甲壳胺影响细菌硫化氢代谢产物的研究

目的:观察甲壳胺对口腔细菌硫化氢产物的影响,评价甲壳胺的抗口臭作用.方法:选择3种口腔主要产臭菌:牙龈卟啉单胞菌、中间普氏菌、具核梭杆菌,分别接种于不含药物的液体培养基、含1%甲壳胺的液体培养基和含0.2%洗必泰溶液的液体培养基中,厌氧培养后,用硫化物测量仪分析3个菌种硫化氢代谢产物的变化.结果:3种细菌在不含药物的试管中有大量硫化氢生成,含1%甲壳胺的实验组和含0.2%洗必泰溶液的对照组试管中检测出硫化氢的量明显降低(P＜0.05).结论:甲壳胺能有效抑制产臭菌异味产物--硫化氢,实验为甲壳胺抗口臭的临床应用提供了可靠的实验依据.     

The proportion of pseudo-halitosis patients in a multidisciplinary breath malodour consultation

AIM: To report the data from a multidisciplinary bad breath consultation in Germany. MATERIALS AND METHODS: In this cross sectional study, 407 patients attending a bad breath consultation were examined by a specially trained dentist, with an ENT-specialist, an internist, and a psychologist on call. RESULTS: All patients reported suffering from bad breath but only 72.1% showed detectable signs of breath malodour. Within this group, 92.7% revealed an oral cause, 7.3% revealed an extra-oral cause. Within the group without malodour, 76.3% had received prior diagnostics and treatments from other doctors, whereby 36% had received one or more gastroscopies and 14% had undergone an ENT operation. In only ten cases had an organoleptic evaluation of the putative malodour been performed. CONCLUSION: Our data reveal that breath malodour is mainly of oral origin and that patients with pseudo-halitosis are frequently not diagnosed correctly by doctors, resulting in a considerable amount of over-treatment.     

挥发性硫化物口臭模型的建立

目的探讨采用挥发性硫化物(volatile sulfur compounds,VSCs)建立试验性口臭模型的可行性。方法36名健康自愿者含漱自制的"口臭造模液"(主要成分为VSCs)前后进行口腔VSCs检测,之后每隔1周重复测试1次,共测试4次。对每次造模前后口腔VSCs体积分数差异进行两样本配对的Wilcoxon秩和检验;对4次测试的基线值差异、4次测试的造模后口腔VSCs体积分数的差异分别进行Friedman秩和检验;对每次测试的基线和造模后口腔VSCs体积分数分别进行Spearman相关性检验。结果4次测试的基线和造模后口腔VSCs体积分数(×10-9)分别为90±61、688±340;100±69、662±303;94±52、684±290和82±54、602±293。每次造模后口腔VSCs体积分数均较基线值升高,差异有统计学意义(P<0.05)。4次测试的口腔VSCs体积分数基线值比较和4次测试的造模后口腔VSCs体积分数差异均无统计学意义(P>0.05)。每次测试获得的基线和造模后口腔VSCs体积分数存在正相关关系(P<0.05)。结论采用自制"口臭造模液"建立的试验性口臭模型稳定性好,可资后续的口臭防治相关产品开发时应用。     

No association between halitosis and upper gastrointestinal endoscopic findings: a prospective study

Aim: Previous studies have focused on the relationship between halitosis, gastroesophageal reflux disease and Helicobacter pylori. In this study we aimed to investigate the interaction between halitosis and whole endoscopic findings. Materials and Methods: Patients who previously had dyspepsia and had undergone endoscopic examination were included in the study. Symptoms of dyspepsia were investigated by means of a questionnaire that investigated halitosis. Patients who suffered from objective halitosis (confirmed by questions both to the patient and their relatives) were further investigated. Patients with known local or systemic causes of halitosis or structural disorders at endoscopy were excluded. Results: The study included 358 patients (121 males and 237 females) with dyspeptic symptoms. The patients with and without halitosis had mean ages of 39.4±13.5 and 43.1±14.9 years, respectively. The group of patients without halitosis were significantly older than the halitosis group (p< 0.05). Patients in the halitosis group had significantly higher frequencies of regurgitation, bloating and nausea (p< 0.05) when compared to patients without halitosis. Endoscopic findings, including esophagitis, open cardia, hiatal hernia, gastritis and duodenitis, were comparable in the two groups. Conclusion: The frequency of halitosis was high in patients with dyspepsia who underwent upper gastrointestinal endoscopy. Halitosis had a close relationship with several upper gastrointestinal symptoms, including regurgitation, nausea and bloating. There was no association between upper gastrointestinal endoscopic findings and halitosis.     

Inhibition of methionine gamma lyase deaminase and the growth of Porphyromonas gingivalis: A therapeutic target for halitosis/periodontitis

Background and objectivesPathogenic infections caused by Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia can result in the production of volatile sulfur compounds (VSC’s) and other toxic compounds from methionine catabolism that can lead to halitosis and periodontitis. Our aim is to block the activity of methionine gammalyase-deaminase (Mgld) of methionine catabolism to prevent halitosis/periodontitis.DesignsCloned, expressed, Mgld protein was tested for purity by SDS-PAGE and western blotting. Mgld activity was tested by UV–vis spectroscopy and DTNB assay. Effects of Mgld inhibitor propargylglycine (PGLY) was tested on P. gingivalis growth by turbidity measurements. The effects of PGLY on oral epithelial and periodontal ligament cells in culture at different concentrations and time were tested for cell viability by MTT and Live-Dead assays. Amino acid comparisons of Mgld from different oral pathogens were done using standard bioinformatics program.ResultsPropargylglycine (PGLY) inhibited purified Mgld activity completely. In vivo, PGLY is a potent inhibitor on the growth of the P. gingivalis over 24 h, grown at 25 °C and 37 °C. Correspondingly in vivo Mgld activity was also affected by PGLY. Amino acid comparisons of oral pathogens showed 100% identity on the key residues of Mgld catalysis. Mammalian oral cell lines with PGLY, showed no difference in cell death over untreated controls assessed by MTT and Live-Dead assays.ConclusionsPGLY arrest’s VSC’s production by P. gingivalis. Since initial Mgld activity is inhibited subsequent enzymatic and nonenzymatic products formed will be prevented. PGLY showed no toxicity towards cultured mammalian oral cells. Thus, PGLY can serve as a mouthwash ingredient to prevent halitosis/periodontitis.     

Gastric diverticulum and halitosis—A case for surgery?

INTRODUCTION

Gastric diverticulum is a rare and frequently asymptomatic condition. Symptoms include vague pain, fullness, dyspepsia, vomiting, hemorrhage and perforation. Occasionally, the patient can present with belching and oral fetor.

PRESENTATION OF CASE

We report a 58-year-old woman with a gastric diverticulum who was suffering from a socially disabling oral fetor. After a thorough evaluation, a laparoscopic resection of the diverticulum was offered and completed successfully. At follow-up, the oral fetor had disappeared. The patient had no complaints and regarded herself as cured.

DISCUSSION

Although indications for the treatment of asymptomatic patients remain to be defined, pharmacological therapies including protein pump inhibitors and histamine receptor blockers have been employed, with limited effects in patients with miscellaneous symptoms. Surgery is required when serious complications such as hemorrhage or perforation of the diverticulum occur.

CONCLUSION

Surgery is required when serious complications such as hemorrhage or perforation of the diverticulum occur. Therapy resistent social disabling oral fetor may add to the indications for surgery.     

Treatment of halitosis with photodynamic therapy in older adults with complete dentures: A randomized,controlled, clinical trial

BackgroundHalitosis of oral origin is mainly caused by the release of H₂S (hydrogen sulfide) by bacteria lodged on the tongue. Antimicrobial photodynamic therapy (aPDT) has been evaluated for the treatment of halitosis, but there are no previous reports of the use of this treatment modality in older people with dentures. The aim of the present study was to compare the effect of aPDT and tongue scraping (standard treatment) in older people with complete dentures diagnosed with halitosis (H2S gas concentration>112 ppb).MethodsThe participants were divided into two groups: G1- treatment with a tongue scraper (n = 20); G2- treatment with aPDT (n = 20). Halimeter testing was performed before and after treatments using gas chromatography and was repeated after seven days.ResultsAfter treatment, the group treated with aPDT had a lower mean concentration of H2S gas (18.5 ppb) than the tongue scraping group (185.3 ppb). After one week, the mean concentration of H2S increased to 218.2 ppb in the tongue scraping group and 39 ppb in the PDT group.ConclusionsBoth treatments were able to reduce the concentration of H2S but only treatment with aPDT was able to decrease halitosis to socially unnoticeable levels. Moreover, this normal breath condition remained for seven days only in the aPDT group.     

牙周病患者口臭的因素分析及伦理诊治策略

口臭是牙周病患者的主要伴发症状之一,直接影响患者的就医和治疗。对牙周病患者口臭的心理状态进行分析,建议采取：解释和引导;尊重和理解;鼓励和治疗;宣教和预防等策略,以应对患者的心理困惑。