口腔种植体周围细菌感染病原菌分布和危险因素分析

Distribution of pathogens and risk factors of bacterial infections around dental implants

目的 探讨口腔种植体周围细菌感染病原菌分布和危险因素.方法 选择杭州市西溪医院2017年1月至2018年12月收治的行口腔种植术患者427例为研究对象,根据是否发生口腔种植体周围细菌感染分为感染组46例与无感染组381 例.采集感染患者龈沟底部标本进行病原菌分离鉴定;采用多因素logistic回归分析影响口腔种植体周围细菌感染危险因素.结果 口腔种植体周围细菌感染46例患者,共分离病原菌59株,其中包括厌氧菌38株,需氧菌17株,有益菌4株.单因素分析结果显示,两组性别、年龄、体质指数、合并高血压等差异均无统计学意义(χ^2 =0.003、3.393、0.744、0.200,均P>0.05);感染组合并糖尿病[19.57%(9/46)]、慢性牙周炎病史[30.43%(14/46)]、吸烟[58.70%(27/46)]、饮酒[69.57%(32/46)]、种植体周围牙槽骨不良[50.00%(23/46)]和过度负载[30.43%(14/46)]高于无感染组[5.77%(22/381)、6.82%(26/381)、29.40%(112/381)、34.91%(133/381)、23.12%(85/381)、11.29%(43/381)],差异均有统计学意义(χ^2 =9.636、24.241、16.048、20.793、16.655、13.011,均P<0.05).将上述单因素分析差异有统计学意义的纳入多因素logistic回归分析显示,合并糖尿病、慢性牙周炎病史、吸烟、饮酒、种植体周围牙槽骨不良和过度负载为影响口腔种植体周围细菌感染危险因素.结论 口腔种植体周围细菌感染病原菌以厌氧菌为主,感染受多因素影响,其中合并糖尿病、慢性牙周炎病史、吸烟、饮酒、种植体周围牙槽骨不良和过度负载为其危险因素.

Objective To investigate the distribution of pathogenic bacteria and the risk factors of bacterial infections around dental implants.Methods From January 2017 to December 2018,427 patients with oral implantation in Xixi Hospital were selected inthe study.According to the occurrence of bacterial infections around oral implants,the patients were divided into infection group(46 patients)and the non -infection group(381 patients).Pathogenic bacteria were isolated and identified from the bottom of gingival sulcus of infected patients.The risk factors of bacterial infection around dental implants were analyzed by multivariate logistic regression analysis.Results A total of 59 pathogenic bacteria were isolated from 46 patients with bacterial infection around dental implants,including 38 anaerobic bacteria,17 aerobic bacteria and 4 beneficial bacteria.Univariate analysis showed that there were no statistically significant differences in sex,age,BMI and hypertension between the two groups(χ^2 =0.003,3.393,0.744,0.200,all P>0.05).The infection group complicated with diabetes mellitus(19.57%),chronic periodontitis(30.43%),smoking(58.70%),drinking(69.57%),periimplantal alveolar bone defects(50.00%)and overloa-ding(30.43%)were higher than those without infection(5.77%,6.82%,29.40%,34.91%,23.12%,11.29%),there werestatistically significant differences(χ^2 =9.636,24.241,16.048,20.793,16.655,13.011,all P<0.05).The results of logistic regression analysis showed that diabetes mellitus,history of chronic periodontitis,smoking,alcohol consumption,poor alveolar bone around implants and overloading were risk factors for bacterial infection around implants.Conclusion Anaerobic bacteria are the main pathogens of bacterial infection around dental implants.Infection is affected by many factors,including diabetes mellitus,history of chronic periodontitis,smoking,alcohol consumption,poor alveolar bone around implants and excessive load.