牙周病与免疫.pptVIP

五、牙周病与免疫 The oral cavity harbors more than 700 bacterial species, coexisting with probably millions of viral genomic copies. 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 （A Tsuo Amano, 2010, Periodontology 2000） Oral bacteria 口腔中的细菌： -- Free to saliva 在唾液中 -- Attachment in biofilm 附着在生物膜 Between closely related Saliva as a carrier, is conducive to horizontal and vertical transmission of bacteria In United States, 75 per cent of adult populations suffer from periodontal disease. 美国占75%成年人群体不同程度患有牙周病 1/3 children of 6~11years old, and 2/3 of adolescent population have some degree of periodontal problems. 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 Over 200 kinds of bacterial form dental plaque, adhere to the surface of the teeth and gums, and cause periodontal infections. 牙周感染细菌达200余种 Periodontitis Ⅰ Gingivitis bleeding，Deep gingival Pocket 3mm Ⅱ Periodontitis bleeding，swelling，initial bone loss, Deep periodontal Pocket = 5mm Ⅲ major stage bleeding，swelling，major bone loss， Deep periodontal Pocket ＞6mm Periodontal Pocket: a unique micro-environment牙周袋是独特的微环境 escape the physical separation force 逃逸物理分离力 hard tissue surface 不剥脱更新的硬组织表面 junctional epithelialization, basically not differentiation有结合上皮，基本上不分化 non-keratinizing epithelium 无角化 facultative anaerobic → 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 Root surface Pellicle P.g P.g P.g P.g P.g Subgingival biofilm formation龈下生物膜形成 Initial colonization早期定居者： actinomyces, streptococci succeeded colonization 微生物交替后： periodontal pathogens 致病微生物定植 Pg，AA, forsythia, T. denticole Fusobacterium nucleatum 1996 confirmed three bacteria for periodontal pathogens : Actinobacillus actinomycetemcomitans (AA) Tannerella forsythia (TF) Porphyromonas gingivalis (Pg) 1996, 牙周致病菌 AA，TF，Pg Recent views change, pathogenic capacity of AA and other culturable or non-culturable