Er: YAG激光对2型糖尿病相关性牙周炎患者龈下菌群动态变化的研究

目的 动态观察2型糖尿病相关性牙周炎患者经Er: YAG激光治疗前后龈下菌群的变化,并与不伴全身疾病的慢性牙周炎龈下菌群进行比较。方法 收集11例2型糖尿病相关性牙周炎患者的13对患牙（26个位点）作为试验组,分别进行Er: YAG激光治疗和超声治疗,采集治疗前及治疗后1、3个月的龈下菌斑;同时收集11例牙周状况相近的不伴全身疾病的中重度慢性牙周炎患者13个位点的龈下菌斑作为对照组,分析试验组是否有菌群种类变化。提取龈下菌斑DNA,进行变性梯度凝胶电泳分离及条带回收测序。结果 试验组与对照组患牙龈下菌斑的优势致病菌存在差异,分别为中间普雷沃菌和福赛斯坦纳菌。激光组治疗前后龈下菌群构成也发生改变,治疗后1个月,有的条带表达减弱或消失,并有新条带出现;测序结果表明,新出现的条带为放线菌的一种,减弱、消失的为福赛斯坦纳菌。结论 Er: YAG激光治疗前后龈下菌群的构成发生变化,治疗后1个月是关键时期;治疗后3个月,激光治疗在阻止细菌再定植方面可能更具优势。     

牙周炎患者龈下菌斑菌群的高通量测序分析

目的利用高通量测序(high?throughput sequencing,HTS)分析广泛型侵袭性牙周炎(generalized ag?gressive periodontitis,GAgP)和重度慢性牙周炎(severe chronic periodontitis,SCP)龈下菌群的组成,利用生物信息学分析其多样性及功能,并观察牙周基础治疗前后龈下菌群的变化。方法选择2018年9月至2019年5月在昆明医科大学附属口腔医院牙周病科就诊的11例GAgP患者和14例SCP患者作为研究对象。在基线及牙周基础治疗后第6周采集龈下菌斑样本并提取DNA,进行MiSeq测序,采用QIIME(quantitative insights in mi?crobial ecology)、Mothur及SPSS等软件分析群落信息,并进行LEfSe差异分析(linear discriminant analysis Effect size,LEfSe)、Network网络分析,使用KEGG PATHWAY数据库(https://www.kegg.jp/kegg/pathway.html)对群落功能进行预测。结果基线时,GAgP和SCP患者的优势菌群相似,均包括拟杆菌门、卟啉单胞菌属和牙髓卟啉单胞菌等。治疗后第6周,GAgP和SCP患者菌群变化相似,由于牙周袋变浅,拟杆菌门、卟啉单胞菌属和牙髓卟啉单胞菌等革兰阴性菌相对丰度降低,变形菌门、放线菌属和空间罗氏菌等革兰阳性菌相对丰度增加;其中放线菌是GAgP治疗后龈下菌群中显著增加的生物标志物;链球菌属是联系牙周炎相关菌属和牙周健康相关菌属的重要菌属。群落功能预测表明基础治疗可降低GAgP和SCP患者群落中的氨基酸代谢、甲烷代谢和肽酶等功能。结论GAgP和SCP患者的龈下菌群相似,链球菌属作为早期定植菌,在龈下菌群由健康向失调转变的过程中可能发挥着促使菌斑生物膜形成及成熟的重要作用;牙周基础治疗可以改变GAgP和SCP患者龈下菌群的组成和结构,降低群落多样性,降低氨基酸代谢、甲烷代谢和肽酶等群落功能。     

Ⅱ型糖尿病合并牙周炎患者龈下菌斑微生物群落分析

目的：本研究旨在比较Ⅱ型糖尿病合并慢性牙周炎患者与无糖尿病的牙周炎患者龈下菌斑微生物构成。方法：12名患者分为糖尿病合并慢性牙周炎组（T2DM＋CP组）与慢性牙周炎组（CP组）2组,各6人。记录所有患者基本信息及牙周临床参数,包括年龄、性别、探诊深度和附着丧失。根据探诊深度和附着丧失取患病位点的菌斑样本。PCR检测7种牙周可疑致病菌。采用DGGE分离扩增的16SrDNA片段。结果：两组结果显示两组牙周参数无显著差异。两组7种细菌检出率相似。所有对象中均检出牙龈卟啉单胞菌、福塞坦氏菌、齿垢密螺旋体和中间普氏菌,而具核梭杆菌在两组中均有一个样本未检出。变黑普氏菌在T2DM＋CP组的2个样本中检出,而CP组有4个样本检出。伴放线共聚菌在所有样本中均未检测到。DGGE分析结果示两组间条带数量及树状聚类分析均无显著差异。结论：Ⅱ型糖尿病合并牙周炎患者龈下菌斑的牙周可疑致病菌的检出情况以及DGGE分析与无糖尿病患者相似。     

2型糖尿病患者慢性牙周炎细菌学研究

目的 :研究 2型糖尿病患者慢性牙周炎的龈下菌群以及菌群变化与血糖、糖化血红蛋白的关系。方法 :细菌学厌氧培养、PCR检测技术。结果 :2型糖尿病患者慢性牙周炎的龈下菌群以厌氧菌为主。产黑菌、二氧化碳噬纤维菌数量与糖尿病患者空腹血糖、糖化血红蛋白之间存在正相关关系。产黑菌、二氧化碳噬纤维菌数量随患者空腹血糖、糖化血红蛋白的升高而增加。结论 :2型糖尿病慢性牙周炎患者龈下菌斑相关菌与血糖、糖化血红蛋白变化密切相关     

牙周炎患者健康部位与病变部位龈下菌群细菌学研究

本研究着重比较牙周炎患者病变部位与健康部位龈下菌群的细菌组成差异,寻找优势菌及其相互关系.结果显示血链球菌是健康部位主要优势菌,血链球菌与产黑色素G~-厌氧杆菌部位百分比呈负相关,牙周可疑致病菌之间呈正相关关系.比较同一患者病变部位与健康部位龈下菌群变化,对研究牙周微生态环境有指导意义.     

慢性牙周炎与2型糖尿病的关系研究进展

慢性牙周炎（chronic periodontitis,CP）与糖尿病（diabetes mellitus,DM）关系密切,其相互影响是近年来牙周医学研究的热点。DM是CP的危险因素之一,可通过多种机制促进CP发生发展,同时CP也是DM的第6大并发症,可影响DM病程进展,约90%以上的DM为2型糖尿病（type 2 diabetes mellitus,T2DM）,本文就CP和T2DM相互影响的特点及机制等方面的研究进展作一综述。     

侵袭性牙周炎和慢性牙周炎的龈下优势菌分析

目的 :分析侵袭性牙周炎 (aggressiveperiodontitis ,AgP)与慢性牙周炎 (chronicperiodontitis ,CP)的龈下优势菌群 ,为探讨牙周炎分类、病因和诊断提供实验依据。方法 :将中学生流调筛选 (16例 )及牙周病专科就诊(2 4例 )的AgP和CP患者 ,采集龈下菌斑样本 ,在厌氧菌基础培养基 (CDC)和选择性培养基 (TSBV)上培养分析。结果 :局限型AgP患者的伴放线放线杆菌 (Actinobacillusactinomycetemcomitans ,Aa)及兼性厌氧菌的检出率显著高于中度CP患者 (P <0 .0 5 ,P <0 .0 1) ,而广泛型AgP和重度CP患者的厌氧菌总数较局限型AgP和中度CP患者显著增加 (P <0 .0 5 )。结论 :局限型AgP和中度CP的龈下优势菌有明显差别 ,Aa是一个重要的危险因子。     

慢性牙周炎合并糖尿病患者唾液及龈下菌斑中牙周致病菌检测临床研究

目的    探讨慢性牙周炎（CP）合并2型糖尿病（T2DM）患者与单纯CP患者唾液及龈下菌斑中牙周致病菌的差异性。方法    选择河南大学第一附属医院口腔科2012年8月至2015年9月伴T2DM的CP患者40例为CP+T2DM组,同时选取背景相似的慢性CP患者65例为CP组,并选取健康体检者35名作为对照组,采用聚合酶链反应（PCR）检测各组受试者唾液及龈下菌斑中牙龈卟啉单胞菌（Pg）、放线共生放线杆菌（Aa）、具核梭杆菌（Fn）、福塞坦菌（Tf）、中间型普里沃菌（Pi）、齿垢密螺旋体（Td）等可疑致病菌种类和相对含量。结果    3组受试者唾液及龈下菌斑中Pg、Aa和Tf检出率比较差异有统计学意义（P＜0.05）,而Fn、Pi和Td检出率差异无统计学意义（P＞0.05）,3组受试者唾液及龈下菌斑中Fn检出率均最高,CP+T2DM组唾液及龈下菌斑中Pg、Aa、Tf检出率均显著高于对照组和CP组（P＜0.05）,而CP组仅Pg检出率显著高于对照组（P＜0.05）,CP+T2DM组和CP组唾液及龈下菌斑中Pg、Aa和Tf相对含量均显著高于对照组（P＜0.05）,且CP+T2DM组唾液及龈下菌斑中Aa和Tf相对含量显著高于CP组,差异有统计学意义（P＜0.05）。结论    CP患者和伴糖尿病的CP患者牙周可疑致病菌的种类和数量存在明显差异,CP+T2DM组患者Pg、Aa和Tf检出率更高,可能与糖尿病关系更为密切。     

福赛斯坦纳菌在2型糖尿病患者龈下菌斑中的分布

目的 观察福赛斯坦纳菌(T.forsythensis)在2型糖尿病患者不同牙周状况下的分布及其与相关影响因素的关系,探讨T.forsythensis在慢性牙周炎与2型糖尿病中的作用.方法采集160例不同牙周状况的2型糖尿病患者的龈下集合菌斑,采用酚-氯仿法提取细菌DNA,应用聚合酶链反应法对T.forsythensis...     

伴2型糖尿病慢性牙周炎患者TNF-α基因携带频率的研究

目的:通过对伴2型糖尿病慢性牙周炎患者、不伴全身系统性疾病的慢性牙周炎患者以及健康对照组中TNF-α基因携带频率的分析,探讨病例组和对照组在该基因携带频率上的差异,并比较各组牙周临床指标和易感等位基因的关系。方法:采用牙周探针,对112例伴2型糖尿病慢性牙周炎患者(DM组)、99例单纯慢性牙周炎患者(CP组)以及健康对照组进行牙周临床指标检查和TNF-α-308基因型(TNF1/2)检测。采用SPSS13.0软件包对数据进行χ2检验和方差分析。结果:在DM组和轻中度CP组之间,轻中度DM组和重度CP组之间,重度DM组和轻中度CP组之间,重度DM组和重度CP组之间,TNF2的阳性基因型分布均有统计学差异(P<0.05)。携带等位基因TNF2的DM组和CP组的牙周探诊深度、临床附着丧失均分别显著高于只携带等位基因TNF1的DM组和CP组患者(P<0.05)。结论:携带TNF-α-308等位基因TNF2可能会增加人群牙周炎的易感性,并且在2型糖尿病和牙周炎协同作用过程中具有重要作用。     

慢性牙周炎患者种植修复的临床观察

目的:探讨种植义齿修复慢性牙周炎患者牙列缺损的手术技巧及局部预防用药的疗效,并分析相关影响因素。方法:16例因慢性牙周炎致牙列缺损病例植入种植体89枚。5～6个月后行二期修复。根据临床检查、X线片和患者主诉评价修复效果。结果:所有病例均已完成修复,平均随访24个月。均无种植体松动脱落,患者咀嚼功能正常。结论:采取微创种植手术及派丽奥创口缓释用药措施,慢性牙周炎缺牙病例行种植义齿修复可以获得满意的早期临床疗效。     

雌激素受体基因多态性与慢性牙周炎相关性研究

目的探讨雌激素受体基因多态性与陕西地区慢性牙周炎易感性的关联。方法收集陕西地区109例慢性牙周炎患者和99例牙周健康对照组的颊黏膜拭子,用Chelex-100方法提取全基因组DNA, 用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）技术检测雌激素α和β受体基因型分布。结果慢性牙周炎组与正常对照组在ER-α受体XbaⅠ基因型分布上有统计学差异,慢性牙周炎组XX型基因频率明显高于正常对照组,尤其在女性患者中此差异显著,男性患者中未见不同;ER-β受体RsaⅠ和AluⅠ基因型在患者组与对照组中分布未见差异。结论慢性牙周炎易感性与雌激素XbaⅠ基因型分布相关,汉族女性群体中ER-α受体XX基因型可能为慢性牙周炎的易感因子。     

Superoxide dismutase activity in gingiva in type-2 diabetes mellitus patients with chronic periodontitis

OBJECTIVE: Antioxidant defence reduces in diabetes mellitus (DM) and periodontitis. This study investigates antioxidant enzyme; superoxide dismutase (SOD) activity in gingiva and blood glucose and lipid levels in type-2 DM patients and systemically healthy individuals with chronic periodontitis (CP). MATERIALS AND METHODS: Periodontal parameters, blood glycated-haemoglobin (HbA1c), glucose and lipid levels, and gingival-SOD activities (spectrophotometric assay) were measured in 17 DM patients with CP (DMCP), 17 systemically healthy CP patients, 18 periodontally healthy DM patients (DMPH), and 17 healthy controls (PH). RESULTS: Periodontal parameters were higher in periodontitis groups than the controls (p<0.05), while there was no difference between the periodontitis groups and between the control groups. HbA1c, glucose, and triglyceride levels were higher in diabetic groups than the non-diabetic groups (p<0.05). Low-density lipoprotein (LDL), very-LDL and cholesterol values of the DMCP group did not significantly differ from the CP group. No differences existed between diabetic patients with and without periodontitis in HbA1c, glucose, and lipid levels and the same was true for non-diabetic patients with and without periodontitis. Gingival-SOD activity was lower in periodontitis groups than the matched control groups (p<0.05). DMPH group had the highest and CP group had the lowest SOD levels. There were correlations between periodontal parameters, gingival-SOD activity, HbA1c, glucose and high-density lipoprotein (HDL) levels. CONCLUSION: The results suggest that gingival-SOD activity increases in diabetes and decreases in periodontitis and relations may exist between gingival-SOD activity, periodontal status, HbA1c, glucose and HDL levels. The higher gingival-SOD activity in diabetes may be attributed to an adaptive mechanism in the tissue.     

牙周炎与肠道菌群相关性研究进展

越来越多的研究表明牙周炎和肠道菌群之间关系密切。牙周炎的患者能够通过吞咽将口腔细菌转移到肠道定植,肠道原生菌群被改变,进而引发一系列肠道黏膜的免疫反应。肠道菌群失调又会导致一系列全身系统疾病,其中代表性的疾病就是炎症性肠病炎症性肠病(inflammatory bowel disease,IBD)。本文以IBD为切入点就牙周炎影响肠道菌群的可能途径以及炎症进展时、炎症得到控制后肠道菌群的变化进行综述。     

Gender differences in HLA phenotype frequencies found in German patients with generalized aggressive periodontitis and chronic periodontitis

HLA antigens have been considered as risk factors for periodontitis. Differences in prevalence and in the extent of attachment loss between males and females have suggested that gender-dependent HLA deviations could play a role in individual predisposition to periodontitis. The aim of the present study was therefore to investigate the incidence of gender-dependent HLA associations in 50 patients with generalized aggressive periodontitis (AP) and 102 patients with chronic periodontitis (CP) in comparison to 102 probands without any attachment loss caused by periodontitis. HLA typing was carried out using a microlymphocytotoxic test and a polymerase chain reaction with sequence-specific primers (PCR-SSP). Female AP patients showed an increase in the frequency of HLA-A*68/69 and a decrease in the frequency of DRBblank* (non-DRB3/4/5*) and DQB1*05-positive probands. Only in female CP patients was HLA-DQB1*0303 absent, whereas HLA-DQB1*06 homozygosity increased significantly. With regard to the (AP + CP) periodontitis group as a whole, the increased frequency of HLA-DQB1*06 homozygosity in females was similar to the findings obtained in the AP group. Evidently, gender is a confounding variable, which should be considered in further studies of HLA and periodontitis.     

Investigation of an IL-2 polymorphism in patients with different levels of chronic periodontitis

BACKGROUND: Interleukin-2 (IL-2) is a pro-inflammatory cytokine derived from Th1 cells. This cytokine is involved in B-cell activation and stimulates macrophages, natural killer cells, T-cell proliferation and osteoclast activity. IL-2 has been also implicated in the stimulation of osteoclast activity in bone resorption. OBJECTIVE: In this study the relationship between the polymorphism - 330 (T-->G) in the IL-2 gene and different levels of chronic periodontal disease was investigated. MATERIAL AND METHODS: DNA was extracted from buccal epithelial cells of 113 unrelated adult individuals acting as controls and with different levels of periodontitis. The PCR-RFLP technique was used to investigate the polymorphism in the promoter of IL-2 gene. RESULTS: When comparing the data of three groups of patients (Control, Moderate and Severe) we did not find significant differences between the studied IL-2 polymorphism and severity levels of PD. However, when the Control and Moderate phenotypes were grouped together and compared with genotypes TT vs. TG/GG, a significant difference was observed. CONCLUSION: We conclude that the - 330 (T-->G) polymorphism in the IL-2 gene is associated with the severity of periodontal disease. The results presented in this study suggest an active role of IL-2 in the pathogenesis of periodontal disease.     

Gingival crevicular fluid glycosaminoglycan levels in patients with chronic adult periodontitis

Abstract This study investigated levels of hyaluronan and chondroitin-4-sulphate in the crevicular fluid of patients with chronic adult periodontitis at diseased and healthy sites before and after treatment. The relationship between clinical diagnostic parameters and levels of glycosaminoglycans in gingival crevicular fluid were also analysed. Within each patient. 4 sites either mesial or distal and on single rooted teeth were classified as diseased or healthy using a modified gingival index, pocket depth and attachment loss. Crevicular fluid was collected from each site using glass micropipettes and analysed for glycosaminoglycan content by cellulose acetate electrophoresis. Significantly higher levels of chondroitin-4-sulphate were detected at diseased sites prior to treatment correlating with increased pocket depth or attachment levels. Following a period of treatment consisting of oral hygiene instruction and root planing, the patients were reassessed for their response to treatment by measuring the modified gingival index, pocket depth, attachment loss and levels of glycosaminoglycans. Analysis of glycosaminoglycan levels at diseased sites that demonstrated a poor response to treatment also demonstrated significantly higher levels of chondroitin-4-sulphate than those sites that responded well to treatment. Hyaluronan levels were less significantly associated with clinically succesful treatment. This study confirmed the use of the sulphated glycosaminoglycan chondroitin-4–sulphate as a potential diagnostic aid of periodontal tissue destruction; however, further longitudinal studies are required to assess their performance.