Socransky Sigmund S, Smith Claire, Haffajee Anne D
Department of Periodontology, The Forsyth Institute, 140 The Fenway, Boston, MA 02115, USA.
J Clin Periodontol. 2002 Mar;29(3):260-8. doi: 10.1034/j.1600-051x.2002.290313.x.
BACKGROUND/AIM: The purpose of the present investigation was to examine subgingival microbial profiles associated with refractory periodontitis and to seek such profiles in periodontally healthy, periodontally well-maintained elder and untreated periodontitis subjects.
36 subjects were defined as refractory on the basis of further attachment loss after scaling and root planing, surgery and systemically administered antibiotics. A total of 890 subgingival plaque samples (mean/subject=24.7) were taken from the mesial aspect of each tooth in each subject at baseline and individually processed for their content of 40 subgingival taxa using checkerboard DNA-DNA hybridization. Cluster analysis was performed on mean within subject species counts using the chord coefficient and an average unweighted linkage sort. Significant differences among clusters for individual and complexes of species were sought using the Kruskal Wallis test. The microbial profiles of the refractory subjects were compared with those of 27 periodontally healthy subjects (n plaque samples=708), 35 periodontally well-maintained elder subjects (n plaque samples=801) and 115 untreated adult periodontitis subjects (n plaque samples=2871).
28 of 36 refractory subjects fell into 4 clusters with >29% similarity. 10 of 40 species and 4 of 7 complexes differed significantly among clusters. Profile (Cluster) I (n=4) was characterized by high proportions of "yellow" and "green" complex species, profile II (n=3) by low total counts and high proportions of "orange" and "purple" complex species, profile III (n=9) by high total counts and counts of Actinomyces and "purple" complex species, profile IV (n=12) by high proportions of "red" and "orange" complex species. The mean profiles of each cluster were subjected to cluster analysis with microbial data from 4380 (mean 24.7) baseline subgingival plaque samples from 27 periodontally healthy, 35 treated, well-maintained elders and 115 untreated adult periodontitis subjects. 12 clusters were formed with >41% similarity. 3 of the refractory profiles were detected in 3 cluster groups. Profile II in a cluster of 1 healthy, 1 elder and 4 untreated periodontitis subjects; profile III in a cluster of 1 healthy, 2 elder and 12 periodontitis subjects; Profile IV, with 1 healthy and 5 untreated periodontitis subjects. The profile not detected in non refractory subjects was dominated by Streptococcus species. 9 clusters did not harbor refractory profiles. 11.1% of healthy, 8.6% of elder and 18.3% of periodontitis subjects were in clusters exhibiting refractory microbial profiles.
4 subgingival microbial profiles were detected among refractory subjects. "Refractory microbial profiles" could be detected in subjects who had not yet exhibited refractory disease.
背景/目的：本研究旨在检测与难治性牙周炎相关的龈下微生物谱，并在牙周健康、牙周状况良好的老年人以及未经治疗的牙周炎患者中寻找此类谱型。
36名受试者在进行龈上洁治、根面平整、手术及全身应用抗生素后仍有进一步的附着丧失，被定义为难治性牙周炎患者。在基线时，从每位受试者每颗牙齿的近中面采集总共890份龈下菌斑样本（平均每位受试者24.7份），并分别采用棋盘式DNA-DNA杂交技术检测40种龈下微生物类群的含量。使用弦系数和平均非加权连锁排序法对受试者内物种计数的平均值进行聚类分析。使用Kruskal Wallis检验寻找各聚类中单个物种及物种复合体之间的显著差异。将难治性牙周炎患者的微生物谱与27名牙周健康受试者（龈下菌斑样本708份）、35名牙周状况良好的老年人（龈下菌斑样本801份）以及115名未经治疗的成人牙周炎患者（龈下菌斑样本2871份）的微生物谱进行比较分析。
36名难治性牙周炎患者中的28名聚为4个相似度>29%的聚类。40种物种中的10种以及7个复合体中的4个在各聚类间存在显著差异。聚类I（n = 4）的特征是“黄色”和“绿色”复合体物种比例较高；聚类II（n = 3）的特征是总数较低，“橙色”和“紫色”复合体物种比例较高；聚类III（n = 9）的特征是总数较高，放线菌和“紫色”复合体物种计数较高；聚类IV（n = 12）的特征是“红色”和“橙色”复合体物种比例较高。对每个聚类的平均谱型与来自27名牙周健康受试者、35名经过治疗且牙周状况良好的老年人以及115名未经治疗的成人牙周炎患者的4380份（平均24.7份）基线龈下菌斑样本的微生物数据进行聚类分析。形成了12个相似度>41%的聚类。在3个聚类组中检测到3种难治性牙周炎患者的谱型。聚类II存在于1名健康受试者、1名老年人和4名未经治疗的牙周炎患者中；聚类III存在于1名健康受试者、2名老年人和12名牙周炎患者中；聚类IV存在于1名健康受试者和5名未经治疗的牙周炎患者中。在非难治性牙周炎患者中未检测到的谱型以链球菌属为主。9个聚类中不存在难治性牙周炎患者的谱型。11.1%的健康受试者8.6%的老年人以及18.3%的牙周炎患者处于呈现难治性微生物谱型的聚类中。
在难治性牙周炎患者中检测到4种龈下微生物谱型。在尚未表现出难治性疾病的受试者中也能检测到“难治性微生物谱型”。
