Chair and Department of Dental Surgery, Poznan University of Medical Sciences, Poznan, Poland.
Med Sci Monit. 2012 Feb;18(2):CR93-104. doi: 10.12659/msm.882464.
Dentigenous, infectious foci are frequently associated with the development of various diseases. The role of such foci in the evolution of endocarditis still remains unclear. This article presents the concluding results of an interdisciplinary study verifying the influence of dentigenous, infectious foci on the development of infective endocarditis.
MATERIAL/METHODS: The study subjects were 60 adult patients with history of infective endocarditis and coexistent acquired heart disease, along with the presence at least 2 odontogenic infectious foci (ie, 2 or more teeth with gangrenous pulp and periodontitis). The group had earlier been qualified for the procedure of heart valve replacement. Swabs of removed heart valve tissue with inflammatory lesions and blood were then examined microbiologically. Swabs of root canals and their periapical areas, of periodontal pockets, and of heart valves were also collected.
Microbial flora, cultured from intradental foci, blood and heart valves, fully corresponded in 14 patients. This was accompanied in almost all cases by more advanced periodontitis (2nd degree, Scandinavian classification), irrespective of the bacterial co-occurrence mentioned. In the remaining patients, such consistency was not found.
Among various dentigenous, infectious foci, the intradental foci appear to constitute a risk factor for infective endocarditis.
牙源性、感染病灶常与各种疾病的发生有关。这些病灶在感染性心内膜炎的发展中的作用仍不清楚。本文介绍了一项多学科研究的结论性结果，该研究旨在验证牙源性、感染病灶对感染性心内膜炎发展的影响。
材料/方法：研究对象为 60 名患有感染性心内膜炎和获得性心脏病且至少有 2 个牙源性感染病灶（即 2 个或更多有坏疽牙髓和牙周炎的牙齿）的成年患者。该组患者之前已具备进行心脏瓣膜置换术的条件。然后对有炎症病变的心脏瓣膜组织和血液进行微生物学检查。同时还收集了根管及其根尖区域、牙周袋和心脏瓣膜的拭子。
在 14 名患者中，从牙内病灶、血液和心脏瓣膜培养出的微生物菌群完全一致。几乎所有这些患者都伴有更严重的牙周炎（斯堪的纳维亚分类法 2 级），而不论是否存在提到的细菌共存。在其余患者中，未发现这种一致性。
在各种牙源性感染病灶中，牙内病灶似乎构成了感染性心内膜炎的一个危险因素。
