| BackgroundChronic periodontitis is a chronic inflammation of periodontal tissue caused by a variety of factors.It has a high incidence rate all over the world,and the situation in China is not optimistic.Periodontitis affects the chewing and eating functions of patients.Severe periodontitis is also closely related to other systemic diseases,causing great physical pain and heavy economic burden to patients.Currently,there is no specific conclusion on the etiology of chronic periodontitis,but much attention has been paid to the microbial etiology,especially Porphyromonas gingivalis(P.gingivalis),which is recognized as the main pathogenic bacteria.In recent years,studies have shown that Helicobacter pylori(H.pylori)colonization in the oral cavity has a certain relationship with the onset of chronic periodontitis.Currently,there is no radical treatment for chronic periodontitis,which requires long-term follow-up and maintenance.Therefore,it is necessary to study the main pathogenic bacteria in the oral cavity of chronic periodontitis and analyze the risk factors of chronic periodontitis with different severity.ObjectiveThe purpose of this study was to explore the relationship between P.gingivalis and H.pylori and chronic periodontitis,and to provide experimental basis for the prevention and treatment of chronic periodontitis.MethodsClinical data of 190 patients with chronic periodontitis were collected from the Department of Dentistry of the Affiliated Stomatological Hospital of Nanchang University from November 2021 to April 2022.They were divided into mild chronic periodontitis group(case group A;n=63),moderate chronic periodontitis(case group B;n=63),and severe chronic periodontitis(case group C;n=64)according to the degree of disease;During the same period,63 gender and age matched oral health examinees from the Affiliated Stomatological Hospital of Nanchang University served as the control group.The periodontal probe was used to collect supragingival plaque and detect H.pylori infection in the oral cavity using a urease based colloidal gold reagent;Special filter paper was used to collect gingival crevicular fluid,and the concentration of anti-P.gingivalis Ig G antibody in gingival crevicular fluid was detected by enzyme linked immunosorbent assay(ELISA).The general clinical data,the detection rate of H.pylori in the oral cavity,and the concentration of anti-P.gingivalis Ig G antibodies of four groups of study subjects were analyzed and statistically analyzed to study the relationship between H.pylori combined with P.gingivalis infection and chronic periodontitis.Results1.There were no significant differences in gender(P=0.960)and age(P=0.736)between case group A,case group B,case group C and control group.2.The positive rate of H.pylori in the oral cavity was 20.6% in case group A,28.6% in case group B,51.6% in case group C,and 23.8% in control group.The positive rate in case group C was significantly higher than that in case group A(P<0.001),case group B(P<0.001),and control group(P<0.001);There was no significant difference between case group A(P=0.668)and case group B(P=0.543)compared to the control group;There was no significant difference between case groups A and B(P=0.301).3.The concentration of anti-P.gingivalis Ig G antibody was 75.43(68.80-83.30)pg/ml in case group A,108.54(102.67-120.18)pg/ml in case group B,164.19(82.71-273.08)pg/ml in case group C,and 53.10(49.52-58.22)pg/ml in control group.There were significant differences between case group A(P<0.001),B(P<0.001),and C(P<0.001)compared to the control group.Pairwise comparison between groups showed that the concentration in case group A was significantly lower than that in case group B(P=0.001),and that in case group B was significantly lower than that of case group C(P=0.001).4.Regarding the infection of P.gingivalis and H.pylori in the case group,case group A was mainly uninfected(55.5%),case group B was mainly infected with P.gingivalis alone(61.9%),and case group C was mainly co-infection(40.6%).The coinfection rate was 17.5% in case group A,23.8% in case group B,and 40.6% in case group C.The rate of co-infection in case group B was higher than that in case group A(P<0.001);The co-infection rate in case group C was higher than that in case group B(P=0.043)and case group A(P<0.001).The co-infection of the two bacteria increased significantly with the aggravation of the disease.5.The concentration of anti-P.gingivalis Ig G antibody,but not H.pylori infection,age,or gender(P>0.05),was a risk factor for mild to moderate chronic periodontitis(P<0.001).The concentration of anti-P.gingivalis Ig G antibody(P<0.001)and H.pylori infection(P=0.038),but not age and gender(P>0.05),were risk factors for severe chronic periodontitis.Conclusion1.The positive rate of H.pylori in the oral cavity of severe chronic periodontitis is significantly increased.2.The concentration of anti-P.gingivalis Ig G antibody progressively increases during the development of periodontitis.3.The infection rate of H.pylori and P.gingivalis in the oral cavity increases as the disease progresses.4.P.gingivalis infection in the oral cavity is a risk factor for chronic periodontitis from mild to severe,while H.pylori infection in the oral cavity is a risk factor for severe chronic periodontitis. |
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