无牙颌患者唾液中牙周致病菌感染状况的横断面研究  

A cross-sectional study of periodontal pathogens in saliva of edentulous patients

作　　者：关筱媛 廖雁婷[1] 和璐[1] 孟焕新[1] 李蓬[1] Guan Xiaoyuan;Liao Yanting;He Lu;Meng Huanxin;Li Peng(Department of Periodontology,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院牙周科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,100081

出　　处：《中华口腔医学杂志》2021年第12期1230-1236,共7页Chinese Journal of Stomatology

摘　　要：目的研究无牙颌患者唾液中牙周致病菌的感染情况及与有天然牙的牙周炎人群的异同。方法从北京市石景山区的一队列体检人群中,选取无牙颌患者27例(无牙颌组),根据年龄(年龄差≤5岁)、性别、吸烟状况及糖尿病、高血压患病情况为无牙颌患者匹配同一队列中不同程度的牙周病患者,分别为无或轻度牙周炎(轻度组)、中度牙周炎(中度组)和重度牙周炎(重度组)患者,每组27例。对108例受试者进行问卷调查和牙周临床检查(包括菌斑指数、探诊深度、出血指数、临床附着丧失、失牙数);并应用PCR技术检测其唾液中牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg)、福赛坦纳菌(Tannerella forsythia,Tf)、齿垢密螺旋体(Treponema denticola,Td)、直肠弯曲菌(Campylobacter rectus,Cr)和变黑普氏菌(Prevotella nigrescens,Pn)的检出率及相对含量,比较4组受检者唾液中牙周致病菌的检出情况。结果无牙颌组78%(21/27)的患者中可以检出1种或多种牙周致病菌。其中Cr检出率最高[56%(15/27)],其他依次递减为Tf[44%(12/27)]、Pn[26%(7/27)]、Pg[22%(6/27)]和Td[11%(3/27)]。轻度组、中度组和重度组中分别有4、2和4种牙周致病菌的检出率显著高于无牙颌组(P<0.05);同时,该3组中分别有3、2和4种牙周致病菌的相对含量显著高于无牙颌组(P<0.05)。轻度组、中度组和重度组的牙周致病菌检出种类数均显著高于无牙颌组(P<0.05),其红色复合体(包括Pg、Tf、Td)检出率[均为96%(26/27)]也显著高于无牙颌组[48%(13/27),P<0.05]。中度组和重度组中红色复合体相对含量占5种牙周致病菌总量的比例(均为83%)显著高于无牙颌组(37%)(P<0.01)。结论无牙颌组中的大多数患者仍可检出牙周致病菌,但其唾液中的牙周致病菌种类与含量低于口内有天然牙的牙周炎人群。Objective To investigate the prevalence of five specific periodontal pathogens in the saliva of edentulous patients and to compare the differences in the saliva of dentulous individuals with various periodontal conditions.Methods All the subjects were patients who received regular care at the Beijing Hypertension Prevention and Management Institute.Twenty-seven edentulous patients(edentulous group)were included.According to age(age gap≤5 years),gender,smoking status,diabetes status and hypertension status,each edentulous patient was paired with dentulous individuals suffering from various severity of periodontitis in the same cohort.Then,we selected 3 groups of patients(n=27 in each group)with no or mild periodontitis(mild group),moderate periodontitis(moderate group)and severe periodontitis(severe group).The whole unstimulated saliva was collected before the periodontal examination.Questionnaire survey and periodontal parameters,including plaque index(PLI),probing depth(PD),bleeding index(BI)and clinical attachment loss(CAL),were examined at mesial-buccal and distal-lingual sites of each tooth respectively.DNA was extracted from each sample of the salivary deposition.Porphyromonas gingivalis(Pg),Tannerella forsythia(Tf),Treponema denticola(Td),Campylobacter rectus(Cr)and Prevotella nigrescens(Pn)were detected by using PCR method based on 16SrRNA.The prevalence and quantity of the pathogens under various severity of periodontitis were compared.Results One or more periodontal pathogens could be detected from the 78%(21/27)of the salivary samples in edentulous group.Thereinto,the prevalences of the five periodontal pathogens were ranked as(from high to low):Cr[56%(15/27)],Tf[44%(12/27)],Pn[26%(7/27)],Pg[22%(6/27)]and Td[11%(3/27)].All five pathogens′prevalences and Pg,Tf,Td and Pn′s quantities showed statistical differences among the four groups.The numbers of detected bacterial species in the mild,moderate and severe groups were significantly higher than that in the edentulous group(P<0.01).Furthermore,the p

关 键 词：颌 无牙 牙周炎 唾液 牙周致病菌 细菌感染 

分 类 号：R781.42[医药卫生—口腔医学]