Rowshani B, Timmerman M F, Van der Velden U
Department of Periodontology, Academic Centre for Dentistry (ACTA), Amsterdam, The Netherlands.
J Clin Periodontol. 2004 Mar;31(3):214-8. doi: 10.1111/j.0303-6979.2004.00468.x.
To investigate the influence of the oral bacterial load on plaque development in various groups of periodontitis patients and in healthy subjects.
This study included subjects with a healthy periodontium, a healthy reduced periodontium after treatment, an inflamed reduced periodontium after treatment and untreated periodontitis. At the start of the study, subjects were instructed to rinse with 10 ml reduced transport fluid (RTF) for 10 s in order to evaluate the oral bacterial load. The microbiological evaluation included anaerobe culture and phase-contrast microscopy. Next, the amount of plaque and the clinical condition were evaluated. Thereafter, all supragingival plaque was removed and patients were instructed to refrain from all oral hygiene procedures for 19 h. Subsequently, the rinsing procedure and the evaluation of the amount of plaque were repeated.
The amount of plaque that developed in 19 h was significantly higher in the untreated periodontitis group as compared with the two healthy groups. In case of an inflamed reduced periodontium, sites with deep pockets developed more plaque in 19 h than sites with shallow pockets. The number of bacteria present in the rinsing samples of the two inflamed groups was considerably higher than of the two periodontally healthy groups. A significant correlation was found between the bleeding index at intake and the plaque index at 19 h. No correlations were found between gingival recession and the bacterial counts at intake, and the plaque index at 19 h.
The present findings support the concept that the periodontal condition is the dominating factor in relation to the rate of plaque formation. The number of bacteria present in the oral cavity as ascertained by means of a rinsing sample does not seem to play a role.
研究口腔细菌载量对不同组牙周炎患者和健康受试者牙菌斑形成的影响。
本研究纳入了牙周组织健康、治疗后牙周组织健康但减少、治疗后牙周组织发炎且减少以及未经治疗的牙周炎患者。在研究开始时,受试者被要求用10毫升稀释转运液(RTF)漱口10秒,以评估口腔细菌载量。微生物学评估包括厌氧菌培养和相差显微镜检查。接下来,评估牙菌斑量和临床状况。此后,清除所有龈上菌斑,并指示患者在19小时内避免所有口腔卫生措施。随后,重复漱口程序和牙菌斑量评估。
与两个健康组相比,未经治疗的牙周炎组在19小时内形成的牙菌斑量显著更高。在牙周组织发炎且减少的情况下,深牙周袋部位在19小时内形成的牙菌斑比浅牙周袋部位更多。两个发炎组漱口样本中的细菌数量明显高于两个牙周健康组。在基线时的出血指数与19小时时的牙菌斑指数之间发现显著相关性。在牙龈退缩与基线时的细菌计数以及19小时时的牙菌斑指数之间未发现相关性。
目前的研究结果支持以下观点,即牙周状况是与牙菌斑形成速率相关的主导因素。通过漱口样本确定的口腔中存在的细菌数量似乎不起作用。