Müller H P, Zöller L, Eger T, Hoffmann S, Lobinsky D
Department of Operative Dentistry, University of Heidelberg, Germany.
J Periodontal Res. 1996 Aug;31(6):373-80. doi: 10.1111/j.1600-0765.1996.tb00506.x.
A total of 1005 subgingival and extracrevicular samples from 201 male recruits, 18-25 yr old, were selectively cultivated for Actinobacillus actinomycetemcomitans. The organism was isolated in 55 subjects (27%); 9.5% of pooled subgingival plaque samples from first molars, 14% cheek mucosa, 20% dorsum of tongue and 20% saliva samples were culture-positive. In order to divide the study population into distinct clinical categories, cluster analysis was performed, based on previous caries experience, probing pocket depth categories, bleeding scores, visible plaque and calculus. Two clusters (n = 86 and n = 92, respectively) were identified with no or minimal periodontal disease (mean +/- standard deviation % of periodontal probing depth 1-2 mm 78.7 +/- 10.4% and 57.4 +/- 12.6%, respectively; virtually no periodontal probing/depth in excess of 4 mm) and a relatively low DMF-S (22 +/- 13). A third cluster (n = 22) had, in contrast, a high DMF-S (47.7 +/- 17.2) and a relatively high % of periodontal pockets of > or = 5 mm (5.9 +/- 5.2%). Prevalence of A. actinomycetemcomitans in this cluster was 41%, while the organism was found in 23% and 27% in the minimally diseased populations (p < 0.15). Whereas no heterogeneity of associations between subgingival and extracrevicular occurrence of the organism could be ascertained in different clusters, the organism was significantly more often identified in extracrevicular material, especially dorsum of tongue samples, compared with subgingival plaque (McNemar's chi2 = 12.45, p < 0.001). Multiple linear regression analysis revealed the number of A. actinomycetemcomitans positive samples as well as the % of sites bleeding on probing being positively associated with the % of sites with a probing pocket depth of > or = 5 mm (R2 = 0.345, p < 0.0001). The present large-scale investigation points to the wide distribution of this putative periodontopathogen in young individuals with minimal periodontal disease.
从201名年龄在18至25岁的男性新兵中，共采集了1005份龈下和龈外样本，用于选择性培养伴放线放线杆菌。在55名受试者（27%）中分离出了该菌；第一磨牙的龈下菌斑样本合并后9.5%培养呈阳性，颊黏膜样本14%培养呈阳性，舌背样本20%培养呈阳性，唾液样本20%培养呈阳性。为了将研究人群分为不同的临床类别，基于既往龋齿经历、探诊袋深度类别、出血评分、可见菌斑和牙石进行了聚类分析。确定了两个聚类（分别为n = 86和n = 92），其牙周疾病无或极少（牙周探诊深度1至2毫米的平均值±标准差百分比分别为78.7±10.4%和57.4±12.6%；几乎没有牙周探诊/深度超过4毫米的情况）且龋失补牙面数（DMF-S）相对较低（22±13）。相比之下，第三个聚类（n = 22）的DMF-S较高（47.7±17.2），且牙周袋深度≥5毫米的比例相对较高（5.9±5.2%）。该聚类中伴放线放线杆菌的患病率为41%，而在疾病轻微的人群中该菌的检出率为23%和27%（p < 0.15）。虽然在不同聚类中未确定该菌在龈下和龈外出现之间的关联存在异质性，但与龈下菌斑相比，该菌在龈外物质中，尤其是舌背样本中更常被检出（麦克内玛检验χ2 = 12.45，p < 0.001）。多元线性回归分析显示，伴放线放线杆菌阳性样本数以及探诊出血部位的百分比与探诊袋深度≥5毫米部位的百分比呈正相关（R2 = 0.345，p < 0.0001）。本次大规模调查表明，这种假定的牙周病原体在牙周疾病极少的年轻个体中分布广泛。
