下颌前牙种植单端桥的临床效果分析

目的:探讨下前牙缺失伴间隙不足采用种植单端固定桥修复的临床效果。方法:选取下前牙缺失,拟行种植义齿修复的单端及双端固定桥病例30例,收集并记录制取模型前种植体动度数据,以及戴入修复体后0、3、6、12月种植体PD值、附着水平及GCF体积变化值,通过数据整理分析探讨下前牙种植体单端固定桥的临床效果。结果:下前牙单端种植桥及双端种植桥组间比较PD值、附着水平、GCF体积变化无统计学差异,同种设计组内比较,差异不具有统计学意义。结论:对于下前牙缺失伴间隙不足不能进行双种植体修复的病例,采用单端种植桥设计后合理设计修复体,其后期具有较稳定的临床效果,降低损伤及患者经济负担,值得临床推广应用。     

Effects of smoking on clinical parameters and the gingival crevicular fluid levels of IL-6 and TNF-alpha in patients with chronic periodontitis

OBJECTIVE: Smoking is an important environmental risk factor for the initiation and progression of periodontal diseases. The aim of this study was to evaluate the effects of smoking on clinical parameters and the gingival crevicular fluid (GCF) contents of the pro-inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) levels in patients with chronic periodontitis. MATERIAL AND METHODS: The study base consisted of 41 patients including 22 volunteer current smokers with an age range of 32-59 (44.41+/-7.88) years and 19 volunteer non-smokers with an age range of 36-59 (46.94+/-6.07) years. The first month after non-surgical periodontal therapy was accepted as the baseline of the study. The clinical parameters including plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL) were recorded and GCF samples were collected for analysis of GCF contents of IL-6 and TNF-alpha levels. At the 3rd and 6th months, all of these procedures were repeated. RESULTS: In smokers, only CAL was significantly higher at the 3rd month compared with non-smokers (p<0.05). GI and BOP were higher in non-smokers than smokers in both periods (p<0.05). PI showed increases from the initial to the 6th month in smokers (p<0.05). Although the differences between two groups with regard to IL-6 and TNF-alpha were not significant (p>0.05), the total amount of TNF-alpha in GCF decreased from the initial to the 6th month in smokers (p<0.05). There were no significant correlations between the mean total amount of IL-6 and TNF-alpha in GCF and clinical parameters in both evaluation periods in smokers (p>0.05). CONCLUSION: The present study demonstrated that cigarette smoking increases the amount of dental plaque over time in smokers and does not influence GCF contents of IL-6 and TNF-alpha.     

牙周洁治对人牙周炎袋底微生物和龈沟液量的影响

目的:探讨牙周洁治对人牙周炎袋底微生物和龈沟液量的影响,为研究牙周洁治机制提供依据。方法:选60例牙周炎患者,随机分为2组,每组30例,洁治组作牙周洁治,对照组用常规漱口液漱口,分别在治疗前、治疗后1周和治疗后1月用刚果红负性染色法观察袋底微生物的变化,并测定牙周探诊深度(PD)、龈指数(GI)和龈沟液量(GCF)的变化。结果:洁治组在洁治后1周时牙周袋底的球菌比率明显增加,杆菌和螺旋体比率及PD和GCF明显降低;对照组GI轻度降低,但PD和GCF以及袋底的球菌、杆菌、螺旋体比率无明显变化;洁治组和对照组的球菌、杆菌和螺旋体比率及PD、GI和GCF均有显著性差异。洁治后1月时PD、GI和GCF量及袋底的微生物比率与洁治1周时无显著性差异。结论:牙周洁治对人牙周炎袋底微生物有明显的改善作用,可通过减少袋底致病菌比率和降低PD以减轻牙周炎症和减少龈沟液的分泌。     

Interleukin-1 alpha, interleukin-8 and interferon-alpha levels in gingival crevicular fluid

Cytokines play an important role in the pathology associated with chronic inflammatory diseases. We measured the total amounts [picograms (pg)] and concentrations (pg/μl) of interleukin-1 alpha (IL-lα), interleukin-8 (IL-8) and interferonalpha (IFN-α) in 20 s gingival crevicular fluid (GCF) samples obtained from 2 diseased and 2 healthy sites in 20 subjects with periodontitis, and from 2 healthy sites in 20 subjects without disease. Both the mean amount and concentration of IL-lα were significantly higher (p < 0.001) in diseased sites compared to healthy sites in subjects with disease. The results for IL-8 and IFN-α differed depending on the method of reporting. Whereas the amount of IL-8 was significantly higher (p < 0.01) in diseased sites, the mean concentration of IL-8 was lower compared to healthy sites. The mean amount of IFN-α was similar in health and disease; however, the concentration of IFN-alpha was significantly lower in diseased sites (p < 0.001) corresponding to the significant increase in crevicular fluid volume (p < 0.001). There were no significant differences in the amount or concentrations of the 3 cytokines between healthy sites from subjects with disease and healthy sites from healthy controls. The total amounts of both IFN-α and IL-8 were correlated between healthy and diseased sites in subjects. These data suggest that, while the disease status of a site is the major determinant of the levels of these cytokines locally, subjects with high levels of IL-8 and IFN-α in healthy sites also tend to have high levels of these cytokines in diseased sites. Finally, both the concentrations and total amounts of IL-8 and IFN-α were significantly correlated in diseased sites, suggesting that levels of these two cytokines rise or fall in tandem. The combination of decreased IL-8 and decreased IFN-α concentrations at diseased sites may reflect the reduced anti-bacterial host defense activity at that site.     

Detection of, and anti-collagen antibody produced by, CD5-positive B cells in inflamed gingival tissues

This study was performed to investigate the frequency and distribution of CD5-positive (CD5+) B cells in inflamed gingival tissues using flow cytometric and immunohistochemical analyses. The ability of CD5+ B cells to produce anti-type I collagen antibody was also examined. CD5+ B cells expressed "low" fluorescence intensity in the peripheral blood of both healthy subjects and patients with adult periodontitis. However, in inflamed gingival tissues the intensity of this surface marker was high. The percentage of B cells bearing CD5 surface marker was statistically higher in gingiva than in peripheral blood obtained from both the patients and healthy subjects. These CD5+ B cells were observed in gingival subepithelial connective tissues from the bottom to the middle of the periodontal pocket. This area showed destruction of collagen fibers and dense cell infiltrations. Anti-collagen IgG antibody level in patients' gingival crevicular fluids (GCF) was higher than that in sera from healthy subjects, and slightly higher than in autologous sera. IgM anti-collagen antibody in GCF was lower than in autologous sera and in sera from healthy subjects. EBV-transformed CD5+ B cells produced considerably more IgM and IgG antibody to collagen than CD5- B cells. Therefore CD5+ B cells may contribute to the pathogenesis of inflamed gingival tissues.     

A new ultrasensitive chemiluminescent assay for the site-specific quantification of alkaline phosphatase in gingival crevicular fluid

The search for markers of periodontal disease activity and progression has accelerated over the last decade, in an effort to replace existing subjective clinical measures of periodontal health status. Research is being aimed at establishing more objective and quantitative methodology, capable of rapid diagnosis prior to the appearance of clinical signs of destructive disease. Such tests need to be sensitive enough to evaluate individual periodontal sites in health as well as disease states. We report the development of a new chemiluminescent assay for the enzyme alkaline phosphatase, that is capable of quantifying the enzyme in sub-microliter volumes of gingival crevicular fluid and serum. The technique will measure alkaline phosphatase (ALP) whilst immobilised on paper strips, without the need for an elution stage. It is simple, versatile and amenable to chair-side use. We discuss in detail the assay procedure and have examined levels of ALP in 11 adult volunteers with clinically healthy periodontal tissues. The mean ALP concentration was 2135 IU/L for GCF and 183 IU/L for serum, a 12-fold difference. There also appeared to be an "oral pattern" of enzyme distribution in healthy periodontal sites, with levels being higher in the anterior region of the mouth and highest in the lower anterior region.     

Differential expression of CR3, FcɛRll and FcγRlll on Polymorphonuclear leukocytes in gingival crevicular fluid

Polymorphonuclear leukocytes (PMNLs) are the most numerous cell population among the cellular infiltrates in gingival crevicular fluid (GCF) and play important roles in the host-defensive system in the gingival crevices. We determined the percentage of neutrophils, cosinophils and basophils in total PMNLs by light microscopic observation using Randolph-methylene blue staining, then assessed flow cytometric differences in the expression of CR3, FcγRIII, FcɛRII. LFA-1α, and LFA-Iβ on PMNL in GCF and peripheral blood (PB) from 21 patients with adult periodontius (AP) and 13 healthy donors. Percentages of basophils and eosinophils were higher in GCF than in PB. In both AP patients and healthy subjects, expression of CR3 and FcɛRll was higher while FeγRIII was lower in GCF than in PB. The statistical analysis showed that the expressions of FcγRIII and FcɛRII on GCF PMNLs were lower in AP patients than in healthy subjects. Expressions of LFA-1α and β on GCF were similar to those on PB PMNLs. PB PMNLs stimulated in vitro with Porphyromonas gingivalts culture supernatant and fMLP displayed an expression pattern of CR3, FcγRIII and FcɛRII on GCF PMNLs. However, C5a and IL-I failed to induce changes in FcγRIII and FcɛRII. The results indicate that GCF neutrophils are activated, present enhanced adhesion and a decreased IgG-binding ability which would reflect that they are at the terminal stage of activation, and that GCF contains a larger eosinophil fraction than in PB. Moreover, these GCF eosinophils appear to be activated.     

RNA干扰GCF2基因沉默对人肝癌BEL-7404细胞侵袭能力的影响

目的 探讨沉默GCF2基因表达对人肝癌BEL-7404细胞侵袭能力的影响.方法 实验分为GCF2-siRNA组、NC-siRNA组及MOCK组,GCF2-siRNA组转染靶向GCF2基因的RNA干扰序列GCF2-siRNA,阴性对照组转染阴性对照序列NC-siRNA,MOCK组不转染任何序列.将靶向GCF2基因的RNA干扰序列 (GCF2-siRNA) 瞬时转染BEL-7404细胞以沉默GCF2表达,采用CCK-8法检测细胞增殖活性,体外侵袭实验检测细胞侵袭能力,Western blot检测基质金属蛋白酶(MMP)-9及GCF2靶基因MMP-23蛋白表达.结果 转染GCF2-siRNA使GCF2表达下调,后者导致BEL-7404增殖受阻;GCF2-siRNA组的穿膜细胞数较阴性对照组(NC-siRNA)及未转染组(MOCK)明显减少(穿膜细胞数分别为41.5±0.95、61.3±1.57、64.5±1.65,P<0.05);MMP-9和MMP-23蛋白表达较两个对照组明显下降(P<0.05).结论 下调GCF2表达能抑制BEL-7404侵袭能力, 提示GCF2促进肝癌细胞的侵袭可能是其参与肝癌发展进程的重要途径.     

复方多西环素缓释凝胶对实验性牙周炎龈沟液IL-4和 TNF-α的影响

目的：研究复方多西环素缓释凝胶对实验性牙周炎大鼠牙龈指数（ GI）、牙周袋深度（ PD）、附着丧失程度（AL）及龈沟液中白介素-4（IL-4）和肿瘤坏死因子-α（TNF-α）水平的影响。方法选用Wister大鼠42只,随机分为3组：正常对照组（N组）,阳性对照组（C组）和实验组（T组）,每组14只。 C组和T组建立牙周炎模型后,C组给米诺环素软膏治疗,T组给复方多西环素缓释凝胶治疗,均为每周上药1次共4次,并分别在治疗前和治疗后记录GI、PD、AL及龈沟液中IL-4和TNF-α水平。结果治疗后,C组和T组GI、PD、AL均较治疗前显著下降（ P ＜08．05）。牙周炎大鼠龈沟液中IL-4水平显著低于正常组（ P ＜0．05）,治疗后显著增高（ P ＜0．05）,且T组明显高于C组（ P ＜0．05）;牙周炎大鼠龈沟液中TNF-α水平显著高于正常组（ P ＜0．05）,治疗后显著降低（ P ＜0．05）,T组和C组治疗后差异无统计学意义（ P ＞0．05）。结论复方多西环素缓释凝胶能明显改善牙周炎临床症状,显著降低龈沟液中TNF-α水平,提高龈沟液中IL-4水平。