全口牙拔除后口腔微生物变化的初步研究

摘要/Abstract

摘要： 目的　本研究探讨全口牙拔除后，口腔微生物群落的变化，寻找可能的原因，并分析对种植体植入后的影响。方法：选择2013年3月—2016年2月于我院口腔科就诊患者75例。入选患者现有余留牙4颗以上（每颗牙齿均有5mm以上深度牙周袋），余留牙无保留必要，拟拔除全部患牙。于患者拔牙前、拔牙后4周、3个月后收集口腔微生物样本。各时间点收集患者唾液2ml，无菌棉签反复擦拭舌背轮廓乳头、颊粘膜、牙槽嵴顶5次。同时在拔牙前用无菌试纸收集牙周袋内微生物。在不同培养基培养一定时间后，观察单个菌落的菌落形态，并对其革兰染色鉴定细菌种类。结果：75名患者中在拔牙前后不同时间点，舌背、颊粘膜、唾液样本中需氧菌和厌氧菌的比例没有明显变化（P＜0.05）。拔牙前，牙周袋内厌氧菌所占比例高于需氧菌。全口牙拔除后，牙槽嵴表面的厌氧菌(中间普氏菌、福赛坦氏菌、微小微单胞菌、具核梭杆菌、直形弯曲菌)数量明显减少（P＜0.05），革兰阴性杆菌数量保持不变（P＞0.05）。吸烟患者的革兰阴性杆菌数量与不吸烟患者相比明显减少（P＜0.05）结论：全口牙拔除后，牙槽嵴厌氧菌数量显著减少，减小种植患者罹患种植体周围炎的风险。

关键词: 全口牙拔除, 牙列缺失, 细菌, 牙周炎, 种植体周围炎

Abstract: Objective　 To evaluate the effect of full-mouth tooth extraction on the oral microflora, and to find the reason and analyze the impact of implants. Method: 75 patients who were treated in Department of Stomatology in our hospital from March 2013 to February 2016 were included in this study. All patients, who had 4 teeth left (each had over-5mm periodontal pocket), with moderate to advanced periodontitis and scheduled for full-mouth tooth extraction, were consecutively selected. 4 weeks and 3 months before and after full-mouth tooth extraction, oral microfloras were collected. At different times, saliva was collected for 2ml; tongue, buccal mucosa and alveolar ridge crest samples were obtained. Aerobic and anaerobic culture techniques were employed for the detection and classification of oral pathogens. Result: No differences were observed in total aerobic and anaerobic bacterial load of the tongue, mucosa and saliva samples during different time points. Before tooth extraction, the number of anaerobe was more than aerobe in periodontal pockets, while after tooth extraction anaerobe obviously decreased (P<0.05) and gram negative bacillus remained constant (P>0.05) on the alveolar ridge. Compared with that in non-smoking ones, the number of gram negative bacillus in smoking patients obviously reduced (P<0.05). Conclusion: After full-mouth tooth extraction, anaerobic species of alveolar ridge crest have reduced, which reduces the risk of peri-implantitis.

Key words: Full-Mouth Tooth Extraction, Edentulous, Bacteria, Periodontitis, Peri-implantitis

张晖徐宏宇. 全口牙拔除后口腔微生物变化的初步研究[J]. , 2017, 37(11): 1021-1024.

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