今回は歯周病患者に対し、歯周治療後に口腔内細菌が
血中にどの程度検出されるかを調べた文献です。
未治療の歯周病を有する患者30名に対し
プロービング、ブラッシング、超音波スケーリング直後の
静脈血中の細菌を計測しています。
Transient bacteraemias are frequently detected following dental manipulation. Infective endocarditis (IE) can arise in susceptible individuals and antibiotic prophylaxis is routinely performed for certain procedures considered to be “at risk” of IE. Evidence is emerging that periodontal disease may be a significant risk factor for the development of certain systemic diseases such as cardiovascular disease. These systemic conditions could be initiated or detrimentally influenced by the repeated entry of bacteria into the bloodstream.
The present study comprised a single blind parallel study of 2 weeks duration. A baseline blood sample was obtained from 30 volunteers with untreated periodontal disease following which a periodontal probing depth chart was collected. A further blood sample was taken following this procedure, and each subject was recalled 2 weeks later. A blood sample was collected, the subject carried out toothbrushing and a further blood sample taken. Full-mouth ultrasonic scaling was then performed and a final blood sample taken. Blood samples were analysed for bacteraemia using conventional microbiological culture and polymerase chain reaction (PCR) using universal bacterial primers that target the 16S ribosomal RNA gene of the vast majority of bacteria.
Using culture methods, the incidence of bacteraemias was as follows: following ultrasonic scaling (13%), periodontal probing (20%) and toothbrushing (3%). PCR analysis revealed bacteraemia incidences following ultrasonic scaling, periodontal probing and toothbrushing of 23%, 16% and 13%, respectively.
These findings suggest that detectable dental bacteraemias induced by periodontal procedures are at a lower level than previously reported.
細菌の検出は培養法とPCR法で行っていますが
前者では
プロービング後に20％、ブラッシング後に3％
超音波スケーリング後に13％に口腔由来細菌が検出され
後者ではそれぞれ16％、13％、23％に検出され
菌血症と判断されました。
結論として
歯周病の各処置によって菌血症が生じるが
その頻度は従来報告されていたものより低かった
ということです。
引用文献
Kinane DF1, Riggio MP, Walker KF, MacKenzie D, Shearer B.
Bacteraemia following periodontal procedures.
J Clin Periodontol. 2005 Jul;32(7):708-13.