青少年牙周炎的分布特征

青少年牙周炎的分布特征汪一鸣赵瑞芳西安市第四军医大学口腔医学院（７１００３２）青少年牙周炎（Ｊｕｖｅｎｉｌｅｐｅｒｉｏｄｏｎｔｉｔｉｓ，简称ＪＰ）的流行病学研究的资料甚少，主要原因有两点：第一、患病率很低北京宣武区一万多名中小学生的调查只有０．４３％...     

代谢综合征患者牙周状况的调查

目的：代谢综合征患者的牙周状况及相关因素分析。方法：按要求选取糖尿病及代谢综合征流行病学调查普查出的代谢综合征患者120例,进行问卷调查,并检查六颗指数牙的牙周探诊深度（PD）、临床附着丧失（CAL）、龈沟出血指数（SBI）、简化口腔卫生指数（0HI—S）、松动度（M）的情况。结果：120例代谢综合征患者的牙周炎患病率为95．0％,其中轻度牙周炎11例,占9．2％;中度牙周炎35例,占29．2％,重度牙周炎68例,占56．7％。共检测4320个位点,平均PD值为（2．92±0．67）mm、平均CAL值为（2．87±1．31）mm。57．1％的患者至少有1颗牙脱落。年龄、性别、吸烟、城乡差异、空腹血糖水平、糖耐量实验2小时血糖水平及总胆固醇水平是影响代谢综合征患者牙周状况的重要因素,受教育程度与牙周病严重程度无关。120名受检者中103人从未接受过牙周治疗,占85．8％,有17人曾接受过洁牙,占14．2％,无1例接受过正规的牙周系统治疗。结论：代谢综合征患者牙周破坏严重,口腔卫生教育及防病、治病意识急待加强。     

妊娠中期孕妇血清IL－1与牙周病的关系

目的：研究妊娠中期孕妇血清白细胞介素－1（IL－1）与牙周炎的关系。方法：选择60例中期妊娠妇女为研究对象,其中牙周炎30例,健康对照者30例。分别检查菌斑指数（PLI）、探诊深度（PD）、临床附着丧失（CAL）和出血指数（BI）;同时抽取空腹静脉血5mL,以ELISA法测定血清IL－1水平。结果：牙周炎组和对照组之间,PLI、PD、CAL、BI和血清IL－1均有统计学差异（P％0．05）;IL－1与牙周临床指数PLI、PD、CAL、BI间相关系数为0．692、0．556、0．342、0．683。结论：血清IL－1与PLI、PD、CAL、BI之间呈正相关关系,提示妊娠中期血清IL－1水平与牙周炎存在关联。     

三种牙周炎患者龈沟液中IL—8的检测

目的：探讨ＩＬ－８与不同种类牙周炎的关系，比较三种牙周炎，即青少年牙周炎（ｊｕｖｅｎｉｌｅｐｅｒｉ－ｏｄｏｎｔｉｔｉｓ，ＪＰ），快速进展型牙周炎（ｒａｐｉｄｐｒｏｇｒｅｓｓｉｖｅｐｅｒｉｏｄｏｎｔｉｔｉｓ，ＲＰＰ）和成人牙周炎（ａｄｕｌｔｐｅｒｉｏｄｏｎｔｉｔｉｓ，ＡＰ）龈沟液（ｇｉｎｇｉｖａｌｃｒｅｖｉｃｕｌａｒｆｌｕｉｄ，ＧＣＦ）中ＩＬ－８浓度和检出率。方法：采集ＪＰ、ＲＰＰ和ＡＰ患者ＧＣＦ，用ＥＬＩＳＡ法对ＧＣＦ中ＩＬ－８进行检测。结果：ＡＰ患者ＧＣＦ中ＩＬ－８检出率为６７．８５％，明显高于ＪＰ组、ＲＰＰ组的检出率（分别为３４．４８％、２５％）；ＧＣＦ中ＩＬ－８浓度无明显差别。结论：ＪＰ、ＲＰＰ患牙ＧＣＦ中ＩＬ－８检出率低可能是造成此种牙周炎局部中性粒细胞趋化异常的原因之一。     

新疆北疆地区哈萨克族12－14岁青少年龋齿患病率的流行病学调查＊

目的：了解新疆北疆地区哈萨克族12－14岁青少年患龋情况及其影响因素。方法：参照第三次全国口腔健康流行病学调查的要求，随机抽取新疆北疆8个地区1836名哈萨克族青少年进行口腔检查，记录相关龋病流行病学指标。结果：城市和乡村患龋率分别为30．50％和39．64％，差异有统计学意义（ P＜0．05）；男性和女性的患龋率分别为38．10％和34．15％，差异无统计学意义（P＞0．05）；城市和乡村的充填率分别为18．70％和5．64％，差异有统计学意义（P＜0．05），12－14岁青少年龋齿充填率分别为8．15％、12．34％和14．07％，差异有统计学意（P＜0．05）。新疆哈萨克族青少年每天坚持刷牙2－3次者占31．79％，刷牙时间大于3 min者占14．32％，最近看牙时间超过2年者占78．02％。结论：新疆北疆地区哈萨克族青少年患龋率高，充填率低，口腔健康行为知识有待进一步普及。     

上海市宝山区居民口腔黏膜疾病的流行病学调查

目的：了解上海宝山地区口腔黏膜疾病发病率及其流行病学特征。方法：在上海市虹口区2个社区采用多阶整群随机抽样方法,抽取653名17～92岁常住居民进行口腔黏膜健康检查及问卷调查。结果：653人中口腔黏膜疾病患病率9．04％,发病率最高的口腔黏膜疾病依次是：萎缩性舌炎（1．84％）、阿弗他溃疡（1．68％）,灼口综合征（1．38％）、口腔扁平苔藓（1．23％）和创伤性溃疡（1．23％）。不同种类疾病在不同年龄组的患病率差异明显,口腔黏膜疾病人群中吸烟、饮酒及精神焦虑状态明显高于无口腔黏膜疾病人群。结论：年龄、烟酒刺激、精神因素等与口腔黏膜疾病的发生、发展有关,应该作为一级预防的重点。     

松牙内固定远期疗效观察

目的：重度松动的牙采用根管内－骨内种植术后的远期（10年）效果进行总结。方法：对35例46颗因严重牙周炎，松动度在三度以上的单根牙行松牙内固定术（根管内骨内种植术）分别在1、5、10年进行临床追踪观察并拍X线片，结果按疾病种类分别进行评价比较。结果：1、5、10年复查的总有效率分别为84．78％、47．83％、36．96％，其中牙周炎的1、5、10上有效率为87％、54．83％、51．61％；有牙周牙髓联合病变者分别为80％、33．33％、6．67％。结论：松牙内固定术可使因牙周炎而严重松动的牙恢复稳固和咀嚼功能，稳定牙周炎病情，远期观察效果良好，其中牙髓牙周联合病变因牙体原因远期效果稍差，但大多能维持1－5年，此术安全有效可以推广。     

牙周炎患者红细胞免疫状态的初步分析

目的：通过对牙周炎患者外周血红细胞Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）和红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ）的检测,观察青少年牙周炎（ＪＰ）、快速进展型牙周炎（ＲＰＰ）、成人牙周炎（ＡＰ）的红细胞免疫功能状况。方法：采用红细胞酵母菌花环试验方法。结果：ＪＰ、ＲＰＰ患者红细胞免疫粘附力明显低于正常人。ＪＰ、ＲＰＰ患者ＲＢＣ－Ｃ３ｂＲＲ分别为（１０．０３±０．９２）％、（１２．２０±０．９４）％,与对照组（１５．９０±１．７７）％有显著差异（Ｐ＜０．００１,Ｐ＜０．０１）;ＲＢＣ－ＩＣＲ分别为（２７．８９±１．７７）％、（２７．０１±１．７９）％,与对照组（３０．６４±３７）％有显著性差异（Ｐ＜０．０１）;ＡＰ患者ＲＢＣ－Ｃ３ｂＲＲ为（１６．０２±１．２５）％、ＲＢＣ－ＩＣＲ为（３０．０４±１．７３）％,与对照组无显著性差异（Ｐ＞０．０５）。结论：提示ＪＰ、ＲＰＰ的发病机理可能与宿主的红细胞免疫功能低下有关。     

糖尿病与牙周病相关性的流行病学调查

目的：探讨天津地区糖尿病病人牙周疾病的发生情况，以及糖尿病与牙周炎之间的关系。方法：对天津市945名参加年度体检的享有卫生保健的干部和知识分子进行牙周健康状况和全身健康状况检查，其中牙周检查以社区牙周指数（CPI）和附着丧失（AL）作为诊断标准。结果：945名受检人群中共检出糖尿病177例，此糖尿病人群中牙周炎的发生率高达51．41％，与非糖尿病人群（40．23％）比较差异有显著性（χ^2=7．363，P=0．007）。CPI值与空腹血糖呈正相关性（r=0．076，P=0．031），且是糖尿病患病的一个独立的危险因素。结论：糖尿病可以增加牙周炎的发病风险，但长期的牙周炎是否可引起糖尿病的发生，有待于进一步研究。     

吸烟与非吸烟者慢性牙周炎龈下福赛类杆菌的检测

目的：利用聚合酶链反应（PCR）检测吸烟与非吸烟者龈下福赛类杆菌（Bf）水平,通过Bf的检出率进一步探讨吸烟与牙周炎的关系。方法：健康者与慢性牙周炎伴吸烟与非吸烟患者共75例,用纸捻法提取每位观察者龈沟液,PCR检测。结果：慢性牙周炎组Bf检出率（59．5％）高于健康组（24．2％）,具有显著性差异（P〈0．01）;吸烟者慢性牙周炎组Bf检出率（72．0％）高于非吸烟者健康组、吸烟者健康组、非吸烟者慢性牙周炎组（15．8％、35．7％、41．2％）,P〈0．05。结论;Bf与吸烟及慢性牙周炎有密切关系。     

沈阳地区大学新生牙周状况及口腔卫生习惯调查分析

目的:调查沈阳地区大学新生的牙周健康状况,分析口腔卫生习惯对这一特殊人群牙周健康的影响。方法:按照WHO 1997年制定的口腔健康调查基本方法,对497名大学一年级新生(男205人,女292人)的牙周健康状况进行检查,并采取问卷调查的方式了解其相关的口腔卫生习惯。通过SPSS 11.0统计软件进行Spearman相关性分析和多元线性回归分析。结果:该人群总的牙石检出率为90.3%,牙石检出平均区段为3.86±0.088;牙龈出血检出率为59.8%,牙龈炎患病率为90.5%;CPI指数为1、2、3的人数合计为86.5%。错畸形与社区牙周指数(CPI)存在相关性(rs=0.126,P<0.01)。初次刷牙时间越早,牙石检出区段数越低(rs=0.091,P<0.05),CPI分值也越低(rs=0.095,P<0.05)。结论:沈阳地区大学新生牙周状况较差,牙周疾病的流行以慢性龈炎为主。错畸形是影响牙周健康的危险因素。     

大学生牙周流行病学调查及相关社会因素分析

目的:通过调查大学新生的牙周状况及相关社会背景,了解这一特殊人群的牙周状况并分析社会因素对这一人群牙周健康的影响。方法:按照WHO 1997年制定的口腔健康调查基本方法检查497名大学一年级新生牙周健康状况,并采取问卷调查了解其相关社会背景。通过SPSS 11.0统计软件进行Spearman相关性分析和多元线性回归分析。结果:该人群牙石检出平均区段数为3.86±0.088,牙石检出率为90.3%,牙龈炎患病率为90.5%。城市与农村学生的牙龈出血检出率分别为56.4%、66.3%,牙龈炎患病率分别为88.7%、94.1%(P<0.01);男女学生牙龈出血检出率分别为65.9%、55.5%,牙龈炎患病率分别为94.1%、88%,差异具有显著性(P<0.01)。父母的受教育程度,家庭收入,及父母对口腔卫生保健的态度对孩子牙周状况有影响。结论:大学新生口腔卫生差,牙龈炎患病率高。男女差异、城乡差异及家庭背景影响其牙周状况。     

Oral malodor-related parameters in the Chinese general population

OBJECTIVES: To estimate the prevalence of halitosis in the Chinese population and to assess the relationships between halitosis and oral health, social and behavioural factors. METHODS: The correlation between the incidence of oral malodor and oral health was surveyed in a sample of 2000 individuals (1000 males and 1000 females) aged 15-64 years residing in urban and rural areas. Malodor was measured with both organoleptic measurements and with a portable sulphide monitor. Assessment of oral health included decayed, missing and filled teeth (DMFT), periodontal status, dental plaque, and tongue coating. Behavioural and social factors related with oral health or halitosis were also investigated. RESULTS: The prevalence of halitosis was 27.5% according to the organoleptic score. The level of volatile sulphur compounds (VSCs) in mouth air was significantly lower in males and in some of the age groups after lunch. Age and location of residence (rural or urban areas) did not influence the VSCs concentration in mouth air. The amount of tongue coating played the most important role in increasing VSCs concentration in mouth air, followed by periodontal status and plaque index values. DMFT, social, and behavioural factors did not contribute to halitosis. CONCLUSIONS: Tongue coating score, modified sulcus bleeding index and calculus index were factors significantly related to oral malodor in this study.     

Dental health behaviors and periodontal disease indicators in Danish youths

The purpose of the present study was to analyse the epidemiologic relationship between dental health behaviors and periodontal disease. Indicators of periodontal disease in terms of bleeding and calculus were measured dichotomously (absence/presence). Periodontal pockets were as follows: normal pockets (0-3 mm), shallow pockets (4-5 mm), and deep pockets (6+ mm). The indicators were measured on 4 surfaces on 6 index teeth (16, 11, 26, 36, 31, 46) in 1984-85. The highest value for each tooth of bleeding (0/1), calculus (0/1) and pockets (0/1/2) was used for calculation of the bleeding index, the calculus index and the pocket index. The participation rate in 1984-85 was 86%, and the study population involved 368 males and 388 females. Information concerning dental health behavior was obtained both in childhood (1974) when the individuals were 9-10 years of age, and in adulthood (1984-85) when the individuals were 20-21 years of age. Information concerning dental health behaviors in adulthood, i.e., regularity of dental visits, frequency of tooth brushing, and regular use of interdental aids, was obtained through a self-administered questionnaire (1984-85). Dental health behaviors in childhood (1974) was operationalized as level of plaque, gingivitis, and dmfs. The results showed that dental health behaviors in childhood and in adulthood were together responsible for 9.4-13.8% of the variance in level of periodontal disease indicators. Determinants of early dental health behaviors in terms of plaque and dmfs at age 9-10 years were significant predictors in pocket index at age 20-21.(ABSTRACT TRUNCATED AT 250 WORDS)     

江苏省12~15岁中学生牙周健康状况抽样调查

目的通过调查江苏省中学生牙龈出血、牙石指数等牙周临床指标,了解该地区中学生牙周健康状况,为制定江苏省中学生口腔卫生保健工作提供一定的理论依据。方法采用分层多阶段等容量随机抽样的方法抽取12~15岁4个年龄段中学生共3914人。检查其牙龈出血、牙石、牙周袋深度及15岁中学生附着丧失情况,采取非参数检验分析均数,采取卡方检验分析率。结果江苏省12~15岁中学生牙龈出血检出率为89.68%,男女间无明显差异,乡村显著低于城市(P<0.001);牙石检出率为84.59%,男性明显高于女性(P<0.05),乡村显著低于城市(P<0.001)。其中12岁、13岁、14岁、15岁牙龈出血检出率分别为89.16%、89.05%、89.06%、91.46%,年龄组间无明显统计学差异;牙石检出率分别为79.75%、83.16%、85.48%、90.02%,其中12与14岁、12与15岁、13与15岁、14与15岁之间有统计学差异(P<0.05)。结论江苏省12~15岁中学生牙龈出血和牙石检出率较高,牙龈炎症控制情况不良,明显低于全国平均水平,应加强中学生的口腔健康教育工作。     

The effect of non-steroidal anti-inflammatory drugs on bleeding during periodontal surgery

BACKGROUND: With the increasing prevalence of individuals taking non-steroidal anti-inflammatory drugs (NSAIDs), there is concern as to whether low-dose NSAIDs cause bleeding problems during periodontal surgery. METHODS: A controlled, single-blind study was designed to measure the effect of ibuprofen at peak plasma levels on intraoperative bleeding. Fifteen medically healthy subjects (seven males and eight females), each having two sites requiring periodontal surgery of similar complexity, type, and duration, were selected for the study. The subjects were instructed to take ibuprofen prior to one of the surgeries. A standard bleeding time and papillary bleeding index score were recorded at initial consultation, and prior to the first and second surgeries. The volume of aspirated blood was measured during each surgery by subtracting the amount of water used for irrigation from the total volume of fluid (blood + irrigation water) collected at 15-minute intervals during the surgery. RESULTS: An analysis of the results showed an increase in intraoperative bleeding when ibuprofen was taken prior to surgery (31.93 +/- 15.72 versus 17.80 +/- 9.57 ml; P <0.01). Ibuprofen appeared to have its greatest effect on bleeding mid-surgery. The average bleeding time also increased significantly (P <0.01) when ibuprofen was preadministered (4.17 +/- 0.96 versus 3.8 +/- 0.92 minutes), although the bleeding remained within the normal range. Papillary bleeding did not show a significant difference between the two surgeries. Surgeries involving osseous resection showed a significant increase in bleeding when ibuprofen was preadministered. CONCLUSION: Taken prior to periodontal surgery, ibuprofen increases intraoperative blood loss in patients up to almost two times that of those who did not take ibuprofen.     

Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994

BACKGROUND: The aim of this study was to assess the prevalence and extent of gingival recession, gingival bleeding, and dental calculus in United States adults, using data collected in the third National Health and Nutrition Examination Survey (NHANES III). METHODS: The study group consisted of 9,689 persons 30 to 90 years of age obtained by a stratified, multi-stage probability sampling method in 1988 to 1994. The weighted sample is representative of U.S. adults 30 years or older and represents approximately 105.8 million civilian, non-institutionalized Americans. Gingival recession, gingival bleeding, and dental calculus were assessed at the mesio-buccal and mid-buccal surfaces in 2 randomly selected quadrants, one maxillary and one mandibular. Data analysis accounted for the complex sampling design used. RESULTS: We estimate that 23.8 million persons have one or more tooth surfaces with > or = 3 mm gingival recession; 53.2 million have gingival bleeding; 97.1 million have calculus; and 58.3 million have subgingival calculus; and the corresponding percentages are 22.5%, 50.3%, 91.8%, and 55.1% of persons, respectively. The prevalence, extent, and severity of gingival recession increased with age, as did the prevalence of subgingival calculus and the extent of teeth with calculus and gingival bleeding. Males had significantly more gingival recession, gingival bleeding, subgingival calculus, and more teeth with total calculus than females. Of the 3 race/ethnic groups studied, non-Hispanic blacks had the highest prevalence and extent of gingival recession and dental calculus, whereas Mexican Americans had the highest prevalence and extent of gingival bleeding. Mexican Americans had similar prevalence and extent of gingival recession compared with non-Hispanic whites. Gingival recession was much more prevalent and also more severe at the buccal than the mesial surfaces of teeth. Gingival bleeding also was more prevalent at the buccal than mesial surfaces, whereas calculus was most often present at the mesial than buccal surfaces. CONCLUSIONS: Dental calculus, gingival bleeding, and gingival recession are common in the U.S. adult population. In addition to their unfavorable effect on esthetics and self-esteem, these conditions also are associated with destructive periodontal diseases and root caries. Appropriate measures to prevent or control these conditions are desirable, and this may also be effective in improving the oral health of the U.S. adult population.     

维持性血液透析患者的龋病和牙周病状况调查

目的比较维持性血液透析治疗的终末期肾脏病患者组和健康人群组龋病和牙周病患病率的差异,初步探讨终末期肾脏病和龋病、牙周病之间的关系。方法选择符合纳入标准的进行维持性血液透析治疗的患者作为病例组(82例),同时选择在体检中心进行口腔检查的正常人群作为健康对照组(86例)。两组采用统一的方法进行龋病和牙周状况的检查。龋病状况检查采用世界卫生组织推荐的龋失补牙数进行诊断和记录,牙周状况检查包括菌斑指数、牙石指数、探诊出血、牙周袋深度和临床附着水平。结果维持性血液透析组和健康对照组的患龋率分别为87.8%和81.4%,两组患龋率间差异无统计学意义(P>0.05);病例组的菌斑指数、牙石指数、探诊出血、牙周袋深度和临床附着水平均高于对照组(P<0.05),病例组的牙周炎患病率(97.6%)高于对照组(88.4%),差异有统计学意义(P<0.05)。结论维持性血液透析组患者的龋齿水平与健康对照人群无明显差异,但牙周炎的患病率和严重程度高于健康人群。     

Dental health status of junior high school students in the suburbs of Chiba city

The Population of 12-15 years is a key age group for oral health because the permanent dentition and periodontal tissues are almost complete at this stage. The purpose of this study was to evaluate oral health status and to develop an effective school dental health program for junior high schools students. The survey was performed on 527 persons aged 12-13 at 2 junior high schools in the suburbs of Chiba city. Periodontal disease was evaluated on the basis of the CPITN, and analyzed for severity and region of periodontal disease. Gingivitis was examined with PMA index, using color photo slides taken of anterior dentition at the time of inspection. At the same time, caries experience and oral hygiene index were also estimated. The results were as follows: (1) The mean DMFT was 3.89. Caries prevalence in females was higher than males. Ratio of treated teeth rate was 77.03%; that of untreated teeth rate was 22.65%. Females revealed less treatment for caries than males. Oral hygiene index showed significant difference between males and females. Labial and buccal parts of the maxillary and molar region on the mandibular showed remarkable plaque deposition. Calculus accumulation in this population was greatest on the lower incisor. (2) The mean PMA index was 7.36. Gingivitis was highly prevalent in both sexes, although it was more severe in males. There was correlations between PMA index and OHI. (3) From the results of CPITN, 10.6% of the subjects showed no signs of periodontal disease (Code 0), and 5.7% exhibited gingival bleeding (Code 1).(ABSTRACT TRUNCATED AT 250 WORDS)     

Juvenile periodontitis – pattern of progression and relationship to clinical periodontal parameters

Abstract – The present investigation was carried out 1) to identify subjects with juvenile periodontitis (JP) in a group of schoolchildren from a community with a high prevalence of periodontal diseases and with no access to preventive dental care, and 2) to study the clinical features of the disease and the progression pattern during a period of 1 yr, and the relationship of JP to clinical periodontal parameters. The periodontal condition of a group of 502 Iraqi schoolchildren (260 girls and 242 boys) was assessed radiographically and clinically at baseline. Children showing 3 mm arc-shaped angular radiographic bone loss at the proximal surfaces of two or more first molars and who showed clinical attachment loss at the same sites were regarded as JP patients. A second group of children with no signs of JP were randomly chosen from the study material. One year later, the JP and the non-JP groups were re-examined radiographically and clinically to assess plaque, gingivitis and presence of calculus. The results showed that nine children (1.8%) had JP. The ratio of girls to boys was 3.5:1, and of localized to generalized forms 2:1. Mesial surfaces of first molars were more often affected than distal surfaces. Clinical assessments showed a more profound loss than was depicted radiographically. All JP patients exhibited evidence of periodontal disease progression during the following year. There were no differences between JP and non-JP children with respect to gingival inflammation, dental plaque, or calculus deposits on teeth. It was concluded that the present findings are consistent with the view that plaque and plaque-retaining factors may predispose to the high rate of periodontal support loss usually seen in JP patients.