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成人牙周炎患者龈上和龈下菌斑的微生物组成

Microbial composition of supra- and subgingival plaque in subjects with adult periodontitis.

作者信息

Ximénez-Fyvie L A, Haffajee A D, Socransky S S

机构信息

Department of Periodontology, The Forsyth Institute, Boston, MA 02115, USA.

出版信息

J Clin Periodontol. 2000 Oct;27(10):722-32. doi: 10.1034/j.1600-051x.2000.027010722.x.

Abstract

BACKGROUND, AIMS: The purpose of the present study was to compare and relate the microbial composition of supra and subgingival plaque in 23 adult periodontitis subjects (mean age 51 +/- 14 years).

METHODS

A total of 1,170 samples of supra and subgingival plaque were collected from the mesial aspect of every tooth (up to 28 supra and 28 subgingival samples) from each subject and evaluated for the presence and levels of 40 bacterial taxa using whole genomic DNA probes and checkerboard DNA-DNA hybridization. Clinical assessments including dichotomous measures of gingival redness, bleeding on probing, plaque accumulation and suppuration, as well as duplicate measures of pocket depth and attachment level, were made at 6 sites per tooth. The counts (levels), % DNA probe count (proportion) and % of sites colonized (prevalence) of each species in supra and separately in subgingival plaque were computed for each subject. Significance of differences between supra and subgingival plaque for each species was sought using the Wilcoxon signed ranks test and adjusted for multiple comparisons.

RESULTS

All 40 taxa were detected in both supra and subgingival plaque. Actinomyces species were the most prevalent taxa in both habitats. 75 to 100% of supra and 62 to 100% of subgingival sites were colonized by at least one of the 5 Actinomyces species. Supragingival samples exhibited significantly higher counts of Actinomyces naeslundii genospecies 1, Actinomyces israelii, Actinomyces odontolyticus, Neisseria mucosa, Streptococcus gordonii, Capnocytophaga ochracea and Capnocytophaga sputigena when compared with mean counts in subgingival samples taken from the same tooth surfaces. Subgingival plaque samples presented significantly higher counts of Prevotella nigrescens, Prevotella intermedia, Bacteroides forsythus and Porphykromonas gingivalis. Subgingival samples exhibited a significantly higher proportion of "red" and "orange complex" species, while supragingival plaque exhibited higher proportions of "green" and "purple" complex species as well as Actinomyces species. Suspected periodontal pathogens could be detected in supragingival plaque from sites where subgingival samples were negative for the same species.

CONCLUSIONS

The data indicate that supragingival plaque can harbor putative periodontal pathogens, suggesting a possible rôle of this environment as a reservoir of such species for the spread or reinfection of subgingival sites.

摘要

背景与目的

本研究旨在比较23名成人牙周炎患者(平均年龄51±14岁)龈上和龈下菌斑的微生物组成并进行关联分析。

方法

从每位受试者每颗牙齿的近中面收集总共1170份龈上和龈下菌斑样本(每位受试者最多28份龈上样本和28份龈下样本),使用全基因组DNA探针和棋盘式DNA-DNA杂交技术评估40种细菌类群的存在情况和水平。在每颗牙齿的6个位点进行临床评估,包括牙龈发红、探诊出血、菌斑积聚和化脓的二分法测量,以及牙周袋深度和附着水平的重复测量。计算每位受试者龈上菌斑和龈下菌斑中每种细菌的计数(水平)、DNA探针计数百分比(比例)和定植位点百分比(患病率)。使用Wilcoxon符号秩检验寻找龈上和龈下菌斑中每种细菌之间差异的显著性,并对多重比较进行校正。

结果

在龈上和龈下菌斑中均检测到所有40种类群。放线菌属是两个部位最常见的类群。75%至100%的龈上部位和62%至100%的龈下部位被5种放线菌中的至少一种定植。与从同一牙齿表面采集的龈下样本的平均计数相比,龈上样本中内氏放线菌基因种1、衣氏放线菌、溶牙放线菌、黏液奈瑟菌、戈登链球菌、黄褐二氧化碳嗜纤维菌和生痰二氧化碳嗜纤维菌的计数显著更高。龈下菌斑样本中变黑普雷沃菌、中间普雷沃菌、福赛坦氏菌和牙龈卟啉单胞菌的计数显著更高。龈下样本中“红色”和“橙色复合体”细菌的比例显著更高,而龈上菌斑中“绿色”和“紫色”复合体细菌以及放线菌属的比例更高。在龈下样本中同一细菌为阴性的部位的龈上菌斑中可检测到疑似牙周病原体。

结论

数据表明龈上菌斑可能含有推定的牙周病原体,提示该环境可能作为此类细菌的储存库,导致龈下部位传播或再次感染。

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