牙周探诊出血检测血糖的可行性研究

目的通过慢性牙周炎患者牙周探诊出血检测血糖发现糖尿病。方法对30例慢性牙周炎患者使用血糖仪测定指尖毛细血管（capillary whole blood glucose，CBG）及牙周探诊出血（periodontal probe blood glucose，PPBG）空腹血糖。结果30例慢性牙周炎患者空腹牙周探诊出血血糖与指尖毛细血管血糖测定值差异无统计学意义（P〉0．05）。结论血糖仪测定末梢血糖能反映静脉血糖水平。使用血糖仪检测牙周探诊出血血糖能反映患者血糖水平，发现血糖异常及糖尿病。     

口腔医学本科生牙周临床实习的教学模式探索与实践

牙周临床实习教学是牙周病学本科教学的重要组成部分,其与理论课和牙周前期实习共同组成了完整的牙周病学本科教学体系.文章结合北京大学口腔医学院·口腔医院牙周科口腔医学本科生牙周临床实习的30余年教学实践,归纳了牙周临床实习的目标,总结了牙周临床实习教学的特点、内容和模式,为国内推广实施规范化的口腔本科生牙周临床实习教学提供...     

口腔医学本科生基于临床实习的牙周诊治能力分阶段提升

牙周临床实习作为牙周病学本科教学的重要组成部分,是口腔医学本科生牙周诊疗实践的第一课。国内口腔医学院校普遍存在牙周临床实习时间短、操作训练少等特点。文章结合北京大学口腔医学院·口腔医院本科生牙周临床实习的教学实践,总结归纳了如何从前期实习到临床实习的过渡、临床实习的多种教学方法以及临床实习的分阶段能力提升和风险防控措施等内容,为国内提高口腔医学生牙周临床实习教学水平提供参考,以促进我国牙周病学教育的发展,培养更多具有规范化牙周诊治能力的口腔医生。     

重度广泛型侵袭性牙周炎患者牙周序列治疗的临床研究

目的：观察重度广泛型侵袭性牙周炎（generalized aggressive periodontitis, GAgP）患者牙周序列治疗后临床指标的变化,并评价其治疗效果。方法：15例GAgP患者在龈上洁治后1个月内完成龈下刮治、根面平整及光动力治疗,刮治后4周再评估,行翻瓣及翻瓣植骨术,每3个月进行1次牙周维护,序列治疗后纵向观察12个月。在基线和维护期各时间点记录全口探诊深度（probing depth,PD）、探诊出血（bleeding on probing, BOP）和牙齿松动度,磨牙记录根分叉病变的程度。结果：在基线时患者平均PD（3．96±2．21）mm,BOP阳性位点占88．1％。序列治疗后12个月平均PD（2．36±1．28）mm,BOP阳性位点减少至8．7％,其中轻、中、重度位点治疗后PD值与治疗前比较差异有统计学意义（P〈0．05）。结论：GAgP患者经牙周序列治疗和定期牙周维护能取得良好的治疗效果。     

牙周袋内硫化物水平与牙周临床指数的关系

目的分析慢性牙周炎患者治疗前、后牙周袋内硫化物水平的变化及与牙周临床指数的关系。方法对35名慢性牙周炎患者,分别在牙周基础治疗前、治疗后2、6周、3个月时进行硫化物的检测和牙周探诊深度（probing depth,PD）和出血指数（bleeding index,BI）的检查。对所得数据进行分析。结果治疗前在PD≥4mm或BI≥2的位点,牙周袋内硫化物检出率和浓度明显高于PD〈4mm或BI〈2的位点（P〈0.05）;治疗后,硫化物水平和PD、BI均明显下降（P〈0.05）;治疗后3个月硫化物水平有上升趋势,但无统计学意义。牙周袋内硫化物水平与牙周炎严重程度之间有相关关系。在深牙周袋、出血的位点硫化物水平增高,治疗后牙周袋内硫化物水平与探诊深度、出血指数变化一致。结论牙周袋内硫化物水平的检测可反映牙周炎症的严重程度,并可作为判断牙周疗效的指标。     

口腔医学本科生牙周前期实习教学的实践与思考

牙周前期实习教学是牙周病学本科教学的重要组成部分,其与理论课和临床实习共同组成了完整的牙周病学本科教学体系.文章结合北京大学口腔医学院·口腔医院牙周科口腔医学本科生牙周前期实习的教学实践,总结了规范化牙周前期实习的主要内容,为国内推广实施规范化的牙周前期实习教学提供借鉴和参考,更好地促进国内牙周病学实习教学的良性发展.     

牙齿的邻面状态与牙周探诊深度关系的研究

本实验对508例后牙牙周组织的健康状态进行临床检查,测量牙周探诊深度及附着丧失水平,并记录相应的牙齿邻面状态.结果得出:牙齿邻面有充填体悬突和充填体合并继发龋的牙周探诊深度比对照组明显增加(P<0.01);牙齿的邻面有龋病和不良固位体牙周探诊深度较对照组有增加(P0.05).牙齿邻面充填体悬突和充填体合并继发龋的牙周探诊深度及附着水平大于3mm所占百分比值明显高于对照组.本研究结果表明:牙齿的邻面状态与牙周探诊深度及附着丧失有关.牙齿邻面充填体悬突、邻面龋是影响牙周组织健康的重要因素.     

牙龈探诊出血与探诊压力相关性的评价

目的：评价牙龈探诊出血（ＢＯＰ）与探诊压力之间的关系．方法：应用自行研制的压力探针对１０名牙龈健康的测试对象共２８０颗牙齿进行探测．结果：随着探诊压力的增大,ＢＯＰ％均值有明显增高趋势,ＢＯＰ％与探诊压力之间呈高度正相关．结论：临床上探诊压力最好控制在０．２Ｎ,探诊压力过大会使ＢＯＰ假阳性数增多．同时表明该压力探针为临床研究提供了一种简便的、较为客观及可定量的检测方法     

上海市不同职业成人牙周健康状况抽样调查

目的抽样调查和分析400例上海市常住在职成年人牙周健康情况及相关因素。方法采用分层、整群、随机抽样方法,在郊区抽取农民200例,市区抽取职员和工人各100例,年龄25～59岁,男249例,女151例,进行问卷调查,并检查全口余留牙的牙龈指数(GI)、牙周探诊深度(PD)、临床附着丧失(CAL)、牙龈探诊出血(BOP)和松动度(mobility)情况。指数牙16、11、26、31、36和46,每个指数牙检查6个位点。采用SAS6.12软件包进行统计学分析。结果上海市成年人人群简化口腔卫生指数OHI-S=2.16±0.99,口腔卫生状况中等;人群牙龈指数GI=1.2227,牙龈炎为中度流行。上海市不同职业成年人牙周破坏程度有显著差异,其中职员的牙周破坏程度最轻;不同年龄组间也有极显著差异,高年龄组的牙周破坏重于低年龄组。轻、中度牙周炎146例,占36.5%,重度牙周炎140例,占35%。受检者中,接受过高中教育者317例,占79.25%;受过大学教育者79例,占19.75%;研究生文化程度者4例,占1%。患者受教育程度与牙周破坏的严重程度无显著相关性。400例被调查者中,330例从未接受过治疗,占82.5%;曾洁牙者70例,占12.5%;接受过正规的牙周治疗者仅13例,占3.25%。结论上海地区人群口腔卫生教育及牙周防病、治病意识还须加强。     

儿童口腔医学临床实习带教体会

儿童口腔医学的临床实习因服务对象特殊、配合程度有限,无论是与患者沟通还是治疗操作,都非常具有挑战性。近年来,我们通过在实习教学中营造宽松的环境,提高教员的自身素质和业务水平,注重实习医生职业素养、沟通能力等方面的培养,多方位调动实习学员的积极性、主动性和创造性,取得了较好的教学效果。     

Florida探针与普通牙周探针测量牙周袋深度的比较

目的比较Florida探针与普通牙周探针测量牙周袋深度(probingdepth ,PD) 的重复性。方法对5例慢性牙周炎患者在牙周基础治疗前后,分别使用Florida探针与普通牙周探针重复测量PD值各两次。分别比较两种探针在治疗前/后测量PD值的重复性,并同一种探针在治疗前后测量PD值的重复性。结果在牙周基础治疗前后,两种探针测量的PD值重复性均良好(P >0 .0 5 ,相关系数范围为0 .77～0 .85 )。对治疗前患者两种探针重复性相近,而对治疗后患者Florida探针的重复性好于普通牙周探针(P <0 .0 5 )。结论Florida探针测量PD值的重复性良好,能可靠地应用于牙周临床研究。     

In-vitro accuracy and reproducibility evaluation of probing depth measurements of selected periodontal probes

AimThe purpose of the present in vitro study was to measure the accuracy and reproducibility of three periodontal probes. To eliminate environment- or examiner-related probing errors, two aluminum blocks with predrilled holes of varying depths were examined by participants who had been trained in probing before the study. This methodology improved the likelihood that any probing errors identified were generated by the probes themselves.Materials and methodsThree probes, Williams 14 W (Hu-Friedy Mfg. Co., LLC, UK), Chapple UB-CF-15 (Implantium, Shrewsbury, UK), and Vivacare TPS (Ivoclar Vivadent, Enderby, UK), were randomly distributed to 23 participants (9 males and 14 females; mean age: 31.35 years). Participants measured 30 holes in two aluminum blocks, average 20 days, SD = 341.05. For each hole, the mean measured depth was calculated for each participant and compared to the true depth. Intra- and inter-examiner accuracy and reproducibility for each of the duplicate measurements were calculated. Data were analyzed by paired-samples t-test with the SPSS 18 software package (IBM Portsmouth, UK). A p-value <0.05 indicated statistical significance. Tables were constructed from the data.ResultsWhen used by participants, the Williams 14 W probe was reproducible but not necessarily accurate; Vivacare TPS was neither accurate nor reproducible; and Chapple UBCF-15 was both accurate and reproducible.ConclusionDepth measurements with the Chapple UB-CF-15 probe were more accurate and reproducible compared to measurements with the Vivacare TPS and Williams 14 W probes. This in vitro model may be useful for intra-examiner calibration or clinician training prior to the clinical evaluation of patients or in longitudinal studies involving periodontal evaluation.     

Non-Gaussian distribution of differences between duplicate probing depth measurements

The present study aims to determine the accuracy and the distribution of the error of probing depth measurements. Duplicate measurements were performed at 1069 sites in 13 subjects. Measurements in shallow pockets (less than or equal to 3 mm) were significantly (p less than 0.001) more reproducible than measurements in deep pockets (greater than 3 mm). The overall standard deviation of the measurements was 0.74 mm. Differences between duplicate measurements were not normally distributed. Differences of 2 mm or more were recorded more frequently than one would expect on basis of the standard deviation and a hypothetical normal distribution. The observed frequency of large differences (greater than or equal to 3 mm) is much higher than the theoretical change as suggested in the literature that such differences may occur as a result of the inaccurate probing measurements. This finding implies consequences for the chance of making false claims that true changes in probing depth and attachment level have occurred over time, if the claims are based on the standard deviation and the wrong assumption that the error of the measurement is normally distributed.     

The role of periodontal probing depth in clinical decision-making

This retrospective study examines the role of periodontal probing depth in clinical decision-making. The expected values of no treatment and surgical and non-surgical therapies were obtained by combining the probability of each treatment outcome and utility values denoting the preference for each outcome. The expected value for non-surgical therapy was higher for sextants exhibiting a positive response to initial therapy than sextants which did not respond to initial therapy (0.735 versus 0.706). This trend was not observed for sextants treated surgically. Surgical therapy was effective over all levels of disease severity and was the preferred form of therapy with respect to reduction of probing depth except for sextants exhibiting 4 to 5 mm pockets. In this latter situation, the expected value at 3 years for non-surgical and surgical therapy was 0.795 and 0.792, respectively. Neither form of therapy could consistently achieve periodontal probing depths equal to or less than 3 mm throughout a given sextant. This study facilitates the selection of an optimal therapeutic strategy with respect to periodontal probing depth.     

北京东城区高三学生牙周健康状况调查

目的 调查北京东城区高三学生的牙周健康状况.方法 对参加高考前体检的750名北京东城区高三学生进行牙周检查,检测牙石、探诊出血、探诊深度以及附着丧失情况,评价牙龈炎和牙周炎的发病率.结果牙龈炎的总体检出率为73.5%,男女学生发病率分别为76.7%和69.2%,差异有统计学意义(P=0.027).牙周炎的总检出率为10.9%,其中男生为11.8%,女生为9.8%,性别差异没有统计学意义(P=0.474).结论 北京东城区高三学生的牙龈炎检出率较高,男生高于女生.牙周炎检出率相对较低,男女生间没有明显差异.     

Effect of probing depth and bleeding tendency on the reproducibility of probing depth measurements

The aim of this study was to determine the influence of the probing depth and the bleeding tendency on the reproducibility of probing depth measurements. Duplicate probing depth and bleeding tendency measurements were performed at 717 interproximal sites in 13 subjects. Analysis indicated that the factor probing depth had a larger effect on the accuracy of probing depth measurements than the factor bleeding tendency.     

Bleeding on probing and probing depth as indicators of the response to plaque control and root debridement

19 adult periodontitis patients were treated with plaque control and a single episode of root debridement. Results of this treatment were monitored in non-molar sites, molar flat surface sites, and molar furcation sites by probing attachment level measurements every 3rd month for 24 months. After 24 months, sites with probing attachment loss were identified using linear regression analysis. Clinical scores for supragingival plaque, bleeding on probing, suppuration on probing, and probing depth, obtained from these sites during the 24-month study, were analyzed to determine if they could be used diagnostically as indicators of probing attachment loss. The results demonstrated that the diagnostic accuracy for these clinical indicators was generally low at all 3 anatomical site locations. A possible explanation for this limited diagnostic accuracy may be that some areas of probing attachment loss following basic periodontal therapy are caused by factors other than the progression of an inflammatory periodontal disease of microbial etiology.     

对新一代Florida探针临床测量可重复性和舒适度的评价

目的：评价新一代Florida探针测量牙周袋深度的可重复性和舒适度。方法在基础治疗后3个月维护期内,选择35例牙周炎患者为研究对象,2位检查者先后使用普通探针与Florida探针重复测量每个位点的探诊深度各2次,分别比较2种探针测量牙周袋探诊深度的可重复性,及2位检查者使用同1种探针测量牙周袋探诊深度的可重复性。应用视觉模拟评分法,比较患者接受2种探针检查时的舒适度。结果新一代Florida探针与普通牙周探针测量的牙周袋探诊深度重复性均良好（P>0.05）,浅袋和中袋的可重复性比深袋更好（P<0.05）。但在不同测量者之间Florida探针可重复性略优于普通牙周探针（P<0.05）,且比使用普通牙周探针让患者感觉更舒适（P<0.05）。结论新一代Florida探针可可靠的在慢性牙周炎维护期患者的临床研究中使用。     

The influence of probing force on the reproducibility of pocket depth measurements

Abstract Seven patients were selected on the basis of having about 50% loss of alveolar bone support in some part of the mouth. All patients received initial treatment consisting of plaque control and removal of subgingival deposits. In these patients, 102 interproximal pockets were measured by three different examiners, both with the pressure probe and a Merritt – B probe (Hu – Friedy®). No specific instructions were given as to how the interproximal regions should be probed. Results indicate that a standardized probing force of 0.75 N does not lead to more reproducible pocket depth measurements.