Assistant professor, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey.
Research assistant, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey.
Am J Orthod Dentofacial Orthop. 2014 Oct;146(4):430-6. doi: 10.1016/j.ajodo.2014.06.009.
The aim of this study was to investigate the presence of transient bacteremia after a piezocision procedure.
The sample consisted of 30 subjects (24 women, 6 men; mean age, 19.6 ± 0.7 years; range, 18.1-22.4 years) with the American Society of Anesthesiologists' physical status I. All patients had Class I skeletal and dental relationships and had fixed orthodontic treatment with the Damon system. The piezocision surgery was performed 1 week after the placement of the orthodontic appliances in all patients. Two 20-mL venous blood samples were collected before and 30 to 60 seconds after the first microincision using an aseptic technique. The samples were inoculated into BACTEC Plus aerobic and anaerobic blood culture bottles and were assessed in the BACTEC blood culture analyzer (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md). The results were analyzed statistically using the McNemar test, with P <0.05 indicating statistical significance.
No significant difference between the preoperative and postoperative samples was determined with respect to transient bacteremia (P = 0.250). No bacteremia was detected in the pretreatment samples, although Gemella sanguinis, Streptococcus pluranimalium, and Streptococcus mitis/oralis were detected in 3 postoperative blood samples.
The piezocision procedure might be related to transitory bacteremia. Hence, orthodontists should consider the possibility of bacterial endocarditis in at-risk patients when piezocision is part of the treatment plan.
本研究旨在探讨牙周超声骨刀（piezocision）术后是否存在一过性菌血症。
本研究共纳入 30 名患者（24 名女性，6 名男性；平均年龄 19.6±0.7 岁，范围 18.1-22.4 岁），美国麻醉医师协会（ASA）身体状况分级 I 级。所有患者均为骨骼和牙齿Ⅰ类关系，且接受 Damon 系统固定正畸治疗。所有患者均在佩戴正畸矫治器 1 周后接受牙周超声骨刀手术。采用无菌技术，分别于术前和首次微切口后 30-60 秒时采集 2 份 20mL 静脉血样。将样本接种于 BACTEC Plus 需氧和厌氧血培养瓶中，并在 BACTEC 血培养分析仪（Becton Dickinson Diagnostic Instrument Systems，Sparks，MD）中进行评估。采用 McNemar 检验对结果进行统计学分析，P＜0.05 表示差异有统计学意义。
与术前样本相比，术后样本未发现一过性菌血症（P=0.250）有显著差异。尽管在 3 份术后血样中检测到了血链球菌、猪链球菌和缓症链球菌，但预处理样本中未检测到菌血症。
牙周超声骨刀手术可能与短暂性菌血症有关。因此，当牙周超声骨刀手术成为治疗计划的一部分时，正畸医生应考虑高危患者发生细菌性心内膜炎的可能性。
