Hirschfeld Josefine, Kawai Toshihisa
Center for Dental and Oral Medicine, Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstraße 17, D-53111 Bonn, Germany.
Cardiovasc Hematol Disord Drug Targets. 2015;15(1):70-84. doi: 10.2174/1871529x15666150108115241.
Gingivitis and periodontitis are both highly prevalent gum diseases characterized by an accumulation of a polymicrobial biofilm (dental plaque) around teeth and inflammation in adjacent soft tissues. During dental procedures, even tooth brushing, these bacteria and their components, such as endotoxin, can easily disseminate into the systemic circulation through minor or major gingival injuries. Particularly in immuno-compromised subjects or patients with preexisting pathologic conditions, bacteremia may lead to bacterial infection of distant organs, which may cause immunological reactions. Oral bacteria and endotoxins have been found in sepsis, infective endocarditis, lung infection, liver disease and many other potentially lethal disorders. This article presents a review of the possible pathologic consequences of bacteremia originating in the oral cavity and points out the most commonly affected organs as well as preventive and treatment measures. At the present time, plaque control by subjects and/or dental professionals is one of the most effective means to prevent the onset and progression of oral bacteremia-induced systemic diseases.
牙龈炎和牙周炎都是非常常见的牙龈疾病，其特征是牙齿周围有多种微生物生物膜（牙菌斑）积聚以及相邻软组织发炎。在牙科手术过程中，甚至在刷牙时，这些细菌及其成分，如内毒素，都可以通过轻微或严重的牙龈损伤轻易地扩散到体循环中。特别是在免疫功能低下的受试者或已有病理状况的患者中，菌血症可能导致远处器官的细菌感染，进而可能引发免疫反应。在败血症、感染性心内膜炎、肺部感染、肝脏疾病和许多其他潜在致命疾病中都发现了口腔细菌和内毒素。本文综述了源自口腔的菌血症可能产生的病理后果，指出了最常受影响的器官以及预防和治疗措施。目前，由受试者和/或牙科专业人员进行牙菌斑控制是预防口腔菌血症引起的全身性疾病的发生和发展的最有效手段之一。
