Meijndert Leo, van der Reijden Wil A, Raghoebar Gerry M, Meijer Henny J A, Vissink Arjan
Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Eur J Oral Sci. 2010 Aug;118(4):357-63. doi: 10.1111/j.1600-0722.2010.00750.x.
This study aimed to assess the prevalence of seven periodontal marker pathogens, before implant placement and 1 yr after loading, in periodontally healthy individuals and to assess the long-term effectiveness of pre-implant reduction of pathogens to below threshold levels. In 93 individuals needing single tooth replacement, pooled subgingival microbiological samples from standard sites were cultured and analyzed before implant treatment and 1 yr after loading. Threshold levels commonly used in periodontology to predict periodontal breakdown were applied. Subjects with levels of pathogens above these thresholds received initial periodontal treatment including systemic antibiotics when indicated. At baseline, 49.5% of periodontally healthy subjects harboured one or more marker pathogens above threshold levels. Periodontal treatment reduced the pathogen levels below threshold values in 78.3% of these initially colonized subjects. In all cases Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were reduced to below threshold. At 1 yr after loading, periodontal pathogens were present above threshold levels in 74.1% of all subjects. It is concluded that in almost half of periodontal healthy individuals the subgingival biofilm harbours periodontal pathogens above threshold values. Long-term effectiveness of pre-implant reduction of the selected marker pathogens appeared limited in our patient population, making pre-implant reduction unpredictive for post-implant levels of these pathogens. Thus, considering the applied microbiological criteria, generalized pre-implant microbiological testing is not contributory in periodontally healthy subjects.
本研究旨在评估牙周健康个体在种植体植入前及负载后1年时7种牙周标志物病原体的患病率，并评估种植前将病原体减少至阈值水平以下的长期有效性。对93例需要单颗牙置换的个体，在种植治疗前及负载后1年，采集标准部位的龈下微生物混合样本进行培养和分析。采用牙周病学中常用的预测牙周破坏的阈值水平。病原体水平高于这些阈值的受试者在必要时接受包括全身用抗生素在内的初始牙周治疗。基线时，49.5%的牙周健康受试者携带一种或多种高于阈值水平的标志物病原体。牙周治疗使这些最初定植的受试者中78.3%的病原体水平降至阈值以下。在所有病例中，伴放线聚集杆菌和牙龈卟啉单胞菌均降至阈值以下。负载后1年时，74.1%的受试者牙周病原体水平高于阈值。结论是，在近一半的牙周健康个体中，龈下生物膜中存在高于阈值水平的牙周病原体。在我们的患者群体中，种植前减少选定标志物病原体的长期有效性似乎有限，这使得种植前减少对这些病原体的种植后水平无法起到预测作用。因此，考虑到所应用的微生物学标准，在牙周健康受试者中进行常规种植前微生物检测并无帮助。
