光动力疗法辅助治疗轻中度牙周炎的疗效观察

目的:探讨光动力疗法(PDT)辅助治疗轻中度牙周炎患者的临床疗效。方法:选取我院2016年1月-2017年8月收治的轻中度牙周炎患者46例为研究对象,共选取患牙276颗,随机分为观察组与对照组,每组138颗患牙,对照组予以龈下刮治术和根面平整术(SRP)治疗,观察组在对照组的基础上联合PDT治疗,比较治疗前、治疗后1个月、2个月、3个月观察两组患者的牙周袋探诊深度(PD)、探诊出血(BOP)阳性率、出血指数(BI)。结果:治疗后1个月、2个月、3个月,两组PD均随着时间的推移逐渐变浅(P0.05),且观察组治疗后各时间点均浅于对照组(P0.05);两组BOP阳性率均较治疗前降低,且观察组治疗后各时间均低于对照组(P0.05);两组BI随着时间的推移呈逐渐下降趋势(P0.05),且观察组治疗后各时间点BI均低于对照组(P0.05)。结论:PDT辅助治疗轻中度牙周炎患者的临床疗效较好,其能减小PD,降低BI和BOP阳性率。     

盐酸米诺环素软膏辅助龈下刮治术及根面平整术对慢性牙周炎患者龈下牙周致病菌和龈沟液炎性因子的影响

目的:探讨盐酸米诺环素软膏辅助龈下刮治术及根面平整术(FM-SRP)对慢性牙周炎(CP)患者龈下牙周致病菌和龈沟液炎性因子的影响。方法:选择2015年10月到2019年10月期间我院收治的82例CP患者,根据随机数字表法分为对照组(n=41)和观察组(n=41),对照组给予FM-SRP,观察组在对照组基础上联合盐酸米诺环素软膏辅助治疗,比较两组疗效、牙周指标、龈下牙周致病菌和龈沟液炎性因子情况,统计两组不良反应情况。结果:与对照组总有效率70.73%(29/41)相比,观察组治疗后的总有效率90.24%(37/41)更高(P<0.05)。治疗后,两组龈沟出血指数(SBI)、附着水平(AL)、菌斑指数(PLI)、牙周袋深度(PD)均下降,且观察组低于对照组(P<0.05)。治疗后,两组转化生长因子-β(TGF-β)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)均下降,且观察组低于对照组(P<0.05)。对比两组不良反应无差异(P>0.05)。治疗后,两组伴防线杆菌、牙龈卟啉单胞菌比例均下降,且观察组低于对照组(P<0.05)。结论:盐酸米诺环素软膏辅助FM-SRP治疗CP患者,可有效消除致病菌,缓解炎性反应,恢复牙周生态平衡,且不增加不良反应发生率,疗效确切。     

牙周内窥镜下超声龈下刮治术联合四手操作护理对重度慢性牙周炎临床疗效的影响

目的:探讨牙周内窥镜下对重度慢性牙周炎患者超声龈下刮治术联合四手操作护理效果与从常规护理的比较。方法:选择45例重度牙周炎患者(180颗牙齿),随机分成两组(每组90颗牙齿),在牙周内窥镜下行超声龈下刮治术后分别进行常规护理和四手操作护理。比较两组的治疗前后牙周袋深度和附着丧失变化的变化;治疗时间;患者医生和护士的满意度;患者牙龈肿痛情况等。结果:治疗一个月后,两组患者牙周探诊深度(Probing depth,PD)、附着丧失(Clinical attachment loss,CAL值均比同组治疗前显著降低,但观察组降低的更明显(P0.05)。观察组治疗时间短于对照组,视觉模拟评分低于对照组患者、医生和护士满意度均明显高于对照组,差异均具有统计学意义(P0.05)。结论:牙周内窥镜下超声龈下刮治术联合四手操作护理能提高重度慢性牙周炎患者的治疗效果,缩短治疗时间,提高患者、医生和护士的满意度,减低患者牙龈肿痛症状等。     

Cervitec凝胶局部应用结合洁刮治术对牙周炎龈下菌群的影响

牙周病为口腔临床的常见病,是导致成人失牙的主要原因.洁刮治与根面平整是牙周病基础治疗的重要手段,已经被作为牙周治疗的"金标准".虽然洁刮治与根面平整可以减少部分龈下致病菌的数量,但不能完全消除龈下致病菌,洁刮治术后龈下细菌会缓慢增长,逐渐恢复到治疗前水平.因此近年来药物治疗作为洁刮治与根面平整的辅助手段,特别是局部用药,日益受到关注.本研究尝试把具有抗菌活性的Cervitec凝胶(Vivadent,Schaah,Liechtenstein)应用于牙周治疗,观察牙周沽刮治术后局部应用Cervitec凝胶对牙周炎龈下菌群变化的影响.     

口炎清颗粒对慢性牙周炎患者牙周症状及炎性细胞因子水平的影响

目的:探讨口炎清颗粒对慢性牙周炎患者牙周症状及炎性细胞因子水平的影响。方法:选取我院2017年3月～2019年3月间收治的94例慢性牙周炎患者作为研究对象,按随机数字表法将患者分为对照组(n=47)和观察组(n=47)。对照组给予常规治疗,观察组在常规治疗基础上联合口炎清颗粒治疗,两组均治疗1个月。治疗后评价两组疗效,观察两组治疗过程中出现的不良反应。检测所有患者治疗前后的牙龈指数(GI)、菌斑指数(PLI)、牙周探诊深度(PD)、临床附着水平(CAL),以及龈沟液中的白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)以及白细胞介素-17(IL-17)水平。结果:观察组总有效率为93.62%,高于对照组的82.98%(P0.05)。两组不良反应发生率比较无统计学差异(P0.05)。治疗后,两组GI、PLI、PD、CAL均明显降低,且观察组GI、PLI、PD、CAL明显低于对照组,差异均具有统计学意义(P0.05)。治疗后,两组IL-1β、IL-6、IL-17水平均明显降低,且观察组IL-1β、IL-6、IL-17水平明显低于对照组,差异均具有统计学意义(P0.05)。结论:口炎清颗粒治疗慢性牙周炎疗效确切,能明显改善牙周症状,降低炎性细胞因子水平,且安全性良好。     

不同类型侵袭性牙周炎患者牙周基础治疗分析与研究

目的:探讨不同类型的侵袭性牙周炎(Aggressive Periodontitis,AgP)患者牙周基础治疗的方法及效果.方法:回顾性分析了2005.10-2011.10就诊我院的120例侵袭性牙周炎(AgP)患者的临床资料,其中广泛型侵袭性牙周炎(Generalized Aggressive Periodontitis,GAgP)56例,局限型侵袭性牙周炎(Localized Aggressive Periodontitis,LAgP)64例.本组所有患者均需进行牙周基础治疗,分别于治疗之前以及治疗后2、4、6个月对患者全口牙的探诊深度(Probing Depth,PD)、临床附着丧失(Clinical Attachment Loss,CAL)、出血指数(Bleeding Index,BI)以及牙齿松动度(Tooth Mobility,TM)进行记录,组间差异以P＜0.05表示具有统计学意义.结果:(1) GAgP与LAgP患者在治疗后的2、4、6个月的PD、CAL、BI以及TM较治疗前均有明显地改善,且具有显著的统计学差异(P＜ 0.05); (2) GAgP患者的PD、CAL在治疗后的6个月与治疗后4个月比较,LAgP患者的PD、CAL在治疗后的4个月与治疗后的2个月比较其差异均存在统计学意义(P＜0.05);(3) GAgP与LAgP患者第一恒磨牙治疗后的2、4、6个月的CAL较同期中切牙的改善情况更为显著(P＜0.0l).结论:牙周基础治疗对GAgP与LAgP具有较好的临床治疗效果,上述两种类型的侵袭性牙周炎患者牙周基础治疗后的中期临床效果存在显著的差异性.     

龈沟液miR-155、miR-223表达水平与慢性牙周炎伴2型糖尿病患者牙周临床指标、口腔龈下菌群以及Th17/Treg失衡的相关性分析

摘要 目的：探讨龈沟液miR-155、miR-223表达水平与慢性牙周炎伴2型糖尿病（T2DM）患者牙周临床指标、口腔龈下菌群以及外周血辅助性T细胞17（Th17）/调节性T细胞（Treg）失衡的相关性。方法：选择2018年1月至2022年1月安徽理工大学第一附属医院口腔科收治的86例慢性牙周炎患者,根据是否伴T2DM将患者分为慢性牙周炎伴T2DM组15例和单纯慢性牙周炎组71例,另选择65例健康体检志愿者为对照组。检测龈沟液miR-155、miR-223表达水平,口腔龈下菌群以及外周血Th17细胞占比、Treg细胞占比、血清白细胞介素（IL）-17、转化生长因子-β（TGF-β）水平。Pearson相关分析龈沟液miR-155、miR-223表达水平与牙周临床指标、口腔龈下菌群、外周血Th17/Treg以及血清IL-17、TGF-β的相关性。结果：慢性牙周炎伴T2DM组、单纯慢性牙周炎组龈沟液miR-155、miR-223表达水平高于对照组（P＜0.05）,且慢性牙周炎伴T2DM组高于单纯慢性牙周炎组（P＜0.05）。慢性牙周炎伴T2DM组龈沟出血指数（SBI）、菌斑指数（PLI）、探诊深度（PD）、附着丧失（AL）、牙龈卟啉单胞菌、二氧化碳噬纤维菌、中间普氏菌、变黑普氏菌数量、外周血Th17细胞占比、Th17/Treg比值、血清IL-17水平高于单纯慢性牙周炎组（P＜0.05）,外周血Treg细胞占比低于单纯慢性牙周炎组（P＜0.05）。龈沟液miR-155、miR-223表达水平与PLI、SBI、AL、PD、牙龈卟啉单胞菌、二氧化碳噬纤维菌、中间普氏菌、变黑普氏菌数量、外周血Th17细胞占比、Th17/Treg比值、血清IL-17水平呈正相关（P＜0.05）,与外周血Treg细胞占比呈负相关（P＜0.05）。结论：慢性牙周炎伴T2DM患者龈沟液中miR-155、miR-233表达均上调,且与牙周组织破坏程度、龈下菌群紊乱和Th17/Treg失衡有关。     

水激光与超声洁治对中度慢性牙周炎的疗效对比

目的:探讨水激光与超声洁治对中度慢性牙周炎的疗效。方法:选取81例中度慢性牙周炎患者,年龄27-62岁,随机分为两组:激光组(41例)采用水激光治疗,超声组(40例)采用超声洁治法治疗。通过患者治疗后1个月,3个月的菌斑指数(plaque index,PLI),牙龈指数(gingival index,GI),牙周袋深度(probing depth,PD),牙周附着水平(clinical attachment level,CAL),治疗过程中的VAS评分等观察指标,对水激光与超声洁治进行疗效对比。结果:与基线各项牙周指数相比,激光组和超声组治疗后1个月,3个月的各项牙周指数均明显降低(P0.05)。与超声组相比,激光组治疗后1个月的GI值明显低于超声组,治疗后1个月和3个月的PD值和CAL值均低于超声组(P0.05)。治疗前,两组VAS评分相比,差异没有统计学意义(P0.05),治疗后,激光组的VAS评分明显低于超声组(P0.05)。结论:水激光治疗中度慢性牙周炎,治疗过程痛觉感受轻微,能轻易清除引起炎症的牙石及菌斑,促进牙周组织愈合。     

双波长激光联合米诺环素对慢性牙周炎牙周临床指标及龈沟液IL-6、IL-8、IL-17、TNF-α水平的影响

摘要 目的：探讨双波长激光联合米诺环素对慢性牙周炎牙周临床指标及龈沟液白细胞介素（IL）-6、IL-8、IL-17、肿瘤坏死因子（TNF）-α水平的影响。方法：回顾性分析2018年5月至2020年12月长沙市第三医院口腔科收治的90例慢性牙周炎患者的诊治资料。根据治疗方法的不同,将患者分为龈下刮治及根面平整术（SRP）组、双波长激光（DWL）组和双波长激光联合米诺环素（DWL+M）组,每组均30例。比较各组的治疗效果,治疗前及治疗后三个月的牙周临床指标：牙龈指数（GI）、龈沟出血指数（SBI）、探针深度（PD）、临床附着丧失（CAL）,龈沟液的炎性因子水平：IL-6、IL-8、IL-17、TNF-α,并记录各组的不良反应情况。结果：DWL+M组总有效率依次高于DWL组、SRP组,差异有统计学意义（P<0.05）。三组治疗后三个月的GI、SBI、PD、CAL均低于治疗前,DWL+M组治疗后三个月的GI、SBI、PD、CAL均低于同期的SRP组和DWL组（P<0.05）。治疗后三个月三组龈沟液IL-6、IL-8、IL-17、TNF-α水平较治疗前降低,DWL+M组治疗后三个月的IL-6、IL-8、IL-17、TNF-α水平均低于同期的SRP组和DWL组,差异均有统计学意义（P<0.05）。三组患者在治疗过程中均未发生不良反应。结论：慢性牙周炎患者采用双波长激光联合米诺环素治疗能使牙周炎症、临床症状明显减轻,且具有较高的安全性。     

牙周炎伴糖尿病患者HbA1c差异性分析及其与口腔龈下菌群分布的关系

目的探讨牙周炎伴糖尿病患者糖化血红蛋白(HbA1c)水平及其与口腔龈下菌群分布的关系。方法将2018年8月至2019年12月本院牙周病科收治的98例慢性牙周炎患者纳入研究,根据是否合并2型糖尿病将患者分为牙周炎组(n=32)和糖尿病组(n=66)。测定和比较2组患者空腹血糖(FBG)、餐后2小时血糖(2hBG)和HbA1c水平,根据HbA1c水平将患者分为轻度组(HbA1c≤7%)(n=26)、中度组(7%10%)(n=18)。利用牙龈指数评估牙周病变程度。取磨牙探诊深度≥4 mm且存在附着丧失位点处龈下菌斑,鉴定菌种种类并计数。结果糖尿病组患者FBG、2hBG和HbA1c水平显著高于牙周炎组(t=2.878,P=0.005;t=9.119,P<0.001;t=3.371,P=0.001)。不同HbA1c水平牙周病变等级分布差异有统计学意义(t=12.364,P=0.002),HbA1c水平与牙龈损伤程度呈正相关(r=0.769,P=0.002)。糖尿病组患者龈下伴放线放线杆菌和二氧化碳嗜纤维菌检出率显著高于牙周炎组(t=3.873,P=0.049;t=14.061,P<0.001)。患者龈下二氧化碳嗜纤维菌、牙龈卟啉单胞菌、中间普氏菌和变黑普氏菌数量随HbA1c水平升高而增加(t=13.914,P<0.001;t=6.985,P=0.002;t=5.955,P=0.004;t=6.808,P=0.002);HbA1c水平与龈下二氧化碳嗜纤维菌、牙龈卟啉单胞菌、中间普氏菌和变黑普氏菌数量呈正相关(r=0.861,P<0.001;r=0.758,P<0.001;r=0.776,P<0.001;r=0.754,P<0.001)。结论牙周炎伴糖尿病患者牙周病变程度及龈下菌群分布变化与HbA1c水平有关,良好的血糖控制有助于维持慢性牙周炎患者龈下菌群稳态,对糖尿病和牙周病预防与治疗具有积极作用。     

亚甲基蓝/光化学法辅助治疗慢性牙周炎对牙龈卟啉单胞菌的影响

目的研究亚甲基蓝/光化学法辅助治疗慢性牙周炎对牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg)检出率的变化。方法经伦理委员会同意后,本研究拟筛选出45例慢性牙周炎患者(每位患者经过详细牙周检查及X线检查后确认为牙周炎,有4个以上≥5 mm的牙周袋并分布在2个以上口腔区域),随机分3组:其中A组在SRP之后接受1次PERIOWAVE光化学治疗,B组在SRP后接受1次PERIOWAVE治疗以及在6周后再一次接受光化学治疗,而SRP组仅接受SRP治疗,各组患者取治疗前后相同4个位点龈下菌斑,聚合酶链式反应(Poly-merase chain reaction,PCR)检测Pg,观察Pg菌的检出率,采用卡方检验,并计算χ2值。结果 SRP组、A组、B组3组各组治疗后均较治疗前检出率降低(P<0.001),A组与SRP组治疗后比较差异无统计学意义[A组:40%(24/60),SRP组:45%(27/60),χ2=1.4815,P>0.05],B组与SRP治疗后比较检出率降低[SRP组:45%(27/60),B组:20%(12/60)χ2=8.547,P<0.01];B组与A组治疗后比较检出率降低[A组:40%(24/60),B组:20%(12/60),χ2=5.7143,P<0.05]。结论亚甲基蓝/光化学法辅助治疗慢性牙周炎后牙龈卟啉单胞菌的检出率较治疗前降低;结合临床试验结果,尚可认为2次激光疗效较1次激光好。     

Impact of Chronic Periodontitis on Levels of Glucoregulatory Biomarkers in Gingival Crevicular Fluid of Adults with and without Type 2 Diabetes

The relationship between diabetes and periodontal disease is bidirectional, but information about the effect of chronic periodontitis on the levels of the glucoregulatory biomarkers locally in gingival crevicular fluid (GCF) is limited. The aim of this study was to compare the levels of 10 glucoregulatory biomarkers in GCF, firstly in subjects with type 2 diabetes (T2DM) presenting with and without chronic periodontitis and secondly, in subjects without diabetes, with and without chronic periodontitis. The material comprised a total of 152 subjects, stratified as: 54 with T2DM and chronic periodontitis (G1), 24 with T2DM (G2), 30 with chronic periodontitis (G3) and 44 without T2DM or periodontitis (G4). The levels of the biomarkers were measured using multiplex biometric immunoassays. Periodontal pocket depths were recorded in mm. Subsets G1 and G2 and subsets G3 and G4 were compared independently. Among T2DM subjects, GIP, GLP-1 and glucagon were significantly up-regulated in G1 compared to G2. Moreover, there were no statistical differences between the two groups regarding C-peptide, insulin, ghrelin, leptin and PAI-1. Comparisons among individuals without T2DM revealed significantly lower amounts of C-peptide and ghrelin in G3 than in G4. The number of sites with pocket depth ≥ 4mm correlated negatively with C-peptide (Spearman’s correlation co-efficient: -0.240, P < 0.01) and positively with GIP and visfatin (Spearman’s correlation co-efficient: 0.255 and 0.241, respectively, P < 0.01). The results demonstrate that chronic periodontitis adversely influences the GCF levels of glucoregulatory biomarkers, as it is associated with disturbed levels of biomarkers related to the onset of T2DM and its medical complications.     

不同根管冲洗方法在瘘管型根尖周炎治疗中的疗效分析

目的:比较普通冲洗和超声冲洗方法对瘘管型慢性根尖周炎一次性根管治疗疗效的影响,以期为超声冲洗方法在慢性根尖周炎临床治疗中的应用提供指导。方法:将2010年6月-2012年6月来我科就诊的166名瘘管型慢性根尖周炎患者随机分为2组,超声冲洗组和普通冲洗组,根据分组分别在一次性根管治疗术中的根管清理过程采用超声根管冲洗方法和普通注射器冲洗方法,术后1周和半年时复诊记录患者一次性根管治疗效果,通过以患者术后1周内的主观"疼痛程度"作为短期评价指标和术后半年治疗效果作为长期评价指标进行比较,采用X2检验进行统计分析。结果:与普通注射器冲洗方法相比,超声冲洗方法可以明显减低一次性根管治疗后短期不适症状的发生率(P0.05),特别是重度反应的发生(P0.05);而术后出现的轻度和中度疼痛反应无明显差异。同时,超声冲洗方法可以明显增加一次性根管治疗术的长期成功率(P0.05)。结论:一次性根管治疗术中使用超声冲洗方法替代常规注射器冲洗方法,能够明显减轻患者短期术后以"疼痛"为主要表现的不适症状,提高一次性根管治疗术在瘘管型根尖周治疗中的长期成功率,是一种较为理想的根管治疗冲洗方法。     

Resistin levels in the gingival crevicular fluid among diabetic and non-diabetic chronic periodontitis patients

It is of interest to document theresistin levels in chronic periodontitis patients (CP) with or without type 2 diabetes mellitus (T2DM) in the gingival crevicular fluid (GCF).The expression of resistin was significantly higher in chronic periodontitis when compared to the periodontally healthy groups. Resistin levels were high in CP and T2DM. Therefore, GCF resistin levels is of interest as a potential incendiary marker for periodontitis with T2DM.     

Alkaline phosphatase and acid phosphatase levels in saliva and serum of patients with healthy periodontium,gingivitis, and periodontitis before and after scaling with root planing: A clinico-biochemical study

Periodontitis is commonly diagnosed based on clinical parameters. However, the analysis of a few unique biomarkers of the disease process present in the saliva and blood can further assist the estimation of the rate of disease progression.AimThe present study attempted to correlate the alkaline phosphatase (ALP) and acid phosphatase (ACP) levels in saliva and serum between patients with healthy periodontium, gingivitis, and chronic periodontitis.Materials and methodsThe present study was conducted in 135 subjects between 20 and 55 years of age. The subjects were divided into three groups, namely healthy (Group A), gingivitis (Group B), and chronic periodontitis (Group C). The clinical parameters were recorded using the plaque index (PI), gingival index (GI), and probing depth (PD). Saliva and serum were analyzed for ALP and ACP levels using an auto analyzer. All patients underwent scaling and root planning (SRP) along with oral hygiene instructions. Patients were then recalled after four weeks, and blood and saliva samples were collected to estimate ALP and ACP levels prior to clinical examination.ResultsThe clinical parameters exhibited a statistically significant decrease in the PI and GI in both group B and group C after SRP. A significant change in the PD and attachment levels (AL) was observed in the periodontitis group after SRP. The mean salivary & serum ALP levels exhibited a statistically significant decrease in group B & C after SRP. The mean serum ACP levels exhibited a statistically significant decrease in group B & C after SRP However, the salivary ACP levels decrease after SRP was only statistically significant in group C.ConclusionSerum and salivary ALP and ACP levels were markedly decreased in the gingivitis and periodontitis groups after SRP and were positively correlated with the clinical parameters.     

Effect of diabetes on collagen metabolism and hypoxia in human gingival tissue: a stereological,histopathological, and immunohistochemical study

Diabetes mellitus and periodontitis are chronic inflammatory diseases that disrupt soft tissue metabolism. The diseases separately or together increase apoptosis in gingival fibroblast cells and reduce cell renewal. We investigated the effects of diabetes and periodontitis on the composition and structure of gingival connective tissue. We used gingival biopsies from 16 healthy individuals (control group, C), 16 type 2 diabetic patients with chronic periodontitis (diabetes + periodontitis group, D + P) and 16 healthy chronic periodontitis patients (periodontitis group, P). Biopsies were obtained under local anesthesia. Clinical attachment level (CAL), gingival index (GI) and plaque index (PI) were measured prior to gingival biopsies. Fibroblast cells were counted stereologically. Inflammatory cells were counted histomorphometrically. Hypoxia-inducible factor (HIF)-1α, lysyl hydroxylase (PLOD-2), neutrophil collagenase (MMP-8), and vascular endothelial growth factor (VEGF) levels were evaluated immunohistochemically. CAL, GI and PI for the C group were lower than for the other groups (p < 0.05). Fibroblast cell counts were lower for the D + P group than for the other groups (p < 0.05). Diabetes increased inflammatory cell numbers in the D and D + P groups compared to the C and P groups. MMP-8 levels were higher for the D + P group than for the other groups. VEGF was elevated in both the P and D + P groups compared to the C group, while HIF-1α and PLOD-2 levels were comparable. Diabetes increased tissue destruction and inflammation, and decreased fibroblast cell numbers without affecting collagen crosslinking and HIF-1α levels.     

Investigation of the Effect of Type 2 Diabetes Mellitus on Subgingival Plaque Microbiota by High-Throughput 16S rDNA Pyrosequencing

Diabetes mellitus is a major risk factor for chronic periodontitis. We investigated the effects of type 2 diabetes on the subgingival plaque bacterial composition by applying culture-independent 16S rDNA sequencing to periodontal bacteria isolated from four groups of volunteers: non-diabetic subjects without periodontitis, non-diabetic subjects with periodontitis, type 2 diabetic patients without periodontitis, and type 2 diabetic patients with periodontitis. A total of 71,373 high-quality sequences were produced from the V1-V3 region of 16S rDNA genes by 454 pyrosequencing. Those 16S rDNA sequences were classified into 16 phyla, 27 classes, 48 orders, 85 families, 126 genera, and 1141 species-level OTUs. Comparing periodontally healthy samples with periodontitis samples identified 20 health-associated and 15 periodontitis-associated OTUs. In the subjects with healthy periodontium, the abundances of three genera (Prevotella, Pseudomonas, and Tannerella) and nine OTUs were significantly different between diabetic patients and their non-diabetic counterparts. In the subjects carrying periodontitis, the abundances of three phyla (Actinobacteria, Proteobacteria, and Bacteriodetes), two genera (Actinomyces and Aggregatibacter), and six OTUs were also significantly different between diabetics and non-diabetics. Our results show that type 2 diabetes mellitus could alter the bacterial composition in the subgingival plaque.     

Effect of a subgingival chlorhexidine chip on the clinical parameters and the levels of alkaline phosphatase activity in gingival crevicular fluid during the non-surgical treatment of periodontitis

The main therapeutic approaches for inflammatory periodontal diseases include the mechanical treatment of root surfaces. Multi-center clinical trials have demonstrated that the adjunctive use of a chlorhexidine (CHX) chip is effective in improving clinical results compared to scaling and root planing (SRP) alone. However, some recent studies failed to confirm these clinical results, nor have any data been reported regarding the capability of the CHX chip in affecting the activity of alkaline phosphatase (ALP) in the gingival crevicular fluid (GCF). This enzyme has been related to a condition of destructive activity of periodontitis. The aim of this study is to provide further data on the clinical and biochemical effects of CHX chips when used as an adjunct to SRP. Eighty-two systemically healthy patients, aged 31-63, with moderate and advanced periodontitis were recruited from the departments of Periodontology of the University of Chieti. In each patient 2 experimental sites, located in two symmetric quadrants, were chosen with a probing depth of > or = 5 mm and bleeding on probing. The 2 sites were selected randomly at the split-mouth level; control sites received SRP alone, and test sites SRP plus 1 CHX chip. Clinical indices, including probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and the ALP activity in GCF were evaluated at baseline and after 6 months. Alkaline phosphatase activity was assayed spectrophotometrically. The PPD and CAL were significantly lower at 6 months as compared to the baseline scores in both treatments (p less than 0.01). The PPD reduction was 2.7 mm in the CHX+SRP group and 1.9 mm in the SRP alone group. The CHX+SRP group showed a significantly greater gain of clinical attachment (mean: 1.4 mm) in comparison with the SRP group (mean: 0.9; p less than 0.05). No differences were observed in the decrease of the percent of BOP-positive sites between the experimental groups. Conversely, the CHX+SRP group underwent a significantly greater decrease (p less than 0.01) of the GCF-ALP activity 6 months after treatment in comparison with the SRP alone group. The adjunctive use of the CHX chip resulted in a significant improvement of pocket reduction and clinical attachment gain as compared with SRP alone. These results were concomitant with a significantly greater reduction of the GCF-ALP activity levels.     

Vitapex糊剂在根管治疗乳牙慢性根尖周炎中的效果分析

目的:探讨Vitapex糊剂在根管治疗乳牙慢性根尖周炎中的效果。方法:选取200例慢性根尖周炎患儿并随机分为两组,观察组(108例)给予Vitapex糊剂充填,对照组(92例)给予氧化锌碘仿糊剂充填,比较两组治疗后1个月的充填质量、治疗前后的VAS评分及治疗后6个月的远期疗效。结果:治疗后1个月,两组患者的根管充填质量构成比比较有统计学差异(P0.05),观察组根管适充率高于对照组;治疗前两组VAS评分相比,无统计学差异(P0.05);治疗后1周、1个月,两组痛觉减轻且观察组痛觉感受更轻微(P0.05)。治疗后随访6个月,观察组治疗成功104例,成功率96.3%;对照组治疗成功80例,成功率87.0%,观察组治疗成功率高于对照组(P0.05)。结论:Vitapex糊剂填充过程简易,易于填充,对乳牙根尖周炎具有较好的治疗效果,能减轻患儿牙痛,远期疗效较佳。