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。     

艾森克人格因素对颌骨囊肿开窗减压术后应用塞制器患者牙科焦虑症和疼痛的影响研究

目的:了解牙科焦虑症在颌骨囊肿开窗减压术后应用囊肿塞制器患者中发生情况,探讨艾森克人格因素对该类患者牙科焦虑症和疼痛的影响。方法:选择2015年1月~2016年10月于我院修复科就诊的该类成人患者126例,请患者于诊疗前填写改良牙科焦虑量表、艾森克人格问卷、视觉模拟量表,用SPSS 22.0进行统计分析。结果:颌骨囊肿开窗减压术后应用囊肿塞制器患者的牙科焦虑症患病率为60.32%。其MDAS得分与艾森克人格P(精神质)(r=0.241)、 N(神经质)(r=0.315)呈正相关,与E(内外倾)呈负相关(r=-0.322)。DA组P、N量表得分高于非DA组(P=0.000),E量表得分低于非DA组(P=0.000)。VAS得分与P(r=0.386)、N(r=0.329)呈正相关,与E(r=-0.237)呈负相关。DA组的VAS得分高于非DA组(P=0.009)。MDAS得分与VAS评分呈正相关(r=0.234)。结论:颌骨囊肿开窗减压术后应用塞制器患者牙科焦虑症及其术后疼痛评分与艾森克人格具有相关性,精神质、神经质高分和内外倾低分者患牙科焦虑症可能性大,疼痛程度较高。     

咪达唑仑对儿童患者焦虑水平及皮质醇影响的初步研究

目的:研究在鼻内和舌下使用咪达唑仑对儿童患者焦虑水平和唾液皮质醇水平的影响,探讨温和镇静剂用于儿童口腔科的可能性。方法:选择2015年3月~2016年2月于我院就诊3~7岁儿童患者82例。将患者随机分为2组,分别于口腔治疗前30 min通过鼻内、舌下途径使用咪达唑仑。常规进行口腔治疗,每5 min记录1次Venham分级。并在用药前与用药30 min后收集唾液,测定唾液皮质醇水平。结果:2组不同时间点(T1、T2、T3、T4)与T0时相比,患儿的焦虑情况均显著改善(P＜0.05)。T1、T2时舌下组患儿的焦虑缓解情况较鼻内组效果更好(P＜0.05)。而两组唾液皮质醇水平在服药前后均没有显著差异。结论:咪达唑仑可以有效缓解儿童患者焦虑,舌下途径给药比鼻内途径吸收更好,对唾液皮质醇水平无影响。     

口腔种植手术对绝经期骨质缺乏患者血清BGP、AKP和唾液钙、磷元素的影响

目的:通过对比绝经期骨质疏松症和骨质减少症患者与正常人口腔种植手术前后血液BGP、AKP和唾液钙、磷元素变化情况,分析种植手术对上述指标的影响。方法:对74名患者按照性别、是否患有骨质疏松症、骨质减少症、是否绝经进行分组。按种植手术不同阶段,在规定时间和条件下采集唾液、血液进行实验室分析。结果:A组和B组患者血液中雌酮、雌二醇、睾酮指数低于C组,A组低于B组(P<0.05)。首诊A、B 组骨钙素(BGP)和碱性磷酸酶(AKP)高于对照组(P<0.05),A组高于B组(P<0.05)。A、B组患者术后至6个月BGP值高于首诊(P<0.05),对照组患者术后2周、3个月的BGP与首诊比较升高显著(P<0.05)。 A、B组患者唾液内钙、磷含量首诊时高于对照组,唾液内钙含量在种植后各期高于首诊值(P<0.05),对照组患者在种植后2周至3个月高于首诊值(P<0.05)。结论:绝经期患者雌激素水平降低导致的骨质疏松,使血液中BGP和AKP含量与唾液内钙、磷含量高于正常人;种植手术后唾液中钙含量的变化与BGP变化呈正相关。     

单颗上颌前牙即刻种植即刻修复后美学评价和患者满意度调查

目的:评估单颗上颌前牙即刻种植即刻修复半年再行永久修复后的美学评分与患者满意度的相互关系。方法:27例患者的单颗上颌前牙即刻拔除即刻种植,同期临时冠行牙龈诱导,6个月后行永久修复, 24个月后分别用红色美学分值PES及白色美学分值WES评价种植体周围软组织及修复体美学效果;以视觉测量尺(visual analog scale.VAS)作为指标测量患者的主观满意度.分析PES与WES、VAS与PES、VAS与WES之间的关系。结果:红色美学分值PES平均得分(8.22±1.48) ,白色美学分值WES平均得分(8.00±1.33),种植体PES与WES值存在显著正相关关系(r=0.612,P<0.001);VAS值为7～10,平均得分为(8.19 +1.08),患者VAS与PES值和WES值均存在显著正相关关系(r=0.448,P=0.019;r=0.423,P=0.028)。结论:单颗上颌前牙即刻种植并采用临时冠诱导牙龈后再永久修复可获得很高的美学效果和患者满意度,其中PES与WES、VAS与PES、VAS与WES有很高的相关性。     

口服泼尼松治疗复发性阿弗他溃疡对患者唾液中Th1/Th2型细胞因子的影响

目的:探讨口服泼尼松对复发性阿弗他溃疡(RAU)患者治疗前后唾液中辅助型T细胞(Th)1/Th2型细胞因子的影响.方法:设置对照组(健康志愿者,n=15)和实验组(RAU患者,n=60);实验组患者口服15 mg/d泼尼松治疗7 d.采集实验组患者治疗前和治疗第7天次日的非刺激性唾液样本.利用流式微球分析检测Th1/T...     

牙周炎伴糖尿病患者全唾液中Pro-CT含量的检测及其意义

目的:比较糖尿病合并牙周炎患者、单纯糖尿病患者、单纯牙周炎患者以及健康者全唾液中降钙素原(Pro-CT)水平,及其与血糖控制情况及牙周病炎严重程度之间的关系。方法:采用病例对照研究,纳入糖尿病合并牙周炎患者(DM+CP组)24例,单纯糖尿病患者(DM组)、单纯牙周炎患者(CP组)以及健康人群各30例,收集受检者静息全唾液,采用酶联免疫吸附试验(ELISA)检测全唾液中Pro-CT水平。结果:DM+CP组全唾液中Pro-CT水平显著高于其他3组,差异极具统计学意义(P<0.01);全唾液中Pro-CT水平随牙周炎严重程度加重而增高,随血糖控制情况的不理想而增高,差异有统计学意义;全唾液中Pro-CT水平与探诊深度(PD)、探诊出血指数(BI)、附着丧失(AL)、缺失牙数均呈正相关,且相关程度由高到低依次为PD、BI、AL、缺失牙数,差异有统计学意义(P<0.05)。结论:糖尿病患者体内的微炎症状态可能与牙周炎症有关,全唾液中Pro-CT水平既受牙周炎症影响也受全身因素的调控。     

白细胞相关免疫球蛋白样受体-2和转化生长因子-β在口腔扁平苔藓患者外周血表达及意义

目的:探讨白细胞相关免疫球蛋白样受体-2(LAIR-2)和转化生长因子-β(TGF-β)在口腔扁平苔藓患者外周血表达及意义。方法:选取53例口腔扁平苔藓患者和50例健康者,利用流式细胞仪检测外周血Treg细胞上LAIR-2表达,利用ELISA法对血清中TGF-β水平进行检测。结果:LAIR-2在口腔扁平苔藓患者外周血Treg细胞上阳性表达率为(4.62±0.33)%,显著低于对照组的(6.47±0.28)%,差异有统计学意义(P<0.05);口腔扁平苔藓患者外周血中TGF-β水平显著高于对照组,差异有统计学意义(P<0.05);Pearson相关分析显示,口腔扁平苔藓患者外周血Treg细胞上LAIR-2阳性表达和TGF-β水平呈负相关(r=-0.416,P=0.011)。结论:LAIR-2在口腔扁平苔藓患者外周血Treg细胞中呈低表达,而外周血TGF-β水平升高,二者可能共同参与了T细胞介导免疫抑制作用,与口腔扁平苔藓发生及进展有关。     

整合素连接激酶和基质金属蛋白酶-9在涎腺腺样囊性癌中的表达及意义

目的: 探讨整合素连接激酶(ILK)和基质金属蛋白酶-9(MMP-9)在涎腺腺样囊性癌(SACC)中的表达及意义。方法: 选取59例SACC患者和42例非肿瘤患者正常涎腺组织,利用qRT-PCR技术检测ILK和MMP-9在SACC组织中表达。结果: SACC组织中ILK mRNA和MMP-9 mRNA相对表达量均高于对照组,差异均有统计学意义(P<0.05);ILK和MMP-9在SACC组织中表达均与组织类型、淋巴结转移、TNM分期有关(P<0.05),实体型和管状型SACC组织中ILK mRNA和MMP-9 mRNA相对表达量均高于筛状型(P<0.05);Pearson相关分析显示,SACC组织中ILK mRNA相对表达量与MMP-9 mRNA相对表达量呈正相关(r=0.586,P=0.000)。结论: ILK和MMP-9在SACC组织中呈高表达,可能共同协同参与了肿瘤细胞侵袭、转移过程。     

复发性阿弗他溃疡患者唾液及血清中TNF-α的表达及其相关性研究

目的:研究复发性阿弗他溃疡(RAU)患者唾液及血清中TNF-α的含量的相关性.方法:临床收集轻型RAU组和健康对照组各30 例,对每个对象采集唾液和血清样本,采用酶联免疫吸附法检测所有样本中TNF-α的含量.结果:RAU组唾液及血清中TNF-α的含量明显高于相应的正常对照组(P<0.001),且RAU患者唾液和血清中TNF-α的含量有显著的相关性(r=0.826,P<0.01).结论:复发性阿弗他溃疡患者唾液及血清中TNF-α的含量具有显著相关性,可通过检测唾液中TNF-α的含量来观察病情变化和临床疗效.     

The evaluation of anxiety and salivary cortisol levels in patients with oral lichen planus

OBJECTIVE: The aim of this study was to determine any association between anxiety and salivary cortisol levels in oral lichen planus (OLP) patients by the case-control method. DESIGN RELEVANT: Forty patients with OLP were evaluated. The OLP diagnosis was established through a composite of accepted clinical and histopathological characteristics. Forty patients from the register of patients who obtained general dental care were selected as controls. MATERIAL AND METHOD: The saliva samples collected between 9:00 and 9:15 am were analysed for the level of cortisol with Cortisol EIA that used competitive enzyme-linked immunosorbent assay method. Trait and state anxiety levels of 80 patients were measured using the Spielberger's State-Trait Anxiety Inventory. RESULTS: The mean level of cortisol from 40 saliva samples in study group was 1.46 and 0.93 microg dl(-1) in 40 controls (P=0.001). The mean level for state anxiety in the study group were 48.85 and 39.45 in control group (P=0.001). Trait anxiety levels in study group were 49.77 and 38.51 in control group (P=0.001). We found that salivary cortisol, state and trait anxiety levels in OLP group were significantly higher than in the control group. CONCLUSION: Because of the fact that the level of anxiety and salivary cortisol of OLP patients were high, our findings concluded that this disease is closely related with stress. Thus besides traditional treatment of OLP patients, our findings suggest that psychological support is also needed.     

Salivary cortisol and dehydroepiandrosterone (DHEA) levels, psychological factors in patients with oral lichen planus

Objective

The aim of this study was to determine the salivary levels of dehydroepiandrosterone (DHEA) and cortisol and scores of depression, anxiety and stress in patients with oral lichen planus (OLP).

Study design

Thirty-one patients with a diagnosis of OLP were selected; they were matched by sex and age with 31 control patients. Symptoms of depression, anxiety and stress were investigated by the instruments Beck Depression Inventory, Beck Anxiety Inventory and Lipp's Inventory of Stress Symptoms for Adults, respectively. Saliva was collected in the morning and at night for the determination of DHEA and cortisol levels by radioimmunoassay.

Results

There was no significant difference between the groups with respect to depression (P = 0.832), anxiety (P = 0.061) or stress (P = 0.611), or with respect to morning and night salivary levels of DHEA (P = 0.888, P = 0.297) and cortisol (P = 0.443, P = 0.983).

Conclusions

The results suggest an association of OLP with anxiety. However, DHEA and cortisol levels did not differ between groups, which does not support any neuroendocrine aetiology for OLP.     

Salivary cortisol determination in patients from the Basque Country with recurrent aphthous stomatitis. A pilot study

Objectives: Stress and anxiety are controversial factors involved in the complex pathogenesis of Recurrent Aphthous Stomatitis (RAS). The determination of salivary cortisol is a useful, simple and safe test to detect states of high stress or anxiety. The aim of this study is to check for changes in salivary cortisol levels in patients with RAS during periods of active disease. Study design: A measurement of cortisol employing Enzyme-Linked Immuno Sorbent Assay (ELISA) was carried out in samples of unstimulated saliva from 20 patients with active lesions of RAS and 10 healthy individuals used as controls. Results: Increased levels of salivary cortisol were detected in 3 cases, all of them within the group of patients with RAS. In none of the control group patients the level of salivary cortisol was increased. The mean level of salivary cortisol was 0.64 mg / dl (range 0.2 to 1.62) for patients with RAS and 0.57 mg / dl (range 0.25 to 1.09) for controls. Conclusion: Salivary cortisol levels are not statistically higher in patients with active lesions of RAS. Key words:Recurrent aphthous stomatitis, cortisol, oral ulcers, canker sores, salivary cortisol.     

Association of Gingival Crevicular Fluid Cortisol/Dehydroepiandrosterone Levels With Periodontal Status

Background: The aim of the present study is to examine whether anxiety and depression scale scores change with regard to clinical periodontal status and to investigate the association between the levels of stress‐related hormones in gingival crevicular fluid (GCF) and extent/severity of periodontal disease. Methods: One hundred twenty participants who fulfilled the study inclusion criteria were chosen. Patients with chronic periodontitis (CP) and those with healthy periodontal tissues/mild gingivitis were included. The clinical examinations were performed on the day after the psychologic evaluations which included anxiety and depression measurements. GCF sampling was undertaken the following day. Commercially available enzyme‐linked immunosorbent assay kits were used to determine GCF cortisol and dehydroepiandrosterone (DHEA) levels. Study groups were assigned as follows: group 1, non‐periodontitis; group 2, localized CP; and group 3, generalized CP. Results: There were no significant differences with respect to age, sex, education, income level, occupation, or smoking history among the groups (P >0.05). There were no significant differences between the non‐periodontitis and CP groups for any of the psychosocial scales (P >0.05). Group 3 had significantly higher mean DHEA scores compared with group 1 (P <0.05); however, the median cortisol scores showed no statistically significant differences among the three groups (P >0.05). Conclusions: Anxiety/depression scores and GCF cortisol levels did not show any difference with regard to clinical periodontal status. However, a significant association was found between elevated levels of GCF DHEA and the severity of periodontitis.     

不同类型牙周炎患者唾液中8-OHdG含量的比较

目的:检测不同类型牙周炎患者非刺激性全唾液中8-OHdG的含量并评价其与PD,CAL等临床指标的关系。方法:留取10名侵袭性牙周炎,10名慢性牙周炎和10名健康对照非刺激性全唾液,并记录全口PD,CAL,PLI,BI。ELLISA试剂盒检测唾液中8-OHdG含量。结果:8-OHdG含量在3组间存在统计学差异,AgP组:(3.8 ±1.0) μg/L, CP组:(2.37±0.7) μg/L,H组:(1.0±0.6) μg/L。PD,BI,PLI,CAL与8-OHdG含量存在相关关系,慢性与侵袭组中8-OHdG含量与平均CAL, CAL>5mm位点所占百分比,CAL>7 mm位点所占百分比相关。结论:唾液中8-OHdG含量可以反映牙周组织的破坏程度并与牙周炎类型存在相关关系。     

RAU患者唾液中TNF-α的表达及临床意义

目的：研究肿瘤坏死因子（TNF-α）在复发性阿弗他溃疡（RAU）患者唾液中的表达及临床意义。方法：用双抗体夹心ELISA法对RAU患者30例（男14例,女16例,年龄14～55岁）唾液中TNF-α的含量进行检测,并以30例（男15例,女15例,年龄19～52岁）健康人做正常对照,对结果进行定量分析。结果：30例RAU患者唾液中TNF-α的平均含量（86.36±26.74）pg/mL比健康人（59.51±19.30）pg/mL明显升高（t=4.458,P〈0.001）。结论：RAU患者唾液中TNF-α的含量明显高于健康对照组,进一步说明TNF-α参与了RAU的病理过程。     

复发性阿弗他溃疡患者心理因素及血浆儿茶酚胺水平变化

目的: 研究复发性阿弗他溃疡（RAU）患者心理因素及血浆儿茶酚胺水平的变化,探讨心理因素与复发性阿弗他溃疡发生、发展间的关系及其可能存在的物质基础。方法: 选择2016年2月—2016年8月在南京大学医学院附属口腔医院口腔黏膜病科门诊就诊的RAU患者30例为实验组,同时选择30名无重大系统性疾病及口腔黏膜疾病的年龄、性别等因素与实验组相匹配的健康人群作为对照组。采用焦虑自评量表（SAS）和抑郁自评量表（SDS）分析2组受试人群的心理状态。于上午9—10点间安静状态下抽取受试者的全血,通过高效液相色谱法检测受试者血浆儿茶酚胺（包括多巴胺、去甲肾上腺素、肾上腺素）水平。数据采用SPSS22.0软件包进行统计学分析。结果: 实验组焦虑自评量表与抑郁自评量表的标准分值显著高于对照组（P<0.01）。血浆儿茶酚胺类物质水平分析,实验组肾上腺素水平显著高于对照组（P<0.01）,多巴胺及去甲肾上腺素值2组间无显著差异。心理量表和血浆肾上腺素水平的相关性分析显示两者显著相关。结论: RAU患者存在明显的心理因素变化,同时伴有体内儿茶酚胺类物质水平明显升高。     

牙周炎与认知功能障碍的相关性研究

目的 通过评估认知功能正常和认知功能障碍中老年人的牙周状况,来研究牙周炎与认知功能障碍之间的关系。 方法 选取认知功能障碍患者40例及认知功能正常的健康对照的中老年人35例,使用简易精神状态量表（MMSE）评估认知功能,并检查和评估其牙周健康状况,包括牙周炎的严重程度、余留牙齿数量、探诊出血阳性率、探诊深度（PD）以及附着水平（AL）。比较两组患者的牙周状况,分析牙周检查指标和认知功能的相关性。使用SPSS 26.0软件进行统计学分析。 结果 认知功能障碍组与健康对照组在牙周炎严重程度的分布情况有明显差异（χ²=13.309,P=0.001）,认知功能障碍组的重度牙周炎比例显著高于健康对照组（P<0.05）。认知障碍组PD≥6 mm、AL≥5 mm的位点百分比显著高于对照组,PD=1~3 mm、AL=0~2 mm的位点百分比明显少于对照组（P<0.05）。两组的探诊出血阳性率无明显差别（P>0.05）,认知功能障碍组的余留牙齿数量明显少于对照组（P<0.05）。认知功能的MMSE评分与牙齿数量、AL=0~2 mm的位点百分比呈正相关,与AL≥5 mm的位点百分比呈负相关（P<0.05）。 结论 牙周炎与认知功能障碍之间存在相关性,二者之间的具体关系及相关机制值得进一步探究。