Department of Endodontics, School of Stomatology, Tianjin Medical University, Tianjin, China.
Department of Stomatology, Tianjin First Central Hospital, Tianjin, China.
J Endod. 2020 Jun;46(6):763-770. doi: 10.1016/j.joen.2020.02.011. Epub 2020 Apr 12.
The composition and relative abundance of bacterial species change throughout the development of dental caries; however, how these changes relate to clinical symptoms remains elusive. In this study, we explored the relationship between clinical symptoms and specific microorganisms in advanced dentinal caries.
A total of 111 permanent premolars and molars were used to simulate the progression from caries to pulpitis indirectly. Clinical symptoms were evaluated, and teeth were diagnosed according to the diagnostic criteria of the American Association of Endodontics. Samples were collected for 16S ribosomal DNA sequencing. Associations between the microbiota and clinical symptoms/diagnosis and the relationship between alpha diversity and clinical symptoms/diagnosis were evaluated independently by the linear discriminant analysis effect size and Spearman rank correlation analyses.
The 16S ribosomal DNA sequences were assigned to 13,852 operational taxonomic units. The linear discriminant analysis effect size and Spearman correlations unveiled negative associations between the relative abundance of Bacteroidia and Gammaproteobacteria and referred pain, Gammaproteobacteria and the electric pulp test response, and Actinomyces and Propionibacterium and diagnosis (r < 0.0, P < .05). Conversely, the relative abundance of Lactobacillus was positively correlated to referred pain, the cold test, the percussion response, and diagnosis (r > 0, P < .05). Lactobillus reuteri, a probiotic bacterium, was more abundant in teeth with referred pain and teeth diagnosed with symptomatic irreversible pulpitis. The Spearman correlation between alpha diversity and clinical symptoms/diagnosis was not significant (P > .05).
Clinical symptoms and diagnosis were significantly associated with specific microorganisms in the most advanced layers of dentinal caries.
在龋齿的发展过程中，细菌的组成和相对丰度会发生变化；然而，这些变化与临床症状的关系仍不清楚。在这项研究中，我们探讨了临床症状与牙本质龋进展过程中特定微生物之间的关系。
共使用 111 颗恒前磨牙和磨牙间接模拟龋病向牙髓炎的进展。评估临床症状，并根据美国牙髓病学会的诊断标准对牙齿进行诊断。采集样本进行 16S 核糖体 DNA 测序。采用线性判别分析效应大小和 Spearman 秩相关分析，分别评估微生物群与临床症状/诊断的关系以及 alpha 多样性与临床症状/诊断的关系。
16S 核糖体 DNA 序列被分配到 13852 个操作分类单元。线性判别分析效应大小和 Spearman 相关性揭示了变形菌纲和γ变形菌纲与牵涉痛、γ变形菌纲与电活力测试反应、放线菌属和丙酸杆菌属与诊断呈负相关（r<0.0，P<0.05）。相反，乳杆菌属的相对丰度与牵涉痛、冷测试、叩诊反应和诊断呈正相关（r>0，P<0.05）。具有牵涉痛和诊断为症状性不可逆牙髓炎的牙齿中，益生菌乳杆菌属的相对丰度更高。alpha 多样性与临床症状/诊断之间的 Spearman 相关性不显著（P>0.05）。
临床症状和诊断与牙本质龋最深处的特定微生物显著相关。
