五、牙周病与免疫Theoralcavityharborsmorethan700bacterialspecies,coexistingwithprobablymillionsofviralgenomiccopies.口腔定居的细菌有700多种与数百万病毒基因组复制物共存(ATsuoAmano,2010,Periodontology2000)Oralbacteria口腔中的细菌:--Freetosaliva在唾液中--Attachmentinbiofilm附着在生物膜BetweencloselyrelatedSalivaasacarrier,isconducivetohorizontalandverticaltransmissionofbacteriaInUnitedStates,75percentofadultpopulationssufferfromperiodontaldisease.美国占75%成年人群体不同程度患有牙周病1/3childrenof6~11yearsold,and2/3ofadolescentpopulationhavesomedegreeofperiodontalproblems.1/3的6~11岁儿童,2/3青春期人群也有某种程度的牙周问题Over200kindsofbacterialformdentalplaque,adheretothesurfaceoftheteethandgums,andcauseperiodontalinfections.牙周感染细菌达200余种PeriodontitisⅠGingivitisbleeding,DeepgingivalPocket<3mmⅡPeriodontitisbleeding,swelling,initialboneloss,DeepperiodontalPocket=5mmⅢmajorstagebleeding,swelling,majorboneloss,DeepperiodontalPocket>6mmPeriodontalPocket:auniquemicro-environment牙周袋是独特的微环境escapethephysicalseparationforce逃逸物理分离力hardtissuesurface不剥脱更新的硬组织表面junctionalepithelialization,basicallynotdifferentiation有结合上皮,基本上不分化non-keratinizingepithelium无角化facultativeanaerobic→anaerobic兼性厌氧→厌氧nutrition,humidity,pH,Eh营养、湿度、pH、Eh龈下细菌附着和聚集模式图RootsurfacePellicleP.gP.gP.gP.gP.gSubgingivalbiofilmformation龈下生物膜形成Initialcolonization早期定居者:actinomyces,streptococcisucceededcolonization微生物交替后:periodontalpathogens致病微生物定植Pg,AA,forsythia,T.denticoleFusobacteriumnucleatum1996confirmedthreebacteriaforperiodontalpathogens:Actinobacillusactinomycetemcomitans(AA)Tannerellaforsythia(TF)Porphyromonasgingivalis(Pg)1996,牙周致病菌AA,TF,PgRecentviewschange,pathogeniccapacityofAAandotherculturableornon-culturablebacteriashouldbeconfirmed.近期:AA待证实50%oralmicrobialcannotbecultivatedandcanbeidentifiedthroughextramethods:口腔中有50%微生物不能培养,可通过下述方...