Nonsurgical periodontal-therapy improves glycosylated hemoglobin levels in pre-diabetic patients with chronic periodontitis

AIM To evaluate the effect of nonsurgical periodontal therapy on glycosylated haemoglobin levels in pre-diabetic patients with chronic periodontitis(CHP).METHODS Sixty pre-diabetic patients with CHP were selected and equally allocated to case and control group. All subjects were evaluated at base line for periodontal parameters(plaque index, oral hygiene index, modified gingival index, probing pocket depth, clinical attachment level) and systemic parameters [glycosylated hemoglobin(HbA1c), fasting lipid profile, and fasting blood glucose]. The case group received non-surgical periodontal therapy. Subjects were re-evaluated for periodontal and systemic parameters after three months.RESULTS Both groups were comparable at baseline. Three months after non surgical periodontal therapy(NSPT), there was significant improvement in periodontal parameters in case group. The mean difference in systemic parameters like HbA1c and fasting plasma glucose from baseline to fourth month for case group was 0.22 ± 0.11 and 3.90 ± 8.48 respectively and control group was-0.056 ± 0.10 and-1.66 ± 6.04 respectively, which was significant between case and control group(P < 0.05). In the case group there was a significant decrease in HbA1c from baseline to three months following NSPT(P < 0.05).CONCLUSION This study showed that periodontal inflammation could affect the glycemic control in otherwise systemically healthy individuals. Periodontal therapy improved periodontal health status and decreased glycosylated haemoglobin levels, thus reducing the probability of occurrence of inflammation induced prediabetes in patients with CHP.

Generalized periodontitis treated with periodontal,orthodontic,and prosthodontic therapy:A case report

BACKGROUND Generalized periodontitis is a severe periodontal disease characterized by rapid periodontal destruction in healthy persons.This case report describes the treatment of a severe crowding,large overjet,and occlusal collapse due to the loss of anterior guidance with generalized periodontitis.CASE SUMMARY A 35-year-old female patient with a chief complaint of crowding and maxillary protrusion was diagnosed with generalized periodontitis by clinical and radiographic examinations.To improve crowding and overjet,orthodontic treatment was performed after basic periodontal therapy.Severely damaged upper right lateral incisor and left canine were extracted,and lower right first premolar and left second premolar were also removed to treat severe crowding.After orthodontic treatment,periodontal flap surgery for upper left molars and guided tissue regeneration for the lower left second molar was performed.Then,a dental implant was inserted in the upper left canine legion.The esthetics of the maxillary anterior tooth was improved by prosthetic restorations.The treatment result showed a well-improved occlusion with proper anterior guidance and healthy periodontal tissue after a retention period of 10 years.CONCLUSION Periodontal,orthodontic,and prosthodontic treatments are extremely useful to improve function and stable periodontal tissue for generalized periodontitis.

Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for severe periodontitis

BACKGROUND Severe periodontitis is a major oral health concern today as it can lead to loss of teeth.Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its entirety.AIM To investigate the effect of dental pulp periodontal therapy on the levels of interleukin-1β(IL-1β)and IL-10 in gingival crevicular fluid(GCF)in patients with severe periodontitis.METHODS Eighty-six patients with severe periodontitis were randomly divided into a research group(n=43)and a control group(n=43).The control group was treated with simple periodontal therapy,and the research group was treated with dental pulp periodontal therapy.The total effective rates of the treatments;periodontal status before and after treatment through the measurement of the periodontal pocket probing depth(PPD),gingival sulcus bleeding index(SBI),mobility(MD),and plaque index(PLI);the levels of inflammatory factors IL-1βand IL-10 in the GCF;and the incidence of complications were calculated for both groups and compared using the Student’s t test and theχ^(2) test.RESULTS The total effective rate of treatment in the study group(93.02%)was higher than that in the control group(76.74%;P<0.05).While before treatment,there was no significant difference in the PLI,MD,SBI,or PPD between the two groups,the post-treatment values of PLI,MD,SBI,and PPD(4.71±0.16 mm,0.61±0.09 mm,0.96±0.17 mm,and 0.76±0.26 mm,respectively)were significantly lower(P<0.05)in the research group than in the control group(5.35±0.24 mm,0.93±0.15 mm,1.35±0.30 mm,and 1.04±0.41 mm,respectively).There was no significant difference in the level of IL-1βor IL-10 in the GCF before treatment between the two groups;after treatment,the IL-1βlevel in the research group(139.04±15.54 pg/mL)was significantly lower than that in the control group(156.35±18.10 pg/mL),and the level of IL-10 in the research group(7.98±1.01 ug/L)was higher than that in the control group(5.56±0.96 ug/L)(P<0.05).The incidence of complications in the study group(4.65%)was significantly lower than that of the control group(18.60%;P<0.05).CONCLUSION Endodontic therapy and periodontal treatment for patients with severe periodontitis can effectively reduce the levels of inflammatory factors in the GCF and the inflammatory reaction.In addition,it can improve the periodontal condition and the overall treatment effect,reduce the risk of complications,and ensure the safety of treatment.

Treatment effects and periodontal status of chronic periodontitis after routine Er:YAG laser-assisted therapy

BACKGROUND Routine preclinical interventions for patients with chronic periodontitis such as supragingival cleaning and subgingival curettage,establishing a balanced occlusal relationship,and irrigation with 3%hydrogen peroxide can relieve the symptoms to some extent.However,there is room for improvement in the overall effect.For example,Er:YAG lasers can quickly increase the temperature of the irradiated tissue,effectively eliminate dental plaque and calculus,reduce periodontal pockets,adjust periodontal microecology,and reduce the gingival sulcus.The content of factors in the liquid,and then achieve the purpose of treatment.AIM The aim was evaluate the effect of Er:YAG laser-assisted routine therapy on the periodontal status in chronic periodontitis.METHODS Between October 2018 and January 2020,106 patients with chronic periodontitis in our hospital were randomly assigned to either the study or control group,with 53 patients in each group.The control group underwent routine therapy,and the study group underwent Er:YAG laser therapy in addition to routine therapy.We evaluated the treatment outcome in both groups.Periodontal status was determined by clinical attachment loss(CAL),gingival index(GI),periodontal probing depth(PD),dental plaque index(PLI),and sulcular bleeding index(SBI),inflammatory factors in the gingival crevicular fluid,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8],and colony forming units(CFUs).RESULTS Total effectiveness in the study group(94.34%)was higher than that in the control group(79.25%,P<0.05).The clinical parameters in the study group(PD,5.28±1.08 mm;CAL,4.81±0.79 mm;SBI,3.37±0.59;GI,1.38±0.40;PLI,2.05±0.65)were not significantly different from those in the control group(PD,5.51±1.14 mm;CAL,5.09±0.83 mm;SBI,3.51±0.62;GI,(1.41±0.37;PLI,1.98±0.70)before treatment(P>0.05).However,after treatment,the parameters in the study group(PD,2.97±0.38 mm;CAL,2.71±0.64 mm;SBI,2.07±0.32;GI,0.51±0.11;PLI,1.29±0.34)were lower than those in the control group(PD,3.71±0.42 mm;CAL,3.60±0.71 mm;SBI,2.80±0.44;GI,0.78±0.23;PLI,1.70±0.51)(P<0.05).Differences in crevicular TNF-α,IL-6,and IL-8 levels in the study(TNF-α,7.82±3.43 ng/mL;IL-6,11.67±2.59 ng/mL;IL-8,12.12±3.19 pg/mL)and control groups(TNF-α,9.06±3.89 ng/ml,IL-6,12.13±2.97 ng/mL,IL-8,10.99±3.30 pg/mL)before therapy(P>0.05)were not significant.Following treatment,the parameters were significantly lower in the study group(TNF-α,2.04±0.89 ng/mL;IL-6,4.60±1.26 ng/mL;IL-8,3.15±1.08 pg/mL)than in the control group(TNF-α,3.11±1.07 ng/mL;IL-6,6.25±1.41 ng/mL;IL-8,4.64±1.23 pg/mL,P<0.05).The difference in the CFU of the study group[(367.91±74.32)×104/mL and control group(371.09±80.25)×104/mL]before therapy was not significant(P>0.05).The CFU decreased in both groups following therapy,however,the CFU values were lower in the study group[(36.09±15.26)×104/mL]than in the control group[(45.89±18.08)×104/mL](P<0.05).CONCLUSION Combining Er:YAG lasers with routine measures significantly improved the overall periodontal therapy outcomes by improving periodontal status and reducing oral levels of inflammatory factors and CFUs.

Non-surgical periodontal therapy:An update on current evidence

Periodontal disease is an inflammatory condition that involves a complex interaction between pathogenic bacteria,environmental and acquired factors and host related factors.Till recently periodontal treatment was directed primarily towards reduction of bacterial load by subgingival debridement of root surfaces and modification of environmental risk factors.The current paradigm of periodontal disease stresses greater role of hostmediated inflammatory response in tissue destruction characteristic of periodontal disease.Various therapeutic modalities have been developed adjuvant to mechanical periodontal therapy.The use of laser and photodynamic therapy show great promise but their effectiveness has still not been conclusively proven.Chemotherapeutic agents,either systemic and local antimicrobials or host modulating drugs,played pivotal role in better and more predictable management of periodontal disease.The present review focuses on the best available evidence,for the current management of the chronic periodontal patients,gathered from systematic reviews and metaanalysis of mechanical non surgical periodontal therapy(NSPT)(subgingival debridement,laser therapy and photodynamic therapy)and the adjunctive chemothera-peutic approaches such as systematic and local antibiotics and antiseptics,subgingival pocket irrigation and host modulation therapies.The review also attempts to briefly introduce future developments in some of these modalities.At the end,the review summarizes the analysis of the current evidence that suggests that thorough subgingival debridement remains the mainstay of NSPT and that adjunct use of chemotherapeutic agents may offer better management of clinical parameters in periodontitis patients.

The Effects of Smoking on Periodontal Therapy: An Evidence-Based Comprehensive Literature Review

The positive relationship between smoking and major general health diseases such as cancer, cardiovascular disease, pulmonary disease and negative pregnancy outcomes is already established. Moreover, the association between smoking as a major environmental risk factor for periodontal disease has also been established. Smoking is considered to have negative adverse effect on periodontal therapy ranging from non-surgical treatment, periodontal surgery, regenerative procedures and implants. This review article will attempt to build on previous studies in the periodontal literature in order to present an evidence-based comprehensive literature review on the effects of smoking on periodontal therapy.

Topical Application of Ascorbic Acid Solution as an Adjunctive Method of Periodontal Therapy among Wet Snuff Users after Prosthodontics Therapy

Background: During several years, ascorbic acid (vitamin C) played a significant role in the health of periodontal tissues. The goals of prosthodontics management are to restore the missing teeth, provide the loss of teeth functions, and establish acceptable dental esthetics, and there are some evidences revealing the passive effects of snuff on the results of prosthodontics and periodontal treatment, so the present study is performed to evaluate the outcomes of topical application of ascorbic acid solution as an adjunctive method of periodontal therapy among wet sniff users after prosthodontics therapy. Methods: The clinical situation was evaluated in 150 moderate periodontitis patients after conventional periodontal and prosthodontics therapy. They were selected from outpatient clinics, college of dentistry, King Khalid University, and from some hospitals Ministry of Health in Tabuk, Jazan and Aseer regions. The study was conducted from September 2020 to December 2020. The time of post-treatment assessment was one year. The study was included 50 patients who don’t use wet snuff as a group I (GI) (control group), 50 patients wet snuff users as group II (GII), and 50 patients wet snuff users were treated with topical application of ascorbic acid solution as group III (GIII). The participants were aged over 20 years, with a mean age of 35 years. The duration of using wet snuff was at least one year. Plaque index (PLI), gingival index (GI), clinical attachment loss (CAL) were recorded at baseline (first visit), then after 4 weeks (second visit) and after 6 weeks (third visit) of conventional periodontal therapy and topical application of ascorbic acid solution. Statistical analysis was done using ANOVA test and paired t-test. Results: According to statistical analysis, there was the inclination of decrease in the mean and standard deviation of plaque index (PLI) from 2.8 ± 1.4 to 2.5 ± 0.51, and 2.7 ± 0.33 in group II, and decrease from 2.7 ± 0.34 to 2.5 ± 0.23 and 2.6 ± 0.65 in group III. Similarly in the gingival index (GI), there was a decrease in the mean and standard deviation from 2.8 ± 0.52 to 2.3 ± 0.62 and 2.5 ± 0.51 in group II and a decrease from 2.5 ± 0.8 to 2.3 ± 0.58 and 2.4 ± 0.47 in group III. Moreover, there was a decrease in the mean and standard deviation of clinical attachment loss (CAL) from 4.5 ± 0.26 to 3.9 ± 0.83 and 4.2 ± 0.83 in group II and from 4.2 ± 0.31 to 3.8 ± 0.46 and 3.8 ± 0.31 in group III;less than group I without significance differences (p > 0. 05) in all study groups at baseline and after 4 weeks, and 6 weeks of follow up except CAL. Conclusion: The results of our study displayed that periodontal parameters vary among wet snuff users after topical application of ascorbic acid solution as an adjunctive method of periodontal therapy

Role of dental plaque,saliva and periodontal disease in Helicobacter pylori infection

Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections in humans. Although H. pylori may be detected in the stomach of approximately half of the world&#x02019;s population, the mechanisms of transmission of the microorganism from individual to individual are not yet clear. Transmission of H. pylori could occur through iatrogenic, fecal-oral, and oral-oral routes, and through food and water. The microorganism may be transmitted orally and has been detected in dental plaque and saliva. However, the role of the oral cavity in the transmission and recurrence of H. pylori infection has been the subject of debate. A large number of studies investigating the role of oral hygiene and periodontal disease in H. pylori infection have varied significantly in terms of their methodology and sample population, resulting in a wide variation in the reported results. Nevertheless, recent studies have not only shown that the microorganism can be detected fairly consistently from the oral cavity but also demonstrated that the chances of recurrence of H. pylori infection is more likely among patients who harbor the organism in the oral cavity. Furthermore, initial results from clinical trials have shown that H. pylori-positive dyspeptic patients may benefit from periodontal therapy. This paper attempts to review the current body of evidence regarding the role of dental plaque, saliva, and periodontal disease in H. pylori infection.

Effect of periodontal treatment on adipokines in type 2 diabetes

The association between adipokines and inflammatory periodontal diseases has been studied over the last two decades. This review was intended to explore the observation that periodontal therapy may lead to an improvement of adipokines in diabetic patients. In summary, substantial evidence suggests that diabetes is associated with increased prevalence, extent and severity of periodontitis. Numerous mechanisms have been elucidated to explain the impact of diabetes on the periodontium. However, current knowledge concerning the role of major adipokines indicates only some of their associations with the pathogenesis of periodontitis in type 2 diabetes. Conversely, treatment of periodontal disease and reduction of oral inflammation may have positive effects on the diabetic condition, although evidence for this remains somewhat equivocal.

A new approach to transfect NF-κB decoy oligodeoxynucleotides into the periodontal tissue using the ultrasound-microbubble method

The objective of this study is to investigate the effect of the ultrasound-microbubble technique in nuclear factor kappa B(NF-κB) decoy oligodeoxynucleotide(ODN) transfection in the gingival tissue in mice. The 6-FAM-labeled scrambled decoy ODN with microbubbles was applied to the periodontal tissue in 8-week-old male C57BL/6J mice by ultrasound radiation at low(LUM-Sc) and high(HUM-Sc) intensities to optimize the transfection condition of the ultrasound-microbubble method.Histological inspections were performed two hours after transfection to compare the expression with that in the sham-operated group without ultrasound radiation(A-Sc). Then, an NF-κB decoy was transfected into the periodontal tissue using the highintensity ultrasound-microbubble(HUM-NF) technique to examine the anti-inflammatory effects of the decoy ODN. Western blot analysis was performed to investigate the expression of interleukin(IL)-1β, IL-6 and intercellular adhesion molecule-1(ICAM-1)in the gingival tissues in the HUM-Sc, the HUM-NF and control groups. The fluorescence microscopy results showed that the fluorescent intensity in the periodontal tissues in the LUM-Sc and HUM-Sc groups was significantly higher than that in the A-Sc and the control groups. The fluorescent intensity in the HUM-Sc group, especially in the gingival connective tissue,was the highest of all groups. Western blot analysis indicated that the protein expression levels of IL-1β, IL-6 and ICAM-1 in the HUM-NF group were significantly lower than those in the HUM-Sc and the control groups. These findings suggest that the high-intensity ultrasound-microbubble technique is an effective tool for decoy transfection into the periodontal tissue.

A Comparable Study of Combinational Regenerative Therapies Comprising Enamel Matrix Derivative plus Deproteinized Bovine Bone Mineral with or without Collagen Membrane in Periodontitis Patients with Intrabony Defects

Aim: The aim of the present study was to examine the effectiveness of collagen membrane (CM) in regenerative therapy with deproteinized bovine bone mineral (DBBM) and enamel matrix derivative (EMD) for periodontal intrabony defects. Methods: Eighteen periodontal intrabony defects of nine chronic periodontitis patients were evaluated. Two defects per patient with probing pocket depth (PPD) ≥ 6 mm were assigned to two different types of treatments: EMD + DBBM + CM or EMD + DBBM. Clinical parameters including Gingival Index (GI), PPD, clinical attachment level (CAL), gingival recession (GR), bleeding on probing (BOP), tooth mobility (MOB), and the filled bone volume/rate (FBV/FBR), which was measured by cone beam computed tomography, were compared at baseline and 12 months post-treatment. Differences between groups were determined by the chisquare test, McNemar’s test, and Wilcoxon signed-rank test. Results: Clinically, PPD, CAL, and FBR significantly improved in both groups (p Conclusion: Periodontal regenerative therapies comprising EMD and DBBM with and without CM resulted in positive clinical outcomes. The use of CM may result in better outcomes in MOB decrease;however, long-term prognosis must be further studied.

<i>Helicobacter Pylori</i>and Periodontal diseases: An update and proposal of a multidisciplinary clinical protocol

Helicobacter Pylori has been closely linked to chronic gastritis, peptic ulcers and increased risk of gastric carcinoma. Oral cavity, in particular dental plaque in periodontal pockets, may be a possible reservoir harboring H. Pylori, and may therefore be involved in the gastric reinfection by the bacterium, even after triple therapy regimen. This report is an update of scientific data showing the potential localization of H. Pylori in the oral cavity of periodontitis patients. A multidisciplinary clinical protocol combining full-mouth disinfection and triple therapy is also suggested. This protocol could permit to enhance oral H. Pylori eradication.

Toluidine blue O and porphyrin-mediated photodynamic therapy on three main pathogenic bacteria of periodontitis using portable LED phototherapy device

Photodynamic therapy(PDT)has been commonly used in treating many diseases,such as cancer and infectious diseases.We investigated the different effects of PDT on three main pathogenic bacteria of periodontitis-Prevotella melaninogenica(P.m.),Porphyromonas gingitvalis(P.g.)and Aggregatibacter actinomycetercomitans(A.a-).The portable red light-ermitting diode(LED)phototherapy device was used to assess the exogenous PDT effects with different light doses and photosensitizer concentrations(Toluidine blue O,TBO).The portable blue LED phototherapy device was used to assess the endogenous PDT effects with the use of endogenous photosensit izers(porphyrin)under dfferent light doses.We found out that both exogenous and endogenous PDT were able to restrict the growth of all the three bacteria significantly.Moreover,the optimal PDT conditions for these bacteria were obtained through this in vitro screening and could guide the clinical PDT on periodontitis.

The Benefits of Non-Surgical Periodontal Treatment in Association with Gastric Eradication

Periodontitis is a chronic degenerative disease which is inflammatory and whose bacteriological aetiology interests the hard and soft tissues supporting the dental elements. A typical characteristic of periodontitis is its correlation with other branches of medicine since periodontal disease is often associated with several other illnesses or systemic conditions which exacerbate or predispose the course of the disease. Amongst the most frequent gastroduodenal diseases are those associated with Helicobacter pylori (Hp) infections such as acute gastritis, chronic atrophic gastritis, gastric atrophy, gastritis ulcers, dysplasia, duodenal ulcer, gastric cancer, gastric MALT-lymphoma. Transmission of the microorganism occurs through iatrogenic pathways (faecal-oral, oral-oral) and through food and water ingestion. From this the possible role of the oral cavity becomes evident as a means of transmitting the microorganism and as an extra-gastric reservoir of Hp which develops inside the oral plaque, the main aetiological agent of periodontal disease. Considering that in a patient affected with periodontal disease the oral cavity presents elevated indices of bacterial plaque in association with infrabony pockets one is brought to ask if it might represent a favourable habitat for Hp colonisation. Furthermore, another query that one might pose is whether the presence of Hp in the oral cavity might be the cause of relapse in gastric infections caused by Hp. Consequently, might non-surgical periodontal treatment, in association with an eradicating gastric therapy, foster decontamination of the microorganism in the oral cavity leading to a better prevention of relapse and re-infection of the gastric cavity? Could non-surgical periodontal treatment thus mean prevention of gastric diseases brought on by Helicobacter pylori? The objective of this study is therefore to evaluate the incidence of periodontal disease and oral Hp infection in patients affected by gastric Hpinfection and to determine the possible benefits of the association of non-surgical periodontal therapy with eradicating gastric therapy compared with treatment that involves just the eradicating gastric therapy in patients who are affected by periodontal disease and Hp infection.

Therapeutic applications of dental pulp stem cells in regenerating dental,periodontal and oral-related structures

Dental pulp stem cells (DPSCs) have emerged as a promising tool with greatpotential for use in tissue regeneration and engineering. Some of the mainadvantages of these cells are their multifaceted differentiation capacity, along withtheir high proliferation rate, a relative simplicity of extraction and culture thatenables obtaining patient-specific cell lines for their use in autologous celltherapy. PubMed, Scopus and Google Scholar databases were searched forrelevant articles related to the use of DPSCs in regeneration of dentin-pulpcomplex (DPC), periodontal tissues, salivary gland and craniomaxillofacial bonedefects. Few studies were found regarding the use of DPSCs for regeneration ofDPC. Scaffold-based combined with DPSCs isolated from healthy pulps was thestrategy used for DPC regeneration. Studies involved subcutaneous implantationof scaffolds loaded with DPSCs pretreated with odontogenic media, or performedon human tooth root model as a root slice. Most of the studies were related toperiodontal tissue regeneration which mainly utilized DPSCs/secretome. Forperiodontal tissues, DPSCs or their secretome were isolated from healthy orinflamed pulps and they were used either for preclinical or clinical studies.Regarding salivary gland regeneration, the submandibular gland was the onlymodel used for the preclinical studies and DPSCs or their secretome were isolatedonly from healthy pulps and they were used in preclinical studies. Likewise,DPSCs have been studied for craniomaxillofacial bone defects in the form ofmandibular, calvarial and craniofacial bone defects where DPSCs were isolatedonly from healthy pulps for preclinical and clinical studies. From the previousresults, we can conclude that DPSCs is promising candidate for dental and oraltissue regeneration.

抗菌光动力疗法辅助龈下刮治治疗慢性牙周炎临床效果观察

目的探讨抗菌光动力疗法(antibacterial photodynamic therapy,aPDT)辅助龈下刮治和根面平整(scaling and root planing,SRP)治疗慢性牙周炎的临床效果。方法本研究已通过单位伦理委员会审查通过,并获得患者知情同意。研究采用随机、对照分口设计,符合纳入标准的16例慢性牙周炎患者随机分为试验侧与对照侧。对照侧接受常规SRP,试验侧SRP基础上联合aPDT治疗(SRP+aPDT)。记录治疗前(基线)、治疗后1个月、3个月和6个月时牙周探诊深度(probing depth,PD)、菌斑指数(plaque index,PLI)、出血指数(bleed⁃ing index,BI)和探诊出血(bleeding on probing,BOP)阳性位点占比(BOP%)。结果13例患者完成了全部随访。对照侧356颗受试牙,2136个位点;试验侧360颗受试牙,2160个位点。治疗前,两侧基线水平各指标差异无统计学意义。在治疗后1个月、3个月和6个月时,试验侧和对照侧的牙周临床指标PD、PLI、BI、BOP%相较于治疗前均有明显改善(P<0.05)。在各时间点,与常规SRP相比,SRP+aPDT联合治疗侧PD、PLI和BI均有改善。SRP+aPDT联合治疗侧在治疗后3个月时BOP%和PLI的改善明显优于常规SRP侧(P<0.05)。结论aPDT辅助治疗慢性牙周炎可以在早期更好地改善牙龈出血,控制牙周炎症。

重点环节护理模式在慢性根尖周炎患者根管治疗中的临床效果

目的探讨重点环节护理模式应用于慢性根尖周炎患者根管治疗中的临床效果。方法94例慢性根尖周炎行根管治疗的患者随机分为两组,对照组予以常规护理,观察组予以重点环节护理模式,比较两组的焦虑症状、疼痛程度以及并发症。结果干预后,观察组的SAS评分、NRS评分均低于对照组(P<0.05)。观察组的并发症发生率为6.38%,低于对照组的21.28%(P<0.05)。结论重点环节护理模式有利于减轻慢性根尖周炎根管治疗患者的焦虑症状及疼痛程度,降低并发症发生风险。

牙周病非手术治疗中的替代或辅助疗法研究进展

牙周病属于口腔常见病,造成牙周病的原因诸多,口腔局部刺激因素如牙菌斑、解剖结构异常、不良修复体等;全身促进因素如遗传因素、全身系统疾病、吸烟等,患者可能出现牙龈红肿、出血、溢脓以及牙龈退缩,严重的会出现牙齿脱落的状况,给患者的心理、工作和社会活动都会带来严重影响。在牙周病的早期阶段,非手术治疗作为牙周病的保守方法 ,有助于控制病情恶化。故本文就牙周病非手术治疗中的替代或辅助疗法进行总结,旨在为牙周病治疗研究提供新思路。

口腔无托槽隐形矫治联合牙周基础治疗对牙周病致前牙扇形移位患者口腔健康及炎症反应的影响分析

目的分析口腔无托槽隐形矫治联合牙周基础治疗对牙周病致前牙扇形移位患者口腔健康及炎症反应的影响,以期为临床治疗牙周病致前牙扇形移位提供参考依据。方法选取60例牙周病致前牙扇形移位的患者作为观察样本,按照计算机分组法分为对照组与观察组,每组30例。对照组开展牙周夹板固定联合牙周基础治疗,观察组开展口腔无托槽隐形矫治联合牙周基础治疗。对比两组治疗前后牙周指标、口腔健康情况、炎性反应指标、牙齿功能。结果两组治疗前牙周袋深度、牙槽骨高度、牙覆盖距离、龈沟出血指数对比无差异(P>0.05);观察组治疗后牙周袋深度(2.65±0.51)mm、牙覆盖距离(1.78±0.25)mm、龈沟出血指数(1.56±0.42)分显著低于对照组的(4.73±0.62)mm、(3.19±0.35)mm、(3.07±0.30)分,牙槽骨高度(5.71±0.29)mm高于对照组的(5.55±0.20)mm(P<0.05)。两组治疗前独立能力、心理不适、疼痛与不适、功能受限评分对比无差异(P>0.05);观察组治疗后独立能力评分(1.86±0.31)分、心理不适评分(1.63±0.21)分、疼痛与不适评分(1.86±0.19)分、功能受限评分(1.58±0.20)分均显著低于对照组的(2.16±0.40)、(2.07±0.38)、(2.33±0.30)、(2.17±0.15)分(P<0.05)。两组治疗前C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平对比无差异(P>0.05);观察组治疗后CRP(4.32±0.30)mg/L、IL-1β(167.26±19.32)pg/ml、IL-6(8.75±1.80)pg/ml均显著低于对照组的(5.20±0.41)mg/L、(210.38±17.95)pg/ml、(10.34±1.23)pg/ml(P<0.05)。两组治疗前牙齿色泽、牙齿形状、边缘密合度及咬合关系评分对比无差异(P>0.05);观察组治疗后牙齿色泽、牙齿形状、边缘密合度及咬合关系评分分别为(6.82±0.46)、(7.12±0.50)、(7.81±0.34)、(7.68±0.22)分,均显著高于对照组的(5.63±0.37)、(5.69±0.38)、(6.19±0.24)、(6.10±0.33)分(P<0.05)。结论口腔无托槽隐形矫治联合牙周基础治疗为牙周病致前牙扇形移位患者提供了一种更舒适的牙齿矫正方式,不仅能够减少炎症反应,还有助于更高效、更精确地矫正患者的牙齿,帮助其恢复正常的口腔健康状态。

光动力疗法与半导体激光辅助治疗重度牙周炎的疗效比较

目的比较光动力疗法(PDT)与半导体激光(DL)辅助龈下刮治和根面平整术(SRP)治疗重度牙周炎的临床疗效。方法筛选成年重度牙周炎患者30例作为研究对象,采用自身对照试验,每位受试者选3个象限,每个象限各选取1颗探诊深度(PD)≥7 mm且病损情况相似的磨牙作为指数牙,共90颗,共355个位点,3颗磨牙被随机分为SRP组(单独SRP治疗,118个位点)、DL组(SRP治疗后1周进行DL辅助治疗,122个位点)、PDT组(SRP治疗后1周进行PDT辅助治疗,115个位点)。比较三组治疗前后的PD、临床附着水平(CAL)、探诊出血(BOP)阳性位点、牙周致病菌[牙龈卟啉单胞菌(P.g)、伴放线共生杆菌(A.a)、福赛斯坦纳菌(T.f)]菌量。结果治疗前SRP组、DL组、PDT组的PD分别为(7.87±0.82)、(7.97±0.72)、(7.93±0.83)mm,治疗后6周PD分别为(5.43±1.25)、(5.17±0.79)、(5.13±0.90)mm,治疗后12周PD分别为(5.07±1.05)、(4.77±0.78)、(4.73±0.83)mm;治疗前SRP组、DL组、PDT组的CAL分别为(8.37±0.49)、(8.43±0.57)、(8.40±0.62)mm,治疗后6周CAL分别为(6.17±0.75)、(5.78±0.62)、(5.73±0.64)mm,治疗后12周CAL分别为(5.83±0.61)、(5.52±0.56)、(5.47±0.57)mm。治疗前,三组PD、CAL水平比较,均无统计学差异(P>0.05)。治疗后6、12周,三组PD、CAL水平较治疗前有所改善,且DL组、PDT组的CAL均优于SRP组(P<0.05);治疗后12周,三组PD、CAL较治疗后6周略降低,但差异不具有统计学意义(P>0.05)。治疗后6周SRP组、DL组、PDT组BOP阳性位点占比分别为78.0%、67.2%、65.2%,治疗后12周,SRP组、DL组、PDT组BOP阳性位点占比分别为77.1%、62.3%、59.1%,均低于治疗前的94.1%、93.4%、94.8%,且治疗后12周DL组、PDT组BOP阳性位点占比持续下降,低于SRP组(P<0.05);但治疗后12周DL组与PDT组BOP阳性位点占比比较,差异不显著(P>0.05)。治疗后6、12周三组P.g、A.a、T.f菌量均低于治疗前,治疗后6周DL组、PDT组的P.g、A.a、T.f菌量均低于SRP组,治疗后12周DL组、PDT组的A.a、T.f菌量均低于SRP组(P<0.05);但治疗后12周,DL组与PDT组的A.a、T.f菌量比较以及三组的P.g菌量比较,均无显著差异(P>0.05)。结论PDT和DL辅助SRP治疗磨牙区重度牙周炎在短期内具有一定的疗效,且对牙周致病菌A.a、T.f有明显的抑制作用。