RPDs基托材料对口腔念珠菌定植的影响

目的：初步研究可摘局部义齿（RPDs）不同基托材料对口腔念珠菌的定植的影响。方法：临床随机选择RPDs修复患者147例。其中树脂基托义齿（A组）58例,钴铬合金铸造基托义齿（B组）63例,纯钛及钛合金铸造基托义齿（C组）26例。吐唾法取样,用CHROMagar培养基鉴定念珠菌菌种。培养基中念珠菌菌落计数为每个样本的念珠菌检出强度。通过统计学方法,比较3组不同基托材料义齿戴用人群念珠菌检出率和检出强度的差异。结果：147例不同基托材料义齿戴用人群中检出的念珠菌包括白色念珠菌、热带念珠菌、克柔念珠菌3个菌种。A、B、C组白色念珠菌和非白色念珠菌检出率无显著差异。白色念珠菌的菌落形成单位数,A组显著高于B、C组（P〈0.05）;B组显著高于C组（P〈0.05）。非白色念珠菌间的菌落形成单位数无明显差异。结论：戴不同材料义齿患者口腔除了能检出白色念珠菌,还可检出非白色念珠菌;口腔念珠菌的菌落形成单位数与义齿基托材料密切相关,钛及钛合金基托义齿应为预防义齿性口炎的首选义齿。     

健康老年人口腔念珠菌与义齿修复的相关研究

目的 研究健康老年人群中口腔念珠菌的定植状况,分析义齿修复对老年人口腔念珠菌定植的影响。方法 212例健康老年人分为4组：A1组（男性,有义齿）,B1组（男性,无义齿）,A2组（女性,有义齿）和B2组（女性,无义齿）。标准含潄法取样,样本接种于沙堡琼脂培养基培养念珠菌,CHROMagar CandidaTM鉴定培养基鉴定白色念珠菌,碳水化合物同化反应鉴定体系鉴定念珠菌菌种。培养基中念珠菌菌落计数为每个样本的念珠菌检出强度。比较4组健康老年人念珠菌检出率和检出强度有无统计学差异。结果 212例老年人中116例检出念珠菌,检出率为54.72％。检出念珠菌包括白色念珠菌、近平滑念珠菌、克柔念珠菌、热带念珠菌等10个菌种。A1、B1、A2和B2组念珠菌检出率分别为66.67%,36.07%,64.15%和56.00%;白色念珠菌检出率分别为56.25%,21.31%,56.60%和38.00%。A1组念珠菌、白色念珠菌检出率高于B1组（P<0.05）。高念珠菌强度者在A1、A2组所占比例分别较B1、
B2组高（P<0.05）。结论 健康老年人口腔总念珠菌及白色念珠菌检出率和检出强度增高与义齿修复相关。老年人
口腔念珠菌检出率和检出强度的差异主要是白色念珠菌检出率和检出强度的差异所造成。     

糖尿病及糖调节受损患者口腔念珠菌感染率及阳性率影响因素研究

目的:研究糖尿病及糖调节受损人群口腔念珠菌感染情况。方法:按照血糖水平将328例血糖异常的患者分为A组(糖尿病组)166例和B组(糖调节受损组)162例。另选择同期在我院门诊体检的血糖正常人群168例为(C组)对照组。统计受检者念珠菌携带、感染、阳性情况,记录受检者空腹血糖、唾液酸碱度、唾液流量,对唾液念珠菌阳性、感染的影响因素行Logistic回归分析。结果:A组口腔念珠菌感染率和阳性率均最高,高于B组和C组(P<0.01)。A组、B组唾液酸碱度、唾液流量均低于C组(均P<0.01)。A组空腹血糖水平最高,高于B组和C组(P<0.01),且B组空腹血糖水平高于C组(P<0.01)。结论:年龄、吸烟、配戴义齿和合并系统性疾病等因素与口腔念珠菌检测阳性及感染密切相关,为其主要危险因素。因此,念珠菌感染的高危人群应建立健康的生活习惯、密切监测血糖水平、保持口腔卫生,做好念珠菌感染的防治工作。     

配戴可摘义齿对口腔白色念珠菌的检出及基因分型的影响

目的：研究配戴活动义齿患者口腔中自色念珠菌的检出及基因分型。方法：研究对象共56例,分两组：实验组30例和对照组26例。含漱液浓缩法取样,CHROMagar Candida鉴定培养基分离鉴定白色念珠菌,PCR（聚合酶链式反应polymerase chain reaction,PCR）方法鉴定并进行基因分型,PCR产物经测序验证。结果：实验组与对照组白色念珠菌的基因型均以A型为主,其检出率分别为46．67％,7．69％,两组间差异有显著性。年龄大于60岁的患者及配戴义齿时间长于10年的患者,白色念珠菌及其它念珠菌的检出率显著增高。结论：配戴活动义齿影响口腔白色念珠菌的检出。     

老年患者牙列缺损伴重度磨耗的可摘局部义齿修复的临床分析

目的:探讨老年患者牙列缺损伴重度磨耗用不同治疗方法后的临床疗效。方法:将牙列缺损伴重度磨耗的老年患者36人随机等量分为2组,分别采用牙合垫式可摘局部义齿修复(A组)、普通可摘局部义齿修复(B组),观察2年后的疗效。结果:A组满意率为88.9%,B组满意率为55.6%。2组满意率比较有统计学意义(χ2=4.985,P=0.026),A组与B间的疗效存在显著性差异(P<0.05)。结论:使用牙合垫式可摘局部义齿修复老年患者牙列缺损伴重度磨耗,能获较佳疗效。     

可摘局部义齿修复效果的调查

目的：研究可摘局部义齿的治疗结果并探讨与患者满意度有关的因素。方法：通过患者满意度的调查和临床检查，对63例戴可摘局部义齿5年以上的患者的治疗效果进行评价。结果：70％以上的患者对可摘局部义齿满意，约1／5的义齿需要修理，约1／3的修复体与基牙的龋患有关。结论：绝大多数患者戴可摘局部义齿5年后仍可使用修复体。     

全国义齿戴用者的口腔和手指分离出的念珠菌的相关性研究

念珠菌通常集聚在义齿戴用者的口腔内。同时,由于这些人手指接触义齿的频率较高,使念珠菌也可能集聚于他们的手上。本文就一组义齿戴用者的口腔和手指分离出的念珠菌进行了相关性研究。 材料和方法 选取25名戴用全口义齿的健康男性为研究对象,从其口腔和手指取样做细菌培养。用细菌试管试验和发酵识别系统对念珠菌进行鉴别。同时,记录每名研究对象的义齿清洁情     

化疗患者口腔白假丝酵母菌的分布及基因分组研究

目的研究以白假丝酵母菌（S.albicans）为代表的假丝酵母菌在化疗肿瘤患者口腔中的分布情况,并对检出的白假丝酵母菌进行基因分组。方法从390例接受化疗1年以上的肿瘤患者口腔中取样,采用颊黏膜拭子法,CHROMagar CandidaTM鉴定培养基初步鉴定,根据白假丝酵母菌25S rDNA基因多态性设计引物,根据PCR产物多态性进行基因分组。结果肿瘤患者口腔假丝酵母菌检出率为53.85％（210/390）,白假丝酵母菌的检出率为48.21％（188/390）,其余为光滑假丝酵母菌5.64%（22/390）;白假丝酵母菌基因分组A、B、C组均有检出,其中以B组为主,59.57%（112/188）。结论肿瘤患者口腔的假丝酵母菌以白假丝酵母菌为主,与健康人群的口腔白假丝酵母菌A组占有绝对多数的情况不同,B组白假丝酵母菌在化疗患者口腔中占主导地位。     

头颈部癌放疗患者口腔念珠菌定植特征及分析

目的 了解头颈部癌(head and neck cancer,HNC)接受放射治疗患者临床分离口腔念珠菌的菌株定植特征,为临床防治方案的制定提供依据。方法 随机抽取60例HNC患者,于放疗前、放疗期间、放疗结束采用口腔含漱法取样,CHROMagar显色培养基、API 20C AUX 酵母菌鉴定系统进行分离培养鉴定,比较2组念珠菌的检出率和不同念珠菌种的检出量的差异。采用SPSS 17.0软件包进行统计学处理。结果 60例HNC放疗患者中,54例出现口干和吞咽困难,50例产生放射性口腔黏膜炎（radiation-induced oral mucositis,RIOM）,18例感染口腔念珠菌病;60例HNC放疗患者放疗期间和放疗结束口腔念珠菌的检出率分别为56.7%和63.3%,较放疗前（26.7%）明显升高,具有显著差异(χ²=18.320,P<0.001);54例临床分离株以白念菌为主（n=42）,其次是近平滑念珠菌（n=6）、热带念珠菌（n=4）和光滑念珠菌（n=2）;放疗患者口腔念珠菌致病菌的检出率量为30%,定植菌占46.7%。结论 HNC放疗患者口腔念珠菌的定植率明显升高,念珠菌感染可能是RIOM发生的重要原因。     

老年人口腔念珠菌与可摘义齿关系初步分析

随着老年人口的增长，老年人的口腔卫生保健与口腔疾病预防也越来越受到重视。口腔念珠菌病是一种多发生于老年人群，且与全身因素有关的口腔黏膜病。长期使用抗生素或皮质激素、吸烟、戴义齿均会诱发或加重该病的发生与发展。本文初步分析老年人口腔中念珠菌检出情况与可摘义齿之间的关系，并对控制口腔念珠菌提出了几点建议，希望对预防念珠菌病有所帮助。     

Oral yeast carriage in patients with advanced cancer

The aim of this study was to investigate oral yeast carriage amongst patients with advanced cancer. Oral rinse samples were obtained from 120 subjects. Yeasts were isolated using Sabouraud's dextrose agar and CHROMagar Candida, and were identified using a combination of the API 20 C AUX yeast identification system, species-specific PCR and 26S rDNA gene sequencing. Oral yeast carriage was present in 66% of subjects. The frequency of isolation of individual species was: Candida albicans, 46%; Candida glabrata, 18%; Candida dubliniensis, 5%; others, < 5%. The increasing isolation of non-Candida albicans species is clinically important, since these species are often more resistant to antifungal drugs. Oral yeast carriage was associated with denture wearing (P = 0.006), and low stimulated whole salivary flow rate (P = 0.009). Identification of these risk factors offers new strategies for the prevention of oral candidosis in this group of patients.     

Carriage of Candida species in the oral cavity in diabetic patients: relationship to glycaemic control

To study the possible relationship between the quality of glycaemic control in diabetes mellitus and the carriage of Candida species, the Candidal carrier status of 412 diabetic patients was examined using an oral rinse technique and correlated with measurements of random blood glucose and total glycosylated haemoglobin. Candida was isolated in 210 diabetics (51%) with 13 patients (6%) carrying more than one species. The positive isolates were: Candida albicans (89%), Candida krusei (2.8%), Candida glabrata (2.8%), Candida tropicalis (6.2%), Candida stellatoidea (2.8%) and Candida parapsilosis (0.5%). No association was identified between carriage rates and the type of treatment of diabetes, or with the quality of glycaemic control. As in non-diabetic subjects, the carriage rates were higher in diabetic patients wearing dentures. Thus, the oral carriage of Candida in diabetic patients was independent of glycaemic control but in certain sub-groups the carriage rates were higher, and involved uncommon candidal species.     

Carriage of Candida species in the oral cavity in diabetic patients: relationship to glycaemic control

To study the possible relationship between the quality of glycaemic control in diabetes mellitus and the carriage of Candida species, the candidal carrier status of 412 diabetic patients was examined using an oral rinse technique and correlated with measurements of random blood glucose and total glycosylated haemoglobin. Candida was isolated in 210 diabetics (51%) with 13 patients (6%) carrying more than one species. The positive isolates were: Candida albicans (89%), Candida krusei (2.8%), Candida glabrata (2.8%), Candida tropicalis (6.2%), Candida stellatoidea (2.8%) and Candida parapsilosis (0.5%). No association was identified between carriage rates and the type of treatment of diabetes, or with the quality of glycaemic control. As in non-diabetic subjects, the carriage rates were higher in diabetic patients wearing dentures. Thus, the oral carriage of Candida in diabetic patients was independent of glycaemic control but in certain sub-groups the carriage rates were higher, and involved uncommon candidal species.     

Mycological and cytological examination of oral candidal carriage in diabetic patients and non-diabetic control subjects: thorough analysis of local aetiologic and systemic factors

In this study, 55 diabetic patients and 45 non-diabetic control subjects were examined to determine oral candidal carriage state. The influence of some local aetiologic and systemic factors such as: salivary flow rate and pH, heredity, alcohol drinking, smoking habits, antimicrobial therapy, wearing of denture, burning sensation, dry mouth, taste alteration and tooth brushing habit on candidal carriage rate were investigated. Imprint culture, cytological smears and biochemical tests were used. Oral carrier rate and density of Candida species were non-significantly higher in the diabetic patients than in the non-diabetic control subjects. This increase was confirmed cytologically too. In both groups, Candida albicans was found to be a predominant species on tongue dorsum. Cigarette and alcohol habits of men were higher while tooth brushing habit was less than in women in diabetic and control groups. Salivary flow rate and pH values of diabetic patients were significantly lower while serum glucose values were significantly higher than of non-diabetic controls. The rate of diabetic patients suffering from dry mouth and having diabetic heredity in the family were significantly higher than control subjects. The candidal colonization was higher and keratinization was lower while diabetic treatment tended from diet and oral antidiabetic towards insulin. The decrease in salivary pH, the increase in serum glucose and wearing denture were correlated with the increased rate and density of C. albicans in both groups. Keratinization was also accompanied with the increase in leucocytes. In diabetic group, positive correlations were found between antimicrobial therapy and C. glabrata carriage; the increase in leucocytes and C. albicans carriage; the increase in keratinization and alcohol habit; serum glucose and smoking habit; dry mouth complaint and antimicrobial therapy. There was a negative correlation between salivary flow rate and C. albicans carriage. In control group a positive correlation was found between antimicrobial therapy and keratinization.     

Natural defenses against Candida colonization breakdown in the oral cavities of the elderly.

Candida colonization of the oral cavity increases in the elderly. A major predisposing condition is denture use, which also increases in the elderly. To test whether the increase in colonization is age-related in a fashion independent of denture use, we analyzed the frequency (incidence) of carriage, the intensity of carriage, the multiplicity of species, and the genetic relatedness of strains in the oral cavities of 93 test subjects separated into the three age groups: 60 to 69 yr, 70 to 79 yr, and > or = 80 yr. Each age group was further subdivided into subjects with and without dentures, and into males and females. The results demonstrate that the frequency of carriage, the intensity of carriage, and multispecies carriage all increase as a function of age and differ according to gender, in both cases independent of denture use, suggesting that the natural suppression of yeast carriage in the oral cavity breaks down in the elderly. In addition, it is demonstrated that Candida glabrata colonizes the oral cavities of elderly individuals without dentures only after 80 yr of age, suggesting that there are age-related compromising conditions other than denture use in this most elderly age group.     

Colonization of the oral cavity by Candida species: risk factors in long-term geriatric care

The population of elderly people in hospitals for long-term geriatric care presents many risk factors for nosocomial infection by Candida species. The aim of this work was to reduce the risk of C. albicans nosocomial infections starting from colonization of the oral cavity. The population of concern was the patients in long-stay geriatrics units; a sample of 110 people was selected by drawing lots. The clinical and biological parameters of each patient included in the study were recorded. The oral cavity was colonized by Candida spp in 67% of cases. The distribution of the strains showed that C. albicans was the most frequently identified strain, followed by C. glabrata; of the 73 patients with at least one strain of Candida spp., 47 had a clinically diagnosed candidiasis (64.4%). The wearing of dentures was not statistically linked with the development of oral candidiasis. Detecting which patients have been colonized, identifying the risk factors and applying preventive measures should reduce the probability of elderly people falling into the vicious circle of infection-malnutrition-immune-depression.     

Effectiveness of two methods of denture sterilization

Species of Candida and in particular Candida albicans may be involved in the aetiology of denture stomatitis. Studies have shown that Candida and other oral micro‐organisms including Streptococcus gordonii are associated with denture plaque; hence denture hygiene is an important factor in the prevention and treatment of the disease. The aim of this investigation was to test in vitro the efficacy of two methods of denture sterilization: (1) microwave irradiation and (2) sodium hypochlorite soak. Twenty upper acrylic dentures were prepared for microbiological assay; 10 were inoculated with C. albicans H1 and 10 with S. gordonii LGR2. Within each group, five dentures were tested in a domestic microwave oven for optimal exposure time and temperature to ensure sterilization; the five control dentures were not microwaved. Microbiological analyses showed that the inoculated dentures became sterile after six min of irradiation at medium setting (2450 MHz, 350 W). Damage to the micro‐organisms after microwave irradiation was clearly visible by scanning electron microscopy (SEM). Following the same protocol as above, experimental dentures were soaked for 8 h in either 0·02%, or 0·0125% sodium hypochlorite solution and control dentures soaked in distilled water. Microbiological analyses showed that the experimental dentures inoculated with C. albicans H1 became sterile. By contrast, those inoculated with S. gordonii LGR2 did not become sterile, and the SEM procedures confirmed these findings. The results of this study indicate that microwaving may be a more effective method of denture sterilization than denture soaking in sodium hypochlorite. However, compared with microwaving, hypochlorite reduces the levels of residual non‐viable micro‐organisms attached to the denture surface.