正畸牙龈炎患者牙龈卟啉单胞菌表达及其与龈沟液MMP-2、IL-1β、sICAM-1水平和牙周健康状况的关系

Expression of Porphyromonas Gingivalis in Patients with Orthodontic Gingivitis and Its Relationship with MMP-2,IL-1β,sICAM-1 levels and Periodontal Health Status of Gingival Crevicular Fluid

目的:探讨正畸牙龈炎患者牙龈卟啉单胞菌(Pg)表达及其与龈沟液基质金属蛋白酶2(MMP-2)、白细胞介素1β(IL-1β)、可溶性细胞间黏附分子1(sICAM-1)水平和牙周健康状况的关系。方法:选取2017年8月-2019年12月笔者医院正畸牙龈炎患者106例为病例组,同期68例健康志愿者为对照组。测定对比两组及病例组不同病情程度(中重度、轻度)患者和治疗前后Pg阳性率、龈沟液MMP-2、IL-1β、sICAM-1水平、牙周健康状况指标[菌斑指数(PLI)、龈沟出血指数(SBI)、牙龈指数(GI)、探诊深度(PD)]水平,分析正畸牙龈炎患者Pg表达与龈沟液各指标水平、牙周健康状况的关系。结果:①病例组Pg阳性率、龈沟液MMP-2、IL-1β及sICAM-1水平高于对照组(P<0.05);②病例组PLI、SBI、GI及PD水平高于对照组(P<0.05);③病例组中重度患者Pg阳性率、龈沟液MMP-2、IL-1β、sICAM-1水平高于病例组轻度患者(P<0.05);④病例组中重度患者PLI、SBI、GI、PD水平高于轻度患者(P<0.05);⑤病例组治疗后Pg阳性率、龈沟液MMP-2、IL-1β及sICAM-1水平低于治疗前(P<0.05);⑥病例组治疗后PLI、SBI、GI、PD水平低于治疗前(P<0.05);⑦病例组Pg表达与龈沟液MMP-2、IL-1β、sICAM-1及PLI、SBI、GI及PD水平呈正相关关系(P<0.05)。结论:Pg感染可能是导致正畸牙龈炎患者龈沟液MMP-2、IL-1β、sICAM-1水平升高及牙周健康损害风险的因素,早期有效抑制Pg感染,有助于减轻正畸牙龈炎患者炎症反应,预防牙龈炎进一步发展为不可逆性牙周炎。

Objective To investigate the expression of Porphyromonas gingivalis(Pg)in orthodontic gingivitis patients and its relationship with gingival crevicular fluid matrix metalloproteinase 2(MMP-2),interleukin 1β(IL-1β)and soluble intercellular adhesion molecule 1(sICAM-1)levels and periodontal health status.Methods From August 2017 to December 2019,106 patients with orthodontic gingivitis in our hospital were selected as the case group,and 68 healthy subjects during the same period as the control group.Measuring and comparing Pg positive rate,gingival crevicular fluid MMP-2,IL-1β,sICAM-1 levels,periodontal health indicators[plaque index(PLI),sulcus bleeding index(SBI),gingival index(GI),depth of exploration(PD)]levels before and after treatment of the patients with different degrees of disease(moderate to severe,mild)in 2 groups and case groups.The relationship between Pg expression,gingival crevicular fluid index and periodontal health status in patients with orthodontic gingivitis was analyzed.Results①The Pg positive rate,gingival crevicular fluid MMP-2,IL-1β,and sICAM-1 levels in the case group were higher than those in the control group(P<0.05).②The levels of PLI,SBI,GI,and PD in the case group were higher than those in the control group(P<0.05).③The Pg positive rate,gingival crevicular fluid MMP-2,IL-1β,and sICAM-1 levels of patients with moderate to severe disease in the case group were higher than those with mild disease(P<0.05).④PLI,SBI,GI,PD levels of patients with moderate to severe disease in the case group were higher than those with mild disease(P<0.05).⑤The Pg positive rate,gingival crevicular fluid MMP-2,IL-1β,and sICAM-1 levels in the case group were lower than those in the case group before treatment(P<0.05).⑥The levels of PLI,SBI,GI,and PD after treatment in the case group were lower than those in the case group(P<0.05).⑦The Pg expression in the case group was positively correlated with the levels of MMP-2,IL-1β,sICAM-1,PLI,SBI,GI,and PD in the gingival crevicular fluid of the case group(P<0.05).Conclusion Pg infection may be a risk factor for the increase of gingival crevicular fluid MMP-2,IL-1β,sICAM-1 levels and periodontal health damage in patients with orthodontic gingivitis.Early effective suppression of Pg infection can help reduce the inflammatory response in patients with orthodontic gingivitis and prevent gingivitis from further developing into irreversible periodontitis.