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?? Sjögren syndrome??SS??is classified as primary Sjögren syndrome??pSS??and secondary Sjögren syndrome??sSS??. It is an autoimmune exocrinopathy characterised by lymphocytic infiltration of exocrine glands in multiple sites??including both lacrimal and salivary glands??so the patients often suffer from dry mouth and dry eyes. Now the pathogeny and its pathogenesis is still  under study??and this review will elaborate from the aspects of cytokines??antibody??gene??virus and so on.     

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目的    评价前方牵引器联合Hass快速扩弓器矫治骨性前牙反牙合的临床疗效。方法    选择2008年8月至2010年12月在丹东市玉乾口腔诊所收治的乳牙期或恒牙早期骨性Ⅲ类错牙合患儿56例,应用前方牵引器联合Hass快速扩弓器矫治前牙反牙合,比较矫治前后的头影测量数据。结果    矫治后56例骨性前牙反牙合患儿上齿槽座点-鼻根点-下齿槽座点角、Wits值明显增加,上颌骨矢状向有明显的骨性生长,上颌牙槽骨也有明显增长。面中长度、下颌骨长度、下颌骨体长度以及下颌平面与鼻底平面的交角均增加（P < 0.05）。结论    前方牵引器联合Hass快速扩弓器治疗骨性前牙反牙合可以显著改善患儿的侧貌,促进上颌骨的唇向生长。     

声动力疗法在牙周病防治中的研究进展

牙周病影响范围广,是我国成年人失牙的首要原因,因此有效的牙周病防治十分重要.当前常见的牙周病防治方法存在一定缺陷,声动力疗法(SDT)作为一种新兴治疗手段可在一定程度上解决这些问题.本文简述了牙周病目前的防治状况,又重点介绍了SDT的概念、由来、对细菌的作用以及在牙周病治疗方面的研究进展.     

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牙菌斑是一种细菌性生物膜。菌斑控制是个人口腔卫生保健及龋病、牙周病防治的必要措施。菌斑控制的方法很多,其中有机械性措施和化学方法,然而每种方法又有其各自的局限性。近年来,光动力疗法在口腔抗菌方面的研究取得了一定进展,声动力疗法继光动力疗法在微生物领域的研究将具有重要的临床应用价值。本文就菌斑控制的方法做一综述。     

Bactericidal effects of a high‐power,red light‐emitting diode on two periodontopathic bacteria in antimicrobial photodynamic therapy in vitro

Aim: Light‐emitting diodes have been investigated as new light activators for photodynamic therapy. We investigated the bactericidal effects of high‐power, red light‐emitting diodes on two periodontopathic bacteria in vitro. Methods: A light‐emitting diode (intensity: 1100 mW/cm², peak wavelength: 650 nm) was used to irradiate a bacterial solution for either 10 or 20 s. Bacterial solutions (Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans) at a concentration of 2.5 × 10⁶ c.f.u./mL were mixed with an equal volume of either methylene blue or toluidine blue O (0–20 μg/mL) and added to titer plate wells. The plate wells were irradiated with red light‐emitting diode light from a distance of 22 or 40 mm. The contents were diluted, and 50 μL was smeared onto blood agar plates. After 1 week of culturing, bacterial c.f.u. were counted. Results: The light‐emitting diode energy density was estimated to be approximately 4 and 8 J/cm² after 10 and 20 s of irradiation, respectively. Red light‐emitting diode irradiation for 10 s from a distance of 22 mm, combined with methylene blue at concentrations >10 μg/mL, completely killed Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Conclusion: High‐power, red light‐emitting diode irradiation with a low concentration of dye showed effective bactericidal effects against two periodontopathic bacteria.     

The antibacterial effect of photodynamic therapy in dental plaque-derived biofilms

Background and Objective:  Photodynamic therapy has been advocated as an alternative to antimicrobial agents to suppress subgingival species and to treat periodontitis. Bacteria located within dense biofilms, such as those encountered in dental plaque, have been found to be relatively resistant to antimicrobial therapy. In the present study, we investigated the ability of photodynamic therapy to reduce the number of bacteria in biofilms by comparing the photodynamic effects of methylene blue on human dental plaque microorganisms in the planktonic phase and in biofilms.
Material and Methods:  Dental plaque samples were obtained from 10 subjects with chronic periodontitis. Suspensions of plaque microorganisms from five subjects were sensitized with methylene blue (25 μg/mL) for 5 min then exposed to red light. Multispecies microbial biofilms developed from the same plaque samples were also exposed to methylene blue (25 μg/mL) and the same light conditions as their planktonic counterparts. In a second set of experiments, biofilms were developed with plaque bacteria from five subjects, sensitized with 25 or 50 μg/mL of methylene blue and then exposed to red light. After photodynamic therapy, survival fractions were calculated by counting the number of colony-forming units.
Results:  Photodynamic therapy killed approximately 63% of bacteria present in suspension. By contrast, in biofilms, photodynamic therapy had much less of an effect on the viability of bacteria (32% maximal killing).
Conclusion:  Oral bacteria in biofilms are affected less by photodynamic therapy than bacteria in the planktonic phase. The antibacterial effect of photodynamic therapy is reduced in biofilm bacteria but not to the same degree as has been reported for treatment with antibiotics under similar conditions.     

Photosensitization of in vitro biofilms by toluidine blue O combined with a light-emitting diode

In natural ecosystems, micro-organisms grow preferentially attached to surfaces, forming matrix-enclosed biofilms. The aim of this study was to determine photodestruction levels in biofilms after subjecting them to photodynamic therapy. Biofilms of Streptococcus mutans, S. sobrinus, and S. sanguinis were grown on enamel slabs for 3, 5 or 7 d. Both the number of viable micro-organisms and the concentration of water-insoluble polysaccharides were analysed, and mineral loss (DeltaZ) analyses were performed on the enamel slabs. The antimicrobial potential of toluidine blue O (0.1 mg ml(-1)), associated with 85.7 J cm(-2) of a light-emission diode, was evaluated on the viability of 5-d biofilms. Both the number of micro-organisms and the concentration of water-insoluble polysaccharide increased with the age of the biofilms. A significant reduction ( approximately 95%) in viability was observed for S. mutans and S. sobrinus biofilms following photosensitization, with a > 99.9% reduction in the viability of S. sanguinis biofilms. In conclusion, a biofilm model was shown to be suitable for studying changes in bacterial numbers and enamel mineralization and for demonstrating the potential value of photosensitization in the control of in vitro biofilms.     

Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial

Objective: The aim of this study was to assess the effect of adjunctive antimicrobial photodynamic therapy (aPDT) in chronic periodontitis. Material and Methods: Twenty patients with untreated chronic periodontitis were included. All teeth received periodontal treatment comprising scaling and root planing. Using a split‐mouth design, two quadrants (test group) were additionally treated with aPDT. Sulcus fluid flow rate (SFFR) and bleeding on probing (BOP) were assessed at baseline, 1 week and 3 months after treatment. Relative attachment level (RAL), probing depths (PDs) and gingival recession (GR) were evaluated at baseline and 3 months after treatment. Results: Baseline median values for PD, GR and RAL were not different in the test group and control group. Values for RAL, PD, SFFR and BOP decreased significantly 3 months after treatment in the control group (median delta RAL: ?0.35 mm, inter‐quartile range: 0.21 mm), with a higher impact on the sites treated with adjunctive aPDT (median delta RAL: ?0.67 mm, inter‐quartile range: 0.36 mm, p<0.05). GR increased 3 months after treatment with and without adjunctive aPDT (p<0.05), with no difference between the groups (p>0.05). Conclusions: In patients with chronic periodontitis, clinical outcomes of conventional subgingival debridement can be improved by adjunctive aPDT.     

光动力疗法在牙周治疗中的应用

光动力疗法在肿瘤治疗中的应用比较常见，但随着研究的不断深入，发现了其抗微生物的生物学作用，光动力疗法在治疗感染性疾病中的作用已日益受到关注。本文就光动力疗法的机制及其在牙周病治疗中的应用现状作一综述。     

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??Objective    To evaluate the effect of HMME-mediated adjunctive sonodynamic therapy??SDT??on periodontitis in rats??in order to provide theoretical and experimental evidence for the clinical application of SDT. Methods    Ligatures were placed on the subgingival regions of the first maxillary molar in 54 rats to induce the periodontitis models. Then the rats were randomly divided into three groups with 18 rats in each group.??1??The control group was treated by normal saline??NS?? to wash the periodontal pocket????2??the scaling and root planing??SRP??group received SRP and was washed with normal saline????3??the SRP plus SDT group was treated by SRP and washed with normal saline?? and then was treated through subcutaneous injection of HMME 1 mL??40 μg/mL??. After 90 min of incubation in the dark??the ultrasonic treatment at the frequency of 1 MHz and the intensity of 3W/cm2 was given for 10 minutes. SDT was performed every other day. Six rats from each group were sacrificed at 6??10??or 14 days postoperatively and periodontal tissue samples were taken for histological examination and immunohistochemical analysis. Results    SRP plus SDT group had reduced number of inflammatory cells. The expression of receptor activator of nuclear factor kappa-B ligand ??RANKL??was weakly positive??and the number of positive Tartrate-resistant acid phosphatase??TRAP?? was significantly reduced ??P < 0.05????compared to the SRP and the control group??P < 0.05??. Conclusion    SDT is an effective adjunctive therapy for periodontitis in rats.