Hibino Kyoko, Wong Ricky W K, Hägg Urban, Samaranayake Lakshman P
Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
Int J Paediatr Dent. 2009 Sep;19(5):301-8. doi: 10.1111/j.1365-263X.2009.00988.x. Epub 2009 Apr 16.
Candida is an opportunistic pathogen present in about 50-60% of the healthy human population, and becomes pathogenic when the host immune defence is undermined such as in HIV infection. Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis, and the presence of orthodontic and other oral appliances seems to alter the oral ecological environment, hence may tip the balance to favour the candidal presence.
The purpose of this paper was to review the literature with specific attention to prevalence; intra-oral density of the candidal organisms; and Candida carriage status in orthodontic patients before, during, and after treatment.
The limited amount of literature demonstrated that the density of Candida increases; the most common Candida species isolated in the orthodontic patients was C. albicans; and that there seems to be a direct relationship between the presence of a removable appliance, Candida, and low salivary pH levels. No healthy patients developed Candida infection from the orthodontic appliances. However, there seems to be a trend that some non-Candida carriers converted to Candida carriers following the insertion of the appliances by unknown mechanism. This may indicate a more cautious approach when providing orthodontic treatments to immunocompromised children concerning the possible increased risk of candidal infection.
念珠菌是一种机会致病菌，约50 - 60%的健康人群体内都有该菌存在，当宿主免疫防御功能受损时，如在感染HIV的情况下，念珠菌就会致病。白色念珠菌在口腔的黏附和定植是念珠菌病的起始步骤，正畸矫治器及其他口腔器具的存在似乎会改变口腔生态环境，因此可能会打破平衡，使念珠菌更易滋生。
本文旨在回顾相关文献，特别关注患病率、念珠菌在口腔内的密度，以及正畸患者在治疗前、治疗期间和治疗后的念珠菌携带状况。
有限的文献表明，念珠菌密度增加；正畸患者中分离出的最常见念珠菌种类是白色念珠菌；可摘矫治器的存在、念珠菌和唾液低pH值之间似乎存在直接关系。没有健康患者因正畸矫治器而发生念珠菌感染。然而，似乎存在一种趋势，即一些非念珠菌携带者在佩戴矫治器后，不明原因地转变为念珠菌携带者。这可能表明，在为免疫功能低下的儿童提供正畸治疗时，鉴于念珠菌感染风险可能增加，需要采取更为谨慎的方法。
