CAJ | 학술논문

目的：探讨侵袭性牙周炎（ aggressive periodontitis ，AgP）患者接受牙周基础治疗后袋深减少不同位点的临床和龈下可疑致病微生物的特征，以期为临床治疗及预后判断提供指导。方法：20例AgP患者拍全口根尖片，完成牙周基础治疗并定期复查，每位患者每象限取同1个位点采集治疗前和治疗后6个月的龈沟液，同时记录菌斑指数、出血指数、牙周袋探诊深度和附着水平，检测龈沟液中6种牙周可疑致病微生物和6种微生物代谢产物有机酸浓度，分析治疗前后不同袋深减少位点间的临床指标、牙周可疑致病微生物检出率及代谢产物有机酸浓度的特征。结果：袋深减少＞2 mm的位点在治疗前的探诊深度、附着丧失和出血指数，琥珀酸、乙酸、丙酸和丁酸浓度，齿垢密螺旋体的检出率均高于袋深减少≤2 mm的位点，差异有统计学意义（P＜0．05），但是治疗后两组临床指标、有机酸浓度和牙周可疑致病微生物检出率间差异无统计学意义（P＜0．05）；治疗后探诊深度≥6 mm的位点仍有红色复合体微生物的感染，多数伴有角型骨吸收。结论：侵袭性牙周炎患者治疗后袋深减少与治疗前的临床指标有关，基础治疗后深袋位点仍有红色复合体微生物的感染，需要积极的进行感染控制。
목적：탐토침습성아주염（ aggressive periodontitis ，AgP）환자접수아주기출치료후대심감소불동위점적림상화간하가의치병미생물적특정，이기위림상치료급예후판단제공지도。방법：20례AgP환자박전구근첨편，완성아주기출치료병정기복사，매위환자매상한취동1개위점채집치료전화치료후6개월적간구액，동시기록균반지수、출혈지수、아주대탐진심도화부착수평，검측간구액중6충아주가의치병미생물화6충미생물대사산물유궤산농도，분석치료전후불동대심감소위점간적림상지표、아주가의치병미생물검출솔급대사산물유궤산농도적특정。결과：대심감소＞2 mm적위점재치료전적탐진심도、부착상실화출혈지수，호박산、을산、병산화정산농도，치구밀라선체적검출솔균고우대심감소≤2 mm적위점，차이유통계학의의（P＜0．05），단시치료후량조림상지표、유궤산농도화아주가의치병미생물검출솔간차이무통계학의의（P＜0．05）；치료후탐진심도≥6 mm적위점잉유홍색복합체미생물적감염，다수반유각형골흡수。결론：침습성아주염환자치료후대심감소여치료전적림상지표유관，기출치료후심대위점잉유홍색복합체미생물적감염，수요적겁적진행감염공제。
Objective:To evaluate the differences of clinical parameters and putative periodontal patho-gens in sites of different probing depth ( PD) reduction after non-surgical periodontal treatment in patients with aggressive periodontitis ( AgP ) .Methods: Clinical examinations including plaque index , probing depth (PD), attachment level (AL) and bleeding index (BI), and full-mouth periapical photographs were collected from 20 patients with AgP .All the patients received non-surgical periodontal treatment , including oral hygiene instruction , supra-gingival scaling , subgingival scaling and root planing ( SRP ) and were followed up for 6 months post-therapy.Gingival crevicular fluids (GCF) were collected at 1 site in each quadrant before and at the end of 6 months post-therapy .Six kinds of putative periodontal patho-gens and 6 kinds of short chain fatty acids ( SCFAs ) were detected in the GCF samples .Results: The baseline clinical parameters of PD , AL and BI , the baseline concentration of succinic acid , acetic acid , propionic acid and butyric acid , and the prevalence of Treponema denticola were significantly higher in sites with PD reduction more than 2 mm sites compared with PD reduction no more than 2 mm sites [(7.7 ±1.2) mm vs.(5.1 ±1.8) mm, (6.3 ±1.9) mm vs.(4.5 ±2.2) mm, 3.8 ±0.4 vs.3.3 ± 0.8, 1.66 mmol/L vs.1.10 mmol/L, 31.67 mmol/L vs.17.78 mmol/L, 3.31 mmol/L vs.1.95 mmol/L, 84.6%vs.56.1%, P<0.05].However, there were no significant differences in the clinical param-eters, the 6 kinds of putative periodontal pathogen detection and SCFAs concentration between the 2 groups at the end of 6 months post-treatment.In sites with PD>5 mm at the end of 6 months post-thera-py , all were found with red complex bacteria infection .Conclusion:The baseline clinical parameters are important factors in predicting PD reduction after non-surgical periodontal treatment in patients with AgP . In sites with deep pockets after non-surgical periodontal treatment , the active control of red complex bac-teria is recommended .