种植修复后牙周菌群在不同时期变化的定量研究

The quantitative investigation of periodontal bacteria in different periods after dental implantation

目的观察种植修复后牙周菌群在不同时期的变化,比较牙周病人群和健康人群种植术后菌群分布差异。方法选择牙种植患者28例,接受37颗种植修复(无牙周病史19颗,有牙周病史18颗),采取前后对照设计。采用细菌分离鉴定及菌落形成单位计数的检测方法,以正常同名天然牙为基线对照,追踪观察愈合基台龈袖口、全冠修复后1周、负荷12个月后牙龈沟菌丛变化情况。结果种植体龈沟液内的细菌数量增加构成日趋复杂,在愈合基台期细菌数量最低,冠修复后1年,两组人群的菌群数量和构成差异有显著性(P<0.05),而健康人群成功种植体和天然牙有相似的菌群构成;但以往有牙周病史的患者,种植体植入区域内普遍有牙周病原体量的增加。结论随着时间的延长,具有牙周病史的患者的种植体周围炎的风险增加。

Objectives To observe the changes of periodontal bacteria in the different periods after implanting, and compare the distribution differences of bacteria between people having dental implants with and without periodontal disease. Methods The research was an anterior-posterio contrast design study. Twenty eight patients with 37 implants were selected, of which 19 implants belonged to patients with periodontal disease histories. The isolation and identification of bacteria and colony-forming unit count（CFU-count） were used as the detection methods and homonymous natural teeth as the control to observe continuously the changes of gingival sulcus bacteria in three periods：healing abutment period, one week after completing coronal restoration, twelve months after functional loading. Results The amount of bacteria increased and the constitution became complicated gradually. One year after completing coronal restoration, the differences of the quantity and constitution of bacteria between two groups were significant （ P 〈 0.05 ）, the amount of bacteria in healing abutment period was the lowest; the constitution of bacteria in successful implants of healthy persons was similar to that of natural teeth. But in the patients who had history of periodontal disease,there was increasing amount of pathogens in the implant areas. Conclusion Along with the extension of time, the patients who had history of periodontal disease faced the increasing risks of peri-implantitis.