老年口腔种植患者龈下菌群变化及其与种植体松动、脱落的关系研究  

Changes of subgingival microbiota in elderly patients with dental implants and its relationship with implant loosening and loss

作　　者：段亮伟 闫森 王晶晶 孙强[3] DUAN Liang-wei;YAN Sen;WANG Jing-jing;SUN Qiang(Department of Stomatology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Orthodontics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院口腔科,河南郑州450000 [2]郑州大学第一附属医院口腔正畸科,河南郑州450000 [3]郑州大学第一附属医院口腔颌面外科,河南郑州450000

出　　处：《海南医学》2024年第17期2480-2486,共7页Hainan Medical Journal

基　　金：2020年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20200270)。

摘　　要：目的探讨老年口腔种植患者龈下菌群变化及其与种植体松动、脱落的关系。方法前瞻性选取2022年1月至2023年8月郑州大学第一附属医院收治105例老年口腔种植患者作为研究对象,根据口腔种植6个月后是否伴随种植体松动、脱落情况分组,其中松脱组31例,未松脱组74例。比较两组患者种植前、种植1个月后、种植2个月后的中间普氏菌(P.i)、福赛坦菌(T.f)、牙龈卟啉单胞菌(P.g)、伴放线放线杆菌(A.a)、口腔链球菌和口腔乳杆菌等后龈下菌群以及改良菌斑指数(MPLI)、探诊深度(PD)和改良龈沟出血指数(MSBI)等牙周临床指标水平,采用Pearson相关系数分析龈下菌群水平与牙周临床指标的相关性,Spearman相关系数分析龈下菌群水平与种植体松动、脱落的相关性,采用Logistic回归分析种植体松动、脱落的影响因素,采用受试者工作特征曲线(ROC)分析龈下菌群水平对种植体松动、脱落的预测价值。结果种植前、种植1个月后、种植2个月后,两组患者的P.i、T.f、P.g、A.a、口腔链球菌水平呈升高趋势,口腔乳杆菌水平呈下降趋势,且种植1个月和2个月后,松脱组患者的P.i、T.f、P.g、A.a、口腔链球菌、MPLI、PD、MSBI水平明显高于未松脱组,口腔乳杆菌水平低于未松脱组,差异均有统计学意义(P<0.05);Pearson相关系数分析显示,种植1个月后、2个月后P.i、T.f、P.g、A.a、口腔链球菌与MPLI、PD、MSBI均呈正相关,口腔乳杆菌与之均呈负相关。Spearman相关系数分析显示,种植1个月后、2个月后P.i、T.f、P.g、A.a、口腔链球菌与种植体松动、脱落呈正相关,口腔乳杆菌与之呈负相关(P<0.05);Logistic回归分析结果显示,P.i、T.f、P.g、A.a、口腔链球菌、口腔乳杆菌、MPLI、PD、MSBI均是老年口腔种植患者种植体松动、脱落的独立影响因素(P<0.05),校正相关因素后,P.i、T.f、P.g、A.a、口腔链球菌、口腔乳杆菌仍是其独立影响Objective To investigate the change of subgingival flora in elderly patients with dental implants and its relationship with implant loosening and loss.Methods A prospective study was conducted in 105 elderly pa-tients undergoing dental implant treatment admitted to the First Affiliated Hospital of Zhengzhou University from Janu-ary 2022 to August 2023.The patients were divided into two groups based on whether they had implant loosening or loss at 6 months after dental implant treatment:the loosening group(n=31)and the non-loosening group(n=74).The levels of subgingival microbiota such as Prevotella intermedia(P.i),Treponema denticola(T.f),Porphyromonas gingivalis(P.g),Actinobacillus actinomycetemcomitans(A.a),oral Streptococcus and oral Lactobacillus,as well as periodontal clinical indi-cators such as modified plaque index(MPLI),probing depth(PD),and modified sulcus bleeding index(MSBI)were compared between the two groups of patients before implantation,at one month and two months after implantation.Pear-son correlation coefficient analysis was used to analyze the correlation between subgingival microbiota levels and peri-odontal clinical indicators.Spearman correlation coefficient analysis was used to analyze the correlation between subgin-gival microbiota levels and implant loosening and loss.Logistic regression analysis was used to analyze the influencing factors of implant loosening and loss,and receiver operating characteristic(ROC)curve was used to analyze the predic-tive value of subgingival microbiota levels for implant loosening and loss.Results Before implantation and at one month and two months after implantation,the levels of P.i,T.f,P.g,A.a,and oral Streptococcus in both groups showed an increasing trend,while the level of oral Lactobacillus showed a decreasing trend.At one month and two months af-ter implantation,the levels of P.i,T.f,P.g,A.a,oral Streptococcus,MPLI,PD,and MSBI in the loosening group were significantly higher than those in the non-loosening group,while the level of oral Lactobacillu

关 键 词：老年 口腔种植 龈下菌群 种植体 松动 脱落 相关性 预测 

分 类 号：R787[医药卫生—口腔医学]