一次与分次完成牙周基础治疗的微生物学比较研究

目的 比较一次性牙周治疗和传统牙周治疗龈下菌群的变化.方法 选择慢性牙周炎患者20名,随机分为两组,一次性牙周治疗组(实验组)和传统牙周治疗组(对照组).一次性牙周治疗组在24小时内完成全口牙齿的刮治,并进行全口消毒;传统牙周治疗组分4次完成全口牙齿的刮治.刮治前(基线)、刮治后6周分别采集龈下菌斑,进行厌氧培养和涂片检查(刚果红负染色法),进行厌氧菌总数和产黑菌计数,计算螺旋体的百分比.比较两种方法治疗前后细菌计数和螺旋体比例的差异.结果 实验组厌氧菌总数和产黑菌数降低程度较对照组明显(P＜0.05),两组螺旋体比例变化无明显差异.结论 一次性牙周治疗方法可行,疗效肯定,微生物检查结果优于传统牙周治疗.     

百蕊牙周康药膏治疗牙周疾病的疗效观察

牙周疾病是口腔常见病,也是造成人类失牙的主要原因之一,对此人类进行大量的研究,以期预防和治疗该类疾病。我科近期将百蕊牙周康药膏,应用于牙周炎、牙龈炎患者,观察其治疗效果。 1 材料和方法 1.1 病例选择 随机抽取我科门诊未作任何全身和局部治疗的牙周疾病患者100人为临床观察对象,其中男66例,女34例;年龄最大67岁,最小18岁,平均35岁;牙龈炎69例,牙周炎31例。 1.2 材料和方法 100例牙周疾病患者分为2组,用药组采用百蕊牙周康药膏(由合肥三安药业有限公司提供,皖卫药准字:1996第100008号),1～2克刷牙,早晚各一次,每次5～8分钟,严重者将药膏直接涂于患处,1～3分钟后漱口;对照组采用普通牙膏,教会病人正确刷牙方法,早晚刷牙各一次,二组     

牙周临床治疗Ⅴ.牙周医学

对宿主易感性的认识使人们能够理解不同个体牙周炎发生、发展的差异，而另一方面，牙周疾病对许多器官系统的潜在影响日益受到关注，牙周医学的兴起开创了崭新的重要研究领域，并有着深远的临床意义。     

牙髓牙周联合病变综合治疗的临床疗效

目的探讨牙髓牙周联合病变综合治疗的临床疗效。方法选择牙髓牙周联合病变120例182颗患牙,采用牙髓牙周综合治疗,观察疗效。结果经2年随访,182颗患牙综合治疗的有效率为84．62％。结论对牙髓牙周联合病变采用综合治疗,可以取得良好的临床疗效。     

聚维酮碘溶液辅助牙周治疗的疗效观察

常规的牙周洁治和刮治治疗虽然有效,但在牙周袋过深、根分叉病变多的情况下,常使疗效有局限性,或者多复发。药物的应用在一定程度上可起到辅助牙周基础治疗的作用。药物放于牙周袋内,能长时间在局部保持药物的高浓度,靶向作用于病变部位,副作用小,被认为是药物辅助牙周治疗最有     

牙髓牙周联合病变的临床疗效分析

目的　观察并分析不同类型的牙髓牙周联合病变的病因和临床疗效。方法　对112例15 2颗牙髓牙周联合病变患牙分析病因,并针对病因采取不同的方法,进行牙髓牙周的联合治疗。结果　经1～4年观察,原发性牙髓病继发牙周病组有效率为6 8.4 % ,原发性牙周病继发牙髓病组有效率为4 7.2 % ,合并性病变组有效率为33.9% ,每两组之间经卡方检验均有显著性差异(P <0 .0 1)。结论　不同类型的牙髓牙周联合病变应根据病因采取不同的治疗措施,且临床疗效差别也较大。     

几种牙周夹板治疗中晚期牙周病的疗效比较

几种牙周夹板治疗中晚期牙周病的疗效比较王涪华，姚翠竹，黄国兴济南市空军济南医院（２５００３１）近８年来，我们根据不同层次病人的要求，采用不同的材料与方法制作牙周夹板矫治松动、移位的前牙共５９例。其中Ａ组：尼龙丝结扎加ＥＢ树脂固定夹板２３例７８牙（尼龙...     

老年人一次性根管治疗术疗效观察

根管治疗术是目前临床治疗牙髓病和根尖周病最普遍、最有效的方法。但其治疗复杂、就诊次数多等特点,给老年患者带来许多不便。为了减少复诊次数,我们对临床适合的老年患者215颗牙行一次性根管治疗,现报告如下。     

一次性塑化法治疗急性牙髓炎疗效观察

自１９９１年以来我们对１４６例急性牙髓炎患者,２４８个根管采用牙髓塑化一次性完成治疗,效果满意,报告如下。一、资料与方法适应症：依临床症状及体征诊断为急性牙髓炎者做为本法治疗及观察的对象。临床资料：治疗患者１４６例,１４６颗患牙２４８个根管。其中男性６７例,女性７９例,最大年龄７４岁,最小年龄１４岁。下前牙２１例,上前牙２例,下双尖牙２３例,上双尖牙９例,下磨牙８６例,上磨牙５例。平均病程１４天。方法：２％利多卡因局部麻醉;常规开髓、揭髓顶,拔髓,用２０＃扩大针扩锉根尖１／３破坏末被拔除的牙髓组…     

Clinical outcomes of quadrant root planing versus full-mouth root planing

OBJECTIVES: To determine the clinical effects of full mouth compared with quadrant wise scaling and root planing. METHOD: Twenty patients with chronic periodontitis (> or = 2 teeth per quadrant with probing pocket depths (PPD) > or = 5 mm and bleeding on probing (BOP) were randomized into a test group treated in two sessions with subgingival scaling and root planing within 24 h (full-mouth root planing (FMRP)) and a control group treated quadrant by quadrant in four sessions in intervals of 1 week (quadrant root planing (QRP)). PPD, relative attachment level (RAL) and BOP were recorded at baseline, 3 and 6 months. RESULTS: Analysing first quadrant data, in moderately deep pockets (5 mm < or = PPD < 7 mm) there was no evidence for a difference (FMRP-QRP) between both groups for PPD reduction (mean: -0.128 mm; CI: [-0.949, 0.693]; p=0.747), RAL gain (mean: 0.118 mm; CI: [-0.763, 1.000]; p=0.781), and BOP reduction (mean: -20.1%; CI: [-44.3, 4.2]; p=0.099). Likewise, no significant differences between treatments were found for initially deep pockets (PPD > or = 7 mm), neither for first quadrant nor for whole mouth data. CONCLUSION: The results of the present study demonstrated equally favourable clinical results following both treatment modalities.     

Efficacy of full-mouth disinfection vs quadrant root planing

This article addresses the capability of full-mouth disinfection, full-mouth root planing, and partial-mouth disinfection to improve periodontal health. A basic premise of full-mouth therapy (full-mouth disinfection or full-mouth root planing) is to eradicate or diminish bacterial reservoirs in the mouth that could impede optimal healing or initiate periodontal disease or disease progression. Several investigations conducted at one university indicated that full-mouth disinfection and full-mouth root planing achieved greater therapeutic improvements compared with partial-mouth disinfection regarding decreased probing depths, gained clinical attachment, diminished bleeding from probing, and reduced subgingival microflora. In contrast, other studies from 2 treatment centers demonstrated that there were no statistically significant differences when the effectiveness of quadrant-by-quadrant root planing was compared with full-mouth root planing and full-mouth disinfection regarding probing depth reduction, gains of clinical attachment, and impact on the magnitude and quality of the immune response. Theoretically, full-mouth therapy could decrease the number of patent visits and allow more efficient use of treatment time. Furthermore, no major adverse reactions to full-mouth root planing with or without adjunctive chemotherapy are evident. Nevertheless, small study populations and noncorroborating data from different treatment centers indicate that more clinical trials are required to determine whether full-mouth therapy provides clinically relevant improvements compared with partial-mouth disinfection.     

Quadrant root planing versus same-day full-mouth root planing

OBJECTIVES: The aim of this study was to determine whether same-day full-mouth scaling and root planing (FM-SRP) and quadrant scaling and root planing (Q-SRP) resulted in variations in the systemic humoral immune response dynamics (antibody titres and avidity) during active treatment and 3 and 6 months post-therapy. MATERIALS AND METHODS: Forty patients with chronic periodontitis were recruited into this study. Subjects were randomised into two groups and received either scaling and root planing quadrant by quadrant at 2-weekly intervals (Q-SRP group) or same-day full-mouth scaling and root planing (FM-SRP group). Clinical measurements and serum samples were obtained at baseline and approximately 6 weeks after the last clinical intervention (R1) and 6 months after the initiation of therapy (R2). Furthermore, serum samples were obtained from each patient undergoing therapy (Q-SRP and FM-SRP) at 3 bi-weekly instances so as to determine the short-term effects of each session of scaling and root planing on the dynamics of the humoral immune response. Serum antibody titre was assayed by enzyme-linked immunosorbent assay (ELISA) and antibody avidity was measured by thiocyanate dissociation against five putative periodontal pathogens: Porphyromonas gingivalis; Actinobacillus actinomycetemcomitans; Prevotella intermedia; Treponema denticola and Bacteroides forsythus. RESULTS: Both therapies resulted in similar antibody titre reductions against the majority of the organisms tested and although there was a distinct trend for antibody avidity to increase following therapy, this was not found to be statistically significant, reflecting marked inter-individual variation. In addition, no evidence emerged from this study to support increased antibody titres following the active phases of both treatment approaches due to an inoculation effect. Nevertheless, significant short-term increases in antibody avidity to most test bacteria were noted for both treatment strategies. CONCLUSION: Both therapies were associated with a reduction in antibody titres and an increase in the binding ability or avidity of antibodies, but there was a marked inter-subject variability and statistical significance was reached for only some of the test bacteria. No significant differences in the humoral antibody dynamics were found between the two treatment approaches.     

Microbiological outcomes of quadrant versus full-mouth root planing as monitored by real-time PCR

OBJECTIVES: To study the short-term microbiological changes following full-mouth compared with quadrant wise scaling and root planing (FMRP and QRP) as well as long-term effects. METHOD: Twenty patients with chronic periodontitis were randomized into a test group treated in two sessions with subgingival scaling and root planing within 24 h (FMRP) and a control group treated quadrant by quadrant in four sessions at intervals of one week (QRP). Microbiological samples were taken in the two deepest pockets of the maxillary right quadrant immediately before treatment and after 1 day, 1, 2, 4, 8, 12, and 24 weeks. The samples were evaluated by real-time PCR for quantification of Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum ssp., Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola, and Tannerella forsythia as well as for total bacterial counts (TBC). RESULTS: Treatment resulted in a TBC median log reduction of 0.75 (FMRP) and 0.72 (QRP). There were no differences between groups either for the short term (1 day-4 weeks) (analysis of variance: p=0.3150) or for long term (4-24 weeks) (analysis of variance: p=0.9671). Likewise, no differences were detected for selected target bacteria. CONCLUSION: The results of the present study showed similar microbiological outcomes following both treatment modalities.     

全口一次龈下刮治与分区段龈下刮治的疗效分析

目的：比较一次全口龈下刮治与分区段龈下刮治的临床疗效。方法：选择需进行牙周洁治的慢性牙周炎患者50例,分为实验组25例和对照组25例,实验组一次全口龈下刮治,对照组分四个区段进行龈下刮治,观察3个月内治疗前后PD、BI、PI的变化,并记录患者对治疗的主观感觉和治疗后是否有发热症状。结果：实验组和对照组龈下刮治后3个月,PD、BI均显著降低,两组间无统计学差异（P〈0.05）;与对照组相比,实验组1个月时P（I1.09±0.57）和VAS值（0.37±0.26）显著降低,差异有统计学意义（P〈0.05）。两组患者均无治疗后发热症状。结论：全口一次龈下刮治与分区段龈下刮治都可获得良好的治疗效果,全口一次龈下刮治更利于菌斑控制和短期消除治疗不适。     

Comparison between full-mouth scaling and root planing and quadrant-wise basic therapy of aggressive periodontitis: 6-month clinical results

BACKGROUND: The aim of this study was to test the hypothesis that there are no differences in clinical parameters in generalized aggressive periodontitis patients after full-mouth scaling and root planing (FRP) or quadrant-wise basic periodontal therapy (BPT) when combined with an antibiotic regimen. METHODS: Patients were allocated randomly to BPT (N = 15; mean age: 29.5 +/- 5.7 years) or FRP (N = 15; mean age: 28.4 +/- 5.7 years). All subjects received oral hygiene instructions including the use of a 0.12% chlorhexidine mouthrinse solution twice a day for 2 months. Patients also received amoxicillin, 500 mg, and metronidazole, 250 mg, three times a day for 7 days. Probing depth (PD), clinical attachment level, visible plaque, and bleeding on probing were recorded at baseline and at 2, 4, and 6 months post-therapy. Statistically significant changes within and between groups were determined using the general linear model repeated measures procedure. RESULTS: Both groups showed a significant improvement in all clinical parameters post-therapy, which was particularly evident at 2 months in the sites that had been deepest at baseline. For instance, the mean PD at sites with mean PD > or =7 mm at baseline had decreased 3.9 mm in the BPT group and 3.6 mm in the FRP group. At 6 months, the percentage of sites with PD > or =7 mm decreased from 13.2% +/- 3.2% to 0% in the BPT group and from 13.3% +/- 3.5% to 0.2% +/- 0.1% in the FRP group. No statistically significant differences were observed between groups for most clinical parameters. CONCLUSION: Within the limits of the present investigation, FRP and BPT caused comparable clinical effects in aggressive periodontitis patients when an adjunctive combined antibiotic regimen was included.     

Quadrant root planing versus same-day full-mouth root planing. I. Clinical findings

OBJECTIVES: The aim of this study was to test the hypothesis that same-day full-mouth scaling and root planing (FM-SRP) resulted in greater clinical improvement compared to quadrant scaling and root planing (Q-SRP) in chronic periodontitis patients over a period of 6 months. MATERIAL AND METHODS: Forty patients were recruited into this study. Subjects were randomised into two groups. The FM-SRP group received full-mouth scaling and root planing completed within the same day, while the Q-SRP group received quadrant root planing at 2-weekly intervals over four consecutive sessions. Whole-mouth clinical measurements were recorded with a manual periodontal probe at baseline (BAS) and at reassessment 1 (R1) (approximately 6 weeks after the completion of therapy), and at reassessment 2 (R2) (6 months after the initiation of therapy). Selected site analyses were performed on the deepest site in each quadrant before and after therapy (R1 and R2) and clinical indices were recorded with an electronic pressure sensitive probe. In addition, during the active phase of treatment clinical data were collected at 2-weekly intervals from the remaining untreated quadrants in the Q-SRP group only. RESULTS: Both therapies resulted in significant improvements in all clinical indices both at R1 and R2. A continuous clinical improvement was seen for both treatment groups during the experimental period, which reached peak levels at 6 months (DeltaPD=1.8 mm, DeltaCAL=1.1 mm, p<0.001; PD: pocket depth; CAL: clinical attachment level). The selected-site analysis revealed no significant differences in any clinical index between the two treatment groups at R2 (DeltaPD=2.8 mm, DeltaRAL=1.1 mm; RAL: relative attachment level). At the selected sites, the analysis of the deep pockets (>7 mm) showed a significantly greater gain in RAL for the FM-SRP group compared to the Q-SRP group at R2 (p<0.05). The results of this analysis however, should be interpreted with care due to the small number of deep pockets. Data from the Q-SRP group provided an insight into how treated and untreated quadrants responded during the initiation of plaque control measures. There were significant reductions in PD, suppuration (SUP), modified gingival index (MGI) and plaque index (PI) in the remaining untreated quadrants in the Q-SRP group during the initial phase of treatment (p<0.05), while minimum changes in RALs and bleeding on probing (BOP) occurred. Nevertheless, the improvement in PD was clearly inferior to that seen after scaling and root planing. CONCLUSION: Following both therapeutic modalities, there were marked clinical improvements at both R1 and R2 (6 months) from baseline. The current study, in contrast to previous findings, failed to show that FM-SRP is a more efficacious periodontal treatment modality compared to Q-SRP. However, both modalities are efficacious and the clinician should select the treatment modality based on practical considerations related to patient preference and clinical workload.     

Quadrant root planing versus same-day full-mouth root planing. II. Microbiological findings

OBJECTIVES: The aim of this study was to test the hypothesis that over a period of 6 months, same-day full-mouth scaling and root planing (FM-SRP) resulted in greater reductions in the detection frequency of five putative periodontal pathogens compared with quadrant scaling and root planing (Q-SRP) in chronic periodontitis patients. MATERIALS AND METHODS: Forty patients were recruited into this study. Subjects were randomised into two groups. The FM-SRP group received full-mouth scaling and root planing completed within the same day, while the Q-SRP group received quadrant root planing at 2-weekly intervals over four consecutive sessions. Selected-site analyses were performed on the deepest site in each quadrant before and after therapy, at approximately 3 and 6 months from baseline (R1 and R2) and clinical indices were recorded with an electronic pressure-sensitive probe. In addition, subgingival plaque samples were collected from these sites at baseline (BAS), at reassessment 1 (R1), approximately 6 weeks after the completion of therapy and at reassessment 2 (R2), 6 months from baseline. Polymerase chain reaction (PCR) was used to determine the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Treponema denticola and Bacteroides forsythus in plaque. RESULTS: Both therapies resulted in significant improvements in all clinical indices both at R1 and R2. A marked reduction in the presence of all candidate periodontal pathogens was noted after both treatment modalities, reaching statistical significance for the majority of the test organisms. These improvements were maintained over a period of 6 months. When the two treatment groups were compared, a significantly higher percentage of Q-SRP patients was positive for P. intermedia at R1 compared with FM-SRP patients (p<0.05). In addition, a greater reduction in the patient prevalence for T. denticola was found for the FM-SRP group than the Q-SRP group at R1 and R2 from baseline (p<0.005), but the significance of this is questionable given the skewed detection frequency of this organism at baseline between the two treatments (p<0.01). CONCLUSION: This study failed to confirm that same-day FM-SRP resulted in greater microbiological improvements compared with Q-SRP at 2-weekly intervals over a 6-month period, as determined by PCR.     

根面平整术一次法与四分法治疗慢性牙周炎的疗效比较

目的 比较根面平整一次法和四分法治疗慢性牙周炎的临床疗效.方法 选取16例慢性牙周炎患者,龈上洁治术后随机分为2组,实验组和对照组,分别采用一次法和四分法进行根面平整术治疗.于治疗前和治疗后1个月和2个月检测牙周探诊深度、菌斑指数和龈沟出血指数.结果 术后1个月和2个月重度探诊位点(PD≥7mm)的牙周探诊深度2组间比较均具有统计学意义(P＜0.05),中度探诊位点(4mm≤PD＜7mm)的牙周探诊深度组间比较均无统计学意义(P＞0.05).术后1个月的菌斑指数和龈沟出血指数实验组与对照组比较均有统计学意义;2个月复查时,两组间菌斑指数和龈沟出血指数比较无统计学意义.结论 一次法和四分法根面平整术对慢性牙周炎的治疗均有效,一次法的短期疗效优于四分法,对深袋的改变尤为显著.