Bacteriological study of therapy-resistant periapical periodontitis

对32例经临床诊断为难治性根尖周炎的患者，采用椅侧厌氧培养系统对其根管内细菌进行了研究。治疗抵抗性根尖周炎病例均为培养阳性。这表明治疗抵抗性根尖周炎是一种传染性疾病。厌氧菌中主要分离出胃链球菌和放线菌，兼性菌中主要分离出肠球菌、葡萄球菌和肠杆菌，真菌中主要分离出念珠菌。这些微生物的感染可能在治疗抵抗性根尖周炎的形成中起重要作用。主要由胃链球菌和放线菌组成的厌氧菌的增殖引起严重的自发疼痛，明显的肿胀，脓流和脓肿形成。另一方面，念珠菌感染可引起严重的叩击痛和牙髓痛。

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.