牙周致病機轉中細菌角色

Microbial Factors in the Pathogenesis of Periodontal Disease

王敏瑩(Man-Ying Wong) ； 連淑君(Shu-Chun Lien)

《臺灣牙周病醫學會雜誌》 18卷2期 (2013/06) Pp. 112-126

https://doi.org/10.6121/TAP.2013.18.2.04

摘要

口腔中細菌估計數目可達600多種，細菌會以生物薄膜方式附着於牙齒上，其中某些特殊之細菌，被認為與牙周致病有密切之相關性，細菌之毒性因子會直接或間接影響牙周組織，在牙周病致病機轉中扮演重要的角色，目前普遍認為細菌與宿主交互作用中，引發宿主之發炎與免疫反應之物質，是造成牙周組織破壞主要原因，而近年分子生物技術之進步，使許多以往未能培養鑑定細菌被發現，更證實牙周微生物之多樣及複雜性，本文就目前國內牙周微生物相關研究，整理主要牙周致病菌與國人及華人群族牙周病之相關性，顯示牙周致病菌P. gingivalis、T. forsythia、T. denticola與國人牙周病有一定之相關性，至於A.a.那一種菌株與國人牙周病更具意義，則有待對毒性菌株之進一步分析，本文也就目前資訊提出在臨床應用之考量。

關鍵字

牙周病 ； 牙周致病菌 ； 種族

並列摘要

It is estimated that there are over 600 different bacterial species able to colonize the oral cavity. The bacteria are organized as biofilm that is attached to the tooth surface and they play a significant role in the pathogenesis of periodontal disease. The challenge that bacteria place on the gingival tissue results in the initiation of the host's inflammatory and immune response, which is aimed at localizing the infection. However, during the process, the mediators that have been activated by the host response also cause the destruction of periodontal tissue. A few bacterial species in the biofilm are considered to be putative pathogens and are believed to be associated with the presence of periodontal disease. This article reviews the association between periodontal disease and the presence of specific periodontal pathogens in the mouth's bacterial population. The present evidence supports the association of the red complex bacteria Porphyromonoas gingivalis, Tannerella forsythia and Treponema denticola with chronic periodontitis in our population. However, the association of the leukotoxic clone and other serotypes of Aggregibacter actinomycetemcomitans with localized aggressive periodontitis needs further investigation. The clinical implications of our present knowledge of periodontal disease associated bacteria on clinical practice is also discussed.

並列關鍵字

periodontal diseases ； periodontal pathogens ； ethnicity