Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA, USA.
J Clin Periodontol. 2013 Aug;40(8):771-80. doi: 10.1111/jcpe.12117. Epub 2013 May 27.
To examine the 2-year post-therapy kinetics of change in the composition of subgingival biofilms.
In this study, 178 chronic periodontitis subjects were recruited and clinically monitored at baseline, 3, 6, 12, 18 and 24 months after therapy. All subjects received scaling and root planing and 156 one or more of periodontal surgery, systemically administered amoxicillin + metronidazole or local tetracycline at pockets ≥5 mm. Subgingival biofilm samples taken from each subject at each time point were analysed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization. The significance of changes in median species counts over time was sought using the Wilcoxon or Friedman tests and adjusted for multiple comparisons.
Mean counts were significantly reduced from baseline to 2 years for 30 of the 40 taxa. Marked reductions were observed for periodontal pathogens including Tannerella forsythia, Treponema denticola and Eubacterium nodatum. The kinetics of change differed from species to species. When data were subset according to baseline PD, patterns of change in the microbial profiles were generally similar.
Periodontal therapy leads to a rapid reduction in periodontal pathogens, followed by a slower reduction in other taxa that can be sustained for at least 2 years.
研究龈下生物膜组成在治疗后 2 年内的变化动力学。
本研究共招募了 178 例慢性牙周炎患者，在治疗前、治疗后 3、6、12、18 和 24 个月进行临床监测。所有患者均接受了牙周刮治和根面平整，并根据需要接受了牙周手术、全身性给予阿莫西林+甲硝唑或局部给予四环素治疗。在每个时间点，从每个患者的龈下生物膜样本中使用斑点杂交 DNA-DNA 杂交技术分析了 40 种细菌的含量。使用 Wilcoxon 或 Friedman 检验来评估中位物种计数随时间的变化，并进行了多次比较调整。
与基线相比，40 个分类单元中有 30 个的平均计数在 2 年内显著降低。牙周病原体，包括福赛坦纳菌、齿密螺旋体和真杆菌等，显著减少。物种变化的动力学因物种而异。当根据基线 PD 对数据进行子集化时，微生物谱的变化模式通常相似。
牙周治疗可迅速降低牙周病原体的数量，然后缓慢降低其他可持续至少 2 年的细菌数量。
