Periodontal health of older men: the MrOS dental study

Objective: The purpose of this study was to evaluate the prevalence and severity of periodontitis in men of 65+ years and identify demographic and lifestyle factors associated with its presence. Methods: Participants were recruited from the Osteoporotic Fractures in Men Study, a longitudinal study of risk factors for fractures in older men. Dental measures included clinical attachment loss (CAL), pocket depth (PD), calculus, plaque and bleeding on a random half‐mouth, plus a questionnaire regarding access to care, symptoms and previous diagnosis. Results: 1210 dentate men completed the dental visit. Average age was 75 years, 39% reported some graduate school education, 32% smoked 20 + pack years and 88% reported their overall health as excellent/good. In terms of periodontal health, 38% had sub‐gingival calculus, 53% gingival bleeding, 82% CAL ≥5 mm and 34% PD ≥6 mm. The prevalence of severe periodontitis was 38%. Significant demographic and lifestyle factors associated with severe periodontitis in multivariate analyses included age ≥75 (OR 1.4, 95% CI 1.1–1.7) non‐white race (OR 1.9, 95% CI 1.3–2.8), less than an annual dental visit (OR 1.5, 95% CI 1.1–2.0), and 20 + pack years (OR 2.1, 95% CI 1.6–2.7). Conclusion: A high proportion of healthy older men have evidence of periodontal destruction which could, given the growing ageing population, have a significant impact on the dental profession’s ability to provide preventive and therapeutic care. The population at highest risk of periodontitis in MrOS is older minority men who smoke and do not have annual dental visits.     

对纳米细菌在牙结石形成过程中的作用的初步研究

目的探讨牙结石中是否含有纳米细菌及其在牙结石形成过程中的作用。方法ELISA法、免疫荧光染色、透射电镜方法、化学成分分析。结果ELISA检测结果显示20例牙周病患者的龈沟液和牙结石分离培养物中阳性结果分别为2例、16例。通过免疫荧光染色、透射电镜方法检测并观察到牙结石及牙结石分离培养物中均存在纳米细菌,化学成分分析证明了纳米细菌分泌晶体成分同牙结石主要化学成分相同。结论本研究证实了牙结石中存在纳米细菌,并且纳米细菌作为矿化中心参与牙结石形成。     

水激光与超声洁治对中度慢性牙周炎的疗效对比

目的:探讨水激光与超声洁治对中度慢性牙周炎的疗效。方法:选取81例中度慢性牙周炎患者,年龄27-62岁,随机分为两组:激光组(41例)采用水激光治疗,超声组(40例)采用超声洁治法治疗。通过患者治疗后1个月,3个月的菌斑指数(plaque index,PLI),牙龈指数(gingival index,GI),牙周袋深度(probing depth,PD),牙周附着水平(clinical attachment level,CAL),治疗过程中的VAS评分等观察指标,对水激光与超声洁治进行疗效对比。结果:与基线各项牙周指数相比,激光组和超声组治疗后1个月,3个月的各项牙周指数均明显降低(P0.05)。与超声组相比,激光组治疗后1个月的GI值明显低于超声组,治疗后1个月和3个月的PD值和CAL值均低于超声组(P0.05)。治疗前,两组VAS评分相比,差异没有统计学意义(P0.05),治疗后,激光组的VAS评分明显低于超声组(P0.05)。结论:水激光治疗中度慢性牙周炎,治疗过程痛觉感受轻微,能轻易清除引起炎症的牙石及菌斑,促进牙周组织愈合。     

Effect of oral hygiene education and motivation on removable partial denture wearers: longitudinal study

Objectives: The purpose of this study was to determine the effect of two different preventive oral hygiene education and motivation programmes on the plaque and gingival index, as well as denture hygiene of patients provided with removable partial denture (RPD) during a 12‐month follow‐up. Material and methods: A total of 53 partially edentulous patients were recruited for this study. The presence or absence of plaque and gingival bleeding by gentle probing was scored on all tooth surfaces at the preliminary visit. The plaque and gingival indexes were measured using the Löe index. Following treatment, the patients were randomly divided into three groups. In Control Group I, subjects were instructed to continue their personal oral hygiene routine. In Group II, participants were given verbal instructions and a self‐educational manual on oral hygiene without illustrations. In Group III, oral hygiene guidance was delivered using a combination of verbal instructions and a self‐teaching manual. To evaluate the effect of the different modes of instruction, the presence or absence of plaque and gingival bleeding was scored on all tooth surfaces (day zero examination) and re‐examined 7, 15 and 30 days, 3, 6 and 12 months following RPD placement. The state of denture hygiene was evaluated 7, 15 and 30 days and 3, 6 and 12 months following rehabilitation. Parametric statistics was applied to dental plaque and gingival indexes. For accumulation of plaque and calculus on the RPD, non‐parametric statistic was applied. Results: The frequency of plaque found during the preliminary visit was higher than that found in the other periods. With regard to gingival index, significant difference was found between the preliminary visit examination and other periods. There was a significant difference in the plaque accumulation on the denture surface between groups I and III. Conclusion: The different methods of oral hygiene instruction used in this study indicate that the type of education was not of significant importance.     

Mechanical force inhibits osteoclastogenic potential of human periodontal ligament fibroblasts through OPG production and ERK‐mediated signaling

Periodontal ligament and gingival fibroblasts play important roles in bone remodeling. Periodontal ligament fibroblasts stimulate bone remodeling while gingival fibroblasts protect abnormal bone resorption. However, few studies had examined the differences in stimulation of osteoclast formation between the two fibroblast populations. The precise effect of mechanical forces on osteoclastogenesis of these populations is also unknown. This study revealed that more osteoclast‐like cells were induced in the co‐cultures of bone marrow cells with periodontal ligament than gingival fibroblasts, and this was considerably increased when anti‐osteoprotegerin (OPG) antibody was added to the co‐cultures. mRNA levels of receptor activator of nuclear factor‐kappaB ligand (RANKL) were increased in both populations when they were cultured with dexamethasone and vitamin D₃. Centrifugal forces inhibited osteoclastogenesis of both populations, and this was likely related to the force‐induced OPG up‐regulation. Inhibition of extracellular signal‐regulated kinase (ERK) signaling by a pharmacological inhibitor (10 µM PD98059) or by siERK transfection suppressed the force‐induced OPG up‐regulation along with the augmentation of osteoclast‐like cells that were decreased by the force. These results suggest that periodontal ligament fibroblasts are naturally better at osteoclast induction than gingival fibroblasts, and that centrifugal force inhibited osteoclastogenesis of the periodontal fibroblasts through OPG production and ERK activation. J. Cell. Biochem. 106: 1010–1019, 2009. © 2009 Wiley‐Liss, Inc.     

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.     

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。     

Gingival and Periodontal Parameters in a Population of Healthy Adults, 22–90 Years of Age1

There are little data concerning the periodontal status of aging individuals free of systemic disease and medication utilization. In the present study 55 healthy male and female, non-medicated adults between the ages of 22 and 90 were evaluated by comparing gingival and periodontal parameters. The results indicate greater proportions of sites with dental plaque, calculus, gingival bleeding and recession, and attachment loss in the oldest age group. The progression of these changes from young to middle to old age was not uniform. Attachment loss showed the most significant age-related changes. Results from this small, cross-sectional study of healthy individuals are generally comparable to findings reported from the NIDR 1985 National Survey of Oral Health in U.S. Adults.     

甘肃临潭磨沟墓地人骨的牙齿健康状况

本文通过甘肃临潭磨沟齐家文化墓地出土的262例人骨标本的牙病情况尤其是龋病、牙周病、根尖周病以及牙结石情况的统计与分析,得知磨沟墓地古代居民牙齿疾病的基本情况:1)牙病的罹患率性别差异显著,女性龋病和根尖周病的罹患率高于男性,而在牙周病和牙结石的出现率上则是男性高于女性;2)牙病的罹患率随着年龄增长而增高;3)龋病、牙周病及根尖周病多发于臼齿,牙结石多发于门齿;4)重度磨耗牙齿多发牙周病及根尖周病;5)牙病罹患率不仅受到性别、年龄、牙位以及齿冠磨耗程度的影响,而且与磨沟组古代居民农业种植食物和采集食物并重的食物结构有关。     

Non‐surgical treatment of gingival overgrowth induced by nifedipine: a case report on an elderly patient

doi:10.1111/j.1741‐2358.2009.00273.x
Non‐surgical treatment of gingival overgrowth induced by nifedipine: a case report on an elderly patient Drug‐induced gingival overgrowth (DIGO) is a significant problem for periodontologists and this side effect is frequently associated with three particular drugs: phenytoin, cyclosporin A and nifedipine. A case report of gingival overgrowth induced by nifedipine in an elderly patient treated with non‐surgical periodontal therapy is described. A 75‐year‐old male with generalised gingival overgrowth reported the problem of oral malodour and significant gingival bleeding. The medical history revealed a controlled hypertensive state and Cerebral Vascular Accident (CVA) 3 years prior to consultation. The diagnosis was gingival overgrowth associated with nifedipine, no other risk factors being identified. The patient had been taking nifedipine for 18 months, but after the consultation with the patient’s doctor, nifedipine was suspended, as the hypertension was controlled. Treatment consisted of meticulous oral hygiene instruction, scaling, root surface instrumentation and prophylaxis. Six months after the first intervention, clinical parameters revealed a significant improvement with a considerable reduction in gingival overgrowth, demonstrating the effect of non‐surgical periodontal therapy in severe cases of gingival overgrowth. Non‐surgical treatment of DIGO is a far less invasive technique than surgical approaches and has demonstrated an impressively positive treatment response. It should therefore be considered as a first treatment option for DIGO.     

Noninvasive multimodal imaging by integrating optical coherence tomography with autofluorescence imaging for dental applications

We report the development of an integrated multifunctional imaging system capable of providing anatomical (optical coherence tomography, OCT), functional (OCT angiography, OCTA) and molecular imaging (light‐induced autofluorescence, LIAF) for in vivo dental applications. Blue excitation light (405 nm) was used for LIAF imaging, while the OCT was powered by a 1310 nm swept laser source. A red‐green‐blue digital camera, with a 450 nm cut‐on broadband optical filter, was used for LIAF detection. The exciting light source and camera were integrated directly with the OCT scanning probe. The integrated system used two noninvasive imaging modalities to improve the speed of in vivo OCT data collection and to better target the regions of interest. The newly designed system maintained the ability to detect differences between healthy and hypomineralized teeth, identify dental biofilm and visualize the microvasculature of gingival tissue. The development of the integrated OCT‐LIAF system provides an opportunity to conduct clinical studies more efficiently, examining changes in oral conditions over time.     

牙周夹板联合正畸治疗对牙周炎所致前牙扇形移位患者咀嚼功能和龈沟液PGE2、sICAM-1、PAK5的影响

目的:探讨牙周夹板联合正畸治疗对牙周炎所致前牙扇形移位患者咀嚼功能和龈沟液中前列素E2(PGE2)、可溶性细胞间黏附分子-1(s ICAM-1)、p2l活化激酶5(PAK5)的影响。方法:采用随机数字表法,将我院2018年2月~2020年2月间接收的93例牙周炎所致前牙扇形移位患者分为对照组(46例,牙周基础治疗、牙周夹板治疗)和研究组(47例,牙周基础治疗、牙周夹板治疗联合正畸治疗),观察两组疗效,对比两组治疗前后的牙周情况,咀嚼功能、美观度,龈沟液PGE2、s ICAM-1、PAK5水平。结果:研究组的临床总有效率高于对照组(P<0.05)。研究组治疗后牙周菌斑指数(PLI)、探诊深度(PD)、牙龈指数(GI)、附着丧失(AL)、龈沟出血指数(SBI)低于对照组(P<0.05)。研究组治疗后探诊出血率、前牙咬合低于对照组,咀嚼功能评分高于对照组(P<0.05)。研究组治疗后牙周袋深度、前牙覆盖度、牙槽骨高度低于对照组(P<0.05)。研究组治疗后龈沟液PGE2、s ICAM-1、PAK5水平低于对照组(P<0.05)。结论:牙周夹板联合正畸治疗可有效恢复牙周炎所致前牙扇形移位患者牙周功能和咀嚼功能,且美观效果好,还可减轻对龈沟液PGE2、s ICAM-1、PAK5水平的影响。     

TiO2‐coated fluoride nanoparticles for dental multimodal optical imaging

Core‐shell nanostructures associated with photonics techniques have found innumerous applications in diagnostics and therapy. In this work, we introduce a novel core‐shell nanostructure design that serves as a multimodal optical imaging contrast agent for dental adhesion evaluation. This nanostructure consists of a rare‐earth‐doped (NaYF₄:Yb 60%, Tm 0.5%)/NaYF₄ particle as the core (hexagonal prism, ~51 nm base side length) and the highly refractive TiO₂ material as the shell (~thickness of 15 nm). We show that the TiO₂ shell provides enhanced contrast for optical coherence tomography (OCT), while the rare‐earth‐doped core upconverts excitation light from 975 nm to an emission peaked at 800 nm for photoluminescence imaging. The OCT and the photoluminescence wide‐field images of human tooth were demonstrated with this nanoparticle core‐shell contrast agent. In addition, the described core‐shell nanoparticles (CSNps) were dispersed in the primer of a commercially available dental bonding system, allowing clear identification of dental adhesive layers with OCT. We evaluated that the presence of the CSNp in the adhesive induced an enhancement of 67% scattering coefficient to significantly increase the OCT contrast. Moreover, our results highlight that the upconversion photoluminescence in the near‐infrared spectrum region is suitable for image of deep dental tissue.      

Periodontal status in an Italian young adult population. Prevalence and relationship with periodontopathic bacteria

To determine the prevalence of periodontitis in an Italian young adult population and the relationship with Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in subgingival plaque. A full-mouth periodontal and oral examination was performed in 70 subjects. Dental and behaviour habits were assessed with a standardised questionnaire. Subgingival plaque samples were collected from the deepest pocket of the first molars in each quadrant with a sterile curette. A. actinomycetemcomitans, P. gingivalis and P. intermedia were detected using a multiplex polymerase chain reaction. At subject level, the prevalence of bleeding on probing, calculus, normal pocket depth (PD), PD > 5mm and bacterial positivity were 44.8%, 43.3%, 22.9%, 11.4% and 95.7%, respectively. At quadrant level bacterial prevalence was 79.4%; P. intermedia was the most common bacteria (79.0%); A. actinomycetemcomitans had a prevalence of 40.8%. A significant linear trend across categories of gingival conditions (healthy, bleeding on probing, calculus presence) was detected for P. intermedia (p = 0.0038) and A. actinomycetemcomitans (p = 0.00005) proportions. No significant association was observed between pathogenic bacteria and PD, nor with behavioural attitudes. Gingival conditions are found to be a good predictors (VPP = 85%) for periodontopathic bacteria. For the Italian population, as no data are present, prospective longitudinal studies are needed to examine the relationship between PD and bacteria presence with periodontal disease onset and/or progression.     

排龈线对牙体楔状缺损患者炎症反应及悬突的预防效果

目的:探讨排龈线技术对牙体楔状缺损患者行充填修复术后发生悬突和炎症反应的预防作用。方法:选择我院收治的100例龈下牙体楔状缺损患者,根据治疗方式不同分为研究组和对照组。研究组采用排龈线技术对牙体楔状缺损排龈后以复合树脂充填,对照组对牙体楔状缺损常规处理后以复合树脂充填。观察并比较两组患者牙体楔状缺损的修复效果、悬突发生率,以及充填体颊侧龈沟液中天冬氨酸转氨酶(AST)的水平变化。结果:治疗后,两组患者AST水平均较治疗前升高,但研究组AST水平低于对照组,差异有统计学意义(P0.05);研究组充填体脱落率及边缘不密合率均低于对照组,差异有统计学意义(P0.05);对患者随访1年,研究组悬突发生率低于对照组,差异有统计学意义(P0.05)。结论:排龈线技术可有效减少牙体楔状缺损患者牙周组织炎症反应,降低悬突的发生率,值得临床推广应用。     

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。     

Quantifying dental biofilm growth using cross-polarization optical coherence tomography

Aims: Quantifying the ex vivo growth of complex multispecies dental biofilms using cross‐polarization 1310‐nm optical coherence tomography (CP‐OCT) system was investigated. Methods and Results: Bacterial microcosms, which were derived from plaque samples of paediatric subjects, were incubated in a biofilm reactor system containing discs of different dental materials for 72 h with daily sucrose pulsing (5×). CP‐OCT analysis of biofilm mass was validated with crystal violet (CV) assays at various growth stages of these complex biofilms. CP‐OCT was able to filter out the back‐reflected signals of water layers in the hydrated biofilm and allowed for direct biofilm quantification. The overall depth‐resolved scattering intensity of the biofilm showed very strong positive correlation with CV assay quantification (Spearman’s ρ = 0·92) during the growth phase of the biofilm. Conclusion: CP‐OCT was able to quantify the mass of the biofilm by measuring the overall depth‐resolved scattering of the biofilm. Significance and Impact of the Study: CP‐OCT has the ability to nondestructively monitor biofilm growth and elucidate the growth characteristics of these microcosms on different dental material compositions.     

Biocompatibility evaluation of bioprinted decellularized collagen sheet implanted in vivo cornea using swept‐source optical coherence tomography

Corneal transplantation by full‐thickness penetrating keratoplasty with human donor tissue is a widely accepted treatment for damaged or diseased corneas. Although corneal transplantation has a high success rate, a shortage of high‐quality donor tissue is a considerable limitation. Therefore, bioengineered corneas could be an effective solution for this limitation, and a decellularized extracellular matrix comprises a promising scaffold for their fabrication. In this study, three‐dimensional bioprinted decellularized collagen sheets were implanted into the stromal layer of the cornea of five rabbits. We performed in vivo noninvasive monitoring of the rabbit corneas using swept‐source optical coherence tomography (OCT) after implanting the collagen sheets. Anterior segment OCT images and averaged amplitude‐scans were acquired biweekly to monitor corneal thickness after implantation for 1 month. The averaged cornea thickness in the control images was 430.3 ± 5.9 μm, while the averaged thickness after corneal implantation was 598.5 ± 11.8 μm and 564.5 ± 12.5 μm at 2 and 4 weeks, respectively. The corneal thickness reduction of 34 μm confirmed the biocompatibility through the image analysis of the depth‐intensity profile base. Moreover, hematoxylin and eosin staining supported the biocompatibility evaluation of the bioprinted decellularized collagen sheet implantation. Hence, the developed bioprinted decellularized collagen sheets could become an alternative solution to human corneal donor tissue, and the proposed image analysis procedure could be beneficial to confirm the success of the surgery.      

Assessment of Oral Conditions and Quality of Life in Morbid Obese and Normal Weight Individuals: A Cross-Sectional Study

The aim of this study was to identify the impact of oral disease on the quality of life of morbid obese and normal weight individuals. Cohort was composed of 100 morbid-obese and 50 normal-weight subjects. Dental caries, community periodontal index, gingival bleeding on probing (BOP), calculus, probing pocket depth, clinical attachment level, dental wear, stimulated salivary flow, and salivary pH were used to evaluate oral diseases. Socioeconomic and the oral impacts on daily performances (OIDP) questionnaires showed the quality of life in both groups. Unpaired Student, Fisher’s Exact, Chi-Square, Mann-Whitney, and Multiple Regression tests were used (p<0.05). Obese showed lower socio-economic level than control group, but no differences were found considering OIDP. No significant differences were observed between groups considering the number of absent teeth, bruxism, difficult mastication, calculus, initial caries lesion, and caries. However, saliva flow was low, and the salivary pH was changed in the obese group. Enamel wear was lower and dentine wear was higher in obese. More BOP, insertion loss, and periodontal pocket, especially the deeper ones, were found in obese subjects. The regression model showed gender, smoking, salivary pH, socio-economic level, periodontal pocket, and periodontal insertion loss significantly associated to obesity. However, both OIDP and BOP did not show significant contribution to the model. The quality of life of morbid obese was more negatively influenced by oral disease and socio-economic factors than in normal weight subjects.