1
|
Manoil D, Cerit EE, Fang H, Durual S, Brundin M, Belibasakis GN. Profiling Antibiotic Susceptibility among Distinct Enterococcus faecalis Isolates from Dental Root Canals. Antibiotics (Basel) 2023; 13:18. [PMID: 38247577 PMCID: PMC10812444 DOI: 10.3390/antibiotics13010018] [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: 11/30/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Enterococcus faecalis, a leading multi-resistant nosocomial pathogen, is also the most frequently retrieved species from persistently infected dental root canals, suggesting that the oral cavity is a possible reservoir for resistant strains. However, antimicrobial susceptibility testing (AST) for oral enterococci remains scarce. Here, we examined the AST profiles of 37 E. faecalis strains, including thirty-four endodontic isolates, two vanA-type vancomycin-resistant isolates, and the reference strain ATCC-29212. Using Etest gradient strips and established EUCAST standards, we determined minimum inhibitory concentrations (MICs) for amoxicillin, vancomycin, clindamycin, tigecycline, linezolid, and daptomycin. Results revealed that most endodontic isolates were susceptible to amoxicillin and vancomycin, with varying levels of intrinsic resistance to clindamycin. Isolates exceeding the clindamycin MIC of the ATCC-29212 strain were further tested against last-resort antibiotics, with 7/27 exhibiting MICs matching the susceptibility breakpoint for tigecycline, and 1/27 reaching that of linezolid. Both vanA isolates confirmed vancomycin resistance and demonstrated resistance to tigecycline. In conclusion, while most endodontic isolates remained susceptible to first-line antibiotics, several displayed marked intrinsic clindamycin resistance, and MICs matched tigecycline's breakpoint. The discovery of tigecycline resistance in vanA isolates highlights the propensity of clinical clone clusters to acquire multidrug resistance. Our results emphasize the importance of implementing AST strategies in dental practices for continued resistance surveillance.
Collapse
Affiliation(s)
- Daniel Manoil
- Division of Cariology and Endodontics, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, Campus Huddinge, 141 52 Stockholm, Sweden;
| | - Ender Efe Cerit
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, Campus Huddinge, 141 52 Stockholm, Sweden;
| | - Hong Fang
- Department of Laboratory Medicine, Karolinska University Hospital Huddinge, Karolinska Institute, Campus Huddinge, 141 52 Stockholm, Sweden;
| | - Stéphane Durual
- Biomaterials Laboratory, Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland;
| | - Malin Brundin
- Division of Endodontics, Department of Odontology, Umeå University, 901 87 Umeå, Sweden;
| | - Georgios N. Belibasakis
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, Campus Huddinge, 141 52 Stockholm, Sweden;
| |
Collapse
|
2
|
Hasan A, Roome T, Wahid M, Ansari SA, Khan JA, Kiyani A, Jilani SNA. A novel experimental model to investigate fungal involvement shows expression of Dectin-1 in periapical lesion pathogenesis. J Oral Rehabil 2023; 50:1043-1057. [PMID: 37263973 DOI: 10.1111/joor.13528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/23/2023] [Accepted: 05/29/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Candida albicans is linked to persistent endodontic lesions. However, the recognition receptor that identifies it is not explored previously. OBJECTIVES The aim of this study was to (1) establish a zymosan-induced model of apical periodontitis in mouse, (2) observe the expression of Dectin-1 and its possible relationship with toll-like receptor (TLR) 2 and (3) observe relationship between Osteopontin (OPN) and inflammatory cytokines. METHODS A total of 138 Naval Medical Research Institute (NMRI) mice were randomly divided into; Experimental Group n = 69 and Zymosan Group n = 69. Periapical periodontitis was developed in right maxillary molar. The animals were sacrificed at 7, 21 and 42 days. Bone blocks containing the mesial root (n = 15 for qRT-PCR, n = 45 for enzyme-linked immune sorbent assay (ELISA)) were collected for mRNA expression and ELISA. While whole maxilla (n = 3 from each time interval) were used for histology and immunohistochemical analysis. One way analysis of variance (ANOVA) and Tuckey's posthoc was used for statistical analysis at p ≤ .05. RESULTS TLR-2, Dectin-1 and TLR4-positive cells was detected at all time intervals in both groups. A strong positive correlation was observed between TLR-2 and Dectin-1 in both lesions (regular r = .680, p = .015, zymosan (r = .861, p < .001)). A significant correlation was found between OPN and tumour necrosis factor-alpha (TNF-α) in zymosan lesion (r = .827, p = .001). CONCLUSIONS Immune cells of inflamed periapical tissue expressed Dectin-1 receptor in response to the microbial challenge from infected root canals and showed positive correlation with TLR-2 and OPN suggesting a possible receptor collaboration mediated by OPN. The expression of OPN and TNF-α showed positive correlation in response to fungal antigen, indicating a possible relationship.
Collapse
Affiliation(s)
- Arshad Hasan
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Talat Roome
- Department of Pathology, Section Molecular Pathology, Dow International Medical College, Karachi, Pakistan
- Dow Institute for Advanced Biological and Animal Research, Dow University of Health Sciences, Karachi, Pakistan
| | - Mohsin Wahid
- Department of Pathology, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
- Dow Research Institute of Biotechnology and Biomedical Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Shazia Akbar Ansari
- Department of Oral Pathology, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Javeria Ali Khan
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Amber Kiyani
- Department of Oral Medicine and Diagnosis, Islamic International dental College, Riphah International University, Islamabad, Pakistan
| | - Syeda Neha Ahmed Jilani
- Dow Institute for Advanced Biological and Animal Research, Dow University of Health Sciences, Karachi, Pakistan
| |
Collapse
|
3
|
Lee ES, de Josselin de Jong E, Kim E, Kim BI. Real-time optical detection of endodontic infection using bacterial autofluorescence. J Dent 2023; 136:104600. [PMID: 37392816 DOI: 10.1016/j.jdent.2023.104600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023] Open
Abstract
OBJECTIVES For successful root canal treatment (RCT), it is essential to objectively assess the presence and activity of bacteria in the root canal system. However, current methods rely on subjective observations of root canal exudates. This study aimed to confirm whether real-time optical detection using bacterial autofluorescence can evaluate endodontic infection status by assessing the red fluorescence (RF) detected from root canal exudates. METHODS During RCT, endodontic paper points were used to collect root canal exudates scored using conventional organoleptic tests to assess the severity of root canal infections. RF on the paper points was assessed using quantitative light-induced fluorescence (QLF) technology. RF intensity and area from the paper points were quantified, and their correlations with infection severity were assessed using their organoleptic scores. The oral microbiome composition of RF samples was compared with non-red fluorescent (non-RF) samples. RESULTS The RF detection rate was nil and >98% in the non-infectious and severe groups. The RF intensity and area significantly increased with infection severity (p<0.001) and showed strong correlations with organoleptic scores (r=0.72, 0.82, respectively). The diagnostic accuracy for detecting root canal infection using RF intensity was good to excellent (AUC = 0.81-0.95) and increased with infection severity. The microbial diversity of the RF samples was significantly lower than that of the non-RF samples. Gram-negative anaerobic bacteria such as Prevotella and Porphyromonas were more predominant in RF samples. CONCLUSIONS Optical detection using bacterial autofluorescence can objectively evaluate endodontic infection status in real-time by assessing the RF of endodontic root canal exudates. CLINICAL SIGNIFICANCE This real-time optical technology can be utilised to detect endodontic bacterial infection without conventional incubation, allowing clinicians to determine the endpoint of chemomechanical debridement and increase the positive outcomes of RCTs.
Collapse
Affiliation(s)
- Eun-Song Lee
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Elbert de Josselin de Jong
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea; Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands; Inspektor Research Systems BV, Amsterdam, The Netherlands
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea; Department of Electrical & Electronic Engineering, Yonsei University College of Engineering, Seoul, Korea
| | - Baek-Il Kim
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea.
| |
Collapse
|
4
|
Occhiogrosso L, Capozza P, Buonavoglia A, Decaro N, Trotta A, Marin C, Corrente M. Bacterial Periodontitis in Horses: An Epidemiological Study in Southern Italy. Animals (Basel) 2023; 13:1814. [PMID: 37889702 PMCID: PMC10251870 DOI: 10.3390/ani13111814] [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: 03/28/2023] [Revised: 05/22/2023] [Accepted: 05/28/2023] [Indexed: 10/29/2023] Open
Abstract
Equine periodontal disease (EPD) is a painful oral inflammatory syndrome characterized by multifactorial pathogenesis. Although it is well known that bacterial proliferation and consequent gingivitis are caused by the decomposition process of food residues, in hypsodont species, the pathogenetic role and the different bacterial species involved in the progression of EPD must be fully clarified. This study aimed to investigate the association of bacteria, including the complex red bacteria (RCB), with EPD, and to evaluate possible EPD risk factors. Bacterial species, including Treponema denticola, Tannerella forsythia, Porphyromonas gingivalis (belonging to the RCB), Fusobacterium nucleatum, Veilonella parvula, and Prevotella intermedia, were investigated in 125 oral swabs from healthy and EPD-affected horses using real-time multiplex PCR. Subsequently, possible risk factors (i.e., age, gender, and breed of the animals and type of feed used) were evaluated using univariate and multivariate analyses. Tannerella spp. and Treponema spp. were detected in a significantly higher proportion of horses affected by EPD than in healthy animals, although pathogens belonging to RCB were detected in low number of horses. At the same time, none of the investigated pathogens was significantly associated with a particular stage of disease severity. Horses aged older than 20 years were at higher risk of EPD. The high rate of coinfection, statistically associated with EPD, supports the hypothesis that EPD is a complex syndrome characterized by the possible simultaneous involvement of several pathogens and an increased risk depending on the animal's age. Constant oral hygiene is the best prevention to prevent and treat the disease, especially in old animals.
Collapse
Affiliation(s)
- Leonardo Occhiogrosso
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Valenzano, Italy
| | - Paolo Capozza
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Valenzano, Italy
| | - Alessio Buonavoglia
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Valenzano, Italy
| | - Nicola Decaro
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Valenzano, Italy
| | - Adriana Trotta
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Valenzano, Italy
| | - Claudia Marin
- Department of Education, Psychology, Communication, University of Bari, 70121 Bari, Italy
| | - Marialaura Corrente
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Valenzano, Italy
| |
Collapse
|
5
|
Prevalence of Fungi in Primary Endodontic Infections of a Greek-living Population Through Real-time Polymerase Chain Reaction and Matrix-assisted Laser Desorption/Ionization Time-of-flight Mass Spectrometry. J Endod 2021; 48:200-207. [PMID: 34800484 DOI: 10.1016/j.joen.2021.11.003] [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: 05/02/2021] [Revised: 10/27/2021] [Accepted: 11/07/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Fungi are considered to be opportunistic pathogens that may play a significant role in the pathogenesis of endodontic infections. The main purpose of this study was to assess the prevalence of 2 selected genera of fungi, Candida albicans and Aspergillus spp., using real-time polymerase chain reaction (RT-PCR) and to compare the findings with the respective ones obtained by a culture-dependent approach, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-ToF MS). A secondary aim was to assess the presence of other bacteria growing under aerobic conditions. METHODS Microbial samples were obtained from the root canals of 60 teeth associated with pulp necrosis and apical periodontitis. DNA was extracted, and RT-PCR was applied for the detection of C. albicans and Aspergillus spp. pathogenic subtypes. In addition, MALDI-ToF MS was performed to identify microorganisms grown under aerobic conditions. RESULTS Based on RT-PCR, Aspergillus was detected in 8 cases, whereas C. albicans was detected in 4 cases. Using MALDI-ToF MS, no trace of Aspergillus was detected, whereas C. albicans was identified in 2 cases. Significant differences were revealed in the detection potential for Aspergillus spp. between MALDI-ToF MS and RT-PCR (P = .01); conversely, this was not the case for C. albicans (P = .50). After MALDI-ToF MS, 35 samples showed evidence of bacterial growth. The vast majority was colonized by Achromobacter xylosoxidans followed by Lactobacillus spp., Methylobacterium spp., and Enterococcus faecalis. CONCLUSIONS The findings confirm the presence of fungi in primarily infected canals with apical periodontitis as well as some rarely inspected aerobic bacterial species. A. xylosoxidans was prevalent; however, the clinical relevance of its presence needs to be investigated further.
Collapse
|
6
|
Motiwala MA, Habib S, Ghafoor R, Irfan S. Comparison of antimicrobial efficacy of Calcipex and Metapex in endodontic treatment of chronic apical periodontitis: a randomised controlled trial study protocol. BMJ Open 2021; 11:e048947. [PMID: 34290069 PMCID: PMC8296811 DOI: 10.1136/bmjopen-2021-048947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Various intracanal medicaments have been used in cases of chronic apical periodontitis for appropriate disinfection of the root canal system to eliminate microbes especially from the inaccessible areas. Calcium hydroxide is the most common intracanal medicament available in various forms, but its effectiveness with or without iodoform using microbial culture is unknown. Therefore, our aim is to compare the antimicrobial efficacy of Calcipex and Metapex in endodontic treatment of teeth presenting with chronic apical periodontitis by assessing the bacterial load reduction. METHOD AND ANALYSIS 60 single rooted teeth of patients with diagnosis of chronic apical periodontitis will be selected and the canals debrided chemomechanically. The patients will be randomised into two groups: Calcipex and Metapex. The first sample (S1) for bacterial culture will be taken before placement of intracanal medicament and the second sample (S2) will be taken after 7 days, before final obturation from the canal and sent to lab for culture. Colony-forming unit will be evaluated. Paired t-test will be used to assess difference between antimicrobial efficacies within the group of medicaments. Independent sample t-test will be used to assess antimicrobial efficacies between groups. Level of significance will be kept at 0.05. ETHICS AND DISSEMINATION Approval from Aga Khan University Hospital Ethical review committee is taken. Findings will be reported according to the Standard Protocol Items for Randomised Trials guidelines. Research findings will be disseminated through annual reports, peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER NCT04336709.
Collapse
Affiliation(s)
- Momina Anis Motiwala
- Operative Dentistry, Surgery, The Aga Khan University Hospital Main Campus, Karachi, Pakistan
| | - Saqib Habib
- Operative Dentistry, Surgery, The Aga Khan University Hospital Main Campus, Karachi, Pakistan
| | - Robia Ghafoor
- Operative Dentistry, Surgery, The Aga Khan University Hospital Main Campus, Karachi, Pakistan
| | - Seema Irfan
- Pathology and laboratory medicine, The Aga Khan University Hospital Main Campus, Karachi, Pakistan
| |
Collapse
|
7
|
Fouad AF. Contemporary Microbial and Antimicrobial Considerations in Regenerative Endodontic Therapy. J Endod 2020; 46:S105-S114. [DOI: 10.1016/j.joen.2020.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
8
|
Lemos SS, Cesar DE, ProcÓpio SW, Machado FC, Ribeiro LC, Ribeiro RA. Qualitative and quantitative molecular analysis of bacteria in root canals of primary teeth with pulp necrosis. Braz Oral Res 2020; 34:e093. [PMID: 32785473 DOI: 10.1590/1807-3107bor-2020.vol34.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/18/2020] [Indexed: 11/21/2022] Open
Abstract
Information about bacterial diversity, such as the number of each species in the root canals of primary teeth, contributes to improving our effective management of infections of endodontic origin in primary teeth. This study made a qualitative and quantitative assessment of the bacteria in the root canals of primary teeth with necrotic pulp, using the fluorescence in situ hybridization (FISH) technique. Thirty-one primary teeth with pulp necrosis from 31 children were evaluated using the FISH technique, to detect the presence and density of Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Enterococcus faecalis, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Streptococcus, Streptococcus mutans, Streptococcus sobrinus, Tannerella forsythia and Treponema denticola. Descriptive measures explained the data related to density, and Student's t-test assessed the differences among the densities of each bacterium, according to signs and symptoms. The bacterial density was paired and correlated. All bacteria tested were detected and identified in all the samples. The average number of bacterial individuals from each species ranged from 1.9 x 108 cells/mL (S. mutans) to 3.1 x 108 cells/mL (F. nucleatum) (p > 0.05). The sum of the mean counts of each bacterium represented almost 80% of the entire microbial community. Patients with pain had significantly more T. denticola, and those with edema showed a greater density of Streptococcus and P. nigrescens (p < 0.05). This study revealed that all 12 bacteria evaluated were found in all primary teeth with pulp necrosis. There was no predominance among the species studied; all species had a similar number of individuals.
Collapse
Affiliation(s)
- Samira Salomão Lemos
- Postgraduate Program in Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Dionéia Evangelista Cesar
- Department of Ecology and Molecular Biology of Microorganisms, Biological Sciences Institute, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Stefânia Werneck ProcÓpio
- Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fernanda Campos Machado
- Department of Social and Child Dentistry, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Luiz Claudio Ribeiro
- Department of Statistics, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Rosangela Almeida Ribeiro
- Department of Social and Child Dentistry, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| |
Collapse
|
9
|
Tiwari S, Saxena S, Kumari A, Chatterjee S, Hazra A, Choudhary AR. Detection of Red complex bacteria, P. gingivalis, T. denticola and T. forsythia in infected root canals and their association with clinical signs and symptoms. J Family Med Prim Care 2020; 9:1915-1920. [PMID: 32670940 PMCID: PMC7346963 DOI: 10.4103/jfmpc.jfmpc_1177_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 12/25/2019] [Accepted: 01/07/2020] [Indexed: 12/17/2022] Open
Abstract
Aim: This study aimed to investigate the association between endodontic clinical signs and symptoms and the presence of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia employing polymerase chain reaction (PCR). Materials and Methods: Microbial samples were obtained from 60 cases with necrotic pulp with primary teeth infections. DNA extracted from samples were analyzed for endodontic pathogens by using species-specific primers. Results: P. gingivalis/T. denticola were detected in 15 symptomatic teeth associated with periapical lesions. T. forsythia/T. denticola were found in 16 symptomatic teeth associated with pain and swelling. P. gingivalis was detected in 9 teeth which were associated with pain, 2 with tenderness on percussion, and 15 with periapical lesions. Statistically significant associations were found between T. forsythia as well as T. denticola in relation to clinical findings of pain and swelling. (P < 0.05). Red complex bacteria showed no statistical significant association with the presence of signs and symptoms. Conclusion: Prevalence of P. gingivalis, T. denticola, and T. forsythia suggested association of these bacteria with symptomatic infected pulp and periradicular diseases.
Collapse
Affiliation(s)
- Sonia Tiwari
- Department of Pediatric and Preventive Dentistry, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| | - Sudhanshu Saxena
- Department of Public Health Dentistry, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| | - Aarti Kumari
- Department of Public Health Dentistry, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| | - Silpi Chatterjee
- Department of Public Health Dentistry, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| | - Adreet Hazra
- Department of Periodontology and Implantology, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| | - Alok Ratan Choudhary
- Department of Periodontology and Implantology, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| |
Collapse
|
10
|
Zargar N, Ashraf H, Marashi SMA, Sabeti M, Aziz A. Identification of microorganisms in irreversible pulpitis and primary endodontic infections with respect to clinical and radiographic findings. Clin Oral Investig 2020; 24:2099-2108. [PMID: 32377864 DOI: 10.1007/s00784-019-03075-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 09/13/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the composition of microbiota of irreversible pulpitis and primary endodontic infections with respect to clinical and radiographic findings by performing cultures and 16s rDNA sequencing in Iranian patients. MATERIAL AND METHODS In this prospective cross-sectional study, samples were collected from 41 root canals for 4 main groups of patients. Bacterial identification was performed by the polymerase chain reaction (PCR) and 16s rDNA sequencing of aerobic and anaerobic cultivable colonies taken from patients' culture plates. Additionally, the presence of 13 bacterial species and 3 nonbacterial species was also explored using PCR and species-specific primers. RESULTS Sixteen microbial species, 1 fungus (Candida albicans), and 1 virus (Herpes simplex virus) were discovered and isolated. Species with the highest prevalence were Dialister invisus (68.3%), Porphyromonas gingivalis (58.8%), Streptococcus salivarius (58.5%), and Treponema denticola (56.1%). Lysinibacillus fusiformis (19.1%) was detected in the root canals for the first time. Candida albicans was seen in 11 cases (26.8%). Herpes simplex virus (HSV) was seen in 4 patients (9.8%). CONCLUSIONS Our results suggest that Gram-negative anaerobic oral bacteria are the majority of the microbes in primary endodontic infections. Various combinations of bacterial species were related to different clinical and radiographic conditions. Lysinibacillus fusiformis was detected for the first time in primary endodontic infections. CLINICAL RELEVANCE The results of this investigation might help clinicians choose to identify suspected endodontic pathogens in the etiology of each form of pulpal and periradicular diseases to determine the best therapeutic measures.
Collapse
Affiliation(s)
- Nazanin Zargar
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blv., Daneshgah Square, Chamran Highway, Tehran, 1983963113, Iran
| | - Hengameh Ashraf
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blv., Daneshgah Square, Chamran Highway, Tehran, 1983963113, Iran
| | - S M Amin Marashi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Sabeti
- UCSF School of Dentistry, 707 Parnassus Ave. Room-D 3226, San Francisco, CA, 94143-0758, USA
| | - Alireza Aziz
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blv., Evin Avenue, Chamran Highway, Tehran, 1983963113, Iran.
| |
Collapse
|
11
|
Zhang W, Chen Y, Shi Q, Hou B, Yang Q. Identification of bacteria associated with periapical abscesses of primary teeth by sequence analysis of 16S rDNA clone libraries. Microb Pathog 2019; 141:103954. [PMID: 31891793 DOI: 10.1016/j.micpath.2019.103954] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/17/2019] [Accepted: 12/27/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aims to detect the predominant bacteria in acute periapical abscesses of primary teeth using culture-independent molecular methods based on 16S ribosomal DNA cloning. METHODS Purulent material was collected from nine children diagnosed with abscesses of endodontic origin. DNA was extracted and the 16S rRNA gene amplified with universal primer pairs 27F and 1492R. Amplified genes were cloned, sequenced by Applied Biosystems, and identified by comparison with known 16S rRNA gene sequences. RESULTS Bacterial DNA was present in all nine purulence samples. A total of 681 clones were classified into 8 phyla, 78 genera, and 125 species/phylotypes. The phyla were Firmicutes, Proteobacteria, Fusobacteria, Bacteroidetes, Actinobacteria, Tenericutes, Deinococcus-Thermus, and Spirochaetes. The most dominant genera were Streptococcus (13.3%), Fusobacterium (11.8%), Parvimonas (7.8%), Prevotella (6.7%), Sphingomonas (5.8%), and Hafnia (5.2%). Fusobacterium nucleatum (11.5%), Parvimonas micra (7.8%), Streptococcus intermedius (6.6%), Sphingomonas echinoides (5.3%), Hafnia alvei (5.2%), and Citrobacter freundii (4.9%) were the most common species/phylotypes. Among these species/phylotypes, F.nucleatum was the most prevalent (7/9). C. freundii, Carnobacterium maltaromaticum, and H. alvei were seldom detected species in acute periapical abscesses but had relatively high abundance and prevalence. CONCLUSION Acute periapical abscesses are polymicrobial with certain prevalent bacteria, especially anaerobic bacterium. The most predominant and prevalent bacteria of acute periapical abscesses in children was F. nucleatum.
Collapse
Affiliation(s)
- Wenwen Zhang
- Beijing Institute for Dental Research, Capital Medical University, School of Stomatology, Beijing, China
| | - Yuanyuan Chen
- Beijing Institute for Dental Research, Capital Medical University, School of Stomatology, Beijing, China
| | - Qing Shi
- Department of Pediatric Dentistry, Capital Medical University, School of Stomatology, Beijing, China
| | - Benxiang Hou
- Department of Endodontics, Capital Medical University, School of Stomatology, Beijing, China
| | - Qiubo Yang
- Beijing Institute for Dental Research, Capital Medical University, School of Stomatology, Beijing, China.
| |
Collapse
|
12
|
Özavci V, Erbas G, Parin U, Yüksel HT, Kirkan Ş. Molecular detection of feline and canine periodontal pathogens. Vet Anim Sci 2019; 8:100069. [PMID: 32734086 PMCID: PMC7386636 DOI: 10.1016/j.vas.2019.100069] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/05/2019] [Accepted: 08/08/2019] [Indexed: 01/14/2023] Open
Abstract
It is concluded that the feline oral flora is highly diverse than canine oral flora. Porphyromonas gingivalis, Prevotella nigrescens and Porphyromonas gulae were the dominant species in cats and dogs. T. forsythia, C. ochracea, and C. sputigena in cats and T. forsythia, C. ochracea, C. sputigena T. denticola and, E. corrodens, in dogs showed that the prevalence was lower than 10%. E. corrodens in cats and, P. intermedia, A. actinomycetemcomitans, and C. rectus in dogs were also isolated from the swab samples with less than 30% percentage. A balanced diet for cats and dogs should be provided to reduce the formation of residues in the oral flora. Daily rinsing with antiseptic solutions may also be helpful against the development of periodontal pathogens.
Periodontal disease is the most common infectious disease of cats and dogs which are strongly associated with periodontal pathogens. The primary etiologic factor in the formation of periodontal disease is microbial dental plaque accumulation on teeth. In our research, we aimed to investigate the presence of periodontal disease-related bacterial species in dental plaques of cats and dogs. Specimens collected from 50 cats and 51 dogs with periodontal disease examined in terms of periodontal pathogens by polymerase chain reaction (PCR) using primers directed to 16S rRNA and tdpA genes. Our findings indicate the presence of periodontal disease-related pathogens, especially Porphyromonas gingivalis (cats 96%, dogs 88%), Prevotella nigrescens (cats 90%, dogs 57%) and, Porphyromonas gulae (cats 70%, dogs 39%). In addition, the prevalence of Tannerella forthysia (cats 2%, dogs 4%) well-known pathogen in cats and dogs were isolated with an extremely low percentage. Furthermore, our results suggest that the feline oral cavity microbiota has considerably more diversity than dogs. Consequently, daily oral hygiene practices may become essential for controlling the pathogenic bacteria which have clinical importance and in preventing the propagation of microorganisms in the oral cavity of cats and dogs.
Collapse
Affiliation(s)
- Volkan Özavci
- Department of Microbiology, Faculty of Veterinary Medicine, Yozgat Bozok University, Yozgat, Turkey
- Corresponding author.
| | - Göksel Erbas
- Department of Microbiology, Faculty of Veterinary Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Uğur Parin
- Department of Microbiology, Faculty of Veterinary Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Hafize Tuğba Yüksel
- Department of Microbiology, Faculty of Veterinary Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Şükrü Kirkan
- Department of Microbiology, Faculty of Veterinary Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| |
Collapse
|
13
|
Silva NS, Borsanelli AC, Gaetti-Jardim Júnior E, Schweitzer CM, Silveira JAS, Bomjardim HA, Dutra IS, Barbosa JD. Subgingival bacterial microbiota associated with ovine periodontitis. PESQUISA VETERINARIA BRASILEIRA 2019. [DOI: 10.1590/1678-5150-pvb-5913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT: Periodontitis is an inflammatory response in a susceptible host caused by complex microbiota, predominantly composed of Gram-negative anaerobic bacteria. Aiming to characterize the subgingival bacterial microbiota associated with ovine periodontitis, polymerase chain reaction (PCR) was performed in subgingival periodontal pocket samples of 14 sheep with severe periodontitis and in subgingival sulcus biofilm of 14 periodontally healthy sheep in search mainly of Gram-negative and Gram-positive microorganisms considered important periodontopathogens. The most prevalent bacteria in the sheep with periodontal lesions were Tannerella forsythia (78.6%), Treponema denticola (78.6%), Fusobacterium nucleatum (64.3%), and Porphyromonas gingivalis (50%), whereas in the healthy sheep, F. nucleatum (42.8%) was the most often detected bacterium. Statistically significant differences were observed for Campylobacter rectus, Enterococcus faecium, Prevotella nigrescens, T. forsythia, and T. denticola (p<0.05) in the sheep with periodontitis in the comparison between groups. Aggregatibacter actinomycetemcomitans, Enterococcus faecalis, and Porphyromonas gulae were not detected in any of the samples analyzed. In conclusion, C. rectus, E. faecium, P. nigrescens, T. forsythia, and T. denticola were associated with severe lesions caused by ovine periodontitis, and F. nucleatum was the most prevalent microorganism in the subgengival sulcus biofilm of healthy sheep.
Collapse
|
14
|
Watanabe S, Toyama T, Sato T, Suzuki M, Morozumi A, Sakagami H, Hamada N. Kampo Therapies and the Use of Herbal Medicines in the Dentistry in Japan. MEDICINES 2019; 6:medicines6010034. [PMID: 30823475 PMCID: PMC6473445 DOI: 10.3390/medicines6010034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 01/03/2023]
Abstract
Dental caries and periodontal disease are two major diseases in the dentistry. As the society is aging, their pathological meaning has been changing. An increasing number of patients are displaying symptoms of systemic disease and so we need to pay more attention to immunologic aggression in our medical treatment. For this reason, we focused on natural products. Kampo consists of natural herbs-roots and barks-and has more than 3000 years of history. It was originated in China as traditional medicine and introduced to Japan. Over the years, Kampo medicine in Japan has been formulated in a way to suit Japan's natural features and ethnic characteristics. Based on this traditional Japanese Kampo medicine, we have manufactured a Kampo gargle and Mastic Gel dentifrice. In order to practically utilize the effectiveness of mastic, we have developed a dentifrice (product name: IMPLA CARE) and treated implant periodontitis and severe periodontitis.
Collapse
Affiliation(s)
- Shuji Watanabe
- Division of Microbiology, Department of Oral Science, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan.
- Odoriba Medical Center, Totsuka Green Dental Clinic, 1-10-46 Gumizawa, Totsuka-ku, Yokohama 245-0061, Japan.
| | - Toshizo Toyama
- Division of Microbiology, Department of Oral Science, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan.
| | - Takenori Sato
- Division of Microbiology, Department of Oral Science, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan.
| | - Mitsuo Suzuki
- Division of Microbiology, Department of Oral Science, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan.
- Dental Design Clinic, 3-7-10 Kita-aoyama, Minato-ku, Tokyo 107-0061, Japan.
| | - Akira Morozumi
- Morozumi Dental Clinic, 1-3-1 Miyamaedaira, Miyamae-ku, Kawasaki 216-0006, Japan.
| | - Hiroshi Sakagami
- Meikai University Research Institute of Odontology (M-RIO), 1-1 Keyakidai, Sakado, Saitama 350-0283, Japan.
| | - Nobushiro Hamada
- Division of Microbiology, Department of Oral Science, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan.
| |
Collapse
|
15
|
Immediate Early and Delayed Implants: A 2-Year Prospective Cohort Study of 131 Transmucosal Flapless Implants Placed in Sites With Different Pre-extractive Endodontic Infections. IMPLANT DENT 2018; 26:654-663. [PMID: 28945667 DOI: 10.1097/id.0000000000000666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION To evaluate clinical outcome of early, immediate, and delayed transmucosal implants placed in patients affected by acute/chronic endodontic lesions. MATERIALS AND METHODS Eighty-five consecutive patients received 131 titanium implants with zirconium-oxide blasted surface. Pre-extractive diagnosis represented the main criteria for implant placement timing, following "best treatment" criteria. Implants were placed with flapless transmucosal technique. Hopeless teeth with chronic periapical lesions received atraumatic extraction, and an implant was immediately placed (Immediate Group, n = 29). Teeth with acute periapical lesion/abscess were extracted and implants placed after 8 to 12 weeks (Early Group, n = 29). Implants placed 10- to 12-month after extraction constituted the control group (delayed group, n = 73). Implants were loaded 3 months after insertion with provisional resin crowns and after approximately 15 days with definitive ceramic crowns. Marginal bone loss (MBL) was measured in a single-blind manner on periapical radiographs at 1, 3, 6, 12, and 24 months. RESULTS Multilevel analysis described exploring factors associated with MBL. Survival rate was 100%. MBL after 24 months was 0.78 ± 0.70 (95% confidence interval [CI]: 0.20 to -1.37) at immediate, 0.48 ± 0.70 at early (95% CI: -0.006 to -0.961), and 1.02 ± 1.01 (95% CI: 0.61 to -1.43) at delayed groups. Implant groups (immediate/early/delayed) and location (maxillary/mandibular) showed statistically significant results. Early group showed the lowest MBL values. The immediate group demonstrated less MBL than the delayed group. CONCLUSION Early implant placement technique preserves periimplant marginal bone level more than immediate and delayed techniques.
Collapse
|
16
|
Abstract
Modern day endodontics is undergoing a massive change with the introduction of new molecular based techniques for microbial identification. This review focuses on the microbiota in untreated and root-filled canals. It will also describe briefly the recent developments in microbial identification and the mechanisms by which certain species of microbes are able to invade and establish themselves in the root canal.
Collapse
|
17
|
Takahama A, Rôças IN, Faustino ISP, Alves FRF, Azevedo RS, Gomes CC, Araújo-Filho WR, Siqueira JF. Association between bacteria occurring in the apical canal system and expression of bone-resorbing mediators and matrix metalloproteinases in apical periodontitis. Int Endod J 2018; 51:738-746. [DOI: 10.1111/iej.12895] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 01/18/2018] [Indexed: 12/16/2022]
Affiliation(s)
- A. Takahama
- Department of Oral Medicine and Pediatric Dentistry; State University of Londrina; Londrina PR Brazil
| | - I. N. Rôças
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - I. S. P. Faustino
- Department of Oral Pathology; Nova Friburgo Health Institute; Federal Fluminense University; Nova Friburgo RJ Brazil
| | - F. R. F. Alves
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - R. S. Azevedo
- Department of Oral Pathology; Nova Friburgo Health Institute; Federal Fluminense University; Nova Friburgo RJ Brazil
| | - C. C. Gomes
- Department of Endodontics; Nova Friburgo Health Institute; Federal Fluminense University; Nova Friburgo RJ Brazil
| | - W. R. Araújo-Filho
- Department of Endodontics; Nova Friburgo Health Institute; Federal Fluminense University; Nova Friburgo RJ Brazil
| | - J. F. Siqueira
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| |
Collapse
|
18
|
Pattanshetty S, Kotrashetti VS, Bhat K, Nayak RS, Somannavar P, Pujar M. Multiplex polymerase chain reaction detection of selected bacterial species from symptomatic and asymptomatic non-vital teeth with primary endodontic infections. ACTA ACUST UNITED AC 2018; 9:e12312. [DOI: 10.1111/jicd.12312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 10/04/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Smita Pattanshetty
- Department of Oral Pathology and Microbiology; Maratha Mandal's Nathajirao G Halgekar’s Institute of Dental Sciences; Karnataka India
| | - Vijayalakshmi S. Kotrashetti
- Department of Oral Pathology and Microbiology; Maratha Mandal's Nathajirao G Halgekar’s Institute of Dental Sciences; Karnataka India
| | - Kishore Bhat
- Department of Oral Pathology and Microbiology; Maratha Mandal's Nathajirao G Halgekar’s Institute of Dental Sciences; Karnataka India
| | - Ramakant S. Nayak
- Department of Oral Pathology and Microbiology; Maratha Mandal's Nathajirao G Halgekar’s Institute of Dental Sciences; Karnataka India
| | - Pradeep Somannavar
- Department of Oral Pathology and Microbiology; Maratha Mandal's Nathajirao G Halgekar’s Institute of Dental Sciences; Karnataka India
| | - Madhu Pujar
- Department of Conservative Dentistry and Endodontics; Maratha Mandal's Nathajirao G Halgekar’s Institute of Dental Sciences; Karnataka India
| |
Collapse
|
19
|
Saeed M, Koller G, Niazi S, Patel S, Mannocci F, Bruce K, Foschi F. Bacterial Contamination of Endodontic Materials before and after Clinical Storage. J Endod 2017; 43:1852-1856. [DOI: 10.1016/j.joen.2017.06.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/29/2017] [Accepted: 06/29/2017] [Indexed: 12/31/2022]
|
20
|
Ran S, Liu B, Gu S, Sun Z, Liang J. Analysis of the expression of NLRP3 and AIM2 in periapical lesions with apical periodontitis and microbial analysis outside the apical segment of teeth. Arch Oral Biol 2017; 78:39-47. [PMID: 28193569 DOI: 10.1016/j.archoralbio.2017.02.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 01/31/2017] [Accepted: 02/05/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To detect the distribution and expression levels of the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) and the absent in Melanoma 2 (AIM2) inflammasomes in periapical lesions and to analyse the possible microbial stimuli outside of teeth. DESIGN The distribution of NLRP3 and AIM2 inflammasomes in sixteen periapical lesions was investigated by immunohistochemistry. Meanwhile, the relative gene expression levels of NLRP3 and AIM2 in sixteen periapical lesions and three health periodontal tissue were quantified by real-time polymerase chain reaction (PCR). Moreover, forty-seven teeth without sinus tracts were obtained in the clinic and included in bacterial analysis using PCR. Then, the mRNA levels of apoptosis-associated speck-like protein (ASC), caspase-1, interleukin-1β (IL-1β), NLRP3 and AIM2 in THP-1-derived macrophages treated with lipopolysaccharides (LPS) of Porphyromonas were also quantified by real-time PCR, and the IL-1β secretion level was investigated using enzyme-linked immunosorbent assay (ELISA). RESULTS NLRP3 and AIM2 were positively expressed in periapical lesions and were mainly distributed in inflammatory cells. Most of the samples that demonstrated up-regulation of NLRP3 mRNA also demonstrated up-regulation of caspase-1 mRNA. Microbial analysis revealed that Porphyromonas endodontalis was the most commonly detected species and was detected in 27 of 47 cases (57.4%), followed by Fusobacterium nucleatum (20/47, 42.6%), Porphyromonas gingivalis (19/47, 40.4%), Tannerella forsythia (19/47, 40.4%), Actinomyces sp. (17/47, 36.17%), Treponema denticola (10/47,21.28%), Actinomyces israelii (9/47,19.15%), Prevotella intermedia (6/47, 12.77%), Enterococcus faecalis (1/47,2.13%) and Enterococcus faecium (0/47,0). Furthermore, we found that LPS of P. gingivalis induced THP-1 cells to produce IL-1β and to activate NLRP3 and AIM2 inflammasomes. CONCLUSIONS Our results suggest that the NLRP3 and AIM2 proteins play a part in the pathogenesis of periapical periodontitis. Anaerobes, such as P. endodontalis, P. gingivalis, F. nucleatum and T. forsythia, were the main detected microbial stimuli that might activate inflammasomes in periapical tissues.
Collapse
Affiliation(s)
- Shujun Ran
- Department of Endodontics and Operative Dentistry, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 639, Zhizaoju Road, Shanghai, 200011, China
| | - Bin Liu
- Department of Endodontics and Operative Dentistry, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 639, Zhizaoju Road, Shanghai, 200011, China
| | - Shensheng Gu
- Department of Endodontics and Operative Dentistry, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 639, Zhizaoju Road, Shanghai, 200011, China
| | - Zhe Sun
- Department of Endodontics and Operative Dentistry, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 639, Zhizaoju Road, Shanghai, 200011, China.
| | - Jingping Liang
- Department of Endodontics and Operative Dentistry, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 639, Zhizaoju Road, Shanghai, 200011, China.
| |
Collapse
|
21
|
Bacteria in the apical root canals of teeth with apical periodontitis. J Formos Med Assoc 2016; 116:448-456. [PMID: 27745799 DOI: 10.1016/j.jfma.2016.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 08/09/2016] [Accepted: 08/15/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND/PURPOSE Bacteria in the tooth root canal may cause apical periodontitis. This study examined the bacterial species present in the apical root canal of teeth with apical periodontitis. Antibiotic sensitivity tests were performed to evaluate whether these identified bacterial species were susceptible to specific kinds of antibiotics. METHODS Selective media plating and biochemical tests were used first to detect the bacterial species in samples taken from the apical portion of root canals of 62 teeth with apical periodontitis. The isolated bacterial species were further confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry. RESULTS We found concomitant presence of two (32 teeth) or three species (18 teeth) of bacteria in 50 (80.6%) out of 62 tested teeth. However, only 34 bacterial species were identified. Of a total of 118 bacterial isolates (83 anaerobes and 35 aerobes), Prophyromonas endodontalis was detected in 10; Bacteroides, Dialister invisus or Fusobacterium nucleatum in 9; Treponema denticola or Enterococcus faecalis in 8; Peptostreptococcus or Olsenella uli in 6; and Veillonella in 5 teeth. The other 25 bacterial species were detected in fewer than five teeth. Approximately 80-95% of bacterial isolates of anaerobes were sensitive to ampicillin/sulbactam (Unasyn), amoxicillin/clavulanate (Augmentin), cefoxitin, and clindamycin. For E. faecalis, 85-90% of bacterial isolates were sensitive to gentamicin and linezolid. CONCLUSION Root canal infections are usually caused by a mixture of two or three species of bacteria. Specific kinds of antibiotic can be selected to control these bacterial infections after antibiotic sensitivity testing.
Collapse
|
22
|
Komiyama EY, Lepesqueur LSS, Yassuda CG, Samaranayake LP, Parahitiyawa NB, Balducci I, Koga-Ito CY. Enterococcus Species in the Oral Cavity: Prevalence, Virulence Factors and Antimicrobial Susceptibility. PLoS One 2016; 11:e0163001. [PMID: 27631785 PMCID: PMC5025163 DOI: 10.1371/journal.pone.0163001] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 09/01/2016] [Indexed: 11/18/2022] Open
Abstract
Enterococci are considered as transient constituent components of the oral microbiome that may cause a variety of oral and systemic infections. As there is sparse data on the oral enterococcal prevalence, we evaluated the Enterococcus spp. and their virulence attributes including antimicrobial resistance in a healthy Brazilian cohort. A total of 240 individuals in different age groups were studied (children 4–11 yrs, adolescents 12–17 yrs, young adults 18–29 yrs, adults 30–59 yrs, elderly over 60 yrs). Oral rinses were collected and isolates were identified by API 20 Strep and confirmed by 16S rDNA sequencing. E. faecalis isolates, in particular, were evaluated for virulence attributes such as their biofilm formation potential, and susceptibility to antimicrobials and an antiseptic, chlorhexidine gluconate. A total of 40 individuals (16.6%) and 10% children, 4% adolescents, 14% young adults, 30% adults, and 25% elderly carried oral enterococci. The oral enterococcal burden in adolescents was significantly lower than in the adults (p = 0.000) and elderly (p = 0.004). The proportion of carriers was higher among females (p = 0.001). E. faecalis was the most frequent isolate in all the age groups (p = 0.000), followed by E. durans and E. faecium. Whilst all the clinical isolates were able to form biofilms, only a proportion of them were able to produce lipase (92%), hemolysin (38%), and gelatinase (39%). Of all the isolates 53.8% were resistant to tetracycline, 12.3% to amoxicillin, 16.0% to ampicillin, 20.8% to chloramphenicol and 43.4% to erythromycin. None of the isolates were resistant to vancomycin. Our data suggest that in this Brazilian cohort the oral cavity may act as a significant reservoir of rather virulent and antibiotic resistant enterococci, with an increasing degree of carriage in the adults and elderly. Hence clinicians should be cognizant of this silent reservoir of virulent enterococci that may pose a particular threat of nosocomial infection.
Collapse
Affiliation(s)
- Edson Yukio Komiyama
- Department of Oral Biosciences and Diagnosis, Oral Biopathology Graduate Program, Institute of Science and Technology, Universidade Estadual Paulista/UNESP, São José dos Campos, São Paulo, Brazil
| | - Laura Soares Souto Lepesqueur
- Department of Oral Biosciences and Diagnosis, Oral Biopathology Graduate Program, Institute of Science and Technology, Universidade Estadual Paulista/UNESP, São José dos Campos, São Paulo, Brazil
| | - Cinthia Gomes Yassuda
- Department of Oral Biosciences and Diagnosis, Oral Biopathology Graduate Program, Institute of Science and Technology, Universidade Estadual Paulista/UNESP, São José dos Campos, São Paulo, Brazil
| | - Lakshman P. Samaranayake
- UQ Oral Health Centre, School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Nipuna B. Parahitiyawa
- Department of Oral Bio-Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Ivan Balducci
- Department of Social Dentistry, Institute of Science and Technology, Universidade Estadual Paulista/UNESP, São José dos Campos, São Paulo, Brazil
| | - Cristiane Yumi Koga-Ito
- Department of Oral Biosciences and Diagnosis, Oral Biopathology Graduate Program, Institute of Science and Technology, Universidade Estadual Paulista/UNESP, São José dos Campos, São Paulo, Brazil
- Department of Environmental Engineering, Institute of Science and Technology, Universidade Estadual Paulista/UNESP, São José dos Campos, São Paulo, Brazil
- * E-mail:
| |
Collapse
|
23
|
Pirani C, Tinarelli V, Gatto M, Iacono F, Gandolfi M, Prati C. Prognosis of root canal treatments filled with Thermafil system: a 5-year retrospective study. GIORNALE ITALIANO DI ENDODONZIA 2016. [DOI: 10.1016/j.gien.2016.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
24
|
BACTERIAL PROFILE OF NECROTIC PULPS IN CHEETAH (ACINONYX JUBATUS) CANINE TEETH. J Zoo Wildl Med 2016; 47:98-105. [PMID: 27010269 DOI: 10.1638/2014-0221.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The role of microbes and their antimicrobial susceptibilities in both acute and chronic infections of the dental pulp in humans has been well studied. Presently, no data are available on endodontic pathogens in cheetahs (Acinonyx jubatus). The aim of this study was to isolate and identify the bacteria found in the canine teeth of cheetahs, where the pulp was necrotic and exposed due to a complicated crown fracture. Thirty-six microbiologic samples were taken from root canals (RCs) of the canine teeth of 19 cheetahs: one pulp sample was taken from 10 cheetahs, four samples from 2 cheetahs, two samples from 3 cheetahs, and three samples from 4 cheetahs. Exposed pulps were cultured for aerobic and anaerobic bacteria; an additional screening with a 16S rRNA-specific polymerase chain reaction (PCR) was used for the last six samples. Antimicrobial susceptibility of isolates was determined by use of the Kirby-Bauer diffusion test. In total, 59 cultivable isolates belonging to 19 microbial species and 13 genera were recovered from the 36 RCs sampled. Only two samples yielded no cultivable bacteria. Thirty-two (54.49%) of the cultivable isolates were Gram positive and 27 (45.71%) were Gram negative. The maximum number of isolates cultivated from an individual RC was six. Facultative anaerobes (62.72%) were the most common bacteria of the RCs that yielded cultivable bacteria. Of the isolates, 28.81% were aerobic and 8.47% were strict anaerobes. The antimicrobials that showed the greatest efficacy in vitro against the different bacteria isolates were amikacin and gentamicin. The more common bacterial species isolated by PCR were anaerobes (60.8%), facultative anaerobes (30.2%), and aerobes (8.6%).
Collapse
|
25
|
Virlan MJR, Miricescu D, Radulescu R, Sabliov CM, Totan A, Calenic B, Greabu M. Organic Nanomaterials and Their Applications in the Treatment of Oral Diseases. Molecules 2016; 21:E207. [PMID: 26867191 PMCID: PMC6273611 DOI: 10.3390/molecules21020207] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 01/20/2016] [Accepted: 01/28/2016] [Indexed: 12/18/2022] Open
Abstract
There is a growing interest in the development of organic nanomaterials for biomedical applications. An increasing number of studies focus on the uses of nanomaterials with organic structure for regeneration of bone, cartilage, skin or dental tissues. Solid evidence has been found for several advantages of using natural or synthetic organic nanostructures in a wide variety of dental fields, from implantology, endodontics, and periodontics, to regenerative dentistry and wound healing. Most of the research is concentrated on nanoforms of chitosan, silk fibroin, synthetic polymers or their combinations, but new nanocomposites are constantly being developed. The present work reviews in detail current research on organic nanoparticles and their potential applications in the dental field.
Collapse
Affiliation(s)
- Maria Justina Roxana Virlan
- Department of Biochemistry, Faculty of Dentistry, University of Medicine and Pharmacy Carol Davila, Blvd. EroiiSanitari, No. 8, RO-050474 Bucharest, Romania.
| | - Daniela Miricescu
- Department of Biochemistry, Faculty of Dentistry, University of Medicine and Pharmacy Carol Davila, Blvd. EroiiSanitari, No. 8, RO-050474 Bucharest, Romania.
| | - Radu Radulescu
- Department of Biochemistry, Faculty of Dentistry, University of Medicine and Pharmacy Carol Davila, Blvd. EroiiSanitari, No. 8, RO-050474 Bucharest, Romania.
| | - Cristina M Sabliov
- Agricultural and Biological Engineering Department, Louisiana State University and LSU Ag Center, 149 EB Doran Building, Baton Rouge, LA 70803, USA.
| | - Alexandra Totan
- Department of Biochemistry, Faculty of Dentistry, University of Medicine and Pharmacy Carol Davila, Blvd. EroiiSanitari, No. 8, RO-050474 Bucharest, Romania.
| | - Bogdan Calenic
- Department of Biochemistry, Faculty of Dentistry, University of Medicine and Pharmacy Carol Davila, Blvd. EroiiSanitari, No. 8, RO-050474 Bucharest, Romania.
| | - Maria Greabu
- Department of Biochemistry, Faculty of Dentistry, University of Medicine and Pharmacy Carol Davila, Blvd. EroiiSanitari, No. 8, RO-050474 Bucharest, Romania.
| |
Collapse
|
26
|
Kesler Shvero D, Zaltsman N, Weiss EI, Polak D, Hazan R, Beyth N. Lethal bacterial trap: Cationic surface for endodontic sealing. J Biomed Mater Res A 2015; 104:427-34. [DOI: 10.1002/jbm.a.35576] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/18/2015] [Accepted: 09/24/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Dana Kesler Shvero
- Department of Prosthodontics, Faculty of Dentistry; The Hebrew University-Hadassah; P.O. Box 12272 Jerusalem 91120 Israel
| | - Nathan Zaltsman
- Department of Prosthodontics, Faculty of Dentistry; The Hebrew University-Hadassah; P.O. Box 12272 Jerusalem 91120 Israel
| | - Ervin I. Weiss
- Department of Prosthodontics, Faculty of Dentistry; The Hebrew University-Hadassah; P.O. Box 12272 Jerusalem 91120 Israel
| | - David Polak
- Department of Periodontology, Faculty of Dentistry; The Hebrew University-Hadassah; P.O. Box 12272 Jerusalem 91120 Israel
| | - Ronen Hazan
- Institute of Dental Sciences, The Hebrew University-Hadassah; P.O. Box 12272 Jerusalem 91120 Israel
| | - Nurit Beyth
- Department of Prosthodontics, Faculty of Dentistry; The Hebrew University-Hadassah; P.O. Box 12272 Jerusalem 91120 Israel
| |
Collapse
|
27
|
Łysakowska ME, Ciebiada-Adamiec A, Sienkiewicz M, Sokołowski J, Banaszek K. The cultivable microbiota of primary and secondary infected root canals, their susceptibility to antibiotics and association with the signs and symptoms of infection. Int Endod J 2015; 49:422-30. [PMID: 26011084 DOI: 10.1111/iej.12469] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 05/18/2015] [Indexed: 11/29/2022]
Abstract
AIM To examine the presence of microbial species in primary and secondary infections and identify the signs and symptoms associated with them. METHODOLOGY A total number of 37 root canals from 33 patients undergoing root canal treatment were selected. Samples were taken using a sterile paper point following chemomechanical canal instrumentation. Microbiological identification was performed by macromorphological, micromorphological and commercial biochemical tests (ATB system). The antibiotic susceptibility profile of isolated Enterococcus, Streptococcus and Propionibacterium spp. was evaluated. RESULTS A total number of 54 species were isolated. The most common was E. faecalis followed by Propionibacterium acnes and Streptococcus spp. Five multidrug-resistant enterococcal strains were isolated. However, resistance to linezolid or glycopeptides was not found. Radiolucency was observed significantly more often in symptomatic infections (P = 0.0061) caused by Actinomyces spp. than in asymptomatic ones. CONCLUSIONS Enterococci and streptococci were the most commonly isolated bacteria from root canals. The resistance of enterococci to many antimicrobials may pose a problem in their eradication.
Collapse
Affiliation(s)
- M E Łysakowska
- Department of Microbiology and Medical Laboratory Immunology, Medical University of Lodz, Lodz, Poland
| | - A Ciebiada-Adamiec
- Medical Diagnostic Laboratory Center, Polish Mother's Memory Institute, Medical University of Lodz, Lodz, Poland
| | - M Sienkiewicz
- Department of Environmental Biology, Medical University of Lodz, Lodz, Poland
| | - J Sokołowski
- Department of General Dentistry, Medical University of Lodz, Lodz, Poland
| | - K Banaszek
- Department of General Dentistry, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
28
|
Zhang C, Du J, Peng Z. Correlation between Enterococcus faecalis and Persistent Intraradicular Infection Compared with Primary Intraradicular Infection: A Systematic Review. J Endod 2015; 41:1207-13. [PMID: 26015157 DOI: 10.1016/j.joen.2015.04.008] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/15/2015] [Accepted: 04/13/2015] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The relationship between Enterococcus faecalis and pulpal or periradicular diseases has been studied for many years; however, whether E. faecalis is correlated with persistent intraradicular infections (teeth after failed endodontic treatments) compared with primary intraradicular infections remains controversial. The objective of this systematic review was to compare the prevalence of E. faecalis in primary and persistent intraradicular infections. METHODS An exhaustive literature search combined with specified inclusion criteria was performed to collect all studies comparing the prevalence of E. faecalis in root canals with primary and persistent intraradicular infections. Descriptive statistics were applied first because of the high heterogeneity among studies. Subgroup analysis according to different detecting methods (culture and polymerase chain reaction) and sensitivity analysis was then applied. Meta-analysis was conducted with the help of Stata/SE 12.0 (StataCorp, College Station, TX) after excluding studies with uncertain forms of pulpal and periradicular lesions in their primary infection groups. RESULTS The systematic review included 10 studies covering 972 teeth. Among them, 2 studies used the culture technique, 6 studies used polymerase chain reaction, and the other 2 used both techniques. The detection rate of E. faecalis by both methods was higher in persistent infections compared with untreated chronic periapical periodontitis as primary infections. The difference was statistically significant (odds ratio = 7.247; 95% confidence interval, 4.039-13.002). CONCLUSIONS E. faecalis is more highly correlated with persistent intraradicular infections compared with untreated chronic periapical periodontitis.
Collapse
Affiliation(s)
- Chenjiao Zhang
- Department of Operative Dentistry and Endodontics, Guanghua School and Hospital of Stomatology, Institute of Stomatological Research, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jianrong Du
- Department of Stomatology, Guangdong No. 2 Provincial People's Hospital, Guangdong, China
| | - Zhixiang Peng
- Department of Operative Dentistry and Endodontics, Guanghua School and Hospital of Stomatology, Institute of Stomatological Research, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
| |
Collapse
|
29
|
Prevalence of Treponema Species Detected in Endodontic Infections: Systematic Review and Meta-regression Analysis. J Endod 2015; 41:579-87. [DOI: 10.1016/j.joen.2015.01.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/25/2014] [Accepted: 01/17/2015] [Indexed: 11/20/2022]
|
30
|
Silva T, Pereira A, Buzalaf M, Machado M, Crielaard W, Deng D. Diverse outcomes of Photodynamic Antimicrobial Chemotherapy on five Enterococcus faecalis strains. Photodiagnosis Photodyn Ther 2014; 11:283-9. [DOI: 10.1016/j.pdpdt.2014.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 04/17/2014] [Accepted: 04/18/2014] [Indexed: 10/25/2022]
|
31
|
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]
|
32
|
Di Bello A, Buonavoglia A, Franchini D, Valastro C, Ventrella G, Greco MF, Corrente M. Periodontal disease associated with red complex bacteria in dogs. J Small Anim Pract 2014; 55:160-3. [PMID: 24450418 DOI: 10.1111/jsap.12179] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Red complex bacteria (Treponema denticola, Tannerella forsythia and Porphyromonas gingivalis) play a major role in the aetiology of periodontal disease in humans. This study was designed to evaluate the association of such bacteria with periodontal disease in dogs. METHODS Seventy-three subgingival samples taken from dogs ranging from 2 months to 12 years (median age 4 years) were tested for red complex bacteria using a polymerase chain reaction assay. RESULTS Thirty-six of 73 (49 · 3%) dogs were found to be positive for T. forsythia and P. gingivalis. Dogs with gingivitis or periodontitis were more likely to be infected with T. forsythia and P. gingivalis [odds ratio (OR) 5 · 4 (confidence interval (CI) 1 · 9-15 · 6), P = 0 · 002] than healthy animals. Only 3 (4 · 1%) of 73 samples were positive for red complex bacteria, but the association with periodontal disease was not significant. CONCLUSION AND CLINICAL RELEVANCE The results indicate that involvement of red complex bacteria in periodontal disease in dogs is similar to that observed in humans. Only the concurrent presence of T. forsythia and P. gingivalis were correlated to periodontal disease in dogs in this study.
Collapse
Affiliation(s)
- A Di Bello
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | | | | | | | | | | | | |
Collapse
|
33
|
Beyth N, Kesler Shvero D, Zaltsman N, Houri-Haddad Y, Abramovitz I, Davidi MP, Weiss EI. Rapid kill-novel endodontic sealer and Enterococcus faecalis. PLoS One 2013; 8:e78586. [PMID: 24223159 PMCID: PMC3819367 DOI: 10.1371/journal.pone.0078586] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 09/15/2013] [Indexed: 11/25/2022] Open
Abstract
With growing concern over bacterial resistance, the identification of new antimicrobial means is paramount. In the oral cavity microorganisms are essential to the development of periradicular diseases and are the major causative factors associated with endodontic treatment failure. As quaternary ammonium compounds have the ability to kill a wide array of bacteria through electrostatic interactions with multiple anionic targets on the bacterial surface, it is likely that they can overcome bacterial resistance. Melding these ideas, we investigated the potency of a novel endodontic sealer in limiting Enterococcus faecalis growth. We used a polyethyleneimine scaffold to synthesize nano-sized particles, optimized for incorporation into an epoxy-based endodontic sealer. The novel endodontic sealer was tested for its antimicrobial efficacy and evaluated for biocompatibility and physical eligibility. Our results show that the novel sealer foundation affixes the nanoparticles, achieving surface bactericidal properties, but at the same time impeding nanoparticle penetration into eukaryotic cells and thereby mitigating a possible toxic effect. Moreover, adequate physical properties are maintained. The nanosized quaternary amine particles interact within minutes with bacteria, triggering cell death across wide pH values. Throughout this study we demonstrate a new antibacterial perspective for endodontic sealers; a novel antibacterial, effective and safe antimicrobial means.
Collapse
Affiliation(s)
- Nurit Beyth
- Department of Prosthodontics, Faculty of Dentistry, The Hebrew University-Hadassah, Jerusalem, Israel
- * E-mail:
| | - Dana Kesler Shvero
- Department of Prosthodontics, Faculty of Dentistry, The Hebrew University-Hadassah, Jerusalem, Israel
| | - Nathan Zaltsman
- Department of Prosthodontics, Faculty of Dentistry, The Hebrew University-Hadassah, Jerusalem, Israel
| | - Yael Houri-Haddad
- Department of Prosthodontics, Faculty of Dentistry, The Hebrew University-Hadassah, Jerusalem, Israel
| | - Itzhak Abramovitz
- Department of Endodontics, Faculty of Dentistry, The Hebrew University-Hadassah Jerusalem, Israel
| | - Michael Perez Davidi
- Department of Prosthodontics, Faculty of Dentistry, The Hebrew University-Hadassah, Jerusalem, Israel
| | - Ervin I. Weiss
- Department of Prosthodontics, Faculty of Dentistry, The Hebrew University-Hadassah, Jerusalem, Israel
| |
Collapse
|
34
|
Abstract
Acute apical abscess is the most common form of dental abscess and is caused by infection of the root canal of the tooth. It is usually localized intraorally, but in some cases the apical abscess may spread and result in severe complications or even mortality. The reasons why dental root canal infections can become symptomatic and evolve to severe spreading and sometimes life-threatening abscesses remain elusive. Studies using culture and advanced molecular microbiology methods for microbial identification in apical abscesses have demonstrated a multispecies community conspicuously dominated by anaerobic bacteria. Species/phylotypes commonly found in these infections belong to the genera Fusobacterium, Parvimonas, Prevotella, Porphyromonas, Dialister, Streptococcus, and Treponema. Advances in DNA sequencing technologies and computational biology have substantially enhanced the knowledge of the microbiota associated with acute apical abscesses and shed some light on the etiopathogeny of this disease. Species richness and abundance and the resulting network of interactions among community members may affect the collective pathogenicity and contribute to the development of acute infections. Disease modifiers, including transient or permanent host-related factors, may also influence the development and severity of acute abscesses. This review focuses on the current evidence about the etiology and treatment of acute apical abscesses and how the process is influenced by host-related factors and proposes future directions in research, diagnosis, and therapeutic approaches to deal with this disease.
Collapse
|
35
|
Teles AM, Manso MC, Loureiro S, Silva R, Madeira IGC, Pina C, Cabeda JM. Effectiveness of two intracanal dressings in adult Portuguese patients: a qPCR and anaerobic culture assessment. Int Endod J 2013; 47:32-40. [PMID: 23647356 DOI: 10.1111/iej.12122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/03/2013] [Indexed: 12/20/2022]
Abstract
AIM To quantify bacterial equivalents before and after chemomechanical preparation using 3% sodium hypochlorite (NaOCl) and intracanal dressing with calcium hydroxide paste (Ca(OH)2 ) or 2% Chlorhexidine digluconate gel (CHX) in necrotic pulps associated or not with apical periodontitis and to further compare this quantification with counts of anaerobic microorganisms. METHODOLOGY Prospective clinical trial in 69 single-rooted adult teeth (strict inclusion criteria); CHX group: 34; Ca(OH)2 group: 35. Bacteria samples were taken at baseline (S1), after chemomechanical preparation (S2) and after 14 days of intracanal dressing (S3). Bacterial equivalents were assessed by broad-range real-time polymerase chain reaction (qPCR), and live viable bacteria measured with conventional anaerobic culture (CFU/mL). Descriptive/inferential analysis was performed with spss vs. 20.0 (α = 0.05) using the Kruskal-Wallis, Mann-Whitney and chi-squared tests and Spearman's correlation coefficients. RESULTS Both groups showed a significant decrease between S1 and S2 (Mann-Whitney U-test; P < 0.001) both in qPCR and in culture. In the Ca(OH)2 -group, no variation was observed between S2 and S3 by qPCR and culture. In contrast, the CHX group showed a significant increase from S2 to S3 by both techniques. The two groups were only significantly different in S3 (Mann-Whitney U-test; P ≤ 0.001), with a worse performance in the CHX group. Again, these results were congruent by both approaches. Data from both approaches correlate reasonably (rS < 0.5). CONCLUSIONS Infected root canals contained a high bacterial load, and the chemomechanical root canal preparation reduced bacterial equivalents by 99.1% and anaerobic counts by 98.5%. Intracanal dressings were not efficient at reducing bacterial load, but the 14-day intracanal dressing with Ca(OH)2 performed significantly better than CHX, particularly in cases with apical periodontitis.
Collapse
Affiliation(s)
- A M Teles
- Health Sciences Faculty, Fernando Pessoa University, Oporto, Portugal; Abel Salazar Institute for the Biomedical Sciences, Oporto University, Oporto, Portugal
| | | | | | | | | | | | | |
Collapse
|
36
|
Cunha RF, Machado AC, Watanabe S, Freire IR, Goiato MC, Júnior EGJ. A combination of clinical and microbiological management of generalized aggressive periodontitis in primary teeth. A case report. Int J Paediatr Dent 2012; 22:310-6. [PMID: 22066568 DOI: 10.1111/j.1365-263x.2011.01194.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Generalized aggressive periodontitis (GAP) in primary teeth is a rare periodontal disease that occurs during or soon after eruption of the primary teeth. An association with systemic diseases is a possibility. CASE REPORT A 4-year-old Brazilian girl presented with GAP involving the entire primary dentition. The patient and her parents and sister were subjected to microbiological testing to identify the microorganisms involved in the disease. The patient underwent tooth extraction to eradicate the disease and received a prosthesis for the restoration of masticatory function. After the permanent teeth erupted, fixed orthodontic appliances were place to restore dental arch form and occlusion. CONCLUSIONS The results show the importance of an early diagnosis of GAP and of a multidisciplinary approach involving laboratory and clinical management to treat the disease and to restore masticatory function, providing a better quality of life for patients.
Collapse
Affiliation(s)
- Robson F Cunha
- Department of Social and Pediatric Dentistry, School of Dentistry, São Paulo State University, Araçatuba, SP, Brazil.
| | | | | | | | | | | |
Collapse
|
37
|
Endo MS, Martinho FC, Zaia AA, Ferraz CCR, Almeida JFA, Gomes BPFA. Quantification of cultivable bacteria and endotoxin in post-treatment apical periodontitis before and after chemo-mechanical preparation. Eur J Clin Microbiol Infect Dis 2012; 31:2575-83. [DOI: 10.1007/s10096-012-1598-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 02/29/2012] [Indexed: 10/28/2022]
|
38
|
Cao H, Qi Z, Jiang H, Zhao J, Liu Z, Tang Z. Detection of Porphyromonas endodontalis, Porphyromonas gingivalis and Prevotella intermedia in primary endodontic infections in a Chinese population. Int Endod J 2012; 45:773-81. [DOI: 10.1111/j.1365-2591.2012.02035.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
39
|
Symptomatic and asymptomatic apical periodontitis associated with red complex bacteria: clinical and microbiological evaluation. Odontology 2011; 101:84-8. [PMID: 22143381 DOI: 10.1007/s10266-011-0053-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 10/30/2011] [Indexed: 10/15/2022]
Abstract
In this study, the association of red complex (RC) bacteria that include Treponema denticola, Tannerella forsythia and Porphyromonas gingivalis with acute, exacerbated or chronic apical periodontitis was evaluated. Seventy-one patients with periapical disease were evaluated by clinical examination and microbiological samples obtained from the root canals were analyzed by a polymerase chain reaction assay. Twenty-one (29.6%) samples were positive for RC bacteria, with T. denticola, T. forsythia and P. gingivalis being detected in 14 (19.7%), 10 (14.1%) and 6 (8.5%) samples, respectively. RC bacteria were mainly associated with acute apical periodontitis (29.2%) and phoenix abscess (63.2%), while they were only sporadically detected (7.1%) in patients with chronic apical periodontitis. Generally, RC bacteria were associated with pain and a higher frequency of intracanalar/intrasulcular pus drainage. Involvement of RC bacteria in symptomatic periapical disease should be suspected in the presence of particularly severe clinical pain and pus drainage.
Collapse
|
40
|
Palazzi F, Morra M, Mohammadi Z, Grandini S, Giardino L. Comparison of the surface tension of 5.25% sodium hypochlorite solution with three new sodium hypochlorite-based endodontic irrigants. Int Endod J 2011; 45:129-35. [DOI: 10.1111/j.1365-2591.2011.01952.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
41
|
Poeschl PW, Crepaz V, Russmueller G, Seemann R, Hirschl AM, Ewers R. Endodontic Pathogens Causing Deep Neck Space Infections: Clinical Impact of Different Sampling Techniques and Antibiotic Susceptibility. J Endod 2011; 37:1201-5. [DOI: 10.1016/j.joen.2011.05.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 05/20/2011] [Accepted: 05/21/2011] [Indexed: 10/18/2022]
|
42
|
Gaibani P, Pellegrino MT, Rossini G, Alvisi G, Miragliotta L, Prati C, Sambri V. The central region of the msp gene of Treponema denticola has sequence heterogeneity among clinical samples, obtained from patients with periodontitis. BMC Infect Dis 2010; 10:345. [PMID: 21138575 PMCID: PMC3004910 DOI: 10.1186/1471-2334-10-345] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Accepted: 12/07/2010] [Indexed: 11/28/2022] Open
Abstract
Background Treponema denticola is an oral spirochete involved in the pathogenesis and progression of periodontal disease. Of its virulence factors, the major surface protein (MSP) plays a role in the interaction between the treponeme and host. To understand the possible evolution of this protein, we analyzed the sequence of the msp gene in 17 T. denticola positive clinical samples. Methods Nucleotide and amino acid sequence of MSP have been determined by PCR amplification and sequencing in seventeen T. denticola clinical specimens to evaluate the genetic variability and the philogenetic relationship of the T. denticola msp gene among the different amplified sequence of positive samples. In silico antigenic analysis was performed on each MSP sequences to determined possible antigenic variation. Results The msp sequences showed two highly conserved 5' and 3' ends and a central region that varies substantially. Phylogenetic analysis categorized the 17 specimens into 2 principal groups, suggesting a low rate of evolutionary variability and an elevated degree of conservation of msp in clinically derived genetic material. Analysis of the predicted antigenic variability between isolates, demonstrated that the major differences lay between amino acids 200 and 300. Conclusion These findings showed for the first time, the nucleotide and amino acids variation of the msp gene in infecting T. denticola, in vivo. This data suggested that the antigenic variability found in to the MSP molecule, may be an important factor involved in immune evasion by T. denticola.
Collapse
Affiliation(s)
- Paolo Gaibani
- Department of Hematology and Oncology L, and A, Seragnoli, University St, Orsola-Malpighi Hospital, V, Massarenti 9, Bologna, Italy.
| | | | | | | | | | | | | |
Collapse
|
43
|
Gaetti-Jardim Júnior E, Fardin AC, Gaetti-Jardim EC, de Castro AL, Schweitzer CM, Avila-Campos MJ. Microbiota associated with chronic osteomyelitis of the jaws. Braz J Microbiol 2010; 41:1056-64. [PMID: 24031586 PMCID: PMC3769776 DOI: 10.1590/s1517-838220100004000025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Revised: 12/11/2009] [Accepted: 05/25/2010] [Indexed: 11/22/2022] Open
Abstract
Chronic osteomyelitis of maxilla and mandible is rare in industrialized countries and its occurrence in developing countries is associated with trauma and surgery, and its microbial etiology has not been studied thoroughly. The aim of this investigation was to evaluate the microbiota associated with osteomyelitis of mandible or maxilla from some Brazilian patients. After clinical and radiographic evaluation, samples of bone sequestra, purulent secretion, and biopsies of granulomatous tissues from twenty-two patients with chronic osteomyelitis of mandible and maxilla were cultivated and submitted for pathogen detection by using a PCR method. Each patient harbored a single lesion. Bacterial isolation was performed on fastidious anaerobe agar supplemented with hemin, menadione and horse blood for anaerobes; and on tryptic soy agar supplemented with yeast extract and horse blood for facultative bacteria and aerobes. Plates were incubated in anaerobiosis and aerobiosis, at 37(o)C for 14 and 3 days, respectively. Bacteria were cultivated from twelve patient samples; and genera Actinomyces, Fusobacterium, Parvimonas, and Staphylococcus were the most frequent. By PCR, bacterial DNA was detected from sixteen patient samples. The results suggest that cases of chronic osteomyelitis of the jaws are usually mixed anaerobic infections, reinforcing the concept that osteomyelitis of the jaws are mainly related to microorganisms from the oral environment, and periapical and periodontal infections may act as predisposing factors.
Collapse
Affiliation(s)
- Elerson Gaetti-Jardim Júnior
- Faculdade de Odontologia de Araçatuba, Departamento de Patologia, Universidade Estadual Paulista , Araçatuba, SP , Brasil ; Laboratório de Anaeróbios, Departamento de Microbiologia, Universidade de São Paulo , São Paulo , Brasil
| | | | | | | | | | | |
Collapse
|
44
|
|
45
|
Kawase N, Kishi JI, Nakamura H, Hayakawa T. Collagenolytic activity in sonic extracts of Tannerella forsythia. Arch Oral Biol 2010; 55:545-9. [PMID: 20619781 DOI: 10.1016/j.archoralbio.2010.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Revised: 05/22/2010] [Accepted: 05/24/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of the present study was to characterize the collagenolytic activity in a sonicated extract of Tannerella forsythia and to investigate the activation of proMMMP-2 and -9 by the T. forsythia extract. METHODS The T. forsythia extract was incubated with type I collagen. The cleaved products were then analyzed by SDS-PAGE using the method of Laemmli. We studied the effects of cysteine, DTT, CaCl(2), and various proteinase inhibitors on collagenolytic activity. A HT1080 cell culture supernatant containing proMMP-2 and -9 was incubated with the T. forsythia extract and analyzed for the activation of proMMP-2 and -9 by gelatin zymography. RESULTS The T. forsythia extract degraded type I collagen. Cysteine increased the collagenolytic activity of the extract, and 5mM CaCl(2) was required for this activity. The collagenolytic activity of T. forsythia was inhibited by N-ethylmaleimide, iodoacetamide, iodoacetic acid, EDTA, and leupeptin, but not by PMSF, E-64, TLCK, or TPCK. When proMMP-2 and -9 were incubated with the T. forsythia extract, gelatinases with the relative molecular masses of MMP-2 and -9 were produced. CONCLUSION The present study suggests that T. forsythia extract is able to degrade type I collagen and activate proMMP-2 and -9.
Collapse
Affiliation(s)
- Norio Kawase
- Department of Endodontics, Aichi-Gakuin University, Suemori-dori, Chikusa-ku, Nagoya, Japan
| | | | | | | |
Collapse
|
46
|
Ozbek SM, Ozbek A, Erdorgan AS. Analysis of Enterococcus faecalis in samples from Turkish patients with primary endodontic infections and failed endodontic treatment by real-time PCR SYBR green method. J Appl Oral Sci 2010; 17:370-4. [PMID: 19936510 PMCID: PMC4327658 DOI: 10.1590/s1678-77572009000500004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Accepted: 11/30/2008] [Indexed: 11/22/2022] Open
Abstract
Objective: The aims of this study were to investigate the presence of Enterococcus faecalis in primary endodontic infections and failed endodontic treatments using real-time PCR and to determine the statistical importance of the presence of E. faecalis in a Turkish population with endodontic infections. Material and Methods: E. faecalis was investigated from 79 microbial samples collected from patients who were treated at the Endodontic Clinic of the Dental School of Atatürk University (Erzurum, Turkey). Microbial samples were taken from 43 patients (Group 1) with failed endodontic treatments and 36 patients (Group 2) with chronic apical periodontitis (primary endodontic infections). DNA was extracted from the samples by using a QIAamp® DNA mini-kit and analyzed with real-time PCR SYBR Green. Results: E. faecalis was detected in 41 out of 79 patients, suggesting that it exists in not less than 61% of all endodontic infections when the proportion test (z= -1.645, <x= 0.05) was applied. Real-time PCR SYBR Green allowed for the detection of E. faecalis in 32 out of 43 (74.4%) in Group 1, and in 9 out of 36 (25%) in Group 2. Conclusions: These results suggest that E. faecalis is a frequent isolate for endodontic infections in Turkish patients, and is more often associated with failed endodontic treatments than primary endodontic infections.
Collapse
Affiliation(s)
- Selcuk M Ozbek
- Department of Endodontics, Dental School, Ataturk University, Erzurum, Turkey
| | | | | |
Collapse
|
47
|
Gaibani P, Vocale C, Ambretti S, Cavrini F, Izard J, Miragliotta L, Pellegrino MT, Sambri V. Killing of Treponema denticola by mouse peritoneal macrophages. J Dent Res 2010; 89:521-6. [PMID: 20200417 DOI: 10.1177/0022034510363105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Treponema denticola has been identified as an important cause of periodontal disease and hypothesized to be involved in extra-oral infections. The objective of this study was to investigate the role of T. denticola cell length and motility during mouse peritoneal macrophages in vitro uptake. Macrophages, incubated under aerobic and anaerobic conditions, produced a similar amount of TNF-alpha when stimulated with Escherichia coli LPS. The uptake of FlgE- and CfpA-deficient mutants of T. denticola was significantly increased compared with the wild-type strain, due to cell size or lack of motility. Opsonization with specific antibodies considerably improved the treponemes' uptake. These results suggest that macrophages, in addition to other phagocytes, could play an important role in the control of T. denticola infection, and that the raising of specific antibodies could improve the efficacy of the immune response toward T. denticola, either at an oral site or during dissemination.
Collapse
Affiliation(s)
- P Gaibani
- Department of Haematology and Oncology L. and A. Seragnoli, Section of Microbiology, University of Bologna, St. Orsola Hospital, 9 via G. Massarenti, 40138 Bologna, Italy
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Gaetti-Jardim Júnior E, Landucci LF, Lins SA, Vieira EMM, de Oliveira SR. Susceptibility of strict and facultative anaerobes Isolated from endodontic infections to metronidazole and beta-lactams. J Appl Oral Sci 2009; 15:539-45. [PMID: 19089195 PMCID: PMC4327506 DOI: 10.1590/s1678-77572007000600016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Accepted: 08/27/2007] [Indexed: 11/21/2022] Open
Abstract
Endodontic infections are mixed aerobic-anaerobic infections and several microbial groups associated to these pathologies are also involved in orofacial infections. The goal of this study was to evaluate the susceptibility of microorganisms isolated from endodontic infections to beta-lactams and metronidazole and verify the production of beta-lactamases. Clinical specimens were collected from 58 endodontic infections of 52 patients. The microorganisms were isolated in selective and non-selective culture media, under anaerobiosis and aerobiosis, and identified using biochemical methods. In the susceptibility tests, it was used an agar dilution method, and Wilkins-Chalgren agar enriched with blood, hemin and menadione for the anaerobes, while Mueller-Hinton agar was employed for the facultative anaerobes. The production of beta-lactamases was evaluated through the biological and chromogenic cephalosporin methods. All tested isolates were sensitive to imipenem and 99.3% to amoxicillin/clavulanate association, while 16.1% showed resistance to amoxicillin and penicillin G, and 4.89% to cefoxitin. Resistance to metronidazole was just found in facultative anaerobes. Production of beta-lactamases was detected in 18.2% of the isolates and presented a correlation with resistance to beta-lactams.
Collapse
Affiliation(s)
- Elerson Gaetti-Jardim Júnior
- Department of Pathology and Propedeutics Clinic, Dental School of Araçatuba, São Paulo State University, Araçatuba, SP, Brazil.
| | | | | | | | | |
Collapse
|
49
|
Pagonis TC, Chen J, Fontana CR, Devalapally H, Ruggiero K, Song X, Foschi F, Dunham J, Skobe Z, Yamazaki H, Kent R, Tanner ACR, Amiji MM, Soukos NS. Nanoparticle-based endodontic antimicrobial photodynamic therapy. J Endod 2009; 36:322-8. [PMID: 20113801 DOI: 10.1016/j.joen.2009.10.011] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Revised: 10/01/2009] [Accepted: 10/18/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To study the in vitro effects of poly(lactic-co-glycolic acid) (PLGA) nanoparticles loaded with the photosensitizer methylene blue (MB) and light against Enterococcus faecalis (ATCC 29212). MATERIALS AND METHODS The uptake and distribution of nanoparticles in E. faecalis in suspension was investigated by transmission electron microscopy (TEM) after incubation with PLGA complexed with colloidal gold particles for 2.5, 5, and 10 minutes. E. faecalis species were sensitized in planktonic phase and in experimentally infected root canals of human extracted teeth with MB-loaded nanoparticles for 10 minutes followed by exposure to red light at 665 nm. RESULTS The nanoparticles were found to be concentrated mainly on the cell walls of microorganisms at all three time points. The synergism of light and MB-loaded nanoparticles led to approximately 2 and 1 log10 reduction of colony-forming units (CFUs) in planktonic phase and root canals, respectively. In both cases, mean log10 CFU levels were significantly lower than controls and MB-loaded nanoparticles without light. CONCLUSION The utilization of PLGA nanoparticles encapsulated with photoactive drugs may be a promising adjunct in antimicrobial endodontic treatment.
Collapse
Affiliation(s)
- Tom C Pagonis
- Advanced Graduate Endodontics, Division of Endodontics, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Real-time Polymerase Chain Reaction Quantification of Porphyromonas gingivalis and Tannerella forsythia in Primary Endodontic Infections. J Endod 2009; 35:1518-24. [DOI: 10.1016/j.joen.2009.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 08/03/2009] [Accepted: 08/05/2009] [Indexed: 11/24/2022]
|