妊娠对牙及牙周组织的影响

妊娠期发生的许多生理变化影响着人体,导致孕妇体内各器官和各系统均发生变化[1],其中包括口腔的变化[2]。本文对妊娠期牙及牙周的潜在变化作一论述,目的是使医务人员对这些变化引起足够的重视。一、妊娠对牙周组织的影响     

单侧完全性唇腭裂儿童牙周状态的临床评价

目的 探讨单侧完全性唇腭裂和无唇腭裂儿童的牙周状况差异.方法 选择5~6岁儿童60名,其中30例单侧完全性唇腭裂患儿为试验组,30名无唇腭裂儿童为对照组.检测特定部位牙齿的菌斑指数和牙龈指数.结果 试验组的平均菌斑指数为1.78±0.36,对照组为1.65±0.27,差异无统计学意义.试验组的平均牙龈指数为1.10±0.26,明显高于对照组的0.85±0.28(P<0.05).试验组前牙区菌斑指数为2.00±0.39,明显高于后牙区的1.78±0.36,前牙区牙龈指数为1.20±0.24,后牙区为1.10±0.26,差异无统计学意义(P>0.05).试验组中73.33%、对照组中80.00%的儿童检测到中度菌斑;但试验组后牙中度牙龈炎患儿占53.33%,高于对照组的30.00%(P<0.05).结论 在菌斑等量的情况下,单侧完全性唇腭裂儿童牙龈炎症更严重.     

数字化印模联合全瓷冠修复牙体缺损的临床疗效分析

目的: 分析数字化印模联合全瓷冠修复牙体缺损的临床疗效。方法: 选择2018年6月—2020年6月东风口腔医院120例牙体缺损患者,随机分为硅橡胶印模和数字印模2组,每组60例。硅橡胶印模组采用硅胶印模联合全瓷冠修复,数字印模组采用数字印模联合全瓷冠修复,观察2组的修复效果,牙体修复前、戴牙时和戴牙后6个月牙龈指数（GI）、牙周指数（PI）、邻面接触情况、咬合度合格率及不良反应。采用SPSS 22.0软件包对数据进行统计学分析。结果: 2组患者对修复体评价均选择A级和B级,数字印模组选择A级的人数多于硅橡胶印模组,但无显著差异（P>0.05）。戴牙后6个月,2组患者的GI、PI指数均增高,硅橡胶印模组显著高于数字印模组（P<0.05）。戴牙时和戴牙后6个月,数字印模组邻面接触合格率显著高于硅橡胶印模组（P<0.05）。戴牙时,数字印模组患者咬合度显著高于硅橡胶印模组（P<0.05）。戴牙后6个月,2组患者咬合度无显著差异（P>0.05）。制取模型时,数字印模组患者不良反应发生率显著低于硅橡胶印模组（P<0.05）。结论: 运用数字化印模联合全瓷冠对牙体缺损患者进行修复,能有效提高工作效率,改善患者GI、PI指数,提升牙体邻面接触及咬合度合格率,降低不良反应发生率。     

妊娠妇女牙髓炎过渡性治疗的临床观察

目的：观察一种既对胎儿无害又能使孕妇行使正常咀嚼功能的牙髓炎过渡性治疗手段。方法：选择妊娠妇女慢性牙髓炎36例，共36个患牙，用Ca(0H)2盖髓，观察整个妊娠期间患牙的临床反应。结果：94．4％的患者妊娠期间未出现自发痛和激发痛等不良反应。结论：用Ca(0H)2盖髓对患有慢性牙髓炎的孕妇恢复正常咀嚼功能是一种简便、有效、安全的暂时性治疗方法。     

牙周组织病

盐酸米诺环素微球凝胶的制备及对大鼠实验性牙龈炎的抑制作用；云南白药对比格犬牙龈炎的治疗作用；细胞凋亡相关基因Bcl-2和Bax在大鼠牙周膜改建中的作用；牙龈卟啉单胞菌膜泡诱导牙龈上皮细胞炎性反应的体外研究；派丽奥软膏辅助治疗慢性牙周炎的疗效观察     

固定矫治中牙周组织损伤的防治

作者对８０名牙　畸形患者采用固定矫治器矫正，对矫治前、中、后的牙周组织测定牙龈指数，并进行了口腔保健和牙周基础治疗，从而使矫治后牙列不仅美观整齐，而且牙周组织健康。     

牙周组织中成纤维细胞异质性的研究进展

牙周组织中的成纤维细胞包括牙龈成纤维细胞(gingival fibroblast,GF)和牙周韧带细胞(periodontal ligament cell,PDLC)。目前的研究表明:不但GF与PDLC之间存在异质性(heterogeneity),而且同一个GF或PDLC细胞群也是由不同的细胞亚型(subsets,subtypes,subpopulations)组成。本文综述了支持牙周组织成纤维细胞异质性的有关证据、表现及其生物学意义。     

牙周组织的增龄改变

一、牙龈的增龄变化:老年期牙龈的最大变化是牙龈缘萎缩和牙周袋加深,以及牙龈上皮层和固有层的变化。现在认为牙龈缘萎缩和牙周袋加深是由于牙齿表面沉积增殖的口腔菌斑的慢性感染,引起的进行性破坏所致。对牙龈上皮层和固有层的变化,有人曾对600天以上高龄大白鼠的牙龈做过观察,见到上皮层和上皮颗粒层以及角化层等萎缩。在固有层可见结缔组织细胞减少。但对58—64岁老年人牙龈的观察,除去上皮细胞数减少之外,一般看不到上皮层的角化、乳头层上部厚度、上皮突起的大小以及上皮细胞的有丝分裂等与增龄有什么关系。另外,     

牙周炎与不良妊娠结局相关关系的研究进展

牙周炎是由牙周致病菌感染引起的慢性炎症性疾病,在妊娠妇女中更容易发生。不良妊娠结局是新生儿围产期死亡的重要原因,受机体全身炎症的影响。该文主要对牙周炎与不良妊娠结局的相关性进行阐述,进一步从阴道感染、菌血症、免疫炎症和肠道菌群方面对其机制进行探讨,并简述了牙周炎与不良妊娠结局共有的宿主易感性遗传背景,以期为临床上预防妊娠期牙周病和不良妊娠结局提供一定的理论指导。     

Clinical changes in periodontium during pregnancy and post-partum

Background and Aim: Pregnancy has been presented to increase susceptibility to gingival inflammation. It is unclear whether pregnancy gingivitis exposes or proceeds to periodontitis. We examined longitudinally the severity of periodontal changes during pregnancy and post-partum, and compared the findings with an age-matched group of non-pregnant women.
Material and Methods: Thirty generally healthy, non-smoking women at an early phase of their pregnancy and 24 non-pregnant women as controls were recruited. The pregnant group was examined three times during pregnancy and twice during post-partum, and the non-pregnant group three times, once per subsequent month. At each visit, visible plaque index (VPI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were measured from six sites per tooth.
Results: In the pregnant group, BOP and PPD increased simultaneously without relation to plaque between the first and second trimesters, and thereafter decreased during subsequent visits. No changes were detected in CAL during the study period. In the non-pregnant group, BOP stayed invariable during the follow-up and correlated with the amount of plaque. Neither periodontal pocket formation nor significant changes in attachment levels were observed.
Conclusion: Based on this study, changes in clinical parameters during pregnancy are reversible, indicating that pregnancy gingivitis does not predispose or proceed to periodontitis.     

Self-reported gingival conditions and self-care in the oral health of Danish women during pregnancy

OBJECTIVES: The purpose of the present study was to describe the self-assessment of gingival health conditions in pregnant women, their oral hygiene behaviour and dental visiting habits, and to analyse self-care practices of pregnant women in relation to perceived gingival problems. MATERIAL AND METHODS: The study group comprised 1935 pregnant women living in two areas of Denmark consecutively recruited from August 1998 to March 1999. The survey data were based on telephone interviews. Questions in the interview concerned general health, lifestyles, socioeconomic conditions, gingival conditions, oral hygiene and utilisation of dental health services. RESULTS: One-third of the study population perceived signs of gingival inflammation; 5% of the pregnant women assessed their gingiva as poor, while 95% reported good or "normal" gingival condition. Ninety six per cent brushed their teeth at least twice a day and nine out of 10 were regular users of the dental-care system. Twenty-seven per cent of those women with pregnancy gingivitis responded to the symptoms by, for example, seeing a dentist or intensifying the oral hygiene habits. CONCLUSION: Despite a high level of self-efficacy among the pregnant women as for oral health and oral health care combined with a high level of oral hygiene and dental visiting habits, there seems to be a substantial need for increased awareness of gingival oral health.     

The effect of periodontal dressings on the healthy periodontium

Twenty-seven proprietory periodontal dressings were applied to the lower labial segments of 18 subjects showing low levels of gingival inflammation when assessed by the Gingival Index system at the time of application. Specimens of each dressing type were subsequently removed at intervals ranging from 3 h to 5 days. The material adhering to the deep surface of the dressing was examined by light, transmission and scanning electron microscopy and was shown to be a complex heterogeneous structure consisting of large intact epithelial cell sheets and oral bacteria in a proteinaceous matrix. Possible mechanisms which could contribute the epithelial cell and protein components to this structure were discussed. It was concluded that the dressings themselves caused little damage to the normal periodontium but could be associated with increased levels of inflammation at longer time intervals because of bacterial growth. The significance of these findings to current clinical practice is discussed.     

Drugs and the periodontium

The periodontium and periodontal disease activity can be affected by systemic drug therapy. Many drugs can have an adverse effect on the periodontium, i.e., gingival hyperplasia. Alternatively, some drugs can modify the inflammatory and immunological responses of the periodontal tissues to bacterial plaque. The aim of this review is to evaluate the effects of drug therapy on the periodontium and periodontal disease activity, and where possible, to relate such changes to the pharmacodynamics of the drugs considered. Drugs which have been reported to affect the periodontium can be categorised as follows: anti-epileptics, immunosuppressants, corticosteroids, non-steroidal anti-inflammatory drugs and hormones. Those drugs whose pharmacodynamics are clearly established and which affect the rate of periodontal disease activity, may provide information on the mechanisms of periodontal destruction. Finally, the mechanisms of drug-induced gingival hyperplasia (overgrowth) are discussed in relationship to the drugs' pharmacodynamics and pharmacokinetics.     

Relationship between Campylobacter rectus and periodontal status during pregnancy

INTRODUCTION: In a previous study, we showed that the growth of Campylobacter rectus is stimulated by the presence of female sex hormones in the culture medium. In the present study, we examined the relationship between C. rectus levels in the saliva and the periodontal status of pregnant women. METHODS: Unstimulated whole saliva was collected from 22 pregnant and 15 non-pregnant women. Periodontal pocket depth (PD) and bleeding on probing (BOP) were recorded. A quantitative real-time polymerase chain reaction was performed to determine the concentrations of suspected periodontopathogenic bacteria in the saliva samples. In addition, the concentration of estradiol in the saliva samples was measured by enzyme immunoassay. RESULTS: The average age, number of teeth, and total number of bacteria in the saliva of subjects in both groups were similar. The percentage of sites with a PD = 4 mm and the salivary estradiol concentrations were significantly higher in pregnant women than in non-pregnant women. In addition, the percentage of BOP sites and the C. rectus levels in the saliva of the pregnant women tended to be higher than in non-pregnant women, although these differences were not statistically significant. There were positive correlations between C. rectus levels and estradiol concentrations, and between C. rectus levels and the percentage of sites with PD = 4 mm in the pregnant women. CONCLUSION: These results indicate that C. rectus levels are higher in the oral flora of pregnant women and that this may be associated with increased salivary estradiol concentrations. This may contribute to periodontal disease progression during pregnancy.     

Influence of sex hormones on the periodontium

OBJECTIVES: Sex hormones have long been considered to play an influential role on periodontal tissues, bone turnover rate, wound healing and periodontal disease progression. The objectives of this review article are to (1) address the link between sex hormones and the periodontium, (2) analyse how these hormones influence the periodontium at different life times and (3) discuss the effects of hormone supplements/replacement on the periodontium. MATERIALS AND METHODS: Two autonomous searches were performed in English language utilizing Medline, Premedline and Pubmed as the online databases. Publications up to 2002 were selected and further reviewed. In addition, a manual search was also performed including specific related journals and books. RESULTS: It is certain that sexual hormones play a key role in periodontal disease progression and wound healing. More specifically, these effects seem to differentiate by gender as well as lifetime period. In addition, the influence of sex hormones can be minimized with good plaque control and with hormone replacement. CONCLUSION: Despite profound research linking periodontal condition with sex hormones kinetics, more definitive molecular mechanisms and therapy still remain to be determined.     

Relationship between gingival inflammation and painfulness of periodontal probing

The relationship of gingival inflammation to the pain associated with periodontal probing was assessed at baseline (B), and 1 month (1M) and 3 months (3M) later in 46 subjects. At each of the 3 sessions, clinical measures of gingival inflammation included an observational gingival index and bleeding score. In addition, periodontal probings of all existing teeth was performed with a constant force probe (25 g). Following completion of the probing at each session, subjects rated the global painfulness of the probing using a visual analog scale for pain. Results of this study showed that judged painfulness of probing was related to clinical inflammation (bleeding score) at baseline and 1 month and suggest that the degree of periodontal inflammation is related to the pain and discomfort associated with periodontal probing.