口腔脱敏糊剂治疗龈下刮治和根面平整术后根面牙本质过敏疗效观察

目的观察口腔脱敏糊剂治疗龈下刮治和根面平整术后根面牙本质过敏的临床疗效。方法将52例接受龈下刮治及根面平整术后出现根面牙本质过敏症的慢性牙周炎患者的368颗患牙随机分为2组,分别采用口腔脱敏糊剂和不含脱敏成分的普通牙膏刷牙,评估使用1周、4周后牙齿敏感情况和安全性。结果脱敏1周后,口腔脱敏糊剂组和普通牙膏组的有效率分别为66.7%、20.0%;脱敏4周后,有效率分别为96.2%、78.9%。两者疗效有显著性差异。试验期间未出现不良反应。结论口腔脱敏糊剂对治疗龈下刮治和根面平整术后产生的根面牙本质过敏有着较为理想疗效,且使用方便。     

光动力疗法联合龈下刮治术治疗慢性牙周炎疗效观察

目的 观察光动力疗法联合龈下刮治和根面平整术治疗慢性牙周炎的临床效果.方法 选择中、重度慢性牙周炎患者30例,随机分为3组,每组10人.A组:单纯龈下刮治和根面平整术治疗;B组:龈下刮治和根面平整术治疗后即刻行光动力疗法;C组:龈下刮治和根面平整术治疗后1周行光动力疗法.治疗前、龈下刮治和根面平整术治疗后6周、12周时分别记录牙周袋探诊深度及探诊出血的阳性牙位点,并进行统计学分析.结果 龈下刮治和根面平整术后6周和12周结果显示,3组牙周袋探诊深度和探诊出血情况较术前均有改善(P＜0.05).B组和C组的牙周袋探诊深度和探诊出血情况改善效果均优于A组(P＜0.05);B组与C组间差异无统计学意义(P＞0.05).结论 对中、重度慢性牙周炎患者应用光动力疗法联合龈下刮治和根面平整术治疗,较单独使用龈下刮治和根面平整术治疗效果更佳.光动力疗法可作为新的辅助治疗手段用于牙周病的治疗.     

牙周非手术治疗对根面牙本质敏感症形成的影响

目的：观察牙周非手术治疗对导致根面牙本质敏感症的影响，并探讨其机理。方法：对52例慢性牙周炎患者的1453颗牙进行龈下刮冶及根面平整术，随访3个月。总结冶疗后患者根面牙本质敏感症的发生情况。结果：52例患者中，39例共432颗牙发生了不同程度的根面牙本质敏感症，给予积极治疗后症状大多消失。龈下刮治术和根面平整术可使部分牙本质小管敞开暴露于口腔环境中，使外来刺激遵循液体动力学原理激发痛觉。结论：脱敏治疗应纳入牙周治疗计划中。     

两种脱敏剂用于牙周非手术治疗术后牙本质过敏的临床研究

目的探讨两种脱敏剂治疗牙周非手术治疗后根面牙本质过敏的临床疗效。方法选择慢性牙周病患者120例(患牙468颗),随机分为4组,在行常规龈下刮治术和根面平整术后,分别采用A组多乐氟、B组多乐氟加氟保护剂、C组氟保护剂、D组碘甘油(安慰剂)进行脱敏治疗,在治疗后即刻、1周、4周,观察评价脱敏疗效,并采用视觉模拟评分(VAS)对患牙的敏感程度进行评估。结果经药物治疗后,A、B、C三组患牙脱敏疗效均明显优于D组(χ2=173.42,P=0.000),B组疗效优于A、C组(χ2=11.379,P=0.003),A、C组间差异则无统计学意义(χ2=0.026,P=0.872)。结论牙周非手术治疗后,联合应用多乐氟和氟保护剂治疗根面牙本质过敏可以取得较为理想的临床效果。     

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目的评价氟化泡沫与氟保护漆治疗龈下刮治及根面平整术后敏感的效果。方法选取2009年9月至2011年3月北京大学口腔医院门诊部牙周科行龈下刮治及根面平整术后1周有1颗以上的切牙中等程度敏感的患者209例（患牙503颗）,根据患者的年龄、性别、牙齿数目分层,随机分为对照组（采用生理盐水涂檫根面）、氟保护漆组（采用氟保护漆脱敏治疗）、氟化泡沫组（采用氟化泡沫脱敏治疗）。用视觉模拟评分（VAS）法对牙齿敏感程度进行评估,分别于脱敏前以及脱敏后即刻、1周、1个月记录VAS值,并记录各组临床操作时间。结果脱敏前各组VAS值相近,差异无统计学意义（P〉0．05）;脱敏后各时间点对照组与其余两组差异有统计学意义（P〈0．05）;氟保护漆组在脱敏后1周和1个月时VAS值均低于氟化泡沫组,但差异无统计学意义（P〉0．05）。氟保护漆组每颗牙的平均{临床操作时间与其余两组差异有统计学意义（P〈0．05）。结论氟化泡沫和氟保护漆均可减轻龈下刮治和根面平整术后敏感的程度,氟化泡沫操作更简单,更适合临床推广使用。     

Nd:YAG激光在牙周治疗中的即刻镇痛及短期脱敏作用的研究

目的:研究脉冲式掺钕钇铝石榴石(neodymium:yttrium aluminum garnet,Nd:YAG)激光在牙周治疗过程中的即刻镇痛作用及脱敏效果。方法:对36例慢性牙周炎患者进行龈上洁治,1周后通过掷硬币方法,随机选择患者口腔左右侧分别作为对照组:即单纯龈下刮治及根面平整组(scaling and root planing,SRP)和实验组:即SRP前后均使用Nd:YAG激光照射组。两组进行治疗后即刻应用视觉模拟评分法(visual analogue scale,VAS)对患者进行疼痛度评分;术前、术后1周、术后1个月对患者进行牙本质敏感程度测试。结果:实验组VAS(1.72±0.62)值明显低于对照组(5.34±0.56),其差异有统计学意义(P<0.05);术后1周,对照组牙本质过敏率(69.11%)明显高于术前(27.94%),实验组(11.76%)明显低于术前(52.94%),差异均有统计学意义。术后1个月,对照组牙本质过敏率(30.88%)和术前(27.94%)差异无统计学意义,实验组(8.82%)和术前(52.94%)差异有统计学意义。对于术前过敏的牙齿,术后1周,术后1个月实验组牙本质过敏的改善有效率(91.67%、83.33%)明显高于对照组(5.26%、11.76%)。结论:Nd:YAG激光在辅助SRP进行牙周非手术治疗中可起到一定的镇痛作用和短期的抗过敏作用。     

短期扩张牙周袋后龈下刮治根面平整术治疗老年牙周炎

目的:观察短期扩张牙周袋后行龈下刮治根面平整术治疗老年慢性牙周炎的临床疗效。方法:对40例中、重度老年慢性牙周炎患者的128颗患牙,行短期扩张牙周袋后龈下刮治根面平整术,或常规龈下刮治根面平整术,记录比较各项临床指标。结果:短期扩张牙周袋后龈下刮治根面平整术疗效明显好于常规方法。结论:对于不愿做牙周手术的中、重度老年慢性牙周炎患者,用短期扩张牙周袋后龈下刮治根面平整术代替常规龈下刮治根面平整术。     

3种脱敏剂治疗超声龈下刮治所致根面牙本质敏感症的疗效观察

目的:评价极固宁、Gluma脱敏剂、75%氟化钠甘油治疗超声龈下刮治所致根面牙本质敏感症的临床疗效,探讨其作用机制.方法:将99例龈下刮冶术所致的774颗根面牙本质过敏症患牙随机分为3组,即极固宁脱敏组、Gluma脱敏剂组和氟化钠甘油脱敏组,分别进行脱敏治疗,观察即刻、1个月疼痛的VAS值.结果:极固宁脱敏组和Gluma脱敏剂的即刻有效率分别为94.32%、93.41%,显著优于氟化钠甘油脱敏组(71.83%),而脱敏后1个月,3组间无显著性差异.结论:极固宁、Gluma脱敏剂对治疗龈下刮治后产生的牙本质过敏有着较为理想疗效.     

极固宁治疗超声龈下刮治所致根面牙本质敏感症的疗效

目的:观察极固宁治疗超声龈下刮治所致根面牙本质敏感症的临床疗效,探讨其作用机制。方法:将66例龈下刮冶术所致的516个根面牙本质敏感症的患牙随机分为2组,即极固宁脱敏组和氟化钠甘油脱敏组,分别使用极固宁或750g/L氟化钠甘油进行脱敏治疗,观察即刻、1个月疼痛的VAS值。结果:极固宁组脱敏组即刻有效率为94.32%,明显高于氟化钠甘油脱敏组71.83%,统计学分析两者有显著性差异(P<0.01)。而脱敏后l个月,两组无显著性差异(P>0.05)。结论:极固宁对治疗龈下刮治后产生的牙本质敏感症有着较为理想的疗效,其操作简单,值得推广应用。     

含精氨酸和碳酸钙的脱敏抛光膏治疗超声龈下刮治后根面敏感症的疗效观察

目的：评价含质量分数为8%精氨酸和碳酸钙脱敏抛光膏治疗超声龈下刮治后根面牙本质敏感症的疗效。方法???依据石川修二评定标准冷空气刺激评分,将超声龈下刮治术后1周内至少2颗前牙或前磨牙出现2~3度的根面牙本质敏感的82名患者随机分为2组,试验组40名（用含质量分数为8%精氨酸和碳酸钙脱敏抛光膏）,对照组42名（用不含脱敏剂的普通抛光膏）,进行脱敏治疗,观察即刻脱敏效果。结果???82名受试者参加并完成了治疗。试验组即刻冷空气刺激评分为1.34±0.48,对照组的即刻冷空气刺激评分为2.24±0.55,两组疗效差异有统计学意义（P<0.05）。结论含质量分数为8%精氨酸和碳酸钙脱敏抛光膏,对超声龈下刮治后根面牙本质敏感症有较好的疗效。     

Effects of gingival curettage when performed 1 month after root instrumentation

Abstract The purpose of the present study was to evaluate biometrically the periodontal response to gingival curettage. 15 subjects having suprabony pockets were selected. Gingival Index (GI) was initially determined for the selected teeth. Measurements of probing depth, and the distance from the free gingival margin to the cemento-enamel junction were also taken at that time, as well as immediately after scaling and root planing of the selected teeth. 4 weeks after scaling and root planing, the clinical parameters were recorded- A split mouth design was used to select 2 quadrants of the mouth in which gingival curettage was to be performed. Immediately after, experimental measurements were again recorded. 5 weeks after gingival curettage, gingival inflammation, probing depth and the location of the tree gingival margin were recorded for the last time. All data were analyzed statistically. It was shown that gingival inflammation, the distance from the free gingival margin to the cemento-enamel junction, and the probing depth were reduced after 4 and 9 weeks. The level of clinical attachment improved after 9 weeks. All these changes were statistically significant. These results were observed after scaling and root planing, as well as after scaling, root planing and gingival curettage. No differences were found between both treatment modalities in any of the parameters analyzed. Gingival curettage did not improve the condition of the periodontal tissues more significantly than scaling and root planing.     

Clinical effects of a 0.12% chlorhexidine rinse as an adjunct to scaling and root planing.

This trial tested the adjunctive effects of a 0.12% chlorhexidine rinse (Peridex) upon gingival healing following scaling and root planing. Assessments were made on reduction in plaque (Pl), gingivitis (GI), pocket depth and gingival bleeding as measures of treatment benefit. All subjects had Class II, III or IV periodontal conditions. Following baseline examinations, subjects received a gross supragingival scaling and polishing. Subjects were separated by sex and periodontal classification, arrayed by GI scores, and randomly assigned to either the chlorhexidine rinse or a placebo rinse. Subjects were instructed to rinse with 1/2 ounce of their assigned products for 30 seconds twice daily. Following two weeks of product use, the clinical examinations were repeated and two randomly selected, opposing contralateral quadrants were scaled and root planed. After two more weeks of product use (week 4), clinical examinations were repeated and the remaining quadrants were scaled and root planed. At week 6, final clinical examinations were conducted. Since half-mouths were treated at different times and exposed to the treatment rinses for different periods, the data were analyzed for the half-mouths independently 2 and 4 weeks after gross scaling, and 2 and 4 weeks after root planing. A total of 94 subjects (47 in each treatment group) completed all phases of the trial. Gingival healing following scaling and root planing in subjects using a chlorhexidine rinse (0.12%) was significantly better than subjects using the placebo rinse as evidenced by less gingivitis (29%), fewer GI bleeding sites (48%) and less plaque (54%).     

The significance of prior mechanical therapy for changes of periodontal status achieved by local delivery of a doxycyclinehyclate containing gel

AIM: The purpose of this retrospective analysis was to examine what effect, if any, the time elapsed between an individual's last episode of scaling and root planing and subsequent treatment with a sustained-release doxycycline hyclate gel (DH) alone or scaling and root planing alone (SRP) would have upon adult periodontitis. METHODS: A total of 207 subjects were included in the DH group and 210 patients in the SRP group. Periodontitis was defined as those sites which presented with pocket depths > or =5 mm and exhibited bleeding upon probing. In both DH and SRP groups, 3 sub-groups of subjects were identified according to their last episode of scaling and root planing prior to the study baseline: within 2 to 6 months, >6 but < or =12 months, and one or more times in their life but not within the last 12 months. Each study site was treated twice over a 9-month study period, once at baseline and again at 4 months. Data from the study sites at 4, 6, and 9 months were then evaluated for changes in probing depth, clinical attachment level, and bleeding upon probing. RESULTS: At the 9-month evaluation, all sub-groups in the DH and SRP treatment arms presented with improvement in the measured clinical parameters, as compared to baseline. No significant differences were observed in the measured periodontal indices among the study sites between the three sub-groups for either treatment. CONCLUSIONS: It is concluded that the time interval since the last episode of scaling and root planing had no observable effect on the results achieved when treating periodontitis sites with locally delivered doxycycline hyclate alone or scaling and root planing alone. The treatment of periodontitis sites with locally delivered doxycycline hyclate resulted in clinical improvement comparable to scaling and root planing irrespective of the patient's prophylaxis frequency.     

The effect of subgingival debridement on periodontal disease parameters and the subgingival microbiota

Abstract The aim of the present investigation was to analyse the effect of subgingival scaling and root planing in subjects who prior to treatment exercised meticulous supragingival plaque control. 300 subjects were examined at baseline and after 1 and 2 years without treatment. After the year 2 examination, 62 subjects were randomly selected for therapy. They were given detailed instruction in proper self-performed toothcleaning measures and were carefully monitored during the subsequent 2 years. Following the year-4 examination, 2 quadrants, 1 maxillary and 1 mandibular in each subject, were randomly selected for additional therapy. The teeth in the selected quadrants were exposed to subgingival scaling and root planing. The subgingival therapy was repeated until a site no longer bled on gentle probing. This basic therapy was completed within a 2-month period. All subjects were re-examined after another 12-month interval. The examinations at year 4 and 5 included assessment of plaque, gingivitis, probing pocket depth and analysis of samples obtained from the subgingival microbiota at 134 selected sites. The findings from the present study demonstrated: (i) that subgingival scaling and root planing were effective in eliminating subgingival plaque and gingivitis; (ii) that professional therapy resulted in a pronounced reduction of probing depth at sites which at year 4 had a probing depth >3 mm; (iii) that in non-scaled quadrants, the extension of self-performed plaque control resulted in a continued improvement of the periodontal conditions at sites which at year 4 were < 5 mm deep.     

Factors associated with pain and analgesic consumption following non‐surgical periodontal therapy under local anaesthesia and carried out by dental students

Aim

Evaluate factors associated with pain and analgesic consumption following non‐surgical periodontal therapy.

Materials and methods

The sample consisted of 218 patients with chronic periodontitis, submitted to non‐surgical scaling and root planing under local anaesthesia at a public dental service in southern Brazil. The data collection instruments included a demographic questionnaire, as well as State‐Trait Anxiety Inventory, Corah?s Dental Anxiety Scale, Visual Analogue Scale, Numerical Rating Scale and Verbal Rating Scale. The presence and intensity of pain were evaluated at 2, 6, 12, 24 and 48 hr after scaling and root planing.

Results

A total of 52.3% of the patients reported mild intensity pain at some point during the 48 hr after scaling and root planing with local anaesthesia. Smoking (PR = 1.47; 95% CI = 1.16–1.65), severe periodontal inflammation (PR = 1.31; 95% CI = 1.09–1.58) and dental anxiety (PR = 1.24; 95% CI = 1.03–1.49) were associated with postoperative pain after adjusting for age, gender and state and trait anxiety scores. Moreover, 46.8% of the subjects used analgesics at some time during the 48‐hr follow‐up period and dental anxiety was the only factor associated with postoperative analgesic use.

Conclusions

Smoking, severe periodontal inflammation and dental anxiety were identified as factors associated with pain after non‐surgical scaling and root planing with local anaesthesia. Dental anxiety was also a factor associated with postoperative analgesic use.     

Effectiveness of scaling and root planing versus modified Widman flap on nitric oxide synthase and arginase activity in patients with chronic periodontitis

BACKGROUND: Nitric oxide (NO) is synthesized from the conversion of L-arginine to L-citrulline by NO synthase (NOS). Arginase, which is an arginine-depleting enzyme, can compete with NOS for the common substrate L-arginine and thus inhibit NO production. OBJECTIVES: In the present study, we aimed to examine the correlation between the arginase and NOS activity in patients with chronic periodontitis and to compare the effects of scaling and root planing and modified Widman flap procedures on enzyme activity. MATERIAL AND METHODS: The study included 13 patients diagnosed with chronic periodontitis. Using a split-mouth design, the defects showing>or=7 mm of attachment loss were treated either with scaling and root planing or with modified Widman flap. Gingival biopsies from both sites were obtained at baseline and 2 months after periodontal treatment. Immunohistochemical staining was performed for evaluating NOS expression and specific arginase activity was determined spectrophotometrically. RESULTS: Although inflamed periodontal tissues demonstrated a strong inducible NOS (iNOS) expression at baseline, immunostaining decreased after periodontal treatment. iNOS expression intensity and the number of inflammatory cells showing iNOS expression were found to be higher in the scaling and root planing group compared to the modified Widman flap group. The specific activity of arginase was measured as 0.18+/-0.07 IU/mg protein in the modified Widman flap group and 0.25+/-0.11 IU/mg protein in the scaling and root planing group at baseline. After periodontal therapy, the enzyme level was increased to 0.68+/-0.14 IU/mg protein in the modified Widman flap and to 1.10+/-0.23 IU/mg protein in the scaling and root planing group. CONCLUSION: This study was the first report of evaluating the involvement of the arginine-NO pathway in chronic periodontitis and this might be considered to be of value in understanding the periodontal disease mechanisms.     

Clinical and laboratory evaluations of non-surgical periodontal treatment in subjects with diabetes mellitus

BACKGROUND: The aim of this study was to evaluate the clinical and laboratory changes 3 months after full-mouth scaling and root planing in subjects with and without diabetes mellitus. METHODS: This study was performed using 10 subjects with type 2 diabetes mellitus who required insulin therapy (DM) and 10 healthy adult control subjects (NDM) with generalized chronic periodontal disease. Both groups were treated with full-mouth scaling and root planing and given oral hygiene instructions. Clinical parameters, including plaque index (PI), gingival index (GI), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL), were measured at four sites per tooth. Subgingival plaque samples were obtained from sites with the deepest PD (> or =5 mm) and with furcations in each subject. Samples were also tested for the presence of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and Tannerella forsythia (previously T. forsythensis) by polymerase chain reaction. Glycemic control (glycosylated hemoglobin [HbA1c] and fasting glucose levels) and clinical and microbiologic assessments were recorded at baseline and 3 months after periodontal treatment. RESULTS: Data revealed statistical changes (P < or =0.05; analysis of variance [ANOVA]) in clinical variables (PI, GI, PD, GR, and CAL) between baseline and 3 months in both groups. Conversely, no improvement in the fasting glucose level or glycosylated hemoglobin (P < or =0.05; ANOVA) was found after treatment. Besides some reduction in the bacterial frequency 3 months after treatment, no statistically significant difference was found between the groups. CONCLUSION: Clinical and laboratory responses were similar in DM and NDM groups 3 months after full-mouth scaling and root planing.     

A six-month comparison of three periodontal local antimicrobial therapies in persistent periodontal pockets

BACKGROUND: Currently, several local antimicrobial delivery systems are available to periodontists. The aim of this 6-month follow-up parallel study was to evaluate the efficacy of three commercially available local delivery systems as adjuncts to scaling and root planing in the treatment of sites with persistent periodontal lesions. METHODS: Seventy-nine patients with 4 pockets > or = 5 mm and bleeding on probing and/or suppuration were randomized into 4 treatment groups which included: scaling and root planing alone (S) (20 patients), or in conjunction with the application of 25% tetracycline fibers (S+Tet) (19 patients), or 2% minocycline gel (S+Min) (21 patients), or 25% metronidazole gel (S+Met) (19 patients). Clinical measurements were taken at baseline, 6 weeks, 3 months, and 6 months after antimicrobial application. Treatments were applied using the distributors' recommended protocols. RESULTS: All 4 therapies resulted in significant improvements from baseline in probing depth, attachment level, bleeding on probing, and the Modified Gingival Index (MGI) scores. The improvements in clinical parameters were greater in all 3 adjunctive treatment groups than scaling and root planing alone. The mean probing depth reductions at 6 months were: scaling + tetracycline = 1.38 mm; scaling + metronidazole = 0.93 mm; scaling + minocycline = 1.10 mm; and scaling alone = 0.71 mm. The probing depth reduction at all time points was significantly greater in the scaling plus tetracycline fiber group than the scaling and root planing alone group (P<0.01). There was also a significant improvement for scaling plus tetracycline fiber application over scaling and metronidazole at both 6 weeks and 3 months, although this did not remain significant at the 6-month visit. While the frequency of sites with suppuration was markedly reduced following all antimicrobial treatments, the most effective reductions were seen in the scaling plus tetracycline fiber group, followed by the minocycline group. CONCLUSIONS: Although all 3 locally applied antimicrobial systems seem to offer some benefit over scaling and root planing alone, a treatment regimen of scaling and root planing plus tetracycline fiber placement gave the greatest reduction in probing depth over the 6 months after treatment.     

Oral health status in an institutionalised elderly Jewish population.

The oral health status and treatment needs of 95 institutionalised elderly Jewish persons were determined. The mean DMFT was 23.4, with the M component increasing with age. Untreated carious lesions were identified in men and women of all ages. A relatively small percentage (10.5%) of subjects were affected by root caries. In 75% of cases of identified periodontal disease, the condition presented as bleeding or calculus. All subjects were in need of oral hygiene instruction and 64 (67.3%) required scaling and root planing. Complex treatment formed only a small percentage of the overall treatment needs. A low prevalence of temporomandibular joint problems, denture stomatitis and angular cheilitis was noted. A relatively high prevalence of untreated oral disease of low severity was observed, indicating the need for a comprehensive form of preventive and basic oral care.     

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.