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Ricucci D, Milovidova I, Rôças IN, Siqueira JF. Surgical management of a lateral lesion refractory to root canal retreatment caused by an extraradicular calculus. A case report. AUST ENDOD J 2022; 49:183-191. [PMID: 35644940 DOI: 10.1111/aej.12632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 11/29/2022]
Abstract
This article describes the management of a root canal-treated maxillary central incisor displaying a radiographic lateral radiolucency and a sinus tract that persisted irrespective of root canal retreatment following high standards. Endodontic microsurgery was indicated and curettage of the pathologic tissue revealed a calculus-like material attached to the outer root surface around the exit of a large lateral canal. A non-conventional approach was chosen: No root-end resection was conducted. Instead, the calculus was removed and the apical surface was scaled and smoothed, conserving the apical structure. Retrocavities were prepared in both lateral and apical foramens and filled with a bioceramic material. Follow-up examination showed optimal soft tissue healing. One-year follow-up of radiographs revealed healing of the lateral lesion. The lesion was diagnosed as a cyst, with an infected lumen. An exuberant calculus-like material attached to the external root surface was the most likely cause of the recalcitrant lateral periradicular lesion.
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Affiliation(s)
| | | | - Isabela N Rôças
- Department of Endodontics, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Brazil.,Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - José F Siqueira
- Department of Endodontics, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Brazil.,Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Brazil
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Nagappan N, Palaneeswaran K, Kumarappan K, Natarajan R, Tajuddin R, Anusha Y. Antimicrobial efficacy of herbal and chlorhexidine mouthrinse against Staphylococcus aureus - An in vitro microbiological study. J Pharm Bioallied Sci 2022; 14:S318-S322. [PMID: 36110729 PMCID: PMC9469420 DOI: 10.4103/jpbs.jpbs_821_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 11/05/2022] Open
Abstract
Background: Microorganisms in the oral cavity are still considered serious public health problems and position a costly burden on health-care services worldwide and elsewhere. Mouthrinses have been used in the oral cavity for decades with the intention of reducing the amount of microorganisms. Mouthrinses are used as additives to oral mechanical hygiene. Therapeutic mouthwashes are also prescribed as an alternative to mechanical plaque control for plaque accumulation prevention and for gingival and peri-implant health maintenance. Mechanical control alone has been questioned to eliminate recalcitrant biofilms in the oral cavity because it is known to be very time-consuming and, most significantly, inadequate for good oral hygiene. The aim of this study was to assess the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and antimicrobial efficacy of herbal and chlorhexidine (CHX) mouthrinse against Staphylococcus aureus. Materials and Methods: For MIC (macrobroth dilution method), MBC and antimicrobial effectiveness (zone of inhibition) of an herbal mouthrinse and 0.2% CHX mouthrinse were determined by the agar well diffusion method. Results: The zone of inhibition of S. aureus was 24 mm for the CHX mouthrinse. The arowash liquid mouthrinse shows that S. aureus does not produce a zone of inhibition. Conclusion: CHX mouthrinse (0.2%) has a better antimicrobial efficacy against the S. mutans when compared to herbal mouthrinse (arowash liquid)
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Siqueira JF, Rôças IN. Present status and future directions - microbiology of endodontic infections. Int Endod J 2021; 55 Suppl 3:512-530. [PMID: 34958494 DOI: 10.1111/iej.13677] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Apical periodontitis has a microbial aetiology and is one of the most common inflammatory diseases that affect humans. Fungi, archaea and viruses have been found in association with apical periodontitis, but bacteria are by far the most prevalent and dominant microorganisms in endodontic infections. Bacterial infection of the root canal system only occurs when the pulp is necrotic or was removed for previous treatment. In some specific cases, including acute and chronic abscesses, the bacterial infection may reach the periradicular tissues. Intracanal bacteria are usually observed as sessile multispecies communities (biofilms) attached to the dentinal root canal walls. Infection in the main root canal lumen can spread to other areas of the root canal system. Although more than 500 bacterial species have been detected in endodontic infections, a selected group of 20 to 30 species are most frequently detected and may be considered as the core microbiome. There is a high interindividual variability in the endodontic microbiome in terms of species composition and relative abundance. Obligate anaerobic species are more abundant in the intraradicular bacterial communities of teeth with primary apical periodontitis, while both anaerobes and facultatives dominate the communities in post-treatment apical periodontitis. Bacterial interactions play an essential role in determining the overall virulence of the community, which has been regarded as the unit of pathogenicity of apical periodontitis. This article reviews the microbiologic aspects of endodontic infections and provides perspectives for future research and directions in the field.
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Affiliation(s)
- José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
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Bronzato JD, Bomfim RA, Hayasida GZP, Cúri M, Estrela C, Paster BJ, Gomes BPFA. Analysis of microorganisms in periapical lesions: A systematic review and meta-analysis. Arch Oral Biol 2021; 124:105055. [PMID: 33588190 DOI: 10.1016/j.archoralbio.2021.105055] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/30/2022]
Abstract
AIMS The aim of this study was to systematically review the literature on prevalence of microorganisms and their viability/activity in endodontic periapical lesions. DESIGN Literature research was performed on five electronic biomedical databases from their start dates to June 2020. Only studies evaluating the presence of microorganisms in periapical lesions in human permanent teeth with secondary/persistent infection were included. Two reviewers independently assessed the eligibility for inclusion, extracted data and evaluated the risk of bias. Meta-analysis and binominal tests were used to analyse the resulting data. RESULTS From the 1,313 records found, 23 full-texts were included for qualitative and quantitative analysis. The prevalence of microorganisms in endodontic periapical lesions was 87 % (95 % CI, 75-94) and the prevalence of viable/active microorganisms was 82 % (95 % CI, 66-91). There were statistical differences in the geographic area subgroup and between viable bacteria and active viruses. The most common detection method of microorganisms was the molecular one (69 %), and the most prevalent bacteria were the species Actinomyces, Fusobacterium and Prevotella (40 %). Most of the included studies had moderate risk of bias. CONCLUSIONS The prevalence of microorganisms in endodontic periapical lesions was 87 % and the prevalence of viable/active microorganisms was 82 %.
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Affiliation(s)
- Juliana D Bronzato
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, SP, Brazil
| | - Rafael A Bomfim
- Department of Community Health, School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Giovanna Z P Hayasida
- Department of Applied Math and Statistics, Institute of Math and Computing Sciences, University of São Paulo, São Carlos, SP, Brazil
| | - Mariana Cúri
- Department of Applied Math and Statistics, Institute of Math and Computing Sciences, University of São Paulo, São Carlos, SP, Brazil
| | - Carlos Estrela
- Department of Endodontics, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Bruce J Paster
- Department of Microbiology, Forsyth Institute, Cambridge, United States
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, SP, Brazil.
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Rusu D, Stratul SI, Calniceanu H, Boariu M, Ogodescu A, Milicescu S, Didilescu A, Roman A, Surlin P, Locovei C, Chiperi M, Solomon S, Nica L. A qualitative and semiquantitative SEM study of the morphology of the biofilm on root surfaces of human teeth with endodontic-periodontal lesions. Exp Ther Med 2020; 20:201. [PMID: 33133249 PMCID: PMC7593830 DOI: 10.3892/etm.2020.9331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/17/2020] [Indexed: 11/17/2022] Open
Abstract
Over the last decades, scanning electron microscopy (SEM) proved to be invaluable for ultrastructural investigation, allowing imaging of the overall appearance and/or specific features of oral biofilms, e.g., microbial colonies and individual cells, glycocalyx, the presence of inorganic products. The aim of this study was the observation and evaluation of the morphology of the biofilm of endodontic-periodontal lesions (EPL) with a modified protocol involving a simplified histologic sample preparation and a low-vacuum SEM examination method. Twenty-one teeth with endodontic-periodontal involvement, extracted for periodontal reasons, were carefully washed with saline, underwent fixation in modified Karnovsky solution and were dehydrated in alcohol series. Samples were examined under low-vacuum SEM. Radicular surfaces were evaluated qualitatively and semiquantitatively for several characteristics, including the presence of bacterial types, the biofilm morphology and the content of root resorptions. Radicular surfaces were divided in four conventional zones Surfaces were evaluated for several characteristics: Presence of bacterial types, biofilm morphology, presence of root resorptions. High-quality images, relevant for endodontic-periodontal biofilms were collected. Continuous, established biofilm was found on all examined surfaces, its detection varying from 19% of the samples on the wall of cemental cone to 52.3% on the radicular surface of the periodontal pocket. Observed microorganisms included cocci, rods an filaments. Spirils and motile bacteria were only accidentally found. SEM investigation of surfaces involved in EPL revealed less surfaces covered by mature biofilm (in only 28.5% of the samples in the ‘transition zone’), especially rods and filaments associated with cemental resorptions and calculus. Biofilm elements were better represented in periodontal pockets than in other zones of EPL (detected in up to 81% of the samples). A strong correlation between mature biofilm and the presence of cocci appears on all investigated zones (P<0.01). Microbiota appeared to be morphologically similar in apical and periodontal areas, especially in old EPL.
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Affiliation(s)
- Darian Rusu
- Department of Periodontology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Stefan-Ioan Stratul
- Department of Periodontology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Horia Calniceanu
- Department of Periodontology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Boariu
- Department of Endodontics, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandru Ogodescu
- Department of Pedodontics, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Stefan Milicescu
- Department of Prosthodontics, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Andreea Didilescu
- Department of Embryology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Alexandra Roman
- Department of Periodontology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Petra Surlin
- Department of Periodontology, University of Craiova, 200349 Craiova, Romania
| | - Cosmin Locovei
- Department of Materials and Manufacturing Engineering, Politehnica University of Timisoara, Timisoara 300006, Romania
| | | | - Sorina Solomon
- Department of Periodontology, 'Grigore T. Popa University of Medicine and Pharmacy, 700020 Iasi, Romania
| | - Luminita Nica
- Department of Endodontics, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Matsui S, Yoneda N, Maezono H, Kuremoto K, Ishimoto T, Nakano T, Yumoto H, Ebisu S, Noiri Y, Hayashi M. Assessment of the functional efficacy of root canal treatment with high-frequency waves in rats. PLoS One 2020; 15:e0239660. [PMID: 32991601 PMCID: PMC7523981 DOI: 10.1371/journal.pone.0239660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/10/2020] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study was to develop a high-frequency wave therapy model in rats and to investigate the influence of high-frequency waves on root canal treatment, which may provide a novel strategy for treating apical periodontitis. Root canal treatments with and without high-frequency wave irradiation were performed on the mandibular first molars of 10-week-old male Wistar rats. The mesial roots were evaluated radiologically, bacteriologically, and immunohistochemically. At 3 weeks after root canal treatment, lesion volume had decreased significantly more in the irradiated group than in the non-irradiated group, indicating successful development of the high-frequency therapy model. The use of high-frequency waves provided no additional bactericidal effect after root canal treatment. However, high-frequency wave irradiation was found to promote healing of periapical lesions on the host side through increased expression of fibroblast growth factor 2 and transforming growth factor-β1 and could therefore be useful as an adjuvant nonsurgical treatment for apical periodontitis.
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Affiliation(s)
- Saori Matsui
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
- Unit of Dentistry, Osaka University Hospital, Suita, Osaka, Japan
| | - Naomichi Yoneda
- Department of Dentistry and Oral Maxillofacial Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Hazuki Maezono
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
- * E-mail:
| | - Katsutaka Kuremoto
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takuya Ishimoto
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka, Japan
| | - Takayoshi Nakano
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka, Japan
| | - Hiromichi Yumoto
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shigeyuki Ebisu
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuichiro Noiri
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
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Karamifar K, Tondari A, Saghiri MA. Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities. Eur Endod J 2020; 5:54-67. [PMID: 32766513 PMCID: PMC7398993 DOI: 10.14744/eej.2020.42714] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 07/09/2020] [Indexed: 12/16/2022] Open
Abstract
Nonsurgical and surgical endodontic treatments have a high success rate in the treatment and prevention of apical periodontitis when carried out according to standard and accepted clinical principles. Nevertheless, endodontic periapical lesions remain in some cases, and further treatment should be considered when apical periodontitis persists. Although several treatment modalities have been proposed for endodontically treated teeth with persistent apical periodontitis, there is a need for less invasive methods with more predictable outcomes. The advantages and shortcomings of existing approaches for the diagnosis and treatment of endodontic periradicular lesions are discussed in this review.
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Affiliation(s)
- Kasra Karamifar
- From the Department of Restorative Dentistry, Rutgers School of Dental Medicine, New Jersey, USA
| | - Afsoon Tondari
- Department of Restorative Dentistry, Dental Branch, Shiraz Azad University, Shiraz, Iran
| | - Mohammad Ali Saghiri
- From the Department of Restorative Dentistry, Rutgers School of Dental Medicine, New Jersey, USA
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, USA
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8
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Gutmann JL, Manjarrés V. Historical and Contemporary Perspectives on the Microbiological Aspects of Endodontics. Dent J (Basel) 2018; 6:E49. [PMID: 30249009 PMCID: PMC6313668 DOI: 10.3390/dj6040049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 12/27/2022] Open
Abstract
The microbiota of the oral cavity plays a significant role in pulpal and periapical diseases. Historically, 100 years ago little was known on microbiota, but after a century of investigations, only now can many of the intimate secrets of microbial growth, expansion, persistence, communal activities, and virulence be revealed. However, with the capabilities of the microbiota for mutation, quorum sensing, and information transference, researchers are hard-pressed to keep up with both the changes and challenges that an amazingly wide range of bacterial species pose for both the scientist and clinician. Fortunately, the development and expansion of a vast array of molecular biological investigative techniques have enabled dentistry and its associated medical fields to attempt to keep pace with the wide and fascinating world of oral microbiology.
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Affiliation(s)
- James L Gutmann
- Department of Endodontics, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
| | - Vivian Manjarrés
- Department of Endodontics, Nova Southeastern University, College of Dental Medicine, Davie, FL 33314, USA.
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Ricucci D, Lopes WS, Loghin S, Rôças IN, Siqueira JF. Large Bacterial Floc Causing an Independent Extraradicular Infection and Posttreatment Apical Periodontitis: A Case Report. J Endod 2018; 44:1308-1316. [DOI: 10.1016/j.joen.2018.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/11/2018] [Accepted: 05/15/2018] [Indexed: 10/28/2022]
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Tewari S, Sharma G, Tewari S, Mittal S, Bansal S. Effect of immediate periodontal surgical treatment on periodontal healing in combined endodontic-periodontal lesions with communication-A randomized clinical trial. J Oral Biol Craniofac Res 2018; 8:105-112. [PMID: 29892531 PMCID: PMC5993466 DOI: 10.1016/j.jobcr.2018.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 04/12/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Management of combined endodontic-periodontal lesions needs more clinical investigations. The aim of this prospective randomized clinical trial was to evaluate the effect oftime interval between the non-surgical endodontic treatment (ET) and open flap debridement (OFD) on periodontal healing in combined endodontic periodontal lesions with apical communication. METHODS Forty patients were randomly allocated to two treatment protocols. Group 1(immediate periodontal surgery): OFD was performed at 21 days of initiation of ET and SRP, and Group 2(delayed periodontal surgery): OFD was performed after 3 months of initiation of ET and SRP. The primary parameters included probing pocket depth (PPD), relative attachment level (RAL) and bleeding on probing (BOP) and tooth mobility (TM). RESULTS Significantly more reduction in PPD, TM and gain in RAL was observed in Group 1 at 3 months of OFD. (P < 0.05) Whereas at 6 months follow up of OFD (6 and 9 months of ET in Group1 and Group 2, respectively), intergroup analysis showed statistically comparable reduction in BOP (%), PPD, TM and gain in RAL (P > 0.05) in both the groups. CONCLUSION Immediate periodontal surgery may not affect the outcome of the treatment of combined endo-perio lesions with apical communication.
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Affiliation(s)
- Shikha Tewari
- Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Geetanjali Sharma
- Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Sanjay Tewari
- Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Shweta Mittal
- Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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11
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Yamaguchi M, Noiri Y, Itoh Y, Komichi S, Yagi K, Uemura R, Naruse H, Matsui S, Kuriki N, Hayashi M, Ebisu S. Factors that cause endodontic failures in general practices in Japan. BMC Oral Health 2018; 18:70. [PMID: 29703201 PMCID: PMC5924503 DOI: 10.1186/s12903-018-0530-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 04/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bacterial biofilms that develop on root surfaces outside apical foramens have been found to be associated with refractory periapical periodontitis. However, several other factors cause endodontic failures apart from extraradicular biofilms. The aim of this study was to identify the factors causing endodontic failures in general practices in Japan. METHODS Patients diagnosed as having refractory periapical periodontitis by general practitioners and who requested endodontic treatment at Osaka University Dental Hospital were selected by checking medical records from April 2009 to March 2013. Factors causing endodontic failures were identified. RESULTS A total of 103 teeth were selected, and 76 teeth completed root-canal treatment. Tooth extractions were required for 18 teeth after or without endodontic treatment. Six teeth required apicoectomy after endodontic treatment. One tooth needed hemisection. One tooth needed intentional replantation. One tooth needed adhesion and replantation. The main causes of treatment failure were open apices (24 teeth), perforation (18 teeth), and root fracture (13 teeth). In six teeth with open apices that required apicoectomy or extraction, extraradicular biofilms may have been related to endodontic failure. CONCLUSIONS Most endodontic cases diagnosed with refractory periapical periodontitis by general practitioners were compromised by any other factors rather than extraradicular biofilms.
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Affiliation(s)
| | - Yuichiro Noiri
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshihiro Itoh
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Shungo Komichi
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kyoko Yagi
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Reo Uemura
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Haruna Naruse
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Saori Matsui
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Nanako Kuriki
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Mikako Hayashi
- Osaka University Graduate School of Dentistry, Osaka, Japan
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12
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Curvers F, Haes PD, Lambrechts P. Non-Surgical Endodontic Therapy as Treatment of Choice for a Misdiagnosed Recurring Extraoral Sinus Tract. Eur Endod J 2017; 2:1-6. [PMID: 33403325 PMCID: PMC7757942 DOI: 10.5152/eej.2017.17007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 02/27/2017] [Accepted: 04/10/2017] [Indexed: 12/29/2022] Open
Abstract
The purpose of this article is to present the treatment of an odontogenic cutaneous sinus tract with exuberant extraoral granulation tissue and its successful endodontic treatment and follow up with Cone-Beam Computed Tomography (CBCT). In this case, a 31-year-old woman was referred for management of a reddish nodule on her chin. Previous surgical and antibiotic intervention by the dermatologist had not resolved the problem. Profound clinical and radiological examination (including CBCT) revealed apical periodontitis of tooth 32 to be the cause of the recurring cutaneous sinus tract. Conservative non-surgical root canal treatment was performed. With the aid of a topical corticosteroid and supplemental antibiotic therapy, healing of the apical periodontitis and resolution of the granulation tissue was evident after 1 year both clinically and radiographically. This case report emphasises the need for more awareness by dermatologists and other medical practitioners for the differential diagnosis of extraoral sinus tracts. Correct diagnosis of the dental cause can prevent unnecessary and multiple antibiotic and surgical interventions. Antibiotic therapy should never be administered without addressing the underlying dental cause. Conservative non-surgical endodontic treatment is the treatment of choice for an extraoral sinus tract of endodontic origin.
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Affiliation(s)
- Frederik Curvers
- Department of Oral Health Sciences, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Petra De Haes
- Department of Dermatology, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, University of Leuven, University Hospitals Leuven, Leuven, Belgium
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13
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Tinoco JM, Liss N, Zhang H, Nissan R, Gordon W, Tinoco E, Sassone L, Stevens R. Antibacterial effect of genetically-engineered bacteriophage ϕEf11/ϕFL1C(Δ36)P nisA on dentin infected with antibiotic-resistant Enterococcus faecalis. Arch Oral Biol 2017. [PMID: 28646693 DOI: 10.1016/j.archoralbio.2017.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Enterococcus faecalis is a gram-positive facultative anaerobic bacterium, which is present in 30-89% of teeth with postendodontic treatment failures. E. faecalis is capable of penetrating dentinal tubules and surviving as a monoculture after conventional endodontic therapy, indicating that it is resistant to commonly used endodontic disinfection protocols. Different E. faecalis strains have shown resistance to several antibiotics, and have been associated with both dental pathology and systemic infections. The aim of this study was to evaluate the efficacy of a genetically engineered bacteriophage to disinfect dentin infected with antibiotic resistant strains of E. faecalis. METHODS Extracted human dentin root segments were cemented into sealable two-chamber devices, fabricated from syringe needle caps to form in vitro infected-dentin models. The models were inoculated with an overnight suspension of either E. faecalis V583 (vancomycin resistant strain) or E. faecalis JH2-2 (fusidic acid and rifampin resistant, vancomycin sensitive strain). After 7days of incubation at 37°C, a suspension of a genetically engineered phage, ϕEf11/ϕFL1C(Δ36)PnisA, was added to the root canal of each infected dentin segment, and the incubation was continued for an additional 72-h. Dentin was harvested from the walls of each root canal and assayed for the residual titer of E. faecalis cells. RESULTS The recovered E. faecalis titer was reduced by 18% for the JH2-2 infected models, and by 99% for the V583 infected models. CONCLUSION Treatment: of E. faecalis-infected dentin with bacteriophage ϕEf11/ϕFL1C(Δ36)PnisA consistently resulted in a decrease in the residual bacterial population of both vancomycin-sensitive and resistant strains.
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Affiliation(s)
- Justine Monnerat Tinoco
- Department of Endodontology, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, RJ 20551-030, Brazil.
| | - Nadia Liss
- Department of Endodontology, School of Dentistry, Temple University, Philadelphia, PA 19140, USA
| | - Hongming Zhang
- Department of Endodontology, School of Dentistry, Temple University, Philadelphia, PA 19140, USA; Laboratory of Oral Infectious Diseases, School of Dentistry, Temple University, Philadelphia, PA 19140, USA
| | - Roni Nissan
- Department of Endodontology, School of Dentistry, Temple University, Philadelphia, PA 19140, USA
| | - Wanda Gordon
- Department of Endodontology, School of Dentistry, Temple University, Philadelphia, PA 19140, USA
| | - Eduardo Tinoco
- Department of Periodontology, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, RJ 20551-030, Brazil
| | - Luciana Sassone
- Department of Endodontology, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, RJ 20551-030, Brazil
| | - Roy Stevens
- Department of Endodontology, School of Dentistry, Temple University, Philadelphia, PA 19140, USA; Laboratory of Oral Infectious Diseases, School of Dentistry, Temple University, Philadelphia, PA 19140, USA
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Yoneda N, Noiri Y, Matsui S, Kuremoto K, Maezono H, Ishimoto T, Nakano T, Ebisu S, Hayashi M. Development of a root canal treatment model in the rat. Sci Rep 2017; 7:3315. [PMID: 28607360 PMCID: PMC5468248 DOI: 10.1038/s41598-017-03628-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/02/2017] [Indexed: 11/09/2022] Open
Abstract
Root canal treatment is performed to treat apical periodontitis, and various procedures and techniques are currently used. Although animal models have been used in the developmental research of root canal treatment, little of this research has used small animals such as rats, because of their small size. In this study, root canal treatment was performed on the rat mandibular first molar, which had four root canals, using a microscope, and the therapeutic effect was evaluated bacteriologically, radiologically and histopathologically. By performing root canal treatment, the level of bacteria in the mesial root of the treated teeth was reduced by 75% compared with the control. Additionally, the volume of the periapical lesions of the treated teeth as measured by micro-computed tomography decreased significantly 2 weeks after the root canal treatment when compared with the control. Histological evidence of healing was observed in the treatment group 8 weeks after root canal treatment. These results suggest that a root canal treatment model using rats can be used in developmental research for novel methods of root canal treatment.
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Affiliation(s)
- Naomichi Yoneda
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, 565-0871, Japan
| | - Yuichiro Noiri
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.
| | - Saori Matsui
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, 565-0871, Japan
| | - Katsutaka Kuremoto
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, 565-0871, Japan
| | - Hazuki Maezono
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, 565-0871, Japan
| | - Takuya Ishimoto
- Department of Biomaterials and Structural Materials Design, Osaka University Graduate School of Engineering, 1-2 Yamadaoka, Suita, 565-0871, Japan
| | - Takayoshi Nakano
- Department of Biomaterials and Structural Materials Design, Osaka University Graduate School of Engineering, 1-2 Yamadaoka, Suita, 565-0871, Japan
| | - Shigeyuki Ebisu
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, 565-0871, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, 565-0871, Japan
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15
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Rotstein I. Interaction between endodontics and periodontics. Periodontol 2000 2017; 74:11-39. [DOI: 10.1111/prd.12188] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 02/06/2023]
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Abstract
Diseases of the dental pulp often have an infectious origin, and treatments are aimed to control infections of the root canal system. Endodontic treatment principles originally evolved on the basis of trial and error, and only in recent decades have scientific methods been adopted to support clinical strategies. Yet, relevant research on the disease processes, their diagnoses, and efficient treatment are rare in the endodontic literature. Hence, the advancement of biologically based knowledge significant to clinical endodontics has been slow. Therefore, many differences of opinion still prevail in this field of dentistry. This review highlights and analyzes the background of some of the more heavily debated issues in recent years. Specifically, it deals with disagreements regarding the clinical management of pulpal exposures by caries in the adult dentition, definitions of success and failure of endodontic therapy, and causes of and measures to control infections of the root canal system. Clearly, a most apparent gap in the published endodontic literature is the lack of randomized clinical trials that address the more significant controversial matters relating to the management of pulpal wounds, medication, and the number of appointments required for the treatment of infected root canals. However, trials in endodontics require extremely long follow-up periods if valid conclusions are to be generated. Therefore, it is not to be expected that there will be rapid solutions to these issues in the foreseeable future.
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Affiliation(s)
- G. Bergenholtz
- Department of Endodontology and Oral Diagnosis, Faculty of Odontology, The Sahlgrenska Academy at Göteborg University, Box 40530, Göteborg, Sweden
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Taylor C, Roudsari RV, Jawad S, Darcey J, Qualtrough A. Modern Endodontic Principles. Part 6: Managing Complex Situations. ACTA ACUST UNITED AC 2016; 43:218-20, 223-6, 229-32. [PMID: 27439269 DOI: 10.12968/denu.2016.43.3.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Clinicians are often faced with endodontic cases that are significantly more challenging than the primary root canal treatment of mature adult teeth. This paper outlines some of the common treatment modalities which can be employed in situations in which either primary treatment has failed, or there is iatrogenic damage or unusual anatomy. CPD/Clinical Relevance: This paper will provide the reader with advice and techniques for undertaking orthograde endodontic retreatment, hemisection, endodontic surgery and management of teeth with incompletely formed roots.
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Taschieri S, Torretta S, Corbella S, Del Fabbro M, Francetti L, Lolato A, Capaccio P. Pathophysiology of sinusitis of odontogenic origin. ACTA ACUST UNITED AC 2015; 8. [DOI: 10.1111/jicd.12202] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/15/2015] [Indexed: 01/29/2023]
Affiliation(s)
- Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Sara Torretta
- Department of Clinical Sciences and Community Health; University of Milan; Milan Italy
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Alessandra Lolato
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Pasquale Capaccio
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
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Ravi Chandra PV, Kumar VH, Reddy SJ, Kiran DR, Krishna MN, Kumar GV. Biofilm forming capacity of Enterococcus faecalis on Gutta-percha points treated with four disinfectants using confocal scanning laser microscope: An in vitro study. Dent Res J (Isfahan) 2015; 12:331-6. [PMID: 26288622 PMCID: PMC4533190 DOI: 10.4103/1735-3327.161446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: The aim of this study was to evaluate and compare the in vitro biofilm forming capacity of Enterococcus faecalis on Gutta-percha points disinfected with four disinfectants. Materials and Methods: A total of 50 Gutta-percha points used in this study were divided into four test groups based on disinfectant (5.25% sodium hypochlorite, 2% chlorhexidine gluconate, 20% neem, 13% benzalkonium chloride [BAK]), and one control group. The Gutta-percha points were initially treated with corresponding disinfectants followed by anaerobic incubation in Brain Heart Infusion broth suspended with human serum and E. faecalis strain for 14 days. After incubation, these Gutta-percha points were stained with Acridine Orange (Sigma – Aldrich Co., St. Louis, MO, USA) and 0.5 mm thick cross section samples were prepared. The biofilm thickness of E. faecalis was analyzed quantitatively using a confocal scanning laser microscope. Results statistically analyzed using analysis of variance. P < 0.05 was considered to be significant. Results: Confocal scanning laser microscope showed reduced amount of E. faecalis biofilm on Gutta-percha points treated with BAK and sodium hypochlorite. Post-hoc (least square differences) test revealed that there is no statistically significant difference between BAK and sodium hypochlorite groups (P > 0.05). Conclusion: This study illustrates that the Gutta-percha points disinfected with sodium hypochlorite and BAK showed minimal biofilm growth on its surface.
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Affiliation(s)
| | - Vemisetty Hari Kumar
- Department of Kamineni Institute of Dental Sciences, Narketpally, Andhra Pradesh, India
| | | | - Dandolu Ram Kiran
- Department of Kamineni Institute of Dental Sciences, Narketpally, Andhra Pradesh, India
| | | | - Golla Vinay Kumar
- Department of Kamineni Institute of Dental Sciences, Narketpally, Andhra Pradesh, India
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20
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Abstract
Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host's defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms’ formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to identify biofilms.
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Affiliation(s)
- Kapil Jhajharia
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Melaka Manipal Medical College, Melaka, Malaysia
| | - Abhishek Parolia
- Department of Restorative Dentistry, Faculty of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - K Vikram Shetty
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Melaka Manipal Medical College, Melaka, Malaysia
| | - Lata Kiran Mehta
- Department of Pedodontics and Preventive Dentistry, P. D. M. Dental College and Research Institute, Jhajjar, Haryana, India
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Ricucci D, Siqueira JF, Lopes WSP, Vieira AR, Rôças IN. Extraradicular infection as the cause of persistent symptoms: a case series. J Endod 2014; 41:265-73. [PMID: 25282379 DOI: 10.1016/j.joen.2014.08.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 08/21/2014] [Accepted: 08/26/2014] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This article describes 3 cases that presented persistent symptoms after appropriate endodontic treatment. Histopathologic and histobacteriologic investigation were conducted for determination of the cause. METHODS Three cases are reported that presented with persistent symptoms after endodontic retreatment (cases 1 and 2) or treatment (case 3). Periapical surgery was indicated and performed in these cases. The biopsy specimens, consisting of root apices and the apical periodontitis lesions, were subjected to histopathologic and histobacteriologic analyses. RESULTS Case 1 was an apical cyst with necrotic debris, heavily colonized by ramifying bacteria, in the lumen. No bacteria were found in the apical root canal system. Case 2 was a granuloma displaying numerous bacterial aggregations through the inflammatory tissue. Infection was also present in the dentinal tubules at the apical root canal. Case 3 was a cyst with bacterial colonies floating in its lumen; bacterial biofilms were also seen on the external apical root surface, filling a large lateral canal and other apical ramifications, and between layers of cementum detached from the root surface. No bacteria were detected in the main root canal. CONCLUSIONS Different forms of extraradicular infection were associated with symptoms in these cases, leading to short-term endodontic failure only solved by periapical surgery.
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Affiliation(s)
| | - José F Siqueira
- Faculty of Dentistry, Department of Endodontics, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Weber S P Lopes
- Specialization Course, Brazilian Association of Dentistry, Juiz de Fora, Minas Gerais, Brazil
| | - Adalberto R Vieira
- Specialization Course, Brazilian Association of Dentistry, Juiz de Fora, Minas Gerais, Brazil
| | - Isabela N Rôças
- Faculty of Dentistry, Department of Endodontics, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
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22
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Jhamb A, Chaurasia VR, Masamatti VKS, Agarwal JH, Tiwari S, Nair D. In vitro evaluation of antimicrobial activity of different Gutta-percha points and calcium hydroxide pastes. J Int Soc Prev Community Dent 2014; 4:92-5. [PMID: 25254192 PMCID: PMC4170551 DOI: 10.4103/2231-0762.137648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose: To evaluate the antimicrobial activity of different compositions of Gutta-percha points and calcium hydroxide (Ca(OH)2) pastes, used in endodontic therapy. Materials and Methods: The evaluated material consisted of Gutta-percha points containing Ca(OH)2, Gutta-percha points containing chlorhexidine (Chx), conventional Gutta-percha points and Ca(OH)2 pastes. Antimicrobial properties of Chx and CaOH paste are compared with CaOH points. Antimicrobial tests included three species of microorganisms: Escherichia coli (ATCC 25923), Staphylococcus aureus (ATCC 25922) Pseudomonas aeruginosa (ATCC BAA-427), the agar disc diffusion method was employed. The plates were kept at room temperature for 2 h for prediffusion and then incubated at 37°C for 24 h. Zones of inhibition were measured. Results and Conclusion: All microbial species used in the study were inhibited by the Gutta-percha points containing Chx and by the Ca(OH)2 pastes, no antimicrobial activity was observed for the other groups (conventional Gutta-percha and Ca(OH)2 group).
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Affiliation(s)
- Ashu Jhamb
- Department of Conservative Dentistry and Endodontics, Yamuna Institute of Dental Sciences and Research, Gadholi, Yamunanagar, Haryana, India
| | | | - Vinay Kumar S Masamatti
- Department of Conservative Dentistry and Endodontics, KLE Dental College, Belgaum, Karnataka, India
| | - Jai Hans Agarwal
- Department of Conservative Dentistry and Endodontics, Indraprastha Dental College, Ghaziyabad, Uttar Pradesh, India
| | - Samarth Tiwari
- Department of Periodontology, Bhabha College of Dental Science, Bhopal, Madya Pradesh, India
| | - Divya Nair
- Department of Oral and Maxillofacial Pathology, DJ College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
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23
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Siqueira JF, Rôças IN. Present status and future directions in endodontic microbiology. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/etp.12060] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Del Fabbro M, Samaranayake LP, Lolato A, Weinstein T, Taschieri S. Analysis of the secondary endodontic lesions focusing on the extraradicular microorganisms: an overview. ACTA ACUST UNITED AC 2013; 5:245-54. [PMID: 23766136 DOI: 10.1111/jicd.12045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 02/23/2013] [Indexed: 01/12/2023]
Abstract
The present study aimed at reviewing the literature on extraradicular infections of endodontically treated teeth, summarizing the main hypotheses on etiopathogenesis and describing the most suitable techniques to identify the composition of pathogenic extraradicular microorganisms. Medline database was searched using the keywords "Apical biofilm," "extraradicular infection," "secondary endodontic lesion," "endodontic retreatment," "biofilm" either alone or combined with AND. A further hand search was performed on the main endodontic journals. The most frequent bacterial species identified in different studies and with different techniques may vary considerably. Although the presence of some species of microorganisms seems to be determinant, the true origin of extraradicular infection is still undetermined. The literature analysis showed marked differences in methodology, materials, aims, and techniques adopted, which led to highly heterogeneous outcomes. The picture emerging from this review is that extraradicular infection is likely a multifactorial disease that requires further systematic investigation using standardized techniques.
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Affiliation(s)
- Massimo Del Fabbro
- Director of Center of Research for Oral Health, Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, IRCCS Galeazzi Orthopedic Institute, Universitá degli Studi di Milano, Milano, Italy
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25
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Phee A, Bondy-Denomy J, Kishen A, Basrani B, Azarpazhooh A, Maxwell K. Efficacy of bacteriophage treatment on Pseudomonas aeruginosa biofilms. J Endod 2012; 39:364-9. [PMID: 23402508 DOI: 10.1016/j.joen.2012.10.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 10/08/2012] [Accepted: 10/18/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Bacterial viruses (phages) have been used successfully in the treatment of animal and human bacterial infections. This study examined the potential use of phage therapy against Pseudomonas aeruginosa strain PA14 biofilms in a root canal model. METHODS Part 1: The 24-hour and 96-hour PA14 biofilms grown in microplates were treated with phages identified as possessing potential biofilm-degrading activities, and the post-treatment bacterial biomass was quantified by using crystal violet staining. Part 2: The 24-hour and 96-hour PA14 biofilms grown in prepared root canals of extracted human mandibular incisors were treated with phages identified with potential biofilm-degrading activities. Post-treatment intracanal samples were taken by using paper points and round burs to assess phage and bacterial counts. RESULTS Part 1: We identified 2 phages (JBD4 and JBD44a) with putative biofilm-degrading activities. Treatment of PA14 biofilms with these phages produced a significant reduction in the mean percentage of biomass in 24-hour (P< .05) and 96-hour (P= .08) biofilms. Part 2: In 24-hour and 96-hour PA14 biofilms in a root canal model, no significant difference was found in the number of colony-forming units after phage treatment (P> .05). CONCLUSIONS Phage application significantly reduced the biomass of 24-hour and 96-hour PA14 biofilms grown on microplates but did not produce significant reduction of 24-hour or 96-hour PA14 biofilms grown in the extracted tooth model.
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Affiliation(s)
- Alysen Phee
- Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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26
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Narayanan LL, Vaishnavi C. Endodontic microbiology. J Conserv Dent 2011; 13:233-9. [PMID: 21217951 PMCID: PMC3010028 DOI: 10.4103/0972-0707.73386] [Citation(s) in RCA: 182] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 09/05/2010] [Accepted: 09/06/2010] [Indexed: 11/04/2022] Open
Abstract
Root canal therapy has been practiced ever since 1928 and the success rate has tremendously increased over the years owing to various advancements in the field. One main reason is the complete understanding of the microbiology involved in the endodontic pathology. This has helped us to modify the conventional treatment plans and effectively combat the microorganisms. Now, studies are aiming to explore the characteristics of the "most" resistant organism and the methods to eliminate them. This article gives an insight of the microbiology involved in endodontic pathology and discusses its role in our treatment procedure. Information from original reviews listed in PubMed, published from 1995 to 2010, has been mainly included in this review.
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Affiliation(s)
- L Lakshmi Narayanan
- Department of Conservative Dentistry & Endodontics, SRM Kattankulathur Dental College & Hospital, SRM University, Chennai, India
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27
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HAAPASALO MARKUS, SHEN YA, RICUCCI DOMENICO. Reasons for persistent and emerging post-treatment endodontic disease. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1601-1546.2011.00256.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Fleisher KE, Welch G, Kottal S, Craig RG, Saxena D, Glickman RS. Predicting risk for bisphosphonate-related osteonecrosis of the jaws: CTX versus radiographic markers. ACTA ACUST UNITED AC 2010; 110:509-16. [DOI: 10.1016/j.tripleo.2010.04.023] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 04/02/2010] [Accepted: 04/11/2010] [Indexed: 10/19/2022]
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Yang CM, Hsieh YD, Yang SF. Refractory apical periodontitis associated with a calculus-like deposit at the root apex. J Dent Sci 2010. [DOI: 10.1016/s1991-7902(10)60015-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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30
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Abbott PV, Salgado JC. Strategies for the endodontic management of concurrent endodontic and periodontal diseases. Aust Dent J 2010; 54 Suppl 1:S70-85. [PMID: 19737270 DOI: 10.1111/j.1834-7819.2009.01145.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Endodontic and periodontal diseases can provide many diagnostic and management challenges to clinicians, particularly when they occur concurrently. As with all diseases, a thorough history combined with comprehensive clinical and radiographic examinations are all required so an accurate diagnosis can be made. This is essential since the diagnosis will determine the type and sequence of treatment required. This paper reviews the relevant literature and proposes a new classification for concurrent endodontic and periodontal diseases. This classification is a simple one that will help clinicians to formulate management plans for when these diseases occur concurrently. The key aspects are to determine whether both types of diseases are present, rather than just having manifestations of one disease in the alternate tissue. Once it is established that both diseases are present and that they are as a result of infections of each tissue, then the clinician must determine whether the two diseases communicate via the periodontal pocket so that appropriate management can be provided using the guidelines outlined. In general, if the root canal system is infected, endodontic treatment should be commenced prior to any periodontal therapy in order to remove the intracanal infection before any cementum is removed. This avoids several complications and provides a more favourable environment for periodontal repair. The endodontic treatment can be completed before periodontal treatment is provided when there is no communication between the disease processes. However, when there is communication between the two disease processes, then the root canals should be medicated until the periodontal treatment has been completed and the overall prognosis of the tooth has been reassessed as being favourable. The use of non-toxic intracanal therapeutic medicaments is essential to destroy bacteria and to help encourage tissue repair.
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Affiliation(s)
- P V Abbott
- School of Dentistry, The University of Western Australia, Nedlands, WA 6009, Australia.
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31
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A decrease in the innate immune response to infection in the presence of root canal sealers. ACTA ACUST UNITED AC 2010; 109:315-23. [DOI: 10.1016/j.tripleo.2009.09.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Revised: 08/28/2009] [Accepted: 09/08/2009] [Indexed: 11/19/2022]
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Soares JA, Leonardo MR, da Silva LAB, Tanomaru Filho M, Ito IY. Histomicrobiologic aspects of the root canal system and periapical lesions in dogs' teeth after rotary instrumentation and intracanal dressing with Ca(OH)2 pastes. J Appl Oral Sci 2009; 14:355-64. [PMID: 19089058 PMCID: PMC4327228 DOI: 10.1590/s1678-77572006000500011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Accepted: 09/01/2006] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: The purpose of this study was to evaluate the distribution of microorganisms in the root canal system (RCS) and periapical lesions of dogs' teeth after rotary instrumentation and placement of different calcium hydroxide [Ca(OHy-based intracanal dressings. MATERIALS AND METHODS: Chronic periapical lesions were experimentally induced in 80 premolar roots of four dogs. Instrumentation was undertaken using the ProFile rotary system and irrigation with 5.25% sodium hypochlorite. The following Ca(OH)2-based pastes were applied for 21 days: group 1 - Calen (n=18); group 2 - Calen+CPMC (n=20); group 3 - Ca(OH2 p.a. + anaesthetic solution (n=16) and group 4 - Ca(OH2 p.a.+ 2% chlorhexidine digluconate (n=18). Eight root canals without endodontic treatment constituted the control group. Histological sections were obtained and stained with Brown & Brenn staining technique to evaluate the presence of microorganisms in the main root canal, ramifications of the apical delta and secondary canals, apical cementoplasts, dentinal tubules, areas of cemental resorption and periapical lesions. The results were analyzed statistically by the Mann-Whitney U test (p<0.05). RESULTS: The control group showed the highest prevalence of microorganisms in all sites evaluated. Gram-positive cocci, bacilli and filaments were the most frequent morphotypes. Similar microbial distribution patterns in the RCS and areas of cementum resorption were observed in all groups (p>0.05). The percentage of RCS sites containing microorganisms in groups 1, 2, 3, 4 and control were: 67.6%, 62.5%, 78.2%, 62.0% and 87.6%, respectively. CONCLUSION: In conclusion, the histomicrobiological analysis showed that the rotary instrumentation and the different calcium hydroxide pastes employed did not effectively eliminate the infection from the RCS and periapical lesions. However, several bacteria seen in the histological sections were probably dead or were inactivated by the biomechanical preparation and calcium hydroxide-based intracanal dressing.
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Affiliation(s)
- Janir Alves Soares
- Discipline of Endodontics, Department of Dentistry, Federal University of Valleys of Jequitinhonha and Mucuri, Diamantina, MG, Brazil.
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Felippe WT, Ruschel MF, Felippe GS, Pozzobon MH, Felippe MCS. SEM evaluation of the apical external root surface of teeth with chronic periapical lesion. AUST ENDOD J 2009; 35:153-7. [PMID: 19961454 DOI: 10.1111/j.1747-4477.2009.00165.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Wilson Tadeu Felippe
- School of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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da Silva LAB, Fernandes PM, da Silva RAB, Nelson-Filho P, Rocha LB, Rossi MA. SEM Study of Apical Morphological Alterations in Primary Teeth with Vital and Necrotic Pulps. Ultrastruct Pathol 2009; 33:183-8. [DOI: 10.3109/01913120903275642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Although fungi, archaea, and viruses contribute to the microbial diversity in endodontic infections, bacteria are the most common micro-organisms occurring in these infections. Datasets from culture and molecular studies, integrated here for the first time, showed that over 460 unique bacterial taxa belonging to 100 genera and 9 phyla have been identified in different types of endodontic infections. The phyla with the highest species richness were Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria. Diversity varies significantly according to the type of infection. Overall, more taxa have been disclosed by molecular studies than by culture. Many cultivable and as-yet-uncultivated phylotypes have emerged as candidate pathogens based on detection in several studies and/or high prevalence. Now that a comprehensive inventory of the endodontic microbial taxa has been established, future research should focus on the association with different disease conditions, functional roles in the community, and susceptibility to antimicrobial treatment procedures.
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Affiliation(s)
- J F Siqueira
- Department of Endodontics and Molecular Microbiology, Faculty of Dentistry, Estácio de Sá University, Av. Alfredo Baltazar da Silveira, 580/cobertura, Recreio, Rio de Janeiro, RJ, Brazil.
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Miranda TT, Vianna CR, Rodrigues L, Monteiro AS, Rosa CA, Corrêa A. Diversity and frequency of yeasts from the dorsum of the tongue and necrotic root canals associated with primary apical periodontitis. Int Endod J 2009; 42:839-44. [PMID: 19712195 DOI: 10.1111/j.1365-2591.2009.01601.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T T Miranda
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, MG, Brazil.
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Siqueira JF, Rôças IN. Distinctive features of the microbiota associated with different forms of apical periodontitis. J Oral Microbiol 2009; 1. [PMID: 21523208 PMCID: PMC3077003 DOI: 10.3402/jom.v1i0.2009] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 07/08/2009] [Accepted: 07/09/2009] [Indexed: 12/17/2022] Open
Abstract
Microorganisms infecting the dental root canal system play an unequivocal role as causative agents of apical periodontitis. Although fungi, archaea, and viruses have been found in association with some forms of apical periodontitis, bacteria are the main microbial etiologic agents of this disease. Bacteria colonizing the root canal are usually organized in communities similar to biofilm structures. Culture and molecular biology technologies have demonstrated that the endodontic bacterial communities vary in species richness and abundance depending on the different types of infection and different forms of apical periodontitis. This review paper highlights the distinctive features of the endodontic microbiota associated with diverse clinical conditions.
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Affiliation(s)
- José F Siqueira
- Department of Endodontics and Molecular Microbiology Laboratory, School of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
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Leonardo MR, Rossi MA, Bonifácio KC, da Silva LAB, Assed S. Scanning Electron Microscopy of the Apical Structure of Human Teeth. Ultrastruct Pathol 2009; 31:321-5. [PMID: 17786833 DOI: 10.1080/01913120701376014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The objective of this research was to evaluate, by scanning electron microscopy, the apical structure of extracted human permanent teeth with different degrees of pulp and periapical pathology. A total of 25 teeth were extracted: 5 teeth with vital pulp (group I); 10 teeth with pulp necrosis without radiographically visible periapical lesion (group II); 10 teeth with pulp necrosis with radiographically visible periapical lesion (group III). The root apex was sectioned and processed for scanning electron microscopy. In groups I and II, fibers covered the root cementum and there was no cementum resorption or microorganisms. There were areas of cementum resorption in group III with microorganisms on the root apex surface (biofilm) and no fibers. The authors conclude that the presence of chronic periapical lesions causes severe changes in the apical structure with a destruction of fibers and different degrees of cementum resorption forming lacunae in which bacterial biofilm persisted.
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Affiliation(s)
- Mário Roberto Leonardo
- Department of Pediatric Dentistry, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
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Handal T, Caugant DA, Olsen I, Sunde PT. Bacterial diversity in persistent periapical lesions on root-filled teeth. J Oral Microbiol 2009; 1. [PMID: 21523213 PMCID: PMC3077005 DOI: 10.3402/jom.v1i0.1946] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 03/19/2009] [Accepted: 05/05/2009] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The purpose of this study was to analyze the bacterial diversity in persistent apical lesions on root-filled teeth by using culture-independent molecular methods. DESIGN Twenty surgically removed apical lesions from therapy-resistant teeth were examined for the presence of bacterial DNA using PCR targeting the 16s ribosomal RNA gene, followed by cloning and sequencing. RESULTS Bacterial DNA was detected in 17 of the 20 samples (85%). A total of 236 clones were analyzed. Seven different bacterial phyla were represented and a total of 75 different bacterial taxa were identified; 36% of the species have not yet been cultivated. Commonly detected bacterial species included Fusobacterium spp., Prevotella spp., Tannerella forsythia, Porphyromonas endodontalis, Treponema denticola, Bacteroidetes spp., Peptostreptococcus spp., and Streptococcus spp. CONCLUSIONS A wide range of bacteria was identified in periapical lesions on therapy-resistant teeth. These bacteria may contribute in the etiology of periapical infection and impede healing of these lesions.
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Affiliation(s)
- Trude Handal
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Ricucci D, Siqueira JF, Bate AL, Pitt Ford TR. Histologic Investigation of Root Canal–treated Teeth with Apical Periodontitis: A Retrospective Study from Twenty-four Patients. J Endod 2009; 35:493-502. [DOI: 10.1016/j.joen.2008.12.014] [Citation(s) in RCA: 170] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 12/23/2008] [Accepted: 12/28/2008] [Indexed: 10/20/2022]
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Metzger Z, Lin YY, Dimeo F, Ambrose WW, Trope M, Arnold RR. Synergistic pathogenicity of Porphyromonas gingivalis and Fusobacterium nucleatum in the mouse subcutaneous chamber model. J Endod 2009; 35:86-94. [PMID: 19084132 DOI: 10.1016/j.joen.2008.10.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Revised: 10/06/2008] [Accepted: 10/08/2008] [Indexed: 10/21/2022]
Abstract
Porphyromonas gingivalis and Fusobacterium nucleatum are often coisolated from sites of infection, such as suppurative apical periodontitis. The synergistic pathogenicity of mixed infection of P. gingivalis HG 405 with F. nucleatum PK 1594 was studied in the mouse subcutaneous chamber model in groups of seven animals. The minimal dose for P. gingivalis HG 405 that was required to infect 100% of the chambers was reduced by 1,000-fold when animals were inoculated in the same chamber with 1 x 10(9)F. nucleatum PK 1594 (p < 0.001). To benefit from the presence of the fusobacteria, P. gingivalis HG 405 had to be coinoculated; inoculation in separate chambers for the same animal had no such effect (p < 0.001). Subinfective F. nucleatum inocula also benefited from the association with P. gingivalis HG 405 and uniformly established an infection when this partner was present (p < 0.001). These results suggest that the frequent and natural coexistence of P. gingivalis and F. nucleatum in diseased sites may express such a synergism in successful establishment and survival of small inocula.
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Affiliation(s)
- Zvi Metzger
- Department of Endodontics, School of Dentistry, University of North Carolina at Chapel Hill, North Carolina, USA
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Rocha CT, Rossi MA, Leonardo MR, Rocha LB, Nelson-Filho P, Silva LAB. Biofilm on the apical region of roots in primary teeth with vital and necrotic pulps with or without radiographically evident apical pathosis. Int Endod J 2008; 41:664-9. [DOI: 10.1111/j.1365-2591.2008.01411.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pallotta RC, Ribeiro MS, de Lima Machado ME. Determination of the minimum inhibitory concentration of four medicaments used as intracanal medication. AUST ENDOD J 2008; 33:107-11. [PMID: 18076578 DOI: 10.1111/j.1747-4477.2007.00095.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this study was to determine the minimum inhibitory concentration (MIC) of iodoform, calcium hydroxide, IKI (iodine potassium iodine) and CFC (ciprofloxacin, Flagyl (metronidazole) and calcium hydroxide) required to kill S. aureus, Pseudomonas aeruginosa, Enterococcus faecalis and B. fragilis. In the experiment, medicaments were added to bacterial species into test tubes, in 10 different concentrations. The MIC was the lowest concentration of the drug at which bacterial growth could not be observed. In this investigation, CFC was the most effective medicament against all bacteria. All drugs were able to eliminate E. faecalis and B. fragilis, while IKI was not effective against S. aureus. IKI and calcium hydroxide were not able to eliminate P. aeruginosa as well.
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Affiliation(s)
- Raul C Pallotta
- Department of endodontics, University Cruzeiro do Sul, Sao Paulo, Brazil.
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Pereira CDC, de Oliveira EPM, Gomes MS, Della-Bona A, Vanni JR, Kopper PMP, de Figueiredo JAP. Comparative in vivo analysis of the sealing ability of three endodontic sealers in dog teeth after post-space preparation. AUST ENDOD J 2008; 33:101-6. [PMID: 18076577 DOI: 10.1111/j.1747-4477.2007.00069.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study compared the sealing ability of RoekoSeal, AH Plus and EndoRez in dog premolars after post-space preparation and exposure to the oral environment. Seventy-four root canals were cleaned, shaped and filled with gutta-percha and one of the sealers. Post spaces were prepared with about 4-mm root canal filling remaining in the apex. Teeth were sealed for 24 h for sealer setting. Teeth were exposed to the oral environment for 45 days. The dogs were killed and root canals were soaked in India ink and sealed for 96 h. The teeth were cleared, and leakage was measured under stereoscopy. The Kruskal-Wallis test was used for analysis. A significant difference was found between EndoRez and RoekoSeal groups (P < 0.05). EndoRez had lower leakage values than RoekoSeal after 45-day exposure to the oral environment. No statistic difference was found in the comparison of AH Plus with the other sealers under study.
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Affiliation(s)
- Charles da Cunha Pereira
- Department of Research and Graduate Studies, Graduate Program in Dentistry, Universidade Luterana do Brasil, Canoas, RS, Brazil.
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Gordon W, Atabakhsh VA, Meza F, Doms A, Nissan R, Rizoiu I, Stevens RH. The antimicrobial efficacy of the erbium, chromium:yttrium-scandium-gallium-garnet laser with radial emitting tips on root canal dentin walls infected with Enterococcus faecalis. J Am Dent Assoc 2007; 138:992-1002. [PMID: 17606499 DOI: 10.14219/jada.archive.2007.0297] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors used an in vitro model to investigate the ability of an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser with radial emitting tips to disinfect Enterococcus faecalis-infected dentin. MATERIALS AND METHODS The in vitro infected-dentin model system consisted of a dentin cylinder, prepared from a human anterior tooth root, cemented into a sealable two-chamber device fabricated from a syringe needle cap. The model's lower chamber contained a buffer solution, and the dentin cylinder was placed between the upper and lower chambers. After sterilization, the authors inoculated the root canal of each dentin cylinder with E. faecalis. They used an Er,Cr:YSGG laser with radial emitting tips to irradiate the root canal of each infected dentin cylinder (varying laser power and exposure time). After laser treatment, the authors machined the root canal dentin walls and collected the resulting dentin fillings in the buffer-reservoir. They quantified the E. faecalis titer of each buffer-reservoir by using selective agar plates. RESULTS The authors found that bacterial recovery decreased when laser irradiation duration or power increased. A greater degree of disinfection was achieved with a 120-second application of laser than with sodium hypochlorite treatment. Finally, they found that a 99.7 percent reduction in bacterial counts could be obtained using the laser. CONCLUSION The results of this study suggest that the Er,Cr:YSGG laser with a radial emitting tip has a significant antimicrobial effect on dentinal tubules infected with E. faecalis. CLINICAL IMPLICATIONS Er,Cr:YSGG laser treatment could be a valuable tool for root canal disinfection during endodontic treatment.
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Affiliation(s)
- Wanda Gordon
- Department of Endodontology, Temple University, Philadelphia, USA
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Lin S, Sela G, Sprecher H. Periopathogenic Bacteria in Persistent Periapical Lesions: An In Vivo Prospective Study. J Periodontol 2007; 78:905-8. [PMID: 17470025 DOI: 10.1902/jop.2007.060224] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this in vivo prospective study was to detect the presence of periopathogenic bacteria in persistent periapical lesions and to compare the reliability of two different methods: anaerobic culture and the DNA hybridization technique. METHODS Samples were obtained from 24 patients with persistent periapical lesions referred for surgical endodontic treatment. A sterile paper point was inserted into the periapical lesion for 10 seconds. The point was stored in sterile transfer tubes and analyzed by DNA hybridization. Tissue samples were transported in transfer medium and analyzed further using anaerobic culture. RESULTS At least one periodontal pathogenic bacterium was found in seven of 24 cases. Bacterial species present were Treponema denticola (three cases), Porphyromonas gingivalis (three cases), Tannerella forsythensis (four cases), Prevotella intermedia (one case), and Actinobacillus actinomycetemcomitans (three cases). No particular signs or symptoms were associated with the presence of these bacterial species. Anaerobic culture failed to identify any of the periopathogenic bacteria. CONCLUSIONS Periodontal pathogenic bacterial DNA can be detected in persistent periapical lesions. Anaerobic cultures failed to detect the periodontal pathogenic bacteria in positive hybridization assays, suggesting that standard culture methods lack sensitivity or that hybridization assays are flawed with low specificity. The clinical significance of the presence of bacterial DNA in persistent periapical lesions remains to be determined.
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Affiliation(s)
- Shaul Lin
- Endodontics and Dental Trauma Unit, Department of Oral and Dental Medicine, Rambam Medical Center, Haifa, Israel.
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Araki AT, Ibraki Y, Kawakami T, Lage-Marques JL. Er:Yag laser irradiation of the microbiological apical biofilm. Braz Dent J 2007; 17:296-9. [PMID: 17262142 DOI: 10.1590/s0103-64402006000400006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Accepted: 08/30/2006] [Indexed: 11/22/2022] Open
Abstract
One problem in cases of healing-resistant periapical lesions is to eradicate the contamination at the periapical area. This contamination is due to the microbiological biofilm formed by microorganisms and their subproducts lodged in apical third of the root, on both cementum and dentin surface. Paraendodontic surgery consists of the mechanical removal of harmful agents to promote healing and periapical health. The purpose of this study was to assess the results of Er:YAG laser irradiation on the apical root third of newly extracted teeth to eliminate microbial contamination on root apex surface. Apical irradiation was performed with an Er:YAG laser device using an experimental contact tip, at 100 mJ, 10 Hz, 1 W, 39 J/cm(2), 3 times on the target area. SEM analysis showed the elimination of part of the irradiated cementum and the formation of small roughened without exposing the subjacent dentin. Vaporization of the remaining periodontal tissue and removal of microbiological apical biofilm (MAB) were also observed on the irradiated areas. Under the tested conditions and based on the findings of this study, Er:YAG laser may be considered effective for removal of microbiological apical biofilm.
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Affiliation(s)
- Angela Toshie Araki
- Department of Endodontics, School of Dentistry, University of São Paulo, Avenida Professor Lineu Prestes 2227, 05508-000 São Paulo, SP, Brazil
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Tanomaru JMG, Pappen FG, Tanomaru Filho M, Spolidorio DMP, Ito IY. In vitro antimicrobial activity of different gutta-percha points and calcium hydroxide pastes. Braz Oral Res 2007; 21:35-9. [PMID: 17384853 DOI: 10.1590/s1806-83242007000100006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2005] [Accepted: 09/25/2006] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the antimicrobial activity of different trademarks and compositions of gutta-percha points and calcium hydroxide pastes used in endodontic therapy. The evaluated material consisted of gutta-percha points containing calcium hydroxide (RoekoTM), gutta-percha points containing chlorhexidine (RoekoTM), two convencional gutta-percha points (Endo PointsTM and RoekoTM) and two calcium hydroxide pastes (CalenTM and Calen/PMCC TM). Antimicrobial tests included five species of microorganisms: Escherichia coli (ATCC10538), Staphylococcus epidermidis (ATCC12228), Staphylococcus aureus (ATCC6538), Pseudomonas aeruginosa (ATCC27853), and Micrococcus luteus (ATCC9341). The Agar difusion method was employed. The plates were kept at room temperature for 2 h for prediffusion and then incubated at 37°C for 24 h. The triphenyltetrazolium chloride gel was added for optimization and the zones of inhibition were measured. Statistical evaluation was carried out using analysis of variance and Tukey Test. The obtained results showed that all microbial species used in the study were inhibited by the gutta-percha points containing chlorhexidine and by the calcium hydroxide pastes (CalenTM and Calen/PMCC TM), with similar results (p > 0.05). No antimicrobial activity was observed for the other groups. It was concluded that the gutta-percha points containing chlorhexidine presented antimicrobial activity, whereas the gutta-percha points containing calcium hydroxide did not.
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Affiliation(s)
- Juliane Maria Guerreiro Tanomaru
- School of Dentistry of Araraquara, State University of São Paulo, Rua Expedicionários do Brazil 2030, Araraquara, SP, Brazil, CEP 14801-360.
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Panzarini SR, Souza V, Holland R, Dezan Júnior E. Association of calcium hydroxide and metronidazole in the treatment of dog's teeth with chronic periapical lesion. J Appl Oral Sci 2006; 14:334-40. [PMID: 19089054 PMCID: PMC4327224 DOI: 10.1590/s1678-77572006000500007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2005] [Accepted: 09/01/2006] [Indexed: 11/21/2022] Open
Abstract
One of the primary objectives of endodontic treatment of teeth with pulp necrosis is the elimination of microorganisms from the root canal system, as effectively as possible, especially in cases with chronic periapical lesions. AIM: The purpose of this study was to analyze the response of the periapical tissue of dogs' teeth with chronic periapical lesions to endodontic treatment performed with utilization of metronidazole, calcium hydroxide, and an association of both as root canal dressings. METHODOLOGY: Forty root canals were submitted to pulpectomy and the root canals were kept exposed to the oral environment for 6 months. Then, they were submitted to biomechanical preparation and divided into 4 study groups with 10 specimens: group I – no root canal dressing; group II – calcium hydroxide; group III – metronidazole; group IV – calcium hydroxide associated to metronidazole. After 15 days, the root canals were filled with Fill Canal sealer. After 90 days, the animals were killed and the especimens processed for histological analysis. RESULTS: Calcium hydroxide dressing provided a significantly better outcome compared to other experimental groups (α = 0.01). Also, the results of the association of metronidazole and calcium hydroxide were similar to those observed for the metronidazole group. The worst results were obtained by the no root canal dressing group. CONCLUSION: The use of metronidazole alone or associated with Calcium hydroxide, did not improve periapical healing when compared to Calcium hydroxide dressing.
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Affiliation(s)
- Sônia Regina Panzarini
- Department of Surgery and Integrated Clinics, Dental School of Araçatuba - UNESP - São Paulo State University, Araçatuba, São Paulo, Brazil.
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