臺灣博碩士論文加值系統

牙齦炎是人類最常見的口腔疾病之一，是白牙菌斑及其所釋放的物質所引起的生物反應結果。而牙齦下菌斑中的黑色厭氧桿菌被認為是牙齦炎致病菌，尤其是Prevotella intermedia及Porphylomonas gingivalis和人類牙齦炎有密切關係，這兩種黑色素厭氧桿菌可利用人體的progesterone和estradiol等女性荷爾蒙做為營養來源而增殖；且progesterone及estradiol在懷孕婦女體內濃度會大量提高，並在牙齦組織中聚積。本研究的目的即期望經由檢測懷孕婦女牙齦溝液中progesterone及estradiol的含量測定，並觀察其與牙齦下菌斑中黑色素厭氧桿菌所佔比率間相互關係以瞭解其牙齦炎之致病機轉。結果顯示，懷孕婦女牙齦溝液中progesterone含量較產後明顯為高，牙齦下菌斑中黑色素厭氧桿菌占有比率也較產後為高，均具統計上差異。而黑色素厭氧桿菌比率則受懷孕，progesterone總活性及牙齦發炎情形影響，並且都呈正相關。牙齦發炎情形則隨牙菌斑指數，及牙齦下菌斑中黑色素厭氧桿菌所佔比例升高而升高，兩者均具統計上意義。
因此，懷孕婦女因為體內荷爾蒙的升高，除了牙齦組織反應的改變外也導致牙齦溝液荷爾蒙含量的增多，正好提供了浴其中的牙齦炎致病菌，特別是黑色素厭氧桿菌中的Prevotellaintermedia和Porphylomonas gingivalis營養來源而大量增殖，因而導致牙齦的發炎，是所謂〝妊娠牙齦炎〞。

Gingivitis is one of the most common oral diseases, which is caused by dental plaque and by the factors produced/released from it. The black pigmented bacteria in subgingival dental plaque is thought to be the pathogens of the gingivitis. Prevotella intermedia and Porphylomonas gingivalis have been shown to be closely associated with human gingivitis. These two kinds of black pigmented bacteria can use female sex hormones such as progesterone or estradiol as a source of nutrients. In pregnant women, the concentrations of progesterone and estradiol are markely increased in serum and both of them are accumulated and found in the gingival tissue. The purpose of this study was to test levels of female sex hormones in gingival crevicular fluid and to observe the relationship between hormones and black pigmented bacteria in subgingival plaque. The results showed that the level of progesterone found in the gingival crevicular fluid of pregnant women was markedly higher than that of women in postpartum stage. The percentage of black pigmented bacteria in subgingival plaque were also higher than that in postpartum stage, and both results were statistically significant. Percentage of black pigmented bacteria was positively correlated with both the progesterone level, pregnancy and the severity of the gingivitis. Severity of the gingivitis was positively correlated with both the plaque index and the percentage of black pigmented bacteria in subgingival plaque.