A study on host-parasite interactions in human periodontal pockets.

我们用扫描电镜观察了18例重度成人牙周炎患者的龈下菌斑。在牙周袋的顶端1 / 3区域，多种细菌聚集形成糖萼样结构，包括网状结构和黏液样结构。在所谓的“无菌斑”区，观察到两种类型的细菌粘附：细菌细胞壁直接与根表面接触，微生物通过糖萼网状物质介导对根表面的粘附。在提供知情同意后，拔牙30颗严重晚期成人牙周炎患者的牙齿，用扫描免疫电镜法检测无菌斑区对牙周病相关细菌的特异性抗体。实际上，7个样本中有4个在无菌斑区发现了牙龈卟啉单胞菌，9个样本中有5个检测到密螺旋体。在7个样品中，只有1个样品中检出了中间普雷沃氏菌，而在4个样品中检出了粘胶放线菌。二次电子成像在无斑块区检测到的螺旋体和杆状体中，有一半以上的螺旋体和杆状体与背散射电子成像检测的四种特异性抗体没有积极反应。这表明，除了上述四种细菌外，在无菌斑区还存在几种未知的微生物。我们还检测了牙周炎中T细胞和B细胞的细胞密度和分布，并分析了它们在牙周组织破坏方面的关系。T细胞出现在低密度浸润中，并随着浸润总数的增加而逐渐增加，而B细胞未出现在小浸润中，但随着浸润数的增加而迅速增加。成纤维细胞数量与浸润总量和B细胞数量呈负相关，与T细胞数量无相关性。这些结果提示，T细胞在发病时浸润到炎症部位，随着炎症的发展逐渐增多，B细胞浸润在T细胞后面，随着炎症的发展数量迅速增加。少

We observed subgingival plaque in 18 severe adult-periodontitis affected teeth by scanning electron microscopy. In the apical one-third zone of periodontal pockets, several bacterial species aggregated with glycocalyx-like structures, which comprised net-like and mucoidal structure. In the so-called "plaque-free" zone, two types of bacterial adherence were observed : bacterial cell walls directly contacted with the root surface, and microorganisms adhered to the root surface mediated by the glycocalyx net-like materials.After Providing informed consent, 30 teeth with severe advanced adult periodontitis were extracted, and the plaque-free zones were investigated with specific antibodies against four periodontal diseaseassociated bacteria by a scanning immunoelectron microscopy method. Porphyromonas gingivalis was actually found in the plaque-free zones in four of the seven samples examined, and Treponema denticola was detected in five of nine samples. Prevotella intermedia occurred in o … More nly one of the seven samples examined, and Actinomyces viscosus was identified in four of the seven samples. More than half of the number of the spirochetes and rods detected by secondary electron imaging in the plaque-free zones did not react positively with the four specific antibodies examined by back-scattered electron imaging. This suggests that several unidentified microorganisms were present in the plaque-free zones in addition to the above four bacterial species.We also examined immunohitologically the cell densities and distribution of T and B cells in periodontitis, and analyzed their relationship in terms of periodontal tissue destruction. T cells appeared in the low density of infiltrates and increased gradually with the number of total infiltrates, whereas B cells did not appear in the small infiltrates but increased rapidly with the number of infiltrates. The number of fibroblastic cells showed negative correlation with that of the total infiltrates and B cells, but it did not correlate with the number of T cells. These findings suggest that the T cells infiltrated into the imflamed sites at the onset and increased gradually with the development of inflammation, and that B cells infiltrated behind the T cells and their number increased rapidly with inflammation. Less