康复新液对口腔正畸所致慢性牙龈炎临床疗效及对牙龈肿胀及疼痛改善情况的影响

为分析康复新液对口腔正畸所致慢性牙龈炎临床疗效及对牙龈肿胀及疼痛改善情况的影响,本研究回顾性地选取2014年12月至2016年8月我院收治的因口腔正畸所致慢性牙龈炎患者85例,根据治疗方法不同分为对照组和观察组。对照组患者单纯采用牙龈清洁术治疗,观察组患者采用牙龈清洁术联合康复新液进行治疗。观察两组患者治疗后疼痛度和肿胀度情况、牙龈指数(GI)、菌斑指数(PLI)、龈沟出血指数(SBI)、探诊深度(PD)及龈沟液中炎性因子和前列腺素E2(PGE2)水平变化情况。研究发现观察组患者治疗后疼痛度和肿胀度改善情况优于对照组(p0.05)。两组患者治疗后GI、PLI、SBI及PD值水平均较治疗前下降。观察组患者治疗后GI、PLI、SBI及PD值水平低于对照组(p0.05)。两组患者治疗后龈沟液中IL-1β、TNF-α及PGE2水平均较治疗前下降,观察组患者治疗后龈沟液中IL-1β、TNF-α及PGE2水平低于对照组(p0.05)。研究说明,康复新液可改善口腔正畸所致慢性牙龈炎患者的疼痛度和肿胀度,促进牙龈健康状态的恢复,降低龈沟液中炎性因子和PGE_2水平。     

牙周组织再生术联合口腔正畸对牙周炎患者血清炎症因子水平的影响及其疗效探究

目的:研究牙周组织再生术联合口腔正畸对牙周炎患者血清白介素-6(IL-6)、白介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)水平的影响及其疗效。方法:选取2014年11月至2015年10月本院收治的78例牙周炎患者,按照入院顺序分为观察组和对照组,39例每组。对照组采取单纯的牙周组织再生术,观察组在此基础上联合口腔正畸进行治疗。治疗后,评价两组患者治疗的临床疗效,比较两组患者治疗前和治疗3个月后血清IL-6、IL-8、TNF-α水平、牙龈指数(GI)、龈沟出血指数(SBI)、牙菌斑指数(PLI)、牙周探诊深度(PD)、临床附着丧失(AL)的变化。结果:治疗后,观察组总的有效率显著高于对照组(P0.05),血清IL-6、IL-8、TNF-α水平、GI、SBI、PLI、PD、AL均显著低于对照组(P0.05)。结论:牙周组织再生术联合口腔正畸治疗能有效降低牙周炎患者血清IL-6、IL-8、及TNF-α水平,提高其临床疗效。     

牙菌斑显示剂应用前景的研究*

目的:研究牙菌斑显示剂在日常生活中辅助维护口腔卫生的应用价值。方法:抽取300名居民进行《牙菌斑显示剂产品的认知程度及接受意愿调查问卷》调查,了解菌斑显示剂在人群中的接受认知及接受意愿等;以40名大学生志愿者为研究对象,进行牙菌斑显示剂组、巴氏刷牙法对照研究,观察菌斑显示剂的应用效果。结果:81.5%的调查对象之前未听说过牙菌斑显示剂,但大部分人愿意尝试使用。专业技术人员接受意愿最高;应用牙菌斑显示剂组除在上颌后牙区颊侧的菌斑清除率低于巴氏刷牙法外,两组间菌斑清除效果的差异无统计学意义(p0.05)。结论:涂有牙菌斑显示剂刷牙清除牙菌斑与巴氏刷牙法效果基本一致,易于掌握,开发该类产品对于提升口腔健康有作用,在日常口腔保健品中应用牙菌斑显示剂有一定的应用前景。     

牙周组织再生术联合正畸治疗对牙周炎患者牙周状况及满意度的影响

目的:探讨牙周组织再生术联合正畸治疗对牙周炎患者牙周状况及满意度的影响。方法:选取我院于2016年3月-2017年4月期间收治的牙周炎患者76例为研究对象。按照随机数字表法将患者分为研究组(n=38)与对照组(n=38),对照组行牙周组织再生术,研究组行牙周组织再生术联合正畸治疗。于治疗前、治疗后3个月检查患者牙周指标情况和X线头影测量情况,对比两组患者治疗前后视觉模拟疼痛评分(VAS),随访一年,于治疗1年后采用医院自制调查问卷评价患者满意度,观察并比较两组患者治疗后并发症发生情况。结果:治疗后3个月,两组患者的牙龈指数(GI)、菌斑指数(PLI)、龈沟出血指数(SBI)、牙周探诊深度(PD)以及临床牙周平均附着丧失(CAL)均显著降低,且研究组低于对照组(P0.05)。治疗后3个月,两组患者的SNA角、SNB角均显著降低,且研究组低于对照组,两组患者的ANB角显著升高,且研究组高于对照组(P0.05)。两组患者治疗后VAS评分较治疗前显著降低,且研究组低于对照组(P0.05)。研究组患者牙龈健康状况评分、口腔清洁能力评分、美观评分、满意度均高于对照组(P0.05),而两组患者咀嚼功能评分相比无统计学差异(P0.05)。两组患者治疗后并发症发生率比较无统计学差异(P0.05)。结论:牙周组织再生术与正畸治疗联合运用,对牙周组织健康状况有显著改善作用,且安全有效,提升患者满意度。     

口腔卫生预防措施对固定正畸患者牙周菌群和牙周临床指数的影响

目的 采用牙周洁治和强化的口腔健康教育方法,通过检测牙周菌群和牙周临床指数的动态变化,探讨口腔卫生预防措施对固定正畸患者牙周菌群的影响。方法 选择正畸初诊患者20例,平均分为试验组（T组）和对照组（C组）。于正畸治疗开始前检查右上颌第一磨牙16和右下颌中切牙41牙周状况,并采集其近中颊轴嵴处龈缘菌斑做细菌分离培养。T组于治疗前进行全口洁治,每月复诊加力时均给予口腔卫生检查,强调口腔卫生的重要性;C组仅在初诊时进行口腔卫生指导,其余不作处理。2组患者分别于矫治器安装后1、3和6个月进行临床及细菌学检查。结果 随观察时间的延长,T组颊侧菌斑指数和牙龈指数在第1、3、6个月时较基线降低;C组颊侧菌斑指数第6个月时较基线降低,舌侧探诊深度则升高（P＜0.05）。细菌检出率和检出量的变化在T组可见韦荣球菌属降低而弯曲杆菌属和Gn产黑色素厌氧杆菌（BPAR）升高,C组消化链球菌属和BPAR升高（P＜0.05）;BPAR在第3个月、消化链球菌属在第6个月时T组检出率低于C组（P＜0.05）,而细菌检出量和牙周临床指数在2组间没有观测到处理因素的作用（P＞0.05）。结论 正畸前即存在牙龈炎的患者,建议进行预防性牙周洁治;牙周洁治必须和口腔卫生教育、正确的日常菌斑控制措施结合进行。     

EXPASYL排龈膏对不同牙龈指数龈下缺损修复的临床研究

目的:观察EXPASYL排龈膏法在不同牙龈指数(gingivalindex,GI)龈下牙体缺损充填修复中的排龈效果及远期疗效。方法:将152例(180颗牙)累及龈下的Ⅱ类洞按照不同GI分级原则,随机分为对照组、G1、G2 3组,对每组排龈临床效果及两年内充填体的脱落率进行对比分析。结果:不同牙龈指数的排龈效果及远期修复效果相同,差异无统计学意义。结论:GI指数≤2时,排龈效果及远期修复效果理想。     

自闭症儿童口腔正畸治疗中系统性心理预防与干预的作用

目的:评估系统性心理预防及干预在自闭症儿童口腔疾病治疗中的作用。方法:将在我医院进行正畸治疗的40例12~16岁自闭症患者按着随机分配分为对照组与实验组,每组各20例。在正畸治疗过程中,对照组实施常规心理行为预防及干预,包括:治疗前的基础准备、治疗过程中注意事项、治疗后康复方案及辅助治疗等。而对于实验组,除了实施常规的行为预防及干预外,还进行系统性心理行为预防及干预,包括:语言疏导、健康教育、辅助矫正、生命体征监测、肢体语言演示等。结果:实验组和控制组的孩子们能够完成正畸治疗,自闭症儿童治疗配合的的程度,听话依从性,显著高于对照组(P0.01),两组之间蛀牙数和牙龈指数存在差异(P0.05)。结论:系统性行为预防及干预能够提高自闭症儿童的配合合作的程度及医嘱依从性,值得在口腔正畸科门诊自闭症儿童患者中推广。     

微型种植体支抗在口腔正畸治疗中的临床效果

为了探讨微型种植体支抗在口腔正畸治疗中的临床效果,本研究选择我院收治的口腔正畸患者100例作为研究对象,根据支抗材料将患者分为观察组和对照组,50例观察组患者采用微型种植支抗技术进行治疗,50例对照组口腔正畸患者采用口外弓加强支抗技术治疗。比较两组患者术后的疗效指标(上中切牙凸距差,磨牙移位和上中切牙倾角)、咀嚼功能(咬合力和咀嚼效率)、牙龈指标(出血指数,菌斑指数和牙龈指数)及并发症。研究表明,术后第2天,观察组患者的中切牙凸距差和上中切牙倾角显著高于对照组(p=0.012,p=0.001),而磨牙移位显著低于对照组(p=0.009)。治疗1个月后,观察组患者的平均咬合力和咀嚼效率显著高于对照组(p0.05)。治疗1个月后,观察组患者的出血指数、菌斑指数和牙龈指数显著低于对照组(p0.05)。观察组患者中有6例(12.00%)患者出现不良并发症,对照组为14例(28.00%),观察组患者的术后并发症发生率显著低于对照组(p=0.036)。本研究结论初步表明,微型种植体支抗在口腔正畸治疗中的疗效优于传统支抗(口外弓加强支抗),可显著改善患者的咀嚼功能和牙龈健康,并且降低并发症发生率。     

Cervitec凝胶局部应用结合洁刮治术对牙周炎龈下菌群的影响

目的:探讨Cervitec凝胶局部应用结合洁刮治术对牙周炎龈下菌群的影响效果。方法:选取我院口腔科已确诊为牙周炎患者60例,根据治疗方案不同分为实验组与对照组,对照组进行传统洁刮术治疗,实验组在对照组基础上将Cervitec凝胶涂抹于牙齿及牙周袋周围,比较两组患者的口腔健康指数、探诊及龈沟液水平、菌群抑制效果及主要细菌杀灭水平变化情况,其数据结果应用统计学软件SPSS 17.0处理。结果:与对照组相比较,实验组患者口腔指数、牙龈水平及菌群杀灭抑制效果明显,表现为:菌斑指数、牙龈指数、出血指数明显降低(P0.05);探诊深度、附着水平、龈沟液含量明显下降(P0.05);总菌群、G-及G+菌群抑制程度提高(P0.05);高登链球菌、缓症链球菌、变黑普氏菌、牙龈卟啉单胞菌杀灭程度明显提高(P0.05)。其结果均有统计学意义。结论:Cervitec凝胶局部应用联合洁刮治术对牙周炎牙龈下菌群有良好抑制效果,并维持长久疗效,降低刺激程度及过敏情况,提高临床有效率,保护牙龈健康,对牙体产生较小的副作用。     

金属桩与玻璃纤维桩对老年上颌前牙残根残冠修复的临床疗效比较

目的:探讨金属桩与玻璃纤维桩对老年上颌前牙残根残冠修复的临床疗效。方法:收集我院口腔科收治的上颌前牙残根残冠修复患者40例,随机分为玻璃纤维桩组和金属桩组,每组各20例,玻璃纤维桩组患者给予玻璃纤维桩进行残根残冠修复,金属桩组给予金属桩进行残根残冠修复,治疗结束后1年随访,对所有患者的牙龈指数(GI)、修复齿出血指数(SBI)、不良反应发生率、患者修复效果以及患者疗效进行检测并比较。结果:与治疗前相比,两组患者的牙龈指数(GI)以及修复齿出血指数(SBI)均下降(P0.05);与金属桩组相比,玻璃纤维桩组患者的牙龈指数(GI)以及修复齿出血指数(SBI)较低(P0.05),不良反应发生率较低(P0.05),颜色匹配率以及边缘适合率较高(P0.05),两组患者修复体完整例数百分率比较无明显差异(P0.05),玻璃纤维桩组患者的治疗成功率较高(P0.05)。结论:玻璃纤维桩在老年上颌前牙残根残冠修复的应用与金属桩组相比临床效果较好。     

Detection of Fusobacterium Nucleatum and fadA Adhesin Gene in Patients with Orthodontic Gingivitis and Non-Orthodontic Periodontal Inflammation

Fusobacterium nucleatum is one of the most abundant gram-negative bacilli colonizing the subgingival plaque and closely associated with periodontal disease. However it is unclear whether F. nucleatum is involved in gingival inflammation under orthodontic appliance. A novel adhesin, FadA, which is unique to oral Fusobacteria, is required for F. nucleatum binding and invasion to epithelial cells and thus may play an important role in colonization of Fusobacterium in the host. In this study, we evaluated the prevalence of F. nucleatum and its virulence factor FadA adhesion gene (fadA) in 169 subgingival biofilm samples from 55 cases of gingivitis patients with orthodontic appliances, 49 cases of gingivitis patients without orthodontic treatment, 35 cases of periodontitis patients and 30 cases of periodontally healthy people via PCR. The correlations between the F. nucleatum/fadA and gingivitis index(GI)was also analyzed. The detection rate of F. nucleatum/fadA in periodontitis group and non-orthodontic gingivitis group was higher than the other two groups (p<0.01) while it was higher in orthodontic gingivitis group than in health people (p<0.05). An obviously positive correlation was observed between the prevalence of F. nucleatum/fadA and GI. F. nucleatum carrying fadA may be more closely related to the development of gingivitis and periodontal disease compared with orthodontic gingivitis.     

Role of Probiotics in Oral Health Maintenance Among Patients Undergoing Fixed Orthodontic Therapy: a Systematic Review of Randomized Controlled Clinical Trials

The aim was to assess the role of probiotics in oral health maintenance among patients undergoing fixed orthodontic therapy (OT). An unrestricted search of indexed databases was performed until April 2020 using the following Mesh-terms: (1) probiotic and (2) orthodontic. Randomized controlled clinical trials (RCTs) evaluating the influence of probiotic therapy (PT) towards oral health maintenance/improvement in patients undergoing fixed OT were included. Data screening, selection, and extraction were performed; and the risk of bias was assessed using the Cochrane Collaboration’s tool. All evaluations were performed by 2 independent researchers; and disagreements were resolved via discussion. Nine RCTs were included. Eight studies reported that PT improves oral health in patients undergoing fixed OT. Seven studies showed that PT reduces the counts of oral pathogenic bacteria in the oral biofilm and/or saliva. One study reported that PT reduces halitosis in patients undergoing fixed OT. One study found that PT reduces the scores of plaque index (PI) and gingival index (GI); and one study reported that PT has no significant influence on PI and GI in patients undergoing fixed OT. One study reported that PT does not prevent the formation of white spot lesions during fixed OT. Three and 6 studies had a moderate and low risk of bias, respectively. A power analysis was performed in 4 studies. In conclusion, probiotics exhibit antimicrobial activity against oral pathogenic bacteria; however, due to the limitations of the studies assessed, further well-designed RCTs are needed.

     

固定矫治器戴入前后牙周可疑病原菌和牙周临床指数的变化

目的:固定矫治器戴入前后的不同时间进行龈缘菌斑的微生物学检查和牙周状况的临床检查,以探讨固定矫治器戴入前后牙周可疑病原菌和牙周状况的动态变化过程.方法:选择18名固定正畸患者,于矫治器戴入前和戴入后1、3、6月分别检查16、41牙位的菌斑指数、牙龈指数、探诊深度、探诊出血,并在近中颊侧颊轴角处采集龈缘菌斑样本,采用细菌培养鉴定方法测定牙周可疑病原菌的检出量(CFU/g)和检出率.结果:与基线相比,观察期内龈缘菌斑的G￣产黑色素厌氧杆菌检出量和检出率在两个牙位均升高(P＜0.05),41的优杆菌、弯曲杆菌、拟杆菌、普氏菌亦有升高(P＜0.05).临床指标中16的牙龈指数(颊侧)和探诊深度(颊、舌侧)升高;41的菌斑指数(舌侧)降低(P＜0.05).结论:固定矫治器戴入后虽然可通过严格的口腔卫生指导有效控制牙面菌斑,但仍可引起牙周可疑病原菌增加.     

Microbiological and clinical periodontal effects of fixed orthodontic appliances in pediatric patients

The aim of this study was to evaluate changes of microbiota in ten patients undergoing orthodontic treatment. For each patient clinical examination of gingival index (GI) and plaque index (PI) were performed at the first molars at: baseline (T1), 2 (T2), 4 (T3) and 12 weeks (T4). At the same time subgingival plaque and tongue samples were taken for the microbiological study. Clinical results showed that at T4, the mean PI score was significantly lower than T1 and the GI was markedly reduced. Microbiological results showed that at T1 and T4 facultative aerobic bacteria were prevalent, whereas anaerobic bacteria were more common at T2 and T3.     

Periodontal Disease in Type 1 Diabetes Mellitus: Influence of Pubertal Stage and Glycemic Control

ObjectiveThough gingivitis is common in children with type 1 diabetes mellitus (T1DM), the overall periodontal health in T1DM during the pubertal stage is less well-characterized. The study was undertaken to explore the possible influence of puberty and metabolic derangement on periodontal health in T1DM.MethodsIn this cross-sectional study, 110 subjects between 10-18 years with T1DM and 52 healthy siblings of similar age were evaluated for pubertal stage, glycosylated hemoglobin (HbA1c), and periodontal health. Simplified oral hygiene index (OHIS), gingival index (GI), plaque index (PI), bleeding on probing (BOP), and probing depth (PPD) were evaluated at 4 sites per tooth as per 6 Ramfjord index teeth used to assess periodontal disease (PD).ResultsPD not merely gingivitis was significantly higher in T1DM (84/110, 76.36%) than the control group (28/52, 53.8%) (P = .004). Irrespective of pubertal status, children with T1DM had worse GI, PI, BOP, and PPD than nondiabetic subjects, although OHIS was better in diabetes. In both T1DM and nondiabetic subjects, pubertal subjects showed significantly worse OHIS, PPD, BOP, and GI than prepubertal subjects. PD was correlated with pubertal stage, age, and HbA1c, although less strongly with the duration of diabetes. In logistic regression, pubertal stage was a stronger predictor of PD (OR = 14.26) than age (OR = 2.22), and HbA1c (OR = 1.5) rather than the presence of diabetes and its duration.ConclusionsThough pubertal status, age, and poor glycemic control rather than the presence of diabetes and its duration are associated with gingivitis and other forms of PD, puberty had a more profound effect in the pathogenesis of PD in T1DM.     

西帕依固龈液联合西吡氯铵治疗牙龈炎的疗效分析

目的:探讨西帕依固龈液联合西吡氯铵治疗牙龈炎的临床疗效。方法:选择我院于2013年10月-2015年2月收治的130例牙龈炎患者,将其随机分成实验组和对照组各65例,对照组给予西吡氯铵治疗,实验组给予西帕依固龈液联合西吡氯铵治疗,比较两组患者的菌斑指数(PLI)、牙龈指数(GI)、龈沟出血指数(SBI)以及治疗疗效。结果:治疗8天后,实验组和对照组患者的治疗总有效率分别为96.92%和81.54%,组间比较差异具有统计学意义(P0.05)。两组患者治疗前PLI、GI、SBI比较无显著差异(P0.05);治疗后,两组患者各项指标均较治疗前有所改善,与各自治疗前比较差异具有统计学意义(P0.05),但两组治疗后的指标差异无统计学意义(P0.05)。两组患者不良反应的发生率分别为10.77%和9.23%,差异无统计学意义(x~2=0.0855,P0.05)。结论:西帕依固龈液与西吡氯铵联合使用治疗牙龈炎具有确切的疗效,同时具有较高的安全性。     

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.     

Macleya cordata and Prunella vulgaris in oral hygiene products - their efficacy in the control of gingivitis

A double-blind, placebo-controlled clinical trial was performed to investigate the effectiveness of a herbal-based dentifrice in the control of gingivitis. Forty volunteers completed the 84-day study. All subjects were balanced for parameters measured - plaque index (PI), community periodontal index of treatment needs (CPITN) and papillary bleeding index (PBI). The dentifrice was effective in reducing symptoms of gingivitis as evaluated by the CPITN and PBI indexes.     

Treatment of periodontal disease using xanthan based chlorhexidine gel

People of all ages are suffering from periodontal disease. It causes indirect damage in the oral cavity. It is of interest to evaluate the efficacy of xanthan-based chlorhexidine gel (Xan-CHX) in patients with mild-severe chronic periodontitis. Five patients with 60 sites were divided in two groups. Group A (treated with SRP) and group B (treated with Chlosite i.e., SRP + CHL). The recorded clinical parameters were Plaque index (PI), Gingival index (GI), Bleeding index (BI), and Clinical attachment Level (CAL) with sub gingival plaque subjected to microbial analysis. Significant reduction was observed in both groups. However, group B (treated with Chlosite i.e., SRP + CHL) showed statistically significant improvement on above mentioned parameters as compared to group A. Data suggest that in the treatment of periodontal disease (viz. PI, GI, BI and CAL) combination of SRP and Chlosite showed added benefits over only SRP.