儿童乳牙根管感染的细菌学分析

对18例3～8岁儿童乳牙的根管感染以无菌技术进行定量取样,按种于12种选择性培养基和2种非选择性培养基上,进行需氧、微需氧和厌氧培养,并对细菌菌落计数。对牙髓拟杆菌和牙龈拟杆菌作半定量免疫荧光染色计数;并对其中9例病牙进行了菌相分析。检出的所有细菌中,厌氧菌占绝对优势;其中检出率较高的菌为:产黑色素拟杆菌属,厌氧革兰氏阳性球菌,微需氧革兰氏阳性球菌等.本试验证明,儿童乳牙根管感染是以厌氧菌为主的混合感染,其中以产黑色素拟杆菌属等最常见.     

Evaluation of the strain identity between isolates from caries lesions and root canals in early childhood caries cases

Early childhood caries (ECC) has become a serious medical problem worldwide in the last decade. Bacterial microflora of the dental plaque and oral cavity is considered an important factor in the formation and progression of dental caries. The aim of this study was strain typing and comparison of bacterial isolates retrieved from caries lesions and root canal contents of the same teeth. In total, 18 pairs of presumptive streptococci and lactobacilli retrieved from dental caries and root canals isolated from ECC-affected children, were selected on the basis of biotyping results and rep-PCR fingerprinting with (GTG)₅ primer. Strain typing was further done using the RiboPrinter microbial characterization system (DuPont Qualicon). The automated ribotyping determined 14 pairs of the strains (77.8 %) to be identical. The results obtained confirmed that identical bacterial strains colonized both the decayed dental surface and the necrotic content of the dental pulp cavity during the cariogenesis. Our finding supports the assumption that bacteria could penetrate through the damaged dental surface to the inner parts of the teeth.     

奥硝唑用于感染根管消毒的细菌学研究

目的　观察和探讨新型抗厌氧菌药物奥硝唑消毒感染根管的抗菌效果。方法　选择感染根管患牙98颗,常规根管预备后,随机分为试验组(奥硝唑组)和对照组(甲醛甲酚组)各4 9颗。分别在根管预备前、预备后及封药后进行根管内细菌标本采样、培养、分离与鉴定,测定根管内细菌变化及检出情况,并观察封药后临床症状和体征的变化。结果　2组封药后,根管内细菌数量及检出率均较封药前明显降低( P<0 .0 5 ) ,根管内细菌数量及检出率比较,差异无显著性( P>0 .0 5 ) ,奥硝唑的近期临床疗效优于甲醛甲酚。结论　奥硝唑是一种较安全、有效的根管消毒药物     

感染根管的厌氧菌培养结果分析

从64只感染根管中的58只根管分离到144株无芽胞厌氧菌,其中类杆菌54株,厌氧性链球菌23株,韦荣氏球菌17株,真杆菌11株,梭杆菌10株,放线菌8株,双岐杆菌2株,消化链球菌和消化球菌19株。40只根管为厌氧菌和兼性厌氧菌或需氧菌混合感染,18只根管和6只根管分别为单独厌氧菌和兼性厌氧菌感染。33只根尖周炎根管分别采集牙髓和根尖渗出物样本进行培养,实验结果表明牙髓样本中革兰氏阳性厌氧杆菌检出率较高,根尖渗出物中以产黑素类杆菌属的细菌检出率较高。根尖周炎和牙槽脓肿患者的感染根管中产黑素类杆菌属的细菌检出率明显高于蜂窝组织炎患者。     

Antibiotic resistance genes in anaerobic bacteria isolated from primary dental root canal infections

Fourty-one bacterial strains isolated from infected dental root canals and identified by 16S rRNA gene sequence were screened for the presence of 14 genes encoding resistance to beta-lactams, tetracycline and macrolides. Thirteen isolates (32%) were positive for at least one of the target antibiotic resistance genes. These strains carrying at least one antibiotic resistance gene belonged to 11 of the 26 (42%) infected root canals sampled. Two of these positive cases had two strains carrying resistance genes. Six out of 7 Fusobacterium strains harbored at least one of the target resistance genes. One Dialister invisus strain was positive for 3 resistance genes, and 4 other strains carried two of the target genes. Of the 6 antibiotic resistance genes detected in root canal strains, the most prevalent were blaTEM (17% of the strains), tetW (10%), and ermC (10%). Some as-yet-uncharacterized Fusobacterium and Prevotella isolates were positive for blaTEM, cfxA and tetM. Findings demonstrated that an unexpectedly large proportion of dental root canal isolates, including as-yet-uncharacterized strains previously regarded as uncultivated phylotypes, can carry antibiotic resistance genes.     

Microflora profiling of infected root canal before and after treatment using culture-independent methods

This study aimed to profile the microflora in infected root canals before and after root canal treatment using culture-independent methods. Six infected root canals in single-rooted teeth with periapical lesions from five subjects were included. Quantification of total bacteria was performed by real-time PCR with primers targeting 16S rRNA genes. PCR products with universal 16S rRNA gene primers were cloned and partially sequenced, and bacterial identification at the species level was performed by comparative analysis with the GenBank database. The concentration of extracted DNA before treatment was higher than that after root canal treatment, although the difference was not statistically significant. Sequence analysis revealed that oral bacteria such as Fusobacterium, Streptococcus, Olsenella, and Pseudoramibacter detected in cases before root canal treatment disappeared after treatment. These results suggest that the root canal microflora are distinct before and after root canal treatment, and that treatment changes the microflora in both quantity and quality.     

Prevalence and Correlates of Dental Caries in an Elderly Population in Northeast China

Objectives

The present study aimed to investigate the prevalence and correlates of dental caries in elderly population in northeast China.

Methods

A community-based, cross-sectional study among 2376 elderly subjects (age: 65–74 years) from nine urban areas and nine rural areas in three provinces of northeast China was conducted using multistage stratified random sampling per the World Health Organization oral health survey methodology. Decayed-missing-filled teeth (DMFT) and decayed-filled teeth (DFT) indices were used to evaluate the prevalence of dental caries. Face-to-face questionnaire survey on oral health was performed in a randomly selected subset (n = 1197). T test and chi square test were employed to compare groups for continuous and categorical variables, respectively. Multivariate logistic regression was used to estimate odds ratios (ORs) and corresponding confidence intervals (CIs).

Results

67.5% of elderly subjects reported dental caries (average DFT = 2.68±3.40), and the prevalence was higher in urban areas (P<0.01). Missing teeth accounted for 80.72% of DMFT, and filled teeth due to caries accounted for 2.08% with a rate higher in urban areas (P<0.01). Logistic regression analysis indicated significant association among elderly population in urban areas (OR 1.713; 95% CI 1.337–2.195), smoking (OR 1.779; 95% CI 1.384–2.288), and individuals without dental insurance (OR 2.050; 95% CI 1.120–3.754) with dental caries.

Conclusions

The prevalence of dental caries in the elderly population in northeast China is high. The elderly from urban areas who smoke and who do not have a dental insurance are at a higher risk to develop dental caries.     

Photoactivated disinfection (PAD) of dental root canal system – An ex-vivo study

AimTo investigate the efficacy of photo activated disinfection (PAD) in reducing colony-forming unit (CFU) counts of Enterococcus faecalis (E. faecalis) in infected dental root canals. The study compared the efficacy of PAD with conventional endodontic treatment (CET) and also a combination of CET along with PAD.Material and Methods53 maxillary incisors were taken for the study. Teeth were divided into 3 groups, CET (Group I) (n = 11), PAD (Group II) (n = 21), and a combination of CET and PAD (Group III) which consisted of (n = 21) samples, Group II and Group III were further divided into 2 subgroups, Group IIa, IIb and Group IIIa, IIIb. Strains of E. faecalis were inoculated in all the root canals. CET group samples were treated by chemo-mechanical preparation (CMP) alone, PAD samples were treated with laser alone at 2 different exposure time (4 min and 2 min). In the combination treatment, samples were treated initially by CET and then by PAD for a time period of 4 min and 2 min. Contents of the root canal were aspirated, diluted and plated in Tryptone Soya Broth (TSB) and plates were incubated for 24 h to observe the bacterial regrowth.ResultsShowed PAD used along with CMP reduced the bacterial load of E. faecalis by 99.5% at 4 min and 98.89% at 2 min.ConclusionPAD may be an adjunctive procedure to kill residual bacteria in the dental root canal systems after standard endodontic root canal preparation.     

Frecuencia de Candida en conductos radiculares de dientes con infección endodóntica primaria y persistente

Background

Microbiological identification in endodontic infections has focused mainly on bacteria without giving much attention to yeasts, which, due to their virulence factors, can affect the outcomes of root canal treatment.

高频电对感染根管消毒作用的初步实验研究

目的:初步验证高频电对感染根管是否具有较理想的消毒作用,并且与氢氧化钙药尖的消毒作用进行初步比较分析。方法:本实验制作10只家兔40颗门齿的感染根管动物模型,其中20颗用高频电消毒为实验组。20颗用氢氧化钙药尖消毒为对照组,消毒前后分别作需氧菌和厌氧菌培养并比较其消毒效果。结果:消毒前实验组和对照组各20个根管的需氧及厌氧菌培养全部阳性。实验组消毒后需氧菌3个阳性根管、厌氧菌2个阳性根管,消毒前后对需氧和厌氧菌杀灭作用的差异均具有极显著性(P<0.005)。对照组消毒后需氧菌13个阳性根管消毒作用的差异有显著性(P<0.05)。对照组消毒后厌氧菌11个阳性根管消毒作用的差异有极显著性(P<0.005)。实验组和对照组分别对需氧和厌氧2个菌种之间消毒作用的差异均无显著性(P>0.05)。实验组和对照组对需氧菌的消毒作用和对厌氧菌的消毒作用的组间差异均具有极显著性(P<0.005)。结论:高频电对感染根管内容物的消毒作用优于氢氧化钙药尖,具有临床应用的可行性。值得进一步研究。     

Three-dimensional observations of accessory canals in mature and developing rat molar teeth.

The structure, distribution and formation of accessory canals in the developing and mature molar teeth of rat mandibular jaws were investigated with scanning electron microscopy and with three-dimensional image analysis using serial light-microscopic sections. In the initial stage of the accessory canal formation, most of the canals appeared in the gaps of the epithelial root sheaths formed by their approaching each other in the initial stage of the root formation. However, some of the canals appeared in the slits which may be formed by the destruction of the epithelial root sheath in the root apex regions. When the gaps and slits were invaded by blood vessels, the regions surrounding the vessels did not mineralize but became accessory canals. Usually, an accessory canal with one blood vessel connected the periodontal ligament to the dental pulp; however, in some cases, the canals were broken off midway following the destruction of the vessels.     

Association of genetic variants in enamel-formation genes with dental caries: A meta- and gene-cluster analysis

Previous studies have reported the association between multiple genetic variants in the enamel-formation genes and the risk of dental caries with inconsistent results. We performed a systematic literature search of the PubMed, Cochrane Library, HuGE and Google Scholar databases for studies published before March 21, 2020 and conducted meta-, gene-based and gene-cluster analysis on the association between genetic variants in the enamel-formation genes and the risk of dental caries. We identified 21 relevant publications including a total of 24 studies for analysis. The genetic variant rs17878486 in AMELX was significantly associated with dental caries risk (OR = 1.40, 95% CI: 1.02–1.93, P = 0.037). We found no significant association between the risk of dental caries with rs12640848 in ENAM (OR = 1.15, 95% CI: 0.88–1.52, P = 0.310), rs1784418 in MMP20 (OR = 1.07, 95% CI: 0.76–1.49, P = 0.702) and rs3796704 in ENAM (OR = 1.06, 95% CI: 0.96–1.17, P = 0.228). Gene-based analysis indicated that multiple genetic variants in AMELX showed joint association with the risk of dental caries (6 variants; P < 10⁻⁵), so did genetic variants in MMP13 (3 variants; P = 0.004), MMP2 (3 variants; P < 10⁻⁵), MMP20 (2 variants; P < 10⁻⁵) and MMP3 (2 variants; P < 10⁻⁵). The gene-cluster analysis indicated a significant association between the genetic variants in this enamel-formation gene cluster and the risk of dental caries (P < 10⁻⁵). The present meta-analysis revealed that genetic variant rs17878486 in AMELX was associated with dental caries, and multiple genetic variants in the enamel-formation genes jointly contributed to the risk of dental caries, supporting the role of genetic variants in the enamel-formation genes in the etiology of dental caries.     

Dental Infection of Porphyromonas gingivalis Induces Preterm Birth in Mice

Background

Epidemiological studies have revealed a link between dental infection and preterm birth or low birth weight (PTB/LBW), however, the underlying mechanisms remain unclear. Progress in understanding the associated mechanisms has been limited in part by lack of an animal model for chronic infection-induced PTB/LBW, mimicking pregnancy under conditions of periodontitis. We aimed to establish a mouse model of chronic periodontitis in order to investigate the link between periodontitis and PTB/LBW.

Methods

To establish chronic inflammation beginning with dental infection, we surgically opened mouse (female, 8 weeks old) 1st molar pulp chambers and directly infected with w83 strain Porphyromonas gingivalis (P.g.), a keystone periodontal pathogen. Mating was initiated at 6 wks post-infection, by which time dental granuloma tissue had developed and live P.g. was cultured from extracted tooth root, which serves as a persistent source of P.g. The gestational day (gd) and birth weight were recorded during for P.g.-infected and control mice, and serum and placental tissues were collected at gd 15 to evaluate the systemic and local conditions during pregnancy.

Results

Dental infection with P.g. significantly increased circulating TNF-α (2.5-fold), IL-17 (2-fold), IL-6 (2-fold) and IL-1β (2-fold). The P.g.-infected group delivered at gd 18.25 vs. gd 20.45 in the non-infected control (NC) group (p < 0.01), and pups exhibited LBW compared to controls (p < 0.01). P.g. was localized to placental tissues by immunohistochemistry and PCR, and defects in placental tissues of P.g. infected mice included premature rupture of membrane, placental detachment, degenerative changes in trophoblasts and endothelial cells, including necrotic areas. P.g. infection caused significantly increased numbers of polymorphonuclear leukocytes (PMNLs) and macrophages in placental tissues, associated with increased local expression of pro-inflammatory mediators including TNF-α and COX-2. Further placental tissue damage was indicated in P.g. infected mice by decreased CD-31 in endothelial cells, increased expression of 8OHdG, an indicator of oxidative DNA damage, and cleaved caspase-3, a marker of apoptosis. In vitro, P.g. lipopolysaccharide significantly increased expression of COX-2, IL-8 and TNF-α, in HTR-8 trophoblasts in an NF-κB-dependent fashion.

Conclusions

Our novel mouse model supports previous epidemiological studies signifying dental infection as predisposing factor for PTB/LBW. We demonstrate PTB and LBW in infected mice, translocation of P.g to placental tissues, increased circulating and local pro-inflammatory markers, and the capability of P.g. LPS to directly induce cytokine production in trophoblasts, in vitro. These findings further underscore the importance of local and systemic infections and inflammation during pregnancy and suggest that prevention and/or elimination of dental infections such as marginal or periapical periodontitis before pregnancy may have a beneficial effect on PTB/LBW.     

Fracture resistance of endodontically treated teeth restored with intra-radicular post: The effects of post system and dentine thickness

To investigate the influence of post system and amount of remaining root tissue on the fracture resistance of endodontically treated teeth. Seventy upper canine teeth were divided into seven groups (n=10), one control (sound teeth) and six experimental groups resulting from the interaction between the two study factors: post system (FB, fiber post; FPC, fiber post relined with resin composite; CPC, cast Ni–Cr alloy post and core) and amount of remaining root tooth tissue (2 or 1 mm of thick root). All teeth were restored with metal crowns and exposed to 250,000 cycles in a controlled chewing simulator. The samples were submitted to the fracture resistance test in a universal testing machine, at an angle of 135° and speed of 0.5 mm/min, until fracture occurred. Failure modes were observed, and the data of fracture resistance, in Newtons, were submitted to the analysis of variance (ANOVA), followed by Tukey′s test (α=0.05). Roots restored with FPC had the highest fracture strength of the experimental groups, being statistically similar to the intact teeth group (P>0.05). FP and CPC did not differ statistically (P>0.05) and were statistically lower than those of FPC (P<0.05). No statistically significant difference was observed between amounts of remaining root tooth tissue to the same post systems (P>0.05). A prevalence of irreparable failures was observed in specimens restored with CPC, whereas FP and FPC posts showed more repairable failures. The post system had an influence significant on fracture resistance. However, the remaining dentine with 2- or 1-mm thickness was not an important factor for the fracture resistance.     

Bacteriology of Most Frequent Oral Anaerobic Infections

The anaerobic infections most frequently found in the oral cavity are gingivoperiodontal diseases and pulpal and periapical infections. Gingivitis and adult periodontitis are the most frequent forms. In adult periodontitis the subgingival microbiota are complex and there is a prevalence of Porphyromonas gingivalis, Prevotella intermedia,Prevotella nigrescens , Actinobacillus actinomycetemcomitans, Bacteroides forsythus,Peptostreptococcus micros , Campylobacter rectus, and species of Fusobacterium, Eikenella andTreponema .The microflora associated with peri-implant infections are similar to the microflora found in periodontal diseases, particularly in partially edentulous patients. Implant placement is therefore not recommended in patients presenting with uncontrolled periodontal disease.Likewise, there is a similarity between the genera identified in periodontal pockets and infected root canals, and in periapical infections. However, some species are more prevalent than others in both infections. The following were predominantly observed inside the root canals: Prevotella intermedia, Prevotella nigrescens,Peptostreptococcus anaerobius , Peptostreptococcus micros, Eubacterium lentum, Eubacterium alactolyticum and Porphyromonas endodontalis, with strong associations among some species.Pericoronaritis is another infection associated with anaerobic Gram-negative bacilli and treponeme. There are a great number of methods for microbiological diagnosis, and treatment of some oral infections depends on close interaction between the microbiologist and the dentist.     

香蕉植株内生细菌群落多态性研究

采用平板法对香蕉(Musa nana)植株的内生细菌进行分离纯化,并采用细菌脂肪酸法进行鉴定。结果表明,从香蕉的健康植株和感病植株中共分离得到内生细菌21属24种。从健株分离得到9种内生细菌,其中根、茎和叶分别分离到6种、2种和8种内生细菌。从病株分离得到15属17种内生细菌,其中根、茎和叶分别分离到3种、11种和6种。香蕉健株根部的内生细菌含量最高,达5.195×106cfu g-1,下部叶片内生细菌的含量最低,仅为30 cfu g-1;香蕉病株茎部内生细菌的数量显著高于其他部位,达1.05×107cfu g-1。这说明香蕉在不同生长状态下,其内生细菌的种类和数量存在多样性。     

Identification of Selected Putative Oral Pathogens in Primary Root Canal Infections Associated with Symptoms

Overwhelming evidence indicates that bacteria play an essential role in the etiology of different forms of periradicular diseases. The purpose of this study was to assess the prevalence of 11 putative oral pathogens in root canals associated with symptoms using a 16S rDNA-directed polymerase chain reaction (PCR) assay. Associations of the target species in pairs were also recorded. Samples were obtained from the root canals of 20 symptomatic teeth. DNA was extracted from the samples and analysed for the presence of the target bacterial species using PCR. All samples were positive for the presence of bacterial DNA. In general, Treponema denticola was detected in 50% of the cases (ten of 20), Bacteroides forsythus in 40% (eight of 20), Porphyromonas endodontalis in 40% (eight of 20), Porphyromonas gingivalis in 30% (six of 20), Campylobacter rectus in 20% (two of ten), Micromonas micros in 20% (two of ten), Prevotella nigrescens in 10% (two of 20), and Streptococcus anginosus in 10% (one of ten cases). No sample yielded Actinobacillus actinomycetemcomitans, Prevotella intermedia or Fusobacterium nucleatum. The most common bacterial pairs observed between the target species were B. forsythus/P. gingivalis (five cases), B. forsythus/P. endodontalis (four cases), P. endodontalis/P. gingivalis (four cases) andB. forsythus/T. denticola (three cases). The relatively high prevalence of T. denticola, B. forsythus, P. endodontalis, and P. gingivalis suggests that these bacterial species are implicated in the development of symptoms associated with infected root canals.     

Comparative in vitro and ex vivo studies on the bactericidal activity of Tetraclean, a new generation endodontic irrigant, and sodium hypochlorite

The aim of this study was to compare the efficacy of a new generation endodontic irrigant, Tetraclean, to the widely used sodium hypochlorite. Tetraclean combines a powerful detergent effect with a strong antimicrobial efficacy, whereas sodium hypochlorite has several drawbacks and is sometimes ineffective in preventing microbial-mediated endodontic failure. The bactericidal activity of both irrigants against Enterococcus faecalis, the most commonly isolated species from root canals of teeth with post-treatment disease, was assessed i) in vitro, according to the European Standard lines for the evaluation of the bactericidal activity of chemical disinfectants, and ii) with an ex vivo model of extracted and decoronated human teeth, infected with E. faecalis and subsequently irrigated with either of the irrigants. Both irrigants display very similar bactericidal activity against E. faecalis in vitro. However, the ex vivo model shows that only in the teeth irrigated with Tetraclean did the bacterial burden gradually drop until no bacteria were detectable a few days post-irrigation. Vice versa, in the teeth irrigated with sodium hypochlorite, the drop in the bacterial burden was rapid but temporary and most of the teeth were colonized again by 48 hours post-irrigation.     

青海地区藏汉族人群下颌第二磨牙根管形态的锥形束CT研究

目的:采用锥形束CT(Cone Beam CT,CBCT)技术探讨青海地区藏汉族人群下颌第二磨牙根管形态、数量以及C型根管发生率和髓腔差值的异同。方法:从2016年5月到2018年12月青大附院口腔门诊牙齿CBCT扫描结果中选择藏、汉民下颌第二磨牙各300颗,其中汉族150例,藏族150例。按照Vertucci分类对根管进行分型,探究青海地区藏、汉族人群下颌第二磨牙根管形态特点,同时对牙根类型、C型根管数量和发生率进行统计研究。结果:青海地区藏汉族人群下颌第二磨牙牙根类型以双根牙为主,且其在藏族人群中的发生率高于汉族人群。青海地区藏汉族人群下颌第二磨牙的根管分型以Ⅰ型和C型根管所占比例最高。在青海地区汉族人群和藏族人群下颌第二磨牙中,C形根管所占比率分别为40.7%和27.0%,汉族人群C型根管发生率显著高于藏族人群(P0.05)。在青海地区藏汉人群下颌第二磨牙中,女性的发生率显著高于男性(P0.05)。青海地区藏族人群的MB-DB、DB-P平均值显著高于汉族人群(P0.05)。结论:青海地区藏汉族人群下颌第二磨牙根管形态基本类似,C型根管发生率汉族人群是远远大于藏族人群的,具有一定的种族差异性。但是C型根管发生率在青海地区藏汉人群中都是女性大于男性。同时藏族人群髓腔差值也具有一定的种族差异性。     

Multiple endosymbiont infections and reproductive manipulations in a linyphiid spider population

In many arthropods, maternally inherited endosymbiotic bacteria can increase infection frequency by manipulating host reproduction. Multiple infections of different bacteria in a single host population are common, yet few studies have documented concurrent endosymbiont phenotypes or explored their potential interactions. We hypothesized that spiders might be a particularly useful taxon for investigating endosymbiont interactions, because they are host to a plethora of endosymbiotic bacteria and frequently exhibit multiple infections. We established two matrilines from the same population of the linyphiid spider Mermessus fradeorum and then used antibiotic curing and controlled mating assays to demonstrate that each matriline was subject to a distinct endosymbiotic reproductive manipulation. One matriline was co-infected with Rickettsia and Wolbachia and produced offspring with a radical female bias. Antibiotic treatment eliminated both endosymbionts and restored an even sex ratio to subsequent generations. Chromosomal and fecundity observations suggest a feminization mechanism. In the other matriline, a separate factorial mating assay of cured and infected spiders demonstrated strong cytoplasmic incompatibility (CI) induced by a different strain of Wolbachia. However, males with this Wolbachia induced only mild CI when mated with the Rickettsia–Wolbachia females. In a subsequent survey of a field population of M. fradeorum, we detected these same three endosymbionts infecting 55% of the spiders in almost all possible combinations, with nearly half of the infected spiders exhibiting multiple infection. Our results suggest that a dynamic network of endosymbionts may interact both within multiply infected hosts and within a population subject to multiple strong reproductive manipulations.