糖尿病牙周炎病人龈沟液TNF-α水平及其与HbA1c的相关性分析

目的:研究依赖胰岛索治疗的糖尿病(IDDM)伴牙周炎病人、单纯牙周炎病人和牙周健康者龈沟液(gingival cervicular fluid,GCF)TNF-α水平及其与糖代谢状况的关系.方法:用ELISA法检测GCF中TNF-α的水平,同时检测受试者的糖化血红蛋白(HbAlc)百分比.结果:IDDM牙周炎组病人GCF中TNF-α水平明显高于单纯牙周炎组及对照组.GCF中TNF-α水平与反映糖代谢控制状况的糖化血红蛋白无相关性.结论:糖尿病可使牙周炎病人龈沟液TNF-α水平显著增高.     

IDDM牙周病患者龈沟液IL-1β的检测与分析

目的 :比较胰岛素依赖性糖尿病 (IDDM)牙周病患者与全身健康者龈沟液IL - 1β的差异及这一炎症介质水平与糖代谢状况的关系。方法 :用ELISA法测龈沟液IL - 1β水平 ,同时测IDDM病人糖化血红蛋白 (HbA1c)浓度。结果 :IDDM病人龈沟液IL - 1β含量明显高于对照组 ,中重度牙周炎中这一炎症介质浓度明显高于轻度牙周病。龈沟液IL - 1β水平不与反映糖代谢控制状况的糖化血红蛋白浓度相关。 结论 :龈沟液IL - 1β水平在受局部环境影响的同时 ,也受全身因素调控。糖尿病人因全身反应异常 ,龈沟液IL - 1β会大幅度上升 ,从而导致重度牙周炎发生。     

IDDM牙周病患者龈沟液IL—1β的检测与分析

目的：比较胰岛素依赖性糖尿病（ＩＤＤＭ）牙周病患者与全身健康者龈沟液ＩＬ－１β的差异及这一炎症介质水平与糖代谢状况的关系。方法：用ＥＬＩＳＡ法测龈沟液ＩＬ－１β水平,同时测ＩＤＤＭ病人糖化血红蛋白（ＨｂＡ１ｃ）浓度。结果：ＩＤＤＭ病人龈沟液ＩＬ－１β含量明显高于对照组,中重度牙周炎中这一炎症介质浓度明显高于轻度牙周病。龈沟液ＩＬ－１β水平不与反映糖代谢控制状况的糖化血红蛋白浓度相关。结论：龈沟液Ｉ     

Ⅱ型糖尿病合并牙周病患者龈沟液中肿瘤坏死因子α水平和意义

目的：比较Ⅱ型糖尿病合并牙周病患者、牙周病患者与健康者龈沟液中肿瘤坏死因子-α（TNF-α）含量和龈沟液量,以及Ⅱ型糖尿病合并牙周病患者龈沟液中TNF-α量与糖代谢状况的关系。方法：使用滤纸条法采集龈沟液,Ⅱ型糖尿病合并牙周病患者、牙周病患者和全身健康者各30例;放射免疫法测定龈沟液中TNF-α含量;运用高效液相层析法测定Ⅱ型糖尿病合并牙周病患者的糖化血红蛋白水平。结果：糖尿病合并牙周病组和牙周病组龈沟液量及龈沟液TNF-α量均显著高于正常对照组（P〈0.01）,糖尿病合并牙周病组龈沟液TNF-α量显著高于牙周病组（P〈0.01）。糖尿病合并牙周病组龈沟液中TNF-α含量与糖化血红蛋白（HbA1c）水平无显著直线相关性。结论：龈沟液中TNF-α含量受牙周炎症影响同时全身因素调控,导致糖尿病合并牙周病患者龈沟液TNF-α水平显著升高,造成牙周病加重。     

2型糖尿病合并牙周病患者龈沟液中基质金属蛋白酶-3水平和意义

目的:研究2型糖尿病合并牙周病患者、龈沟液中基质金属蛋白酶-3(MMP-3)和龈沟液量,及其与糖代谢状况的关系。方法:2型糖尿病合并牙周病患者、牙周病患者和全身健康者各30例;使用滤纸条法采集龈沟液,用ELISA法测定龈沟液中MMP-3含量;用自动糖化血红蛋白分析仪VarintⅡ测定2型糖尿病合并牙周病患者的糖化血红蛋白(HbA1c)水平。结果:糖尿病合并牙周病组和牙周病组龈沟液中MMP-3含量显著高于正常对照组(P<0.01)。糖尿病合并牙周病组龈沟液中MMP-3含量显著高于牙周病组(P<0.01),其龈沟液的量与牙周病组没有显著差异。糖尿病合并牙周病组龈沟液中MMP-3含量与HbA1c水平无显著相关性。结论:龈沟液中MMP-3含量受牙周炎症影响并受全身因素调控。     

龈沟液中IL-1β与2型糖尿病和牙周病相关性的研究

目的：比较2型糖尿病患者（DM）、2型糖尿病伴牙周病患者（DM＆AP）及牙周病患者（AP）龈沟液（GCF）中的白细胞介素-1β（IL-1β）水平,探讨DM和DM＆AP糖化血红蛋白（HbAlc）浓度与IL-1β的相关性。方法：使用滤纸条法采集GCF,DM、DM＆AP、AP患者及正常对照组各30例;ELISA法测定GCF中IL-1β含量;运用高效液相层析法测定DM和DM＆AP的糖化血红蛋白水平。结果：DM、DM＆AP、AP的GCF量和IL-1β量均高于正常对照组（P〈0．05）;DM＆AP、AP组GCF量显著高于DM组（P〈0．05）;DM＆AP组IL-1B含量高于DM组和AP组（P〈0．05）。结论：糖尿病患者和糖尿病伴牙周病患者IL-1β均高于正常人,长期的高血糖会使糖尿病患者易患牙周病,提示糖尿病患者在关注血糖控制的同时还高度关注牙周健康。     

牙周炎患者GCF及血清中IL-6测定及其与牙周炎的关系

目的：研究龈沟液（GCF）中白细胞介素－6（IL－6）的来源及其与牙周炎的关系。方法：采用双抗夹心酶联免疫吸附法（ELISA）测定了72例成人牙周炎，13例牙龈炎，18例健康对照组GCF IL－6含量，及17例牙周炎患者，7例健康人血清IL－6水平。结果：牙周炎患者GCF IL－6水平显著高于健康人，牙周炎患者GCF IL－6II与牙周炎患者血清中IL－6含量有显著性差异，牙龈炎患者血清IL－6含量比正常对照组含量高，牙周炎患者GCF IL－6含量与牙龈炎患者有显著性差异，重度牙周炎患者GCF中IL－6含量高于轻度牙周炎患者，牙周炎患者GCF中IL－6含量与出血指数（BI）、牙周袋深度（PD）、附着丧失（AL）有正相关关系。结论：龈沟液中IL－6主要来源于局部牙龈组织，IL－6在牙周炎的发生，发展过程中起一定作用。     

Ⅱ型糖尿病合并牙周病患者龈沟液中细胞因子/趋化因子的表达水平

目的 探讨Ⅱ型糖尿病合并牙周病患者与单纯牙周病患者龈沟液（gingival crevicular fluid,GCF）中细胞因子/趋化因子的表达水平。 方法 选取伴Ⅱ型糖尿病的牙周病患者52例,单纯牙周病患者40例,用Luminex FLEXMAP3D仪和Human Cytokine/Chemokine试剂盒检测GCF中14种细胞因子/趋化因子的表达水平。 结果 牙周病部位：嗜酸性粒细胞趋化因子、巨噬细胞炎症蛋白-1α、粒细胞-巨噬细胞集落刺激、白介素-6、肿瘤坏死因子-α和白介素-12的浓度,糖尿病组受试者高于非糖尿病组受试者（P<0.0035）。 结论 糖尿病可影响牙周病部位细胞因子/趋化因子的表达,糖尿病可能是牙周病的促进因素。     

糖尿病对牙周炎病人龈沟液白介素-1β、前列腺素E2水平的影响

目的：探讨Ⅱ型糖尿病对牙周炎病人龈沟液白介素-1β（IL-1β）、前列腺素E2（PGE2）水平的影响及其与糖脂代谢情况的关系。方法：选择Ⅱ型糖尿病伴发牙周炎病人18例（DM组）、单纯牙周炎病人18例（PD组）和全身、牙周健康者18例（H组）为研究对象。分别测定各组糖化血红蛋白（HbA1C）、血脂水平以及龈沟液（gingival cervicular fluid GCF）中IL-1β、PGE2水平,并同时测定牙周龈沟出血指数、探诊深度、附着丧失等指标。结果：DM、PD组龈沟出血指数（SBI）、探诊深度（PD）、附着丧失（AL）、龈沟液PGE2水平明显高于H组（P〈0．05）,DM与PD组无明显差异;DM组病人糖化血红蛋白、龈沟液IL-1B指标均明显高于PD、H组（P〈0．05）;龈沟液IL-1β水平与HbA1C含量正相关。结论：糖尿病伴发牙周炎病人龈沟液IL-1β水平升高可能受全身因素影响,进一步促进牙周病变发展。     

中文文摘

1．2型糖尿病合并牙周病患者龈沟液中基质金属蛋白酶-3水平和意义 2型糖尿病合并牙周病患者、牙周病患者和全身健康者各30例;使用滤纸条法采集龈沟液,用ELISA法测定龈沟液中MMP-3含量;用自动糖化血红蛋白分析仪VarintⅡ测定2型糖尿病合并牙周病患者的糖化血红蛋白（HbAlC）水平。     

Variation in periodontal referral in 2 regions in theUK

This study investigated the periodontal referral patterns of general dental practitioners (GDPs) in Northern Ireland (NI) and North West England (NWE). A questionnaire dealing with periodontal referral was sent to all 520 GDPs registered in NI and to 274 GDPs in NWE. A usable return was made by 355 (68%) in NI and 189 (70%) in NWE. The NI dentists made significantly more periodontal referrals (median 5, range 0-80) in the year preceding the survey than those in NWE (median 2, range 0-50), p<0.001. Distance was the only factor significantly related to the referral rate in both regions with those who practised more than 25 miles from a specialist referring significantly fewer patients in both regions. In NI, there was a trend towards increased periodontal referral by GDPs who had attended more postgraduate courses; however, in NWE, this was not the case. The GDPs in NWE were significantly less likely than those in NI to refer patients with medical conditions. It is concluded that there is considerable variation in periodontal referral both within and between the 2 regions studied. It is further concluded that in many cases, non-disease factors, such as the accessibility of the specialist service, have powerful effects on the decisions made by dentists and patients in these regions (NI and NWE) in relation to periodontal referral. Much of the variance in referral in North West England, as in Northern Ireland, remains unexplained.     

Trends in socioeconomic disparities in oral health in Brazil and Sweden

Celeste RK, Nadanovsky P, Fritzell J. Trends in socioeconomic disparities in oral health in Brazil and Sweden. Community Dent Oral Epidemiol 2011; 39: 204–212. © 2010 John Wiley & Sons A/S Abstract – Objectives: To describe the dynamics of trends in socioeconomic disparities in oral health in Brazil and Sweden among adults, to assess whether trends follow expected patterns according to the inverse equity hypothesis. Methods: In Sweden, we obtained nationally representative data for the years 1968, 1974, 1981, 1991 and 2000, and in Brazil, for 16 state capitals in 1986 and in 2002. Trends in the prevalence of ‘edentulism’ and of ‘teeth in good conditions’ were described in two groups aged 35–44 with lower and higher economic standards, respectively. Results: There was an annual decline in disparities in ‘edentulism’ of 0.4 percentage points (pp) (95% CI = 0.2–0.7) in Brazil and 0.7pp (95% CI = 0.5–0.9) in Sweden, as a result of improvements in both income groups. Concerning ‘teeth in good conditions’, in Brazil, there was improvement only in the higher income group and absolute disparities have increased (0.5pp annually), while in Sweden, there was a nonsignificant decrease (0.3pp annually) with improvements in both groups. Since 1991 in Sweden and in 2002 in Brazil, our measures of socioeconomic disparities in ‘edentulism’ were not statistically significant. Trends did not differ by sex or dental visit. Conclusions: Despite improvements in both income groups and a decrease in disparities in ‘edentulism’, the poorer group in Brazil has seen no improvement in ‘teeth in good conditions’ and disparities have increased. It appears that Brazil and Sweden reflect different stages of trend for ‘teeth in good conditions’ and the same stages for ‘edentulism’, represented by the inverse equity hypothesis.     

Fluorosis in relation to fluoride levels in water in central Nigeria

Abstract– Objectives : This study was conducted to examine the prevalence of dental fluorosis in relation to fluoride levels in water among children aged 12–15 years in the states of Plateau and Bauchi, Nigeria. Methods : Children ( N =203) were examined using WHO criteria. The children were from two schools and permanent residents of the communities in which the schools are located (Tilden Fulani and Kanadap). Intra-examiner reliability for determining fluorosis scores was 80%. Results : Fluoride levels in the water ranged from 0.0–0.4 mg/L. Prevalence of dental fluorosis in the sample was 51%. Forty-one percent had very mild fluorosis, 7% had mild fluorosis and 3% had moderate to severe fluorosis. The lowest DMFT was observed in the school where the fluoride level of the water ranged between 0.0 and 0.4 mg/L, and in the group with very mild fluorosis. Conclusion : Fluoride levels in water for central Nigeria were appropriate for oral health. In the areas where the children were permanent residents, factors other than the fluoride levels of the water contributed to the severity of dental fluorosis.     

Trends in endodontic claims in Italy

According to the scant data available in the literature, endodontic claims are common among dental professional liability cases and the second most common type of claim. This study aimed to describe the characteristics of endodontic claims in Italy and the most frequently disputed errors, and the discussion below includes consideration of ethical and medico‐legal aspects thereof. We retrospectively analysed 120 technical reports written on cases of professional malpractice in endodontics in the last 5 years. The complainant patients were males in 22.5% of the cases, while females made up the remaining 77.5%. In the dentist sample, male operators were more often involved in litigation cases (80%) than female operators. The most frequently claimed technical errors were: lack of a complete filling of root canal/s (71.7%), the perforation of tooth structure (12.7%), extrusion of sealing materials beyond the apex of the tooth (9.6%) and the fracture of an endodontic instrument (5.9%). In 1.7% of cases it was found that the expert did not make any errors performing the endodontic therapy. In only very few cases (2.7%) no therapy was considered necessary, while the most common therapeutic solution involved in endodontic misconduct was tooth extraction (53.0%). In many cases the dentist preferred to extract the endodontically undertreated tooth and substitute it prosthetically rather than trying to re‐treat it. The discrepancy between the total number of cases examined and those that eventually go to court leads us to believe that the majority of endodontic malpractice cases are resolved in out‐of‐court settlements.     

Human Herpesviridae in acute necrotizing ulcerative gingivitis in children in Nigeria

Herpesviruses have been implicated in the pathogenesis of human periodontitis. The present study investigated whether herpeasviruses are present in the lesions of acute necrotizing ulcerative gingivitis. Sixty-two Nigerian children, aged 3–14 years, were studied. Twenty-two children had acute necrotizing ulcerative gingivitis and were also malnourished, 20 exhibited no acute necrotizing ulcerative gingivitis but were malnourished, and 20 were free of acute necrotizing ulcerative gingivitis and in a good nutritional state. Polymerase chain reaction methods were used to determine the presence of human cytomegalovirus (HCMV), Epstein-Barr virus type 1 and type 2 (EBV-1, EBV-2), herpes simplex virus (HSV), human herpes virus 6 (HHV-6), human papilloma virus and human immunodeficiency virus type 1 in crevicular fluid specimens collected by paper points. Of the 22 acute necrotizing ulcerative gingivitis patients, 15 (68%) revealed viral infection and 8 (36%) viral coinfection. Thirteen (59%) acute necrotizing ulcerative gingivitis patients demonstrated HCMV, 6 (27%) EBV-1, 5 (23%) HSV and 1 (5%) HHV-6. Only 2 (10%) subjects from each group not affected by acute necrotizing ulcerative gingivitis showed viral presence, and no control subject revealed viral coinfection. These findings suggest that HCMV and possibly other herpesviruses contribute to the onset and/or progression of acute necrotizing ulcerative gingivitis in malnourished Nigerian children.     

Changes in caries prevalence in Japan

In Japan, the mean DMFT at 12 years of age increased from 2.8 in 1957 to 5.9 in 1975. From the 1981 survey (DMFT=5.43), conversely, the mean DMFT decreased and reached 3.64 in 1993. The increase in caries prevalence can, without doubt, be explained by an increment of sugar consumption, since the intake of sugar increased after World War II and exceeded 18.25 kg/year (50 g/day) in 1965 and reached a maximum value (29.3 kg/year) in 1973 in Japan. On the other hand, the reason why the DMFT has decreased since 1981 is not clear. In many industrialized countries, a caries reduction has been achieved with acceptable fluoride exposure, although sugar consumption was still at a high level. However, fluoride usage was still limited during the last 2 decades in Japan. There is no community where fluoridated drinking water has been supplied since 1972. Fluoride tablet use was also discontinued for children in the 1970s. Fluoride mouthrinsing programs were available for only 19r of school children in 1992. Moreover, the market share of fluoridated dentifrices stayed at 10% until 1986 and became 30% only in 1988. An excellent correlation (r=0.91; P 0.01) is observed between the DMFT in 12-year-olds and per capita sugar consumption per year between 1957 and 1987 in Japan.     

Advances in local anesthesia in dentistry

Local pain management is the most critical aspect of patient care in dentistry. The improvements in agents and techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This article provides an update on the most recently introduced local anesthetic agents along with new technologies used to deliver local anesthetics. Safety devices are also discussed, along with an innovative method for reducing the annoying numbness of the lip and tongue following local anesthesia.     

Localization of SOST/sclerostin in cementocytes in vivo and in mineralizing periodontal ligament cells in vitro

Jäger A, Götz W, Lossdörfer S, Rath‐Deschner B. Localization of SOST/sclerostin in cementocytes in vivo and in mineralizing periodontal ligament cells in vitro. J Periodont Res 2009; doi: 10.1111/j.1600‐0765.2009.01227.x. © 2009 John Wiley & Sons A/S Background and Objective: Cementum and bone are rather similar hard tissues, and osteocytes and cementocytes, together with their canalicular network, share many morphological and cell biological characteristics. However, there is no clear evidence that cementocytes have a function in tissue homeostasis of cementum comparable to that of osteocytes in bone. Recent studies have established an important role for the secreted glycoprotein sclerostin, the product of the SOST gene, as an osteocyte‐derived signal to control bone remodelling. In this study, we investigated the expression of sclerostin in cementocytes in vivo as well as the expression of SOST and sclerostin in periodontal ligament cell cultures following induction of mineralization. Material and Method: Immunolocalization of sclerostin was performed in decalcified histological sections of mouse and human teeth and alveolar bone. Additionally, periodontal ligament cells from human donors were cultured in osteogenic conditions, namely in the presence of dexamethasone, ascorbic acid and β‐glycerophosphate, for up to 3 wk. The induction of calcified nodules was visualized by von Kossa stain. SOST mRNA was detected by real‐time PCR, and the presence of sclerostin was verified using immunohistochemistry and western blots. Results: Expression of sclerostin was demonstrated in osteocytes of mouse and human alveolar bone. Distinct immunolocalization in the cementocytes was shown. In periodontal ligament cultures, following mineralization treatment, increasing levels of SOST mRNA as well as of sclerostin protein could be verified. Conclusion: The identification of SOST/sclerostin in cementocytes and mineralizing periodontal ligament cells adds to our understanding of the biology of the periodontium, but the functional meaning of these findings can only be unravelled after additional in vitro and in vivo studies.