Müller H P, Müller R F, Lange D E
Department of Periodontology, School of Dental Medicine, Westfälische Wilhelms-Universität, Münster, FRG.
J Clin Periodontol. 1990 Sep;17(8):549-56.
Infrequent occurrence of spirochetes and rather low proportions of these organisms have been reported in localized juvenile periodontitis, where periodontal lesions often harbour large numbers of Actinobacillus actinomycetemcomitans, a suspected principal periopathogen strongly implicated in the pathogenesis of this and other forms of chronic periodontitis. We studied the association of subgingival A. actinomycetemcomitans with the morphological composition of the subgingival microbiota in a large population of patients suffering from advanced periodontitis. Subgingival plaque from the deepest pockets of every quadrant of their dentitions was sampled and pooled in 70 patients between 14 and 63 years of age, and analysed morphologically by phase-contrast microscopy. A minimum % similarity index was employed to define 4 clusters with different morphological composition of the floras. The actual proportion of A. actinomycetemcomitans was determined at 2 sites with deep periodontal pockets. All clusters harboured patients infected with A. actinomycetemcomitans. If present, in clusters predominated by motile rods or medium-sized spirochetes, the organism was found in rather low proportions (median 5.3% and 3.4%, respectively). However, the cluster with a pooled flora mainly consisting of coccoid cells revealed periodontal sites with A. actinomycetemcomitans in proportions of more than 53% (median), if the organism was present (p less than 0.01). We found a positive correlation between proportions of A. actinomycetemcomitans and cocci (R = 0.65) and negative correlations with spirochetes and motile rods (R = 0.61, R = -0.59, respectively). Cautious interpretation of subgingival plaque predominated by coccoid cells is recommended, if deep periodontal pockets and obvious signs of inflammation are present, since these pockets were found to be often infected with large numbers of A. actinomycetemcomitans.
据报道，在局限性青少年牙周炎中，螺旋体出现频率较低且所占比例相当小，而牙周病变部位常存在大量伴放线放线杆菌，这是一种被怀疑在该型及其他类型慢性牙周炎发病机制中起主要作用的牙周病原体。我们研究了大量晚期牙周炎患者龈下伴放线放线杆菌与龈下微生物群形态组成之间的关联。从70名年龄在14至63岁患者牙列每个象限最深牙周袋中采集龈下菌斑并混合，通过相差显微镜进行形态学分析。采用最小相似度指数定义菌群形态组成不同的4个簇。在2个有深牙周袋的部位测定伴放线放线杆菌的实际比例。所有簇中均有感染伴放线放线杆菌的患者。如果存在，在以运动杆菌或中型螺旋体为主的簇中，该菌所占比例相当低（中位数分别为5.3%和3.4%）。然而，如果存在伴放线放线杆菌，以球菌样细胞为主的混合菌群簇显示牙周部位该菌比例超过53%（中位数）（p<0.01）。我们发现伴放线放线杆菌比例与球菌呈正相关（R = 0.65），与螺旋体和运动杆菌呈负相关（分别为R = 未找到相关内容0.61，R = -0.59）。如果存在深牙周袋和明显炎症迹象，建议谨慎解读以球菌样细胞为主的龈下菌斑，因为这些牙周袋常发现感染大量伴放线放线杆菌。
