Mombelli A, Schmid B, Rutar A, Lang N P
School of Dental Medicine, Department of Periodontology and Fixed Prosthodontics, University of Bern, Switzerland.
J Periodontol. 2000 Jan;71(1):14-21. doi: 10.1902/jop.2000.71.1.14.
The aim of this study was to determine the distribution patterns of Porphyromonas gingivalis, Prevotella intermedia/nigrescens, and Actinobacillus actinomycetemcomitans in periodontitis patients after standard mechanical periodontal therapy, and to determine factors increasing the odds to detect these target organisms in treated sites.
Eight hundred fifty-two (852) separate subgingival microbial samples were taken from the mesial and distal aspects of every tooth in 17 patients. Target organisms were identified culturally.
The 3 microorganisms showed different persistence patterns: P. gingivalis was detected in a high percentage of subjects (59%), but in a low proportion of sites (5.4%). P. intermedia/nigrescens was detected in all subjects except one, and in 40.6% of the tested sites. Only 5 subjects were A. actinomycetemcomitans positive, but 2 of them showed a very high number of positive sites (44% and 75%, respectively). A highly significant relationship was found between a subject's tendency to bleed upon sampling and the number of P. intermedia/nigrescens-positive sites. A significant portion of the variation in frequency of persisting P. gingivalis could be explained by the frequency of persisting pockets deeper than 4 mm. No similar relationship could be established between clinical parameters and A. actinomycetemcomitans. On a site level, the odds of detecting P. gingivalis increased by a factor of 2.47 (P= 0.0001) for every millimeter of residual probing depth; the odds of detecting P. intermedia/nigrescens increased by a factor of 1.84 (P= 0.0001).
If, after standard mechanical periodontal therapy, a large number of sites continue to bleed, one may expect an increased number of sites positive for P. intermedia/ nigrescens. If many deep pockets persist, a greater number of P. gingivalis-positive sites can be expected.
本研究的目的是确定标准机械性牙周治疗后牙周炎患者牙龈卟啉单胞菌、中间普氏菌/变黑普氏菌和伴放线放线杆菌的分布模式，并确定增加在治疗部位检测到这些目标微生物几率的因素。
从17例患者每颗牙齿的近中面和远中面采集852份独立的龈下微生物样本。通过培养鉴定目标微生物。
这3种微生物表现出不同的持续存在模式：牙龈卟啉单胞菌在高比例的受试者中被检测到（59%），但在低比例的部位被检测到（5.4%）。除1例受试者外，其余所有受试者均检测到中间普氏菌/变黑普氏菌，且在40.6%的检测部位被检测到。只有5例受试者伴放线放线杆菌呈阳性，但其中2例显示出非常高比例的阳性部位（分别为44%和75%）。发现受试者采样时出血倾向与中间普氏菌/变黑普氏菌阳性部位数量之间存在高度显著的关系。持续存在的牙龈卟啉单胞菌频率的很大一部分变异可以用深度超过4mm的持续存在的牙周袋频率来解释。临床参数与伴放线放线杆菌之间未建立类似关系。在部位水平上，残余探诊深度每增加1毫米，检测到牙龈卟啉单胞菌的几率增加2.47倍（P = 0.0001）；检测到中间普氏菌/变黑普氏菌的几率增加1.84倍（P = 0.0001）。
在标准机械性牙周治疗后，如果大量部位持续出血，则可能预期中间普氏菌/变黑普氏菌阳性部位数量会增加。如果许多深牙周袋持续存在，则可能预期牙龈卟啉单胞菌阳性部位数量会更多。
