Severe periodontitis is associated with the serum levels of hypersensitive C reactive protein and lipoprotein-associated phospholipase A2 in the patients of acute ischemic stroke

BackgroundPeriodontitis is associated with the pathogenesis of atherosclerotic plaque, and hypersensitive C reactive protein (hs-CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) are the serum biomarkers of the stability of atherosclerotic plaque. Whether periodontitis is associated with the serum level of hs-CRP and Lp-PLA2 of acute ischemic stroke remains unclear.Material and MethodsWe recruited 103 cases with acute ischemic stroke within 7 days after stroke onset. Pocket depth and clinical attachment loss were assessed by oral examination to define the severe periodontitis. Demographic information including gender, age and body weight index, income level, education level, past medical history include smoking history, drinking history, ischemic stroke history, coronary heart disease, hypertension, diabetes and hyperlipidemia were collected, and serum biomarkers including white blood cell (WBC), fibrinogen, total cholesterol (TC), triglyceride (TG), lower density lipoprotein (LDL-C), high density lipoprotein (HDL-C), hs-CRP, HemoglobinA1c (HbAlc), Homocysteine (HCY) and Lp-PLA2 were tested.Results65 (63.1%) cases were diagnosed as severe periodontitis. Severe periodontitis group showed more male, age, drinking history, higher levels of hs-CRP and Lp-PLA2. Multivariate logistic regression showed that severe periodontitis was were significantly associated with hs-CRP (OR = 2.367, 95%CI: 1.182–4.738; P = .015) and Lp-PLA2 (OR = 2.577, 95% CI: 1.010–6.574; P = .048).ConclusionsSevere periodontitis is independently associated with the serum Level of hs-CRP and Lp-PLA2 in patients with acute ischemic stroke. Whether the improvement of periodontitis could decrease the occurrence and re-occurrence of ischemic stroke by stablizating atherosclerotic plaque need be further studied in future.     

Case of autoimmune neutropenia with severe marginal periodontitis

Early onset periodontitis is rarely seen in infants, though often leads to an acute and serious clinical course when encountered in such patients. Autoimmune neutropenia presents systemic and dental symptoms, as depressed resistance to bacterial infection is caused by a disorder that reduces the number of neutrophils. This disease can result in not only gingival inflammation but also destruction of periodontal tissues, such as attachment loss, alveolar bone absorption, and early tooth loss in primary as well as mixed dentition. Here, we report treatment of a child with marginal periodontitis from the age of 3 years–7 years 9 months. No systemic manifestations were noted until 3 years of age, thus the patient had never received a detailed examination or medication related to the disease. Following examinations at our department, we referred the patient to a pediatrician at our university hospital for possible systemic disease, who made a diagnosis of autoimmune neutropenia. Although administration of antibiotics and professional dental care were continued, neutrophil count was not increased and progressive periodontal destruction was observed. Extraction of teeth with poor prognosis was performed and a prosthetic strategy for the missing teeth developed. It is important to recognize that periodontitis along with autoimmune neutropenia can appear in infants, even though the incidence is quite low. Early detection and early treatment of this disease is necessary for delaying progression of periodontitis and optimal occlusal induction of permanent teeth.     

维生素D受体基因多态性与汉族人群慢性牙周炎易感性的关系

目的 探讨维生素D受体(VDR)基因多态性与汉族人群慢性牙周炎(CP)易感性的关系。方法 收集汉族轻、中、重度CP患者共166例及80名无牙周炎对照者的颊黏膜拭子，以Chelex-100法提取DNA，采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法测定VDR BsmI、VDR ApaI和VDR TaqI的基因型，分析组间基因型分布和等位基因频率的差异。结果 轻、中、重度CP患者中VDR ApaI等位基因A携带者明显多于对照组，重度CP与中度CP、重度CP与轻度CP患者间VDR ApaI基因型的分布差异均有统计学意义，中度CP与轻度CP患者间VDR ApaI基因型分布差异无统计学意义，而VDR BsmI、TaqI位点的基因型分布在患者组和对照组间差异无统计学意义。结论 VDR ApaI等位基因A可能与汉族人群CP的易感性有关。     

90例慢性牙周炎临床分析

目的评价不同治疗方法对慢性牙周炎的临床效果。方法对90例慢性牙周炎患者,随机分成三组:龈上洁治术 抗生素组(A组),单纯龈上洁治术组(B组)和单纯抗生素组(C组)。分别给予不同的治疗,在治疗后1周、2周和4周记录牙周袋探诊深度(PPD)、探诊附着水平(PAL)、菌斑指数(PLI)、龈沟出血指数(SBI)。结果治疗1周和2周后各指标显著减轻(P<0.05),2周比1周减轻更明显(P<0.05),4周与2周比较无明显差异(P>0.05),A组各指标减轻比B组显著(P<0.05);B组比C组疗效显著(P<0.05)。结论A组作用优于B组(P<0.05),B组优于C组(P<0.05)。     

高压氧对人重症牙周炎牙龈血流量、血流速度和血浓度作用及机理研究

目的 :探讨高压氧 (HBO)对人重症牙周炎牙龈血流量 (GBF)、血流速度 (BCV)和血浓度 (BC)的作用及HBO治疗牙周炎的机理。方法 :选自口腔中心门诊的 3 0例重症牙周炎患者 ,随机分为二组 ,即治疗组和对照组 ,治疗组用HBO治疗 ,对照组用漱口液漱口。用激光多普勒血流仪测定二组治疗前后的GBF、BCV和BC。结果 :HBO能使牙周炎患者GBF增加 2 .1倍 ,BCV增加 6.7倍 ,BC降低为治疗前的 5 8.2 % ,与对照组比均有非常显著性差异 (P <0 .0 1)。结论 :HBO能使牙周炎患者GBF和BCV增加 ,BC减少 ,能改善牙龈微循环 ,对治疗牙周炎有积极意义     

Association of natural tooth loss with genetic variation at the human matrix Gla protein locus in elderly women

Natural tooth loss represents a major medical issue within the elderly population, since it impairs masticatory function critical for oral intake of essential nutrition. Contribution of genetic factors has been implicated in the determination of natural tooth loss; degree of reduction in number of natural teeth remaining intact (NTI) varies among individuals; thus, heterogeneity in NTI might reflect genetic variation within the population. One candidate gene, the matrix Gla protein gene (MGP), has been implicated in the pathogenesis of bone loss through a repression of bone/tooth formation. We have investigated a possible association between the CA repeat polymorphism at the human MGP gene locus and the NTI in 458 elderly Japanese women. In 916 chromosomes tested, ten alleles of the polymorphic nucleotide repeat were observed (designated A1–A10), among which five alleles were regarded as major alleles to be tested for the association. Twenty-seven women who possessed an A6 allele (164 bp) had significantly higher NTI than the remaining participants (n=431), who did not carry an allele of that size (mean: 10.0 teeth vs 5.6 teeth; P=0.007, Mann-Whitney test). An eight-year longitudinal follow-up study of NTI suggested that the genetic variations at the MGP locus did not affect the rate of tooth loss in the elderly period. These results suggest that genetic variation at the MGP gene locus is associated with some determinants for tooth loss in elderly women.     

尼美舒利对大鼠实验性牙周炎防治作用的评价

目的： 评价尼美舒利对实验性牙周炎的防治效果，探讨前列腺素与牙周炎发病的关系，为牙周炎临床治疗的联合用药提供依据。方法： Sprague-Dawly大鼠120只，随机分成4组。正常对照组及各实验组分别于4、5和8周末分批处死动物。在处死动物前测量各时点的牙龈指数，通过组织学方法观察各组动物牙周组织的病理学改变，用Tiger细胞图像分析仪测量牙周附着丧失情况。结果： （1）大鼠经丝线结扎4周后成功复制出牙周炎模型。（2）实验性牙周炎组，4周时牙龈指数明显高于正常对照组(P<0.01)，附着丧失明显高于正常对照组(P<0.01)。组织学观察到牙周组织出现明显的病理改变，并且牙周组织破坏程度随着时间的推移逐渐加重。（3）尼美舒利预防组牙龈指数和附着丧失明显低于牙周炎组(P<0.01)，组织学观察到牙周组织的炎症较轻，牙槽骨未见明显破坏吸收。（4）在实验性牙周炎形成后，尼美舒利治疗组自第5周开始给予尼美舒利治疗，5周和8周末时牙龈指数和附着丧失明显低于牙周炎组(P<0.01)，8周时牙龈指数和附着丧失降低尤为明显。结论： 预防性给予尼美舒利，可有效阻止实验性牙周炎的发展；在牙周炎发生后，给予尼美舒利治疗，能有效降低牙周组织的炎症和破坏程度。     

大鼠实验性牙周炎一氧化氮含量改变的研究(英文)

目的：通过建立大鼠牙周炎实验模型，测量牙龈组织中亚硝酸盐(NO2-)和硝酸盐(NO3-)的含量，比较一氧化氮(NO)含量与附着丧失(AL)的关系，探讨NO在牙周炎病理进程中的作用。 方法： 健康Sprague-Dawley大鼠共72只，随机分为两组：正常对照组和牙周炎组，每组36只。参照Di Paola法复制大鼠牙周炎动物模型。分别于术后1、4和8周时处死动物，每个时点每组处死的动物数为12只。采用分光光度仪测量大鼠牙龈组织中亚硝酸盐（NO2-）和硝酸盐(NO3-)的含量，以间接确定NO含量；采用组织切片法观察牙周组织的组织学改变；应用Tiger细胞图像仪测量AL。 结果： 术后4周和8周时，实验性牙周炎组牙龈组织NO2-/NO3-含量明显高于正常对照组(P<0.01)；在牙周炎组，术后8周牙龈组织NO2-/NO3-含量明显高于术后4周(P<0.01)。在牙周炎组，术后4周和8周与术后1周比较，AL显著增加(P<0.01)；术后8周与4周比较，AL显著增加(P<0.01)。 结论： 牙周炎组牙龈组织NO2-/NO3-含量明显高于正常对照组；NO2-/NO3-含量与牙周组织的AL直接相关。结果表明NO在牙周组织的炎症和破坏过程中发挥作用，提示在牙周炎的治疗中控制NO具有临床应用价值。