Difficulties encountered in the search for the etiologic agents of destructive periodontal diseases.
Difficulties encountered in the search for the etiologic agents of destructive periodontal diseases.
复制标题
在寻找破坏性牙周病的病因中遇到了困难。
DOI：
10.1111/j.1600-051x.1987.tb01520.x
复制
发表时间：
1987
影响因子：
6.7
通讯作者：
Dzink,JL
中科院分区：
文献类型：
--
作者：
Socransky,SS;Haffajee,AD;Smith,GL;Dzink,JL
本文概述了在寻找破坏性牙周病的病原体方面遇到的一些困难。这些问题包括技术问题，如获取适当的微生物样本，以及在该样本中分散、培养和鉴定分离物的困难。目前正在成功地解决其中许多困难。第二组问题在本质上更具概念性。这些问题包括难以区分牙周疾病和确定牙周病变的活动状态。此外，生物体的复合体和/或物种序列可能参与了病变的进展。在试图区分机会性物种的过度生长和真正病原体比例的增加时，还会遇到另一个问题。最后，不同的感染似乎很可能同时发生在一个口腔中。技术和概念上的困难最终会渗透到数据分析步骤，并向分析师提出许多问题。考虑到所有这些困难，破坏性牙周病的病因没有明确定义也就不足为奇了。然而，改进对微生物区系的技术评估和对疾病的临床评估应允许采取合理的方法。破坏性牙周病的病原学描述必然是一个多阶段的迭代过程。主要的可培养研究和关于这些病原体亚群的假设将被提出，这些病原体的亚群使用更具体的程序进行测试，如选择培养基、免疫荧光技术或DNA探针。病原体将通过这样的程序进行验证或丢弃。当在没有识别病原体的情况下发现新的病变时，这一过程将再次迭代回到主要的可培养方法。
The present paper outlines some of the difficulties encountered in the search for the etiologic agents of destructive periodontal diseases. These include technical problems such as acquiring an appropriate microbial sample, as well as difficulties in the dispersion, cultivation and identification of isolates in that sample. Many of these difficulties are currently being successfully addressed. A second set of problems is more conceptual in nature. These include difficulties in distinguishing between periodontal diseases and determining the state of activity of periodontal lesions. In addition, complexes of organisms and/or sequences of species may be involved in the progress of lesions. A further problem is encountered in attempting to distinguish overgrowths of opportunistic species from increases in proportions of true pathogens. Finally, it appears likely that different infections occur at the same time in a single oral cavity. The technical and conceptual difficulties eventually filter down to the data analytical step and present numerous problems to the analyst. With all of these difficulties in mind it is not surprising that the etiologic agents of destructive periodontal diseases are not clearly defined. However, improvement in technological assessments of the microbiota and clinical evaluation of the disease should permit reasoned approaches to be taken. The delineation of the etiologic agents of destructive periodontal diseases will be, of necessity, a multistage iterative process. Etiologic agents will be suggested by predominant cultivable studies and hypotheses concerning subsets of these agents tested using more specific procedures such as selective media, immunofluorescent techniques or DNA probes. Etiologic agents will be verified or discarded by such procedures. When new lesions are found without recognized pathogens, the process will iterate back to the predominant cultivable methodology again.