与接受治疗的成年人慢性牙周炎进展相关的龈下微生物和炎症细胞形态类型

Subgingival Microbial and Inflammatory Cell Morphotypes Associated with Chronic Periodontitis Progression in Treated Adults.

作者信息

Keyes Paul H, Rams Thomas E

出版信息

J Int Acad Periodontol. 2015 Apr;17(2):49-57.

PMID:26242011

Abstract

OBJECTIVE

In a secondary data analysis, this pilot study evaluated the relationship between subgingival biofilm morphotypes and chronic periodontitis progression in treated adults.

METHODS

Periodontal parameters in 47 adults with chronic periodontitis were assessed by a calibrated examiner at baseline and a mean 4.5 years after a non-surgical periodontal therapy regimen. Microbial and inflammatory cell morphotypes in subgingival biofilm specimens from each patient were evaluated with phase-contrast microscopy at baseline, and at post-treatment intervals. Chronic periodontitis progression in patients was defined as ≥ 2 teeth exhibiting ≥ 3 mm interproximal clinical periodontal attachment loss from baseline evaluations. Bivariate and odds ratio analysis assessed baseline and post-treatment variables relative to chronic periodontitis progression.

RESULTS

Eight (17%) patients had chronic periodontitis progression. No baseline clinical, radiographic or microbiological variables, and no post-treatment clinical variables demonstrated statistically significant relationships with chronic periodontitis progression. Elevated post-treatment counts of subgingival spirochetes, medium to large-sized motile rods, and crevicular leukocytes, both alone and concurrently, appeared more frequently in patients experiencing chronic periodontitis progression. A post-treatment occurrence of high concurrent counts of subgingival spirochetes and crevicular leukocytes exhibited the strongest association with chronic periodontitis progression (odds ratio = 10.1; 95% Cl = 2.2, 45.4; p = 0.004), which was greater than with either morphotype alone.

CONCLUSIONS

Joint morphotype analysis of subgingival spirochetes and crevicular leukocytes, as simplified biomarkers of pathogenic biofilm infection and host inflammatory responses in periodontal pockets, may be diagnostically useful in assessing risk of progressive disease in treated chronic periodontitis patients.

摘要

目的

在一项二次数据分析中，本初步研究评估了经治疗的成年患者龈下生物膜形态型与慢性牙周炎进展之间的关系。

方法

由一名经过校准的检查者在基线时以及在接受非手术牙周治疗方案后平均4.5年时，对47名患有慢性牙周炎的成年人的牙周参数进行评估。在基线时以及治疗后的不同时间间隔，用相差显微镜对每位患者龈下生物膜标本中的微生物和炎症细胞形态型进行评估。患者慢性牙周炎的进展定义为与基线评估相比，有≥2颗牙齿出现≥3mm的邻间临床牙周附着丧失。二元变量和比值比分析评估了与慢性牙周炎进展相关的基线和治疗后变量。

结果

8名（17%）患者出现慢性牙周炎进展。没有基线临床、影像学或微生物学变量，以及治疗后临床变量与慢性牙周炎进展呈现出统计学上的显著关系。在经历慢性牙周炎进展的患者中，治疗后龈下螺旋体、中到大型活动杆菌以及龈沟白细胞数量单独或同时升高的情况更为常见。治疗后龈下螺旋体和龈沟白细胞高并发计数的出现与慢性牙周炎进展的关联最强（比值比=10.1；95%可信区间=2.2，45.4；p=0.004），这一关联大于单独任何一种形态型。