根尖周炎的免疫调节机制及治疗研究进展  

Progress of research on immunomodulatory mechanisms of periapical periodontitis and treatment

作　　者：文照取[1] 王燕一[1] WEN Zhao-qu;WANG Yan-yi(Hainan Hospital,Chinese PLA General Hospital,Sanya,Hainan 572000,China)

机构地区：[1]解放军总医院海南医院口腔科,海南三亚572000

出　　处：《中华医院感染学杂志》2022年第17期2716-2720,共5页Chinese Journal of Nosocomiology

摘　　要：根尖周炎是口腔科一种很常见的主要发生在患牙根尖周组织间的炎症性疾病,其病因主要以牙髓感染坏死为主,引起牙髓感染坏死的病因有很多,其中因细菌感染导致牙髓坏死最为常见。若有感染坏死的牙髓不及时给予治疗,根管内残存的坏死组织和细菌发生反应,其代谢分解产物会进一步扩散传播至根尖周组织,继而可能引起根尖周局部组织的炎性改变,形成根尖周炎。因此,根尖周炎是根尖周组织抵抗病原微生物侵袭产生的一种免疫相互交叉作用的结果。近年来,细菌与宿主免疫反应的作用引起越来越多的关注。细菌和宿主免疫反应释放不同细胞因子、内毒素及基质金属蛋白酶等,可不同程度调节根尖周炎的病理变化。本文就细菌感染在免疫细胞和免疫分子等方面对根尖周炎的影响进行综述,更好地了解细菌免疫调节与根尖周炎的关系,为根尖周炎的治疗提供新思路。OBJECTIVE Periapical periodontitis is an inflammatory disorder of periradicular tissues developed from endodontic infections.Microbes in the oral environment are the primary cause of infection in the root canal system as well as dental pulp and periapical tissues.One of the consequences of endodontic infections is a chronic inflammatory disorder of periradicular tissues.It involves the dynamic interaction between host immune response and microbial factors at the interface between infected radicular pulp and periodontal ligament,and it is usually manifested by localized inflammation,hard tissue resorption,and destruction of other periapical tissue.The exact etiology of apical periodontitis has not been well elucidated.Evidence has shown that bacteria and their toxins,enzymes,and matrix metalloproteinases play a significant role in inducing host immune response and regulate pathological changes of periapical periodontitis.The objective of this review is to analyze the influence of bacterial infection on periapical periodontitis by immune cells and immune molecules and understand the relationship between bacterial immunoregulation and periapical periodontitis,which may provide new ideas for treatment of periapical periodontitis.

关 键 词：根尖周炎 牙髓感染 病原微生物 免疫应答 治疗 

分 类 号：R781.4[医药卫生—口腔医学]