儿童超重及肥胖与牙周健康状况的相关性调查

［摘要］目的 探究10～11岁儿童超重及肥胖与牙周状况之间的关系。方法 纳入成都市198名10～11岁儿童,其中男106名,女92名。检查受试者身高、体重、腰围,计算体质指数(BMI)、记录刷牙习惯和牙周状况。以BMI作为标准纳入超重肥胖组（实验组）98人、正常组（对照组）100人,以腰围为标准纳入超重肥胖组（实验组）94人、正常组（对照组）104人。牙周检查内容包括探诊出血指数(BOP)、可见菌斑指数(VPI)、牙石指数(CI)和探诊深度(PD)。采用χ2检验、t检验、单因素及多因素Logistic回归模型进行分析。 结果BMI和腰围标准分组下,实验组的口腔卫生习惯均差于对照组（P＜0.01）,BOP、VPI＞0.25人数、CI高于对照组（P＜0.01）,出现PD＞3 mm的人数无统计学差异。控制VPI＞0.25、口腔卫生习惯不良作为混杂因素,BMI标准的超重/肥胖是BOP>0.25的危险因素(OR=1.911,95% CI 1.02~3.58),腰围标准的超重/肥胖是BOP>0.25（OR=1.78,95% CI 1.28~3.39）和出现牙石（OR=1.88,95% CI 1.03~3.58）的危险因素。 结论 10～11岁儿童中全身性肥胖与BOP相关,腹型肥胖与BOP和出现牙石均存在关联。     

阿莫西林与甲硝唑联合龈下刮治和根面平整术治疗侵袭性牙周炎的短期疗效观察

目的观察龈下刮治和根面平整术（scaling and root planing,SRP）联合应用阿莫西林和甲硝唑治疗侵袭性牙周炎的短期临床疗效。方法采取随机法将30例侵袭性牙周炎患者分为单纯机械洁刮治的对照组与机械洁刮治联合药物治疗的试验组。分别在治疗前、治疗后3个月检查记录探诊出血（bleeding on probing,BOP）、探诊深度（probing depth,PD）及临床附着丧失（clinical attachment loss,CAL）情况,对所得数据进行统计学分析。结果 2组治疗3个月后BOP阳性率、PD、CAL均较治疗前明显改善。对照组患牙的平均PD值为（3.2±0.6）mm,试验组为（2.7±0.5）mm,2组比较差异有统计学意义（P〈0.05）;30例患者治疗后CAL均有改善,平均改善0.96 mm;试验组PD〈5 mm的平均位点百分比的增加值明显高于对照组,差异有统计学意义（P〈0.05）。结论 SRP联合应用阿莫西林和甲硝唑治疗侵袭性牙周炎短期效果显著优于单纯SRP治疗,临床指标得到明显改善。     

牙周炎与类风湿关节炎相关性的Meta分析

目的    系统评价牙周炎与类风湿关节炎（rheumatoid arthritis,RA）之间的关系。方法    计算机检索PubMed（1966年至2014-12-30）、EMBASE（1974年至2014-12-30）、CNKI（1979年至2014-12-30）和万方数字化期刊全文数据库（1997年至2014-12-30）,并手工检索相关杂志及会议论文集中未发表的文献。由2位研究者按照纳入和排除标准筛选文献、提取资料并评价质量后,采用 RevMan 5.3软件进行Meta分析。结果    共纳入8个病例对照研究,合计1068例患者,其中RA组556例,非RA组512例。8个研究的合并分析结果显示,RA组临床附着丧失（CAL）程度重于非RA组,差异有统计学意义［MD=0.99,95％CI（0.81,1.77）］。6个研究的合并分析结果显示,RA组牙周袋深度（PD）大于非RA组,差异有统计学意义［MD=0.74,95％CI （0.59,0.89）］。5个研究的合并分析结果显示,RA组探针后出血（BOP）重于非RA组,差异有统计学意义［MD=7.72,95％CI （5.66,9.78）］。2个研究的合并分析结果显示,RA组牙龈指数（GI）水平高于非RA组,差异有统计学意义［MD=0.24,95％CI （0.14,0.34）］。3个研究的合并分析结果显示,RA组与非RA组之间的菌斑指数（PI）差异无统计学意义［MD=0.08,95％CI （-0.13,0.28）］。结论    RA患者更易罹患牙周炎或其牙周炎病情容易加重。鉴于本Meta分析纳入的研究数量较少且病例不多,以及测量指标不全面等影响论证强度及全面性的因素存在,以上结论尚需开展更多大样本、高质量、长期随访的研究来加以验证。     

慢性牙周炎伴2型糖尿病患者牙周基础治疗前后牙周状况及血清C反应蛋白水平分析

目的探讨牙周基础治疗对慢性牙周炎伴2型糖尿病患者牙周状况及血清C反应蛋白（C-reactive pro-tein,CRP）水平的影响。方法慢性牙周炎和慢性牙周炎伴2型糖尿病患者各15例,行牙周基础治疗,观察2组治疗前、后探诊出血（bleeding on probing,BOP）、牙周探诊深度（probing depth,PD）、附着丧失（attachment loss,AL）以及血清CRP水平的变化情况。结果慢性牙周炎组治疗后PD减小（1.18±0.52）mm,BOP阳性率减少（29.0±5.0）%,CRP值减小（6.67±4.22）mg/mL,治疗前、后差异均有统计学意义（F=12.03、F=3.41、F=17.38,P〈0.05）。慢性牙周炎伴2型糖尿病组治疗后PD减小（0.57±0.26）mm,BOP阳性率降低（19.0±3.0）%,CRP值减小（3.19±2.33）mg/mL,治疗前、后差异均有统计学意义（F=1.58、F=3.41、F=20.38,P〈0.05）。结论牙周基础治疗可在一定程度上改善慢性牙周炎伴2型糖尿病患者的牙周状况,降低患者血清CRP水平。     

米诺环素局部应用对洁治和根面平整影响的Meta分析

目的：比较并评价在牙周炎治疗过程中,牙周袋内局部应用米诺环素辅助用于洁治和根面平整（scalingand root paning,SRP）的临床效果是否优于单纯的SRP。方法：主要检索6个数据库,一些全文通过手工检索获得。收集至2009年5月公开发表的中英文牙周局部应用米诺环素辅助用于洁治和根面平整的随机对照试验,随访时间至少1个月。测量结果包括术后牙周探诊深度（probing depth,PD）的减少、临床附着水平（clinical attachmentlevel,CAL）的增加。结果：最终13个研究纳入本系统评价。Meta分析结果显示牙周局部应用米诺环素辅助用于SRP与单纯SRP相比,可以使PD指标显著降低,CAL指标显著增加。结论：在慢性牙周炎的治疗过程中,牙周局部应用米诺环素辅助用于SRP可以使牙周探诊深度显著降低,附着水平显著增加。     

IL-1β基因3954C＞T位点多态性与侵袭性牙周病易感性的Meta分析

目的:通过Meta分析进一步探究IL-1β基因3954C＞T位点多态性改变与侵袭性牙周炎的相关性.方法:检索PubMed,Embase,CNKI和万方数据库中有关IL-1β基因3954C＞T位点多态性与侵袭性牙周炎易感性相关文献,以OR值和95％的可信区间为效应指标,应用STATA 11.0软件进行Meta分析,并对发表偏倚及敏感性分析进行检验.结果:纳入22个病例对照研究,共计965例侵袭性牙周炎患者和1234例对照,Meta分析结果显示,总人群中,IL-1β基因3954C＞T位点多态性与牙周病风险之间没有显着关联(T vs.C:OR=0.966,95 ％CI=0.696～1.341:CT vs.CC:OR=0.936,95％CI=0.761～1.151;TT vs.CC:OR=0.892,95％CI=0.464～1.715;CT+TT vs.CC:OR=1.026,95％CI=0.795-1.323;TT vs.CC+CT:OR=0.864,95％CI=0.436、1.713).相应的亚组分析未发现IL-1β基因3954C＞T位点多态性和侵袭性牙周炎易感性无显著相关性.结论:IL-1β基因3954C＞T位点多态性多态性可能与侵袭性牙周炎的发生无关.     

牙龈卟啉单胞菌与牙周基础治疗关系的实验研究

目的应用TaqMan实时荧光定量聚合酶链反应法检测慢性牙周炎患者牙周洁刮治术（SRP）治疗前后龈下菌斑中牙龈卟啉单胞菌（P. gingivalis）的变化,分析P. gingivalis与SRP疗效之间的关系,探讨应用实时荧光定量聚合酶链反应监测和评价SRP的可能性。方法选择20例中重度慢性牙周炎患者为研究对象,检查SRP治疗前后的临床指标,包括探诊深度（PD）、临床附着丧失（CAL）和探诊出血（BOP）;采集SRP治疗前后的龈下菌斑共142个样本,应用TaqMan实时荧光定量聚合酶链反应检测样本中的P. gingivalis。构建含有P. gingivalis扩增片段的重组质粒,建立定量标准。结果慢性牙周炎患者SRP治疗后PD、CAL和BOP均明显下降（P<0.001）;治疗前P. gingivalis检出率为80.28%,治疗后下降为54.23%;治疗前P. gingivalis数量与PD相关,Kendall相关系数为0.70（P<0.001）,治疗后牙周袋内细菌数量明显减少（P<0.001）。治疗前牙周袋内P. gingivalis的定植数量与PD、CAL和BOP的改善无相关性（P>0.05）,但治疗后治疗有效位点P. gingivalis数量减少程度明显大于治疗无效位点（P<0.05）,细菌减少量与PD改善弱相关（r=0.25,P=0.04）。结论SRP治疗可以明显改善临床症状,降低P. gingivalis检出率和绝对数量;治疗前P. gingivalis定植水平对临床指标的改善没有影响,治疗后P. gingivalis数量下降程度可以反映治疗效果。TaqMan实时荧光定量聚合酶链反应可以用于牙周炎治疗效果的监测和评价。     

类风湿关节炎和慢性牙周炎临床指标的相关性研究

目的 研究类风湿关节炎(rheumatoid arthritis,RA)患者的牙周状况,初步探讨慢性牙周炎(chronic periodontitis,CP)与RA的关系.方法 收集48例诊断为类风湿关节炎患者作为RA组,同时在口腔门诊中进行常规龈上洁治的、无特殊口腔疾病的患者中选择42例作为健康对照组.记录相关的类风湿的临床指标,包括红细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)、血清中抗环瓜氨酸化抗体(anticycliccitrullinated peptide antibody,Anti-CCP)和口腔指数,包括非刺激性唾液流速(unstimulated salivary flow rate,UWS)、刺激性唾液流速(stimulated salivary flow rate,SWS)、探诊出血指数(bleeding on probe,BOP)、牙周袋探诊深度(periodontal probing pocket,PPD)、临床附着水平(clinical attachment level,CAL),并做均数比较及相关性分析.结果 RA组与健康对照组在唾液流速、PPD、CAL等口腔指标方面差异均具有统计学意义(P<0.05).RA组中慢性牙周炎的发病率与健康对照组的发病率存在差异(P<0.001).CAL与Anti-CCP抗体浓度具有相关性(P=0.01).结论 RA患者慢性牙周炎发病率较健康人高,类风湿关节炎与慢性牙周炎在发病机制有可能存在一定的关联性.     

糖尿病与重症牙周病相关的证据

数据来源：检索MEDLINE数据库从1970年1月至2003年10月出版的所有文献．并手工检索参考文献中的相关文献。纳入标准：以人为对象的临床试验或观察性研究，且以英语发表的文献。数据提取和合成：由3位作者分别提取数据，意见不同则由讨论解决。记录一系列指标：菌斑指数（PI）、牙石指数、牙龈指数（GI）、探诊出血指数（BOP）、牙周探诊深度（PPD）、临床附着丧失（CAL）、牙龈退缩、牙周指数和骨丧失指数。用血液中糖化血红蛋白百分浓度显示糖尿病控制与否。评估各牙周参数的整体差异，并应用固定效应模型或随机效应模型计算相应的95％CI。用Q检验进行同质性检验。用漏斗图检测发表偏倚。结果：18个横断面对照研究、3个前瞻性队列研究和2个临床试验的基线资料入选。     

牙周非手术治疗对2型糖尿病伴慢性牙周炎患者血糖代谢水平的影响

目的探讨牙周非手术治疗对2型糖尿病伴慢性牙周炎患者牙周状况和血糖代谢水平的影响。方法 2型糖尿病伴慢性牙周炎患者135例,糖化血红蛋白（glycosylated hemoglobin,HbA1c）平均值（7.33±1.42）%,随机分为治疗组和对照组。治疗组接受牙周非手术治疗,对照组暂不接受治疗,只接受口腔卫生宣教。观察2组干预前及干预后3个月、干预后6个月的牙周临床指标,包括探诊深度（probing depth,PD）、菌斑指数（plaque index,PLI）、探诊出血（bleeding on probing,BOP）和血糖代谢指标,包括空腹血糖（fasting plasma glucose,FPG）、HbA1c的变化情况。结果同治疗前相比,治疗组全口平均PD（F=89.956,P=0.000）、PLI（F=82.399,P=0.000）、BOP（F=169.535,P=0.000）随时间推移下降,差异有统计学意义。对照组全口平均PD随时间推移差异无统计学意义（F=3.002,P=0.076）;PLI（F=11.443,P=0.001）、BOP（F=6.537,P=0.008）下降有统计学意义。干预后6个月,组间比较PD（t=-3.318,P=0.001）、PLI（t=-4.354,P=0.000）、BOP（t=-5.868,P=0.000）差异有统计学意义。治疗组FPG（F=4.325,P=0.015）和HbA1c（F=6.654,P=0.003）随时间推移下降,差异有统计学意义;对照组FPG（F=0.215,P=0.756）和HbA1c（F=1.767,P=0.184）随时间推移变化无统计学意义;干预后6个月,两组间FPG（t=-1.386,P=0.171）和HbA1c（t=-1.065,P=0.289）差异无统计学意义。结论牙周非手术治疗能有效控制2型糖尿病伴牙周炎患者的牙周炎症;尚不能认为牙周非手术治疗可以改善糖尿病患者的血糖代谢。     

Maternal periodontitis as a potential risk variable for preeclampsia: a case-control study

BACKGROUND: Association studies between maternal periodontitis and an elevated risk for preeclampsia have shown conflicting results. The aims of the present case-control study were: 1) to evaluate the association between maternal periodontitis and preeclampsia before and after matching, assessing confounding and interaction; and 2) to evaluate the influence of the extent and severity of periodontal parameters, bleeding on probing (BOP), probing depth (PD), and clinical attachment loss (CAL), in association with preeclampsia. METHODS: Initially, 1,206 Brazilian women were included and divided into a control group (1,042 non-preeclamptic women who gave birth to infants with adequate gestational age and birth weight) and a case group (164 preeclamptic women). Further, 125 preeclamptic women were matched according to age, chronic hypertension, and primiparity to 375 non-preeclamptic women randomly selected from the control group. Maternal periodontitis was defined as PD > or =4 mm and CAL > or =3 mm at the same site in at least four teeth. The effect of variables of interest and confounding were assessed by univariate and multivariate analysis. RESULTS: After controlling for confounders, maternal periodontitis was included in the multivariate final model (odds ratio [OR] = 1.94; 95% confidence interval [CI]: 1.37 to 2.77; P <0.001) and remained associated with preeclampsia after matching (OR = 1.52; 95% CI: 1.01 to 2.29; P = 0.045). The odds of preeclampsia were associated with an increase in the number of sites with BOP and PD and CAL > or =4 mm. CONCLUSION: Maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.     

中医药治疗慢性牙周炎的临床初步研究

目的 :探讨中医药治疗慢性牙周炎的临床效果。方法 :选择 2 0例中重度慢性牙周炎的女性围绝经期患者 ,随机分为 2组。实验组给补肾清火的中药治疗和牙周基础治疗 ,对照组只作牙周基础治疗 ,并对各临床指标进行检测。结果 :2组治疗后菌斑指数 (PLI)、牙周探诊深度 (PPD)、牙周附着水平 (PAL)都有显著下降 (P <0 .0 1) ,但 2组的下降程度无差异。实验组中药治疗 1月后龈沟探诊出血 (BOP)较治疗前明显下降(P <0 .0 1) ,3月后较 1月后又有下降 (P <0 .0 5 ) ,3个月时较治疗前有明显下降 (P <0 .0 1) ;对照组在 1月时BOP比治疗前有下降 (P <0 .0 5 ) ,3个月时较 1月时及治疗前均有下降 (P <0 .0 5 ) ;实验组 1月后BOP的改善程度与对照组相比有显著性差异 (P <0 .0 1)。结论 :中药对牙周炎症具有明显的改善作用     

Association between maternal periodontitis and an increased risk of preeclampsia

BACKGROUND: Periodontal disease has been considered a systemic exposure implicated in a higher risk of adverse pregnancy outcomes. The aim of the present study was to determine whether maternal periodontitis is associated with an increased risk of preeclampsia. METHODS: A case-control study was conducted in a public hospital in Belo Horizonte, Brazil. During the study period, 588 women, aged 14 to 46 years, were deemed eligible and had data available for analysis. Maternal demographic and medical data were collected from medical records. Preeclampsia was defined as blood pressure >140/90 mm Hg and > or =1+ proteinuria after 20 weeks of gestation. A periodontal examination was performed postpartum. Maternal periodontitis was defined as the presence of four or more teeth with one or more sites with a probing depth > or =4 mm and clinical attachment loss > or =3 mm at the same site. The effects of maternal age, chronic hypertension, primiparity, smoking, alcohol use, and number of prenatal visits were analyzed. Adjusted odds ratios (ORs) for preeclampsia were calculated using multivariate logistic regression. RESULTS: The prevalence of periodontitis was 63.9% and preeclampsia was 18.5%. Variables associated with preeclampsia were chronic hypertension (OR = 4.10; 95% confidence interval [CI] = 2.0 to 8.4; P = 0.001), primiparity (OR = 2.40; 95% CI = 1.5 to 3.9; P = 0.004), maternal age (OR = 1.07; 95% CI = 1.0 to 1.1; P = 0.001), and maternal periodontitis (OR = 1.88; 95% CI = 1.1 to 3.0; P = 0.001). CONCLUSION: Maternal periodontitis was determined to be associated with an increased risk of preeclampsia.     

Association of Untreated Metabolic Syndrome With Moderate to Severe Periodontitis in Thai Population

Background: Metabolic syndrome (MetS) correlates with systemic inflammation. A relation of MetS to periodontitis has been reported. This study aims to evaluate whether periodontitis is associated with untreated MetS, plasma adiponectin, and leptin among Thai people. Methods: One hundred twenty‐five participants (aged 35 to 76 years) were recruited. Demographic and biologic data, bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) of all teeth were examined. Plasma adiponectin and leptin levels were measured. Results: Forty‐four participants (35.2%) were healthy, and 81 (64.8%) had MetS. All periodontal conditions (BOP, PD, and CAL) were significantly worse in patients with MetS than healthy participants. After adjustment for confounders, MetS was strongly associated with severe periodontitis (odds ratio [OR] = 3.60, 95% confidence interval [CI]: 1.34 to 9.65). MetS with four to five components had a higher association with periodontitis than did MetS with three components (OR = 5.49, 95% CI: 1.75 to 17.19), whereas each separate component had no association with periodontitis, except for high diastolic blood pressure. Periodontitis was also associated with age (OR = 1.08, 95% CI: 1.01 to 1.14) and education (OR = 3.76, 95% CI: 1.05 to 13.40). The risk of MetS was predicted by body mass index and plasma adiponectin (OR = 1.90, 95% CI: 1.24 to 2.92 and OR = 0.93, 95% CI: 0.88 to 0.98, respectively). Conclusions: There may be a relationship between untreated MetS and periodontitis in Thai people. Periodontal diagnosis should be regularly conducted in patients with MetS.     

Comparison of clinical outcomes following treatment of chronic adult periodontitis with subgingival scaling or subgingival scaling plus metronidazole gel

BACKGROUND, AIMS: Conventional treatment of chronic periodontitis involves mechanical debridement of periodontal pockets. Recently, subgingival antimicrobials have been used adjunctively following such debridement. This 2-centre study compared the clinical effects of subgingival scaling (SRP) with SRP plus subgingival application of 25% metronidazole gel, Elyzol (SRP+gel), in patients with chronic adult periodontitis. METHOD: Voluntary informed written consent was obtained from 45 subjects at the Eastman (mean age 46, range 34-63) and 43 subjects at RAF Halton (mean age 47, range 34-71) who participated in this blind, randomised split-mouth design study. All had at least 2 sites in each quadrant with probing pocket depth (PPD) > or = 5 mm. PPD, bleeding on probing (BOP), and clinical probing attachment levels (CAL) measured using a stent, were recorded at baseline and at 1, 3, 6 and 9 months post-therapy. After subgingival scaling of all quadrants, 2 quadrants were randomly selected to be treated with metronidazole gel. RESULTS: A paired t-test on baseline values showed no bias between groups. Both treatments effectively reduced the signs of periodontitis. At each follow-up visit, reduction in PPD, CAL and BOP after the combined treatment was greater than for SRP alone. Paired t-tests showed that the improvement in the SRP+gel group was statistically significantly better (p<0.001) than for SRP alone (mean 0.5 +/- 0.6 mm. 95% CI 0.4-0.6 mm.) Similarly, the % of sites which improved to a final pocket depth of < or = 3 mm and the % of sites which improved over the 9 months of the study by as much as > or = 2 mm were greater for SRP+gel than for SRP alone. CONCLUSIONS: At the end of the study, the mean reductions for PPD were 1.0 mm (SRP) compared to 1.5 mm (SRP+gel), and for CAL they were 0.4 mm (SRP) compared to 0.8 mm (SRP+gel), with mean difference for CAL between treatments of 0.4 +/- 0.6 mm (95% confidence intervals of 0.3-0.6 mm). The combination therapy of SRP+gel was superior to the conventional treatment of SRP alone, and these differences were maintained for 9 months.     

Postoperative bleeding tendency as a risk factor in Actinobacillus actinomycetemcomitans-associated periodontitis

Frequent bleeding on probing (BOP) has been considered a risk factor for recurrence of periodontitis. In the present study, 29 patients with Actinobacillus actinomycetemcomirans-associated periodontitis were enrolled in a carefully performed recall system. At 6 sites per tooth, periodontal probing depth (PPD), gingival index (GI), plaque index (PII) and BOP was assessed 6 weeks, 6 months, 1 and 2 years after comprehensive therapy. Professional toothcleaning and subgingival scaling at sites with PPD ≥ 5 mm and BOP was carried out every 2nd or 3rd month. Subgingival samples from 2 sites, a pooled subgingival sample, check mucosa, saliva and tongue samples were selectively cultivated for A. actinomycetemcomitans after 2 years. Following active therapy, 8 % sites had a PPD of ≥ 4 mm, whereas 21 % sites bled on probing. After 2 years, respective figures were 12 and 27 %. During maintenance, frequent BOP (≥3 times at 4 visits) had a predictive value of 0.133 to indicate an increase in PPD of ≥ 2 mm and a negative predictive value of 0.947. The predictive value of no bleeding to indicate a stable site was 0.972, the negative predictive value 0.078. There was evidence for heterogeneity of associations between increase in PPD of ≥ 2 mm and ≥ 3 times BOP among patients (X²₍₂₈₎ = 41.45, p < 0.05). Significant sources for the variation of weighted In-transformed estimates of individual odds ratios (range -0.83 to 6.21, median 1.52) were relative numbers of A. actinomycetemcomitans-positive samples 2 years after therapy, age, and mean % of PII 2 (R² =0.439, p<0.001). No association between increase in PPD and BOP was found in patients where A. actinomycetemcomitans was not recovered from any sample (X²_MH = 1.96), but A. actinomycetemcomitans-positive subjects still had inconsistent associations (X²_MH = 37.65. p < 0.01). Ignoring patient characteristics may be misleading in the search for risk factors for recurrence of the disease.     

Association Between Periodontitis and Gestational Diabetes Mellitus: A Case‐Control Study

Background: Some studies have reported an association between gestational diabetes mellitus (GDM) and periodontitis. The aim of the present study is to analyze this potential association and the influence of risk variables associated with GDM. Methods: This case‐control study includes 360 women, 90 with GDM and 270 controls. Participants received a full‐mouth periodontal examination with a record of bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). Periodontitis is defined as the presence in ≥4 teeth of ≥1 sites with PD ≥4 mm and CAL ≥3 mm associated with BOP. The influence of risk variables in the occurrence of GDM is tested through univariate analysis and multivariate logistic and multinomial regression. Odds ratio (ORs) and respective confidence intervals (CIs) are calculated and reported. Results: The prevalence of periodontitis was 40% in the case group (GDM) and 46.3% in the control group. There was a lack of association between periodontitis and GDM (OR = 0.74; 95% CI = 0.40 to 1.38). The multivariate final logistic regression model retained the following as significant variables associated with GDM: maternal age (OR = 2.65; 95% CI = 1.97 to 3.56), chronic hypertension (OR = 3.16; 95% CI = 1.35 to 7.42), and body mass index (OR = 1.99; 95% CI = 1.41 to 2.81). Conclusions: A high prevalence of periodontitis was found among cases and controls, with no association between periodontitis and GDM. The present study suggests the need for implementation of health policies directed to the periodontal care of pregnant women.     

中、重度牙周炎与冠心病患者C反应蛋白及血脂水平的比较

目的 研究汉族人群中、重度牙周炎与冠心病的相关性并初步探讨C反应蛋白在二者相关性中的可能作用.方法 检测和分析40名健康者(健康组)、40例中、重度牙周炎患者(牙周炎组)、28例冠状动脉粥样硬化性心脏病(简称冠心病)患者(冠心病组)及47例同时患冠心病及中、重度牙周炎的患者(冠心病+牙周炎组)血清C反应蛋白水平、血脂水平(血清低密度脂蛋白、高密度脂蛋白胆固醇、总胆固醇和甘油三酯)和牙周临床指数(附着丧失、探诊深度和探诊出血).结果 单因素方差分析结果显示,健康组、牙周炎组、冠心病组及牙周炎+冠心病组的血清C反应蛋白水平分别为(1.30±0.15)、(2.44±0.18)、(5.99±0.82)和(6.88±0.71)mg/L,各组血清C反应蛋白水平间的差异具有统计学意义(P<0.001),且经协方差分析校正年龄、受教育状况、血压和体重指数后显示,各组血清C反应蛋白水平间的差异仍具有统计学意义(P<0.001).多元Logistic回归分析结果显示,中、重度牙周炎患者发生冠心病的可能性高于牙周健康者,其发生冠心病的相对风险率比值比为2.417(P=0.039;95%CI:1.126～6.659).经协方差分析校正年龄、受教育状况、血压和体重指数后,各组血清总胆固醇水平间差异仍具有统计学意义(P=0.017).结论 严重的牙周感染可能通过改变血清C反应蛋自水平继而影响全身炎症反应和冠心病的发生及发展,可能是冠心病事件的危险因素之一.     

盐酸米诺环素联合翻瓣术辅助治疗慢性牙周炎疗效的Meta分析

目的 系统评价牙周翻瓣术中使用2%盐酸米诺环素处理根面的疗效,为其治疗慢性牙周炎提供循证医学证据。方法 检索中国期刊全文数据库、维普、万方、中国生物医学文献数据库、PubMed、ScienceDirect和Embase等数据库,检索时限为从建库到2017年7月。由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3对数据进行Meta分析。结果 最终纳入7个随机对照实验,共217例受试者。Meta分析结果显示,与单纯翻瓣术（FO）组比较,盐酸米诺环素联合翻瓣术（FM）组患者随访3个月时的探诊深度减少[MD=-0.55,95%CI（-0.84,-0.26）,P=0.000 2],菌斑指数降低[MD=-0.08,95%CI（-0.15,-0.01）,P=0.03],随访6个月时探诊深度减少[MD=-0.62,95%CI（-1.04,-0.21）,P=0.003]方面更加明显,组间比较差异有统计学意义（P<0.05）。FM组患者随访3个月时在临床附着丧失获得[MD=-0.21,95%CI（-0.47,0.04）,P=0.10]方面改变的差异无统计学意义（P>0.05）。结论 在翻瓣下机械清创治疗慢性牙周炎中,使用2%盐酸米诺环素处理根面减少探诊深度和炎症控制方面有明显的效果。