不同感染狀態(tài)下根管內(nèi)細(xì)菌定植狀態(tài)的初步研究
發(fā)布時(shí)間：2019-01-07 21:58
【摘要】：目的：本研究旨在探究不同感染狀態(tài)下（慢性根尖周炎、慢性牙周炎、牙周牙髓聯(lián)合病變）根管內(nèi)細(xì)菌定植的情況與相互間的差異。 材料與方法：本研究共納入27例樣本，A組為慢性根尖周炎患牙（10例），B組為慢性牙周炎患牙（10例），C組牙周牙髓聯(lián)合病變患牙（7例）。采用組織學(xué)BrownBrenn染色法與掃描電鏡（SEM）相結(jié)合的方法對(duì)納入樣本進(jìn)行超微結(jié)構(gòu)觀察，將新鮮拔除的患牙沿牙長軸近遠(yuǎn)中向劈為兩半，一半做組織學(xué)切片，采用BrownBrenn染色觀察，另一半做掃描電鏡觀察。 結(jié)果：組織切片細(xì)菌染色顯示，慢性根尖周炎、慢性牙周炎以及牙周牙髓聯(lián)合病變根管冠1/3、根尖1/3牙本質(zhì)小管內(nèi)側(cè)細(xì)菌定植陽性率有統(tǒng)計(jì)學(xué)差異（P 0.05）。其中，A組細(xì)菌侵入牙本質(zhì)小管深度為100-1100μm，主要集中在根尖1/3段；B組細(xì)菌可侵入牙本質(zhì)小管深度為50-700μm，根冠1/3段最為嚴(yán)重；C組僅觀察到少量細(xì)菌侵入牙本質(zhì)小管內(nèi)側(cè)，深度為40-100μm。掃描電鏡結(jié)果顯示，A組可見大量球菌、桿菌鑲嵌于無定形的基質(zhì)中，以生物膜的形式附著于根管壁，或侵入牙本質(zhì)小管內(nèi)，或分布于管間牙本質(zhì)上；B組可見細(xì)菌簇集成團(tuán)或散在分布于牙根表面暴露的牙本質(zhì)小管開口處；C組可見大量的球菌、桿菌侵入牙本質(zhì)小管內(nèi)側(cè)，同時(shí)分布于管間牙本質(zhì)上，牙本質(zhì)小管內(nèi)膠原纖維排列錯(cuò)雜。 結(jié)論：不同感染狀態(tài)下牙本質(zhì)小管內(nèi)細(xì)菌定植情況存在差異，慢性根尖周炎患牙根管細(xì)菌定植陽性率最高，主要集中在根尖1/3段，并以生物膜的形式存在，形成了感染難以清除的區(qū)域；慢性牙周炎患牙細(xì)菌定植主要集中在根冠1/3牙本質(zhì)小管外側(cè)，通過牙本質(zhì)小管對(duì)牙髓組織產(chǎn)生影響；牙周牙髓聯(lián)合病變牙本質(zhì)小管內(nèi)定植的細(xì)菌對(duì)其發(fā)生發(fā)展過程起到了重要的作用，因此臨床治療中不僅要控制牙周組織感染，，牙髓組織的感染控制也不容忽視。
[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.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R780.2
本文編號(hào)：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.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R780.2
【參考文獻(xiàn)】
相關(guān)期刊論文 前2條
1 郭惠杰;岳林;;糞腸球菌在根管內(nèi)定植模式的體外研究[J];北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2009年06期
2 郭惠杰;岳林;高巖;;感染根管內(nèi)細(xì)菌定植狀態(tài)的觀察[J];北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2011年01期
本文編號(hào)：2404218
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