Persistence of extracrevicular bacterial reservoirs after treatment of aggressive periodontitis.
Persistence of extracrevicular bacterial reservoirs after treatment of aggressive periodontitis.
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DOI：
10.1902/jop.2008.080254
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发表时间：
2008-12
影响因子：
4.3
通讯作者：
Rudney, Joel D.
中科院分区：
文献类型：
--
作者：
Johnson, Jason D.;Chen, Ruoqiong;Lenton, Patricia A.;Zhang, Guizhen;Hinrichs, James E.;Rudney, Joel D.
这项研究的目的是检验一种假设，即与侵袭性牙周炎相关的牙周病原体在洁治和根面平整、全身抗生素和抗菌冲洗后持续存在于库外位置。对18例侵袭性牙周炎患者进行了临床检查，并采集了龈下菌斑和颊上皮细胞标本。治疗包括全口根面平整、全身抗生素和洗必泰冲洗。在3个月和6个月时重复临床测量和取样。定量聚合酶链式反应检测伴生放线菌、中间普氏杆菌、牙龈卟啉单胞菌、福赛氏坦纳菌和齿密螺旋体的菌斑数量。荧光原位杂交和共聚焦显微镜检测上皮细胞的细胞内侵袭程度。治疗后临床测量显著改善。从基线到3个月，菌斑中除牙龈假单胞菌外的所有细菌均显著减少。然而，所有物种都表现出在3-6个月之间重新种群的趋势。这一增长对齿纹夜蛾的原木计数具有统计学意义。所有菌种均在细胞内检出。细胞内感染细胞的百分比不受治疗的影响。菌斑细菌水平在6个月内呈上升趋势，这表明牙龈下重新定植正在发生。由于这些物种在上皮细胞中的存在在治疗后没有改变，因此有可能从口腔粘膜发生重新定植。有趣的是，全身抗生素和外用洗必泰并没有减少侵袭的上皮细胞的百分比。这些数据支持这样的假设，即存在库外细菌，这可能导致一些患者的复发或难治性疾病。
The purpose of this study was to test the hypothesis that periodontal pathogens associated with aggressive periodontitis persist in extracrevicular locations following scaling and root planing, systemic antibiotics, and anti-microbial rinses. Eighteen aggressive periodontitis patients received a clinical exam during which samples of subgingival plaque and buccal epithelial cells were obtained. Treatment consisted of full-mouth root planing, systemic antibiotics, and chlorhexidine rinses. Clinical measurements were repeated along with sampling at 3 and 6 months. Quantitative PCR determined the number of plaque Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphymonas gingivalis, Tannerella forsythensis, and Treponema denticola. Fluorescence in situ hybridization and confocal microscopy determined the extent of intracellular invasion in epithelial cells. Clinical measurements significantly improved following treatment. All bacterial species except P. gingivalis were significantly reduced in plaque from baseline to 3 months. However, all species showed a trend to repopulate between 3 and 6 months. This increase was statistically significant for log T. denticola counts. All species were detected intracellularly. The percentage of cells infected intracellularly was not affected by therapy. The 6-month increasing trend in levels of plaque bacteria suggests that subgingival re-colonization was occurring. Since the presence of these species within epithelial cells was not altered after treatment, it is plausible that re-colonization may occur from the oral mucosa. Interestingly, systemic antibiotics and topical chlorhexidine did not reduce the percentage of invaded epithelial cells. These data support the hypothesis that extracrevicular reservoirs of bacteria exist, which might contribute to recurrent or refractory disease in some patients.
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