牙种植体周围炎龈下菌群分布的研究

Research on Subgingival Flora Colonization in Partial Edentulous Patients with Peri-implantitis

目的:探讨牙种植体周围炎的发生与龈下菌群中有益菌和可疑致病菌菌群失调的关系.方法:筛选16名患者的32枚种植体,按照自身对照的配对设计分为健康组和炎症组,观察指标包括PD、mPLI和GBI及牙种植体周围龈下菌群的构成比,细菌鉴定方法为PCR技术和微量生化实验.结果:炎症组和健康组的PD值有统计学差异(P<0.05).炎症组中G-厌氧杆菌占44.86%,G+兼性厌氧球菌占32.68%,健康组中则分别为17.41%和47.36%.其中Pg、Pi、Fn、Ss和Vp的构成比在两组均有统计学差异(P<0.01).结论:G+兼性厌氧球菌和G-厌氧杆菌比例失调,尤其是有益菌和可疑致病菌的比例失调导致了种植体周围炎的发生.

Objective： Microorganism is the mast important factor in subgingival microecosystem around dental implants. Purpose of this study was to investigate colonization of subgingival rnicroorganisms, especially the peri- implantal beneficial bacteria and suspected pathogens, in partial edentulous patients with periimplantitis. Methods： 32 implants in 16 patients, every patient at least with 1 healthy implant and 1 inflammatory implant, were divided into healthy group （H） and peri- implantitis group （P）. Clinical parameters included peri - implant pocket depth （PPD）, modified plaque index （mPLI）, gingival blood index （GBI） and the proportion of subgingival microorganisms around implants. 16S rRNA- based polymerase chain reaction （PCR） techniques was used to identify the subgingival microorganisms. Results： PD was significantly deeper in P group than that in H group （P 〈 0.05）. In P group, 44.86 % was gram- negative anaerobic rods and 32.68% gram- positive facultative anaerobic cocci; but in H group, 17.41% and 47.36 % respectively. The proportion of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Streptococcus sanguis and Veillonella parvula had significant difference between inflammatory and healthy group （P 〈 0.01 ）. Conclusion： The imbalance between gram- positive facultatively anaerobic cocci and gram- negative anaerobic rods, especially the beneficial bacteria and suspected pathogens around implant, results in peri - implantitis.