Haapasalo M
Endod Dent Traumatol. 1989 Feb;5(1):1-10. doi: 10.1111/j.1600-9657.1989.tb00330.x.
A summary of a series of bacteriological studies of endodontic infections is presented in this article. The bacteriology of 62 root canal infections was studied with special attention focused on the occurrence, role and taxonomy of Bacteroides spp. All infections except one were mixed infections dominated usually by anaerobic bacteria. Four to 6 different species were present in most canals. Species of the genus Bacteroides were found more frequently than species of any other genus. Seventy-eight Bacteroides strains were isolated from 45 canals. B. buccae, B. intermedius, B. denticola, B. oris, B. oralis, and B. gingivalis were the most common Bacteroides spp. At the beginning of the treatment 35 of 62 teeth caused acute symptoms. The results indicated that symptoms were a result of the synergistic action of the mixed anaerobic flora. The presence of B. gingivalis, B. endodontalis, and B. buccae was more often related to acute cases than other Bacteroides spp. Black-pigmented Bacteroides and a new Bacteroides-like organism, Mitsuokella dentalis, seemed to increase the probability that acute symptoms would persist one week after the beginning of the treatment. However, the treatment result assessed after 4 weeks and after 1 year was not affected by the composition of the mixed anaerobic flora. Calcium hydroxide was the only canal disinfectant used. Its efficacy was proved by a bacteriological sample at the second appointment in 10 cases. All teeth were asymptomatic at the third appointment. The susceptibility of the isolated Bacteroides strains to penicillin G was also studied. Only 2 B. buccae strains and 2 B. denticola strains were resistant at a concentration of 2.4 micrograms/ml. The patients were randomly divided into 3 groups which received 1) no antibiotics, 2) penicillin V (650 mg x 3) for 7 days, or 3) for 12 weeks. There was no difference between the 3 groups in the healing of the periapical lesion after one year. All patients attended the 1-year control. Fifty cases showed complete healing, partial healing was obtained in 11 cases and in 1 case no healing was observed.
本文介绍了一系列牙髓感染细菌学研究的总结。对62例根管感染的细菌学进行了研究，特别关注拟杆菌属的发生、作用和分类学。除1例感染外，所有感染均为混合感染，通常以厌氧菌为主。大多数根管中存在4至6种不同的细菌。拟杆菌属的菌种比其他任何属的菌种更频繁地被发现。从45个根管中分离出78株拟杆菌。口腔拟杆菌、中间拟杆菌、齿龈拟杆菌、口拟杆菌、口腔拟杆菌和牙龈拟杆菌是最常见的拟杆菌属菌种。在治疗开始时，62颗牙齿中有35颗出现急性症状。结果表明，症状是混合厌氧菌协同作用的结果。牙龈拟杆菌、牙髓拟杆菌和口腔拟杆菌的存在比其他拟杆菌属菌种更常与急性病例相关。产黑色素拟杆菌和一种新的类拟杆菌生物体——牙密螺旋体，似乎增加了治疗开始后一周急性症状持续的可能性。然而，4周和1年后评估的治疗结果不受混合厌氧菌菌群组成的影响。氢氧化钙是唯一使用的根管消毒剂。在10例患者的第二次就诊时，通过细菌学样本证明了其有效性。所有牙齿在第三次就诊时均无症状。还研究了分离出的拟杆菌菌株对青霉素G的敏感性。在浓度为2.4微克/毫升时，只有2株口腔拟杆菌菌株和2株齿龈拟杆菌菌株耐药。患者被随机分为3组，分别接受1）不使用抗生素，2）青霉素V（650毫克×3次），疗程7天，或3）疗程12周。一年后，三组根尖周病变的愈合情况没有差异。所有患者均参加了1年的复查。50例显示完全愈合，11例部分愈合，1例未观察到愈合。
