Department of Oral Rehabilitation Faculty of Dentistry, University of Khartoum, Khartoum, Sudan.
Wellcome Wolfson Institute for Experimental Medicine, Faculty of Medicine Dentistry and Biomedical Sciences, Queen's University of Belfast, Belfast, United Kingdom.
Eur Endod J. 2021 Apr;6(1):50-55. doi: 10.14744/eej.2020.52297. Epub 2021 Mar 3.
To investigate the prevalence of key endodontic pathogens and their association with the clinical features and the cause of apical periodontitis.
The study population included patients referred to Khartoum Dental teaching Hospital, Sudan for endodontic treatment. Samples were collected from single-rooted teeth carious or traumatised teeth with clinical and radiographic evidence of apical periodontitis. The endodontic pathogens Porphyromonas endodontalis, Fusobacterium nucleatum and Treponema denticola were quantified by real time polymerase chain reaction (qPCR). The prevalence of each species was identified at both a low detection threshold (>50 bacteria) and a high detection threshold (>1000 bacteria).
75 patients (mean age 30.1 yrs SD 10.1) were included in the analysis. The most prevalent bacterium at both the low and high threshold was F. nucleatum followed by T. denticola at the low threshold and P. endodontalis at the high threshold. There was no association with symptoms at the low detection threshold, but at high threshold P. endodontalis was associated with swelling, adjusted odds ratio (OR), 9.32 95%CI 1.11- 78.66, P=0.04. All species were more prevalent in apical periodontitis due to caries only at the low detection threshold, OR=5.01 (P=0.006) for T. denticola; 4.84 (P=0.01) for F. nucleatum; and 3.62 (P=0.03) for P. endodontalis.
There was a high prevalence of the F. nucleatum, T. denticola and P. endodontalis in apical periodontitis associated with caries. None of these bacterial were associated with pain but the presence of P. endodontalis at high levels was associated with swelling.
调查主要牙髓病原体的流行情况及其与根尖周炎临床特征和病因的关系。
研究对象为苏丹喀土穆牙科教学医院因牙髓病就诊的患者。从临床和影像学显示有根尖周炎的单个根牙龋病或外伤牙中采集样本。采用实时聚合酶链反应（qPCR）定量检测牙髓病原体牙髓卟啉单胞菌、核梭杆菌和中间普氏菌。以低检测阈值（>50 细菌）和高检测阈值（>1000 细菌）鉴定每种细菌的流行率。
75 例患者（平均年龄 30.1 岁，标准差 10.1）纳入分析。在低检测阈值和高检测阈值下，最常见的细菌均为核梭杆菌，其次是低检测阈值下的中间普氏菌和高检测阈值下的牙髓卟啉单胞菌。在低检测阈值下，症状与任何一种细菌均无相关性，但在高检测阈值下，牙髓卟啉单胞菌与肿胀相关，调整后的比值比（OR）为 9.32（95%CI 1.11-78.66），P=0.04。在低检测阈值下，所有细菌在龋病引起的根尖周炎中更为常见，中间普氏菌的 OR=5.01（P=0.006）；核梭杆菌的 OR=4.84（P=0.01）；牙髓卟啉单胞菌的 OR=3.62（P=0.03）。
在龋病相关根尖周炎中，核梭杆菌、中间普氏菌和牙髓卟啉单胞菌的流行率较高。这些细菌均与疼痛无关，但高水平的牙髓卟啉单胞菌与肿胀有关。
