The Study Of The Clinical And Blood Biochemical Of Gingivitis Before And After Treatment

Objective:Gingivitis is the most common disease in Periodontal . Its incidence in mass is so high, that even all of people may suffer this kind of a disease in some degree and in some periods of one`s life. As the period disease of periodontitis , gingivitis always is a chronic bacterial condition and most common in Periodontal .More and more research has shown that periodontitis may harm one's oral health, it can not only lead to loss of tooth, but also its inflammations closely related to diabetes mellitus, atherosclerosis and other serious systemic diseases. The relation between periodontitis and these systemic diseases has been paid close attention by many oral experts and clinical medical specialists from home and abroad.But in clinical work, the relation between gingivitis and systemic diseases has not been paid enough attention so far . This may because gingivitis has a high disease incidence with a minor inflammation symptoms, high recover rate , so many people may suppose its harm is less. Compare to periodontitis, diagnosis and treatment of gingivitis has a simple process, a good effect, a short course, a comfort feeling and a high cure rate. If it can be found that a timely and positively treatment of gingivitis can help to prevent periodontitis, reduce or retards the systemic diseases, so as to ease pain. This project plays an important role in improving the quality of life and decreasing the medical cost. Furthermore, treatment of gingivitis is becoming a hot topic in prevent periodontitis, reduce or retards the systemic diseases. So the main object of this project is to investigate the clinical characteristics of patients after the treatment of gingivitisl especially after the dispel of infection ,by measuring the examine the changes of clinical indices , and certain biochemical indexes before and after combined therapy. So as to asses the value of indexes during treatment of gingivitis to provide the references in prevention of periodontitis , reduction or retardtion of the systemic diseases.Methods:This research includes ten parts:1.30patients were chosen randomly referred for diagnostic gingivitis disease in BeiJing Mei Tan Hospital during period of May, 2009 to Mar. 2011 .Among them,these are 13 males and 17 females, age from 28 to 65 with average age is 46.5 years old.All the cases were informed before exam.2.According to the new method of periodontal disease classification of 1999, this thesis only discuses gingivitis related to bacterial plaque, but exclude gingivitis led by systemic factor, medicine factor and nutritional..3.Formulates the strict standard, inquires every cases' medical history in detail, remove the cases who have whole body hemorrhagic disease, all object of study does not have the systematic disease, not take the antibiotic, non-smoking history, feminine patient not pregnancy and nursing in the last three months..4.make periodontal condition inspection with international standard : Including the gum index, the bacterial spot index, the soft filthy index, the hemorrhage index, the tooth stone index, then records the periodontal condition inspection result data.5. make blood biochemical indexes inspection: After the oral cavity periodontal condition inspection, all object of study were gathered venous blood 4m1,when they have no food in stomach early morning of next day. . then centrifugal for 10 minutes by a 1000g/min machine, then separate liquid supernatant and the blood plasma, chooses the supernate to make blood test biochemistry target with the completely automatic blood biochemistry meter, then chemical examination data were recorded.6. Before scaling the gingivitisl, determine and record the baseline of periodontal condition and blood biochemical indexes7. Treatment of gingivitis :patients treated with ultrasonic scaling with Kavo1066 universal dental unit. If these are some remain in gingival groove , then use sub-gingival scaling elimination bacterial spot, soft filthy, tooth stone thoroughly . After clean, carries on the oral hygiene propaganda, instructs the patient to clean the teeth correctly the method, so as to maintain good oral hygiene.8.carry on the oral cavity reexamination when the treatment finished a month and two months separately, in the mean time, examine periodontal indexes and blood biochemical indexes once more.9. In order to reduce the error to lest, guarantee the findings data identity, all three oral and periodontal inspection must be carried by myself, and the chemical examination results must be be inspected by the identical automatic blood biochemistry instrumentation of Mei Tan Hospital which imported from Taiwan .10. Carry on the statistical analysis to the data get from these three inspections , the measurement description indicated with the mean value±standard deviationt, then compare these data before and after clean treatment. It was considered the difference to have statistics significance when p <0.05.Results:1.All 30 cases have smoothly completed clean treatment ,the result of all three clinical indexes and the blood biochemistry has recorded in the assigned. After clean the teeth, they all pay attention to the maintenance oral hygiene, so there was no gingivitis recrudescence example during the experimental stage 2. The periodontal inspection result showed that: the periodontal condition has improved distinctly , The gum index, the bacterial spot index, the soft filthy index, the hemorrhage index and the tooth stone index all reduced obviously after the treatment of gingivitis. From the comparison between data from before and after two months of the clean treatment of gingivitis, we found that the clinical inspection data drop more obviously. This phenomena showed that the result of gingivitis treatment is remarkable. If drive out the pathogenesis factor, the inflammation degree reduces obviously.3.(1) At 1 month after gingivitis therapy,Gingival index reduced from (1.70±0.83 to 1.66±0.679), plaque index reduced from (1.57±0.774 to 0.030±0.183), bleeding index reduced from (2.88±1.099 to 1.66±0.787), debris index reduced from (0.60±0.498 to 0.55±0.291), calculus index reduced from (1.30±0.651 to 0.03±0.183). Compared with the control group, P =0.001,P <0.05 , the differences had dramatically statistic significance.(2)At 2 month after gingivitis therapy, Gingival index reduced from (1.70±0.83 to 0.33±0.479), plaque index reduced from (1.57±0.774 to 0.03±0.173), bleeding index reduced from (2.88±1.099 to 1.02±0.510), debris index reduced from( 0.60±0.498 to 0.55±0.280), calculus index reduced from (1.30±0.651 to 0.03±0.170.) Compared with the control group, P =0.001,P <0.05, the differences had dramatically statistic significance.(3) compared these two experimental groups above , the result is:Gingival index reduced from (1.66±0.679 to 0.33±0.479), P=0.003, P<0.05. plaque index reduced from( 0.030±0.183 to 0.03±0.173), P=1.000, P>0.05. bleeding index reduced from (1.66±0.787 to 1.02±0.510), P =0.001, P<0.05. debris index reduced from( 0.55±0.291 to 0.55±0.280), P=1.000, P>0.05. calculus index reduced from( 0.03±0.183 to 0.03±0.170),P=0.001,P>0.05. It is found that change is not significant between the during this month. Especially gingival index,debris index and calculus index, P>0.05,so the differences had no statistic significance. It is mean that if a patient maintain oral hygiene after treatmentof gingivitis, inflammation would not be worse in two months.4.Biochemical studies result show: index of C-reactive protein, fasting blood-glucose, cholesterol total, low densith lipoportein , high density lipoportein , lipoportein, globin all differences had statistic significance when experimental group were compared with control one (p<O.05)(1)At 1 month after gingivitis therapy,index of C-reactive protein reduced from (1.060±1.415 to 0.861±1.0900), fasting blood-glucose reduced from (4.888±0.523 to 4.611±0.370), cholesterol total reduced from (4.520±1.093to 4.190±0.690), high density lipoportein reduced from (1.269±0.269 to 1.363±0.294), low densith lipoprotein reduced from (2.827±0.718 to 2.668±0.6350), lipoportein reduced from(74.95±3.738 to 73.99±3.264.) P<0.05 , the differences had dramatically statistic significance.(2)At 2 month after gingivitis therapy,index of C-reactive protein reduced from( 1.060±1.415 to 0.523±0.801), fasting blood-glucose reduced from (4.888±0.523 to 4.500±0.444), cholesterol total reduced from (4.520±1.093 to 4.071±0.611), high density lipoportein raised from (1.269±0.269 to 1.417±0.325), low densith lipoportein reduced from (2.827±0.718 to 2.466±0.657), lipoprotein reduced from(74.95±3.738 to 73.613±10.049). P<0.05 , the differences had dramatically statistic significance.(3) compared these two experimental groups above, the result is:index of C-reactive protein reduced from( 0.861±1.09 to 0.523±0.801), fasting blood-glucose reduced from (4.611±0.370 to 4.500±0.444), cholesterol total reduced from (4.190±0.690 to 4.071±0.611), high density lipoprotein raised from (1.363±0.294 to 1.417±0.325), low densith lipoprotein reduced from (2.668±0.635 to 2.466±0.657), lipoprotein reduced from(74.95±3.738 to 73.613±10.049). P<0.05 , the differences had dramatically statistic significance. Index At 2 month2 after gingivitis therapy had more difference compare to index at 1 month, high density lipoprotein rise significantly. Index of Triglyceride. blood urea nitrogen, creatinine, Glutamate pyruvate transaminase, bilirubin direct, indirect bilirubin,purine triune,total bile acid,ttotal protein,total bile acid. etc had no difference statistic significance in comparison.Conclusion.1. After gingivitis clean treatment, the inflammation of the gum can be cured obviously, the periodontal condition is good.2.Gingivitis clean treatment possibly help to reduces the patient's C- response protein level, the blood fats level has a obvious change, but the glycerin does not have the significance. According to the above, it is conclude that the treatment for gum inflammation abates is possibly helpful in reduces risks to suffer cardiovascular disease and other coronary diseases for a patient who suffer this disease.3. After gingivitis clean treatment, the blood sugar level has obvious change, this possibly is helpful in reduces the risk to suffer diabetes disease for this kind of patient4. Gingivitis clean treatment possibly to be able to prevent the occurrence of parodontitis and whole body systematic disease correlated to it .