侵袭性牙周炎患者龈沟液中有机酸的研究

检测侵袭性牙周炎(aggressive periodontitis,AgP)患者龈沟液中7种有机酸的浓度,探讨其与AgP的关系.方法应用高效毛细管电泳技术,检测38例AgP患者152个位点和14名牙周健康对照者56个位点龈沟液中甲酸、琥珀酸、乙酸、乳酸、丙酸、丁酸和异戊酸的浓度,比较AgP组和健康对照组之间、AgP患者不同袋深组之间龈沟液中有机酸浓度的差别,分析出血指数(bleedingindex,BI)、探诊深度(probing depth,PD)和附着丧失(attachment loss,AL)与有机酸浓度的相关关系.结果 AgP组龈沟液中琥珀酸(1.00 mmoL/L)、乙酸(24.13 mmol/L)、乳酸(8.33 mmoL/L)、丙酸(4.37 mmoL/L)、丁酸(2.33 mmol/L)和异戊酸(2.63 mmol/L)的浓度均显著高于健康对照组(依次为0.33、11.35、3.88、2.07、0.00、0.00 mmoL/L,P<0.05),甲酸浓度(7.08 mmoL/L)显著低于健康对照组(14.03 mmoL/L,P<0.05);除乳酸外其余6种有机酸在不同袋深组间浓度差异均有统计学意义(P<0.05);AgP组甲酸浓度与BI、PD和AL呈负相关,BI与琥珀酸、乙酸、乳酸、丙酸和丁酸浓度呈正相关,PD和AL与琥珀酸、乙酸、丙酸、丁酸和异戊酸浓度呈正相关.结论 AgP的病变状况町能与龈沟液中琥珀酸、乙酸、丙酸、丁酸和异戊酸浓度升高而甲酸浓度降低有关.     

慢性牙周炎患者基础治疗前后龈沟液中瘦素水平变化的研究

目的：检测慢性牙周炎患者牙周基础治疗前后龈沟液中瘦素水平的变化。方法：选择轻、中、重度牙周炎患者共3组,每组11人,基础治疗前后收集龈沟液,采用酶联免疫法（Enzyme-Linked ImmunoSorbent Assay,ELISA）检测瘦素含量。结果：3组患者牙周基础治疗后龈沟液中瘦素水平均明显高于治疗前（P＜0.01）;瘦素与轻度牙周炎组治疗前的出血指数正相关（r=0.675）（P＜0.05）,与重度牙周炎组治疗前的探诊深度负相关（r=-0.799）（P＜0.01）;重度牙周炎组治疗后比治疗前的探诊深度减小（P＜0.01）,附着丧失减小（P＜0.05）。结论：龈沟液中瘦素含量变化与牙周炎的基础治疗密切相关,可以通过测定瘦素水平评估牙周炎治疗的临床疗效。     

成人慢性牙周炎患者龈沟液β2-MG的放射免疫分析

成人慢性牙周炎是口腔科最常见的疾病之一,但目前对引起本病的宿主原因仍有争议。自80年代以来,放射免疫测定已得到广泛应用,血清β2-MG(β2-微球蛋白)的测定在临床上已较普及,但经文献检索,目前国内对各年龄组龈沟液中β2-MG的分析报道较少,仅有对牙周炎患者唾液的β2-MG进行放免分析的报道[1]。本文对成人慢性牙周炎患者的龈沟液β2-MG进行放免分析,并与健康人比较,以探讨成人慢性牙周炎的发病情况与β2-MG之间的关系。1材料与方法1.1病例选择从本院门诊就诊的慢性牙周病患者中按Page和Schroeder[2]所述标准,选择合适患者31例,男12例…     

慢性牙周炎患者血浆和龈沟液蛋白羰基水平的研究

目的 分析慢性牙周炎患者血浆和龈沟液中蛋白羰基水平,评价慢性牙周炎引起的氧化应激下蛋白氧化损伤情况.方法 本研究共纳入慢性牙周炎组患者24例和正常对照组牙周健康者22例.对所有对象进行详细的口腔检查,获取外周血和龈沟液样本,检测血浆和龈沟液中蛋白羰基的水平,分析蛋白羰基水平与牙周临床参数的相关性.结果 慢性牙周炎组患者...     

慢性牙周炎患者龈沟液中白细胞介素-4的检测和意义

目的检测慢性牙周炎患者牙周基础治疗前后龈沟液中白细胞介素-4(IL-4)的质量浓度,探讨IL-4与牙周炎的关系及其在牙周炎发病机制、病情进展等方面所起的作用。方法用滤纸条浸润法采集成年健康者和牙周炎患者治疗前后的龈沟液样本,用酶联免疫吸附测定检测样本中IL-4的质量浓度。结果慢性牙周炎患者龈沟液中IL-4的质量浓度低于健康对照组(P<0.05)。经牙周基础治疗1个月后,IL-4的质量浓度无明显变化,治疗前后的差异无统计意义(P>0.05);IL-4的质量浓度与探诊深度呈显著负相关,与牙龈指数和附着丧失无明显相关性。结论IL-4缺乏可能会导致牙周病的发生,IL-4可作为早期诊断牙周病和检测易患人群的敏感性指标。     

慢性牙周炎活动性与龈沟液中β2微球蛋白表达的关系

牙周炎是一种活动期与静止期交替出现的慢性炎症性疾病。判断疾病处于活动期或静止期不但有助于明确牙周治疗方案,而且对口腔种植手术、牙周炎患者的正畸治疗以及心脏外科手术等多种疾病治疗时机的选择具有重要意义。目前常用的诊断指标如通过X线片观察骨密度等多为回顾性指标,     

牙周非手术治疗对重度慢性牙周炎患者龈沟液中C反应蛋白的影响

目的检测牙周基础治疗对慢性牙周炎患者龈沟液中C反应蛋白(CRP)的影响,为牙周病活动期诊断及判断牙周治疗的效果提供一定的客观依据。方法治疗前及治疗后1、3、6、12个月,用滤纸条收集30例重度慢性牙周炎患者的60个重度牙周炎牙位(探诊深度PD≥6 mm)和60个轻度牙周炎牙位(PD≤4 mm)的龈沟液并称重,用酶联免疫吸附测定法(ELISA)测定CRP的含量并记录牙周临床指标,15例牙周健康者的30个健康牙位作为对照。结果深牙周袋牙位的CRP在龈沟液中的浓度((968.06±360.54)pg/m L)显著高于浅牙周袋牙位((291.65±65.62)pg/m L),且疾病牙位的CRP浓度均显著高于健康牙位((33.47±24.53)pg/m L),龈沟液中CRP浓度与探诊深度(r=0.825,P<0.05)、附着丧失(r=0.833,P<0.05)、菌斑指数(r=0.741,P<0.05)呈正相关关系。同时,牙周基础治疗后沟液中CRP浓度明显降低,并且与口腔卫生情况有关。结论龈沟液中CRP浓度与牙周破坏程度有关,非手术治疗后龈沟液中CRP浓度下降。     

慢性牙周炎患者牙周治疗前后龈沟液中白介素-10水平的变化

目的探讨慢性牙周炎患者牙周治疗前后龈沟液中抗炎性细胞因子白介素(IL)-10水平的变化。方法采集12例慢性牙周炎患者的12个健康牙位和36个炎症牙位于治疗前及治疗后6、122、4周的龈沟液,用酶联免疫吸附分析法(ELISA)检测龈沟液中IL-10的浓度。另外,分别记录治疗前、后的探诊深度(PD)、临床附着丧失(CAL)、牙龈指数(GI)和菌斑指数(PlI)。结果IL-10浓度在健康牙位明显高于炎症牙位(P<0.01),且于牙周治疗后明显升高。IL-10浓度与探诊深度(PD)、临床附着丧失(CAL)呈负相关(P<0.05)。结论IL-10浓度与牙周组织破坏程度呈负相关,在牙周炎中起抗炎作用。     

慢性牙周炎患者龈沟液中MCP-1的检测及临床意义

目的:检测慢性牙周炎患者龈沟液中单核细胞趋化蛋白-1(MCP-1)的浓度,并探讨其与牙周临床指标及碱性磷酸酶分泌的关系。方法:采用常规滤纸条法收集慢性牙周炎患者基础治疗前(T1)、基础治疗后(T2)及正常对照组(C)各位点的龈沟液样本,用ELISA法检测各样本中MCP-1及碱性磷酸酶的浓度。采用SPSS11.0软件包对数据进行t检验和直线相关分析。结果:3组受检者中,慢性牙周炎患者龈沟液中MCP-1平均浓度显著高于正常对照组(P<0.01),基础牙周治疗可使牙周炎患者龈沟液中MCP-1含量显著下降(P<0.01),治疗前后MCP-1的浓度变化与菌斑指数、探诊深度、牙龈指数、临床附着丧失以及碱性磷酸酶的分泌均呈正相关。结论:MCP-1作为一个重要的炎性趋化因子参与了慢性牙周炎的发生、发展过程,龈沟液MCP-1可作为牙周病防治及疗效评估的潜在靶分子。     

牙周炎患者龈沟液中sICAM-1含量的研究

目的 :研究牙周炎患者龈沟液可溶性细胞间粘附分子 (sICAM - 1)的含量。方法 :牙周炎患者 15例 ,正常对照20例。用ELISA法检测牙周炎患者龈沟液sICAM - 1的含量。结果 :正常对照龈沟液sICAM - 1含量为145.014±43.745ng/ml,男女间无显著性差异 (p >0.05)。牙周炎患者龈沟液sICAM - 1的含量为23.716±8.195ng/ml,明显低于正常对照 (p <0.01)。结论 :龈沟液sICAM - 1含量的降低与牙周炎有关。     

龈沟液中有机酸与龈下牙龈卟啉单胞菌间的关系

目的分析慢性牙周炎患者相同龈沟液样本中挥发性有机酸与牙龈卟啉单胞菌（Porphyromonas gingivalis,P.g）间的关系。方法应用高效毛细管电泳技术分析慢性牙周炎患者治疗前龈沟液中有机酸的浓度;应用多聚酶链反应（polymerase chain reaction,PCR）技术检测相同样本中牙龈卟啉单胞菌。结果慢性牙周炎患者龈下菌斑中牙龈卟啉单胞菌检出率显著高于牙周健康对照者;慢性牙周炎患者P.g阳性组龈沟液中丁酸与异戊酸浓度显著高于P.g阴性组。结论结果表明相同样本龈沟液中丁酸与异戊酸的表达与P.g的检出相关联,P.g是重要牙周致病菌     

Protein carbonyl levels in serum and gingival crevicular fluid in patients with chronic periodontitis

OBJECTIVE: Evidence reveals the role of reactive oxygen species (ROS) in many pathologies including periodontitis. Protein carbonylation is the most widely used biomarker for oxidative damage to proteins, and reflects cellular damage induced by ROS. In this study protein carbonyl (PC) levels in serum and gingival crevicular fluid (GCF) in patients with chronic periodontitis (CP) was evaluated. MATERIALS AND METHODS: Thirty-three patients with CP and 24 healthy controls were included in the study. Following the clinical measurements and samplings, total protein levels in serum and GCF were determined by Bradford method, and serum and GCF PC levels were measured by modified Levine method. RESULTS: PC levels in serum and GCF were significantly higher in the CP group compared to the control group (p<0.05). In all subjects, serum and GCF PC levels showed statistically significant positive correlations with all clinical parameters (p<0.05). CONCLUSIONS: The results suggest that both systemic and local/periodontal protein carbonylation increase in CP compared to health and that elevated levels of PCs may be a sign of oxidative damage in periodontitis and correlate well with the periodontal status.     

快速进展性牙周炎患者龈沟液中的弹性蛋白酶活性

目的探讨中性多形核白细胞与快速进展性牙周炎的关系。方法检测２例快速进展性牙周炎患者共１０２个位点（其中２８个位点进行治疗前后的对比）的龈沟液弹性蛋白酶活性,将人多形核白细胞弹性蛋白酶特异底物———Ｓ２４８４与龈沟液反应,测吸光度值,以反映龈沟液弹性蛋白酶活性。结果快速进展性牙周炎龈沟液中的弹性蛋白酶活性［（０．６３±０．３８）Ａｂｓ／位点］明显高于健康对照组［（０．０７±０．０５）Ａｂｓ／位点］,差异有显著性;弹性蛋白酶活性的高低与龈沟液体积、探诊深度、附着丧失和出血指数呈正相关关系;治疗后龈沟液体积和各临床指数显著降低,弹性蛋白酶活性也从治疗前的（０．７３±０．３６）Ａｂｓ／位点下降为（０．１±０．１７）Ａｂｓ／位点,差异有显著性。结论快速进展性牙周炎患者的中性多形核白细胞并不是趋化反应不足,而是过度浸润与释放溶酶体酶,起协同致炎作用。     

Longitudinal study of volatile fatty acids in the gingival crevicular fluid of patients with periodontitis before and after nonsurgical therapy

Qiqiang L, Huanxin M, Xuejun G. Longitudinal study of volatile fatty acids in the gingival crevicular fluid of patients with periodontitis before and after nonsurgical therapy. J Periodont Res 2012; 47: 740–749. © 2012 John Wiley & Sons A/S Background and Objective: Short‐chain fatty acids (SCFAs) are important metabolic products of subgingival organisms and their concentrations are associated with the status of inflammation. The purpose of this study was to observe and analyze the change in concentration of SCFAs in the gingival crevicular fluid of patients with chronic periodontitis before and after periodontal treatment. Material and Methods: Gingival crevicular fluid samples were taken from 21 patients with chronic periodontitis before periodontal treatment and 2 wk, and 2, 4 and 6 mo after treatment. The concentrations of six different SCFAs in the gingival crevicular fluid were measured using high‐performance capillary electrophoresis. The presence of porphyromonas gingivalis in the same pretreatment gingival crevicular fluid samples used to measure SCFAs was analyzed using PCR amplification. Results: Two weeks after periodontal treatment, the concentrations of lactic acid, propionic acid, butyric acid and isovaleric acid in the gingival crevicular fluid of patients with chronic periodontitis had decreased to the levels found in the healthy control group. However, the concentration of formic acid had increased. Statistically significant differences were found in the levels of these SCFAs before and after treatment. In the longitudinal observation, the concentrations of butyric acid and isovaleric acid in the gingival crevicular fluid had increased to a high level 2 mo after treatment. At the last two study time‐points (4 and 6 mo after treatment), butyric acid and isovaleric acid were still present at a high level and showed a tendency to continue to increase. In contrast, the concentration of formic acid in gingival crevicular fluid showed a gradual decrease over the study period. Conclusions: The concentration of formic acid in the gingival crevicular fluid has an inverse relationship with the severity of periodontitis, whereas the increased concentrations of butyric and isovelaric acids during the long‐term observation period after therapy may indicate the status of recolonization of periodontal pathogens and reflect the subgingival ecology. These two fatty acids could be used as indicators for the development and progression of periodontitis.     

牙周炎治疗后龈沟液中弹性蛋白酶水平的变化

目的 观察龈沟液中细胞外弹性蛋白酶和细胞内弹性蛋白酶在牙周基础治疗后的变化。方法用滤 要的袋内取样法取８例患者４３个牙位治疗前后的ＧＣＦ样本,以底物检测法测定其中的ＥＡ－Ｓ及ＥＡ－Ｐ水平。结果 治疗后的ＧＣＦ－ＥＡ－Ｓ、ＥＡ－Ｐ总量及ＥＡ－Ｓ浓度、ＥＡ－Ｓ／ＥＡ／Ｐ比值均较治疗前师表ＥＡ－Ｐ浓度治疗前后无显著差异。结论ＧＣＦ－ＥＡ水平反映牙周组织的炎症破坏程度,可作为评价疗效的客观指标,尤其是ＥＡ     

成人牙周炎治疗前后龈沟液蛋白质的电泳分析

目的通过分析成人牙周炎患者同一位点基础治疗前后１个月龈沟液（ｇｉｎｇｉｖａｌｃｒｅｖｉｃｕｌａｒｆｌｕｉｄ，ＧＣＦ）中蛋白成分的改变，以期发现能够反映牙周健康及疾病状况的特异蛋白。方法采用滤纸条法收集１２例成人牙周炎患者５６个位点ＧＣＦ样本，以十二烷基磺酸钠聚丙烯酰胺凝胶电泳（ＳＤＳＰＡＧＥ）法分离，ＩｍａｇｅＭａｓｔｅｒＴＭ电泳图象分析仪分析其中的蛋白质。结果治疗后蛋白区带数及非血清源低分子量１２０００，１００００蛋白的丰度及百分含量较治疗前显著减少（分别为Ｐ＜０００１和Ｐ＜００５），而３８０００蛋白百分含量呈增加趋势且与治疗前牙周探诊深度和ＧＣＦ量呈负相关（Ｐ＜００５）。结论分子量为１２０００，１００００的蛋白与牙周炎症有关；分子量３８０００的蛋白与疾病的好转有关     

牙龈沟液中骨膜蛋白含量与牙周炎的关系

目的探讨骨膜蛋白与牙周炎的关系,检测和对比牙周炎患者与健康对照组龈沟液中骨膜蛋白的含量。 方法从2016年9月至2018年6月于深圳市人民医院口腔内科的初诊患者中直接抽选法随机选取48例慢性牙周炎患者作为试验组,17名牙周健康者作为对照组。在入选病例选取观察牙,记录观察牙的出血指数（BI）、牙周袋探诊深度（PD）、附着丧失（AL）。依据观察牙PD和AL分为轻度牙周炎组15例、中度牙周炎组22例及重度牙周炎组11例。采集观察牙的龈沟液,酶联免疫吸附实验（ELISA）法检测样本中骨膜蛋白的含量。采用SPSS 25.0统计软件对实验数据进行分析。 结果牙周病患者龈沟液中均可检测出较低浓度的骨膜蛋白[（0.45 ± 0.13）pg/μL],而牙周健康人群的龈沟液中均检测出较高浓度的骨膜蛋白[（0.56 ± 0.23）pg/μL],两者差异具有统计学意义（t = 2.40,P = 0.019）;牙周炎轻度、中度、重度各组骨膜蛋白的浓度值分别为（0.57 ± 0.09）、（0.43 ± 0.09）和（0.34 ± 0.11）pg/μL,骨膜蛋白浓度值随炎症程度加重而逐渐降低;经相关分析,龈沟液中骨膜蛋白与BI呈负相关关系（r = -0.529,P<0.001）,与PD、AL均分别呈负相关关系（r = -0.806/-0.772,P<0.001）。 结论牙周炎患者龈沟液中骨膜蛋白的含量显著低于牙周健康人群;骨膜蛋白可能与牙周炎的病变严重程度之间具有密切关系。     

Comparison of gingival crevicular fluid sampling methods in patients with severe chronic periodontitis

Background: The analysis of samplings from periodontal pockets is important in the diagnosis and therapy of periodontitis. In this study, three different sampling techniques were compared to determine whether one method yielded samples suitable for the reproducible and simultaneous determination of bacterial load, cytokines, neutrophil elastase, and arginine‐specific gingipains (Rgps). Rgps are an important virulence factor of Porphyromonas gingivalis, the exact concentration of which in gingival crevicular fluid (GCF) has not been quantified. Methods: GCF was sampled from four sites per patient (one sample per quadrant using two samples per method) in 36 patients with chronic periodontitis. One week later, the procedure was repeated with alternative methods. Variables determined were loads of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) and P. gingivalis, levels of interleukin‐6 and ‐8, activity of neutrophil elastase, and level of Rgps. Results: The detected cytokine levels were higher using paper strips compared to paper points. Bacteria were found in similar loads from paper strips and paper points. Rgps were only detectable in high quantities by washing the periodontal pocket. The level of Rgps correlated with the load of P. gingivalis. Conclusions: The use of paper strips was suitable for the simultaneous determination of microbial and immunologic parameters. Obtaining GCF by washing can be useful for special purposes. The gingipain concentration in periodontal pockets was directly determined to be ≤1.5 μM. This value indicated that most of the substrates of these proteases by in vitro assays identified until now can be easily degraded in P. gingivalis–infected sites.     

Anaerobes and short-chain fatty acids in crevicular fluid from adults with chronic periodontitis

Pathogeny of adult chronic periodontitis is still unclear. Bacteriological and chemical analysis of crevicular fluid have shown, in active sites of the disease, a simultaneous presence of anaerobes and their major by-product: short-chain fatty acids. The last can decrease "in vitro" the neutrophil intracellular pH, whenever these cells are incubated in an acid medium. Clinical investigations are scarce which hold out data useful to attempt verifying this possible physiopathological mechanism. This work shows the presence of anaerobes in the active periodontal pockets, together with the presence of short-chain fatty acids likely to reach a concentration level comparable to that used for inhibiting neutrophils "in vitro". Forthcoming studies should investigate about a possible intracellular pH drop in the neutrophils and other cells of the inflamed periodontium.