Schein W, Meryn S
Neue Wiener Privatklinik, Wien.
Wien Klin Wochenschr. 1994;106(17):547-9.
In view of the possibility of reinfection after successful treatment and the pitfalls in eradicating Helicobacter pylori (H. pylori) from gastric mucosa, it is of great interest to identify natural reservoirs for this organism, other than the stomach. This review discusses the results of investigations as to whether H. pylori can be harboured in the microaerobic environment of dental plaques in saliva. Only few data are available on the prevalence of H. pylori in the mouth. Data from conventional microbiological technique studies are contradictory, with the prevalence varying from 3.4% to 100%. Different diagnostic procedures were used to identify H. pylori, but only a few seem to be reliable enough to detect H. pylori in clinical samples taken from the mouth. Moreover, insufficient information is provided on the role of hygienic conditions in the investigated oral cavity and the existence of gingival or periodontal disease. The mechanisms of oral colonisation with H. pylori are still unknown. Human periodontal disease is associated with a complex microflora in which more than 350 microbial species can be encountered. The periodontal pocket may be important as a natural reservoir for H. pylori, because it can provide microaerobic conditions. Recently reported molecular techniques such as the highly sensitive and specific polymerase chain reaction (PCR) may help to clarify the prevalence of oral carriage of H. pylori in future.
鉴于成功治疗后存在再次感染的可能性以及从胃黏膜根除幽门螺杆菌(H. pylori)存在的困难,确定除胃以外该病原体的天然储存库具有重要意义。本综述讨论了关于唾液中牙菌斑微需氧环境是否可携带幽门螺杆菌的调查结果。关于幽门螺杆菌在口腔中的患病率仅有少量数据。传统微生物技术研究的数据相互矛盾,患病率从3.4%到100%不等。采用了不同的诊断程序来鉴定幽门螺杆菌,但似乎只有少数方法足够可靠,能够在从口腔采集的临床样本中检测到幽门螺杆菌。此外,关于所研究口腔中的卫生条件以及牙龈或牙周疾病的存在情况,提供的信息不足。幽门螺杆菌在口腔定植的机制仍然未知。人类牙周病与复杂的微生物群落有关,其中可发现350多种微生物。牙周袋作为幽门螺杆菌的天然储存库可能很重要,因为它可以提供微需氧环境。最近报道的分子技术,如高度灵敏和特异的聚合酶链反应(PCR),可能有助于在未来阐明幽门螺杆菌口腔携带的患病率。