牙周非手术治疗对重度慢性牙周炎患者龈沟液中C反应蛋白的影响

目的检测牙周基础治疗对慢性牙周炎患者龈沟液中C反应蛋白(CRP)的影响,为牙周病活动期诊断及判断牙周治疗的效果提供一定的客观依据。方法治疗前及治疗后1、3、6、12个月,用滤纸条收集30例重度慢性牙周炎患者的60个重度牙周炎牙位(探诊深度PD≥6 mm)和60个轻度牙周炎牙位(PD≤4 mm)的龈沟液并称重,用酶联免疫吸附测定法(ELISA)测定CRP的含量并记录牙周临床指标,15例牙周健康者的30个健康牙位作为对照。结果深牙周袋牙位的CRP在龈沟液中的浓度((968.06±360.54)pg/m L)显著高于浅牙周袋牙位((291.65±65.62)pg/m L),且疾病牙位的CRP浓度均显著高于健康牙位((33.47±24.53)pg/m L),龈沟液中CRP浓度与探诊深度(r=0.825,P<0.05)、附着丧失(r=0.833,P<0.05)、菌斑指数(r=0.741,P<0.05)呈正相关关系。同时,牙周基础治疗后沟液中CRP浓度明显降低,并且与口腔卫生情况有关。结论龈沟液中CRP浓度与牙周破坏程度有关,非手术治疗后龈沟液中CRP浓度下降。     

慢性牙周炎龈沟液中硫离子水平与临床相关性研究

目的:分析慢性牙周炎(CP)患者龈沟液中硫离子(su lfides)水平的变化与临床牙周指数的相关关系及其对诊断预后的意义。方法:采用金刚牙周诊断仪进行龈沟液硫离子和牙周临床指标测定。选定实验组(T):36例慢性牙周炎患者,57颗牙位,共342个位点。其中健康牙位(T1)21颗,位点126个;炎症牙位(T2)36颗,位点216。对照组(C):全身及牙周健康者8例,16颗牙位,共96个位点。测定所选位点龈沟液(GCF)中硫化物水平(su lcussu lph ide level,SUL),牙周袋探诊深度(prob ing depth,PD),牙周临床附着丧失水平(c lin ical attachm ent level,CAL),龈沟出血指数(su lcus b leed ing index,SB I)。所有统计结果均采用SPSS11.0进行统计学分析。结果:1)牙周健康对照组(C)GCF中硫离子SUL的浓度均值为(0.0648±0.0169)pg/mL,明显低于慢性牙周炎炎症牙位组(T2)(0.3249±0.0489)pg/mL及慢性牙周炎健康牙位组(T1)(0.1160±0.0271)pg/mL;慢性牙周炎炎症牙位组(T2)GCF中硫离子(SUL)的浓度均值均高于正常对照组及慢性牙周炎健康牙位组(T1)。2)经相关性分析,慢性牙周炎炎症牙位组(T1)GCF中SUL的浓度均值与PD、SB I和CAL均呈正相关关系。而慢性牙周炎健康牙位组(T1)及正常对照组(C)GCF中SUL的浓度均值与PD、SB I及CAL间无相关性。结论:慢性牙周炎(CP)炎症牙位组龈沟液中硫离子(SUL)的浓度均值与牙周临床指标之间具有相关关系,其水平的高低变化可客观反映牙周组织的炎症状态。     

侵袭性牙周炎龈沟液中硫化物的检测

目的:检测侵袭性牙周炎(AgP)龈沟液中硫化物浓度水平变化并探讨其与牙周临床指标的关系。方法:采用金刚牙周诊断仪进行龈沟液硫化物和牙周临床指标测定。选定实验组(T)16例侵袭性牙周炎病人,56个牙,共336个位点。其中健康牙(T1)16个,位点96个;炎症牙(T2)40个,位点240。对照组(C):全身、牙周健康者10例,20个牙,共120个位点。测定所选位点龈沟液(gingival crevicu lar flu id,GCF)中硫化物水平(su lcus su lph ide level,SUL),牙周袋探诊深度(pocket prob ing depth,PPD),牙周临床附着丧失水平(c lin i-cal attachm ent level,CAL),龈沟出血指数(su lcus b leed ing index,SB I)。结果:①3组受检牙龈沟液中硫化物浓度不同。侵袭性牙周炎炎症牙位组GCF中硫化物浓度(0.2210±0.0415)×10-6mol/L高于健康牙位组(P<0.05)、正常对照组;健康牙位组GCF中硫化物浓度(0.1025±0.0198)×10-6mol/L高于正常对照组(0.0523±0.0044)×10-6mol/L。②经相关性分析,侵袭性牙周炎炎症牙位组(T1)GCF中硫化物的浓度均值与PD、SB I和CAL均呈正相关关系,健康牙位组(T1)、正常对照组(C)GCF中硫化物浓度均值与PD、SB I及CAL无相关性。结论:侵袭性牙周炎病人龈沟液中的硫化物是参与牙周炎症反应的重要调节因子,其水平变化可反映牙周组织的炎症状态。     

慢性牙周炎龈沟液中白细胞介素-8与硫化物的相关关系

目的：探讨慢性牙周炎龈沟液（gingival crevicular fluid，GCF）中白细胞介素-8（interleukin-8，IL-8）与硫化物（suleus sulphide level，SUL）的关系。方法：采用双抗体夹心ELISA法、金刚牙周诊断仪对龈沟液中IL-8和硫化物的含量和临床指标进行测定。23个牙周健康牙作正常对照组（C），12个慢性牙周炎健康牙作实验组1（T1），30个慢性牙周炎患牙作实验组2（T2）。用标准化滤纸条采集观察牙位GCF样本，记录相应位点30’硫化物浓度，同时记录龈沟出血指数（SBI）、牙周袋探诊深度（PPD）、牙周附着丧失水平（CAL）。结果：①受检位点龈沟液中IL-8总量存在显著性差别，其中慢性牙周炎炎症牙位组IL-8总量高于健康牙位组、正常对照组（p〈0.05），但龈沟液中IL-8浓度无显著性差别。龈沟液中IL-8总量与SBI、PPD、CAL之间有明显相关关系（P〈0.05），但IL-8的浓度与临床指标间相关关系不明显。②慢性牙周炎炎症牙位组的硫化物浓度与健康牙位组、正常牙位组之间均有显著性差别（P〈0.05），慢性牙周炎健康牙位组与正常牙位组之间无显著性差别。③慢性牙周炎炎症牙位组硫化物浓度与临床指标间具正相关关系（P〈0.05），而健康牙位组和正常对照组硫化物浓度与临床指标间无相关关系。GCF中慢性牙周炎炎症牙位组的硫化物浓度与IL-8总量具负相关关系（P〈0．05），而慢性牙周炎健康牙位组和正常对照组的硫化物浓度与IL-8总量之间无相关关系。结论：慢性牙周炎患牙龈沟液中IL-8和硫化物的含量与临床指标之间有相关性。龈沟液中细菌代谢产物所产生的硫化物对IL-8的含量存在一定抑制作用。     

龈沟液中正五聚体蛋白3水平与慢性牙周炎的相关性研究

目的：研究慢性牙周炎患者牙周基础治疗前后龈沟液中正五聚体蛋白3（Pentraxin-3,PTX3）的水平变化及其与牙周临床指标的相关性,探讨龈沟液中PTX3水平与牙周状态的关系。方法：采集20例慢性牙周炎患者20个牙周相对健康位点、20个炎症位点治疗前后的龈沟液,同时记录治疗前后炎症位点的探诊深度（probing depth,PD）、临床附着丧失（clinical attachmentloss,CAL）、龈沟出血指数（sulcus bleeding index,SBI）。用酶联免疫吸附法（ELISA）检测龈沟液中的PTX3的浓度。结果：炎症组龈沟液中PTX3的水平显著高于牙周相对健康组,龈沟液中PTX3水平在牙周基础治疗后显著下调,且与PD、CAL、SBI及龈沟液的量呈正相关。结论：龈沟液中PTX3的水平与牙周组织炎症程度具有显著相关性。     

广泛型侵袭性牙周炎患者龈沟液中白介素-17的检测

目的 比较广泛型侵袭性牙周炎患者与健康人龈沟液中白介素-17(IL-17)的表达水平及与临床指标的关系。方法 选择广泛型侵袭性牙周炎患者18例和健康人16例,共68颗牙,记录临床牙周检查指标,用滤纸条法收集龈沟液。采用抗体夹心ELISA法测定广泛型侵袭性牙周炎患者治疗前、治疗后3个月及健康对照者龈沟液中IL-17总量和浓度。结果 广泛型侵袭性牙周炎患牙治疗前龈沟液中IL-17的总量和浓度高于牙周健康牙,基础治疗3个月后广泛型侵袭性牙周炎患牙龈沟液中IL-17的总量和浓度较治疗前下降。广泛型侵袭性牙周炎患牙龈沟液中IL-17浓度与探诊深度、附着丧失和出血指数呈正相关关系,而IL-17总量仅与探诊深度呈正相关关系。结论 龈沟液中IL-17浓度可能与广泛型侵袭性牙周炎牙周破坏及炎症的严重程度相关。?     

白细胞介素-21在不同牙周状态龈沟液中的表达及相关性分析

目的检测白细胞介素(Interleukin,IL)-21在不同牙周状态下龈沟液中的表达,探讨IL-21在牙周免疫中的可能作用。方法本研究共纳入47例患者,分为健康对照组(15例),轻度牙周炎组(10例),中重度牙周炎组(22例);记录患者一般信息、用Florida牙周探针检查牙周袋探诊深度(PD)和临床附着丧失(CAL)情况;收集牙周治疗前的龈沟液样本,采用酶联免疫吸附法(ELISA)测定不同牙周条件下龈沟液中IL-21的水平;并进行Pearson秩相关检验统计IL-21的表达与相关临床指标的关系。结果 3组龈沟液中IL-21平均浓度分别为(107.20±2.54)、(218.90±5.11)、(367.80±7.27)pg/m L,轻度牙周炎组及中重度牙周炎组龈沟液中IL-21水平显著高于对照组(P<0.05),其中以中、重度牙周炎组增高最为显著;中、重度牙周炎组龈沟液中IL-21水平分别与PD、CAL呈正相关关系(P<0.001)。结论 IL-21在牙周疾病中有较高的表达,尤其是以中重度牙周炎患者最为显著;由此推测IL-21在牙周疾病的发生发展中占有重要地位,与牙周组织的破坏有密切关系。     

慢性牙周炎患者龈沟液中白细胞介素-4的检测和意义

目的检测慢性牙周炎患者牙周基础治疗前后龈沟液中白细胞介素-4(IL-4)的质量浓度,探讨IL-4与牙周炎的关系及其在牙周炎发病机制、病情进展等方面所起的作用。方法用滤纸条浸润法采集成年健康者和牙周炎患者治疗前后的龈沟液样本,用酶联免疫吸附测定检测样本中IL-4的质量浓度。结果慢性牙周炎患者龈沟液中IL-4的质量浓度低于健康对照组(P<0.05)。经牙周基础治疗1个月后,IL-4的质量浓度无明显变化,治疗前后的差异无统计意义(P>0.05);IL-4的质量浓度与探诊深度呈显著负相关,与牙龈指数和附着丧失无明显相关性。结论IL-4缺乏可能会导致牙周病的发生,IL-4可作为早期诊断牙周病和检测易患人群的敏感性指标。     

IL-35在慢性牙周炎血清及龈沟液中的表达及相关性

目的通过检测牙周炎患者血清及龈沟液中白细胞介素35( IL-35)的水平,分析其与临床指标的相关性,初步探讨IL-35在牙周疾病过程中的变化情况。方法按纳入标准选择20例中、重度牙周炎患者作为实验组,20例健康人群作为对照组;记录患者的一般信息、牙周袋探诊深度( PD)和临床附着丧失( CAL) 情况;收集静脉血清及龈沟液样本,采用酶联免疫吸附法(ELISA)测定血清及龈沟液中的IL-35水平;利用SPSS19.0软件包进行Pearson秩相关检验,分析IL-35的表达及与临床指标的关系。结果实验组血清及龈沟液中IL-35平均浓度分别为（330.42±19.23）ng/mL、(205.56±14.42) ng/mL,对照组分别为(206.89±45.01) ng/mL、(101.88±3.34 ) ng/mL,实验组血清及龈沟液中IL-35水平显著高于对照组( P<0.01)。实验组血清及龈沟液中IL-35水平分别与PD和CAL呈负相关。结论慢性牙周炎可导致血清及龈沟液中IL-35水平显著升高, 其升高程度与牙周炎呈负相关。     

牙龈卟啉单胞菌与龈沟液中白细胞介素8关系的研究

目的:探讨龈沟液(GCF)中白细胞介素8(IL -8)在慢性牙周炎病程中的变化、IL- 8与牙周临床检测指标以及同龈下菌斑中细菌含量的相关关系。方法: 5名非牙周炎患者的10颗牙周健康牙和30名慢性牙周炎(CP)患者的70颗牙(其中10颗为健康牙, 60颗为牙周炎患牙)纳入本研究。采集观察牙的GCF样本、龈下菌斑样本,同时记录所有牙的牙龈指数(GI)、牙周袋探诊深度(PPD)、临床附着丧失水平(CAL)。用ELISA法检测样本中IL -8的水平,用厌氧菌培养技术培养菌斑标本,用PCR法检测菌斑中的牙龈卟啉单胞菌(Pg),结果:慢性牙周炎组的GCF中IL -8的总量高于临床牙周健康组,而IL -8的质量浓度在各组中无差异。GCF中IL- 8浓度与GI、PPD、CAL无相关关系,而IL -8的总量与GI、PPD、CAL呈正相关关系。龈下菌斑中Pg的检出量与GCF中IL- 8的含量间未发现有相关关系。结论:慢性牙周炎患者龈沟液中IL- -8量增加与龈沟液分泌增加有关而与牙龈卟啉单胞菌检出CFU无关。     

牙周炎症对牙龈组织巨噬细胞胞外诱捕网形成的影响

目的:探讨牙周炎症对牙龈组织中巨噬细胞胞外诱捕网(METs)形成的影响。方法:纳入基础治疗后,需进行牙周翻瓣手术的牙周炎患者29例,以牙周健康的牙冠延长术患者20例作为对照。术前记录菌斑指数(PLI)、牙龈指数(GI)、探诊深度(PD)、临床附着丧失(CAL)等牙周临床指标,收集龈沟液(GCF)样本,术中收集牙周炎患者牙周破坏最严重部位的牙龈组织及牙冠延长术患者的健康牙龈组织。采用激光共聚焦显微镜观察牙龈组织中METs的形成情况,采用ELISA技术检测GCF中TNF-α和IL-9表达水平,分析两组样本METs形成水平与各牙周临床指标、GCF中TNF-α、IL-9水平的相关性。结果:牙周炎组METs形成分数,PLI、GI、PD、CAL等牙周临床指标,以及TNF-α、IL-9水平均显著高于正常对照组(P<0.05)。METs形成分数与PD、CAL正相关(P<0.05)。结论:牙周炎症破坏可以促进牙龈组织中METs的形成。     

牙周治疗前后龈沟液中白细胞介素-6水平的变化

目的：探讨牙周洁利治对患牙龈沟液中IL-6水平的影响。方法：选取12例成人牙周炎患者的重度牙周炎换牙12颗,采集治疗前患牙的龈沟液并记录相关的临床指标。然后对患牙进行龈上洁治和龈下刮治,两周后,再次采集患牙的龈沟液并记录相关的临床指标。采用双抗体夹心ELISA法对牙周炎患牙龈沟液中IL-6水平进行检测。比较牙周洁刮治前后龈沟液中IL-6水平的差异。结果：经过牙周洁刮治,患牙龈沟中IL-6的水平明显降低,同时患牙的牙周临床指标也有明显的改善。结论：牙周基础治疗在缓解牙周炎患牙局部炎症的同时,也对患牙局部的IL-6水平产生明显影响。     

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.     

Effect of meloxicam on gingival crevicular fluid IL-1beta and IL1 receptor antagonist levels in subjects with chronic periodontitis, and its effects on clinical parameters

The aim of the present study was to determine the effects of meloxicam after initial periodontal treatment on interleukin-1beta (IL-1β) and IL-1 receptor antagonist (IL-1ra) in gingival crevicular fluid (GCF) and clinical parameters in the chronic periodontitis patients. Data were obtained from 30 patients with chronic periodontitis. Fifteen chronic periodontitis patients received 7.5 mg meloxicam, and 15 patients received placebo tablets in a 1×1 regimen for 1 month. All subjects were nonsmokers and had not received any periodontal therapy. The plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were recorded. The GCF was collected using a paper strip: eluted and enzyme-linked immunoabsorbent assays (ELISAs) were performed to determine the cytokine levels. The clinical data and GCF samples were obtained after periodontal therapy and 1 month after periodontal therapy. The PI, GI, PD, and GCF IL-1ra decreased significantly (p<0.05) in meloxicam group at first month when comparing the initial levels. While decrease of the PI was statistically significant in control group (p<0.05), statistically significant changes were not determined in the other clinical parameters and GCF cytokine levels (p>0.05). There were no significant differences between two groups in any of the investigated parameters. Our observations did not reveal any influence of meloxicam on levels of IL-1β and IL-1ra in chronic periodontitis. Additional clinical studies are advisable to determine whether COX-2 selective drugs alter periodontal disease outcome with greater safety.     

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.     

The effect of non-surgical periodontal therapy on peroxidase activity in diabetic patients: a case-control pilot study

Objective: To evaluate the effect of periodontal therapy on clinical parameters as well as on total salivary peroxidase (TSP) activity and myeloperoxidase (MPO) activity in the gingival crevicular fluid (GCF) of patients with type 2 diabetes mellitus (DM2) and of systemically healthy individuals.
Material and Methods: Twenty DM2 subjects with inadequate metabolic control (test group) and 20 systemically healthy individuals (control group), both groups with chronic periodontitis, were enrolled. Periodontal clinical parameters, namely periodontal probing depth (PD), clinical attachment level (CAL), visible plaque index (VPI), bleeding on probing (BOP), gingival bleeding index (GBI) and presence of suppuration (SUP), as well as TSP activity and GCF MPO activity, were assessed before and 3 months after non-surgical periodontal therapy.
Results: At baseline and 3 months post-treatment, the test group presented a higher percentage of sites with VPI and BOP ( p <0.01). MPO activity in the GCF presented lower values ( p <0.05) for the test group at both baseline and the post-treatment period. The periodontal treatment resulted in a significant improvement of most clinical and enzymatic parameters for both groups ( p <0.05).
Conclusions: In both groups, the periodontal therapy was effective in improving most clinical parameters and in reducing salivary and GCF enzymatic activity. The diabetic individuals presented lower MPO activity in the GCF.     

Effect of periodontal therapy on crevicular fluid interleukin-1beta and interleukin-10 levels in chronic periodontitis

OBJECTIVES: This study aimed to analyse the levels of the proinflammatory cytokine IL-1beta and the anti-inflammatory cytokine IL-10 in gingival crevicular fluid (GCF) of patients with chronic periodontitis prior to, and following, periodontal therapy for a period of 32 weeks. MATERIAL AND METHODS: GCF samples were obtained from 24 non-diseased and 72 diseased sites of 12 periodontal patients prior to as well as at 6, 16 and 32 weeks post-periodontal therapy. All sites received conventional periodontal treatment and IL-1beta and IL-10 levels (concentration and total amount) were determined by enzyme linked immunosorbent assay (ELISA). Additionally, probing pocket depth (PD), clinical attachment loss (CAL), gingival (GI) and plaque (PII) indices were evaluated pre-and post-therapy. RESULTS: IL-1beta was detected in 382 out of 384 samples, while IL-10 was detected in 337 out of 384 samples. The total amount of IL-1beta was significantly higher at diseased compared to non-diseased sites (p<0.01). Following therapy, IL-1beta total amounts were reduced, while IL-1beta concentration gradually increased. IL-10 total amounts (per 30 s sample) were similar in diseased and non-diseased sites, and following therapy they remained almost unchanged. By contrast, IL-10 concentration was significantly higher in non-diseased sites (p<0.01) and displayed a significant increase post-therapy. Moreover, IL-1beta concentration and total amount were significantly greater in smokers following therapy, while IL-10 total amount was significantly higher in non-smokers both prior to and following therapy. Total IL-1beta amounts were positively correlated with GI and Pll. A weak negative correlation between IL-1beta and IL-10 levels was noted (p<0.05). CONCLUSIONS: The data suggest that the total amount rather than the concentration of IL-1beta in GCF seemed to be closely associated with periodontal disease severity. Moreover, smoking status influenced IL-1beta and IL-10 levels. An inverse relationship between IL-1beta and IL-10 was evident.