牙龈卟啉单胞菌与牙周基础治疗关系的实验研究  

Association between Porphyromonas gingivalis and scaling and root planning therapy

作　　者：杨禾[1] 徐屹[2] 赵蕾[1] 孟姝[1] 吴亚菲[2] 

机构地区：[1]口腔疾病研究国家重点实验室,四川大学 [2]四川大学华西口腔医院牙周科,四川成都610041

出　　处：《华西口腔医学杂志》2008年第2期147-151,共5页West China Journal of Stomatology

基　　金：国家“十五”科技攻关资助项目(2004BA720A26)

摘　　要：目的应用TaqMan实时荧光定量聚合酶链反应法检测慢性牙周炎患者牙周洁刮治术(SRP)治疗前后龈下菌斑中牙龈卟啉单胞菌(P.gingivalis)的变化,分析P.gingivalis与SRP疗效之间的关系,探讨应用实时荧光定量聚合酶链反应监测和评价SRP的可能性。方法选择20例中重度慢性牙周炎患者为研究对象,检查SRP治疗前后的临床指标,包括探诊深度(PD)、临床附着丧失(CAL)和探诊出血(BOP);采集SRP治疗前后的龈下菌斑共142个样本,应用TaqMan实时荧光定量聚合酶链反应检测样本中的P.gingivalis。构建含有P.gingivalis扩增片段的重组质粒,建立定量标准。结果慢性牙周炎患者SRP治疗后PD、CAL和BOP均明显下降(P<0.001);治疗前P.gingivalis检出率为80.28%,治疗后下降为54.23%;治疗前P.gingivalis数量与PD相关,Kendall相关系数为0.70(P<0.001),治疗后牙周袋内细菌数量明显减少(P<0.001)。治疗前牙周袋内P.gingivalis的定植数量与PD、CAL和BOP的改善无相关性(P>0.05),但治疗后治疗有效位点P.gingivalis数量减少程度明显大于治疗无效位点(P<0.05),细菌减少量与PD改善弱相关(r=0.25,P=0.04)。结论SRP治疗可以明显改善临床症状,降低P.gingivalis检出率和绝对数量;治疗前P.gingivalis定植水平对临床指标的改善没有影响,治疗后P.gingivalis数量下降程度可以反映治疗效果。TaqMan实时荧光定量聚合酶链反应可以用于牙周炎治疗效果的监测和评价。Objective Porphyromonas gingivalis （P. gingivalis） is considered to be major putative periodontal pathogens. The purpose of the study was to evaluate P. gingivdis and clinical effects of scaling and root planning （SRP） in 20 subjects after 3 months. Methods Twenty periodontitis patients were selected. The mean age was （44.33±13.86） years old. Clinical assessments of probing depth（PD）, clinical attachment loss（CAL） and bleeding on probing （BOP） were made prior to SRP and at 3 months post-therapy. Subgingival plaque samples were taken at each visit and analyzed using TaqMan real-time polymerase chain reaction for the presence and levels of P. gingivalis. The quantification for P. gingivalis was also performed with the help of the species-specific primers/probes and the serial dilution of the plasmid standards. Results Mean probing depth, mean clinical attachment loss and bleeding on probing showed significant reduction at 3 months（P〈0.001）. The prevalence and level of P. gingivalis were significantly reduced after SRP（P〈0.001）. A positive correlation was found between the numbers of P. gingivalis and PD at baseline （P〈0.001）. There were no correlation between the initial level of P. gingivalis at baseline and the clinical improvement after therapy. But the number of P. gingivalis at responding sites was more decreased than non-responding sites after SRP（P〈0.05）. Conclusion SRP produced a good clinical improvement. The prevalence and level of P. gingivalis were significantly reduced after SRP. The effect of SRP may be determined by the degree of P. gingivalis decreased. The real-time polymerase chain reaction can be used to evaluate the effect of periodontal therapy.

关 键 词：牙周炎 牙龈卟啉单胞菌 牙周洁刮治术 实时荧光定量聚合酶链反应 

分 类 号：R781.4[医药卫生—口腔医学]