本文選題：牙周炎 + 內(nèi)毒素��； 參考：《中國人民解放軍醫(yī)學(xué)院》2017年碩士論文

【摘要】：牙周炎是最常見的口腔疾病之一,是導(dǎo)致牙齒缺失的主要疾病,其病因及發(fā)病機(jī)制仍是牙周病學(xué)研究熱點(diǎn)。牙周炎患牙的部分牙根表面牙骨質(zhì)暴露于牙周袋內(nèi),感染后會發(fā)生結(jié)構(gòu)性和理化性變化,嚴(yán)重影響牙周功能性細(xì)胞在牙根表面的生長和附著,阻礙牙周組織再生修復(fù)。人牙周膜成纖維細(xì)胞(human periodontal ligament fibroblasts,hPDLFs)是構(gòu)成牙周韌帶的重要細(xì)胞,在牙周致病菌及其毒性產(chǎn)物作用下會發(fā)生直接損傷或引發(fā)免疫應(yīng)答反應(yīng),導(dǎo)致牙周組織破壞。本研究主要觀察內(nèi)毒素對hPDLFs增殖及IL-8分泌的影響;不同方法處理牙周炎患牙根面牙骨質(zhì)后內(nèi)毒素水平變化及其根面處理后的牙周炎牙骨質(zhì)片對牙周膜成纖維細(xì)胞分泌細(xì)胞因子水平變化,為選擇臨床牙周炎治療方法提供依據(jù)。本研究主要分為三部分實(shí)驗(yàn)其目的、方法和結(jié)果如下:實(shí)驗(yàn)一:內(nèi)毒素對人牙周膜成纖維細(xì)胞增殖及IL-8分泌的影響目的:觀察不同濃度的內(nèi)毒素(Lipopolysaccharides ,LPS )對PDLFs的影響及IL-8的分泌情況。方法:本實(shí)驗(yàn)分為五組,PDLFs組(陰性對照組)、11μg/mlLPS組、10μg/mlLPS 組、100μg/mlLPS組、200μg/mlLPS 組。各組細(xì)胞進(jìn)行培養(yǎng),MTT 法觀察細(xì)胞增殖變化。24h, 96h ELISA法檢測IL-8分泌情況。結(jié)果:與PDLFs組比較,10μg/ml LPS 促進(jìn) PDLFs 增殖;200μg/ml LPS 抑制 PDLFs 增殖;24h: 200μg/ml LPS組促進(jìn)IL-8分泌,有顯著性統(tǒng)計(jì)學(xué)差異。96h: 1OOμg/mlLPS、200μg/mlLPS組促進(jìn)IL-8分泌,有顯著性統(tǒng)計(jì)學(xué)差異。結(jié)論:不同濃度的內(nèi)毒素對PDLFs增殖、IL-8分泌合成釋放有調(diào)節(jié)作用。實(shí)驗(yàn)二:根面處理牙周炎患牙根面牙骨質(zhì)后內(nèi)毒素水平變化研究目的:觀察不同方法處置牙周炎患牙根面牙骨質(zhì)后內(nèi)毒素水平變化。方法:選擇臨床上正疇拔除的健康的前磨牙6例,重度牙周炎拔除的后牙36例。每顆牙進(jìn)行編號,依分組根面處理后于釉牙骨質(zhì)界下2 mm制成2片4 mmx4 mmx1 mm的牙骨質(zhì)片。健康牙為陰性對照組,36顆牙周炎患牙每顆牙中1個牙片不進(jìn)行根面處理,為牙周炎組。其余36片牙周炎牙片隨機(jī)平均分成6組:齦下刮治及根面平整(scaling and root planning ,SRP)組、SRP+ 抗菌肽 A 組、SRP+ 抗菌肽 B 組、SRP+EDTA 組、SRP+ Nd:YAG激光組和SRP +Er: YAG激光組。顯色基質(zhì)鱟試劑檢測每個牙片內(nèi)毒素濃度。按照編號記錄每顆牙齒內(nèi)毒素濃度,計(jì)算每組每個牙周炎患牙處理前后內(nèi)毒素濃度變化。采用SPSS17.0軟件包對數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:與牙周炎組相比,各處理組內(nèi)毒素濃度有不同程度降低,均有顯著性差異(P0.01 )。與SRP組相比,SRP+抗菌肽A組、SRP+抗菌肽B組、SRP +Er: YAG激光組,內(nèi)毒素濃度顯著下降(P0.01 );SRP+EDTA組、SRP+Nd: YAG激光組均無顯著性差異(P0.05)。結(jié)論:不同方法處理牙周炎患牙根面均可降低內(nèi)毒素含量,抗菌肽A+SRP處理牙周炎根面降低內(nèi)毒素含量最多。實(shí)驗(yàn)三:根面處理牙周炎患牙根面牙骨質(zhì)對牙周膜成纖維細(xì)胞分泌細(xì)胞因子的影響目的:觀察不同方法處理牙周炎患牙根面對PDLFs分泌細(xì)胞因子的影響。方法:實(shí)驗(yàn)二根面處置的牙周炎牙骨質(zhì)片(6組)及健康牙牙骨質(zhì)片與PDLFs共培養(yǎng),ELISA檢測24h時上清液IL-6、IL-8、TNF-α水平。結(jié)果:(1)與SRP組比較:其余組IL-8、TNF-α含量均低于SRP組,有顯著性差異(P0.01)。(2)抗菌肽A+SRP組IL-6含量與健康牙組無顯著性差異(P0.05)。(3)除SRP組,其余根面處理組IL-8含量與健康牙組比較無顯著性差異(P0.05 )。( 4 ) Nd: YAG激光+SRP組與Er: YAG激光+SRP的TNF-α含量與健康牙組無顯著性差異(P0.05)。結(jié)論:抗菌肽(A、B)、Er: YAG激光、Nd: YAG激光、EDTA聯(lián)合SRP處理組IL-8、TNF-α含量均少于SRP組,其IL-8含量組間無差異�？咕腁+SRP在處理組中IL-6含量最低。Nd: YAG激光+SRP在處理組中TNF-α含量最低。
[Abstract]:Periodontitis is one of the most common oral diseases and is the main disease causing tooth loss. Its etiology and pathogenesis is still a hot spot in periodontitis. The surface of the root surface of periodontitis teeth is exposed to the periodontal pocket, and the structural and physical changes will occur after infection, which seriously affects the surface of periodontal functional cells on the root surface. The growth and attachment of human periodontal ligament fibroblasts (hPDLFs) is an important cell for the periodontal ligament, and the periodontal pathogens and their toxic products will be directly damaged or triggered by the immune response, leading to the destruction of periodontal tissue. This study is mainly observed in this study. The effects of endotoxin on the proliferation of hPDLFs and the secretion of IL-8; the changes in endotoxin level after treatment of periodontitis and the root surface of periodontitis and the level of the secretory cytokines in periodontal ligament fibroblasts after root surface treatment are the basis for the treatment of clinical periodontitis. This study is mainly divided into three parts. The purpose, methods and results are as follows: Experiment 1: the effect of endotoxin on the proliferation and IL-8 secretion of human periodontal ligament fibroblasts: the effect of Lipopolysaccharides (LPS) on PDLFs and the secretion of IL-8. Methods: this experiment was divided into five groups, PDLFs group (negative control group), 11 g/mlLPS group, 10 u g/m. Group lLPS, 100 mu g/mlLPS group and 200 g/mlLPS group. Cells were cultured in each group. MTT method was used to observe cell proliferation and.24h, 96h ELISA method was used to detect IL-8 secretion. Results: compared with group PDLFs, 10 mu g/ml LPS promoted PDLFs proliferation, and 200 micron inhibited the proliferation of IL-8. H: 1OO mu g/mlLPS, 200 g/mlLPS group promote IL-8 secretion, there are significant statistical differences. Conclusion: different concentrations of endotoxin can regulate the proliferation of PDLFs and the release of IL-8 secretion. Experiment two: root surface treatment of periodontitis with dental root surface endoendotoxin level changes: Observation of different methods of treatment of periodontitis and tooth root teeth Methods: 6 healthy premolars, 36 cases of severe periodontitis and 36 cases of posterior teeth extracted from severe periodontitis were selected, and each tooth was numbered. 2 slices 4 mmx4 mmx1 mm of cementum were made from 2 mm in the enamel cementum boundary. The healthy teeth were negative control group, 36 periodontitis and each tooth in 1 teeth. The other 36 slices of periodontitis were divided into 6 groups randomly: subgingival scaling and root surface leveling (scaling and root planning, SRP), SRP+ antibacterial peptide A group, SRP+ antibacterial peptide B group, SRP+EDTA group, SRP+ Nd:YAG laser group and laser group. Chromogenic matrix limulus test was used to detect each tooth The concentration of endotoxin in each tooth was recorded by serial number and the endotoxin concentration in each group of periodontitis and teeth was calculated before and after treatment. The data were statistically analyzed by SPSS17.0 software package. Results: compared with the periodontitis group, the concentration of endotoxin in each treatment group decreased in varying degrees (P0.01) and SRP. Group SRP+ antibacterial peptide A, SRP+ antibacterial peptide B group, SRP +Er: YAG laser group, the concentration of endotoxin decreased significantly (P0.01), SRP+EDTA group, SRP+Nd: YAG laser group had no significant difference (P0.05). Conclusion: different methods to treat periodontitis with root surface can reduce endotoxin content, antibacterial peptide treatment of periodontitis root surface to reduce endotoxin content of the most Experiment three: the effect of root surface treatment on periodontitis with root surface cementum on the secretory cytokines of periodontal ligament fibroblasts in order to observe the effects of different methods to treat PDLFs secretory cytokines in periodontitis and tooth roots. Methods: the treatment of periodontitis with two surfaces (6 groups) and healthy teeth bone slices were co cultured with PDLFs, E LISA detected the level of IL-6, IL-8, and TNF- alpha in the supernatant of 24h. Results: (1) the content of IL-8 and TNF- in the rest group was lower than that of the SRP group, and there was a significant difference (P0.01). (2) there was no significant difference between the IL-6 content of the antibacterial peptide A+SRP group and the healthy teeth group. (3) there was no significant difference in the content of the remaining root surface treatment group compared with the healthy tooth group. (.05) (4) there was no significant difference in the TNF- alpha content between the Nd: YAG laser +SRP group and the Er: YAG laser +SRP in the healthy teeth group (P0.05). The content of TNF- alpha in the treated group was the lowest in the light +SRP.

【學(xué)位授予單位】：中國人民解放軍醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R781.4

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本文編號：1847768