妊娠期口腔急症的临床考量

妊娠期是口腔疾病患病和治疗的特殊时期,妊娠期发生的口腔急症需得到恰当的处置。一方面,孕妇生理环境、个人习惯的改变增加了部分口腔疾病的易患性;另一方面,为了保证孕妇和胎儿安全,临床治疗策略局限。孕妇应掌握口腔健康知识、增强口腔保健意识。口腔医生应在“孕前预防,孕期治标,孕后治本”的原则下,根据不同的妊娠时期制定合适的治疗方案,以最安全、简单、有效的手段控制急症、防止疾病进展,避免对孕妇和胎儿的不良影响。防治结合,让孕妇和口腔医生共同维护妊娠期口腔健康。本文围绕妊娠期治疗原则,对妊娠期口腔急症治疗的时机选择、临床管理和不同疾病的治疗策略等进行了总结。     

妊娠期口腔疾病患者的治疗

随着医疗保健知识的普及,很多人认识到牙周炎等感染性疾病可致胎儿发育异常甚至流产。目前,越来越多的准备怀孕的女性主动到口腔诊室进行潜在牙病处理及口腔保健。怀孕后发生的一系列生理变化,可引发或加剧口腔疾患,并在妊娠各时期出现。对于孕妇的常规口腔疾病治疗,国内传统观点与国外最新观点在检查、治疗、预防宣教等多方面存在不同。口腔医生如何评价孕妇和胎儿的生理指标？在保证孕妇和胎儿安全前提下,如何提供口腔疾病的有效救治？本期争鸣栏目邀请以下几位专家,就妊娠期患者口腔疾病治疗时机的选择、诊疗方案的确定以及孕婴生理指标的评价进行探讨。     

口腔疾病对心脏疾病的影响

本文从细菌性心内膜炎、风湿性心脏病、冠心病、心律失常、心肌梗塞等几方面介绍了口腔疾病对心脏疾病的影响,这种影响对于内科医生与口腔医生都是有意义的。研究表明:口腔疾病与心脏病存在着千丝万缕的联系,而大部分是由口腔不洁和感染所引起,其中绝大多数是完全可以预防的。     

阻塞性睡眠呼吸暂停低通气综合征与口腔疾病关系研究进展

阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）是一种常见的睡眠障碍性疾病，其是睡眠过程中发生的呼吸系统疾病，长时间上气道多个水平的间断阻塞，这种异常通气方式通常伴随夜间打鼾、睡眠障碍和白天异常精神行为等症状。OSAHS涉及全身多个系统的器官组织，是医学领域重要的交叉学科内容，与口颌系统更是紧密相关。因此，文章就OSAHS与口腔疾病关系研究进展做一综述，以提高口腔医生对OSAHS的认知，为OSAHS患者口腔疾病的预防及治疗提供更好的临床指导和帮助。     

外泌体与口腔疾病关系的研究进展

外泌体是由各种类型的细胞分泌的多形性囊泡样小体,其中含有蛋白质和RNA等多种成分,具有抗肿瘤免疫、促血管新生等生理功能,并且与口腔疾病密切相关.外泌体可作为口腔癌、口腔黏膜病、唾液腺疾病等口腔疾病诊断的生物标志物,还有作为口腔癌候选抗癌疫苗的可能.本文主要就外泌体及其与口腔疾病的关系作一综述.     

口腔疾病患者唾液中超氧化物歧化酶含量测定的初步观察

<正> 超氧化物歧化酶(SOD)是一种氧自由基(O~-_2)清除剂,是保护机体的重要酶系统之一。已有不少报道 O~-_2及 SOD 与炎症、衰老、致癌、致突变的关系密切。但有关口腔疾病与 SOD 的关系,迄今国内尚未见报道。为了探讨 SOD 与口腔疾病的关系,我们对某些常见口腔疾病患者唾液中 Cu.Zn—SOD 含量作了初步观察,现     

潜江地区妊娠妇女口腔疾病及健康知识的调查

目的：调查潜江地区妊娠期妇女口腔卫生状况及其对口腔卫生知识掌握情况。方法：对我院产科门诊孕妇随机抽样130例进行口腔卫生检查及健康教育知识调查。结果：本地区妊娠期妇女口腔疾病患病率79.23%,其中牙龈炎患病率为65.38%,龋齿患病率为60.77%,两病同时患病率为30.00%,主动保健率为6.92%,对口腔健康知识知晓率为43.08%。结论：本地区妊娠期妇女口腔卫生状况欠佳,虽对相关卫生知识有一定了解,仍需加大口腔健康教育宣传力度。     

幽门螺旋杆菌与口腔疾病

幽门螺旋杆菌与慢性胃炎及消化性溃疡密切相关 ,但最近研究发现与某些口腔疾病亦有一定关系。本文从阐述幽门螺旋杆菌的生物学性状、诊断技术、流行病学及抗幽门螺旋杆菌治疗入手 ,综述了幽门螺旋杆菌与口腔疾病的关系 ,为从系统因素出发研究口腔疾病提供一条新思路     

噬菌体对口腔疾病发生发展和治疗的影响及机制

噬菌体是特异性感染细菌、真菌等微生物的病毒,是人类口腔生态系统中具有特异性的重要组成部分.在口腔微生物群落、牙菌斑和咽峡部微生物群落中均匀分布有多种噬菌体,与细菌群落相互作用,维持着口腔微生态系统的稳定.许多研究显示,噬菌体与口腔疾病的发生发展相关,并且在相关口腔疾病的治疗中发挥重要作用.本文对噬菌体在口腔微生物群落中的分布特点及其在口腔疾病发生发展和治疗的作用和机制进行综述,旨在为相关口腔疾病的发病机制及临床治疗提供新的思路.     

噬菌体对口腔疾病发生发展和治疗的影响及机制

噬菌体是特异性感染细菌、真菌等微生物的病毒,是人类口腔生态系统中具有特异性的重要组成部分.在口腔微生物群落、牙菌斑和咽峡部微生物群落中均匀分布有多种噬菌体,与细菌群落相互作用,维持着口腔微生态系统的稳定.许多研究显示,噬菌体与口腔疾病的发生发展相关,并且在相关口腔疾病的治疗中发挥重要作用.本文对噬菌体在口腔微生物群落中的分布特点及其在口腔疾病发生发展和治疗的作用和机制进行综述,旨在为相关口腔疾病的发病机制及临床治疗提供新的思路.     

口腔卫生师的职业与职责

口腔卫生师(hygienist)是口腔医疗卫生保健的特殊职业,是口腔卫生保健的专业人才,是口腔疾病预防的主力,作为口腔医学的重要组成部分,组成了口腔医疗的基本结构单元.口腔卫生师有明确的职业特征和社会属性,在大众的口腔医疗卫生保健中发挥独特的重要作用.口腔卫生师通过口腔卫生宣教,提高大众的口腔健康素质和修养;通过口腔照...     

白斑脱落粘膜上皮细胞与组织上皮细胞微核率相关性分析

目的 检测口腔白班患者脱落粘膜细胞微核细胞率及相应组织细胞微核细胞率,并进行相关性分析,为将该项指标应用于口腔白斑的治疗和判断预后提供依据。方法 采用Ｆｅｕｇｌｅｎ染色方法,对５９例单纯增生、３２例轻和中度异常增生性白斑及２８例重度异常增生性白斑和口腔鳞癌患者的口腔脱落粘膜细胞和组织上皮细胞微核进行了检测,同时检测了１００例健康人的口腔脱落粘膜细胞微核作为正常对照。结果 口腔白斑患者脱落粘膜细胞微     

Two-year incidence of oral disadvantage,a measure of oral health-related quality of life

Dental research has progressed from describing the burden of oral disease using traditional epidemiologic measures of incidence and prevalence, to measuring how oral disease, oral signs, and oral symptoms affect the daily activities and the overall quality of life of the individual. However, longitudinal evaluation of these associations remains rare. OBJECTIVES: To (i). describe the 2-year incidence and patterns of oral disadvantage; (ii). identify dimensions of oral health measures that are significant antecedents of oral disadvantage; and (iii). determine which oral health dimensions are the most strongly predictive of oral disadvantage. METHODS: The Florida Dental Care Study was a longitudinal study of oral health in diverse groups of persons who at baseline had at least one tooth and were 45 years or older. Incidence rates, odds ratios, and 95% confidence intervals were used to describe oral disadvantage and its relation to other measures of oral health. RESULTS: Nearly one-half of the participants experienced oral disadvantage at least once during 24 months of follow-up. The strongest antecedents associated with oral disadvantage were toothache pain and chewing difficulty. CONCLUSIONS: The incidence of oral disadvantage is substantial and consistent with the notion that oral health has a substantial impact on quality of life. Measures of oral pain and oral functional limitation were more strongly predictive of oral disadvantage than disease and tissue damage antecedents.     

Aromatase expression in normal human oral keratinocytes and oral squamous cell carcinoma

Aromatase is the enzyme that catalyzes the conversion of androgen to oestrogen. Aromatase expression in extra-gonadal sites and local oestrogen synthesis play an important role in the physiological conditions and in the growth of certain neoplasms. OBJECTIVE: The purpose of this study was to investigate aromatase expression in oral keratinocytes and oral squamous cell carcinoma (SCC). DESIGN: Immunocytochemistry and RT-nested PCR were used to detect aromatase protein and mRNA expression in primary human oral epithelial cell culture and in an oral SCC cell line. Immunohistochemistry was used to detect aromatase protein expression in frozen and archival human tissue sections of normal oral epithelium and oral SCC. RESULTS: Cytoplasmic immunostaining was found in normal oral keratinocytes and SCC cells in culture. The common coding region of aromatase mRNA was detected in the oral keratinocytes derived from five different normal individuals and in the SCC cell line. However, there were variations in aromatase exon 1 expression among normal oral keratinocyte samples. Cytoplasmic staining was found in normal oral epithelium and well-differentiated oral SCC but not in poorly differentiated oral SCC by immunohistochemistry. CONCLUSION: Aromatase was expressed in normal oral keratinocytes and oral SCC both in cell culture and in tissues, indicating local oestrogen synthesis in normal and neoplastic conditions of oral epithelium.     

口腔健康行为的影响因素

个体的口腔健康行为直接影响到个体的口腔健康状况。而个体的口腔健康行为受个体因素、家庭因素和社会因素等的影响。口腔健康教育和口腔健康促进就是通过改善人群的口腔健康行为,达到改善人群的口腔健康状况的根本目的。所以,只有深刻认识口腔健康行为的各种影响因素,才能为更好地实施口腔健康教育和口腔健康促进提供依据。本文对口腔健康行为的影响因素作一综述。     

器官型口腔黏膜感染模型在宿主-微生物关系研究的应用与展望

构建体外口腔黏膜感染模型有助于研究口腔黏膜感染性疾病的发病机制与防治策略。器官型口腔黏膜感染模型以组织工程化口腔黏膜为基础,通过引入病原体提取物、接种浮游微生物或与细菌生物膜、唾液共培养,在体外模拟口腔微生物与宿主的相互作用。近年来,学者们通过该技术研究微生物对口腔黏膜疾病和牙周疾病的发生、发展作用及致病机理。本文将对器官型口腔黏膜感染模型的建立、研究进展与应用前景等进行阐述。     

抗氧化蛋白Prx1在口腔黏膜白斑中的表达

目的检测抗氧化蛋白Prx1和DNA氧化损伤标记物8-OHdG在口腔黏膜白斑中的表达,探讨Prx1在口腔黏膜白斑中的作用。方法选择40例口腔黏膜白斑,包括单纯增生10例,白斑伴上皮轻度异常增生15例,白斑伴上皮中度异常增生15例,正常口腔黏膜10例。采用免疫组织化学染色方法,分别检测Prx1、8-OHdG在黏膜中的表达。结果口腔黏膜白斑伴上皮中度异常增生组Prx1和8-OHdG染色的MOD值均高于正常组、白斑单纯增生组、白斑伴上皮轻度异常增生组,且差异有统计学意义(P0.01)。结论 Prx1与口腔黏膜白斑的发病有关,口腔黏膜白斑的发生可能与氧化损伤有关。     

口腔微生物与口腔鳞状细胞癌关系的研究进展

口腔微生物群落在人类微生物群落和人类健康中发挥着重要作用,微生物与宿主的不平衡可导致口腔疾病和全身疾病。一些肿瘤已经被认为与细菌等微生物的存在相关,口腔肿瘤和微生物的关系也被逐渐认识。本文对口腔鳞状细胞癌与口腔微生物之间的关系进行综述,阐述口腔微生物导致口腔鳞状细胞癌发生的可能途径以及口腔鳞状细胞癌微环境对微生物的影响,为口腔微生物与肿瘤关系的进一步研究提供参考,以实现口腔鳞状细胞癌早期诊断,甚至辅助治疗的目的。     

Oral disadvantage among dentate adults

Abstract Oral disadvantage can be defined as the avoidance of certain daily activities because of decrements in oral health. These decrements include oral disease and tissue damage, pain, and functional limitation. The Florida Dental Care Study (FDCS) is a longitudinal study of changes in oral health, which included at baseline 873 subjects who had at least I tooth, were 45 years old or older, and who participated for an interview and clinical examination. Three objectives of the FDCS are: (1) to describe selected psychometric properties of the measurement of oral disadvantage; (2) to describe oral disadvantage in a diverse sample of dentate adults; and (3) to describe the relationship between disadvantage and other aspects of oral health, such as disease/tissue damage, pain, and functional limitation. The prevalence of oral disadvantage within the previous 6 months, using eight self-reported measures, ranged from 5% to 25%, depending upon the measure. Factor analysis suggested that oral disadvantage is best described as three factors: disadvantage due to (1) oral disease/tissue damage, (2) oral pain, and (3) oral functional limitation. Irregular dental attenders, poor persons, and blacks had the highest prevalence of oral disadvantage. Clinical measures of oral disease/tissue damage, self-reported measures of oral disease/tissue damage, oral pain, and oral functional limitation were strongly associated with the presence of oral disadvantage. In multivariate analyses that accounted for differences in clinical measures of disease/tissue damage, self-reported disease/tissue damage, oral pain, and oral functional limitation, females were more likely to report disadvantage due to disease/tissue damage, and middle-aged persons and irregular dental attenders were more likely to report oral disadvantage due to pain. In these same regressions, differences in disadvantage due to race, poverty status, socioeconomic status, and rural/urban area of residence were not evident. These results have implications regarding the use of oral disadvantage to assess the long-term effectiveness of dental care.     

儿童口腔健康认知和行为对其口腔健康状况的影响

目的: 调查上海市儿童口腔健康认知、行为及其口腔健康现状,分析影响儿童口腔健康的因素。方法: 采用儿童口腔健康调查问卷和中文版儿童口腔健康相关生存质量量表（child oral health impact profile,COHIP）,对上海市城区2018年12月—2019年2月期间的387名小学生进行问卷调查。采用SPSS 24.0软件包,通过描述性、单因素和多因素分析法对结果进行统计学分析。结果: 上海市城区6~9岁儿童的口腔健康认知情况总体较好,但口腔健康行为一般。387名儿童中,患龋率为57.4%,口腔健康状况一般。相关性分析和回归分析显示,儿童口腔健康行为与口腔健康认知呈正相关（r=0.260,P<0.05）,与口腔健康状况的积极影响和消极影响呈负相关 （r=-0.333,-0.181,P<0.05）;而儿童口腔健康认知对口腔健康状况的影响无统计学差异（P>0.05）。结论: 儿童口腔健康行为习惯越好,对口腔健康状况的积极影响越大。对儿童开展口腔健康教育时,应注重口腔健康行为模式培养,以达到促进口腔健康的目的。