Periodontics

牙周病
  • DOI:
    文章类型: Case Reports
    此病例报告描述了与上皮下结缔组织移植物(SCTG)相关的改良横向定位皮瓣(LPF)技术的使用,用于同源下颌磨牙的根部覆盖,并伴有深牙龈凹陷(GR)。一名25岁的女性患有深GR,影响下颌右和左第二磨牙(分别为31号和18号牙齿),报告了双侧牙本质过敏。牙齿31中的缺损为5mm深和4mm宽。在牙齿18中,缺损为6mm深和5mm宽。在牙齿31处存在Imm的角化组织,并且在牙齿18处不存在角化组织。选择改良的LPF-SCTG技术与皮瓣的近端到远端定位来治疗缺损。通过在距GR最远的牙齿上的边缘切口对皮瓣进行了修改,以保持供体部位的完整性。手术后一年,牙齿31的覆盖率为80.0%,临床依恋增加了66.6%,角化组织宽度增加5毫米。牙齿18的根部覆盖率为83.3%,临床依恋增加了71.4%,角化组织宽度增加5毫米。患者对超敏反应的抱怨得到了解决,和组织增益提供更好的访问和更舒适的清洁牙齿。皮瓣供体部位没有表现出GR的临床体征。根据为期一年的后续评估,改良的LPF-SCTG技术可有效治疗下颌磨牙深单齿GR,而不会对皮瓣供体部位造成不良影响。
    This case report describes the use of the modified laterally positioned flap (LPF) technique associated with a subepithelial connective tissue graft (SCTG) for root coverage of homologous mandibular molars with deep gingival recession (GR). A 25-year-old woman with deep GR affecting the mandibular right and left second molars (teeth 31 and 18, respectively) reported bilateral dentinal hypersensitivity. The defect in tooth 31 was 5 mm deep and 4 mm wide. In tooth 18, the defect was 6 mm deep and 5 mm wide. There was 1 mm of keratinized tissue at tooth 31, and no keratinized tissue was present at tooth 18. The modified LPF-SCTG technique with mesial to distal positioning of the flap was selected to treat the defects. The flap was modified by a submarginal incision in the tooth farthest from the GR to preserve the integrity of the donor site. One year postsurgery, tooth 31 had 80.0% coverage, a 66.6% gain in clinical attachment, and a 5-mm increase in keratinized tissue width. Tooth 18 had 83.3% root coverage, a 71.4% gain in clinical attachment, and a 5-mm increase in keratinized tissue width. The patient\'s complaints of hypersensitivity were resolved, and the tissue gain provided better access and more comfort during cleaning of the teeth. The flap donor sites demonstrated no clinical signs of GR. Based on the 1-year follow-up assessments, the modified LPF-SCTG technique was effective for the treatment of deep single-tooth GR in mandibular molars without causing adverse affects on the flap donor sites.
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  • 文章类型: Journal Article
    目的:Rete钉是口腔上皮向结缔组织的突起。它们的尺寸在病理状况期间会发生变化,并且可能与伤口愈合状态相关。非侵入性,高频超声(US)可能能够捕获这些变化,并有助于早期发现组织病理学变化。这项临床前研究的目的是将US图像与组织学相关联,并量化不同牙齿部位的上皮层。
    方法:使用二次谐波模式(12/24MHz)的线性阵列,在临床前小型猪模型中记录了中面和邻间口腔软组织部位的矢状B模式图像。来自相同位置的组织学样本被染色(苏木精和曙红),数字化并注册了美国图像。手动注释用于测量距离D1(组织学上的上皮厚度与US上的高回声区)和D2(组织学上的上皮厚度和网钉长度之和与美国高回声和低回声区的总和)进行统计分析。
    结果:对于D1和D2,超声衍生的尺寸分别产生-0.64(55%的变异系数[COV]:-180至180µm)和-12µm(39%COV:-260至240µm)的平均偏差。根据牙齿类型对D1和D2进行的个性化分析显示,在不同牙齿位置的上皮之间进行区分的能力相似。组织学和美国。
    结论:使用临床成像硬件以亚毫米尺度评估软组织尺寸仍然是一个发展中的领域。未来的研究可能会为诊断口腔疾病和异常伤口愈合打开大门。并可能限制活检的假阳性指征。
    OBJECTIVE: Rete pegs are projections of the oral epithelium into connective tissue. Their dimensions change during pathological conditions and may correlate with wound-healing status. Non-invasive, high-frequency ultrasound (US) may be able to capture these changes and aid in early detection of histopathological changes. The aim of this preclinical study is to correlate US images with histology and quantify epithelial layers at different tooth sites.
    METHODS: Sagittal B-mode images of mid-facial and interproximal oral soft tissue sites were recorded in a preclinical minipig model using a linear array in second harmonic mode (12/24 MHz). Histology samples from the same locations were stained (hematoxylin and eosin), digitized and registered with US images. Manual annotations were used to measure distances D1 (thickness of epithelium on histology vs. hyperechoic zone on US) and D2 (sum of epithelial thickness and length of rete pegs on histology vs. sum of hyperechoic and hypoechoic zone on US) to statistically analyze them.
    RESULTS: Ultrasonic-derived dimensions yielded a mean bias of -0.64 (55% coefficient of variance [COV]: -180 to +180 µm) and -12 µm (39% COV: -260 to +240 µm) for D1 and D2, respectively. Individualized analysis of D1 and D2 by tooth type showed similar tends in the ability to differentiate between epithelium at different tooth locations, on both histology and US.
    CONCLUSIONS: Assessing soft tissue dimensions on a sub-millimeter scale using clinical imaging hardware is still a developing area. Future research might open doors for diagnosis of oral pathologies and abnormal wound healing, and may limit false-positive indications for biopsies.
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  • DOI:
    文章类型: English Abstract
    目的:评价标准化牙周探诊培训在佛罗里达探针系统应用于大学生牙周临床探诊教学中的效果。
    方法:选取2022年5月至2022年11月在常州市口腔医院牙周病科实习的20名本科生为研究对象,随机分为两组,每组10名。实验组接受规范化牙周探诊训练,而对照组没有接受培训。两组学生使用传统探测器和佛罗里达探测器探测一名患者的左右半口牙齿。此外,一位牙周专家使用佛罗里达探针对同一位患者进行了全面的口腔检查,并将结果与两组学生的结果进行比较。采用SPSS26.0软件包对所得数据进行统计分析。
    结果:实验组大学生与牙周专科医生的探诊深度(PD)差异无统计学意义(P>0.05)。对照组差异有统计学意义(P<0.05)。在对照组中,前区PD值与牙周专科医生比较差异无统计学意义(P>0.05),后区PD值差异有统计学意义(P<0.05).两组患者都报告佛罗里达探测系统更舒适。
    结论:规范化牙周探诊训练有助于提高大学生临床探诊能力。使用佛罗里达探针系统不仅可以评价教学效果,还能提高患者的舒适度,值得在本科生牙周探诊教学中进一步应用。
    OBJECTIVE: To evaluate the effect of standardized periodontal probing training on the teaching of periodontal clinical probing for undergraduates by using Florida probe system.
    METHODS: Twenty undergraduates who practiced in the Department of Periodontology of Changzhou Stomatological Hospital from May 2022 to November 2022 were selected as the study objects and randomly divided into two groups with 10 students in each group. The experimental group received standardized periodontal probing training, while the control group did not receive training. Two groups of students used the traditional probe and the Florida probe to probe the left and right half-mouth teeth of one patient. In addition, a periodontal specialist used Florida probe to conduct full oral examination of the same patient, and the results were compared with those of the two groups of students. SPSS 26.0 software package was used for statistical analysis of the obtained data.
    RESULTS: There was no significant difference of probing depth(PD) between undergraduates and periodontal specialist in the experimental group (P>0.05), while there was significant difference in the control group (P<0.05). In the control group, PD values in the anterior area were not statistically different from those of periodontal specialist (P>0.05), while PD values in the posterior area were statistically different (P<0.05). Both groups of patients reported that the Florida probe system was more comfortable.
    CONCLUSIONS: Standardized periodontal probing training is helpful to improve the clinical probing ability of undergraduates. The use of Florida probe system can not only evaluate the teaching effect, but also improve the comfort level of patients, which is worthy of further application in the teaching course of periodontal probing for undergraduates.
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  • 文章类型: Journal Article
    心血管疾病是全球死亡的主要原因,牙周炎是牙齿脱落的主要原因。据报道,受牙周炎影响的个体中动脉粥样硬化疾病的发病率高于无牙周炎的个体。尽管存在许多常见的风险因素。已经提出了各种致病模型来阐明这两种疾病之间的密切关系。首先,牙周细菌及其毒素可以在牙科手术和正常活动(如进食和刷牙)期间进入循环。牙周细菌可能间接导致冠状动脉疾病(例如,通过引起免疫反应)或直接通过损害冠状动脉。牙周治疗可显着减少深牙周袋中的牙周病原体,例如牙龈卟啉单胞菌(Pg)或放线菌放线杆菌(Aa)。此外,牙周治疗可能降低血液炎症介质,增强脂质分布,并在心血管疾病的各种替代标志物中引起有利的变化。口腔菌血症和牙周炎症引起动脉粥样硬化的方式尚不清楚,需要进一步研究。牙周治疗在预防心血管事件中的真正有效性是当前感兴趣的主题。在这方面,这篇综述文章探讨了牙周炎症和口腔细菌在动脉粥样硬化和心血管疾病的发生和发展中的作用,并为未来的方向提供了新的见解,主要关注评估牙周治疗对心血管疾病预后生物标志物的影响。
    Cardiovascular diseases represent the primary worldwide cause of mortality, and periodontitis is the main cause of tooth loss. The incidence of atherosclerotic disease has been reported to be higher in individuals affected by periodontitis than in individuals without, regardless of many common risk factors are present. Various pathogenetic models have been presented to clarify the close correlation between these two diseases. First, periodontal bacteria and their toxins can enter the circulation both during dental procedures and normal activities such as eating and teeth brushing. Periodontal bacteria may indirectly contribute to coronary artery disease (e.g., by causing immunological reactions) or directly by damaging coronary arteries. Periodontal treatment significantly reduces periodontal pathogens such as Porphyromonas gingivalis (Pg) or Actinobacillus actinomycetemcomitans (Aa) in deep periodontal pockets. Moreover, periodontal treatment may lower blood inflammatory mediators, enhance the lipid profile, and cause favourable changes in various surrogate markers for cardiovascular disease. The way in which oral bacteremia and periodontal inflammation cause atherosclerosis is still unclear and needs further studies. The real effectiveness of periodontal treatment in preventing cardiovascular events is a topic of current interest. In this regard, this review article explores new insights and provides an indication of future directions on the function of periodontal inflammation and oral bacteria in the incidence and progression of atherosclerosis and cardiovascular diseases, with the main focus on assessing the impact of periodontal treatment on cardiovascular disease outcome biomarkers.
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  • 文章类型: English Abstract
    牙周病是一种多因素慢性炎症性疾病,因此,关于这种疾病的知识对于卫生专业人员的自信和早期诊断很重要。
    确定利马-秘鲁一所私立大学的健康科学学生对牙周健康的知识水平。
    通过描述性和横断面研究,对来自健康科学学院的200名学生进行了评估。使用比例估计公式获得样本量。使用特定的虚拟和自我适用问卷测量有关牙周健康的知识水平,这是完全验证的。包括法定年龄和签署知情同意书的大学生。这包括16个关于原因的问题,标志,预防习惯及与牙周病相关全身疾病的关系。使用描述性统计(绝对和相对频率)以及年龄的平均值和平均值分析数据。
    知识水平中等,为38%,32.5%的学生高,29.5%的学生低。96.5%的人知道牙周病是可以预防的;然而,91.5%不知道其主要临床体征是什么。
    使用自我适用的特定问卷有利于评估和测量有关牙周健康的知识,被评估的健康科学专业学生对牙周健康有中等水平的知识。
    UNASSIGNED: Periodontal disease is a multifactorial chronic inflammatory disease, so knowledge about this disease is important for health professionals for an assertive and early diagnosis.
    UNASSIGNED: Determine the level of knowledge about periodontal health in Health Sciences students at a private university in Lima-Perú.
    UNASSIGNED: Through a descriptive and cross-sectional study, 200 students from the Faculty of Health Sciences were evaluated. The sample size was obtained using a proportion estimation formula. The level of knowledge about periodontal health was measured using a specific virtual and self-applicable questionnaire, which was fully validated. University students of legal age and who signed the informed consent were included. This consisted of 16 questions about the causes, signs, prevention habits and relationship with systemic diseases related to periodontal disease. The data were analyzed using descriptive statistics (absolute and relative frequencies) and means and averages for age.
    UNASSIGNED: The level of knowledge was medium in 38%, high in 32.5% and low in 29.5% of the students surveyed. 96.5% knew that periodontal disease is preventable; However, 91.5% do not know what its main clinical sign is.
    UNASSIGNED: The use of a self-applicable and specific questionnaire is beneficial to evaluate and measure knowledge about periodontal health, and the Health Sciences students evaluated have a medium level of knowledge about periodontal health.
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  • 文章类型: Case Reports
    目的:口鼻瘘是唇腭裂术后常见的后遗症,可显著影响患者的生活质量。它们是由各种因素造成的,包括手术技术,组织管理,和患者特定因素。本病例报告探讨了使用牙周整形外科原理进行口鼻瘘闭合的现代方法。
    方法:该报告介绍了2例因先前的颌面外科手术而导致口鼻瘘的患者。这些患者接受了显微外科手术,包括瘘管区域的部分皮瓣厚度准备,使用来自腭的结缔组织移植物,和细致的缝合技术,以确保移植物的完整性。这些程序是分阶段进行的,并提供术后护理。
    结果:两例病例均显示成功的瘘管闭合和移植物存活。患者报告呼吸有所改善,演讲,美学,和生活质量。第二种情况还包括引导骨再生和植入物放置。
    结论:使用牙周整形外科技术可以有效治疗颌面手术引起的口鼻瘘,显着改善患者的生活质量和美学结果。这种方法代表了对现有的口鼻瘘闭合方法的有价值的补充。
    OBJECTIVE: Oronasal fistulas are common sequelae following cleft lip and palate surgery and can significantly impact a patient\'s quality of life. They result from various factors, including surgical techniques, tissue management, and patient-specific factors. This case report explores the modern approach to oronasal fistula closure using periodontal plastic surgery principles.
    METHODS: The report presents two cases of patients with oronasal fistulas due to previous maxillofacial surgical intervention. These patients underwent microsurgical procedures that involved partial flap thickness preparation of the fistula areas, the use of connective tissue grafts from the palate, and meticulous suturing techniques to ensure graft integrity. The procedures were performed in stages, and postoperative care was provided.
    RESULTS: Both cases demonstrated successful fistula closure and graft survival. The patients reported improvements in breathing, speech, aesthetics, and quality of life. The second case also included guided bone regeneration and implant placement.
    CONCLUSIONS: Oronasal fistulas resulting from maxillofacial surgery can be effectively treated using periodontal plastic surgery techniques, significantly improving patients\' quality of life and aesthetic outcomes. This approach represents a valuable addition to the existing repertoire of oronasal fistula closure methods.
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  • 文章类型: Journal Article
    目的:本研究旨在评估在COVID-19大流行期间,课程修改对2021年,2022年和2023年班级牙周仪器技能发展的影响。
    方法:大流行开始,并在研究的不同阶段影响了三个班级。2021年和2022年的课程采用了基于现场模拟的学习(SBL);2023年的课程采用了远程SBL。改良临床教育,由于社会距离准则,对2021年的等级影响显著,对2022年的等级影响较小。建立了多元线性回归模型,以检查基于患者的第四年扩展能力检查得分与选定预测因子之间的关联。
    结果:随着时间的推移,2021年和2023年的班级表现一致,而2022年的班级表现出明显的差异,在第二年的实践考试中表现最差。虽然2021年班级的临床经验明显少于2022年和2023年班级的临床经验,但这三个班级的第四年能力考试成绩没有差异。临床积分(p=0.014)显着影响四年级能力考试成绩,而学生性别(p=0.18),第一年(p=0.736),和第二年(p=0.198)的实际考试成绩没有相关性。
    结论:根据学生在四年级扩展能力考试中的表现,由于COVID大流行而导致的课程修改并不影响学生的学习结果.临床经验是牙周仪器技能发展的最有影响力的决定因素。
    OBJECTIVE: This study aimed to evaluate the impact of curriculum modifications on periodontal instrumentation skills development among classes of 2021, 2022, and 2023 during the COVID-19 pandemic.
    METHODS: The pandemic began and affected the three classes at different stages of their studies. Onsite simulation-based learning (SBL) was employed for the classes of 2021 and 2022; remote SBL was adopted for the class of 2023. Modified clinical education, due to social distancing guidelines, impacted the class of 2021 significantly and the class of 2022 to a lesser extent. A multiple linear regression model was built to examine the association between the fourth-year patient-based scaling competency examination scores and selected predictors.
    RESULTS: The classes of 2021 and 2023 showed consistent performances over time, while the class of 2022 exhibited significant variation exhibiting the lowest performance at the second-year practical examination. While the clinical experience of the class of 2021 was significantly less than that of the classes of 2022 and 2023, the fourth-year competency examination scores did not differ across the three classes. The clinic points (p = 0.014) significantly affected the fourth-year competency examination score while student gender (p = 0.18), the first-year (p = 0.736), and second-year (p = 0.198) practical examination scores showed no correlations.
    CONCLUSIONS: Based on student performance in the fourth-year scaling competency examination, the curriculum modifications due to the COVID pandemic did not affect student learning outcomes. Clinical experience was the most influential determinant of skill development in periodontal instrumentation.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Systematic Review
    牙周炎非手术治疗的金标准是刮削和牙根平整(SRP)。近年来,自体血小板浓缩物的使用已经遍布牙科的许多专业,因此,在牙周治疗中也越来越受欢迎。它的两个主要部分是富血小板血浆(PRP)和富血小板纤维蛋白(PRF),which,自2014年起,也可以通过注射作为可注射的富血小板纤维蛋白(i-PRF)使用。作者根据PRISMA2020指南进行了全面的系统评价。它涉及搜索PubMed,Embase,Scopus,和GoogleScholar数据库使用短语(“根平整”或“牙龈下刮治”或“牙周清创”)和(“富含血小板的血浆”)。根据作者的纳入和排除标准,12个结果包括在审查中,在1170个总结果中。本综述的目的是确定在SRP中使用PRP和i-PRF的影响。结果表明,发现PRP和i-PRF的掺入与牙龈袋深度和临床附着水平的差异显着相关;然而,i-PRF在改善临床参数方面显示出优越性。此外,i-PRF对牙龈卟啉单胞菌表现出明显的杀菌效果。另一方面,PRP在临床参数改善方面被证明不如Nd:YAG激光;但是,它也表现出显著的效率。这篇文献综述使作者得出结论,自体血小板浓缩物可能是改善SRP治疗效果的有效药物。
    The gold standard in the non-surgical treatment of periodontitis is scaling and root planing (SRP). In recent years, the use of autogenous platelet concentrates has spread over many specialties in dentistry and, thus, has also been gaining popularity in periodontal treatment. Its two main fractions are platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), which, since 2014, can also be used via injection as injectable platelet-rich fibrin (i-PRF). The authors conducted a comprehensive systematic review in accordance with the PRISMA 2020 guidelines. It involved searching PubMed, Embase, Scopus, and Google Scholar databases using the phrases (\"Root Planing\" OR \"Subgingival Curettage\" OR \"Periodontal Debridement\") AND (\"Platelet-Rich Plasma\"). Based on the authors\' inclusion and exclusion criteria, 12 results were included in the review, out of 1170 total results. The objective of this review was to ascertain the impact of utilizing PRP and i-PRF in SRP. The results revealed that both the incorporation of PRP and i-PRF were found to be significantly associated with are duction in gingival pocket depth and again in clinical attachment level; however, i-PRF demonstrated superiority in improving clinical parameters. Furthermore, i-PRF demonstrated notable bactericidal efficacy against Porphyromonas gingivalis. On the other hand, PRP proved inferior to an Nd:YAG laser in clinical parameter improvement; however, it demonstrated significant efficiency as well. This literature review led the authors to the conclusion that autologous platelet concentrates might be competent agents for improving the therapeutic outcomes of SRP.
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  • DOI:
    文章类型: Journal Article
    随着宾夕法尼亚大学牙科学校为其牙科认证委员会(CODA)批准的双证牙周病/修复计划做准备,本文通过Compendium的创始编辑D.WalterCohen博士共同创立的著名的牙周学和牙周修复计划,回顾了该大学这些专业的根源。文章赞扬了该计划对当今公共卫生的影响。
    As Penn Dental School prepares for its Commission on Dental Accreditation (CODA)-approved dual-certificate periodontics/prosthodontics program, this article looks back at the roots of these specialties at the university via the renowned Periodontics and Periodontal Prosthesis program co-founded byCompendium\'s founding editor Dr. D. Walter Cohen as seen through the eyes of one of its graduates. The article commends the program\'s impact on public health today.
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