慢性牙周炎与冠心病患者血清炎症因子含量及其作用的相关研究

目的 通过检测慢性牙周炎与冠心病患者血清中血脂、C反应蛋白(C-reactive protein,CRP)以及炎症因子的水平,探讨牙周炎与冠心病之间的相关关系.方法 选择经冠状动脉造影确诊并伴牙周炎的冠心病患者[(C+P)组]66例,单纯慢性牙周炎患者(P组)56例,单纯冠心病患者(C组)44例和健康志愿者(H组)43人.记录牙石指数、探诊出血阳性率、探诊深度和附着丧失,抽取血清,采用定量央心ELISA法,检测白细胞介索(IL)-1β、IL_6、肿瘤坏死因子(TNF)-α、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)及CRP的含量.结果 (C+P)组的探诊深度和附着丧失[分别为(4.55±0.85)、(3.78±0.34)mm]显著大于P组[(4.06±0.61)、(3.05±0.44)mm]、C组[(1.85±0.67)、(1.26±O.39)mnl]和H组[(1.12±0.33)、(0.42±0.83)mm],差异有统计学意义(P<0.05);(C+P)组的探诊出血阳性率(69.6%)显著高于C组(20.5%,P<0.01)、H组(4.6%,P<0.01)和P组(63.6%,P<0.05).(C+P)组、P组、C组、H组血清中HDL-C水平分别为(1.04±0.22)、(1.24±0.21)、(1.22±0.18)、(1.42±0.21)mmol/L,(C+P)组较后三组显著降低(P<0.05);CRP、IL-6、IL-1β、TNF-α水平(C+P)组与其他三组相比显著升高(P<0.05).结论 牙周炎和冠心病之间存在一定的关联性,HDL-C、CRP、IL-6、IL-1β和TNF-α可能与冠心病和牙周炎的发病机制相关.     

补肾合剂对大鼠牙周袋菌群的影响

目的研究中药补肾合剂对牙周炎大鼠牙周袋菌群的影响并探讨其作用机制.方法选用10月龄SD大鼠80只,雌雄各半.随机分为3组:正常对照组16只,牙周炎造膜对照组40只,中药治疗组24只.分别于造膜完成后、中药治疗前、中药治疗结束后处死实验大鼠.处死实验大鼠前在全麻下,用无菌刮匙和棉签去除龈上菌斑后,用两根无菌纸尖分别置于大鼠左上第一磨牙的近中颊侧和远中颊侧龈下10s来采集龈下菌斑标本.采集龈沟内细菌进行细菌培养鉴定.同时观察各阶段大鼠的生活状态.结果牙周炎模型建立后,牙周微生态发生变化,需氧及兼性厌氧菌减少,产黑色素等致病性厌氧菌增加.中药治疗后,牙周厌氧性致病菌明显减少,需氧和/或兼性厌氧菌明显减少.结论补肾合剂可使牙周局部有益菌增加,产黑色素等厌氧致病菌减少,达到治疗牙周炎的目的.     

The influence of diet consistence, drinking water and bedding on periodontal disease in Sprague-Dawley rats

BACKGROUND: Although rats have been extensively used in periodontal research, pre-experimental periodontal inspection has not been given high priority in previous studies of experimental periodontal disease in rats. An inspection of 50 Sprague-Dawley rats, which were to be used in a model of experimental periodontal disease, revealed signs of periodontal disease in a considerable proportion of the animals. OBJECTIVES: The objectives of the present study were to describe disease progression, identify factors responsible for induction of periodontal disease and test a method for breeding of healthy rats. METHODS AND RESULTS: A longitudinal study revealed that 33% of rats, bred under the same conditions, showed signs of periodontal disease during, or shortly after, eruption of the molars. Regular diet caused significantly more horizontal bone loss (P = 0.0001) and significantly less periodontal bone support (P < 0.0001) than the same kind of diet with a smaller grain size. Wood chip bedding in the rats' cages significantly reduced periodontal bone support (P < 0.0001) compared to a wire mesh floor and a simultaneous use of regular diet and bedding decreased it even further (P = 0.0023). Finally, by using finely milled diet, a wire mesh floor and tap water, instead of conventional breeding methods of regular diet, bedding and acidic water, it was possible to breed rats with minimal signs of periodontal disease. CONCLUSIONS: The results of the present study emphasize the need for pre- experimental examination of rats. They also show that diet and bedding conditions have the potential of seriously influencing outcomes of studies of periodontal disease in rats.     

The association between periodontal disease,physical activity and healthy diet among adults in Jordan

Bawadi HA, Khader YS, Haroun TF, Al‐Omari M, Tayyem RF. The association between periodontal disease, physical activity and healthy diet among adults in Jordan. J Periodont Res 2011; 46: 74–81. © 2010 John Wiley & Sons A/S Background and Objective: Physical inactivity and an unhealthy diet have been implicated as risk factors for several chronic diseases that are known to be associated with periodontitis, such as cardiovascular diseases, obesity and diabetes. Studies investigating the relationship between periodontitis and physical activity and diet are limited. Therefore, this study was conducted to determine the relationship between physical activity, healthy eating habits and periodontal health status. Material and Methods: A systematic random sample of 340 persons, 18–70 years of age, was selected from persons accompanying their relative patients who attended the outpatient clinics in the medical center of Jordan University of Science and Technology in north of Jordan. Data collected included socio‐demographic and clinical characteristics, anthropometric measurements, physical activity level and dietary assessment. Results: Individuals who were highly physically active had a significantly lower average plaque index, average gingival index, average clinical attachment loss (CAL) and percentage of sites with CAL ≥ 3 mm compared to individuals with a low level of physical activity and individuals with a moderate level of physical activity. Those who had a poor diet had a significantly higher average number of missing teeth and an average CAL compared with those who had a good diet. In the multivariate analysis, a low level of physical activity and a poor diet (diets with a healthy eating index score of < 50 points) were significantly associated with increased odds of periodontitis. Conclusions: A low physical activity level and a poor diet were significantly associated with increased odds of periodontal disease. Further studies are needed to understand this relationship in greater detail.     

200例慢性牙周炎患者的病情调查

目的 调查城区职工中未经治疗的慢性牙周炎患者的疾病状况。方法 从北京城区某单位职工中筛选出未经治疗的慢性牙周炎患者200例，检查除第三磨牙外的全口牙、6个住点／牙的牙周情况，指标为探诊深度、附着丧失、探诊后出血。结果 附着丧失程度随患者的年龄增长而加重，男性的附着丧失重于女性，探诊出血位点的附着丧失重于不出血住点。在全口牙中，下切牙和上颌第一磨牙的附着丧失最多。结论 慢性牙周炎的程度与年龄、性别、牙龈炎症有关，病变的分布有牙位特异性。     

无托槽隐形矫治器对牙周炎错胎患者的疗效观察

目的观察无托槽隐形矫治器对中、重度牙周炎错胎患者的治疗效果。方法牙周炎错胎畸形患者9例,其中男性5例,女性4例,平均年龄37．8岁。多数牙齿均有不同程度的牙周附着丧失,少数牙齿为重度牙周附着丧失、牙齿松动Ⅰ～Ⅱ度、牙槽骨吸收至根尖1／3。Ⅰ类错胎患者1例,Ⅱ类错骀患者5例,Ⅲ类错骀患者3例。经牙周基础治疗,控制牙周炎症后开始正畸治疗,均为非拔牙矫治,全部采用无托槽隐形矫治技术矫治。结果隐形矫治疗程最短6个月,最长17个月,平均疗程12．5个月。9例患者咬合关系和面型都得到明显改善,前牙殆创伤消除,牙周炎症控制良好,治疗后牙周探诊深度减小。结论无托槽隐形矫治器对牙周炎错骀患者的治疗是有效的,有利于矫治过程中口腔卫生维护和牙周治疗。     

The association between periodontal disease and cancer: A review of the literature

Objectives

Periodontal disease has long been linked to many systemic diseases, and recently a link between periodontal disease and cancer has been established. The purpose of this paper is to review the literature to explore the evidence to date of a relationship between periodontal disease and cancer. In addition, the main hypotheses for the association are discussed along with challenges in evaluating the evidence.

Data/sources/study selection

In this review, English-language papers studying the relationship between periodontal disease or tooth loss in humans and increased risk of several types of cancers along with overall cancer risk between 1990 and April 2009 were reviewed.

Conclusions

The most consistent increased risk was noted in studies of oral and esophageal cancers and periodontal disease. Gastric and pancreatic cancers had an association in most but not all studies. Lung, prostate, hematologic and other cancers were less consistently associated or did not have sufficient studies to determine a predictable pattern. Studies to date indicate a positive correlation between several forms of cancer and periodontal disease.     

Clinical,pathological and immunological aspects of periodontal disease

The inflammatory and immune responses during the development and progression of periodontitis are reviewed. Susceptibility to periodontitis may be related to whether plasma cells predominate in the tissues of an individual, or a site, in response to the microbial insult from dental plaque. The tendency for an individual or site to form an extensive plasma cell infiltrate may indicate an inability to defend against periodontopathogenic bacteria and thus a predisposition to periodontitis. Selected pertinent areas of current interest in cellular and humoral immunology are considered within the periodontal context. These topical issues include (a) homing of immune and inflammatory cells to target tissues; (b) the local proliferation and synthetic activity of immune and inflammatory cells; (c) the cytokine profile of the inflammatory and immune cells; and (d) the immunoglobulin subclasses of locally produced antibodies.     

Immuno-localization of COX-1 and COX-2 in the rat molar periodontal tissue after topical application of lipopolysaccharide

Up-regulation of prostaglandin E2 (PGE2) production in the periodontal tissue is considered to be important for periodontal tissue destruction. The purpose of the study was to demonstrate the dynamic changes of immuno-localization of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) in rat periodontal tissue after topical application of lipopolysaccharide (LPS: 5 mg/ml in physiological saline) from Escherichia coli into the rat molar gingival sulcus. In the normal periodontal tissue, small numbers of junctional epithelium (JE) cells and numerous osteocytes embedded in alveolar bone constitutively expressed COX-1. The COX-1 expression was not effected by LPS application. JE cells, especially in the coronal portion of JE also expressed COX-2. LPS application induced the JE cells with consequent transient expression of COX-2 with a peak at day 1. These findings suggest that JE cells may play a critical role in first defense line against LPS challenge and PGE2 from JE cells may be responsible for the initiation of periodontal inflammation. In the deep periodontal tissue, cementoblasts and osteoblasts showed constitutive expression of COX-2, which may be induced by continuous cyclic tension force due to occlusal pressure. LPS application caused a transient up-regulation of COX-2 expression in periodontal ligament fibroblasts, cementoblasts and osteoblasts. It is suggested that the inducible production of PGE2 via COX-2 by these cells may be associated with connective tissue destruction and alveolar bone resorption.     

IL-12和Th亚群细胞在牙周病免疫病理及免疫调节中的作用

目的：探讨白细胞介素12（interleukin-12,IL-12）在牙周病免疫病理及免疫调节中的作用。方法：选取2016年1月—2019年1月收治的98例慢性牙周炎患者,按照牙周炎严重程度分为轻度组（30例）、中度组（35例）与重度组（33例）,选取同期进行牙周检查的健康者30例作为对照组,观察各组间临床牙周指标[探诊深度（probing depth,PD）、附着丧失（attachment loss,AL）、菌斑指数（plague index,PLI）、出血指数（bleed index,BI）]、外周血中Th细胞表达（Th1、Th2、Th17）、龈沟液及血清中IL-12水平。采用SPSS 20.0软件包对数据进行统计学分析。结果：各组间PD、PLI、BI等指标相比差异有统计学意义（P<0.05）;轻、中、重度3组PD、PLI、BI显著高于对照组（P<0.05）;轻、中、重度3组AL指标相比差异显著（P<0.05）;中、重度组PD、AL、PLI、BI显著高于轻度组（P<0.05）,且重度组PD、AL、PLI、BI显著高于中度组（P<0.05）;轻、中、重度3组Th1、Th2、Th17显著高于对照组（P<0.05）;中、重度组Th1、Th2、Th17显著高于轻度组（P<0.05）,且重度组Th1、Th2、Th17显著高于中度组（P<0.05）;轻、中、重度龈沟液及血清中IL-12水平显著高于对照组（P<0.05）;中、重度组龈沟液及血清中IL-12水平显著高于轻度组（P<0.05）,且重度组龈沟液及血清中IL-12水平显著高于中度组（P<0.05）;龈沟液及血清中IL-12与PD、AL、PLI、BI、Th1、Th2及Th17等指标呈正相关（P<0.05）。H-E染色中、轻度组淋巴细胞较少,中度组淋巴细胞数目明显增加,重度组淋巴细胞表现为密集状态,同时在细胞间质中出血明显;IL-12蛋白阳性染色结果均在牙龈组织淋巴细胞质中表达,可见明显棕褐色,轻、中、重度3组IL-12蛋白阳性染色在牙龈组织中数量显著高于对照组,且着色随着轻、中、重度炎症变化而加重。结论：IL-12参与牙周病的免疫调节机制,可能是牙周炎发生的关键促炎细胞因子。     

Decreased phagocytic function in neutrophils and monocytes from peripheral blood in periodontal disease

Phagocytosis by neutrophils and monocytes constitutes the main defense mechanism against bacterial challenges in periodontitis. Phagocytosis by neutrophils has already been evaluated, whereas phagocytic function of monocytes has hardly been addressed so far.

Objectives

The aim of this study was to assess phagocytosis by neutrophils and monocytes in periodontitis.

Material and Methods

The sample included 30 subjects with severe periodontitis and 27 control subjects without periodontal disease. The phagocytic index (PhI) was calculated as the mean number of adhered/ingested Saccharomyces cerevisiae per phagocytozing monocyte or neutrophil multiplied by the percentage of phagocytes involved in phagocytosis.

Results

A significant reduction in phagocyte functions was observed in individuals with periodontitis. The median of PhI of neutrophils using non-sensitized S. cerevisiae was 3 for the control group, and 1.5 for the periodontitis group (p=0.01, Mann-Whitney test). The median of PhI of monocytes with non-sensitized S. cerevisiae was 26.13 for the control group, and 13.23 for the periodontitis group (p=0.03, Mann Whitney test). The median of PhI of monocytes assessed with sensitized S. cerevisiae was 97.92 for the control group and 60.1 for the periodontitis group (p=0.005, t-test).

Conclusion

The data demonstrated a reduction in the function of phagocytes, suggesting a decrease in immune defenses in periodontitis.     

牙周病伴2型糖尿病248例种植义齿治疗总结

目的 探讨牙周病伴2型糖尿病患者实施种植义齿治疗的风险和处理对策.方法 回顾分析2000至2008年在成都华西牙种植医院、华西口腔深圳门诊部、华西口腔重庆门诊部接受种植义齿治疗的248例牙周病伴2型糖尿病患者,以种植体存留率为评价指标,对数据进行统计分析.结果 248例患者选用Nobel Replace和CDIC两个种植系统,采用不翻瓣和骨膨胀的微创植入术,共植入牙种植体1190枚(Nobel Replace 333枚、CDIC 857枚).6枚(0.5％)种植体在术后6个月愈合期内脱落,术后1年种植体存留率为98.4％ (1165/1184)、5年存留率为95.3％ (487/511)、8年存留率为89.2％ (91/102).结论 严格掌握适应证和控制风险的情况下,牙周病伴2型糖尿病患者种植修复可获得较高的满意度.     

牙周炎症对冠心病患者CRP水平影响的初探

目的通过横向研究初步探讨牙周炎症对冠心病患者CRP水平的影响。方法受检者共60人,包括冠心病＋牙周炎组、单纯牙周炎组和健康对照组,每组20人。检测超敏C反应蛋白（hs—CRP）,牙周临床指标包括牙周探诊深度、附着丧失、出血指数、菌斑指数,并检测血脂水平（HDL、LDL、TG、CHO）和白细胞计数。采用ANOVA法分析以上指标在各组间的差别,Pearson法分析hs—CRP与牙周指标间的相关性。结果牙周炎＋冠心病组hs．CRP显著高于单纯牙周炎组和健康组（P〈0．05）,单纯牙周炎组的hs—CRP水平又显著高于健康组（P〈0．05）。牙周炎＋冠心病组牙周指标均高于单纯牙周炎组和健康组。受检者的血清hs—CRP水平与牙周指数显著相关（P〈0．05）。结论牙周感染和炎症可能是牙周炎＋冠心病患者hs—CRP水平升高的原因之一。     

Experimental periodontal disease treatment by subgingival irrigation with tetracycline hydrochloride in rats

Objective

The aim of this study was to compare subgingival irrigation with tetracycline hydrochloride (TTC-HCL) as adjunctive treatment to scaling and root planning (SRP) on induced periodontitis in rats.

Material and methods

In 60 rats, periodontal disease was ligature-induced at the mandibular left first molar. After 7 days, the ligature was removed and all animals were submitted to SRP, and divided into 2 groups according to the following treatment: C (n=30) - subgingival irrigation with 1 mL of saline; T (n=30) - subgingival irrigation with 1 mL of TTC-HCL (50 mg/mL). Ten animals in each group were euthanized at 7, 15 and 30 days posttreatment. The histometric values were statistically analyzed (p<0.05).

Results

In the histometric analysis, at 7, 15 and 30 days, Group T (0.72±0.05 mm², 0.57±0.14 mm², 0.62±0.07 mm²), showed less bone loss (p<0.05) than Group C (1.35±0.25 mm²; 1.40±0.31 mm²; 1.29±0.27 mm²), respectively.

Conclusions

Subgingival irrigation with TTC-HCL was an effective adjunctive treatment for periodontal disease induced in rats.     

Correlation of histometric, microbial, and clinical indicators of periodontal disease status before and after root planing

Effective diagnosis and treatment of periodontal disease requires accurate evaluation of disease status before and after treatment. This study evaluated relationships among multiple parameters that have been used for periodontal disease evaluation. A total of 61 initially deep (greater than or equal to 6 mm) interproximal pockets from 16 patients examined before and after a 3-week course of root planing therapy were evaluated for probing depth, bleeding on probing, darkfield and cultural characterization of subgingival plaque, and histometric indices of infiltrated connective tissue (ICT) and mature plasma cell infiltrate. 36 sites were evaluated before treatment, and 25 after treatment. A comparison of mean scores for pre-treatment sites versus post-treatment sites indicated that there was an average improvement in most disease-related parameters. However, patterns of significant correlations among the parameters differed markedly. Motile bacteria enumerated by darkfield microscopy were significantly correlated with ICT and plasma-cell populations before, but not after treatment. In contrast, probing depth and populations of black pigmented Bacteroides (BPB's), principally B. gingivalis, were significantly correlated with ICT after, but not before, treatment. Bleeding on probing was not significantly correlated with ICT levels before or after treatment. This suggests that different sets of parameters should be used for evaluating periodontal disease status before or after treatment. Our data further suggest that B. gingivalis populations may be related to delayed healing of deep periodontal lesions after instrumentation.     

牙周检查指数与舌苔的相关性研究

目的探讨牙周检查指数(牙周袋探诊深度,出血指数及菌斑指数)和舌苔状况之间的相关性。方法全身健康牙周炎患者117例,检查和记录菌斑指数(PLI)、牙周袋探诊深度(PD)、出血指数(BI)以及舌苔的厚度和面积。其中4 6例完成牙周基础治疗(龈上洁治和龈下刮治)后重复以上检查。结果Spearman相关分析法显示,117例牙周炎患者PLI(2 .3)、BI(2 .8)和舌苔厚度(2 .2 )呈明显的正相关关系(r =0 .387,0 .311,P <0 .0 1) ,PD(3.4mm)和舌苔厚度也呈正相关性(r=0 .2 18,P <0 .0 5 )。而这三个牙周指数与舌苔面积(2 .6 )均无相关性。4 6例牙周基础治疗后,PD、BI和PLI均显著降低(P <0 .0 1) ,舌苔厚度也从治疗前的2 .5下降为2 .2 ,有明显的统计学意义(t=3.5 0 1,P <0 .0 1) ,舌苔面积治疗前为2 .7,治疗后为2 .6 ,改变无统计学意义。结论菌斑指数、出血指数、牙周袋探诊深度与舌苔厚度有相关性,尤其是菌斑指数和出血指数。而与舌苔面积无关。     

Association between periodontal disease and oral squamous cell carcinoma: a systematic review and meta-analysis

To investigate the relation between periodontal disease (PD) and oral squamous cell carcinoma (OSCC) we systematically searched records published up to August 2022. Odds ratios (OR) and relative risk (RR) with 95% confidence intervals (95% CI) were estimated to evaluate this relation, then sensitivity analysis was performed accordingly. Begg’s test and Egger’s test were used to detect publication bias. Out of 970 papers from several databases, 13 studies were included. Summary estimates showed that PD was positively associated with the prevalence of OSCC (OR = 3.28, 95% CI: 1.87 to 5.74), especially for severe PD (OR = 4.23, 95% CI: 2.92 to 6.13). No evident publication bias was revealed. No increased OSCC risk among patients with PD was shown according to the combined results (RR = 1.50, 95% CI: 0.93 to 2.42). Patients with OSCC exhibited significant differences in alveolar bone loss, clinical attachment loss, and bleeding on probing, when compared with controls. The systematic review and meta-analysis suggested that there was a positive association between PD and prevalence of OSCC. However, according to the current evidence, a causal relation is unclear.