NAKAE Hideaki Tokushima University, School of Dentistry, Research Associate, 歯学部, 助手 (30227730)
MATSUO Takashi Tokushima University, University Dental Hospital, Assistant Professor, 歯学部附属病院, 講師 (30173800)
|Budget Amount *help
¥6,400,000 (Direct Cost : ¥6,400,000)
Fiscal Year 1991 : ¥1,600,000 (Direct Cost : ¥1,600,000)
Fiscal Year 1990 : ¥4,800,000 (Direct Cost : ¥4,800,000)
This study was designed to investigate diagnostic methods for measurement of periodontal disease activity. In the first experiment, subgingival plaque and gingival crevicular fluid (GCF) were taken from 17 periodontally health sites and 53 diseased sites in 39 subjects with untreated periodontitis. Absolute counts of subgingival plaque bacteria. the proportion of Spirochetes, Motile rods, Porphyromonas gingivalis (Pg) and Prevotella intermedia (Pi), prostaglandin E_2 (PGE_2) and interleukin-1alpha (IL-1alpha) in GCF were significantly higher in diseased sites. The results suggested that these tests may aid in diagnosis of periodontal disease.
In the second experiment, subgingival plaque and GCF were taken from active and inactive lesions in 10 subjects with untreated adult periodontitis and also from 7 subjects in whom periodontitis was maintained after periodontal treatment. Active diseased sites were defined as pockets showing more than 2mm loss of connective attachment during 42-day
monitoring period. Inactive diseased sites had a pocket depth comparable to the active sites, but connective attachment level did not change during the monitoring period. Subgingival plaque bacteria, and PGE_2, IL-1alpha, IL-1beta, collagenase activity and lipopolysaccharide(LPS)in GCF we're compared in active and inactive sites.
In untreated periodontitis patients, PGE_2 in GCF and absolute counts of subgingival plaque bacteria were significantly higher in active sites. IL-1alpha, IL-1beta, active collagenase in GCF and the proportion of motile rods were elevated more often in active sites. In periodontitis patients on maintenance treatment, absolute counts of bacteria were significantly higher at active sites, and PGE_2 in GCF was elevated more often at such sites.
Linear discriminant analysis of data was shown to be useful for detecting active sites in untreated periodontitis, because each test alone could not distinguish them. The combination of PGE_2, IL-1alpha, IL-1beta, LPS and collagenase determinations, was most useful for detecting active sites, and the sensitivity and specificity for detection of active lesions was 62% and 100%, respectivity. In contrast, the absolute counts of bacteria could be used by itself for detection of active sites in the periodontitis patients on maintenance treatment. Its sensitivity and specificity were both 82%. In conclusion, the linear discriminant analysis could be one of the useful diagnostic methods for measurement of periodontal disease activity. Less