国际口腔医学杂志

国际口腔医学杂志 ›› 2025, Vol. 52 ›› Issue (5): 614-620.doi: 10.7518/gjkq.2025066

• 论著 • 上一篇    下一篇

青少年正畸患者釉质脱矿的发生与口腔菌群及分泌型免疫球蛋白A的关系

胡凯1(),张延晓2,毛丙永1,唐鑫1,王跃岩3,潘月2,张秋香1(),崔树茂1   

  1. 1.江南大学食品学院 无锡 214122
    2.无锡口腔医院正畸科 无锡 214000
    3.无锡口腔医院牙体牙髓病科 无锡 214000
  • 收稿日期:2024-04-08 修回日期:2025-04-08 出版日期:2025-09-01 发布日期:2025-08-27
  • 通讯作者: 张秋香
  • 作者简介:胡凯，硕士，Email：hkaimyt1999@gmail.com
  • 基金资助:
    国家自然科学基金(32372300);江苏省口腔医学会正畸专业委员会中青年项目(Joa-2022-3);江苏省口腔疾病研究重点实验室课题(JSKLOD-KF-2108);无锡市卫生健康委员会科研项目(M202338)

Relationship between enamel demineralization and oral microbiota with secretory immunoglobulin A in adolescent orthodontic patients

Kai Hu1(),Yanxiao Zhang2,Bingyong Mao1,Xin Tang1,Yueyan Wang3,Yue Pan2,Qiuxiang Zhang1(),Shumao Cui1   

  1. 1.School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
    2.Dept. of Orthodontics, Wuxi Stomatological Hospital, Wuxi 214000, China
    3.Dept. of Endodontics, Wuxi Stomatological Hospital, Wuxi 214000, China
  • Received:2024-04-08 Revised:2025-04-08 Online:2025-09-01 Published:2025-08-27
  • Contact: Qiuxiang Zhang
  • Supported by:
    National Natural Science Foundation of China(32372300);Young and Middle-aged Researchers Project of Orthodontic Specialty Committee, Jiangsu Stomatological Association(Joa-2022-3);Jiangsu Provincial Key Laboratory of Oral Diseases Research Project(JSKLOD-KF-2108);Wuxi Municipal Health Commission General Program(M202338)

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摘要：

目的 解析正畸患者发生釉质脱矿的关键因素，确定与釉质脱矿发生相关的生物标志物，并探讨青少年正畸患者釉质脱矿与口腔菌群的相关性。 方法 选取2组患者，每组各22人，S组佩戴自锁托槽，M组佩戴传统金属托槽。在正畸基线期及3个月后收集龈上菌斑进行菌群分析，同时收集患者唾液并测定分泌型免疫球蛋白A（sIgA）的含量。每月复诊时，对釉质脱矿（EDI）、菌斑指数（PLI）、牙龈指数（GI）、牙周指数（PI）等临床指标进行统计和分析。 结果 正畸3个月后，所有患者釉质脱矿发生率显著升高，平均脱矿率较治疗前增加20%以上，其中S组Fusobacterium、Campylobacter、Neisseria和Prevotella菌属的丰度显著增加（P<0.05），而M组Rothia菌属丰度显著上升（P<0.05）；Arthrobacter、Bacillus、Acinetobacter、Prevotella、Campylobacter菌属丰度与釉质脱矿评分及菌斑指数评分呈正相关；唾液中sIgA的含量与釉质脱矿的发生呈负相关，S组正畸后唾液sIgA含量显著下降（P<0.01）。 结论 佩戴自锁托槽的正畸患者更易发生釉质脱矿，Campylobacter和Prevotella菌属可能是加剧青少年正畸患者釉质脱矿的关键微生物。唾液中sIgA含量的下降可能预示着正畸患者釉质脱矿的风险增加。

关键词: 正畸, 釉质脱矿, 口腔菌群, 分泌型免疫球蛋白A

Abstract:

Objective This study aimed to elucidate the key factors contributing to enamel demineralization in or-thodontic patients, identify biomarkers associated with its occurrence, and explore the relationship between enamel demine-ralization and oral microbiota in adolescent orthodontic patients. Methods Two groups of patients were selec-ted, one group with self-ligating brackets (Group S) and the other with traditional metal brackets (Group M), with 22 participants in each group. Subgingival plaque was collected for microbiome analysis at the baseline of orthodontic treatment and after 3 months. Simultaneously, saliva was collected to measure the levels of secretory immunoglobulin A (sIgA). Clinical indices such as the enamel demineralization index, plaque index (PLI), gingival index, and periodontal index were statistically analyzed during monthly recall visits. Results After 3 months of orthodontic treatment, the incidence of enamel demineralization among patients significantly increased, with an average increase of over 20% in demineralization rates. In Group S, the abundance of Fusobacterium, Campylobacter, Neisseria, and Prevotella significantly increased after 3 months of orthodontics (P<0.05). In Group M, the abundance of Rothia significantly increased (P<0.05). The abundance of Arthrobacter, Bacillus, Acinetobacter, Prevotella, and Campylobacter was positively correlated with enamel demineralization and PLI scores. The levels of sIgA in saliva were negatively correlated with the occurrence of enamel demineralization, with a significant decrease in sIgA levels in Group S after orthodontic treatment (P<0.01). Conclusion Orthodontic patients with self-ligating brackets are more prone to enamel demineralization, and Campylobacter and Prevotella may be key bacterial species that exacerbate enamel demineralization in adolescent orthodontic patients. A decrease in salivary sIgA levels may indicate an increased risk of enamel demineralization in or-thodontic patients.

Key words: orthodontics, enamel demineralization, oral microbiota, secretory immunoglobulin A

中图分类号: 

  • R781.5

表 1

研究对象信息"

基本信息S组M组P值
年龄/岁13.4±1.914.3±1.80.997
性别/例男9100.228
女1312
身高/cm162.9±7.9166.5±7.80.996
体重/kg47±6.748.7±8.30.871
BMI/（kg/m2）17.6±2.017.5±2.50.819
每日刷牙频率/次110150.650
2127
≥300
每周高糖食物食用次数/次0820.774
1~21219
≥321

表 2

2组研究对象临床指数"

临床指标ST0占比/%ST3占比/%MT0占比/%MT3占比/%P值 （ST0vsST3）P值（MT0vsMT3）
EDIN=01464418167313590.0020.007
N=16271150523523
N=22941815418
N=3003140000
PLIN=0135941815687320.0070.003
N=17321150627627
N=22941815732
N=3003140029
PIN=019861986188217771.0000.998
N=1314314418523
N=200000000
N=300000000
GIN=01359627167311500.1150.530
N=194113596271045
N=2003140015
N=300000000

图 1

2组正畸前后口腔菌群多样性分析A：物种丰富度Chao1指数；B：物种多样性Shannon指数；C：S组龈上菌斑的β多样性；D：M组龈上菌斑的β多样性；*：P<0.05，***：P<0.001。"

图2

2组口腔微生物群丰度的比较"

图3

2组口腔健康指标的相关性分析"

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