Associated Factors of Dental Caries among Intellectually Disabled Persons in Specialized Centers of Ouagadougou

Introduction: Several studies have reported a high prevalence of dental caries among the people with intellectual disabilities. In order to identify the sociodemographic, clinical and behavioral factors associated with it, we conducted a study in specialized centers welcoming subjects with intellectual disabilities in Ouagadougou (Burkina Faso). Objectives: The objective of this study was to identify the factors associated with it among intellectually disabled in the specialized centers of Ouagadougou. Methods: The study was cross-sectional analytical. The survey took place between November 2020 and January 2021 among people with intellectual disabilities in reception centers receiving a grant from the Ministry of Women, National Solidarity, Family and Humanitarian Action. Data collection was done with a questionnaire adapted from the World Health Organization (WHO) and dental caries was recorded according to WHO criteria in decayed, missing or filled teeth generating a DMF index. Logistic regression was used to identify factors associated with the presence of dental caries. Results: A total of 193 participants were included in the study with an average age of 12.4 years ± 7.9. The overall prevalence of caries measured with the DMF index was 58.6% 95% CI [51.2 - 65.8]. It was significantly associated with female gender (OR = 4.2;95% CI [1.4 - 12.5], p = 0,01), the clinical form of mental illness (epilepsy OR = 3.8 95%;CI [1.2 - 12.7], p = 0,02, trisomy OR = 5.0;95% CI [1.1 - 22.9], p = 0,03, motor autonomy OR = 0.2 95%;CI [0.1 - 0.7], p = 0,01) and at use of toothpaste OR = 9.33;95% CI [1.05 - 82.7], p = 0,04. Conclusion: Dental caries remains a very present pathology in most people living with an intellectual disability. Also, it is necessary to put in place prevention strategies to reduce its prevalence and improve access to oral care for these people.

Adjuvant postbiotic administration improves dental caries prognosis by restoring the oral microbiota

Conventional filling therapy fails to fundamentally reduce oral cariogenic bacteria.Thus,oral microbiota follow-up intervention after filling would be necessary for improving dental caries prognosis.We recruited 9 caries-free individuals,and 89 dental caries subjects(5 dropouts).Eighty-nine patients were randomized into three groups:caries(n=8;no treatment),control(n=40;filling),and postbiotics(n=41;filling and 14-day Probio-Eco®intervention).Salivary samples were collected at 0 day(after filling)and 14 days.Our results showed that the diversity of dental caries oral microbiota was significantly increased compared with healthy subjects,and filling could restore a healthier oral microbiota partially and temporarily.Thepostbiotics intervention keeps a low alpha-diversity.Co-occurrence network analysis showed that a more stable oral microbiota structure after postbiotics intervention.Taxonomic and functional annotation of the microbiota revealed that postbiotics co-treatment significantly:increased the relative abundance of Pseudomonas and P.reactans,decreased the relative abundance of Prevotella shahii,and enriched the energy metabolism-related pathways.BugBase-predicted phenotypes inferred to an oral microbiota with decreased potential pathogenic bacteria and increased oxidative stress-tolerant bacteria after postbiotics intervention.Collectively,it suggested that postbiotics co-treatment could be a promising strategy that restores the oral microecological balance for dental caries.

Family counseling of dental and oral care for preventing caries of dental during preschool age: a literature review

Incorrect family behavior in caring for the dental and oral health of preschool-aged children can affect the incidence of dental caries in these children and can cause more serious health problems in the future if not treated immediately,so it is important to find the right solution.This study aims to determine the effect of family counseling on dental and oral care for preschoolers.This study uses a narrative literature review method.Search articles using 5 databases(Pubmed,ScienceDirect,SpringerLink,ProQuest,and Google Scholar)to search for articles with the keywords family counseling AND Oral health AND Early Childhood Caries AND Behavior Change AND Family and the article selection process refers to the Flow diagram of the PRISMA Statement 2020.The results showed that there were 7 articles analyzed in this study.The implementation of family counseling has a significant effect in increasing self-efficacy,knowledge,ability,and motivation of the family,as well as the behavior of the child,to reduce the risk of dental caries in preschool-age children,taking into account several conditions.It was determined that family counseling is effective in reducing the incidence of dental caries in preschool children.

Analysis of the Effectiveness of Modified Non- Traumatic Filling Technology in the Treatment of Pediatric Dental Caries

Objective:To analyze the effectiveness of modified non-traumatic filling technology in the treatment of pediatric dental caries.Methods:Ninety-seven children with dental caries who were treated in our hospital(Panyu Maternal and Child Care Service Center of Guangzhou)from January 2022 to December 2023 were selected and randomly divided into two groups,with 48 cases in the experimental group and 49 in the control group.The experimental group was treated with modified non-traumatic filling techniques,while the control group was treated with conventional filling techniques.Observation indicators such as the total effectiveness of the treatment,incidence of adverse events,treatment compliance,and pain scores were analyzed after the intervention.Result:After intervention,the total effectiveness of the treatment in the experimental group was higher than that in the control group(P<0.05).The incidence of adverse events in the experimental group was lower than that of the control group(P<0.05).The treatment compliance of patients in the experimental group was higher than that in the control group(P<0.05).The pain score of the experimental group was lower than that of the control group(P<0.05).Conclusion:The application of modified non-traumatic filling technology in the treatment of pediatric dental caries showed good therapeutic outcomes.After the intervention,the child’s symptoms were significantly alleviated,the incidence of adverse events such as filling material falling off was reduced,their compliance was improved,and the pain was relieved.This procedure is worth to be promoted for clinical application.

Analysis of the Clinical Effect of Carisolv Minimally Invasive Gel in the Treatment of Pediatric Dental Caries

Objective:To study the clinical effect of Carisolv minimally invasive gel in the treatment of pediatric dental caries and its effect on pain.Methods:The research subjects of this paper were 113 cases of pediatric caries admitted to the hospital from April 2021 to April 2023,which were divided into two groups by the randomized table method.The control group(n=56)received the traditional dental drilling treatment method,and the observation group(n=57)applied Carisolv minimally invasive gel for treatment.The pain sensitivity and clinical efficacy as well as the emotions and adherence of the children were compared between the two groups.Results:The emotional score(ES)of children in the observation group was significantly lower than that of the control group,and the Frankl Adherence Scale score was significantly higher than that of the control group,P<0.05;the pain sensitivity of children in the observation group was better than that of the control group,and the total clinical efficacy rate of children in the observation group was significantly higher than that of the control group,P<0.05.Conclusion:Carisolv minimally invasive gel has considerable efficacy in the treatment of pediatric caries,and it can alleviate pain and improve children’s emotional state and adherence to the program.Thus,it is suitable for wide clinical applications.

Application of Scanning Acoustic Microscopy for Detection of Dental Caries Lesion

Introduction: A scanning acoustic microscope (SAM) is an apparatus for imaging acoustic properties. This apparatus can non-invasively and rapidly evaluate the hardness of materials in the elastic region. This device shows great potential for the diagnosis of dental caries in the clinical setting. However, since the tissue elastic modulus measured using a SAM is a property of the elastic region and the Knoop hardness is a property of the plastic region, the hardness properties differ completely. Therefore, we investigated whether the acoustic impedance measured using a SAM is related to the Knoop hardness, which is used as the standard for removal of carious dentin. Method: Polished sections were prepared from 20 extracted carious wisdom teeth. The acoustic impedance and Knoop hardness were measured for each section. In addition to comparing carious and healthy dentin in SAM images, we evaluated the difference between the carious and healthy dentin in terms of the acoustic impedance and Knoop hardness. We also evaluated the correlation between the Knoop hardness and acoustic impedance. Results: The SAM images were visualized as two-dimensional color images based on the acoustic impedance values. The mean acoustic impedance of carious dentin was significantly lower than that of healthy dentin, showing a similar trend as Knoop hardness. A strong correlation was observed between the two. Discussion: The acoustic impedance values obtained through acoustic microscopy differed significantly between carious and sound dentin. Both types of dentins were visualized using two-dimensional color images. A strong correlation was observed between the acoustic impedance value, which indicates the hardness of the elastic region, and the Knoop hardness, which indicates the hardness of the plastic region. The results of the present study indicate that acoustic impedance accurately reflects the hardness of dentin.

Research on the detection of early caries based on hyperspectral imaging

Objective:We applied hyperspectral imaging(HSI)system to distinguish early caries from soundand pigmented areas.It will provide a theoretical basis and technical support,for research anddevelopment of an instrument that could be used for screening and detection of early dentalcaries.Methods:Eighteen extracted human teeth(molars and premolars),with varying degrees ofnatural pathology and no degree of decay involving dentin were obtained.HSI system with awavelength range from 400 to 1000nm was used to obtain images of all 18 teeth containingsound,carious and pigmented areas.We compared the spectra of the wavebands at both 500 nmand 780 nm from the different tooth states,and the reflectance diference bet ween sound versuscarious lesions and sound versus pigmented areas,respectively.Results:There was a slight diference in refectance bet ween carious areas and pigmented areas at500 nm.A substantial difference was additionally noted in refectance bet ween carious areas andpigmented areas at 780 nm.Conclusion:The results have shown that the interference of tooth surface pigment can be elim-inated in the near-infrared(NIR)waveband,and the caries can be effectively identifed from the pigmented areas.Thus,it could be used to detect carious areas of teeth in place of the traditionalvisual inspection method or white light endoscopy.Clinical significance:The NIR difused light signal enables the identification of early caries frompigment and other interference,providing a reasonable detection tool for early detection andearly treatment of teeth diseases.

北京市2011-2022年5岁儿童乳牙龋纵向变化分析

目的了解北京市5岁儿童口腔健康状况及趋势,对自2011年开始每年开展的3~5岁儿童氟化泡沫项目进行效果评价。方法对照三次流调抽样原则,进行分层、整群随机抽样,每个区县根据经济水平高低随机各抽取3所幼儿园5岁儿童进行调查,每所幼儿园抽取60人。分析其患龋率、龋均及充填率等变化情况。结果2011年患龋率和龋均为最高值,2012-2022年患龋率及龋均均低于2011年,并自2018年后逐渐趋于稳定。充填率呈上升趋势;SiC指数位于7~8之间。患龋率、龋均及充填率男女对比无差异(P>0.05),城乡有差异(P<0.05)。结论从2011年起在全北京市范围内开展氟化泡沫等综合龋病预防项目以来,北京市患龋情况得以初步控制,但仍需进一步加强防治工作。

牙科全麻技术在不同阶段低龄儿童牙科治疗中的应用

目的:分析婴幼儿及学龄前两个阶段牙科全麻技术(DGA)应用的临床效果。方法:收集牙科治疗中需要进行全身麻醉的儿童647例,按照年龄段分为两组。婴幼儿组(3岁以下)135例,学龄前组(3~6岁)512例,分析其性别、年龄、合并疾病、就诊原因、治疗牙数、治疗内容、治疗时间、麻醉效果及术后并发症情况。结果:总中位数年龄47(38~56)月,并发其他疾病者占比32.25%,两组间比较无统计学差异(P>0.05)。就诊原因主要为疼痛和猛性龋,组间比较有统计学差异(均P<0.05)。治疗牙数中位数14(12~16)颗,治疗时间中位数110(95~130)min,婴幼儿组均低于学龄前组(均P<0.05)。治疗内容包括窝沟封闭、拔牙、充填治疗和牙髓治疗,组间比较有统计学差异(均P<0.05)。麻醉效果评价为优者占比96.91%,组间比较无统计学差异(P>0.05)。术后婴幼儿组烦躁比例高于学龄前组(P<0.05),但口渴、进食困难发生率低于对照组(均P<0.05)。结论:3岁以下婴幼儿较3~6岁学龄前儿童DGA下治疗牙数量更少,时间更短,虽然术后烦躁发生率较高,但是疼痛、口渴和进食困难发生率更低。对于3岁以下婴幼儿牙科疾病,DGA技术是较为安全、高效的解决办法。

石家庄市区3岁儿童乳牙患龋与家庭喂养习惯的相关性分析

目的了解石家庄地区3岁儿童龋齿的患病状况,探讨其与家庭喂养习惯的关系,对其预防和早期干预提供依据。方法在石家庄市区抽取1680名3岁儿童进行临床口腔检查并向接受检查的儿童监护人发放调查问卷,最终统计分析调查数据。结果共有1104名儿童患龋,患龋率为66.67%。单因素分析结果显示患龋儿童与未患龋儿童在孩子长牙后是否有含奶头或奶瓶入睡、长牙后孩子喂奶或进食后是否及时清洁牙面、孩子现在是否经常吃零食方面相比,差异均具有统计学意义(P<0.05);在对孩子采取的喂养方式以及母亲是否与孩子共用餐具两方面相比,差异均无统计学意义(P>0.05)。多因素分析结果显示孩子长牙后含奶头或奶瓶入睡、孩子现在经常吃零食是3岁儿童患龋的危险因素,孩子长牙后喂奶或进食后及时清洁牙面是3岁儿童患龋的保护因素。结论石家庄市区3岁儿童患龋率较高,孩子长牙后含奶头或奶瓶入睡、孩子现在经常吃零食均是低龄儿童龋的危险因素,应加强口腔护理。

重庆市12岁儿童第一恒磨牙龋患率及相关因素研究

目的了解重庆市12岁儿童第一恒磨牙龋患率及相关因素,为开展儿童口腔疾病综合干预提供建议。方法采用随机整群抽样的方法在重庆市6个区县抽取12岁儿童进行问卷调查与口腔健康检查,采用SPSS 25.0进行统计分析,第一恒磨牙龋患率相关因素采用多因素Logistic回归分析。结果共计调查12岁儿童3770人,其中男生与女生分别为1953人(51.80%)与1817人(48.20%);城市与农村儿童分别占49.97%与50.03%;正确刷牙率为26.37%;口腔健康知识知晓率为2.23%;对口腔健康持正确态度的儿童比例为67.88%;牙龈出血和牙石检出率分别为33.69%与4.62%,接受过窝沟封闭的占42.86%。12岁儿童第一恒磨牙龋患率为33.69%,龋均为1.47。多因素Logistic回归分析结果提示,农村居住(OR=1.38,95%CI:1.20~1.59)、每天饮用碳酸饮料或含糖饮料(OR=1.38,95%CI:1.05~1.82)、每天摄入甜点或糖果(OR=1.30,95%CI:1.07~1.58)、牙龈出血(OR=0.70,95%CI:0.60~0.81)、牙石(OR=2.17,95%CI:1.58~2.96)、接受过窝沟封闭(OR=0.61,95%CI:0.53~0.70)是重庆市12岁儿童第一恒磨牙龋患率的影响因素。结论重庆市12岁儿童龋患率高,正确刷牙率低,窝沟封闭率低,应针对龋患率的影响因素开展有针对性的干预,扩大窝沟封闭的覆盖率,降低儿童龋患率。

60例鼻咽癌长期生存者放射性龋齿现状及其影响因素分析

目的 调查鼻咽癌长期生存者放射性龋齿的现状,分析其发生、发展的影响因素。方法 收集2012年1月至2017年12月在福建医科大学附属第一医院接受根治性放疗且生存期>5年的鼻咽癌患者60例,采用龋齿、缺牙和补牙指数(DMFS160)和中文版的口腔健康影响概况5(OHIP5)评估患者的放射性龋齿程度及口腔相关并发症、口腔相关生活质量。分析放射性龋齿对口腔相关生活质量的影响,探讨其发生、发展的影响因素。结果 60例患者中,出现放射性龋齿38例(63.3%)。口腔相关并发症评估中,放射性龋齿和口干的严重程度较高,二级以上放射性龋齿和口干的发生率分别达到51.7%和48.4%。OHIP5总分平均为[5.5(3,7)]分,OHIP2和OHIP3得分最高,分别为[1.5(1,2)]分。将患者分为发生和未发生龋齿组,龋齿组的口腔相关生活质量明显下降。多因素分析结果显示,年龄(β=0.200,P=0.026)、有无龋齿(β=0.266,P=0.002)、吞咽困难(β=0.660,P<0.001)对口腔相关生活质量的影响,差异有统计学意义(P <0.05);放疗后刷牙次数(β=-2.166,P=0.022)和每次刷牙时长(β=-1.844,P=0.039)是放射性龋齿发生的保护性因素。结论 鼻咽癌长期生存者放射性龋齿的发生率较高,对口腔相关生活质量产生负面影响。放疗后刷牙的频率和每次刷牙的时长是放射性龋齿发生的临床保护性因素。

活髓切断术与间接盖髓术对乳磨牙深龋患儿治疗效果及预后的影响比较

目的:对比分析活髓切断术与间接盖髓术对乳磨牙深龋患儿治疗效果及预后的影响。方法:对2019年1月-2023年2月笔者医院收治的152例乳磨牙深龋患儿的临床资料进行回顾性分析,按治疗方法的不同分为A组(n=78,96颗患牙)和B组(n=74,96颗患牙),A组予以活髓切断术治疗,B组予以间接盖髓术治疗,治疗后均随访12个月。比较两组治疗效果、牙本质桥形成率、牙齿咀嚼功能、并发症发生情况和学龄前儿童口腔健康影响量表(ECOHIS)的差异。结果:治疗后12个月,A组患牙的修复成功率高于B组(P<0.05);治疗后6、12个月,A组患牙的牙本质桥形成率均高于B组(P<0.05);治疗后12个月,两组牙齿咀嚼功能各维度评分均高于同组治疗前,且A组均高于B组(P<0.05);A组的并发症发生率低于B组(P<0.05);两组ECOHIS量表口腔症状、口腔功能、心理状态、社会交往评分均低于同组治疗前,且A组低于B组(P<0.05)。结论:活髓切断术相较间接盖髓术对乳磨牙深龋患儿的疗效更加显著,能有效提高修复成功率,促进牙本质桥形成,改善牙齿咀嚼功能,提高生存质量,减少并发症的发生。

新疆桑白皮提取物对主要致龋细菌生物膜作用的实验研究

目的探讨新疆桑白皮提取物对主要致龋细菌在生物膜状态下产酸、产糖等致龋毒力因子及生物膜活性的影响。方法制备变异链球菌、血链球菌和黏性放线菌3种单菌种菌悬液,分为阴性对照组[不添加新疆桑白皮提取物或氯己定(CHX)];阳性对照组(添加0.05%CHX);实验组(添加不同浓度新疆桑白皮提取物),测定新疆桑白皮提取物对3种致龋细菌生物膜状态下产酸能力的影响,通过测定24 h内不同时间节点pH值制作pH曲线。采用蒽酮硫酸法测定新疆桑白皮提取物对水溶性及水不溶性胞外多糖合成水平的影响。分别采用乳酸脱氢酶(Lactate dehydrogenase,LDH)活性试验和钙离子(Ca^(2+))泄漏实验,测定新疆桑白皮提取物对3种致龋菌生物膜上清液中LDH含量和Ca^(2+)浓度的影响;采用活死菌染色实验,测定新疆桑白皮提取物对3种致龋菌生物膜活性的影响。结果与阴性对照组比较,实验组(除1/4MBIC_(50)实验组)和CHX组生物膜ΔpH值均减小,3种致龋细菌单菌种生物膜产IEPS、SEPS能力降低,上清液中LDH含量和Ca^(2+)浓度升高,生物膜细菌总量下降,死细菌数量增大,活/死细菌比值百分比下降,差异有统计学意义(P<0.05)。与CHX组比较,实验组3种致龋细菌生物膜ΔpH值均增大,生物膜产IEPS、SEPS能力升高,上清液中LDH含量和Ca^(2+)浓度降低,差异有统计学意义(P<0.05)。结论新疆桑白皮对3种致龋细菌生物膜状态下产酸、产糖能力具有一定抑制作用,能够影响破坏3种致龋细菌生物膜的活性。

基于患龋风险评估的口腔健康教育对儿童口腔健康干预效果的评价

目的探究基于患龋风险评估的口腔健康教育方式对学龄期儿童口腔健康状态及其家长口腔保健意识的影响。方法采取整群抽样的方法选取在川北医学院附属医院行集体窝沟封闭的南充市某小学二年级294例儿童作为研究对象,按照随机数表法将其分为龋态宣教组(A组)和传统宣教组(B组)。传统宣教组对儿童及其家长进行常规宣教,龋态宣教组在常规宣教基础上利用龋态对其进行患龋风险评估,干预时长均为6个月,比较干预前后两组儿童的龋病和口腔卫生状况,口腔卫生保健措施实施情况及其家长的口腔保健知识知晓率,以评价基于患龋风险评估的口腔健康教育方式对学龄期儿童口腔健康状况的影响。结果干预结束后,儿童的口腔卫生状况、口腔卫生保健措施实施情况,家长的口腔保健意识在两组间差异有统计学意义(P<0.05),龋病情况比较,差异无统计学意义(P>0.05)。结论龋活跃性检测技术结合口腔健康教育能有效提高家长对儿童口腔状况的重视程度和口腔健康知识掌握程度,能有效改善儿童的口腔卫生状况,有利于龋病的远期预防。

199例学龄前儿童龋齿的影响因素研究

目的探讨学龄前儿童患龋的影响因素,为预防龋齿提供参考依据。方法选取2020年3月1日至6月30日该院口腔科就医1~6岁学龄前儿童199例,根据是否龋齿将研究对象分为病例组(119例)和对照组(80例)。比较2组喂养方式、断夜奶年龄等因素,并分析学龄前儿童患龋的影响因素。结果2组在年龄、身高方面比较,差异有统计学意义(P<0.05),在性别、体重、家庭所在地,家庭人均年收入方面比较,差异无统计学意义(P>0.05)。2组在喂养方式、断夜奶年龄、断母乳年龄、口腔检查目的、第1次去口腔医院就诊年龄比较,差异具有统计学意义(P<0.05)。断母乳年龄、第1次去口腔医院就诊年龄和口腔检查目的是预防龋齿的影响因素(P<0.05)。结论断母乳年龄、第1次去口腔医院就诊年龄和口腔检查目的是预防龋齿的影响因素。尽早看牙医,及时治疗,同时注意口腔卫生,及时采取干预措施,可降低学龄前儿童龋齿发生率。

伢典微创去腐联合树脂充填治疗学龄前儿童龋齿疗效观察

目的:探讨Carisolv伢典微创去腐联合树脂充填治疗学龄前儿童龋齿的疗效。方法:选取2019年1月-2022年1月笔者医院就诊的88例学龄前儿童龋齿患者为研究对象,随机数字表法分为两组。对照组:44例,给予传统机械去腐联合树脂充填;研究组:44例,给予Carisolv伢典微创去腐联合树脂充填。比较两组治疗时间、儿童疼痛行为量表(The face,legs,activity,cry,consolability behavioral tool,FLACC)评分及牙周指标菌斑指数(Plaque index,PLI)、牙龈指数(Gingival index,GI)变化,统计修复效果。结果:两组去腐时间、充填时间及总体治疗时间比较,差异无统计学意义(P>0.05);研究组无痛、轻度疼痛发生率高于对照组,中度及重度疼痛发生率低于对照组(P<0.05);治疗后,研究组PLI、GI低于本组治疗前及对照组(P<0.05);研究组修复总有效率为98.11%,高于对照组的85.45%(P<0.05)。结论:学龄前儿童龋齿采用Carisolv伢典微创去腐联合树脂充填治疗可获得理想的修复效果,改善牙周健康,且疼痛程度轻。

Er:YAG激光和传统车针去龋后牙本质粘接强度的比较

目的:比较使用不同模式Er:YAG激光以及传统车针去龋后牙本质与复合树脂的粘接强度。方法:选用人类离体磨牙模拟龋坏,分别采用Er:YAG激光中短脉冲(medium short pulse,MSP)模式、Er:YAG激光超短脉冲(super short pulse,SSP)模式和传统车针去除模拟的龋坏后,采用自酸蚀粘接剂将牙体标本与复合树脂粘接制成试件。使用万能试验机对试件进行拉伸试验,测得断裂负荷和粘接强度,并采用单因素方差分析和Tukey多重比较进行统计学分析。采用扫描电子显微镜观察3种不同去龋方式处理后的牙本质表面形态,以及涂布自酸蚀粘接剂并固化后试件的横截面形态。结果:使用Er:YAG激光MSP模式处理后牙本质与复合树脂的粘接强度最高,SSP模式处理后次之,传统车针处理后最低,但差异无统计学意义(P>0.05)。扫描电子显微镜图像显示,Er:YAG激光MSP模式处理后的牙本质表面较平坦,牙本质小管内几乎没有残屑;Er:YAG激光SSP模式处理后的牙本质表面呈现鳞片状,牙本质小管内可见少量碎屑;而传统车针处理后牙本质小管大部分处于被表面牙本质部分甚至完全遮盖的状态,牙本质小管内充满残屑。结论:使用Er:YAG激光去龋相比传统车针去龋可以获得较好的牙本质粘接强度,且对牙本质小管的处理深度和洁净度明显优于传统车针去龋,其中MSP模式更佳。

浓缩生长因子血纤维蛋白用于恒磨牙深龋直接盖髓术的临床研究

目的:将浓缩生长因子血纤维蛋白(CGF)作为盖髓材料应用于恒磨牙深龋去尽龋坏后穿髓的直接盖髓术(DPC)中,观察患牙术后反应,明确其作为盖髓材料的临床可行性。方法:选取2021年05月至2023年12月就诊于宁夏医科大学总医院口腔医院牙体牙髓病科诊断为恒磨牙深龋且去尽龋坏后穿髓、符合DPC治疗的患者。根据直接盖髓材料的不同以及患者意愿分为Dycal对照组和CGF试验组,两组除直接盖髓材料不同以外,垫底材料及充填材料均相同。术后1、3、6个月定期复查,观察2组术后反应及临床效果。结果:共有132例患牙纳入本研究,8例失访。Dycal对照组和CGF试验组各62例。治疗前出现牙齿敏感的患者在术后6个月复查时,Dycal对照组和CGF试验组牙齿敏感缓解情况分别为58.62%、71.92%,差异无统计学意义(P>0.05)。术后6个月,两组共成功115例,失败9例。两组总体成功率为92.74%,Dycal组和CGF组成功率分别为93.54%、91.93%,差异无统计学意义(P>0.05)。结论:将CGF作为盖髓剂用于恒磨牙去尽龋坏后穿髓的DPC可以达到保存生活牙髓,降低牙髓摘除率及根管治疗率的目的。

基于网络药理学探讨新疆桑白皮防龋机制及其对主要致龋菌作用的研究

目的探讨新疆桑白皮防龋潜在机制,并分析其对主要致龋菌的作用。方法TCMSP数据库筛选新疆桑白皮活性成分及靶点。Genecards、DisGENET和TTD数据库获取龋病靶点。获取新疆桑白皮防龋的共同靶点,并筛选核心基因。使用DAVID数据平台进行富集分析。采用AutoDock软件进行分子对接验证。通过体外抑菌实验,首先测定新疆桑白皮提取物对变异链球菌、血链球菌、黏性放线菌的50%最低抑菌浓度(50%minimum inhibitory concentration,MIC50)、最低杀菌浓度(minimal bactericidal concentration,MBC),并绘制生长曲线;分别测定新疆桑白皮提取物对变异链球菌、血链球菌、黏性放线菌浮游状态产酸、产糖和黏附能力的影响;通过结晶紫染色法测定新疆桑白皮提取物对主要致龋细菌单菌种50%最低生物膜抑制浓度(50%minimum biofilm inhibition concentration,MBIC50)和50%最低已形成生物膜清除浓度(50%minimum biofilm re-duction concentration,MBRC50),并利用扫描电子显微镜观察生物膜形态。结果筛选出新疆桑白皮防龋关键活性成分包括槲皮素、山奈酚、β-谷甾醇等。肿瘤坏死因子(tumor necrosis factor,TNF)、白细胞介素-6(interleu-kin-6,IL-6)、白细胞介素-1β(interleukin-1beta,IL-1β)等可能是新疆桑白皮防龋的关键靶点。富集分析结果显示新疆桑白皮可能对AGE-RAGE信号通路、IL-17信号通路、TNF信号通路等产生影响。抑菌实验结果显示新疆桑白皮提取物对变异链球菌、血链球菌、黏性放线菌的MIC50分别为0.5、0.5、0.25 mg/mL,MBC分别为4.0、2.0、1.0 mg/mL。新疆桑白皮提取物对3种主要致龋细菌浮游状态产酸、产多糖以及黏附能力的抑制作用较对照组强,差异均具有统计学意义(P<0.05)。新疆桑白皮提取物对变异链球菌、血链球菌、黏性放线菌的MBIC50分别为1.0、1.0、0.5 mg/mL,MBRC50分别为4.0、4.0、2.0 mg/mL。扫描电镜结果显示随着新疆桑白皮药物浓度的增加,生物膜形成量与对照组相比逐渐减少。结论新疆桑白皮可通过槲皮素、山奈酚、β-谷甾醇等活性成分,TNF、IL-6、IL-1β等关键靶点及多种作用途径防龋,不仅能抑制主要致龋细菌浮游状态生长、产酸、产糖、黏附能力且对致龋菌生物膜形成有一定的抑制作用。