多西环素缓释凝胶治疗牙周炎的临床研究

目的观察多西环素缓释凝胶剂治疗牙周炎的临床疗效。方法选取牙周炎患者30例,采用自身对照法,随机分为2组,试验组与对照组各30例,试验组治疗药物为多西环素凝胶,对照组为台氏液。观察用药前后临床症状及各项牙周指数PLI、GI、SBI、PD、AL、MD的变化。结果试验组牙周炎患者用药4周,停药1周时PLI、GI、SBI、PD、AL与用药前相比均有非常显著性差异(P<0.01);试验组与对照组疗效比较,两者有非常显著差异(P<0.01)。治疗过程中均未发现药物不良反应。结论多西环素凝胶是一种局部治疗牙周炎的安全有效的药物。     

缓释氯己定凝胶在慢性牙周炎治疗中的应用

目的:观察龈上洁治术、龈下刮治术和根面平整术(scaling and root planing,SRP)结合缓释氯己定凝胶(chlorhexidine,CHX)对慢性牙周炎的治疗作用。方法:选择35～65岁的慢性牙周炎患者36例,将后牙区牙周袋数目较多的单颌设定为实验组,对颌为对照组。实验组采取SRP+CHX治疗,对照组采取SRP治疗。分别于牙周治疗前、中、后3个阶段,记录每个受试牙近颊、颊侧、远颊、近舌、舌侧和远舌位点的牙龈指数(GI)、探诊出血(BOP)、探诊深度(PD)、临床附着水平(CAL)、探诊出血指数(SBI)。结果:BOP、SBI、PD、GI四项指标在治疗后1个月,实验组与对照组之间有显著差异(P<0.05),4个月后则无显著性差异(P>0.05)。CAL在治疗后1个月,两组间无显著(P>0.05),而4个月后差异显著性差异(P<0.05)。无论是实验组还是对照组,治疗前后各项牙周指标后牙区位点对治疗的反应明显不如前牙区,但无显著性差异(P>0.05)。PD>7 mm的深牙周袋,SRP+CHX组与SRP组之间4个月后仍有显著性差异。结论:在慢性牙周炎治疗过程中,SRP+CHX治疗能够改善牙周临床指标,尤其对PD>7 mm的深牙周袋有更好的治疗作用。     

葛根素影响去势雌性大鼠牙周炎症的实验研究

目的探讨葛根素对去势SD大鼠牙周炎形成和发展的影响。方法雌性3月龄SD鼠60只分为6组,A组（正常对照组）、B组（牙周结扎组）、C组（去势组）、D组（去势结扎组）、E组（去势葛根素组）、F组（去势结扎葛根素组）各10只。C、D、E、F组大鼠分别经腹部切口摘除双侧卵巢;B组作假手术。B、D、F组在大鼠右侧上颌第一磨牙牙颈部结扎1根0.2 mm不锈钢丝。E、F组大鼠术后1周开始每天腹腔注射100 mg/kg葛根素;B、C、D组大鼠每天腹腔注射相应剂量生理盐水。给药12周后分别观察各组大鼠牙槽骨吸收值、血钙值、血磷值、血清碱性磷酸酶含量以及牙槽骨组织病理学改变。结果所有牙周结扎组都表现出不同程度的局部牙周炎症;各去势组大鼠都存在不同程度的骨质疏松改变,注射葛根素组病理学表现较未注射葛根素组为轻。血清钙水平去势各组与正常对照组差异均有统计学意义（P〈0.05）;血清碱性磷酸酶水平去势各组与正常对照组差异有统计学意义（P〈0.05）;血清磷水平在各组间差异无统计学意义（（F=1.764 1,P〉0.05）。A、C、E组未观察到明显的牙周骨质吸收,B、D、F组牙槽骨吸收值分别为（0.21±0.08）mm、（0.55±0.07）mm、（0.42±0.10）mm,3组两两比较,差异均有统计学意义（P〈0.01）。结论在局部刺激因素存在的前提下,雌激素水平降低可增加大鼠对牙周炎症的易感性和反应程度;葛根素对伴随雌激素降低的牙周炎的发生发展有一定的阻缓作用。     

布洛芬缓释凝胶治疗慢性牙周炎的临床研究

目的:探讨布洛芬局部用药新剂型的研制及其对慢性牙周炎的临床治疗效果.方法:采用PLGA(聚乳酸-乙醇酸共聚物)作为缓释辅料制备布洛芬缓释凝胶.运用紫外分光光度法检测布洛芬缓释凝胶的体外释放度.临床选择慢性牙周炎患者30例共60颗患牙作为研究对象,每例患者保证口腔内有2颗病情相近的患牙用作自身对照,分别分入实验组和对照组.实验组患牙在进行牙周洁刮治及根面平整后向牙周袋内注入实验药物,每周1次,共2次;而埘照组患牙仅进行牙周洁刮治及根面平整.分别于基线、治疗后第2周及第4周观察患牙局部的临床症状、龈沟出血指数、牙周袋探诊深度及附着丧失.2组间对比并进行统计学处理.结果:实验组与对照组在治疗后各项临床指标差异具有显著性(P＜0.05).结论:布洛芬缓释凝胶能有效改善慢性牙周炎的临床症状,控制牙周炎症,减少组织破坏,具有很好的临床实用意义.     

正畸力作用下垂直型骨吸收牙周炎大鼠牙槽骨改建的实验研究

目的：观察正畸力作用下牙周炎大鼠垂直吸收的牙槽骨改建,为牙周炎的临床正畸治疗提供依据。方法：将75只10周龄雄性SD大鼠,随机分为3组,正常加力对照组（ A）、牙周炎垂直骨吸收对照组（ B）、牙周炎垂直骨吸收加力实验组（ C）,每组各25只,各组动物分别于加力后8 h,1、7、14、21 d处死,取动物模型上颌左侧第一磨牙近中牙槽骨进行组织学及免疫学检测,所得结果进行对比研究。结果：正畸加力至7d时,实验组大鼠垂直吸收侧牙周膜纤维排列紊乱,出现无细胞结构,结缔组织可见少量炎症细胞,牙槽骨表面还可见功能活跃的多核破骨细胞,与对照组相比较无显著差异,实验组大鼠牙周组织中IGF?1表达达到峰值,光密度值最高,与对照组比较有显著差异（ P＜0．05）;加力至14 d时,实验组大鼠垂直吸收侧牙周组织中RUNX2的表达达到峰值,其光密度值最高,明显高于正常加力对照组,其变化有统计学意义（P＜0．05）。结论：控制牙周炎症和消除咬合创伤后,正畸力能刺激牙周炎大鼠垂直缺损牙槽骨区域的RUNX2和IGF?1的表达增强,合成骨胶原和骨基质的能力增强,从而促进牙槽骨的改建。     

环肌酸抑制大鼠牙周炎周围牙槽骨吸收的实验研究

目的:通过体外和体内实验探讨环肌酸对牙周炎造成的牙槽骨吸收的抑制作用.方法:体外实验通过细胞活力测定、碱性磷酸酶染色和茜素红染色、抗酒石酸酸性磷酸酶染色和实时反转录聚合酶链反应(RT-PCR)等检测,评价环肌酸对成骨细胞和破骨细胞增殖和分化的影响.动物实验将20只大鼠分为4组,A组为对照组,B组采用牙周结扎+生理盐水注...     

雷洛昔芬防治骨质疏松大鼠牙周炎牙槽骨吸收的实验研究

目的:探讨雷诺昔芬对骨质疏松大鼠实验性牙周炎牙槽骨吸收的防治作用.方法:选用3~4 月龄雌性SD大鼠,随机分为假手术组(SHAM)、卵巢切除组(OVX)、雷诺昔芬治疗组(RAL)及雌激素治疗组(EST),每组8 只.采用卵巢切除术及钢丝结扎法建立骨质疏松大鼠实验性牙周炎动物模型,灌胃给药7 周后处死,通过体重、骨密度测量、血清生化检测及组织学观察对药效进行评价.结果: RAL 组大鼠骨密度值明显高于OVX 组,血清碱性磷酸酶及骨钙素水平下降,而血清雌二醇水平显著增加.股骨骨小梁排列整齐,皮质骨致密,与EST 组及SHAM 组比较无明显差别.OVX 组牙周炎牙槽骨吸收(0.33±0.02) mm2,明显大于RAL、EST 组及SHAM 组[(0.18±0.02) mm2、(0.19±0.02) mm2、(0.20±0.01) mm2](P<0.01).结论: 雷诺昔芬可在一定程度上抑制骨质疏松大鼠实验性牙周炎所致病理性牙槽骨吸收.     

细胞凋亡在糖尿病大鼠牙周炎中参与牙槽骨吸收的实验研究

目的研究糖尿病伴牙周炎牙槽骨破坏机制,初步探讨牙周组织细胞凋亡在该类疾病中所起的作用。方法采用腹腔注射链脲佐菌素（Streptozocin,STZ）制备SD大鼠糖尿病模型,并利用0.2mm不锈钢丝环扎大鼠磨牙颈部制备牙周炎动物模型。观察牙周组织细胞在高血糖状态及正常血糖状态下的组织形态并检测细胞凋亡情况。结果高血糖状态下大鼠牙周炎发病程度明显高于血糖正常大鼠。牙周组织中成骨细胞及牙周膜成纤维细胞凋亡数量高血糖组高于血糖正常组,而破骨细胞数量则相反。结论高血糖状态下牙周炎病损程度较正常血糖状态下严重,牙周组织细胞凋亡参与和加重病程。     

牙周炎牙槽骨吸收的基础研究—PGE2对破骨细胞性骨吸收的作用

本研究采用分离破骨细胞的体外培养方法,将分离的兔破骨细胞与牛骨片共同培养。相差显微镜观察前列腺素E_2.(Prostaglaodin E_2,PGE_2)对破骨细胞所形成的骨吸收陷窝数及形态学影响。并利用图象分析系统计算吸收陷窝的表面积。结果表明:PGE_2对体外分离的破骨细胞所形成的吸收陷窝数及吸收陷窝面积具有抑制作用。     

Effects of Melatonin on Oxidative Stress Index and Alveolar Bone Loss in Diabetic Rats With Periodontitis

Background: The aim of this study is to evaluate the effects of systemic melatonin treatment on serum oxidative stress index (OSI) and alveolar bone loss (ABL) in rats with diabetes mellitus (DM) and periodontitis. Methods: Seventy Sprague Dawley rats were divided into control, experimentally induced periodontitis (EP), DM, EP‐DM, EP and melatonin treatment (EP‐MEL), DM and melatonin treatment (DMMEL), and EP‐DM‐MEL groups. DM was induced by alloxan, after which periodontitis was induced by ligature for 4 weeks. After removal of the ligature, the rats in the melatonin groups (EP‐MEL, DM‐MEL, and EP‐DM‐MEL) were treated with a single dose of melatonin (10 mg/body weight) every day for 14 consecutive days. At the end of the study, all of the rats were euthanized, and intracardiac blood samples and mandible tissues were obtained for biochemical and histologic analyses. Serum levels of total oxidant status/total antioxidant status and OSI were measured. In addition, neutrophil and osteoclast densities and myeloperoxidase activities were determined in gingival tissue homogenates, and ABL was evaluated with histometric measurements. Results: Melatonin treatment significantly reduced fasting plasma glucose levels in the rats with DM. In addition, reduced OSI and ABL levels were detected in the EP‐MEL and DM‐MEL groups; the reductions in the EP‐DM‐MEL group were found to be more prominent. Melatonin also significantly decreased the increased myeloperoxidase activities and osteoclast and neutrophil densities in the EP, DM, and EP‐DM groups. Conclusion: It is revealed in this experimental study that melatonin significantly inhibited hyperglycemia‐induced oxidative stress and ABL through antiDM and antioxidant effects in rats with DM and periodontitis.     

雷尼酸锶对实验性牙周炎大鼠牙槽骨改建的影响

目的:通过观察雷尼酸锶对大鼠实验性牙周炎治疗后牙槽骨组织中酸性磷酸酶及碱性磷酸酶的变化,评估雷尼酸锶对实验性牙周炎的治疗作用,为应用雷尼酸锶治疗牙周炎提供理论依据和实验参考.方法:选取50只3月龄雄性SD大鼠,随机分为5组:正常组(A组)、牙周炎组(B组)、牙周炎局部治疗组(C组)、牙周炎雷尼酸锶治疗组(D组)、牙周炎...     

Therapeutic Effects of Melatonin on Alveolar Bone Resorption After Experimental Periodontitis in Rats: A Biochemical and Immunohistochemical Study

Background: The present study aims to investigate the effects of systemic melatonin administration on alveolar bone resorption in experimental periodontitis in rats. Methods: Twenty‐four male Sprague‐Dawley rats were divided into three groups (control, experimental periodontitis [Ped], and experimental periodontitis treated with melatonin [Mel‐Ped]). For periodontitis induction, first molars were ligatured submarginally for 4 weeks. After ligature removal, rats in the Mel‐Ped group were treated with a daily single dose of 10 mg/kg body weight melatonin for 15 consecutive days. At the end of the study, intracardiac blood samples and mandible tissues were obtained for histologic, biochemical, and radiographic analysis. Serum markers related to bone turnover, calcium, phosphorus, bone alkaline phosphatase (b‐ALP), and terminal C telopeptide of collagen Type I (CTX) were analyzed. Myeloperoxidase levels were determined in gingival tissue homogenates, and receptor activator of nuclear factor‐kappa B ligand (RANKL) activation was analyzed in the mandible samples stereologically. Alveolar bone loss was also evaluated radiographically in the mandible samples of each group. Results: Melatonin treatment decreased serum CTX levels and increased b‐ALP levels. Serum calcium and phosphorus levels were not statistically different among groups (P >0.05). Alveolar bone resorption and myeloperoxidase activity were statistically higher in the Ped group compared to the Mel‐Ped group (P <0.05). Immunohistochemical staining of RANKL and osteoclast activity were significantly lower in the Mel‐Ped group compared to the Ped group (P <0.05). Conclusion: This study reveals that melatonin treatment significantly inhibits regional alveolar bone resorption and contributes to periodontal healing in an experimental periodontitis rat model.     

Investigating the Effects of Systemically Administered Strontium Ranelate on Alveolar Bone Loss Histomorphometrically and Histopathologically on Experimental Periodontitis in Rats

Background: The aim of this study is to investigate effects of strontium ranelate (SR) on alveolar bone loss (ABL) in rats with experimental periodontitis. Methods: Forty Wistar rats were randomly divided into five groups: 1) control (n = 8); 2) ligated (n = 8); 3) 300 mg/kg SR (SR300, n = 8); 4) 625 mg/kg SR (SR625, n = 8); and 5) 900 mg/kg SR (SR900, n = 8). To create experimental periodontitis, 4/0 silk ligatures were inserted submarginally around first molars at the right mandible. After 11 days, rats were sacrificed. ABL was calculated by measuring cemento‐enamel junction and alveolar crest distance. Interleukin (IL)‐1β, osteoprotegerin (OPG), and bone‐specific alkaline phosphatase (BALP) serum levels were determined by enzyme‐linked immunosorbent assay. Histopathologic analysis was used to evaluate inflammatory cell infiltration, numbers of osteoblasts and osteoclasts, and receptor activator of nuclear factor‐kappa B ligand (RANKL) activity. Results: ABL was significantly lower in SR900 group than in the ligated group (P <0.05). Osteoclast numbers in ligated group were significantly higher than in the control, SR300, and SR900 groups (P <0.05). In ligated, SR625, and SR900 groups, significantly higher osteoblast numbers were detected than in control group (P <0.05). Osteoblast numbers in SR625 group were significantly higher than in the SR300 group (P <0.05). RANKL activities in SR900 and control groups were close to each other (P >0.05). Serum IL‐1β, OPG, and BALP levels revealed no significant difference (P >0.05). Conclusion: It can be concluded that SR can reduce RANKL activity and osteoclast numbers, as well as ABL.     

牙周基础治疗对伴高脂血症牙周炎大鼠血清IL-6及牙槽骨吸收影响的研究

目的:建立慢性牙周炎(chronic periodontitis,CP)合并高脂血症(hyperlipidemia,HL)的SD大鼠模型并对其进行牙周基础治疗,观察血清白介素-6(interleukin 6,IL-6)炎症因子及牙槽骨的影响。方法:SD大鼠随机分为4组,对照组(A)、HL组(B)、CP组(C)、HL+CP组(D);进行相应的建模处理,从建模开始15周后随机处死B组大鼠1只,取颈动脉分叉血管组织进行油红O染色,观察到泡沫细胞形成,则建模成功。再将C/D组随机分为2小组,C1/D1为自然进程组,C2/D2为牙周基础治疗组,进行2次牙周干预,分别于干预前1周、第1次干预后1周、第2次干预后1、3、5周采血,酶联免疫吸附法测定血清IL-6含量。实验结束后处死所有大鼠,取单侧上颌骨,剥离牙龈,进行亚甲基蓝染色,使用电子数显卡尺在徕卡显微镜(16X)下测量离体上颌骨实验牙釉质牙骨质界至牙槽嵴顶(cementoenamel junction and alveolar bone crest,CEJ- ABC)的距离(第一、二磨牙共12个位点)作为牙槽骨吸收值以检测牙槽骨吸收情况。使用SPSS21.0软件对所得数据进行统计学分析。结果:血清IL-6含量C、D组明显高于A组(P<0.05),其中,C1/D1组随时间推移一直呈现上升趋势,C2/D2组则在第2次干预后1周血清IL-6含量达到高峰,随观察时间延长则逐渐下降并低于基线水平(P<0.05);牙槽骨丧失量:C、D组>A组(P<0.001),而C2/D2组较C1/D1组牙槽骨丧失略有改善,但差异无统计学意义;牙槽骨吸收与血清IL-6水平呈Pearson正相关关系(P<0.01)。结论:高脂血症可加重牙周炎病变,牙周干预后短期内表现为机体炎症反应加重,远期则可能因炎症因子水平的降低而减轻全身病变进程。血清IL-6水平升高后,牙周局部表现为牙槽骨的吸收量增加。牙周基础治疗一定程度上可改善伴或不伴有高脂血症的牙周炎大鼠牙槽骨丧失的进程。     

Therapeutic Effects of Systemic Vitamin K2 and Vitamin D3 on Gingival Inflammation and Alveolar Bone in Rats With Experimentally Induced Periodontitis

Background: The synergistic effects of vitamin D3 and vitamin K2 on bone loss prevention have been reported. This study evaluates the effects of vitamin D3 and vitamin K2 supplementation in conjunction with conventional periodontal therapy (scaling and root planing [SRP]) on gingival interleukin (IL)‐1β and IL‐10, serum bone alkaline phosphatase (B‐ALP) and tartrate‐resistant acid phosphatase 5b (TRAP‐5b), and calcium and alveolar bone levels in rats with experimentally induced periodontitis. Methods: Seventy‐two rats were divided into the following groups: 1) healthy; 2) periodontitis; 3) SRP; 4) SRP + vitamin D3; 5) SRP + vitamin K2; and 6) SRP + vitamins K2 and D3. Periodontitis was induced by ligature placement for 7 days, and vitamin K2 (30 mg/kg) and/or vitamin D3 (2 μg/kg) were administered for 10 days in the SRP + vitamin D3, SRP + vitamin K2, and SRP + vitamins K2 and D3 groups by oral gavage. On day 18, the animals were sacrificed, serum B‐ALP, TRAP‐5b, and calcium levels were measured, gingiva specimens were extracted for IL‐1β and IL‐10 analysis, and distances between the cemento‐enamel junction and alveolar bone crest were evaluated. Results: Alveolar bone levels in the periodontitis group were significantly greater than those in the other five groups. No significant differences were found in gingival IL‐1β and IL‐10, serum B‐ALP and TRAP‐5b, and calcium and alveolar bone levels between the groups receiving SRP and vitamins and the group receiving SRP alone. Conclusion: Within the limitations of this study, vitamin D3 and K2 alone or in combination did not affect gingival IL‐1β and IL‐10, serum B‐ALP and TRAP‐5b levels, or alveolar bone compared with conventional periodontal therapy alone.     

拜阿蒙骨诱导人工骨治疗重度牙周炎的临床疗效

目的了解拜阿蒙（BAM）骨诱导人工骨通过引导牙周骨组织再生术治疗重度牙周炎患牙的临床疗效。方法选择45例重度牙周炎患者的患牙67颗为研究对象。患牙完成基础治疗后翻瓣刮治，根面平整，乙二胺四乙酸（EDTA）处理，牙周骨缺损区植入BAM骨诱导人工骨后，缝合结扎固定。术后6个月和12个月复查临床疗效。结果67颗重度牙周炎患牙治疗后1年，失败拔除5颗，余62颗治疗后6个月和12个月复查牙周各项指数均比治疗前有明显改善。结论重度牙周炎患牙植入BAM骨诱导人工骨治疗临床疗效满意。     

Therapeutic Effects of Alpha Lipoic Acid and Vitamin C on Alveolar Bone Resorption After Experimental Periodontitis in Rats: A Biochemical,Histochemical, and Stereologic Study

Background: Alpha lipoic acid (ALA) and vitamin C (Vit‐C) are very important and powerful antioxidants that have been used for the treatment of many diseases. The present study aims to investigate the role of ALA and Vit‐C substances in the treatment of alveolar bone resorption in periodontal diseases. Methods: Thirty‐six male Wistar albino rats were randomly divided into four groups as follows: 1) control rats; 2) rats with experimental periodontitis (PED); 3) rats with PED treated with ALA (ALA); and 4) rats with PED treated with ALA+Vit‐C (ALA+Vit‐C). PED was simulated by placing ligatures around the neck of teeth for 5 weeks. After ligature removal, the PED group was given a single intragastric dose of 1 mL saline, and the ALA and ALA+Vit‐C groups were treated with an intragastric dose of 50 mg/kg ALA and ALA+Vit‐C for 15 days, respectively. Levels of serum bone alkaline phosphatase (B‐ALP) and myeloperoxidase (MPO) activity in gingival tissues were analyzed. To evaluate the osteoclast activation, expression of activated receptor activator nuclear factor‐kappa B ligand (RANKL) and bone density index (BDI) were determined stereologically in the bone sections obtained from the mandibles of the rats. Results: The results showed statistically significant differences between the PED group and groups treated with antioxidant according to B‐ALP, MPO, RANKL, and BDI values (P <0.05). ALA and ALA+Vit‐C treatments showed beneficial effects on the mesial/distal periodontal bone support at the ligature‐induced periodontitis tooth areas. Conclusion: This study shows that ALA and Vit‐C treatment provides therapeutic effects on inhibition of alveolar bone resorption and periodontal tissue destruction.     

Osteocytic Sclerostin Expression in Alveolar Bone in Rats With Diabetes Mellitus and Ligature‐Induced Periodontitis

Background: Osteocytic sclerostin inhibits bone formation, and its expression is stimulated by tumor necrosis factor (TNF)‐α. This study investigates sclerostin and TNF‐α expression in rats with diabetes mellitus (DM) and periodontitis. Methods: Rats were divided into control (C), periodontitis (P), and DM + periodontitis (DP) groups. After induction of DM by streptozotocin, periodontitis was induced by ligature. At day 0 (control) and at days 3 and 20 after induction of periodontitis, alveolar bone, osteoclasts, osteoid area, and TNF‐α and sclerostin expression were evaluated. Results: The distance between the cemento‐enamel junction and the alveolar bone crest of the DP group was longer than that of the P group at day 20 after induction of periodontitis, but the number of osteoclasts was not different. Osteoid area decreased in both the P and DP groups by day 3, but whereas sustained osteoid suppression was observed in the DP group at day 20, osteoid formation was increased in the P group. The number of sclerostin‐positive osteocytes increased in both groups at day 3, but the increased number of sclerostin‐positive osteocytes was maintained only in the DP group through day 20. The number of TNF‐α–positive cells increased more in the DP group than in the P group. Conclusions: Enhanced alveolar bone loss, suppressed bone formation, and prevalent TNF‐α expression were characteristic of the DP group compared with the P group. Suppressed bone formation in the DP group was observed simultaneously with increased sclerostin and TNF‐α expression. These results suggest that upregulated osteocytic sclerostin expression in periodontitis accompanied by DM may play a role in suppressed bone formation.