慢性牙周炎患者龈下菌斑中福赛斯坦纳菌与临床指标的关系

目的分析慢性牙周炎患者龈下菌斑中福赛斯坦纳菌（T.forsythensis）的分布情况,及其与牙周临床指标的关系,探讨T.forsythensis与慢性牙周炎发生发展的关系。方法采集108例慢性牙周炎患者的216个病变位点和108个健康位点的龈下菌斑,共324个样本,采用16S rRNA聚合酶链反应检测T.forsythensis的分布情况。对324个取样位点进行临床检查,记录探诊深度、临床附着丧失和探诊出血情况,分析T.forsythensis与临床指标的相互关系。结果慢性牙周炎患者病变位点与健康位点T.forsythensis的检出率分别为59.72%和3.70%,二者间有统计学差异（P<0.001）。随着探诊深度和临床附着丧失的增加,T.forsythensis的检出率也升高,Spearman相关系数分别为0.48和0.51。探诊出血阳性位点T.forsythensis的检出率为61.31%,明显高于探诊出血阴性位点的检出率8.80%（P<0.001）。结论T.forsythensis与慢性牙周炎发生、发展关系密切。     

牙龈卟啉单胞菌PG0717基因与慢性牙周炎的相关性研究

目的检测慢性牙周炎患者和牙周健康者龈下菌斑中牙龈卟啉单胞菌（P.gingivalis）PG0717基因,探讨PG0717基因与牙周临床指数之间的关系。方法选取慢性牙周炎（CP）患者90例和牙周健康者90例,共采集龈下菌斑标本540个;记录临床牙周指数（牙周探诊深度、临床附着丧失和探诊出血）;设计特异性引物检测P.gingivalis阳性龈下菌斑标本的PG0717基因。结果在P.gingivalis阳性龈下菌斑中,CP组PG0717基因检出率显著高于对照组,分别为56.22%和41.27%（掊2=4.50,P＜0.05）;随着牙周探诊深度、临床附着丧失加重和探诊出血趋势的增加,CP组该基因检出率呈现增高趋势。结论PG0717基因与P.gingivalis的致病性有关。     

慢性牙周炎栖牙密螺旋体和牙周袋内硫化物水平的相关性研究

目的 研究慢性牙周炎病人牙周袋内栖牙密螺旋体和牙周袋内硫化物水平的关系。方法 临床上选取17例诊断为慢性牙周炎的病人,采用金刚探针/牙周诊断仪检测牙周袋内硫化物水平,记录牙周袋探诊深度、临床附着丧失以及探诊出血相关牙周指标。同时,采用16S rRNA PCR检测相同位点的栖牙密螺旋体。结果 慢性牙周炎病人栖牙密螺旋体检出率为88.2%,硫化物阳性位点和硫化物阴性位点中栖牙密螺旋体的检出率分别为68.5%和43.2%。硫化物阳性位点与阴性位点中牙周附着丧失（clinical attachment loss, CAL）平均值分别为（2.84±2.33）mm和（1.83±1.60）mm,两者差异有统计学意义（P<0.01）。硫化物阳性位点与阴性位点牙周探诊深度（probing depth, PD）平均值分别为（4.20±1.57）mm和（3.83±1.30）mm,两者差异无统计学意义(P＞0.05)。硫化物阳性位点中牙周探诊出血（bleeding on probing, BOP）阳性检出为率92.5%,大于硫化物阴性位点（75.8%）,两者差异有统计学意义（P<0.01）。结论 慢性牙周炎病人牙周袋内的硫化物水平能反映牙周栖牙密螺旋体分布情况,与牙周附着丧失存在相关性。     

龈沟产线菌检出率与牙周健康状况的相关性分析

目的 分析不同牙周健康状况者龈下菌斑中龈沟产线菌的检出率差异及其与牙周临床指标间的相关关系。方法 应用聚合酶链反应法分别检测17例牙周健康者的68个牙周健康位点、19例菌斑性牙龈炎患者的64个牙周健康位点和76个病变位点、14例慢性牙周炎患者的36个牙周健康位点和56个病变位点的龈下菌斑中龈沟产线菌的检出率,并分析检出率与牙周临床检查指标之间的相关关系。结果 龈沟产线菌的检出率在不同人群的健康位点组及不同人群疾病位点组依次分别增高,其中牙周健康者龈下菌斑中龈沟产线菌检出率最低,为30.88%（21/68）,而慢性牙周炎患者病变位点组龈下菌斑中龈沟产线菌检出率最高,为91.07%（51/56）。龈沟产线菌与位点发生牙周病变之间的相关性有统计学意义（P<0.000 1）,其检出率与位点牙龈出血指数、临床探诊深度、临床附着水平的比值比分别为5.26、8.85、11.65。结论 牙周炎患者口腔中携带龈沟产线菌的风险升高;局部携带龈沟产线菌增加了位点牙周临床指标（牙龈出血指数、临床探诊深度、临床附着水平）异常的风险。     

5种牙周龈下可疑致病微生物与慢性牙周炎局部不同牙周状态间的关系

目的 观察5种龈下微生物检出水平与慢性牙周炎局部牙周状态的关系。方法 选择20例慢性牙周炎患者的80个位点及10例牙周健康者的20个位点为观察位点,采集龈下微生物样本,记录牙周探诊深度（PD）,根据所测位点的PD进行分组。PD≤4 mm为A组,4 mm＜PD≤6 mm为B组,PD>6 mm为C组,健康对照组为H组。通过聚合酶链反应（PCR）和DNA探针反杂交技术半定量检测各组伴放线菌嗜血菌、牙龈卟啉单胞菌、福赛斯坦纳菌、齿垢密螺旋体和中间普氏菌的检出率和检出水平。结果 B、C组牙龈卟啉单胞菌、福赛斯坦纳菌、齿垢密螺旋体和中间普氏菌的检出率和检出水平均高于H组,A组牙龈卟啉单胞菌的检出率和检出水平也高于H组,C组福赛斯坦纳菌和齿垢密螺旋体检出水平高于B组,以上差异均有统计学意义（P<0.05）;伴放线菌嗜血菌在各组间的检出率及检出水平都无明显差异。结论 随着牙周袋的加深,牙龈卟啉单胞菌、福赛斯坦纳菌、齿垢密螺旋体和中间普氏菌体的阳性检出率和检出水平都有随之增加的趋势;牙龈卟啉单胞菌与慢性牙周炎的早期炎症关系较为密切,而福赛斯坦纳菌和齿垢密螺旋体与中重度慢性牙周炎炎症位点的严重程度有关。     

Ⅱ型糖尿病合并牙周炎患者龈下菌斑微生物群落分析

目的：本研究旨在比较Ⅱ型糖尿病合并慢性牙周炎患者与无糖尿病的牙周炎患者龈下菌斑微生物构成。方法：12名患者分为糖尿病合并慢性牙周炎组（T2DM＋CP组）与慢性牙周炎组（CP组）2组,各6人。记录所有患者基本信息及牙周临床参数,包括年龄、性别、探诊深度和附着丧失。根据探诊深度和附着丧失取患病位点的菌斑样本。PCR检测7种牙周可疑致病菌。采用DGGE分离扩增的16SrDNA片段。结果：两组结果显示两组牙周参数无显著差异。两组7种细菌检出率相似。所有对象中均检出牙龈卟啉单胞菌、福塞坦氏菌、齿垢密螺旋体和中间普氏菌,而具核梭杆菌在两组中均有一个样本未检出。变黑普氏菌在T2DM＋CP组的2个样本中检出,而CP组有4个样本检出。伴放线共聚菌在所有样本中均未检测到。DGGE分析结果示两组间条带数量及树状聚类分析均无显著差异。结论：Ⅱ型糖尿病合并牙周炎患者龈下菌斑的牙周可疑致病菌的检出情况以及DGGE分析与无糖尿病患者相似。     

200例慢性牙周炎患者的病情调查

目的 调查城区职工中未经治疗的慢性牙周炎患者的疾病状况。方法 从北京城区某单位职工中筛选出未经治疗的慢性牙周炎患者200例，检查除第三磨牙外的全口牙、6个住点／牙的牙周情况，指标为探诊深度、附着丧失、探诊后出血。结果 附着丧失程度随患者的年龄增长而加重，男性的附着丧失重于女性，探诊出血位点的附着丧失重于不出血住点。在全口牙中，下切牙和上颌第一磨牙的附着丧失最多。结论 慢性牙周炎的程度与年龄、性别、牙龈炎症有关，病变的分布有牙位特异性。     

牙周袋内挥发性硫化物与牙周炎症程度的关系

目的初步探讨牙周袋内挥发性硫化物与侵袭性牙周炎(aggressive periodontitis,AgP)和慢性牙周炎(chronic periodontitis,CP)炎症程度的关系。方法用金刚牙周探针诊断仪检查探诊深度、附着丧失、探诊出血等临床指标的同时,检测牙周袋内硫化物水平。共检查15例AgP和16例CP患者870个患牙的5 220个位点。结果无论是AgP还是CP患者,硫化物阳性位点的各项临床指标均明显高于阴性位点(P<0.001);硫化物水平与各项临床指标间都有明显的正相关关系(P<0.001);中、深袋组的硫化物水平和阳性位点率均明显高于浅袋位点(P<0.001);有附着丧失位点的硫化物水平和阳性位点率均高于无附着丧失位点,在浅袋组其差异有显著性。结论牙周袋内挥发性硫化物的检测可以反映侵袭性牙周炎和慢性牙周炎患者的牙周炎症程度。     

纸尖法和刮匙法对龈下牙周致病菌检出比较研究

目的：比较纸尖法和刮匙法对慢性牙周炎患者龈下菌斑中牙龈卟啉单胞菌、福赛斯坦纳菌、伴放线菌嗜血菌、具核梭杆菌检出的影响。方法：对30例慢性牙周炎患者分别用纸尖和刮匙法收集4个区域牙周袋探诊最深位点龈下菌斑，采用16SrRNAPCR方法检测两种方法收集到的龈下菌斑样本中的牙龈卟啉单胞菌、福赛斯坦纳菌、伴放线菌嗜血菌、具核梭杆菌。结果：两种方法一致性较好，纸尖法与刮匙法无显著差异（P〉0．05）。结论：纸尖法与刮匙法均为比较准确的取样方法。     

牙龈卟啉单胞菌毒力岛基因检出与慢性牙周炎的相关性研究

目的:检测慢性牙周炎患者龈下菌斑中牙龈卟啉单胞菌(Porphyromonas gingivalis)毒力岛中PG0836、PG0838和PG0839基因,探讨3个基因与临床牙周指数之间的关系.方法:选取慢性牙周炎(chronic periodoiltitis,CP)患者90例,共采集龈下菌斑标本270个.记录受试位点的牙周探诊深度、临床附着丧失和探诊出血情况.设计特异性引物,检测P.gingivalis阳性龈下菌斑标本的PG0836、PG0838和PG0839基因.采用SPSS 11.0软件包进行统计学分析,采用X2检验对不同牙周临床指数基因的检出率进行比较.结果:在CP患者P.gingivalis阳性龈下菌斑中,PG0836、PG0838和PG0839基因检出率分别为66.17%、24.88%和27.86%.探诊出血阳性位点的PG0839基因检出率(28.35%)显著高于探诊出血阴性位N(14.29%,P<0.05).在牙周探诊深度为4～6mm和>6mm的受试位点,PG0839基因检出率均显著高于牙周探诊深度<4mm的位点(P<0.05).PG0836和PG0838基因在不同牙周指数组检出率无显著差异.结论:PG0839基因的检出与CP病损部位的临床指标呈正相关关系,提示该基因可能与P.gingivalis的致病性有关.     

Detection of major putative periodontopathogens in Korean advanced adult periodontitis patients using a nucleic acid-based approach

BACKGROUND: Although extensive microbial analyses have been performed from subgingival plaque samples of periodontitis patients, systematic analysis of subgingival microbiota has not been carried out in a Korean population so far. The purpose of this study was to describe the prevalence of major putative periodontopathogens in Korean patients by culture-independent methods. METHODS: A total of 244 subgingival plaque samples (5 sites in each participant) were taken from 29 advanced adult periodontitis (AP) patients and 20 periodontally healthy subjects. AP samples were obtained from the 4 deepest periodontal pockets (> or =6 mm probing depth [PD]) and 1 healthy site (< or =3 mm PD) in each patient. Polymerase chain reaction (PCR) of 16S ribosomal DNA (rDNA) of subgingival plaque bacteria was performed with eubacterial primers. Aliquots of PCR products were then applied on nylon membranes and hybridized with specific oligonucleotide probes labeled with digoxigenin. RESULTS: All diseased sites harbored Fusobacterium sp., while Porphyromonas gingivalis, Treponema sp., and Bacteroides forsythus were detected in more than 96% of 116 diseased sites. Peptostreptococcus micros, Actinobacillus actinomycetemcomitans, and Prevotella intermedia were present in 82%, 74%, and 71% of diseased sites, respectively. In sites of periodontally healthy subjects, Fusobacterium sp. was present in the highest proportion (58%). Treponema sp., P. gingivalis, and B. forsythus were detected in 22%, 18%, and 18% of healthy sites, respectively. P. micros, P. intermedia, and A. actinomycetemcomitans were found in 8%, 2%, and 1% of healthy sites, respectively. The prevalence of the periodontopathogens, with the exceptions of Fusobacterium sp. and B. forsythus, was significantly higher in the healthy sites of periodontitis subjects than in the healthy sites of periodontally healthy subjects (P <0.05). CONCLUSIONS: Using highly sensitive methods relying on 16S ribosomal RNA-based oligonucleotide probes, we confirmed the strong association of 7 putative periodontopathogens with AP patients in a Korean population. With the exceptions of Fusobacterium sp. and B. forsythus, all the periodontopathogens were significantly more associated with the healthy sites of periodontitis subjects than in the healthy sites of periodontally healthy subjects.     

Clinical and microbiological profiles of human immunodeficiency virus (HIV)-seropositive Brazilians undergoing highly active antiretroviral therapy and HIV-seronegative Brazilians with chronic periodontitis

BACKGROUND: This study compares the periodontal clinical profile and the composition of the subgingival microbiota of human immunodeficiency virus (HIV)-seropositive and HIV-seronegative subjects with chronic periodontitis. METHODS: A total of 172 subjects were distributed into two HIV-seropositive groups (37 chronic periodontitis [H+CP+] and 35 periodontally healthy [H+CP-] individuals) and two HIV-seronegative groups (49 chronic periodontitis [H-CP+] and 51 periodontally healthy [H-CP-] subjects). Subgingival samples were collected from six sites with the deepest probing depth in the periodontitis groups and six random sites in the groups with periodontal health. All HIV-infected patients had undergone highly active antiretroviral therapy (HAART) for at least 2 years. The presence and levels of 33 bacterial species were detected by DNA probes and the checkerboard method. Kruskal-Wallis and Mann-Whitney tests were used to seek for significant differences among and between groups. RESULTS: H-CP+ patients showed significantly more periodontal destruction and inflammation than H+CP+ patients, whereas H+CP- subjects presented a greater percentage of sites with bleeding than H-CP- subjects (P <0.01). Patients who were HIV seronegative showed higher prevalence and levels of most bacterial species than HIV seropositive patients. Periodontal pathogens including Tannerella forsythensis, Porphyromonas gingivalis, Prevotella nigrescens, Eubacterium nodatum, Fusobacterium nucleatum, and Selenomonas noxia were more frequently detected in H-CP+ subjects compared to H+CP+ and controls. In contrast, Enterococcus faecalis and Acinetobacter baumannii were more commonly found in HIV-infected than in non-HIV-infected subjects (P <0.05). CONCLUSION: Putative periodontal pathogens are more prevalent in the subgingival microbiota of HIV-seronegative patients with chronic periodontitis, whereas species not usually associated with periodontitis are detected in higher frequency in HIV-seropositive subjects under HAART.     

HHV-6, HHV-7, HHV-8 in gingival biopsies from chronic adult periodontitis patients. A case-control study

BACKGROUND: Recent reports have suggested that various herpesviruses may be involved in the occurrence and progression of different forms of periodontal disease. OBJECTIVE: The objective of the present study was to investigate the presence of the novel herpesviruses HHV-6, HHV-7 and HHV-8 in gingival biopsies from patients affected by chronic adult periodontitis. As control, gingival biopsies from periodontally healthy subjects were analysed. MATERIALS AND METHODS: Gingival biopsies were harvested from 23 volunteers: 13 patients affected by chronic adult periodontitis (CAP) and 10 periodontally healthy subjects. Each CAP patient contributed two biopsies involving the epithelium and connective tissue facing the sulcus/periodontal pockets: one biopsy from a site having a probing pocket depth (PPD) > or =5 mm and presenting with bleeding upon probing (affected site) at the time of biopsy collection, and the other biopsy from a site with PPD< or =3 mm and without bleeding on probing (nonaffected site). After DNA extraction, nested PCR was used in herpesvirus identification. RESULTS: HHV-6 DNA sequences were detected in one non-affected site (8%) and no affected sites (0%) of CAP patients. One biopsy (10%) in healthy subjects revealed HHV-6 positivity. Tissue specimens in 10/13 CAP patients (77%) and 7/10 healthy subjects (70%) contained HHV-7 DNA. HHV-7 prevalence in affected and nonaffected sites of CAP patients was 77% and 54%, respectively. HHV-8 was detected in 7.7% of CAP patients and 0% of healthy subjects. CONCLUSIONS: Gingival tissue may act as a reservoir for HHV-7. A high prevalence of HHV-7 was detected in both periodontally diseased and healthy individuals. The prevalence of HHV-6 and -8 was similarly low in both groups. Our data do not support an association of investigated herpesvirus species with destructive periodontal disease.     

Association of T CD4 lymphocyte levels and chronic periodontitis in HIV-infected brazilian patients undergoing highly active anti-retroviral therapy: clinical results

BACKGROUND: Controversial data regarding the association between immunosuppression and prevalence/ severity of periodontal diseases in HIV infection have been reported. Thus, the aim of this study was to test the hypothesis that lower T CD4 lymphocyte levels are not related to a higher prevalence of chronic periodontitis in HIV-infected Brazilians undergoing highly active anti-retroviral therapy (HAART). METHODS: Sixty-four HIV-infected patients under HAART were classified as having chronic periodontitis; i.e., > or = three sites with probing depth (PD) and/or clinical attachment level (CAL) > or = 5 mm or periodontal healthy (no sites with PD > 3 mm and/or CAL > 4 mm). All subjects received conventional periodontal therapy. Bleeding on probing, plaque accumulation, PD, and CAL were registered at six sites/tooth at baseline and 4 months after therapy. Epidemiological features and levels of T CD4 lymphocytes were obtained from medical records. Significance of differences in periodontal clinical parameters within and between groups were determined using Wilcoxon signed-rank and Mann-Whitney or independent sample t tests. Associations between T CD4 levels and clinical parameters were determined using the chi square test. RESULTS: Sixty-one percent of the HIV-infected patients represented AIDS cases, although 69% of them were periodontally healthy. The overall T CD4 lymphocyte mean levels was 333 +/- 254 cells/mm3 and viral load was 12,815 +/- 24,607 copies/mm3. Yet the prevalence of chronic periodontitis was relatively low (36%). In addition, patients with periodontitis presented a moderate disease (mean PD = 2.2 +/- 0.10; mean CAL = 2.6 +/- 0.13) and responded successfully to periodontal therapy. These subjects showed higher levels of T CD4 cells, but lower counts of neutrophils than periodontally healthy patients. Among periodontally healthy and chronic periodontitis patients, 41.7% and 22.9%, respectively, had low levels of T CD4 lymphocytes. No significant differences between periodontal status and epidemiological and immunological parameters were observed. CONCLUSION: Based on these results, the hypothesis that lower T CD4 lymphocyte levels are not associated with higher prevalence of chronic periodontitis in HIV-infected Brazilians under HAART cannot be rejected.     

Clinical and microbiological effect of scaling and root planing in smoker and non-smoker chronic and aggressive periodontitis patients

OBJECTIVES: To compare the effects of scaling and root planing (SRP) on clinical and microbiological parameters at selected sites in smoker and non-smoker chronic and generalized aggressive periodontitis patients. MATERIALS AND METHODS: Clinical parameters including probing depth (PD), relative attachment level (RAL), and bleeding upon probing (BOP), and subgingival plaque samples were taken from four sites in 28 chronic periodontitis (CP) and 17 generalized aggressive periodontitis (GAgP) patients before and after SRP. Polymerase chain reaction assays were used to determine the presence of A. actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythensis, Prevotella intermedia and Treponema denticola. RESULTS: Both CP and GAgP non-smokers had significantly greater reduction in pocket depth (1.0+/-1.3 mm in CP smokers versus 1.7+/-1.4 mm in non-smokers, p=0.007 and 1.3+/-1.0 in GAgP smokers versus 2.4+/-1.2 mm in GAgP non-smokers, p<0.001) than respective non-smokers, with a significant decrease in Tannerella forsythensis in CP sites (smokers 25% increase and non-smokers 36.3% decrease, p<0.001) and Prevotella intermedia at GAgP sites (smokers 25% reduction versus 46.9% in non-smokers, p=0.028). CONCLUSION: SRP was effective in reducing clinical parameters in both groups. The inferior improvement in PD following therapy for smokers may reflect the systemic effects of smoking on the host response and the healing process. The lesser reduction in microflora and greater post-therapy prevalence of organisms may reflect the deeper pockets seen in smokers and poorer clearance of the organisms. These detrimental consequences for smokers appear consistent in both aggressive and CP.     

Relationship of Actinobacillus actinomycetemcomitans serotypes to periodontal condition: prevalence and proportions in subgingival plaque

No study available has utilized the new classification scheme (the consensus report of the American Academy of Periodontology 1999) to determine the prevalence of Actinobacillus actinomycetemcomitans in different periodontal conditions. The purpose of this study was to investigate prevalence and proportions of A. actinomycetemcomitans serotypes in subgingival plaque samples from a young Taiwanese population with aggressive periodontitis, chronic periodontitis and no periodontal disease. A total of 221 subgingival plaque samples from 171 diseased subjects (70 had aggressive periodontitis, and 101 had chronic periodontitis) (mean age 25.0 +/- 8.2 yr) and 50 periodontally healthy subjects (mean age 18.4 +/- 9.5 yr) were screened for A. actinomycetemcomitans. Serotypes of A. actinomycetemcomitans were determined by an indirect immunofluorescence assay using serotype-specific polyclonal antisera to A. actinomycetemcomitans strains ATCC 29523 (serotype a), ATCC 43728 (serotype b) and ATCC 33384 (serotype c). Prevalence (% of positive samples) of A. actinomycetemcomitans was 84.3% in aggressive periodontitis, 60.4% in chronic periodontitis, and 64.0% in periodontally healthy subjects. Proportions of A. actinomycetemcomitans (mean percentage per total bacteria) in periodontally healthy subjects were significantly lower than in aggressive periodontitis subjects. The proportion of serotype b in subjects with aggressive periodontitis and subjects with chronic periodontitis were significantly greater than that in periodontally healthy subjects. The proportion of serotype c in periodontally healthy subjects was much higher than that in chronic periodontitis subjects. The results of this study suggest that prevalence and proportions of A. actinomycetemcomitans are significantly greater in patients with aggressive periodontitis than in those with chronic periodontitis. Serotype b is the predominant serotype of A. actinomycetemcomitans in patients with diseased periodontal conditions. Serotype c is a more common serotype detected in periodontally healthy subjects.     

Clinical responses to mechanical periodontal treatment in Chinese chronic periodontitis patients with and without Actinobacillus actinomycetemcomitans

BACKGROUND: The purpose of this study was to compare 12-month clinical responses to mechanical periodontal treatment in Chinese chronic periodontitis patients at sites with and without Actinobacillus actinomycetemcomitans at baseline, and to investigate the ability of mechanical periodontal treatment to eliminate A. actinomycetemcomitans. METHODS: Nineteen patients and a total of 76 selected sites with a mean probing depth (PD) of > or = 7 mm were studied. Whole mouth presence or absence of supragingival plaque (PI%), bleeding on probing (BOP%), probing depth (PD), and probing attachment level (PAL) were recorded at six sites per tooth at baseline and after 3, 9, and 12 months. Baseline subgingival plaque samples were taken from the deepest PD site in each quadrant using sterile paper points and were cultured on TSBV plates for 5 days in a 5% CO2-air incubator. All sites received mechanical periodontal treatment, which included oral hygiene instructions and supragingival and subgingival instrumentation with or without surgical access, with maintenance care being provided once every 3 months thereafter. RESULTS: At baseline, A. actinomycetemcomitans was isolated in 13 of the 19 subjects (68%) and in 29 out of the 76 sampled sites (38%). At the end of 12 months, in three of the initially A. actinomycetemcomitans-positive subjects, A. actinomycetemcomitans was not detected in the sampled sites, while one subject, in whom A. actinomycetemcomitans was not initially found at the sampled sites was A. actinomycetemcomitans-positive at 12 months. Multi-level variance component models showed there was no statistically significant difference in all clinical parameters between A. actinomycetemcomitans-positive and -negative subjects (P > 0.05). In the sampled sites of the initially A. actinomycetemcomitans-positive subjects, the mean PD was reduced from 7.6 +/- 1.6 mm to 3.2 +/- 1.8 mm, the mean PAL gain was 1.4 +/- 2.0 mm, and the mean recession was 3.0 +/- 2.3 mm. The corresponding figures in the sampled sites of the initially A. actinomycetemcomitans-negative subjects were 7.5 +/- 1.6 mm to 2.7 +/- 1.0 mm, 2.3 +/- 2.6 mm and 2.4 +/- 2.2 mm for mean PD changes, PAL gain, and mean recession, respectively. CONCLUSIONS: Favorable clinical responses to mechanical periodontal therapy may occur in Chinese chronic periodontitis patients at sites infected with A. actinomycetemcomitans. The mere detection of subgignival A. actinomycetemcomitans does not necessarily imply poorer treatment outcomes in the control of chronic periodontitis.     

伴放线放线杆菌在龈下菌斑和颊黏膜分布研究

目的:比较伴放线放线杆菌(actinobac illus actinomycetem com itans,A.a)在不同类型牙周炎患者龈下菌斑和颊黏膜中的分布。方法:通过聚合酶链反应(polym erase chain reaction,PCR)对侵袭性牙周炎患者(AgP)、慢性牙周炎患者(CP)、牙周健康者口腔龈下菌斑和颊黏膜中的A.a进行检测,分析该菌分别在两部位的相对含量。结果:AgP组菌斑和颊黏膜样本中A.a阳性检出率均为41.7%,分别高于CP组(菌斑16.7%、颊黏膜10.0%)和牙周健康组(菌斑和颊黏膜均为0%)。AgP组A.a在菌斑和颊黏膜的相对含量分别为38.5%和22.2%,高于CP组(菌斑19%、颊黏膜12.75%)。结论:A.a不仅存在于龈下菌斑中,也能够粘附于颊黏膜;A.a是AgP的主要优势菌也参与了CP的菌群组成。     

Detection of putative periodontal pathogens in non-insulin-dependent diabetes mellitus and non-diabetes mellitus by polymerase chain reaction

It has been assumed that there is a relationship between periodontal diseases and diabetes mellitus, however the putative periodontal microorganisms in non-diabetes mellitus (non-DM) individuals and non-insulin-dependent diabetes mellitus (NIDDM) patients have not been well studied. In this study, the detection rates of 5 putative periodontal pathogens: Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Eikenella corrodens, Treponema denticola, and Candida albicans by polymerase chain reaction (PCR) between NIDDM and non-DM adults were compared. A total of 246 adults were randomly recruited and periodontal parameters including: plaque index (P1I), gingival index (GI), probing depth (PD) and attachment level (AL) were recorded. Subgingival plaque samples were collected by sterile curettes from the most diseased and healthy sites based on PD and AL. The differences in periodontal parameters and microbiological data in healthy and diseased sites between non-DM and NIDDM patients were compared by chi-square analysis. The results showed no significant differences in age, gender, GI, P1I, PD, and prevalence of the 5 microorganisms between the NIDDM and the non-diabetic groups. However, except for A. actinomycetemcomitans, the prevalence of the periodontal microorganisms tested was significantly higher (p <0.001) in diseased sites than in the healthy sites in both groups. The P1I, GI, PD and AL were significantly higher in T. denticola positive sites than in negative sites. The results suggested that P. gingivalis, T. denticola, E. corrodens and C. albicans may play important roles in the periodontitis of both NIDDM and non-DM individuals, however the etiology of periodontitis in both groups may not be different from each other.     

慢性牙周炎患者与牙周健康患者种植修复疗效的对比与分析

目的研究种植术后3 ~ 4年慢性牙周炎患者与牙周健康患者的种植疗效差异。 方法选择符合纳入标准的慢性牙周炎患者22例,共植入48枚种植体,选择符合纳入标准的牙周健康患者25例,共植入34枚种植体,观察植入后3 ~ 4年种植体周围情况,测量种植体边缘牙槽骨吸收（MBL）情况,记录改良出血指数（mBI）、牙周探诊深度（PD）、种植体存留率,并采用非参数检验Mann-Whitney检验进行统计学分析。 结果慢性牙周炎组与牙周健康组均获得100%的种植体存留率。慢性牙周炎组的MBL为[（0.25 ± 0.56）mm],与牙周健康组[（0.34 ± 0.49）mm]相比较差异无统计学意义（U = 730,P = 0.416）。慢性牙周炎组与牙周健康组的PD分别为（1.63 ± 0.78）和（1.49 ± 0.62）mm,差异无统计学意义（U = 901,P = 0.415）。 结论慢性牙周炎患者种植3 ~ 4年时观察种植效果与牙周健康患者无明显差别,慢性牙周炎患者种植修复仍可获得良好的疗效。