Mombelli A, Gmür R, Gobbi C, Lang N P
University of Bern, School of Dental Medicine, Switzerland.
J Periodontol. 1994 Sep;65(9):820-6. doi: 10.1902/jop.1994.65.9.820.
The aim of this investigation was to study the topographic distribution of Actinobacillus actinomycetemcomitans in patients with adult periodontitis before and after mechanical periodontal treatment (repeated oral hygiene instructions, systematic deep scaling, and root planing). In 10 A. actinomycetemcomitans-positive patients, subgingival microbial samples were obtained from the mesial and distal aspect of every tooth (38 to 56 sites per patient, 479 sites in total) before and one month after treatment. The samples were cultured on TSBV agar. A. actinomycetemcomitans was identified based on phenotypical and serological criteria. A. actinomycetemcomitans was present in 40% of the samples taken before and in 23% of the samples taken after treatment. Before treatment, the frequency of A. actinomycetemcomitans-positive samples per patient was wide spread and ranged from 7 to 90%. After treatment, two patterns of A. actinomycetemcomitans distribution could be recognized: the majority of the patients showed only a limited percentage of positive samples and yielded less than 10(5) A. actinomycetemcomitans. In three subjects, however, relatively high numbers of positive sites were still present, and many of these positive sites showed high A. actinomycetemcomitans counts. Logistic multiple regression showed the presence of A. actinomycetemcomitans before treatment depended strongly on the individual and was significantly associated with probing depth (P < 0.001) and bleeding upon sampling (P = 0.07). The highest chance of detecting A. actinomycetemcomitans existed in deep pockets which bled upon sampling. After treatment, there was a strong individual influence and an influence of probing depth (P < 0.001). The highest chance of detecting A. actinomycetemcomitans existed in residual pockets in the range of 5 mm.
本研究的目的是探讨伴放线放线杆菌在成人牙周炎患者接受机械性牙周治疗（反复口腔卫生指导、系统性深度洁治和根面平整）前后的地形分布。对10名伴放线放线杆菌阳性患者，在治疗前及治疗后1个月，从每颗牙齿的近中面和远中面获取龈下微生物样本（每位患者38至56个位点，共479个位点）。样本在TSBV琼脂上培养。根据表型和血清学标准鉴定伴放线放线杆菌。治疗前采集的样本中有40%存在伴放线放线杆菌，治疗后采集的样本中有23%存在该菌。治疗前，每位患者伴放线放线杆菌阳性样本的频率分布广泛，范围为7%至90%。治疗后，伴放线放线杆菌的分布可分为两种模式：大多数患者仅显示有限百分比的阳性样本，且伴放线放线杆菌数量少于10⁵ 。然而，在三名受试者中，仍存在相对较多的阳性位点，其中许多阳性位点的伴放线放线杆菌数量较高。逻辑多元回归分析显示，治疗前伴放线放线杆菌的存在强烈依赖于个体，且与探诊深度（P < 0.001）和采样时出血（P = 0.07）显著相关。在采样时出血的深牙周袋中检测到伴放线放线杆菌的可能性最高。治疗后，存在强烈的个体影响以及探诊深度的影响（P < 0.001）。在5mm范围内的残留牙周袋中检测到伴放线放线杆菌的可能性最高。
