Riviere G R, DeRouen T A
Department of Pediatric Dentistry, School of Dentistry, Oregon Health Sciences University, Portland 97201-3097, USA.
J Periodontol. 1998 Apr;69(4):496-501. doi: 10.1902/jop.1998.69.4.496.
The purpose of this investigation was to determine whether the presence of selected disease-associated bacteria in health-associated plaque correlated with future gingivitis. Sites of periodontal health were identified in 65 adults. Six months later (recall 1) plaque was collected from sites that remained in periodontal health, and 5 species of specific bacteria and pathogen-related oral spirochetes were detected using monoclonal antibodies in a microscopic assay. Members of the spirochete morphogroup were also identified by phase contrast microscopy. The relationship between site-specific detection of bacteria at recall 1 and development of gingivitis at recall 2 or 3 was evaluated by means of logistic regression using generalized estimating equations, from which odds ratios (OR) were estimated. Significance was conservatively defined as OR > 2.0 and P < 0.05. We found that 488 of 1,424 healthy sites developed gingivitis over the 12-month interval between recall 1 and 3. Only the spirochete morphogroup (OR =2.04; P=0.002) was significantly associated with the transition from health to gingivitis. The association of Treponema socranskii with future gingivitis was higher than expected (OR=2.27), but the relationship was not statistically significant (P=0.163). Campylobacter rectus, Eikenella corrodens, Porphyromonas gingivalis, and pathogen-related oral spirochetes did not correlate well with gingivitis (OR < 2.0). Health-associated plaque from 5 sites contained Treponema denticola, and all 5 sites progressed to gingivitis. An OR could not be calculated because T. denticola was not detected in health-associated plaque from stable healthy sites. These findings indicated that the presence of T. denticola and unidentified spirochetes in health-associated plaque was associated with increased susceptibility to gingival inflammation. Future studies assessing a larger panel of dental plaque microorganisms, with shorter intervals between baseline and follow-up assessment, are necessary to more fully evaluate the association between detection of specific organisms at healthy sites and risk for gingivitis.
本研究的目的是确定健康相关菌斑中某些疾病相关细菌的存在是否与未来的牙龈炎相关。在65名成年人中确定了牙周健康部位。6个月后（回访1），从仍保持牙周健康的部位采集菌斑，并在显微镜检测中使用单克隆抗体检测5种特定细菌和与病原体相关的口腔螺旋体。螺旋体形态组的成员也通过相差显微镜进行鉴定。使用广义估计方程通过逻辑回归评估回访1时细菌的部位特异性检测与回访2或3时牙龈炎发展之间的关系，由此估计比值比（OR）。显著性保守定义为OR>2.0且P<0.05。我们发现，在回访1和3之间的12个月间隔内，1424个健康部位中有488个发展为牙龈炎。只有螺旋体形态组（OR=2.04；P=0.002）与从健康到牙龈炎的转变显著相关。索氏密螺旋体与未来牙龈炎的关联高于预期（OR=2.27），但该关系无统计学意义（P=0.163）。直肠弯曲菌、啮蚀艾肯菌、牙龈卟啉单胞菌和与病原体相关的口腔螺旋体与牙龈炎的相关性不佳（OR<2.0）。来自5个部位的健康相关菌斑含有齿垢密螺旋体，所有5个部位均发展为牙龈炎。由于在稳定健康部位的健康相关菌斑中未检测到齿垢密螺旋体，因此无法计算OR。这些发现表明，健康相关菌斑中齿垢密螺旋体和未鉴定螺旋体的存在与牙龈炎症易感性增加有关。未来有必要进行研究，评估更大范围的牙菌斑微生物群，在基线和随访评估之间设置更短的间隔时间，以更全面地评估健康部位特定微生物的检测与牙龈炎风险之间的关联。
