Tolboe H, Isidor F, Budtz-Jörgensen E, Kaaber S
Department of Prosthetic Dentistry and Stomatognathic Physiology, Royal Dental College, Aarhus, Denmark.
Scand J Dent Res. 1987 Dec;95(6):475-82. doi: 10.1111/j.1600-0722.1987.tb01963.x.
The purpose of the present study was to elucidate the relationship between the oral hygiene at the bridge pontic and the inflammatory changes in the adjacent mucosa. The study consisted of three 4-wk periods with different hygienic measures: 1) no oral hygiene around and beneath the pontic, 2) thorough hygiene using toothbrush and toothpicks and 3) thorough hygiene using a toothbrush and dental floss every day. The amount of accumulated bacterial deposits on the pontic and the inflammation in the pontic area were estimated using quantitative microbiologic tests, and clinical and histologic examinations. When dental floss had been used the mucosa was healthy while it showed mild or moderate inflammation after the other experimental periods. There was a high correlation between the amount of mucosal exudate and the inflammation in the mucosa as measured by a modified Gingival Index. Daily use of dental floss resulted in a significantly lower number of microorganisms per mm2 compared with the other hygienic measures. Histologic sections of the biopsies showed changes in form of parakeratosis with thinning or loss of stratum corneum. The investigations have demonstrated that insufficient oral hygiene is an important factor in the development of inflammatory changes in the oral mucosa beneath bridge pontics. Regular use of dental floss ought to be a part of the oral hygiene regimen in patients wearing fixed bridges.
本研究的目的是阐明桥体处的口腔卫生与相邻黏膜炎症变化之间的关系。该研究包括三个为期4周的不同卫生措施阶段：1）桥体周围及下方不进行口腔卫生清洁；2）使用牙刷和牙签进行彻底清洁；3）每天使用牙刷和牙线进行彻底清洁。通过定量微生物检测、临床和组织学检查来评估桥体上累积的细菌沉积物数量以及桥体区域的炎症情况。使用牙线时黏膜健康，而在其他实验阶段后黏膜显示轻度或中度炎症。通过改良牙龈指数测量，黏膜渗出物的量与黏膜炎症之间存在高度相关性。与其他卫生措施相比，每天使用牙线导致每平方毫米的微生物数量显著减少。活检组织学切片显示有角化不全的变化，伴有角质层变薄或缺失。研究表明，口腔卫生不足是桥体下方口腔黏膜炎症变化发展的一个重要因素。定期使用牙线应该成为佩戴固定桥患者口腔卫生方案的一部分。
