口腔生物学（第3版）

本书是一本关于口腔生物学的研究生教材。本版保持了第二版的框架，根据教学中各种的反馈，对错误内容进行了删除，并适当增加一些新的研究成果。本书增加了口腔微生物与全身病，尤其是高通量测序技术的广泛应用，极大地扩展了我们对口腔微生物组在健康和疾病中所扮演角色的认识，提示口腔微生物可能对消化系统、免疫系统、心血管系统、内分泌系统和神经系统可能的影响。本教材的宗旨是介绍基础医学相对成熟的知识与少量前沿成果，为同学们更好地理解与学习口腔临床专业课，也为将来可能从事的口腔医学研究打下一定的基础，起到抛砖引玉的作用。

第一章  口腔微生物学 Oral Microbiology ·····················1 第一节  口腔生态系 Oral Ecosystem ······················1 一、口腔生态系的构成及特点 ···········1 二、口腔微生物生长的影响因素 ········3 第二节  口腔正常菌群 Oral Normal Flora ···················6 一、口腔正常菌群的获得与发展 ········6 二、微生物的分类和命名 ·················7 三、口腔正常菌群成员 ····················9 第三节  牙菌斑 Dental Plaque ······················ 20 一、牙菌斑形成 ··························· 20 二、菌斑的组成与结构 ·················· 22 三、菌斑分类和细菌成分 ··············· 23 第四节  口腔微生物与全身疾病 Oral Microbiome and Human Diseases ····························· 24 一、消化系统疾病 ························ 24 二、内分泌系统疾病 ····················· 26 三、免疫系统疾病 ························ 27 四、神经系统疾病 ························ 27 五、心血管系统疾病 ····················· 28 六、小结 ···································· 28 第五节  菌斑与口腔疾病 Plaque and Oral Diseases ········· 28 一、龋病与牙菌斑的关系 ··············· 29 二、牙周疾病与菌斑 ····················· 30 第六节  口腔微生物学的研究方法 Study Methods of Oral Microbiology ······················· 32 一、临床信息 ······························ 32 二、标本的采集和转运 ·················· 32 三、实验室分析 ··························· 33 第二章  口腔生物化学 Oral Biochemistry ··················· 38 第一节  牙及周围组织的化学组成 Chemical Composition of Teeth and Periodontal Tissues ················ 38 一、釉质 ···································· 38 二、牙本质 ································· 40 三、牙骨质 ································· 41 四、牙槽骨 ································· 41 五、牙龈和牙周膜 ························ 41 第二节  口腔黏膜 Oral Mucosa ························ 42 一、黏膜上皮的代谢特点 ··············· 43 二、基底膜的组成 ························ 43 三、黏膜结缔组织的生化特征 ········· 43 第三节  唾液腺、唾液和龈沟液 Salivary Glands， Saliva and Gingival Crevicular Liquid ······· 43 一、唾液腺的分泌功能 ·················· 43 二、唾液的成分和功能 ·················· 44 三、龈沟液的来源和功能 ··············· 48 第四节  菌斑的生化特征 Biochemical Characters of Plaque ······························· 48 一、菌斑的化学成分 ····················· 48 二、菌斑内的物质代谢 ·················· 49 三、菌斑引发口腔疾病的机制 ········· 55 第五节  牙齿硬组织矿化 Mineralization of Dental Hard Tissues ······························ 57 一、生物矿化 ······························ 57 二、牙齿硬组织的矿化 ·················· 61 2 临床牙周病学（第 3 版） 三、脱矿与再矿化 ························ 62 四、仿生矿化与牙体硬组织修复 ······ 69 第六节  舌与味觉 Tongue and Taste ·················· 69 一、味觉分子与味觉 ····················· 69 二、味蕾和味觉细胞 ····················· 70 三、受体和换能 ··························· 70 四、甜味 ···································· 71 五、苦味 ···································· 72 六、咸味 ···································· 73 七、酸味 ···································· 73 八、鲜味 ···································· 73 第三章  口腔免疫学 Oral Immunology ··················· 74 第一节  口腔免疫器官和细胞 Organs and Cells of Oral Immune System······························· 74 一、口腔免疫器官 ························ 74 二、口腔免疫细胞 ························ 76 第二节  口腔免疫体系 Oral Immune System ·············· 80 一、口腔天然免疫系统 ·················· 80 二、口腔获得性免疫系统 ··············· 84 第三节  口腔疾病免疫 Oral Diseases Immunology······· 90 一、龋病免疫 ······························ 90 二、牙髓炎免疫 ··························· 93 三、根尖周病免疫 ························ 94 四、牙周病免疫 ··························· 95 五、口腔黏膜病的免疫 ·················· 98 六、肿瘤免疫 ·····························103 七、移植免疫 ·····························106 第四章  口腔分子生物学 Oral Molecular Biology ···········109 第一节  口腔组织发育的分子生物学基础 Molecular Biological Basis of Oral Tissues Development ·············109 一、颌面部发育 ··························109 二、牙齿发育的分子调控机制 ········ 112 第二节  口腔疾病的分子生物学基础 Molecular Biological Basis of Oral Diseases ···························· 116 一、龋病相关因子 ······················· 116 二、牙周病相关因子 ···················· 117 三、口腔肿瘤相关因子 ·················120 四、口腔常见发育异常的分子生物学 基础 ···································127 五、口腔遗传性疾病的分子生物学 基础 ···································130 第五章  口腔细胞生物学 Oral Cell Biology ···················133 第一节  牙齿相关细胞 Tooth-Associated Cells ··········133 一、牙齿相关细胞的来源 ··············134 二、牙源性干细胞 ·······················134 第二节  口腔黏膜相关细胞 Oral Mucosa-Associated Cells ·····139 一、口腔黏膜的组织结构及上皮细胞的 来源和分化 ··························140 二、口腔黏膜上皮细胞 ·················141 三、口腔黏膜上皮干细胞 ··············144 第三节  唾液腺细胞 Salivary Gland Cells ·············145 一、唾液腺组织中的细胞来源及 特点 ···································145 二、唾液腺干细胞 ·······················146 第四节  口腔颌面部肿瘤细胞 Oral and Maxillofacial Tumor Cells ································147 一、常见的口腔癌细胞系 ··············148 二、细胞系鉴定 ··························148 三、临床联系 ·····························149 第六章  口腔骨组织生物学 Oral Biology of Bone Tissue ······150 第一节  与骨代谢相关的牙周组织 Periodontal Tissues Related to Bone Metabolism ························150 一、牙槽骨组织的生物学特点 ········150 二、牙周膜 ································151 三、牙骨质 ································152 四、研究骨组织代谢在口腔医学中的 意义 ···································152 目  录 3 第二节  骨改建的细胞生物学 Cell Biology for Bone Remodeling ························153 一、破骨细胞 ·····························154 二、成骨细胞 ·····························157 三、成骨细胞和破骨细胞的关系 ·····158 第三节  影响牙周组织改建的生物学因素 Biological Factors Affecting the Remodeling of Periodontal Tissues ·····························163 一、骨组织改建的全身调节因素 ·····163 二、骨组织改建的局部调节因素 ·····165 第四节  机械力在牙周组织骨改建的作用 Roles of Mechanical Force in the Remodeling of Periodontal Tissues ·····························167 一、机械力对牙周组织生物学行为的 影响 ···································167 二、正畸牙齿移动的生物学基础 ·····168 三、机械力引起细胞骨架的改变 ·····169 第五节  口腔骨改建的临床应用及生物学 基础 Clinical Application and Biological Foundation of Bone Remodeling in Oral Medicine ·····················170 一、牵张成骨术 ··························170 二、口腔种植学 ··························171 三、引导组织再生生物膜技术的 发展 ···································172 四、牙周骨增量手术 ····················172 中英文专业词汇索引 ···························174 主要参考文献 ····································177