五种牙周致病菌与药物性牙龈增生的关系

目的 探讨牙周致病菌在药物性牙龈增生发展过程中的作用评价57例服用环孢素的肾移植患者的牙龈增生(gingival overgrowth,GO)指数,将GO指数为1、2、3的患者列为牙龈增生组(A组,28例),将GO指数为0的患者列为牙龈未增生组(B组,29例),采用实时聚合酶链反应(PCR)技术对龈下菌斑内的牙龈卟啉单孢菌(Porphyromonas gingivdis,Pg)、伴放线放线杆菌(Actinobacillus actinomycetemcomitans,Aa)、中间普氏菌(Prevotella intermedia,Pi)、齿垢密螺旋体(Treponema denticola,Td)和福赛氏类杆菌(Tannerella forsythia,Tf)进行定量检测,比较两组患者中细菌检出率的差异,并分析细菌数量和牙龈增生的严重程度之间的相关性.结果 Pg、Td和Tf的检出率在A组分别为96%、82%和89%,均显著高于B组(分别为69%、55%和66%),差异有统计学意义(P<0.05);同时检测出Pg、Td和Tf的概率在A组(79%)明显高于B组(38%),差异有统计学意义(P<0.01);Pg、Td、Tf和Pi的细菌数量随着牙龈增生指数的升高而增加,Aa的细菌数量未发现与牙龈增生相关的变化.结论 Pg、Td和Tf可能在药物性牙龈增生发展过程中起着重要的作用.     

伴2型糖尿病的慢性牙周炎牙周可疑致病菌的检测

目的 检测伴2型糖尿病(diabetes mellitus,DM)的慢性牙周炎(chronic periodontitis,CP)患者龈下菌斑中牙周可疑致病菌的种类和构成,从微生物学角度探讨牙周炎与DM的相互作用机制.方法 采集伴2型DM的CP患者154例(DM组)、不伴DM的单纯CP患者120例(CP组)及40名全身及牙周健康者(N组)的龈下集合菌斑,传统酚-氯仿法提取菌斑DNA,以牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg),伴放线放线杆菌(Actinobacillus actinomycetemcomitans,Aa),具核梭杆菌(Fusobacterium nucleatum,Fn),中间普氏菌(Prevotella intermedia,Pi),福塞坦氏菌(Tannerella forsythia,Tf),齿垢密螺旋体(Treponema denticola,Td)为目标菌,应用以16SrRNA为基础的聚合酶链反应(PCR)技术对龈下菌群进行检测.结果 Pg、Aa、Fn、Pi、Tf、Td在DM组中均可检出;与CP组相比,在性别、年龄、牙周状况基本一致的情况下,轻度牙周炎者DM组Pi的检出率为35%(8/23),CP组为65%(13/20),两组间差异有统计学意义(P<0.05);重度牙周炎者DM组Pg、Aa、Tf的检出率分别为78%(72/92)、27%(25/92)、67%(62/92),CP组分别为58%(35/60)、17%(10/60)、43%(26/60),DM组均显著高于CP组,差异有统计学意义(P<0.05).同时,DM组Aa、Tf PCR产物的平均灰度值(average gradation,AVG)比值显著高于CP组,Pi的AVG比值明显低于CP组,P<0.05.结论 与单纯CP相比,伴2型DM的牙周炎患者龈下菌斑中Pg、Aa、Tf的数量增多,Pi的数量减少.     

伴2型糖尿病的慢性牙周炎牙周可疑致病菌的检测

目的 检测伴2型糖尿病(diabetes mellitus,DM)的慢性牙周炎(chronic periodontitis,CP)患者龈下菌斑中牙周可疑致病菌的种类和构成,从微生物学角度探讨牙周炎与DM的相互作用机制.方法 采集伴2型DM的CP患者154例(DM组)、不伴DM的单纯CP患者120例(CP组)及40名全身及牙周健康者(N组)的龈下集合菌斑,传统酚-氯仿法提取菌斑DNA,以牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg),伴放线放线杆菌(Actinobacillus actinomycetemcomitans,Aa),具核梭杆菌(Fusobacterium nucleatum,Fn),中间普氏菌(Prevotella intermedia,Pi),福塞坦氏菌(Tannerella forsythia,Tf),齿垢密螺旋体(Treponema denticola,Td)为目标菌,应用以16SrRNA为基础的聚合酶链反应(PCR)技术对龈下菌群进行检测.结果 Pg、Aa、Fn、Pi、Tf、Td在DM组中均可检出;与CP组相比,在性别、年龄、牙周状况基本一致的情况下,轻度牙周炎者DM组Pi的检出率为35%(8/23),CP组为65%(13/20),两组间差异有统计学意义(P<0.05);重度牙周炎者DM组Pg、Aa、Tf的检出率分别为78%(72/92)、27%(25/92)、67%(62/92),CP组分别为58%(35/60)、17%(10/60)、43%(26/60),DM组均显著高于CP组,差异有统计学意义(P<0.05).同时,DM组Aa、Tf PCR产物的平均灰度值(average gradation,AVG)比值显著高于CP组,Pi的AVG比值明显低于CP组,P<0.05.结论 与单纯CP相比,伴2型DM的牙周炎患者龈下菌斑中Pg、Aa、Tf的数量增多,Pi的数量减少.     

伴2型糖尿病的慢性牙周炎牙周可疑致病菌的检测

目的 检测伴2型糖尿病(diabetes mellitus,DM)的慢性牙周炎(chronic periodontitis,CP)患者龈下菌斑中牙周可疑致病菌的种类和构成,从微生物学角度探讨牙周炎与DM的相互作用机制.方法 采集伴2型DM的CP患者154例(DM组)、不伴DM的单纯CP患者120例(CP组)及40名全身及牙周健康者(N组)的龈下集合菌斑,传统酚-氯仿法提取菌斑DNA,以牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg),伴放线放线杆菌(Actinobacillus actinomycetemcomitans,Aa),具核梭杆菌(Fusobacterium nucleatum,Fn),中间普氏菌(Prevotella intermedia,Pi),福塞坦氏菌(Tannerella forsythia,Tf),齿垢密螺旋体(Treponema denticola,Td)为目标菌,应用以16SrRNA为基础的聚合酶链反应(PCR)技术对龈下菌群进行检测.结果 Pg、Aa、Fn、Pi、Tf、Td在DM组中均可检出;与CP组相比,在性别、年龄、牙周状况基本一致的情况下,轻度牙周炎者DM组Pi的检出率为35%(8/23),CP组为65%(13/20),两组间差异有统计学意义(P<0.05);重度牙周炎者DM组Pg、Aa、Tf的检出率分别为78%(72/92)、27%(25/92)、67%(62/92),CP组分别为58%(35/60)、17%(10/60)、43%(26/60),DM组均显著高于CP组,差异有统计学意义(P<0.05).同时,DM组Aa、Tf PCR产物的平均灰度值(average gradation,AVG)比值显著高于CP组,Pi的AVG比值明显低于CP组,P<0.05.结论 与单纯CP相比,伴2型DM的牙周炎患者龈下菌斑中Pg、Aa、Tf的数量增多,Pi的数量减少.     

慢性牙周炎合并糖尿病患者唾液及龈下菌斑中牙周致病菌检测临床研究

目的    探讨慢性牙周炎（CP）合并2型糖尿病（T2DM）患者与单纯CP患者唾液及龈下菌斑中牙周致病菌的差异性。方法    选择河南大学第一附属医院口腔科2012年8月至2015年9月伴T2DM的CP患者40例为CP+T2DM组,同时选取背景相似的慢性CP患者65例为CP组,并选取健康体检者35名作为对照组,采用聚合酶链反应（PCR）检测各组受试者唾液及龈下菌斑中牙龈卟啉单胞菌（Pg）、放线共生放线杆菌（Aa）、具核梭杆菌（Fn）、福塞坦菌（Tf）、中间型普里沃菌（Pi）、齿垢密螺旋体（Td）等可疑致病菌种类和相对含量。结果    3组受试者唾液及龈下菌斑中Pg、Aa和Tf检出率比较差异有统计学意义（P＜0.05）,而Fn、Pi和Td检出率差异无统计学意义（P＞0.05）,3组受试者唾液及龈下菌斑中Fn检出率均最高,CP+T2DM组唾液及龈下菌斑中Pg、Aa、Tf检出率均显著高于对照组和CP组（P＜0.05）,而CP组仅Pg检出率显著高于对照组（P＜0.05）,CP+T2DM组和CP组唾液及龈下菌斑中Pg、Aa和Tf相对含量均显著高于对照组（P＜0.05）,且CP+T2DM组唾液及龈下菌斑中Aa和Tf相对含量显著高于CP组,差异有统计学意义（P＜0.05）。结论    CP患者和伴糖尿病的CP患者牙周可疑致病菌的种类和数量存在明显差异,CP+T2DM组患者Pg、Aa和Tf检出率更高,可能与糖尿病关系更为密切。     

侵袭性牙周炎病原微生物的检测

目的检测侵袭性牙周炎（AgP）患者和牙周健康者龈下菌斑中的7种病原微生物,旨在寻找AgP的主要致病微生物.方法应用以16S rRNA为基础的聚合酶链反应（PCR）技术,检测55例AgP患者和17名健康对照者龈下菌斑中的7种牙周病原微生物：伴放线放线杆菌（Aa）,牙龈卟啉单胞菌（Pg）,福赛坦氏菌（Tf）,牙密螺旋体（Td）,直肠弯曲杆菌（Cr）,中间普氏菌（Pi）,变黑普氏菌（Pn）.结果55例AgP患者中仅有1例检测出Aa,而在健康对照者中未检出该菌.Pg、Tf、Td和Cr在AgP组的检出率分别为81.8%、83.6%、80.0%和81.8%,显著高于健康对照者（17.6%、11.8%、5.9%、29.4%）,差异有统计学意义（P＜0.01）.结论Pd、Tf、Td和Cr 4种微生物在AgP患者中有较高的检出率,提示它们的共同定植可能在AgP中起重要作用.     

牙周致病菌在冠心病患者龈下茵斑中的分布

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Pg 6(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.     

氧化锆全瓷和钴铬合金冠修复对基牙牙周指数及致病菌的影响

目的:探讨氧化锆全瓷和钴铬合金冠修复对基牙牙周指数及致病菌的影响。方法:142例行全冠修复患者随机分为氧化锆组和钴铬合金组,分别于修复前(T₀)、修复后6月(T₁)、修复后12月(T₂)和修复后24月(T₃)时,记录患者牙龈颜色、牙龈出血指数(BI)、牙周探诊深度(PD)和菌斑指数(PLI),利用PCR技术对龈下菌斑标本中伴放线嗜血杆菌(Aa)、具核酸杆菌(Fn)、牙龈卟啉单胞菌(Pg)、中间普氏菌(Pi)、福赛斯坦纳菌(Tf)和齿垢密螺旋体(Td)进行检测。结果:与T₀相比,两组患者T_1～3时BI和PD均增加,氧化锆组患者T_1～3时BI和PD均小于钴铬合金组,差异均有统计学意义(P<0.05);修复后12个月时,氧化锆组患者龈下菌斑标本致病菌Aa、Fn、Pg、Tf和Td检出率均低于钴铬合金组,差异均有统计学意义(P<0.05)。结论:相比于钴铬合金全冠修复,氧化锆全瓷全冠修复对患者牙周影响较小,且龈下菌斑中致病菌检出率较低。     

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。     

慢性牙周炎致病菌与冠状动脉粥样硬化相关性研究

目的 探讨慢性牙周炎与冠状动脉粥样硬化性心脏病(简称冠心病)发病的相关性机制。方法 收集36例行冠状动脉搭桥手术并伴有慢性牙周炎患者的冠状动脉粥样硬化斑块和龈下菌斑,50例慢性牙周炎患者的龈下菌斑,采用Chelex-100法提取细菌DNA,以聚合酶链反应(PCR)法检测冠状动脉粥样硬化斑块和龈下菌斑中牙龈卟啉单胞菌(Porphyromonasgingivalis,Pg)、伴放线放线杆菌(Actinobacillus actinomycetemcomitans,Aa)、具核梭杆菌(Fusobacterium nucleatum,Fn)、中间普氏菌(Preuotella intermedia,Pi)、福赛斯坦纳菌(Tannerella forsythensis,Tf)5种慢性牙周炎相关致病菌。结果 36例患者冠状动脉粥样硬化斑块中,各种牙周炎相关致病菌的检出率分别为:Pg 36%,Aa 3%,Pi 14%,Fn 25%,Tf 47%;同一患者冠状动脉粥样硬化斑块及龈下菌斑中同时检出5种牙周炎相关致病菌的一致的例数:Tf 15例,Pg 13例,Fn 5例,Pi 3例,Aa 0例;冠心病组的Pi检出率高于对照组,二者差异具有统计学意义(P<0.05)。结论 在冠状动脉粥样硬化斑块中慢性牙周炎相关致病菌DNA的检出,提示慢性牙周炎相关致病菌在冠心病的发生、发展中可能起着重要的作用;中间普氏菌可能是冠心病的危险因素。     

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??Objective    To investigate the differences in detection results of periodontal pathogens in saliva and gingival crevicular fluid between patients with chronic periodontitis??CP?? and those complicated with diabetes mellitus??DM??. Methods    Of the patients treated in the First Affiliated Hospital of Henan University between Aug. 2012 and Sep. 2015??40 cases of patients with CP complicated with T2DM were selected as CP+T2DM group??65 cases of patients with simple CP were selected as CP group??and 35 cases of healthy subjects were selected as the control group. The kinds and relative contents of suspected pathogens??such as Porphyromonas gingivalis??Pg????Actinobacillus actinomycetemcomitans??Aa????Fusobacterium nucleatum??Fn????Tannerella forsythia??Tf????intermediate type Prevotella intermedia??Pi??and Treponema denticola??Td????in saliva and gingival crevicular fluid were detected by polymerase chain reaction??PCR??. Results    The detection rates of Pg??Aa and Tf in the saliva and gingival crevicular fluid showed statistically significant differences among the three groups??P??0.05????but there were no significant differences in the detection rates of Fn??Pi or Td??P??0.05??. The detection rate of Fn in saliva and gingival crevicular fluid of the three groups was the highest??and the detection rates of Pg??Aa and Tf in saliva and gingival crevicular fluid of CP +T2DM group were significantly higher than those in control group and CP group??P??0.05??. The detection rate of Pg in CP group was significantly higher than that in the control group??P??0.05??. The relative contents of Pg??Aa and Tf in the saliva and gingival crevicular fluid of CP+T2DM group and CP group were significantly higher than those in the control group??P??0.05??. The relative contents of Aa and Tf in saliva and gingival crevicular fluid of CP+T2DM group were significantly higher than those in CP group??P??0.05??. Conclusion    There are significant differences in the types and number of suspected pathogens between patients with simple CP and those with CP and DM. Pg??Aa and Tf have more advantages in patients with DM??which may be closely related to DM.     

正畸治疗中牙龈增生的致病因素分析

目的 探讨正畸治疗中牙龈增生的相关致病因素.方法 12例因接受固定正畸治疗而出现牙龈增生的患者纳入牙龈增生组,对照组为12例牙龈健康者.分别于基线时采集两组研究对象的牙周检查指标、龈下菌斑标本和龈沟液标本,采用实时PCR技术对龈下菌斑内的牙龈卟啉单孢菌（Pg）、伴放线放线杆菌（Aa）、中间普氏菌（Pi）、齿密螺旋体（Td）和福赛氏类杆菌（Tf）进行定量检测,使用ELISA法测量龈沟液中白介素-1β的含量,比较牙龈增生组和对照组各项指标间的差异.对牙龈增生组患者实施牙周基础治疗,并于4周后重新采样比较牙周治疗前后上述指标间的差异.结果 基线时,牙龈增生组中龈下菌斑内五种牙周可疑微生物的检出率均显著高于对照组（P＜0.05）,龈沟液内白介素-1β的含量显著高于对照组（P＜0.05）.牙周基础治疗后4周时,牙龈增生患者的各项牙周检查指标均明显下降,同时Pg、Aa和Td的检出率、细菌数量以及龈沟液内白介素-1β的含量均显著减少（P＜0.05）.结论 Pg、Aa和Td等牙周病原菌和白介素-1β与正畸治疗中牙龈增生的发生和发展密切相关.     

Microbiological shifts in intra- and extraoral habitats following mechanical periodontal therapy

OBJECTIVES: The aim of the present study was to analyze the intra- and extraoral colonization dynamics of periodontal pathogens following supra- and subgingival debridement. MATERIAL AND METHODS: Thirty five patients with chronic periodontitis were enrolled in the study. Supra- and subgingival plaque samples, saliva, and swab samples from mucosa and extraoral sites were taken at baseline and 6 weeks, 3 months and 6 months after mechanical periodontal therapy. Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Eikenella corrodens (Ec), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Prevotella nigrescens (Pn), and Treponema denticola (Td) were identified by PCR. RESULTS: Supra- and subgingival debridement decreased the number of subgingival sites infected with the analyzed pathogens only transiently, if at all. However, the detection frequencies of Tf, Td, Ec, Pi, and Pn in the supragingival region, of Pg, Td, and Pn at the oral mucosa sites (mostly the tongue), and of all pathogens except Aa in saliva increased over the 6-month observation period. Td was the only pathogen recorded in notable quantities in the extraoral habitat (external ear canal). CONCLUSION: The results indicate that supra- and subgingival debridement results in a dissemination of periodontal pathogens within the oral cavity.     

Microbiological findings after periodontal therapy using curettes, Er:YAG laser, sonic, and ultrasonic scalers

AIM: To evaluate and compare the microbiological effects of hand instruments, Er:YAG-laser, sonic, and ultrasonic scalers in patients with chronic periodontitis. Patient perception of each treatment was documented. MATERIAL AND METHODS: From 72 patients, bacterial samples were collected from the deepest pocket in each quadrant (total: 288 sites). A polymerase chain reaction kit estimated the amount of Aggregatibacter (Actinobacillus) actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythensis (Tf), and Treponema denticola (Td) at baseline as well as 3 and 6 months after therapy. One quadrant in each patient was randomly assigned to curettes (H-group), Er:YAG laser (L-group), sonic device (S-group), or ultrasonic device (U-group). RESULTS: Three months post-operatively, the amounts of Pg, Pi, Tf, and Td were significantly reduced in all groups. Laser and sonic instrumentation failed to reduce Aa. Six months after therapy, significant differences were still detected for Pg (L- and U-group), for Pi and Tf (S-group), and for Td (L-, S- and U-group). Patients rated ultrasonic treatment as more preferable than hand and laser instrumentation. CONCLUSION: The various treatment methods resulted in a comparable reduction of the evaluated periodontal pathogens, and bacterial increase was only partially different 6 months post-operatively. Ultrasonic instrumentation caused less discomfort.