侵袭性牙周炎在非手术治疗后不同治疗反应位点的临床和可疑致病微生物特性

摘要/Abstract

摘要： 目的：探讨侵袭性牙周炎（aggressive periodontitis，AgP）患者接受牙周基础治疗后袋深减少不同位点的临床和龈下可疑致病微生物的特征，以期为临床治疗及预后判断提供指导。方法：20例AgP患者拍全口根尖片，完成牙周基础治疗并定期复查，每位患者每象限取同1个位点采集治疗前和治疗后6个月的龈沟液，同时记录菌斑指数、出血指数、牙周袋探诊深度和附着水平，检测龈沟液中6种牙周可疑致病微生物和6种微生物代谢产物有机酸浓度，分析治疗前后不同袋深减少位点间的临床指标、牙周可疑致病微生物检出率及代谢产物有机酸浓度的特征。结果：袋深减少>2 mm的位点在治疗前的探诊深度、附着丧失和出血指数，琥珀酸、乙酸、丙酸和丁酸浓度，齿垢密螺旋体的检出率均高于袋深减少≤2 mm的位点，差异有统计学意义（P＜0.05），但是治疗后两组临床指标、有机酸浓度和牙周可疑致病微生物检出率间差异无统计学意义（P＜0.05）；治疗后探诊深度≥6 mm的位点仍有红色复合体微生物的感染，多数伴有角型骨吸收。结论：侵袭性牙周炎患者治疗后袋深减少与治疗前的临床指标有关，基础治疗后深袋位点仍有红色复合体微生物的感染，需要积极的进行感染控制。

关键词: 侵袭性牙周炎, 龈沟液, 微生物学, 牙菌斑

Abstract: Objective：To evaluate the differences of clinical parameters and putative periodontal pathogens in sites of different probing depth (PD) reduction after non-surgical periodontal treatment in patients with aggressive periodontitis (AgP). Methods: Clinical examinations including plaque index, probing depth (PD), attachment level (AL) and bleeding index (BI), and full-mouth periapical photographs were collected from 20 patients with AgP. All the patients received non-surgical periodontal treatment, including oral hygiene instruction, supra-gingival scaling, subgingival scaling and root planing (SRP) and were followed up for 6 months post-therapy. Gingival crevicular fluids (GCF) were collected at 1 site in each quadrant before and at the end of 6 months post-therapy. Six kinds of putative periodontal pathogens and 6 kinds of short chain fatty acids (SCFAs) were detected in the GCF samples. Results: The baseline clinical parameters of PD, AL and BI, the baseline concentration of succinic acid, acetic acid, propionic acid and butyric acid, and the prevalence of Treponema denticola were significantly higher in sites with PD reduction more than 2 mm sites compared with PD reduction no more than 2 mm sites ［(7.7±1.2) mm vs. (5.1±1.8) mm, (6.3±1.9) mm vs. (4.5±2.2) mm, 3.8±0.4 vs. 3.3±0.8, 1.66 mmol/L vs. 1.10 mmol/L, 31.67 mmol/L vs.17.78 mmol/L, 3.31 mmol/L vs.1.95 mmol/L, 84.6% vs. 56.1%, P<0.05］. However, there were no significant differences in the clinical parameters, the 6 kinds of putative periodontal pathogen detection and SCFAs concentration between the 2 groups at the end of 6 months post-treatment. In sites with PD>5 mm at the end of 6 months post-therapy, all were found with red complex bacteria infection. Conclusion: The baseline clinical parameters are important factors in predicting PD reduction after non-surgical periodontal treatment in patients with AgP. In sites with deep pockets after non-surgical periodontal treatment, the active control of red complex bacteria is recommended.

Key words: Aggressive periodontitis, Gingival crevicular fluid, Microbiology, Dental plaque

路瑞芳, 冯向辉, 徐莉, 孟焕新. 侵袭性牙周炎在非手术治疗后不同治疗反应位点的临床和可疑致病微生物特性[J]. 北京大学学报（医学版）, 2015, 47(1): 13-18.

LU Rui-Fang, FENG Xiang-Hui, XU Li, MENG Huan-Xin. Clinical and putative periodontal pathogens’ features of different sites with probing depth reduction after non-surgical periodontal treatment of patients with aggressive periodontitis[J]. Journal of Peking University(Health Sciences), 2015, 47(1): 13-18.

参考文献

相关文章 15

[1]	朱小玲,李文静,王宪娥,宋文莉,徐莉,张立,冯向辉,路瑞芳,释栋,孟焕新. 细胞色素B-245α链及胆固醇酯转运蛋白基因多态性与广泛型侵袭性牙周炎易感性的关系[J]. 北京大学学报（医学版）, 2022, 54(1): 18-22.
[2]	刘建,王宪娥,吕达,乔敏,张立,孟焕新,徐莉,毛铭馨. 广泛型侵袭性牙周炎患者牙根形态异常与相关致病基因的关联[J]. 北京大学学报（医学版）, 2021, 53(1): 16-23.
[3]	杜仁杰,焦剑,周彦恒,施捷. 侵袭性牙周炎患者正畸前后的咬合变化[J]. 北京大学学报（医学版）, 2019, 51(5): 919-924.
[4]	沈潇，施捷，徐莉，焦剑，路瑞芳，孟焕新. 伴错牙合畸形的侵袭性牙周炎患者牙周-正畸联合治疗的临床评价[J]. 北京大学学报(医学版), 2017, 49(1): 60-066.
[5]	黄振，栾庆先. 数字图像分析技术定量分析牙菌斑的效果评价[J]. 北京大学学报(医学版), 2016, 48(2): 320-323.
[6]	宋文莉，田雨，王宪娥，张立，徐莉，释栋，冯向辉，路瑞芳，陈智滨，孟焕新. FADS1 rs174537基因多态性与侵袭性牙周炎患者血清蛋白的相关性[J]. 北京大学学报(医学版), 2016, 48(1): 10-15.
[7]	冯向辉，张立，徐莉，孟焕新，陈智滨，释栋，路瑞芳. 侵袭性牙周炎患者抗伴放线聚集杆菌血清c型IgG滴度分析[J]. 北京大学学报(医学版), 2015, 47(5): 820-824.
[8]	韩劼, 陈智滨, 李玮, 孟焕新. 早期愈合阶段牙种植体周沟液骨代谢相关因子的检测和种植体稳定性共振频率分析[J]. 北京大学学报（医学版）, 2015, 47(1): 37-41.
[9]	路瑞芳, 冯琳, 高学军, 孟焕新, 冯向辉. 侵袭性牙周炎龈沟液中有机酸与牙龈卟啉单胞菌和齿垢密螺旋体的关系[J]. 北京大学学报（医学版）, 2013, 45(1): 12-16.
[10]	吕达, 孟焕新, 徐莉, 张立, 陈智滨, 冯向辉, 释栋, 路瑞芳, 王宪娥. 侵袭性牙周炎患者治疗后失牙的预测模型[J]. 北京大学学报（医学版）, 2013, 45(03): 480-483.
[11]	赵宁宁, 林久祥, 陈智滨, 刘妍. 正畸保持期龈沟液骨保护素/核因子kappa B受体活化因子配体水平对牙槽骨改建状态的意义[J]. 北京大学学报（医学版）, 2012, 44(1): 108-112.
[12]	朱卫东, 侯建霞, 刘凯宁, 唐晓琳, 孟焕新. 牙周手术治疗对猴Ⅲ度根分叉病变模型龈下菌斑中牙周致病微生物的影响[J]. 北京大学学报（医学版）, 2012, 44(1): 22-28.
[13]	康军, 沙月琴, 陈智滨. 不同牙周状况下唾液和龈沟液中弹性蛋白酶的含量[J]. 北京大学学报（医学版）, 2012, 44(1): 17-21.
[14]	丁芳, 孟焕新, 李启强, 赵亦兵, 冯向辉, 张立. 牙周机械治疗对慢性牙周炎患者龈沟液中牙周致病菌的影响[J]. 北京大学学报（医学版）, 2010, 42(2): 202-206.
[15]	冯向辉, 张立, 孟焕新, 徐莉, 陈智滨, 释栋, 路瑞芳. 牙周炎患者唾液和龈下菌斑3种厌氧微生物的检测[J]. 北京大学学报（医学版）, 2009, 41(1): 44-48.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed