不同感染状态下根管内细菌定植状态的初步研究
发布时间：2019-01-07 21:58
【摘要】：目的：本研究旨在探究不同感染状态下（慢性根尖周炎、慢性牙周炎、牙周牙髓联合病变）根管内细菌定植的情况与相互间的差异。 材料与方法：本研究共纳入27例样本，A组为慢性根尖周炎患牙（10例），B组为慢性牙周炎患牙（10例），C组牙周牙髓联合病变患牙（7例）。采用组织学BrownBrenn染色法与扫描电镜（SEM）相结合的方法对纳入样本进行超微结构观察，将新鲜拔除的患牙沿牙长轴近远中向劈为两半，一半做组织学切片，采用BrownBrenn染色观察，另一半做扫描电镜观察。 结果：组织切片细菌染色显示，慢性根尖周炎、慢性牙周炎以及牙周牙髓联合病变根管冠1/3、根尖1/3牙本质小管内侧细菌定植阳性率有统计学差异（P 0.05）。其中，A组细菌侵入牙本质小管深度为100-1100μm，主要集中在根尖1/3段；B组细菌可侵入牙本质小管深度为50-700μm，根冠1/3段最为严重；C组仅观察到少量细菌侵入牙本质小管内侧，深度为40-100μm。扫描电镜结果显示，A组可见大量球菌、杆菌镶嵌于无定形的基质中，以生物膜的形式附着于根管壁，或侵入牙本质小管内，或分布于管间牙本质上；B组可见细菌簇集成团或散在分布于牙根表面暴露的牙本质小管开口处；C组可见大量的球菌、杆菌侵入牙本质小管内侧，同时分布于管间牙本质上，牙本质小管内胶原纤维排列错杂。 结论：不同感染状态下牙本质小管内细菌定植情况存在差异，慢性根尖周炎患牙根管细菌定植阳性率最高，主要集中在根尖1/3段，并以生物膜的形式存在，形成了感染难以清除的区域；慢性牙周炎患牙细菌定植主要集中在根冠1/3牙本质小管外侧，通过牙本质小管对牙髓组织产生影响；牙周牙髓联合病变牙本质小管内定植的细菌对其发生发展过程起到了重要的作用，因此临床治疗中不仅要控制牙周组织感染，，牙髓组织的感染控制也不容忽视。
[Abstract]:Objective: to investigate the differences of bacterial colonization in root canals under different infection conditions (chronic apical periodontitis, chronic periodontitis and periodontal pulp disease). Materials and methods: 27 cases of periodontitis were included in this study. Group A was treated with chronic apical periodontitis, group A with chronic periodontitis (n = 10) and group), B with chronic periodontitis (n = 10) and), C with periodontal pulp disease (n = 7). Histological BrownBrenn staining and scanning electron microscopy (SEM) were used to observe the ultrastructure of the samples. The freshly extracted teeth were split into two halves along the long axis of the teeth, and half of the teeth were made histological sections. BrownBrenn staining was used to observe the ultrastructure of the samples. The other half was observed by scanning electron microscope. Results: bacterial staining showed that the positive rates of bacterial colonization on the root canal of chronic periapical periodontitis, chronic periodontitis and periodontal pulp syndesis were 1 / 3 and 1 / 3 of the root tip respectively (P 0.05). In group A, the depth of invading dentine tubules was 100-1100 渭 m, mainly concentrated at 1 / 3 of the root tip, while in group B, the depth of invading dentin tubules was 50-700 渭 m, and the root crown was the most serious. In group C, only a few bacteria were observed invading the medial dentin tubules with a depth of 40-100 渭 m. The results of scanning electron microscope showed that a large number of cocci were found in group A, and the bacillus were embedded in the amorphous matrix, attached to the root canal wall as biofilm, or invaded into the dentine tubules or distributed on the intertube dentin. In group B, bacteria were clustered or scattered at the orifice of dentin tubules exposed to the surface of the root. In group C, a large number of cocci and bacilli invaded the medial side of the dentine tubules and distributed in the intertube dentin. The collagenous fibers in the dentine tubules were disordered. Conclusion: there are differences in bacterial colonization in dentine canals under different infection conditions. The positive rate of bacterial colonization in dental canals with chronic periapical periodontitis is the highest, mainly in 1 / 3 segment of root tip and in the form of biofilm. Forming an area where infection is difficult to remove; Bacterial colonization of chronic periodontitis was mainly located on the lateral side of dentin tubules in 1 / 3 of root crown, which had an effect on pulp tissue through dentine tubules. Bacterial colonization in dentine tubules of periodontal pulp synpathic lesions plays an important role in the process of its occurrence and development, so not only periodontal infection should be controlled in clinical treatment, but also dental pulp infection should not be ignored.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R780.2
本文编号：2404218
[Abstract]:Objective: to investigate the differences of bacterial colonization in root canals under different infection conditions (chronic apical periodontitis, chronic periodontitis and periodontal pulp disease). Materials and methods: 27 cases of periodontitis were included in this study. Group A was treated with chronic apical periodontitis, group A with chronic periodontitis (n = 10) and group), B with chronic periodontitis (n = 10) and), C with periodontal pulp disease (n = 7). Histological BrownBrenn staining and scanning electron microscopy (SEM) were used to observe the ultrastructure of the samples. The freshly extracted teeth were split into two halves along the long axis of the teeth, and half of the teeth were made histological sections. BrownBrenn staining was used to observe the ultrastructure of the samples. The other half was observed by scanning electron microscope. Results: bacterial staining showed that the positive rates of bacterial colonization on the root canal of chronic periapical periodontitis, chronic periodontitis and periodontal pulp syndesis were 1 / 3 and 1 / 3 of the root tip respectively (P 0.05). In group A, the depth of invading dentine tubules was 100-1100 渭 m, mainly concentrated at 1 / 3 of the root tip, while in group B, the depth of invading dentin tubules was 50-700 渭 m, and the root crown was the most serious. In group C, only a few bacteria were observed invading the medial dentin tubules with a depth of 40-100 渭 m. The results of scanning electron microscope showed that a large number of cocci were found in group A, and the bacillus were embedded in the amorphous matrix, attached to the root canal wall as biofilm, or invaded into the dentine tubules or distributed on the intertube dentin. In group B, bacteria were clustered or scattered at the orifice of dentin tubules exposed to the surface of the root. In group C, a large number of cocci and bacilli invaded the medial side of the dentine tubules and distributed in the intertube dentin. The collagenous fibers in the dentine tubules were disordered. Conclusion: there are differences in bacterial colonization in dentine canals under different infection conditions. The positive rate of bacterial colonization in dental canals with chronic periapical periodontitis is the highest, mainly in 1 / 3 segment of root tip and in the form of biofilm. Forming an area where infection is difficult to remove; Bacterial colonization of chronic periodontitis was mainly located on the lateral side of dentin tubules in 1 / 3 of root crown, which had an effect on pulp tissue through dentine tubules. Bacterial colonization in dentine tubules of periodontal pulp synpathic lesions plays an important role in the process of its occurrence and development, so not only periodontal infection should be controlled in clinical treatment, but also dental pulp infection should not be ignored.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R780.2
【参考文献】
相关期刊论文 前2条
1 郭惠杰;岳林;;粪肠球菌在根管内定植模式的体外研究[J];北京大学学报(医学版);2009年06期
2 郭惠杰;岳林;高岩;;感染根管内细菌定植状态的观察[J];北京大学学报(医学版);2011年01期
本文编号：2404218
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