Berglundh T, Liljenberg B, Lindhe J
Department of Periodontology, Göteborg University, Sweden.
J Clin Periodontol. 1999 Feb;26(2):91-8. doi: 10.1034/j.1600-051x.1999.260205.x.
The aim of the present investigation was to study the effect of nonsurgical periodontal therapy on some local (gingival) and systemic host defense characteristics in subjects with advanced periodontal disease. 16 individuals with advanced periodontal disease were recruited. Following a clinical examination, the 3 deepest interproximal sites in the upper and lower premolar- or molar segments were selected for further analysis. Samples from the subgingival microbiota were obtained from the pocket of the selected sites and were prepared for a microbiological examination. The gingival tissue at one of the selected sites was also biopsied. Each excised soft tissue specimen was snap frozen and prepared for immunohistochemical analysis. A sample of peripheral blood was obtained from each individual and prepared for immunohistochemical analysis. Following the baseline examination, all 16 patients received periodontal therapy including oral hygiene instruction and scaling and root planing. Re-examinations regarding the clinical parameters were performed, the subgingival microbiota harvested from the sampling sites and one gingival biopsy was collected at 12 months and 24 months, respectively, among the selected sites. Samples of peripheral blood were obtained from the subjects at the 24-month re-examination. It was demonstrated that non-surgical periodontal therapy effectively reduced symptoms such as gingivitis and probing pocket depth in the subject sample and improved the overall probing attachment level. The treatment applied also markedly reduced (i) the total number of micro-organisms present in selected gingival pockets as well as (ii) the relative proportions of A. actinomycetemcomitans, P. gingivalis and P. intermedia of the subgingival microbiota. The improved clinical condition was, in addition, accompanied by a substantial reduction in the size of the inflammatory lesion (P-ICT) which in the soft tissue samples harvested at baseline was found to reside lateral to the pocket epithelium. Also qualitative alterations occurred in the lesions. Hence, following therapy (i) both the density of CD19 positive cells and the proportion of CD3 positive cells expressing TCR Vbeta genes were reduced in the P-ICT. while (ii) the overall relative number of CD3 positive cells remained unchanged. In conclusion, non-surgical periodontal therapy markedly changed the size and composition of the plaque associated lesion in the gingival tissue but apparently failed to affect the relative distribution of lymphocyte subsets in peripheral blood.
本研究的目的是探讨非手术牙周治疗对晚期牙周病患者某些局部（牙龈）和全身宿主防御特征的影响。招募了16名晚期牙周病患者。经过临床检查后，选择上下前磨牙或磨牙段中最深的3个邻间隙部位进行进一步分析。从选定部位的牙周袋中获取龈下微生物样本，准备进行微生物学检查。还对选定部位之一的牙龈组织进行活检。每个切除的软组织标本速冻后准备进行免疫组织化学分析。从每个个体采集外周血样本，准备进行免疫组织化学分析。在基线检查后，所有16名患者均接受了包括口腔卫生指导以及龈上洁治和根面平整在内的牙周治疗。进行了关于临床参数的复查，在选定部位分别于12个月和24个月时采集从采样部位获取的龈下微生物群以及一次牙龈活检样本。在24个月复查时从受试者采集外周血样本。结果表明，非手术牙周治疗有效减轻了受试者样本中的牙龈炎和探诊深度等症状，并改善了整体探诊附着水平。所应用的治疗还显著减少了（i）选定牙龈袋中存在的微生物总数以及（ii）龈下微生物群中伴放线放线杆菌、牙龈卟啉单胞菌和中间普氏菌的相对比例。此外，临床状况的改善伴随着炎症病变（P-ICT）大小的大幅减小，在基线时采集的软组织样本中发现该病变位于牙周袋上皮外侧。病变中也发生了定性改变。因此，治疗后（i）P-ICT中CD19阳性细胞的密度和表达TCR Vβ基因的CD3阳性细胞的比例均降低，而（ii）CD3阳性细胞的总体相对数量保持不变。总之，非手术牙周治疗显著改变了牙龈组织中与菌斑相关病变的大小和组成，但显然未能影响外周血中淋巴细胞亚群的相对分布。
