Ⅱ期牙周炎的临床诊断与治疗

2018年公布的牙周病和植体周病国际新分类对比1999年的牙周病分类系统有许多改变.旧分类系统中的"侵袭性牙周炎"和"慢性牙周炎"被归于一个类别(即牙周炎),并进行多维的分期分级描述.目前这种新分类已引入临床以指导实践,但许多口腔医生尚不熟悉.其中Ⅱ期牙周炎是中度牙周炎,此阶段炎症已对牙周组织造成一定损坏,若能早诊断、...     

2018牙周病和植体周病国际新分类 ——牙周炎分期分级疾病定义系统临床应用体会

对比1999年牙周病分类体系,2018年公布的牙周病和植体周病国际新分类有许多改变,其中构建牙周炎分期分级疾病定义系统,对患者进行个性化的牙周炎定义尤其受到国内外牙周学者的关注。本文将简要介绍牙周炎分期分级疾病定义系统提出的背景、具体内容以及临床意义,同时尝试结合中国国情,探索牙周病新分类风险评估与预后判断的临床应用。     

从前后两次牙周病国际分类看牙周病学的发展及今后主要任务

笔者作为1998年国际分类研讨会的受邀专家和综述撰写者,时隔19年又有幸受邀参加了2017年11月在芝加哥举办的牙周病和植体周病国际分类研讨会.两次会议的参会经历和对分类共识报告的学习感触颇深,从1999年的牙周病分类(共识报告正式发表于1999年,简称"1999年分类")到2018年的牙周病分类(共识报告发表于201...     

侵袭性牙周炎病因的研究进展

侵袭性牙周炎（aggressive periodontitis,AgP）是牙周炎的一个亚类,典型的临床表现是快速进展的牙周结缔组织的破坏和牙槽骨的丧失,常发生于全身健康的年轻患者,具有一定的家族聚集性,不同于慢性牙周炎,对人类牙周系统危害较大,疗效欠佳。该命名于1999年由美国牙周病学会组织的牙周病分类国际研讨会上提出,包括了原分类的青少年牙周炎、快速进展性牙周炎和部分青春前期牙周炎。     

牙周病的分类

牙周病分类学说纷纭尚难统一。本文汇集整理了有关的分类方法及作者提出的新的分类法。1957年美国牙周病学会分类: 1.炎症:(1)牙龈炎。(2)牙周炎(单纯性,混合性)。2.营养异常症:(1)咬(牙合)创伤。(2)牙周萎缩。(3)牙根症。(4)牙周症。1961年WHO牙周病专门委员会分类: 1.牙龈炎:(1)急性:①急性溃疡性牙龈炎(奋森氏病)。②急性非特异性牙龈炎。(2)慢性:①慢性牙龈炎。②慢性增生性牙龈炎。     

牙骨质-牙本质撕裂1例

根据1999年美国牙周病国际研讨会牙周病的分类,牙骨质撕裂属于发育或获得性异常,它是影响或促进菌斑性龈病及牙周炎的局部因素[1].国外文献有少数病例报告,国内尚未见到报道.     

牙周炎新分类概述

牙周病和植体周病国际分类研讨会提出牙周炎分类的新框架,对牙周炎进行分期和分级,为牙周炎患者提供个性化的诊断和治疗策略。     

中国汉族牙周炎患者的FcyRⅢb基因型分析

目的:研究FcγRⅢb基因型与中国汉族人群侵袭性牙周炎、慢性牙周炎易感性的关系.方法:参照1999年10月牙周病分类国际研讨会制定的标准选择病例,实验分为3组,AgP组23例,CP组20例,Cont组22例.提取受检者静脉血白细胞DNA,用PCR扩增和DNA测序的方法检测FcγtRⅢb基因型,以χ2检验比较各实验组基因型的差异.结果:在各实验分组中FcγRⅢb-NA1、-NA2基因(旧定义)分布频率总和小于1,且不含-SH、-NANULL基因型,但存在新的NA1、NA2基因多态性.各基因多态性在组内及组间分布无规律(P＞0.05),无统计学差异.NA1、NA2(新定义)在本实验的汉族人群中分布频率为0.77和0.23.结论:本实验的汉族人群中FcγRⅢb包括NA1、NA2基因型,同时还存在其他新的基因多态性(-NA1*01b、-NA1*02a、-NA1*02b、-NA1*03a、-NA1*03b、-NA2*02、-NA2*03、-NA2*04).FcyRⅢb可能不完全是中国汉族人群牙周病的易感因素.     

放线共生放线杆菌与青少年牙周炎

最近几年来,特异性细菌感染在牙周病病因学中的作用日益受到重视,目前对于青少年牙周炎(juvenile Periodontitis-JP)与牙周菌丛之间的关系有了许多新的认识。大量证据表明青少年牙周炎,特别是局部型青少年牙周炎(LJP)与牙周放线共生放线杆     

血栓素B2、6-酮-前列腺素F1α与牙周病和冠心病关系的研究

目的:通过观察冠心病伴中重度牙周炎组、单纯冠心病组、单纯中重度牙周炎组以及健康对照组间血栓素B2(TXB2)和6-酮-前列腺素F1α(6-K-PGF1α)水平的差异,探讨牙周炎与心血管疾病的相互关系.方法:选取经冠脉造影明确诊断为冠心病且伴有中重度牙周炎的病人10名(CP组),单纯冠心病病人10名(C组),单纯中重度牙周炎病人10名(P组)及健康对照组(H组)10名;4组受检者的年龄、性别、体质量指数、吸烟史无统计学差异(P>0.05),高血压史4组间有统计学差异(P<0.05).对所有受检者进行口腔检查,记录其基本资料及相关牙周指标,并抽取清晨空腹静脉血3 mL,采用放射免疫分析方法(RIA)检测其血清中TXB2和6-K-PGF1α水平,进行统计学分析.结果:CP组、C组、P组的TXB2和6-K-PGF1α水平高于H组,差异有统计学意义(P<0.05).结论:冠心病和牙周病病人血清中TXB2和6-K-PGF1α水平升高,提示牙周炎能促进冠心病的发生发展.     

Mood and malignancy: head and neck cancer and depression

Head and neck cancer patients have been reported to show high rates of depression. However, it is important to differentiate between depressive symptoms and a depressive disorder. This review critically examines the relationship between head and neck cancer and depression. There appears to be little evidence for depression leading to an increased risk of developing cancer and although depressive symptoms in head and neck cancer patients are common, very few studies have investigated depressive disorders. The studies that investigated the incidence of a comorbid depressive disorder report a prevalence very close to that of the general population, implying that major depression is not a normal response to cancer. Finally, the evidence suggests that comorbidity of depression with cancer has a negative impact on morbidity and mortality. Both psychosocial and biological factors could account for this. Dysregulation of the stress hormone axis and increased inflammation are common in depressive disorders and have been suggested as underlying pathological mechanisms and are both markers of poor prognosis in cancer. This evidence suggests that a relatively small number of patients develop a depressive disorder following a diagnosis of cancer, but for those that do it may have a substantial impact on their prognosis.     

低氧和自噬与肿瘤的发生发展

自噬作为真核生物的一种应激调控机制,既可以促进肿瘤的发生发展,又可以抑制肿瘤的增殖。在肿瘤局部低氧的微环境下,低氧诱导因子-1α、哺乳动物雷帕霉素靶蛋白信号转导通路抑制、内质网应激均可促进自噬的发生。在肿瘤快速地发生发展过程中,肿瘤的糖代谢功能增强、活性氧族增多、窖蛋白1下调以及上皮间质转化的激活均诱导了自噬的发生并促进肿瘤的局部浸润、侵袭转移和耐药,因此,抑制自噬可能为肿瘤治疗提供一种新的策略。     

Survey of Australian and New Zealand Oral and Maxillofacial Surgery trainees and recent specialists--education and experience

This study examined the demographic characteristics, educational background and attitudes toward training of all recent OMS specialists and all current trainees in Australia and New Zealand in 1996. The early nineties is a key period as it marks the transition from an essentially dentally based speciality (85% dental degree in 1990); to recent specialists with an increasing number with both medical and dental degrees (33% dual degree 1990-1996); to predominantly dual degree training (84.4% dual in 1996). Current trainees had more extensive experience in pathology, preprosthetic and reconstructive surgery. They were also strongly critical of the length and cost of training.     

Open bite and and therapeutic strategy

Anterior open bites can be divided into two categories: skeletal and dento-alveolar. The etiology, basically affecting dento-alveolar structures, is functional or mechanical such as the rotation of the first higher molars, the exaggerated curve of Spee and the incisor supraclusion and the simple orthodontic treatment can bring a therapeutic success but functional rehabilitation remains the guaranty of such a stability of our treatment. The purpose of this work is to make a teaching article which puts the point on the interest of the elements of the diagnosis and the orthodontic treatment indicated in certain clinical situations of anterior open-bite; this by detailing biomechanics of correction of this anomaly requiring various therapeutic strategies. Functional rehabilitation remains always the guaranty of such a therapeutic stability. For the teaching aspect, we want to attach stereotypic forms and also to present clinical cases treated in the service of consultation and dental treatment in order to answer such a request.