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有约的一篇关于口腔疾病的帖
以前信手翻译的一篇关于猫的口腔疾病的文章，如果对大家有用就最好了
如果没什么用处也权当灌水:Z
Advances in Feline Dentistry
Thomas J. Klein
猫牙科诊疗中遇到的最大的挑战是下述三种最常见的口腔疾病在日常临床接诊病例中的诊断：牙周疾病、猫破牙质细胞重吸收性病变(FORLs)、淋巴性-浆细胞性龈口炎综合症(LPGS)，它们有着很多相似的大体病征和交叠的组织学表现。后两者(FORLs和LPGS)表现极端的疼痛，但适当的治疗可以明显改善患猫的健康状况。
牙周疾病
牙周疾病是成年猫的常见疾病，它常表现为牙龈炎——牙龈组织的炎症反应，和牙周炎——牙龈支持组织的附加损坏(包括牙骨质、牙周韧带和牙槽骨)。牙龈炎是牙周疾病的可逆阶段，它能够通过适当方法加以治疗，也能够通过彻底的菌斑清除及持续的龈上菌斑控制加以预防。牙周炎却往往更加严重并且病程难以逆转，更加复杂的治疗以及更加深入的菌斑控制才能防治病情的恶化。微生物菌斑是牙周疾病的首要病原，菌斑一种主要由细菌、唾液糖蛋白和细胞外多糖在牙齿表面形成的软粘性物质。其中细菌以及产物引起直接牙龈炎症，并间接性的激活宿主的免疫反应，此后牙龈将持续性发炎，病情持续性恶化，除非入侵细菌被清除。
未予干预的菌斑将矿化为坚硬的钙质壳，钙质壳为细菌的存在和更紧密的附着提供了稳固的表面，它的存在将推动病程的发展。钙质同时还充当了牙龈炎症的机械刺激来源。
影响牙周炎严重程度和发病率的其他因素包括：品种、遗传、年龄、饮食、咀嚼习惯和机体的系统健康状况。
虽然具体的病理生理机制尚不明确，但可以确定未予治疗的牙龈炎将会发展成为牙周炎，引起口腔疼痛、机能退化和牙齿脱落。（见图1）
牙周疾病在其他口腔疾病(例如FORLs和LPGS)的病原学方面所扮演的角色仍不明确，牙周组织健康的保持依赖于适当专业的治疗和持续的家庭牙科护理。龈上下菌斑、钙质、食物碎屑的深度清洁；齿面抛光；以清洁碎屑控制微生物为目的的齿龈沟冲洗，以及含氟药物的应用都是日常牙周治疗的内容。根据病程发展状况，类似牙周手术、牙根平整和刮治术、牙髓拔出和疼痛控制这些辅助手段也需要使用。为了制定合理的治疗计划，准确地确定牙周疾病的当前发展状况是相当关键的。(见表1)
有约的一篇关于口腔疾病的帖
以前信手翻译的一篇关于猫的口腔疾病的文章，如果对大家有用就最好了
如果没什么用处也权当灌水:Z
Advances in Feline Dentistry
Thomas J. Klein
猫牙科诊疗中遇到的最大的挑战是下述三种最常见的口腔疾病在日常临床接诊病例中的诊断：牙周疾病、猫破牙质细胞重吸收性病变(FORLs)、淋巴性-浆细胞性龈口炎综合症(LPGS)，它们有着很多相似的大体病征和交叠的组织学表现。后两者(FORLs和LPGS)表现极端的疼痛，但适当的治疗可以明显改善患猫的健康状况。
牙周疾病
牙周疾病是成年猫的常见疾病，它常表现为牙龈炎——牙龈组织的炎症反应，和牙周炎——牙龈支持组织的附加损坏(包括牙骨质、牙周韧带和牙槽骨)。牙龈炎是牙周疾病的可逆阶段，它能够通过适当方法加以治疗，也能够通过彻底的菌斑清除及持续的龈上菌斑控制加以预防。牙周炎却往往更加严重并且病程难以逆转，更加复杂的治疗以及更加深入的菌斑控制才能防治病情的恶化。微生物菌斑是牙周疾病的首要病原，菌斑一种主要由细菌、唾液糖蛋白和细胞外多糖在牙齿表面形成的软粘性物质。其中细菌以及产物引起直接牙龈炎症，并间接性的激活宿主的免疫反应，此后牙龈将持续性发炎，病情持续性恶化，除非入侵细菌被清除。
未予干预的菌斑将矿化为坚硬的钙质壳，钙质壳为细菌的存在和更紧密的附着提供了稳固的表面，它的存在将推动病程的发展。钙质同时还充当了牙龈炎症的机械刺激来源。
影响牙周炎严重程度和发病率的其他因素包括：品种、遗传、年龄、饮食、咀嚼习惯和机体的系统健康状况。
虽然具体的病理生理机制尚不明确，但可以确定未予治疗的牙龈炎将会发展成为牙周炎，引起口腔疼痛、机能退化和牙齿脱落。（见图1）
牙周疾病在其他口腔疾病(例如FORLs和LPGS)的病原学方面所扮演的角色仍不明确，牙周组织健康的保持依赖于适当专业的治疗和持续的家庭牙科护理。龈上下菌斑、钙质、食物碎屑的深度清洁；齿面抛光；以清洁碎屑控制微生物为目的的齿龈沟冲洗，以及含氟药物的应用都是日常牙周治疗的内容。根据病程发展状况，类似牙周手术、牙根平整和刮治术、牙髓拔出和疼痛控制这些辅助手段也需要使用。为了制定合理的治疗计划，准确地确定牙周疾病的当前发展状况是相当关键的。(见表1)
Advances in Feline Dentistry
Thomas J. Klein
The greatest challenge in feline dentistry is in diagnosing which of the three most common oral maladies is being presented in the clinical setting. Periodontal disease, feline odontoclastic resorptive lesions (FORLs), and lymphocytic-plasmacytic gingivitis/stomatitis (LPGS) syndrome are manifested by many similar gross signs and can have overlapping pathologies. The latter two conditions are extremely painful,and proper therapy can greatly improve an affected cat’s well-being.
PERIODONTAL DISEASE
Periodontal disease is the most common disease of adult cats. Periodontal disease typically refers to gingivitis, which is defined as inflammation of the gingival tissues, and to periodontitis, which is gingivitis plus destruction of the supporting periodontal tissues (cementum, periodontal ligament, alveolar bone).Gingivitis is the reversible stage of periodontal disease; it can be appropriately treated and largely prevented by thorough plaque removal and continued supragingival plaque control. Periodontitis is more severe and primarily irreversible. It may require advanced therapy and thorough plaque control to prevent disease progression. Microbial plaque is the primary etiologic agent responsible for periodontal disease. Plaque is primarily bacteria admixed with salivary(唾液) glycoproteins and extracellular polysaccharides that form a soft, sticky mass on tooth surfaces. The bacteria and their byproducts cause direct gingival inflammation as well as indirect activation of the host immune response. The gingiva will remain inflamed and the disease may progressively worsen until the offending bacteria are removed.
Undisturbed plaque mineralizes into a hard shell of calculus, which contributes to the disease process by providing a roughened surface for enhanced attachment and retention of plaque bacteria. Calculus also acts as a mechanical irritant exacerbating gingival inflammation.
Other factors contributing to the prevalence and severity of periodontal disease include breed, genetics, age, diet, chewing behavior, and systemic health.
Although the specific pathophysiology remains undefined, gingivitis, left untreated, may progress to periodontitis, with resulting oral pain, dysfunction, and tooth loss (Figure 1).
The role of periodontal disease in the etiology of other oral diseases such as FORLs and LPGS remains unclear. Maintenance of periodontal health depends on appropriate professional therapy combined with continued dental home care. Thorough removal of supragingival and subgingival plaque, calculus, and debris, polishing to smooth tooth surfaces, sulcus irrigation to remove debris or to aid in microbial control,and fluoride application, if indicated, are all part of routine periodontal therapy. Depending on the degree of disease present, ancillary steps such as periodontal surgery, root planing or curettage, and exodontic of endodontic procedures, as well as pain management,may be used. For the proper therapeutic steps to be taken in the cat, it is critical to appropriately determine the grade of periodontal disease present (Table1).
Thomas J. Klein
The greatest challenge in feline dentistry is in diagnosing which of the three most common oral maladies is being presented in the clinical setting. Periodontal disease, feline odontoclastic resorptive lesions (FORLs), and lymphocytic-plasmacytic gingivitis/stomatitis (LPGS) syndrome are manifested by many similar gross signs and can have overlapping pathologies. The latter two conditions are extremely painful,and proper therapy can greatly improve an affected cat’s well-being.
PERIODONTAL DISEASE
Periodontal disease is the most common disease of adult cats. Periodontal disease typically refers to gingivitis, which is defined as inflammation of the gingival tissues, and to periodontitis, which is gingivitis plus destruction of the supporting periodontal tissues (cementum, periodontal ligament, alveolar bone).Gingivitis is the reversible stage of periodontal disease; it can be appropriately treated and largely prevented by thorough plaque removal and continued supragingival plaque control. Periodontitis is more severe and primarily irreversible. It may require advanced therapy and thorough plaque control to prevent disease progression. Microbial plaque is the primary etiologic agent responsible for periodontal disease. Plaque is primarily bacteria admixed with salivary(唾液) glycoproteins and extracellular polysaccharides that form a soft, sticky mass on tooth surfaces. The bacteria and their byproducts cause direct gingival inflammation as well as indirect activation of the host immune response. The gingiva will remain inflamed and the disease may progressively worsen until the offending bacteria are removed.
Undisturbed plaque mineralizes into a hard shell of calculus, which contributes to the disease process by providing a roughened surface for enhanced attachment and retention of plaque bacteria. Calculus also acts as a mechanical irritant exacerbating gingival inflammation.
Other factors contributing to the prevalence and severity of periodontal disease include breed, genetics, age, diet, chewing behavior, and systemic health.
Although the specific pathophysiology remains undefined, gingivitis, left untreated, may progress to periodontitis, with resulting oral pain, dysfunction, and tooth loss (Figure 1).
The role of periodontal disease in the etiology of other oral diseases such as FORLs and LPGS remains unclear. Maintenance of periodontal health depends on appropriate professional therapy combined with continued dental home care. Thorough removal of supragingival and subgingival plaque, calculus, and debris, polishing to smooth tooth surfaces, sulcus irrigation to remove debris or to aid in microbial control,and fluoride application, if indicated, are all part of routine periodontal therapy. Depending on the degree of disease present, ancillary steps such as periodontal surgery, root planing or curettage, and exodontic of endodontic procedures, as well as pain management,may be used. For the proper therapeutic steps to be taken in the cat, it is critical to appropriately determine the grade of periodontal disease present (Table1).
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