Rams Thomas E, Balkin Burton E, Roberts Thomas W, Molzan Arthur K
1 Department of Periodontology and Oral Implantology, and Oral Microbiology Testing Service Laboratory, Temple University School of Dentistry, Philadelphia, Penn.
J Oral Implantol. 2013 Dec;39(6):714-22. doi: 10.1563/AAID-JOI-D-11-00023. Epub 2011 Jul 18.
Clinical, microbiological, and biochemical features of human mandibular subperiosteal dental implants exhibiting peri-implantitis were compared with those experiencing long-term peri-implant health. After evaluation of clinical parameters, submucosal plaque samples were obtained from permucosal implant abutment posts exhibiting probing depths ≥5 mm and bleeding on probing in subjects with peri-implantitis (n = 3) and from posts with peri-implant health in subjects with long-term subperiosteal implant health (n = 8). The microbial specimens were transported in VMGA III and plated onto enriched Brucella blood agar and Hammond's selective medium with anaerobic incubation, and onto selective TSBV with 5% CO2 incubation. Total anaerobic viable counts and selected bacterial species were identified using established phenotypic methods and criteria. In vitro resistance to doxycycline (2 μg/mL), amoxicillin (2 μg/mL), or metronidazole (4 μg/mL) was recorded per subject when bacterial pathogen growth was noted on antibiotic-supplemented isolation plates. Interleukin (IL)-1β levels were measured with an enzyme-linked immunosorbent assay in peri-implant crevicular fluid samples from 5 study subjects. Significantly higher Plaque Index scores, higher total anaerobic viable counts, more red complex species, and lower proportions of gram-positive facultative viridans streptococci and Actinomyces species were detected on peri-implantitis-affected subperiosteal implants as compared with subperiosteal implants with long-term peri-implant health. No in vitro resistance to the 3 test antibiotic breakpoint concentrations studied was found, except a Fusobacterium nucleatum strain resistant to doxycycline at 2 μg/mL from 1 peri-implantitis subject. Subperiosteal implants with peri-implantitis tended to yield higher peri-implant crevicular fluid IL-1β levels. The level of peri-implant supramucosal plaque control and the composition of the peri-implant submucosal microbiome may be important determinants of the long-term clinical status of mandibular subperiosteal dental implants.
将表现出种植体周围炎的人类下颌骨骨膜下牙种植体的临床、微生物学和生化特征与长期保持种植体周围健康的种植体进行了比较。在评估临床参数后，从种植体周围炎患者（n = 3）中，从探诊深度≥5 mm且探诊出血的经黏膜种植体基台上获取黏膜下菌斑样本；从长期保持骨膜下种植体健康的受试者（n = 8）中，从具有种植体周围健康的基台上获取样本。微生物标本用VMGA III运送，并接种到改良布氏血琼脂和哈蒙德选择性培养基上进行厌氧培养，以及接种到含5%二氧化碳培养的选择性TSBV上。使用既定的表型方法和标准鉴定总厌氧活菌计数和选定的细菌种类。当在补充抗生素的分离平板上发现细菌病原体生长时，记录每个受试者对强力霉素（2 μg/mL）、阿莫西林（2 μg/mL）或甲硝唑（4 μg/mL）的体外耐药性。用酶联免疫吸附测定法测量了5名研究对象种植体周围沟液样本中的白细胞介素（IL）-1β水平。与长期保持种植体周围健康的骨膜下种植体相比，在受种植体周围炎影响的骨膜下种植体上检测到明显更高的菌斑指数评分、更高的总厌氧活菌计数、更多的红色复合体菌种，以及更低比例的革兰氏阳性兼性草绿色链球菌和放线菌属菌种。在所研究的3种测试抗生素断点浓度下，未发现体外耐药性，除了1例种植体周围炎患者的具核梭杆菌菌株对2 μg/mL的强力霉素耐药。患有种植体周围炎的骨膜下种植体往往会产生更高的种植体周围沟液IL-1β水平。种植体周围黏膜上菌斑的控制水平和种植体周围黏膜下微生物群的组成可能是下颌骨骨膜下牙种植体长期临床状况的重要决定因素。
