口臭与牙周炎及舌苔的相关性研究

目的　探讨口臭及口气中挥发性硫化物 (volatilesulphurcompounds ,VSCs)与牙周炎及舌苔的相关性 ,舌在口臭及VSCs产生中的作用。方法　选择 6 0例全身健康、有口臭的牙周炎患者 ,鼻闻法检查口臭程度 ,使用便携式口臭测量仪分别测量清除舌苔前后的VSCs量。记录牙周袋探诊深度(probingdepth ,PD)及PD≥ 4mm位点比例 ,出血指数 (bleedingindex ,BI) ,菌斑指数 (plaqueindex ,PLI)及舌苔厚度与面积。结果　Spearman相关分析法显示 ,口臭值、VSCs量与BI、PLI、舌苔厚度存在明显的正相关性 (P <0 0 1) ,与舌苔面积也有关系 (P <0 0 5 )。口臭值与PD及PD≥ 4mm位点比例无关 ,VSCs量与PD及PD≥ 4mm位点比例存在一定的相关性 (r=0 2 6 ,P <0 0 5 )。清除舌苔可以明显降低VSCs量 (t=10 15 ,P <0 0 1) ,其减少量与舌苔厚度及面积均有明显相关性 (P <0 0 1)。结论　口臭值、VSCs量与BI、PLI及舌苔均有关系 ,而牙周袋PD只与VSCs量有关系 ;虽然清除舌苔可以明显降低VSCs量 (降低 36 7% ) ,但由于存在如何完全彻底清除舌苔的问题 ,所以舌与牙周炎在口臭及VSCs形成中的作用尚需进一步研究。

The relationship between oral malodor, VSCs levels in the mouth air with periodo ntitis and tongue coating

OBJECTIVE: To assess the relationship between oral malodor, volatile sulphur compounds (VSCs) levels in the mouth air and periodontal index; the role of tongue in the production of VSCs and halitosis. METHODS: 60 periodontitis patients with oral malodor were included. Oral malodor was estimated by organoleptic method (organoleptic rating, OR); VSCs level measurements before and after cleaning the tongue coating were made with a portable sulphide monitor (halimeter), respectively; periodontal probing depth (PD) and the proportion of PD >/= 4 mm sites, bleeding index (BI) and plaque index (PLI) were examined; tongue coating was estimated with thickness (Tt) and area (Ta) on the dorsal surface of tongue. RESULTS: The correlation was analyzed with Spearman method. There was a significantly positive correlation between OR, VSCs levels and BI, PLI, and Tt, respectively (P < 0.01). OR and VSCs levels was also related with Ta (P < 0.05). There was a weakly correlation between VSCs levels and PD, and the proportion of PD >/= 4 mm sites (r = 0.26, P < 0.05). No correlation between OR and PD, and the proportion of PD >/= 4 mm sites was existed. Reduction of VSCs levels after cleaning tongue coating was statistically significant (t = 10.15, P < 0.01), and also significantly related with thickness and area of tongue coating (P < 0.01). CONCLUSIONS: In present study, OR and VSCs levels were significantly correlated with gingival inflammation (BI), condition of oral hygiene (PLI), and tongue coating. The relationship between OR, VSCs levels and periodontal probing depth was not found obviously. VSCs levels were significantly reduced after cleaning tongue coating, but the percentage of reduction was less than that of the previous studies.