Plaque control in therapy of gastric ulcer

• Main Authors: Bo-Ine Chan, 陳柏穎
• Other Authors: Kun-Yen Ho
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/98190894252309956726

碩士 === 高雄醫學大學 === 牙醫學研究所碩士班 === 93 === Background: Helicobacter pylori is one of the most common pathogens worldwide,and approximately 50% of the world population is infected with it . Many investigators had reported strong correlation between H. pylori and duodenal ulcer, gastric ulcer, gastritis, and even gastric cancer, but most of all have no clinical symptom . Microaerophilic acidic environment of dental plaque can be an ideal environment for growth of H pylori. However, whether dental plaque is a potential reservoir for gastric H. pylori reinfection remains controversial. Objective : The aim of this study is to investigate the relationship of H. pylori in the stomach and dental plaque, and plaque control would benefit therapy of gastric ulcer by full mouth scaling. Material & Methods: forty-two patients who first received gastric endoscopic biopsy in Kaohsiung Medical University Hospital were enrolled in our study. Patients were excluded if they were edentulous or had received gastrointestinal tract surgery and medical therapy that may alter the results (include proton pump inhibitors, antibiotics and compounds containing bismuth) within one month. Gastric specimens were obtained from gastric antrum and body, and were assessed by rapid urease test, culture, histology and 13-C urea breath test. Gastric H. pylori infection was confirmed when the culture was positive or a concordance of two of the other three tests was positive. At the same day of endoscopy ,dental plaque specimens were collected after recording the plaque index、 gingival index and probing depth of patients, and then assessed by rapid urease test (RUT) and polymerase chain reaction (PCR) (cagA gene). According to patients’mind to receive full mouth scaling and oral hygiene instruction, or not. Four months after H. pylori eradication therapy for 4 months, above assessments were repeated to confirm the outcome of therapy. Results: Those patients to receive full mouth scaling and oral hygiene instruction H. pylori before eradication therapy is positive and after is negative in dental plaque and stomach is 44% and 48 % individually. It shows that plaque control has a tendency towards eradication therapy of H. pylori . The existence of H. pylori in the dental plaque after the eradication therapy indicated that the antibiotics might not be as effective in such a biofilm as in the stomach and oral cavity . It shows that the presence of H. pylori in dental plaque is one of the risk factors of gastric infection. The fact that the plaque index、 gingival index and probing depth of gastric H. pylori (+) patients were significantly higher than gastric H. pylori (-) patients suggested that oral hygiene is important to gastric H. pylori infection status. Conclusions: 1.Oral cavity is a reservoir of H. pylori,2. plaque control has a tendency towards eradication therapy of H. pylori , 3. oral hygiene is important to gastric H. pylori infection status .The existence of H. pylori in the dental plaque after the eradication therapy infers that the recolonization of H. pylori from dental plaque may be a source of the transmission and recrudescence of gastsric infection.