Mombelli A, Gmür R, Gobbi C, Lang N P
University of Bern, School of Dental Medicine, Switzerland.
J Periodontol. 1994 Sep;65(9):827-34. doi: 10.1902/jop.1994.65.9.827.
Ten systemically healthy subjects (ages 28 to 60 years) with untreated moderate to severe periodontal disease and evidence of presence of A. actinomycetemcomitans underwent standard mechanical periodontal treatment consisting of oral hygiene instruction and systematic deep scaling and root planing. Before, and 4 to 5 weeks after treatment, clinical measurements and separate subgingival microbiological samples were taken from the mesial and distal aspect of every tooth, with the exception of the third molars. A. actinomycetemcomitans could still be detected in all patients after treatment. In 9 of the 10 patients, all tested isolates from both examinations were of a single type. Two patients carried serotype a; 2 serotype b; 2 serotype c; and 1 serotype e. Two individuals showed only non-typeable isolates lacking serotype a, b, c, d, or e specific antigens. Another subject was colonized by serotype c and, in addition, yielded a non-typeable isolate. Persistence of A. actinomycetemcomitans after treatment was significantly correlated with the frequency of A. actinomycetemcomitans before treatment (P < 0.001) and the mean probing depth before treatment (P < 0.05). No serotype-specific patterns of treatment outcome could be recognized. The analysis of the site specific effect of treatment showed a significant relationship between post treatment levels of A. actinomycetemcomitans and both probing depth reduction as well as attachment gain. Individuals showing evidence of A. actinomycetemcomitans in a multitude of sites appeared to be more difficult to treat than patients with few positive sites only. Within such individuals, the deeper pockets showed the greater resistance to eradication of A. actinomycetemcomitans.
10名全身健康、患有未经治疗的中度至重度牙周病且有伴放线放线杆菌存在证据的受试者（年龄在28至60岁之间）接受了标准的机械性牙周治疗，包括口腔卫生指导以及系统性的深度洁治和根面平整。在治疗前以及治疗后4至5周，除第三磨牙外，从每颗牙齿的近中面和远中面采集临床测量数据和单独的龈下微生物样本。治疗后所有患者中仍可检测到伴放线放线杆菌。在10名患者中的9名患者中，两次检查的所有测试分离株均为单一类型。2名患者携带a血清型；2名携带b血清型；2名携带c血清型；1名携带e血清型。2名个体仅显示缺乏a、b、c、d或e血清型特异性抗原的不可分型分离株。另一名受试者被c血清型定植，此外还产生了一株不可分型分离株。治疗后伴放线放线杆菌的持续存在与治疗前伴放线放线杆菌的频率（P < 0.001）和治疗前的平均探诊深度（P < 0.05）显著相关。未识别出特定血清型的治疗结果模式。治疗部位特异性效应分析显示，治疗后伴放线放线杆菌水平与探诊深度减少以及附着增加之间存在显著关系。在多个部位显示有伴放线放线杆菌证据的个体似乎比仅在少数部位呈阳性的患者更难治疗。在这些个体中，较深的牙周袋显示出对根除伴放线放线杆菌的更大抵抗力。
