Bacteriological study of therapy-resistant periapical periodontitis

采用椅旁厌氧培养系统对32例临床诊断为难治性根尖周炎的根管内细菌进行了研究，所有难治性根尖周炎的根管内细菌培养均为阳性。厌氧菌以消化链球菌属和放线菌属为主，肠球菌属、葡萄球菌属和肠杆菌属以肠杆菌属为主，真菌以念珠菌属为主。这些微生物的感染可能在难治性根尖周炎的形成中起重要作用，以消化链球菌和放线菌为主的厌氧菌的大量繁殖可引起严重的自发性疼痛、明显的肿胀、流脓和脓肿形成，而念珠菌的感染可引起严重的叩诊痛和牙髓痛。

The bacteria in root canals of 32 cases diagnosed as therapy-resistant periapical periodontitis based on clinical progress were studied using chair-side anaerobic incubation system.All the case of therapy-resistant periapical periodontitis is cultivation positivities. This shows that therapy-resistant periapical periodontitis is an infectious disease.Peptostreptococcus and Actinomyces of anaerobes, Enterococcus, Staphylococcus and Enterobactor of facultatives, and Candida of fungus were isolated predominantly. Infection by these microbes may have play the significant role in formation of therapy-resistant periapical periodontitis.Multiplication of the anaerobic bacteria consisting mainly of Peptostreptococcus and Actinomyces causes sever spontaneous pain, markable swelling and pus flow and abscess formation.On the other hand, infection by Candida produces sever percussion pain and pulpation pain.