摘要
目的 探讨梅毒血清固定患者口腔种植修复后并发口腔感染的风险因素。方法 选取2019年3月-2024年12月中国人民解放军南部战区总医院口腔科实施种植修复的121例(132个种植牙位)梅毒血清固定患者作为研究组,以同期接受种植修复的121例(138个种植牙位)非血清固定梅毒患者作为对照组,对比两组患者间基础临床资料和口腔感染率。将研究组患者进一步根据口腔感染情况划分为未感染组(n=106)和口腔感染组(n=15),对比未感染组和口腔感染组患者基础临床资料、牙列缺失特征、种植修复特征的差异,以及两组患者种植前及种植后1周唾液炎症因子水平变化及差异。通过单因素logistic回归分析、共线性检验及多因素线性回归分析筛选梅毒血清固定患者口腔种植修复术后合并口腔感染的影响因素。结果 研究组患者中接受口腔种植修复术后发生口腔感染15例(12.4%,15/121),高于对照组患者的术后口腔感染率(5.0%,6/121),差异有统计学意义(χ2=4.22,P<0.05)。口腔感染组的15例患者中共检测出病原菌22株,包括厌氧菌14株(63.6%)、牙龈卟啉单胞菌3株(13.7%)、口腔链球菌5株(22.7%)。口腔感染组患者中合并吸烟史、合并糖尿病病史、多牙缺失、既往有牙周病史、种植修复时间≥1 h占比均高于未感染组(均P<0.05)。种植后1周,口腔感染组、未感染组患者唾液C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均显著高于治疗前,且口腔感染组患者唾液CRP、IL-6、TNF-α水平较未感染组更高(P<0.05)。单因素logistic回归分析、共线性检验及多因素线性回归分析表明糖尿病病史、种植后1周CRP、IL-6均是梅毒血清固定患者口腔种植修复后并发口腔感染的独立危险因素(P<0.05)。结论 种植修复术后梅毒血清固定患者并发口腔感染以厌氧菌为主。合并糖尿病病史、术后炎症因子水平较高是口腔种植术后感染的独立危险因素。
Objective To explore the risk factors for oral infections after dental implant restoration in patients with syphilis serofast reaction.Methods A total of 121 patients with syphilis serofast reaction(132 implant sites)who underwent dental implant restoration in the Department of Stomatology,Southern Theater Command General Hospital from March 2019 to December 2024 were enrolled in the study group.Another 121 non-serofast syphilis patients(138 implant sites)who received implant restoration during the same period served as the control group.Basic clinical data and oral infection rates were compared between these two groups.The study group was further divided into a non-infection subgroup(n=106)and an oral infection subgroup(n=15)based on the presence of oral infections.Differences in basic clinical data,characteristics of dentition defects,and implant restoration features were compared between the two subgroups.Changes in salivary inflammatory factor levels before implantation and 1 week after implantation were also analyzed.Univariate logistic regression analysis,collinearity test,and multivariate linear regression analysis were used to identify factors influencing post-implant oral infections in patients with syphilis serofast reaction.Results After implant restoration,the infection rate was significantly higher in the study group than in the controls[15/121 cases(12.4%)vs.6/121 cases(5%),2=4.22,P<0.05].A total of 22 pathogenic strains were detected in the 15 infected patients of the study group,including 14 anaerobic bacteria(63.6%),3 Porphyromonas gingivalis(13.7%),and 5 oral streptococci(22.7%).Compared with the non-infection subgroup,the oral infection subgroup had higher proportion of patients with a history of smoking,diabetes mellitus,multiple tooth loss,previous periodontal disease,and implant restoration duration≥1 hour(all P<0.05).One week after implantation,the levels of CRP,IL-6 and TNF-αin both the oral infection group and the non-infection group were significantly higher than before treatment.Moreover,the levels of CRP,IL-6,and TNF-αin the oral infection group were higher than those in the non-infection group(P<0.05).Univariate logistic regression,collinearity test,and multivariate linear regression analyses showed that a history of diabetes mellitus,and CRP and IL-6 levels one week after implantation were independent risk factors for post-implant oral infections in patients with syphilis serofast reaction(P<0.05).Conclusions In patients with syphilis serofast reaction undergoing dental implant restoration,postoperative oral infections are predominantly caused by anaerobic bacteria.A history of diabetes and elevated levels of inflammatory markers after surgery are independent risk factors for infections following dental implantation.
作者
赵金花
雒静
王伟娜
ZHAO Jinhua;LUO Jing;WANG Weina(General Hospital of Southern Theater Command of PLA,Guangzhou 510010,China)
出处
《皮肤性病诊疗学杂志》
2025年第8期552-559,共8页
Journal of Diagnosis and Therapy on Dermato-venereology
基金
广州市科技计划项目(202102021252)。
关键词
梅毒血清固定
种植修复
口腔感染
危险因素
syphilis serofast
implant restoration
oral infection
risk factors
