不同去龋技术在乳牙龋病治疗中的应用疗效分析

目的:比较传统机械切割法、非创伤性充填法(atraumatic restorative treatment,ART)和Carisolv化学法在临床乳牙龋病治疗中的应用效果差异。方法:选取2011年1月-2012年6月来我科就诊的5-8岁儿牙患者96名,患牙180颗,随机分为3个不同的治疗组:传统机械去龋组、ART组和Carisolv化学去龋组进行相应牙体充填治疗,通过去龋效果、去龋时间、术中疼痛发生率和术后长期疗效等方面比较不同去龋技术之间的差异。结果:常规机械去龋组和Carisolv组的去龋效果明显优于ART组(P0.05),二者之间无明显差异(P0.05);3种去龋方法的去龋操作时间无明显差异(P0.05);Carisolv组和ART组去龋治疗中患儿术中疼痛发生例数明显低于常规机械去龋组(P0.05),二者之间无明显差异(P0.05);治疗1年后的复诊发现,常规机械去龋组和Carisolv组中患牙继发龋发生率明显低于ART组(P0.05),二者之间无明显差异(P0.05);三种方法治疗后患牙充填物折断/脱落发生率无明显差异(P0.05)。结论:Carisolv化学去龋法能有效减轻术中疼痛和术后复发率,值得在临床乳牙治疗中推广应用;ART的去龋效果和远期疗效可能限制其广泛应用。     

Association Between Obesity,Flow Rate of Whole Saliva,and Dental Caries in Adolescents

In a cross‐sectional study design, we test the hypothesis whether childhood obesity is associated with reduced flow rate of stimulated whole saliva and dental caries. Obese adolescents (n = 65) with a mean age of 14.5 years and normal weight subjects (n = 65) with a mean age of 14.2 years were clinically examined with respect to dental caries, visible plaque accumulation (visible plaque index (VPI%)), gingival inflammation in terms of bleeding on probing (BOP%) as well as answered a questionnaire concerning medical history, medication, oral hygiene habits, smoking habits, and sociodemographic background. The flow rate of stimulated whole saliva (ml/min) was determined. BMI was calculated and adjusted for age and gender (BMI‐sds). The obese subjects exhibited higher number of decayed surfaces (DS), 0.7 vs. 0.1 (P = 0.008) and lower flow rate of stimulated whole saliva 1.2 vs. 2.0 ml/min (P < 0.001). Of obese patients, 17 subjects had VPI% >25 and 21 had BOP% >25, both compared to only 5 subjects of the normal weight with P values of 0.005 and <0.001, respectively. In a multivariate logistic regression model BMI‐sds was significantly associated with the flow rate of stimulated whole saliva less than the median value 1.5 ml/min (P < 0.001; odds ratio (OR) 1.36) as well as with DS (DS >0) (P = 0.002; OR 1.31) and the associations were not found to be confounded by any of the studied variables. The results indicate that childhood obesity is associated with reduced flow rate of stimulated whole saliva and dental caries and further strengthens obesity's negative effect on children's oral health.     

Lactobacilli Isolation from Dental Plaque and Saliva of a Group of Patients with Caries and Characterization of their Surface Properties

The oral cavity is a complex ecosystem colonized by micro-organisms which play different roles. The aims of this study were to identify Lactobacillus strains from the teeth and saliva of children lacking in dental care and to study the surface characteristics related to the adhesion capability of these micro-organisms. The population considered is from Tucumán, Argentina. It is characterized by a dmfs index over 5 and an absence of dental care. Lactobacilli were isolated and identified by microscopic observations, biochemical tests and modified API CH 50. Bacterial surface studies included: hydrophobicity, acid and basic characteristics, blood cell agglutination and salt aggregation. Thirty strains were isolated. The major group was facultative heterofermentative. The surface characteristic studies did not indicate that lactobacilli are hydrophobic, neither do they show high basic nor acid charges. Lactobacilli isolated from saliva auto-agglutinated and also agglutinated ABO red blood cells. Salt aggregation was not a characteristic property. In this preliminary work, lactobacilli from teeth and saliva from this specific population were not demonstrated to have relevant adhesion properties.     

Study of Salivary Strontium and Silver Concentrations in Primary School Children Related to Dental Caries

To investigate the relationship between the salivary Sr and Ag concentrations and tooth conditions, saliva was collected from 521 primary school children in Kitakyushu. The salivary Sr and Ag levels were determined using an atomic absorption spectrophotometry. The salivary Sr and Ag levels were 7.73 +/- 3.62 and 0.03 +/- 0.15 ng/ml, respectively, in the sound teeth group. No sex differences were noted in either element level, nor were there differences between the lower and upper grade groups. In the caries teeth group, the Sr and Ag levels were significantly higher than those in the sound teeth group. The Sr level was significantly increased by caries experience regardless caries being treated or untreated. In second to third grade children, in whom the fluoride experience rate was high, the Sr level tended to be lower than that in the other grades. The salivary Ag level increased as the number of teeth treated with silver alloy rose. These findings suggested that the salivary Sr level increases because of caries susceptibility, and F inhibits Sr dissolution from the teeth. The salivary Ag level varied depending on the type of dental filling and was dependent on the amount of silver alloy in children treated with low-fusing silver alloy.     

Artificial Saliva in the Management of Patients Suffering from Xerostomia

Hyposalivation results in the sensation of a dry mouth “subjective xerostomia.” Besides the sensation of a dry mouth in serious conditions, distressing clinical symptoms are observed, e.g. difficulties in oral functioning, mucositis, progressive dental caries and nocturnal oral discomfort. A mucin-containing artificial saliva to relieve patients'complaints from xerostomia has been developed. Its chemical and physical properties are demonstrated. In a 3-year retrospective study the efficacy of this substitute and a CMC-containing saliva has been evaluated for a total of 137 patients. Patients were free in choosing a mucin- or CMC preparation. Ninety-six patients reported a considerable relief of their complaints with mucin-saliva, one patient wished to continue using the CMC product. To increase efficacy of the saliva substitute on intra-oral saliva reservoir has been developed for dentate and edentulous persons.     

Comparative Properties of Deciduous and Permanent (Young and Old) Human Enamel1

Some physico-chemical properties of the enamel of deciduous and permanent (young and old) teeth were investigated and compared using x-ray diffraction, infrared absorption spectroscopy, scanning electron microscopy and chemical analyses. Results demonstrated the following: all enamel samples gave x-ray diffraction patterns of only apatite; all enamel samples gave IR absorption spectra of carbonate-containing apatite; the α-axis of deciduous enamel apatite was larger than that of permanent (both young and old) enamel apatite (mean values, deciduous = 9.458 ± 0.003A; permanent =9 443 ± 0.003A); apatite crystallite dimensions increased with age especially along the c-axis; when compared to permanent, deciduous enamel contained slightly more carbonate, magnesium and HPO₄^2-; the prism (enamel rods) dimensions were slightly smaller, and the extent of acid-etching was more extensive in deciduous enamel than in permanent enamel. These observations combined with other factors such as the difference in the orientation of and crystal density in prism rods and the difference in conditions of the oral environment between deciduous and permanent enamel may account for the reported observations of a decrease in caries prevalance with age.     

Inhibition of Rat Dental Caries by Dextranase from a Strain of Spicaria violacea

Dextranase AD17 obtained from a culture liquor of a strain of Spicaria violacea was assessed for its ability to inhibit the development of dental caries in conventional Sprague-Dawley rats which had been infected with one of the Streptococcus mutans strains, MT6R (serotype c), OMZ 176R (d), or MT-703R (e). These experiments showed that caries was significantly inhibited when rats were given cariogenic diet # 2000 and drinking water containing AD17 at a concentration of 10 units/g, as compared to control rats not given dextranase. The inhibitory effects of AD17 were more prominent in smooth surface caries than in total caries. AD17 had a tendency to retard both the establishment of inoculated S. mutans and plaque deposition on tooth surfaces. However, S. mutans could be implanted in the rat oral cavity after repeated inoculation of the bacteria, even in the presence of AD17. These results suggest that the anticaries activity of AD17 is due to not only inhibition of adherence of S. mutans cells on tooth surfaces but also to physicochemical changes of dental plaque formed under the enzymatic action of AD17. Preliminary histopathological examination showed that AD17 had no significant toxicity in rats.     

Zinc and Metallothionein in the Development and Progression of Dental Caries

Biological Trace Element Research - Chronic oxidative stress and reactive oxygen species (ROS) in oral cavity as well as acidic pH on dental enamel surface due to the metabolic activities of...     

Influence of seawater Sr content on coral Sr/Ca and Sr thermometry

The Ca content of a Porites coral from Xisha, South China Sea is quite uniform along its 18-year growth axis. A comparison with previously published data shows that the Ca content of corals from different sites varies by only 0.4%. This is much smaller than the variation of Ca in seawater (2.2%), indicating that Ca variations in seawater do not significantly affect the Ca compositions of coral skeletons. The variation in skeletal Ca contents results in only ±0.6°C of uncertainty in SST calculations, which is much smaller than the large disparities observed for previously established coral Sr/Ca thermometers. In contrast, Sr in tropical seawater varies spatially by as much as 2.4%, corresponding to ~4°C offset for coral Sr/Ca calibrations. The effect of seawater Sr variations on coral Sr/Ca thermometers is evaluated and we demonstrate that the content of seawater Sr is the major factor responsible for disparities in these coral Sr/Ca thermometers. The disparities can be significantly reduced when seawater Sr contents are included in the Sr/Ca thermometers.     

Bacteriological Studies of the Effects of Cow's Milk on Dental Plaque and Dental Caries in Rats

The effects of liquid milk and skim milk powder on the bacterial composition of rat dental plaque and dental caries were examined in two separate experiments. First, groups of rats fed a cariogenic diet plus one or other of three types of liquid milk had. after 28 d. similar plaque flora. Those rats receiving reconstituted spray-dried skim milk had a significantly higher incidence of dental caries than those receiving either pasteurized and homogenized milk or ultra-heat treated milk. The differences in caries scores may be related to differences in inorganic phosphate and calcium levels of the milks. Secondly, rats fed a diet containing 65% phosphate-free sucrose plus 32% spray-dried skim milk in powder form had a significantly lower dental caries score than did rats receiving a diet containing 65% sucrose plus 32% autoclaved roller-dried skim milk powder. At the end of this experiment, the plaque flora had changed significantly and the difference in caries incidence was related to the reduction in the percentage of potentially cariogenic bacteria.
These results indicate that the mechanism by which milk reduces dental caries incidence may be (a) by remineralizing incipient carious lesions or (b) by mediating changes in the bacterial composition of dental plaque.     

窝沟封闭和涂氟同时应用对乳磨牙龋病干预的研究

目的:探讨同时应用窝沟封闭和涂氟预防干预乳磨牙预防龋齿的效果,为学龄前儿童乳磨牙龋齿的预防提供新的干预措施。方法:通过Cariostat法对150名学龄前儿童乳磨牙进行龋蚀活跃性试验,将其分为龋活跃高危人群和低危人群,检查其乳磨牙患龋情况,计算龋均。随机抽取30名龋活跃高危人群儿童做为实验组1,30名龋活跃低危人群儿童做实验组2,应用窝沟封闭和多乐氟护齿剂同时对乳磨牙进行龋病预防干预;同时抽取30名龋活跃低危人群做对照组应用多乐氟护齿剂对乳磨牙进行龋病预防干预,于干预后6、12、18个月计算龋病发病率。结果:龋活跃高危人群和低危人群的患龋率分别为68.75%、28.6%,两组比较有显著性差异(P<0.05)。干预后6个月时,实验组1、实验组2、对照组龋病发病率分别为12.3%、11.6%、13.1%,三组比较无显著性差异(P>0.05);12个月时,龋病发病率分别为12.4%、11.8%、23.2%,实验组1、实验组2比较无显著性差异(P>0.05),实验组1、实验组2均显著低于对照组,有显著性差异(P<0.05);18个月时,龋病发病率分别为13.2%、12.9%、29.3%,实验组1、实验组2均显著低于对照组,有显著性差异(P<0.05),但实验组1、实验组2比较无显著性差异(P>0.05)。结论:同时应用窝沟封闭和涂氟对乳磨牙可以有效防龋,降低学龄前儿童的龋发病率。     

Measurement of uptake of chelated and unchelated Ca and Sr from solution culture

Summary The uptake of Ca and Sr by three-week old tomato (Lycopersicon esculentum) plants from solutions containing Ca⁺⁺ and Sr⁺⁺, and chelated Ca and Sr (CaL and SrL) was measured over a two-day period. The solution was double-labelled with Ca⁴⁵ and Sr⁸⁵. Two chelates, EDTA (ethylenediaminetetraacetic acid) and DTPA (diethylenetriaminepentaacetic acid) were used at five chelate-cation ratios. When the Ca and Sr content of the solution was held constant, addition of chelate reduced uptake. The reduction was greater with EDTA than with DTPA.The Ca/Sr ratio of uptake was used to measure the proportion of uptake as the chelated and unchelated species. The Ca⁺⁺/Sr⁺⁺ ratio was different from the CaL/SrL ratio in solution because of the different equilibrium reactions of Ca and Sr with L. Direct uptake of the CaL and SrL was indicated. In solutions where Ca⁺⁺ = CaL, uptake of CaEDTA was 0.47 of uptake of Ca⁺⁺ and uptake of CaDTPA was 0.95 of uptake of Ca⁺⁺.Journal Paper No. 4969. Purdue University Agricultural Experiment Station, Lafayette, Indiana 47907. Contribution from the Department of Agronomy. This research was supported in part by the U.S. Atomic Energy Commission under Contract AT(11-1)-1495.     

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.     

广西崇左智人洞早期现代人龋病及牙槽骨异常研究

2007-2008年, 广西崇左智人洞发现了3件智人化石标本, 智人Ⅱ号为下颌右侧第3臼齿伴有部分下颌骨, 智人Ⅱ号为游离的下颌右侧第2或第3臼齿, 智人Ⅲ号为人类下颌骨中间部分残段。釉系测年结果显示其为距今10万年左右, 是目前东亚地区最古老的早期现代人。这3件化石标本显示出一系列的病理及异常现象:智人Ⅱ号牙齿齿根大部分暴露, 牙槽骨萎缩, 个体生前患有严重的牙周炎; 智人Ⅱ号牙齿龋病严重伴随齿根部大区域突起的白色钙化状的牙骨质增生, 个体生前可能患有严重的牙周组织炎症; 智人Ⅲ号下颌骨牙列拥挤, 双侧中门齿扭转, 双侧前臼齿对称性出现根尖周炎症状, 最大可能个体生前双侧前臼齿具有畸形中央尖, 突出的牙尖折断后牙髓感染导致根尖部牙槽腔扩大。更新世古人类出现龋病的情况非常罕见, 智人洞发现的人类龋齿是目前我国乃至东亚地区报道的最早的龋病病例。智人Ⅲ号下颌显示的牙列拥挤与牙齿扭转对于探讨人类咀嚼器官的退行性演化有重要参考价值。     

Geographic Variation in Nonmetric Dental Traits of the Deciduous Molars of Pan and Gorilla

Physical anthropologists often use nonmetric dental traits to trace the movement of human populations, but similar analysis of the teeth of nonhuman primates or the deciduous teeth is rare. Because nonmetric dental characteristics are manifestations of genetic differences among groups, they vary among geographically distant members of the same species and subspecies. We use 28 nonmetric dental traits in the deciduous molars to compare genetically and geographically distinct groups of extant African apes (Gorilla and Pan). Previous researchers have studied these traits in the adult or juvenile teeth of great apes and humans, and we score our observations according to established standards for hominins. We observe marked differences in trait frequencies between Gorilla and Pan, Pan troglodytes and P. paniscus, and two P. troglodytes subspecies but we find no significant differences between geographically isolated groups within the subspecies. Trait frequencies differ from those found in previous studies that contained fewer individuals. We find that the deciduous molars show similar variation to adult premolars and molars within Pan and Gorilla. This suggests that the deciduous dentition of these and other apes may contain diagnostic traits that are not currently in use.