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Arias-Moliz MT, Pérez-Carrasco V, Uroz-Torres D, Santana Ramos JD, García-Salcedo JA, Soriano M. Identification of keystone taxa in root canals and periapical lesions of post-treatment endodontic infections: Next generation microbiome research. Int Endod J 2024; 57:933-942. [PMID: 38357799 DOI: 10.1111/iej.14046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
AIM The aim of this study was to analyse and compare the microbiome present in root canals and periapical lesions of teeth with post-treatment infections, and to identify the presence of keystone taxa in both habitats using next-generation sequencing analysis. METHODOLOGY Apices and periapical lesions of patients with post-treatment apical periodontitis were surgically extracted. Specimens were cryo-pulverized, bacterial DNA was extracted, and the V3-V4 hypervariable regions of the 16S rRNA gene were sequenced using the Illumina Miseq platform. Bioinformatic analysis was carried out with Mothur software, whilst diversity indices were obtained using operational taxonomic units (OTUs). The diversity indices were compared with the Kruskal-Wallis test, and community composition differences were explored with Permutational Multivariate Analysis of Variance (PERMANOVA). A bacterial functional study was performed with the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis. Co-occurrence network analyses were performed using the Sparse Correlations for Compositional data (SparCC). Eigencentrality, clr-based abundance and ubiquitousness were applied to infer keystone taxa. P values <.05 were considered statistically significant. RESULTS Thirty-two apices and thirty-nine periapical lesions were sequenced and analysed. A similar alpha-diversity (p < .05) and community composition (p = .91) was observed for apices and lesion samples. The most abundant OTUs identified amongst all samples included Fusobacterium nucleatum, Prevotella loescheii, Streptococcus intermedius, Porphyromonas gingivalis, Parvimonas micra, Synergistetes bacterium, Tannerella forsythia and Peptostreptococcus stomatis. The metabolic pathways with >0.81% abundances included membrane transport, genetic information processing and metabolic pathways. F. nucleatum was identified as a keystone taxon as it showed ubiquitousness, an eigenvector centrality value of 0.83 and a clr-based abundance >4. CONCLUSIONS The microbiome in apices and periapical lesions of post-treatment endodontic infections showed a similar diversity and taxonomic composition. Co-occurrence network analyses at OTU level identified F. nucleatum as a keystone taxon candidate in these infections.
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Affiliation(s)
- Maria Teresa Arias-Moliz
- Department of Microbiology, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Virginia Pérez-Carrasco
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
- Microbiology Unit, University Hospital Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | | | - Jose Antonio García-Salcedo
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
- Microbiology Unit, University Hospital Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Miguel Soriano
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
- Center for Research in Mediterranean Intensive Agrosystems and Agri-Food Biotechnology (CIAIMBITAL), University of Almeria, Almería, Spain
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Ozdemir B, Ersahan S, Ozcelik F, Hepsenoglu YE, Sirin DA, Topbas C. Relationship of MMP-9 with the clinical course of apical periodontitis and the main bacterial species in the oral microbiota. Odontology 2024:10.1007/s10266-023-00895-w. [PMID: 38252232 DOI: 10.1007/s10266-023-00895-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Bacterial products, host immune cells and cytokines have been reported to play an important role in the pathogenesis of apical periodontitis (AP). This study aimed to determine the main bacterial species in the microbiota as gram positive and negative and to compare the relationship between matrix metalloproteinase (MMP)-9 and tumor necrosis factor (TNF)-α with controlled patient groups. 60 patients with AP and extraction indication were included in the study. 30 systemically healthy volunteers without AP were selected as the control group. After access cavity preparation, an initial microbiologic sample (S1) was taken from the root canal. After atraumatic extraction of the tooth, a second microbial sample (S2) was taken from the extraradicular region. After bacterial DNA extraction, 16S rRNA gene primer was designed for sequence analysis. Bacterial community profiling was made by Sanger sequencing of the PCR products. In addition, serum MMP-9 and TNF-α levels were measured from all patients. TNF-α levels of the AP group were higher than the control group, while MMP-9 levels were found to be lower (p = 0.0264 and p = 0.0146, respectively). There was no difference in the main bacterial species isolated from the samples taken from the intracanal and extraradicular region of the tooth with AP (p = 0.714). The main bacterial species in the intracanal region of the tooth with AP are similar to the main bacterial species in the extraradicular region. The pathophysiology of the tooth with AP is associated with low MMP-9 and high TNF-α, independent of the bacterial species in the intracanal and extraradicular regions.
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Affiliation(s)
- Burcu Ozdemir
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Seyda Ersahan
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey.
| | - Fatih Ozcelik
- Department of Medical Biochemistry Department, Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Yelda Erdem Hepsenoglu
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Dursun Ali Sirin
- Faculty of Dentistry, Department of Endodontics, University of Health Sciences, Istanbul, Turkey
| | - Celalettin Topbas
- Faculty of Dentistry, Department of Endodontics, University of Health Sciences, Istanbul, Turkey
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Kamburoğlu K, Sönmez G, Koç C, Yılmaz F, Tunç O, Isayev A. Access Cavity Preparation and Localization of Root Canals Using Guides in 3D-Printed Teeth with Calcified Root Canals: An In Vitro CBCT Study. Diagnostics (Basel) 2023; 13:2215. [PMID: 37443609 DOI: 10.3390/diagnostics13132215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/26/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Pulp canal obliteration (PCO) is a significant complication in endodontics that can occur due to various factors. Cone beam computed tomography (CBCT) is a useful diagnostic tool for identifying root canal anatomy and variations, and guided endodontics is emerging as an alternative treatment solution for teeth with partially or entirely obliterated pulpal canals. However, the accuracy of CBCT-guided 3D-printed guides on different materials and layer thicknesses is not well understood. Therefore, this study aimed to evaluate the accuracy of guides prepared using CBCT images on 3D-printed teeth with stereolithography (SLA) using three different materials and two different layer thicknesses. This study found that 3D-printed guides were accurate and reliable for accessing 3D-manufactured obliterated teeth and reaching the apical area. No significant differences in distance or angle measurements were found when different guide materials were used, suggesting that materials can be selected based on availability and cost. These findings contribute to the knowledge base regarding the effectiveness of 3D printing technology in guided endodontics and can help to identify the most suitable materials and techniques for this application.
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Affiliation(s)
- Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, 06560 Ankara, Turkey
| | - Gül Sönmez
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ada Kent University, 33010 Mersin, Turkey
| | - Cemre Koç
- Department of Endodontics, Faculty of Dentistry, Adnan Menderes University, 09010 Aydın, Turkey
| | - Funda Yılmaz
- Department of Endodontics, Faculty of Dentistry, Ankara University, 06500 Ankara, Turkey
| | - Osman Tunç
- BTech Innovation, Teknokent METU, 06800 Ankara, Turkey
| | - Abulfaz Isayev
- School of Dental Medicine, Boston University, Boston, MA 02118, USA
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The Influence of Endodontic Lesions on The Clinical Evolution of Odontogenic Sinusitis-A Cohort Study. J Clin Med 2023; 12:jcm12031103. [PMID: 36769751 PMCID: PMC9918245 DOI: 10.3390/jcm12031103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/01/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Endodontic disease with formation of periapical lesions (PALs) is one of the most common causes of chronic odontogenic sinusitis (ODS). It requires close collaboration between otolaryngologists and dentists, but the best sequence of management is still unknown. The aim of the present study is to clarify how radiological characteristics of teeth with PALs and previous root-canal treatment (RCT) influence the clinical evolution of the disease and to define the predictive value of its radiological and endoscopic features in determining the need for further surgical intervention. A total of 68 symptomatic patients with ODS with PALs were included in the study. The evaluation was performed by an otolaryngologist and a dentist based on a medical interview, nasal endoscopy, cold pulp testing and tomography images. Patients were prospectively followed for at least 12 months, during which nasal steroids, saline irrigations and RCT were administered. The criteria of disease improvement were: decrease of symptoms, healed sinonasal mucosa in endoscopy and radiological resolution of periapical radiolucency and sinus inflammation. Results showed that 9 (13%) patients improved after conservative treatment and 59 (87%) required further surgical intervention. Patients who improved after medical treatment and RCT were younger (p = 0.043) and had a greater distance from the top of the periapical lesion to the maxillary sinus' floor (p = 0.003). When expansion of PALs and bone destruction toward the maxillary sinus was observed on radiological imaging (p = 0.041), and when more than one tooth root was affected (p = 0.004), patients were more likely to require surgical intervention. In conclusion, the more roots that are affected and the closer the top of the PAL is to the maxillary sinus' floor, the greater the possibility of medical treatment and RCT failure. When the bone destruction extends into the maxillary sinus, patients eventually require both tooth extraction and FESS in order to resolve ODS completely.
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Pérez-Carrasco V, Uroz-Torres D, Soriano M, Solana C, Ruiz-Linares M, Garcia-Salcedo JA, Arias-Moliz MT. Microbiome in paired root apices and periapical lesions and its association with clinical signs in persistent apical periodontitis using next-generation sequencing. Int Endod J 2023; 56:622-636. [PMID: 36689323 DOI: 10.1111/iej.13893] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/24/2023]
Abstract
AIM To assess and compare the microbiome of paired root apices and periapical lesions from cases with failed endodontic treatment and to associate the microbiome and bacterial metabolic pathways in both sites with asymptomatic apical periodontitis (AAP) and symptomatic apical periodontitis (SAP), using next-generation sequencing (NGS). METHODOLOGY Matched root apices and periapical lesions of patients with failed root canal treatments were surgically extracted. Specimens were cryopulverized, bacterial DNA was extracted and the V3-V4 hypervariable regions of the 16 S rRNA gene were amplified and sequenced using the Illumina Miseq platform. Diversity and community composition were studied in the paired samples, as well as in AAP and SAP cases. Diversity indices were compared in each case by means of the Wilcoxon matched-pairs signed rank and Mann-Whitney U tests. Differences in the community composition were explored with multivariate statistical analysis and Linear discriminant analysis Effect Size (LEfSe). Bacterial functional study was performed through the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis. RESULTS Twenty-one paired apices and lesions were successfully sequenced and analysed, identifying a total of 21 phyla and 600 genera. A higher alpha-diversity was observed in the periapical lesions, although no global differences in the community composition between the two sites were found (p = .87), the most prevalent genera being Fusobacterium, Porphyromonas and Streptococcus. Prevotella, Clostridiales_vadinBB60_group, Bosea, Phreatobacter, Afipia and Xanthobacteriaceae_unclassified were enriched in SAP samples, while Pseudopropionibacterium, Campylobacter and Peptoniphilus were significantly more abundant in AAP cases (p < .05). Metabolic pathways involved in the amino acid metabolism or degradation and flagellum assembly were more abundant in SAP samples, whereas glucose metabolism-related pathways were associated with AAP. CONCLUSIONS The bacterial community composition was similar in the apices and periapical lesions. The microbiome was different in AAP and SAP samples, gram-negative bacteria showing higher relative abundances in SAP cases. An association was observed between amino acid degradation and flagellum assembly pathways, and the development of tenderness to percussion or palpation.
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Affiliation(s)
- Virginia Pérez-Carrasco
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain.,Microbiology Unit, University Hospital Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - David Uroz-Torres
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Private Practice, Granada, Spain
| | - Miguel Soriano
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain.,Center for Research in Mediterranean Intensive Agrosystems and Agri-Food Biotechnology (CIAIMBITAL), University of Almeria, Almería, Spain
| | - Carmen Solana
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Private Practice, Granada, Spain
| | - Matilde Ruiz-Linares
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Stomatology, University of Granada, Granada, Spain
| | - Jose Antonio Garcia-Salcedo
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain.,Microbiology Unit, University Hospital Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Maria Teresa Arias-Moliz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Microbiology, University of Granada, Granada, Spain
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Briseño-Marroquín B, Callaway A, Shalamzari NG, Wolf TG. Antibacterial efficacy of peracetic acid in comparison with sodium hypochlorite or chlorhexidine against Enterococcus faecalis and Parvimonas micra. BMC Oral Health 2022; 22:119. [PMID: 35397605 PMCID: PMC8994351 DOI: 10.1186/s12903-022-02148-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/25/2022] [Indexed: 11/29/2022] Open
Abstract
Background The main goal of an endodontic treatment is a complete debridement of the root canal system; however, currently mechanical shaping and chemical cleaning procedures for this purpose have deemed non-satisfactory.
Methods The efficacy of peracetic acid (PAA; 0.5, 1.0, 2.0%), as a root canal irrigation solution, against Enterococcus faecalis (DSM 20478) and Parvimonas micra (DSM 20468) when compared with the one of sodium hypochlorite (NaOCI; 1.0, 3.0, 5.0%), chlorhexidine digluconate (CHX; 0.12, 0.2, 2.0%) and 0.9% NaCI (as a control solution) was in vitro investigated with the agar diffusion and direct contact methods. The inhibition zone diameters observed with the agar diffusion test were determined. The viable bacterial counts (CFU/ml) were calculated with the direct method. Results The agar diffusion test showed that all three root canal irrigation solutions had an efficacy against E. faecalis at all concentrations. The largest inhibition zone diameters against E. faecalis were observed with 5.0% NaOCI. At all three concentrations of PAA, NaOCI, and CHX, the inhibition zone diameter increased with increase in concentration. For P. micra, PAA had a similar inhibition zone diameter despite a concentration increase. In contrast, for NaOCI and CHX, the inhibition zone diameter increased with increasing concentration. 2.0% CHX produced the largest inhibition zone diameter against P. micra. For E. faecalis, only the comparison between 2.0% PAA and 5.0% NaOCI showed statistical significance (p = 0.004). For P. micra the efficacy comparison between the lowest, middle, and highest concentrations of each solution, a statistical significance (p < 0.05) was found for all three solutions. After direct contact with PAA, NaOCI and CHX, no viable bacteria could be determined for either P. micra or E. faecalis. Conclusions PAA had a similar antibacterial efficacy as the one of NaOCl and CHX when in direct contact with E. faecalis and P. micra. In the agar diffusion test, PAA showed a similar antibacterial efficacy as the one of CHX and a lower one as the one of NaOCl for E. faecalis.
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Preclinical Testing of Boron-Doped Diamond Electrodes for Root Canal Disinfection—A Series of Preliminary Studies. Microorganisms 2022; 10:microorganisms10040782. [PMID: 35456832 PMCID: PMC9024724 DOI: 10.3390/microorganisms10040782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/29/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
While numerous approaches have meanwhile been described, sufficient disinfection of root canals is still challenging, mostly due to limited access and the porous structure of dentin. Instead of using different rinsing solutions and activated irrigation, the electrolysis of saline using boron-doped diamond (BDD) electrodes thereby producing reactive oxygen species may be an alternative approach. In a first step, experiments using extracted human teeth incubated with multispecies bacterial biofilm were conducted. The charge quantities required for electrochemical disinfection of root canals were determined, which were subsequently applied in an animal trial using an intraoral canine model. It could be shown that also under realistic clinical conditions, predictable disinfection of root canals could be achieved using BDD electrodes. The parameters required are in the range of 5.5 to 7.0 V and 9 to 38 mA, applied for 2.5 to 6.0 min with approximately 5 to 8 mL of saline. The direct generation of disinfective agents inside the root canal seems to be advantageous especially in situations with compromised access and limited canal sizes. The biologic effect with respect to the host reaction on BDD-mediated disinfection is yet to be examined.
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Root Canal Obturation by Electrochemical Precipitation of Calcium Phosphates. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12062956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Achieving adequate disinfection and preventing reinfection is the major goal in endodontic treatment. Variation in canal morphology and open porosity of dentine prevents achieving complete disinfection. Questionable biocompatibility of materials as well as a lack of sealing ability questions the usefulness of current obturation methods. With a novel disinfection approach based on the use of boron-doped diamond (BDD) electrodes having shown promising results it was the goal of this series of experiments to investigate the possibility of BDD-mediated in situ forming of a biocompatible obturation material. A combination of calcium phosphate and maleic acid was used as precursor solution while Ion Chromatography Mass Spectrometry (IC-MS), Raman spectroscopy (RAMAN), X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), dye penetration and micro-computed tomography (µCT) were applied for characterizing the precipitate. It was possible to achieve a BDD-mediated precipitation of brushite in a clinically applicable timeframe. However, tight sealing of the canal system based on brushite could not be achieved.
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Fonseca Tavares WL, de Oliveira Murta Pedrosa N, Moreira RA, Braga T, de Carvalho Machado V, Ribeiro Sobrinho AP, Amaral RR. Limitations and Management of Static-guided Endodontics Failure. J Endod 2021; 48:273-279. [PMID: 34801590 DOI: 10.1016/j.joen.2021.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 10/21/2021] [Accepted: 11/10/2021] [Indexed: 11/24/2022]
Abstract
Endodontic treatment in severely calcified canals is always a challenging task because it can result in accidents such as deviations or perforations. Recently, guided endodontics has become an alternative approach for pulp canal calcification, facilitating the location of root canals more predictably through the combined use of cone-beam computed tomographic imaging, oral scanning, and endodontic access guides. Although several reports have shown that guided endodontics is safer, faster and can be performed without an operating microscope and by less experienced operators, the technique has limitations, and iatrogenesis may occur. This article describes the limitations of static-guided endodontics and possible causes of failures. In the present case, not fixing the guide to the bone and inaccuracies generated by manually performing mesh merger software led to root perforation. Endodontic microsurgery was effective in resolving this case and should be considered the treatment of choice when guided endodontics cannot be used safely or when it fails.
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Affiliation(s)
- Warley Luciano Fonseca Tavares
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Natália de Oliveira Murta Pedrosa
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Raphael Alves Moreira
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tiago Braga
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Vinícius de Carvalho Machado
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Antônio Paulino Ribeiro Sobrinho
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Radiographic and antimicrobial evaluation of enterococcus Faecalis and Actinomyces Israelii micro-organisms after photodynamic therapy (aPDT). Photodiagnosis Photodyn Ther 2021; 35:102433. [PMID: 34256171 DOI: 10.1016/j.pdpdt.2021.102433] [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: 02/26/2020] [Revised: 05/02/2021] [Accepted: 07/01/2021] [Indexed: 11/23/2022]
Abstract
This study evaluated the action of Antimicrobial Photodynamic Therapy (aPDT) on Enterococcus faecalis and Actinomyces israelii. Samples were taken from the root canal system, at different stages of treatment and bacteria were identified through qPCR. Fifty teeth (incisors, canines, and premolars) with pulp necrosis and periapical lesion diagnosis were randomly selected and divided into 2 groups: Group 1 (G1) - Endodontic Therapy with Mechanical Chemical Preparation (MPQ) and intracanal medication; Group 2 (G2) - Endodontic therapy with MPQ, intracanal medication, and 2 applications of aPDT. APDT was performed with application of 0.005% methylene blue, wavelength of 660 nm, and 90 seconds. Follow-up was performed with an initial x-ray and an x-ray 60 days after the end of treatment. The radiographs were scored evaluated by two examiners to classify periapical repair: total repair, partial repair, doubtful repair, or no repair. Enterococcus faecalis was found more frequently in G1 than G2. Actinomyces israelii was found equally in G1 and G2. Evaluation of the two bacteria between collections 1, 2 and 3, showed that there was no difference, both in G1 and in G2. There was association between the variables group and repair classification in radiographs evaluation. APDT did not promote better results in endodontic treatment, being similar to conventional treatment. However, this study pointed out that molecular methods may not be efficient in detecting bacteria after treatment, and colony-forming units may complement, being an effective quantifying method. Therefore, new studies must be carried out to show the possible effectiveness of aPDT.
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Lima AR, Ganguly T, Walker AR, Acosta N, Francisco PA, Pileggi R, Lemos JA, Gomes BPFA, Abranches J. Phenotypic and Genotypic Characterization of Streptococcus mutans Strains Isolated from Endodontic Infections. J Endod 2020; 46:1876-1883. [PMID: 32919986 PMCID: PMC7686129 DOI: 10.1016/j.joen.2020.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/13/2020] [Accepted: 09/02/2020] [Indexed: 12/16/2022]
Abstract
Streptococcus mutans plays an important role in caries etiology and eventually in systemic infections. However, it is often found in infected root canals, but the pathophysiological characteristics of strains residing in this site are largely unknown. Here, we characterized strains of S. mutans isolated from root canals of primary (PI) and secondary/persistent (SI) endodontic infections in relation to serotype and genotype; presence of genes coding for collagen binding proteins (CBPs); collagen binding activity and biofilm formation capacity; ability to withstand environmental stresses; systemic virulence in Galleria mellonella; and invasion of human coronary artery endothelial cells and human dental pupal fibroblasts. Samples from 10 patients with PI and 10 patients with SI were collected, and a total of 14 S. mutans isolates, belonging to 3 genotypes, were obtained. Of these, 13 were serotype c, and 1 was serotype k. When compared with the reference strains, the clinical isolates were hypersensitive to hydrogen peroxide. Remarkably, all 14 strains harbored and expressed the CBP-encoding gene cbm, showing increased binding to collagen, enhanced systemic virulence in G. mellonella, and ability to invade human coronary artery endothelial cells and human dental pupal fibroblasts when compared with CBP-negative strains. Whole genome sequence analysis of PI and SI isolates revealed that these strains are phylogenetically related but genetically distinct from each other. Our findings highlight the importance of CBPs in facilitating colonization and persistence of S. mutans in collagenous substrates such as root canals and their potential role in the pathogenesis of endodontic infections.
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Affiliation(s)
- Augusto R. Lima
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
- Department of Oral Biology, University of Florida, Gainesville, FL, United States of America
| | - Tridib Ganguly
- Department of Oral Biology, University of Florida, Gainesville, FL, United States of America
| | - Alejandro R. Walker
- Department of Oral Biology, University of Florida, Gainesville, FL, United States of America
| | - Natalia Acosta
- Department of Oral Biology, University of Florida, Gainesville, FL, United States of America
| | - Priscila A. Francisco
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Roberta Pileggi
- Department of Endodontics, University of Florida, Gainesville, FL, United States of America
| | - José A. Lemos
- Department of Oral Biology, University of Florida, Gainesville, FL, United States of America
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Jacqueline Abranches
- Department of Oral Biology, University of Florida, Gainesville, FL, United States of America
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Morphologic Changes of Apical Foramen and Microcrack Formation after Foraminal Enlargement: A Scanning Electron Microscopic and Micro–computed Tomographic Analysis. J Endod 2020; 46:1726-1732. [DOI: 10.1016/j.joen.2020.07.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 12/30/2022]
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13
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Preserving the Neurovascular Bundle in Targeted Endodontic Microsurgery: A Case Series. J Endod 2020; 47:509-519. [PMID: 33096194 DOI: 10.1016/j.joen.2020.10.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 12/15/2022]
Abstract
Endodontic microsurgery encompasses the use of microscopy, specialized instruments, and advanced imaging with cone-beam computed tomographic (CBCT) imaging. This treatment modality results in high clinical success rates and facilitates the enucleation of osteolytic lesions, the resection of apical root canal complexities harboring persistent bacterial biofilms, and the evaluation of possible root defects and fractures. However, there is the risk of injury to important anatomic structures, particularly when treating posterior teeth. Neurovascular bundles are among these structures at risk for injury. Fortunately, high-resolution CBCT scans can be used to detect these structures that are known to have a high anatomic variability. In addition, CBCT information can be combined with high-resolution intraoral scans to plan, design, and fabricate surgical guides to be used in a targeted endodontic microsurgery (TEMS) approach. We report 3 cases with previous endodontic treatment having persistent apical periodontitis that were treated with TEMS to avoid damage to the neurovascular bundles at risk of injury. In the first case, the palatal root of tooth #14 was adjacent to the greater palatine artery. In the second case, the mental nerve exited through 2 separate foramina close to the predictive osteotomy site for the mesial root of tooth #19. In the third case, the posterior superior alveolar artery was in close proximity to the mesiobuccal root of tooth #14. Collectively, these cases illustrate the diagnostic value of CBCT imaging for detecting neurovascular bundles and the use of TEMS to mitigate the risk of injury to these important structures. Thus, the combination of CBCT imaging and TEMS can potentially minimize the risk of intraoperative complications and postoperative sequelae while increasing the predictability of endodontic microsurgeries in complex cases.
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14
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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: 42] [Impact Index Per Article: 10.5] [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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15
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Dioguardi M, Alovisi M, Crincoli V, Aiuto R, Malagnino G, Quarta C, Laneve E, Sovereto D, Lo Russo L, Troiano G, Lo Muzio L. Prevalence of the Genus Propionibacterium in Primary and Persistent Endodontic Lesions: A Systematic Review. J Clin Med 2020; 9:jcm9030739. [PMID: 32182900 PMCID: PMC7141369 DOI: 10.3390/jcm9030739] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 03/05/2020] [Indexed: 12/26/2022] Open
Abstract
Propionibacterium are anaerobic/aero-tolerant rod Gram-positive bacteria, and numerous studies are associated with primary and secondary endodontic infections. The data in the literature on the prevalence of Propionibacterium are conflicting, and there are studies that report conflicting data on the prevalence in primary and secondary endodontic infections. This review aims to clarify the prevalence of bacteria of the genus Propionibacterium in endodontic lesions. The present systematic review work was performed on the basis of the Prisma protocol. A search was carried out on the PubMed and Scopus databases with the use of keywords. The research produced 410 records, which, after the elimination of the overlaps and the application of the inclusion and exclusion criteria, led to a number of 36 included articles divided by the three outcomes. The first outcome concerns prevalence of bacteria of the genus Propionibacterium in primary and secondary endodontic lesions. The secondary outcome, differences in the prevalence of bacteria of the genus Propionibacterium between primary endodontic infections and secondary endodontic infections. The tertiary outcome, differences in the prevalence of Propionibacterium Acnes compared to Propionibacterium propionicum in endodontic infections. The results of the meta-analysis show that the genus Propionibacterium bacteria are more prevalent in secondary endodontic infections and that P. Acnes has a higher prevalence than P. propionicum.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (G.M.); (C.Q.); (E.L.); (D.S.); (L.L.R.); (G.T.); (L.L.M.)
- Correspondence:
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, 10126 Turin, Italy;
| | - Vito Crincoli
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Division of Complex Operating Unit of Dentistry, “Aldo Moro” University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy;
| | - Riccardo Aiuto
- Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy;
| | - Giancarlo Malagnino
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (G.M.); (C.Q.); (E.L.); (D.S.); (L.L.R.); (G.T.); (L.L.M.)
| | - Cristian Quarta
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (G.M.); (C.Q.); (E.L.); (D.S.); (L.L.R.); (G.T.); (L.L.M.)
| | - Enrica Laneve
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (G.M.); (C.Q.); (E.L.); (D.S.); (L.L.R.); (G.T.); (L.L.M.)
| | - Diego Sovereto
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (G.M.); (C.Q.); (E.L.); (D.S.); (L.L.R.); (G.T.); (L.L.M.)
| | - Lucio Lo Russo
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (G.M.); (C.Q.); (E.L.); (D.S.); (L.L.R.); (G.T.); (L.L.M.)
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (G.M.); (C.Q.); (E.L.); (D.S.); (L.L.R.); (G.T.); (L.L.M.)
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (G.M.); (C.Q.); (E.L.); (D.S.); (L.L.R.); (G.T.); (L.L.M.)
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16
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Electrochemical Disinfection of Experimentally Infected Teeth by Boron-Doped Diamond Electrode Treatment. J Clin Med 2019; 8:jcm8122037. [PMID: 31766433 PMCID: PMC6947473 DOI: 10.3390/jcm8122037] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 02/05/2023] Open
Abstract
Disinfection and prevention of re-infection are the decisive treatment steps in endodontic therapy. In this study, boron-doped diamond (BDD) electrodes have been fabricated and used for disinfecting the root canals of extracted human teeth, which had been covered with bacterial biofilms formed by Bacillus subtilis and Staphylococcus epidermidis. The growth of B. subtilis could be successfully impaired, achieving a complete disinfection after 8.5 min treatment time with the success of disinfection depending on the insertion depth of the electrode in the root canal. S. epidermidis could completely be removed after 3.5 min treatment time. A clinically applicable electrode array led to complete disinfection after treatment times of 10 min for S. epidermidis and 25 min for B. subtilis. BDD electrode application allowed for the improved disinfection of root canals and dentin tubules based on a continuous production of reactive oxygen species and their enhanced penetration of dentin tubules most likely due the formation of a continuous stream of small gas bubbles. The treatment times that are required here will be shortened in clinical application, as mechanical shaping of the canal system would precede the disinfection process.
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17
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Laureano NK, Bernardi L, Bundrich L, Brand LM, Visioli F, Lamers ML, Rados PV. Development of an
in vitro
model to study tooth cystogenesis. Int Endod J 2019; 52:1750-1757. [DOI: 10.1111/iej.13193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 07/24/2019] [Indexed: 01/22/2023]
Affiliation(s)
- N. K. Laureano
- Basic Research Center, Dentistry School Federal University of Rio Grande do Sul Porto AlegreBrazil
| | - L. Bernardi
- Basic Research Center, Dentistry School Federal University of Rio Grande do Sul Porto AlegreBrazil
- Department of Morphological Sciences Federal University of Rio Grande do Sul Porto AlegreBrazil
| | - L. Bundrich
- Basic Research Center, Dentistry School Federal University of Rio Grande do Sul Porto AlegreBrazil
| | - L. M. Brand
- Basic Research Center, Dentistry School Federal University of Rio Grande do Sul Porto AlegreBrazil
| | - F. Visioli
- Department of Oral Pathology, Dentistry School Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - M. L. Lamers
- Department of Morphological Sciences Federal University of Rio Grande do Sul Porto AlegreBrazil
| | - P. V. Rados
- Department of Oral Pathology, Dentistry School Federal University of Rio Grande do Sul Porto Alegre Brazil
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18
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Kang P, Li L, Yan L, Ju X, Hu C, Yao X. Enhancement of erythritol production in Trichosporonoides oedocephalis by regulating cellular morphology with betaine. CHEMICAL PAPERS 2019. [DOI: 10.1007/s11696-019-00766-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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19
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A novel antibacterial resin-based root canal sealer modified by Dimethylaminododecyl Methacrylate. Sci Rep 2019; 9:10632. [PMID: 31337813 PMCID: PMC6650501 DOI: 10.1038/s41598-019-47032-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 07/09/2019] [Indexed: 02/05/2023] Open
Abstract
Persistent apical periodontitis, mainly caused by microorganisms infections, represents a critical challenge for endodontists. Dimethylaminododecyl methacrylate (DMADDM) is a well-studied and potent antibacterial agent used in various studies described in the literature. The aim of this study is to develop a novel antibacterial root canal sealer by incorporating DMADDM into EndoREZ and investigate the properties of the resulting material. Different mass fractions (0, 1.25%, 2.5%, and 5%) of DMADDM were incorporated into EndoREZ and the cytotoxicity, apical sealing ability and solubility of the resulting material were evaluated. Furthermore, a direct contact test, determination of colony-forming units, a crystal violet assay, scanning electronic microscopy and live/dead bacteria staining were performed to evaluate the antibacterial effect of the sealer to multispecies bacteria (Enterococcus faecalis, Streptococcus gordonii, Actinomyces naeslundii, and Lactobacillus acidophilus), in planktonic cells or biofilms. Fluorescence in situ hybridization and quantitative real-time polymerase chain reaction were carried out to assess the composition of the multispecies biofilms. No difference on the cytotoxicity, apical sealing ability and solubility between sealers containing DMADDM (1.25%, 2.5%) and EndoREZ (0%) could be determined. However, when the mass fraction of DMADDM increased to 5%, significantly different properties were found compared to the 0% (p < 0.05) group. Moreover, incorporating DMADDM into the sealer could greatly improve the antibacterial properties of EndoREZ. In addition, the composition ratio of E. faecalis could be decreased in multispecies microecology in sealers containing DMADDM. Therefore, a EndoREZ sealer material containing DMADDM could be considered useful in clinical applications for preventing and treating persistent apical periodontitis.
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20
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Inspection of the Microbiota in Endodontic Lesions. Dent J (Basel) 2019; 7:dj7020047. [PMID: 31052361 PMCID: PMC6630690 DOI: 10.3390/dj7020047] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 03/23/2019] [Accepted: 04/09/2019] [Indexed: 02/08/2023] Open
Abstract
The primary objective of endodontic therapy is to create a biologically acceptable environment within the root canal system that allows for the healing and maintenance of the health of the peri-radicular tissue. Bacteria are one of the main causes of pulp problems, and they have different methods of penetrating and invading the endodontic space such as through carious lesions, traumatic pulp exposures, and fractures. The types of bacteria found range from facultative anaerobes to aerobes, up to the most resistant species able to survive in nutrient-free environments; the bacterial species Enterococcus faecalis belongs to this last group. Enterococcus faecalis is considered one of the main causes of recurring apical periodontal lesions following endodontic treatment, with persistent lesions occurring even after re-treatment. The review presented in this paper was performed in accordance with the PRISMA protocol and covers articles from the related scientific literature that were sourced from PubMed, Scopus, and Google Scholar using the following terms as keywords: “endodontic treatment”, “endodontic bacteria”, “microbial endodontic”, and “endodontic failure”. Only the articles considered most relevant for the purposes of this paper were read in full and taken into consideration for the following review. The results show that Enterococcus faecalis, Actinomycetes, and Propionibacterium propionicum are the species most frequently involved in persistent radicular and extra-radicular infections.
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21
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Shimizu R, Tanaka K, Oikawa Y, Tomioka H, Kayamori K, Ikeda T, Yoshioka T, Ebihara A, Harada H. Epithelioid cell granuloma with caseating necrosis possibly caused by periapical periodontitis: a case report. J Med Case Rep 2018; 12:365. [PMID: 30537983 PMCID: PMC6290520 DOI: 10.1186/s13256-018-1891-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/24/2018] [Indexed: 11/29/2022] Open
Abstract
Background Epithelioid cell granuloma with caseating necrosis is a typical pathological finding in tuberculosis. While specific inflammation, including that related to tuberculosis, can induce caseating granuloma formation, there have been very few reports on the induction of caseating granuloma by non-specific inflammation. Chronic periapical periodontitis is usually related to bacterial biofilm formation as well as fungal or viral infection in the periapical lesion. However, it is difficult to eliminate these extraradicular pathogenic microbes by normal endodontic therapy alone, and more invasive surgical removal is almost always required. Case presentation Here we describe the case of a 30-year-old Japanese woman who had suffered from dull pain related to periapical periodontitis for approximately 10 years. Although the causal tooth had been previously extracted at the Department of Oral Surgery of another hospital in 2015, inflammation of the surrounding tissue had not abated. She was referred to our hospital in May 2016 and underwent surgical debridement via an intra/extraoral approach under general anesthesia. A caseating granuloma accompanied by a small amount of fungi was histopathologically confirmed in the excised specimen. Her inflammation has not been exacerbated since the operation. Conclusions This is the first report in which non-specific inflammation is shown to induce caseating granuloma arising in the jaw. Our report also highlights the importance of sufficient root canal treatment during the first stage of the procedure.
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Affiliation(s)
- Risa Shimizu
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Kae Tanaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Yu Oikawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hirofumi Tomioka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Kou Kayamori
- Section of Diagnostic Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Tohru Ikeda
- Section of Diagnostic Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Takatomo Yoshioka
- Yoshioka Dental Office, 2-3-13 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan
| | - Arata Ebihara
- Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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22
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Kim Y, Lee D, Kim DV, Kim SY. Analysis of Cause of Endodontic Failure of C-Shaped Root Canals. SCANNING 2018; 2018:2516832. [PMID: 30595786 PMCID: PMC6286757 DOI: 10.1155/2018/2516832] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/27/2018] [Accepted: 10/04/2018] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to analyze various characteristics and classification of C-shaped root canals and evaluate the causes of endodontic failure of C-shaped root canals by examining the resected root surface with an endodontic microscope and a scanning electron microscope (SEM). Forty-two teeth with C-shaped root canals were included in this study and had undergone intentional replantation surgery. Before surgery, periapical radiography and cone-beam computed tomography were taken. The root canal configuration was analyzed and classified according to Melton's classification at coronal and apical level. After injection of 1 : 100,000 epinephrine with 2% lidocaine, the tooth was carefully extracted. After the root-end resection, the resected root surface was examined using an operating microscope and SEM. Mandibular second molars were most frequently involved teeth (90.4%). The most frequently observed root canal configurations were C1 at the coronal level (45.2%) and C3 at the apical 3 mm level (45.2%). The most common cause of failure for a C-shaped root canal treatment was a leaky canal (45.2%), followed by an isthmus (23.8%), missing canal, overfilling, and iatrogenic problems. In conclusion, C-shaped root canals were most frequently found in mandibular second molars. The most common cause of failure was a leaky canal and isthmus.
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Affiliation(s)
- Yemi Kim
- Department of Conservative Dentistry, Dental Research Institute, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Donghee Lee
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Da-Vin Kim
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sin-Young Kim
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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23
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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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24
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Endal U, Shen Y, Ma J, Yang Y, Haapasalo M. Evaluation of Quality and Preparation Time of Retrograde Cavities in Root Canals Filled with GuttaCore and Cold Lateral Condensation Technique. J Endod 2018; 44:639-642. [DOI: 10.1016/j.joen.2017.11.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 11/29/2022]
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25
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Cavalli D, Toia CC, Flores Orozco EI, Khoury RD, Cardoso FGDR, Alves MC, Carvalho CAT, Valera MC. Effectiveness in the Removal of Endotoxins and Microbiological Profile in Primary Endodontic Infections Using 3 Different Instrumentation Systems: A Randomized Clinical Study. J Endod 2017; 43:1237-1245. [DOI: 10.1016/j.joen.2017.03.032] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 03/20/2017] [Accepted: 03/20/2017] [Indexed: 11/17/2022]
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26
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Wolgin M, Grundmann MJ, Tchorz JP, Frank W, Kielbassa AM. Ex vivo investigation on the postoperative integrity of the apical constriction after the sole use of electronic working length determination. J Dent 2017. [PMID: 28642058 DOI: 10.1016/j.jdent.2017.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AIM The present study investigated the accuracy of root canal preparation with regard to the integrity of the apical constriction (AC) using two different working length determination approaches: (1) the electronic method of working length determination (EWLD), and (2) the radiologic "gold standard" method (GS). METHODOLOGY Simulation models were constructed by arranging extracted human teeth by means of silicon bolstered gingiva masks, along with a conductive medium (alginate). Electronic working length determination (group 1; EWLD) and radiologic plus initial electronic working length determination for posterior comparability (group 2; GS) preceded manual root canal preparation of teeth in both groups. Master cones were inserted according to working lengths obtained from the group specific method. Subsequently, root apices (n=36) were longitudinally sectioned using a diamond-coated bur. The distance between the achieved apical endpoint of the endodontic preparation and the apical constriction (AC) was measured using digital photography. Then, distances between radiologically identified apical endpoints and AC (GS-AC) were compared with the corresponding distances EWLD-AC. Moreover, the postoperative status of the AC was examined with regard to both preparation approaches. RESULTS Differences between distances GS-AC and EWLD-AC were not statistically significant (p >0.401) (Mann-Whitney-U). Among EWLD samples, 83% of the master cones exhibiting tugback at final insertion terminated close to the apical constriction (±0.5 mm), and no impairment of the minor diameter's integrity was observed. CONCLUSIONS The sole use of EWLD allowed for a high accuracy of measurements and granted precise preparation of the apical regions.
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Affiliation(s)
- Michael Wolgin
- Center for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstraße 124, 3500 Krems, Austria
| | - Markus J Grundmann
- Center for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstraße 124, 3500 Krems, Austria
| | - Jörg P Tchorz
- Center for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstraße 124, 3500 Krems, Austria; Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Medical Center University of Freiburg, Albert-Ludwigs-University, Hugstetterstraße 55, 79106 Freiburg, Germany
| | - Wilhelm Frank
- Center for Preclinical Education, Dept. of Biostatistics, University of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstraße 124, 3500 Krems, Austria
| | - Andrej M Kielbassa
- Center for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstraße 124, 3500 Krems, Austria.
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27
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Sousa BCD, Gomes FDA, Ferreira CM, Rocha MMDNP, Barros EB, Albuquerque DSD. Persistent extra-radicular bacterial biofilm in endodontically treated human teeth: scanning electron microscopy analysis after apical surgery. Microsc Res Tech 2017; 80:662-667. [DOI: 10.1002/jemt.22847] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 01/04/2017] [Accepted: 01/19/2017] [Indexed: 01/29/2023]
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28
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Kang S, Kim HC, Lee CY, Jung IY, Kim E. Scanning electron microscopic examination of resected root apices obtained from endodontic microsurgery. SCANNING 2016; 38:455-461. [PMID: 26751015 DOI: 10.1002/sca.21296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/17/2015] [Indexed: 06/05/2023]
Abstract
This study was designed to examine the morphological features of the resected root apices obtained from endodontic microsurgery using a scanning electron microscope (SEM) as well as their anatomical effect on the clinical outcome of the surgical treatment. One-hundred-six resected root apices from 91 patients/surgeries were obtained by endodontic microsurgery, and fixed immediately for storage. The resected apices were prepared for SEM to examine their morphological features, such as the number and size of the apical foramina. The patients were periodically checked up at least 1 year and the clinical outcome of the microsurgery was judged as a success or failure according to the Molven's criteria. The SEM findings and the clinical outcome of apical surgery were evaluated to see any potential correlation between them. The SEM examination revealed that 60.4% of specimens had more than two portals of exit on the resected root apices and the size of the major foramen was at least 386 micrometer and 334 micrometer from maxillary and mandibular molar, respectively. With a recall rate of 72.9%, 91.9% of the surgical cases were decided to have successful outcomes. Based on this SEM study, a relatively high frequency of multiple portals of exit was existed and the sizes of major foramina were bigger than that were reported in previous reports. The clinical outcomes of endodontic microsurgery were not correlated with the anatomical features of resected apical root apices. SCANNING 38:455-461, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sumi Kang
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
| | - Chan-Young Lee
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Il-Young Jung
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Euiseong Kim
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
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Saini HR, Sangwan P, Sangwan A. Pain following foraminal enlargement in mandibular molars with necrosis and apical periodontitis: A randomized controlled trial. Int Endod J 2015; 49:1116-1123. [DOI: 10.1111/iej.12583] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 11/12/2015] [Indexed: 11/27/2022]
Affiliation(s)
- H. R. Saini
- Postgraduate Institute of Dental Sciences (PGIDS); Rohtak India
| | - P. Sangwan
- Postgraduate Institute of Dental Sciences (PGIDS); Rohtak India
| | - A. Sangwan
- Postgraduate Institute of Dental Sciences (PGIDS); Rohtak India
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Abstract
Actinomyces israelii has long been recognized as a causative agent of actinomycosis. During the past 3 decades, a large number of novel Actinomyces species have been described. Their detection and identification in clinical microbiology laboratories and recognition as pathogens in clinical settings can be challenging. With the introduction of advanced molecular methods, knowledge about their clinical relevance is gradually increasing, and the spectrum of diseases associated with Actinomyces and Actinomyces-like organisms is widening accordingly; for example, Actinomyces meyeri, Actinomyces neuii, and Actinomyces turicensis as well as Actinotignum (formerly Actinobaculum) schaalii are emerging as important causes of specific infections at various body sites. In the present review, we have gathered this information to provide a comprehensive and microbiologically consistent overview of the significance of Actinomyces and some closely related taxa in human infections.
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ROSA TP, SIGNORETTI FGC, MONTAGNER F, GOMES BPFDA, JACINTO RC. Prevalence of Treponemaspp. in endodontic retreatment-resistant periapical lesions. Braz Oral Res 2015; 29:S1806-83242015000100228. [DOI: 10.1590/1807-3107bor-2015.vol29.0031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 10/15/2014] [Indexed: 11/22/2022] Open
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Peters LB, Peterson B, Jaramillo DE, van der Sluis L. The Use of Scanning Electron Microscopy (SEM) in Visualizing the Root Canal Biofilm. SPRINGER SERIES ON BIOFILMS 2015. [DOI: 10.1007/978-3-662-47415-0_4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Cardinali F, Fornara R, Gorni F, Gagliani M. La risoluzione delle complessità nei ritrattamenti. DENTAL CADMOS 2014. [DOI: 10.1016/s0011-8524(14)70242-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Investigation of Cultivable Bacteria Isolated from Longstanding Retreatment-resistant Lesions of Teeth with Apical Periodontitis. J Endod 2013; 39:1240-4. [DOI: 10.1016/j.joen.2013.06.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 06/07/2013] [Accepted: 06/24/2013] [Indexed: 11/20/2022]
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Wang J, Chen W, Jiang Y, Liang J. Imaging of extraradicular biofilm using combined scanning electron microscopy and stereomicroscopy. Microsc Res Tech 2013; 76:979-83. [PMID: 23857917 DOI: 10.1002/jemt.22257] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 06/12/2013] [Accepted: 06/26/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Juan Wang
- Department of Endodontics and Operative Dentistry; Ninth People's Hospital; Shanghai Key Laboratory of Stomatology; School of Medicine; Shanghai Jiao Tong University; Shanghai; 200011; China
| | - Wu Chen
- Department of Periodontology; Jiangsu Province Stomatological Hospital; Institute of Stomatology; Nanjing Medical University; Nanjing; Jiangsu; 210029; China
| | - Yuntao Jiang
- Department of Endodontics and Operative Dentistry; Ninth People's Hospital; Shanghai Key Laboratory of Stomatology; School of Medicine; Shanghai Jiao Tong University; Shanghai; 200011; China
| | - Jingping Liang
- Department of Endodontics and Operative Dentistry; Ninth People's Hospital; Shanghai Key Laboratory of Stomatology; School of Medicine; Shanghai Jiao Tong University; Shanghai; 200011; China
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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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Zhao L, Chen J, Cheng L, Wang X, Du J, Wang F, Peng Z. Effects of Enterococcus faecalis lipoteichoic acid on receptor activator of nuclear factor-κB ligand and osteoprotegerin expression in periodontal ligament fibroblasts. Int Endod J 2013; 47:163-72. [PMID: 23710898 DOI: 10.1111/iej.12127] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 04/17/2013] [Indexed: 01/01/2023]
Abstract
AIM To investigate the influence of Enterococcus faecalis lipoteichoic acid (LTA) on the key bone resorption-regulating proteins, receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG) in human periodontal ligament fibroblasts (PDL cells). METHODOLOGY Periodontal ligament cells were subjected to various concentrations of LTA. Cell viability was then determined by methyl thiazolyl tetrazolium (MTT) assay, whilst the expression levels of RANKL and OPG were investigated by enzyme-linked immunosorbent assay (ELISA) and Western blotting. The effect of the inhibitors [IL-1 receptor-associated kinase (IRAK)-1/4, p38 mitogen-activated protein kinase (MAPK) (SB203580)] on LTA-stimulated RANKL/OPG activation was examined. Cell viability and RANKL/OPG ratio in PDL cells were also analysed by MTT assay and Western blotting. Data were analysed using one-way anova or t-test at a significance level of P = 0.05. RESULT Cell viability was reduced significantly in the LTA group in a dose-dependent fashion (P < 0.05). In addition, LTA was found to upregulate the protein expression of RANKL, OPG and their relative ratio in PDL cells (P < 0.05). The optimal concentration of LTA used in PDL cells was determined to be 10 μg mL(-1) . Following IRAK1/4 and p38MAPK inhibition, LTA-stimulated increases of RANKL/OPG ratio were significantly reduced (P < 0.05). CONCLUSION Enterococcus faecalis LTA could upregulate the expression of RANKL and OPG at different rates, suggesting a potential role for LTA in the bone resorption process of refractory apical periodontitis through the regulation of RANKL and OPG. In addition, IRAK1/4 and p38MAPK signalling involving RANKL/OPG may contribute to inflammatory responses from PDL cells.
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Affiliation(s)
- L Zhao
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
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Bacterial Flora and Extraradicular Biofilm Associated with the Apical Segment of Teeth with Post-treatment Apical Periodontitis. J Endod 2012; 38:954-9. [DOI: 10.1016/j.joen.2012.03.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 02/27/2012] [Accepted: 03/11/2012] [Indexed: 11/18/2022]
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