根管治疗对牙周源性牙周牙髓联合病变细菌谱的影响

Effect of Root Canal Therapy on Bacterial Colonization of Periodontal-derived Combined Periodontal and Endodontic Lesions

目的:分析牙周源性牙周牙髓联合病变根管治疗前、后牙周微生物的差异,探讨根管治疗对牙周牙髓联合病变预后的影响。方法:收集2018~2020年新疆维吾尔自治区人民医院接诊的牙周源性牙周牙髓联合病变并发逆行性牙髓炎的患牙31例,采集根管治疗前、后牙周袋和根管治疗前根管内标本,提取DNA采用荧光定量PCR对福赛斯坦纳菌、牙龈卟啉单胞菌、具核梭杆菌、中间普氏菌、齿垢密螺旋体、消化性链球菌、粪肠球菌、牙髓卟啉单胞菌数量进行检测。结果:根管治疗后牙周袋内细菌数量较根管治疗前明显降低,差异有统计学意义(P<0.05);其中牙髓卟啉单胞菌、中间普氏菌、牙龈卟啉单胞菌差异最明显。结论:牙周源性牙周牙髓联合病变以牙周可疑致病菌感染为主,完善的根管治疗术对牙周病引起的牙周牙髓联合病变的预后具有促进作用。

Objective:To explore the effect of root canal treatment on the prognosis of combined periodontal and endodontic lesions of periodontal origin,according to the difference of periodontal microorganisms.Methods:From 2018 to 2020,31 cases of periodontal-derived combined periodontal and endodontic lesions with retrograde pulpitis and root canal treatment were collected from the People’s Hospital of Xinjiang Uygur Autonomous Region.Clinical samples were collected from the root canal and periodontal pocket before and after root canal treatment.DNA was extracted from the samples and respectively detected 8 suspected pathogenic microorganisms through qRT-PCR,including T.forsythensis,P.gingivalis,F.nucleatum,P.intermedia,T.denticola,D.streptococcus,E.faecalis,P.endodontics.Results:The number of bacteria in periodontal pocket was significantly reduced after root canal treatment(P<0.05).Among them,the difference of P.gingivalis,P.intermedia,and P.endodontics were the most obvious.Conclusion:The periodontal-derived combined periodontal and endodontic lesions are mainly caused by suspected pathogenic bacteria infection.Perfect root canal treatment can promote the prognosis of the combined periodontal and endodontic lesions caused by periodontal disease.