Haapasalo M
Department of Cariology, University of Helsinki, Finland.
FEMS Immunol Med Microbiol. 1993 Mar;6(2-3):213-7. doi: 10.1111/j.1574-695X.1993.tb00329.x.
Necrotic dental root canal infections are polymicrobial infections dominated by anaerobic bacteria. The number of different species in one canal is usually low, approx. 4-7 species. The species isolated most frequently belong to the genera Prevotella, Porphyromonas, Fusobacterium, Peptostreptococcus, Eubacterium and Streptococcus. The frequency of isolation of black-pigmented Gram-negative anaerobes in endodontic infections varies from 25% to > 50%. Pr. intermedia is the most commonly found pigmented species, followed by Pr. denticola and two Porphyromonas species, P. gingivalis and P. endodontalis. Several studies have shown that P. gingivalis and P. endodontalis are closely related to the presence of acute symptoms in endodontic infections, whereas other black-pigmented Gram-negative anaerobes are not. However, several other species may also be involved in acute infections. Moreover, Porphyromonas species have occasionally been isolated from cases with no symptoms. Although Porphyromonas spp. are clearly related to symptoms at the beginning of therapy, they are not important for the prognosis of the treatment.
坏死性牙髓根管感染是由厌氧菌主导的混合感染。一根根管中不同菌种的数量通常较少，约为4至7种。最常分离出的菌种属于普氏菌属、卟啉单胞菌属、梭杆菌属、消化链球菌属、真杆菌属和链球菌属。牙髓感染中黑色色素沉着革兰氏阴性厌氧菌的分离频率在25%至超过50%之间。中间普氏菌是最常见的色素沉着菌种，其次是龋齿普氏菌以及两种卟啉单胞菌，即牙龈卟啉单胞菌和牙髓卟啉单胞菌。多项研究表明，牙龈卟啉单胞菌和牙髓卟啉单胞菌与牙髓感染中的急性症状密切相关，而其他黑色色素沉着革兰氏阴性厌氧菌则不然。然而，其他几种菌种也可能参与急性感染。此外，偶尔也会从无症状病例中分离出卟啉单胞菌属菌种。虽然卟啉单胞菌属菌种在治疗开始时显然与症状有关，但它们对治疗预后并不重要。
