龋齿、牙周炎患牙和健康牙的菌斑生物膜特征

目的研究牙面菌斑生物膜特征与口腔疾病的关系。方法选择牙周健康而牙冠严重龋坏的龋齿5颗、无龋损而极度松动的牙周炎患牙6颗及正畸原因拔除的健康牙4颗,在扫描电镜下,观察分析龈上、龈下及移行生态区的菌斑生物膜特征。结果龋齿、牙周炎患牙和健康牙的牙面均观察到细菌混合物组成的菌斑生物膜,健康牙菌斑生物膜以球菌为主,放线菌和短杆菌少量;龋齿牙的龋坏处为坏死组织和细菌,龋边缘及龈沟处的球菌和短杆菌较健康牙多;牙周炎患者牙菌斑生物膜的细菌种类多,在龈上、龈下移行处可见典型的玉米棒状菌斑或以杆菌为主的紧密附着菌斑,龈下可见球菌、杆菌、梭菌及螺旋体等构成的复杂菌斑。结论龋齿、牙周炎患牙和健康牙菌斑生物膜细菌组成、集聚秩序和立体结构不同,菌斑生物膜的形成与细菌的附着、集聚、生长有关,也与局部病变密切相关。

Characteristics of dental plaque biofilm on healthy, carious and periodontitis involved teeth

Objective To investigate the relationship between the characterizations of dental plaque biofilm and different oral diseases. Methods Three sorts of removed teeth were selected in the study: 5 severe decayed teeth with healthy periodontium, 6 highly mobile periodontitis teeth without carious lesion and 4 healthy teeth removed due to orthodontic reasons. Dental plaque biofilms in supragingival, subgingival and migrant areas were observed and analyzed under scanning electron microscope. Results The plaque biofims consisting of mixed microbial community could all be seen in healthy, carious and periodontitis involved tooth surfaces, but obviously distincted in structure modes. Cocci predominate and small amount of short rods and Spirochetes were found on health teeth, whereas massive necrotic tissue and bacteria on decayed area, and cocci and short rods were more than those on health teeth. The sorts of bacteria of dental plaque biofilm on periodontitis involved teeth increased, as typical "corncob" arrangement plaque and compact rod hacteria attached to plaque were often observed on migrant areas, and subgingival plaque demonstrated complex flora including cocci, rods, Fusobacteria and Spirochetes etc. Conclusion The bacterium composition, aggregation order and spatial structure of dental plaque biofilm on healthy, carious and periodontitis involved teeth are distinct. The formation of dental plaque biofilm is associated with bacterium adhesion, coaggregation, growth, and tissue damage.