根管治疗后继发根尖周炎患者根管内微生物群落的研究

【目的】探讨根管治疗后继发根尖周炎患者根管内微生物群落的情况。【方法】选取2014年2月至2015年1月期间在本院接受根管治疗的86例根尖周炎患者的致病牙为研究对象，把其中行根管治疗后伴根尖周炎的16例患者分为观察组，把行根管治疗后不伴根尖周炎的70例患者分为对照组。观察比较两组患者致病牙根管内的微生物群落构成、细菌种类的检出率和微生物群落98%成分的菌门各样本丰度的差异。【结果】观察组患者致病牙根管内微生物群落主要由肠球菌、链球菌、放线菌、葡萄球菌、乳杆菌、消化链球菌、丙酸杆菌、优杆菌、类杆菌、梭杆菌、韦荣球菌，真菌类有白色念球菌构成；对照组患者患牙根管内微生物群落中主要有无肠球菌、葡萄球菌和白色念球菌。观察组中链球菌、放线菌、乳杆菌的检出率均明显高于对照组；观察组中粪杆菌和梭杆菌的检出率明显低于对照组；两组中消化链球菌、丙酸杆菌、优杆菌和韦荣球菌的检出率变化较小。两组微生物群落中放线菌门和拟杆菌门的丰度差异具有统计学意义(P <0.01)；两组微生物群落中变形菌门、厚壁菌门和梭杆菌门的样本丰度比较差异无统计学意义(P >0.05)。【结论】行根管治疗后伴根尖周炎的患者致病牙根管内微生物群落的组成较丰富，放线菌、拟杆菌的检出率变化和二者菌门丰度差异显示放线菌和拟杆菌对于根尖周炎的感染有相关关系。

Composition of Microbial Community in Patients with Secondary Apical Paradentosis after Root Canal Therapy

Obj ective]To explore the composition of microbial community in patients with secondary api-cal paradentosis after root canal therapy.[Methods]Eighty-six patients with secondary apical paradentosis during February 2014 to January 2015 from our hospital were chosen for the study and were divided into two groups based on the presence of infection after root canal therapy.The observation group consisted of 1 6 cases with secondary apical paradentosis,and the control group consisted of 70 cases without secondary apical para-dentosis.The composition of the microbial community within the root canal,bacterial species detection rate, and sample abundance according to 98% of the microbial community composition were analyzed and compared between the two groups.[Results]Pathogenic root canal microflora in the observation group were mainly en-terococci,streptococcus,actinomyces,staphylococcus,lactobacillus,peptotreptococcus,propionibacterium acnes,eubacterium,bacteroidete,fusobacterium,veillonella sp,and fungi-like candida albicans.The root ca-nal microflora in the control group appeared mainly to be enterococci,staphylococcus aureus and Candida albi-cans.The detection rate of streptococci,actinomycetes,and lactobacillus was significantly higher in the obser-vation group than in control group;however,the detection rate of fusobacterium and fecal coli was significant-ly lower than that in the control group.Generally two groups showed tiny different changes in detection of pep-totreptococcus ,propionibacterium,eubacterium and veillonella.The differences were statistically significant in terms of microbial abundance of actinobacteria and bacteroidete phylotypes of the two groups (P <0.01), but no significant differences were observed in microbial abundance of proteobacteria,firmicutes and fusobac-terium between the two groups (P >0.05).[Conclusion]Patients with apical paradentosis after root canal therapy have a variety of root pathogenic microflora composition.Changes in detection rate of actinomycetes and bacteroides plus the difference in their abundance suggest they both may have certain relations to periapical infection.