牙周炎患者基础治疗后牙龈卟啉单胞菌的定植研究

Study on Porphyromonas gingivalis colonization in patients with periodontitis after periodontal initial therapy

目的通过对牙周炎患者龈下菌斑中牙龈卟啉单胞菌（Porphyromonas gingivalis，Pg）的检测，探讨慢性牙周炎（chronic periodontitis，CP）和侵袭性牙周炎（aggressive periodontitis，AgP）患者牙周基础治疗后Pg的定植规律。方法选取90例CP患者和90例AgP患者，在牙周基础治疗前、治疗后6周、12周共采集龈下菌斑样本1620个，运用AmpliFluor终末点定量聚合酶链反应方法检测赡含量。结果治疗后6周CP和AgP组Pg活动位点分别为61（22．6％）和66（24．4％）个，两者差异无统计学意义（P〉0．05）；治疗后6周赡活动位点在治疗前检测的牙周临床指数高于赡静止位点。治疗后12周两组Pg活动位点分别为96（35．6％）和18（6．7％）个，差异有统计学意义（P〈0．05）；治疗后12周赡活动位点在治疗后6周时检测的牙周临床指数高于赡静止位点。结论在牙周基础治疗后6周时，CP和AgP患者赡定植均已开始，但是两组定植规律存在一定差异。在牙周基础治疗后，治疗前牙周组织炎性反应严重的龈下位点赡易于定植。

Objective To examine Porphyromonas gingivalis （Pg） in subgingival plaque of the patients with periodontitis and to find out the rules of Pg colonization after periodontal initial treatment. Methods A total of 1620 subgingival plaque samples were collected from 180 subjects including chronic periodontitis （CP） patients （ n = 90）, and aggressive periodontitis （AgP） patients （ n = 90 ） in different periods of periodontal initial therapy the baseline, 6 weeks, and 12 weeks after treatment. The following periodontal clinical parameters were recorded with Florida probe at sampled sites： probing depth （PD） , clinical attachment loss （ CAL）, and bleeding on probing （ BOP）. Quantities of Pg were examined by AmpliFluor endpeint quantitative polymerase chain reaction. Results At the 6th week of periodontal initial therapy, there were 61 （22. 6% ） and 66 （24. 4% ） Pg increased sites respectively, in which no significant difference was detected （ P 〉 0. 05 ）. At baseline of periodontal initial therapy, more severe periodontal clinical parameters of Pg increased sites were observed than those of Pg stationary sites. At the 12th week, however, there were 96 （35.6%） and 18 （6. 7% ） Pg increased sites respectively, significant difference detected （P 〈 0. 05 ）. At 6th week of periodontal initial therapy, more severe periodontal clinical parameters of Pg increased sites were observed than those of Pg stationary sites. Conclusions Pg colonization in AgP and CP patients started 6 weeks after periodontal initial therapy, but the recolonization pattern was different between these two groups of patients. Severe periodontitis sites in baseline seemed to place them at risk of Pg colonization after periodontal initial therapy.