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全口拔牙对定植于口腔黏膜的牙周病原体的短期影响。

Short-term effect of full-mouth extraction on periodontal pathogens colonizing the oral mucous membranes.

作者信息

Danser M M, van Winkelhoff A J, de Graaff J, Loos B G, van der Velden U

机构信息

Department of Periodontology, Academic Centre for Dentistry Amsterdam, The Netherlands.

出版信息

J Clin Periodontol. 1994 Aug;21(7):484-9. doi: 10.1111/j.1600-051x.1994.tb00412.x.

Abstract

In this study, we investigate the prevalence of selected periodontal pathogens on the oral mucous membranes before and after full-mouth tooth extractions in patients with severe periodontitis. 8 patients were microbiologically examined 2 x before and 2 x after extraction; several locations on the oral mucous membranes, saliva, supra- and subgingival plaque, were sampled. Besides their presence in subgingival plaque, we detected before extraction on the mucous membranes Actinobacillus actinomycetemcomitans in 2 patients (mean 0.03%), Porphyromonas gingivalis in 6 patients (mean 9%), and Prevotella intermedia (mean 2%) and other Prevotella species (mean 7%) in all patients. At 1 and 3 months after extraction, A. actinomycetemcomitans and P. gingivalis could not be detected in any of these patients on the oral mucous membranes and in saliva, while from all patients still P. intermedia (mean 3%) and the other blackpigmented Prevotella species (mean 4%) could be isolated. These results indicate that the preferable habitat for A. actinomycetemcomitans and P. gingivalis is dental plaque in subgingival lesions. P. intermedia and the other blackpigmented Prevotella species can colonize the oral mucous membranes of edentulous patients irrespective of the presence of a subgingival microflora. We speculate that in periodontal patients the colonization of mucous membranes with P. gingivalis and A. actinomycetemcomitans is transient in nature and most likely the result of dissemination from the subgingival microflora. Thus it seems unlikely that edentulous patients constitute a reservoir of infection of P. gingivalis A. actinomycetemcomitans.

摘要

在本研究中,我们调查了重度牙周炎患者全口拔牙前后口腔黏膜上特定牙周病原体的流行情况。8名患者在拔牙前和拔牙后分别进行了2次微生物学检查;对口腔黏膜、唾液、龈上和龈下菌斑的多个部位进行了采样。除了在龈下菌斑中存在外,我们在拔牙前检测到2例患者的口腔黏膜上有伴放线放线杆菌(平均0.03%),6例患者有牙龈卟啉单胞菌(平均9%),所有患者均有中间普氏菌(平均2%)和其他普氏菌属(平均7%)。拔牙后1个月和3个月,在这些患者的口腔黏膜和唾液中均未检测到伴放线放线杆菌和牙龈卟啉单胞菌,而所有患者仍可分离出中间普氏菌(平均3%)和其他产黑色素普氏菌属(平均4%)。这些结果表明,伴放线放线杆菌和牙龈卟啉单胞菌的适宜生存环境是龈下病变中的牙菌斑。中间普氏菌和其他产黑色素普氏菌属可以在无牙患者的口腔黏膜定植,而与龈下微生物群的存在无关。我们推测,在牙周炎患者中,牙龈卟啉单胞菌和伴放线放线杆菌在黏膜上的定植本质上是短暂的,很可能是龈下微生物群传播的结果。因此,无牙患者似乎不太可能构成牙龈卟啉单胞菌和伴放线放线杆菌的感染源。

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