Tran S D, Rudney J D, Sparks B S, Hodges J S
Department of Oral Science, School of Dentistry, University of Minnesota, Minneapolis, USA.
J Periodontol. 2001 Jan;72(1):1-10. doi: 10.1902/jop.2001.72.1.1.
Previous longitudinal studies investigating the role of microorganisms in periodontitis have focused on subjects with a high prevalence and severity of disease. The complex profile of microbial species in severe cases of periodontitis might not allow us to differentiate which bacterial species initiate disease or which species simply proliferate after disease progression. This prospective longitudinal study followed a group of 205 subjects who showed a low prevalence and severity of adult periodontitis, and thus allowed us to monitor early microbiological changes in the development of periodontitis.
Subgingival plaque was collected from proximal surfaces of a posterior sextant at 6-month intervals for 2 years. During the monitoring period, 44 subjects had either attachment loss or attachment gain. Using multiplex polymerase chain reaction (PCR), all plaque samples from those 44 subjects were analyzed for the presence of Actinobacillus actinomycetemcomitans, Bacteroides forsythus, and Porphyromonas gingivalis.
Both subjects with attachment loss and those with attachment gain had a high prevalence of these 3 periodontal pathogens. The mere presence of any of the 3 species at a site could not predict future attachment loss at that specific site. However, subjects with a persistent presence of B. forsythus at any site across all visits had 5.3 times higher odds of having at least one site in their mouth losing attachment compared to subjects with occasional or no presence of B. forsythus.
The persistence of B. forsythus identified subjects at higher risk, but not which specific sites in those subjects would lose attachment.
以往关于微生物在牙周炎中作用的纵向研究主要集中在疾病患病率和严重程度较高的人群。重度牙周炎病例中复杂的微生物种类分布可能使我们无法区分哪些细菌种类引发疾病，哪些种类只是在疾病进展后增殖。这项前瞻性纵向研究跟踪了一组205名成人牙周炎患病率和严重程度较低的受试者，从而使我们能够监测牙周炎发展过程中的早期微生物变化。
在2年时间里，每隔6个月从后牙区近中面采集龈下菌斑。在监测期间，44名受试者出现了附着丧失或附着增加。使用多重聚合酶链反应（PCR）分析这44名受试者所有菌斑样本中伴放线放线杆菌、福赛坦氏菌和牙龈卟啉单胞菌的存在情况。
附着丧失和附着增加的受试者中，这3种牙周病原体的患病率都很高。这3种细菌中任何一种在某一部位的单纯存在，并不能预测该特定部位未来的附着丧失情况。然而，在所有访视中，任何部位持续存在福赛坦氏菌的受试者，其口腔中至少有一个部位发生附着丧失的几率，是偶尔或未检测到福赛坦氏菌的受试者的5.3倍。
福赛坦氏菌的持续存在表明受试者处于较高风险，但无法确定这些受试者中哪些特定部位会发生附着丧失。
