种植体周围炎龈沟液中SOD、GP-x、MDA水平的初步研究

Analysis of glutathione peroxidase,superoxide dismutase and malondialdehyde concentration in gingival crevicular fluid in patients with human peri-implantitis

目的:检测种植修复患者种植牙及天然牙龈沟液中氧化应激标记物超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GP-x)和丙二醛(malondialdehyde,MDA)的浓度,探讨种植体周围炎与氧化应激的关系。方法:收集重庆医科大学附属口腔医院修复科完成种植上部修复1年后的患者62名,共计81个种植牙位,实验分为4组:炎症种植体(peri-implantitis group,PI)组,15颗;健康种植体(health implant group,HI)组,66颗;炎症种植体患者口内天然牙(tooth in peri-implantitis group,TPI)组,15颗;健康种植体患者口内天然牙(tooth in health implant group,THI)组,66颗。检查所选牙位的菌斑指数(plaque index,PLI)、探诊深度(pocket depth,PD)、龈沟出血指数(sulcus bleeding index,SBI)/改良龈沟出血指数(modified sulcus bleeding index,m BI)并收集龈沟液;利用ELISA法检测炎症因子白细胞介素-β(IL-lβ)、SOD、GP-x和MDA的浓度。结果:PI组的PLI、PD、m BI、IL-1β值以及龈沟液的量(2.20±0.78,4.63±0.92,2.60±1.12,21.07±2.29,1.34±0.17)较HI组(1.03±0.89,1.76±0.73,1.14±0.97,18.79±2.07,0.83±0.23)高,差异有统计学意义(P=0.000,0.000,0.001,0.000,0.000);较TPI组(1.13±0.92,1.53±0.72,1.00±0.93,18.52±2.37,0.74±0.26)高,差异有统计学意义(P=0.011,0.000,0.001,0.000,0.000)。PI组SOD及GP-x浓度(218.65±16.27,178.66±21.77)低于HI组(243.52±19.71,211.96±21.43),差异有统计学意义(P=0.000,0.000);也低于TPI组(230.63±26.91,213.04±25.75),差异有统计学意义(P=0.016,0.000)。HI组的PLI、PD、m BI、IL-1β、SOD、GP-x值以及龈沟液量与THI组无统计学意义,MDA在各组间无统计学意义。结论:炎症种植体龈沟液内SOD、GP-x的浓度较健康植体、炎症种植体患者口内天然牙均低、MDA浓度无明显改变,提示氧化应激可参与种植体周围炎,抗氧化应激酶可为种植体周围炎的一个临床诊断指标,为种植体周围炎的诊断以及治疗提供一定的理论依据。

Objective：To investigate glutathione peroxidase,superoxide dismutase and malondialdehyde concentration in gingival crevicular fluid in patients with human peri-implantitis and to provide the basis for diagnosis and adjunctive treatment for peri-implantitis. Methods：Peri-implant sulcular/gingival crevicular fluid（GCF）samples were collected from sixty-two patients loaded more than one year. The experiment was divided into 4 groups：peri-implantitis group（PI,n=15）,health implant group（HI,n=66）,tooth in peri-implantitis group（TPI,n=15）,tooth in health implant group（THI,n=66）. After the clinical measurements（probing depth,gingival index,gingival bleeding index,plaque index）,GCF samples were collected. Then glutathione peroxidase,superoxide dismutase,malondialdehyde and IL-1β were analyzed by enzyme-linked immunosorbentassays. Results：PLI,PD,m BI,IL-1β and gingival crevicular fluid in PI group（2.20±0.78,4.63±0.92,2.60±1.12,21.07±2.29,1.34±0.17）were higher than those of HI group（1.03±0.89,1.76±0.73,1.14±0.97,18.79±2.07,0.83±0.23）,（P=0.000,0.000,0.001,0.000,0.000）and TPI group（1.13±0.92,1.53±0.72,1.00±0.93,18.52±2.37,0.74±0.26）（P=0.011,0.000,0.001,0.000,0.000）.SOD and GP-x concentrations were lower in PI group（218.65±16.27,178.66±21.77）than in HI group（243.52±19.71,211.96±21.43）（P=0.000,0.000）and TPI group（230.63±26.91,213.04±25.75）（P=0.016,0.000）. No difference was observed in PLI,PD,m BI,IL-lβ,SOD,GP-x,and gingival crevicular fluid in THI group and HI group. No difference in MDA was observed among all groups. Conclusion：Oxidative stress may play a role in the inflammation and destruction of the implant periodontium in peri-implantitis.