国际口腔医学杂志 ›› 2019, Vol. 46 ›› Issue (2): 238-243.doi: 10.7518/gjkq.2019004

• 综述 • 上一篇    下一篇

持续性根尖周炎根管内外生物膜特性的研究进展

杨子,侯本祥()   

  1. 首都医科大学附属北京口腔医院牙体牙髓病科 北京 100050
  • 收稿日期:2018-04-22 修回日期:2018-10-15 出版日期:2019-03-01 发布日期:2019-03-15
  • 通讯作者: 侯本祥 E-mail:endohou@qq.com
  • 作者简介:杨子,硕士,Email:paranoia- yz@qq.com
  • 基金资助:
    北京市医院管理局临床医学发展专项基金(XMLX201-30);北京市东城区科技计划项目(2017-3-004)

Research progress on the extra- and intra-radicular biofilm associated with persistent apical periodontitis

Zi Yang,Benxiang Hou()   

  1. Dept. of Conservative Dentistry and Endodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
  • Received:2018-04-22 Revised:2018-10-15 Online:2019-03-01 Published:2019-03-15
  • Contact: Benxiang Hou E-mail:endohou@qq.com
  • Supported by:
    This study was supported by Beijing Municipal Administration of Hospital Clinical Medicine Development of Special Funding(XMLX201-30);Science and Technology Project of Dongcheng District, Beijing(2017-3-004)

摘要:

持续性根尖周炎又称为难治性根尖周炎,其与细菌在根管内和根外形成的生物膜有关,是临床研究的热点。持续性根尖周炎根管内外生物膜虽相邻,但形态学及细菌构成等方面均有所区别,本文就近年来持续性根尖周炎根管内生物膜与根外生物膜的形态结构及细菌组成方面的异同,及其依存关系等方面的研究现状作一综述。

关键词: 持续性根尖周炎, 根管生物膜, 根外生物膜

Abstract:

Persistent apical periodontitis is commonly related to the presence of intraradicular biofilm that persists in the complex apical root canal system and extraradicular biofilm. This review highlights the main differences and similarities between intraradicular and extraradicular biofilms, especially in structure and microbial composition. In addition, the relationship between intraradicular and extraradicular biofilms is summarized.

Key words: persistent apical periodontitis, extraradicular biofilm, intraradicular biofilm

中图分类号: 

  • R781.05

表 1

PAP根管生物膜优势菌检出各研究比较"

研究者 入组要求 样本数目/例 取样方法 检测方法 优势菌
Gomes等[16] 至少于4年前行根管治疗,仍有持续性根尖周低密度影 45 根管再治疗取根充物后无菌纸尖取样 PCR 粪肠球菌(77.8%)、消化链球菌(51.1%)、牙龈卟啉单胞菌(35.6%)、Filifactor alocis(26.7%)、齿垢密螺旋体(24.4%)、中间普氏菌(22.2%)、产黑普氏菌 (11.1%)、福赛斯坦纳菌(4.4%)
R??as等[14] 至少1年前行根管治疗,但仍存在根尖周低密度影 17 再治疗时取根充物 反向捕捉棋盘杂交法 链球菌属(47%)、乳杆菌属(35%)、难见戴阿利斯特杆菌(29%),肠杆菌(29%)、中间普氏菌(29%)、生痰新月形单胞菌(29%)、互养菌属基因型BA121(29%)、梅毒螺旋体(29%)
Sakamoto等[15] 至少于5年前行根管治疗,患牙无临床症状,但仍有持续性根尖周低密度影 19 再治疗时取根充物 16S rRNA基因克隆文库 厚壁菌门、放线菌门、拟杆菌门、变形菌门、梭杆菌门、互养菌门
研究者 入组要求 样本数目/例 取样方法 检测方法 优势菌
Schirrmeister等[12] 至少于4年前行根管治疗,根充物距根尖不大于4 mm,根尖周有持续性低密度影 20 再治疗取根充后无菌纸尖取样 16S rRNA测序方法 具核梭杆菌、微小微单胞菌、难见戴阿利斯特杆菌、Solobacterium moorei、河流漫游球菌
Subramanian和Mi-ckel[17] 根管治疗后根充恰填但仍存在根尖周低密度影 34 根尖手术取根尖,去除外表面细菌后进行涡旋取样 16S rRNA测序方法 丙酸杆菌属、奈瑟氏菌属、月单胞菌属、营养缺陷菌属、双歧杆菌
Li等[18] 至少于2年前行根管治疗但仍存在根尖低密度影 7 再治疗取根充物后无菌纸尖取样 16S rRNA测序方法 洋葱伯克霍尔德氏菌、嗜二氧化碳噬细胞菌属、卟啉单胞菌属、茄科雷尔氏菌
Murad等[13] 至少于1年前行根管治疗但仍存在根尖低密度影 36 再治疗取根充物后无菌纸尖取样 棋盘DNA杂交 粪肠球菌、难见戴阿利斯特杆菌、表皮葡萄球菌、幽门螺旋杆菌
Antunes等[19] 至少于1年前行根管治疗,无症状但存在根尖低密度影 27 根尖手术取根尖外表面消毒后冷冻研磨法取样 实时PCR 链球菌属(76%)、放线菌门(52%)、假分支乳杆菌(19%)
Henriques等[20] 根管治疗后根尖周病变持续存在 40 再治疗取根充物后10#K锉取样 棋盘DNA杂交 白喉棒状杆菌、牙龈卟啉单胞菌,表兄链球菌、嗜麦芽糖寡养单胞菌

表 2

PAP根尖生物膜优势菌的检出比较"

研究者 入组要求 样本数目/例 取样方法 检测方法 优势菌
Noguchi等[21] 根管治疗后病变持续存在需行根尖手术者 27 根尖手术术中刮取牙根外表面生物膜 16S rRNA测序方法 具核梭杆菌、牙龈卟啉单胞菌、假丝酵母菌
Fujii等[22] 根管治疗后病变持续存在需行根尖手术者 20 根尖手术取根尖 16S rRNA测序方法 丙酸杆菌、表皮葡萄球菌、铜绿假单胞菌、具核梭杆菌
Wang等[8] 至少1年前行根管治疗,根尖病变直径<1 cm,需行根尖手术者 23 根尖手术取根尖 电子显微镜、改良Brown以及Brenn染色、PCR扩增及测序 放线菌属、丙酸杆菌属、普雷沃菌属、链球菌、牙龈卟啉单胞菌、伯克霍尔德氏菌
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[1] 李红 侯本祥. 持续性根尖周炎根外生物膜的研究进展[J]. 国际口腔医学杂志, 2013, 40(6): 754-757.
[2] 古丽莎,凌均棨,. 根管生物膜及其临床控制的研究进展[J]. 国际口腔医学杂志, 2006, 33(05): 349-351.
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