Test Of The Periodontal Microbiota In The Subgingival Plaque Of Periodontal Patients With Coronary Artery Disease

Background:Periodontal disease is the one of two main oral diseases.It has a high morbidity on the world.In our country,its morbidity is higher than caries'.Now with a comeing old-age society,periodontal disease,especially periodontitis,will become the most major disease in health care.Today the study of periodontal disease has run into discussing the relationship between periodontal disease and diseases of the whole body,instead of researching the disease itself.Recent studies have shown that periodontal disease has lots of relationships with many diseases,such as diabetes,cardiovascular diseases,etc.The relation of periodontal disease and cardiovascular diseases,especially coronary artery disease(CAD),has caused the attention of periodontal and cardiovascular doctors.Recently many doctors have done a series of studies on periodontal disease and cardiovascular diseases which including clinical questionnaire,periodontal examination and immune exam.They all found that there were some relation in periodontal disease and coronary artery disease.As we know periodontal disease is a multifactor disease and bacteria are the main factor. But the composing of bacteria is very complicated.With deeper study,it has shown that CAD is a infected disease and some microbe play a important role in the process of CAD.Many clinical pathology and epidemiology studies have shown that nearly 40%patients who have myocardial infarction and cerebrovascular disease are in the estate of infection,inflammation immunity and self-immunity.Cotrutz said that oral sanitation and periodontal index have been affirmed an absolute dangerous factor of cardiovascular diseases which have osculatory relationship with cardiovascular diseases.Both periodontal disease and CAD base on bacteria infection,and they have some contact with each other,so if we can find their contact on bacteria infection, even more,if we can find their common bacteria,then study their mechanism of disease,it will run important guidable effect to the CAD patient especially to the CAD patient with periodontitis.So in this study,we will study their bacterial contact measured on the gene level by real-time polymerase chain reaction.Objective:1.To find the difference of periodontal index between the periodontitis patient with CAD and without CAD.2.To analyze the difference among the proportion of the CAD patient respective in the gently periodontitis,middling periodontitis and serious periodontitis.3.To analyze the component difference of the periodontal bacteria in the subgingival plaque of the periodontitis patient with CAD and without CAD,then to offer some reference to the prevention and treatment of CAD by finding the special bacterial.Methods:1.To choose periodontitis patients with CAD and without CAD,then mark their periodontal index:bleeding on probing(BOP),probing depth(PD) and attachment loss(AL).Then to study the realitonship of these indexs.2.To divide all these patients into three groups by the probing depth(PD) index and the attachment loss(AL) index:gently periodontitis(PD≤4 mm,AL=1～2 mm), middling periodontitis(PD≤6 mm,AL=3～4 mm) and serious periodontitis(PD＞6 mm,AL≥5 mm).Then to analyze the difference among the three groups.3.To collect the subgingival plaque of these patients and analyze the proportional relationship of actinobacillus actinomycetemcomitans(A.a), porphyromonas gingivalis(P.g.),prevotella intermedia(P.i.),bacteroides forsythus (B.f.) and treponema denticola(T.d.) by real-time polymerase chain reaction, (real-time PCR).Results:1.The result of periodontal exam between periodontitis patients with CAD and without CAD shows that Bop,PD and AL all has statistic sense(P＜0.05) by statistic analysis.2.After dividing all these patients into three groups by the probing depth(PD) index and the attachment loss(AL) index,gently periodontitis(PD≤4 mm,AL=1～2 mm),middling periodontitis(PD≤6 mm,AL=3～4 mm) and serious periodontitis(PD＞6 mm,AL≥5 mm),and we know the proportion of the CAD patients in three groups is 13.43%,51.85%,76.67%respectively.Then we check it byχ~2 test,P＜0.05, so we know they have statistic sense.3.After real-time PCR and statistic analysis,the numerical value of P.g.has statistic sense(P＜0.05),the numerical value of A.a.,P.i.,B.f and T.d.all haven't statistic sense(P＞0.05).Conclusions:1.The periodontal index of the patients with CAD is more serious than the patients without CAD.It means that there is some contact between periodontitis and CAD.2.The incidence of CAD with serious periodontitis is higher and it tells us that periodontitis is a dangerous factor of CAD.3.The number of P.g.in the CAD~+ group is higher than that in the CAD~-.And the result has statistic sense.It shows that the periodontal patients who have more P.g. in the subgingival plaque can have CAD easilier.So this bacterium has an important sense in the infection on periodontitis and CAD.