应用16S rDNA检测固定矫治患者牙周可疑病原菌变化研究

应用16S rDNA检测固定矫治患者龈下菌斑中牙周可疑病原,探讨戴用固定矫治器对牙周组织健康的影响。随机选择36例治疗时间超过6个月的固定矫治患者组成实验组,29例未经正畸治疗者组成对照组。分别检验特定部位牙周临床指数并收集龈下菌斑样本。采用16S rDNA检测9种牙周可疑致病菌。实验组与对照组相比牙龈指数、牙周袋深度、探诊出血差异有明显统计学意义(P<0.05);牙周可疑病原菌中牙龈卟啉菌、齿垢密螺旋体在实验组的检出率明显高于对照组(P<0.05)。固定矫治器戴入可引起患者牙周可疑病原菌的明显变化。     

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。     

牙周可疑致病菌与下呼吸道感染的关系

牙菌斑生物膜是牙周炎的始动因子。研究发现,牙周炎与全身多器官或系统的感染性疾病有关,如心脑血管疾病、糖尿病、消化道和呼吸道疾病。近年来,牙周炎与呼吸道疾病之间的关系备受关注,本文将近期对牙周可疑致病菌感染下呼吸道的途径及其作用研究做简要综述。     

血液链球菌对牙周可疑致病菌的拮抗作用

本实验观察了血液链球菌对与牙周组织破坏关系密切的５种细菌的拮抗作用,包括：放线共生放线杆菌、牙龈类杆菌１中间类杆菌,产黑色素类杆菌、具核梭杆菌、二氧化碳噬纤维菌和放线菌。结果表明,在体外,血液链球菌除对粘性放线菌无拮抗作用外,对所有参试的这几种牙周可疑致病菌均有拮抗作用。拮抗物质存在于血液链球菌生活的细胞内。     

血链球菌拮抗可疑牙周病原菌机理探讨：Ⅱ细胞素的产生及…

血链球菌产生细菌素至培养上清液中,无论是需氧或厌氧环境,血链球菌均可产生血逻素。采用无水乙醇沉淀法提取血链球菌培养上清液中的蛋白质,运用ＳＤＳ－ＰＡＥＧ分析其蛋白成份,发现１３０ｋｄ、１２０ｋｄ、７４ｋｄ、和５６ｋｄ四条蛋白区带,通过电泳凝胶弥散法抑菌试验显示,５６ｋｄ蛋白带具很强的抑菌活性,提示此蛋白质可能为血链素的所在位置。     

血链球菌拮抗可疑牙周病原菌机理探讨I．血链球菌培养上清液抑菌活性研究

本研究建立一种敏感的抑菌试验,微量琼脂糖弥散法,分析血链球菌培养上清液的抑菌作用。结果发现,牙周病原菌在血链球菌培养上清液中孵育３０ｍｉｎ,菌落形成数低于对照组,微量琼糖弥散法测定血链球菌培养上清液的抑菌活性,显示血链球茵培养１２ｈ后,培养上清液出现抑菌活性,７２ｈ达高峰。在有蔗糖及ｐＨ８．５ＴＰＹ培养基中培养的血链球菌上清液可形成较大抑菌环,厌氧环境培养的血链球菌上清掖抑菌活性略高于需氧环境。     

粘接性牙周夹板固定修复在慢性牙周炎患者的临床应用

目的:观察粘接性牙周夹板固定修复治疗慢性牙周炎的临床效果。方法:选择25例(93颗松动患牙)慢性牙周炎患者,记录牙周治疗前、采用粘接性牙周夹板固定修复后即刻、3、6及12个月的牙周状况,包括菌斑指数(PLI)、探针深度(PD)、牙龈出血指数(BOP)、牙龈指数(GI)和附着丧失(AL)的变化;检测牙龈龈沟液中卟啉单胞菌、血链球菌数量的变化;评估患者行固定夹板修复后对美观、舒适、咀嚼、发音等方面的满意度。结果:经牙周夹板固定修复后,各阶段的PLI、PD、GI和AL的指标值与治疗前相比差异均有统计学意义(P0.05),但固定后各阶段之间的牙周临床指标差异无统计学意义(P0.05);牙龈卟啉单胞菌和血链球菌数的数量在固定后各阶段较治疗前均显著减少(P0.05),但固定期间各阶段比较差异不明显(P0.05);固定修复后,各阶段患者的满意度均较高。结论:慢性牙周炎患者经完善的牙周基础治疗后,应用粘接性牙周夹板固定修复,能够有效固定患者松动患牙,恢复其咀嚼功能,有效地控制慢性牙周炎的发展。     

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。     

1275株临床感染病原菌的鉴定和临床分析

目的：研究临床感染性疾病病原菌的分类和菌群分布特点,探讨临床感染的发病机制和防护措施。方法：按《全国临床检验操作规程》分离培养,用法国Bio Mericux的Vite-ATB仪和API系统鉴定菌种。结果：1275株病原菌分37属95种,其中革兰阴性（G^-）杆菌(56.5%）,革兰阳性（G^ ）球菌(25.3%）,酵母样菌（15.8%）。病原菌的主要来源是呼吸道感染、泌尿生殖道感染、手术和伤口感染及菌血症。G^-杆菌以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌和鲍曼不动杆菌为主;G^ 球菌以溶血葡萄球菌、表皮葡萄球菌、金黄色葡萄球菌和粪肠球菌较常见。结论：呼吸道感染,泌尿生殖道感染,手术和和伤口感染及菌血症是临床感染的主要类型,低毒性的条件致病菌和正常菌群成为感染性疾病的主要病原菌。     

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。     

Rapid and simple detection of eight major periodontal pathogens by the loop-mediated isothermal amplification method

Loop-mediated isothermal amplification (LAMP) was applied to develop a rapid and simple detection system for eight periodontal pathogens: Aggregatibacter (Actinobacillus) actinomycetemcomitans, Campylobacter rectus, Eikenella corrodens, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola and Tannerella forsythia. Primers were designed from the 16S ribosomal RNA gene for each pathogen, and the LAMP amplified the targets specifically and efficiently under isothermal condition at 64 degrees C. To simplify the manipulation of LAMP examination, boiled cells and intact cells suspended in phosphate-buffered saline (PBS) were tested as templates besides extracted DNA template. The detection limits were 1-10 cells per tube using extracted DNA template. However, LAMP methods using boiled cells and intact cells required 10-100 and 100-1000 cells per tube, respectively. LAMPs for A. actinomycetemcomitans, P. gingivalis and P. intermedia were then applied to clinical plaque samples, and the method demonstrated equal or higher sensitivity compared with the conventional real-time PCR method. These findings suggest the usefulness of the LAMP method for the rapid and simple microbiological diagnosis of periodontitis, and the possibility of LAMP examination without the DNA extraction step.     

Three-dimensional assessment of transverse dentoskeletal mandibular dimensions after utilizing two designs of fixed mandibular expansion appliance: A prospective clinical investigation

The aim of this clinical study was to evaluate and compare the dentoskeletal transverse mandibular arch dimensions following the use of two designs of fixed mandibular expanders using cone beam computed tomography (CBCT). Twenty orthodontic patients, 12 females and 8 males, with mean age of 13.4 ± 0.5 years were selected and randomly divided into two equivalent groups; group A consisted of 10 patients (4 boys, 6 girls) who were treated with modified Williams expander and group B consisted of 10 patients (4 boys, 6 girls) who were treated with a two-arm fixed expander. Consistent expansion instructions were given to all patients according to a standardized slow protocol of one quarter turn twice/week for both expanders. Routine orthodontic records as well as mandibular CBCTs were obtained before (T1) and immediately after expansion (T2) to estimate changes in dentoskeletal mandibular transverse dimensions. The data was statistically analyzed and the significance level was set at p ≤ 0.05. Mandibular intercanine, inter-premolar, intermolar widths; and arch perimeter were significantly increased (p ≤ 0.05) following expansion with both fixed expanders. However, the changes in inter-premolar width, intercanine width, and arch perimeter were significantly augmented in two-arm fixed expander group than modified Williams’s group. In contrast, their effects on the skeletal mandibular body width were non-significant (p > 0.05). Both expanders yielded significant and equivalent dentoalveolar effects that were more evident with two-arm fixed expander than the William one. Both fixed designs enhanced mandibular transverse dental dimensions; however, they were unsuccessful to create any considerable skeletal effects.     

Microbiological and clinical periodontal effects of fixed orthodontic appliances in pediatric patients

The aim of this study was to evaluate changes of microbiota in ten patients undergoing orthodontic treatment. For each patient clinical examination of gingival index (GI) and plaque index (PI) were performed at the first molars at: baseline (T1), 2 (T2), 4 (T3) and 12 weeks (T4). At the same time subgingival plaque and tongue samples were taken for the microbiological study. Clinical results showed that at T4, the mean PI score was significantly lower than T1 and the GI was markedly reduced. Microbiological results showed that at T1 and T4 facultative aerobic bacteria were prevalent, whereas anaerobic bacteria were more common at T2 and T3.     

Potential effect of Allium sativum bulb for the treatment of biofilm forming clinical pathogens recovered from periodontal and dental caries

Biofilm producing clinical bacterial isolates were isolated from periodontal and dental caries samples and identified as, Lactobacillus acidophilus, Streptococcus sanguis, S. salivarius, S. mutansand Staphylococcus aureus. Among the identified bacterial species, S. aureus and S. mutansshowed strong biofilm producing capacity. The other isolated bacteria, Streptococcus sanguis, S. salivarius showed moderate biofilm formation. These pathogens were subjected for the production of extracellular polysaccharides (EPS) in nutrient broth medium and the strain S. aureus synthesized more amounts of EPS (610 ± 11.2 µg/ml) than S. sanguis (480 ± 5.8 µg/ml).EPS production was found to be less in S. salivarius (52 ± 3.8 µg/ml).The solvent extract of A. sativum bulb showed the phytochemicals such as, carbohydrate, total protein, alkaloids, saponins, flavonoids, tannins and sterioids. The solvent extract of A. sativum bulb showed wide ranges of activity against the selected dental pathogens. The difference in antibacterial activity of the solvent extract revealed differences in solubility of phytochemicals in organic solvents. Ethanol extract was highly active againstS. aureus (25 ± 2 mm). The Minimum Inhibitory Concentration (MIC) of crude garlic bulb varied widely and this clearly showed that bacteria exhibits different level of susceptibility to secondary metabolites. MIC value ranged between 20 ± 2 mg/ml and 120 ± 6 mg/ml and Minimum Bactericidal Concentration (MBC) value ranged from 60 ± 5 mg/l to 215 ± 7 mg/ml. To conclude, A. sativum bulb can be effectively used to treat periodontal and dental caries infections.     

Bone mass index analysis in elderly people before and after change prosthesis

Objectives: To evaluate the bone mass index (BMI) of senescent patients before and after prosthetic rehabilitation by complete dentures and evaluating any correlations between prosthetic rehabilitation and changes in BMI. Subjects: Thirty‐two edentulous elder patients who were in need of new complete dentures. Setting: Dental clinic of the Prosthodontics Department (Dental Branch) of the University of São Paulo, Brazil. Materials and methods: The study was performed in three different phases: the first one took place before any procedures relating to the new complete dentures had started and consisted of clinical records and a prosthetic anamnesis. The second and third phases took place after the prosthetic rehabilitation was completed, normally after 3 and 5–6 months respectively. The data collected in the different phases were analysed by using bioestat 3.0; the level of significance was p < 0.05, in a bilateral proof. Results: The non‐parametric statistical analysis of BMI did not show any significant differences when compared with the three phases analysed during the study. Conclusion: There was no evidence that accurate prosthetic rehabilitation could influence BMI.     

网织红细胞在消化道肿瘤化疗前后的变化及临床意义

目的：探讨采用网织红细胞监测消化道肿瘤患者化疗前、后骨髓造血功能恢复的临床价值。方法：采用Sysmex XE2100全自动细胞分析仪对60例消化道恶性肿瘤患者化疗过程中白细胞数（WBC）、血小板（PLT）、网织红细胞百分率（RET％）、未成熟网织红细胞指数（IRF）进行动态监测。结果：化疗后骨髓造血功能受到抑制,RET％和IRF从化疗后第3天开始出现明显下降,差异有统计学意义（P〈0．01）,在化疗后第14天开始出现回升,其中IRF值较第7天显著升高,两者间差异具有统计学意义（P〈0．01）;WBC和PLT则于化疗后第7天出现明显下降,差异具有统计学意义（P〈0．01）,化疗后第21天开始出现回升。结论：未成熟网织红细胞指数是预测化疗后骨髓造血恢复的较敏感指标。     

网织红细胞在消化道肿瘤化疗前后的变化及临床意义

目的:探讨采用网织红细胞监测消化道肿瘤患者化疗前、后骨髓造血功能恢复的临床价值。方法:采用SysmexXE2100全自动细胞分析仪对60例消化道恶性肿瘤患者化疗过程中白细胞数(WBC)、血小板(PLT)、网织红细胞百分率(RET%)、未成熟网织红细胞指数(IRF)进行动态监测。结果:化疗后骨髓造血功能受到抑制,RET%和IRF从化疗后第3天开始出现明显下降,差异有统计学意义(P<0.01),在化疗后第14天开始出现回升,其中IRF值较第7天显著升高,两者间差异具有统计学意义(P<0.01);WBC和PLT则于化疗后第7天出现明显下降,差异具有统计学意义(P<0.01),化疗后第21天开始出现回升。结论:未成熟网织红细胞指数是预测化疗后骨髓造血恢复的较敏感指标。     

Prognostic value of prognostic nutritional index and systemic immune-inflammation index in patients with osteosarcoma

The aim of this study was to evaluate the relationship between prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) and clinical features and prognosis of osteosarcoma patients. We retrospectively investigated 126 patients with surgery for osteosarcoma between 2012 and 2018 at our hospital. The preoperative PNI was calculated as albumin level (g/L) + 5 × total lymphocyte count (10 ⁹/L). The SII was defined as platelet × neutrophil/lymphocyte counts. The optimal cut-off values for PNI and SII were evaluated with receiver operating curve analysis. Clinical features and PNI and SII were tested with the χ ² test. The effects of PNI and SII on overall survival (OS) was investigated by Kaplan–Meier method and Cox proportional hazards model. A low preoperative PNI was remarkably correlated with tumor size, Enneking stage, pathological fracture, local recurrence, metastasis, and neoadjuvant chemotherapy ( p < 0.05). Whereas, a high SII was significantly associated with tumor size, histological type, Enneking stage, and neoadjuvant chemotherapy ( p < 0.05). There was a significant negative relationship between the PNI and SII ( r = 0.384; p < 0.001). For univariate analyses, the results revealed that tumor size, local recurrence, metastasis, PNI, and SII were predictors of OS ( p < 0.05). In multivariate analyses, local recurrence ( p = 0.010), metastasis ( p < 0.001), PNI ( p < 0.001), and SII ( p = 0.029) as independent prognostic factors were significantly correlated with OS. This study suggested that PNI and SII could be important prognostic parameters for patients with osteosarcoma.