Studies on diagnostic methods for measurement of periodontal disease activity

本研究旨在探讨测量牙周病活动性的诊断方法。在第一个实验中，从39例未经治疗的牙周炎患者的17个牙周健康部位和53个病变部位采集了龈下菌斑和牙周沟液(GCF)。龈下菌斑细菌的绝对计数。牙周液中螺旋体、游动杆菌、牙龈卟啉单胞菌(PG)、中间普氏杆菌(PI)、前列腺素E_2(PGE_2)、白介素1α(IL-1α)在病变部位所占比例均显著高于病区。在第二个实验中，从10例未经治疗的成人牙周炎患者和7例牙周治疗后牙周炎患者的活动性和非活动性病变中提取菌斑和GCF。活动性病变部位被定义为在42天的…中表现出超过2 mm的结缔组织附着丧失的口袋更多的监控期。不活跃的病变部位的口袋深度与活跃部位相当，但连接性附着水平在监测期间没有变化。比较活动期和非活动期牙周炎患者牙周液中PGE_2、IL-1α、IL-1β、胶原酶活性和脂多糖(LPS)的变化。GCF中IL-1α、IL-1β、活性胶原酶和活动杆比例在活动部位明显升高。在接受维持治疗的牙周炎患者中，活性部位的细菌绝对数量显著增加，牙周液中前列腺素E_2在这些部位升高的频率更高。数据的线性判别分析被证明对检测未经治疗的牙周炎活性部位是有用的，因为每项测试都不能区分它们。联合检测前列腺素E_2、IL-1α、IL-1β、内毒素和胶原酶对诊断活动性病变的敏感性和特异性分别为62%和100%。相比之下，细菌的绝对计数可以单独用于检测牙周炎患者在维持治疗中的活性部位。其敏感性和特异性均为82%。结论：线性判别分析可作为测量牙周病活动性的有效诊断方法之一。较少

This study was designed to investigate diagnostic methods for measurement of periodontal disease activity. In the first experiment, subgingival plaque and gingival crevicular fluid (GCF) were taken from 17 periodontally health sites and 53 diseased sites in 39 subjects with untreated periodontitis. Absolute counts of subgingival plaque bacteria. the proportion of Spirochetes, Motile rods, Porphyromonas gingivalis (Pg) and Prevotella intermedia (Pi), prostaglandin E_2 (PGE_2) and interleukin-1alpha (IL-1alpha) in GCF were significantly higher in diseased sites. The results suggested that these tests may aid in diagnosis of periodontal disease.In the second experiment, subgingival plaque and GCF were taken from active and inactive lesions in 10 subjects with untreated adult periodontitis and also from 7 subjects in whom periodontitis was maintained after periodontal treatment. Active diseased sites were defined as pockets showing more than 2mm loss of connective attachment during 42-day … More monitoring period. Inactive diseased sites had a pocket depth comparable to the active sites, but connective attachment level did not change during the monitoring period. Subgingival plaque bacteria, and PGE_2, IL-1alpha, IL-1beta, collagenase activity and lipopolysaccharide(LPS)in GCF we're compared in active and inactive sites.In untreated periodontitis patients, PGE_2 in GCF and absolute counts of subgingival plaque bacteria were significantly higher in active sites. IL-1alpha, IL-1beta, active collagenase in GCF and the proportion of motile rods were elevated more often in active sites. In periodontitis patients on maintenance treatment, absolute counts of bacteria were significantly higher at active sites, and PGE_2 in GCF was elevated more often at such sites.Linear discriminant analysis of data was shown to be useful for detecting active sites in untreated periodontitis, because each test alone could not distinguish them. The combination of PGE_2, IL-1alpha, IL-1beta, LPS and collagenase determinations, was most useful for detecting active sites, and the sensitivity and specificity for detection of active lesions was 62% and 100%, respectivity. In contrast, the absolute counts of bacteria could be used by itself for detection of active sites in the periodontitis patients on maintenance treatment. Its sensitivity and specificity were both 82%. In conclusion, the linear discriminant analysis could be one of the useful diagnostic methods for measurement of periodontal disease activity. Less