三种硝基咪唑类药物对牙周病原菌的抗菌活性比较

目的：比较甲硝唑、替硝唑和奥硝唑对4种牙周优势病原菌的抗菌活性。方法：采用琼脂稀释法测定三种实验药物对牙龈卟啉单胞菌、中间普氏菌、具核梭杆菌和消化链球菌的最低抑菌浓度（MIC）。结果：甲硝唑对以上4种实验细菌的MIC90分别为0.125、0.5、0.5、1.0mg/L和0.125、0.5、1.0、4.0mg/L；替哨唑的MIC50和MIC90分别为0.062、0.25、0.125、0.25mg/L和0.125、0.25、0.25、0.5mg/L；奥硝唑的MIC50和MIC90分别为0.062、0.15、0.125、0.125mg/L和0.125、0.25、0.25、0.25mg/L。细菌浓度对其抗牙周病原菌的MCI值略有影响。结论：三种药物对牙周优势病原菌活性均较强，其大小依次为奥硝唑、替硝唑和甲硝唑。     

茶多酚对牙周主要病原菌的体外抗菌活性研究

目的　探讨茶多酚对牙周主要病原菌的抗菌活性。方法　采用琼脂稀释法药物敏感试验,测定茶多酚对牙周主要病原菌的最小抑菌浓度(MIC)。结果　茶多酚对99株牙周主要病原菌均有明显的抗菌作用,对牙龈卟啉单胞菌的MIC50 、MIC90 为2 5 0mg/L ,对中间普氏菌的MIC50 、MIC90 为5 0 0mg/L ,对产黑色素普氏菌、具核梭杆菌和生痰二氧化碳噬纤维菌的MIC50为5 0 0mg/L ,MIC90 为10 0 0mg/L。本实验中1×10 6CFU/ml与1×10 8CFU/ml细菌接种密度对茶多酚的MIC值无明显影响。结论　茶多酚对牙周主要病原菌具有抗菌活性。     

降糖固齿汤抑制牙周致病菌实验的研究

［摘要］ 目的 观察降糖固齿汤中药组方的抗菌效能。方法 配制中药组方,提取药液,采用二倍稀释法进行中药和奥硝唑抑制牙龈卟啉单胞菌(Pg)、伴放线放线杆菌(Aa)生长实验,观测各组最小抑菌浓度(MIC)。结果 中药对Pg的MIC为0.128 mg/ml,奥硝唑对Pg的MIC为5 mg/ml;中药对Aa的MIC为0.256 mg/ml,奥硝唑的浓度在5~5×1/212 mg/ml范围内都可以抑制Aa的生长。结论 中药原液能抑制Pg、Aa的增长。     

五倍子对5种常见牙周细菌抑制作用的体外研究

目的：观察五倍子对5种常见牙周细菌的作用。方法：采用试管二倍稀释法，测定五倍子水提取物在体外厌氧环境对牙龈卟啉单胞菌，中间普氏菌，伴放线放线杆菌，具核俊杆菌和血链球菌的最小抑菌浓度（MIC），结果：五倍子对各实验细菌均有抑制作用。对牙周常见可疑致病菌牙龈卟啉单胞菌，伴放线放线杆菌，中间普错菌，具核梭杆菌的MIC值均为3．12％，对牙周有益菌血链球菌的MIC值则为12．5％，结论：浓度为3．12％的五倍子在不破坏牙周局部生态平衡的情况下可有效抑制牙周细菌的生长。     

替硝唑棒局部应用治疗牙周周炎的细菌学研究

目的：探讨局部应用替硝唑棒对牙周炎病原菌的抗菌作用。方法：选择41例牙周炎患者，局部应用替硝唑棒和甲硝唑棒前后采集龈下细菌并分离、培养，测定产黑色素厌氧杆菌、梭杆菌、优杆菌等牙周病原菌的检出变化。结果：替硝唑棒对产黑色素厌氧杆菌、梭杆菌和普氏菌的清除率均高于甲硝唑棒。替硝唑棒和甲硝唑棒使用前后，龋下优势牙周病原菌的检出量均有显著性差异，但替硝唑棒的抗菌效果优于甲硝唑棒。结论：局部应用替硝唑棒对牙周病原菌有明显的抗菌作用。     

奥硝唑加地塞米松糊剂治疗急性冠周炎的序贯试验研究

目的：观察奥硝唑加地塞米松糊剂治疗急性冠周炎的临床治疗效果。方法：选择第三磨牙冠周炎病人75例,按就诊顺序号分组,单号为实验组,双号为对照组。两组均用30mL／L过氧化氢液反复冲洗盲袋,再用9g／L等渗生理盐水冲洗,然后隔湿、吹干。实验组以地塞米松0．75mg片剂和奥硝唑0．25g片剂研磨成的粉末,适量加入碘甘油,制成糊剂状膏体,以牙周探针导入盲袋内。对照组在冲洗后直接导入碘甘油,不添加其他任何药物。结果：奥硝唑加地塞米松糊剂对急性冠周炎的有效率可达90％;试验至不同对为20时,试验线触及U,奥硝唑加地塞米松糊剂优于碘甘油治疗急性冠周炎。结论：应用奥硝唑加地塞米松糊剂治疗急性冠周炎具有明显效果。     

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目的探讨评价奥硝唑治疗牙周牙髓病临床效果。方法应用奥硝唑治疗2007—2008年在武汉市蔡甸区妇幼保健院口腔科就诊的牙周牙髓病患者80例,对其临床疗效和治疗前后X光片结果进行比较。结果奥硝唑治疗牙周牙髓病患者总有效率为88.75%。结论奥硝唑治疗牙周牙髓病效果明显,并能有效地保留患牙。     

国产盐酸加替沙星对口腔中脆弱类杆菌的抗菌作用研究

目的：评价国产盐酸加替沙星与甲硝唑、司帕沙星、环丙沙星和克林霉素对口腔脆弱类杆菌的体外抗菌活性。方法：采用琼脂平板稀释法测定最小抑菌浓度（MIC）。结果：盐酸加替沙星、甲硝唑、司帕沙星、环丙沙星和克林霉素对口腔脆弱类杆菌MIC90分别为1．0μg/ml、2．0μg/ml、16μg/ml和32μg/ml。结论：盐酸加替沙星对口腔脆弱类杆菌有着较高的抗菌活性，在体外的抗菌作用是司帕沙星的2倍，环丙沙星的16倍，克林霉素的32倍、甲硝唑的8倍。     

不同浓度复方奥硝唑甲磺酸培氟沙星牙栓的体外抑菌作用的实验研究

目的：观察5种不同浓度（10g／L、20g／L、50g／L、100g／L、200g／L）的复方奥硝唑甲磺酸培氟沙星牙栓的体外抑菌作用。方法：采用Kirby—Bauer纸片扩散法测定5种不同浓度的复方牙栓对牙周主要可疑致病菌的抑菌作用。结果：不同浓度的复方牙栓对牙龈卟啉单胞菌、具核梭杆菌、中间普氏菌、消化链球菌、变形链球菌、金黄色葡萄球菌、表皮葡萄球菌均有一定的抑菌作用。7种菌株间的抑菌圈直径不同、5种不同药物浓度之间的抑菌圈直径也不同，并且菌株和药物浓度两个因素之间存在交互作用（P〈0．001）。上述7种菌株间的F值分别为：91．391、170．431、255．187、143．636、211．839、347．639、580．238（P〈0．001），具有显著性差异。结论：5种不同浓度的复方奥硝唑甲磺酸培氟沙星牙栓在体外均有明显的抑菌作用，以200g／L的给药浓度的抑菌效果最强。     

二甲胺四环素胶原制剂体外抗菌研究

目的研究胶原蛋白为载体复合二甲胺四环素制成的牙周缓释制剂的抗菌效果,以期寻找辅助治疗牙周炎的新制剂。方法采用杯碟法对含20mg/g盐酸二甲胺四环素的胶原牙周缓释剂和派丽奥软膏进行牙周常见致病菌的抑菌实验,测定最小抑菌浓度（MIC）和抑菌环直径。菌珠选用国际标准菌株牙龈卟啉单胞菌、中间型普里沃氏菌、巨核梭形杆菌、伴放线放线杆菌和粘性放线菌。结果胶原牙周缓释制剂和派丽奥软膏对各实验菌株均有抑菌作用,牙龈卟啉单胞菌、中间型普里沃氏菌、巨核梭形杆菌、伴放线放线杆菌的MIC为0.31mg/L,粘性放线菌的MIC为1.2mg/L。2种药物比较抑菌效果无显著性差异（P〉0.05）。结论胶原牙周缓释制剂对牙周主要致病菌具有良好的抑制作用。     

替硝唑棒对牙周炎和冠周炎病原菌的抗菌作用

目的:评价替硝唑棒对牙周炎和冠周炎病原菌的抗菌作用。方法:(1)采用厌氧菌药物敏感试验的二倍琼脂稀释法测定替硝唑和甲硝唑对200株临床分离株的MIC50和MIC90。(2)采用厌氧菌培养方法测定51例牙周炎和冠周炎患者局部应用替硝唑和甲硝唑前后,牙周炎病原菌和冠周炎病原菌的变化。结果:替硝唑棒剂对牙龈卟啉单胞菌、中间普氏菌、梭杆菌和消化链球菌具有明显抗菌作用,其MIC50和MIC90分别为0.25、0.25、0.25、8 mg/L和0.5、0.5、1、8mg/L;其清除率为94.4％～100％,细菌数量均有明显减少。替硝唑对牙周炎和冠周炎病原菌的抗菌活性明显强于甲硝唑(P<0.05)。结论:局部应用替硝唑棒可明显抑制牙周炎和冠周炎的病原菌。     

黄芩对5种常见牙周细菌抑制作用的体外研究

目的：观察黄芩对5种常见牙周细菌的作用。方法：采用试管两倍稀释法测定黄芩甲醇提取物在体外厌氧环境对牙龈卟啉单胞菌、中间普氏菌、伴放线放线杆菌、具核梭杆菌、血链球菌的最小抑菌浓度(MIC)和最小杀菌浓度(MBC)。结果：黄芩对各实验菌株均有抑制作用，对牙周常见可疑致病菌牙龈卟啉单胞菌、中间普氏菌、伴放线放线杆菌、具核梭杆菌的MIC值为5g／L、MBC值为20g／L，对牙周有益菌血链球菌的MIC值为40g/L、MBC值为40g/L，结论：浓度为5g/L的黄芩在不破坏牙周局部生态平衡的情况下可有效抑制牙周可疑致病菌的生长。     

Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in The Netherlands and Spain

BACKGROUND AND AIM: Antimicrobial resistance of periodontal pathogens towards currently used antibiotics in periodontics has been investigated in a previous study. Microbial resistance in the periodontal microflora was more frequently observed in Spanish patients in comparison with Dutch patients. The aim of the present study was to compare antimicrobial susceptibility profiles of five periodontal bacteria isolated from periodontitis patients in Spain and in The Netherlands. MATERIAL AND METHODS: Subgingival plaque samples from adult patients with periodontitis were collected and cultured on selective and non-selective plates. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Micromonas micros were isolated and used for minimal inhibitory concentration tests using the Epsilometer (E-test) technique. Eight different antibiotics were tested on all bacterial isolates. MIC50 and MIC90 values for each antibiotic and each species were determined and the percentage of resistant strains was calculated. RESULTS: Significantly higher MIC values were noted in Spanish strains of F. nucleatum for penicillin, ciprofloxacin, of P. intermedia for penicillin, amoxicillin and tetracycline, of M. micros for tetracycline, amoxicillin and azithromycin, and of P. gingivalis for tetracycline and ciprofloxacin. Based on breakpoint concentrations, a higher number of resistant strains in Spain were found in F. nucleatum for penicillin, amoxicillin and metronidazole, in Prevotella intermedia for tetracycline and amoxicillin, and in A. actinomycetemcomitans for amoxicillin and azithromycin. Resistance of P. gingivalis strains was not observed for any of the antibiotics tested both in Spain and The Netherlands. CONCLUSIONS: Differences exist in the susceptibility profiles of periodontal pathogens isolated from periodontitis patients in Spain and in The Netherlands. This implicates that antibiotic susceptibility testing is necessary to determine efficacy of antimicrobial agents. Also, clinical studies with antibiotics should take these differences into account. The information from the present study indicates that it may not be possible to develop uniform protocols for usage of antibiotics in the treatment of severe periodontitis in the European Union.     

68例慢性牙周炎患者龈下菌斑致病菌的分布及耐药性分析

目的：了解慢性牙周炎患者龈下菌斑可疑致病菌的分布及抗生素耐药情况,为临床治疗提供参考。方法对口腔门诊诊断为慢性牙周炎患者龈下菌斑中的致病菌进行分离培养,采用琼脂稀释法测定分离菌对甲硝唑、阿莫西林等10种常用抗生素的敏感性。结果从68例慢性牙周炎患者龈下菌斑中共分离到262株可疑致病菌,所有病例均检出有致病菌感染,其中以牙龈卟啉单胞菌和产黑色素普雷沃菌分离率较高,分别检出66.2%和60.3%,其次为伴放线嗜血杆菌（55.9%）、具核梭杆菌（51.5%）和消化链球菌（45.6%）等。药敏结果显示：所测菌株对硝基咪唑类药物敏感性较高,对甲硝唑、替硝唑、奥硝唑的敏感率均在90%以上,对阿莫西林/克拉维酸全部敏感,对阿奇霉素、米诺环素、克林霉素的敏感率在51%~78%之间,但对青霉素、红霉素耐药性高,敏感率仅分别为2.3%和17.9%。结论牙龈卟啉单胞菌、产黑色素普雷沃菌等菌为宁夏青铜峡市小坝地区慢性牙周炎患者龈下菌斑中主要的可疑致病菌,对阿莫西林/克拉维酸和硝基咪唑类药物普遍敏感。     

Antimicrobial susceptibility variation of 50 anaerobic periopathogens in aggressive periodontitis: an interindividual variability study

BACKGROUND/AIMS: The frequent use of antibiotics in developed countries has led to the emergence of widespread bacterial resistance. In this study, the interindividual variability of the antibiotic susceptibility of 50 putative microorganisms in aggressive periodontitis patients has been evaluated by means of VC (variation coefficient). MATERIAL AND METHODS: A total of 60 microbial samples were collected from 20 adult patients diagnosed with aggressive periodontitis (2-4 samples by patient). Bacterial strains of Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Fusobacterium nucleatum, and Peptostreptococcus micros were isolated according to Slots' rapid identification method. The susceptibilities to 10 antibiotics were studied: penicillin G (PEN), ampicillin (AMP), amoxicillin (AMX), amoxicillin/clavulanate (AMC), tetracycline (TET), doxycycline (DOX), ciprofloxacin (CIP), erythromycin (ERY), spiramycin (SPI) and clindamycin (CLIN), using the Disk Diffusion Susceptibility test (DDS test: Kirby-Bauer's modified method for anaerobic bacteria). The broth microdilution Minimum Inhibitory Concentration test was carried out as a control test. RESULTS: Among the 50 identified bacteria, 15 were P. gingivalis, 12 P. intermedia, 8 T. forsythia, 9 F. nucleatum, and 6 P. micros. The results of the DDS test show that penicillins (especially AMC, AMP, and AMX), cyclines (especially DOX) and CLIN are highly effective against the 50 anaerobic studied bacteria. CIP and ERY have the lowest efficacy against those bacteria. CIP shows a very variable activity according to anaerobic bacteria species, being particularly inactive against P. gingivalis and very efficient against T. forsythia and P. micros. SPI is also highly efficient but not against P. micros. CONCLUSIONS: The interindividual susceptibility of principal periodontal pathogens to antibiotics is not homogeneous and seems to vary according to bacterial species and antimicrobial molecules. This variability seems to be greater with older molecules (PEN, TET, ERY) than with more recent ones, which indicates more stable results (AMC, AMX, AMP, and DOX). P. intermedia appeared to be the bacteria most resistant to penicillins and showed the highest coefficient variation. Together with scaling and root planing, the combination of two antibiotics would therefore seem to be recommended in the treatment of aggressive periodontitis, particularly in the presence of P. intermedia.     

新型盐酸米诺环素缓释凝胶对牙周致病菌的缓释抑菌作用

目的:评价新型盐酸米诺环素缓释凝胶对牙周主要致病菌的体外缓释抑菌效果。方法:采用超声乳化法制备20 g/L盐酸米诺环素缓释凝胶及非缓释凝胶,以琼脂纸片扩散法检测二者在1、3、5 h和1、3、5、7 d七个时间点的释放液对Pg、Fn、Av、Pi.的抑菌活性,测量抑菌环直径。结果:缓释凝胶组对于Pg、Fn、Av、Pi抑菌作用均可持续到7 d;而非缓释凝胶组对Pg、Fn、Av的抑菌作用仅能维持到3 d,对Pi的抑菌作用可持续到5 d。结论:新型盐酸米诺环素纳米缓释凝胶对Pg、Fn、Av、Pi抑菌作用均可持续到7 d以上,具有较好的缓释抑菌效果。     

牙周致病菌的共聚及其对人工牙根面黏附力的影响

目的比较具核梭杆菌、牙龈卟啉单胞菌、中间普雷沃菌和伴放线嗜血菌等牙周病致病菌彼此之间的共聚力大小,观察四者在具核梭杆菌介导下对人工牙根面黏附力的影响,了解牙周生物膜结构中细菌间可能存在的相互作用。方法目测具核梭杆菌、牙龈卟啉单胞菌、中间普雷沃菌和伴放线嗜血菌彼此间的共聚力,以放射性核素闪烁计数四者在具核梭杆菌黏附和未黏附状况下对胶原包被羟磷灰石(c-HA)的黏附间是否存在着差异。结果具核梭杆菌、牙龈卟啉单胞菌、中间普雷沃菌和伴放线嗜血菌彼此间存在着共聚作用,其中,具核梭杆菌与牙龈卟啉单胞菌、牙龈卟啉单胞菌与中间普雷沃菌间的共聚度均可达4度,具核梭杆菌与其他三菌间的共聚度均大于3度。牙龈卟啉单胞菌、中间普雷沃菌和伴放线嗜血菌在具核梭杆菌黏附的状况下对c-HA的黏附率高于其在具核梭杆菌未黏附时的黏附率,具核梭杆菌在未黏附的状况下对c-HA的黏附率高于其在黏附后的黏附率。结论具核梭杆菌、牙龈卟啉单胞菌、中间普雷沃菌和伴放线嗜血菌彼此间均存在共聚关系,具核梭杆菌可能对其他牙周病致病菌定植于牙菌斑起到了桥梁作用。