慢性牙周炎栖牙密螺旋体和牙周袋内硫化物水平的相关性研究

目的 研究慢性牙周炎病人牙周袋内栖牙密螺旋体和牙周袋内硫化物水平的关系。方法 临床上选取17例诊断为慢性牙周炎的病人,采用金刚探针/牙周诊断仪检测牙周袋内硫化物水平,记录牙周袋探诊深度、临床附着丧失以及探诊出血相关牙周指标。同时,采用16S rRNA PCR检测相同位点的栖牙密螺旋体。结果 慢性牙周炎病人栖牙密螺旋体检出率为88.2%,硫化物阳性位点和硫化物阴性位点中栖牙密螺旋体的检出率分别为68.5%和43.2%。硫化物阳性位点与阴性位点中牙周附着丧失（clinical attachment loss, CAL）平均值分别为（2.84±2.33）mm和（1.83±1.60）mm,两者差异有统计学意义（P<0.01）。硫化物阳性位点与阴性位点牙周探诊深度（probing depth, PD）平均值分别为（4.20±1.57）mm和（3.83±1.30）mm,两者差异无统计学意义(P＞0.05)。硫化物阳性位点中牙周探诊出血（bleeding on probing, BOP）阳性检出为率92.5%,大于硫化物阴性位点（75.8%）,两者差异有统计学意义（P<0.01）。结论 慢性牙周炎病人牙周袋内的硫化物水平能反映牙周栖牙密螺旋体分布情况,与牙周附着丧失存在相关性。     

侵袭性牙周炎及慢性牙周炎患者血清Dickkopf-1水平的影响因素研究

目的 观察牙周炎与血清Dickkopf-1(DKK-1)水平的关系,探讨影响血清DKK-1水平的可能因素.方法 收集侵袭性牙周炎(aggressive periodontitis,AgP)、慢性牙周炎(chronic periodontitis,CP)患者各20例(分别为AgP组、CP组)及分别与AgP、CP患者年龄匹配的健康对照者各20名(分别为H1组、H2组),采用酶联免疫吸附测定法检测血清DKK-1水平.采用t检验比较各组血清中DKK-1水平的差异,并采用相关分析和多元线性回归方法分析血清DKK-1水平与牙周临床参数及年龄等因素的关系,检测水准为双侧α =0.05.结果 AgP组血清DKK-1水平[(12.36±3.19) μg/L]显著高于CP组[(8.90 ±2.73) μg/L] (P=0.001),但与其对照组H1组[(12.37±2.74) μg/L]相比差异无统计学意义(P=0.99),CP组与H2组[(8.85 ±2.56) μg/L]相比差异也无统计学意义(P =0.896);AgP与CP组血清DKK-1水平与牙周探诊深度、附着丧失、出血指数、探诊出血阳性位点百分比间均未见显著相关(AgP组r值分别为-0.029、-0.223、0.062、-0.412;CP组r值分别为-0.156、0.185、-0.379、0.051);总体样本血清DKK-1水平与年龄呈显著负相关(r=-0.453,P =0.000);多元线性回归分析显示年龄对血清DKK-1水平有影响(β=-0.391,t=-3.626,P=0.001).结论 未发现牙周炎对血清DKK-1水平产生影响;年龄是影响血清DKK-1水平的重要因素,血清DKK-1水平随年龄增加而降低.     

慢性牙周炎基础治疗后维护期疗效纵向观察及分析

目的观察慢性牙周炎患者基础治疗后维护期的疗效,并分析牙位和位点因素对牙周袋探诊深度变化的影响。方法对牙周基础治疗后进入维护期的22例慢性牙周炎患者进行9个月的纵向观察。每3个月给予口腔卫生宣教,龈上洁治、龈下刮治和根面平整。在基线(基础治疗完成后)和每次复查时记录牙周袋探诊深度、临床附着丧失和探诊出血情况。结果维护治疗期间,牙周袋探诊深度、临床附着丧失、探诊出血等临床指标均有进一步改善。牙周袋深度前牙减少(0.52±1.02)mm,后牙减少(0.37±1.26)mm,差异有统计学意义(P<0.05);邻面位点与非邻面位点相比,邻面位点的牙周袋深度减少更显著(P<0.05);6 mm及以上的位点牙周袋深度减少(1.88±2.19)mm,4~5 mm的位点牙周袋深度减少(1.12±1.32)mm,差异有统计学意义(P<0.05)。结论慢性牙周炎患者基础治疗后每3个月进行维护治疗,可使牙周临床指标进一步改善,牙位与位点因素均对牙周袋深度的变化有影响。     

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。     

牙周袋内硫化物与牙周状况的相关性研究

目的探讨牙周袋内硫化物（VSCS）与牙周状况的相关性。方法选择慢性牙周炎患者14例,慢性牙龈炎患者15例,对全口牙齿进行探诊深度及出血指数的检查,并用硫化物检测仪对牙周袋内VSCS进行测定。结果牙周袋内VSCS水平与探诊深度具有正相关性（P〈0.05）;牙周炎组VSCS阳性牙位率和阳性位点率与牙龈炎组具有非常显著性差异（P〈0.005）。结论牙周袋内VSCS测定可作为评价牙周状况的辅助指标之一。     

牙周袋内硫化物水平与牙周临床指数的关系

目的分析慢性牙周炎患者治疗前、后牙周袋内硫化物水平的变化及与牙周临床指数的关系。方法对35名慢性牙周炎患者,分别在牙周基础治疗前、治疗后2、6周、3个月时进行硫化物的检测和牙周探诊深度（probing depth,PD）和出血指数（bleeding index,BI）的检查。对所得数据进行分析。结果治疗前在PD≥4mm或BI≥2的位点,牙周袋内硫化物检出率和浓度明显高于PD〈4mm或BI〈2的位点（P〈0.05）;治疗后,硫化物水平和PD、BI均明显下降（P〈0.05）;治疗后3个月硫化物水平有上升趋势,但无统计学意义。牙周袋内硫化物水平与牙周炎严重程度之间有相关关系。在深牙周袋、出血的位点硫化物水平增高,治疗后牙周袋内硫化物水平与探诊深度、出血指数变化一致。结论牙周袋内硫化物水平的检测可反映牙周炎症的严重程度,并可作为判断牙周疗效的指标。     

牙周炎患者基础治疗前后牙周袋内挥发性硫化物水平的变化

目的 :了解牙周炎患者治疗前后牙周袋内挥发性硫化物水平的变化。方法 :对 8例牙周炎患者的 5 1颗牙进行牙周基础治疗 ,并于治疗前及治疗后 4周用金刚牙科探针记录颊侧近远中牙周袋内共 10 2个位点的挥发性硫化物 (volatilesulfurcompounds,VSC )水平及菌斑指数 (plaqueindex ,PI)、牙周探诊深度 (probingdepth ,PD )、出血指数(bleedingindex ,BI )及临床附着水平 (clinicalattachmentlevel ,CAL )。结果 :牙周基础治疗后 4周 ,牙周袋内VSC水平及牙周各项临床指标均明显下降 (P <0 .0 0 1)。结论 :牙周袋内VSC可能是反映牙周组织状况的一项较为客观的指标。     

牙周炎患者基础治疗后牙龈卟啉单胞菌的定植研究

目的 通过对牙周炎患者龈下菌斑中牙龈卟啉单胞菌(Porphyromonas gingivalu,Pg)的检测,探讨慢性牙周炎(chronic periodontitis,CP)和侵袭性牙周炎(aggressive periodontitis,AgP)患者牙周基础治疗后Pg的定植规律.方法 选取90例CP患者和90例AgP患者,在牙周基础治疗前、治疗后6周、12周共采集龈下菌斑样本1620个,运用AmpliFluor终末点定量聚合酶链反应方法 检测Pg含量.结果 治疗后6周CP和AgP组Pg活动位点分别为61(22.6%)和66(24.4%)个,两者差异无统计学意义(P>0.05);治疗后6周Pg活动位点在治疗前检测的牙周临床指数高于Pg静止位点.治疗后12周两组Pg活动位点分别为96(35.6%)和18(6.7%)个,差异有统计学意义(P<0.05);治疗后12周Pg活动位点在治疗后6周时检测的牙周临床指数高于Pg静止位点.结论 在牙周基础治疗后6周时,CP和AgP患者Pg定植均已开始,仉是两组定植规律存在一定差异.在牙周基础治疗后,治疗前牙周组织炎性反应严重的龈下位点Pg易于定植.     

实时荧光定量PCR检测牙周炎患者龈下菌斑的分布

目的 应用实时荧光定量PCR技术探索侵袭性牙周炎（aggressive periodontitis,AgP）、慢性牙周炎（chronic periodontitis,CP）患者龈下菌斑中伴放线聚集杆菌(A. actinomycetemcomitans,Aa)、牙龈卟啉单胞菌（P. gingivalis,Pg）的分布规律。方法 采集32例AgP、33例CP、32例牙周健康者的龈下菌斑,构建含有2种待测细菌基因片段的重组质粒,建立定量标准,采用TaqManMGB探针实时荧光定量PCR方法检测样本中细菌数量。结果 本实验构建的引物及TaqManMGB探针特异性及敏感性较好。AgP组龈下菌斑Aa的检出率高于CP组（P＜0.01）,但2种细菌数量在组间无显著差异,两组内Pg的检出率及数量都明显高于Aa（P＜0.001）,另外AgP组Aa的数量、CP组Pg数量与牙周探诊深度密切相关（P＜0.01及P＜0.001）。结论 龈下菌斑Aa的检出率可能与牙周炎类型存在一定关联,Aa可能并不是中国人群样本AgP患者龈下菌斑的优势菌,实时荧光定量PCR对牙周病学研究有广泛应用前景。     

1%聚维酮碘液龈下冲洗对牙周炎的治疗作用

目的观察龈下超声刮治及根面平整后,采用1%聚维酮碘进行牙周袋内冲洗治疗慢性牙周炎的疗效。方法选择中度和重度慢性牙周炎患者30人,进行全口洁治、龈下超声刮治及根面平整,选取左侧前牙较重的一颗为实验组,用1%的聚维酮碘液进行牙周袋内冲洗;对照组选用同患者对侧同名牙,用生理盐水冲洗;避免选相邻的牙。记录治疗前、治疗后3、6个月的菌斑指数、探诊出血、牙周袋深度、附着丧失、龈沟出血指数;及厌氧菌和产黑色素类杆菌总数。结果治疗3个月后,2组的牙周袋探诊深度、菌斑指数、龈沟出血指数及探诊出血较治疗前明显改善(P<0.05);实验组附着丧失比治疗前明显下降(P<0.05);实验组牙周袋探诊深度、附着丧失、龈沟出血指数及探诊出血改善程度均大于对照组(P<0.05);2组牙周袋内厌氧菌总数与产黑色素类杆菌量较治疗前均有降低(P<0.05),实验组优于对照组(P<0.05)。治疗6个月后与治疗3个月后各项临床指标及细菌学检查结果基本相同,差异无统计学意义(P>0.05)。结论龈下超声刮治及根面平整结合1%的聚维酮碘液牙周袋内冲洗,能提高治疗效果及较长时间控制龈下菌斑。     

侵袭性牙周炎龈沟液中白介素-8 的检测

目的：检测侵袭性牙周炎（AgP）龈沟液中白细胞介素（IL-8）的总量和浓度并探讨其与牙周临床指标的关系。方法：采用常规滤纸条法收集侵袭性牙周炎实验组患牙（T1）和健康牙（T2）各位点及正常对照组（C）各位点的龈沟液（GCF）样本,用ELISA法检测各样本中IL-8的总量和浓度。结果：3组受检牙龈沟液中IL-8的总量和浓度不同。侵袭性牙周炎患牙组GCF中IL-8总量高于健康牙位组（P〈0．05）及正常对照组;而3组中IL-8浓度差异也有显著性,侵袭性牙周炎患牙组GCF中IL-8的浓度高于健康牙位组（P〈0．05）和正常对照组;虽然GCF中IL-8浓度与牙周探诊深度（PD）、牙龈出血指数（BOP）、附着丧失（AL）无相关关系;但IL-8总量与以上牙周临床指标相关。结论：在侵袭性牙周炎患者龈沟液中IL-8是参与牙周炎症反应的重要调节因子。     

龈沟内硫化物水平与牙周炎症关系的研究

目的观察龈沟内硫化物水平(sulfide levels,SUL)与牙周炎症之间的相关性,探讨SUL作为牙周监测指标的价值和可行性。方法通过临床检查和X线摄片,对牙周炎组17例,牙龈炎组15例及健康对照组15例,记录每颗牙齿6个位点的探诊深度、附着水平、松动度和探诊出血等临床指标,并用Perio2000 system金刚探针牙周诊断仪测定各位点的硫化物水平。结果3组研究对象的龈沟SUL差异有显著性(P<0.001),牙周炎组最高,牙龈炎组次之,对照组最低。SUL与上述几项牙周临床指标之间均呈正相关(P<0.001)。结论挥发性硫化物(VSC)可能在牙周炎症的病理过程中发挥重要作用。结合牙周临床指标,龈沟内SUL可作为反映牙周组织健康状况的监测指标。     

Influence of Periodontal Clinical Status on Salivary Levels of Glutathione Reductase

Background: Inadequate antioxidant balance may play a role in the excessive tissue breakdown in periodontitis. Because aggressive periodontitis (AgP) not only differs from chronic periodontitis (CP) in terms of clinical manifestations, this study investigates whether the salivary levels of glutathione reductase (GR) may be linked with periodontal status. Methods: Saliva samples from patients with CP (n = 121), patients with AgP (n = 18), and healthy controls (n = 69) were collected. Periodontal status was assessed by criteria based on probing depth, clinical attachment level, and extent and severity of periodontal breakdown. GR salivary levels were analyzed by spectrophotometry. The association among GR concentration and CP or AgP was analyzed individually and adjusted for confounding using multivariate binary logistic regression models. Results: GR levels not only differed significantly between the two periodontitis groups, being significantly greater in patients with AgP, but also were significantly greater than those observed in healthy controls. Synchronously, positive significant correlations between salivary GR concentration and clinical parameters were observed. After binary logistic regression analysis, both GR salivary levels ≥15.38 and ≥24.20 mU/mL were associated independently with CP and AgP, respectively. A significant interaction effect was also detected between increased GR salivary concentration and aging in the CP group. Conclusions: Increased GR salivary concentration may be a strong/independent prognostic indicator of the amount and extent of oxidative stress‐induced periodontal damage in both CP and AgP. Likewise, saliva samples might reflect an interactive effect of GR levels associated with the aging‐related cumulative characteristics of periodontal damage in CP.     

Elevated Levels of a Disintegrin and Metalloproteinase 8 in Gingival Crevicular Fluid of Patients With Periodontal Diseases

Background: A disintegrin and metalloproteinase 8 (ADAM8) is involved in inflammation and is essential for osteoclastogenesis. Elevated ADAM8 levels are detected in human serum and other body fluids in several inflammatory conditions. Therefore, we hypothesized that ADAM8 levels are also raised in gingival crevicular fluid (GCF) of patients with periodontal diseases. Methods: Forty‐five patients with periodontal diseases (n = 15 for each group: the group of patients with gingivitis, the group with aggressive periodontitis [AgP], and the group with chronic periodontitis [CP]) and 15 volunteers who exhibited healthy gingiva were recruited. Four periodontal parameters, gingival index, plaque index, probing depth, and clinical attachment level, were recorded before GCF collection. The presence of ADAM8 in GCF was shown by immunoblotting using anti‐human ADAM8 polyclonal antibody against its prodomain, and the ADAM8 levels were measured by an enzyme‐linked immunosorbent assay. Results: Four immunoreactive bands at 120, 70, 50, and <30 kDa were detected in the groups of patients with periodontitis, whose intensities were stronger than those in the group of patients with gingivitis, consistent with significantly greater ADAM8 levels in both groups of patients, with either CP or AgP, than those in the group of patients with gingivitis and in the group that was healthy (P <0.001). Moreover, the ADAM8 levels correlated significantly with the four periodontal parameters (P <0.001), indicating that ADAM8 levels are positively associated with the degree of periodontal tissue inflammation and destruction. Conclusions: The ADAM8 levels are elevated in the GCF of patients with periodontal diseases, including gingivitis, CP, and AgP, in comparison to control participants who are healthy, and they correlate with four clinical parameters that reflect the degree of disease severity.     

Neutrophil elastase activity, levels of prostaglandin E2, and matrix metalloproteinase-8 in refractory periodontitis sites in smokers and non-smokers.

The study was aimed to determine elastase activity, levels of prostaglandin E2 (PGE2), and matrix metalloproteinase-8 (MMP-8) in gingival crevicular fluid (GCF) in 20 smokers and 20 non-smokers, mean age 47.4 (+/-2.9 SD) years with refractory periodontal diseases. GCF was collected with intracrevicular washing from four sites in each subject. Clinical assessments, included gingival index, probing depth, clinical attachment level, bleeding on probing, bone height, and plaque accumulation. Smokers had a significantly higher percentage of the gingival margin covered by plaque (P%Im), higher number of sites with probing pocket depth > or = 5 mm, higher mean values of probing pocket depth and probing attachment level (P< 0.01). Smokers had significantly higher mean levels of neutrophil elastase activity (P< 0.01) in the supernatants than non-smokers did. In sites with matching pocket depths, neutrophil elastase activity was significantly higher in smokers (P< 0.001) than in non-smokers. In sites with high levels of MMP-8 the PGE2 levels were significantly (P< 0.001) higher compared to sites with low levels in smokers as well as in non-smokers. A significant correlation was found between probing pocket depth and levels of MMP-8 (P< 0.001) and in non-smokers between probing pocket depth and levels of PGE2 (P< 0.05).     

The periodontal condition of regular dental attenders in Northern Ireland

The aim of this study was to assess the prevalence and severity of periodontal destruction in regular dental attenders in Northern Ireland. 132 individuals aged between 20 and 49 years who had recently had a course of routine treatment in the General Dental Service completed a questionnaire and had a periodontal examination. Measurements of plaque, subgingival calculus, bleeding, probing pocket depth and periodontal attachment level were made at 4 proximal sites per tooth. Plaque was present at an average of 17%, subgingival calculus at 13%, and bleeding on probing at 34% of interproximal surfaces examined. The mean probing pocket depth was 2.7 mm and the mean probing attachment level was 1.0 mm. Incipient periodontal destruction was common with all subjects having at least 1 pocket of greater than or equal to 3 mm and 90% having at least 1 site with greater than or equal to 2 mm attachment loss. Only 24 (18%) of those examined had deep pocketing or severe loss of periodontal attachment (greater than or equal to 6 mm). The extent of deep pocketing and severe attachment loss was low at only 0.2% and 0.6%, respectively, of the sites examined. It was concluded that gingivitis and incipient periodontitis were prevalent and extensive in the regular dental attenders investigated, but that severe periodontal destruction was uncommon.     

Salivary Levels of NLRP3 Inflammasome‐Related Proteins as Potential Biomarkers of Periodontal Clinical Status

Background: Emerging evidence suggests that activation of inflammasomes plays a central mechanism in pathogenesis of periodontitis. This study aims to compare salivary levels of nod‐like receptor family pyrin domain containing protein (NLRP) 3, apoptosis‐associated speck‐like protein containing a caspase recruitment domain (ASC), cysteine aspartase (caspase)‐1, and interleukin (IL)‐1β from individuals with aggressive (AgP) or chronic periodontitis (CP) and healthy controls (HC), as well as elucidate its association with periodontal clinical status. Methods: Saliva samples from individuals with CP (n = 75), AgP (n = 20), and HC (n = 69) were collected. Periodontal status was assessed by measurement of probing depth, clinical attachment level, and extent and severity of disease. Salivary levels of analytes were analyzed by enzyme‐linked immunosorbent assay. Association between biomarkers with CP or AgP was analyzed using multivariate binary logistic regression models. Results: Significantly higher levels of NLRP3, ASC, and IL‐1β were detected in periodontitis groups in comparison to the periodontally HC group. However, no significant differences were observed for caspase‐1 levels between clinical groups, and only NLRP3 salivary concentration was significantly higher in AgP compared with CP patients. Also, positive significant correlations among NLRP3, ASC, and IL‐1β salivary concentrations and clinical parameters were observed. Logistic regression analyses revealed a strong/independent association of NLRP3, ASC, and IL‐1β salivary levels with CP and AgP. Conclusion: Although the concentration of caspase‐1 in saliva samples makes its determination useless for detection of periodontal disease and/or its severity, salivary levels of NLRP3, ASC, and IL‐1β may act as strong/independent indicators of amount and extent of periodontal breakdown in both CP and AgP and could potentially be used for prevention and therapy of this group of diseases.     

Relationship of sulcular sulfide level to severity of periodontal disease and BANA test

BACKGROUND: Volatile sulfur compounds (VSC), such as hydrogen sulfide and methyl mercaptan, are toxic metabolites produced by periodontal pathogens. Their relationship to periodontal disease severity is not yet fully understood. Hence, the aims of this study were to: 1) examine the relationship between sulcular sulfide (pS) levels and severity of periodontal disease and 2) examine the link between pS level and the BANA (benzoyl-DL-arginine-naphthylamide) test. METHODS: Seventy systemically healthy subjects with a mean age of 53.0 +/- 13.8 years participated. Three sites were selected from each subject based upon radiographic bone loss (RBL): RBL < 2 mm, healthy; RBL > or = 2 to < 4, low to moderate; RBL > or = 4 mm, severe. Periodontal parameters, probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP), were recorded. The pS level was measured using a portable sulfide monitor in a digital score ranging from 0.0 (< 10(-7) M of S) to 5.0 (> or = 10(-2) M of S) in increments of 0.5. The presence of specific bacteria in subgingival plaque was detected using BANA test. RESULTS: The mean pS level was 0.10 +/- 0.23, 0.36 +/- 0.48, and 1.10 +/- 0.87 for healthy, low to moderate, and severe disease sites, respectively, and was statistically different (P<0.001). The pS level was positively correlated with the BANA test, and was higher in untreated subjects than maintenance subjects (P<0.01). CONCLUSIONS: The pS level may be a potential indicator for detecting severity of periodontal disease and identifying bacteria that are capable of hydrolyzing BANA.