台灣小學學童牙周病原菌分析 (PCR研究)

Analysis of Periodontal Pathogens (Based on PCR method) in Elementary School children in Taiwan

張心怡(Hsin-Yi Chang)

指導教授 ： 賴辰雄

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2009年)

摘要

本研究以聚合酶鏈鎖反應(PCR)檢測台灣小學學童口腔內與青春期前牙周炎相關之牙周致病菌存在狀況，並期依此建立出更完善的口腔衛生教育方法及治療模式。
材料方法:
牙齦炎組(Group A)有31名男性與20名女性，平均年齡為10.6±1.59歲，牙齦炎組之受試者牙齦指數皆大於1。健康組(Group B)有25名男性與21名女性，平均年齡為9.5±1.54歲，健康組之受試者牙齦指數皆小於1。使用無菌periodontal curette採集牙齦邊緣處之牙菌斑樣本後，置於VMGA溶液中並進行DNA萃取，以PCR方式檢測致病菌的存在情形。
結果:
Campylobacter rectus、Eikenella corrodens、Porphyromonas gingivalis、 Prevotella intermedia、Prevotella nigrescens之PCR檢出率依序如下所示：牙齦炎組- 86.27 %、90.2%，13.73%，41.18%，96.08%；牙齦健康組-63.04%、91.3%、19.57%、21.74%、76.09%
Campylobacter rectus, Prevotella intermedia及Prevotella nigrescens在牙齦炎組的檢出率於統計學上顯著性的高於牙齦健康組。本研究無任何樣本對Treponema denticola, Aggregatibacter actinomycetemcomitains及Tanerella forsythia呈陽性反應。

結論:
Prevotella intermedia, Prevotella nigrescens及Campylobacter rectus與台灣青春期前學童牙齦組織發炎有關係。而本研究所有受試樣本皆檢測出至少一種以上之目標菌種，因此推論與疾病相關的口腔微生物會無臨床表徵的潛藏在學童口腔內，當口腔環境改變時，病菌量的多寡可能是左右發病與否的關鍵因素。

關鍵字

聚合酶鏈鎖反應 ； 牙菌斑 ； 牙周致病菌

並列摘要

Introduction
The aim of this study was to detect the presence of periodontal pathogens associated with prepubertal periodontal disease in Taiwan and hope to establish a better approach for improving the oral hygiene and treatment modular for Taiwanese elementary school children.
Materials and Methods
A total of 97 elementary school children were recruited for this study. Thirty-one males and 20 females with mean age of 10.6±1.59 years old and gingival index greater than 1 were assigned as gingivitis group (group A). Twenty-five males and 21 females with mean age of 9.5±1.54 years old and gingival index less than 1 were assigned as gingival healthy group (group B). Plaque samples near the gingival margin were collected using sterile periodontal curettes, suspended in VMGA transport media for DNA extraction. The PCR method was used to detect the presence of periodontal pathogens.
Result
The PCR detection rate for Campylobacter rectus(Cr), Eikenella corrodens(Ec), Porphyromonas gingivalis(Pg), Prevotella intermedia(Pi), Prevotella nigrescens(Pn) in group A and group B in this study were as follows:
Group A (Cr:86.27 %, Ec:90.2%, Pg:13.73%, Pi :41.18%, Pn :96.08%)
Group B(Cr:63.04%, Ec :91.3%, Pg :19.57%, Pi :21.74%, Pn :76.09%)
Campylobacter rectus, Prevotella intermedia and Prevotella nigrescens were statistically significant greater in group A than group B.
Aggregatibacter actinomycetemcomitains, Treponema denticola and Tanerella forsythia were not detected in any of samples in this sudy.
Conclusion
The occurrence of gingivitis in prepubertal Taiwanese school children may be associated with the infection of Prevotella intermedia, Prevotella nigrescens and Campylobacter rectus.

並列關鍵字

Polymerase chain reaction ； dental plaque ； periodontal pathogens

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