Chaves E S, Jeffcoat M K, Ryerson C C, Snyder B
Oral Care, Hill Top Research Inc, West Palm Beach, FL 33409, USA.
J Clin Periodontol. 2000 Dec;27(12):897-903. doi: 10.1034/j.1600-051x.2000.027012897.x.
BACKGROUND, AIMS: The purpose of this study was to determine whether the presence of bacterial antigens for Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), and Actinobacillus actinomycetemcomitans (Aa) in subgingival plaque of periodontitis patients after periodontal treatment was associated with progressive alveolar bone loss.
39 (39) subjects in good general health previously diagnosed with adult periodontitis within the last 2 years, and still presenting with probing depth >5 mm in 2 to 6 teeth, were studied. All subjects were treated with scaling and root planing. Half of the subjects were randomly assigned to receive adjunctive systemic doxycycline (200 mg the 1st day, then 100 mg per day for 21 days). Subgingival plaque samples were taken at baseline, 1, 3 and 6 months after therapy. A modified ELISA test (Evalusite, Periodontal Test Kit, Eastman Kodak Co., Rochester, NY) was used to test for plaque antigens associated with P. gingivalis, P. intermedia and A. actinomycetemcomitans. Progressive alveolar bone loss was determined using digital subtraction radiography with standardized radiographs taken at baseline and 6 months after treatment.
The presence of P. gingivalis in plaque after treatment was significantly associated with progressive bone loss (positive predictive value 84%, negative predictive value 85%, odds ratio 31.9, p<0.0001). In contrast, the presence of P. intermedia in plaque after treatment was not indicative of progressive loss (positive predictive value 39%, negative predictive value 82%). Too few sites had evidence of A. actinomycetemcomitans to be amenable to statistical analysis. No significant difference in bone loss was attributable to the systemic antibiotic therapy.
These data indicated that, in this population, the presence of P. gingivalis in plaque after treatment might be indicative of progressive alveolar bone loss.
背景、目的：本研究旨在确定牙周炎患者在牙周治疗后，龈下菌斑中牙龈卟啉单胞菌（Pg）、中间普氏菌（Pi）和伴放线放线杆菌（Aa）的细菌抗原的存在是否与牙槽骨的进行性丧失有关。
对39名一般健康状况良好、在过去2年内被诊断为成人牙周炎且仍有2至6颗牙齿探诊深度>5mm的受试者进行研究。所有受试者均接受了龈上洁治和根面平整治疗。一半受试者被随机分配接受辅助性全身强力霉素治疗（第1天200mg，然后每天100mg，共21天）。在基线、治疗后1、3和6个月采集龈下菌斑样本。使用改良的ELISA试验（Evalusite，牙周检测试剂盒，伊士曼柯达公司，纽约罗切斯特）检测与牙龈卟啉单胞菌、中间普氏菌和伴放线放线杆菌相关的菌斑抗原。使用数字减影放射成像技术，通过在基线和治疗后6个月拍摄的标准化X线片来确定牙槽骨的进行性丧失情况。
治疗后菌斑中牙龈卟啉单胞菌的存在与骨的进行性丧失显著相关（阳性预测值84%，阴性预测值85%，优势比31.9，p<0.0001）。相比之下，治疗后菌斑中中间普氏菌的存在并不能预示骨的进行性丧失（阳性预测值39%，阴性预测值82%）。有伴放线放线杆菌证据的部位太少，无法进行统计学分析。全身抗生素治疗在骨丧失方面无显著差异。
这些数据表明，在该人群中，治疗后菌斑中牙龈卟啉单胞菌的存在可能预示牙槽骨的进行性丧失。
