活性银离子抗菌液治疗青春期龈炎的临床效果观察

目的观察活性银离子抗菌液治疗青春期龈炎的临床效果。方法选择78例青春期龈炎患者,随机分成两组,试验组使用活性银离子抗菌液配合洁治术,对照组单纯使用洁治术,分别在治疗前后检测牙龈指数(GI)、菌斑指数(PLI)、龈沟出血指数(SBI),并作统计学处理。结果通过临床对两组患者进行比较发现,使用活性银离子抗菌液含漱后试验组和对照组的GI、PLI差异有统计学意义(P<0.05),使用活性银离子抗菌液含漱后试验组和对照组的SBI差异无统计学意义(P>0.05)。结论用活性银离子抗菌液配合洁治术是治疗青春期龈炎的有效方法。     

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     

实验性龈炎的细菌成分变化的分析

目的:观察实验性龈炎发展过程中细菌成分的变化,分析细菌成分与临床指标间的关系。方法:选取11名受试者,在其停止口腔卫生措施后21d内(第0、2、4、7、14、21天)和恢复口腔卫生措施1周后(第28天)取龈下菌斑作刚果红涂片,分析细菌成分;同时记录临床指标的变化。结果:在实验性龈炎发展过程中,螺旋体的百分含量在基线时最低,随着停止刷牙的时间的延长而逐渐增加,并达到峰值,与基线存在显著性差异(P<0.05),恢复刷牙后迅速降低。其百分含量与各临床指标(菌斑指数、出血指数、牙龈指数)有显著性正相关(P<0.01),杆菌和球菌所占比例在试验过程中无明显变化(P>0.05)。结论:螺旋体的百分含量在基线、停止刷牙和恢复刷牙1周后存在显著差异,并与各临床指标有显著性正相关,其变化与牙龈炎症的形成和发展过程一致。     

牙龈卟啉单胞菌的牙龈蛋白酶K-caspase样亚基的表达与青春期龈炎的临床相关性

目的检测并比较青春期龈炎的牙龈卟啉单胞菌（Porphyromonas gingivalis，PS）临床分离株的分泌蛋白和菌体蛋白中牙龈蛋白酶K（gingipain K，Kgp）-caspase样亚基的表达强度及酶活性，揭示Kgp与青春期龈炎之间可能存在的致病关系。方法检测并记录36例14～17岁的青春期龈炎患者的牙龈指数、龈沟出血指数及探诊深度，取龈下菌斑进行Pg的分离培养，16SrRNA PCR法鉴定。将获得的10个Pg临床分离株复苏，在对数生长期末提取分泌蛋白和菌体蛋白，测定其酶活性，并用Kgp-caspaae样亚基的单克隆抗体进行Western blot检测。Kgp的表达强度及酶活性与各牙周指数之间的相关关系用等级相关系数。结果青春期龈炎的Pg临床分离株的分泌蛋白和菌体蛋白中，Kgp-caspase样亚基的表达强度及酶活性与各牙周指数的大小呈正相关关系，差异有统计学意义（P〈0．05）。结论青春期龈炎龈下菌斑中Pg的Kgp十分复杂，存在表现为低相对分子质量形式的caapase样活性分子，这些细胞内功能蛋白分子将影响Pg和宿主间的相互作用；Kgp对青春期龈炎有一定的致病作用。     

牙周菌斑控制对孕妇妊娠期龈炎龈沟液CRP的影响

目的：探讨牙周基础治疗中菌斑控制对孕妇妊娠期龈炎龈沟液中C反应蛋白（CRP）影响。方法：选择在深圳市龙岗区妇幼保健院妇保科建档的单胎,无系统性疾病,患妊娠期龈炎的孕妇65例,随机分为实验组（牙周菌斑控制＋牙周洁治组）33例、对照组（单纯牙周洁治组）32例。收集患者初始时及治疗后龈沟液（GCF）,用ELISA法测定其中CRP含量,记录治疗前后牙周健康指数（PLI、SBI、PD）。比较各组龈沟液CRP表达与牙周健康状况。结果：妊娠期龈炎患者初始龈沟液CRP水平均高于各组牙周基础治疗后龈沟液CRP表达,差异有统计学意义（P＜0．01）;牙周菌斑控制＋牙周洁治组患者治疗后龈沟液CRP水平低于单纯牙周洁治组,与牙周健康指数呈正相关,差异有统计学意义（P＜0．05）。结论：实施菌斑控制的牙周基础治疗能更有效降低孕妇妊娠期龈炎龈沟液CRP水平,改善牙周健康状况。     

龈沟液中挥发性短链脂肪酸的气相色谱分析

用气相色谱的方法对龈沟液中的短链脂肪酸(SCFA)进行了检测,并比较了SCFA与临床牙周病变程度间的关系,发现龈沟液中的乙酸,丁酸和异戊酸与牙周病的严重程度间有较明显的关系,但不能反映正常人与龈炎患者间的差别,丙酸能揭示龈炎与正常者间的差别,而不能反映龈炎与牙周炎间的差别,只有异丁酸才能反映牙周组织在不同损伤程度之间的差别,因此提示对龈沟液中短链脂肪酸的整体检测,特别是异丁酸的浓度是反映牙周病严重程度的一较理想途径。     

口洁素抑制菌斑和实验性龈炎的效果

本研究采用双盲自身对照实验方法,比较了一种新型浓缩芳香复方含酚漱口剂——口洁素,与0.15％洗必太抑制菌斑和实验性龈炎发生的效果。结果显示:口洁素与0.15％洗必太效果相近,可明显抑制菌斑的形成和龈炎的发生,与空白对照组相比,可使受试者菌斑指数分别下降0.65和0.83,牙龈指数下降38.7％和46.8％(p<0.05)。口洁素较0.15％洗必太口感好,不影响味觉,用后口腔清爽,是一种很有希望的可长期使用的含漱剂。     

实验性种植体周围炎各时期龈沟液量变化的研究

目的：研究实验性种植体周围炎龈沟液（PISF）和种植体周围组织健康状态的关系。方法：通过丝线结扎法建立犬的种植体周围炎模型,以基台连接术为基线（作自身对照）0,在结扎后3、6、9周时检测种植体36个位点的龈沟液量和种植体周围组织各项临床病理指标变化,并对检测结果进行分析。结果：①种植体周龈沟液量（PISF）、菌斑指数（PLI）、改良龈沟出血指数（mBI）及探诊深度（PPD）等临床指标在结扎后3、6、9周时,均大于自身对照组,有显著性差异（P〈0．05）,第6周时单纯黏膜炎无骨吸收和伴骨吸收位点之间的PISF和各项临床指标无显著性差异（P〉0．05）;②种植体组龈沟液量同各项临床指标之间都有显著的正相关关系。结论：种植体周龈沟液量可以在一定程度上反映种植体周围软组织的健康状态,有可能作为评价种植体周围软组织炎症状况的一项参考指标,但并不一定能反映骨组织状况。     

甲硝唑用于慢性龈炎的临床疗效观察

慢性龈炎是牙龈病中最常见的一种疾病,当炎症主要局限于牙龈组织的边缘部位时,称之为边缘性龈炎;当炎症主要局限于龈乳头时,则称为牙龈乳头炎。本病发病年龄广泛,男、女、老、幼皆可发病,世界各地、各种族每个人在其一生中均可发生不同程度和范围的慢性龈炎。慢性龈炎可以长期单独存在,其中一部分也可能发展为牙周炎。笔者对90例慢性龈炎患者口服甲硝唑及龈袋内置甲硝唑棒进行治疗和临床分析,报道如下。     

楔状缺损与龈沟液流量和pH值的关系

目的研究龈沟液流量和pH值对楔状缺损发生的影响。方法选取43例楔状缺损患者,每例选择3颗楔状缺损患牙和3颗正常牙,分别检测龈沟液流量和pH值。经统计学分析,比较楔状缺损牙和正常牙的龈沟液流量和pH值。结果楔状缺损组的龈沟液量大于正常组（P〈0．05）,pH值小于正常组（P〈0．01）。结论龈沟液流量和酸性程度可能与楔状缺损的发生有关。     

The effect of different cigarette smoking levels on gingival crevicular fluid volume and periodontal clinical parameters in Saudi Arabia

IntroductionPeriodontal disease is a chronic inflammatory condition of the periodontium. It is the main cause of tooth loss and is considered one of the biggest threats to the oral cavity. Tobacco smoking has long been associated with increased risk for periodontal, peri-implant, and other medical diseases.ObjectiveTo evaluate the effect of smoking and its level on periodontal clinical parameters (probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), bleeding on probing (BOP), and the volume of gingival crevicular fluid (GCF)) in healthy and chronic periodontitis individuals.Material and MethodA total of 160 participants were recruited in the present study, who were equally divided into the following five groups: healthy controls (C), healthy smokers (HS), nonsmokers with periodontitis (PNS), light smokers with periodontitis (PLS), and heavy smokers with periodontitis (PHS). GCF volume and periodontal clinical parameters (PD, PI, GI, CAL, and BOP) were assessed for each participant and compared between the study groups.ResultThere was a statistically significant difference in PD, PI, GI, CAL, and BOP between healthy and periodontitis patients (p < 0.001). The mean PI, PD, and CAL were considerably higher in heavy smokers than light smokers and non-smokers (P < 0.001). In contrast, the mean GI and BOP were significantly lower in heavy smokers than in light smokers and non-smokers. There was a statistically significant difference in GCF between healthy and periodontitis patients (p < 0.001). The mean GCF readings were higher in heavy smokers than light smokers or non-smokers (P < 0.001).ConclusionThe present study confirms the influence of smoking on periodontal clinical parameters. Smoking was associated with increased PD, PI, CAL, and GCF readings; however, GI and BOP were decreased in smokers. The number of cigarettes played a key role in the volume of GCF and periodontal clinical parameters.     

龈沟液蛋白质成分的电泳分析

目的筛选出与疾病相关的蛋白质分子。方法采用龈沟冲洗法获取龈沟液，用微量自动快速电泳仪分析了８６例龈沟液样本（其中健康龈２０例、龈炎２４例、牙周炎４２例）。十二烷基磺酸钠－聚丙烯酰胺电泳分离的蛋白质区带用快速图象分析仪进行测量。结果在炎症情况下分子量为８２０００、７７０００及１７０００的血清源蛋白质发生率较健康龈升高，分子量为４１０００、２１０００、１２０００的非血清源蛋白质发生率亦较健康龈高，丰度值大。结论分子量为８２０００、４１０００、２１０００及１２０００的蛋白质可能与牙周炎有较密切的关系。     

种植牙与自然牙龈沟液量及蛋白含量的比较

目的：观察比较修复后1年内种植牙龈沟液(PISF)和自然牙龈沟液(ISCF)量及其中蛋白含量的变化，初步探讨PISF在监测种植牙周状况方面的可能性。方法：以基台连接术后0．5～1个月为基线，在修复体完成后3、6、12个月时，对9名患者13颗Branemark种植牙及相邻同名自然牙的各26个位点的临床指标、龈沟液量及其中的蛋白含量进行检测。结果：在种植牙行使功能后，PISF与GCF的量及蛋白含量无显著性差异；PISF量与出血指数(BI)有较明显的正相关关系，PISF中的蛋白含量与BI未见明显的相关关系。结论：行使功能后1年内种植牙的PISF量及其中蛋白含量有着与自然牙相似的特征，对其在监测种植牙周组织状况的意义尚需进一步的研究。     

Estimation of soluble CD14 levels in gingival crevicular fluid and serum in diseased and healthy periodontium

ObjectiveTo estimate the levels of sCD14 in gingival crevicular fluid and serum under periodontally-healthy and diseased conditions.MethodsThe subjects were divided into three groups of 15, each as follows: healthy, gingivitis, and periodontitis. Periodontal parameters including Probing pocket depth, Clinical attachment level, Bleeding index, and Plaque index. Gingival crevicular fluid and serum samples were collected and analyzed for sCD14 levels using commercially-available ELISA kits.ResultsThe mean concentration of sCD14 in GCF was significantly lower in the gingivitis (134.5 ± 26.85 ng/mL) and periodontitis (103.23 ± 20.36 ng/mL) groups than in the healthy group (172.77 ± 46.33 ng/mL); p < 0.001. The mean serum concentration of sCD14 in the healthy group was 1528.13 ± 387.37 ng/mL, which was significantly less than that of the periodontitis group (2051.50 ± 381.10 ng/mL); p = 0.011.ConclusionsThe serum sCD14 levels in the periodontitis groups were significantly higher than those in the healthy controls. The levels of sCD14 in GCF were significantly lower in the gingivitis and periodontitis groups than in the healthy group.     

吸烟对牙周基础治疗前后龈沟液量和弹性蛋白酶水平的影响

目的　评价吸烟是否影响牙周炎基础治疗前、后龈沟液 (gingivalcrevicularfluid ,GCF)量和龈沟液中弹性蛋白酶 (elastase ,EA)的水平。方法　将 37例男性慢性牙周炎患者分为吸烟组 (2 2例 ,12 2个牙位点 ,每日吸烟≥ 2 0支 )和非吸烟组 (15例 ,90个牙位点 )。牙周炎基础治疗前、后用滤纸条法收集GCF ,用Periotron 6 0 0 0龈沟液测量仪测定GCF量。对吸烟组 92个位点和非吸烟组 6 0个位点GCF样本 ,用底物分解法检测EA水平。结果　治疗前吸烟组GCF量 (139 2± 33 4 )U和EA水平(0 6 34± 0 5 87)明显低于非吸烟组 [GCF量 :(15 5 4± 39 7)U ,EA水平 :0 835± 0 5 72 ],P <0 0 1。治疗后 ,两组GCF量和EA水平均显著降低 (P <0 0 0 1)。但吸烟组 91个位点 (74 6 % )GCF和 70个位点(76 1% )的EA水平治疗后有改善 ;而非吸烟组高达 88个位点 (97 8% )GCF和 5 6个位点 (93 3% )的EA水平有改善 (P <0 0 1)。结论　治疗前探诊深度相同的情况下 ,吸烟组GCF量和EA水平均低于非吸烟组 ,治疗后吸烟组的GCF和EA的减少程度不如非吸烟组明显。     

龈沟液中的炎症调节因子——白细胞介素8

为研究白细胞介素８（ｉｎｔｅｒｌｅｕｋｉｎ－８，ＩＬ－８）在牙周炎中的作用，作者应用ＥＬＩＳＡ法检测了５４例（１０５个牙）成人牙周炎和２４名（５４个牙）健康对照者龈沟液中ＩＬ－８的水平。结果显示：龈沟液中ＩＬ－８的浓度低于３０μｇ／Ｌ时，ＩＬ－８与龈沟出血指数呈正相关（Ｐ＜０．０１）。龈沟液中ＩＬ－８的浓度高于３０μｇ／Ｌ时，ＩＬ－８与出血指数和探诊深度呈负相关（Ｐ值均小于０．０１）。９１％的牙周炎患牙龈沟液中ＩＬ－８低于３０μｇ／Ｌ。结果提示：ＩＬ－８可能具有抗炎和致炎的双重调节作用；其抗炎和致炎作用的分界值约为３０μｇ／Ｌ。高浓度的ＩＬ－８具有抗炎作用，低浓度的ＩＬ－８具有致炎作用。牙周炎时，龈沟液中的ＩＬ－８主要起致炎作用。     

牙周炎患者龈沟液和龈组织中IL—8的测定

采用ELISA间接夹心法测定了23名成人牙周炎患者34个患牙龈沟液中的IL-8.并用免疫组织化学法对相应的炎性龈组织进行检测.结果表明IL-8与牙周炎症密切相关,牙周炎龈沟液(GCF)中IL-8检出率为88.24%.IL-8含量范围为0.006～2.772ng/μl.其含量与牙龈指数相关非常显著,与牙周袋深度相关显著,与附着丧失、菌班指数无明显相关.炎性龈组织切片染色表明龈上皮组织和胶原组织中含有大量的阳性染色,从组织学上证明了GCF中IL-8的来源.提示IL-8可能在牙周炎发病机制中起着重要作用.     

Effect of smoking on gingival crevicular fluid cytokine profile during experimental gingivitis

BACKGROUND: Cigarette smoking is a significant risk factor in the pathogenesis of periodontal disease, able to influence both the subgingival microbiota and host responses. AIM: The aim of the present study was to determine the influence of smoking on the amount of IL-1beta, IL-4 and IL-8 in gingival crevicular fluid (GCF) during experimental gingivitis in humans. MATERIAL AND METHODS: Twenty-two healthy subjects, 10 smokers and 12 non-smokers, participated in the study. After professional cleaning, they performed optimal hygiene to reach perfect clinical gingival health. Oral hygiene measures were ceased for a period of 10 days. Clinical indices, including plaque index (PI), gingival index (GI), probing pocket depth (PPD) and bleeding on probing (BOP), were assessed 2 days before (day -2), at the beginning (day 0) and at the end of the experimental gingivitis period (day 10). At the same time, GCF was collected from 12 sites in each patient, by means of durapore filter membranes. Total amounts of IL-1beta, IL-4 and IL-8 were determined by enzyme-linked immunoadsorbent assay. RESULTS: Clinical data revealed that both smokers and non-smokers showed an increase in PI, GI and BOP scores during the experiment. Although no differences were noted with regard to PI at day 10, the GI and BOP were significantly less pronounced in smokers than non-smokers (p < 0.005). Non-smokers showed higher total amounts of IL-4 but lower amounts of IL-8 than smokers, throughout the experiment. Total amounts of IL-1beta and IL-8 increased significantly during plaque accumulation in both groups. IL-4 remained stable for the smoker group and decreased for the non-smoker group. CONCLUSIONS: The present results indicate that smoking interferes with cytokine production. When performing studies regarding the pathogenesis of periodontitis, the smoking status of the participants needs to be taken into consideration.     

龈沟液中弹性蛋白酶水平与白细胞数目的关系

目的初步探讨龈沟液（ｇｉｎｇｉｖａｌｃｒｅｖｉｃｕｌａｒｆｌｕｉｄ，ＧＣＦ）中细胞外弹性蛋白酶（ｅｌａｓｔａｓｅｉｎｔｈｅｓｕｐｅｒｎａｔａｎｔ，ＥＡｓ）、细胞内弹性蛋白酶（ｅｌａｓｔａｓｅｉｎｔｈｅｐｅｌｅｔ，ＥＡｐ）及中性多形核白细胞（ｐｏｌｙｍｏｒｐｈｏｎｕｃｌｅａｒｌｅｕｋｏｃｙｔｅ，ＰＭＮ）间的关系。方法先用滤纸条法取ＧＣＦ样本，以底物检测法分别测定其中的ＥＡｓ和ＥＡｐ水平；２４ｈ后在同一部位用龈沟灌洗法收集ＧＣＦ灌洗液，光镜下计数ＰＭＮ。结果ＥＡｓ与ＥＡｐ的总水平和ＰＭＮ数目三者间均呈正相关（Ｐ＜０．００１）。结论ＧＣＦ中弹性蛋白酶水平与ＰＭＮ数目一致，可以用ＥＡｐ的水平代表同一样本中ＰＭＮ的数量。