VA Hospital, Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
J Periodontol. 2012 Feb;83(2):162-73. doi: 10.1902/jop.2011.110086. Epub 2011 May 16.
Bone microbial contamination can impair osteogenesis. Human herpesviruses-associated vasculitis can cause vascular damage within the osseous graft and host. This study is conducted to substantiate specific contamination and assess the impact 6 months after sinus augmentation.
Culture- and polymerase chain reaction (PCR)-based identification were done on harvested bone particles and unstimulated whole saliva in a group of 30 patients undergoing maxillary sinus augmentation. Patients were divided into two groups: those with and those without a history of periodontitis. Radiographic evaluation was done to assess and compare bone healing and volume gain at baseline and 6 months post-transplantation.
Seventeen patients had a history of periodontitis, and 13 did not. Ten showed culture- and PCR-negative results and belonged to the periodontally healthy group. The 17 patients with periodontitis showed culture- or PCR-positive results for the targeted periodontal pathogens. Patients with periodontitis were 2.3 times more likely to have positive salivary Epstein-Barr virus type 1 (EBV-1) than those with no history of periodontitis. The likelihood of having moderate to pronounced bone volume loss 6 months postaugmentation was 7.5 times greater in those patients presenting contamination with ≥3 specific pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, or Prevotella intermedia) versus those with only one (P <0.05). The odds ratio (OR) of pronounced volume loss was 16.3 times higher in those contaminated with a combination of salivary EBV-1 and ≥3 of the previously mentioned species versus only EBV-1 (P <0.05). Individuals showing positive salivary EBV-1 had bone bacterial contamination associated 57% of the time. The OR of having bone microbial contamination in patients with a history of periodontitis was 37.5 times higher than in individuals without periodontitis.
This study confirms contamination of bone, harvested intraorally, with key periodontopathogens in individuals undergoing sinus augmentation. Specific microbial contamination can impair osteogenesis. Saliva may act as a vehicle to transport EBV and other pathogens into the sinus. Increased bone volume loss seems to be associated with the occurrence of specific periodontal anaerobic species, salivary EBV-1, or the combination of both.
骨微生物污染会影响成骨。人类疱疹病毒相关性脉管炎可导致骨质移植物和宿主内的血管损伤。本研究旨在证实特定的污染，并评估鼻窦提升后 6 个月的影响。
对 30 名接受上颌窦提升术的患者的采集骨颗粒和未刺激全唾液进行基于培养和聚合酶链反应（PCR）的鉴定。患者分为两组：有牙周病史组和无牙周病史组。影像学评估用于评估和比较基线和移植后 6 个月的骨愈合和体积增加。
17 名患者有牙周病史，13 名患者无牙周病史。10 名患者的培养和 PCR 结果为阴性，属于牙周健康组。17 名牙周炎患者的目标牙周病原体培养或 PCR 结果阳性。有牙周病史的患者唾液中 Epstein-Barr 病毒 1（EBV-1）阳性的可能性是无牙周病史患者的 2.3 倍。在那些有≥3 种特定病原体（牙龈卟啉单胞菌、伴放线放线杆菌、福赛斯坦纳菌或中间普氏菌）污染的患者中，6 个月时出现中度至重度骨量丢失的可能性是仅有一种病原体的患者的 7.5 倍（P <0.05）。与仅 EBV-1 相比，同时存在唾液 EBV-1 和上述 3 种物种中≥3 种的患者，出现明显体积丢失的比值比（OR）高 16.3 倍（P <0.05）。唾液 EBV-1 阳性的个体有 57%的时间存在骨细菌污染。有牙周病史的患者骨微生物污染的 OR 是无牙周病史患者的 37.5 倍。
本研究证实了在接受鼻窦提升术的患者中，口腔内采集的骨与关键牙周病原体发生了污染。特定的微生物污染会影响成骨。唾液可能是 EBV 和其他病原体进入鼻窦的载体。骨量丢失增加似乎与特定的牙周厌氧物种、唾液 EBV-1 或两者的组合有关。
