Kowolik M J, Dowsett S A, Rodriguez J, De La Rosa R M, Eckert G J
Indiana University School of Dentistry, Indianapolis 46202, USA.
J Periodontol. 2001 Feb;72(2):146-51. doi: 10.1902/jop.2001.72.2.146.
There is considerable current interest in putative relationships between oral and systemic diseases. Since the host response to oral bacteria may be the critical link in this association, our hypothesis was that dental plaque accumulation in healthy subjects would elicit a systemic inflammatory response.
Twenty-three healthy subjects, aged 18 to 25, participated in a 4-phase study. An initial hygiene phase was followed by a 21-day experimental phase (the so-called experimental gingivitis model) in which subjects refrained from all oral hygiene practices, thus permitting the accumulation of bacterial plaque. At days 0, 7, and 21 total and differential peripheral white blood cell (wbc) counts, together with full mouth plaque and gingivitis scores, were recorded. Following a 28-day recovery phase, in which normal oral hygiene practices were resumed, subjects entered the final 21-day control phase which mirrored the experimental phase but with subjects maintaining normal oral hygiene practices.
The experimental model performed as anticipated with a correlation between plaque and gingivitis scores of 0.95, also reflecting subject compliance. Total wbc and neutrophil counts increased during the experimental phase. Furthermore, comparison of neutrophil counts between the experimental and control phases demonstrated a significantly higher cell count for the experimental phase on both days 7 and 21 (P= 0.0301 and 0.009, respectively). For total wbc, this was significant on day 21 (P= 0.0262).
The results of this study support the hypothesis that the accumulation of dental plaque can result in a measurable systemic inflammatory response, providing further in vivo data to support a mechanistic relationship between oral and systemic pathology.
目前人们对口腔疾病与全身疾病之间的假定关系极为关注。由于宿主对口腔细菌的反应可能是这种关联的关键环节，我们的假设是健康受试者牙菌斑的积累会引发全身炎症反应。
23名年龄在18至25岁之间的健康受试者参与了一项分为四个阶段的研究。初始的清洁阶段之后是一个为期21天的实验阶段（即所谓的实验性牙龈炎模型），在此阶段受试者停止所有口腔卫生措施，从而使细菌菌斑得以积累。在第0天、第7天和第21天记录外周血白细胞（WBC）总数及分类计数，同时记录全口菌斑和牙龈炎评分。在一个为期28天的恢复期（恢复正常口腔卫生措施）之后，受试者进入最后的21天对照阶段，该阶段与实验阶段相似，但受试者保持正常口腔卫生措施。
实验模型按预期运行，菌斑与牙龈炎评分之间的相关性为0.95，这也反映了受试者的依从性。实验阶段白细胞总数和中性粒细胞计数增加。此外，实验阶段与对照阶段中性粒细胞计数的比较表明，在第7天和第21天实验阶段的细胞计数均显著更高（分别为P = 0.0301和0.009）。对于白细胞总数，在第21天具有显著性差异（P = 0.0262）。
本研究结果支持牙菌斑积累可导致可测量的全身炎症反应这一假设，为支持口腔与全身病理学之间的机制关系提供了更多体内数据。
