慢性牙周炎龈下菌群与龈沟液炎症因子及种植修复后种植体周围骨吸收的关系

Relationship between subgingival microbiota and inflammatory factors in gingival crevicular fluid in chronic periodontitis,and peri-implant bone resorption after implant restoration

目的:探究慢性牙周炎(CP)龈下菌群与龈沟液炎症因子及种植修复后种植体周围骨吸收的关系。方法:选取行种植修复的108例CP牙列缺损患者纳入CP组,另选取50例同时期牙周健康的牙列缺损患者作为对照组。比较两组患者种植修复前后龈下菌群分布情况、龈沟液炎症因子[白细胞介素6(IL-6)、白细胞介素1β(IL-1β)、基质金属蛋白酶9(MMP-9)]水平及修复后3个月种植体周围骨吸收情况,采用Pearson相关性分析CP患者术前龈下菌群数量与龈沟液炎症因子及修复后3个月种植体周围骨吸收量的相关性。结果:两组种植修复后3个月龈下菌斑中牙龈卟啉单胞菌(P.g)、中间普氏菌(P.i)、具核梭杆菌(F.n)、粘性放线菌(A.v)、变形链球菌(S.m)数量均较修复前下降(P<0.05),且CP组修复前后P.g、P.i、F.n、A.v、S.m菌群数量均大于对照组(P<0.05);两组修复后3个月龈沟液IL-6、IL-1β、MMP-9水平均较修复前下降,且CP组修复前后水平均大于对照组(P<0.05);CP组修复后3个月种植体周围近中、远中边缘骨吸收量均大于对照组(P<0.05);Pearson相关性分析显示,CP组龈下P.g、P.i、F.n、A.v、S.m菌群数量与龈沟液IL-6、IL-1β、MMP-9水平及种植修复后3个月近中、远中边缘骨吸收量均呈正相关关系(P<0.05)。结论:CP患者龈下菌斑中P.g、P.i、F.n、A.v、S.m菌群数量的增加与局部炎症加重及种植修复后种植体周围骨吸收密切相关。

Objective:To explore the relationship between subgingival microbiota and inflammatory factors in gingival crevicular fluid(GCF)in chronic periodontitis(CP),as well as peri-implant bone resorption after implant restoration.Methods:A total of 108 patients with CP who underwent implant restoration were included in the CP group,50 patients with periodontally healthy dentitions and tooth loss during the same period were selected as the control group.The distribution of subgingival microbiota,levels of inflammatory factors in gingival crevicular fluid[interleukin-6(IL-6),interleukin-1β(IL-1β),matrix metalloproteinase 9,(MMP-9)],and peri-implant bone resorption 3 months after restoration were compared between the two groups.Pearson correlation analysis was used to evaluate the correlation between the preoperative subgingival microbiota count in CP patients and the levels of inflammatory factors in gingival crevicular fluid,as well as the amount of peri-implant bone resorption 3 months after restoration.Results:In both groups,the counts of Porphyromonas gingivalis(P.g),Prevotella intermedia(P.i),Fusobacterium nucleatum(F.n),Aggregatibacter actinomycetemcomitans(A.v),and Streptococcus mutans(S.m)in subginagivl plaque decreased 3 months after implant restoration compared to pre-restoration levels(P<0.05).The CP group had higher counts of P.g,P.i,F.n,A.v,and S.m both before and after restoration compared to the control group(P<0.05).The levels of IL-6,IL-1β,and MMP-9 in gingival crevicular fluid decreased after restoration in both groups,with the CP group exhibiting higher levels before and after restoration compared to the control group(P<0.05).Peri-implant bone resorption at the mesial and distal aspects 3 months after restoration was higher in the CP group compared to the control group(P<0.05).Pearson correlation analysis revealed positive correlations between the counts of P.g,P.i,F.n,A.v,S.m in subgingival plaque,levels of IL-6,IL-1β,MMP-9 in gingival crevicular fluid,and the amount of peri-implant bone resorption at the mesial and distal aspects in the CP group(P<0.05).Conclusion:The increased counts of P.g,P.i,F.n,A.v,and S.m in subgingival plaque of CP patients are closely associated with aggravated local inflammation and peri-implant bone resorption after implant restoration.