维持性血液透析患者的龋病和牙周病状况调查

目的比较维持性血液透析治疗的终末期肾脏病患者组和健康人群组龋病和牙周病患病率的差异,初步探讨终末期肾脏病和龋病、牙周病之间的关系。方法选择符合纳入标准的进行维持性血液透析治疗的患者作为病例组(82例),同时选择在体检中心进行口腔检查的正常人群作为健康对照组(86例)。两组采用统一的方法进行龋病和牙周状况的检查。龋病状况检查采用世界卫生组织推荐的龋失补牙数进行诊断和记录,牙周状况检查包括菌斑指数、牙石指数、探诊出血、牙周袋深度和临床附着水平。结果维持性血液透析组和健康对照组的患龋率分别为87.8%和81.4%,两组患龋率间差异无统计学意义(P>0.05);病例组的菌斑指数、牙石指数、探诊出血、牙周袋深度和临床附着水平均高于对照组(P<0.05),病例组的牙周炎患病率(97.6%)高于对照组(88.4%),差异有统计学意义(P<0.05)。结论维持性血液透析组患者的龋齿水平与健康对照人群无明显差异,但牙周炎的患病率和严重程度高于健康人群。     

跟骨骨密度与弥漫型侵袭性牙周炎关系的探讨

目的:评价跟骨骨密度与弥漫型侵袭性牙周炎的关系。方法:选取38例弥漫型侵袭性牙周炎患者作为实验组,31例牙周正常者作为对照组,2组平均年龄分别为27岁和23岁。临床上测定牙周指数并摄取全景片,应用跟骨骨密度仪测定超声振幅衰减值(BUA)及峰值差(T-score),用SAS6.12软件包进行数据分析。结果:2组的BUA值分别为62.76±4.61和70.47±4.41,实验组BUA值显著低于对照组(P<0.001);2组的T-score亦有显著性差异,实验组显著低于对照组(P<0.001)。结论:弥漫型侵袭性牙周炎患者的BUA值与T-score显著低于牙周健康组,提示弥漫型侵袭性牙周炎患者伴有全身骨密度下降。     

牙周炎患者的血脂、血糖水平分析

目的分析牙周炎对患者血糖和血脂水平的影响。方法对117例侵袭性牙周炎(AgP)患者、40例慢性牙周炎(CP)患者及37名牙周健康者,空腹抽取静脉血,检测血脂、血糖水平,比较3组之间的差异。结果AgP患者平均甘油三酯水平[(1．09±0．79)mmol／L]显著高于健康对照者[(0．94±0．28)mmol／L,P<0．05];CP和AgP患者的血糖水平[分别为(5．40±1．01)mmol／L和(5．07±0．66)mmoL／L]均高于健康对照者(4．62±0．64 mmol／L),P< 0．01;CP组的总胆固醇高于健康对照组,P<0．05;AgP组的重度位点百分比与总胆固醇呈正相关(r=0．25,P<0．01)。结论牙周炎可能会影响血糖和血脂的水平。     

龋病患牙牙周健康状况调查分析

目的：检查龋病患牙的牙周健康状况,探讨龋病对牙周健康状况的影响。方法：在武汉大学口腔医学院牙体牙髓科和牙周黏膜科就诊的患者中,选择一侧牙有龋,而对侧同名牙无龋的牙齿86对,每对牙齿依次检查牙体龋坏情况（包括冠龋和根龋）及牙周状况（包括探诊深度、探诊出血、牙石指数、牙龈退缩程度、松动度）,并进行统计学分析,研究龋病患牙的牙周健康状况。结果：86对牙齿比较结果显示,有龋组的牙周探诊深度、牙石指数、牙龈退缩程度、松动度均显著高于无龋组（P〈0.05）。对有龋组牙仅有冠龋的71对牙齿做比较,结果显示有龋组患牙的牙周探诊深度、牙石指数、牙龈退缩程度均高于无龋组,有显著性差异,且探诊深度、牙石指数有非常显著的差异（P〈0.01）。对有龋组中既有冠龋又有根龋的15对牙齿牙周情况做比较,结果显示有龋组牙龈退缩、松动度均高于无龋组且有显著性差异（P〈0.05）。结论：在同一口腔环境中龋病的发生和牙周炎症程度呈正相关,两者的微生态联系和相互影响有待深入的研究。     

130例终末期肾脏病患者的龋病和牙周病状况调查

目的:探讨终末期肾脏病患者的龋病和牙周病状况。方法:纳入130例行血液透析治疗的终末期肾脏病患者,对照组人群行性别年龄(±3岁)的匹配,采用统一的方法行龋病和牙周病状况的检查比较。结果:终末期肾脏病患者组的龋病患病率为67.69%,对照组为76.92%(P=0.096),与对照组相比,龋损牙数、缺失牙数、充填牙数和龋失补指数值均差异无显著性(P值分别为0.095、0.423、0.054和0.581);患者组的菌斑指数、牙龈指数和牙周病指数值以及牙周病严重程度显著高于对照组(P<0.001)。结论:行血液透析治疗的终末期肾脏病患者的龋病状况无明显变化,但牙周状况较差,在临床治疗时需得到重视。     

西安市临潼区出土2200年前人龋病研究

目的:通过调查西安市临潼区出土2 200年前人牙齿的龋病流行情况,为研究龋病的发生发展规律提供依据。方法:对61例临潼区出土颅骨的999个牙齿进行详细的龋病情况观察,计算出总患龋率、不同年龄组龋齿率、不同牙位组龋齿率、不同牙面部位组龋齿率、不同年龄组龋患程度的龋齿率及不同年龄组不同性别的龋齿率进行统计学分析。结果:①本研究中有年龄标识的颅骨共43例,患龋率79.07%,龋齿率21.20%,龋均3.95。不同年龄组间龋齿率有显著性差异(P<0.05);各年龄组内不同性别间龋齿率无显著性差异(P>0.05);不同年龄组间龋患程度无显著性差异(P>0.05);②999个牙齿中共有199个龋齿,从龋患的牙位分布看,下颌第三磨牙﹥上颌第三磨牙﹥下颌第二磨牙﹥上颌第二磨牙,上颌与下颌组间龋齿率有显著性差异(P<0.05)。从龋患的牙面部位分布看,牙齿根面(颈部)龋最多,占总患龋牙面数的37.15%;其次为邻面龋,占35.37%。结论:龋病在战国中晚期至先秦时期普通人群中已经较为常见,但患龋率较现代人低,龋病的发生率随着人类不断进化和社会文明的进步而不断提高。     

成人牙周炎病人龋患情况的初步调查

目的：探讨成人牙周炎病人与牙周正常者龋患情况有无差别。方法：收集在协和医院门诊口腔科就诊的病人132例，其中牙周炎组病人91例，牙周正常组病人41例，分别检查这132例病人口腔卫生状况和牙体龋患情况。结果：两组的饮食习惯无显著差异，而实验组牙周炎病人的口腔卫生状况较对照组差，但其龋补牙面数却明显低于对照组，两组有显著性差异（P〈0．01）。结论：同一口腔范围内牙周炎和龋病的发病可能有拮抗倾向。     

牙周袋内挥发性硫化物与牙周炎症程度的关系

目的初步探讨牙周袋内挥发性硫化物与侵袭性牙周炎(aggressive periodontitis,AgP)和慢性牙周炎(chronic periodontitis,CP)炎症程度的关系。方法用金刚牙周探针诊断仪检查探诊深度、附着丧失、探诊出血等临床指标的同时,检测牙周袋内硫化物水平。共检查15例AgP和16例CP患者870个患牙的5 220个位点。结果无论是AgP还是CP患者,硫化物阳性位点的各项临床指标均明显高于阴性位点(P<0.001);硫化物水平与各项临床指标间都有明显的正相关关系(P<0.001);中、深袋组的硫化物水平和阳性位点率均明显高于浅袋位点(P<0.001);有附着丧失位点的硫化物水平和阳性位点率均高于无附着丧失位点,在浅袋组其差异有显著性。结论牙周袋内挥发性硫化物的检测可以反映侵袭性牙周炎和慢性牙周炎患者的牙周炎症程度。     

维族绝经妇女龈沟液IL-6、血清雌二醇水平与牙周炎的关系

目的:探讨维吾尔族绝经早期的牙周炎患者龈沟液IL-6及血清雌二醇(E2)水平与牙周炎的关系。方法:共79例绝经年限均≤5a的妇女纳入本研究。采集30颗牙周健康牙和49颗牙周炎患牙的龈沟液(GCF),记录牙周临床观察指标。采集慢性牙周炎患者的血样本。应用放射免疫分析法检测GCF中IL-6和血清中E2的浓度。结果:牙周健康组GCF中IL-6浓度为(1088.10±102.33)pg/ml;慢性牙周炎组GCF中IL-6浓度明显高于牙周健康牙组(P<0.005);慢性牙周炎患牙GCF中IL-6浓度与GI、PPD、CAL均呈正相关(r=0.564,P<0.005;r=0.335,P<0.05;r=0.324,P<0.05)。血清E2≤30pg/ml组的妇女牙周炎患牙牙周临床指标、GCFIL-6浓度与E2>30pg/ml组无显著差异(P>0.05)。结论:健康牙GCF中含有微量IL-6。牙周炎患牙GCF中IL-6的水平反映了牙周炎症的严重程度,可以尝试作为判断维族妇女牙周病变程度的一个指标。绝经早期患慢性牙周炎的维族妇女,血清E2水平与牙周炎患牙的病变程度及GCF中IL-6的水平无关。     

HIV+牙周炎患者免疫状态和龈沟液中TNF-α与牙周临床指标的相关性研究

目的 评估HIV+牙周炎患者的免疫状态和龈沟液中肿瘤坏死因子α与牙周临床指标的相关性,以期为临床提供指导.方法 对20例HIV+牙周炎患者计数其血液CD4+T淋巴细胞,对共计120颗指数牙进行牙周检查,包括:菌斑指数、出血指数、附着水平和牙周探诊深度.按免疫状态分组:重度免疫抑制组(CD4<200个/mm3)5例30颗牙;中度免疫抑制组(200≤CD4≤500个/mm3)13例78颗牙;轻度免疫抑制组(CD4>500个/mm3)2例12颗牙.用放射免疫方法检测龈沟液中TNF-α.组间比较采用Mann-Whitney秩和检验,CD4计数和牙周参数的相关性采用偏相关分析,TNF-α与牙周临床参数的关系采用Spearman相关分析.结果 结果非正态分布,采用中位数和四分位间距[M(Q)]表示.中度免疫抑制组的BI值为[3.00(2.00)],显著高于重度免疫抑制组[2.00(1.25)]和轻度免疫抑制组[2.00(1.00)](P<0.0167);轻度免疫抑制组的TNF-α总量为[0.04(0.02)]pg,显著低于重度免疫抑制组组[0.06(0.04)]pg和中度免疫抑制组[0.06(0.05)]pg(P<0.0167);3组间的TNF-α浓度、牙周探诊深度和附着水平差异均无统计学意义(P>0.0167).中、重度免疫抑制组的CD4计数和出血指数有相关性,偏相关系数分别为0.657(P<0.001)、-0.369(P=0.001).轻度免疫抑制组CD4计数和出血指数无相关性(P=0.625).TNF-α总量和各项牙周临床指标间均正相关(P<0.05).结论 HIV+牙周炎患者的牙周炎症状态与免疫状态有关,中度免疫抑制者的牙周炎症表现最为明显,其龈沟液中TNF-α水平与牙周破坏程度呈正相关.     

Clinical and microbiological effect of scaling and root planing in smoker and non-smoker chronic and aggressive periodontitis patients

OBJECTIVES: To compare the effects of scaling and root planing (SRP) on clinical and microbiological parameters at selected sites in smoker and non-smoker chronic and generalized aggressive periodontitis patients. MATERIALS AND METHODS: Clinical parameters including probing depth (PD), relative attachment level (RAL), and bleeding upon probing (BOP), and subgingival plaque samples were taken from four sites in 28 chronic periodontitis (CP) and 17 generalized aggressive periodontitis (GAgP) patients before and after SRP. Polymerase chain reaction assays were used to determine the presence of A. actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythensis, Prevotella intermedia and Treponema denticola. RESULTS: Both CP and GAgP non-smokers had significantly greater reduction in pocket depth (1.0+/-1.3 mm in CP smokers versus 1.7+/-1.4 mm in non-smokers, p=0.007 and 1.3+/-1.0 in GAgP smokers versus 2.4+/-1.2 mm in GAgP non-smokers, p<0.001) than respective non-smokers, with a significant decrease in Tannerella forsythensis in CP sites (smokers 25% increase and non-smokers 36.3% decrease, p<0.001) and Prevotella intermedia at GAgP sites (smokers 25% reduction versus 46.9% in non-smokers, p=0.028). CONCLUSION: SRP was effective in reducing clinical parameters in both groups. The inferior improvement in PD following therapy for smokers may reflect the systemic effects of smoking on the host response and the healing process. The lesser reduction in microflora and greater post-therapy prevalence of organisms may reflect the deeper pockets seen in smokers and poorer clearance of the organisms. These detrimental consequences for smokers appear consistent in both aggressive and CP.     

Root surface and coronal caries in adults with type 2 diabetes mellitus

OBJECTIVES: To determine the effect of type 2 diabetes mellitus (DM) on coronal and root surface caries and to investigate some factors suspected of being related to or interacting with DM, that may be associated with coronal and root surface caries. METHODS: A stratified cross-sectional study was conducted in 105 type 2 diabetic patients and 103 non-diabetic subjects of the same age and gender. Coronal and root surface caries, exposed root surfaces, periodontal status, stimulated salivary functions, oral hygiene status, oral health behaviors, and counts of mutans streptococci and lactobacilli were measured. RESULTS: Type 2 diabetic patients compared with non-diabetic subjects had a higher prevalence of root surface caries (40.0% versus 18.5%; P = 0.001), a higher number of decayed/filled root surfaces (1.2 +/- 0.2 versus 0.5 +/- 0.1; P < 0.01) and a higher percentage of generalized periodontitis (98.1% versus 87.4%; P < 0.01); but the prevalence and decayed/filled surface of coronal caries was not significantly different (83.8% versus 72.8% and 8.0 +/- 9.4 versus 6.3 +/- 7.5 respectively). The factors associated with root surface caries included type 2 DM, a low saliva buffer capacity, more missing teeth, and existing coronal caries; whereas wearing removable dentures, more missing teeth, a high number of lactobacilli, and a low saliva buffer capacity were associated with coronal caries. CONCLUSION: Type 2 DM is a significant risk factor for root surface, but not for coronal caries. Periodontal disease should be treated early in type 2 diabetic subjects to reduce the risk of subsequent root surface caries.     

Bone height changes in individuals with periodontal disease: a 17-year prospective longitudinal study

OBJECTIVE: The aim of this study was to analyse changes in bone height after 17 years in smokers and non-smokers with periodontal disease, and to compare these with clinical assessment outcome. MATERIAL AND METHODS: Participants comprised 50 adults with periodontitis and 18 healthy controls from a randomly selected epidemiological sample. Their mean age at the end of the study was 54.2 (SD+/-3.09) years. The study included radiographic analysis compared with clinical data. RESULTS: The periodontitis group had significantly (p<0.001) higher values than their healthy counterparts for plaque index (PLI), gingival index (GI), calculus index (CI), and bleeding on probing (BOP) at baseline and after 17 years. At the end of the follow-up, never-smokers with periodontitis had higher values for PLI (p<0.05) and ex-smokers and smokers had higher GI and BOP (p<0.001) than the controls. In all individuals with periodontitis, maxillary molars were most affected. Smokers had more severe marginal bone loss over time. Vertical bone defects were more often seen on the mesial side of teeth (p<0.05). CONCLUSION: Marginal bone level in this prospective study did reveal tooth groups at higher risk for progression of periodontal disease.     

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.     

Oral health status of individuals with cerebral palsy at a nationally recognized rehabilitation center

Cerebral palsy (CP) is a set of nonprogressive neuromuscular disorders caused by defects in the developing fetal brain. The aim of this study is to investigate the prevalence and distribution of various dental conditions including dental caries and periodontitis among individuals with CP who receive care at the Rancho Los Amigos National Rehabilitation Center dental clinic. Medical records of 478 patients between the ages of 3 and 78 years were reviewed. Patients were divided into four age groups: 3–20, 21–35, 36–55, and 56 and above year old. Data related to their dental conditions including caries, periodontitis, and other oral diseases were assessed. Statistical analyses were conducted to evaluate the correlations between these oral diseases and age, gender, ethnicity as well as their living conditions (home or group home). The 36–55‐year‐old age group displayed significantly more caries and periodontitis than any other age groups. Individuals aged 3–20 years showed a significantly lower rate of periodontitis and caries. There was no significant association between gender and race with these outcome variables but there was a correlation between these variables and living conditions. Differences in oral health exist among people with CP from different age groups and living conditions. These findings suggest that there is a dire need for more oral hygiene training and education for the care givers. Dental schools should better prepare their graduates to meet the treatment demands of individuals with special healthcare needs.     

Compromised GCF total antioxidant capacity in periodontitis: cause or effect?

BACKGROUND: Oxidative stress is implicated in the pathogenesis of periodontitis. The total antioxidant capacity (TAOC) of gingival crevicular fluid volume (GCF) and plasma appears compromised in periodontitis, but it is unclear whether this predisposes to, or results from the inflammatory process. AIM: To investigate longitudinal changes in GCF and plasma TAOC following reductions in periodontal inflammation with successful non-surgical therapy. MATERIALS AND METHODS: Two longitudinal studies were run in series on non-smokers with chronic periodontitis (CP). Study-1 (n=17) assessed index sites with mild disease; Study-2 (n=18) investigated deep sites. GCF sampling and clinical measures were performed at baseline and 3 months post-therapy. Plasma and GCF TAOC was determined by enhanced chemiluminescence and 32 age/sex-matched periodontally healthy controls were used. RESULTS: Therapy improved clinical outcomes consistent with the literature. There were no differences in plasma TAOC between periodontitis patients (507+/-92 microMTeq) and controls (520+/-100 microMTeq; p=0.57) at baseline, but GCF TAOC was lower (p<0.0001) in CP patients (680+/-371 microMTeq) than controls (1129+/-722 microMTeq). Successful periodontal therapy did not alter plasma TAOC (p=0.56), but GCF TAOC increased (by 449+/-722 microMTeq, p<0.001) to control subject levels (p=0.47) CONCLUSIONS: Local total antioxidant capacity in CP appears to reflect increased oxygen radical activity during periodontal inflammation and can be restored to control subject levels by successful non-surgical therapy.     

Attitudes and lifestyle factors in relation to oral health and dental care in Sweden: a cross-sectional study

Objective: The aim of the present study was to investigate attitudes to and perceptions of dental treatment and costs, self-assessed personal oral health status and dental self-care in an adult Swedish population, with special reference to potential associations between these factors and periodontal status.

Material and methods: The study population comprised 1577 subjects who had undergone radiographic dental examination. The subjects were grouped by severity of periodontitis, based on extent of bone loss, as none, mild/moderate or severe. Subjects answered a questionnaire about socioeconomic factors, oral care habits and attitudes to dental treatment. Other questions covered medical history, smoking and other life style factors. Associations were tested using the Chi-squared test and a logistic regression model.

Results: Compared to subjects with no periodontitis, those with mild/moderate or severe periodontitis were less likely to afford (p?<?.001), more often refrained from treatment due to costs (p?<?.001) and in the past year had experienced dental problems for which they had not sought treatment (p?<?.001). They also reported more anxiety in relation to dental appointments (p?=?.001). Regarding caries prevention, the severe periodontitis group used least fluoride products (p?=?.002).

Conclusions: Swedish adults regard their oral health as important, those with periodontitis have a more negative perception of their oral health and are less prone to seek help. These discouraging findings suggest the need for targeted measures, which focus on improving the care of this group of patients.     

Smoking and caries experience in subjects with various form of periodontal diseases from a teaching hospital clinic

Abstract: Objective: The aim of this study was to assess the relationships between aggressive periodontitis (AgP), caries and smoking. Method and materials: A cross‐sectional study was conducted among patients who were specifically referred to the Dental Teaching Clinic in Irbid, Jordan for periodontal treatment. Self‐administered questionnaire related to socio‐demographic data and smoking habits was completed. The oral hygiene, gingival status, periodontal health and dental status of the participants was determined by using the plaque index of Silness and Loe [Acta Odontol Scand, 22 (1964), 121], the gingival index of Loe and Silness [Acta Odontol Scand, 21 (1963), 233], clinical attachment level (CAL) and decayed, missing and filled teeth (DMFT) index respectively. Result: The prevalence of smoking was greater in chronic periodontitis (CP) group (44.2%) than in either chronic gingivitis (CG) (27.4%) or AgP (29.9%) group. Self‐reported perio‐diseases in the close family was more prevalent (77%) among subjects diagnosed with AgP. The mean plaque scores were significantly higher for smoker than non‐smoker in AgP group only (P = 0.04), with significantly greater plaque and gingival scores in CG and CP groups than AgP group (P = 0.012, 0.004). A significantly greater mean gingival scores were noted among CG and CP groups than AgP group (P = 0.004). The mean CAL was higher in smokers than in non‐smokers in the three groups, with statistically significant differences in CP and AgP groups (P = 0.04, 0.01 respectively).The mean number of DMFT was significantly higher in smoker than in non‐smoker of all age groups (P = 0.016, 0.043 and 0.01). However, mean DMFT was significantly greater in CP and CG than AgP groups. Conclusion: It was concluded that (i) higher plaque and gingival index among smokers in all groups; (ii) significant difference in the CAL between smoker and non‐smoke in CP and AgP groups; (iii) significant increase in caries risk among smokers in all groups; (iv) smokers and non‐smokers of AgP group had significantly lower mean DMFT scores than those of CG or CP groups.