慢性根尖周炎影响因素及其根管内病原菌定植情况  

Influencing factors for chronic periapical periodontitis and pathogens colonized in root canals

作　　者：王少华[1] 熊战胜 樊丽娟 梁峰[1] 刘培文 WANG Shao-hua;XIONG Zhan-sheng;FAN Li-juan;LIANG Feng;LIU Pei-wen(Zhengzhou Seventh People's Hospital,Zhengzhou,Henan 450016,China)

机构地区：[1]郑州市第七人民医院口腔科,河南郑州450016

出　　处：《中华医院感染学杂志》2023年第21期3279-3283,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划联合共建基金资助项目(LHGJ20191122)。

摘　　要：目的探讨慢性根尖周炎影响因素及其根管内病原菌定植情况.方法随机选取2020年10月-2022年10月郑州市第七人民医院收治的102例慢性根尖周炎患者为研究组,其他口腔门诊治疗的650例非慢性根尖周炎患者为对照组.统计慢性根尖周炎患者根管内病原菌定植情况及病原学特点,比较两组临床资料,予以多因素Logistic回归分析法分析慢性根尖周炎影响因素.结果慢性根尖周炎患者牙本质小管根冠1/3内侧细菌阳性检出率为71.57%.102例慢性根尖周炎患者患牙根管中共检出113株病原菌,其中革兰阳性菌占比较高,主要为葡萄球菌属.研究组年龄>60岁、刷牙时间≤3 min、刷牙方式错误、有既往不当口腔治疗史、牙冠填充不佳、有龋病、牙冠修复不佳、根管填充不佳、嚼食槟榔、长期应用抗菌药物患者占比均高于对照组(P<0.05).多因素Logistic回归分析结果显示,刷牙方式错误、有既往不当口腔治疗史、牙冠填充不佳、有龋病、牙冠修复不佳、根管填充不佳是慢性根尖周炎影响因素(P<0.05).结论慢性根尖周炎患者根管内病原菌定植以根冠为主,刷牙方式错误、有既往不当口腔治疗史、牙冠填充不佳、有龋病、牙冠修复不佳、根管填充不佳是慢性根尖周炎影响因素,且病原菌中革兰阳性菌占比较高,临床可据此给予针对性的预防及抗菌治疗.OBJECTIVE To explore the influencing factors for chronic periapical periodontitis and the pathogens colonized in the root canals.METHODS A total of 102 patients with chronic periapical periodontitis who were treated in Zhengzhou Seventh People's Hospital from Oct 2020 to Oct 2022 were randomly chosen as the study group,and 650 non-chronic periapical periodontitis patients who were treated in stomatology clinic were selected as the control group.The pathogens colonized in the root canal and the etiological characteristics were statistically analyzed,the clinical data were compared between the two groups,and multivariate logistic regression analysis was performed for the influencing factors for the chronic periapical periodontitis.RESULTS The positive rate of bacteria was 71.57%in the medial 1/3 of the root crown of the dentinal tubules of the patients with chronic periapical periodontitis.Totally 113 strains of pathogens were isolated from the root canals of the 102 patients with chronic periapical periodontitis,among which gram-positive bacteria were dominant,and the Staphylococcus was the predominant genus.The proportions of patients with more than 60 years of age,teeth brushing time no more than 3 min,incorrect brushing method,previous history of improper oral treatment,poor dental crown filling,dental caries,poor dental crown repair,poor root canal filling,chewing betel nut and long-term use of antibiotics were significantly higher in study group than in the control group(P<o.05).The result of multivariate logistic regression analysis showed that the incorrect teeth brushing method,previous history of improper dental treatment,poor dental crown filling,dental caries,poor dental crown repair and poor root canal filling were the influencing factors for the chronic periapical periodontitis(P<0.05).CONCLUSION The root crown is the major location where the pathogens are colonized in the root canal of the patients with chronic periapical periodontitis.The incorrect teeth brushing method,previous history of improper

关 键 词：慢性根尖周炎 根管 病原菌 定植 临床资料 影响因素 

分 类 号：R781.341[医药卫生—口腔医学]