Timmerman M F, Van der Weijden G A, Armand S, Abbas F, Winkel E G, Van Winkelhoff A J, Van der Velden U
Department of Periodontology, Academic Centre for Dentistry Amsterdam - ACTA, The Netherlands.
J Clin Periodontol. 1998 Mar;25(3):215-24. doi: 10.1111/j.1600-051x.1998.tb02431.x.
At present, several risk factors for the initiation and progression of periodontitis have been identified. In order to investigate the rôle of various potential clinical and microbiological risk factors and indicators, a longitudinal study was initiated in a young population deprived from regular dental care. The present communication describes the baseline cross-sectional data obtained in 1987 in terms of the clinical periodontal condition and prevalence of periodontal bacteria in the oral cavity. All inhabitants in the age range 15-25 years of a village with approximately 2000 inhabitants at a tea estate on Western Java, Indonesia, were examined clinically and microbiologically. In total, 255 adolescents, comprising 130 males and 125 females participated in the study. Samples for bacteriological examination were taken from the gingiva, the dorsum of the tongue, and the saliva. Plaque index, bleeding upon probing, pocket depth, and attachment loss (AL) were scored on the approximal surfaces from the vestibular aspect of all teeth as well as the mid-vestibular and mid-lingual aspects of the Ramfjord teeth. Calculus was scored only on the 4 surfaces of the Ramfjord teeth. Following the clinical measurements, the deepest bleeding pocket with no clinical loss of attachment was sampled for microbiological examination. In addition, in 37 subjects a deep bleeding (> or = 4 mm) with at least 4 mm of attachment loss was sampled. Moderate periodontitis (max. AL 3-4 mm) was found in 26% of the population, advanced periodontitis (max. AL > or = 5 mm) in 8%, whereas 66% of the population showed no or minor periodontitis (max. AL 0-2 mm). Actinobacillus actinomycetemcomitans was found in 57% of the population, Porphyromonas gingivalis in 87%, Prevotella intermedia and motile rods in all cases and spirochetes in 89%. P. gingivalis (66%), A. actinomycetemcomitans (37%) and spirochetes (63%) were, of all the sampled sites of the oral cavity, most frequently detected in pockets without attachment loss. Motile rods were most prevalent on the tongue and in the saliva (92% and 89%, respectively). A high prevalence of the investigated periodontal bacteria was detected both in the pockets without and with attachment loss. No significant association between the clinical periodontal parameters and the prevalence of the microorganisms was observed at a patient level. At a site level, both P. gingivalis and spirochetes were more prevalent in sites with attachment loss. The actual rôle of these putative periodontal pathogens may be elucidated more extensively, when longitudinal data on the present population become available.
目前，已确定了几种导致牙周炎发生和发展的风险因素。为了研究各种潜在的临床和微生物风险因素及指标的作用，在一个缺乏定期牙科护理的年轻人群中开展了一项纵向研究。本报告描述了1987年获得的关于临床牙周状况和口腔中牙周细菌患病率的基线横断面数据。对印度尼西亚西爪哇一个茶园中约2000名居民的所有15 - 25岁居民进行了临床和微生物学检查。共有255名青少年参与了该研究，其中包括130名男性和125名女性。采集了牙龈、舌背和唾液的样本用于细菌学检查。从所有牙齿的前庭面以及Ramfjord牙的前庭中部和舌中部测量菌斑指数、探诊出血、牙周袋深度和附着丧失（AL）。仅对Ramfjord牙的4个面进行牙结石评分。临床测量后，对无临床附着丧失的最深出血牙周袋进行微生物学检查。此外，在37名受试者中，对至少有4mm附着丧失的深度出血（≥4mm）部位进行了采样。26%的人群患有中度牙周炎（最大AL为3 - 4mm），8%的人群患有重度牙周炎（最大AL≥5mm），而66%的人群无牙周炎或患有轻度牙周炎（最大AL为0 - 2mm）。57%的人群检测到伴放线放线杆菌，87%检测到牙龈卟啉单胞菌，所有病例均检测到中间普氏菌和能动菌，89%检测到螺旋体。在口腔所有采样部位中，牙龈卟啉单胞菌（66%）、伴放线放线杆菌（37%）和螺旋体（63%）在无附着丧失牙周袋中最常检测到。能动菌在舌部和唾液中最为普遍（分别为92%和89%）。在无附着丧失和有附着丧失的牙周袋中均检测到所研究的牙周细菌的高患病率。在患者层面，未观察到临床牙周参数与微生物患病率之间存在显著关联。在部位层面，牙龈卟啉单胞菌和螺旋体在有附着丧失的部位更为普遍。当获得该人群的纵向数据时，这些假定的牙周病原体的实际作用可能会得到更广泛的阐明。
