- 學位論文
台灣學童青春期前牙齦炎與厭氧病原菌之關聯性
Anaerobic Pathogens Associated with Prepubertal Gingivitis in Taiwanese Children
摘要
背景： 牙菌斑引起的牙齦炎是兒童最常見的牙周疾病。厭氧致病菌與牙周疾病密切相關，但在台灣關於學童牙齦炎的致病菌研究未曾探討過。 研究目的： 分析學童牙齦炎與厭氧病原菌之相關，評估病原菌群聚之潛在風險。 研究方法： 研究對象為104位6-12歲學童，依其牙齦狀況分為牙齦炎(n=54)及牙齦健康(n=50)兩組，採取牙齦溝內外之牙菌斑，以厭氧性培養法與間接免疫螢光法進行菌種鑑定。結果以two sample t-test、chi-square test、two-way ANOVA及stepwise logistic regression統計分析。 研究結果： 厭氧培養法顯示，Capnocytophaga spp、parvimonas micra在牙齦炎組的檢出率(27.78、44.44%)高於牙齦健康組(12、16%)，有顯著差異(p＜0.05)。間接免疫螢光法顯示，Porphyromonas gingivalis、Campylobacter rectus、Tannerella forsythia、Eikenella corrodens在牙齦炎組的檢出率(64.81、66.67、50、40.74%)高於牙齦健康組(12、10、16、6%)，有顯著差異(p＜0.05)。對數迴歸模式中，牙齦炎組檢測出P. micra、P. gingivalis、T. forsythia、E.corrodens、C.rectus的odds ratio，分別是牙齦健康組的4.2、5.65、5.87、10.77、18倍。經調整牙齦指數及口腔衛生指數後，體位過重肥胖者比過輕適中者，有4.12倍的機率檢測到P.gingivalis；T. forsythia則是3.08倍。 結論： P. gingivalis、T. forsythia、E. corrodens、C. rectus 和P.micra 五種病原菌與台灣學童青春期前的牙齦炎有關聯。在考慮牙齦發炎與口腔衛生程度的影響下，體位過重及肥胖的學童可能會增加感染P. gingivalis及T. forsythia的機率。 關鍵詞: 青春期前牙齦炎；厭氧病原菌；牙菌斑
並列摘要
Background: Dental plaque-induced gingivitis is the most common form of the periodontal disease in children. A few putative anaerobic pathogens are closely related to periodontal disease. Little information is available on the pathogens associated with prepubertal gingivitis in Taiwanese children. Objectives: To identify the anaerobic pathogens associated with prepubertal gingivitis in Taiwanese children and evaluate the possible risk factors for colonization of the detected anaerobic pathogens. Method: 104 prepubertal children were recruited, aged 6 to 12 years old, and divided into gingivitis (n=54) and healthy gingiva groups (n=50). Pooled dental plaque samples were collected from gingival crevice of the subjects. Pathogens were identified by anaerobic culture and indirect immunofluorescence. The statistical analysis was performed with two sample t- test, chi-square test, two-way ANOVA and stepwise logistic regression. Result: Based on anaerobic culture results, the detection frequencies of Capnocytophaga spp and Parvimonas micra were higher in gingivitis group (27.78%; 44.44%) than in healthy gingiva group (12%; 16%). Indirect Immunofluorescence method revealed the detection frequencies of 4 selected bacteria (Porphyromonas gingivalis, Campylobacter rectus, Tannerella forthysia, and Eikenella corrodens) were higher in gingivitis group (64.81, 66.67, 50.00 and 40.74%) than in healthy gingiva group (12, 10, 16 and 6%). The bacterial risk indicators of gingivitis were C. rectus, E. corrodens, T. forthysia, P. gingivalis and P. micra (odds ratios 18, 10.77, 5.87, 5.65 and 4.2, respectively).The risk of high body mass index occurred with odds ratio 4.51 for P. gingivalis, and 3.08 for T. forthysia, respectively. Conclusion: P. gingivalis, C. rectus, T. forthysia, E. corrodens and P. micra have a strong association with prepubertal gingivitis T. forthysia and P. gingivals have a considerable correlation with body mass index. Key words: Prepubertal gingivitis; Anaerobic pathogens;Dental plaque.