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다운증후군 환자의 치아우식증과 치아우식 원인균 및 타액내 면역항체의연관성

The dental caries, cariogenic microorganisms and levels of salivary immunoglobulin in subjects with down’s syndrome

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다운증후군 환자의 치아우식증과 구강내 여러 요인들과의 연관성을 평가하고자 9-18세의 다운증후군 환자 25명과 정상인 63명을 대상으로 치아우식경험지수, 치태지수를 조사하고 효소면역분석법을 이용하여 타액의 면역항체 IgA와 뮤탄스 연쇄상구균-특이 IgA 농도를 측정하고, Dentocult 키트를 이용하여 뮤탄스 연쇄상구균과 유산간균의 수, 타액의 완충능을 측정하여 두 군의 각 값들을 독립 t-test와 카이제곱 검정을 시행하였다. 다운증후군 환자에서 유치우식경험은 정상인에 비해 유의하게 낮았으나(p<0.001), 영구치우식경험은 유의한 차이를 보이지 않았다. 치태지수와 타액의 IgA의 농도는 두 군 간에 차이를 보이지 않았으며, 뮤탄스 연쇄상구균 특이-IgA 농도와 타액 완충능은 다운증후군환자에서 낮았다(p<0.05). 뮤탄스 연쇄상구균 수와 유산간균 수는 두 군간에 유의한 차이는 없었다. 9-11세 군에서 뮤탄스 연쇄상구균의 수는 다운증후군 환자에서 정상인보다 낮았으며(p<0.001), 뮤탄스 연쇄상구균 특이-IgA는 다운증후군 환자에서 유의하게 낮았다(p<0.05). 유치의 치아우식경험치면지수는 완충능, 뮤탄스 연쇄상구균의 수와 유의한 상관관계를 보였다.

Abstract

This study investigated the relationship between dental caries and various oral factors in subjects with Down’s syndrome. We compared 25 subjects with Down’s syndrome with 63 healthy control. The dental caries index and plaque index were examined, and the total salivary immunoglobulin A and S. mutans specific salivary immunoglobulin A concentration were measured using ELISA. The S. mutans counts, Lactobacillus counts and buffer capacity were measured with Dentocult test medium. The decayed and filled surface index of deciduous teeth in subjects with Down’s syndrome was lower than in controls(p<0.001). The plaque index and total salivary immunoglobulin A concentration showed no difference, S. mutans specific salivary immunoglobulin A concentration and buffer capacity in subjects with Down’s syndrome were lower than in controls(p<0.001). There was no significant difference between two groups in the S. mutans counts and Lactobacillus counts. In 9-11 year age group, S. mutans counts in subjects with Down’s syndrome was lower than in controls(p<0.001) and S. mutans specific salivary immunoglobulin A concentration was lower(p<0.05). There was a high correlation among deciduous dental caries index and buffering capacity and S. mutans counts.

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