牙周病与免疫教学提纲.ppt

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1、牙周病与免疫Oralbacteria口腔中的细菌：--Freetosaliva在唾液中--Attachmentinbiofilm附着在生物膜BetweencloselyrelatedSalivaasacarrier,isconducivetohorizontalandverticaltransmissionofbacteriaInUnitedStates,75percentofadultpopulationssufferfromperiodontaldisease.美国占75%成年人群体不同程度患有牙周病1/3childrenof6~11yearsol

2、d,and2/3ofadolescentpopulationhavesomedegreeofperiodontalproblems.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Over200kindsofbacterialformdentalplaque,adheretothesurfaceoftheteethandgums,andcauseperiodontalinfections.牙周感染细菌达200余种PeriodontitisⅠGingivitisbleeding，DeepgingivalPocket<3mmⅡPeriodon

3、titisbleeding，swelling，initialboneloss,DeepperiodontalPocket=5mmⅢmajorstagebleeding，swelling，majorboneloss，DeepperiodontalPocket＞6mmPeriodontalPocket:auniquemicro-environment牙周袋是独特的微环境escapethephysicalseparationforce逃逸物理分离力hardtissuesurface不剥脱更新的硬组织表面junctionalepithelialization,

4、basicallynotdifferentiation有结合上皮，基本上不分化non-keratinizingepithelium无角化facultativeanaerobic→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RootsurfacePellicleP.gP.gP.gP.gP.gSubgingivalbiofilmformation龈下生物膜形成Initialcolonization早期定居者：actinomyces,streptococcisucceededc

5、olonization微生物交替后：periodontalpathogens致病微生物定植Pg，AA,forsythia,T.denticoleFusobacteriumnucleatum1996confirmedthreebacteriaforperiodontalpathogens:Actinobacillusactinomycetemcomitans(AA)Tannerellaforsythia(TF)Porphyromonasgingivalis(Pg)1996,牙周致病菌AA，TF，PgRecentviewschange,pathogenic

6、capacityofAAandotherculturableornon-culturablebacteriashouldbeconfirmed.近期：AA待证实50%oralmicrobialcannotbecultivatedandcanbeidentifiedthroughextramethods:口腔中有50%微生物不能培养，可通过下述方法鉴定：quantitativeRT-PCR定量PCRphylogenetic16s-rRNAgeneclonelibraryanalysis用基因组或16srRNA探针checkerboardhybridiza

7、tion棋盘杂交high-throughputfingerprinttechnology高通量指纹技术pyrophosphatesequencing454技术（焦磷酸盐测序）metagenometechnology宏基因组技术Generalview:PeriodontitisiscausedbyendogenousG-periodontalbacteria.目前普遍认为：牙周炎是由内源性G-牙周细菌所致Redcomplex:Porphyromonasgingivalis牙龈卟啉菌Tannerellaforsythia弗赛菌Treponemadentic

8、ola齿密螺旋体Potentialvirulencefactors潜在毒力因子Neutrali