Bacteriological study of therapy-resistant periapical periodontitis

对32例临床诊断为难治性根尖周炎的根管内细菌进行了椅子侧厌氧培养系统的细菌检测。结果表明，难治性根尖周炎是一种感染性疾病，以消化链球菌和厌氧放线菌、肠球菌、葡萄球菌和兼性肠杆菌为主，真菌以念珠菌为主。这些微生物的感染可能在根尖周耐药的形成中起着重要作用。以消化链球菌和放线菌为主的厌氧菌的繁殖会导致严重的自发性疼痛、明显的肿胀和脓液流动以及脓肿的形成。另一方面，念珠菌的感染会引起严重的敲击痛和牙髓疼痛。

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.