唾液による総合的な口腔検査法の開発

• Published in: The Japanese Journal of Conservative Dentistry Vol. 58; no. 3; pp. 219 - 228
• Main Authors: Eiji NISHINAGA, 牧 利一, 斉藤 浩一, 深澤 哲, 鈴木 苗穂, Chiyoko UCHIYAMA, 山本 高司, 村越 倫明, 大寺 基靖, 福田 功, 大久保 章男, 冨士谷 盛興, 千田 彰
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Conservative Dentistry 2015; 特定非営利活動法人 日本歯科保存学会
• Subjects: clinical efficiency; comprehensive oral health assessment; oral condition; salivary multi-test; 口腔内検査; 口腔状態; 唾液検査; 臨床的有用性
• ISSN: 0387-2343; 2188-0808
• DOI: 10.11471/shikahozon.58.219

Purpose: In order to achieve a comprehensive oral health assessment, a new salivary multi-test system (AL-55) has been developed. This test system can assay seven saliva analytes measuring color changes of the test strip as reflectance: [Dental caries] cariogenic bacteria, pH, buffer capacity, [Periodontal disease] blood, leukocyte, protein, [Oral cleanliness] ammonia. The purpose of this study was to evaluate the clinical efficiency of this system by examining the correlation between oral conditions and reflectance measured by AL-55. Methods: Oral rinse samples (3 ml-DW, 10 sec rinse) were collected from 231-adults (40.3±12.8 y). Ten μl of the sample was dropped on each pad of the strip, and the reflectance was measured after 1 and 5 min. After collecting the samples, the oral conditions of the subjects were examined: [Dental caries] DMFT, [Periodontal disease] probing pocket depth (PPD), bleeding on probing (BOP %), gingival index (GI) and Community periodontal index (CPI), [Oral cleanliness] total number of bacteria. The correlation between the oral conditions and the reflectance was assessed with the Spearman correlation test (p<0.01). In addition, the subjects were stratified into 3 groups (high, middle and low) on the basis of DMFT, PPD or total number of bacteria. The reflectance between the groups was compared with Tukey’s test (p<0.05). Results: [Dental caries] DMFT was significantly correlated with reflectance of cariogenic bacteria measured by AL-55, and was not correlated with pH and buffer capacity. There was a significant difference in reflectance of cariogenic bacteria between high and low groups stratified by DMFT. In the cases of pH and buffer capacity, no significance was found between the three groups. [Periodontal disease] PPD, BOP, GI and CPI were significantly correlated with blood, leukocyte and protein measured by AL-55. There were significant differences in blood between the three groups stratified by PPD, while leukocyte and protein exhibited significant differences between high and middle groups and between high and low groups. [Oral cleanliness] The total number of bacteria was significantly correlated with ammonia measured by AL-55. There are significant differences in ammonia between the three groups stratified by the total number of bacteria. Conclusion: This particular study revealed that the oral conditions associated with dental caries, periodontal disease and oral cleanliness were correlated with the reflectance measured by the newly-developed salivary multi-test system (AL-55). These results may indicate clinical usefulness of this system for assessing oral health.  目的 : 唾液による総合的な口腔検査法の確立を目指し, う蝕, 歯周病, 口腔清潔度に関する7項目の唾液因子を5分間で測定できる唾液検査システム (AL-55) を開発した. AL-55は, 7項目の試験片 ([う蝕] う蝕原性菌, pH, 酸緩衝能, [歯周病] 潜血, 白血球, タンパク質, [口腔清潔度] アンモニア) を貼付したストリップ状試験紙の色調変化を反射率として検出する. 本研究では, 口腔内およびAL-55の検査結果の相関を解析し, AL-55による検査が, 口腔内の状態把握に有用なものであるかについて検討を行った.  方法 : 成人231名の対象者から, 洗口吐出液 (蒸留水3mlで10秒間含嗽した後の吐出液) を採取し, AL-55の試験紙に10μlずつ点着後, 1分および5分後に反射率を測定した. その後, 口腔内検査として, DMFT, PPD, BOP, GI, CPIを評価し, 口腔清潔度については洗口吐出液中の総菌数を測定した. 口腔内およびAL-55の検査結果の相関について, Spearman相関解析を用いて評価し (α=0.01), また, 対象者をDMFT, PPD, 総菌数によりおのおの3層別し, 各群におけるAL-55の検査結果を, Tukeyの多重比較検定を用いて群間比較した (α=0.05).  結果 : [う蝕] DMFTは, AL-55によるう蝕原性菌の検査結果 (反射率) と有意な相関を示したが, pH・酸緩衝能の検査結果との相関は認められなかった. また, 対象者のDMFTを3層別し, AL-55による検査結果を比較した結果, う蝕原性菌の検査結果は軽度群と重度群の間に有意差を示したが, pH・酸緩衝能は3群間に有意差を認めなかった. [歯周病] PPD, BOP, GI, CPIは, AL-55による潜血, 白血球, タンパク質の検査結果と有意な相関を認めた. また, PPDを基に対象者を3層別し, AL-55の検査結果を比較した結果, 潜血は, 軽度群・中等度群・重度群のそれぞれの間に有意差を示し, 白血球, タンパク質は, 軽度群と重度群, および中等度群と重度群の間に有意差を示した. [口腔清潔度] 総菌数は, アンモニアの検査結果と有意な相関を認めた. また, 総菌数により対象者を3層別し比較した結果, アンモニアは3群間にそれぞれ有意差を認めた.  結論 : 新たに開発した多項目唾液検査システム (AL-55) による検査結果と, 口腔内の検査結果に有意な相関を認め, AL-55が口腔内の状態把握に有用であることが明らかとなった.