乳酸菌配合シュガーレスガムが歯周病患者唾液中の歯周病原細菌叢へ与える影響  [in Japanese] Effects of Sugar-free Chewing Gums Containing Enterococcus faecium on Periodontal Pathogens in Saliva from Patients with Periodontitis  [in Japanese]

Access this Article

Search this Article

Author(s)

    • 山口 人巳 YAMAGUCHI Hitomi
    • 新潟大学大学院医歯学総合研究科口腔生命科学専攻摂食環境制御学講座歯周診断・再建学分野:やまぐち歯科医院 Division of Periodontology, Department of Oral Biological Science, Course for Oral Science, Niigata University Graduate School of Medical and Dental Sciences:Yamaguchi Dental Clinic
    • 久保田 健彦 KUBOTA Takehiko
    • 新潟大学大学院医歯学総合研究科口腔生命科学専攻摂食環境制御学講座歯周診断・再建学分野 Division of Periodontology, Department of Oral Biological Science, Course for Oral Science, Niigata University Graduate School of Medical and Dental Sciences
    • 濃野 要 NOHNO Kaname
    • 新潟大学大学院医歯学総合研究科口腔生命科学専攻口腔健康科学講座予防歯科学分野 Division of Preventive Dentistry, Department of Oral Health Science, Course for Oral Science, Niigata University Graduate School of Medical and Dental Sciences
    • 両角 俊哉 MOROZUMI Toshiya
    • 新潟大学大学院医歯学総合研究科口腔生命科学専攻摂食環境制御学講座歯周診断・再建学分野 Division of Periodontology, Department of Oral Biological Science, Course for Oral Science, Niigata University Graduate School of Medical and Dental Sciences
    • 飯山 真奈美 IIYAMA Manami
    • 新潟大学大学院医歯学総合研究科口腔生命科学専攻摂食環境制御学講座歯周診断・再建学分野 Division of Periodontology, Department of Oral Biological Science, Course for Oral Science, Niigata University Graduate School of Medical and Dental Sciences
    • 吉江 弘正 YOSHIE Hiromasa
    • 新潟大学大学院医歯学総合研究科口腔生命科学専攻摂食環境制御学講座歯周診断・再建学分野 Division of Periodontology, Department of Oral Biological Science, Course for Oral Science, Niigata University Graduate School of Medical and Dental Sciences

Abstract

【目的】Enteyococcus faecium (E. faecium)乳酸菌配合シュガーレスガムが,歯周組織の健康および口腔内細菌叢に与える影響について評価した.【材料および方法】本研究に対して,インフォームドコンセントが得られた慢性歯周炎患者30名(男性14名,女性16名,平均年齢57.3±8.4歳)を研究の被験者とした.二重盲検法を用い,被験者にはEnterococcus faecium配合シュガーレスガム(以下,乳酸菌ガム)および配合なしのPlaceboガム(以下,Placeboガム)のどちらかを喫食してもらい乳酸菌ガム群(15名),Placeboガム群(15名)を設定した.4週間の試験期間中1日4粒のガムを毎食後および就寝前に喫食してもらい,機械的プラークコントロールは停止しなかった.4週間の喫食期間前後に5分間ガムベース咀嚼刺激によって唾液を採取し,生化学的検索として,乳酸脱水素酵素(LDH), Alkaline phosphatase (ALP)活性,遊離ヘモグロビン(F-Hb)量,唾液pHを測定した.細菌学的検索として,全唾液中および残存歯の最深部歯周ポケットから採取した歯周病原細菌Poyphyromonas gingivalis (P. gingivalis), Treponema denticola (T. denticola), Tannerella forsythia (T. forsythia), Prevotella intermedia (P. inteymedia), Aggregatibacter actinornycetemcomitans (A. actinomycetemcomitans)および総細菌数のリアルタイムポリメラーゼ連鎖反応(PCR)法による定量を行った.同時に,E. faecium菌の口腔内への定着の有無を調べるために,唾液試料と歯肉縁下プラークを培養法にて簡易定量した.臨床検査項目としてはRamfjordの6歯に対して,プラーク指数(PlI),プロービングポケット深さ(PPD),歯肉炎指数(GI),プロービング時の出血(BOP)を測定した.統計解析は,被験者特性の群間比較にはStudent's t検定を用いた.ガム摂取前後の各検査値の比較にはWilcoxon符号付順位和検定を用いた.いずれも有意水準は5%に設定した.【結果】全唾液中では,総菌数において両ガム群で減少した.歯周病原細菌では,Placeboガム群は個人間のばらつきがあるもののT. forsythiaのみ有意に減少した.一方,乳酸菌ガム群はT. forsythiaに加え,Red complex細菌として知られるP. gingivalisおよびT. denticolaにおいても有意に減少した(p<0.05).歯肉縁下プラーク中の細菌数においては,全体的に低下傾向を示したが,Placeboガム群でT. forsythiaのみ有意に減少した.被験者の各臨床検査項目において,4週間後改善傾向を示したが,両群間での有意差は認められなかった.唾液生化学的パラメーターの変動では,両ガム群においてLDHでは変化がなかったものの,ALPおよびF-Hbでは両群ともに減少傾向を示しPlaceboガム群では有意に減少した.E. faecium菌の定着およびpHの酸性化は30名すべての被験者から検出されなかった.【結論】乳酸菌配合シュガーレスガムの喫食は,唾液中の歯周病原細菌,特にRed complex菌群を減少させることにより,歯周組織破壊抑制にかかわる可能性が示唆された.

Objectives: The purpose of the present study was to evaluate the effect of sugar-free chewing gums containing Enterococcus faecium (E. faecium) on periodontal health and oral microbial flora. Material and methods: Thirty generalized chronic periodontitis patients (57.3 y ± 8.4) who signed an informed consent were recruited in this study. The subjects were grouped double-blindly into two groups: 1) fifteen subjects chewing E. faecium gum or 2) fifteen subjects chewing placebo gum. Before and after the four-week experiment period, saliva was collected after 5 minutes of stimulation and then used for biochemical measurements (lactate dehydrogenase (LDH), alkaline phosphatase (ALP) activities, free hemoglobin (F-Hb), pH) and microbiological measurements for periodontopathic bacteria: Porphyromonas gingivalis gingivalis), Treponema denticola (T denticola), Tannerella forsythia (T forsythia), Prevotella intermedia (P intermedia), Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) and total bacterial counts by using the real-time polymerase chain reaction (PCR) method. The microbiological quantitative measurements were also taken from the deepest periodontal pocket of each patient. To evaluate whether E. faecium was fixed in the oral cavity or not, saliva and periodontal pocket samples were also analyzed by conventional bacterial culture of E. faecium. Clinical periodontal measurements were done for Ramfjord's six representative teeth including plaque index (PlI), probing pocket depth (PPD), gingival index (GI), and bleeding on probing (BOP). Statistical analyses were performed with Student's t-test for subjects' distribution and Wilcoxon's signed-ranks test for microbial, biochemical and clinical data. A P value of below 5 % was considered significant. Results: The E. faecium gum group showed a significant decrease in red complex periodontal pathogens including 7: forsythia, 7: denticola and P.gingivalis compared to the base-line, especially in saliva samples (p<0.05). However, this tendency was not seen in subgingival plaque samples from each deepest periodontal pocket. Both groups had significantly improved clinical status in PH, GI, PPD, BOP and biochemical markers for ALP and F-Hb in saliva at four weeks after the experiments compared to the base-line. None of the patients showed E. faecium fixation or acidific change of pH. Conclusion: The present study suggests that sugar-free chewing gums containing the lactic acid-producing bacteria, E. faecium, could have beneficial effects on periodontal health by inhibiting periodontal red complex pathogens including P. gingivalis, T. denticola and T. forsythia.

Journal

  • The Japanese Journal of Conservative Dentistry

    The Japanese Journal of Conservative Dentistry 54(6), 466-475, 2011

    The Japanese Society of Conservative Dentistry

References:  42

Codes

  • NII Article ID (NAID)
    110009419175
  • NII NACSIS-CAT ID (NCID)
    AN00191201
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    0387-2343
  • Data Source
    CJP  NII-ELS  J-STAGE 
Page Top