种植体龈下菌群构成情况分析

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目的了解种植体龈下菌群的构成情况,分析不同种植体龈下菌群构成的差异,从而探讨种植体周围炎发生与菌群变化的关系。方法选择我院口腔科进行义齿种植的患者作为研究对象,根据改良菌斑指数(modified Plaque Index,mPLI)、牙龈出血指数(Gingival Blood Index,GBI)及种植体周围袋深度(Peri-implant Probing pokect Depth,PPD)等指标将研究对象划分为健康种植体(一组)及炎症种植体(二组)两组,分析两组患者种植体周围菌群的检出及构成情况。结果本次共检查的66颗种植体中,有益菌血链球菌一组检出率高于二组、小韦荣菌在两组间无差异;而致病菌具核梭杆菌、中间型普氏菌和变黑普雷沃菌检出率二组高于一组,牙龈卟啉菌在两组间的检查率无差异。一组和二组各类菌群菌落形成单位的构成比差异具有统计学意义(P<0.05),两组的菌群分布不同,一组患者革兰阳性兼性厌氧菌如血链球菌及其与链球菌的比例较高,而革兰阴性厌氧杆菌如具核梭杆菌、变黑普雷沃菌所占比例较低,而二组则呈相反的分布状况。结论种植体周围炎的发生与种植体周围菌群平衡破坏有一定的关系,龈下菌群革兰阳性兼性厌氧链球菌比例的降低及革兰阴性厌氧杆菌比例的升高是导致菌群平衡破坏的主要原因。 Objective To understand the constitution of subgingival flora of implants and to analyze the differences of subgingival flora among different implants so as to discuss the relationship between peri-implantitis and flora changes. Methods The patients who underwent denture implantation in our department were enrolled in this study. According to modified Plaque Index (mPLI), Gingival Blood Index (GBI) and peri-implant Probing pokect Depth, PPD) and other indicators will be divided into two groups of healthy implants (one group) and inflammatory implants (two groups). The detection and composition of the flora around the implants in both groups were analyzed. Results Among the 66 implants examined this time, the detection rate of S. aureus in one group was higher than that in the other two groups. There was no difference in the two groups between the two groups. However, the pathogens Fusobacterium nucleatum, The detection rates of Pseudomonas and Pneumocystis carinii in the two groups were higher than those in the other two groups, and there was no difference in the detection rate of Porphyromonas gingivalis between the two groups. The differences in the composition ratio of colony forming units between groups of one and two groups were statistically significant (P <0.05). The distribution of the two groups was different. Gram-positive facultative anaerobes such as Streptococcus sanguis and The higher the ratio of Streptococcus, and Gram-negative anaerobic bacteria such as Fusobacterium nucleatum, a relatively small proportion of Pneumocystis carinii, while the two groups showed the opposite distribution. Conclusion The occurrence of peri-implant inflammation is related to the balance destruction of the flora around the implant. The decrease of the proportion of Gram-positive facultative anaerobic streptococci in the subgingival flora and the increase of the proportion of Gram-negative anaerobes are the main causes of The main reason for group balance destruction.
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