인접치아가 임플란트 치은연하 세균총의 분포에 미치는 영향

The influence of adjacent tooth to the microbiology of implant sulcus

  • 이동영 (경희대학교 치과대학 치주과학교실) ;
  • 이만섭 (경희대학교 치과대학 치주과학교실) ;
  • 권영혁 (경희대학교 치과대학 치주과학교실) ;
  • 박준봉 (경희대학교 치과대학 치주과학교실) ;
  • 허익 (경희대학교 치과대학 치주과학교실) ;
  • 정종혁 (경희대학교 치과대학 치주과학교실)
  • 발행 : 2005.09.30

초록

The aim of present study is to evaluate the influence of adjacent tooth to the microbiology of clinically healthy implant. Control group included patients who had clinically healthy implant and tooth with healthy $periodontium(PD{\leq}3mm)$, test group was composed of patients who had clinically healthy implant and tooth with periodontal pocket(PD>3mm). The criteria of clinically health implant are no pain or discomfort, the restorative suprastructure provide satisfactory fit and function, and the tissue around the fixtures were firm and probing with standard periodontal probe with a rounded tip 0.5mm in diameter resulted in penetration of no more than 5mm when using a force of 0.5N at any location. 38 patients, partially edentulous subjects with endosseous root-form implants were selected. All subjects were medically healthy and had not taken systemic antibiotics and professional plaque control 3 months before sampling. Number of control group is 25(mean age $52{\pm}13$, 26 teeth, 34 implants) and test group is 13(mean age $60{\pm}13$, 13 teeth, 17 implants). All teeth and implants of each patient were examined probing depth(PD), bleeding on probing(BOP), and plaque index(PI), and samples of subgingival plaque were obtained at each site with sterile curet or fine paper points, then the plaque transferred to PBS. Obtained samples were examined for the presence of P. gingivalis, T. forsythensis, and T. denticola by the polymerase chain reaction(PCR). The relationship among clinical parameters and the colonizations by the 3 bacterial species from natural teeth and implants region were analyzed by student t-test. The results of this study were as follows: 1. PD was different in teeth between 2 groups(p<0.05), but the other parameters were not. 2. Statistically significant difference was not found in clinical parameters of implants between 2 groups. 3. All bacterial prevalences of teeth were higher in test group than in control group, and prevalence of T. forsythensis had statistically significant difference between 2 groups(p<0.05). 4. Prevalences of P. gingivalis and T. forsythensis are higher in test group than control group, and that of T. denticola is higher in control group than in test group. But there were no statistically significant differences between 2 groups. In conclusion, there is no statistically significant difference in prevalence of implant microbiology between 2 groups. But if the number of samples increased, it will be possible to find out statistical significance in prevalence of P. gingivalis. It seems that pocket of adjacent tooth influences prevalence of P. gingivalis. These results mean that improvement of the periodontal condition before implantation is very important.

키워드

참고문헌

  1. Ionannis KK, Giovanni ES, Lisa JA, Urs B, Christoph HF, and Niklaus PL. Longterm implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study of the $ITI^{\circledR}$ Dental Implant system. Clin Oral Impl Res 2003: 14: 329- 339 https://doi.org/10.1034/j.1600-0501.000.00934.x
  2. Rams TE, Roberts TW, Tatum H Jr, Keyes PH. The subgingival microbial flora associated with human dental implants. J Prostho Dentistry 1984:51:529-534 https://doi.org/10.1016/0022-3913(84)90309-3
  3. Lekholm U, Ericsson I, Adell R, Slots J. The condition of the soft tissues at tooth and fixture abutments supporting fixed bridges. A microbiological and histological study. J Clin Periodontol 1986: 13: 558-562 https://doi.org/10.1111/j.1600-051X.1986.tb00847.x
  4. Mombelli A. Van Oosten MAC, Schurch E, Lang NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol and Immunology 1987:2:145-151 https://doi.org/10.1111/j.1399-302X.1987.tb00298.x
  5. Mombelli A. Microbiology of the dental implant. [Review]. Adv Dent Res 1993;7:202-206.
  6. Mombelli A. Marxer M, Gaberthuel T, Grunder U, Lang NP. The microbiota of osseointegrated implants in patients with a history of periodontal disease. J Clin Periodontol 1995:22: 124-130 https://doi.org/10.1111/j.1600-051X.1995.tb00123.x
  7. Mombelli A. and Lang NP, Microbial aspects of implant dentistry. Periodontol 2000, 1994:4:74-80 https://doi.org/10.1111/j.1600-0757.1994.tb00007.x
  8. Lee KH, Tanner ACR, Maiden MFJ, Weber H P. Pre-and post-implantation microbiota of the tongue, teeth, and newly-placed implant. J Clin Periodontol 1999: 26: 822-832 https://doi.org/10.1111/j.1600-051X.1999.tb02527.x
  9. Danser MM, van Winkelhoff AJ, vander Velden U. Periodontal bacteria colonizing oral mucous membranes in edentulous patients wearing dental implants. J Periodontol 1997;68(3) :209-216 https://doi.org/10.1902/jop.1997.68.3.209
  10. Leonhardt A, Renvert S, Dahlen G. Microbial findings at failing implants. Clin Oral Imp Res 1999: 10:339-345 https://doi.org/10.1034/j.1600-0501.1999.100501.x
  11. Apse P, Ellen RP, Overall CM, Zarb GA. Microbiota and crevicular fluid collagenase activity in the osseointe-grated dental implant sulcus: A comparison of sites in edentulous and partially edentulous patients. J Periodoniol Res 1989;24: 96-105 https://doi.org/10.1111/j.1600-0765.1989.tb00863.x
  12. Lekholm U. Adell R, Lindhe J. Marginal tissue reaction at osseointegrated titanium fixtures (II). A cross-sectional retrospective study. Int J Oral Mexillofac Surg 1986; 15:53-61 https://doi.org/10.1016/S0300-9785(86)80011-4
  13. Quirynen M, Papaioannou W, van Steenberghe D. Intraoral transmission and the colonization of oral hard surface. J Periodontol 1996; 67: 986-993 https://doi.org/10.1902/jop.1996.67.10.986
  14. Papaioannou W, Quirynen M. van Steenberghe D. The influence of periodontitis on the subgingival flora around implants in partially edentulous patient. Clin Oral Impl Res 1996:7:405-419 https://doi.org/10.1034/j.1600-0501.1996.070415.x
  15. Leonhardt A. Adolfsson B, Lekholm U, Wickstrom M, Dahlen G. A long-itudinal microbiolgical study on osseointegrated titanium implants in partially edentulous patients. Clin Oral Impl Res 1993;4: 113-120 https://doi.org/10.1034/j.1600-0501.1993.040301.x
  16. Quirynen M, Listgarten MA. The distribution of bacterial morphotypes around natural teeth and titanium implants ad modum Branemark. Clin Oral Impl Res 1990:1:8-12 https://doi.org/10.1034/j.1600-0501.1990.010102.x
  17. Lee KH, Maiden MFJ, Tanner ACR, Weber HP. Microbiota of successful osseointegrated dental implants. J Periodontol 1999:70:131-138 https://doi.org/10.1902/jop.1999.70.2.131
  18. Socransky SS, haffajee AD, Cugini MA, Smith C, Kent Jr. RL. Microbial complexes in subgingival plaque. J Clin Periodontol 1998:25:134-144 https://doi.org/10.1111/j.1600-051X.1998.tb02419.x
  19. Tanner A. Maiden MF. Macuch PJ, Murray LL. Kent Jr. RL. Microbiota of health. ginigvitis, and initial periodontitis. J Clin Periodontol 1998:25:85-98 https://doi.org/10.1111/j.1600-051X.1998.tb02414.x
  20. Riviere GR, Smith KS. Tzagaroulaki E. Periodontal status and detection frequency of bacteria at sites of periodontal health and gingivitis. J Periodontol 1996 :67:109 -115 https://doi.org/10.1902/jop.1996.67.2.109
  21. Socransky SS. Tanner ACR.. Haffajee AD. Hillman JD Goodson JM Present status of studies on the microbial etiology of periodontal disease. In: Host-parasi te interactions in periodontal diseases. American Society for Microbiology 1982:1-12
  22. Papaiannou W., Quirynen M.. Nys M.. van Steenberghe D. The effect of periodontal parameters on the subgingival microbiota around implants. Clin Oral Imp Res 1995:6: 197-204 https://doi.org/10.1034/j.1600-0501.1995.060401.x
  23. Sillness P. Loe H. Periodontal disease in pregnancy. 2. Correlation between oral hygiene and periodontal condition. Acta Odontologica Scandinavia 1964:24:744 -759
  24. Muhlemann HR, Son S. Gingival sulcus bleeding leading symptom in initial gingivitis. Helvetica Odontologica Acta 1971: 15: 105-113
  25. Watanabe K, Frommel O. Detection of Porphyromonas gingivalis in oral plaque samples by use of the polymerase chain reaction. J Dent Res 1993:72:1040-1044 https://doi.org/10.1177/00220345930720060801
  26. Watanabe K, Frommel TO. Porphyromonas gingivalis, Actinobacillus actino-mycetemcomitans and Treponema denticola detection in oral plaque samples using the polymerase chain reaction. J Clin Periodontol 1996:23:212-219 https://doi.org/10.1111/j.1600-051X.1996.tb02078.x
  27. Ashimoto A, Chen C, Bakker I. Slots J. Polymerase chain reaction detection of 8 putative periodontal pathogens in subgingival plaque of gingivitis and advanced periodontitis lesions. Oral Microbiol Immunol 1996: 11:266-273 https://doi.org/10.1111/j.1399-302X.1996.tb00180.x
  28. Lindhe J, Liljenberg B, Listgarten M. Some microbiological and histopathological features of periodontal disease in men. J Periodontol 1980:51:264-269 https://doi.org/10.1902/jop.1980.51.5.264
  29. Listgarten MA Levin S. Positive correlation between the proportions of subgingival spirochetes and motile bacteria and susceptibility of human subjects to periodontal deterioration. J Clin Periodontol 1981:8: 122-138 https://doi.org/10.1111/j.1600-051X.1981.tb02352.x
  30. Gouvoussis J, Gouvoussis, Sindhusake D, Yeung S. Cross-infection from periodontitis sites to failing implant sites in the same mouth. Int J Oral Maxillofac Implants 1997:12:666-673
  31. Sumida S, Ishihara K, Kishi M, Okuda K. Transmission of periodontal disease-associated bacteria from teeth to osseointegrated implant regions. Int J Oral Maxillofac Implants 2002:17:696-702
  32. Umeda M, Contreas A, Chen C, Bakker I, Slots J. The utility of whole saliva to detect the oral presence of periodontopathic bacteria. J Periodontol 1998:69: 828-833 https://doi.org/10.1902/jop.1998.69.7.828
  33. Amano A, Sharma A, Lee JY, Sojar HT, Raj PA, Genco RJ. Structural domains of Phorphyomonas gingivalis recombinant fimbrillin that mediate binding to salivary proline-rich protein and statherin. Infect Immun 1996;64: 1631-1637
  34. Petit MD, van Steengbergen TJ. Timmerman MF, de Graff J, van der Velden U. Prevalence of periodontitis and suspectd periodontal pathogens in families of adult periodontitis patients. J Clin Periodontol 1994:21 :76-85 https://doi.org/10.1111/j.1600-051X.1994.tb00283.x
  35. Leonhardt A. Benvert S, Dahlen G. Microbial findings at failing implants. Clin Oral Impl Res 1999; 10:339-345 https://doi.org/10.1034/j.1600-0501.1999.100501.x
  36. Esposito M, Hirsch JM, Lekholm U. Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (II) Etiopathogenesis. European Journal of Oral Sciences 1998: 106: 721-764 https://doi.org/10.1046/j.0909-8836..t01-6-.x