牙周炎患者血浆雌二醇,睾酮水平的初步观察

临床上发现,青春期和妊娠期妇女常可有牙龈炎症和牙龈增生肥大等现象发生。以往认为这可能是由于循环血中性激素水平增高所致。此外,动物实验证明,类似于人牙龈的这种病理改变,可通过使用性激素引起。也有人认为性激素在口腔细菌生长方面可起促进作用,因而考虑它与牙周炎症有关。至于性激素是直接作用于牙周组织,使之对周围环境     

妊娠期多发性牙龈瘤1例

妊娠期牙龈瘤是妊娠期女性由于性激素水平升高导致牙龈慢性炎症加重,从而在牙龈局部形成的瘤样病变,多见形成单个龈瘤,而多发性者少见。本文报道1例罕见的妊娠期多发性牙龈瘤,患者在行全口洁治后未行其他特殊治疗,病变大小未见明显改变,于分娩后5个月内龈瘤全部自行消退。     

富氢水减轻丝线诱导的SD大鼠妊娠牙龈炎

目的： 探讨氢气对牙龈炎孕鼠牙龈局部损伤的保护作用及其可能的机制。方法： 取SD雌鼠,采用结扎法诱导牙龈炎后,与雄鼠合笼交配。将孕鼠随机分为对照组、造模组和氢水组。对照组和造模组孕鼠饮用纯水,氢水组给予饱和氢水,1天2次。于妊娠第16天处死孕鼠,ELISA法检测各实验组孕鼠牙龈中Prog、SOD、TNF-α的水平,免疫组织化学和Western 免疫印迹法检测牙龈中PR、NFκB和TNF-α的表达。采用SPSS13.0软件包对数据进行统计学分析。结果： 丝线结扎可诱导SD大鼠妊娠期牙龈炎,PR主要分布于各实验组牙龈上皮细胞的胞质中,孕激素（Prog）及其受体（PR）的水平在各实验组孕鼠牙龈局部无显著差异（P>0.05）。造模组大鼠牙龈内SOD含量显著降低,NFκB和TNF-α表达显著升高。与造模组相比,氢水组孕鼠牙龈炎症反应明显减轻,牙龈内NFκB和TNF-α的表达下调。结论： 孕激素及其受体可能在实验大鼠妊娠牙龈炎的发生与发展过程中发挥间接作用,氢气可能通过抑制氧化应激相关炎症反应,减轻实验大鼠的妊娠牙龈炎。     

龈上洁治1个月后受试者牙龈炎变化的研究

第二次全国口腔健康流行病学调查显示,我国成年人牙周炎患病率高达97.15%。牙龈炎病人牙龈出血指数增高,而通过龈上洁治在短期内可使出血指数降低,炎症减轻。本研究选择51名牙龈炎病人,观察洁治后3 d、1个月的牙龈指数(G I)的变化,并分析龈上洁治与牙龈炎症的关系。1临床资料选     

妊娠期牙龈炎龈沟液中免疫球蛋白测定

妇女在怀孕期，由于体内性激素含量变化常会出现牙龈肿胀、充血、出血等现象。本文对妊娠12周以内与28周以后，并患有不同程度牙龈炎孕妇的龈沟液进行IgA、IgG、IgM含量测定（共31份），另以16份同样患有不同程度的牙龈炎非妊娠妇女的龈沟液作对照，目的在于了解妊娠期内龈沟液中免疫球蛋白的含量有无特殊性。1材料与方法1．1对象及分组在上海石化疾病防治所与金山医院作产前检查的孕妇，随机抽样患有牙龈炎的妊娠12周以内的16人（下称初孕组），妊娠28周之后的15人（下称晚孕组），同时设相同年龄段并患有类似程度牙龈炎的非妊娠妇女16…     

正畸牙龈炎患者龈沟液中牙龈卟啉单胞菌及致病岛rag基因的研究

目的探讨正畸过程中牙龈卟啉单胞菌及致病岛rag基因与牙龈炎症程度的相关关系,分析其在正畸牙龈炎发生发展中的作用。方法收集102例来自济南市口腔医院正畸科和口腔内科患者组成正畸牙龈炎组（57例）、对照组（20例）、牙周炎组（25例）,并记录其各临床指标,分别采集牙周袋最深处或龈沟液标本,采用16SrDNAPCR和多重PCR对牙龈卟啉单胞菌及致病岛rag基因进行检测,分析其与临床指标的关系。结果102例患者临床标本,共扩增出牙龈卟啉单胞菌65株,其中正畸牙龈炎组35株;对照组7株;牙周炎组23株,经Spearman等级相关分析,牙龈卟啉单胞菌检出率与牙龈指数之间存在明显的正相关关系（P〈0．01）。正畸牙龈炎组检出率明显高于对照组,牙周炎组高于正畸牙龈炎组和对照组,三者之间有显著性差异（X2=15．918,P〈0．001）,65例牙龈卟啉单胞菌阳性患者临床标本,扩增出rag基因的有52例,其中正畸牙龈炎组29例;对照组1例;牙周炎组22例,正畸牙龈炎组明显高于对照组,牙周炎组高于正畸牙龈炎组和对照组,三者之间有显著性差异（X2=22．593,P〈0．001）。结论牙龈卟啉单胞菌致病岛rag基因与正畸治疗中牙龈炎性反应密切相关。     

实验性牙龈炎Ⅰ型胶原的变化

目的观察实验性牙龈炎早期炎症牙龈组织Ⅰ型胶原的变化。方法以正畸钢丝拴结豚鼠切牙牙颈部，取临床牙周炎患者牙周袋内菌斑种入豚鼠受试牙龈沟，连续5天，受试牙龈局部红肿、龈沟加深，形成实验性牙龈炎动物模型。取其切牙连同周围牙同组织，常规石蜡切片，免疫组化PAP法检查牙龈Ⅰ型胶原，同时HE染色。结果炎性牙龈Ⅰ型胶原较正常着色明显减弱，着色缺乏连续性。结论早期炎症已有胶原受损，其损伤可能主要由炎症反应所致。     

实验性牙龈炎I型胶原的变化

目的观察实验性牙龈炎早期炎症牙龈组织Ｉ型胶原的变化。方法 以正畸钢丝拴结豚鼠切牙牙颈部，取临床牙周炎患者牙周袋内菌斑种人豚鼠受试牙龋沟，连续５天，受试牙龈局部红肿，龋沟加深，形成实验性牙龈炎动物模型。取其切牙连同周围牙周组织，常规石蜡切片，免疫组化ＰＡＰ法检查牙龈Ｉ型胶原，同时ＨＥ染色。结果 炎性牙龈Ｉ型胶原较正常着色明显减弱，着色缺乏连续性。结论 早期炎症已有胶原受损，其损伤可能主要由炎症反应所     

近红外漫反射光谱-慢性牙周炎早期诊断方法

目的:通过近红外漫反射光谱(DCS)技术测量正常、炎症状态时牙龈组织的相对血流量变化,为早期诊断慢性牙周炎提供依据.方法:随机选择30名门诊患者,应用DCS技术研发的流量仪,测量牙周治疗前、治疗后1周和1个月上前牙唇侧近、远中部位龈乳头的相对血流量,并同时做牙周探诊检查及常规临床治疗.结果:不同时期牙龈的相对血流量,健康牙龈组(129.73±10.70)高于慢性牙龈炎组(95.51 ±11.83),慢性牙龈炎组高于慢性牙周炎组(67.84±13.05).与治疗前相比,治疗后1周和1个月牙周指数均降低,牙龈相对血流量亦显著增加.牙龈指数和龈沟出血指数与相对血流量具有相关性(r=-0.902,r=-0.893).结论:DCS能无创性测量牙龈炎症不同时期牙龈组织的相对血流量变化,期望成为慢性牙周炎早期诊断方法之一.     

百蕊牙周康药物牙膏治疗牙龈炎临床效果观察

目的 观察百蕊牙周康药物牙膏治疗牙龈炎的临床效果。方法 随机选择６０名单纯性牙龈炎病人,分成实验组和对照组。观察用药前后临床症状和菌斑指数、牙龈指数、龈沟出血指数的变化。结果 两组用药前牙周各项指数的平均值无明显差异（Ｐ〉０．０５）,用药１０天后有显著性差异（Ｐ〈０．０１）。结论 百蕊牙周康药物牙膏对牙龈炎症有一定的疗效。     

Gingivitis and periodontal disease in pregnancy.

Forty pregnant women in each of three trimesters of pregnancy and forty nonpregnant women of comparable age, socioeconomic status and dietary habit have been examined to evaluate the gingival condition and the calculus and debris deposits. The study has shown that: There is a significant increase in the severity of gingivitis during pregnancy; The gingival changes progressively increase during the course of pregnancy; The gingival changes are more marked than the periodontal changes seen during pregnancy (increase in periodontal disease was seen in only a limited number of cases); There was an appreciable increase in the calculus and debris deposits in the pregnant as compared to the nonpregnant women; Increase in the calculus and debris deposits was apparent in all the trimesters of pregnancy; Gingival changes showed a greater correlation with the calculus and the debris index in the pregnant than in the nonpregnant women; The role of the irritant oral deposits either as a precipitating or perpetuating factor in the genesis of gingivitis during pregnancy can not be excluded.     

武汉市1009名孕妇牙周状况调查

目的:了解武汉市孕妇的牙周状况及其影响因素。方法:采用横断面研究的方法,按照纳入标准抽取2006-05—12在省妇幼保健院进行孕检或生产的已作婚姻登记的妇女1009名。调查方法包括问卷调查和临床牙周检查。运用卡方检验及Logistic回归分析的统计学方法对数据进行分析。结果:受检孕妇的牙龈炎和牙周炎患病率分别为74.8%和37.2%。大于30岁者患牙周炎的危险度比值(oddsratio,OR)为1.6;学历较低者患牙龈炎的OR为1.4;月收入为中或低水平的孕妇患牙周疾病的几率较大,牙龈炎OR分别为1.5和2.1,牙周炎OR分别为1.1和1.7;孕前近1年内没有口腔就诊行为的孕妇,患牙龈炎和牙周炎的OR分别为2.3和2.1;孕前或孕期患有全身性疾病的孕妇,患牙龈炎和牙周炎的OR分别为1.8和2.2;孕期有过吸烟和饮酒行为的孕妇患牙周炎的OR分别为3.8和1.6。结论:牙周疾病较易发生于年龄较大、学历和月收入较低、口腔健康行为较差、孕前或孕期患有全身性疾病及有吸烟或饮酒行为的孕妇,应加强对这部分孕妇的口腔健康教育。     

700名孕妇的妊娠期龈炎的调查分析

目的调查妊娠期龈炎的患病率与妊娠时间的关系。方法对１９９５年１月到１９９６年４月间来诊的７００名孕妇进行问卷调查及临床检查。结果妊娠期龈炎患病率为７３．５７％,其中妊娠早期为６７．４９％;中期为７４．１９％;后期为７９．１７％。妊娠期龈瘤患病率为０．４３％。结论随着妊娠时间的延长,妊娠期龈炎的患病率也提高,提示加强孕妇口腔卫生宣传的重要性     

口腔卫生健康指导对孕期妇女口腔健康的促进作用

目的:观察口腔卫生健康指导对孕期妇女口腔健康的促进作用。方法:从2010—2011年在海珠区妇幼保健院进行产前检查的初孕妇进行初筛后,从中选择780名,经基线检查并对相关口腔疾病治疗后,分为实验组(350名)和对照组(430名),实验组由口腔医师定期进行口腔卫生指导,对照组不进行口腔卫生指导。6个月后口腔检查,评价口腔卫生健康指导对孕期妇女口腔健康的作用。结果:经过口腔卫生健康指导后,实验组口腔卫生状况优于对照组(P<0.05),牙龈炎、龋病发病率均低于对照组(P<0.05)。结论:孕妇口腔卫生健康指导对其口腔健康具有促进作用,建议纳入社区卫生服务范围。     

牙周疾病与早产儿及低体重儿相关性的研究进展

妇女在妊娠期间身体和情绪的变化会影响其口腔健康。孕期常见的口腔表现是牙龈炎和牙周炎。牙周疾病与分娩出早产儿(PTB)及低体重儿(LBW)的相关性是近年颇具争议的研究热点。本文就这一方面的研究现状作一综述。     

The oral conditions and pregnancy study: periodontal status of a cohort of pregnant women

BACKGROUND: Our objective was to describe the oral health of pregnant women, to determine oral health changes during pregnancy, and to determine factors associated with maternal periodontal health or disease. MATERIALS AND METHODS: Between December 1997 and July 2001, 1,224 pregnant women at < 26 weeks' gestation were enrolled in the study and oral health examinations were performed at enrollment and within 48 hours of delivery. Demographic, medical, and health behavior data were determined by chart abstraction and questionnaire. Comparisons between oral health at enrollment and delivery were made by student t test or Fisher's exact test. Ordinal logistic regression analysis was used to identify risk factors for maternal periodontal disease. RESULTS: Among 903 women, there was a significant increase in those with health/periodontal disease absence between enrollment and delivery (P < 0.001). However, we also observed a significant increase in women with four or more sites with attachment loss > or = 2 mm or > or = 3 mm (P < 0.05, 0.001). Race, smoking, and insurance status were significantly associated with maternal periodontal disease. Black women were more likely than white women to have periodontal disease at enrollment (adj. odds ratio 2.9, 95% confidence interval 2.2 to 3.9) and delivery (adj. odds ratio 3.1, 95% confidence interval 2.2 to 4.2), and experience incident disease (adj. odds ratio 2.3, 95% confidence interval 1.6 to 3.4). CONCLUSIONS: Oral health examinations were well accepted by pregnant women. An increase in attachment loss may represent active periodontal infection accelerated by pregnancy. Further study on racial disparity in oral health among pregnant women is needed. Continued efforts to evaluate and establish appropriate definitions of oral disease in pregnancy are warranted.     

Ovarian hormones and gingivitis

Elevated plasma concentrations of the ovarian hormones--estrogen and progestins--during pregnancy, puberty, the menstrual cycle, and oral contraceptive (OC) use are associated with an increased incidence of gingival inflammation and exudate. Gingivitis is induced by the micro- organisms that compose subgingival plaque, particularly anaerobic organisms. The ovarian hormones both stimulate bacterial growth and promote the inflammatory process. In the presence of sex hormones, the metabolic breakdown of folate is increased, leading to a folate deficiency that enhances the inflammatory destruction of oral tissue. Gingivitis occurs in an estimated 60-75% of pregnancy women, but the numbers of gingivitis-producing bacteria decrease toward the end of pregnancy and the gingival tissues return to their previous state. In OC users, on the other hand, inflammation of the gingiva is chronic and may increase over time. If gingivitis is already present at the onset of pregnancy or OC use, the inflammation will become progressively more severe. Although these effects cannot be avoided, ovarian hormone- induced gingivitis can be substantially minimized of low plaque levels exist at the beginning of pregnancy or pill initiation.     

Factors affecting oral health-related quality of life among pregnant women

Abstract: Objectives: To assess oral health status and to describe the possible factors that could affect the oral health‐related quality of life (OHRQoL) among a group of pregnant rural women in South India. Materials and methods: A total of 259 pregnant women (mean age 26 ± 5.5 years) who participated in the cross‐sectional study were administered the Oral Health Impact Profile (OHIP‐14) questionnaire and were clinically examined for caries and periodontal status. Results: The highest oral impact on quality of life was reported for ‘painful mouth’ (mean: 1.7) and ‘difficulty in eating’ (mean: 1.1). On comparing the mean OHIP‐14 scores against the various self‐reported oral problems, it was seen that the mean OHIP‐14 scores were significantly higher among those who reported various oral problems than those who did not. Those with previous history of pregnancies had more severe levels of gingivitis than those who were pregnant for the first time. Also gingival index scores, community periodontal index of treatment needs scores and previous pregnancies was associated with poorer OHRQoL scores. Conclusion: Increased health promotion interventions and simple educational preventive programmes on oral self‐care and disease prevention during pregnancy can go a long way in improving oral health and lessening its impact on the quality of life in this important population.     

Self-reported gingival conditions and self-care in the oral health of Danish women during pregnancy

OBJECTIVES: The purpose of the present study was to describe the self-assessment of gingival health conditions in pregnant women, their oral hygiene behaviour and dental visiting habits, and to analyse self-care practices of pregnant women in relation to perceived gingival problems. MATERIAL AND METHODS: The study group comprised 1935 pregnant women living in two areas of Denmark consecutively recruited from August 1998 to March 1999. The survey data were based on telephone interviews. Questions in the interview concerned general health, lifestyles, socioeconomic conditions, gingival conditions, oral hygiene and utilisation of dental health services. RESULTS: One-third of the study population perceived signs of gingival inflammation; 5% of the pregnant women assessed their gingiva as poor, while 95% reported good or "normal" gingival condition. Ninety six per cent brushed their teeth at least twice a day and nine out of 10 were regular users of the dental-care system. Twenty-seven per cent of those women with pregnancy gingivitis responded to the symptoms by, for example, seeing a dentist or intensifying the oral hygiene habits. CONCLUSION: Despite a high level of self-efficacy among the pregnant women as for oral health and oral health care combined with a high level of oral hygiene and dental visiting habits, there seems to be a substantial need for increased awareness of gingival oral health.     

影响妊娠妇女孕前口腔检查的多因素综合分析

[摘要] 目的 通过调查问卷综合分析影响妊娠妇女孕前口腔检查的因素。方法 采用系统抽样的方法按照样本纳入标准选取广州市花都区妇幼保健院514例产检妇女作为问卷调查对象。在第三次全国口腔健康流行病学调查问卷的基础上,结合本课题的研究目的 设计问卷。调查问卷的内容包括:人口统计学资料、口腔健康知识的认知、口腔健康态度、孕前进行口腔检查的情况、未进行孕前口腔检查的原因、看牙费用支付途径;通过问卷结果进行分析。结果 514例调查对象中共有121名进行了孕前的口腔检查,占25.5%,孕前是否进行口腔检查与受教育程度和月收入相关(P<0.001),与口腔健康知识的认知和看牙费用是否报销之间明显相关(P<0.001),和口腔健康态度间相关性不明显。383例孕前未进行口腔检查的主要原因依次是牙齿没有问题、没有必要,没有时间及害怕看牙疼痛,仅仅有6.5%认为是因为经济因素。结论 广州市花都区妊娠妇女孕前进行口腔检查的比例偏低,建议将孕前口腔健康检查严格纳入孕前保健的基本项目中并为妊娠妇女提供特殊口腔保险项目。