[Changes of factors on disease activity in advancing periodontitis].

H Masunaga
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Abstract

Two test teeth, anteriors with greater than or equal to 6 mm deep periodontal pockets from each of 10 patients with advancing periodontitis were included in this study. The clinical signs of advancing periodontitis, generalized moderate to deep pockets and to severe loss of alveolar bone, were observed in young adult. There have been several reports on factors, which reflect the conversion clinically from infection by highly pathogenic plaque bacteria to a from of periodontitis displaying relatively rapid loss of clinical attachment. The purpose of this investigation was to detect parameters in fluid, which could leak from the underlying inflamed connective tissue into the gingival crevice, and which could shown correlatively the progressive variations of periodontal disease by recurrent acute stage. In order to determine active disease sites and to monitor guantitatively response to therapy or to measure degree to susceptibility of future breakdown. Examinations on following parameters at pre- and post- periodontal treatment stages were carried out. Endotoxin, collagenase, alkaline phosphatase, beta-glucuronidase, interleukin-1 alpha, IgG antibody levels to Bacteroides gingivalis, Bacteroides intermedius were measured in gingival exudate samples, which were collected by the microtips technique from periodontal pockets. The following results were obtained: 1) Considering the effect of periodontal therapy, pathogenic responses on total colony forming unit (CFU), interleukin-1 alpha and changes of endotoxin and beta-glucuronidase levels after the treatment have indicated that specific changes in humoral responses. 2) There was not significant relation between alkaline phosphatase, collagenase, IgG antibodies level to Bacteroides gingivalis, Bacteroides intermedius and responses in active and also inactive disease sites. 3) This study has been resulted in the development of diagnostic techniques which requires strict criteria on the disease activity of the periodontal disease very specific in order to permit a more scientific approach to the care of periodontitis patients and to speculate the prognosis of the patients after the treatment.

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进展性牙周炎患者疾病活动性因素的变化。
本研究包括10名进展性牙周炎患者的两颗试验牙,前牙的牙周袋深度大于或等于6mm。进展牙周炎的临床症状,广泛的中度至深袋和牙槽骨严重损失,观察到在年轻的成年人。有一些报道反映了临床上从高致病性菌斑细菌感染到牙周炎的转变,表现出相对快速的临床附着丧失。本研究的目的是检测可能从炎症结缔组织渗漏到龈缝的液体参数,这些参数可以显示牙周病在复发急性期的进展变化。为了确定活动性疾病部位和监测对治疗的定量反应或测量对未来崩溃的易感性程度。对牙周治疗前后各阶段的下列参数进行了检查。采用微针尖法采集牙周袋内牙龈渗出液,测定其内毒素、胶原酶、碱性磷酸酶、β -葡萄糖醛酸酶、白细胞介素-1 α、牙龈拟杆菌、中间拟杆菌IgG抗体水平。结果如下:1)考虑到牙周治疗的效果,治疗后病原菌对总菌落形成单位(CFU)、白细胞介素-1 α的反应以及内毒素和β -葡糖醛酸酶水平的变化表明了体液反应的特异性变化。2)碱性磷酸酶、胶原酶、牙龈拟杆菌(Bacteroides gingivalis)、中间拟杆菌(Bacteroides intermedius) IgG抗体水平与活动性和非活动性部位的应答均无显著相关性。3)这项研究导致了诊断技术的发展,它要求对牙周病的疾病活动有严格的标准,非常具体,以便对牙周炎患者的护理有更科学的方法,并推测患者治疗后的预后。
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