Van der Reijden W A, Dellemijn-Kippuw N, Stijne-van Nes A M, de Soet J J, van Winkelhoff A J
Sections of Clinical Periodontal Microbiology and Oral Microbiology, Department of Oral Biology, Academic Centre for Dentistry Amsterdam, The Netherlands.
J Clin Periodontol. 2001 Jul;28(7):686-91. doi: 10.1034/j.1600-051x.2001.028007686.x.
The etiology of root caries is thought to be identical to coronal caries, though root caries seem to be more complicated because of the higher susceptibility of exposed roots (dentin) by periodontal therapy to demineralization than intact enamel. This implies that mutans streptococci are the most likely pathogens in the development of root caries. Although it is known that both the numbers of mutans streptococci and the frequency of isolation in root caries lesions are negatively correlated with the distance from the gingival margin, the subgingival sulcus has not been considered a possible habitat for mutans streptococci. However, subgingival occurrence of mutans streptococci in both untreated and treated periodontal patients has not been documented well in the literature.
To investigate the presence and levels of mutans streptococci in the subgingival plaque of patients (n=154) in different stages of periodontal therapy. The subgingival sulcus may be a possible habitat for mutans streptococci. This localisation of mutans streptococci may be of importance in the development of root caries after periodontal surgery.
In this cross-sectional study, subgingival plaque samples from 154 consecutive adult periodontitis patients were tested for presence and levels of mutans streptococci and putative periodontal pathogens by anaerobic cultures. These patients were divided into 4 groups based on their stage of periodontal treatment: (1) untreated patients; (2) patients after initial periodontal therapy only; (3) patients in the maintenance phase who not underwent periodontal surgery; (4) patients after periodontal surgery.
The prevalence of mutans streptococci in the 4 study groups varied from 82% in untreated patients to 94% in maintenance patients. The mean proportion of mutans streptococci was 6.65% in maintenance patients versus 1.86% in untreated patients (p=0.005) and 2.51% in patients after scaling and root planing (p=0.041).
The subgingival area is a microbial habitat for mutans streptococci that may be of importance in the development of root caries in periodontitis patients.
尽管由于牙周治疗后暴露的牙根（牙本质）比完整的牙釉质更易脱矿，使得根龋似乎更为复杂，但人们认为根龋的病因与冠龋相同。这意味着变形链球菌很可能是根龋发生过程中的病原体。虽然已知变形链球菌的数量以及在根龋损害中的分离频率与距牙龈边缘的距离呈负相关，但龈下沟尚未被视为变形链球菌可能的生存环境。然而，未经治疗和已治疗的牙周病患者龈下出现变形链球菌的情况在文献中尚未得到充分记载。
调查处于不同牙周治疗阶段的患者（n = 154）龈下菌斑中变形链球菌的存在情况及其水平。龈下沟可能是变形链球菌的一个潜在生存环境。变形链球菌的这种定位在牙周手术后根龋的发生中可能具有重要意义。
在这项横断面研究中，通过厌氧培养对154例连续的成年牙周炎患者的龈下菌斑样本进行检测，以确定变形链球菌以及假定的牙周病原体的存在情况及其水平。这些患者根据牙周治疗阶段分为4组：（1）未经治疗的患者；（2）仅接受过初始牙周治疗的患者；（3）处于维护阶段且未接受过牙周手术的患者；（4）接受过牙周手术的患者。
4个研究组中变形链球菌的患病率从未经治疗患者的82%到维护期患者的94%不等。维护期患者中变形链球菌的平均比例为6.65%，而未经治疗患者为1.86%（p = 0.005），龈上洁治和根面平整术后患者为2.51%（p = 0.041）。
龈下区域是变形链球菌的一个微生物生存环境，这在牙周炎患者根龋的发生中可能具有重要意义。
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