固定矫正器矫正治疗错颌畸形对口腔微生态环境的影响

目的探讨固定矫正器矫正治疗错颌畸形对口腔微生态环境的影响。方法选择51例在口腔科采用固定矫正器进行矫正的错颌畸形患者,分别在矫正前后对口腔微生物进行培养,观察并比较矫正前后口腔微生态环境的变化情况。结果矫正治疗后1个月口腔牙龈卟啉单胞菌、伴放线杆菌、产黑色素类杆菌的检出率较矫正前升高(P均0.05),而口腔核酸杆菌、衣氏放线菌的检出率与矫正前比较差异无统计学意义(P均0.05),矫正后2个月、4个月、6个月口腔牙龈卟啉单胞菌、伴放线杆菌、核酸杆菌、产黑色素类杆菌及衣氏放线菌的检出率均高于矫正前(P0.05或P0.01)。结论采用固定矫正器矫正治疗错颌畸形会造成口腔微生态的改变,破坏口腔内环境的平衡,容易引起口腔疾病的发生,应早期进行预防及干预治疗。     

戴用可摘义齿的微生态学问题

微生态学是研究正常微生物群与宿主相互关系 ,微生态环境生态平衡和生态失调、以及建立生态调整和生态防治的一门新的学科。戴用可摘义齿可能引起口腔微生态环境的改变、促进菌斑的沉积 ,导致龋病和牙周病发病率增加等 ,在口腔修复学中已成为一急待解决的临床问题 ,本文就戴用可摘义齿的微生态学问题作一综述。1　正常口腔的微生态环境由于口腔的特殊环境 ,如有适宜的温度、湿度、营养源以及复杂的结构和理化性质等 ,给口腔内各种微生物的生长、繁殖、定居提供了良好的环境和条件 ,这些微生物在口腔不同部位栖息、共存 ,竞争和拮抗 ,与宿主…     

将微生态学理论贯穿于口腔微生物的教学中

口腔微生物学,是医学微生物学的重要分支,为使口腔系学生对口腔微生物的重要性和特殊性有所认识,在学习了医学微生物学的基础上,我室从九六年起给口腔系四年级学生开设了口腔微生物学课程。通过四年的教学实践,我们认识到:在口腔微生物教学中,必须以口腔微生态学作为贯穿口腔微生物教学的中心环节,紧密结合口腔微生态环境的维持和改变是保持口腔菌群正常和导致细菌引起口腔疾病的主要原因来设计和组织教学。从而有利于学生认识复杂的口腔微生态关系,建立从微生态平衡失调来分析口腔感染性疾病的发病机理和检查、防治原则等概念,为其今后的临…     

可摘局部义齿戴入后义齿区微生态的改变

可摘局部义齿是口腔活动修复中运用最久最为广泛的一种修复方式,其通过卡环的固位,基托的稳定,连接体的连接,可以使人工牙在患者缺牙间隙发挥相应的咀嚼功能。但是,可摘局部义齿作为一个外源性的异物戴入患者口内后,由于其理化性质与口腔正常环境差别极大,并且占据了口腔中的天然间隙,势必会导致口腔内环境的相应改变。口腔微生物依附于口腔内环境,与宿主共生。当口腔内环境变化时,口腔微生态也会产生相关的变化。研究可摘局部义齿戴入后口腔内微生态的变化可以使我们更好地评估可摘局部义齿的适应证,并指导我们新义齿的设计及开发方向。目前相关研究已相当充分,本文就可摘局部义齿戴入后,口腔微生态的变化作一简单综述。     

口腔矫正器对错颌畸形患者口腔微生态环境的影响

目的:探讨口腔矫正器对错颌畸形患者口腔微生态环境的影响。方法:选取在我院口腔科进行口腔矫正器治疗的错颌畸形患者48例,分别在矫正治疗前、治疗后1个月、3个月、6个月对其口腔微生物进行培养,观察比较错颌畸形患者在矫正治疗前后口腔微生态环境的变化。结果:1矫正治疗后1个月口腔变形链球菌、乳酸杆菌的检出率分别为16.7%、9.3%,均高于矫正治疗前,且变形链球菌在矫正治疗前后的检出率差异有统计学意义(P0.05)。矫正治疗后3个月、6个月口腔变形链球菌、乳酸杆菌的检出率均较矫正前明显升高,差异有统计学意义(P0.05或P0.01)。2矫正治疗后1个月牙龈卟啉单胞菌、伴放线杆菌、核酸杆菌的检出率分别为14.8%、13.0%和11.1%,均高于矫正治疗,且牙龈卟啉单胞菌、伴放线杆菌在矫正治疗前后的检出率差异有统计学意义(P0.05)。矫正治疗后3个月、6个月牙龈卟啉单胞菌、伴放线杆菌、核酸杆菌的检出率均比矫正前明显升高,差异有统计学意义(P0.05或P0.01)。结论:矫正器的放置破坏口腔微生态环境的平衡,影响牙齿、牙周的健康,应引起临床重视,及早做好预防及干预治疗。     

口腔微生态与干燥综合征相关性研究进展

干燥综合征是一种炎性细胞侵犯外分泌腺体的慢性自身免疫疾病,口干是其最常见的症状。伴随着干燥综合征患者口腔内微环境的改变,口腔各种微生物之间及微生物与宿主之间的平衡被打破,进而出现口腔微生态失调。口腔微生态失调与自身免疫疾病关系密切,其不仅是疾病所导致的结果,也可能是疾病进一步发展的原因。目前研究认为干燥综合征患者口腔微生态失调与唾液微环境的改变及口腔黏膜免疫受损存在密切的关系,本文对口腔微生态与干燥综合征关系的新近研究进展进行综述。     

溶菌酶活性与口腔微生态变化的实验研究

本文应用比浊法和需氧培养细菌、真菌、放线菌对咽炎患者的唾液溶菌酶活性与口腔微生态变化关系进行了初步研究。结果证明,口腔溶菌酶的下降可导致病菌生长,并显示严重的口腔感染;而真菌的存在似与溶菌酶之间无明显关系,为此,进一步对如何维持口腔微生态平衡以预防口腔感染以及真菌在微生态变化中的作用,似有进一步深入研讨的价值。     

三种药物牙膏对四种口腔常驻菌最低抑菌浓度的测定

采用琼脂稀释法,测定了三种药物牙膏对四种口腔常驻菌的最低抑菌浓度（ＭＩＣ）,结果表明,药物牙膏对口腔中的常驻菌有一定的抑制作用;提示,健康人长期使用药物牙膏,可能造成口腔微生态环境的失衡。     

快速上颌扩大术的力学实验分析

前言快速上颌扩大术(Rapid MaxillaryExpansion)简称RME是口腔矫形术的一种有效方法。它是使用装有扩大螺丝的固定于矫正器短时期内扩大上颌复合体(EaxillaryComplex)而达到治疗目的的一种矫治方法,其对患有上、下颌骨狭窄畸形的矫正治疗可以获得较理想的疗效。在进行RME治疗过程中,由于常伴有矫治力撑开、分离以腭中缝为主的颅面有关骨缝的现象,故有时也称为腭中缝分离术(Midpalatalsuture Opening)或快速腭扩大术(Rapid Palatal Expansion)。由于RME的口腔矫形治疗术易于控制、疗     

上颌固定矫治器联合下颌He垫及颏兜矫治恒前牙反He

目的：探讨矫治恒前牙反He的方法。方法：将50例恒前牙反He患者分为两组,用固定矫治器和活动矫治器矫治,观察解除反He所需的时间。结果：结果显示固定矫治组疗程明显于活动矫治组。结论：对于恒前牙反He患者,可以用固定矫治器联合下颌He垫、颏兜矫治,缩短疗程,达到理想治疗效果。     

Prediction of fibre architecture and adaptation in diseased carotid bifurcations

Many studies have used patient-specific finite element models to estimate the stress environment in atherosclerotic plaques, attempting to correlate the magnitude of stress to plaque vulnerability. In complex geometries, few studies have incorporated the anisotropic material response of arterial tissue. This paper presents a fibre remodelling algorithm to predict the fibre architecture, and thus anisotropic material response in four patient-specific models of the carotid bifurcation. The change in fibre architecture during disease progression and its affect on the stress environment in the plaque were predicted. The mean fibre directions were assumed to lie at an angle between the two positive principal strain directions. The angle and the degree of dispersion were assumed to depend on the ratio of principal strain values. Results were compared with experimental observations and other numerical studies. In non-branching regions of each model, the typical double helix arterial fibre pattern was predicted while at the bifurcation and in regions of plaque burden, more complex fibre architectures were found. The predicted change in fibre architecture in the arterial tissue during plaque progression was found to alter the stress environment in the plaque. This suggests that the specimen-specific anisotropic response of the tissue should be taken into account to accurately predict stresses in the plaque. Since determination of the fibre architecture in vivo is a difficult task, the system presented here provides a useful method of estimating the fibre architecture in complex arterial geometries.     

脉冲式冲牙器预防正畸患者牙龈炎的纵向对比研究

目的:正畸患者口腔内环境往往会受到多种不良影响,造成大量微生物种群定植于牙龈周围,并形成牙菌斑改变牙周组织的形态和结构,对正畸效果及疗程产生较大不利因素,如何采用合理干预措施降低口腔正畸患者牙菌斑和牙龈炎的发生率,成为正畸是否成功的关键因素之一。本研究旨在探讨脉冲式冲牙器对正畸患者牙菌斑及牙龈炎症的影响。方法:以82例青少年正畸患者及健康志愿者为研究对象,将正畸患者随机分为研究组(41例)和对照组(41例);于正畸后30天后对患者进行口腔卫生宣教及日常刷牙方法系统培训,研究组正畸患者采用脉冲式冲牙器;于干预前后评价牙龈指数(gingival index,GI)和Quigley-Hein菌斑指数(plaque index,PI)。结果:在干预前,志愿者与正畸30天患者均存在不同程度口腔卫生问题,正畸患者GI及PI等指数明显高于健康人群,差异具有统计学意义(P0.05);经过一定周期的干预,两组正畸患者的GI均有不同程度的改善,但以研究组患者效果更为明显,差异具有统计学意义(P0.05)。结论:脉冲式冲牙器能够产生超细高压脉冲水柱,可以在正畸治疗期间有效提高菌斑清除率,减缓牙龈炎的进程,不同程度改善正畸患者口腔卫生,有助于提高正畸治疗效果。     

Possible variation of the human oral bacterial community after wearing removable partial dentures by DGGE

Although it is well-known that variations of the microbial community in a specific location of human body may be associated with some diseases, the developing change of the oral microbiota related to oral diseases before and after wearing the removable partial dentures (RPD) is not completely understood. In this study, three kinds of samples (saliva, supra- and subgingival plaque, and oral mucosal surfaces) were collected from the 10-patients group at three different times: before, 1-month and 6-months after the treatment. Ten healthy adults were also selected as the control group. Denaturing gradient gel electrophoresis was applied to identify the bacterial profiles and to analyze the dynamics of the oral microbial population in the pre- and post-therapy. The ANOVA of Repeated Measurement Data indicated that, in the saliva and mucosal surfaces, wearing RPDs caused significant change of numbers of amplicons. As many as 607 amplicons were chosen to cut out and re-amplify by PCR. After cloning and sequencing, a total of 16 bacterial genera were identified. The health-associated genera such as Streptococcus, Neisseria, Rothia, Corynebacterium, Leptotrichia, Gemella, Veillonella, Selenomona and Actinomyces tended to decrease, whereas the disease-associated species including Streptococcus mutans tended to increase. In general, wearing RPDs influenced the diversity of the bacterial species in the oral microbial ecosystem. It is noteworthy that the oral environment will be changed from the healthy status towards the disease status after the treatment.     

牙菌斑生物膜的形成与控制

牙菌斑生物膜是附着于牙釉质表面,由复杂的微生物群落构成的一种聚集体。牙菌斑生物膜的形成与生长对口腔健康有着直接或间接的影响,许多研究证实口腔疾病如龋齿和牙周病都与细菌的积累及牙菌斑的形成有关。在牙菌斑生物膜形态建成过程中,牙齿表面最初的定殖菌对生物膜的微生物组成和结构至关重要,这些初级定殖菌决定了后续与之结合形成共生体的微生物种类和数量。不同的微生物组成可能在与生物膜形成相关的口腔病理状况中发挥不同的作用。因此,本文就牙菌斑生物膜的生长及控制进行综述,介绍其微生物的早期定殖和成熟过程、以及通过物理和化学方法对牙菌斑生物膜的控制,以期为了解牙菌斑生物膜的形成机制及相关口腔疾病的预防和治疗提供有价值的参考。     

牙周炎治疗过程中龈下菌斑的动态观察

目的　通过对牙周炎治疗过程中龈下菌斑内螺旋体和球菌的百分比组成的改变进行动态观察研究,为牙周炎的诊断和疗效评价提供依据。方法　选择１８ 例经门诊确诊为成人牙周炎的患者,随机分为Ａ、Ｂ、Ｃ 三组,均施以龈上洁治、龈下刮治和根面平整术。其中Ａ 组和Ｂ 组分别给予艾利克及洗必太含漱液含漱。所有患者每周复诊一次,采集龈下菌斑,进行刚果红染色,镜检计数螺旋体及球菌的百分比,同时检测患处牙龈指数（ＧＩ） 。结果　Ａ、Ｂ 组患者经治疗１ 周后,ＧＩ值变化极为显著（Ｐ＜ ０．０１） ,螺旋体的减少及球菌的增加也极具显著性（Ｐ＜ ０．０１） ,至３ 周时趋于稳定;Ｃ 组则在１ 周时ＧＩ值及菌斑组成的变化有显著性（Ｐ＜ ０．０５） ,至２ 周时变化才最为明显（Ｐ＜ ０．０１） ,４ 周时趋于稳定。结论　牙周基础治疗能明显改善临床症状,使螺旋体百分比显著降低,球菌百分比显著增加。口腔含漱液作为一种牙周炎的辅助用药,可明显改善菌斑的组成,促进正常口腔卫生环境的建立。     

Extracellular Glycoside Hydrolase Activities in the Human Oral Cavity

Carbohydrate availability shifts when bacteria attach to a surface and form biofilm. When salivary planktonic bacteria form an oral biofilm, a variety of polysaccharides and glycoproteins are the primary carbon sources; however, simple sugar availabilities are limited due to low diffusion from saliva to biofilm. We hypothesized that bacterial glycoside hydrolase (GH) activities would be higher in a biofilm than in saliva in order to maintain metabolism in a low-sugar, high-glycoprotein environment. Salivary bacteria from 13 healthy individuals were used to grow in vitro biofilm using two separate media, one with sucrose and the other limiting carbon sources to a complex carbohydrate. All six GHs measured were higher in vitro when grown in the medium with complex carbohydrate as the sole carbon source. We then collected saliva and overnight dental plaque samples from the same individuals and measured ex vivo activities for the same six enzymes to determine how oral microbial utilization of glycoconjugates shifts between the planktonic phase in saliva and the biofilm phase in overnight dental plaque. Overall higher GH activities were observed in plaque samples, in agreement with in vitro observation. A similar pattern was observed in GH activity profiles between in vitro and ex vivo data. 16S rRNA gene analysis showed that plaque samples had a higher abundance of microorganisms with larger number of GH gene sequences. These results suggest differences in sugar catabolism between the oral bacteria located in the biofilm and those in saliva.     

Resting dental plaque pH values after repeated measurements at different sites in the oral cavity

Plaque pH measurements can be used to detect individual's caries susceptibility and the cariogenic potential of ingested foods. However, repeated measurements with a touch electrode at a single site may affect the metabolic state of the dental plaque and result in changes of its inherent pH values. The purposes of this study were to evaluate the influence of repeated measurements of resting plaque pH values and to determine the pH values at different interdental sites. Eleven dental students participated in the study. The dental plaque was built up after thorough oral hygiene care. The subjects were then instructed to maintain a normal diet but to refrain from any oral hygiene care for the next 48 hours. Measurement of plaque pH was performed with an antimony electrode at 6 interproximal sites, including central spaces between the upper and between the lower central incisors, and the area between the second premolar and the first molar in each quadrant. At each tested site, measurements were taken 5 times at 0, 10, 30, 45 and 60 min. The results showed that the plaque pH became slightly alkaline at all the tested locations after repeated measurements. However, only the lower incisor area showed a significant change in pH values. Interdental plaque on the lower arch showed higher pH values than did that on the upper arch. There was no significant difference between the pH values on the right and left corresponding sites as determined using the Wilcoxon signed ranks test.     

PCR指纹图谱技术分析人体口腔内微生物菌群结构

目的 应用PCR-DGGE指纹图谱技术对人体口腔微生物菌群结构进行系统性研究.方法 对1例健康人唾液周期性采集的样品和8例健康人个体的唾液与牙菌斑采集的样品,进行微生物群落总DNA的抽提.以此为模板扩增16S rRNA V3可变区,产物经DGGE指纹图谱分析其组成结构,并运用UVIBAND/MAP等软件比较所得群落指纹图谱的相似性指数.结果 同一健康人个体不同采样时间的唾液菌群结构相似性系数＞74%,通过对不同健康个体口腔样本的研究,发现同一个体的唾液与牙菌斑菌群结构存在差异（84%～95%）.结论 同一健康个体其唾液微生物菌群在一定时间内基本稳定,仅有微小的变化;唾液与同个体牙菌斑的微生物组成虽然存在差异,但这种差异要明显小于个体间的差异.     

Developing an instrument to support oral care in the elderly

Background: The dramatic increase in the number of dependent elderly in developed countries has created a great need for their improved oral care. However, optimal oral care by caregivers is not possible because of time constraints, difficulty involved in brushing other individuals' teeth, lack of co‐operation, and the lack of perceived need. Therefore, the development of an effective instrument simplifying and supporting oral care to relieve the strain on caregivers is a matter of some urgency. Purpose: In order to clean the mouths of elderly dependent patients, we have developed a new oral care support instrument (an electric toothbrush in combination with an antibacterial‐agent supply and suction system). The purpose of the present study was to develop and evaluate a new oral care support instrument. Methods: a) Plaque removal study: The plaque‐ removing ability of this new instrument in 70 outpatients was compared with the Plak Control D9011 (Braun Gillette Japan Inc.) as a control by means of the Turesky modification of the Quigley and Hein plaque index, b) Clinical study: The subjects were 10 dependent elderly who received oral care using the new oral care support instrument for two weeks. The plaque and gingival indices were used for clinical evaluations. Results: a) Plaque removal study: Brushing with the new oral care support instrument removed significantly more plaque than with the Plak Control D9011. b) Clinical study: The new oral care support instrument allows a more effective removal of dental plaque and shows a significant improvement in the gingival indices in dependent elderly. Conclusion: It is concluded that the new oral care support instrument is effective and can be recommended for oral care in the dependent elderly.