口源性口臭病因及治疗的研究进展

口臭是指呼吸时出现的臭味气体,气体中所含的主要成分是挥发性硫化物。它由多种因素造成,但约80-90%是来源于口腔内因素。研究表明,口腔微生物与口臭及口气中挥发性硫化物存在密切关系。传统的机械治疗方法和化学治疗方法虽然可以短期内改善口臭状况,但长期疗效不尽如人意。近年来,对化学抗菌剂替代品的研究和开发,成效显著。本文综述了口源性口臭病因及治疗的最新研究进展。     

口臭微生态治疗技术研究进展

口臭是指呼吸时排出挥发性硫化物等臭味气体,主要由口腔微生态失调引起,具体为生理性菌群数目减少,产臭类菌群种类和数目增加。口臭是局部口腔或全身系统不良代谢状况的一种表现,临床可根据口腔异味来诊断疾病,并通过口腔微生态的调整来治疗口臭。本研究从口臭与微生态的关系、口臭主要相关微生物等方面进行分析,综述机械、化学和中医药等方法调整口腔微生态来治疗口臭的进展。     

口臭患者口腔微生物区系研究

目的研究口臭口腔微生物区系组成,为口臭治疗提供依据。方法采用稀释平板测数法对需氧和厌氧细菌、真菌、放线菌分别进行计数。结果非口臭口腔好氧细菌数量(1180±380)和厌氧细菌数量(680±100)分别低于口臭口腔好氧细菌数量(7200±800)和厌氧细菌数量(12520±120),差异有统计学意义(P0.01),且口臭口腔以革兰阳性菌和杆菌占优势,非口臭口腔真菌数量低于口臭口腔真菌数量,两者差异无统计学意义(P0.05)。口腔中没有检出放线菌。结论口臭患者口腔微生物多样性高于非口臭组,可以通过调整口腔微生态改善口臭。     

两种漱口液对口腔挥发性硫化物及舌背细菌的影响

目的评价常见的两种市售漱口液对口腔挥发性硫化物水平及舌背菌群的影响。方法采用为期1月的单中心、随机、对照、双盲的临床研究方法。研究对象共60人。分为李斯德林漱口液组(A组),高露洁贝齿漱口液组(B组),阴性对照组(C组)。分别在基线、半个月、1个月时检测各组研究对象的口腔挥发性硫化物水平及舌背厌氧菌的数量变化,并进行统计学分析处理。结果对于口腔挥发性硫化物水平,在半个月及1个月时,A组、B组均有明显的下降,均优于C组,差异具有统计学意义(P<0.05);且A组与B组之间的差异也具有统计学意义(P<0.05)。对于舌背厌氧菌的数量变化,在半个月及1个月时,A组、B组厌氧菌数量均有所下降,均优于C组,差异具有统计学意义(P<0.05);但A组与B组之间的差异没有统计学意义(P>0.05)。结论李斯德林漱口液及高露洁贝齿漱口液均能有效降低口腔挥发性硫化物水平及舌背厌氧菌的数量,且李斯德林漱口液降低硫化物的效果更优。     

抗口臭中药复方的筛选

目的筛选有效、安全的抗口臭中药处方,为抗口臭护理用品提供研发实验依据。方法选用9味可食性中药用口臭主要相关菌种的敏感试验及硫化物检测仪（Hallimeter）检测含硫代谢产物。按单味中药及复合配方两步筛选,确定有效处方。结果9味中药敏感试验证实乌梅、丁香抑菌作用强于其它中药,菊花降低硫化物较强,特别在无抑菌浓度作用下仍有减低硫化物作用。结论乌梅、丁香、菊花配方有较强抗口臭作用,待进一步临床证实。     

幽门螺杆菌感染与慢性口臭关系的初步研究

目的 调查主诉口臭患者的幽门螺杆菌（H．pylori）感染率和主诉消化不良的口臭发生率。方法 研究对象为125例主诉慢性口臭患者和212例主诉慢性消化不良患者。口臭以口气挥发性硫化物（VSC）检测与闻诊联合诊断,H．pylori感染以^14C-尿素呼气试验诊断。结果 125例主诉慢性口臭的患者有87例是真性口臭,其余38例为假性口臭,真性口臭患者的H．pylori感染率显著高于假性口臭（40．2％和13．2％,P〈0．01）。212例主诉慢性消化不良的患者发生口臭105例（49．5％）、感染H．pylori 94例（44．3％）,H．pylori阳性患者的口臭发生率显著高于H．pylori阴性患者（57．5％和43．2％,P〈0．05）。无论何种主诉,大部分口臭患者属于VSC阳性（88．5％）,但H．pylori阳性患者和H．pylor阴性患者口气VSC水平差异无显著性,VSC阳性口臭和VSC阴性口臭的H．pylori感染率差异也无显著性。结论 H．pylori感染可能与口臭的发生有一定关系,但口气VSC并非由H．pylori直接产生。     

口臭症口腔微生态学的研究

目的 :研究口臭症患者口腔菌群分布。方法 :选择 3 0例口臭患者和 3 0例健康人 ,分别采集舌背舌苔和牙周袋菌斑作细菌的需氧、微需氧和厌氧菌的定量培养 ,并对牙龈卟啉单胞菌及衣氏放线菌做抑菌试验。结果 :口臭组舌背厌氧菌及微需氧菌总数 (12 .2± 1.3 2 )与健康对照组 (9.5± 1.2 4)差异有非常显著性 (P<0 .0 1) ,口臭组需氧菌总数与健康组差异有显著性 (P<0 .0 5) ;口臭组牙周袋厌氧菌及微需氧菌总数 (13 .12± 1.2 6)明显高于健康对照组 (11.3± 1.82 ) ,两者差异有非常显著性 (P<0 .0 1) ,而需氧菌差异无显著性 ;口臭症舌背以小韦荣菌为主 ,其次是黑色普氏菌 ;牙周袋菌斑以牙龈卟啉单胞菌和黑色普氏菌为主 ,其次是衣氏放线菌。并筛选出两类抗菌漱口水和一种中外合资抗口臭牙膏 ,对舌背及牙周袋菌斑的主要细菌牙龈卟啉单胞菌和衣氏放线菌有明显的抑制作用。结论 :口臭症患者口腔菌群分布和总数与正常人群存在显著的差异 ,与牙周病有关的致病菌数量明显高于正常人群 ,据抑菌试验结果采用有效的漱口液及牙膏可明显降低口腔内致病菌和改善口臭症状。     

唾液链球菌SB3和ICDC2对口腔微环境有益作用的研究

目的本研究从中国健康儿童口腔分离得到2株唾液链球菌SB3和ICDC2,研究其对口腔微生态环境有益作用的机制,为预防和治疗口腔疾病提供理论依据。方法将唾液链球菌K12作为标准益生菌株,具核梭杆菌作为阳性对照,通过共聚集试验、挥发性硫化物抑制试验及FaDu细胞感染试验,评价唾液链球菌SB3和ICDC2作为益生菌的潜能。结果共聚集试验中唾液链球菌SB3和ICDC2的5 min共聚率分别为62.5%和76.8%,3 h共聚率分别为75.0%和83.4%。唾液链球菌SB3和ICDC2均能抑制具核梭杆菌产生挥发性硫化物。FaDu细胞感染试验表明,唾液链球菌SB3或ICDC2与具核梭杆菌同时感染均能够显著降低IL-6水平(t=4.925,P=0.008;t=3.789,P=0.019)。唾液链球菌SB3能够显著升高IL-10水平(t=6.807,P=0.002),1 h预感染组IL-6水平降低较同时感染组更明显,2株菌均能够显著升高IL-10水平(t=14.540,P0.001;t=22.030,P0.001)。结论唾液链球菌SB3和ICDC2具有对具核梭杆菌的抑菌能力,有望成为适合中国人口腔微环境的益生菌,应用于口腔疾病的预防与治疗。     

葡萄酒中重要挥发性硫化物的代谢及基因调控

葡萄酒中的挥发性硫化物是由酿酒微生物在葡萄酒发酵过程中代谢所产生的,主要包括硫化氢、硫醇、硫醚、硫醇酯、含硫杂醇油及杂环化合物等,它们对葡萄酒的风味会产生重要影响。本综述介绍了葡萄酒中重要的挥发性硫化物的主要代谢途径及相关基因的调控机制,并提出酿酒微生物的相关研究是提高优良风味物质含量,同时抑制不良风味产生的有效途径。     

水体沉积物中酸可挥发性硫化物(AVS)研究进展

水体沉积物中酸可挥发性硫化物 (AVS)是总硫含量中活性最高的部分 ,是沉积物中有毒重金属的重要结合形态 ,它的含量在很大程度上影响着沉积物重金属的生物有效性 ,从而作为沉积物中有毒重金属环境污染评价的一个重要指标 ;就十多年来水体沉积物中酸可挥发性硫化物 (AVS)的研究进行了综述。概述了 AVS的测定方法及其影响因素 ;探讨了水体沉积物中 AVS含量时空变化的规律 ;同时就目前“同时可提取重金属”(SEM)与 AVS摩尔浓度比值和水体沉积物重金属生物毒性关系的研究进行了概括和分析。     

义齿口臭的相关因素研究

目的:探讨义齿口臭的的相关因素。方法:选择62例无牙周疾病且全身健康(心血管系统疾病除外)的上颌义齿修复者,鼻闻法检查口臭程度(OR值),使用便携式口气测量仪(halitosis)测量VSCs量,记录义齿使用时间、菌斑指数(plaque index,PLI)。结果:Spearman相关分析法显示口臭值与义齿使用时间、PLI存在正相关(r=0.73,r=0.52,P<0.01),义齿口臭OR值与VSCs量存在正相关(r=0.62,p<0.01),义齿使用时间与PLI也有一定的相关性(r=0.259,P<0.05)。结论:口臭值、VSCs量与聚甲基丙烯酸脂基托义齿使用时间、PLI均有关系,义齿口臭的气体成份不完全同于其它口源性口臭。     

Therapeutic Effectiveness of a Dietary Supplement for Management of Halitosis in Dogs

Halitosis is a common complaint involving social and communicational problems in humans and also affects the pet-owner relationship. In this randomized placebo-controlled crossover clinical evaluation, we assessed the effectiveness of a dedicated dietary supplement to improve chronic halitosis in 32 dogs of different breeds and ages. This protocol describes how to evalute the presence of oral volatile suphur compunds, e.g. methyl mercaptan, hydrogen sulfide and dimethyl sulfide, by means of a portable gas chromatograph device coupled with a syringe, which was used to collect the breath, and a dedicated software, which allows the operator to monitor each compound concentration during each measurement, in a relatively short time (8 min).A significant modification of halitosis parameters was observed after 30 days since the beginning of treatment (p <0.05), while a long-lasting effect was still observed even 20 days after the suspension of the treatment. Portable gas chromatograph, which is also widely used in clinical practice, can be therefore used to confirm and control halitosis in humans and animals. Even though human and animal species present some differences, this innovative and alternative therapy for halitosis management might be extended to human clinical practice as an adjuvant dietary approach.     

Halitosis associated volatiles in breath of healthy subjects

BACKGROUND: Halitosis can have an intra- or extra-oral origin. In all cases, bad breath is caused by the presence of volatile organic compounds originating from the mouth or the expired air. They can be specific for certain diseases or infections. STUDY OBJECTIVE: This study explored the presence and concentration of these volatile compounds normally associated with halitosis in the breath of healthy symptomless volunteers. METHODS: Alveolar and mouth air of 40 healthy volunteers as well as environmental air were analyzed by gas chromatography-mass spectrometry (GC-MS) and by a commercially available GC device (OralChroma). RESULTS: 14 compounds, associated with halitosis could be detected. All of them except carbon disulfide, appeared to be (partly) produced endogenously and/or in the mouth. Acetone, 2-butanone, 2-pentanone and 1-propanol were common to all volunteers in both alveolar and mouth air and indole and dimethyl selenide in alveolar air. CONCLUSIONS: GC-MS seems a promising tool for differential diagnosis of halitosis, with the possibility to detect extra-oral causes, which often remain undetected unless characterized by a specific smell.     

A preliminary study of the effect of probiotic Streptococcus salivarius K12 on oral malodour parameters

AIMS: To determine whether dosing with bacteriocin-producing Streptococcus salivarius following an antimicrobial mouthwash effects a change in oral malodour parameters and in the composition of the oral microbiota of subjects with halitosis. MATERIALS AND RESULTS: Twenty-three subjects with halitosis undertook a 3-day regimen of chlorhexidine (CHX) mouth rinsing, followed at intervals by the use of lozenges containing either S. salivarius K12 or placebo. Assessment of the subjects' volatile sulphur compound (VSC) levels 1 week after treatment initiation showed that 85% of the K12-treated group and 30% of the placebo group had substantial (>100 ppb) reductions. The bacterial composition of the saliva was monitored by culture and PCR-denaturing gradient gel electrophoresis (PCR-DGGE). Changes in the PCR-DGGE profiles occurred in most subjects following K12 treatment. In vitro testing showed that S. salivarius K12 suppressed the growth of black-pigmented bacteria in saliva samples and also in various reference strains of bacteria implicated in halitosis. CONCLUSIONS: Administration of bacteriocin-producing S. salivarius after an oral antimicrobial mouthwash reduces oral VSC levels. SIGNIFICANCE AND IMPACT OF THE STUDY: The outcome of this preliminary study indicates that the replacement of bacteria implicated in halitosis by colonization with competitive bacteria such as S. salivarius K12 may provide an effective strategy to reduce the severity of halitosis.     

Correlation between oral malodor and periodontal bacteria

Volatile sulfur compounds (VSCs), including hydrogen sulfide, methyl mercaptan, and dimethyl sulfide, are primarily responsible for oral malodor. Recently, the mgl gene encoding L-methionine-alpha-deamino-gamma-mercaptomethane-lyase, which produces methyl mercaptan, was cloned from Porphyromonas gingivalis. This article discusses the mechanism and pathogenic role of the formation of VSCs by oral bacteria.     

幼儿舌脱落细胞形态与口气关系的研究分析

目的:比较分析高口气值组和低口气值组幼儿舌脱落细胞形态计量学参数及分类计数上的差异,探讨口气是否影响舌粘膜上皮细胞的角化、凋亡过程。方法:3-5岁幼儿40名,其中高口气值组幼儿20名,低口气值组幼儿20名,,取舌背中1/3脱落细胞,制作细胞涂片、H.E染色。应用计算机图像分析系统对舌脱落细胞进行形态计量学检测和分类计数。结果:高口气值组幼儿的舌脱落细胞的各类细胞的细胞形态较低口气值组幼儿小,且细胞核也更小。中层细胞、完全角化细胞计数在两组间的差异无统计学意义(P>0.05),高口气值组角化前细胞计数明显高于低口气值组(P<0.01),而高口气值组不全角化细胞计数明显低于低口气值组(P<0.01)。结论:高口气值组幼儿的舌脱落细胞较小,细胞角化程度较低,凋亡速度较慢。     

The effect of cetylpyridinium chloride on halitosis and periodontal disease-related parameters in dogs

Periodontal disease is an oral disease common in middle-aged dogs and cats, with halitosis being the most common sign. There are many commercial products containing chlorhexidine, cetylpyridinium chloride (CPC), zinc salts and essential oils for controlling halitosis and periodontal disease. CPC is a quaternary ammonium compound and has a broad spectrum antimicrobial activity. In this study, oral spray (OS) and gel (OG) containing CPC was applied to the dogs’ teeth twice daily for 3 weeks, and their effect in controlling periodontal disease and halitosis was examined. In the 3-week study, OS and OG were significantly effective in controlling plaque, calculus, and halitosis. Therefore, the OS and OG containing CPC were effective in controlling periodontal disease and halitosis in dogs.