Center for Oral Health Research, Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, UK.
College of Dentistry, Ohio State University, Columbus, OH, USA.
J Periodontol. 2019 Jun;90(6):627-636. doi: 10.1002/JPER.18-0156. Epub 2019 Jan 17.
This study uses multiple, contemporary methodologies to expand our knowledge of the temporal relationship between host-microbial interactions and clinical signs of gingivitis.
Subgingival plaque and crevicular fluid samples were collected from 31 systemically healthy adults with naturally occurring plaque-induced gingivitis. Professional prophylaxis was administered and participants were followed over 7 weeks. Microbial characterization was performed using a bead-based hybridization assay and cytokine analysis using bead-based flow cytometry.
The provision of sequential interventions, oral hygiene instruction, and subsequent professional prophylaxis brought about significant reduction of plaque and resolution of gingivitis at all post baseline time points (P < 0.0001). Candidate cytokines that increased significantly (95% level) were interleukin (IL)-1β, matrix metalloproteinases (MMP)-1, MMP-3, MMP-8, MMP-9, from baseline to week 2; regulated on activation, normal T cell expressed and secreted (RANTES) at week 4 and week 8; macrophage inflammatory protein (MIP)-1α and MIP-1β at week 8. Resolution of inflammation was accompanied by a shift in the microbiological flora toward those species associated with health.
This study provides further evidence of the dynamic relationships that exist between the overt clinical signs, the microbial biofilm, and the host response in gingivitis and upon resolution following clinical interventions. Understanding the interactions between the host immune system and subgingival microbial communities during the resolution of established gingivitis continues to evolve as additional knowledge is achieved through using new analytical technologies. The present study confirms a critical effect of oral hygiene measures on restoration of microbial eubiosis in subgingival communities, confirming the important role for home care and professional intervention in maintaining oral health.
本研究采用多种现代方法，扩展了我们对宿主-微生物相互作用与牙龈炎临床症状之间时间关系的认识。
从 31 名患有自然发生的菌斑性牙龈炎的系统健康成年人中采集龈下菌斑和龈沟液样本。给予专业的预防措施，并在 7 周内对参与者进行随访。使用基于珠的杂交测定法进行微生物特征分析，使用基于珠的流式细胞术进行细胞因子分析。
连续干预、口腔卫生指导和随后的专业预防措施使所有基线后时间点的菌斑显著减少和牙龈炎得到缓解（P<0.0001）。显著增加的候选细胞因子有白细胞介素（IL）-1β、基质金属蛋白酶（MMP）-1、MMP-3、MMP-8、MMP-9，从基线到第 2 周；调节激活正常 T 细胞表达和分泌（RANTES）在第 4 周和第 8 周；巨噬细胞炎症蛋白（MIP）-1α和 MIP-1β在第 8 周。炎症的消退伴随着微生物菌群向与健康相关的物种的转变。
本研究进一步证明了在牙龈炎的明显临床症状、微生物生物膜和宿主反应之间存在动态关系，并在临床干预后得到缓解。随着通过使用新的分析技术获得更多的知识，宿主免疫系统和龈下微生物群落之间在已建立的牙龈炎消退过程中的相互作用的理解不断发展。本研究证实了口腔卫生措施对恢复龈下微生物生态平衡的重要作用，证实了家庭护理和专业干预在维护口腔健康方面的重要作用。
