Riviere G R, Smith K S, Tzagaroulaki E, Kay S L, Zhu X, DeRouen T A, Adams D F
Department of Pediatric Dentistry, Oregon Health Sciences University, Portland, USA.
J Periodontol. 1996 Feb;67(2):109-15. doi: 10.1902/jop.1996.67.2.109.
It is generally recognized that bacteria in dental plaque at sites of periodontal diseases are not commonly found at sites of periodontal health. One hypothesis to explain the etiology of periodontitis is that pathogenic bacteria from diseased sites infect healthy sites. It has been suggested that gingival inflammation may predispose sites to colonization by bacteria associated with periodontal diseases. The purpose of this cross-sectional study was to determine whether the detection frequency of selected bacteria at sites of periodontal health or gingivitis differed between subjects who were in good periodontal health, subjects who had gingivitis, or subjects with periodontitis. The clinical status of every tooth (except third molars) from 106 subjects was characterized by means of clinical attachment level, probing depth and by signs of inflammation. Subgingival plaque was collected from mesio-facial and disto-lingual surfaces. Specific monoclonal antibodies were used in an immunocytochemical assay to identify Campylobacter rectus, Eikenella corrodens, Porphyromonas gingivalis, pathogen-related oral spirochetes (PROS, using Treponema pallidum subspecies pallidum monoclonal antibodies), T. denticola (serotypes A-D), T. socranskii subspecies buccale and T. socranskii subspecies socranskii. Differences in detection of bacteria between groups of subjects were measured using odds ratios (OR). Results of this study indicate that PROS was the only identified bacterium at sites of both health and gingivitis that demonstrated a significant positive relationship with the presence of periodontitis. These findings do not prove that bacteria spread from periodontitis sites, nor do they imply that disease necessarily results from infection. However, these data do suggest that some bacteria associated with periodontitis are more likely than others to tolerate conditions at healthy sites and that the presence of periodontitis increases risk of infection at healthy sites.
人们普遍认为，牙周疾病部位牙菌斑中的细菌在牙周健康部位通常不存在。解释牙周炎病因的一种假说是，患病部位的致病菌会感染健康部位。有人提出，牙龈炎症可能使这些部位易于被与牙周疾病相关的细菌定植。这项横断面研究的目的是确定在牙周健康、患有牙龈炎或患有牙周炎的受试者中，牙周健康部位或牙龈炎部位所选细菌的检出频率是否存在差异。通过临床附着水平、探诊深度和炎症体征对106名受试者的每颗牙齿（第三磨牙除外）的临床状况进行了表征。从近中面部和远中舌面采集龈下菌斑。在免疫细胞化学分析中使用特异性单克隆抗体来鉴定直肠弯曲菌、腐蚀艾肯菌、牙龈卟啉单胞菌、病原体相关口腔螺旋体（PROS，使用梅毒螺旋体亚种梅毒单克隆抗体）、齿垢密螺旋体（血清型A - D）、颊栖螺旋体亚种和索氏螺旋体亚种。使用比值比（OR）来衡量受试者组之间细菌检测的差异。这项研究的结果表明，PROS是在健康部位和牙龈炎部位唯一被鉴定出的与牙周炎存在显著正相关的细菌。这些发现既没有证明细菌从牙周炎部位传播，也没有暗示疾病必然由感染引起。然而，这些数据确实表明，一些与牙周炎相关的细菌比其他细菌更有可能耐受健康部位的条件，并且牙周炎的存在会增加健康部位感染的风险。
