Masunaga H, Matsue M, Matsue I, Hirasawa M, Takeuchi T, Ikeda T
Department of Periodontology, Nihon University School of Dentistry at Matsudo.
Nihon Shishubyo Gakkai Kaishi. 1990 Mar;32(1):261-74. doi: 10.2329/perio.32.261.
Samples of subgingival bacteria were collected from two sites of offanteriors with greater than or equal to 6 mm deep pockets in each ten patients in a clinically characterized rapidly progressive periodontal disease. The purpose of this investigation was to study the predominant cultivable microflora at pre- and post-periodontal treatment stages, in order to monitor the clinical effects of periodontal treatment and possibly to determine the presence or absence of active disease. "Non effective site" was defined as little elimination of periodontal pocket. Some patients responded remarkably well to root curettage. However the subgingival flora of effective sites, which had been successfully treated and maintained over a period of three weeks, was still significantly different from the subgingival floras of people with healthy gingiva. The predominant cultivable microflora of diseased lesions at the pre-treatment stage, in which a similar proportion of microbiota were detected on both sites in each patient, were significantly increased proportions of Bacteroides sp., B. intermedius and B. gingivalis. Although B. gingivalis has been implicated as the etiologic agent of the disease, to which marked antibody response has been found in periodontal pockets, there were decreased proportions of B. intermedius and B. gingivalis after treatment, compared to pre-treatment stage. The results showed that non-effective lesions were associated with subgingival microflora which were populated by higher proportions of B. intermedius and E. corrodens. H. actinomycetemcomitans were detectable during the experimental periods in all sites. It was possible to indicate progressing periodontitis by examining these microflora at the pre-treatment stage. However active or progressing disease in young adults might represent not only an overgrowth of existing organisms but also an abnormality in host resistance.
在一项具有临床特征的快速进展性牙周病中，从每10名患者上前牙区两个牙周袋深度大于或等于6mm的部位采集龈下细菌样本。本研究的目的是研究牙周治疗前后可培养的主要微生物群落，以监测牙周治疗的临床效果，并可能确定是否存在活动性疾病。“无效部位”定义为牙周袋减少不明显。一些患者对根面刮治反应良好。然而，成功治疗并维持三周的有效部位的龈下菌群，仍与健康牙龈人群的龈下菌群有显著差异。治疗前阶段患病损害的主要可培养微生物群落中，每名患者的两个部位检测到的微生物比例相似，其中拟杆菌属、中间普氏菌和牙龈卟啉单胞菌的比例显著增加。尽管牙龈卟啉单胞菌被认为是该疾病的病原体，在牙周袋中已发现明显的抗体反应，但与治疗前阶段相比，治疗后中间普氏菌和牙龈卟啉单胞菌的比例有所下降。结果表明，无效损害与龈下菌群有关，其中中间普氏菌和具核梭杆菌的比例较高。在实验期间，所有部位均可检测到伴放线聚集杆菌。通过在治疗前阶段检查这些微生物群落，有可能指示牙周炎的进展。然而，年轻成年人中的活动性或进展性疾病可能不仅代表现有微生物的过度生长，还代表宿主抵抗力的异常。
