CLINICAL, MICROBIOLOGICAL AND IMMUNOLOGICAL FEATURES OF SUBJECTS WITH REFRACTORY PERIODONTAL-DISEASES
CLINICAL, MICROBIOLOGICAL AND IMMUNOLOGICAL FEATURES OF SUBJECTS WITH REFRACTORY PERIODONTAL-DISEASES
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DOI：
10.1111/j.1600-051x.1988.tb01017.x
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发表时间：
1988-07-01
影响因子：
6.7
通讯作者：
EBERSOLE, JL
中科院分区：
文献类型：
--
作者：
HAFFAJEE, AD;SOCRANSKY, SS;EBERSOLE, JL
27名患有活动性破坏性牙周病的受试者接受改良Widman皮瓣手术和系统性四环素治疗，并根据治疗前和治疗后的风险率（1年内附着丧失> 3 mm的部位%）分为4组。治疗前和治疗后的危险率分别为：组I（3名受试者）< 4和< 4;组II（8名受试者）> 4和< 4;组III（3名受试者）< 4和<4;组IV（13名受试者的难治性组）> 4和> 4。第I组和第II组受试者的基线平均囊袋深度和附着丧失小于第III组和第IV组受试者，并且表现出较少的化脓。6名IV组受试者在治疗后总共失去38颗牙齿，而其他3组受试者没有牙齿脱落。发红、探诊出血、斑块水平和年龄在各组之间没有差异。4组受试者的龈下物种不同，他们表现出血清抗体反应升高。第IV组受试者对选定范围的革兰氏阴性菌种（包括伴放线放线杆菌菌株Y 4或ATCC 29523、具核梭杆菌和中间拟杆菌）的反应升高。任何其他组中的受试者均未表现出对B的应答升高。中间体计算每例受试者治疗前后所有采样部位中每种属的平均%。第III组和第IV组受试者（高治疗后风险率）的B平均水平升高。Pasthus，F.具核链球菌、中间链球菌、腐蚀艾肯氏菌和B.牙龈炎第I组和第II组受试者显示未命名放线菌属的平均水平升高。难治性受试者（第IV组）不构成同质组。虽然这组受试者的病原体水平较高，但似乎他们在主要物种的组合方面有所不同。共观察到3种主要微生物复合体：（1）B. Pasthus，F. nucleatum和Wolinella recta（3例）; intermedius，B. gingivalis和Peptostreatitis micros（3例）; intermedius和F.有或无B的有核细胞（7例受试者）。牙龈炎
27 Subjects with active destructive periodontal diseases were treated by modified Widman flap surgery and systemic tetracycline and divided into 4 groups based on pre- and post-therapy hazard rates (% of sites losing > 3 mm of attachment in 1 year). Pre- and post-therapy hazard rates were respectively: group I (3 subjects) < 4 and < 4; group II (8 subjects) > 4 and < 4; group III (3 subjects) < 4 and G 4; group IV (refractory group of 13 subjects) > 4 and > 4. Baseline mean pocket depths and attachment loss of groups I and II subjects were less than groups III and IV subjects and exhibited less suppuration. 6 group IV subjects lost a total of 38 teeth after therapy, in contrast to no tooth loss in subjects in the other 3 groups. Redness, bleeding on probing, plaque levels and age did not differ among groups. Subjects in the 4 groups differed in the subgingival species to which they showed elevated serum antibody responses. Group IV subjects showed elevated responses to a select range of gram-negative species, including Actinobacillus actinomycetemcomitans strains Y4 or ATCC 29523, Fusobacterium nucleatum and Bacteroides intermedius. No subject in any of the other groups exhibited an elevated response to B. intermedius. The mean % of each species in all sampled sites, both before and after therapy, was computed for each subject. Subjects in groups III and IV (high post-therapy hazard rates) exhibited elevated mean levels of B. forsythus, F. nucleatum, Streptococcus intermedius, Eikenella corrodens, and B. gingivalis. Groups I and II subjects showed elevated mean levels of an unnamed Actinomyces species. Refractory subjects (group IV) did not constitute a homogeneous group. While subjects in this group had higher levels of pathogens, it appeared that they differed in the combination of predominant species. 3 major microbial complexes were observed: (1) B. forsythus, F. nucleatum and Wolinella recta (3 subjects); (2) S. intermedius, B. gingivalis and Peptostreptococcus micros (3 subjects); (3) S. intermedius and F. nucleatum (7 subjects) with or without B. gingivalis.