应用排龈线预防牙体修复悬突的临床评价

目的:探讨在涉及龈下的牙体龋损及楔状缺损充填修复时应用排龈线可否预防悬突的形成。方法:选择牙周组织健康的门诊患者24人口腔中齐龈或涉及龈下≤1mm的唇颊侧牙颈部龋缺损共80颗牙,随机分配样本为两组,试验组应用排龈线对窝洞处的牙龈进行排龈后用复合树脂充填。对照组常规窝洞预备后直接用复合树脂充填。充填1个月检查悬突的发生情况;收集两组充填前、充填1、3及6个月测试位点的龈沟液(GCF)量、检测GCF中天门冬氨酸转氨酶(AST)水平。测量菌斑指数(PLI)、龈沟出血指数(SBI)、牙周探诊深度PD)进行统计学分析。结果:充填1个月试验组修复后悬突的发生率低于对照组,差异有显著性(P<0.01)。充填后6个月试验组与对照组的PLI、SBI、PD、GCF无统计学差异(P>0.05),试验组GCF-AST水平明显低于对照组,差异有显著性(P<0.01)。结论:排龈线对齐龈或龈下边缘的充填悬突形成的预防效果好。建议临床中充填上述龋缺损时将使用排龈线作为一项常规措施。     

银汞充填体悬突的发生率及其与牙周病的关系

本文调查了７５颗行Ⅱ类洞银汞充填半年以上患牙的悬突发生率，并同时检查记录了有悬突的牙及同颌对侧同名牙的牙周各项临床指标。结果表明，充填体悬突的发生率为７２％；邻近悬突处牙的各项牙周临床指标，如菌斑指数，出血指数，牙周袋探诊深度、附着丧失及牙槽骨吸收程度均显著高于对照牙（Ｐ＜０．０１）。说明充填体悬突的发生率极高，悬突与牙周支持组织的破坏较为密切。提示口腔科医师应高度重视预防悬突发生、减少医源性牙周织组损伤的重要性。     

乳牙化学去龋法的细菌学研究

目的：比较化学去龋法和机械去龋法清除细菌的效果。方法：选取40个龋坏深至牙本质的乳磨牙，中龋或深龋，随机分为化学法去龋组和机械法去龋组，每组20个牙，去龋前后使用无菌挖匙对龋坏牙本质进行取样，分别在4种不同的培养基上进行厌氧培养和计数。结果：两种方法去龋后，除机械法去龋组放线菌外，两种方法其他细菌数显著减少，有统计学意义（P〈0．05），化学法去龋组比机械法去龋组的总菌数量减少更显著（p〈0．05）。结论：化学去龋法比机械去龋法清除乳牙龋坏细菌效果好。     

深龋乳牙根管细菌学分析

目的本研究的目的是对患有深龋的乳牙根管内细菌进行分析。方法选择12颗深龋乳牙，其中3颗有冷热刺激痛，其余9颗无临床症状。分别在微需氧(80％N2，10％H2，10％CO2)及厌氧条件(90％N2，10％CQ)下进行患牙根管细菌分离和鉴定。结果结果显示有症状牙的菌落形成单位(Colony Fomation Unit，简称CFU，下同)比无症状牙高，但二者间的差异无显著性。在这两组中，根管细菌的组成相似，并且与深龋的细菌组成相似。变链菌和乳杆菌占可培养细菌的比例比其它细菌高，差异有显著性，而且变链菌和乳杆菌的检出率比其它细菌高，差异亦有显著性。专性厌氧菌，如消化链球菌、韦荣氏菌、梭杆菌和普氏菌也有所检出，但其检出率和占可培养菌百分比均很低。结论微需氧致龋菌是乳牙龋源性牙髓炎的主要致病菌。     

根周细菌对胶原包被羟磷灰石粘附的体外实验研究

目的：细菌对牙面的粘附能力与其致龋性密切相关，本研究旨在比较对牙面具有粘附能力的变形链球菌ATCC25175、粘性放线菌ATCC15987、乳杆菌ATCC4546、牙龋卟啉菌ATCC33277及中间普氏菌ATCC25611对胶原包被羟磷灰石实验膜（C－HA）的粘附能力，探讨口腔细菌在根周疾病中的作用。方法：采用同位素闪烁计数法测定上述五种细菌对胶原处理的羟基磷灰石（C－HA）的粘附能力，以[^3H]胸腺嘧啶核苷为标记对细菌的粘附进行定量观察，用每分钟的同位素放射量CPM表示（counts per mintue）。结果：所有细菌对C－HA表面的粘附率均有统计学意义（P＜0．01），粘性放线菌对C－HA表面的粘附率显著高于其它细菌组，牙龋卟啉菌及乳杆菌对C－HA表面的粘附率次之，变形链球菌及中间普氏菌对C－HA表面的粘附能力最弱。结论：不同的根周细菌对胶原包被的羟磷灰石的选择性粘附作用不同，粘性放线菌、乳杆菌及牙龋卟啉菌对胶原具较强的亲和作用，在细菌的局部定植过程及疾病的进展中发挥重要作用。     

孤独症谱系障碍儿童的唾液微生物群落研究

目的：通过宏基因组学方法结合Pacbio SMRT高通量测序技术探究孤独症谱系障碍（ASD）儿童中口腔健康和罹患龋齿者的唾液微生物菌群的组成及其差异。方法：收集42名ASD儿童唾液样本,其中无龋组22名,高龋组20名,提取DNA进行聚合酶链式反应扩增,利用PacBio SMRT高通量测序技术对16S rRNA全长进行测序,进行口腔菌群结构和组成的分析比较。结果：两组间唾液菌群结构差异有统计学意义（P<0.05）,且高龋组的菌落结构更为相似和保守（P<0.05）。在种水平上,无龋组高表达有伯杰氏杆菌、南锡普氏菌、金黄色葡萄球菌三个健康相关微生物（P<0.05）,高龋组高表达有变形链球菌、口普氏菌、浑浊戴阿利斯特杆菌、具核梭杆菌四个龋病相关微生物（P<0.05）。结论：ASD儿童的龋齿唾液菌群有整体菌群结构和特定物种组成的改变,为ASD儿童的龋齿预防和诊断提供新策略。     

不同龋状况母子间口腔微生物群落结构分析

目的：应用PCR-DGGE（变性梯度凝胶电泳）技术,分析20对不同龋状况母子口腔唾液中微生物群落组成的多样性。方法：分别采集20名不同龋状况儿童及母亲的唾液样本,提取细菌总DNA,进行16SrDNA的PCR扩增及DGGE,克隆测序分析。结果：母子口腔唾液中分别检出42、48个菌种,其共同菌种为37个,归属于16个菌属,同时,检出新菌种Megasphaeraspp.,且在无龋儿童及高龋母亲唾液中分别检出Abiotrophiaspp.和Olsenellaspp.两个特异菌属。无龋组母子唾液中嗜血菌属的相对数量显著高于高龋组（P〈0.001）;无龋儿童携带的放线菌属相对数量也多于高龋组（P〈0.001）;而链球菌属,奈瑟菌属低于高龋组（P〈0.001）,而高龋组母亲口腔微生物中相对数量最多的为乳杆菌属,其次为放线菌属,奈瑟菌属,与无龋组比较差异显著（P〈0.001）。结论：母子口腔唾液菌群组成具有多样性,且随龋状况不同而有所差异。     

龋齿、牙周炎患牙和健康牙的菌斑生物膜特征

目的研究牙面菌斑生物膜特征与口腔疾病的关系。方法选择牙周健康而牙冠严重龋坏的龋齿5颗、无龋损而极度松动的牙周炎患牙6颗及正畸原因拔除的健康牙4颗,在扫描电镜下,观察分析龈上、龈下及移行生态区的菌斑生物膜特征。结果龋齿、牙周炎患牙和健康牙的牙面均观察到细菌混合物组成的菌斑生物膜,健康牙菌斑生物膜以球菌为主,放线菌和短杆菌少量;龋齿牙的龋坏处为坏死组织和细菌,龋边缘及龈沟处的球菌和短杆菌较健康牙多;牙周炎患者牙菌斑生物膜的细菌种类多,在龈上、龈下移行处可见典型的玉米棒状菌斑或以杆菌为主的紧密附着菌斑,龈下可见球菌、杆菌、梭菌及螺旋体等构成的复杂菌斑。结论龋齿、牙周炎患牙和健康牙菌斑生物膜细菌组成、集聚秩序和立体结构不同,菌斑生物膜的形成与细菌的附着、集聚、生长有关,也与局部病变密切相关。     

伢典化学与机械去龋法的光镜研究

目的：通过对伢典和传统牙钻去除牙本质龋后的磨片观察，评价伢典的去龋效果。方法：选取龋损已到牙本质的离体牙9个，分为对照组、机械组、伢典组3组，每组3个牙。对照组不处理，机械组用传统牙钻去龋，伢典组用伢典去龋。然后磨制成磨片，在光学显微镜下观察去龋效果。结果：对照组能观察到明显的龋损病理组织结构。伢典组、牙钻组的龋损组织被完全去除。结论：伢典能有效去除龋损组织。     

与窝沟龋有关的优势耐酸菌构成的分析

目的　分析不同患龋状态窝沟中的优势耐酸菌构成,了解其在龋病发病中的作用。方法　第一年轻恒磨 牙窝沟新发早期龋儿童10名,2年无龋儿童10名。取新发龋窝沟处菌斑和同口正常第一恒磨牙窝沟菌斑及无龋 儿童第一恒磨牙窝沟菌斑,用平皿培养法分析菌群构成;用最可能数法(MPN)分离优势耐酸菌;API 20 Strep试剂盒 鉴定链球菌。结果　变形链球菌是无龋组窝沟的优势耐酸菌,且中性条件下检出较多;血链球菌是新龋组正常窝 沟和新龋窝沟处的优势耐酸菌;革兰阳性杆菌在酸性条件下占总检出菌比例(82%)显著高于中性条件下(61%)。 结论　菌斑生态构成非常复杂,在各个生态阶段,菌群组成不同。菌斑内局部pH值伴随菌群构成的变化推动着龋 病过程。     

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.     

Superbond粘结系统作为牙周夹板对牙周组织影响的临床研究

目的:观察Superbond粘结系统作为牙周夹板固定重度牙周炎导致的松动前牙后对牙周组织的影响。方法:选择重度牙周炎导致的前牙松动病人64例,随机分为实验组(Superbond固定组)和对照组(钢丝结扎加树脂组),每组32例。牙周基础治疗后1个月牙周炎症得到控制,消除咬合创伤后固定。每3个月复查维护,观察12个月。比较固定前后所观察位点的牙周探诊深度(PD)、附着丧失(CAL)、龈沟出血指数(SBI)、菌斑指数(PLI)、牙龈指数(GI),并记录两种固定方法的美观性和舒适性。结果:实验组29例有效;对照组28例有效。实验组PD变浅(P<0.05),SBI、GI、PLI、AL固定后与固定前比较无显著性差异。对照组PD变浅(P<0.05)、SBI、PLI高于固定前(P<0.05),CAL、GI与固定之前比较无显著性差异(P>0.05)。实验组美观性和舒适性调查满意度高于对照组。结论:在选择合适病例的前提下,Superbond粘结系统作为牙周夹板固定松动前牙美观、舒适,可提高咀嚼力,对牙周组织影响小,不妨碍菌斑控制。     

老年人可摘局部义齿修复后对基牙牙周状况的影响

目的：研究老年人戴用可摘局部义齿对基牙牙周健康状况的影响。方法：对56例牙列缺失后的老年人行可摘局部义齿修复,3个月、12个月后复查并记录基牙与对侧同名牙的菌斑指数、牙龈指数、探诊出血指数、探诊深度等四项牙周指标。结果：患者戴用可摘局部义齿后基牙的四项牙周指标明显高于对照牙（P〈0．01）;老年患者戴用可摘局部义齿后的3个月内,基牙的牙周指数均明显升高（P〈0．01）,12个月时基牙的牙周状况趋于稳定状态。结论：老年人戴用可摘局部义齿可引起基牙的牙周指数增加。     

Periodontal response to all-ceramic crowns (IPS Empress) in general practice

Abstract:  Objective:  The purpose of this study was to investigate the periodontal response to the presence of all-ceramic crowns (IPS Empress) in general practice patients. Methods:  The convenience sample included 82 IPS Empress crowns placed in 64 patients. These crowns had been in place for an average of 16.27 (SD 9.26) months and ranged from 6.2 to 48.87 months at the time of clinical examination. Periodontal health status (as determined by dental plaque, gingival health status, periodontal pockets) was assessed around all crowned teeth and around matched contralateral teeth by one calibrated examiner. Periodontal indices utilized included the Plaque Index (PI), Gingival Index (GI) and pocket depth (PD) with calibrated probes graduated in millimetres. Plaque, gingival and PD values for crowned teeth were compared with those for control teeth using Wilcoxon signed-rank test for each clinical parameters. Chi-square was used to test the significance of the difference in their distribution between crowns and control teeth. Results:  Statistically, PI (0.35), GI (0.41) and mean PD scores (1.42) of IPS Empress crowned teeth compared less favourably with scores of the control teeth (0.27, 0.23 and 0.86 respectively). Conclusion:  Teeth with IPS Empress crowns had poorer periodontal health and more clinically evident plaque than uncrowned teeth.     

The relationship of oral malodor in patients with or without periodontal disease

BACKGROUND: Halitosis has been correlated with the concentration of volatile sulfur compounds (VSC) produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal area and the dorsum of the tongue. The aim of this study was to determine whether there is some relationship between the presence of N-benzoyl-DL-arginine-2-napthylamide (BANA)-positive species Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus and clinical and oral malodor parameters. METHODS: Twenty-one subjects (21 to 59 years old) with probing depths (PD) > 3.0 mm and 20 subjects (21 to 63 years old) with PD < or = 3.0 mm (controls) participated. The quality of the mouth air was assessed organoleptically, and a portable sulfide monitor was used to measure the concentration of VSC. Clinical parameters, plaque index (PI) and gingival index (GI), were obtained from 6 teeth. Samples for BANA test were taken from the dorsal surface of the tongue, saliva, and the 6 reference teeth. RESULTS: The scores of PI, GI, subgingival samples that tested positive for BANA hydrolyzing species, organoleptic ratings, and VSC values were significantly higher in the subjects with PD > 3.0 mm (P < 0.01, Mann-Whitney U test). There was a correlation between BANA hydrolysis by subgingival plaque bacteria and VSC values (r = 0.55, P < 0.01), and between GI and VSC values (r = 0.48, P < 0.05) in patients with PD > 3.0 mm. There was no significant correlation between these parameters in the control group. CONCLUSION: These results confirm that the BANA hydrolyzing bacteria in the subgingival plaque are an important source of malodor production in the oral cavity.     

A clinical follow‐up study of the periodontal conditions of RPD abutment and non‐abutment teeth

Summary The purpose of this study was to evaluate the periodontal conditions of removable partial denture (RPD) wearers, comparing direct and indirect abutment teeth, and the teeth not involved in the denture design before denture placement and 1 year later. Fifty patients (32 women and 18 men), average age 45, were assessed by the same examiner at the moment of denture insertion and 3, 6, 9 and 12 months later. The following items were verified in each assessment: probing depth (PD), plaque index (PI) and gingival index (GI). PD and PI data were evaluated by anova test for linear trend followed by Tukey–Kramer post‐test, while GI data were analysed by Friedman’s test. Results showed that the teeth not involved in the denture design were the least affected for all variables studied. It was also verified that PD and GI mean values increased from the initial assessment to 1 year of RPD wearing in every group, but that only PI showed a significant increase. This study indicated that direct and indirect retainer elements tend to undergo more damaging periodontal effects associated with RPD wearing when compared with non‐abutment elements. Plaque index values were significantly higher after 1 year of denture use.     

IL-6 and IL-8 levels in GCF of the teeth supporting fixed partial denture

Objectives:  To evaluate the gingival crevicular fluid (GCF) contents of interleukin-6 (IL-6) and interleukin-8 (IL-8) and the clinical parameters of the teeth supporting fixed partial denture (FPD) and the contralateral teeth and to assess the effect of scaling and root planning (SRP) on clinical parameters and the GCF levels of cytokines.
Materials and methods:  The study population included 23 patients. Probing depth (PD), clinical attachment level (CAL), plaque index (PI), and gingival index (GI) were recorded, and GCF samples were collected for analysis of cytokine levels from the teeth with FPD (Test Group), the contralateral teeth (Control Group) of each participant at baseline. After initial measurements, all participants received primary phase of non-surgical treatment including oral hygiene instruction and scaling and root planning (SRP). At the 1st month and the 3rd month after SRP, these procedures were repeated.
Results:  In both groups, all clinical parameters and the total amount of IL-8 showed decreases from initial to the 3rd month ( P  < 0.05), but from the 1st month to the 3rd month; PD, PI, and GI values significantly increased in the test group ( P  < 0.05).
Conclusion:  The non-surgical periodontal treatment reduced the total amount of IL-8, not IL-6, and the clinical parameters of the teeth with FPD and contralateral teeth. But, there was a trend to the higher levels of PD, PI, and GI in the teeth with FPD. Therefore, a regular program for dental prophylaxis is also important for the maintenance of periodontal health in patients with FPD.     

The applicability of half-mouth examination to periodontal disease assessment in untreated adult populations

BACKGROUND: Data from whole-mouth examinations are the gold standard for accurate assessment of periodontal disease. Since periodontal destruction exhibits left-right symmetry, however, it is hypothesized that a half-mouth exam provides an appropriate alternative to whole-mouth assessment, with considerable advantage over a more limited partial-mouth assessment of index teeth. METHODS: Data from 2 untreated populations were utilized in the analyses. Half-mouth (random diagonal quadrants) and Ramfjord teeth assessment was compared with whole-mouth assessment as follows. Intraclass correlation coefficients (ICCs) were calculated for mean plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) and for percentage of sites with PD > or = 4, 5, or 6 mm; CAL > or = 3, 4, 5, or 6 mm; and recession > or = 3 mm to determine the agreement between the whole- and partial-mouth assessment. Disease prevalence was also determined for both whole- and partial-mouth assessments. RESULTS: For mean PI, GI, PD, and CAL, both half-mouth and Ramfjord teeth assessment provided an acceptable alternative to whole-mouth assessment (ICCs > 0.92). For percentage of sites above a specified threshold, ICCs were generally greater than 0.90 in all age cohorts for half-mouth assessment, but consistently lower for Ramfjord teeth assessment. Ramfjord teeth assessment also considerably underestimated disease prevalence compared with half-mouth assessment. CONCLUSIONS: These results support the use of a half-mouth examination procedure, to conserve time, limit cost, and reduce patient and examiner fatigue while providing maximal clinical information. Ramfjord teeth assessment was not as suitable for evaluation of either disease extent or prevalence.     

复合树脂高强纤维修复牙周炎患者下前牙缺失及固定松动牙

目的: 探讨采用复合树脂高强纤维修复牙周病伴牙列缺损的临床疗效。方法: 选择30例经过完善牙周治疗并伴下前牙区牙列缺损的患者, 使用EverStick复合树脂高强纤维直接法制作下前牙牙周夹板并修复其前牙缺失。修复后1、6个月、1、2 a复诊, 对临床修复效果进行评价, 并检查患者牙周情况和菌斑控制情况, 记录治疗前及每次复诊时的菌斑指数(PLI)、牙龈指数(GI)、探诊深度(PD)。采用SPSS17.0统计软件包进行成组t检验和χ2检验。结果: PLI和GI在治疗后1、6个月、1 a和2 a时差异无显著性(P>0.05);PD在治疗后1个月与6个月时逐渐变浅, 其差异具有显著性(P<0.05), 6个月与1、2 a相比差异无显著性(P>0.05), 治疗后各时间点与治疗前相比均降低(P<0.05)。患者对牙周夹板黏结桥的美观、发音、舒适及咀嚼功能的满意度为80%以上。结论: 下前牙牙周炎伴牙列缺损病例采用FRC技术修复缺失牙, 既可有效固定松动牙, 使之符合生理功能的要求, 又可为患者提供较为舒适与美观的修复体;每隔6个月1次的牙周维护治疗, 是影响其治疗效果的重要因素。     

Clinical evaluation of periodontal surgical treatment with an Er:YAG laser: 5-year results

BACKGROUND: The aim of the present study was to evaluate and compare the long-term clinical outcomes of erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser-assisted periodontal flap surgery versus conventional treatment with the modified Widman flap procedure. METHODS: A total of 146 single-rooted periodontally involved teeth from 25 patients were included in this study. In each patient, left or right maxillary single-rooted teeth were assigned randomly to one of two groups: group A (Er:YAG laser) and group B (modified Widman flap surgery). Er:YAG laser was used to debride the bone pockets, scale the root surface, and trim the periodontal flap. Recession, probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and bleeding on probing (BOP) scores were recorded at baseline and at 3, 6, 12, 24, 36, 48, and 60 months. RESULTS: Both treatments resulted in decreases in PD, PI, GI, and BOP, increases in gingival recession, and gains in CAL. PD reduction in group A versus group B was statistically significant at 6, 12, 24, and 36 months (P < 0.05). Gains in CAL were significantly greater in group A versus group B at 6, 12, 24, and 36 months. BOP scores were significantly lower in group A versus group B at 3 and 6 months (P < 0.05). All other differences between treatment groups were not statistically significant. CONCLUSIONS: Surgical treatment of single-rooted teeth with chronic periodontitis using the Er:YAG laser yields greater PD reduction and gains in CAL for up to 3 years compared to conventional Widman flap surgery. The short-term results obtained with both treatments can be maintained over 5 years.