| Background:H.pylori (Helicobacter pylori) is a kind of Gram-negative, micro-aerobic, bending, rod-shaped bacteria. In last two decades research, Stomach is an important storage space for H.pylori. And, Helicobacter pylori infection is major pathogenic factors of chronic active gastritis, peptic ulcer, gastric mucosa-associated lymphoid tissue (MALT) lymphoma and stomach cancer. In 1994, World Health Organization/International Agency for Research on Cancer (WHO/IARC) has recognized Helicobacter pylori as a class I carcinogen. H. pylori infection rate is extremely high, in some developed countries, H. pylori infection accounts for 30%-50% in adult, in developing countries, the rate is 40%-80%, result of Chinese epidemiological survey is 40%-90%, an average level is 59%.In recent years, a lot of scholars believed that the oral cavity is another important cluster place of H.pylori besides the stomach. H.pylori has constantly been reported to be isolated and cultured from the mouth, which has the same morphology, biochemical characteristics and immunological characteristics with H.pylori in stomach. Since then a large number of domestic and foreign researches shows H.pylori is presence in dental plaque with the patients with digestive disease, and its Morphological, biochemical and immunological characteristics are similar with gastric H.pylori. Increased scholars think that H. pylori is an opportunistic pathogen, which is widely present in the oral cavity of healthy people and patients with oral chronic gastritis. Under normal circumstances may not be pathogenic, when circumstance changes, it may be.Oral mucosa and gastric mucosa both belong to digestive system and originating from ectoderm. The resemblance was found in their structure, function, physiology, pathology, etc. and these contribute to the assumption of similar immune pathogenesis of the two. Bielahski W also found in his research the correlation between HP infection and periodontal diseases [18]. Periodonitis and HP caused gastric ulcer shares similar characteristic in clinical features. Besides, periodontal pockets and stomach are resembled in environment. All these give us the hint that H.pylori might cause the occurrence of periodonitis.Are there any correlations between periodontal health condition and H.pylori infection? Will the H.pylori existing in oral cavity bring the infection and reinfection in stomach? Can we acquire the quantitative correlations? 13C urease breathe test (13C-UBT) [1] is an invasive test method for checking the existance of gastric H.pylori in human-beings. The research is aimed to seek the gastric H.pylori infectious status in patients with periodontitis using 13C-UBT and to study the correlation between them by so as to ascertain the relationship between periodontal health condition and gastric H.pylori infection.Objectives:The research is aimed to seek the gastric H.pylori infectious status in patients with periodontitis using 13C-UBT and to study the correlation between them by so as to ascertain the relationship between periodontal health condition and gastric H.pylori infection. Materials and Methods:1. Patients84 patients (40 males and 44 females) with periodontitis were collected from Guangdong provincial stomatological hospital. The periodontal health indices were measured, including depth of periodontal pocket, periodontal recession and loss of periodontal attachment.2. A database was established.The inclusion criteria were(1)haven't received periodontal treatment within 6 weeks (2) haven't taken antibiotics, Bitmuth preparation, proton pump inhibitor which are sensitive to H. pyliori and garglin (3)haven't taken steroids or NSAID within one month (4) no gastrointestinal surgery history (5) without severe mental disorder, so that can be devoted into the research2.Detection of H pyloriThe protocol of 13C urease breathe test (13C-UBT) was applied to check the DOB value.3. Statistic analysisSPSS 13.0 was applied for analyzing:①The total of 84 patients were divided into A group (PD>3mm) and B group (PD<3mm), and a model of logistic analysis was established to test the possible influences of gender, age, DOB and H.pylori infection on the PD.②regrouped the 84 patients by the infectious of H.pylori into positive (32 patients) group and negative (52 patients) group. The correlation between DOB and PD was analyzed using a logistic analysis in H.pylori into positive group.④The correlations between periodontal recession and DOB or age were analyzed using a linear analysis in the total of 84 patients.④The correlation between PD and periodontal recession was analyzed. A P value of <0.05 was considered significant Results:1.Among the 84 patients, the DOB value was different significantly between deep periodontal pocket group and shallow groupThe 84 patients were separated into two groups according to the average periodontal pocket depth 3 mm. Accessed with t test, age and sex weren't different significantly within the two groups, while the DOB value differs significantly (t=2.735,P=0.008) within the two groups which infers that patients of varied periodontal condition may have different DOB result.2. Among the 32 patients which are H. Pylori-positive, DOB value was different statistically between the deep periodontal pocket group and the shallow one.According to the DOB value (DOB>4 as positive), there are totally 32 patients who are considered H. Pylori positive. Then the 32 patients were separated into two groups by the average periodontal depth 3mm. according to t test, the age and gender factor doesn't differ significantly, while the DOB value differs significantly (t=2.639,P=0.013), which suggest that the different severity the periodontitis is, the different rate the Hp infection is.3. Among 32 H. Pylori positive patients, the DOB value is positive correlation to that of average periodontal depthAmong the 32 H. Pylori-positive patients, using pearson correlation analysis to access the DOB value and mean periodontal pocket depth. Results indicateed that correlation coefficient of DOB value and mean periodontal pocket depth is 0.413, which means they are positive correlation, P 0.019<0.05, which suggest that the severity the periodontitis is, the severity the gastric H. Pylori infection is. 4. DOB result is a risk factor of periodontal pocket depthTo make further understanding of the cause-and-effect relationship of periodontitis and gastric H. Pylori infection, we conduct an influence factor analysis toward the 84 patients' average periodontal pocket depth. Whether the 84 patients have affect the H. Pylori serve as the dependent variable. Gender, age and mean periodontal pocket depth as independent variable for Logistic regression analysis. Result shows that average periodontal pocket depth doesn't serve as a risk factor for DOB result, suggest that we couldn't yet draw the conclusion that periodontitis serve as a risk factor for gastric H. Pylori infection.84 patient using gender, age, DOB, whether H. Pylori positive or not as the independent variable, using mean periodontal pocket depth as dependent variable for Logistic regression analysis to analysis the correlatiopship of age, DOB, whether H. Pylori positive or not and the mean periodontal pocket depth. Results indicated that DOB is a risk factor for periodontal pocket depth, infers that gastric H. Pylori infection serves as a risk factor of gastric H. Pylori infection.5. Conduct influence factor of mean periodontal pocket depth of the 32 H. Pylori-positive patients, the DOB result serves a risk factor of periodontal pocket depth.Among the 32 H. Pylori-positive patients, using gender, age, DOB, H.pylori infecting rate as independent variable, mean periodontal pocket depth as dependent variable to conduct Logistic regression analysis. It indicates that DOB is a risk factor for periodontal pocket depth, which means that the severe the H. Pylori infection is, the higher the risk of periodontitis. ConclusionThe degree of gingiva regeneration can possibly represent the degree of before periodontal destruction,and the depth of peridontal pocket means how suitable the oral anaerobic condition is for the growth of H.Pylori.Our research use 13C-urea breathe test to test the degree of gastric Helicobacter pylori infection of periodontitis, and discuss the correlation between periodontal status and gastric H. Pylori infection rate and degree.We may draw a conclusion that,H.Pylori infection is one of the risk factors of periodontiis,and the more severe the H. Pylori is,the deeper the periodontal pocket depth is,and the depth of the periodontal depth doesn't affect the degree of gastric H.Pylori infection.We could not yet draw a conclusion that the deeper the periodontal pocket is,the more gastric H.Pylori can we found.1)Although the severity of periodontitis varied significantly with the degree of gastric Hp infection,we can't consider periodontitis as a possible source of gastric H.pylori infection.2)The severity of periodontitis is positive correlation to the degree of gastric H. pylori infection,and gastric H.pylori infection is one of the risk factors of periodontitis,Key words:Helicobacter pylori,periodontitis,stomach,13C-urea breath test,gastritis. |
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