老年糖尿病患者牙周翻瓣术治疗对血糖水平的影响

目的：探讨牙周翻瓣手术治疗对老年糖尿病患者牙周炎症控制及血糖水平的影响。方法：选择24例已行牙周洁、刮治术的患有2型糖尿病的老年牙周炎患者,随机分成两组,每组12例,治疗组行牙周翻瓣术治疗,对照组不行翻瓣术治疗,测量并比较两组治疗前及12周后的探诊出血、探诊深度及糖化血红蛋白水平。结果：治疗组所有患者治疗后探诊出血、探诊深度明显减少。糖化血红蛋白从（7.96±1.37）%降低为（7.11±1.05）%,差异有统计学意义（P〈0.05）,对照组此三项指标变化差异无统计学意义,并且在治疗12周后治疗组三项指标均低于对照组,差异有统计学意义。结论：糖尿病患者牙周炎症控制能在一定程度上改善糖代谢水平,且改善的效果可能与牙周炎症控制有关。     

牙周治疗对非胰岛素依赖型糖尿病患者的短期影响

目的　研究非胰岛素依赖型糖尿病牙周病患者牙周常规非手术治疗后 ,牙周状况及糖代谢的改变。方法　选择非胰岛素依赖型糖尿病患者 2 5例 ,进行牙周非手术治疗 ,比较治疗前及治疗后 4周、8周牙周状况 (探诊出血 ,牙周袋深度 )和糖化血红蛋白的水平。结果　患者治疗后 ,牙周探诊出血、探诊深度明显减轻。重度牙周炎患者治疗后 4周、8周糖化血红蛋白的水平降至 9.0 1± 0 .85 %和 8.84± 1.5 2 % ,与治疗前相比差异有显著性。轻中度牙周炎组治疗后 4周糖化血红蛋白略有下降 ,8周时与治疗前相比差异无显著性。结论　非胰岛素依赖型糖尿病患者牙周炎症控制短期内使糖代谢水平得到一定改善 ,但远期影响尚不肯定 ,有待进一步研究     

口腔卫生指导对2型糖尿病伴慢性牙周炎患者牙周炎症控制及血糖代谢水平的影响

目的探讨口腔卫生指导对2型糖尿病伴慢性牙周炎患者牙周状况和血糖水平的影响。方法 31例2型糖尿病伴慢性牙周炎患者,接受口腔卫生指导后,分别在基线、6周、3个月、6个月、12个月和18个月检测牙周临床指标和血糖代谢指标。牙周临床指标包括:探诊深度、附着丧失、探诊出血、菌斑指数;血糖代谢指标包括:空腹血糖、糖化血红蛋白。结果 31例患者基线、6周、3个月、6个月、12个月和18个月6个时间点的附着丧失量(P=0.003)和探诊出血阳性率(P=0.022)差异有统计学意义;其它指标如探诊深度(P=0.203)、菌斑指数(P=0.087)、空腹血糖(P=0.352)和糖化血红蛋白(P=0.071)的变化没有统计学意义。结论口腔卫生指导可以短期改善2型糖尿病伴慢性牙周炎患者的牙周炎症,但对牙周组织退缩没有更大的帮助,尚不能认为口腔卫生指导对血糖代谢有显著影响。     

伴糖尿病的慢性牙周炎患者牙周基础治疗效果研究

目的研究牙周基础治疗对伴有糖尿病的慢性牙周炎患者的治疗效果。方法选择伴Ⅱ型糖尿病的老年慢性牙周炎患者(糖尿病组)与不伴糖尿病的老年慢性牙周炎患者(非糖尿病组)各20例行牙周基础治疗,记录并比较两组患者在基线和术后3、6、12个月的菌斑指数、牙龈指数、探诊出血、探诊深度、附着丧失等指标。结果牙周基础治疗对两组患者均有较好的治疗效果,各项指标均明显改善,与基线水平比较差异有统计学意义(P<0.01),而两组间各项牙周指数的改善在术后3、6、12个月差异均无统计学意义(P>0.05)。结论牙周基础治疗对伴有糖尿病的老年慢性牙周炎患者在短期内(12个月)有良好的治疗效果。     

糖尿病患者牙周非手术治疗对血糖水平的影响

目的　探讨牙周非手术治疗对糖尿病患者牙周炎症控制及血糖水平的影响。方法　从83例胰岛素非依赖性糖尿病牙周炎患者中选出代谢控制不良的 31例 ,行牙周非手术治疗 ,测量并比较术前、术后 4、8周的探诊出血、探诊深度及糖化血红蛋白水平。结果　所有患者治疗后探诊出血、探诊深度明显减少。重度牙周炎患者糖化血红蛋白从 ( 9 86± 2 1 0 ) %降低为 ( 8 77± 1 62 ) % ,差异有显著性 (P <0 0 1 ) ;中轻度牙周炎患者糖化血红蛋白的变化差异无显著性 (P >0 0 5)。结论　糖尿病患者牙周炎症控制能在一定程度上改善代谢水平 ,但改善的效果可能与治疗前血糖水平和牙周状况有关     

牙周基础治疗对伴2型糖尿病的中、重度牙周炎患者牙周炎症控制、血清炎症指标及代谢水平影响

目的 探讨牙周基础治疗对伴 2型糖尿病的中、重度牙周炎患者牙周炎症控制、血清炎症指标以及糖代谢水平的影响。方法 将前期临床试验人群中的 56例中、重度牙周炎患者（平均临床附着水平> 3 mm）纳入本研究进行亚组分析,采用重复测量的方差分析比较治疗组和对照组牙周指数（包括平均探诊深度、临床附着水平和探诊出血指数）、超敏 C反应蛋白（ hsCRP）、糖化血红蛋白（ HbA1c）、空腹血糖在基线、 1.5个月、 3个月、 6个月连续 4次的变化。结果 伴2型糖尿病的中、重度牙周炎患者在牙周治疗后平均探诊深度（ F=62.898,P=0.000）、临床附着水平（ F=51.263,P=0.000）和探诊出血指数（ F=75.164,P=0.000）在治疗后逐渐改善,其中平均探诊深度（t=-2.050,P=0.045）和探诊出血指数（ t=-4.538,P=0.000）显著优于对照组;治疗后 hsCRP（F=6.391,P=0.010）、 HbA1c（F=4.536,P=0.011）、空腹血糖（ F=3.073,P=0.031）降低,其中 hsCRP显著低于对照组（ t=-2.261,P=0.028）。结论 牙周基础治疗有助于改善伴 2型糖尿病的中、重度牙周炎患者的牙周炎症和血清炎症指标以及糖代谢水平。     

米诺环素作为牙周手术根面处理剂的临床研究

目的:探讨牙周翻瓣术后用米诺环素作为根面处理剂的临床效果。方法:将23名有中到重度牙周炎需做牙周翻瓣术的患者随机分成两组:对照组仅进行牙周翻瓣术,不做根面处理。实验组在牙周翻瓣术后,用米诺环素处理根面。观察两组术后3d和7d的术区反应及基线时、术后8周及12周的菌斑指数、牙龈指数、探诊出血、探诊深度的动态变化。结果:术后3d,实验组的术后反应显著轻于对照组(P<0.01)。与基线检查时相比,两组菌斑指数,牙龈指数,探诊出血及探诊深度均有显著改善。除8周时,实验组的探诊出血率显著低于对照组(P<0.05)外,两组之间的牙周指数并无显著性差异(P>0.05)。结论:米诺环素作为根面处理剂,能迅速减轻术后牙周组织的炎症反应,促进创口愈合。     

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。     

糖尿病患者牙周病的正畸治疗对牙周状况及血糖水平的影响

目的：探讨牙周病的正畸治疗对糖尿病患者的牙周炎症控制与血糖水平的影响。方法：选择12例患有2型糖尿病的牙周炎患者先行牙周洁、刮治术,待牙周组织炎症消除后再行正畸治疗,并对牙龈炎的严重度、牙齿松动度、牙周袋探诊深度、牙槽骨吸收度及糖化血红蛋白水平进行评价。结果：通过正畸治疗,探诊出血、探诊深度明显减少。糖化血红蛋白从（7．87±1．12）％降低为（7．02±0．97）％。结论：糖尿病患者的牙周炎症通过正畸治疗显著好转,基本达到个别聘正常、恢复咀嚼功能,并能在一定程度上改善糖代谢水平,且改善的效果可能与牙周炎症控制有关。     

2型糖尿病合并慢性牙周炎患者血清与龈沟液中抵抗素水平的研究

目的:探讨2型糖尿病合并慢性牙周炎患者血清、龈沟液抵抗素水平以及与牙周临床指标的相关性.方法:将60名受试者分成三组,1组:2型糖尿病伴慢性牙周炎患者20人,2组:慢性牙周炎患者20人,3组:健康对照者20人.对所有受试者进行牙周临床检查,检测指标包括:菌斑指数,牙龈指数,出血指数,探诊深度,附着丧失.同时用酶联免疫吸...     

Effect of non-surgical periodontal treatment with or without doxycycline on the periodontium of type 1 diabetic patients

AIM: The present investigation was performed to study how type 1 diabetics responded to non-surgical periodontal treatment with and without adjunctive doxycycline. METHOD: Sixty diabetic type 1 patients (mean age 35.3+/-9 years) with moderate-to-severe periodontal disease were selected and divided into two groups of 30 patients each. Both groups were sex and age matched and had similar amounts of periodontal destruction. Plaque index (PI), bleeding on probing (BOP), probing depth (PD) and clinical attachment levels (CAL) were recorded. Group 1 (30 patients) was treated with oral hygiene instruction, scaling and root planing, chlorhexidine rinses twice a day and doxycycline (100 mg/day for 15 days). Group 2 (30 patients) had the same treatment but without doxycycline. After 12 weeks their periodontal condition was reevaluated. RESULTS: After treatment, both groups had a significant improvement in all periodontal parameters, since PI, BOP, probing pocket depth (PPD) and CAL were significantly reduced. However, the reduction in PD in pockets > or =6 mm and in BOP were more evident when doxycycline was used (group 1). Differences between groups for these parameters were statistically significant (p=0.03). CONCLUSION: Although both periodontal treatment regimens are effective in type 1 diabetics, the use of doxycycline as an adjunct, provided more significant results when good plaque control was achieved.     

Association of Serum Triglyceride Level and Gemfibrozil Consumption With Periodontal Status

Background: Hyperlipidemia is a major risk factor for cardiovascular diseases. Considering the suggested association between periodontal and cardiovascular diseases, this study sought to assess the association, if any, between serum triglyceride (TG) levels and gemfibrozil consumption with periodontal parameters. Methods: This cross‐sectional study was conducted on 90 participants, including 30 individuals with a normal lipid profile (group H), 30 patients with hypertriglyceridemia and not on medication (group N), and 30 patients with hypertriglyceridemia and taking gemfibrozil over a 3‐month period (group M). Periodontal parameters including probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index were measured at four sites of each tooth. Serum levels of total cholesterol (TC), TG, low‐density lipoprotein, and high‐density lipoprotein were measured. Results: Mean values for PD and CAL in the two hypertriglyceridemic groups were significantly higher than those of the H group (P <0.001). After controlling for confounding variables, significant linear correlations were noted between PD and BOP, PD and TC, PD and TG, and CAL and TG in each group (P <0.01). Conclusions: Patients with hypertriglyceridemia had worse periodontal status than healthy controls. Patients with hypertriglyceridemia who were taking gemfibrozil did not show significant differences in CAL and PD compared with untreated patients with hypertriglyceridemia.     

慢性牙周炎维护治疗期临床纵向观察

目的:了解慢性牙周炎维护治疗期临床指标变化规律。方法:对牙周非手术基础治疗后进入维护治疗期的22名慢性牙周炎病人进行9个月的纵向观察。每3个月给予口腔卫生宣教,龈上下洁刮治和根面平整。并在基线和每次复查时记录临床检查指标,包括探诊深度(PD)、临床附着水平(CAL)、探诊出血(BOP)。结果:后牙较前牙更易出现牙周袋加深,>6 mm深袋的比例6个月后显著下降,CAL改善在邻面及舌侧更加明显,BOP比例持续下降。结论:非手术基础治疗配合定期维护,可使临床指标在较短期内获得明显改善。     

Association of Untreated Metabolic Syndrome With Moderate to Severe Periodontitis in Thai Population

Background: Metabolic syndrome (MetS) correlates with systemic inflammation. A relation of MetS to periodontitis has been reported. This study aims to evaluate whether periodontitis is associated with untreated MetS, plasma adiponectin, and leptin among Thai people. Methods: One hundred twenty‐five participants (aged 35 to 76 years) were recruited. Demographic and biologic data, bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) of all teeth were examined. Plasma adiponectin and leptin levels were measured. Results: Forty‐four participants (35.2%) were healthy, and 81 (64.8%) had MetS. All periodontal conditions (BOP, PD, and CAL) were significantly worse in patients with MetS than healthy participants. After adjustment for confounders, MetS was strongly associated with severe periodontitis (odds ratio [OR] = 3.60, 95% confidence interval [CI]: 1.34 to 9.65). MetS with four to five components had a higher association with periodontitis than did MetS with three components (OR = 5.49, 95% CI: 1.75 to 17.19), whereas each separate component had no association with periodontitis, except for high diastolic blood pressure. Periodontitis was also associated with age (OR = 1.08, 95% CI: 1.01 to 1.14) and education (OR = 3.76, 95% CI: 1.05 to 13.40). The risk of MetS was predicted by body mass index and plasma adiponectin (OR = 1.90, 95% CI: 1.24 to 2.92 and OR = 0.93, 95% CI: 0.88 to 0.98, respectively). Conclusions: There may be a relationship between untreated MetS and periodontitis in Thai people. Periodontal diagnosis should be regularly conducted in patients with MetS.     

Correlation Between Gingival Crevicular Fluid Hemoglobin Content and Periodontal Clinical Parameters

Background: Probing depth (PD) and bleeding on probing (BOP) are essential clinical parameters used for periodontal diagnosis. This study investigated whether detection of hemoglobin (Hb) in gingival crevicular fluid (GCF), along with PD and BOP, would improve diagnostic accuracy. Methods: After plaque index (PI) was measured, GCF was collected from the gingival sulci of 401 anterior teeth in the maxilla and mandible from 184 patients who had entered periodontal maintenance therapy. Clinical parameters (gingival index [GI], PD, clinical attachment level [CAL], and BOP) were recorded. Hb values in GCF were assessed by immunochromatography. Moreover, cutoff values for PI, GI, and CAL based on the degree of PD and amount of GCF were created and analyzed. Results: Hb was detected in 64.8% of GCF samples in 105 BOP‐negative (–) sites in the periodontally stable group out of 107 sites that were less than all cutoff values. There were 71 BOP(–) sites in the periodontal‐management‐required group out of 122 sites that were more than all cutoff values, although no improvement in periodontal disease was observed. Hb was detected in 88.7% of GCF samples from these 71 BOP(–) sites. Conclusions: Hb was observed in more than 60% of GCF samples in BOP(–) gingival sulci in both periodontally stable and periodontal‐management‐required groups. These results suggest inspection of Hb derived from microbleeding in gingival sulci may serve as an index for preclinical diagnosis.     

Bisphosphonate therapy improves the outcome of conventional periodontal treatment: results of a 12-month, randomized, placebo-controlled study

BACKGROUND: Bone loss in periodontitis results from inflammatory reactions that stimulate osteoclastic bone resorption. Bisphosphonates inhibit bone resorption and increase bone mass. This study evaluated the effect of bisphosphonate therapy as an adjunct to non-surgical periodontal treatment in patients with moderate to severe chronic periodontitis. METHODS: Patients were randomized (2:1) to one of two bisphosphonate therapies or placebo for 1 year. All patients received non-surgical periodontal treatment (scaling, root planing) and periodontal maintenance therapy every 3 months. Clinical assessments at baseline and 6 and 12 months included clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP). Periodontal bone mass was assessed by dental radiographs at baseline and 12 months using fractal analysis and digital subtraction radiography (DSR). RESULTS: Seventy patients were randomized, 43 to the bisphosphonate group and 27 to the placebo group. Bisphosphonate therapy significantly improved CAL, PD, and BOP relative to the placebo group during the 6- to 12-month period (CAL, P = 0.0002; PD, P = 0.0156; BOP, P = 0.0079). There was no difference in the change in periodontal bone mass between the bisphosphonate and placebo groups as measured by fractal analysis and DSR. CONCLUSION: These data suggest that bisphosphonate treatment improves the clinical outcome of non-surgical periodontal therapy and may be an appropriate adjunctive treatment to preserve periodontal bone mass.     

Periodontal status in men with hypergonadotropic hypogonadism: effects of testosterone deficiency

BACKGROUND: The purpose of this clinical study was to evaluate the possible influence of testosterone hormone on common clinical measurements of periodontal disease in men with hypergonadotropic hypogonadism. METHODS: Twenty-four hypergonadotropic hypogonadal men (H) and 24 systemically healthy men (S) were divided into two groups as chronic periodontitis and clinically healthy controls after clinical examinations and radiographs. The H group consisted of 12 control (H/C) and 12 chronic periodontitis (H/P) patients, and the S group consisted of 12 control (S/C) and 12 chronic periodontitis (S/P) patients. Plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment loss (CAL) scores were recorded. RESULTS: The mean of all clinical parameters (PI, GI, BOP, PD, and CAL) were significantly (P<0.05) higher in periodontitis groups (H/P and S/P) than controls (H/C and S/C). There were no significant differences in the PD and CAL scores between periodontitis groups (S/P and H/P). The mean of GI and BOP scores were statistically higher in the H/P group than the S/P group (P<0.05). There was a negative correlation between GI and free testosterone levels (r=-0.794; P<0.05). CONCLUSION: According to these results, serum testosterone levels may possibly influence periodontal disease in men, and testosterone may have an inhibitory effect on gingival inflammation.     

Clinical outcome observed in subjects with recurrent periodontal disease following local treatment with 25% metronidazole gel

BACKGROUND: The aim of this study was to evaluate the clinical outcome in patients with recurrent periodontal disease following treatment with 25% metronidazole gel. METHODS: Twenty subjects in a maintenance care program but with recurrent periodontal disease participated. Three months after scaling and root planing, a total of 40 sites, 2 in each patient, with probing depth > or = 5 mm were selected. One site randomly selected was treated with metronidazole gel (test) and the other site with a placebo gel (control). Baseline and follow-up measurements included plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). RESULTS: There were no statistically significant differences in PI, GI, BOP, PD, or CAL between test and control sites. CONCLUSION: This study showed that local treatment with 25% metronidazole gel did not seem to influence the clinical healing in this group of subjects with recurrent periodontal disease.     

Periodontal assessment of patients undergoing angioplasty for treatment of coronary artery disease

BACKGROUND: The purpose of this cross-sectional study was to assess the periodontal condition of patients with coronary artery disease (CAD) in order to verify the association between CAD and certain periodontal parameters. METHODS: Eighty patients (48 males and 32 females) were recruited from the Cleveland University Hospitals, Division of Cardiology (aged 23 to 83, median age 54 years). Upon cardiac catheterization, 50 were diagnosed with severe CAD (experimental group) and 30 with no angiographic evidence of CAD (control group). Patients with CAD were divided into 3 subgroups according to the clinical diagnosis of acute infarction (Al) (n = 20), stable angina (SA) (n = 20), and unstable angina (UA) (n = 10). The following dental, medical, and social histories were recorded: number of dental visits/year, frequency of brushing/day and flossing/week, tobacco use, presence/absence of hypertension, diabetes, total cholesterol level, and the highest level of education completed. The following periodontal parameters were also assessed for each subject: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and number of missing teeth. Logistic regression analysis was used to determine whether there was a significant correlation between these periodontal parameters and CAD. RESULTS: The significant confounding factors for the present study were found to be age and gender. The periodontal condition of the 80 subjects was clinically diagnosed as gingivitis and/or mild periodontitis. Analysis of the data after adjusting for age and gender demonstrated a statistically significant association between BOP and GI and CAD in patients with Al; and facial/lingual CAL in patients with UA. No significant associations were found between PD, interproximal CAL, number of missing teeth, or dental/medical histories and CAD. CONCLUSION: Based on the results of this study, gingival inflammation may be considered a more significant risk factor for CAD than previously reported.