Kurata Hiroshi, Awano Shuji, Yoshida Akihiro, Ansai Toshihiro, Takehara Tadamichi
Division of Community Oral Health Science, Department of Health Promotion, Kyushu Dental College, 2-6-1 Manazuru, Kokurakitaku, Kitakyushu 803-8580, Japan.
J Med Microbiol. 2008 May;57(Pt 5):636-642. doi: 10.1099/jmm.0.47706-0.
This study investigated whether an improvement in periodontal health resulted in changes in the prevalence of periodontopathogenic bacteria in saliva and tongue coatings and a reduction in volatile sulfur compounds (VSCs: H(2)S and CH(3)SH) linked to oral malodour. The subjects were 35 patients who visited the breath odour clinic of Kyushu Dental College, Japan. Their mean age was 51.2+/-18.3 years (mean+/-sd). A clinical examination performed at baseline and 2 months after periodontal treatment assessed VSCs in mouth air using gas chromatography, periodontal probing depth and bleeding on probing (BOP) in all subjects; saliva and tongue coatings were also collected. Genomic DNA was isolated from the samples, and the proportions of five periodontopathogenic bacteria (Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Prevotella intermedia and Prevotella nigrescens) were investigated using quantitative real-time PCR. The subjects were classified into four groups based on the presence of a periodontal pocket of more than 4 mm (PD) and VSCs above the organoleptic threshold level (VSCT) as follows: -PD/-VSCT group, subjects without PD or VSCT; -PD/+VSCT group, those without PD but with VSCT; +PD/-VSCT group, those with PD but without VSCT; and +PD/+VSCT group, those with PD and VSCT. Although the mean PD values in the +PD/-VSCT and +PD/+VSCT groups, BOP in the +PD/+VSCT group, and H(2)S and CH(3)SH concentrations in the -PD/+VSCT and +PD/+VSCT groups were greater than in the other groups at baseline, we found no significant difference among the four groups after periodontal treatment. The proportion of periodontopathogenic bacteria in saliva was higher in the +PD/-VSCT and +PD/+VSCT groups than in the -PD/-VSCT and -PD/+VSCT groups at baseline and after treatment, but the proportions of bacteria in saliva after treatment were reduced compared to the baseline. Furthermore, the differences in the proportions of the five target bacteria in the tongue coating were not as apparent as those in saliva at baseline or after treatment. The prevalence of periodontopathogenic bacteria in saliva may reflect periodontal health status and influence VSC levels in mouth air.
本研究调查了牙周健康状况的改善是否会导致唾液和舌苔中牙周病原菌的流行率发生变化，以及与口腔异味相关的挥发性硫化物（VSCs：H₂S和CH₃SH）含量是否会降低。研究对象为35名前往日本九州牙科大学口臭门诊就诊的患者。他们的平均年龄为51.2±18.3岁（平均值±标准差）。在基线时以及牙周治疗后2个月进行临床检查，使用气相色谱法评估口腔空气中的VSCs，测量所有受试者的牙周探诊深度和探诊出血（BOP）；同时收集唾液和舌苔样本。从样本中提取基因组DNA，使用定量实时PCR法检测5种牙周病原菌（牙龈卟啉单胞菌、福赛坦氏菌、具核梭杆菌、中间普氏菌和变黑普氏菌）的比例。根据是否存在深度超过4mm的牙周袋（PD）以及VSCs是否高于感官阈值水平（VSCT），将受试者分为四组：-PD/-VSCT组，无PD或VSCT的受试者；-PD/+VSCT组，无PD但有VSCT的受试者；+PD/-VSCT组，有PD但无VSCT的受试者；+PD/+VSCT组，有PD且有VSCT的受试者。尽管在基线时，+PD/-VSCT组和+PD/+VSCT组的平均PD值、+PD/+VSCT组的BOP以及-PD/+VSCT组和+PD/+VSCT组的H₂S和CH₃SH浓度均高于其他组，但在牙周治疗后，我们发现四组之间无显著差异。在基线时和治疗后，+PD/-VSCT组和+PD/+VSCT组唾液中牙周病原菌的比例高于-PD/-VSCT组和-PD/+VSCT组，但治疗后唾液中细菌的比例相较于基线有所降低。此外，在基线时或治疗后，舌苔中5种目标细菌比例的差异不如唾液中明显。唾液中牙周病原菌的流行率可能反映牙周健康状况，并影响口腔空气中的VSC水平。
