上海口腔医学

上海口腔医学 ›› 2021, Vol. 30 ›› Issue (4): 374-378.doi: 10.19439/j.sjos.2021.04.007

• 论著 • 上一篇    下一篇

三重抗生素糊剂对乳牙感染根管中微生物的影响

蔡文燕, 周淑, 林良缘   

  1. 南京医科大学附属儿童医院 口腔科,江苏 南京 210008
  • 收稿日期:2020-06-12 修回日期:2020-08-05 出版日期:2021-08-25 发布日期:2021-09-23
  • 通讯作者: 周淑,E-mail:cwy19901026@163.com
  • 作者简介:蔡文燕（1990-）,女,硕士研究生,医师,E-mail:xjr6q4@163.com
  • 基金资助:
    国家自然科学基金（81701011）

Effect of triple antibiotic paste on microorganisms in root canals of deciduous teeth

CAI Wen-yan, ZHOU Shu, LIN Liang-yuan   

  1. Department of Stomatology, Children's Hospital of Nanjing Medical University. Nanjing 210008, Jiangsu Province, China
  • Received:2020-06-12 Revised:2020-08-05 Online:2021-08-25 Published:2021-09-23

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摘要： 目的: 探讨三重抗生素糊剂对乳牙根尖周炎不同分期感染根管中微生物样本的影响。方法: 将2017年4月—2020年4月南京医科大学附属儿童医院口腔科收治的89例儿童乳牙根尖周炎患儿纳入研究,根据临床症状及根尖X线片,将患儿分为急性炎症组和慢性炎症组。收集感染根管内感染样本,对样本进行细菌鉴定、分离与纯化,分析2组患儿感染根管内微生物检出情况和厌氧菌构成情况。制备标准菌液,采用纸片扩散法比较三重抗生素糊剂和氢氧化钙糊剂对常见厌氧菌的抑菌性以及不同厌氧菌对三重抗生素糊剂的敏感性。采用SPSS 20.0软件包对数据进行统计学分析。结果: 急性和慢性炎症组患儿感染根管内微生物均以厌氧菌为主;2组患儿感染根管内需氧菌和厌氧菌检出率相比,差异无统计学意义（P>0.05）。感染根管内厌氧菌检出率前5位依次为消化链球菌、拟杆菌、粪肠球菌、牙龈卟啉单胞菌、具核梭杆菌,急性炎症组患儿感染根管内牙龈卟啉单胞菌、具核梭杆菌、拟杆菌检出率高于慢性炎症组,粪肠球菌检出率低于慢性炎症组（P<0.05）。三重抗生素糊剂对消化链球菌、拟杆菌、粪肠球菌、牙龈卟啉单胞菌、具核梭杆菌形成的抑菌环直径显著大于氢氧化钙糊剂（P<0.05）;各细菌对三重抗生素糊剂敏感性从大到小依次为粪肠球菌、消化链球菌、牙龈卟啉单胞菌、具核梭杆菌、拟杆菌,差异具有统计学意义（P<0.05）。结论: 三重抗生素糊剂对急、慢性乳牙根尖周炎感染根管中常见菌均有较好的抑菌效果。

关键词: 三重抗生素糊剂, 氢氧化钙糊剂, 儿童, 乳牙根尖周炎, 根管治疗, 抑菌性

Abstract: PURPOSE: To analyze the effect of triple antibiotic paste on root canal microorganisms in periapical periodontitis of different stages. METHODS: Eighty-nine children with periapical periodontitis of deciduous teeth in Department of Stomatology, Children's Hospital of Nanjing Medical University from April 2017 to April 2020 were enrolled, and divided into two groups according to the clinical symptoms and root X-ray films, i.e., acute inflammation group and chronic inflammation group. Samples of infected root canals were collected for bacterial identification, isolation and purification. The detection of microorganisms in the infected root canal and the composition of anaerobic microorganisms were analyzed in both groups. Disk diffusion method was used to observe antimicrobial effects of triple antibiotic paste and calcium hydroxide against common anaerobic bacteria, and the sensitivity of different anaerobic bacteria to triple antibiotic paste. Statistical analysis was completed by SPSS 20.0 software package. RESULTS: The microorganisms in both groups were mainly anaerobic bacteria. The detection rates of aerobes and anaerobic bacteria in the infected root canals had no significant difference between the two groups (P>0.05). The top five anaerobes detected in infected root canals were Peptostreptococcus, Bacteroidetes, Enterococcus faecalis, Porphyromonas gingivalis and Fusobacterium nucleatum. The detection rates of Porphyromonas gingivalis, Fusobacterium nucleatum and Bacteroidetes in infected root canal of acute inflammation group were significantly higher than those of chronic inflammation group, and the detection rate of Enterococcus faecalis was significantly lower than that of chronic inflammation group(P<0.05). The bacteriostatic circle diameter of triple antibiotic paste against Peptostreptococcus, Bacteroidetes, Enterococcus faecalis, Porphyromonas gingivalis and Fusobacterium nucleatum was significantly larger than that of calcium hydroxide(P<0.05). The sensitivity of different anaerobic bacteria to triple antibiotic paste was highest in Enterococcus faecalis, followed by Peptostreptococcus, Porphyromonas gingivalis, Fusobacterium nucleatum, and Bacteroidetes(P<0.05). CONCLUSIONS: Triple antibiotic paste has good antimicrobial effect on the common bacteria in the infected root canal of acute and chronic periapical periodontitis.

Key words: Triple antibiotic paste, Calcium hydroxide paste, Children, Periapical periodontitis of deciduous teeth, Root canal therapy, Antimicrobial effect

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