Oral Hijyen İndeksi ve Gastrik Helicobacter Pylori Pozitifliği İlişkisi

Amaç: Helicobacter pylori (HP), gastroduodenal infla- masyona neden olan, gastrik ve duodenal ülser ile atrofik gastrite yol açabilen bakteriyel bir patojendir. Endoskopi sırasında yapılan üreaz testi ile bakterinin kolonizasyonu gösterilebilmektedir. Rezervuarı ve geçiş yolları hakkında çelişkili veriler mevcuttur. Oral yoldan bulaşın ön planda olduğu düşünülmektedir. Çok sayıda çalışmada dental plaklarda bakterinin varlığının gastrik kolonizasyon ve eradikasyon üzerine etki ettiği sonucu elde edilmiştir. Oral flora bakterilerinin HPyi inhibe ettiğine dair veriler mev- cuttur. Çalışmamızda sağlıklı bir ağız florasının temsili olabilecek basitleştirilmiş oral hi jyen indeksi (OHİ) ile HP pozitifliği arasındaki birlikteliği saptamak amaçlanmıştır. Yöntemler: Dispeptik yakınmalar nedeni ile üst gastro- intestinal sistem endoskopisi planlanan hastaların oral hi jyen indeksleri diş hekimi tarafından işlem öncesinde değerlendirildi. Oral hi jyen indeksi skalası ile hastalar iyi, zayıf ve orta şeklinde üç gruba ayrıldı. Gastroskopi yapı- lan hastaların tümünden alınan pre-pilorik biyopsi örnek- leri hızlı üreaz testi ile değerlendirildi. Retrospektif olarak oral hi jyen indeksleri incelendi ve HP pozitifliği açısından gruplar incelendi. Bulgular: Çalışmaya 66 hasta (30 kadın,% 45,5) dahil edildi. Hastaların ortalama yaşları 34,17 ± 14,7 idi. İyi, za- yıf ve kötü olarak gruplandırılan 11 (%16,7), 29 (%43,9) ve 26 (%39,4) hasta saptandı. OHİ grubu iyi olan hasta- larda gastrik HP varlığına daha az oranda rastlanmıştır. Sonuç: İdeal oral hi jyenin sağlanması ile gastrik HP sıklı- ğında azalma gözlenebilir

The Relationship between Oral Hygiene Index and Gastric Helicobacter Pylori Positivity

Objective: Helicobacter pylori (HP) is a bacterial patho- gen that leads to gastroduodenal inflammation, gastric and duodenal ulcer and atrophic gastritis. Colonization of bacteria can be shown by using rapid-urease test during endoscopy. There are conflicting data about the route of transmission and reservoir. Its thought to be transmitted primarily by oral route. Many studies showed results sup- porting that the presence of bacteria in dental plaques has effects on gastric colonization and eradication. There are data about the potential inhibitory effect of oral flora on HP. We aimed to analyze the association of simplified oral hygiene index -a possible representation of a healthy oral flora- with HP positivity. Methods: Patients undergoing upper gastrointestinal system endoscopy for symptoms of dyspepsia were as- sessed by a dentist for the simplified oral hygiene index (OHI). Patients were classified as good, poor and bad groups based on oral hygiene index scale. Pre-pyloric biopsy materials were assessed using rapid-urease test. Oral hygiene indexes were analyzed retrospectively, groups were compared for HP positivity. Results: 66 patients (30 females, 45.5%) were included. Mean age of patients was 34.17±14.7 years. 11 (16.7%), 29 (43.9%) and 26 (39.4%) patients were classified as in good, poor and bad hygiene index groups, respectively. In patients with good OHI gastric HP positivity was less frequent. Conclusion: Decreased frequency in gastric HP may be observed with maintaining an ideal oral hygiene

PDF

___

1. McColl KE. Clinical practice. Helicobacter pylori infection. N Engl J Med 2010;362:1597-1604. 2. Şimşek İ, Binicier ÖB. Helicobacter Pylori. İç Hastalıkları Dergisi 2011;18:13-26. 3. Schein W, Meryn S. Helicobacter pylori and the mouth cavity--overview and perspectives. Wien Klin Wochenschr 1994;106:547-549. 4. Esfahanizadeh N, Modanlou R. Correlation between oral hygiene and Helicobacter pylori infection. Acta Med Iran 2010;48:42-46. 5. Tsami A, Petropoulou P, Kafritsa Y, et al. The presence of Helicobacter pylori in dental plaque of children and their parents: is it related to their periodontal status and oral hy- giene? Eur J Paediatr Dent 2011;12:225-230. 6. Bharath TS, Reddy MS, Dhanapal R et al. Molecular detec- tion and correlation of Helicobacter pylori in dental plaque and gastric biopsies of dyspeptic patients. J Oral Maxillofac Pathol 2014;18:19-24. 7. Silva DG, Stevens RH, Macedo JM, et al. Presence of He- licobacter pylori in supragingival dental plaque of indi- viduals with periodontal disease and upper gastric diseases. Arch Oral Biol 2010;55:896-901. 8. Contractor QQ, Tahir MY, Naseem S, et al. Helicobacter py- lori in the dental plaque of healthy Saudis. Saudi J Gastro- enterol 1998;4:13-16. 9. Al-Refai AN, Fathalla SE, Nagamani R et al. Incidence of he- licobacter pylori in dental plaque of Saudi gastritis patients. J Family Community Med 2002;9:27-36. 10. Butt AK, Khan AA, Bedi R. Helicobacter pylori in dental plaque of Pakistanis. J Int Acad Periodontol 1999;1:78-82. 11. Liu P, Yue J, Han S, et al. A cross-sectional survey of dental caries, oral hygiene, and Helicobacter pylori infection in adults. Asia Pac J Public Health 2013;25:49-56. 12. Liu Y, Lin H, Bai Y, et al. Study on the relationship be- tween Helicobacter pylori in the dental plaque and the oc- currence of dental caries oral hygiene index. Helicobacter 2008;13:256-260. 13. Zheng Y, Liu M, Shu H, et al. Relationship between oral problems and Helicobacter pylori infection. Arch Oral Biol. 2014;59:938-943. 14. Song HY, Li Y. Can eradication rate of gastric Helicobacter pylori be improved by killing oral Helicobacter pylori? World J Gastroenterol 2013;19:6645-6650. 15. Jia CL, Jiang GS, Li CH et al. Effect of dental plaque con- trol on infection of Helicobacter pylori in gastric mucosa. J Periodontol 2009;80:1606-1609. 16. Namiot DB, Namiot Z, Kemona A, et al. Peptic ulcers and oral health status. Adv Med Sci 2006;51:153-155. 17. Peach HG, Pearce DC, Farish SJ. Helicobacter pylori in- fection in an Australian regional city: prevalence and risk factors. Med J Aust 1997;167:310-313. 18. Berroteran A, Perrone M, Correnti M, et al. Detection of Helicobacter pylori DNA in the oral cavity and gastroduo- denal system of a Venezuelan population. J Med Microbiol 2002;51:764-770. 19. Chaudhry S, Khan AA, Butt AK et al. Helicobacter pylori in dental plaque; is it related to brushing frequency, plaque load and oral health status? J Coll Physicians Surg Pak 2011;21:589-592. 20. Namiot DB, Namiot Z, Kemona A, et al. Oral health status and oral hygiene practices of patients with peptic ulcer and how these affect Helicobacter pylori eradication from the stomach. Helicobacter 2007;12:63-67. 21. Hardo PG, Tugnait A, Hassan F, et al. Helicobacter pylori infection and dental care. Gut 1995;37:44-46. 22. Sudhakar U, Anusuya CN, Ramakrishnan T, et al. Isolation of Helicobacter pylori from dental plaque: A microbiologi- cal study. J Indian Soc Periodontol 2008;12:67-72. 23. Kilmartin CM. Dental implications of Helicobacter pylori. J Can Dent Assoc 2002;68:489-493. 24. Sgouras D, Maragkoudakis P, Petraki K et al. In Vitro and in Vivo Inhibition of Helicobacter pylori by Lactobacil- lus case Strain Shirota. Apple Environ Microbiol 2004 ;70:518-526. 25. Cui Y, Wang CL, Liu XW, et al. Two stomach-originated lactobacillus strains improve Helicobacter pylori infected murine gastritis. World J Gastroenterol 2010; 16: 445-452. 26. Aas JA, Paster BJ, Stokes LN et al. Defining the Nor- mal Bacterial Flora of the Oral Cavity. J Clin Microbiol 2005;43:57215732 27. Ishihara K, Miura T, Kimizuka R, et al. Oral bacteria in- hibit Helicobacter pylori growth. FEMS Microbiol Lett 1997;152:2,355361. 28. Kadayifci A, Buyukhatipoglu H, Savas MC, ve ark. Eradi- cation of Helicobacter pylori with triple therapy: an epide- miologic analysis of trends in Turkey over 10 years. Clin Ther 2006;28:1960-1966. 29. Uyanıkoğlu A, Coşkun M, Binici DN, ve ark. Frequency of Helicobacter pylori in patients underwent endoscopy. Dicle Med J 2014;41:507-511. 30. Demirtaş L, Sayar İ, Akbaş EM, ve ark. Distribution of the incidence and location of the Helicobacter pylori according to age and gender in patients who undergone endoscopy. Dicle Med J 2014;41:507-511.