实验性龈炎的临床观察和龈沟液量的分析

目的　观察实验性龈炎发展过程中的临床表现及龈沟液 (GCF)量的变化 ,探讨GCF量与牙龈炎症发生和发展的关系。方法　选取 11名受试者 ,在其停止口腔卫生措施后 2 1d内 (第 0、7、14、2 1天 )和恢复口腔卫生措施 1周后 (第 2 8天 )记录临床指标的变化 ,并且测量GCF量 (每人测18颗牙 )。结果　在实验性龈炎发展过程中 ,各项临床指标 (菌斑指数、出血指数、牙龈指数、探诊深度 )和GCF量在基线时数值较低 ,停止刷牙后随着菌斑量的不断增多而逐渐上升 ,恢复刷牙后又下降到接近基线水平。GCF量与各项临床指标均为显著正相关。结论　临床指标和GCF量在基线、停止刷牙和恢复刷牙 1周后随菌斑量的改变而存在显著差异 ,反映了牙龈炎症的形成和发展过程     

P.gingivalis level in gingival crevicular fluid before and after supragingival scaling by electrochemical method

目的 观察龈上洁治术后临床指标及龈沟液中牙龈卟啉单胞菌含量的变化.方法 选取30例慢性龈炎患者,采集洁治术前、后患牙的龈沟液,以健康的第一磨牙为对照,应用电化学测菌法分别检测治疗前后龈沟液中牙龈卟啉单胞菌的数量,同时记录临床指标,包括菌斑指数、牙龈指数、探诊深度.结果 龈上洁治术前患牙与健康对照牙龈沟液牙龈卟啉单胞菌的绝对数量有显著差异性(P<0.05);龈上洁治术后慢性龈炎患者临床指标菌斑指数、牙龈指数、探诊深度均有明显下降(P<0.05);龈上洁治术后龈沟液中牙龈卟啉单胞菌的绝对数量亦有明显下降(P<0.05).结论 龈沟液内牙龈卟啉单胞菌含量变化临床指标一致,可以反映洁治效果.     

口腔冲洗器治疗冠桥修复体龈炎的疗效分析

目的观察口腔冲洗器治疗冠桥修复体龈炎的疗效。方法用随机方法对67例冠桥修复体龈炎患者进行临床研究。治疗一组22例,常规刷牙加使用口腔冲洗器护理口腔,治疗二组23例,只使用口腔冲洗器作口腔护理,对照组22例,常规刷牙作口腔护理。1个月后复查疗效。结果冠桥修复体龈炎经口腔冲洗器治疗1个月后,牙龈指数、菌斑指数均有明显下降,治疗组与对照组疗效有显著性差异(P<0．05)。结论使用口腔冲洗器能控制冠桥修复体龈炎,有效改善牙龈健康。     

固定矫治器对牙龈状况与龈沟液中内毒素含量影响的研究

目的：探讨固定矫治对牙龈状况的影响和有效控制牙龈炎症的方法。方法：将临床就诊采用固定矫治器进行治疗的患者作研究对象，临床就诊的100例患者，分别于矫治前，矫治后1、3、6个月，矫治结束前，结束后3个月的牙龈炎症指数，龈沟液细菌内毒素进行测试比较，统计学处理。结果：1)牙龈炎症指数：固定矫治器戴于后1个月牙龈指数最高，3个月后趋于稳定，此时牙龈炎症指数接近正常，6个月后至矫治结束时基本无明显变化，矫治结束后3个月牙龈组织恢复完全正常；2)细菌内毒素：细菌内毒素含量与牙龈炎症指数呈正相关关系。结论：1)固定矫治器对牙龈组织的健康有一定的影响，但患者只要掌握正确的刷牙方法，养成良好的口腔卫生习惯，就可以是牙龈组织的炎症得到有效控制。2)固定矫治过程中的牙龈炎性反应同细菌内毒素含量有非常密切的正相关关系，而细菌内毒素是G^-菌的裂解产物，故对于固定矫治过程中出现的牙龈炎症，可以应用对G^-菌有效的抗菌素进行有效控制。     

局部涂抹雅皓乳膏对重症龈炎的临床疗效

目的:探讨雅皓乳膏对重症龈炎的疗效.方法:选择临床诊断为重度菌斑相关性牙龈炎的患者10例,随机分为实验组和对照组,每组30个牙.采取直接将乳膏涂抹患处的方法,2次/d,受试者治疗全程统一使用不含任何抗菌斑药物成分的爽箭牙膏和欧乐-B牙刷刷牙,在实验的第1、3、5天对龈炎指数、龈沟出血指数、菌斑指数进行检查,同时在第1、5天取患牙龈缘菌斑样本,进行微生物学观察.结果:实验组的临床指标明显改善,且与对照组相比有显著的统计学差异(P＜0.001),实验组的疗效优于阴性对照组.刚果红涂片染色显示实验组球菌数量增加,螺旋体、弯曲菌和杆菌数量下降,菌斑中细菌组成趋于正常,表明雅皓乳膏对牙周致病菌有抑制作用.结论:雅皓乳膏局部涂抹并配合刷牙等机械口腔清洁措施对于重症龈炎有一定的疗效.     

洁治术前后龈沟液中牙龈卟啉单胞菌含量与疗效的关系

目的观察龈上洁治术后临床指标及龈沟液中牙龈卟啉单胞菌含量的变化。方法选取30例慢性龈炎患者,采集洁治术前、后患牙的龈沟液,以健康的第一磨牙为对照,应用电化学测菌法分别检测治疗前后龈沟液中牙龈卟啉单胞菌的数量,同时记录临床指标,包括菌斑指数、牙龈指数、探诊深度。结果龈上洁治术前患牙与健康对照牙龈沟液牙龈卟啉单胞菌的绝对数量有显著差异性(P0.05);龈上洁治术后慢性龈炎患者临床指标菌斑指数、牙龈指数、探诊深度均有明显下降(P0.05);龈上洁治术后龈沟液中牙龈卟啉单胞菌的绝对数量亦有明显下降(P0.05)。结论龈沟液内牙龈卟啉单胞菌含量变化临床指标一致,可以反映洁治效果。     

固定矫治错患者牙周维护中龈下微生物的变化

目的 探讨固定矫治中0.12％氯已定溶液漱口对龈下微生物的影响。方法 选择龈炎明显的48例10-17岁固定矫治患者,经龈上洁治后随机分为生理盐水漱口(对照组)、口腔卫生宣教加生理盐水漱口(NS组)、口腔卫生宣教加0.12％氯已定漱口(CH组)3组,镜下比较洁治前及洁治后1周、1个月和3个月时龈下微生物(球菌、杆菌、螺旋体)比例的变化。结果 对照组和NS组的球菌比例先升后降,螺旋体的比例变化相反;CH组4次的检测结果,球菌比例呈升高状态,螺旋体呈下降趋势。对照组和CH组洁治后3个月检测,球菌和杆菌比例变化的差异有显著性(P<0.05)。结论 用0.12％氯已定溶液漱口对龈下微生物的变化有良性影响,有助于正畸患者牙周健康的维护。     

青春期龈炎龈下菌斑中牙龈卟啉单胞菌的牙龈蛋白酶K的表达

目的:检测并比较青春期龈炎的牙龈卟啉单胞菌(P.gingivalis)临床分离株的分泌蛋白和菌体蛋白中牙龈蛋白酶K(Kgp)的表达强度,揭示Kgp与青春期龈炎之间可能存在的致病关系。方法:受试对象为14～17岁青春期龈炎患者36例,检测并记录受检者的各牙周指数GI、SBI和PD测值,取龈下菌斑进行P.gin-givalis的分离培养,16SrRNAPCR法鉴定。将P.gingivalis临床分离株于对数生长期末提取分泌蛋白和菌体蛋白,用抗KgpN-末端IgG亚基的单克隆抗体进行Westernblot检测,采用SPSS11.0软件包,秩相关检验分析Kgp的表达强度与各牙周指数之间的相关关系。结果:青春期龈炎的P.gingivalis临床分离株的分泌蛋白和菌体蛋白中,KgpN-末端IgG亚基的表达强度与各牙周指数数值的高低有正相关关系,统计学上有显著性差异(P<0.01)。结论:Kgp对青春期龈炎有一定的致病作用。     

口腔卫生宣教和强化刷牙对学龄前儿童口腔卫生的影响

目的研究口腔卫生宣教和强化刷牙对学龄前儿童口腔卫生的影响。方法以全口牙平均菌斑指数(PLI)为指标,比较实验组和对照组的强化卫生宣教和强化刷牙前后儿童口腔菌斑指数的变化。结果半年后的检查结果对照组平均菌斑指数为3.14±0.53,实验组为2.71±0.56,两者差异显著(P=0.012);实验组在强化卫生宣教和强化刷牙前后全口平均菌斑指数分别为3.23±0.51和2.71±0.56,两者有显著性差异(P=0.002)。结论口腔卫生宣教和强化刷牙有助于提高儿童的口腔卫生。     

大鼠实验性牙周炎中牙龈卟啉单胞菌rgpB和kgp变化的研究

目的:通过建立大鼠实验性牙周炎模型,检测不同时段大鼠上颌第一磨牙龈下人工定植的牙龈卟啉单胞菌、牙龈素rgpB和kgp相对含量的改变,动态观察牙周炎发展不同阶段牙龈卟啉单胞菌致病基因的变化。方法:选择6周的成年雄性大鼠13只,应用钢丝结扎法和细菌种植法建立大鼠实验性牙周炎模型。分别在4周和8周取上颌第一磨牙龈下菌斑,提取细菌DNA,应用PCR方法进行牙龈卟啉单胞菌、牙龈素基因rgpB和kgp特异引物扩增,应用SPSS13.0统计软件,分析大鼠牙周炎不同时段rgpB和kgp的相对变化。结果:大鼠实验性牙周炎模型,龈下菌斑中牙龈卟啉单胞菌的相对含量实验组明显高于对照组,8周组高于4周组;实验组牙龈卟啉单胞菌牙龈素rgpB和kgp明显高于对照组,4周组和8周组rgpB和kgp相对含量无显著性差异。结论:rgpB基因和kgp基因与牙周炎的致病性有关而与牙周炎的严重程度可能无直接相关。     

The influence of gingival stimulation on recovery from human experimental gingivitis

The present study concerns an investigation carried out to determine the effects of gingival stimulation on the resolution of a human experimental gingivitis. 10 young male dental students participated in the experiment. Following the baseline examination (day 0), the participants were instructed to abstain from all oral hygiene procedures during a 21-day period. Heavy plaque accumulation and gingivitis developed during the 21-day induction period. On the evening of the 21st day, active oral hygiene measures were reinstitued, for an 8-day period, using 2 different methods. For the left side of the maxillary arch, a hygiene procedure including gingival stimulation was prescribed. On the other hand, for the right side, a hygiene method without gingival stimulation was instituted. On both sides of the upper arch, the gingival condition was assessed by means of the gingival index, and soft deposits were assessed by the plaque index (selected teeth: 13, 14, 15, 23, 24, 25). Measurements were performed on days 0, 21, 22, 23, 24, 25, 26, 27, 28, 29. On day 29, ideal oral hygiene conditions and gingival health were re-established on both sides. However, a statistical analysis of the data collected during the recovery period revealed that gingival index scores were temporarily, but significantly, higher on the side where mechanical stimulation was performed, although plaque deposits there decreased more rapidly. Thus the present work supports the idea that gingival stimulation does not in any way improve recovery from experimental gingivitis.     

Oral hygiene compliance and gingivitis expression in cigarette smokers

The compliance with an oral hygiene intervention program and its effect on oral cleanliness and gingivitis was studied in smokers and non-smokers. The study group represented patients with regular dental attendance. It comprised 68 patients 21-60 yr of age, including 28 habitual smokers. The program included toothbrushing with an electric toothbrush for 12 months. Oral cleanliness was evaluated according to a percentage plaque index and gingivitis according to the percentage of bleeding sites. The compliance with the oral hygiene program was very high among smokers and non-smokers. Plaque index at baseline was very similar in smokers and non-smokers and remained so during the course of the investigation. Following the introduction of the oral hygiene program, plaque index decreased in both groups, and there were no statistically significant differences between the two groups. In spite of the similarity in plaque index, gingival bleeding was significantly lower in smokers than non-smokers. The results suggest that smokers and non-smokers do not differ with respect to habitual oral hygiene or compliance with hygiene programs. In smokers, however, the clinical gingivitis expression in response to plaque is suppressed.     

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。     

Oral hygiene compliance and gingivitis expression in cigarette smokers

Abstract – The compliance with an oral hygiene intervention program and its effect on oral cleanliness and gingivitis was studied in smokers and non-smokers. The study group represented patients with regular dental attendance. It comprised 68 patients 21-60 yr of age, including 28 habitual smokers. The program included toothbrushing with an electric toothbrush for 12 months. Oral cleanliness was evaluated according to a percentage plaque index and gingivitis according to the percentage of bleeding sites. The compliance with the oral hygiene program was very high among smokers and non-smokers. Plaque index at baseline was very similar in smokers and non-smokers and remained so during the course of the investigation. Following the introduction of the oral hygiene program, plaque index decreased in both groups, and there were no statistically significant differences between the two groups. In spite of the similarity in plaque index, gingival bleeding was significantly lower in smokers than non-smokers. The results suggest that smokers and non-smokers do not differ with respect to habitual oral hygiene or compliance with hygiene programs. In smokers, however, the clinical gingivitis expression in response to plaque is suppressed.     

Effect of two new chlorhexidine mouthrinses on the development of dental plaque, gingivitis, and discolouration. A randomized, investigator-blind, placebo-controlled, 3-week experimental gingivitis study

OBJECTIVE: The aim of this experimental gingivitis study was to assess the efficacy and safety of two new chlorhexidine (CHX) mouthrinses. MATERIAL AND METHODS: Ninety volunteers participated in this investigator-blind, randomized, clinical-controlled trial in parallel groups. During the treatment period, no oral hygiene measures except rinsing with non-alcoholic 0.2% CHX or 0.2% CHX/0.055% sodium fluoride mouthrinses, a positive control, or a negative control were permitted. The primary parameter was the gingival index; the secondary parameters were plaque index, discolouration index, and bleeding on probing. Clinical examinations were conducted 14 days before the start of the study, at baseline, and after 7, 14, and 21 days. The two sample t-test, anova, and ancova were used for the statistical analysis. RESULTS: No difference in efficacy was found between the two new CHX formulations and the positive control. On day 21, statistically significantly less gingival inflammation and plaque accumulation compared with placebo were observed. Besides discolouration and taste irritations, no adverse events were recorded. CONCLUSION: The two new CHX mouthrinses were able to inhibit plaque re-growth and gingivitis. Neither the omission of alcohol nor the supplementation with sodium fluoride had weakened the clinical efficacy of CHX with respect to the analysed clinical parameters.     

Clinical and microbial evaluation of a histatin-containing mouthrinse in humans with experimental gingivitis: a phase-2 multi-center study

OBJECTIVE: P-113, a 12 amino acid histatin-based peptide, was evaluated in a mouthrinse formulation for safety and efficacy in a phase 2 multi-center clinical study. METHOD: 294 healthy subjects abstained from oral hygiene procedures and self-administered either 0.01% P-113, 0.03% P-113 or placebo mouthrinse formulations twice daily over a 4-week treatment period. During this time, the safety, anti-gingivitis, and anti-plaque effects of P-113 were evaluated. RESULTS: There was a significant reduction in the change from baseline to Day 22 in bleeding on probing in the 0.01% P-113 treatment group of the intent to treat population (p=0.049). Non-significant trends in the reduction of the other parameters were observed in this population (p> or =0.159). A sub-group of subjects which developed significant levels of disease within the four-week timeframe of the study was identified based on baseline gingival index scores > or =0.75. Significant findings were observed for bleeding on probing, gingival index and plaque index within this population (p<0.05). There were no treatment-related adverse events, and there were no adverse shifts in supragingival microflora during the study. Significant amounts of the peptide were retained in the oral cavity following rinsing. CONCLUSION: These data suggest that P-113 mouthrinse is safe and reduces the development of gingival bleeding, gingivitis and plaque in the human experimental gingivitis model.     

Quantification of gingival edema using a new 3-D laser scanning method

OBJECTIVES: The aim of the study was to investigate the suitability of measuring volume differences in the gingival tissue for monitoring changes in the inflammatory status of the gingiva. MATERIALS AND METHODS: Data for this investigation were obtained from a mouthrinse evaluation which was performed as a 4-week, double-blind, placebo-controlled, cross-over study in which localised experimental gingivitis was induced. 24 volunteers were enrolled in the study. Only the data from the placebo period of each subject were used in the current investigation. During the plaque accumulation periods, plaque guards were worn during routine performance of oral hygiene measures to prevent any plaque removal from the experimental area (1st and 2nd premolars and molars in one upper quadrant). Clinical examinations with assessment of plaque and gingivitis were performed on days 0, 4, 7, 14, 21, 28 and 42. Volume differences in the gingival papillae were determined between day 0 and days 21, 28, and 42, and between days 28 and 42 by taking measurements from replicas of the respective clinical situations using a 3-D laser scanner and reference-free automated 3-D superimposition software. Data were analysed with the Wilcoxon signed ranks test. RESULTS: Plaque accumulation in the experimental area resulted in a highly significant increase (p<0.001) of inflammation of the gingival papillae. The mean (standard deviation) papillary GI at baseline was 0.23 (0.34) as compared to 1.22 (0.27) and 1.2 (0.31) on days 21 and 28, respectively. The mean increase in volume of all papillae as compared to baseline was 25,478 micrometer3 after 21 days and 24,210 micrometer3 after 28 days. After resuming a normal oral hygiene regimen, mean volume of the papillae decreased between days 28 and 42 by 19,250 micrometer3. CONCLUSION: With this novel method, gingival papillary edema can be quantified in vivo from replicas of the clinical situation.     

Observations on the initial stages of healing following human experimental gingivitis A clinical and morphometric study

The aim of the present study was to investigate stereologically the histologic alterations occurring during gingival healing after experimental gingivitis and to compare clinical parameters with histological findings. 8 dental students volunteered for the investigation. After a prophylaxis, they performed optimal oral hygiene to reach mean plaque and gingival indices approaching zero. They then abolished all oral hygiene procedures for a period of 21 days. After this experimental gingivitis phase, they again performed optimal oral hygiene for 8 days to restore gingival health. At days 0, 1, 2, 4 and 8 after experimental gingivitis, the plaque index (PlI), the gingival index (GI) and the gingival exudate flow rate (GEFR) were assessed and their buccal gingiva was biopsied. Point counting procedures were performed at 2 different levels of magnification on light microscopic sections to estimate the volume fractions of epithelium, infiltrated and non-infiltrated connective tissue, and collagen. The relative numbers of fibroblasts, polymorphonuclear neutrophils, lymphocytes, plasma cells and macrophages were estimated by counting the number of profiles of these cells in a specific connective tissue area adjacent to the apical end of the junctional epithelium. A rapid drop in the PlI was noted with increasing time after oral hygiene, followed by a slower decrease in the GI and GEFR scores. The histological picture during the entire experiment was that of an initial gingival lesion. At day 0, no chronic inflammation of the gingiva characterized by a predominance of plasma cells was observed.(ABSTRACT TRUNCATED AT 250 WORDS)     

Crevicular fluid levels of interleukin-1alpha and interleukin-1beta during experimental gingivitis in young and old adults

The purpose of the present investigation was to study the effect of age on interleukin-1alpha (Il-1alpha) and interleukin-1beta (Il-1beta) production during experimental gingivitis. One group of five young subjects (20-22 years old) and another group of five older subjects aged 61-65 years were involved in the study. A professional plaque control programme was undertaken to establish healthy gingival conditions at baseline. The examination included the mesiobuccal sites of the Ramfjord teeth (16, 21, 24, 36, 41, 44). Clinical measurements and gingival crevicular fluid (GCF) samples were obtained at baseline, at 21 days of no oral hygiene and one week later after professional cleaning and re-establishment of oral hygiene procedures. Results showed significant differences between the two groups with regard to the amount of plaque accumulation clinical signs of gingival inflammation and GCF volume all of which proved to be more pronounced in the older group. The laboratory data presented a remarkable increase of Il-1alpha levels at day 21 for both groups which were significantly reduced at day 28. For the older adults group the Il-1beta values increased significantly at day 21 and recovered at day 28. For the young adults group these values, despite a small statistically insignificant progressive increase at day 21, remained at low levels during the experimental process. This was the only difference in the cytokines values between older and young adults. It was concluded that low Il-1beta levels observed in the young adults group might explain the less pronounced clinical signs observed during the development of gingivitis in the younger subjects.