行规范的口腔卫生宣教 ,使其有效地控制菌斑至关重要。     

三种金属烤瓷冠对基牙牙周组织影响的定量研究

目的研究3种金属烤瓷冠对基牙龈沟液（gingival crevicular fluid,GCF）量、GCF中天冬氨酸转氨酶（aspartate aminotransferase,AST）和碱性磷酸酶（alkalinephosphatase,ALP）水平的影响。方法磨牙行烤瓷单冠修复的患者90例,分成3组,分别行镍铬合金、钴铬合金、金合金烤瓷冠修复,于修复前及修复后1周、1个月、6个月检测基牙GCF量、GCF中AST和ALP活性水平。结果3组修复前GCF量、龈沟液AST活性、龈沟液ALP活性的差异无统计学意义（P〉0.05）。镍铬合金组修复后1周、1个月和6个月的GCF量（t=2.738、t=2.694、t=2.501,P〈0.05）、龈沟液AST活性（t=2.537、t=2.463、t=2.389,P〈0.05）、龈沟液ALP活性（t=2.359、t=2.278、t=2.046,P〈0.05）较修复前均增加。钴铬合金组修复后6个月,GCF量（t=0.791）、龈沟液AST活性（t=1.380）、龈沟液ALP活性（t=1.195）与修复前的差异无统计学意义（P〉0.05）。金合金组修复后1个月,GCF量（t=0.759）、龈沟液AST活性（t=1.431）、龈沟液ALP活性（t=1.106）同修复前的差异无统计学意义（P〉0.05）。结论金合金是理想的金属烤瓷冠材料,钴铬合金烤瓷冠对牙周健康影响较小。     

三种不同材料烤瓷冠对龈沟液内天冬氨酸转氨酶和碱性磷酸酶水平的影响

目的:通过对不同材料的烤瓷冠修复后龈沟液(gingivalcrevicularfluid,GCF)内天冬氨酸转氨酶(aspartatetransaminase,AST)和碱性磷酸酶(alkalinephosphatase,ALP)总量的测定,来探讨内冠材料对牙周的影响。方法:选择临床病例26例,采用镍铬合金烤瓷冠、钛合金烤瓷冠和金铂合金烤瓷冠修复,分别在修复前、修复后1个月和3个月进行临床检查和取GCF,进行GCF量和AST、ALP总量的测定,从而进行分析。结果:1个月时,3组之间并未见指标差异;3个月时镍铬合金组和钛合金组之间未见指标差异,此时镍铬合金组和钛合金组分别与金铂合金组在指标上均有明显差异。结论:非贵金属对牙周组织有不利影响,同时通过测定GCF中AST和ALP的总量,可以方便的动态观察烤瓷冠对牙周的影响。     

钴铬合金烤瓷冠对龈沟液中天冬氨酸转氨酶和碱性磷酸酶的影响

目的探讨钴铬合金烤瓷冠修复后,患牙龈沟液（GCF）的质量及GCF中天冬氨酸转氨酶（AST）和碱性磷酸酶（ALP）的变化,以评价钴铬合金作为烤瓷冠内冠材料对牙周组织的影响。方法经患者知情同意,选取采用钴铬合金烤瓷冠修复并符合纳入标准的30例患者的30颗患牙,分别采集修复前、修复后1个月、修复后3个月所有修复患牙及修复前、修复后3个月对侧同名牙的GCF并称其质量,同时检测GCF内AST和ALP的水平,对不同时间的检测结果进行对比分析。结果钴铬合金烤瓷冠修复不同时间内,修复患牙GCF量、AST和ALP的差异均有统计学意义。经两两比较,GCF量和AST在3个阶段的差异均有统计学意义,术前、术后1个月、术后3个月依次升高（P＜0.05）;ALP术前与术后3个月比较,其差异有统计学意义（P＜0.05）,术后3个月高于术前。修复患牙与对侧同名牙的GCF量、AST、ALP相比较,修复术前的差异均无统计学意义（P＞0.05）,而术后3个月的差异均有统计学意义（P＜0.05）。结论在修复术后3个月内,钴铬合金烤瓷冠可造成修复患牙的GCF量、AST和ALP的增加,在一定程度上对牙周健康有不良的影响。     

钴铬合金、纯钛及全瓷冠种植体周围龈沟液中ALP、AST的表达

目的:探讨3种不同材料的全冠修复体在种植体周围组织龈沟液(GCF)、牙龈指数(gingival index,GI)、牙龈龈沟探诊深度(gingival crevice depth,GCD)变化及GCF中天冬氨酸转氨酶(AST)和碱性磷酸酶(ALP)水平,以评价不同烤瓷内冠材料对种植体周围牙周组织的影响.方法:经患者知情同意,随机选择临床病例90颗,平均分为3组,分别采用钴铬合金烤瓷冠,纯钛烤瓷冠,全瓷冠作为种植体上部修复材料,每组30颗.在修复前,后1个月、3个月,分别进行CGF量、GI、GCD、AST和ALP水平的测定和分析.结果:钴铬合金组、纯钛组、全瓷冠组术前龈沟液中各指标间差异均无统计学意义(P＞0.05),钴铬合金组,纯钛组,全瓷冠组修复术前、后1个月,3个月龈沟液中GCF量、GI、GCD、AST、ALP各指标间差异均有统计学意义(P＜0.05).术后1个月ALP、AST在钴铬合金组、全瓷组及纯钛组间差异均有统计学意义差别(P＜0.05),而GCF、GI、GCD组间差异均无统计学意义(P＞0.05);术后3个月,钴铬合金组、全瓷组、纯钛组各指标间差异均有统计学意义(P＜0.05).GCF、GI、GCD、AST、ALP分别进行三组间两两比较,GCF、GCD、AST、ALP各对比组间差异均有统计学意义(P＜0.05),但GI三组间两两比较全瓷组与钴铬合金组差异有统计学意义(P＜0.05),与其他对比组差异均无统计学意义(P＞0.05).结论:钴铬合金烤瓷冠可导致修复患牙的GCF量及其中酶的变化,对牙周组织有不利影响,纯钛烤瓷冠和全瓷冠对牙周组织的影响相对较小.     

The effect of sequential sampling on crevicular fluid volume and enzyme activity

Gingival crevicular fluid (GCF) volume and constituents in static samples were compared to volume and constituents in subsequent GCF samples collected during a 60-min interval. Using deep intracrevicular placement of precut filter paper strips, GCF was collected from interproximal and facial sites from patients with gingivitis (N = 14; 28 interproximal sites, 28 facial sites) and chronic adult periodontitis (N = 11; 26 interproximal sites, 18 facial sites). The strips were inserted for 30 s at 0, 4, 8, 30 and 60 min. The amount of fluid on each strip was determined and microspectrophotometric techniques were used to assess cytoplasmic and lysosomal enzyme activity. Within each group of sites, mean GCF volume showed minimal fluctuation with repeated sampling. In contrast, the static GCF sample contained the greatest amount of total enzyme activity, and differences were detected between groups. The interproximal sites and the gingivitis-facial sites displayed a similar pattern of change in total enzyme activity during the test period. The highest total enzyme activity was observed in the first sample and decreased at 4 and 8 minutes. At 30 and 60 min, the amount of enzyme either remained at the level detected at 8 min, or displayed a mild tendency to recover towards baseline. A different pattern of total enzyme activity was observed for the periodontitis-facial sites, where a significant decrease was first observed at 30 min. Enzyme concentration was higher in the facial sites than the interproximal sites, and enzyme concentration was generally highest in the static samples. The concentration data, however, is difficult to interpret since a number of sites demonstrated a converted GCF volume of 0 microliter. Our data suggests that total enzyme activity and enzyme concentration are generally greater in the static GCF samples compared to subsequent samples.(ABSTRACT TRUNCATED AT 250 WORDS)     

Crevicular fluid myeloperoxidase at healthy, gingivitis and periodontitis sites

The volume and myeloperoxidase (MPO) activity of gingival crevicular fluid (GCF) collected with filter paper strips for 30 s from the sulcus of healthy, gingivitis and periodontitis sites of Chinese subjects were measured. MPO/site and MPO/microliter GCF were both greater at gingivitis and periodontitis sites than at healthy sites. Enzyme activity was similar at the 2 categories of diseased sites. Mean GCF volume and MPO activity were calculated for all samples from healthy, gingivitis and periodontitis sites with GI 0, 1, 2 and 0 + 1. GCF volume, MPO/site and MPO/microliter GCF all were greater at GI 2 than GI 0 or 0 + 1. These data indicate that increased GCF MPO previously observed at periodontitis sites is not specific to such sites. Rather increased GCF MPO likely occurs when additional polymorphonuclear leukocytes enter the sulcus as a result of gingival inflammation. A second sample was obtained from 22 sites 4 weeks after the initial collection. These samples were collected for 5 s rather than 30 s. The GCF volume, MPO/site and MPO/microliters GCF were each greater in samples collected for 30 s rather than 5 s. Correlation coefficients showed that the amount of GCF and MPO activity of the fluid collected for 5 s and 30 s was dependent upon the site even though the 5-s and 30-s samples were collected 4 weeks apart.     

Crevicular fluid myeloperoxidase and periodontitis disease

The volume and myeloperoxidase (MPO) activity of gingival crevicular fluid (GCF) collected with filter paper strips for 30 sec from the sulcus of healthy, gingivitis and periodontitis sites of Chinese subjects were measured. MPO/site and MPO/microliter GCF were both greater at gingivitis and periodontitis sites than healthy sites. Enzyme activity was similar at the 2 categories of diseased sites. Mean GCF volume and MPO activity of the samples were calculated for all sites with GI 0, 1, 2 and 0 + 1 irrespective of experimental group assignment. GCF volume MPO/site and MPO/microliter GCF all were greater at GI 2 than GI 0 or 0 + 1. These data indicate that increased GCF MPO previously observed at periodontitis sites is not specific to these sites. Rather, increased GCF MPO likely occurs when additional polymorphonuclear leukocytes enter the sulcus as a result of gingival inflammation. A second sample was obtained from 22 sites 4 weeks after the initial collection. These samples were collected for 5 rather than 30 sec. The GCF volume, MPO/site and MPO/microliter GCF each were greater in samples collected for 30 rather than 5 sec. Correlation coefficients showed that the amount of GCF and MPO activity of the fluid collected for 5 and 30 sec was dependent upon the site even though the samples were collected at different times.     

Enzyme activity in human gingival crevicular fluid: considerations in data reporting based on analysis of individual crevicular sites

Using a reproducible approach to collection, processing and analysis of gingival crevicular fluid (GCF), this study examined 284 fluid samples from individual crevicular sites for the presence of the enzymes lactate dehydrogenase (LDH), B-glucuronidase (BG) and arylsulfatase (AS). 88 of the sites were from periodontally healthy individuals (probing depth 1-3 mm), while 98 sites from patients with periodontitis were examined before and 2 weeks after scaling and root planing (probing depths 1-3 mm, 4-6 mm and 7-10 mm). This study demonstrated the sensitivity of the enzyme assays. When GCF was collected with a 30-s insertion of the filter strip, 90% of the sites from the control subjects demonstrated LDH activity, 85% demonstrated BG activity and 73% demonstrated AS activity. For the 1-3 mm sites from the patients with periodontitis, 100% of sites from which fluid was collected demonstrated LDH and BG activity, and 90% of sites had AS activity before therapy. After therapy, 100% of sites demonstrated LDH activity, 90% had BG activity and 83% had AS activity. All sites in the 4-6 mm and 7-10 mm categories demonstrated activity of all 3 enzymes. The data were analyzed in terms of enzyme activity/30-s sample and as concentration of enzyme in a standard volume of GCF. Enzyme activity/30-s sample was a different and possibly more sensitive indicator of periodontal pathology than standard clinical parameters. There was a disassociation between clinical parameters and the data for enzyme analysis when it was reported as concentration.     

Effect of sampling time and repetition on gingival crevicular fluid and aspartate aminotransferase activity

Tests based on the composition of gingival crevicular fluid (GCF) for detection of active periodontitis require a better understanding of sampling variables than currently exists. We have studied the effects of sample time and repetition on the presence and activity of aspartate aminotransferase (AST). Two 30-second samples of GCF were harvested within 10-minute intervals from 192 teeth with periodontitis. GCF sample size and AST activity were measured. GCF volume and AST activity of first samples were each approximately 10% greater than for second samples. The differences were significant. AST activity correlated positively with gingival index scores and probing pocket depth. Samples were also harvested from groups of 4 teeth during 5-, 10-, 20- and 30-s periods with 1-min intervals and varying sample order. For these samples, first samples contained the greatest amount of enzyme activity, regardless of sample time. When only first samples were considered, the 5- and 10-s samples showed more total activity than the 20- and 30-s samples, and differences were statistically significant. Flow rate for the 5-s sample was always higher than for all other samples, regardless of its position in the sampling sequence. Our observations are consistent with the existence of a reservoir of AST activity that is, in major part, depleted during the first 5 to 10 s of sampling, and that requires a time period of more than 10 min to reequilibrate. Five- to 10-s samples may distinguish active disease better than 20- or 30-s samples, since most of the activity is taken onto the strip in the first few seconds, and the activity is subsequently partly inactivated or diluted by the uptake of fluid less rich in enzyme activity.     

龈沟液中天冬氨酸转氨酶和碱性磷酸酶水平相关性的研究

目的　观察成人牙周炎龈沟液中天冬氨酸转氨酶 (AST)和碱性磷酸酶 (ALP)水平的相关性 ,并探讨两种酶在牙周炎活动性诊断中的意义。方法　利用全自动生化分析仪检测 6 0例成人牙周炎患者共 72个位点、15例健康对照 15个位点龈沟液中AST、ALP水平 ,并进行分析。结果　成人牙周炎患者龈沟液中AST、ALP两种酶之间具有一定的相关性 ,二者均与探诊深度、附着丧失、牙龈指数呈正相关关系 ,其中总量与临床指标相关性更高。结论　龈沟液中AST、ALP浓度和总量 (特别是总量 )均反映牙周炎的严重程度 ,可用于牙周炎活动性的监测。     

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。     

Aspartate aminotransferase levels in gingival crevicular fluid before and after initial periodontal treatment

The present study investigates the presence of the enzyme aspartate aminotransferase (AST) in the gingival crevicular fluid (GCF) of untreated periodontal patients and determines the alterations in enzyme activity after the initial phase of periodontal treatment. From 12 patients suffering from advanced periodontitis, 54 pockets exhibiting severe attachment loss and depth > 4 mm were selected. Measurements of pocket depth (PD), attachment level (AL) and bleeding upon probing (BOP) were undertaken. For the GCF collection, sterile strips were gently placed at the previously isolated gingival crevice for 30 seconds and afterwards the GCF volume was determined with a Periotron 6000. The AST measurements were based on the establishment absorbency coefficient of NADH. The rate of decrease in the concentration of NADH is directly proportional to the AST activity in the sample. Four weeks after completion of the initial treatment, the patients were re-examined and the same clinical and laboratory measurements were performed. The parameters obtained were statistically analysed. The clinical parameters showed a statistically significant improvement, while the laboratory data expressed a statistically significant decrease of GCF volume as expected. Further, the sites were divided in two groups--pathological (pi) and physiological (phi)--according to Persson and Page (1991). After treatment a marked improvement concerning these values was noticed and it was noteworthy that these alterations occured regardless of initial AST presence.     

Prediction and diagnosis of attachment loss by enhanced chemiluminescent assay of crevicular fluid alkaline phosphatase levels

The current study aimed to apply a novel enhanced chemiluminescence assay in the analysis of gingival crevicular fluid (GCF) alkaline phosphatase (ALP) levels from patients with untreated adult periodontitis. 3666 sites in 25 patients were monitored prior to and after attachment loss was detected with a Florida disc probe. Parameters assessed were, relative attachment level, probing pocket depth, occurrence of bleeding on probing (single episode), GCF volume (microliter), total ALP levels (microIU/30 s sample time) and ALP concentration (IU/l). After recruiting patients to the study, all measures were taken at baseline and 3 months later, prior to the institution of non-surgical periodontal therapy at active sites. Thresholds for determining attachment loss were calculated using a modification of the tolerance method. The mesio-buccal sites of all teeth had GCF samples collected. The size of individual patient thresholds used to define whether attachment loss had occurred, was dependent upon the discomfort felt by that patient during electronic probing, with a positive correlation existing between discomfort on probing (10 cm visual analogue scale) and threshold size (R = 0.52, p < 0.049). A total of 274 sites (7.5%) experienced attachment loss of which 39 sites had GCF samples available for analysis. Total ALP levels were significantly higher at baseline for sites that progressed to attachment loss than paired controls (p < 0.003), but all other parameters showed no differences (p > 0.1). There were significant increases in total ALP levels and GCF volumes for active sites between baseline and 3 month measures (p < 0.01), but not for control sites or test site ALP concentration (p > 0.8). The diagnostic accuracy for GCF ALP as a predictor of future attachment loss (threshold 900 microIU/30 s) was 64%, with +ve and -ve predictive values of 62% and 68%. When a threshold of 1300 microIU/30 s was selected for ALP as a marker of recent or currently active disease, diagnostic accuracy and +ve/-ve predictive values were 77% and 77%/76%, respectively. These results indicate that total GCF ALP levels may serve as a predictor of future or current disease activity.