种植体周围炎患者龈沟液内炎性因子与血链球菌及牙龈卟啉单胞菌变化研究
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摘要
目的探讨种植体周围炎患者龈沟液炎性因子、血链球菌、牙龈卟啉单胞菌变化,为种植体周围炎的临床诊治提供参考。方法选取2017年1-6月在医院诊治的种植体周围炎患者30例(30颗炎症种植体)为种植体周围炎组,同期健康种植体患者30例(30颗无炎症种植体)为健康种植体组作为对照。检测两组研究对象龈沟液内白细胞介素-6(IL-6)、8(IL-8)、17(IL-17)、18(IL-18)和35(IL-35)和干扰素γ(IFN-γ)指标水平及血链球菌和牙龈卟啉单胞菌含量。结果种植体周围炎组IL-6、IL-8、IL-17、IL-18指标水平高于健康种植体组,IL-35和IFN-γ低于健康种植体组,比较差异有统计学意义(P<0.05);种植体周围炎组血链球菌数量为(3.67±1.34)×105个/ml,低于健康种植体组(8.84±2.79)×105个/ml;牙龈卟啉单胞菌数量为(9.43±1.55)×105个/ml,高于健康种植体组(2.42±0.88)×105个/ml,比较差异有统计学意义(P<0.05);Pearson相关分析显示种植体周围炎组患者牙龈沟液内IL-6、IL-8、IL-17、IL-18与血链球菌数量呈负相关,与牙龈卟啉单胞菌数量呈现正相关性;IL-35、IFN-γ与血链球菌数量呈正相关,与牙龈卟啉单胞菌数量呈负相关。结论种植体周围炎患者龈沟液存在促炎因子高表达及抑炎因子低表达,血链球菌数量下降、牙龈卟啉单胞菌数量升高,龈沟液内炎性因子与病原菌的变化与种植体周围炎关系密切。
OBJECTIVE To explore the changes of inflammatory cytokines,Streptococcus sanguis and Porphyromonas gingivalis in gingival crevicular fluid of patients with peri-implantitis so as to provide guidance for clinical diagnosis and treatment of the patients with peri-implantitis.METHODS Totally 30 patients with peri-implantitis(30 implants with inflammation)who were treated in hospitals from Jan 2017 to Jun 2017 were chosen as the periimplantitis group,meanwhile,30 patients with healthy implants(30 implants without inflammation)were set as the control group.The levels of interleukin-6(IL-6),IL-8,IL-17,IL-18,IL-35,and interferonγ(IFN-γ)as well as the contents of S.sanguis and P.gingivalis in gingival crevicular fluid were detected for the two groups of study objects.RESULTS The levels of IL-6,IL-8,IL-17 and IL-18 of the peri-implantitis group were significantly higher than those of the healthy implant group,the levels of IL-36 and IFN-γof the peri-implantitis group were significantly lower than those of the healthy implant group(P<0.05).The bacterial colony counts of S.sanguis of the peri-implantitis group were(3.67±1.34)×105/ml,significantly less than(8.84±2.79)×105/ml of the healthy implant group;the bacterial colony counts of P.gingivalis of the peri-implantitis group were(9.43±1.55)×105/ml,significantly more than(2.42±0.88)×105/ml of the healthy implant group(P<0.05).Pearson correlation analysis indicated that the levels of IL-6,IL-8,IL-17 and IL-18 in gingival crevicular fluid of the patients with peri-implantitis were negatively correlated with the bacterial colony counts of S.sanguis but were positively correlated with the bacterial colony counts of P.gingivalis;the levels of IL-35 and IFN-γwere positively correlated with the bacterial colony counts of S.sanguis but were negatively correlated with the bacterial colony counts of P.gingivalis.CONCLUSIONThere are high expression of proinflammatory factors and low expression of inhibitory factors in the gingival crevicular fluid of the patients with peri-implantitis,the bacterial colony counts of S.sanguis are decreased,the bacterial colony counts of P.gingivalis are increased,and the changes of inflammatory cytokines and pathogens in gingival crevicular fluid are closely correlated with the peri-implantitis.
OBJECTIVE To explore the changes of inflammatory cytokines,Streptococcus sanguis and Porphyromonas gingivalis in gingival crevicular fluid of patients with peri-implantitis so as to provide guidance for clinical diagnosis and treatment of the patients with peri-implantitis.METHODS Totally 30 patients with peri-implantitis(30 implants with inflammation)who were treated in hospitals from Jan 2017 to Jun 2017 were chosen as the periimplantitis group,meanwhile,30 patients with healthy implants(30 implants without inflammation)were set as the control group.The levels of interleukin-6(IL-6),IL-8,IL-17,IL-18,IL-35,and interferonγ(IFN-γ)as well as the contents of S.sanguis and P.gingivalis in gingival crevicular fluid were detected for the two groups of study objects.RESULTS The levels of IL-6,IL-8,IL-17 and IL-18 of the peri-implantitis group were significantly higher than those of the healthy implant group,the levels of IL-36 and IFN-γof the peri-implantitis group were significantly lower than those of the healthy implant group(P<0.05).The bacterial colony counts of S.sanguis of the peri-implantitis group were(3.67±1.34)×105/ml,significantly less than(8.84±2.79)×105/ml of the healthy implant group;the bacterial colony counts of P.gingivalis of the peri-implantitis group were(9.43±1.55)×105/ml,significantly more than(2.42±0.88)×105/ml of the healthy implant group(P<0.05).Pearson correlation analysis indicated that the levels of IL-6,IL-8,IL-17 and IL-18 in gingival crevicular fluid of the patients with peri-implantitis were negatively correlated with the bacterial colony counts of S.sanguis but were positively correlated with the bacterial colony counts of P.gingivalis;the levels of IL-35 and IFN-γwere positively correlated with the bacterial colony counts of S.sanguis but were negatively correlated with the bacterial colony counts of P.gingivalis.CONCLUSIONThere are high expression of proinflammatory factors and low expression of inhibitory factors in the gingival crevicular fluid of the patients with peri-implantitis,the bacterial colony counts of S.sanguis are decreased,the bacterial colony counts of P.gingivalis are increased,and the changes of inflammatory cytokines and pathogens in gingival crevicular fluid are closely correlated with the peri-implantitis.
引文
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[8] Mettraux GR,Sculean A,Burgin WB,et al.Two-year clinical outcomes following non-surgical mechanical therapy of peri-implantitis with adjunctive diode laser application[J].Clin Oral Implants Res,2016,27(7):845-849.
[9] Vo N,Trang N,Hao J,et al.Ligature induced peri-implantitis:tissue destruction and inflammatory progression in a murine model[J].Clin Oral Implants Res,2017,28(2):129-136.
[10]赵国强,林海升.口腔种植体周围炎与炎症细胞因子的相关性研究[J].中国现代医学杂志,2018,28(2):106-109.
[11] Tzach-Nahman R,Mizraji G,Shapira L,et al.Oral infection with Porphyromonas gingivalis induces peri-implantitis in a murine model:evaluation of bone loss and the local inflammatory response[J].J Clin Periodontol,2017,44(7):739-748.
[12]陈新,熊萍,钟科,等.种植体周围黏膜炎龈下微生物群落多样性研究[J].口腔医学研究,2015,31(7):719-723.
[13]林立垚.炎性指标与口腔种植修复术患者种植体预后的相关性[J].中国现代医学杂志,2017,27(9):104-107.
[14] Albertini M,Lopez-Cerero L,O'Sullivan MG,et al.Assessment of periodontal and opportunistic flora in patients with peri-implantitis[J].Clin Oral Implants Res,2015,26(8):937-941.
[15] Isehed C,Holmlund A,Renvert S,et al.Effectiveness of enamel matrix derivative on the clinical and microbiological outcomes following surgical regenerative treatment of peri-implantitis.A randomized controlled trial[J].J Clin Periodontol,2016,43(10):863-873.
[16]朱永武,杨庆福,应凯,等.种植体周围炎龈沟液内牙龈卟啉单胞菌和血链球菌的变化与临床指标的关系[J].中华医院感染学杂志,2017,27(10):2332-2335.
[2]任家卉,尼加提,吐尔逊.口腔种植义齿修复失败16例原因分析[J].口腔医学,2017,37(9):815-818.
[3]叶淑华,何福明.口腔种植早期失败原因分析[J].口腔医学,2017,37(7):642-646.
[4] Kawai T,Ohshima T,Shin R,et al.Determination of the antibacterial constituents produced by Lactobacilli against a periodontal pathogen:sodium lactate and a low molecular weight substance[J].J Prob Health,2016,4(1359):1-7.
[5] Perez-Chaparro PJ,Goncalves C,Figueiredo LC,et al.Newly identified pathogens associated with periodontitis:a systematic review[J].J Dent Res,2014,93(9):846-858.
[6] Hyvarinen K,Salminen A,Salomaa V,et al.Systemic exposure to a common periodontal pathogen and missing teeth are associated with metabolic syndrome[J].Acta Diabetol,2015,52(1):179-182.
[7]牛忠英,裴振华,施生根,等.慢性牙周炎患者粘接性牙周夹板固定修复的临床应用研究[J].口腔颌面修复学杂志,2013,13(4):193-197.
[8] Mettraux GR,Sculean A,Burgin WB,et al.Two-year clinical outcomes following non-surgical mechanical therapy of peri-implantitis with adjunctive diode laser application[J].Clin Oral Implants Res,2016,27(7):845-849.
[9] Vo N,Trang N,Hao J,et al.Ligature induced peri-implantitis:tissue destruction and inflammatory progression in a murine model[J].Clin Oral Implants Res,2017,28(2):129-136.
[10]赵国强,林海升.口腔种植体周围炎与炎症细胞因子的相关性研究[J].中国现代医学杂志,2018,28(2):106-109.
[11] Tzach-Nahman R,Mizraji G,Shapira L,et al.Oral infection with Porphyromonas gingivalis induces peri-implantitis in a murine model:evaluation of bone loss and the local inflammatory response[J].J Clin Periodontol,2017,44(7):739-748.
[12]陈新,熊萍,钟科,等.种植体周围黏膜炎龈下微生物群落多样性研究[J].口腔医学研究,2015,31(7):719-723.
[13]林立垚.炎性指标与口腔种植修复术患者种植体预后的相关性[J].中国现代医学杂志,2017,27(9):104-107.
[14] Albertini M,Lopez-Cerero L,O'Sullivan MG,et al.Assessment of periodontal and opportunistic flora in patients with peri-implantitis[J].Clin Oral Implants Res,2015,26(8):937-941.
[15] Isehed C,Holmlund A,Renvert S,et al.Effectiveness of enamel matrix derivative on the clinical and microbiological outcomes following surgical regenerative treatment of peri-implantitis.A randomized controlled trial[J].J Clin Periodontol,2016,43(10):863-873.
[16]朱永武,杨庆福,应凯,等.种植体周围炎龈沟液内牙龈卟啉单胞菌和血链球菌的变化与临床指标的关系[J].中华医院感染学杂志,2017,27(10):2332-2335.