龋病和牙周病主要致病菌分布的影响因素

The factors affecting the distribution of dental caries and periodontal pathogens

目的本研究分析龋病和牙周病主要致病菌的分布与研究人群人口统计学特征、口腔卫生状况和习惯及吸烟、饮酒习惯之间的关系。方法选纽约港医疗保健系统和纽约贝勒维医疗中心2009年3月30日至2011年4月27日之间的98名应试者的人口统计学变量、口腔健康状况、口腔健康维护行为及吸烟、饮酒习惯等数据库信息及唾液和牙菌斑样本DNA进行实验研究。唾液和牙菌斑样本DNA,进行实时定量PCR,SPSS19.0统计软件分析实验所得数据,卡方检验比较不同细菌的分布情况,Kruskal-Wallis非参数检验比较不同组别DNA水平的差异。结果性别、收入水平、受教育程度和身高体重指数不同组间,所有被测细菌均无显著性差异。口腔健康状况(包括牙齿和牙龈)较差组的人群牙龈卟啉单胞菌,牙密螺旋体,福赛斯坦纳菌,变异链球菌和远缘链球菌的检出率均高于口腔健康状况较好的2组。从不使用牙线组的牙周主要致病菌的检出率均高于其他3组,牙密螺旋体的检出率有显著性差异(P=0.023)。吸烟者与饮酒者的被测细菌与不吸烟不饮酒者有所不同。牙龈卟啉单胞菌,牙密螺旋体,伴放线放线杆菌,福赛斯坦纳菌4种细菌在牙菌斑中的DNA水平均高于唾液。相关性分析结果表明,四种细菌在唾液中和龈下菌斑中的DNA水平具有显著相关性(P<0.001)。结论口腔健康状况、使用牙线、吸烟、饮酒可能影响龋病和牙周致病菌的分布,龈下菌斑中的牙周致病菌含量高于唾液,不同个体的龈下菌斑中牙周致病菌的DNA水平与唾液密切相关。

Objective To investigate the association between the main pathogens of dental caries and periodontal disease and the socio-demographic and clinical oral health characteristics in study population. Methods The population of this study consisted of 98 individuals in the Veterans Affairs New York Harbor Heahhcare System and Bellevue Hospital Center. Bacterial samples were taken from all 98 subjects at the time of dental examination performed. The study evaluated the demographic variables, oral health status, oral health behavior and smoking/drinking habits in the study population. After extracting DNA from saliva and plaque samples, real-time quantitative PCR was performed. SPSS19.0 statistical software was used to analysis the experimental data. Results There were no significant differences of all tested bacteria in different gender, income, educational attainment and BMI groups. The detection rates of Porphyromonas gingivalis （Pg）, Treponema denticola （ Td ） , Tannerella forsythensis （ Tf） , Streptococcus mutans （Sm ） and Streptococcus sobrinus （ Sb ） in the population having poor oral health status （including teeth and gums） were higher than those in the population having healthy oral status. Periodontal pathogen detection rate of people who never used dental floss was higher than the other three groups, the detection rate of Td had significant difference （ P = 0. 023 ）. The tested bacteria in smokers and drinkers were different from people who never smoked or drank. The DNA levels of four periodontal pathogens Pg, Td, Actinobacillus actinomycetemcomitaus （Aa）and Tf in dental plaque were higher than that in saliva. The DNA levels of the four bacteria in saliva and in the plaque were significantly correlated （P 〈 0. 001 ）. Conclusion The oral health status and dental flossing, smoking and drinking habits may influence the distribution of caries and periodontal pathogens. The content of periodontal pathogens in the subgingival plaque was higher than that of the saliva. DNA levels of periodontal pathogens in the gingival plaque were closely related to that in saliva.