口腔种植体周围感染病原菌分布特点及对策分析

Distribution characteristics and countermeasures of pathogens in oral implant infection

目的观察口腔种植体周围感染常见的病原菌分布特点,并探讨具体应对措施。方法回顾性选取2020年3月至2022年3月期间在黄河三门峡医院接受口腔种植治疗的150例患者以及同期在他院行口腔种植后发生种植体周围感染到本院就诊的9例患者,共159例患者纳为研究对象,根据是否发生术后感染将患者分为未感染组[146例,男77例,女69例,年龄(52.71±0.42)岁]与感染组[13例,男7例,女6例,年龄(52.54±0.38)岁]。收集并对比两组患者一般资料和临床资料,通过单因素、多因素分析归纳可导致种植体周围感染的主要因素,并结合分析结果提出具体防治措施。采用t检验、χ^(2)检验。结果13例患者的种植体中分离出病原菌45株,病原菌类型以厌氧菌[62.22%(28/45)]、需氧菌[26.67%(12/45)]为主。多因素logistic回归分析显示,长期吸烟、饮酒、合并糖尿病、骨结合不良、不良口腔卫生习惯均是可导致种植体周围感染的危险因素(OR=3.125、2.614、3.215、3.126、3.198,P=0.013、0.017、0.042、0.016、0.015)。结论种植体周围感染病原菌多为厌氧、需氧菌,患者发生感染考虑与自身吸烟、饮酒、合并糖尿病及不良口腔卫生习惯相关,骨结合不良也是种植体周围感染的重要因素,需嘱患者戒烟、戒酒、保持口腔卫生、控制个人血糖并密切关注观察种植体骨结合情况以防止感染。

Objective To observe the distribution characteristics of common pathogens in oral implant infection,and discuss the specific countermeasures.Methods A total of 159 patients who received oral implant treatment in Sanmenxia Hospital of the Yellow River from March 2020 to March 2022 and 9 patients who had peri-implant infection after oral implant treatment in other hospitals during the same period were selected for retrospective analysis.According to whether postoperative infection occurred,the patients were divided into a non-infected group[146 cases,77 males and 69 females,aged(52.71±0.42)years]and an infected group[13 cases,7 males and 6 females,aged(52.54±0.38)years].The general and clinical data of the two groups were collected and compared.The main factors leading to peri-implant infection were summarized through single-factor and multi-factor analysis,and the specific prevention and control measures were proposed based on the analysis results.t test and χ^(2) test were used.Results Forty-five strains of pathogenic bacteria were isolated from the implants of 13 patients,and the main types of pathogenic bacteria were anaerobic bacteria[62.22%(28/45)]and aerobic bacteria[26.67%(12/45)].Multivariate logistic regression analysis showed that long-term smoking,drinking,diabetes,poor osseointegration,and bad oral hygiene habits were all risk factors that could lead to peri-implant infection(OR=3.125,2.614,3.215,3.126,and 3.198;P=0.013,0.017,0.042,0.016,and 0.015).Conclusions The pathogens of peri-implant infection are mostly anaerobic and aerobic bacteria.The occurrence of patients'infection should be related to their own smoking,drinking,diabetes,and bad oral hygiene habits.Poor osseointegration is also an important factor of peri-implant infection.Patients should be instructed to quit smoking,quit drinking,maintain oral hygiene,control blood glucose,and pay close attention to the osseointegration of implants to prevent infection.