The relationship between oral malodor, gingivitis, and periodontitis. A review
The relationship between oral malodor, gingivitis, and periodontitis. A review
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DOI：
10.1902/jop.1999.70.5.485
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发表时间：
1999-05-01
影响因子：
4.3
通讯作者：
Johnson, PW
中科院分区：
文献类型：
--
作者：
Ratcliff, PA;Johnson, PW
挥发性硫化合物（VSC）是一种主要导致口臭的气体家族，口臭是口腔空气中存在令人讨厌的气味的一种情况。虽然大多数患者认为这种情况主要是一个美容问题，但越来越多的证据表明，极低浓度的这些化合物中的许多对组织具有高度毒性。因此，VSC可能在诸如牙周炎等炎症的发病机制中发挥作用。由于这些化合物是由蛋白质的细菌腐烂产生的，因此进行了调查以确定特定细菌是否与气味产生有关。这个家族的两个成员，硫化氢（H2S）和甲基硫醇（CH3SH），主要负责口腔气味。虽然许多细菌产生H2S，但CH3SH的产生，特别是在高水平时，主要局限于牙周病原体。直接暴露于这些代谢物中的任何一种都会对培养的人牙龈成纤维细胞的蛋白质合成产生不利影响。然而，甲基硫醇的效果最大。其他体外实验表明，暴露于甲基巯基醇的细胞合成胶原较少，降解胶原较多，并积累交联性差且易被蛋白水解的胶原前体。CH3SH还增加完整粘膜的通透性，刺激与牙周病相关的细胞因子的产生。因此，VSC，特别是甲基硫醇，能够诱导细胞外基质和牙周组织对牙菌斑抗原的局部免疫反应发生有害变化。本文回顾了这些数据，并强调了VSC在牙周组织从临床健康到牙龈炎再到牙周炎的转变中的潜在重要性。
Volatile sulfur compounds (VSC) are a family of gases which are primarily responsible for halitosis, a condition in which objectionable odors are present in mouth air. Although most patients perceive this condition as primarily a cosmetic problem, an increasing volume of evidence is demonstrating that extremely low concentrations of many of these compounds are highly toxic to tissues. VSC may, therefore, play a role in the pathogenesis of inflammatory conditions such as periodontitis. Since these compounds result from bacterial putrefaction of protein, investigations have been conducted to determine whether specific bacteria are associated with odor production. Two members of this family, hydrogen sulfide (H2S) and methyl mercaptan (CH3SH), are primarily responsible for mouth odor. Although many bacteria produce H2S, the production of CH3SH, especially at high levels, is primarily restricted to periodontal pathogens. Direct exposure to either of these metabolites adversely affects protein synthesis by human gingival fibroblasts in culture. However, methyl mercaptan has the greatest effect. Other in vitro experiments have demonstrated that cells exposed to methyl mercaptan synthesize less collagen, degrade more collagen, and accumulate collagen precursors which are poorly cross-linked and susceptible to proteolysis. CH3SH also increases permeability of intact mucosa and stimulates production of cytokines which have been associated with periodontal disease. VSC, and in particular methyl mercaptan, are therefore capable of inducing deleterious changes in both the extracellular matrix and the local immune response of periodontal tissues to plaque antigens. This article reviews these data and emphasizes the potential importance of VSC in the transition of periodontal tissues from clinical health to gingivitis and then to peri odontitis.