牙菌斑和胃幽门螺杆菌感染联合治疗对复发性口腔溃疡疗效的影响

目的：探讨对牙菌斑和胃幽门螺杆菌（helicobacter pylori,Hp)感染联合治疗对复发性口腔溃疡（recurrent oral ulcer,ROU)疗效的影响。方法：对198例牙菌斑标本Hp-PCR检测阳性患者进行分组治疗：胃镜检查无胃病的ROU患者（A组）仅接受针对ROU的治疗;伴有胃病的患者随机分成B、C组,B组接受抗Hp治疗,C组在清除牙菌斑的同时接受A、B组的联合治疗。观察根除Hp对口腔溃疡疗效及复发的影响。结果：198例ROU中,130例（65．66％）患有不同类型的慢性胃炎和消化性溃疡（peptic ulcer,PU),对口腔溃疡和胃病的疗效以及Hp的清除效果均以C组最佳（P＜0．05）,C组ROU的复发率明显低于A、B组（P＜0．01）。结论：牙菌斑和胃粘膜联合治疗Hp可以提高ROU的疗效,减少其复发;ROU的发病可能与Hp感染有关。     

口腔幽门螺杆菌对胃幽门螺杆菌根除率的影响

目的　明确口腔幽门螺杆菌 (Helicobacterpylori,Hp)对胃幽门螺杆菌根除率的影响。方法　选择 10 2例有上腹部症状、并经全口牙周检查有不同程度牙周炎的患者进行胃镜检查 ,每例均取口腔标本进行Hp检测。用二氧化硅微粒法提取所有样本中的DNA ,引物选用尿素酶C基因和CagA基因进行PCR扩增。结果　胃Hp阳性组的口腔Hp检出率 (n =5 8,4 3.1% )高于胃Hp阴性组(n =4 4 ,2 2 .7% ) ,两者比较差异有显著性 (P <0 .0 5 )。 5 8例胃Hp阳性患者经药物治疗后 4周进行胃Hp的复查 ,其中口腔Hp阳性者的胃Hp根除率 (6 4 0 % ,16 / 2 5 )低于口腔Hp阴性者 (72 .7% ,2 4 / 33) ;治疗后 1年 ,口腔Hp阳性者的胃Hp根除率 (36 .0 % )与Hp阴性者的根除率 (6 3.6 % )相比差异有显著性 (P <0 .0 5 )。结论　胃Hp的根除率受口腔Hp存在的影响 ;口腔Hp阳性者的胃Hp根除率显著低于口腔Hp阴性者根除率     

口腔健康教育对牙周参数和幽门螺杆菌在牙菌斑中分布的影响

目的 探讨口腔卫生教育对牙周参数和幽门螺杆菌（Hp）在牙菌斑中分布的影响。方法 自愿受检人群进行口腔健康教育，统一指导漱口、刷牙并口腔洁治，抽样观察牙周参数和菌斑Hp阳性率的变化。结果 口腔健康教育后，牙周参数和Hp阳性率均有显著性降低（P＜0.01），其效果以洁治教育后最为显著（P＜0.001），但正确的刷牙是保持口腔卫生最基本的方法。结论 进行口腔健康教育不仅可以减少口腔疾病，对减小胃病的发病与复发亦有重要意义。     

不同方法检测牙菌斑中幽门螺杆菌的比较

目的 探讨用二氧化硅微粒法提取DNA检测口腔标本中幽门螺杆菌可行性及临床应用的意义。方法 选择50例因上腹部症状且有不同程度牙周炎的胃镜检查者50例。每例均取口腔标本。比较二氧化硅微粒法与DNA快提法两种不同方法提取胃及口腔样本中的DNA，引物选用尿素酶C基因和CagA基因进行PCR扩增。结果 SiO2微粒法提取DNA检测菌斑和含漱液中的幽门螺杆菌与Instagene Matrix提取DNA(Bio-rad)比较灵敏度为93．8％(30／32)，特异性为100％(68／68)。结论 SiO2微粒法提取菌斑和含漱液中的DNA操作简便，可作为Instagene Matrix替代方法检测口腔中的Hp。     

幽门螺杆菌口腔定植和胃肠疾病的关联性研究

目的 分析口腔中幽门螺杆菌(H.pylori)的定植与胃肠疾病的关联性.方法 采用细菌培养法,对173名胃肠疾病患者的唾液标本进行H.pylori检测,同时根据年龄、性别、胃肠疾病类型和牙周状况分组,分析不同组别H.pylori检测结果的差异性.结果 胃肠疾病患者口腔唾液中H.pylori阳性率为40.46%.其中,男...     

口腔中幽门螺杆菌的研究进展

口腔宿主为幽门螺杆菌 (Ｈｐ)的存在提供各种适宜条件 ,常规根除Ｈｐ三联疗法对口腔Ｈｐ不敏感 ,本文就改善Ｈｐ诊断方法和探讨口腔中Ｈｐ的重要作用作一简要综述。一、幽门螺杆菌的发现及意义1893年 ,Ｂｉｚｚｏｚｅｒｏ[1] 首次报道在狗的胃腺内发现有一种螺旋形微生物 (Ｓｐｉｒａｌｏｒｇａｎｉｓｍ ) ,之后的学者相继在猫、大鼠、狗、猴的胃肠道溃疡内观察到“螺旋体”(Ｓｐｉｒｏｃｈａｃｔｅｓ)。190 6年 ,Ｋｒｅｉｎｔｚ在胃癌患者的胃内观察到一种螺旋体 ,人们并未重视。 1917年 ,Ｋｅｌｌｅ发现口腔牙菌斑中有“螺旋体”的存在。…     

应用漱口液对根治幽门螺杆菌的疗效

目的 :了解漱口液根除口腔内幽门螺杆菌的疗效。方法 :98例胃粘膜幽门螺杆菌阳性的患者随机分为两组 ,A组与B组。两组幽门螺杆菌阳性率相同。两组均采用奥美拉唑、阿莫西林和甲硝唑口服 ,A组另以漱口液 (阿莫西林、甲硝唑 )漱口 ,每日 3次 ,治疗 2周。治疗前后均取牙菌斑、唾液及胃粘膜标本作幽门螺杆菌培养。结果 :A组胃粘膜标本治疗前 5 1例阳性 ,治疗后仅 3例阳性 ,口腔HP治疗前 2 3例阳性 ,治疗后 3例阳性。B组胃粘膜标本治疗前 4 7阳性 ,治疗后仅 2例阳性 ,口腔HP治疗前 2 1例阳性 ,治疗后 18例阳性。胃粘膜HP转阴率两组之间无显著差异 (p >0 0 5 ) ,而口腔HP转阴率两组之间有极为显著的差异 (p<0 0 0 1)。结论 :采用漱口液治疗口腔中幽门螺杆菌可能具有根治幽门螺杆菌的作用。     

口腔幽门螺杆菌的研究进展

１９８３年Ｗａｒｒｅｎ和Ｍａｒｓｈａｌｌ从胃活体组织中分离出幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,缩写Ｈｐ）,引起广泛重视。经过世界范围长期的临床、基础研究,目前,Ｈｐ已被认为是慢性活动性胃炎的病原菌,而且是引起消化性溃疡、胃粘膜相关淋巴样组织（ｍｕｃｏｓａ－ａｓｓｏｃｉａｔｅｄｌｙｍｐｈｏｉｄｔｉｓｓｕｅ,ＭＡＬＴ）淋巴瘤发生的重要致病因子,最近世界卫生组织又把Ｈｐ列为Ⅰ类致癌因子,它与功能性消化不良也有关［１,２］。长期以来,人们认为胃是Ｈｐ唯一的生存环境,但近几年的研究证明,人…     

高压氧对口腔牙菌斑幽门螺杆菌的作用

目的：寻找一种较为理想的根除口腔幽门螺杆菌（Hp)的方法。方法：将120例口腔牙菌斑Hp-PCR检测阳性的Ⅱ度牙周炎患者分为A、B、C、D4组,治疗1、3、6月后分别对所有患者牙周参数和龈下菌斑进行Hp-PCR检测并比较检测结果。结果：4组Hp阳性率分别为96.7%、80.0%、73.3%和0,有显著性差异（P＜0.05),其中以D组最低（P＜0.05)。结论：高压氧对口腔Hp有明显抑制或杀灭作用,高压氧配合治疗,有助于口腔Hp的根除和与Hp有关的疾病的治疗。     

二联和三联方案治疗感染幽门螺杆菌的复发性口疮

复发性口疮 (ＲＡＵ)病因不明 ,幽门螺杆菌 (Ｈｐ)已被确定是消化道溃疡的病因 ,有报道Ｈｐ可从口腔粘膜溃疡活检标本中检测到 ,它可能在胃肠和口腔之间活动 ,引起ＲＡＵ的周期性发作[1] 。本研究对ＲＡＵ发作的口腔溃疡进行Ｈｐ检测确诊阳性。目前国内外对消化道溃疡Ｈｐ感染的治疗原则 :质子泵抑制剂 (ＰＰＩ)联合两种抗生素[2 ] 。但因本组阳性者仍有部分患者无胃肠病史 ,所以选用二种抗生素的二联疗法做为根除Ｈｐ的一种疗法。近年来多有对ＲＡＵ患者缺铁、锌、铜、维生素Ｂ12 、叶酸等报道[3 ] ,在另一组患者用相同的二联抗生素加多种…     

牙周基础治疗对胃内幽门螺杆菌根除率的影响

目的 :分析牙周炎与胃内幽门螺杆菌 (Helicobacterpylori ,Hp)的关系以及牙周基础治疗对胃内幽门螺杆菌根除率的影响。方法 :选择有慢性牙周炎且胃镜活检尿素酶阳性、病理诊断为慢性胃炎、胃或十二指肠溃疡患者91人进行三联药物治疗 ,其中 3 3人还同时进行了牙周基础治疗。三联药物治疗后分析胃内幽门螺杆菌根除率与患者牙周临床指数的关系 ,以及牙周基础治疗对胃内Hp根除率的影响。 结果 :4个位点平均牙周袋深 <4mm组的患者三联药物治疗 4周后及 1年后的Hp根除率明显高于平均袋深≥ 4mm组的患者 (80 %vs5 2 .2 % ,62 .9%vs 3 4.5 % ,P <0 .0 5 )。经过牙周基础治疗的患者 1年后的Hp根除率显著高于未做牙周基础治疗的患者 (63 .6%vs 3 4.5 % ,P <0 .0 5 )。结论 :药物治疗Hp的根除率与患者的牙周状况和口腔卫生状况有关。口腔Hp可能是胃Hp再感染的病原因素 ,因此对胃内Hp感染同时伴有牙周炎的患者在进行三联药物治疗的同时应配合牙周基础治疗。     

The effectiveness of systemic eradication therapy against oral Helicobacter pylori

J Oral Pathol Med (2010) 40 : 428–432 Background: Helicobacter pylori infection is associated with numerous gastroduodenal diseases. The oral cavity could be a potential extragastric reservoir for H. pylori, and oral H. pylori might cause gastric reinfection after the eradication therapy. The aim of the study was to evaluate the presence of H. pylori in oral cavity of patients with gastric H. pylori infection and to examine the effectiveness of the eradication therapy against H. pylori in stomach and in the oral cavity. Methods: Fifty‐six patients with chronic periodontitis and gastric H. pylori were enrolled in the study. Gastric H. pylori infection was determined using ¹³C‐urea breath test before and 3 months after eradication therapy. The presence of the oral H. pylori was assessed using polymerase chain reaction before and 3 months after eradication therapy. The 1‐week eradication therapy consisted of amoxycilin 1 g, clarithromycin 500 mg, and proton pump inhibitor 20 mg twice a day. Results: Of 56 subjects with gastric infection, 23 (41.1%) harbored H. pylori in the oral cavity. Eradication rate in stomach was 78.3%, whereas in the oral cavity, H. pylori was not detected from any sample after the eradication therapy. Conclusion: Almost half of the patients with gastric H. pylori harbored the bacterium in the oral cavity. After the eradication therapy, H. pylori was not detected in the oral cavity, what suggests high effectiveness of the therapy protocol in the oral cavity, or it is possible that oral H. pylori is of a transient character.     

Persistence of Helicobacter pylori in the oral cavity after systemic eradication therapy

AIM: The present study aimed to evaluate if the oral cavity of chronic periodontitis patients can harbor Helicobacter pylori after systemic eradication therapy. MATERIALS AND METHODS: Samples of 30 patients (15 with gingivitis and 15 with chronic periodontitis) positive for H. pylori in the stomach were evaluated. Samples were collected 3 months after triple systemic antibiotic therapy from saliva, microbiota from the dorsum of the tongue, supra- and sub-gingival plaque as well as gastric biopsies. DNA of each sample was extracted by the boiling method and used as a template in polymerase chain reaction with the primers JW22/23. RESULTS: Eighteen patients (60%) harboured H. pylori in their mouths. Five patients (16.6%) were positive in saliva, two (6.6%) on the dorsum of the tongue, nine (30%) in supra-gingival plaque, 14 (46.6%) in sub-gingival plaque and three (10%) in the stomach. There was no statistically significant difference between study groups. CONCLUSION: Eradication of H. pylori after therapy was more effective for the stomach than for the mouth (p<0.001). Mouths of patients with gingivitis or with chronic periodontitis, who are positive for H. pylori in their stomachs, may be considered as reservoirs of these bacteria.     

Outcome following treatment for Helicobacter pylori in patients with recurrent aphthous stomatitis

Objective: The aim of the current study was to investigate any association of Helicobacter Pylori (HP) in recurrent aphthous stomatitis (RAS) and the effect of eradication of the microorganism in the clinical course of the disease. Study design: Forty‐eight patients with RAS were included in the study. Twenty‐six were women and 22 men, of average age 41.3 ± 2.44. Thirty‐four out of these 48 patients were HP positive and the rest 14 who were negative were used as a control group. The diagnosis of HP infection was based on the detection of specific immunoglobulin G (IgG), and immunoglubulin A (IgA) antibodies using the enzyme‐linked immunoabsorbent assay technique in the serum and the saliva of the patients. In all HP carriers an eradication therapy was administered. After a 2‐month period the patients were checked for HP status, using ¹³ C‐UBT. The follow up period was 6–12 months following the eradication therapy. Results: At entry patients with HP infection suffered from more severe symptoms compared with HP negative patients (P < 0.05). After the administration of HP eradication therapy, patients who had become negative showed a remarkable improvement (62.5%) with reference to recurrence of RAS as well as to symptom intensity. In 29.2% of patients symptoms had disappeared and in 33.3% of patients there was a decrease in both the frequency of recurrence and the intensity of symptoms. After the eradication treatment, the periods between recurrence of RAS in patients who had become negative were statistically significantly longer compared with those before treatment (P < 0.001). Another important observation was that patients who became negative after eradication therapy were of comparable clinical status with those who were HP negative from the beginning of the study (P > 0.05). Conclusions: These findings support the concept of a potential association between RAS and HP.     

Periodontal treatment is more effective in gastric Helicobacter pylori eradication in those patients who maintain good oral hygiene

Objectives: This study aimed to investigate the effect of periodontal treatment and oral hygiene on the eradication of gastric Helicobacter pylori. Materials and methods: In this clinical trial, the 98 patients with gastric H. pylori infection that were enrolled received either triple-therapy regimen only or triple-therapy regimen plus periodontal treatment given during triple therapy. Eradication of H. pylori was checked at 3 months, and then after therapy using the urea breath test. Results: The triple-therapy plus periodontal treatment regime resulted in a 64.7% eradication rate, and the triple-therapy regime alone resulted in a 51.1% eradication rate (P = 0.17). Additionally, subgroup analysis indicated that the beneficial effect of periodontal treatment on the gastric H. pylori eradication rate improved if adequate plaque control was maintained (P = 0.02). Multivariate logistic regression analysis showed that post-treatment oral hygiene status [as indicated by the Oral Hygiene Index (OHI)] was associated with H. pylori eradication (P = 0.02), but not with pretreatment oral hygiene status (P = 0.24). Oral hygiene measures without periodontal treatment appear to have a limited impact on H. pylori eradication. Post-treatment oral hygiene level (OHI ≤ 1.25) had a positive effect on H. pylori eradication, increased the gastric eradication rate, with an OR of 3.19, and the oral H. pylori eradication rate, with an OR of 4.57. Furthermore, if periodontal treatment was unsuccessful in eliminating oral H. pylori, as tested using the Campylobacter-like organism test, the OR for the unsuccessful gastric eradication increased 64-fold. Conclusion: This result illustrates that the key factors for achieving successful gastric H. pylori eradication are professional periodontal treatment and the patients’ later adherence to an oral hygiene regimen.     

胃幽门螺杆菌感染与口臭关系的初步研究

目的：探讨胃幽门螺杆菌感染与口臭的关系。方法：选择无牙周疾病和全身疾病（上消化道疾病除外）的受试者50例．在胃镜检查或呼气试验前进行口臭测试及口腔相关指标检查,然后进行胃镜活检和呼气试验检测胃内幽门螺杆菌感染情况。使用SPSS11．5对数据进行统计学分析。结果：50例受试者经鼻测法测试有口臭28例,无口臭22例。各项牙周指标表明,受试者均牙周健康。χ^2检验表明,有、无口臭的受试者中,幽门螺杆菌的阳性率分别为57．1％和18．2％．差异具有统计学意义（P〈0．01）。Logistic回归方程显示,胃内幽门螺杆菌感染是方程中唯一有统计学意义的变量（P〈0．05）。结论：幽门螺杆菌可能与牙周健康者的口臭有关。     

复发性口疮与幽门螺杆菌感染免疫相关性研究

目的 :探讨复发性口疮的发生与幽门螺杆菌 (H .pylori)感染相关性免疫反应的关系 ,旨在了解H .pylori感染在复发性口疮发生机制中的作用及意义。 方法 :采用快速尿素酶实验及ELISA等方法检测复发性口疮患者和正常对照人群牙菌斑中H .pylori的存在情况及其血中的抗H .pylori抗体的水平。结果 :复发性口疮患者口腔牙菌斑中H .pylori的检出率 (53 .3 % )明显高于正常对照人群 (3 2 .3 % )(P <0 .0 1) ,口腔牙菌斑中H .pylori的检出率与复发性口疮的严重程度之间无明显关系 (P >0 .0 5) ;血中抗H .pylori抗体的检出率与复发性口疮及其严重程度之间无明显关系 (P >0 .0 5)。而血中抗H .pylori抗体的浓度水平与复发性口疮及其严重程度明显相关 (P <0 .0 1)。 结论 :口腔中的H .pylori感染与复发性口疮的发生相关 ,而血液中由H .pylori与人上皮细胞表面抗原等结构类似的多糖链抗原诱导的自身免疫反应可能是复发性口疮发生机制中的重要因素     

Helicobacter pylori DNA in recurrent aphthous stomatitis

BACKGROUND: Considering not only the fact that recurrent aphthous stomatitis (RAS) and stomach ulcers are immunologically mediated ulcers associated with Helicobacter pylori, but also the recent evidence that anaemia can be associated with both diseases, and the discovery of H. pylori in the oral mucosa led us to hypothesize that this bacteria may be related to RAS pathogenesis. METHODS: Thirty-six consecutive subjects affected by minor and major forms of RAS and 48 healthy volunteers were included in the present study. The nested polymerase chain reaction (PCR) technique was used to detect the presence of H. pylori in the oral lesion, the normal contralateral mucosa of patients affected by RAS and the oral mucosa of control subjects. The chi2- and Fisher's tests were used for statistical analysis. RESULTS: No association between RAS lesions and H. pylori was observed. However, 14 out of 36 (38.9%) of the patients with RAS were found to show the presence of H. pylori DNA in the lesion and/or contralateral mucosa. Sixteen out of 48 (33.3%) of the patients without RAS (control subjects) were positive (P > 0.05). CONCLUSION: The present study does not give support to the assumption that H. pylori could be involved in RAS development.     

Helicobacter pylori in the oral cavity is associated with gastroesophageal disease

Background:  In Mexico, more than 80% of the population is infected with Helicobacter pylori . The frequency of H. pylori detection in the oral cavity is unknown, as its relationship with gastroesophageal pathology.
Aim:  To detect the presence of H. pylori in the oral cavity in Mexican population by PCR and to determine its association with gastroesophageal disease.
Methods:  Patients were divided into two groups with different clinic conditions from whom gastric biopsy, dental plaque, and saliva samples were taken and analyzed. The first group comprised of hospitalized patients, the majority of whom were diagnosed with gastroesophageal disease, while the second group was selected from a dental clinic (ambulatory population) the majority of whom appeared to be healthy subjects.
Results:  H. pylori was detected in gastric biopsy, dental plaque and saliva samples by PCR using a set of specific primers for the signal sequence of the vacuolating cytotoxin gene; detection of H. pylori in general was higher in gastric biopsy and dental plaque samples than in saliva samples. Detection of H. pylori in the oral cavity is significantly ( P  = 0.0001) associated with patients presenting gastroesophageal disease, while healthy subjects and those with other non-gastric disease do not present with H. pylori in their oral cavity.
Conclusions:  H. pylori detection in the oral cavity is associated to gastroesophageal disease. In addition, it is suggested that all patients presenting gastric symptoms and H. pylori detection in the oral cavity would begin bacterial treatment immediately.     

Detection of Helicobacter pylori in oral aphthous ulcers

A causative role for Helicobacter pylori (H. pylori) in the pathogenesis of oral mucosal ulcerations has been suggested previously. We have adopted the polymerase chain reaction (PCR) as a rapid and sensitive means to detect H. pylori in swabs of recurrent oral aphthous ulcers and in samples of other oral sites. Of the oral aphthous ulcer samples, 32 (71.8%) were found to be positive, while the saliva and plaque samples (most of them taken from the patients with aphthous ulcers) were consistently negative for H. pylori DNA, as detected by the PCR assay. Only two of the swab samples from the tongue (collected at the time of concurrent, H. pylori-positive oral aphthous ulcers) were found to be positive. The data suggest that H. pylori may be associated frequently with recurrent oral aphthous ulcers, and are consistent with previous studies indicating that saliva and plaque are not likely sources of contamination with this microorganism. There was no apparent correlation with HIV status (infection with human immunodeficiency virus). The possible pathogenic significance of Helicobacter pylori in oral ulcerations is discussed.