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.     

无托槽隐形矫治器与固定矫治器对牙周病正畸治疗患者龈下菌群、龈沟液炎症因子和氧化应激的影响

摘要 目的：对比固定矫治器与无托槽隐形矫治器对牙周病正畸治疗患者龈沟液炎症因子、龈下菌群和氧化应激的影响。方法：选取2016年1月～2021年10月于河北省眼科医院口腔正畸科接受正畸治疗的112例牙周病患者,根据矫治器的不同分为对照组（固定矫治器,n=54）和实验组（无托槽隐形矫治器,n=58）。对比两组牙周健康指标、龈下菌群、龈沟液炎症因子、氧化应激指标和疼痛评分的变化情况。结果：两组矫治10个月后牙龈指数、菌斑指数、龈沟出血指数、牙周探诊深度下降,且实验组低于对照组（P<0.05）。实验组矫治10个月后牙龈卟啉单胞菌（Pg）、具核梭杆菌（Fn）、福塞斯坦氏菌（Tf）和中间型普里沃菌（Pi）含量低于对照组（P<0.05）。两组矫治10个月后肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素1β（IL-1β）下降,且实验组低于对照组（P<0.05）。两组矫治10个月后丙二醛（MDA）、活性氧（ROS）水平下降,且实验组低于对照组;超氧化物歧化酶（SOD）升高,且实验组高于对照组（P<0.05）。两组矫治1 d、7 d后疼痛视觉模拟评分（VAS）评分升高后下降,且实验组低于对照组（P<0.05）。结论：无托槽隐形矫治器与固定矫治器对牙周病正畸治疗患者均有较好的疗效,其中无托槽隐形矫治器在改善牙周健康指标、龈下菌群、龈沟液炎症因子和氧化应激等方面的效果较为显著。     

乳杆菌代谢产物对于固定矫治患者牙周指数和龈下菌群的敏感性研究

目的对已佩带固定矫治器6个月的患者采用乳杆菌DM9811代谢产物提取液制成的含漱液含漱治疗,探讨治疗前后牙周指数和牙周可疑病原菌的动态变化过程。方法采取自身前后对照和组间对照。记录治疗前后牙周指数的变化情况。并采用细菌培养鉴定法检测含漱前后龈下菌群的变化情况,测定牙周可疑病原菌的检出量和检出率。结果（1）试验组的牙龈指数（GI）、菌斑指数（PI）、龈沟出血指数（SBI）、探诊深度（PD）在治疗后均有下降,且试验组低于对照组。（2）试验组G^-产黑色素厌氧杆菌（BPAR）、梭杆菌、拟杆菌的检出量以及BPAR的检出率治疗后均有下降,试验组低于对照组;血链球菌的检出量有所上升,试验组高于对照组。结论乳杆菌DM9811代谢产物对固定矫治患者带环牙牙龈炎的各项临床指标均有改善作用,且颊侧优于舌侧;对龈下菌斑中梭杆菌、拟杆菌、BPAR等均有抑制作用,对有益菌中的血链球菌有扶植作用。     

固定矫治器对牙周指数及龈下菌群影响的实验研究

选择15例口腔卫生良好、牙周组织健康的正畸患者的90个牙位点,在黏接固定矫治器附件前进行菌斑指数、牙龈指数和探诊深度等临床牙周指数及龈下细菌的检测;根据患者上下颌牙齿错位畸形严重程度进行单颌牙齿黏接固定矫治器附件作为实验组,以暂不黏接固定矫治器附件的对颌牙齿作为对照组,在患者4周、8周复诊时进行重复检测。结果显示,戴用固定矫治器后牙齿的临床牙周指数与对照组及戴用矫治器前相比较,没有显著性差异(p>0.05);龈下细菌构成及比例亦未发生明显变化(p>0.05)。研究表明,戴用固定矫治器的患者如能认真保持口腔卫生,对牙周组织健康不会产生显著不良影响。     

PCR直接检测龈下菌斑主要可疑牙周致病菌

目的：应用PCR方法直接检测龈下菌斑主要可疑牙周致病菌与牙周病活动部位的关系,探讨其方法的可行性并探讨其主要可疑牙周致病菌的分布规律。方法：应用聚合酶链反应(polymerase chain reaction,PCR)直接检测龈下菌斑主要可疑致病菌16s RNA保守区域片段。40名受试者包括牙周病患者20人,每人同口取一个牙周病活动部位,一个相对健康或牙周病静止对照部位;成人健康者20人,每人各取一个标本。结果：龈下菌斑5种可疑牙周致病菌在牙周病活动部位的检出率牙龈卟啉菌为86％,福赛类杆菌为95％,螺旋体为86％,中间普氏菌和黑色普氏菌分别为95％和33％,均显著高于同口部位对照组和健康对照组。结论：PCR直接检测菌斑牙龈卟啉单胞菌、中间普氏菌、福赛类杆菌、齿密螺旋体及黑色普氏菌匀与牙周炎活动部位相关。     

牙龈卟啉单胞菌、嵴链球菌、口腔链球菌属在口腔内不同解剖部位的分布

目的探讨牙龈卟啉单胞菌(Porphyromonas gingivalis)、嵴链球菌(Streptococcus cristatus)、口腔链球菌属(Streptococci oralis)在慢性牙周炎患者及牙周健康者不同口腔解剖部位生物膜的分布情况。方法选取慢性牙周炎患者25例,牙周健康者24例,分别作为慢性牙周炎组及健康对照组。测量临床指标(探诊深度、附着丧失和探诊出血),取受试者龈下菌斑、舌背、颊黏膜和唾液样品。Real-time PCR分析受试者不同受检部位S.cristatus、P.gingivalis、Streptococci oralis相对数量。结果慢性牙周炎组四个受检部位中P.gingivalis数量均大于健康对照组;慢性牙周炎组龈下菌斑中P.gingivalis数量大于其余受检部位;而慢性牙周炎组龈下菌斑、舌背、颊黏膜三个受检部位S.cristatus、Streptococci oralis数量小于健康对照者。结论与牙周健康者比较,慢性牙周炎患者口腔内不同解剖位置P.gingivalis数量增多,S.cristatus、Streptococci oralis数量减少;P.gingivalis检出数量增加提示牙周炎患病风险增加,而S.cristatus、Streptococci oralis检出数量降低提示牙周炎患病风险降低。     

正常口腔中的可疑牙周致病菌

本实验对49例正常口腔的龈上和龈下菌斑内的可疑牙周致病菌(SPB)的分布情况进行了观察分析。 49例研究对象男21例,女28例;6～25岁,无龋,无牙周病的健康人。三月内未服用抗生素,未接受任何牙周治疗。定对在右上颌第一磨牙(No.3)的龈上及龈下菌斑。用BHI培养基厌氧培养37℃,4天以后进行细菌菌落计数,转种分离和鉴定。龈上菌斑内SPB的检出率按其高低顺序依次为:二氧化碳噬纤维菌、梭杆菌、消化链球菌、唾液弯曲杆菌、产黑色素类杆菌、优杆菌,溶蚀艾肯氏菌、生疾月形单胞菌。二氧化碳噬纤维菌中依次为牙龈二氧化碳噬纤维菌、黄褐二氧化碳噬纤维菌及生疾二氧化碳噬纤     

慢性牙周炎患者龈下菌群与病情及种植修复临床效果的相关性

目的 研究慢性牙周炎(CP)患者龈下菌群与病情及种植修复临床效果的相关性。方法 选择2019年5月至2020年5月在我院接受种植修复治疗的130例CP患者作为CP组,选择同期进行体检的100例牙周健康者作为对照组。检测两组对象龈下菌斑中口腔链球菌、口腔乳杆菌、伴放线放线杆菌(A.a)、牙龈卟啉单胞菌(P.g)、福赛坦菌(T.f)、中间普氏菌(P.i)的数量,龈沟液中肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、基质金属蛋白酶9(MMP9)的水平,随访种植修复后1年植体周炎的发生情况。结果 CP组患者龈下菌斑中A.a、P.g、T.f、P.i数量高于对照组(均P<0.05),口腔链球菌、口腔乳杆菌数量与对照组比较差异无统计学意义(均P>0.05)。CP组患者病情越重,龈下菌斑中A.a、P.g、T.f、P.i数量及龈沟液中TNF-α、IL-6、MMP9水平越高(均P<0.05)。CP组患者龈下菌斑中A.a、P.g、T.f、P.i数量与龈沟液中TNF-α、IL-6、MMP9水平呈正相关。CP组患者龈下菌斑中A.a、P.g、T.f、P.i数量大于等于中位数者种植修复后...     

替硝唑在牙周炎治疗中的临床及微生物学观察

本文通过对３０例牙周炎患者在口服替硝唑前后的临床症状及龈下菌斑的暗视野显微镜下螺旋体等菌种比例的变化,观察该药对牙周炎及其致病菌的疗效。结果：服用替硝唑后,在龈下菌斑中螺旋体的比例明显下降,而球菌的比例明显增高。牙龈指数、牙龈出血指数和探针深度均较服药前有明显好转（Ｐ＜０．００１）。提示：替硝唑能有效地抑制和杀灭龈下菌斑中的厌氧菌,并迅速消除牙周炎症,减轻症状。     

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。     

Quantitative analysis of three hydrogenotrophic microbial groups, methanogenic archaea, sulfate-reducing bacteria, and acetogenic bacteria, within plaque biofilms associated with human periodontal disease

Human subgingival plaque biofilms are highly complex microbial ecosystems that may depend on H(2)-metabolizing processes. Here we investigated the ubiquity and proportions of methanogenic archaea, sulfate reducers, and acetogens in plaque samples from 102 periodontitis patients. In contrast to the case for 65 healthy control subjects, hydrogenotrophic groups were almost consistently detected in periodontal pockets, with the proportions of methanogens and sulfate reducers being significantly elevated in severe cases. In addition, antagonistic interactions among the three microbial groups indicated that they may function as alternative syntrophic partners of secondary fermenting periodontal pathogens.     

Prevalence of putative periodontopathogens in subgingival dental plaques from gingivitis lesions in Korean orthodontic patients

The objective of this study was to detect and compare the presence of periodontopathogens in the subgingival plaques of gingivitis lesions in adults who wore fixed orthodontic appliances, as opposed to adults who did not wear any orthodontic appliances. Thirty-six individuals participated in this study. Nineteen of these subjects did not wear any orthodontic appliances, and these subjects comprised the control group. The other 17 individuals had been wearing fixed orthodontic appliances for at least 3 months each. After a periodontal examination, we collected subgingival plaque samples from the gingivitis lesions of each patient. Using PCR based on 16S rDNA, we detected the presence of 6 putative periodontopathogenic species, Treponema denticola, Porphyromonas gingivalis, Tannerella forsythia (formerly Bacteroides forsythus), Prevotella nigrescens, Prevotella intermedia, and Actinobacillus actinomycetemcomitans. With regard to the presence of individual periodontopathogens, we found that T. forsythia, T. denticola, and P. nigrescens were significantly more common in the samples obtained from the orthodontic patients than in the samples obtained from the non-orthodontic patient controls. Our results indicate that the local changes associated with the wearing of fixed orthodontic appliances may affect the prevalence of periodontopathogens in subgingival dental plaques.     

Bacterial adhesion to sulcular epithelium in periodontitis

The purpose of this study was to investigate, by electron microscopy, the type of bacterial attachment to the sulcular epithelium in periodontitis. Gingiva biopsies were observed in a transmission electron microscope using cytochemical staining with ruthenium red for glycocalyx visualisation. In addition, subgingival plaque samples and biopsies from the sulcular epithelium in periodontitis from the patients were estimated microbiologically. Aerobic bacteria only were estimated in the subgingival plaque and both aerobic and anaerobic bacteria in the gingival biopsies. No bacterial internalisation could be observed. Fimbria-mediated adhesion as the only type of bacterial attachment and a large diversity of bacterial glycocalyces were detected. As the fimbrial adhesins of putative periodontal pathogens are able in vitro to induce inflammation and bone resorption via stimulation of the proinflammatory cytokine production, the demonstrated fimbrial adhesins suggest the significant role of bacterial adhesion to sulcular epithelium in periodontitis.     

Identification of archaeal rDNA from subgingival dental plaque by PCR amplification and sequence analysis

A PCR assay for the amplification of small subunit ribosomal DNA (SSU rDNA) of Euryarchaea was developed and used to detect archaeal rDNA in 37 (77%) out of 48 pooled subgingival plaque samples from 48 patients suffering from periodontal disease. One major group of cloned periodontal sequences was identical to Methanobrevibacter oralis and a second minor group to Methanobrevibacter smithii. These two groups and a third novel group were found to be more than 98% similar to each other over an 0.65-kb segment of the 16S rRNA gene sequenced. M. oralis was found to be the predominant archaeon in the subgingival dental plaque. Phylogenetic analysis of partial SSU rDNA sequences revealed evidence for a distinct cluster for human and animal Methanobrevibacter sp. within the Methanobacteriaceae family.     

镍铬合金烤瓷冠修复牙与对照牙牙周微生态及龈沟液蛋白水平的比较

目的观察比较镍铬合金烤瓷冠（Ni-Cr based porcelain-fused-metal crown）修复患牙与牙周健康对照牙龈下菌斑微生物分布、龈沟液总蛋白水平及牙周临床指标的差异。方法选择临床病例13例,前牙区咬合关系基本正常。采用镍铬合金烤瓷冠修复上颌切牙17颗,对侧同名健康天然牙作为对照。烤瓷冠戴入6～8个月后复诊,进行牙周健康状况的临床检查,分别取患牙、对照牙龈沟液及龈下菌斑盐水涂片。龈沟液定量并检测总蛋白水平。龈下菌斑涂片革兰染色,分类计数革兰阴性球菌、杆菌、弯曲菌、螺旋体及革兰阳性球菌、杆菌,共计数200个细菌。结果修复患牙与对照牙比较探诊深度、龈沟出血指数、龈沟液量、龈沟液总蛋白水平、龈下菌斑中革兰阴性杆菌增加,革兰阳性球菌减少,差异均有显著性（P〈0．05）。而菌斑指数及其他形态的细菌数差异无显著性。结论临床合格的镍铬合金烤瓷冠修复亦使患牙龈下菌群分布发生变化,可能是导致患牙牙龈炎症的原因之一;龈沟液量及总蛋白水平增加;牙周临床指标显示不良改变。     

Distribution of Archaea in Japanese patients with periodontitis and humoral immune response to the components

There is controversy regarding the existence of archaeal pathogens. Periodontitis is one of the human diseases in which Archaea have been suggested to have roles as pathogens. This study was performed to investigate the distribution of Archaea in Japanese patients with periodontitis and to examine the serum IgG responses to archaeal components. Subgingival plaque samples were collected from 111 periodontal pockets of 49 patients (17 with aggressive periodontitis and 32 with chronic periodontitis), and 30 subgingival plaque samples were collected from 17 healthy subjects. By PCR targeting the 16S rRNA gene, Archaea were detected in 15 plaque samples (13.5% of total samples) from 11 patients (29.4% of patients with aggressive periodontitis and 18.8% of patients with chronic periodontitis). Archaea were detected mostly (14/15) in severe diseased sites (pocket depth >/=6 mm), while no amplicons were observed in any samples from healthy controls. Sequence analysis of the PCR products revealed that the majority of Archaea in periodontal pockets were a Methanobrevibacter oralis-like phylotype. Western immunoblotting detected IgG antibodies against M. oralis in eight of the 11 sera from patients. These results suggest the potential of Archaea (M. oralis) as an antigenic pathogen of periodontitis.