Ejeil Anne-Laure, Gaultier Frédérick, Catherine Bisson, Chaubron Franck, Lupi Laurence, Dridi Sophie-Myriam
Faculty of Dental Surgery University Paris Cité Paris France.
Department of oral surgery Bretonneau Hospital AP-HP Paris France.
Health Sci Rep. 2024 Jul 26;7(7):e2163. doi: 10.1002/hsr2.2163. eCollection 2024 Jul.
In the case of mucous membrane pemphigoid with gingival expression (gMMP), the complete healing of the gingiva is generally not achieved despite medical treatment. Therefore, patients' oral comfort is impaired. The dysbiotic periodontal microbiota, generated by a lack of oral hygiene associated with persistent gingival pain, could the immunopathological mechanism to persist. The main objective of this study was to characterize the subgingival microbiota of the gMMP patients, and to highlight a potential link between this microbiological data and the clinical data.
Subgingival biofilm was collected from 15 gMMP patients, medically treated or not, but not receiving periodontal treatment. The usual clinical periodontal parameters were recorded. The biofilm was analyzed by polymerase chain reaction quantitative. The risk factors of severe erosive gingivitis and severe periodontitis were assessed using Chi-square or Fischer's exact test were used.
Whatever the medical and periodontal conditions of the patients, the results showed the existence of three main communities of periodontopathic, dysbiotic bacteria. The first including , and , was found in 100% of the patients, the second enriched with in 60% and the third enriched with and in 26%. Furthermore, there was a significant positive link between the duration of gMMP and the severity of erosive gingivitis ( = 0.009), and the loss of deep periodontal tissue ( = 0.04).
This pilot study suggests a high periodontal risk in gMMP patients. The pathological processes, autoimmune on the one hand and plaque-induced on the other, may amplify each other. The application of periodontal therapy is therefore necessary in parallel with medical treatment. Nevertheless, further controlled studies are required to validate and complement these preliminary results.
在伴有牙龈表现的类天疱疮（gMMP）病例中，尽管进行了药物治疗，牙龈通常仍无法完全愈合。因此，患者的口腔舒适度受到损害。与持续牙龈疼痛相关的口腔卫生缺乏所产生的牙周微生物群失调，可能是免疫病理机制持续存在的原因。本研究的主要目的是对gMMP患者的龈下微生物群进行特征分析，并突出这些微生物学数据与临床数据之间的潜在联系。
从15例gMMP患者中收集龈下生物膜，这些患者无论是否接受过药物治疗，但均未接受过牙周治疗。记录常见的临床牙周参数。通过聚合酶链反应定量分析生物膜。使用卡方检验或费舍尔精确检验评估严重糜烂性牙龈炎和严重牙周炎的危险因素。
无论患者的药物治疗和牙周状况如何，结果显示存在三种主要的牙周病性、失调性细菌群落。第一种包括……，在100%的患者中发现，第二种在60%的患者中富含……，第三种在26%的患者中富含……和……。此外，gMMP的持续时间与糜烂性牙龈炎的严重程度之间存在显著正相关（P = 0.009），与深部牙周组织丧失之间也存在显著正相关（P = 0.04）。
这项初步研究表明gMMP患者存在较高的牙周风险。一方面是自身免疫性，另一方面是菌斑诱导的病理过程可能相互放大。因此，在进行药物治疗的同时，有必要应用牙周治疗。然而，需要进一步的对照研究来验证和补充这些初步结果。
