Zaremba M, Górska R, Suwalski P, Czerniuk M R, Kowalski J
Department of Periodontology and Oral Medicine, Medical University of Warsaw, Poland.
Adv Med Sci. 2006;51 Suppl 1:34-9.
Unstable atherosclerotic plaque is a dangerous clinical state, possibly leading to acute coronary deficiency resulting in cardiac infarction. Inflammatory factor's role in creating pathological lesions in the endothelium of coronary vessels is frequently raised. This state may be caused by bacteria able to initiate clot formation in blood vessel and destabilizing atherosclerotic plaque already present. Source of these pathogens are chronic inflammatory processes occurring in organism, among them periodontal disease as one of more frequent. Aim of the work was to evaluate incidence of selected anaerobic bacteria in subgingival plaque and in atherosclerotic plaque in patients treated surgically because of coronary vessels' obliteration.
Study was performed on 20 individuals with chronic periodontitis. Subgingival plaque was collected from periodontal pockets deeper than 5 mm DNA test was used for marking eight pathogens responsible for periodontal tissues destruction. In the same patients, as well as in 10 edentulous individuals material from atherosclerotic plaque was collected during by-pass implantation procedure, and identical DNA testing occurred.
In 13 of 20 patients pathogens most frequent in severe chronic periodontitis were found in coronary vessels. In 10 cases those bacteria were also present in atherosclerotic plaque. Pathogens linked with periodontal disease were also found in 7 of 10 edentulous individuals. Most frequently marked bacteria were: Porphyromonas gingivalis and Treponema denticola.
It seems that advancement of periodontal disease does not have influence on bacteria permeability to coronary vessels. Important is the presence of active inflammatory process expressed by significantly higher bleeding index in patients with marked bacteria in atherosclerotic plaque.
不稳定的动脉粥样硬化斑块是一种危险的临床状态，可能导致急性冠状动脉供血不足，进而引发心肌梗死。炎症因子在冠状动脉血管内皮形成病理病变中的作用经常被提及。这种状态可能由能够在血管中引发血栓形成并使已存在的动脉粥样硬化斑块不稳定的细菌引起。这些病原体的来源是机体中发生的慢性炎症过程，其中牙周病是较为常见的一种。本研究的目的是评估因冠状动脉闭塞而接受手术治疗的患者龈下菌斑和动脉粥样硬化斑块中特定厌氧菌的发生率。
对20名慢性牙周炎患者进行研究。从深度超过5mm的牙周袋中采集龈下菌斑，采用DNA检测来标记8种导致牙周组织破坏的病原体。在这些患者以及10名无牙患者中，在旁路植入手术过程中采集动脉粥样硬化斑块样本，并进行相同的DNA检测。
在20名患者中的13名患者的冠状动脉中发现了重度慢性牙周炎中最常见的病原体。在10例患者中，这些细菌也存在于动脉粥样硬化斑块中。在10名无牙患者中的7名患者中也发现了与牙周病相关的病原体。最常检测到的细菌是：牙龈卟啉单胞菌和具核梭杆菌。
牙周病的进展似乎对细菌渗透至冠状动脉没有影响。重要的是，在动脉粥样硬化斑块中有明显细菌的患者中，由明显更高的出血指数所表现出的活跃炎症过程的存在。
