Albandar J M, Brown L J, Löe H
National Institute of Dental Research, Bethesda, MD, USA.
J Periodontol. 1997 Oct;68(10):973-81. doi: 10.1902/jop.1997.68.10.973.
This study assessed the associations between putative periodontal pathogens and early-onset periodontitis (EOP) in a population of 248 subjects, 13 to 19 years of age at baseline, derived from a representative sample of U.S. young adults. The subjects were selected based on the presence or absence of attachment loss at baseline. The attachment level was assessed clinically at baseline and at a 6-year follow-up examination, and the presence of 7 bacterial species was assessed at follow-up using DNA probes. The individuals were classified into generalized, localized, incidental EOP, and no-periodontitis groups based on the extent and severity of attachment loss; and classified as having rapid, moderate, slow, and no progression based on the rate of periodontal progression during the 6 preceding years. In the EOP groups there were significantly higher percentages of individuals with detectable levels of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Campylobacter rectus, and Treponema denticola. In addition, the EOP group had significantly higher levels of these 5 microorganisms compared to the no-periodontitis group. There were also higher percentages of individuals with these species and higher levels of bacteria in the group showing disease progression than the group without progression. In a descending order of importance, P. gingivalis, T. denticola, and P. intermedia were the microorganisms significantly associated with the generalized and/or rapidly progressing disease. F. nucleatum and C. rectus were also associated with EOP, but to a lesser degree. In the present population Actinobacillus actinomycetemcomitans was not significantly associated with EOP, though it was recovered more often from subjects with localized EOP. Eikenella corrodens was present equally in subjects with and without disease. The results show that several bacterial species are associated with EOP, and that P. gingivalis and T. denticola are of particular importance and may play a significant role in the more severe and progressive forms of EOP.
本研究评估了248名基线年龄在13至19岁的受试者中假定的牙周病原体与早发性牙周炎(EOP)之间的关联,这些受试者来自美国年轻成年人的代表性样本。受试者根据基线时是否存在附着丧失进行选择。在基线和6年随访检查时临床评估附着水平,并在随访时使用DNA探针评估7种细菌的存在情况。根据附着丧失的程度和严重程度,将个体分为广泛型、局限型、偶发性EOP和无牙周炎组;并根据前6年牙周进展的速率分为快速进展、中度进展、缓慢进展和无进展组。在EOP组中,牙龈卟啉单胞菌、中间普氏菌、具核梭杆菌、直肠弯曲菌和齿垢密螺旋体检测水平阳性的个体百分比显著更高。此外,与无牙周炎组相比,EOP组这5种微生物的水平显著更高。与无疾病进展组相比,疾病进展组中这些菌种的个体百分比更高,细菌水平也更高。按重要性降序排列,牙龈卟啉单胞菌、齿垢密螺旋体和中间普氏菌是与广泛型和/或快速进展性疾病显著相关的微生物。具核梭杆菌和直肠弯曲菌也与EOP相关,但程度较轻。在本研究人群中,伴放线放线杆菌与EOP无显著关联,尽管在局限型EOP患者中更常检测到该菌。腐蚀埃肯菌在患病和未患病受试者中的出现频率相同。结果表明,几种细菌与EOP相关,牙龈卟啉单胞菌和齿垢密螺旋体尤为重要,可能在更严重和进展性的EOP形式中起重要作用。