Experimental gingivitis in relation to susceptibility to periodontal disease

The aim of the present study was to investigate the rate of development of experimentally-induced gingival inflammation in relation to the susceptibility to periodontal disease. By selection according to age, a younger (25-39 years) and an older (45-54 years) age group, with a comparable reduced but healthy periodontium, was selected. This equal amount of periodontal breakdown may suggest that the younger age group represented individuals with a relatively higher degree of susceptibility to periodontal disease. At the start of the experiment, each patient was instructed to abstain from oral hygiene procedures in 1 quadrant of the mouth for a period of 18 days. Results showed that all subjects developed signs of gingival inflammation. Regarding the development of redness and swelling, no differences could be assessed between the 2 age groups. However, analysis of the bleeding scores revealed that bleeding on probing developed more rapidly in the younger age group. It was concluded that those patients who have suffered from a more rapid form of periodontal disease also develop inflammation, in terms of bleeding on probing, more rapidly.     

Modulation of clinical expression of plaque-induced gingivitis: response in aggressive periodontitis subjects

AIM: The aim of this study was to characterize the gingival inflammatory response to de novo plaque accumulation in subjects treated for aggressive periodontitis (AP). The gingival inflammatory response of the AP subjects was retrospectively compared with that of periodontally healthy individuals (PH) matched for exposure to plaque and of periodontally healthy subjects previously identified as "high responders" (HR) and "low responders" (LR). MATERIALS AND METHODS: 13 AP subjects and 26 matched PH subjects participated in a 21-day experimental gingivitis trial. Plaque index (PlI), Gingival index (GI), gingival crevicular fluid volume (GCF) and angulated bleeding score (AngBS) were recorded at days 0, 7, 14 and 21. Cumulative plaque exposure (CPE), i.e. PlI over time, was also calculated. RESULTS: GCF was significantly higher in AP compared with PH group at each observation interval (p< or =0.001). In addition, GCF was significantly higher in AP group compared with either LR or HR groups at each observation interval (p<0.001). CONCLUSIONS: These results suggest that susceptibility to gingival inflammation in response to de novo plaque accumulation may be related to susceptibility to periodontitis.     

Modulation of clinical expression of plaque-induced gingivitis. II. Identification of "high-responder" and "low-responder" subjects

AIM: The aims of this study were to validate a randomized, split-mouth, localized experimental gingivitis model and to identify subjects with different gingivitis susceptibility. MATERIAL AND METHODS: In each of 96 healthy subjects, one maxillary quadrant was randomly assigned as "test" (experimental gingivitis) and the contralateral quadrant as "control". Plaque index (PlI), gingival index (GI), gingival crevicular fluid volume (GCF), and angulated bleeding score (AngBS) were recorded in both quadrants at days 0, 7, 14, and 21. Cumulative plaque exposure (CPE), i.e. PlI over time, was calculated. Day-21 GCF was standardized according to CPE, and residuals of GCF on CPE were calculated. Two subpopulations were then defined, based on upper and lower quartiles of GCF-residual distribution and were, respectively, identified as "high-responder" (HR; n=24) and "low-responder" (LR; n=24). RESULTS: At test quadrants, all parameters significantly increased throughout the trial, while in control quadrants, PlI, GI, and AngBS remained low. Significant differences were noted between test and control quadrants on days 7, 14, and 21 for all parameters. Significant increases in GI, AngBS, and GCF were observed in test quadrants over the course of the study in both HR and LR groups. Significant differences were noted between HR and LR groups for all gingivitis parameters on day 21 in test quadrants, without any significant differences in PlI or CPE between the groups. CONCLUSIONS: We identified two subpopulations characterized by significant differences in clinical parameters of plaque-induced gingival inflammation, despite similar amounts of plaque deposits and plaque accumulation rates.     

Experimental gingivitis in periodontitis-susceptible subjects

Abstract The purpose of this study was to evaluate clinical, microbiological, and gingival crevicular fluid (GCF) profiles in periodontitis-resistant and periodontitis-susceptible subjects during 4 weeks of experimental gingivitis. Experimental groups of similar ages were defined as gingivitis controls (GC; n=10) and history of rapidly progressive periodontitis (RPP; n=10). respectively. Prior to baseline, all subjects achieved good plaque control (plaque index (P1I) ～0) and gingival health (gingival index (GI)=0). and had probing depths ≤4 mm on experimental teeth. For 4 weeks after baseline, oral hygiene around maxillary 2nd premolar and 1st molar teeth was inhibited by a plaque guard. The plaque guard was removed weekly for GCF sampling to determine interleukin (IL)-1β and prostaglandin (PG)E₂ amounts by ELISAs. In addition. PII. GI. probing depth, and gingival recession measurements were made. Subgingival plaque darkfield microscopy and DNA probe analysis also were performed. Results indicated that clinical signs of inflammation, microbiological patterns and GCF profiles progressed similarly in both groups. However, plaque accumulated more rapidly in the susceptible subjects. PII in RPP at 4 weeks was 2.1±0.1 compared to 1.5±0.2 in GC, with an incidence of PII>1 of 100% versus 50%, respectively (logistic regression; p<0.000l). Hence, the clinical, microbiological and host factors selected for this study were unrelated to previous susceptibility to periodontitis when evaluated in the experimental gingivitis model. However, the increased rate of plaque accumulation, following thorough plaque removal, in RPP patients suggests a potential factor in disease recurrence in these susceptible subjects.     

Experimental gingivitis in relation to susceptibility to periodontal disease II. Phase-contrast microbiological features and some host-response observations

In the present investigation, a number of histological and immunohistochemical characteristics of periodontal tissues as well as the phase-contrast microscopy of dental plaque were studied after experimentally-induced gingival inflammation in relation to susceptibility to periodontal disease. The study included a younger (mean age 34.1 years) and an older age group (mean age 48 years) with a reduced but healthy periodontium. Both age groups had the same amount of loss of attachment which may suggest that they had different degrees of susceptibility to periodontal disease. At the start of the experiment, each patient was instructed to abstain from oral hygiene in one quadrant of the mouth for a period of 18 days. At the end of the 18-day period, supra-gingival plaque and gingival tissue samples were taken. As determined by phase-contrast microscopy, the plaque samples of both age groups contained relatively high proportions of spirochetes. This may indicate that the patients are at risk for recurrence of periodontal breakdown. The general histopathologic picture of the gingival tissue samples of both age groups was similar to the so-called 'early lesion'. However, IgA-producing plasma cells were found in most tissue samples of both age groups. The first part of this study showed that the younger, in comparison to the older, patients developed inflammation in terms of bleeding on probing more rapidly. These clinical results cannot be explained by the host-parasite parameters investigated in the present study.     

Gengigel凝胶在菌斑性牙龈炎治疗中的作用

目的:观察局部应用Gengigel凝胶治疗菌斑性牙龈炎的临床疗效。方法:采用口内自身对照,选择菌斑性牙龈炎患者30例,每位受试对象口内每个象限选取至少2个磨牙和(或)前磨牙作为受试牙。4个象限分别给予洁治 用Gengigel凝胶(SG组),洁治(S组),用Gengigel凝胶(G组),空白对照(C组)等处理。观察治疗前及治疗后4d和7d的菌斑指数(PLI),牙龈指数(GI)和龈沟液流速(SFFR)的变化。结果:SG组的各项指标(除PLI外)下降显著快于S组(P<0.05);G组的各项指标下降显著快于C组(P<0.05)。结论:Gengigel凝胶辅助洁治术或单独使用Gengigel凝胶对菌斑性牙龈炎均有一定治疗效果。     

Oral microbiota in subjects with a weak or strong response in experimental gingivitis

Abstract. The purpose of the present study was to examine the composition of the oral microbiota in subjects who had previously demonstrated to develop either a weak or strong response to experimental gingivitis. For this study, subjects were selected from a pool of 25 individuals who had participated twice in an experimental gingivitis trial. Out of these 25 panellists, 6 subjects were selected who had developed 2× a weak gingival inflammatory response and 7 subjects who had developed 2× a strong gingival inflammatory response. Approximately 9 months after the 2nd experimental gingivitis trial, we evaluated the clinical condition and the prevalence of a panel of selected oral micro-organisms in these subjects. The subjects were clinically examined for the presence of plaque, bleeding, pocket depth and loss of attachment. For the microbiological evaluation, samples were taken from the mucous membranes, subgingival sites and saliva. Samples were analyzed for the presence of Actiilobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Peptostreptococcus micros. Actinomyces spp., Fusohacterium mucleatum, Campylobacter rectus , spirochaetes and motile rods. Clinical evaluation showed that most subjects had a relatively healthy periodontal condition. No clinically significant differences could be detected between the weak and strong responding groups. The microbial evaluation showed absence of A. actinomycetemcomitans, P. gingivalis and P. micros in all subjects in either group. Analysis of the microbial data for the weak and strong responding group showed no differences between the groups. This indicates that differences in response to experimental gingivitis are probably not caused by major differences in the compositon of the oral microbiota. The strong or weak inflammatory response may be related to differences in the microflora at the time of the experiments and/or differences in host response.     

Modulation of clinical expression of plaque-induced gingivitis. III. Response of "high responders" and "low responders" to therapy

AIM: The aim of the present study was to characterize the subject-based clinical behavior of the gingiva in response to a tooth-cleaning regimen in two subpopulations, "high-responder" (HR) and "low-responder" (LR) groups, presenting a different inflammatory response to plaque accumulation. MATERIAL AND METHODS: The study population comprised of 96 systemically and periodontally healthy subjects, 46 males and 50 females, non-smokers, enrolled in an experimental gingivitis trial. At completion of the experimental gingivitis period (day 21), all subjects were prescribed the same 21-day treatment regimen of amine/stannous fluoride (AmF/SnF(2))-containing toothpaste and mouthrinse. Plaque index (PlI), gingival index (GI), gingival crevicular fluid volume (GCF), and angulated bleeding score (AngBS) were recorded on three selected teeth. Treatment efficacy was evaluated in the overall population as well as in HR and LR groups, separately. RESULTS: A statistically significant decrease of PlI was observed after treatment (p<0.001), with PlI reversing to baseline levels. Changes in PlI revealed the same trend in both HR and LR groups, without differences between groups. Treatment also resulted in a significant decrease of all gingivitis parameters (p<0.001 for all comparisons). After treatment, GI, AngBS, and GCF were comparable with baseline condition. However, when the two groups were compared, day 42-GCF was significantly higher in the HR group than the LR group. CONCLUSIONS: A treatment regimen based on mechanical plaque control supplemented with AmF/SnF(2)-containing toothpaste and mouthrinse is effective in reducing plaque accumulation and re-establishing healthy gingival conditions after experimentally induced gingivitis, even in subjects with different inflammatory response to plaque accumulation.     

The optimization of the BANA test as a screening instrument for gingivitis among subjects seeking dental treatment

Abstract Porphyromonas gingivalis, Treponema denticola and Bacteroides forsythus have been implicated in periodontal disease and each possesses an enzyme capable of hydrolyzing the synthetic trypsin substrate, BANA. We have used a chairside test for BANA hydrolysis to diagnose an anaerobic periodontal infection in patients with advanced forms of clinical disease using a 15-min/55°C incubation protocol. However, the BANA test performance is dependent upon the length and temperature of incubation. In the present study, we have evaluated a 5-min/35°C. a 5-min/55°C and a 15-min/55°C incubation protocol to determine whether the performance of the BANA test could be optimized using plaque samples obtained from subjects seeking dental treatment. Logistic regression models were tested with age, smoking status, and gingivitis scores as covariates. The best fitting model obtained with the 5-min/35°C protocol had a sensitivity of 71%, a specificity of 68%, a false-positive proportion of 9%, a false-negative proportion of 65%, and an overall accuracy of 80%. When maximum likelihood estimates were obtained in this model, plaques from individuals who reported that they currently smoked were 9.57×, and those who quit smoking were 4.73× more likely to have a positive BANA score than someone who never smoked. Plaques were 4.55× more likely to be BANA-positive if they were removed from sites with gingivitis. These findings indicate that the performance of the BANA test is best using the 5-min/35°C incubation protocol.     

Comparison of different approaches to assess bleeding on probing as indicators of gingivitis

Abstract. The purpose of this study was to evaluate different methods of eliciting gingival bleeding as indicators of gingival inflammation in the experimental gingivitis model. Following a period of stringent oral hygiene, 103 dental students were scored for plaque and gingival bleeding assessed by 4 methods. From this group, 41 volunteers were randomly allocated to 2 treatment groups. Dental students with clean teeth and healthy gingivae were asked to abolish all mechanical tooth cleaning in the lower jaw for a period of 3-weeks. During the 21-day experimental period, chlorhexidine (Peridex®) or a placebo mouthrinse was applied to the lower jaw. Subjects brushed the upper jaw with a standard toothpaste. In principal, 2 different methods were employed to provoke bleeding: (1) at the marginal gingival tissue by running a probe along the soft tissue wall at the orifice of the pocket, and (2) by probing to the "bottom" of the pocket. Variations in the methods were based on angulation (AngBI, ParBI) of the probe in relation to the tooth surface and to the probing force (PPBI.25N, PPBI.757V). 1 randomly selected quadrant in the lower jaw was scored using the AngBI. The opposing quadrant was scored with a randomly-allocated bleeding index, either ParBI, PPBI.25 N or PPBI.75 N . The results of this study confirm earlier findings that the angulation of the probe determines the number of sites with bleeding observed. It also indicates that bleeding as elicited by probing to the bottom of the pocket is a poor indicator of early gingivitis. It is recommended that gingivitis should be assessed by probing the marginal gingiva.     

Role of IL-6, TNF-A and LT-A variants in the modulation of the clinical expression of plaque-induced gingivitis

AIM: The purpose of the present study was to assess the association of interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-A) and lymphotoxin alpha (LT-A) gene polymorphisms with the clinical parameters of gingivitis in a large experimental gingivitis trial and with each of two subgroups, "high responder" (HR, n=24) and "low responder" (LR, n=24), with distinct susceptibility to gingivitis. MATERIAL AND METHODS: Ninety-six systemically and periodontally healthy non-smokers, 46 males (mean age: 23.9+/-1.7) and 50 females (mean age: 23.3+/-1.6), were included in a randomized split-mouth localized 21-day experimental gingivitis trial. Plaque index, gingival index, gingival crevicular fluid volume and angulated bleeding score were recorded. HR and LR subgroups were characterized by substantially different severities of gingival inflammation despite a similar plaque accumulation rate. All subjects were genetically characterized for IL-6(-174), IL-6(-597), TNF-A(-308) and LT-A(+252) polymorphisms. RESULTS: None of the variants analysed, either as single polymorphisms or as a combined genotype, was associated with the clinical parameters in the overall population. For the polymorphisms studied, genotypic distributions in HR and LR subjects were not significantly different. CONCLUSIONS: The present results suggest an absence of association between IL-6, TNF-A and LT-A polymorphisms and subject-based clinical behaviour of the gingiva in response to de novo plaque accumulation.     

Aberrant blastogenic response to LPS in experimental gingivitis of elderly subjects

Abstract – The blastogenic response of peripheral blood leukocytes to lipopolysaccharide (LPS), phytohemagglutinin (PHA) and LPS/PHA mixtures was followed over a short course of experimental gingivitis in elderly subjects (65–81 years) who strictly avoided oral hygiene procedures for periods up to 9 d. The leukocytes responded poorly to LPS, PHA and to LPS/PHA combinations. The concomitant heightened sensitivity of the gingiva to dental plaque among the elderly subjects may relate to the altered leukocyte response in this age group.     

Clinical and microbiological findings in elderly subjects with gingivitis or periodontitis

Abstract. The objective of the present study was to study the supra- and subgingival microflora by culture and cDNA probe methods in 20 elderly subjects who were between 62 and 93 years of age, 10 of them had gingivitis only, and 10 had periodontitis. B. forsythus (BF). P. gingivalis (PG), P intermedia (PI), P. nigrescens (PN), A. actinomycetemcomitans (AA), T. denticola (TD), and pathogen-related oral spirochetes (PROS) were studied. Oral hygiene was similar and poor in both groups. The mean probing depth at sample sites was 6.7 mm (S.D±1.3) in the periodontitis group and 2.2 mm (S.D.±1.5) in the gingivitis group (F=17.75, p < 0.001). Mean clinical attachment levels (CAL) were 4.3 mm (S.D.±2.0) and 1.7 mm (S.D.±0.9) respectively (p < 0.001). Total viable counts >1.0×10⁵ in supra-gingival plaque samples were found in all periodontitis and in eight gingivitis subjects, 70× more black-pigmented organisms were found in supra-gingival and 185 times more in sub-gingival plaque from the periodontitis group (p < 0.01). Culture data showed P nigresecens in 10% periodontitis and 50% gingivitis subjects (p < 0.03). In supra-gingival samples by the Affirm? DP test, BF was present in 50% periodontitis and 60% gingivitis while culture data were negative for all subjects, PG was found in 30%. periodontitis and 50% gingivitis subjects with TD in 70% periodontitis and in 30% gingivitis subjects. In the ub-gingival plaque samples 80% periodontitis and 70% gingivitis subjects had >1×10⁵ anaerobes. The total count of black-pigmented organisms was significantly greater in the periodontitis elders (p < 0.001). cDNA probes by the Affirm? DP test identified subgingival presence of BF (80%) PG (80%), PI(80%), AA (0%), TD (50%) in periodontitis subjects with BF (70%), PG (40%), PI (30%) and TD (20%) in gingivitis subjects. PROS were found in (80%) samples from periodontitis and in (60%) of gingivitis elderly. Only the quantities of PI (r=0.48, p < 0.01) and TD (r=0.37, p < 0.01) were associated with the disease definition. The smoking habit in the periodontitis group was significantly higher (p < 0.01). A history of smoking may contribe significantly to periodontitis in the presence of pathogens.     

Serum antibody titers to Bacteroides forsythus in elderly subjects with gingivitis or periodontitis

BACKGround: The risks for periodontal disease appear to increase with age. STUDY PURPOSE: To determine associations between clinical findings, the presence of specific bacteria in periodontal pockets, and serum antibody titers. 10 older subjects (mean age=73.0 years SD+/-4.9) with confirmed gingivitis only (gingivitis group) and 10 subjects with periodontitis (mean age: 76.1 years, SD+/-10.4) (periodontitis group) were studied. RESULTS: The mean group differences for probing depth and clinical attachment levels were 4.1 mm and 5.6 mm, respectively, and were significantly different (p<0.001). Both groups had high plaque scores (>60% surfaces with plaque). DNA probes demonstrated that B. forsythus was present in 8/10 samples from the periodontitis group and in 7/10 samples from the gingivitis group. The B. forsythus isolates studied were found in four of the subjects with periodontitis and from 2 of the subjects with gingivitis. Serum antibody titers to 6 ribotypes of B. forsythus were studied. Western blots, gradient gels, and pulsed field gel electrophoresis concurrently demonstrated that the B. forsythus isolates were genotypically, and phenotypically unique for each subject. Antibody titers to two selected B. forsythus isolates were significantly higher in the periodontitis group (p<0.01, Mann-Whitney test). The study confirmed that antibody serum titers to the six different ribotypes of B. forsythus varied greatly between older individuals with gingivitis or periodontitis. Not all strains of B. forsythus elicited higher titers in periodontitis affected subjects. CONCLUSIONS: The results of the present study suggest genotype variation of B. forsythus that is unique to the individual and that serotype variation can be expected. It is possible that B. forsythus under specific host conditions can modulate surface antigen factors to evade the host immune response.     

Serum IgG reactivity to subgingival bacteria in initial periodontitis, gingivitis and healthy subjects

BACKGROUND/AIMS: Established periodontal diseases may be associated with antibody responses to periodontal pathogens, but it is not known at which stage of disease this antibody response is initiated. This study aimed to characterize the host systemic response in initial periodontitis, gingivitis, and periodontal health, to evaluate whether elevated serum antibodies to subgingival species could be detected in initial periodontitis. METHOD: Human systemic immune response were evaluated to 40 subgingival bacterial species in 16 healthy, 21 gingivitis, 11 initial periodontitis and 5 progressing recession adults. Subjects had minimal periodontal attachment level (AL) loss at baseline. Disease categories were determined after 12 months monitoring at three-month intervals. Increased AL loss > or = 1.5 mm (disease activity) at interproximal sites defined initial periodontitis, recession was characterized by AL loss at buccal sites. Serum IgG antibodies were evaluated semi-quantitatively by immunoblot from blood taken at baseline, active and final visits. RESULTS: No antibody was detected from 55% of reactions. When detected, levels were below those reported for advanced periodontitis subjects. There were no major differences in serum antibody levels between healthy, gingivitis and initial periodontitis subjects, despite differences in the subgingival microbiota. Serum antibodies for more species were detected in recession subjects, compared with the other study subjects. No changes in antibody levels were detected between baseline, active, and final visits. No systematic association between species colonization and presence of systemic antibody was observed. CONCLUSIONS: This study did not detect differential elevation of mean serum antibody levels in initial periodontitis subjects, suggesting that serum antibody levels are not sensitive risk markers for initial periodontitis.     

Desquamative gingivitis responding to treatment with tetracycline: a pilot study

Abstract – We experienced remarkable regression of clinical signs and symptoms in three patients suffering from desquamative gingivitis, after treatment with 100 mg doxycycline monohydrate daily for 8 wk. The possible role of plaque substances as etiologic factors in the development or maintenance of desquamative gingivitis is postulated.     

Novel pathogenic role of fibrin as revealed by a case study on ligneous gingivitis

Purpose of the researchLigneous gingivitis is a rare disease characterized by nodular gingival enlargement secondary to fibrin deposits induced by micro-injury in the gingiva, which disorder results from plasminogen (PLG) deficiency. Although none have investigated the association of wound healing factors with ligneous gingivitis. In this study, in addition to a histopathologic examination of ligneous gingivitis in a case of type I PLG deficiency, we further present data showing the effect of wound healing factors in association with fibrin in vitro to clarify the pathobiology of ligneous gingivitis in PLG-deficient patients.Principle resultsImmunohistochemical analysis revealed that transforming growth factor (TGF)-β1, connective tissue growth factor/CCN2 (CCN2), and endothelin-1 (ET-1) had accumulated in the extracellular matrix around the epithelial and fibroblastic cells near the fibrin deposition. Consistent with these results, fibrin and TGF-β1 synergistically up-regulated CCN2 and ET-1 gene expression in human dermal fibroblasts.Major conclusionsFibrin plays a vicious role in ligneous gingivitis pathobiology by up-regulating CCN2 and ET-1 expression through the TGF-β signaling pathway.     

全冠修复后重度龈炎患者基因型对IL-1表达的影响

目的：探讨全冠修复后重度龈炎患者基因型对白细胞介素1（interleukin-1,IL-1）表达的影响。方法：根据龈沟出血指数选取重度龈炎组50名,采用37名健康志愿者对照。分离外周血单个核细胞（PBMC）,1ug/ml脂多糖（LPS）刺激培养24h后测IL-1含量。结果：重度龈炎组的IL-1ra浓度和IL-1β/IL-1ra比值较健康对照组有显著性差异（P〈0.05）。与I/I基因型相比较,IL-1RN内含子2等位基因Ⅱ、IL-1RN内含子2和IL-1B＋3953复合等位基因Ⅱ携带组的IL-1ra浓度和IL-1β/IL-1ra比值差异有显著性（P〈0.01）。结论：IL-1RN内含子2等位基因Ⅱ通过影响IL-1ra的表达从而在全冠修复后重度龈炎中发挥重要作用。     

Gingival crevicular fluid inflammatory mediators and bacteriology of gingivitis in nonhuman primates related to susceptibility to periodontitis

The hypothesis to be tested was that the microbiota and resulting local host inflammatory response characteristics in oral conditions of high levels of chronic gingival inflammation increases susceptibility to progressing periodontitis. This study used cynomolgus monkeys, Macaca fascicularis (nonhuman primates), with high and low levels of long-standing gingival inflammation to define the profiles of gingival crevicular fluid mediators, cytokines and immunoglobulins; describe the subgingival microbiota; and evaluate their susceptibility to ligature-induced periodontitis. Sixteen nonhuman primates were stratified into two groups (HI, LO) based upon Bleeding Index as a measure of the natural level of inflammation (HI = 1.26 +/- 0.45; LO = 0.22 +/- 0.16). The host mediator levels, subgingival microbiota, and clinical characteristics of the LO and HI groups were compared after 30 days of oral hygiene, during a 30 day experimental gingivitis (7, 14, and 30 days), and during periodontitis (30, 60, and 90 days). The results demonstrated that nonhuman primates with high levels of long-standing gingival inflammation when compared to those nonhuman primates with low inflammation show: 1) different inflammatory mediator profiles in gingival crevicular fluid (particularly for immunoglobulin A (IgA) and IgG levels), 2) a different quantitative and qualitative subgingival microbiota; and 3) a similar progression of periodontitis. Thus, while variations in host inflammatory responses to local factors exist in the nonhuman primates, an extensive subgingival challenge (such as ligation) may negate these individual differences.     

吸烟对牙龈炎患者和健康人龈沟液中弹性蛋白酶水平的影响

目的比较牙龈炎患者和健康人龈沟液中细胞外弹性蛋白酶EA-s和细胞内弹性蛋白酶EA-p水平的变化。方法选取慢性牙龈炎患者37人,共119个探诊出血、牙龈指数(gingival index,GI)≥2、牙周袋探诊深度(probing depth,PD)≤3mm、附着丧失(attachment loss,AL)≤1mm的牙龈炎位点,将其分为吸烟组59个,非吸烟组60个。同时选取牙周健康者31人作为对照,共85个探诊不出血、GI≤1、PD≤3mm、AL≤1mm的位点,同样分为两组,吸烟组45个,非吸烟组40个。观察牙周临床指标菌斑指数(plaque index,PLI)、GI、探诊出血指数(bleeding on probing,BOP)和龈沟液中EA-S、EA-p水平的变化。结果牙龈炎患者中,吸烟组的PLI明显高于非吸烟组(P<0.05),GI低于非吸烟组(P<0.05),健康者的各临床指标均无显著差异(P>0.05)。无论是牙龈炎患者还是健康者,吸烟组与非吸烟组间EA-s,EA-p水平均无显著差异(P>0.05)。结论吸烟对牙龈炎患者和健康人龈沟液EA水平无显著影响。