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The impact of an enhanced infection control protocol on the microbial community profile in molar root canal treatment-an in vivo NGS molecular study. J Endod 2022; 48:1352-1360.e3. [PMID: 36087763 DOI: 10.1016/j.joen.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Recent findings demonstrated that one-year CBCT-based outcomes of molar root canal treatment were improved through an Enhanced infection protocol (EnP), when compared to a current best-practice standard infection control protocol (StP). The EnP comprised measures to reduce iatrogenic contamination from direct and indirect contact surfaces, including the replacement of the rubber dams, gloves, files, all instruments, and surface barriers before root canal obturation. The aim of this study was to investigate the effect of such an enhanced infection control protocol on resident microbiome present after chemomechanical instrumentation and the protocol ability in reducing iatrogenic contamination in molar teeth during root canal treatment. METHODS Molar teeth were block-randomized to receive either treatment under EnP or StP. To compare the differential effect of the protocol on the identity of bacteria present, one hundred and fifty, matched DNA extracts from 75 molar teeth samples (StP, n=39; EnP, n=36), were evaluated. Samples were taken before (S1) and after (S2) chemomechanical preparation and were subjected to next-generation sequencing of the V3-V4 region of the 16S rRNA gene, prior to bioinformatical identification using the HOMD oral microbiome database and downstream taxonomic processing, providing measures of richness and diversity of bacteria and significant bacterial taxa during chemomechanical instrumentation and the effect of the two treatment groups. RESULTS 88 microbial taxa were significantly more abundant in StP S2 samples, including endodontically relevant contaminants taxa as Actinomyces, Cutibacterium, and Haemophilus. The S2 samples demonstrated fewer residual bacterial species in the EnP group, with 26.8 observed species compared to 38.3 in the StP. Reduced diversity and richness measures were noted in the EnP pre-obturation samples compared to the StP in OTU, Chao1 and ACE indices (p≤0.05). Differential microbial identities between S1 and S2 samples and protocols demonstrated that the previously observed increased effectiveness of the EnP protocol was likely to prevent recontamination or de novo contamination of the root canal space during treatment. CONCLUSIONS The implemented enhanced infection control protocol resulted in a specific reduction of microbial taxa often associated with recontamination or iatrogenic contamination, suggesting the basis for improved infection control measures during root canal treatment.
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Assessing the Iatrogenic Contribution to Contamination During Root Canal Treatment. J Endod 2022; 48:479-486. [DOI: 10.1016/j.joen.2022.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/22/2021] [Accepted: 01/13/2022] [Indexed: 12/14/2022]
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Siqueira JF, Rôças IN. Present status and future directions - microbiology of endodontic infections. Int Endod J 2021; 55 Suppl 3:512-530. [PMID: 34958494 DOI: 10.1111/iej.13677] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Apical periodontitis has a microbial aetiology and is one of the most common inflammatory diseases that affect humans. Fungi, archaea and viruses have been found in association with apical periodontitis, but bacteria are by far the most prevalent and dominant microorganisms in endodontic infections. Bacterial infection of the root canal system only occurs when the pulp is necrotic or was removed for previous treatment. In some specific cases, including acute and chronic abscesses, the bacterial infection may reach the periradicular tissues. Intracanal bacteria are usually observed as sessile multispecies communities (biofilms) attached to the dentinal root canal walls. Infection in the main root canal lumen can spread to other areas of the root canal system. Although more than 500 bacterial species have been detected in endodontic infections, a selected group of 20 to 30 species are most frequently detected and may be considered as the core microbiome. There is a high interindividual variability in the endodontic microbiome in terms of species composition and relative abundance. Obligate anaerobic species are more abundant in the intraradicular bacterial communities of teeth with primary apical periodontitis, while both anaerobes and facultatives dominate the communities in post-treatment apical periodontitis. Bacterial interactions play an essential role in determining the overall virulence of the community, which has been regarded as the unit of pathogenicity of apical periodontitis. This article reviews the microbiologic aspects of endodontic infections and provides perspectives for future research and directions in the field.
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Affiliation(s)
- José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
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Salgado-Peralvo AO, Peña-Cardelles JF, Kewalramani N, Mateos-Moreno MV, Jiménez-Guerra Á, Velasco-Ortega E, Uribarri A, Moreno-Muñoz J, Ortiz-García I, Núñez-Márquez E, Monsalve-Guil L. Preventive Antibiotic Therapy in the Placement of Immediate Implants: A Systematic Review. Antibiotics (Basel) 2021; 11:antibiotics11010005. [PMID: 35052882 PMCID: PMC8773177 DOI: 10.3390/antibiotics11010005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/21/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2022] Open
Abstract
Immediate implants present a high risk of early failure. To avoid this, preventive antibiotics (PAs) are prescribed; however, their inappropriate administration leads to antimicrobial resistance. The present study aims to clarify whether the prescription of PAs reduces the rate of early failure of immediate implants and to establish guidelines to avoid the overprescription of these drugs. An electronic search of the MEDLINE database (via PubMed), Web of Science, Scopus, LILACS and OpenGrey was carried out. The criteria described in the PRISMA® statement were used. The search was temporarily restricted from 2010 to 2021. The risk of bias was analysed using the SIGN Methodological Assessment Checklist for Systematic Reviews and Meta-Analyses and the JBI Prevalence Critical Appraisal Tool. After searching, eight studies were included that met the established criteria. With the limitations of this study, it can be stated that antibiotic prescription in immediate implants reduces the early failure rate. Preoperative administration of 2–3 g amoxicillin one hour before surgery followed by 500 mg/8 h for five to seven days is recommended. It is considered prudent to avoid the use of clindamycin in favour of azithromycin, clarithromycin or metronidazole in penicillin allergy patients until further studies are conducted.
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Affiliation(s)
- Angel-Orión Salgado-Peralvo
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (Á.J.-G.); (E.V.-O.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (L.M.-G.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (J.-F.P.-C.); (N.K.)
- Correspondence:
| | - Juan-Francisco Peña-Cardelles
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (J.-F.P.-C.); (N.K.)
- Department of Basic Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Naresh Kewalramani
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (J.-F.P.-C.); (N.K.)
- Department of Nursery and Stomatology, Rey Juan Carlos University, 28922 Madrid, Spain
| | - María-Victoria Mateos-Moreno
- Department of Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Álvaro Jiménez-Guerra
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (Á.J.-G.); (E.V.-O.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (L.M.-G.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (J.-F.P.-C.); (N.K.)
| | - Eugenio Velasco-Ortega
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (Á.J.-G.); (E.V.-O.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (L.M.-G.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (J.-F.P.-C.); (N.K.)
| | - Andrea Uribarri
- Department of Basic Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Jesús Moreno-Muñoz
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (Á.J.-G.); (E.V.-O.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (L.M.-G.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (J.-F.P.-C.); (N.K.)
| | - Iván Ortiz-García
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (Á.J.-G.); (E.V.-O.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (L.M.-G.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (J.-F.P.-C.); (N.K.)
| | - Enrique Núñez-Márquez
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (Á.J.-G.); (E.V.-O.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (L.M.-G.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (J.-F.P.-C.); (N.K.)
| | - Loreto Monsalve-Guil
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (Á.J.-G.); (E.V.-O.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (L.M.-G.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (J.-F.P.-C.); (N.K.)
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Siqueira JF, Rôças IN. A critical analysis of research methods and experimental models to study the root canal microbiome. Int Endod J 2021; 55 Suppl 1:46-71. [PMID: 34714548 DOI: 10.1111/iej.13656] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 12/15/2022]
Abstract
Endodontic microbiology deals with the study of the microbial aetiology and pathogenesis of pulpal and periradicular inflammatory diseases. Research in endodontic microbiology started almost 130 years ago and since then has mostly focussed on establishing and confirming the infectious aetiology of apical periodontitis, identifying the microbial species associated with the different types of endodontic infections and determining the efficacy of treatment procedures in eradicating or controlling infection. Diverse analytical methods have been used over the years, each one with their own advantages and limitations. In this review, the main features and applications of the most used technologies are discussed, and advice is provided to improve study designs in order to properly address the scientific questions and avoid setbacks that can compromise the results. Finally, areas of future research are described.
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Affiliation(s)
- José F Siqueira
- Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Brazil.,Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Isabela N Rôças
- Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Brazil.,Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
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Bordagaray MJ, Fernández A, Garrido M, Astorga J, Hoare A, Hernández M. Systemic and Extraradicular Bacterial Translocation in Apical Periodontitis. Front Cell Infect Microbiol 2021; 11:649925. [PMID: 33816354 PMCID: PMC8017189 DOI: 10.3389/fcimb.2021.649925] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/01/2021] [Indexed: 12/19/2022] Open
Abstract
Apical periodontitis is an inflammatory disease of microbial etiology. It has been suggested that endodontic bacterial DNA might translocate to distant organs via blood vessels, but no studies have been conducted. We aimed first to explore overall extraradicular infection, as well as specifically by Porphyromonas spp; and their potential to translocate from infected root canals to blood through peripheral blood mononuclear cells. In this cross-sectional study, healthy individuals with and without a diagnosis of apical periodontitis with an associated apical lesion of endodontic origin (both, symptomatic and asymptomatic) were included. Apical lesions (N=64) were collected from volunteers with an indication of tooth extraction. Intracanal samples (N=39) and respective peripheral blood mononuclear cells from apical periodontitis (n=14) individuals with an indication of endodontic treatment, as well as from healthy individuals (n=14) were collected. The detection frequencies and loads (DNA copies/mg or DNA copies/μL) of total bacteria, Porphyromonas endodontalis and Porphyromonas gingivalis were measured by qPCR. In apical lesions, the detection frequencies (%) and median bacterial loads (DNA copies/mg) respectively were 70.8% and 4521.6 for total bacteria; 21.5% and 1789.7 for Porphyromonas endodontalis; and 18.4% and 1493.9 for Porphyromonas gingivalis. In intracanal exudates, the detection frequencies and median bacterial loads respectively were 100% and 21089.2 (DNA copies/μL) for total bacteria, 41% and 8263.9 for Porphyromonas endodontalis; and 20.5%, median 12538.9 for Porphyromonas gingivalis. Finally, bacteria were detected in all samples of peripheral blood mononuclear cells including apical periodontitis and healthy groups, though total bacterial loads (median DNA copies/μL) were significantly higher in apical periodontitis (953.6) compared to controls (300.7), p<0.05. Porphyromonas endodontalis was equally detected in both groups (50%), but its bacterial load tended to be higher in apical periodontitis (262.3) than controls (158.8), p>0.05; Porphyromonas gingivalis was not detected. Bacteria and specifically Porphyromonas spp. were frequently detected in endodontic canals and apical lesions. Also, total bacteria and Porphyromonas endodontalis DNA were detected in peripheral blood mononuclear cells, supporting their plausible role in bacterial systemic translocation.
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Affiliation(s)
- María José Bordagaray
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Alejandra Fernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Faculty of Dentistry, Universidad Andres Bello, Santiago, Chile
| | - Mauricio Garrido
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Jessica Astorga
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Anilei Hoare
- Department of Pathology and Oral Medicine, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Laboratory of Oral Microbiology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Marcela Hernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Pathology and Oral Medicine, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
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Bronzato JD, Bomfim RA, Hayasida GZP, Cúri M, Estrela C, Paster BJ, Gomes BPFA. Analysis of microorganisms in periapical lesions: A systematic review and meta-analysis. Arch Oral Biol 2021; 124:105055. [PMID: 33588190 DOI: 10.1016/j.archoralbio.2021.105055] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/30/2022]
Abstract
AIMS The aim of this study was to systematically review the literature on prevalence of microorganisms and their viability/activity in endodontic periapical lesions. DESIGN Literature research was performed on five electronic biomedical databases from their start dates to June 2020. Only studies evaluating the presence of microorganisms in periapical lesions in human permanent teeth with secondary/persistent infection were included. Two reviewers independently assessed the eligibility for inclusion, extracted data and evaluated the risk of bias. Meta-analysis and binominal tests were used to analyse the resulting data. RESULTS From the 1,313 records found, 23 full-texts were included for qualitative and quantitative analysis. The prevalence of microorganisms in endodontic periapical lesions was 87 % (95 % CI, 75-94) and the prevalence of viable/active microorganisms was 82 % (95 % CI, 66-91). There were statistical differences in the geographic area subgroup and between viable bacteria and active viruses. The most common detection method of microorganisms was the molecular one (69 %), and the most prevalent bacteria were the species Actinomyces, Fusobacterium and Prevotella (40 %). Most of the included studies had moderate risk of bias. CONCLUSIONS The prevalence of microorganisms in endodontic periapical lesions was 87 % and the prevalence of viable/active microorganisms was 82 %.
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Affiliation(s)
- Juliana D Bronzato
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, SP, Brazil
| | - Rafael A Bomfim
- Department of Community Health, School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Giovanna Z P Hayasida
- Department of Applied Math and Statistics, Institute of Math and Computing Sciences, University of São Paulo, São Carlos, SP, Brazil
| | - Mariana Cúri
- Department of Applied Math and Statistics, Institute of Math and Computing Sciences, University of São Paulo, São Carlos, SP, Brazil
| | - Carlos Estrela
- Department of Endodontics, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Bruce J Paster
- Department of Microbiology, Forsyth Institute, Cambridge, United States
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, SP, Brazil.
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Bronzato JD, Davidian MES, de Castro M, de-Jesus-Soares A, Ferraz CCR, Almeida JFA, Marciano MA, Gomes BPFA. Bacteria and virulence factors in periapical lesions associated with teeth following primary and secondary root canal treatment. Int Endod J 2020; 54:660-671. [PMID: 33270246 DOI: 10.1111/iej.13457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022]
Abstract
AIM This cross-sectional study aimed to investigate the microbial profile and to quantify the levels of endotoxins (LPS) and lipoteichoic acid (LTA) present in periapical lesions associated with root filled teeth and those that had received root canal retreatment. It also aimed to investigate the association between microorganisms and their virulence factors with clinical and radiographic features. METHODOLOGY Patients with periapical lesions in teeth with post-treatment endodontic disease following primary root canal treatment (n = 19) and unsuccessful root canal retreatment (n = 13) were treatment planned for endodontic microsurgery, where the periapical lesions were collected. Clinical and radiographic data were also collected. For microbiological analysis, nested polymerase chain reaction was used to detect 17 bacterial species. Levels of LPS and LTA were determined using limulus amebocyte lysate and enzyme-linked immunosorbent assays, respectively. The Student t-test or Wilcoxon-Mann-Whitney tests were applied to compare the data on LPS and LTA with clinical and radiographic features. The associations between the clinical and radiographic features and the bacterial species were analysed using the Fisher's exact test. A significance level of 5% was adopted. RESULTS Bacterial DNA, LPS and LTA were detected in all samples. Parvimonas micra was the most commonly detected species in all groups, followed by Enterococcus faecalis, Fusobacterium nucleatum and Porphyromonas endodontalis. The type of endodontic treatment, whether a primary root canal treatment or retreatment, was not associated with the presence of any bacterial species in periapical lesions. The levels of LPS and LTA in periapical lesions of root filled teeth were not significantly different from those that had been retreated. Associations between the levels of LPS and LTA with clinical signs and symptoms were found. No association was found between specific bacteria and clinical features. CONCLUSION Periapical lesions associated with teeth after primary root canal treatment and retreatment had similar polymicrobial composition. The levels of LPS and LTA in periapical lesions associated with teeth after primary root canal treatment and retreatment were similar, and both were associated with the same symptomatology.
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Affiliation(s)
- J D Bronzato
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - M E S Davidian
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - M de Castro
- Department of Applied Mathematics and Statistics, Institute of Mathematics and Computing Sciences, University of São Paulo, São Carlos, Brazil
| | - A de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - C C R Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - J F A Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - M A Marciano
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
| | - B P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, Brazil
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Characterization of Root Canal Microbiota in Teeth Diagnosed with Irreversible Pulpitis. J Endod 2020; 47:415-423. [PMID: 33359531 DOI: 10.1016/j.joen.2020.12.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/04/2020] [Accepted: 12/14/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Previous studies have shown that in teeth presenting with symptoms of irreversible pulpitis (IP), bacteria and their by-products driving inflammation are confined mainly within the coronal pulpal tissue. The present study aimed to determine the presence and identity of bacteria within pulps presenting with clinical symptoms of IP using molecular methods. METHODS Samples were obtained from 30 adult patients presenting to the dental emergency department with signs and symptoms of IP. After meticulous surface decontamination, the pulp space was accessed, and clinical samples were collected from inflamed pulp tissue using sterile paper points. Genomic DNA was extracted from the clinical samples, and quantification of bacteria was performed using quantitative polymerase chain reaction targeting the conserved 16S ribosomal RNA (rRNA) gene. To characterize the microbial composition, the V3-V5 hypervariable regions of the 16S rRNA gene were amplified and subjected to next-generation sequencing on the MiSeq platform (Illumina, San Diego, CA). RESULTS Of the 30 teeth that presented with IP, half of the intracanal samples had a substantial bacterial load (16S rRNA copies) within the IP vital pulp as determined by quantitative polymerase chain reaction. Next-generation sequencing microbial identification was successful in 7 intracanal samples and yielded 187 bacterial operational taxonomic units within the IP samples. The most abundant genera observed among the vital cases were Veillonella (16%), Streptococcus (13%), Corynebacterium (10%), Cutibacterium (9.3%), and Porphyromonas (5.7%). CONCLUSIONS The current study highlighted the evidence of vital teeth diagnosed as IP harboring considerable bacterial loads and composed of genera reflective of established endodontic pathology and thus may offer insights into the initial events preceding pulpal necrosis.
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Bergamini ML, Mardegan AP, DE Rosa CS, Palmieri M, Sarmento DJDS, Hiraki KRN, Costa ALF, HassÉus B, Jonasson P, Braz-Silva PH. Presence of langerhans cells, regulatory T cells (Treg) and mast cells in asymptomatic apical periodontitis. Braz Oral Res 2020; 34:e108. [PMID: 32876121 DOI: 10.1590/1807-3107bor-2020.vol34.0108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 07/10/2020] [Indexed: 11/22/2022] Open
Abstract
Asymptomatic Apical Periodontitis is essentially an inflammatory disease of microbial aetiology. Association and function of the cell components involved, or specific inductive factors and growth mediators associated with development, maintenance and resolution of the periapical lesions are still unknown. The objective of this study was to evaluate the concentration of Regulatory T cells (FoxP3+; Treg), Langerhans cells (CD1a+; LC) and mast cells in asymptomatic apical periodontitis. 73 cases were selected: 30 periapical granulomas, 29 radicular cysts and 14 residual cysts. All groups were submitted to morphological analysis for classification of inflammatory infiltrate and thickness of the epithelial lining as well as to immunohistochemical analysis for detection of LC and Treg cells. Toluidine blue staining was used for detecting mast cells. Analysis showed higher mean numbers of LC (8.2 cells/0.2mm2), and Treg cells in radicular cysts (5.910 cells/0.2mm2). As for mast cells, it was found that radicular cysts had a higher mean number of these cells compared to other periapical lesions (12.68 cells/0.2mm2). The association between thickness of the epithelial lining and inflammatory cells showed that the presence of hypertrophic epithelium in radicular cysts presented higher density of LC. The number of LC and Treg cells play an important role in the control of the inflammatory micro-environment in periapical granulomas and radicular cysts, respectively. The presence of mast cells in radicular cysts may be associated with progression of the lesion. Knowledge regarding the inflammatory cell profile is therefore essential for a better understanding of the pathogenesis of asymptomatic periapical periodontitis.
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Affiliation(s)
- Mariana Lobo Bergamini
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Andressa Pinto Mardegan
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Michelle Palmieri
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Karen Renata Nakamura Hiraki
- Department of Cell Biology, Histology and Embryology, Institute of Biomedical Sciences, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | | | - Bengt HassÉus
- Institute of Odontology, The Sahlgrenska Academy, Göteborgs Universitet, Gothenburg, Sweden
| | - Peter Jonasson
- Institute of Odontology, The Sahlgrenska Academy, Göteborgs Universitet, Gothenburg, Sweden
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12
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Fouad AF. Microbiological aspects of traumatic injuries. Dent Traumatol 2019; 35:324-332. [PMID: 31125490 DOI: 10.1111/edt.12494] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 05/21/2019] [Indexed: 12/11/2022]
Abstract
After traumatic injuries to teeth, microorganisms may invade the compromised pulp tissue and initiate pulp infection and periapical inflammation. In addition to bone resorption that typically accompanies pulp necrosis, root resorption frequently occurs. Root resorption has several variants that may occur shortly after the trauma or at a later stage. The pathological changes seen after traumatic injuries to teeth are invariably linked to the presence of microbial irritants. The presence of bacterial biofilms in the dental pulp space can be treated with regenerative or therapeutic endodontic procedures. However, necrosis of periodontal ligament is usually terminal for the tooth involved. In this review, the sources of bacteria after traumatic injuries are discussed. The types and role of microorganisms involved in the pathogenesis of endodontic pathosis after traumatic injuries are presented, and contemporary approaches for the management of these conditions are reviewed. Contemporary antimicrobial strategies are discussed. The rationale for the use of systemic and topical antimicrobials is presented. Finally, novel approaches to the use of antimicrobial therapies, particularly in regenerative procedures, are reviewed.
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Affiliation(s)
- Ashraf F Fouad
- Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Braz-Silva PH, Bergamini ML, Mardegan AP, De Rosa CS, Hasseus B, Jonasson P. Inflammatory profile of chronic apical periodontitis: a literature review. Acta Odontol Scand 2019; 77:173-180. [PMID: 30585523 DOI: 10.1080/00016357.2018.1521005] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Apical periodontitis caused by root canal infection is the most frequent pathological lesion in the jaws, mainly manifested as periapical granulomas and cysts. Understanding of the formation and progression of apical periodontitis as well as the identification of inflammatory biomarkers can help increase the knowledge of pathogenic mechanisms, improve the diagnosis and provide support for different therapeutic strategies. The objective of the present article is to review inflammatory biomarkers such as cytokines, chemokines, inflammatory cells, neuropeptides, RANK/RANKL/OPG system and other inflammatory markers and to relate these systems to the development and progression of pathological conditions related to apical periodontitis.
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Affiliation(s)
- Paulo Henrique Braz-Silva
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Virology, Institute of Tropical Medicine of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil
| | - Mariana Lobo Bergamini
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Andressa Pinto Mardegan
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Catharina Simioni De Rosa
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Bengt Hasseus
- Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Jonasson
- Department of Endodontology, Institute of Odontology The Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden
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Kim SM. Definition and management of odontogenic maxillary sinusitis. Maxillofac Plast Reconstr Surg 2019; 41:13. [PMID: 30989083 PMCID: PMC6439010 DOI: 10.1186/s40902-019-0196-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 02/22/2019] [Indexed: 02/07/2023] Open
Abstract
Background Maxillary sinusitis of odontogenic origin, also known as maxillary sinusitis of dental origin or odontogenic maxillary sinusitis (OMS), is a common disease in dental, otorhinolaryngologic, allergic, general, and maxillofacial contexts. Despite being a well-known disease entity, many cases are referred to otorhinolaryngologists by both doctors and dentists. Thus, early detection and initial diagnosis often fail to detect its odontogenic origin. Main body We searched recent databases including MEDLINE (PubMed), Embase, and the Cochrane Library using keyword combinations of "odontogenic," "odontogenic infection," "dental origin," "tooth origin," "sinusitis," "maxillary sinus," "maxillary sinusitis," "odontogenic maxillary sinusitis," "Caldwell Luc Procedure (CLP)," "rhinosinusitis," "functional endoscopic sinus surgery (FESS)," "modified endoscopy-assisted maxillary sinus surgery (MESS)," and "paranasal sinus." Aside from the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) trial, there have been very few randomized controlled trials examining OMS. We summarized the resulting data based on our diverse clinical experiences. Conclusion To promote the most efficient and accurate management of OMS, this article summarizes the clinical features of rhinosinusitis compared with OMS and the pathogenesis, microbiology, diagnosis, and results of prompt consolidated management of OMS that prevent anticipated complications. The true origin of odontogenic infections is also reviewed.
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Affiliation(s)
- Soung Min Kim
- Oral and Maxillofacial Microvascular Reconstruction LAB, Ghana Health Service, Brong Ahafo Regional Hospital, P.O. Box 27, Sunyani, Brong Ahafo Ghana.,2Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768 South Korea
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Pourhajibagher M, Bahador A. An in vivo evaluation of microbial diversity before and after the photo-activated disinfection in primary endodontic infections: Traditional phenotypic and molecular approaches. Photodiagnosis Photodyn Ther 2018; 22:19-25. [DOI: 10.1016/j.pdpdt.2018.02.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/01/2018] [Accepted: 02/20/2018] [Indexed: 12/30/2022]
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Yamaguchi M, Noiri Y, Itoh Y, Komichi S, Yagi K, Uemura R, Naruse H, Matsui S, Kuriki N, Hayashi M, Ebisu S. Factors that cause endodontic failures in general practices in Japan. BMC Oral Health 2018; 18:70. [PMID: 29703201 PMCID: PMC5924503 DOI: 10.1186/s12903-018-0530-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 04/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bacterial biofilms that develop on root surfaces outside apical foramens have been found to be associated with refractory periapical periodontitis. However, several other factors cause endodontic failures apart from extraradicular biofilms. The aim of this study was to identify the factors causing endodontic failures in general practices in Japan. METHODS Patients diagnosed as having refractory periapical periodontitis by general practitioners and who requested endodontic treatment at Osaka University Dental Hospital were selected by checking medical records from April 2009 to March 2013. Factors causing endodontic failures were identified. RESULTS A total of 103 teeth were selected, and 76 teeth completed root-canal treatment. Tooth extractions were required for 18 teeth after or without endodontic treatment. Six teeth required apicoectomy after endodontic treatment. One tooth needed hemisection. One tooth needed intentional replantation. One tooth needed adhesion and replantation. The main causes of treatment failure were open apices (24 teeth), perforation (18 teeth), and root fracture (13 teeth). In six teeth with open apices that required apicoectomy or extraction, extraradicular biofilms may have been related to endodontic failure. CONCLUSIONS Most endodontic cases diagnosed with refractory periapical periodontitis by general practitioners were compromised by any other factors rather than extraradicular biofilms.
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Affiliation(s)
| | - Yuichiro Noiri
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshihiro Itoh
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Shungo Komichi
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kyoko Yagi
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Reo Uemura
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Haruna Naruse
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Saori Matsui
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Nanako Kuriki
- Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Mikako Hayashi
- Osaka University Graduate School of Dentistry, Osaka, Japan
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Jabbour Z, do Nascimento C, El-Hakim M, Henderson JE, de Albuquerque RF. Profile of bacteria colonizing the exposed bone of patients with anti-osteoclastic drug-related osteonecrosis of the jaws. Can J Microbiol 2016; 62:772-80. [PMID: 27419922 DOI: 10.1139/cjm-2016-0212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Microbial etiology for anti-osteoclastic drug-related osteonecrosis of the jaw (ARONJ) was suggested. This study investigates any link between bacteria colonizing ARONJ sites and other oral cavity sites. Microbiota samples of 10 ARONJ patients were collected from the exposed bone, adjacent teeth, contralateral teeth, and tongue. DNA checkerboard hybridization was used for microbiota analysis with 43 genomic DNA probes prepared from human oral bacterial (38) and candida (5) species, using Socransky's bacterial complexes as a guide. The frequency and the mean proportion of each bacterial species were used. Eikenella corrodens, Streptococcus constellatus, and Fusobacterium nucleatum were dominant in the ARONJ sites and detected in most teeth samples. Staphylococcus aureus was also dominant in the ARONJ sites and tongue. Significant correlations were found between the mean proportions of bacterial species colonizing adjacent teeth, contralateral teeth, and tongue (p < 0.001, R(2) > 0.69). No significant correlation (p > 0.05, R(2) < 0.025) was found between bacteria colonizing ARONJ sites and other evaluated sites. Within the study limitations, it was concluded that the primary sources of microorganisms colonizing ARONJ sites could be other sites such as teeth and tongue. The microbial profile of the necrotic bone is predominantly colonized with bacteria from Socransky's green and orange complexes, as well as with species associated with bone infections.
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Affiliation(s)
- Zaher Jabbour
- a Division of Restorative Dentistry, Faculty of Dentistry, McGill University, Montréal, Quebec, Canada.,d Bone Engineering Labs, Research Institute, McGill University Health Center, Montréal, Quebec, Canada
| | - Cássio do Nascimento
- b Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | - Michel El-Hakim
- c Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, McGill University, Montréal, Quebec, Canada
| | - Janet E Henderson
- d Bone Engineering Labs, Research Institute, McGill University Health Center, Montréal, Quebec, Canada.,e Department of Medicine and Surgery, Faculty of Medicine, McGill University, Montréal, Quebec, Canada
| | - Rubens F de Albuquerque
- b Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
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Crespi R, Capparé P, Crespi G, Lo Giudice G, Gastaldi G, Gherlone E. Dental Implants Placed in Periodontally Infected Sites in Humans. Clin Implant Dent Relat Res 2016; 19:131-139. [DOI: 10.1111/cid.12425] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Roberto Crespi
- Dental School, Vita-Salute University; Milan Italy
- Department of Dentistry; IRCCS San Raffaele Hospital; Milan Italy
| | - Paolo Capparé
- Dental School, Vita-Salute University; Milan Italy
- Department of Dentistry; IRCCS San Raffaele Hospital; Milan Italy
| | | | - Giuseppe Lo Giudice
- Department of Medical, Surgical and Dental Experimental Sciences; University of Messina; Messina Italy
- “G.Martino” Hospital, V. Cons. Valeria Gazzi; Messina Italy
| | - Giorgio Gastaldi
- Dental School, Vita-Salute University; Milan Italy
- San Rocco Clinical Institute; Ome Italy
| | - Enrico Gherlone
- Dental School, Vita-Salute University; Milan Italy
- Department of Dentistry; IRCCS San Raffaele Hospital; Milan Italy
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Crespi R, Capparé P, Crespi G, Lo Giudice G, Gastaldi G, Gherlone E. Immediate Implant Placement in Sockets with Asymptomatic Apical Periodontitis. Clin Implant Dent Relat Res 2016; 19:20-27. [DOI: 10.1111/cid.12422] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 03/15/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Roberto Crespi
- Adjunct Professor, Department of Dentistry; Vita Salute University, San Raffaele Hospital; Milan Italy
| | - Paolo Capparé
- Researcher, Department of Dentistry; Vita Salute University, San Raffaele Hospital; Milan Italy
| | | | - Giuseppe Lo Giudice
- Department of Medical, Surgical and Dental Sperimental Sciences; University of Messina, Messina, Italy, “G.Martino” Hospital, V. Cons. Valeria Gazzi; Messina Italy
| | - Giorgio Gastaldi
- Associate Professor, Dental School; Vita Salute University, Milan, Italy and San Rocco Hospital; Brescia Italy
| | - Enrico Gherlone
- Full Professor and Chairmen, Department of Dentistry; Vita Salute University, San Raffaele Hospital; Milan Italy
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Taschieri S, Torretta S, Corbella S, Del Fabbro M, Francetti L, Lolato A, Capaccio P. Pathophysiology of sinusitis of odontogenic origin. ACTA ACUST UNITED AC 2015; 8. [DOI: 10.1111/jicd.12202] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/15/2015] [Indexed: 01/29/2023]
Affiliation(s)
- Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Sara Torretta
- Department of Clinical Sciences and Community Health; University of Milan; Milan Italy
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Alessandra Lolato
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Pasquale Capaccio
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
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Ping Y, Wang J, Liang J. Pyrosequencing analysis of apical microbiota of teeth with persistent apical periodontitis. J Dent Sci 2015. [DOI: 10.1016/j.jds.2015.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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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]
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Lima SMDF, de Pádua GM, Sousa MGDC, Freire MDS, Franco OL, Rezende TMB. Antimicrobial peptide-based treatment for endodontic infections--biotechnological innovation in endodontics. Biotechnol Adv 2014; 33:203-213. [PMID: 25447423 DOI: 10.1016/j.biotechadv.2014.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 10/07/2014] [Accepted: 10/31/2014] [Indexed: 01/30/2023]
Abstract
The presence/persistence of microorganisms in the pulp and periapical area corresponds to the maintenance of an exacerbated immune response that leads to the start of periradicular bone resorption and its perpetuation. In endodontic treatment, the available intracanal medications do not have all the desirable properties in the context of endodontic infection and apical periodontitis; they need to include not only strong antimicrobial performance but also an immunomodulatory and reparative activity, without host damage. In addition, there are various levels of resistance to root canal medications. Thus, antimicrobial agents that effectively eliminate resistant species in root canals could potentially improve endodontic treatment. In the emergence of new therapies, an increasing number of studies on antimicrobial peptides (AMPs) have been seen over the past few years. AMPs are defense biomolecules produced in response to infection, and they have a wide spectrum of action against many oral microorganisms. There are some studies that correlate peptides and oral infections, including oral peptides, neuropeptides, and bacterial, fish, bovine and synthetic peptides. So far, there are around 120 published studies correlating endodontic microbiota with AMPs but, according to our knowledge, there are no registered patents in the American patent database. There are a considerable number of AMPs that exhibit excellent antimicrobial activity against endodontic microbiota at a small inhibitory concentration and modulate an exacerbated immune response, down-regulating bone resorption. All these reasons indicate the antimicrobial peptide-based endodontic treatment as an emerging and promising option.
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Affiliation(s)
- Stella Maris de Freitas Lima
- Centro de Análises Proteômicas e Bioquímicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916N, Av. W5, Campus II, Modulo C, Brasília, DF, Brazil; Curso de Odontologia, Universidade Católica de Brasília, Campus I, QS 07 Lote 01 room S213 EPCT, Águas Claras, Taguatinga, DF, Brazil
| | - Gabriela Martins de Pádua
- Curso de Odontologia, Universidade Católica de Brasília, Campus I, QS 07 Lote 01 room S213 EPCT, Águas Claras, Taguatinga, DF, Brazil
| | - Maurício Gonçalves da Costa Sousa
- Centro de Análises Proteômicas e Bioquímicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916N, Av. W5, Campus II, Modulo C, Brasília, DF, Brazil; Curso de Odontologia, Universidade Católica de Brasília, Campus I, QS 07 Lote 01 room S213 EPCT, Águas Claras, Taguatinga, DF, Brazil
| | - Mirna de Souza Freire
- Centro de Análises Proteômicas e Bioquímicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916N, Av. W5, Campus II, Modulo C, Brasília, DF, Brazil; Programa de Doutorado da Rede Centro-Oeste, Brasília, DF, Brazil
| | - Octávio Luiz Franco
- Centro de Análises Proteômicas e Bioquímicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916N, Av. W5, Campus II, Modulo C, Brasília, DF, Brazil; Programa de Doutorado da Rede Centro-Oeste, Brasília, DF, Brazil; S-Inova, Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande, MS, Brazil
| | - Taia Maria Berto Rezende
- Centro de Análises Proteômicas e Bioquímicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916N, Av. W5, Campus II, Modulo C, Brasília, DF, Brazil; Curso de Odontologia, Universidade Católica de Brasília, Campus I, QS 07 Lote 01 room S213 EPCT, Águas Claras, Taguatinga, DF, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade de Brasília, Faculdade de Ciências da Saúde (FS), Campus Universitário Darcy Ribeiro, Brasília, DF, Brazil.
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Ricucci D, Siqueira JF, Lopes WSP, Vieira AR, Rôças IN. Extraradicular infection as the cause of persistent symptoms: a case series. J Endod 2014; 41:265-73. [PMID: 25282379 DOI: 10.1016/j.joen.2014.08.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 08/21/2014] [Accepted: 08/26/2014] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This article describes 3 cases that presented persistent symptoms after appropriate endodontic treatment. Histopathologic and histobacteriologic investigation were conducted for determination of the cause. METHODS Three cases are reported that presented with persistent symptoms after endodontic retreatment (cases 1 and 2) or treatment (case 3). Periapical surgery was indicated and performed in these cases. The biopsy specimens, consisting of root apices and the apical periodontitis lesions, were subjected to histopathologic and histobacteriologic analyses. RESULTS Case 1 was an apical cyst with necrotic debris, heavily colonized by ramifying bacteria, in the lumen. No bacteria were found in the apical root canal system. Case 2 was a granuloma displaying numerous bacterial aggregations through the inflammatory tissue. Infection was also present in the dentinal tubules at the apical root canal. Case 3 was a cyst with bacterial colonies floating in its lumen; bacterial biofilms were also seen on the external apical root surface, filling a large lateral canal and other apical ramifications, and between layers of cementum detached from the root surface. No bacteria were detected in the main root canal. CONCLUSIONS Different forms of extraradicular infection were associated with symptoms in these cases, leading to short-term endodontic failure only solved by periapical surgery.
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Affiliation(s)
| | - José F Siqueira
- Faculty of Dentistry, Department of Endodontics, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Weber S P Lopes
- Specialization Course, Brazilian Association of Dentistry, Juiz de Fora, Minas Gerais, Brazil
| | - Adalberto R Vieira
- Specialization Course, Brazilian Association of Dentistry, Juiz de Fora, Minas Gerais, Brazil
| | - Isabela N Rôças
- Faculty of Dentistry, Department of Endodontics, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
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Siqueira JF, Rôças IN. Present status and future directions in endodontic microbiology. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/etp.12060] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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de Oliveira RDCM, Beghini M, Borges CRB, Alves PM, de Araújo MS, Pereira SADL, Rodrigues V, Rodrigues DBR. Higher expression of galectin-3 and galectin-9 in periapical granulomas than in radicular cysts and an increased toll-like receptor-2 and toll-like receptor-4 expression are associated with reactivation of periapical inflammation. J Endod 2013; 40:199-203. [PMID: 24461404 DOI: 10.1016/j.joen.2013.10.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 09/25/2013] [Accepted: 10/18/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Cysts and periapical granulomas are inflammatory reactions that develop in response to periapical infection by microbial species in dental root canal. It is known that toll-like receptors (TLRs) are pathogen recognition molecules and that galectins are lectins that can be associated with the inflammatory process, stimulating or inhibiting the immune system. The objective of this study was to evaluate the in situ expression of TLRs and galectins in radicular cysts and periapical granulomas. METHODS We analyzed 62 cases (30 radicular cysts, 27 periapical granulomas, and 5 control cases). Indirect immunohistochemistry was used to evaluate the expression of TLRs (TRL-2 and TLR-4) and galectins (Gal-3 and Gal-9). RESULTS The expression of Gal-3 and Gal-9 was significantly higher in periapical granulomas and radicular cysts than in the control group. Similarly, both Gal-3 and Gal-9 were expressed significantly more in periapical granulomas than in radicular cysts. The expression of TLR-2 was significantly higher in periapical granulomas and radicular cysts than in the control group, and it was also significantly higher in radicular cysts with sinus tract than in the cases without sinus tract. Furthermore, the expression of TLR-4 was significantly higher in the cases of periapical granulomas with sinus tract than in the cases without sinus tract. CONCLUSIONS Gal-3/Gal-9 and TLR-2/TLR-4 expression in the periapical granulomas and radicular cysts is associated with reactive periapical inflammation. Pathobiology of periapical disease is a very complex interplay of many bioactive molecules involved in immunoinflammatory responses. Up-regulation of these bioactive molecules might be an important modulator of inflammatory periapical lesions.
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Affiliation(s)
| | - Marcela Beghini
- Federal University of Triângulo Mineiro (UFTM/CEFORES), Uberaba, Minas Gerais, Brazil
| | | | | | - Marcelo Sivieri de Araújo
- Laboratory of Biopathology and Molecular Biology, University of Uberaba (UNIUBE), Uberaba, Minas Gerais, Brazil
| | - Sanívia Aparecida de Lima Pereira
- Laboratory of Biopathology and Molecular Biology, University of Uberaba (UNIUBE), Uberaba, Minas Gerais, Brazil; Federal University of Triângulo Mineiro (UFTM/CEFORES), Uberaba, Minas Gerais, Brazil
| | - Virmondes Rodrigues
- Federal University of Triângulo Mineiro (UFTM/CEFORES), Uberaba, Minas Gerais, Brazil
| | - Denise Bertulucci Rocha Rodrigues
- Laboratory of Biopathology and Molecular Biology, University of Uberaba (UNIUBE), Uberaba, Minas Gerais, Brazil; Federal University of Triângulo Mineiro (UFTM/CEFORES), Uberaba, Minas Gerais, Brazil.
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Chrcanovic BR, Martins MD, Wennerberg A. Immediate Placement of Implants into Infected Sites: A Systematic Review. Clin Implant Dent Relat Res 2013; 17 Suppl 1:e1-e16. [PMID: 23815434 DOI: 10.1111/cid.12098] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Maximiliano Delany Martins
- Laboratório de Nanoscopia - LabNano; Centro de Desenvolvimento da Tecnologia Nuclear - CDTN; Comissão Nacional de Energia Nuclear - CNEN; Belo Horizonte Brazil
| | - Ann Wennerberg
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
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Del Fabbro M, Samaranayake LP, Lolato A, Weinstein T, Taschieri S. Analysis of the secondary endodontic lesions focusing on the extraradicular microorganisms: an overview. ACTA ACUST UNITED AC 2013; 5:245-54. [PMID: 23766136 DOI: 10.1111/jicd.12045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 02/23/2013] [Indexed: 01/12/2023]
Abstract
The present study aimed at reviewing the literature on extraradicular infections of endodontically treated teeth, summarizing the main hypotheses on etiopathogenesis and describing the most suitable techniques to identify the composition of pathogenic extraradicular microorganisms. Medline database was searched using the keywords "Apical biofilm," "extraradicular infection," "secondary endodontic lesion," "endodontic retreatment," "biofilm" either alone or combined with AND. A further hand search was performed on the main endodontic journals. The most frequent bacterial species identified in different studies and with different techniques may vary considerably. Although the presence of some species of microorganisms seems to be determinant, the true origin of extraradicular infection is still undetermined. The literature analysis showed marked differences in methodology, materials, aims, and techniques adopted, which led to highly heterogeneous outcomes. The picture emerging from this review is that extraradicular infection is likely a multifactorial disease that requires further systematic investigation using standardized techniques.
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Affiliation(s)
- Massimo Del Fabbro
- Director of Center of Research for Oral Health, Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, IRCCS Galeazzi Orthopedic Institute, Universitá degli Studi di Milano, Milano, Italy
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Characterization of microbiota of root canal-treated teeth with posttreatment disease. J Clin Microbiol 2012; 50:1721-4. [PMID: 22403423 DOI: 10.1128/jcm.00531-12] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study evaluated the microbiota of root canals undergoing retreatment. The most prevalent taxa detected by checkerboard included Propionibacterium species, Fusobacterium nucleatum, streptococci, and Pseudoramibacter alactolyticus. Quantitative real-time PCR detected Enterococcus faecalis and streptococci in 38% and 41% of the cases, comprising 9.76% and 65.78% of the total bacterial counts, respectively. The findings call into question the status of E. faecalis as the main pathogen and suggest that other species can be candidate pathogens associated with persistent/secondary endodontic infections.
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Narayanan LL, Vaishnavi C. Endodontic microbiology. J Conserv Dent 2011; 13:233-9. [PMID: 21217951 PMCID: PMC3010028 DOI: 10.4103/0972-0707.73386] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 09/05/2010] [Accepted: 09/06/2010] [Indexed: 11/04/2022] Open
Abstract
Root canal therapy has been practiced ever since 1928 and the success rate has tremendously increased over the years owing to various advancements in the field. One main reason is the complete understanding of the microbiology involved in the endodontic pathology. This has helped us to modify the conventional treatment plans and effectively combat the microorganisms. Now, studies are aiming to explore the characteristics of the "most" resistant organism and the methods to eliminate them. This article gives an insight of the microbiology involved in endodontic pathology and discusses its role in our treatment procedure. Information from original reviews listed in PubMed, published from 1995 to 2010, has been mainly included in this review.
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Affiliation(s)
- L Lakshmi Narayanan
- Department of Conservative Dentistry & Endodontics, SRM Kattankulathur Dental College & Hospital, SRM University, Chennai, India
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Quirynen M, Van Assche N. Microbial changes after full-mouth tooth extraction, followed by 2-stage implant placement. J Clin Periodontol 2011; 38:581-9. [DOI: 10.1111/j.1600-051x.2011.01728.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kusek ER. Immediate Implant Placement Into Infected Sites: Bacterial Studies of the Hydroacoustic Effects of the YSGG Laser. J ORAL IMPLANTOL 2011; 37 Spec No:205-11. [DOI: 10.1563/aaid-joi-d-10-00014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article describes the use of an erbium laser to use photoacoustics to reduce the bacteria in osteotomy sites that were infected by apical pathology. The author shows reduced bacterial counts by performing bacterial cultures following laser treatment. Swabs were taken after the extraction of the tooth and then after the laser was placed into the osteotomy site. The results showed a noticeable reduction of bacteria and no traces of virulent bacteria.
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Kapalas A, Spratt DA, Ng YL, Gulabivala K. An investigation of a potential confounder in ex vivo microbiological studies--the bulk flow of fluid through apical foramina during tooth extraction. Int Endod J 2011; 44:534-42. [PMID: 21272043 DOI: 10.1111/j.1365-2591.2011.01858.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS To investigate the factors affecting bulk flow of dye and bacterial suspensions into and out of apical foramina during simulated tooth extraction, using an ex vivo model. METHODOLOGY Sixty extracted, single-rooted, human teeth were accessed, root canals located and in 50 the pulps dissolved; 10 teeth with attached periapical lesions were preserved. The size of apical foramina was determined digitally. The teeth were mounted in vials with polyvinylsiloxane impression material. Part 1: different dyes were inoculated in the coronal half of root canals or cervical 'gingival' margin, respectively, in separate experiments using the same teeth. Tooth extraction movements were simulated and apical penetration of the dye solutions with and without coronal restorations were examined in each case (20 teeth re-used 4 × ). Part 2: the same procedures were repeated on 30 more teeth but using a standard inoculum of Acidovorax sp. Part 3: 10 teeth with attached periapical lesions were inoculated with Acidovorax sp. in the absence of coronal restorations. Bacterial leakage into the periapical lesions was assessed. RESULTS Coronal restorations significantly reduced the flow of dyes (P=0.002) or bacterial suspension (P=0.001) out of the canals and bacterial suspension into (P=0.02) the canals during simulated tooth extraction. The 'size of apical foramina' were positively correlated with passage of bacterial suspension out of the canal (P=0.04) and from the gingival trough into the canal (P=0.008), in the presence of a coronal restoration. CONCLUSIONS The presence of coronal restorations, the size of apical foramina and presence of native canal contents with attached periapical lesions, all influenced fluid flow into and out of canals during simulated tooth extraction movements.
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Affiliation(s)
- A Kapalas
- Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, UK
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35
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Flanagan D. Calcium hydroxide paste as a surface detoxifying agent for infected dental implants: two case reports. J ORAL IMPLANTOL 2009; 35:204-9. [PMID: 19813427 DOI: 10.1563/1548-1336-35.4.204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dental implant treatment is successful; however, an implant can become infected during or after osseointegration. The two case reports presented here demonstrate, anecdotally, the effectiveness of endodontic calcium hydroxide paste for the surface treatment of infected, healing, or osseointegrated dental implants. Calcium hydroxide may be an appropriate surface detoxifying agent for local dental implant infections. A sequence of calcium hydroxide and 0.2% chlorhexidine gluconate surface treatment may provide a broad range of antimicrobial action for detoxifying recalcitrant infections. Calcium hydroxide should not be left in the surgical site.
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Abstract
Although fungi, archaea, and viruses contribute to the microbial diversity in endodontic infections, bacteria are the most common micro-organisms occurring in these infections. Datasets from culture and molecular studies, integrated here for the first time, showed that over 460 unique bacterial taxa belonging to 100 genera and 9 phyla have been identified in different types of endodontic infections. The phyla with the highest species richness were Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria. Diversity varies significantly according to the type of infection. Overall, more taxa have been disclosed by molecular studies than by culture. Many cultivable and as-yet-uncultivated phylotypes have emerged as candidate pathogens based on detection in several studies and/or high prevalence. Now that a comprehensive inventory of the endodontic microbial taxa has been established, future research should focus on the association with different disease conditions, functional roles in the community, and susceptibility to antimicrobial treatment procedures.
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Affiliation(s)
- J F Siqueira
- Department of Endodontics and Molecular Microbiology, Faculty of Dentistry, Estácio de Sá University, Av. Alfredo Baltazar da Silveira, 580/cobertura, Recreio, Rio de Janeiro, RJ, Brazil.
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Siqueira JF, Rôças IN. Distinctive features of the microbiota associated with different forms of apical periodontitis. J Oral Microbiol 2009; 1. [PMID: 21523208 PMCID: PMC3077003 DOI: 10.3402/jom.v1i0.2009] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 07/08/2009] [Accepted: 07/09/2009] [Indexed: 12/17/2022] Open
Abstract
Microorganisms infecting the dental root canal system play an unequivocal role as causative agents of apical periodontitis. Although fungi, archaea, and viruses have been found in association with some forms of apical periodontitis, bacteria are the main microbial etiologic agents of this disease. Bacteria colonizing the root canal are usually organized in communities similar to biofilm structures. Culture and molecular biology technologies have demonstrated that the endodontic bacterial communities vary in species richness and abundance depending on the different types of infection and different forms of apical periodontitis. This review paper highlights the distinctive features of the endodontic microbiota associated with diverse clinical conditions.
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Affiliation(s)
- José F Siqueira
- Department of Endodontics and Molecular Microbiology Laboratory, School of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
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Papaioannou W, Gizani S, Haffajee AD, Quirynen M, Mamai-Homata E, Papagiannoulis L. The microbiota on different oral surfaces in healthy children. ACTA ACUST UNITED AC 2009; 24:183-9. [DOI: 10.1111/j.1399-302x.2008.00493.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Handal T, Caugant DA, Olsen I, Sunde PT. Bacterial diversity in persistent periapical lesions on root-filled teeth. J Oral Microbiol 2009; 1. [PMID: 21523213 PMCID: PMC3077005 DOI: 10.3402/jom.v1i0.1946] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 03/19/2009] [Accepted: 05/05/2009] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The purpose of this study was to analyze the bacterial diversity in persistent apical lesions on root-filled teeth by using culture-independent molecular methods. DESIGN Twenty surgically removed apical lesions from therapy-resistant teeth were examined for the presence of bacterial DNA using PCR targeting the 16s ribosomal RNA gene, followed by cloning and sequencing. RESULTS Bacterial DNA was detected in 17 of the 20 samples (85%). A total of 236 clones were analyzed. Seven different bacterial phyla were represented and a total of 75 different bacterial taxa were identified; 36% of the species have not yet been cultivated. Commonly detected bacterial species included Fusobacterium spp., Prevotella spp., Tannerella forsythia, Porphyromonas endodontalis, Treponema denticola, Bacteroidetes spp., Peptostreptococcus spp., and Streptococcus spp. CONCLUSIONS A wide range of bacteria was identified in periapical lesions on therapy-resistant teeth. These bacteria may contribute in the etiology of periapical infection and impede healing of these lesions.
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Affiliation(s)
- Trude Handal
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Frid P, Tornes K, Nielsen Ø, Skaug N. Primary chronic osteomyelitis of the jaw—a microbial investigation using cultivation and DNA analysis: a pilot study. ACTA ACUST UNITED AC 2009; 107:641-7. [DOI: 10.1016/j.tripleo.2009.01.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Revised: 11/08/2008] [Accepted: 01/05/2009] [Indexed: 11/17/2022]
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do Nascimento C, Barbosa RES, Issa JPM, Watanabe E, Ito IY, de Albuquerque Junior RF. Use of checkerboard DNA-DNA hybridization to evaluate the internal contamination of dental implants and comparison of bacterial leakage with cast or pre-machined abutments. Clin Oral Implants Res 2009; 20:571-7. [PMID: 19250244 DOI: 10.1111/j.1600-0501.2008.01663.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate the checkerboard DNA-DNA hybridization method for detection and quantitation of bacteria from the internal parts of dental implants and to compare bacterial leakage from implants connected either to cast or to pre-machined abutments. MATERIALS AND METHODS Nine plastic abutments cast in a Ni-Cr alloy and nine pre-machined Co-Cr alloy abutments with plastic sleeves cast in Ni-Cr were connected to Branemark-compatible implants. A group of nine implants was used as control. The implants were inoculated with 3 microl of a solution containing 10(8) cells/ml of Streptococcus sobrinus. Bacterial samples were immediately collected from the control implants while assemblies were completely immersed in 5 ml of sterile Tripty Soy Broth (TSB) medium. After 14 days of anaerobic incubation, occurrence of leakage at the implant-abutment interface was evaluated by assessing contamination of the TSB medium. Internal contamination of the implants was evaluated with the checkerboard DNA-DNA hybridization method. RESULTS DNA-DNA hybridization was sensitive enough to detect and quantify the microorganism from the internal parts of the implants. No differences in leakage and in internal contamination were found between cast and pre-machined abutments. Bacterial scores in the control group were significantly higher than in the other groups (P<0.05). CONCLUSION Bacterial leakage through the implant-abutment interface does not significantly differ when cast or pre-machined abutments are used. The checkerboard DNA-DNA hybridization technique is suitable for the evaluation of the internal contamination of dental implants although further studies are necessary to validate the use of computational methods for the improvement of the test accuracy.
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Affiliation(s)
- Cássio do Nascimento
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Metzger Z, Blasbalg J, Dotan M, Weiss EI. Enhanced Attachment of Porphyromonas gingivalis to Human Fibroblasts Mediated by Fusobacterium nucleatum. J Endod 2009; 35:82-5. [DOI: 10.1016/j.joen.2008.10.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Revised: 10/06/2008] [Accepted: 10/08/2008] [Indexed: 10/21/2022]
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Abstract
Samples from infected root canals of 43 teeth with chronic apical periodontitis were analyzed for the presence and relative levels of 83 oral bacterial species and/or phylotypes using a reverse-capture checkerboard hybridization assay. Associations between the most frequently detected taxa were also recorded. The most prevalent taxa were Olsenella uli (74%), Eikenella corrodens (63%), Porphyromonas endodontalis (56%), Peptostreptococcus anaerobius (54%), and Bacteroidetes oral clone X083 (51%). When prevalence was considered only for bacteria present at levels >10(5), Bacteroidetes clone X083 was the most frequently isolated bacterium (37%), followed by Parvimonas micra (28%), E. corrodens (23%), and Tannerella forsythia (19%). The number of target taxa per canal was directly proportional to the size of the apical periodontitis lesion, with lesions >10 mm in diameter harboring a mean number of approximately 20 taxa. Several positive associations for the most prevalent taxa were disclosed for the first time and may have important ecological and pathogenic implications. In addition to strengthening the association of several cultivable named species with chronic apical periodontitis, the present findings using a large-scale analysis allowed the inclusion of some newly named species and as-yet-uncultivated phylotypes in the set of candidate pathogens associated with this disease.
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Ricucci D, Siqueira JF. Apical Actinomycosis as a Continuum of Intraradicular and Extraradicular Infection: Case Report and Critical Review on Its Involvement with Treatment Failure. J Endod 2008; 34:1124-9. [DOI: 10.1016/j.joen.2008.06.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2008] [Revised: 06/10/2008] [Accepted: 06/17/2008] [Indexed: 10/21/2022]
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Vianna ME, Horz HP, Conrads G, Feres M, Gomes BPFA. Comparative analysis of endodontic pathogens using checkerboard hybridization in relation to culture. ACTA ACUST UNITED AC 2008; 23:282-90. [DOI: 10.1111/j.1399-302x.2007.00425.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Saito Y, Fujii R, Nakagawa KI, Kuramitsu HK, Okuda K, Ishihara K. Stimulation of Fusobacterium nucleatum biofilm formation by Porphyromonas gingivalis. ACTA ACUST UNITED AC 2008; 23:1-6. [PMID: 18173791 DOI: 10.1111/j.1399-302x.2007.00380.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS Bacterial infection is a major cause of periapical periodontitis. Eradication of these microorganisms from apical lesions is essential to the success of endodontic treatment. The aim of this study was to clarify the molecular interaction between Fusobacterium nucleatum, Porphyromonas gingivalis and other microorganisms associated with periapical periodontitis. METHODS Microorganisms isolated from periapical lesions were inoculated into type-I collagen-coated polystyrene microtiter plates and maintained at 37 degrees C under anaerobic conditions for 2 days, after which, the quantity of organized biofilm on the plates was evaluated by crystal violet staining. Growth enhancement via soluble factor was evaluated by separated coculture using a 0.4-mum membrane filter. RESULTS F. nucleatum exhibited strong adherence to type-I collagen-coated polystyrene microplates. Biofilm formation by F. nucleatum was significantly enhanced by P. gingivalis. It was complemented by compartmentalized coculture with P. gingivalis. Enhancement of biofilm formation by P. gingivalis was only slightly reduced by inactivation of its autoinducer-2-producing gene luxS. CONCLUSION The results suggest that P. gingivalis enhances biofilm formation by F. nucleatum by releasing diffusible signaling molecules other than autoinducer-2.
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Affiliation(s)
- Y Saito
- Department of Endodontics, Pulp and Periapical Biology, Tokyo Dental College, Chiba, Japan
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Brito LCN, Teles FR, Teles RP, França EC, Ribeiro-Sobrinho AP, Haffajee AD, Socransky SS. Use of multiple-displacement amplification and checkerboard DNA-DNA hybridization to examine the microbiota of endodontic infections. J Clin Microbiol 2007; 45:3039-49. [PMID: 17634304 PMCID: PMC2045303 DOI: 10.1128/jcm.02618-06] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Multiple-displacement amplification (MDA) has been used to uniformly amplify bacterial genomes present in small samples, providing abundant targets for molecular analysis. The purpose of this investigation was to combine MDA and checkerboard DNA-DNA hybridization to examine the microbiota of endodontic infections. Sixty-six samples were collected from teeth with endodontic infections. Nonamplified and amplified samples were analyzed by checkerboard DNA-DNA hybridization for levels and proportions of 77 bacterial taxa. Counts, percentages of DNA probe counts, and percentages of teeth colonized for each species in amplified and nonamplified samples were computed. Significance of differences for each species between amplified and nonamplified samples was sought with Wilcoxon signed-rank test and adjusted for multiple comparisons. The amount of DNA in the samples ranged from 6.80 (+/- 5.2) ng before to 6.26 (+/- 1.73) mug after MDA. Seventy of the 77 DNA probes hybridized with one or more of the nonamplified samples. All probes hybridized with at least one sample after amplification. Most commonly detected species at levels of >10(4) in both amplified and nonamplified samples were Prevotella tannerae and Acinetobacter baumannii at frequencies between 89 and 100% of samples. The mean number of species at counts of >10(4) in amplified samples was 51.2 +/- 2.2 and in nonamplified samples was 14.5 +/- 1.7. The endodontic microbiota was far more complex than previously shown, although microbial profiles at teeth with or without periradicular lesions did not differ significantly. Species commonly detected in endodontic samples included P. tannerae, Prevotella oris, and A. baumannii.
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Affiliation(s)
- L C N Brito
- Department of Periodontology, The Forsyth Institute, Boston, Massachusetts, USA.
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Lin S, Sela G, Sprecher H. Periopathogenic Bacteria in Persistent Periapical Lesions: An In Vivo Prospective Study. J Periodontol 2007; 78:905-8. [PMID: 17470025 DOI: 10.1902/jop.2007.060224] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this in vivo prospective study was to detect the presence of periopathogenic bacteria in persistent periapical lesions and to compare the reliability of two different methods: anaerobic culture and the DNA hybridization technique. METHODS Samples were obtained from 24 patients with persistent periapical lesions referred for surgical endodontic treatment. A sterile paper point was inserted into the periapical lesion for 10 seconds. The point was stored in sterile transfer tubes and analyzed by DNA hybridization. Tissue samples were transported in transfer medium and analyzed further using anaerobic culture. RESULTS At least one periodontal pathogenic bacterium was found in seven of 24 cases. Bacterial species present were Treponema denticola (three cases), Porphyromonas gingivalis (three cases), Tannerella forsythensis (four cases), Prevotella intermedia (one case), and Actinobacillus actinomycetemcomitans (three cases). No particular signs or symptoms were associated with the presence of these bacterial species. Anaerobic culture failed to identify any of the periopathogenic bacteria. CONCLUSIONS Periodontal pathogenic bacterial DNA can be detected in persistent periapical lesions. Anaerobic cultures failed to detect the periodontal pathogenic bacteria in positive hybridization assays, suggesting that standard culture methods lack sensitivity or that hybridization assays are flawed with low specificity. The clinical significance of the presence of bacterial DNA in persistent periapical lesions remains to be determined.
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Affiliation(s)
- Shaul Lin
- Endodontics and Dental Trauma Unit, Department of Oral and Dental Medicine, Rambam Medical Center, Haifa, Israel.
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49
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Affiliation(s)
- Anne C R Tanner
- Department of Molecular Genetics, The Forsyth Institute, Boston, Massachusetts, USA
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50
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Rôças IN, Siqueira JF. Culture-independent detection of Eikenella corrodens and Veillonella parvula in primary endodontic infections. J Endod 2006; 32:509-12. [PMID: 16728238 DOI: 10.1016/j.joen.2005.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2005] [Accepted: 07/16/2005] [Indexed: 11/30/2022]
Abstract
Eikenella corrodens and Veillonella parvula are normal cultivable inhabitants of the oral cavity but their presence in endodontic infections has not been as common as it could be anticipated. This might have been because of shortcomings of culture techniques when it comes to bacterial isolation or identification. The present study intended to survey samples from primary endodontic infections for the presence of E. corrodens and V. parvula using a culture-independent 16S rRNA gene-based nested PCR protocol. Genomic DNA was isolated directly from samples taken from different forms of periradicular lesions, and the presence of E. corrodens and V. parvula was determined by nested PCR. Specificity for each primer pair was confirmed by sequence analysis of PCR products from positive clinical samples. V. parvula and E. corrodens were, respectively, detected in 33% and 14% of the root canals associated with chronic apical periodontitis. Both V. parvula and E. corrodens were found in 10% of the cases diagnosed as acute apical periodontitis. V. parvula and E. corrodens were detected in 21% and 26% of the samples from acute apical abscesses, respectively. In general, species-specific nPCR allowed the detection of V. parvula in 24% and E. corrodens in 18% of the samples taken from primary endodontic infections. Findings confirmed that V. parvula and E. corrodens can take part in the microbiota of primary endodontic infections, but in prevalence values somewhat higher when compared to most of the previous culture studies that had reported recovery of these species.
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Affiliation(s)
- I N Rôças
- Department of Endodontics, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
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