Beighton D, Lynch E, Heath M R
Hunterian Dental Research Unit, London Hospital Medical College, Whitechapel, United Kingdom.
J Dent Res. 1993 Mar;72(3):623-9. doi: 10.1177/00220345930720031201.
Samples of altered or carious dentin for microbiological culture were obtained from 301 primary root-caries lesions in 59 patients by means of a standardized sampling procedure. This involved the cleansing of each root surface of extraneous supragingival plaque by means of a hand-held toothbrush and distilled water and the collection of the sample with a sterile dental excavator passed through the entire vertical dimension of each lesion. The total number of colony-forming units (cfu) in each sample and the numbers of mutans streptococci (primarily Streptococcus mutans), lactobacilli, yeasts, and Gram-positive pleomorphic rods (GPPR) were determined. Individual bacterial counts were expressed as log10 (cfu per sample), as a percentage of the total number of bacteria per sample, and as a frequency of isolation from lesions with different clinical diagnostic criteria. Clinical measurements of each lesion were made for color, texture, position relative to the gingival margin, and treatment need. Lesions classified as soft yielded significantly more bacteria, mutans streptococci, lactobacilli, and GPPR than leathery lesions, which yielded more bacteria than hard lesions. Lesions were classified into 5 treatment categories: soft and restore, leathery and restore, leathery and debride of caries; leathery and treat therapeutically; and hard no treatment. The total numbers of bacteria, mutans streptococci, lactobacilli, GPPR, and yeasts decreased significantly with decreasing treatment need. The frequency of isolation of mutans streptococci, lactobacilli, and yeasts was significantly greater from lesions requiring restoration and from lesions situated within 1 mm of the gingival margin. We suggest that the majority of root caries is initiated adjacent to the gingival margin.
通过标准化采样程序，从59例患者的301个原发性根龋损害中获取用于微生物培养的病变或龋坏牙本质样本。这包括用手持牙刷和蒸馏水清洁每个根面的龈上多余菌斑，并用无菌牙用挖匙穿过每个损害的整个垂直维度采集样本。测定每个样本中的菌落形成单位（cfu）总数以及变形链球菌（主要是变形链球菌）、乳酸杆菌、酵母菌和革兰氏阳性多形杆菌（GPPR）的数量。个体细菌计数以log10（每样本cfu）表示，作为每个样本中细菌总数的百分比，并作为从具有不同临床诊断标准的损害中分离的频率。对每个损害进行颜色、质地、相对于龈缘的位置以及治疗需求的临床测量。分类为软质的损害比皮革样损害产生的细菌、变形链球菌、乳酸杆菌和GPPR显著更多，而皮革样损害比硬质损害产生的细菌更多。损害被分为5个治疗类别：软质并修复、皮革样并修复、皮革样并去除龋坏；皮革样并进行治疗；以及硬质无需治疗。随着治疗需求的降低，细菌、变形链球菌、乳酸杆菌、GPPR和酵母菌的总数显著减少。从需要修复的损害以及位于龈缘1毫米内的损害中，变形链球菌、乳酸杆菌和酵母菌的分离频率显著更高。我们认为大多数根龋始于龈缘附近。
