益生元对口腔健康促进作用和机制研究进展

口腔微生物群落的动态平衡是维持口腔健康的关键因素。益生元是一类具有选择性、能够促进体内有益菌代谢增殖从而改善宿主健康的有机物质,主要通过调节口腔微生物生长代谢、抑制口腔菌斑生物膜形成、调节宿主免疫反应、参与硝酸盐-亚硝酸盐-一氧化氮代谢循环通路、调节氧化应激反应等途径调控口腔微生态,从而对口腔常见疾病,如龋齿、牙周病、口腔黏膜病的防治起到积极作用。本文主要就近年来益生元在口腔健康中的作用及相关机制的研究情况进行综述。     

口腔微生物与全身健康研究进展

口腔微生物是定植于人体口腔的微生物集合。众多研究证实,口腔微生物与多种口腔感染性疾病及系统性疾病紧密相关。随着“人类微生物组计划”及其他微生物宏基因组学相关项目的开展,人们对口腔微生物群落的认识不断深入。本文基于最新研究进展,就口腔微生物的组成、演替特点、与口腔和全身系统性疾病的关系及与肠道微生物的交互作用进行综述。     

半导体激光在口腔临床医疗中的应用和研究进展

激光在口腔领域中的应用越来越多。半导体激光以其诸多的优点,在口腔领域的应用也越来越广泛,现就半导体激光在口腔内科、口腔正畸学、口腔修复学、口腔种植学以及颌面外科等领域的临床应用现状及目前的研究进展加以综述。     

成人口腔黏膜念珠菌病的多因素分析

为探讨影响成人口腔黏膜念珠菌病发生的因素,选取口腔黏膜念珠菌病、复发性阿弗他溃疡、扁平苔藓、舍格伦综合征、白斑、天疱疮、类天疱疮患者及口腔黏膜健康者为研究对象,详细记录731个样本的年龄、性别、吸烟、口腔卫生情况、抗生素使用、义齿、口腔黏膜疾病、全身疾病,对结果进行多元Logistic回归分析,得到影响口腔黏膜念珠菌病发生的因素有4类,分别为发病前使用抗生素、口腔卫生情况、口腔黏膜疾病、全身疾病,即多种因素的作用导致口腔黏膜念珠菌病的发生。     

口腔微生态失衡导致口腔异味的研究

目的介绍口腔微生态失调与口腔疾病的关系,口腔疾病出现口腔气味异常的机制。综合分析口腔微生态与口腔健康的研究动态及意义。展望口腔微生态调整在口腔疾病治疗中的作用研究,尤其在消除口腔异昧的积极作用。方法由第一、二作者应用计算机通过pubmed检索NCBI数据库1992年至2007年相关文献,检索词为“Micro ecology”,限定语言种类为“English”;同时检索CNKI全文数据库、维普全文数据库1995年至2007年相关文献,检索词为“微生态”,限定语言种类为中文。纳入标准：文章内容与口腔微生态相关的研究、以及在口腔疾病研究领域有关。排除标准：较陈旧的文献和重复研究。结果共收集到106篇相关文献,21篇文献纳入本文,其中,19篇为综述和述评类文献,19篇为中文杂志,2篇为外文杂志。结论致病菌大量生长繁殖,口腔微生态失调,菌斑内微生物之间以及机体与菌斑之间相互作用分解蛋白产生硫化物,这些代谢产物包括H2S、CH3SH、CH3SCH3、吲哚、甲基吲哚、挥发脂肪酸和聚胺等发出刺激性气味,产生口腔异味。治疗口腔异味应该考虑平衡口腔微生态,调整口腔菌群。口腔异味的治疗又有利于口腔菌群平衡。提示我们治疗口腔疾病应该考虑口腔微生态平衡。     

甲硝唑联合碳酸氢钠在昏迷患者口腔护理中的应用研究

目的探讨颅脑外科昏迷患者安全有效的口腔清洁方法。方法选择脑出血或重型颅脑损伤昏迷需行口腔护理的患者130例,随机分为观察组和对照组各65例。观察组采用0.5%甲硝唑和5%碳酸氢钠混合液进行口腔护理;对照组采用3%过氧化氢溶液和生理盐水进行口腔护理。结果观察组在保持口腔清洁湿润、改变口腔酸性环境、消除口臭、防治口腔感染和肺部并发症方面均明显优于对照组。结论甲硝唑与碳酸氢钠混合液能有效预防和控制颅脑术后昏迷患者口腔感染和肺部并发症的发生。     

口腔微生态失衡导致口腔异昧的研究

目的介绍口腔微生态失调与口腔疾病的关系,口腔疾病出现口腔气味异常的机制。综合分析口腔微生态与口腔健康的研究动态及意义。展望口腔微生态调整在口腔疾病治疗中的作用研究,尤其在消除口腔异昧的积极作用。方法由第一、二作者应用计算机通过pubmed检索NCBI数据库1992年至2007年相关文献,检索词为“Micro ecology”,限定语言种类为“English”;同时检索CNKI全文数据库、维普全文数据库1995年至2007年相关文献,检索词为“微生态”,限定语言种类为中文。纳入标准：文章内容与口腔微生态相关的研究、以及在口腔疾病研究领域有关。排除标准：较陈旧的文献和重复研究。结果共收集到106篇相关文献,21篇文献纳入本文,其中,19篇为综述和述评类文献,19篇为中文杂志,2篇为外文杂志。结论致病菌大量生长繁殖,口腔微生态失调,菌斑内微生物之间以及机体与菌斑之间相互作用分解蛋白产生硫化物,这些代谢产物包括H2S、CH3SH、CH3SCH3、吲哚、甲基吲哚、挥发脂肪酸和聚胺等发出刺激性气味,产生口腔异味。治疗口腔异味应该考虑平衡口腔微生态,调整口腔菌群。口腔异味的治疗又有利于口腔菌群平衡。提示我们治疗口腔疾病应该考虑口腔微生态平衡。     

MACC1和C-Met在口腔白斑和口腔鳞状细胞癌中的表达及意义

目的:探讨分析MACC1和C-Met在正常口腔黏膜、口腔白斑及口腔鳞状细胞癌中的表达及其临床意义。方法:采用免疫组化SP法检测20例口腔黏膜、20例上皮异常增生白斑、50例口腔鳞癌组织中的MACC1、C-Met蛋白的表达情况,采用X2和spearman等级相关分析对结果进行判定。结果:MACC1、C-Met蛋白在异常增生型白斑和口腔鳞癌中的阳性表达率分别为50%、76%,35%、66%,均明显高于正常口腔黏膜(17.6%,5.0%),差异均有统计学意义(P0.05)。MACC1和C-Met蛋白表达与口腔鳞癌的分期、淋巴结转移及分化程度密切相关(P0.05)。Spearman等级相关分析显示口腔白斑及口腔鳞癌中MACC1和C-Met的表达呈现正相关(P0.05)。结论:MACC1和C-Met在上皮不典型增生性白斑和口腔鳞癌中高表达,二者在口腔黏膜白斑的癌变和口腔鳞癌的发生发展中可能起重要作用。     

口腔微生态的研究进展

口腔微生物与人体始终处于动态生态平衡状态,对于维护人体的健康发挥重要的作用,也与多种口腔疾病的发生发展有密切关系.随着现代科学技术的发展,越来越多的新技术、新方法用于口腔微生态领域的研究,这使得人们对口腔微生态的认识不断深入.以下将从口腔微生态的组成、口腔微生态与机体的关系及其研究方法三个方面简要介绍近年来口腔微生态的相关研究进展.     

口腔微生物群和人体健康

口腔微生物群作为人体微生物群的重要组成部分,其与人体健康之间的关系已成为各领域研究的焦点。口腔微生物群种类繁多、组成复杂,涵盖了细菌、真菌、古细菌和病毒等。近年来的研究显示,口腔微生物群的组成和比例与人体健康密切相关,会影响口腔疾病如龋齿、牙周病的发生。同时口腔微生物也是全身系统性疾病如肺炎、肿瘤和糖尿病等发生的危险因素之一。大量研究认为,口腔微生物群组成的改变、口腔微生物群之间的相互作用对疾病的发生有协同促进作用。本文聚焦于口腔微生物群的组成相关研究、口腔微生物组的最新进展,并对其与人体健康之间的关系进行综述。     

Expression of Wnt signalling pathway genes during tooth development.

We have carried out comparative in situ hybridisation analysis of six Wnt genes Wnts-3, -4, -5a, -6, -7b, and 10b together with Wnt receptor MFz6 and receptor agonist/antagonists MFrzb1 and Mfrp2 during murine odontogenesis from the earliest formation of the epithelial thickening to the early bell stage. Expression of Wnt-4, Wnt-6, and one Wnt receptor MFz6 was observed in the facial, oral and dental epithelium. Wnt10b was localised specifically to the presumptive dental epithelium. Wnts-3 and -7b were expressed in oral epithelium but showed no expression in the presumptive dental epithelium. Wnt-3 also showed no expression in the epithelial cells of the molar bud stage tooth germs, but showed restricted expression in the enamel knots which are signalling centres believed to be involved in regulating tooth shape. Wnts -6, -10b and MFz6 were also detected in the primary and secondary enamel knots. Wnt-5a and agonist/antagonists MFrzb1 and Mfrp2 were expressed in a graded proximo-distal (P-D) manner in mesenchymal cells during the early stages of tooth development with no overlying expression in the oral or dental epithelium. Wnt-5a and MFrzb1 show strong expression in the dental papilla mesenchyme.     

Incidence of caries in children of rural and subrural areas in Croatia

The aim of this paper was to determine certain regularities in caries incidence in children in primary and permanent dentition in respect of clinical and non-clinical variables that can be collected in everyday dental practice. This way it could be easier for the operator to adjust individual preventive therapy of patients. The study was conducted on 301 subjects, aged 3-6 (74 subjects) and 11-14 (227 subjects) inhabitants of Petrinja and Topusko, postwar rural and subrural areas in Central Croatia. Using an oral hygiene questionnaire, habits, diet and use of fluoride were assessed. The clinical finding comprised the dental status, amount of stimulated saliva, oral hygiene index and the presence of orthodontic anomaly. Children showed very high values of the dmf-t/DMF-T (decayed, missing, filled index) (7.7/6.7), dmf-s/DMF-S (16.5/11.8), and significant index of caries (SiC = 10.89). The study confirmed correlation between the OHI (oral hygiene index) and dmf-t/DMF-T and dmf-s/DMF-S index, and the influence of the regularity of dental check-ups and frequency of tooth brushing on OHI. Furthermore, the children that started practicing oral hygiene later, brush their teeth irregularly, and visit dentists only when having pain. It can be concluded that Croatia is still very far from achieving the goals set by WHO concerning oral health improvement.     

Oral health related to demographic features in Bosnian children aged six

The main aim of this paper is to present epidemiological indicators of oral health among six-year olds in Bosnia and Herzegovina (BH) and to analyze values of dmft index and dental treatment needs in order to identify differences in parts of the country. Another aim is to identify the needs from the public oral health care system in Bosnia and Herzegovina related to early permanent dentition by analyzing the condition of first permanent molars (FPM) as an indicator of oral health of permanent dentition. Survey was carried out in 2004 in 8 cantons of the Federation of BH (FBH) and in the Republic of Srpska (RS). Final sample included 560 participants aged six (mean 6.2, SD +/- 0.87). One dental team clinically examined all participants according to WHO methodology and criteria. The parameters used were: dmft index, DMFT index of first permanent molars (FPM), presence of sealants and treatment needs. A questionnaire about oral health habits had been administered. Dmft was 6.71 in that the d-component constituted the major part of the index. DMFT index of FPM was 0.61 (SD +/- 1.08). Percentage of caries free participants aged 6 was 6.8%. Average number of FPM with fissure sealants in BH was 0.25 (SD +/- 0.78). Significant demographic differences in dmft index, DMFT FPM and treatment needs were identified. Most participants (48.5%) had their first dental visit between the ages of five and seven. National oral health goal for Bosnia and Herzegovina should be to develop and implement disease prevention programs based on education of both parents and dental practitioners. It is necessary to improve access to dental care and shift focus from curative to preventive procedures. It is also necessary to set real goals for improvement of oral health which can be achieved within a desired time frame, as well as to precisely define measures to be taken.     

Perceived Impact of Dental Pain on the Quality of Life of Preschool Children and Their Families

The aim of the present study was to evaluate the perceived impact of dental caries and dental pain on oral health-related quality of life (OHRQoL) among preschool children and their families. A cross-sectional study was conduct with 843 preschool children in Campina Grande, Brazil. Parents/caregivers answered a questionnaire on socio-demographic information, their child’s general/oral health and history of dental pain. The Brazilian version of the Early Childhood Oral Health Impact Scale was administered to determine the perceived impact of caries and dental pain on OHRQoL. The children underwent an oral examination. Logistic regression for complex sample was used to determine associations between the dependent and independent variables (OR: Odds ratio, α = 5%). The independents variables that had a p-value <0.20 in the bivariate analysis were selected for the multivariate model. The prevalence of dental caries and dental pain was 66.3% and 9.4%, respectively. Order of birth of the child, being the middle child (OR: 10.107, 95%CI: 2.008-50.869) and youngest child (OR: 3.276, 95%CI: 1.048-10.284) and dental pain (OR: 84.477, 95%CI: 33.076-215.759) were significant predictors of the perceived impact on OHRQOL for children. Poor perception of oral health was significant predictor of the perceived impact on OHRQOL for family (OR=7.397, 95%CI: 2.190-24.987). Dental caries was not associated with a perceived impact on the ORHQoL of either the children or their families. However, order of child birth and dental pain were indicators of impact of OHRQoL on preschool children and poor perception of oral health was indicators of impact on families.     

Measuring psychosocial variables that predict older persons’oral health behaviour

The importance of recognising psychosocial characteristics of older people that influence their oral health behaviours and the potential success of dental procedures is discussed. Three variables and instruments developed and tested by the author and colleagues are presented. A measure of perceived importance of oral health behaviours has been found to be a significant predictor of dental service utilization in three studies. Self-efficacy regarding oral health has been found to be lower than self-efficacy regarding general health and medication use among older adults, especially among non-Western ethnic minorities. The significance of self-efficacy for predicting changes in caries and periodontal disease is described. Finally, a measure of expectations regarding specific dental procedures has been used with older people undergoing implant therapy. Studies with this instrument reveal that patients have concerns about the procedure far different than those focused on by dental providers. All three instruments can be used in clinical practice as a means of understanding patients’values, perceived oral health abilities, and expectations from dental care. These instruments can enhance dentist-patient rapport and improve the chances of successful dental outcomes for older patients.     

Dental anxiety among middle-aged and elderly women in Sweden. A study of oral state,utilisation of dental services and concomitant factors

The aim of this project was to investigate dental anxiety and its expression in utilisation of dental services, oral health and oral symptoms. In a cross-sectional study of women's health in Göteborg (population 432,000), Sweden, 1016 women aged 38 to 84 years participated. This randomly selected population took part in a series of investigative procedures including medical and dental clinical examinations, interviews and questionnaires. Levels of dental anxiety were measured on the Corah Dental Anxiety Scale (DAS). The average DAS score obtained was 7.2. The study showed that older women were significantly less anxious than younger ones. Severe dental anxiety (DAS 15) was experienced by 3.9% of the participants. This frequency corresponds well with findings by Hällström and Halling in their analysis of data from the first Göteborg study of women's health 24 years ago. High levels of dental anxiety were correlated with longer intervals between dental visits, poorer oral function and aesthetics and a higher frequency of oral symptoms. Headaches were more prevalent in the younger age groups and a correlation with dental anxiety was revealed. Our previous studies have shown that symptoms such as tension headaches are prevalent among dental phobic patients and that they are reported to be reduced by therapy for dental fear. The clinical and radiographical examinations revealed a generally poorer oral status, with a statistically significant higher number of decayed teeth among women with high dental anxiety.     

Historical perspectives on advertising and the meme that personal oral hygiene prevents dental caries

The consensus of a leading scientific panel in 1930 was that oral hygiene products could not prevent dental caries. Their view was that dental caries prevention required the proper mineralisation of teeth and that vitamin D could achieve this goal. Over a hundred subsequent controlled trials, conducted over seven decades, largely confirmed that this scientific panel had made the right decisions. They had, in 1930, when it comes to dental caries, correctly endorsed vitamin D products as dental caries prophylactics and oral hygiene products as cosmetics. And yet, despite this consistent scientific evidence for close to a century, an opposing conventional wisdom emerged which thrives to this day: oral hygiene habits (without fluoride) protect the teeth from dental caries, and vitamin D plays no role in dental caries prevention. This historical analysis explores whether persistent advertising can deeply engrain memes on dental caries prevention which conflict with controlled trial results. The question is raised whether professional organisations, with a dependence on advertising revenues, can become complicit in amplifying advertised health claims which are inconsistent with the principles of evidence‐based medicine.     

Sources and patterns of referrals of oral cancer: role of general practitioners.

Referrals of patients with oral squamous cell carcinomas to an oral medicine clinic were assessed with regard to the sources, delays, and pattern of referrals from general medical practitioners and general dental practitioners. Slightly more patients were referred by dental practitioners than by medical practitioners, but general medical practitioners were far more likely to see advanced tumours and to request an urgent second opinion or suggest a diagnosis of malignant disease. The greatest delay overall was caused by the patients in seeking advice from their practitioner, particularly those who attended a general medical practitioner. Both groups of practitioners requested a hospital opinion within roughly a month--a reasonable interval. Subsequent delays were minimal. Delays occur mainly because the patients are slow in seeking professional advice and, in general, do not appear to have been reduced over the decade since a previous British study on referral patterns was carried out. This study emphasises the importance of educating patients about oral cancer since it is they who appear to be mainly responsible for the delays in diagnosis. The results also help to dispel the myth that general medical practitioners might be less competent at diagnosis and referral of patients with oral cancer than are dental practitioners, though we are aware of misdiagnoses from both groups.     

Stem cells: Sources,and regenerative therapies in dental research and practice

Stem cells are considered to be among the principle scientific breakthroughs of the twentieth century for the future of medicine, and considered to be an important weapon to fight against diseases, particularly those that have resisted the efforts of science for a long time. Human dental tissues have limited potentials to regenerate but the discovery of dental stem cells have developed new and surprising scenario in regenerative dentistry. Stem cell treatments are one example of the possibility using adult cells sourced from patients’ own bodies’ means that it can be expected that in the near future such treatments may become routine at dental practices. The hope is that it will become possible to regenerate bone and dental tissues including the periodontal ligament, dental pulp and enamel, and that the creation of new teeth may also become feasible. In view of this possibility of achieving restoration with regenerative medicine, it can be considered that a new era of dentistry is beginning. Thus the aim of this review is to give dental professionals a brief overview of different stem cells sources and the latest findings and their implications for improving oral health and treating certain conditions of the human mouth and face.     

Korean Version of Child Perceptions Questionnaire and Dental Caries among Korean Children

Although dental caries has been a major oral health problem for children, the association between dental caries and oral health related quality of life has been still controversial. This study aims to evaluate the association between the Korean version of the Child Perceptions Questionnaire (K-CPQ) and dental caries among Korean children. Eight hundred one school children aged 8 to 14 years participated in this study. After the K-CPQ was validated we performed an association study. The K-CPQ was self-reported. Dental caries were evaluated by dentists using the World Health Organization Index. Correlation analyses (intraclass correlation coefficient, Cronbach’s alpha and Pearson’s correlation coefficient [r]) and linear regression models (partial r) including age, gender and type of school were applied. Untreated deciduous dental caries was associated with the K-CPQ_8-10 overall score (partial r = 0.15, P <0.05). The link was highlighted in the domains of functional limitation and emotional well-being. Filled teeth due to caries (FT) was associated with the K-CPQ_11-14 overall domain (partial r = 0.14, P = 0.002) as well as with the oral symptoms domain (partial r = 0.16, P = 0.001). This association was highlighted among public school children. Our data indicate that K-CPQ was independently associated with dental caries. The K-CPQ could be a practical tool to evaluate the subjective oral health among Korean children aged 8 to 14.