目的:探讨种植修复对慢性牙周炎牙列缺损患者牙周指数及炎性因子的影响。方法:选择2016年7月~2017年6月收治的行种植修复的慢性牙周炎牙列缺损患者64例(72颗)为实验组,同期选择行种植修复的牙列缺损且牙周健康患者66例(78颗)为对照组。...目的:探讨种植修复对慢性牙周炎牙列缺损患者牙周指数及炎性因子的影响。方法:选择2016年7月~2017年6月收治的行种植修复的慢性牙周炎牙列缺损患者64例(72颗)为实验组,同期选择行种植修复的牙列缺损且牙周健康患者66例(78颗)为对照组。随访6个、12个月,比较两组患者临床疗效、牙周指数、牙龈沟炎性因子含量。结果:随访6个月,两组牙周缺损患者临床疗效比较,差异无统计学意义(93.06%vs 97.33%),实验组患者PIS、PD明显高于对照组[(2.26±0.21 vs 2.15±0.24)、(1.82±0.20 vs 1.67±0.18)mm],龈沟液hs-CRP、IL-1β、IL-6、TNF-α明显高于对照组[(12.15±2.32 vs 9.21±1.67)μg/mL、(2.24±0.45 vs 0.52±0.21)ng/mL、(3.12±0.65 vs 1.74±0.42)ng/mL、(14.36±2.24 vs 10.45±1.42)ng/m、](t=8.312,28.063,14.421,11.924);随访12个月,实验组有效率80.56%明显低于对照组92.00%,PLI、PIS、SBI、PD明显高于对照组[(0.98±0.15 vs 0.87±0.13)、(2.45±0.32 vs 2.20±0.26)、(1.23±0.20 vs 1.06±0.24)、(2.34±0.26 vs 2.06±0.32)mm],龈沟液hs-CRP、IL-1β、IL-6、TNF-α明显高于对照组[(17.54±3.40 vs 9.75±1.35)μg/m、(3.54±0.65 vs 0.56±0.12)ng/mL、(4.85±0.72 vs 1.82±0.54)ng/mL、(16.24±3.12 vs 11.33±2.20)ng/mL]。结论:种植修复治疗慢性牙周炎牙列缺损近期疗效较好,远期存在种植周围炎的患病风险,可能与慢性牙周炎所致炎症状态以及修复种植会刺激炎性因子释放等因素有关。临床应联合牙周基础治疗,以提高远期疗效。展开更多
Periprosthetic joint infection(PJI) is a devastating complication after total joint arthroplasty, occurring in approximately 1%-2% of all cases. With growing populations and increasing age, PJI will have a growing eff...Periprosthetic joint infection(PJI) is a devastating complication after total joint arthroplasty, occurring in approximately 1%-2% of all cases. With growing populations and increasing age, PJI will have a growing effect on health care costs. Many risk factors have been identified that increase the risk of developing PJI, including obesity, immune system deficiencies, malignancy, previous surgery of the same joint and longer operating time. Acute PJI occurs either postoperatively(4 wk to 3 mo after initial arthroplasty, depending on the classification system), or via hematogenous spreading after a period in which the prosthesis had functioned properly. Diagnosis and the choice of treatment are the cornerstones to success. Although different definitions for PJI have been used in the past, most are more or less similar and include the presence of a sinus tract, blood infection values, synovial white blood cell count, signs of infection on histopathological analysis and one ormore positive culture results. Debridement, antibiotics and implant retention(DAIR) is the primary treatment for acute PJI, and should be performed as soon as possible after the development of symptoms. Success rates differ, but most studies report success rates of around 60%-80%. Whether single or multiple debridement procedures are more successful remains unclear. The use of local antibiotics in addition to the administration of systemic antibiotic agents is also subject to debate, and its pro's and con's should be carefully considered. Systemic treatment, based on culture results, is of importance for all PJI treatments. Additionally, rifampin should be given in Staphylococcal PJIs, unless all foreign material is removed. The most important factors contributing to treatment failure are longer duration of symptoms, a longer time after initial arthroplasty, the need for more debridement procedures, the retention of exchangeable components, and PJI caused by Staphylococcus(aureus or coagulase negative). If DAIR treatment is unsuccessful, the fo展开更多
文摘目的:探讨种植修复对慢性牙周炎牙列缺损患者牙周指数及炎性因子的影响。方法:选择2016年7月~2017年6月收治的行种植修复的慢性牙周炎牙列缺损患者64例(72颗)为实验组,同期选择行种植修复的牙列缺损且牙周健康患者66例(78颗)为对照组。随访6个、12个月,比较两组患者临床疗效、牙周指数、牙龈沟炎性因子含量。结果:随访6个月,两组牙周缺损患者临床疗效比较,差异无统计学意义(93.06%vs 97.33%),实验组患者PIS、PD明显高于对照组[(2.26±0.21 vs 2.15±0.24)、(1.82±0.20 vs 1.67±0.18)mm],龈沟液hs-CRP、IL-1β、IL-6、TNF-α明显高于对照组[(12.15±2.32 vs 9.21±1.67)μg/mL、(2.24±0.45 vs 0.52±0.21)ng/mL、(3.12±0.65 vs 1.74±0.42)ng/mL、(14.36±2.24 vs 10.45±1.42)ng/m、](t=8.312,28.063,14.421,11.924);随访12个月,实验组有效率80.56%明显低于对照组92.00%,PLI、PIS、SBI、PD明显高于对照组[(0.98±0.15 vs 0.87±0.13)、(2.45±0.32 vs 2.20±0.26)、(1.23±0.20 vs 1.06±0.24)、(2.34±0.26 vs 2.06±0.32)mm],龈沟液hs-CRP、IL-1β、IL-6、TNF-α明显高于对照组[(17.54±3.40 vs 9.75±1.35)μg/m、(3.54±0.65 vs 0.56±0.12)ng/mL、(4.85±0.72 vs 1.82±0.54)ng/mL、(16.24±3.12 vs 11.33±2.20)ng/mL]。结论:种植修复治疗慢性牙周炎牙列缺损近期疗效较好,远期存在种植周围炎的患病风险,可能与慢性牙周炎所致炎症状态以及修复种植会刺激炎性因子释放等因素有关。临床应联合牙周基础治疗,以提高远期疗效。
文摘Periprosthetic joint infection(PJI) is a devastating complication after total joint arthroplasty, occurring in approximately 1%-2% of all cases. With growing populations and increasing age, PJI will have a growing effect on health care costs. Many risk factors have been identified that increase the risk of developing PJI, including obesity, immune system deficiencies, malignancy, previous surgery of the same joint and longer operating time. Acute PJI occurs either postoperatively(4 wk to 3 mo after initial arthroplasty, depending on the classification system), or via hematogenous spreading after a period in which the prosthesis had functioned properly. Diagnosis and the choice of treatment are the cornerstones to success. Although different definitions for PJI have been used in the past, most are more or less similar and include the presence of a sinus tract, blood infection values, synovial white blood cell count, signs of infection on histopathological analysis and one ormore positive culture results. Debridement, antibiotics and implant retention(DAIR) is the primary treatment for acute PJI, and should be performed as soon as possible after the development of symptoms. Success rates differ, but most studies report success rates of around 60%-80%. Whether single or multiple debridement procedures are more successful remains unclear. The use of local antibiotics in addition to the administration of systemic antibiotic agents is also subject to debate, and its pro's and con's should be carefully considered. Systemic treatment, based on culture results, is of importance for all PJI treatments. Additionally, rifampin should be given in Staphylococcal PJIs, unless all foreign material is removed. The most important factors contributing to treatment failure are longer duration of symptoms, a longer time after initial arthroplasty, the need for more debridement procedures, the retention of exchangeable components, and PJI caused by Staphylococcus(aureus or coagulase negative). If DAIR treatment is unsuccessful, the fo
