基础治疗对慢性牙周炎临床疗效和龈下牙周致病菌的影响

目的:评价牙周基础治疗对慢性牙周炎临床疗效及龈下牙周致病菌的影响.方法:纳入慢性牙周炎患者 120例,在牙周基础治疗前和治疗后1个月时检查牙周探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、菌斑指数(plaque index,PLI)和牙龈指数(gingival index,GI).采用实时荧光定量聚合酶链反应法(real-time PCR)检测基础治疗前和治疗后6周时龈下菌斑中牙龈卟啉单胞菌(P.g)和伴放线放线杆菌(A.a)比例的变化.采用SAS6.12软件包对所得数据进行t检验.结果:各项指数在治疗前、后比较差异有统计学意义(P＜0.05).治疗后P.g占总菌的比例与基线相比有显著性差异(P＜0.05),治疗后A.a占总菌的比例与基线相比,无显著差异(P＞0.05).结论:基础治疗可以有效治疗慢性牙周炎,并能降低致病菌P.g的比例.     

尼古丁和美卡拉明对牙周致病微生物的影响

目的 探讨尼古丁和美卡拉明对主要牙周致病微生物生长及生物膜形成的影响.方法 采用二倍稀释法,研究尼古丁对牙龈卟啉单胞菌和伴放线放线杆菌的最低抑菌浓度(MIC)和最低杀菌浓度(MBC).通过酶标仪测定吸光度值,研究在1/16 MIC、1/8 MIC、1/4 MIC、1/2 MIC、MIC等不同浓度的尼古丁对这2种细菌生物膜形成的影响.结果 尼古丁对2种细菌的菌悬液的MIC均为8 mg·mL-1,MBC为16 mg·mL-1.尼古丁浓度逐渐增加时,生物膜吸光度值逐渐增大;继续增加浓度,吸光度值减小;在8 mg.mL-1时,吸光度值减小到最低值,最低生物膜抑制浓度为8 mg.mL-1.添加尼古丁受体拮抗剂美卡拉明组较对照组吸光度值高.结论 小剂量的尼古丁能增加牙龈卟啉单胞菌和伴放线放线杆菌的生物膜形成,浓度继续增加则抑制生物膜形成,加入美卡拉明后降低尼古丁浓度,更能明显观察到尼古丁对两种细菌生物膜的促进作用.     

实时荧光定量PCR检测牙周炎患者龈下菌斑的分布

目的 应用实时荧光定量PCR技术探索侵袭性牙周炎（aggressive periodontitis,AgP）、慢性牙周炎（chronic periodontitis,CP）患者龈下菌斑中伴放线聚集杆菌(A. actinomycetemcomitans,Aa)、牙龈卟啉单胞菌（P. gingivalis,Pg）的分布规律。方法 采集32例AgP、33例CP、32例牙周健康者的龈下菌斑,构建含有2种待测细菌基因片段的重组质粒,建立定量标准,采用TaqManMGB探针实时荧光定量PCR方法检测样本中细菌数量。结果 本实验构建的引物及TaqManMGB探针特异性及敏感性较好。AgP组龈下菌斑Aa的检出率高于CP组（P＜0.01）,但2种细菌数量在组间无显著差异,两组内Pg的检出率及数量都明显高于Aa（P＜0.001）,另外AgP组Aa的数量、CP组Pg数量与牙周探诊深度密切相关（P＜0.01及P＜0.001）。结论 龈下菌斑Aa的检出率可能与牙周炎类型存在一定关联,Aa可能并不是中国人群样本AgP患者龈下菌斑的优势菌,实时荧光定量PCR对牙周病学研究有广泛应用前景。     

牙龈卟啉单胞菌与牙周病相关性的聚合酶链反应研究

目的利用PCR检测慢性牙周炎患者龈下菌斑中牙龈卟啉单胞菌(Porphyromonas gingivalis,P. g)的16S rDNA水平,通过检测该基因水平来探讨牙龈卟啉单胞菌的水平与牙周病的相关性.方法采集慢性牙周炎患者12例共36个龈下菌斑标本,记录临床指标(探诊深度、临床附着水平、牙龈指数、菌斑指数、龈沟出血指数),PCR检测龈下菌斑标本中的P. g 16S rDNA基因,扩增产物经琼脂糖电泳、拍照后,应用计算机软件GeneTools扫描并计量其中的相对核酸含量.结果P. g16S rDNA水平与探诊深度(P＜0.001)及牙龈指数(P＜0.01)之间存在正相关关系.结论P.g16S rDNA水平与牙周状态密切相关,对于P.g16S rDNA水平的监测有望成为牙周病诊断和治疗方案制定的辅助检查手段.     

聚合酶链式反应在3种牙周病原菌检测中的应用

应用聚合酶链式反应检测临床标本中的Pg、Aa与Fn具有很高的敏感性和特异性。聚合酶链式反应及其扩增产物测序结果以及AP-PCR指纹图分析提示不同标本分离的Pg与Aa菌株所携带的毒力基因有差异。分析不同Pg、Aa与Fn等牙周致病菌基因型与其致病力之间的关系,对于阐明牙周炎的发病机制、改善诊断方法、采取更有效的治疗措施等方面具有重要意义。     

赤藓糖醇对牙周致病菌抗菌性能的影响

目的 研究赤藓糖醇对牙周致病菌牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg)、 伴放线聚集杆菌(Aggregatibacter actinomycetemcomitans, Aa)和粘性放线菌（Actinomyces viscous,Av）生长的影响,探讨不同浓度赤藓糖醇作用后的Pg对牙周膜细胞炎症相关细胞因子mRNA表达水平的影响。方法 将Pg、Aa、Av 3种致病菌接种于0、2、4、8、16、32、64、128 g/L的赤藓糖醇-BHI液中,37℃厌氧培养一定时间,检测其最低抑菌浓度。将Pg分别接种于MIC、1/2、1/4、1/8 MIC 4个赤藓糖醇质量浓度的培养基以及不含赤藓糖醇的培养基,离心并清洗后,加入细胞DMEM培养基重悬,与培养至第4代的人牙周膜细胞共培养24 h,弃上清,裂解细胞,提取总RNA,反转录,实时荧光定量PCR检测IL-1β、IL-6、TNF-α的mRNA相对表达量。采用SPSS19.0软件包对数据进行统计学分析。结果 赤藓糖醇对3种细菌的最低抑菌浓度分别为Pg：64 g/L,Aa：128 g/L,Av：128 g/L。不同浓度赤藓糖醇条件下培养的细菌,刺激牙周膜细胞产生IL-1β、IL-6 、TNF-α的能力不同。赤藓糖醇浓度为8 g/L时,炎症因子量与不加赤藓糖醇的对照组无显著差别;浓度升高达到16 g/L时,IL-1β、IL-6 、TNF-αmRNA的相对表达量有所降低,且浓度越高,炎症因子释放越少;但所有实验组炎症因子量始终高于未加细菌的空白对照组（P<0.05）。结论 赤藓糖醇对Pg、 Aa、 Av的生长能力有抑制作用,且在一定范围内,赤藓糖醇质量浓度越高,抑制效果越明显。赤藓糖醇还可通过某种方式对致病菌毒力因子起抑制作用,进而降低Pg的牙周致炎性,减少牙周膜细胞IL-1β、IL-6、TNF-α的mRNA相对表达量。     

聚合酶链式反应在3种牙周病原菌检测中的应用

应用聚合酶链式反应检测临床标本中的Pg、Aa与Fn具有很高的敏感性和特异性。聚合酶链式反应及其扩增产测结果以及AP－PCR指纹图分析提示不同标本分离的Pg与Aa菌株所携带的毒力基因有差异。分析了不同Pg、Aa与Fn等牙周致病菌基因型与其致病力之间的。对于阐明牙周炎的发病机制、改善诊断方法、采取更有效的治疗措施等方面具有重要意义。     

免疫低下豚鼠伴放线放线杆菌和牙龈卟啉单胞菌感染特征

目的　研究免疫低下对青少年牙周炎(JP)特异性病原菌感染的影响。方法　二次60Co全身照射制备免疫低下豚鼠及正常豚鼠各36只,随机分组,下前牙龈沟接种伴放线放线杆菌(Aa)和/或牙龈卟啉单胞菌(Pg),于2、3、 6周分批处死,进行组织病理学及破骨细胞计数对比研究。结果　免疫低下Aa、Pg、Aa+Pg组2、3周时牙周破坏明显,重于免疫正常组,破骨细胞计数高于免疫正常组,有统计学差异(P<0·05)。结论　免疫低下加重Aa、Pg对牙周组织破坏,机体免疫状态是JP发生发展的重要环节。     

牙龈卟啉单胞菌和伴放线聚集杆菌在江苏汉族牙周炎人群中的分布研究

目的:从龈下菌斑总菌数、牙龈卟啉单胞菌(P.gingivalis)、伴放线聚集杆菌(A.actinomycetemcomitans)及白细胞毒素(LTX)在江苏汉族牙周炎人群中分布的角度,比较牙周病2018年新分类与1999年分类.方法:纳入73名牙周炎患者和26名牙周健康者,分别按照牙周病2018年新分类与1999年...     

氟化钠对5种常见龈下细菌抑制作用的体外研究

采用试管二倍液体稀释法，测定氟化钠在体外厌氧环境对雅 龈卟啉单胞菌，伴放线放线杆菌，中间型普氏菌，血链球菌和亲缘链球菌的最小抑菌浓度，比较氟化钠对上述细菌的抗菌作用。结果显示：氟化钠对各实验细菌细菌都有抑制作用，对牙周主要强疑致病菌牙龈卟啉单胞菌，伴放线放线杆菌，中间型普氏菌和龋相关菌关缘链球菌有较明显的抑制作用，ＭＩＣ值为１２８－１０２４μｇ／ｍｌ，而对牙周有益菌血链球菌则需高浓度才有抑制作用，     

Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis subgingival presence, species-specific serum immunoglobulin G antibody levels, and periodontitis disease recurrence

BACKGROUND AND OBJECTIVE: The biological and clinical effects of antibody against periodontal pathogenic bacteria are incompletely understood. This study evaluated the inter-relationships among periodontal levels of cultivable Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis, species-specific serum immunoglobulin G (IgG) antibody levels, and periodontitis disease activity. MATERIAL AND METHODS: Forty-three adults who had previously been treated for periodontitis and who also harbored cultivable A. actinomycetemcomitans or P. gingivalis were evaluated semiannually for clinical disease recurrence over a 36-month period. Each patient provided subgingival microbial samples, for the recovery of A. actinomycetemcomitans and P. gingivalis, from the two deepest pockets in each dentition sextant. A. actinomycetemcomitans and P. gingivalis serum IgG antibody levels were assessed using enzyme-linked immunosorbent assay (ELISA), together with whole-cell sonicate extracts from A. actinomycetemcomitans serotypes a-c and P. gingivalis ATCC 33277. Data were analyzed using the Mantel-Haenszel chi-square and Fisher exact two-tailed tests. RESULTS: Eighteen (60.0%) of 30 A. actinomycetemcomitans-positive subjects, and 10 (76.9%) of 13 P. gingivalis-positive subjects, exhibited recurrent periodontal breakdown within 36 months of periodontal therapy. Nineteen (67.9%) of the 28 patients with active periodontitis had A. actinomycetemcomitans or P. gingivalis serum antibody levels below designated threshold values. In comparison, 10 (66.7%) of 15 culture-positive clinically stable subjects showed A. actinomycetemcomitans or P. gingivalis serum antibody levels above threshold values. The difference between specific antibody levels in periodontitis-active and periodontitis-stable patients was statistically significant (p = 0.032). CONCLUSIONS: Serum levels of IgG antibodies against A. actinomycetemcomitans or P. gingivalis in periodontitis-stable patients were higher than those in patients with active periodontitis. The results suggest that elevated levels of IgG antibody against A. actinomycetemcomitans and P. gingivalis have a detectable protective effect against periodontal infections with these microorganisms.     

冠心病患者的牙周状况与Fg和hs-CRP相关性的研究

目的：通过牙周临床检查和血生化指标检测,观察冠心病患者的牙周状况,探讨纤维蛋白原和高敏C反应蛋白在两者间的相关关系。方法：按照冠心病及慢性牙周炎临床诊断标准随机选择200名研究对象,年龄35～80岁,分为急性冠脉综合征（ACS）组50人,慢性冠脉病（CAD）组50人,单纯慢性牙周炎（CP）组50人,健康（H）对照组50人,每组都进行牙周探诊深度（PD）、临床附着丧失度（CAL）、龈沟出血指数（SBI）和简化卫生指数（OHI-S）检查,采集清晨静脉血检测Fg和hs-CRP水平。结果：PD、CAL、OHI-S在ACS组中最高,与CP组比较有显著性差异（P〈0.001）;SBI在CAD组中最高,ACS组与CP组比较有显著性差异（P〈0.001）;Fg和hs-CRP在ACS组中测定值最高,与CP组比较有显著性差异（P〈0.05）;血生化指标Fg和hs-CRP的水平与牙周临床指标PD、CAL、SBI、OHI-S比较呈正相关（P〈0.01）。结论：冠心病患者无论是急性期还是稳定期牙周状况都比单纯慢性牙周炎患者严重;PD、CAL、OHI-S的升高可引起血清中Fg和hs-CRP水平的变化,牙周临床指标的改变可能与冠心病的急性发作和加重冠心病病程有关。     

Periodontal pathogens in the shallow pockets of immigrants from developing countries

The aim of this study was to examine the distribution of typical periodontitis-associated microorganisms in refugees arriving from non-industrialized countries, and to relate the presence of these organisms to the periodontal condition of the subjects. Thirty males between 35-44 years of age were surveyed. Dental plaque, calculus, gingivitis, loss of attachment, and probing depths were recorded for all surfaces. A total of 90 microbiological samples were taken with paper points from mesial sites of teeth 16, 36 and 41. Microbiological test sites were grouped by probing depths and loss of attachment. Only 16.8% of all surfaces had probing depths > 3 mm, although 90.7% of surfaces had loss of attachment > 1 mm. Twenty-one sites with obvious periodontal destruction (PD > 3 mm, LA > 2 mm) showed the greatest recovery of Porphyromonas gingivalis (66.7%). However, 51 sites with minimal periodontal disease (PD < or = 3 mm, LA < 2 mm) and with no gingival recession also showed a relatively high detection frequency of P. gingivalis (34.1%). Twenty-four of these samples came from 12 patients with no pockets > 5 mm and with less than 10% of all sites yielding pockets > 3 mm. The detection frequencies of Prevotella intermedia (91.6%), Bacteroides forsythus (25.0%), Wolinella spp. (33.3%) and Actinobacillus actinomycetemcomitans (50.0%) were similar in these sites compared with periodontitis sites. Morphologically distinct isolates, from 19 individuals positive for A. actinomycetemcomitans, were serotyped by indirect immunofluorescence.(ABSTRACT TRUNCATED AT 250 WORDS)     

Immunohistological characteristics of periodontal lesions associated with Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans infections

In this study, various phenotypes of infiltrating cells in the periodontium adjacent to pockets harboring Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans were evaluated. Furthermore, the pattern of Class II antigen expression in the periodontal tissues was determined. Eight lesions were associated with the presence of P. gingivalis and 12 with A. actinomycetemcomitans. Predominant cells in the inflammatory infiltrate were T- and B-cells. In most biopsies T-cells dominated over B-cells. The proportion of P. gingivalis , but not of A. actinomycetemcomitans , was positively correlated to the total number of infiltrating cells in the tissue. A. actinomycetemcomitans sites demonstrated somewhat lower proportions of CD3+, CD4+ and CD19+ cells than P. gingivalis sites. However, the tendency of decreasing CD4+/CD8+ ratio with increasing number of A. actinomycetemcomitans indicates a local imbalance in immunoregulation. The frequency of class II antigen expression of both mononuclear and epithelial cells, a sign of immunological activation, was generally high.     

Likelihood of transmitting Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in families with periodontitis

This study examined the frequency of spouse-to-spouse and parent-child transmission of the periodontal pathogens Actinobacillus actinomycetemcomitans (124 subjects in 47 families) and Porphyromonas gingivalis (78 subjects in 31 families). The two test organisms were recovered from subgingival and tongue surface specimens using established microbiological techniques. Arbitrarily primed polymerase chain reaction (AP-PCR) was used to genetically characterize isolates of the test species. The probability of isolating identical AP-PCR types of A. actinomycetemcomitans and P. gingivalis in family members by chance was estimated from the AP-PCR genotype distribution of the two species among unrelated individuals. A probability of 5% or less for occurrence by chance alone suggests intra-familial transmission. With a bacterium-positive spouse, A. actinomycetemcomitans revealed inter-spousal transmission in 4/11 (36%) married couples and P. gingivalis in 2/10 (20%) married couples. Parent-child transmission of A. actinomycetemcomitans took place in 6/19 (32%) families. P. gingivalis was not transmitted from parent to child in any of the study families. The intra-familial transmission of A. actinomycetemcomitans and P. gingivalis may in part explain a familial pattern of periodontitis and may have important prophylactic and treatment implications.     

牙周致病菌在冠心病患者龈下菌斑中的分布

目的:分析牙周致病菌在冠心病患者龈下菌斑中的分布情况,及冠心病患者龈下菌斑中牙周致病菌的分布与慢性牙周炎(chronic periodontitis,CP)病变程度之间的关系。方法:收集44例患冠心病并伴有CP患者的龈下菌斑,采用Chelex-100法提取细菌DNA,以聚合酶链反应(polymerase chain reaction,PCR)法检测龈下菌斑中牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg)、伴放线菌嗜血菌(Haemophilus actinomycetemcomitans,Ha)、具核梭杆菌(Fusobacterium nucleatum,Fn)、中间普氏菌(Prevotella intermedia,Pi)、福赛斯坦纳菌(Tannerella forsythensis,Tf)五种牙周炎相关致病菌。结果:44例冠心病患者的龈下菌斑中各牙周致病菌的检出率分别为:Pg 19(43.18%)、Ha 9(20.45%)、Pi 27(61.36%)、Fn 38(86.36%)、Tf 41(93.18%);轻度CP患者1例,Fn 1例(100%);中度CP患9例,其中Pg6(66.67%)、Ha 2(22.22%)、Pi 7(77.78%)、Fn 9(100%)、Tf 8(88.89%);重度CP患者34例,其中Pg13(38.24%)、Ha 7(20.59%)、Pi 20(58.82%)、Fn 28(82.35%)、Tf 33(97%)。结论:Tf、Fn可能在冠心病的发生发展中起着重要作用,冠心病患者中CP的发病和进展可能有其特定的细菌学病因。     

Prognostic criteria for the efficiency of non-surgical periodontal therapy in advanced periodontitis

Abstract The aim of the study was to find out which clinical, radiographic and microbiological variables can be used as prognostic criteria for the efficiency of the commonly used initial treatment protocol comprising scaling, root planing and instruction on oral hygiene in advanced adult periodontitis. 46 patients (mean age 48 years) with untreated, advanced periodontitis volunteered for the study. The clinical examination included recordings of plaque, gingival and calculus indices, probing pocket depths, bleeding and suppuration after probing, probing attachment levels and furcation involvements. Infrabony and furcation lesions were assessed from panoramic radiographs. Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were cultured from the deepest, most inflamed periodontal pockets, from surface of the tongue and from saliva. 3 months after the completion of non-surgical treatment comprising meticulous scaling and root planing and instruction on oral hygiene, the healing was assessed clinically, and 13 patients were assigned to a maintenance care programme (MC) and 33 to further treatment procedures (FT). Evaluation of the baseline clinical and radiographic data showed a significantly higher %s of 6 mm deep periodontal pockets, surfaces with suppuration, and sites with subgingival calculus, as well as higher numbers of infrabony lesions, in FT-patients than in MC-patients. Subgingival A. actinomycetemcomitans was isolated at baseline in 55% of the FT-patients and in 38% of the MC-patients, and P. gingivalis in 27% and 23%, respectively. A. actinomycetemcomitans was eradicated by non-surgical treatment from only one patient. P. gingivalis was detected in 15% of the patients in both groups after treatment. Combining of the clinical and the microbiological baseline data demonstrated that simultaneous presence of multiple deep periodontal pockets (6 mm at 10% of the sites) and subgingival A. actinomycetemcomitans alone or concomitant with P. gingivalis was significantly more prevalent in the FT-group than in the MC-group. This simultaneous presence anticipated insufficient response to initial non-surgical therapy. The results suggest that a treatment regimen more efficient than the traditional one is needed without delay in the treatment of A. actinomycetemcomitans infected generalized, severe periodontal disease in adults.     

Actinobacillus actinomycetemcomitans, Capnocytophaga and Porphyromonas gingivalis in subgingival plaque of adolescents with Down''s syndrome

Levels of Actinobacillus actinomycetemcomitans, Capnocytophaga and Porphyromonas gingivalis were determined in subgingival plaque samples from 37 adolescents with Down's syndrome and 37 healthy controls matched with respect to age and sex. Gingival inflammation, supra- and subgingival calculus, periodontal pockets ( > 4 mm) and alveolar bone loss were registered. Alveolar bone loss was more frequent in Down's syndrome subjects (32%) than in the controls (3%). A. actinomycetemcomitans was detected in the subgingival plaque in 35% of the Down's syndrome adolescents and in 5% of the controls. On site level, A. actinomycetemcomitans and Capnocytophaga were more frequent in the subgingival plaque samples of Down's syndrome children than in those of controls. Comparing Down's syndrome subjects positive or negative for A. actinomycetemcomitans and Capnocytophaga, no significant differences were found in terms of gingival inflammation, periodontal pockets ( > 4 mm) or number of sites with alveolar bone loss. The results indicate an altered microbial composition of the subgingival plaque of Down's syndrome subjects compared with healthy controls, with higher frequency of A. actinomycetemcomitans.