便携式气相色谱仪与感官法、硫化物检测仪检测口臭的相关性研究

目的:评价新型便携式气相色谱仪(GC-SCS)与常用口臭检测方法检测口臭的相关性.方法:选择55例全身健康的受试者,由嗅辨员对其进行感官分析评分,同时采用便携式硫化物检测仪(HalimeterTm)检测口腔可挥发性硫化物总量,应用GC-SCS检测3种挥发性硫化物含量.所得结果采用SPSS11.5软件包进行Pearson和Spearman相关性分析.结果:GC-SCS所测硫化氢、甲硫醇及VSCs总量与感官分析法均值之间的相关系数分别为0.486、0.529和0.491(P<0.01).GC-SCS所测硫化氢、甲硫醇及VSCs总量与Halimetr所测VSCs含量之间的相关系数分别为0.458、0.522和0.436(P<0.01).结论:GC-SCS检测所得的挥发性硫化物的含量与感官分析得分、Halimeter检测所得挥发性硫化物总量之间的相关性较好,是一种很有潜力的口臭检测方法.     

唾液中尸胺水平与口源性口臭的相关研究

目的:建立高效液相色谱测定唾液尸胺含量的方法,探讨唾液尸胺水平与口臭鼻测法结果的相关性。方法:56例实验对象的唾液经纯化,以DiamonsilC18柱为反相色谱柱,用1,6-己二胺为内标,流动相由A液(甲醇)和B液(水∶磷酸∶三乙胺=360∶9∶6)组成,检测波长为231nm,流速1ml/min。口臭鼻测法使用0～5级评分标准,由2位嗅辨员独立完成,以鼻测法均值为应变量,唾液尸胺浓度为自变量,使用SPSS11.0软件包进行Pearson相关分析。结果:尸胺在5～80nmol/ml范围内线性关系良好(r=0.9985),本法回收率为91.5%,精密度为6.93%;唾液尸胺浓度与鼻测法结果呈正相关(P<0.01)。结论:唾液中尸胺的形成和口臭有一定联系,高效液相色谱法测定唾液尸胺浓度在口臭临床诊断方面具有实用价值。     

口臭与幽门螺杆菌感染的关系——病例对照研究

目的运用病例对照研究方法,对有无口臭人群进行检查和分析,探讨胃幽门螺杆菌(H.pylori)感染与口臭的关系。方法选择无牙周疾病和全身疾病(胃肠道疾病除外)的受试者共226人,以鼻测法将受试者分为口臭组和非口臭组,即病例组和对照组;两组对象的性别、年龄等基本信息和口腔健康状况相互匹配,无显著差异。对上述研究对象进行口气评估(鼻测法、Halimeter检测挥发性硫化物、Oral Chroma检测3种挥发性硫化物含量)、口腔检查、问卷调查及胃幽门螺杆菌病理检查。使用SPSS19.0软件,对数据进行统计学分析,采用Logistic回归法,统计排除混杂因素后胃幽门螺杆菌与口臭之间的关系。结果共有226人纳入实验,其中病例组117人,对照组109人。病例组中,71人H.pylori感染,占60.7%;对照组25人H.pylori阳性,占22.9%(P<0.01)。在双因素分析基础上进行Logistic回归结果显示,H.pylori感染的比值比为4.6(P<0.01)。当以VSC≥110μg/L作为口臭诊断标准时,H.pylori感染在Logistic回归中的比值比为9.3(P<0.05)。结论口臭人群的幽门螺杆菌感染率明显高于非口臭人群,提示幽门螺杆菌感染可能为口臭发病的影响因素,但其致病机制仍需进一步研究。幽门螺杆菌感染是否是非口源性口臭产生的病因,还需今后开展大样本的前瞻性研究进行证实。     

口臭的检测方法

口臭可由多种疾病引起,细菌产生的以硫化氢、甲基硫醇、乙基硫化物为主的气体混合物(VSC)是口臭气味的主要成分。口臭的主要测量方法有:感官分析法、化学分析法和细菌分析法。利用硫化物检测器检测VSC水平更为准确、客观。     

唾液潜血与口腔硫化物水平的相关分析

目的 探讨牙周基础治疗后唾液潜血的转归及其与口腔挥发性硫化物(volatile sulphur compounds,VSC)、牙周临床指标的关系,以期评价唾液潜血在牙周疾病及口气诊疗中的作用.方法 对50例菌斑性龈炎或轻、中度慢性牙周炎患者行牙周基础治疗,治疗前、后分别用口气检测仪(Halimeter)检测口腔VSC水平,用潜血试纸检测唾液潜血,并依次记录全口菌斑指数(plaque index,PLI)、探诊深度(probing depth,PD)、出血指数(bleeding index,BI)及Ramfj(o)rd指数牙的附着丧失(attachment loss,AL).结果 治疗前唾液潜血与BI(r=0.294)及PU(r=0.308)呈显著正相关(P<0.01);治疗后唾液潜血与口腔VSC水平(r=0.386)、PLI(r=0.456)、BI(r=0.352)、AL(r=0.325)显著正相关(P<0.05);唾液潜血阳性转阴性率达80%(40/50);治疗后PLI(0.4±0.6)、BI(0.4 ±0.7)、AL[(0.1±0.5)mm]、PD[(2.7±0.9)mm]、口腔VSC水平[(100.0(46.3-165.3)×10-9]均较治疗前[分别为(1.3±1.0)、(1.8±1.2)、(1.0±1.1)mm、(3.7±1.5)mm、211.0(111.0～389.5)×10-9]显著降低(P<0.001).随着唾液潜血由强阳性到阴性的变化,口腔VSC水平和各牙周临床指标逐渐降低,该趋势差异有统计学意义(P<0.001).结论 唾液潜血是判断个体牙龈炎症程度的客观指标,与治疗后的口腔VSC密切相关.     

口源性口臭检测指标的初步研究

目的：探讨寻找鼻测法替代检测手段的可能性.方法：选取56例医学院在校学生作为研究对象,使用Spearman法和Pearson法,分析鼻测法与口腔可挥发性含硫化合物、唾液pH、舌背微生物培养、唾液尸胺等检测结果间的相关关系.结果：口腔可挥发性含硫化合物（rMax=0.537,P＜0.01;r稳定值=0.572,P＜0.01）、唾液pH（r=0.344,P＜0.01）、唾液尸胺浓度（r=0.352,P＜0.01）、口腔卫生指数的检测结果（r=0.323,P＜0.05）、唾液兼性厌氧培养菌落计数（r=0.398,P＜0.01）、舌背兼性厌氧培养菌落计数（r=0.293,P＜0.05）及舌背专性厌氧培养菌落计数结果（r=0.473,P＜0.01）均与鼻测法结果呈正相关,但相关性均较弱.结论：任一单一指标均不能替代鼻测法对口臭进行诊断.     

Halimeter与嗅觉测量口臭的相关研究

目的　比较Halimeter与感官分析测量口臭的相关性。方法　用Halimeter测量 68名受试者 ,与嗅觉测量的结果作相关分析。结果　二者有显著相关 ,r =0 .80 7(P <0 .0 1)。结论　二者用于口臭测量有显著相关。提示Halimeter可作为用于口臭临床研究的一种简便工具 ,可更准确地表达口臭的程度     

口气检测中气相色谱法和Halimeter法的比较

目的探讨口气检测过程中气相色谱法与Halimeter口气分析仪法的相关性。方法选择口臭患者50例,使用气相色谱仪与Halimeter口气分析仪检测患者口气中挥发性硫化物(volatilesulfurcompounds,VSCs)浓度,检测结果作相关性分析。结果两者有显著相关性,P<0.001。结论两者均可用于口气的检测。在科研工作中,应将两种方法结合运用。     

牙周炎患者牙周袋内硫化物水平与牙周临床指标的相关分析

目的评价牙周炎患者牙周袋内硫化物（pS）与口气挥发性硫化物（VSC）及牙周临床指标的相关性。方法全口洁治后1周，对20例慢性牙周炎伴口臭的患者龈下刮治和根面平整（SRP）前后用Halimeter检测口气中VSC，用金刚探针检测pS，并对牙周袋内pS及菌斑指数、出血指数、探诊深度、临床附着水平纵向观察6个月。结果口内pS〉0的位点数（r=0．592，P〈0．001）和ps值（r=0．506，P〈0．001）与口气VSC均呈显著正相关；治疗后6周、3个月、6个月，pS与出血指数呈低度相关，r值分别为0．183、0．411、0．350（P〈0．05）；SRP后6周，pS及各临床指标较基线水平显著改善（P〈0．001），并在第3、6个月时进一步改善或保持稳定。结论pS值可以特异性地反映牙周袋内硫化物的水平，可作为牙周疗效判断的客观指标，反映和监测维护期的牙周组织炎症状况。     

口气成分与牙周和舌苔指标的关系初探

目的初探口气中各硫化物水平与牙周临床指标、舌苔的相关关系。方法选择30例口源性口臭的患者,用OralChroma^TM检测口气中硫化氢（H2S）、甲基硫醇（CH3SH）、二甲基硫[（CH3）2S]的浓度,用Halimeter检测口腔挥发性硫化物（volatile sulfur compounds,VSCs）水平,记录受检者牙周临床指标、舌苔指标。结果OralChroma^TM所测口气CH3SH与菌斑指数（PLI）、牙周探诊深度（PD）、出血指数（BI）、舌苔厚度（Tt）均正相关（P〈0.05）,而（CH3）2S仅与PD和BI正相关（P〈0.05）,H2S与舌苔面积（Ta）正相关（P〈0.05）。H2S水平（r=0.470）、CH3SH水平（r=0.431）与Halimeter测得口气VSCs水平显著正相关（P〈0.05）。结论（CH3）2S可能主要为牙周袋来源,CH3SH则为牙周与舌苔两种来源,H2S的口腔来源可能最为表浅,舌苔因素为主。     

口臭与主要产臭菌的相关性分析

目的分析口臭与主要产臭菌的相关性.方法选择口臭患者29名,用鼻闻法确定口臭的来源和部位,使用口气测量仪测量口腔中挥发性硫化物(volatile sulfur compounds,VSCs)的浓度;分别从产臭牙周袋、舌苔和唾液中采集标本,进行厌氧培养,并进行菌落计数.结果VSCs水平与龈下菌斑中的厌氧菌总数明显正相关(P＜0.01),与龈下菌斑中产黑菌数(black-pigment bacteria,BPB)和具核梭杆菌数(Fusobacterium nucleatum,FN)也相关(P＜0.05),舌苔上的厌氧菌总数、产黑菌和具核梭杆菌与VSCs水平呈正相关(P＜0.05).结论牙周病和大量舌苔可能是引起口臭的主要原因,而细菌(主要包括产黑菌和具核梭杆菌)在口臭的形成中起重要作用.     

The relationship between physiologic halitosis and periodontopathic bacteria of the tongue and gingival sulcus

To determine the influence of oral status on halitosis, the relationship between halitosis and periodontopathic bacteria present in plaque on the tongue and the subgingival sulcus was examined in 62 periodontally healthy adults. Halitosis indicators used were the organoleptic score; gas chromatography results [total volatile sulfur compounds (VSCs) = H₂S + CH₃SH + (CH₃)₂S]; Halimeter values; and the results of three clinical tests, plaque control record (PlCR), plaque index (PlI), and tongue coat status. Significant correlations with organoleptic scores was observed for PlCR, PlI, tongue coat status, VSC amounts, and Halimeter values, indicating that halitosis in periodontally healthy subjects tended to originate from tongue plaque deposits. Polymerase chain reaction analysis was used to detect six periodontopathic bacteria (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, and Treponema denticola) from the tongue and subgingival plaque. Significant effects on the organoleptic scores, tongue coat status, total VSC, H₂S and CH₃SH amounts, and Halimeter values were observed only for T. denticola and F. nucleatum and only in the tongue plaque, not in the subgingival plaque. Thus, therapies developed to inhibit the growth of these bacteria may lead to future treatments of halitosis.     

Characteristics of patients complaining of halitosis and the usefulness of gas chromatography for diagnosing halitosis

OBJECTIVE: The purpose of this study was to examine the characteristics of patients complaining of halitosis and to evaluate the diagnostic accuracy of 3 methods of measuring halitosis.Study Design: The actual degree of halitosis was determined through use of an organoleptic test in 155 patients aged 46 +/- 17 years (mean +/- SD). The volatile sulfur compounds (VSCs) were determined with gas chromatography and with sulfide monitoring. RESULTS: The organoleptic test revealed that 55% of the subjects had either no mouth odor or slight mouth odor. There was a significant correlation between the organoleptic score and the total VSC level as determined through use of other methods. The critical discrimination value of the total VSC level was calculated to be 0.057 ppm for gas chromatography and 0.117 ppm for sulfide monitoring; high sensitivity and specificity were obtained when the gas chromatography value was used. The amount of tongue coating was significantly greater in the halitosis-positive group than in the halitosis-negative group, whereas there was no difference in salivary flow rate between the 2 groups. CONCLUSION: These results indicate that determining VSCs with gas chromatography is a useful means of diagnosing halitosis.     

Intra- and extra-oral halitosis: finding of a new form of extra-oral blood-borne halitosis caused by dimethyl sulphide

AIM: The aim of this study was to unravel the origen and cause of intra-oral and extra-oral halitosis. MATERIAL AND METHODS: We studied 58 patients complaining of halitosis, using gas chromatography of volatile sulphur compounds (VSCs) in mouth and nose breath, organoleptic scoring of mouth and nose breath, Halimeter readings of mouth air and tongue-coating inspection. Subjects had no precence or history of periodontitis. RESULT: Of 58 patients, 47 patients had halitosis of oral origin, six had halitosis of extra-oral origin and five had no halitosis (halitophobia). A strong correlation was found between the degree of intra-oral halitosis as measured by organoleptic scoring of mouth breath and the concentration of the VSCs hydrogen sulphide (H(2)S) and methyl mercaptan (CH(3)SH) in mouth breath. Taking into account the much larger odour index of CH(3)SH, it was concluded that CH(3)SH is the main contributor to intra-oral halitosis. In all six cases of extra-oral halitosis, halitosis was caused by the presence of elevated levels of dimethyl sulphide (CH(3)SCH(3)) in mouth and nose breath. CONCLUSION: Our study provides evidence that the VSC, CH(3)SH and to a lesser extent H(2)S are the main contributors to intra-oral halitosis and that CH(3)SCH(3) is the main contributor to extra-oral or blood-borne halitosis, due to a hitherto unknown metabolic disorder.     

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.     

Comparison of volatile sulfur compound concentrations measured with a sulfide detector vs. gas chromatography

The accuracy of the Halimeter, an inexpensive, simple instrument that measures total breath volatile sulfur compounds (VSCs), has not been adequately tested. We compared Halimeter measurements with those obtained with a specific and sensitive gas chromatographic (GC) technique. The Halimeter gave different, biexponential responses to a constant concentration of different VSCs: The relative response rate and sensitivity were hydrogen sulfide > methyl mercaptan > dimethylsulfide. The transient peak VSC concentration of oral samples was reached long before the sulfide detector fully responded. The GC measurement of initial total VSCs in breath samples was 2.7+/-0.48 times greater than the peak concentration of the Halimeter. However, the plateau phase measurement of the Halimeter was 25% greater than that of GC. While GC and Halimeter measurements positively correlated, appreciable differences were observed. In studies where relatively precise VSC measurements are required, GC is the preferable technique.     

口臭与牙周炎及舌苔的相关性研究

目的　探讨口臭及口气中挥发性硫化物 (volatilesulphurcompounds ,VSCs)与牙周炎及舌苔的相关性 ,舌在口臭及VSCs产生中的作用。方法　选择 6 0例全身健康、有口臭的牙周炎患者 ,鼻闻法检查口臭程度 ,使用便携式口臭测量仪分别测量清除舌苔前后的VSCs量。记录牙周袋探诊深度(probingdepth ,PD)及PD≥ 4mm位点比例 ,出血指数 (bleedingindex ,BI) ,菌斑指数 (plaqueindex ,PLI)及舌苔厚度与面积。结果　Spearman相关分析法显示 ,口臭值、VSCs量与BI、PLI、舌苔厚度存在明显的正相关性 (P <0 0 1) ,与舌苔面积也有关系 (P <0 0 5 )。口臭值与PD及PD≥ 4mm位点比例无关 ,VSCs量与PD及PD≥ 4mm位点比例存在一定的相关性 (r=0 2 6 ,P <0 0 5 )。清除舌苔可以明显降低VSCs量 (t=10 15 ,P <0 0 1) ,其减少量与舌苔厚度及面积均有明显相关性 (P <0 0 1)。结论　口臭值、VSCs量与BI、PLI及舌苔均有关系 ,而牙周袋PD只与VSCs量有关系 ;虽然清除舌苔可以明显降低VSCs量 (降低 36 7% ) ,但由于存在如何完全彻底清除舌苔的问题 ,所以舌与牙周炎在口臭及VSCs形成中的作用尚需进一步研究。     

成都地区健康人群口腔挥发性硫成分水平的测量及影响因素分析

目的:了解成都地区人群口腔挥发性硫成分(VSCs)的分布、口臭发病情况及影响因素。方法:对符合纳入标准的成都地区384个健康成人使用便携式口气测定仪Halimeter及口气感官检测法分别检测人群口腔VSCs水平及口气指数,采用舌苔指数评价受检者舌苔情况并进行问卷调查,统计学分析观察结果了解口臭在人群中的分布及影响因素。结果:21161%受检者的VSCs值大于300 ppb。28191%受检者口气值大于6,表明有慢性口臭,男女之间口气值有显著差异(P<0105)。无论VSCs水平或口气指数与患者舌苔指数均有显著相关。结论:人群中有口臭的患者占有相当比例,舌苔与口臭有密切相关关系,口腔卫生应重视舌苔的清洁。     

Association between oral malodor and measurements obtained using a new sulfide monitor

OBJECTIVE: The purpose of this study was to evaluate the ability of a new volatile sulfur compounds (VSCs) monitor to assess oral malodor in subjects and compare its performance with those of organoleptic testing and gas chromatography. METHODS: The mouth air of 260 patients was measured by three methods: VSCs monitor (Breathtron), organoleptic test by two judges and gas chromatography (GC). Mcnemar test and Pearson correlation were used to analyze the data among these methods. RESULTS: The log values of VSCs measured by a sulfide monitor were significantly correlated with the organoleptic ratings, and also with log values of H(2)S, CH(3)SH, and (CH(3))(2)S determined by GC (P<0.01). Using the results of organoleptic and GC to classify subjects into normal and malodor groups, the sulfide monitor's sensitivity was shown to be more than 79% and the specificity was 61-73%. CONCLUSIONS: This sulfide monitor could be used for oral malodor measurement, moreover, according to its portability, it could be conveniently used for clinical setting and field surveys.