不同治疗方法对牙龈炎患者口气的影响

目的：研究牙龈炎患者口气的一般状况，观察不同治疗方法对牙龈炎患者口气的影响。方法：根据纳入标准选择四川大学华西校区口腔专业患牙龈炎的学生0名，按不同的口臭程度分层，将学生分为4组，对照组，口泰组，洁牙组和舌清洁组，用口臭测定仪Halimeter在治疗前和治疗后7天，1个月分别测定其口气值，并进行统计学分析。结果：（1）治疗后7天，口泰组，洁牙组和舌清洁组的口气值都较治疗前有所下降，但只有洁牙组和舌清洁组有显著差异（P＜0．05）；（2）治疗1个月后，除舌清洁组外，其它治疗组的口气值均有所回升，但洁牙组和舌清洁组的口气值与其它两组比较仍有显著差异（P＜0．05），结论：进行正确的口腔卫生清洁可有效降低牙龈炎患者的口气值。     

O.4%硫酸锌溶液对口气中挥发性硫化物浓度的影响

目的 观察0.4％硫酸锌溶液漱口前后口气中挥发性硫化物(volatile sulfur compounds,VSCs)浓度的变化,研究硫酸锌用于口臭的疗效。方法 根据相关标准筛选出口臭患者125例,随机分为3组,分别采用0.4％硫酸锌溶液、成品漱口水和蒸馏水漱口,使用口气测量仪检测各组患者漱口前和漱口后0、1、2、3 h的VSCs值。结果 漱口后0 h,3组VSCs值均有所下降,硫酸锌组与蒸馏水组差异显著(P<0.001);漱口后1、2、3 h,硫酸锌组VSCs值明显低于其他2组(P<0.001);漱口后3 h时,硫酸锌组的VSCs值仍明显低于漱口前的VSCs值(P<0.001)。结论0.4％硫酸锌溶液漱口可以在短期内有效消除口臭,可以用作口臭的辅助治疗。     

李施德林漱口水辅助治疗牙龈炎的疗效观察

目的:观察李施德林漱口水辅助治疗牙龈炎的疗效。方法:选择18～60岁的符合纳入标准的牙龈炎病人60例,随机分为试验组和对照组,试验组在牙周基础治疗后含漱李施德林漱口水,对照组行牙周基础治疗后清水含漱,分别于治疗后1、2周,观察病人的菌斑指数和牙龈指数,进行统计学分析。结果:治疗后1、2周,试验组的菌斑指数和牙龈指数明显低于对照组。结论:李施德林漱口水可作为牙龈炎病人牙周基础治疗后的辅助局部用药。     

洗必泰漱口液对牙龈炎及牙菌斑作用的研究

目的:研究洗必泰对固定矫治患者牙龈炎及牙菌斑的临床作用.方法:①选择24例固定正畸伴有牙龈炎患者,年龄11～17岁,随机分成实验组和对照组.②洁治后8～10 d,记录指数牙的菌斑指数、牙龈指数作为基线值,对照组用安慰剂漱口,实验组以洗必泰漱口.③分别于4周、8周、12周后记录菌斑指数、牙龈指数.结果:8周、12周后,实验组各项指数明显低于对照组.结论:应用0.12%洗必泰漱口配合日常的口腔卫生措施,能有效减少固定正畸患者牙龈炎的发生.     

中药大黄对正畸固定矫治中龈炎的治疗研究

目的:评价中药大黄对正畸固定矫治中龈炎治疗的临床疗效。方法:选择牙周健康者20例(尚未矫治)和矫治6个月临床诊断为牙龈炎的患者60例为研究对象,牙周健康患者20例设为牙周健康组,60例牙龈炎患者随机分为3组:大黄组、明胶海绵组和对照组。分别于治疗前采集4组研究对象的牙周临床指数和龈沟液标本,使用ELISA法测量龈沟液中白介素-1β的含量,比较组间各项指标间的差异。对牙龈炎3组患者,其中大黄组用大黄明胶海绵药条,明胶海绵组用灭菌蒸馏水明胶海绵条,分别置于龈袋内,每周上药1次,共4次,对照组患者龈袋内不放任何药物。于4周后重新采样比较牙周治疗前后上述指标间的差异。结果:牙龈炎组治疗前牙周临床指数、龈沟液IL -1β浓度均显著高于牙周健康组(P＜0.05),大黄组、明胶海绵组与对照组比较无显著性差异。治疗后明胶海绵组上述指标与对照组比较无显著性差异,且明显高于牙周健康组(P＜0.05)。治疗后明胶海绵组和对照组分别与治疗前比较均无显著性差异。治疗后大黄组上述指标相比治疗前及对照组均明显降低(P＜0.05),与牙周健康组比较,龈沟出血指数(SBI)接近正常。结论:中药大黄对正畸固定矫治中龈炎具有明显的治疗效果。     

西吡氯铵漱口液对牙龈炎、牙周炎疗效的临床评价

目的：评价1g/L西哟氯铵（CPC）漱口液对牙龈炎、牙周炎的疗效，以及对口腔环境的清洁作用。方法：受试者除保持原有口腔卫生习惯外，每天两次使用漱口水，每次含漱60s，为期4周。在实验前、后观察临床指标和实验室指标。结果：1g/L CPC漱口后，临床观察指标、菌斑生成 指数均明显低于阴性对照组。结论：受试者在保持正常的口腔护理习惯下，每日两次使用1g/L CPC漱口液能降低各类口腔卫生指数，减轻牙龈炎、牙周炎症状。     

2种含氟牙膏和漱口水预防正畸牙龋病的研究

目的观察分别使用2种含氟牙膏和漱口水预防正畸牙初期龋病的效果。方法对97例采用固定矫治器正畸治疗的患者进行前瞻性、随机、双盲研究。A组(50人)用氟化胺/氟化亚锡牙膏刷牙,用氟化胺/氟化亚锡溶液漱口。B组(47人)用氟化钠牙膏刷牙,用氟化钠溶液漱口。分别记录黏接托槽前与去除托槽时6个上颌前牙的白垩色初期龋损指数、菌斑指数和牙龈出血指数,并进行统计学分析。结果黏接托槽前与去除托槽后A组的白垩色初期龋损指数、菌斑指数、牙龈出血指数无差异(P>0.05),而B组的白垩色初期龋损指数、菌斑指数、牙龈出血指数的差异有统计学意义(P<0.05)。结论在固定矫治器正畸治疗期间联合使用氟化胺/氟化亚锡牙膏和漱口水比使用氟化钠对白垩色初期龋损、菌斑堆积和牙龈炎的发生有更显著的预防效果。     

西吡氯铵含漱液对单纯性牙龈炎患者临床症状的改善作用

目的 :观察 1g/L西吡氯铵含漱液对单纯性牙龈炎患者临床症状的改善作用。方法 :纳入单纯性牙龈炎患者 48例 ,随机均等分为 2组 ,用随机双盲法 ,分别给予 1g/L西吡氯铵含漱液或爱诺天健含漱液。患者用含漱液漱口 ,每天晨起、睡前、饭后各一次 ,每次含 15ml,持续漱口 60s ,漱口后 1h内禁饮食 ,7d为一疗程。就诊当天 (第 1天 )、第 4天、第 8天测定观察患者牙龈指数 (GI)、龈沟出血指数 (SBI) ,患者自行确定口臭 (OS)值。结果 :实验组和对照组各 2 4例 ,年龄、性别、吸烟史分布无组间差异 (P >0 .0 5 ) ,基线检查GI、SBI、OS值无组间差异 (P >0 .0 5 ) ,中期检查GI、SBI、OS值分别显著低于基线值 (P <0 .0 5 ) ,组间比较无显著差异 (P >0 .0 5 ) ,终点检查GI、SBI、OS值分别显著低于中期检查值 (P <0 .0 5 ) ,组间比较无显著差异 (P >0 .0 5 )。结论 :1g/L西吡氯铵含漱液可减轻单纯性牙龈炎患者的临床症状     

体验式口腔卫生指导方法在单纯性牙龈炎患者中的应用效果研究

目的　探讨体验式口腔卫生指导方法在单纯性牙龈炎患者中的应用效果。方法　选取2017年1—7月于青岛大学医学院附属青岛市市立医院口腔医学中心就诊的单纯性牙龈炎患者62例，随机均分为试验组（32例）和对照组（30例）。试验组患者采用体验式口腔卫生指导方法教授患者刷牙，对照组患者采用模型教授法，研究两组患者在口腔护理方面的差异，分析两组患者治疗1个月后的菌斑指数、探诊出血（bleeding on probing，BOP）阳性位点数及BOP百分率。结果　治疗前两组患者的菌斑指数、BOP阳性位点数及BOP百分率差异均无统计学意义（P＞0.05）；治疗1个月后，两组患者的上述指标均有改善（P＜0.05），其中试验组的菌斑指数、BOP阳性位点数及BOP百分率均有更加显著的改善（P＜0.01），且两组患者上述指标的差异具有统计学意义（P＜0.05）。结论　对单纯性牙龈炎患者采用体验式口腔卫生指导方法，可显著改善菌斑指数、BOP阳性位点数及BOP百分率，值得在临床上推广。     

雅皓乳膏对菌斑相关性牙龈炎的临床疗效评价

目的 :评价雅皓乳膏对菌斑相关性牙龈炎的临床疗效。方法 :选择临床诊断为菌斑相关性牙龈炎患者 90例 ,随机分为实验组、阳性对照组 (全效高露洁 )和阴性对照组 (爽箭牙膏 ) 3组 ,每组 30例。分别在实验前和实验后的第 4、8、12周对牙龈指数、龈沟出血指数和菌斑指数进行检查 ,同时测量患者口气中挥发性硫化物的含量。结果 :实验组和阳性对照组随着疗程的进行临床指标明显改善 ,挥发性硫化物 (VSCs)的含量明显减少 ,两组间差别无统计学意义 (P >0 .0 5 ) ,而实验组和阴性对照组间的临床指标、VSCs含量差别在统计学上均有显著性意义 (P <0 .0 0 1)。结论 :雅皓乳膏作为牙周病常规治疗后的维护期口腔保洁用品对于维持疗效 ,减轻口臭 ,有一定的临床意义。     

黄芪素和氯己定漱口水对无生活自理能力病人的口腔卫生维护的比较研究

目的:评估黄芪素对无生活自理能力病人抗口臭、抗菌斑和预防牙龈炎的效果。方法:以2 g/L氯己定漱口水为阳性对照,通过测试0.5 g/L黄芪素漱口后8 h嗅觉法计分和挥发性硫化物水平的变化来评估黄芪素的抗口臭效果,通过每天2次、共14 d用0.5 g/L黄芪素漱口后菌斑指数和出血指数的变化来评估黄芪素的抗菌斑和预防牙龈炎效果。结果:与氯己定相比,黄芪素在嗅觉法计分和挥发性硫化物水平以及菌斑指数方面不如氯己定,但预防牙龈炎的效果在第7天和第14天与氯己定相似。结论:作为预防性应用,黄芪素漱口水可预防牙龈炎的发生,其效应可能是抗炎和抗菌作用的综合体现。     

脱敏抛光膏和氟化物凝胶对洁治后牙本质敏感和菌斑控制的疗效观察

目的观察脱敏抛光膏和氟化物凝胶对牙周洁治术后牙本质敏感和菌斑控制的影响。方法选择菌斑性龈炎需行龈上洁治术的口腔本科生40名,采用自身对照,随机选择一侧牙列为试验侧,对侧牙列为对照侧,试验侧超声洁治后使用脱敏抛光膏和氟化物凝胶,对照侧超声洁治后使用普通抛光膏,于洁治后即刻和抛光后即刻,治疗后1周、2周、3周、4周检查牙齿吹气刺激敏感值（blowing stimulation test scores,BST）和菌斑指数（plaque index,PLI）。结果抛光后即刻试验侧BST均值为0.60±0.40,明显低于对照侧0.91±0.73（P〈0.05）,治疗后1周、2周、3周试验侧BST均值分别为0.48±0.51、0.45±0.42、0.51±0.83,对照侧BST均值分别为0.88±0.50、0.86±0.45、0.84±0.52,试验侧均低于对照侧（P〈0.05）,4周时双侧BST差异无统计学意义（P〉0.05）。洁治后1周、2周试验侧PLI分别为0.75±0.78、0.82±0.73,对照侧PLI分别为1.06±0.89、1.14±0.86,试验侧均明显低于对照侧（P〈0.05）,3周、4周时双侧PLI差异无统计学意义（P〉0.05）。结论菌斑性龈炎患者牙周洁治后使用脱敏抛光膏和氟化物凝胶可即刻并持续减轻牙齿敏感症状达3周,并可延缓菌斑再沉积达2周。     

Clinical trial of oral malodor treatment in patients with periodontal diseases

Pham TAV, Ueno M, Zaitsu T, Takehara S, Shinada K, Lam PH, Kawaguchi Y. Clinical trial of oral malodor treatment in patients with periodontal diseases. J Periodont Res 2011; 46: 722–729. © 2011 John Wiley & Sons A/S Background and Objective: Only a few clinical research studies have assessed different therapeutic approaches to oral malodor in subjects affected by periodontal diseases. The aim of this study was to evaluate the effects of periodontal treatment and tongue cleaning on oral malodor parameters in periodontitis and gingivitis patients. Material and Methods: The subjects were 102 periodontitis and 116 gingivitis patients with oral malodor. Oral malodor was measured by organoleptic test and Oral Chroma™. Oral health status, including tooth conditions, periodontal health, tongue coating and proteolytic activity of the BANA test in tongue coating were assessed. Subjects in each periodontal disease group were randomly assigned into two subgroups depending on the sequence of treatment: periodontal treatment and tongue cleaning. Oral malodor and oral health parameters were compared by groups and sequence of treatment. Results: For subjects in the periodontitis group, there were statistically significant reductions in oral malodor after periodontitis treatment or tongue cleaning; however, major reductions were found after periodontitis treatment. For those in the gingivitis group, there were also statistically significant reductions in oral malodor after gingivitis treatment or tongue cleaning, but the most marked reductions were observed after tongue cleaning. At the completion of treatment, all oral malodor parameters fell below the threshold levels in all subgroups. Conclusion: The present study indicated that periodontal treatment played an important role and tongue cleaning contributed to a lesser extent to reduction in oral malodor in periodontitis patients. In contrast, tongue cleaning alone can be the primary approach to reduce oral malodor in gingivitis patients.     

两种不同设计的刮舌器清除口臭效果的比较研究

目的：比较两种有代表性的刮舌器对口臭的短期和长期治疗效果。方法：采用嗅觉法计分和检测挥发性硫化物（VSC）水平评估1d内和3周内使用无让性的塑料刃刮舌器和有让性的橡胶刃刮舌器的抗口臭效果,并与使用氯己定漱口水组及安慰剂组进行比较。结果：1d内的结果显示氯己定漱口水组和2种刮舌器组在第3、6h的抗口臭效果比安慰剂组强,而2种刮舌器的抗口臭效果更优于氯己定漱口水;3周内的结果显示氯己定组、塑料刃组和橡胶刃组在第1、2、3周的嗅觉法计分和VSC水平均低于安慰剂组,在第3周橡胶刃组的嗅觉法计分和VSC水平低于塑料刃组。结论：刮舌器的抗口臭效果均优于氯己定漱口水,橡胶刃刮舌器的长期效果要优于硬质塑料刃刮舌器。     

The analysis of characteristics of elderly people with high VSC level

Objective:  The purpose of this study was to examine the characteristics of elderly subjects who had objectionable levels of volatile sulfur compound (VSC).
Subjects and method:  In 2002, a total of 115 85-year-old persons in Japan were subjected to oral examinations, tongue coat collections, measurements of VSCs levels inside the mouth using a portable gas chromatography (Oral Chroma^TM, Abilit, Japan), and assessments of quality of life (QOL) using an SF-36 questionnaire.
Results:  Sixty-six of the subjects were edentulous and 49 were dentulous. They were divided into two groups by VSC levels, those with oral malodor (both H₂S > 112 ppb and CH₃SH > 26 ppb; subjects with oral malodor, OM group; n  = 7) and those without ( n  = 108). Our results showed that tongue coat deposit amounts and proportion of dentulous subjects were significantly higher in the OM group. Further, in an analysis of QOL, the SF-36 scores for vitality, social functioning and mental health were significantly higher in OM.
Conclusion:  We found that elderly subjects with oral malodor tended to be dentulous and had large deposits of tongue coating. However, oral malodor in the OM group subjects did not appear to cause a disadvantage in their social lives.     

Use of a novel group of oral malodor measurements to evaluate an anti-oral malodor mouthrinse (TriOralTM) in humans

OBJECTIVE: This study compared the ability of a test mouthwash containing zinc chloride and sodium chlorite (TriOral) to reduce intrinsic oral malodor, to that of two other mouthrinses, one with zinc chloride only and the other with no zinc chloride/no sodium chlorite, using a novel group of oral malodor parameter measurements. METHODOLOGY: Forty-eight subjects completed the study; 16 in the test group, 17 in the zinc only group, and 15 in the no zinc chloride/ no sodium chlorite group. At baseline and after two and four weeks, parameters assessed were 1) malodorants in the headspace of and in solution in resting whole saliva determined organoleptically, 2) breath volatile sulfur compounds (VSC) measured with a sulfide monitor (Halimeter), 3) fresh and incubated saliva oxidation-reduction potential (E(h)) measured with a platinum electrode, and 4) level of saliva indolic compounds (IC), indole and skatole, determined colorimetrically with Kovac's reagent. The VSC, E(h), and IC data for the three mouthrinses were analyzed statistically by repeated measures ANOVA between groups, and by 2-way ANOVA within groups. Corresponding organoleptic data were analyzed by Kruskal-Wallis and Friedman non-parametric tests. RESULTS: Organoleptic, VSC, and E(h) evaluations clearly showed the zinc chloride/sodium chlorite test mouthrinse to be more effective than the other two rinses. In all cases, the level of significance was p < 0.001 between the test mouthrinse and its no zinc chloride/no sodium chlorite control; between test mouthrinse and the zinc chloride only product, significance was p < 0.05, < 0.001 and < 0.01 for the organoleptic, VSC, and E(h) tests, respectively. Noteworthy was the observation that the mean organoleptic saliva headspace score with the test mouthrinse was reduced to zero, and VSC levels fell below 50 ppb S by the end of the study, a level where the breath is usually non-odorous. The test mouthwash also appeared more effective in reducing the salivary IC levels, but the results did not reach significance at p < 0.05 unless IC levels were amplified in the saliva by incubation overnight at 37 degrees C. Correlations between the various procedures were highly significant, achieving in almost all cases a probability level of p < 0.001. CONCLUSION: The results supported the conclusion that the zinc chloride plus sodium chlorite mouthrinse (TriOral) is more effective in reducing oral malodor than a zinc chloride alone mouthrinse, and even more effective than its no zinc chloride/no sodium chlorite mouthrinse control. The methods used in this study were consistent with one another, and highly effective in measuring various parameters that characterize oral malodor.     

口腔卫生指导对慢性龈炎的临床疗效的影响

目的：探讨口腔卫生指导对慢性龈炎的临床疗效的影响。方法：采用随机分组法将100名慢性龈炎患者分为实验组和对照组。对照组行龈上洁治术和龈下刮治术,不作口腔卫生指导;实验组在龈上,下刮治后增加口腔卫生指导。分别于术后第1、2、4、12周通过探诊出血百分率来评价口腔卫生指导的效果。应用SPSS16.0软件对实验数据进行统计学分析。结果：在第1、2周,实验组与对照组相比探诊出血百分率无统计学差异（P〉0.05）,到第4、12周,实验组探诊出血百分率明显低于对照组,有统计学差异（P〈0.05）。结论：口腔卫生指导可以有效地控制探诊出血,从而影响慢性龈炎的远期临床疗效。     

Effects of oral prophylaxis including tongue cleaning on halitosis and gingival inflammation in gingivitis patients—a randomized controlled clinical trial

Objective

The objective of this study was to assess the effect of oral prophylaxis including tongue scraping on level of halitosis, clinical periodontal parameters and local cytokine response in gingivitis patients.

Materials and methods

In this randomized controlled clinical trial, 36 gingivitis patients were randomly assigned into two subgroups after scaling and polishing. Group 1 received oral hygiene instructions including the use of tongue scraper; group 2 received oral hygiene instructions alone without tongue cleaning. Levels of volatile sulfur compounds (VSC), organoleptic and tongue coating scores, clinical periodontal parameters and gingival crevicular fluid (GCF) samples were collected at baseline and 7 days after oral prophylaxis. GCF samples were analyzed using multiplexing analysis for the simultaneous measurements of cytokines. The Chi-square, Mann-Whitney U, Wilcoxon, and Student’s paired and unpaired t tests were used for statistical analysis.

Results

Statistically significant reductions were found in terms of clinical periodontal parameters in both groups. However, significant improvements in VSC levels, organoleptic and tongue coating scores were observed just in tongue scraping group. Moreover, the GCF levels of IL-1β and IL-8 significantly decreased after the treatment in group 1 according to the baseline values.

Conclusion

The present study indicated that oral prophylaxis including tongue scraping was effective in improving intra-oral halitosis and pro-inflammatory cytokine response in GCF in gingivitis patients.

Clinical relevance

The results suggest that tongue scraping can be taken into consideration in order to manage gingival inflammation as well as VSC levels in gingivitis patients but further clinical studies are required to judge the clinical relevance.

     

迈格牙科综合治疗仪牙周治疗的临床效果评价

目的：临床验证迈格牙科综合治疗仪（PR-ZH1）的安全性及有效性。方法：以PR-ZH1为实验组,对纳入的24例慢性牙周病患者采用split-mouth原则进行龈上龈下洁刮治,治疗结束记录疼痛指数VAS（verbal ana-logue scale,VAS）。在龈上洁治前及龈下刮治后1个月分别记录患者每个牙的各项临床指标,包括菌斑指数、牙龈指数、探诊出血指数、探诊深度和临床附着水平。并以奥丹超声治疗仪（Odontogain）作为对照进行对比分析。试验结果采用统计学软件SPSS 17.0进行统计学分析。结果：两组在龈下刮治术后1个月后,各项临床指标较试验前均有明显改善（P〈0.05）,但两组之间无显著差异。多数患者术中无不适感或仅略有疼痛,且两组患者的疼痛指数在统计学上无显著性差异。结论：PR-ZH1在临床牙周治疗中获得良好的治疗效果,并未对患者造成不适感。     

Association between oral malodor and adult periodontitis: a review

BACKGROUND: Bad breath has a significant impact on our daily social life to those who suffer from it. The majority of bad breath originates within the oral cavity. However, it is also possible that it can come from other sources such as gastric-intestine imbalance. The term "oral malodor" is used to describe a foul or offensive odor emanating from the oral cavity, in which proteolysis, metabolic products of the desquamating cell, and bacterial putrefaction are involved. Recent evidence has demonstrated a link between oral malodor and adult periodontitis. The process of developing bad breath is similar to that noted in the progression of gingivitis/periodontitis. Oral malodor is mainly attributed to volatile sulfur compounds (VSC) such as hydrogen sulfide, methyl mercaptan and dimethyl sulfide. The primary causative microbes are gram-negative, anaerobic bacteria that are similar to the bacteria causing periodontitis. These bacteria produce the VSC by metabolizing different cells/tissues (i.e., epithelial cells, leukocytes, etc.) located in saliva, dental plaque, and gingival crevicular fluid. Tongue surface is composed of blood components, nutrients, large amounts of desquamated epithelial cells and bacteria, suggesting that it has the proteolytic and putrefactive capacity to produce VSC. One of the challenges in dealing with oral malodor is to identify a reliable test for detecting bad breath. AIMS: The purposes of this review article were: (1) to correlate the relationship between oral malodor and adult periodontitis; (2) to analyze current malodor tests and discuss available treatment regimens.