Microbial Profile and Endotoxin Levels in Primary Periodontal Lesions with Secondary Endodontic Involvement

Abstract

This study was carried out to investigate the microbial profile and endotoxin levels of endodontic-periodontal lesions of periodontal origin. Periodontal and endodontic samples were taken from periodontal pockets and necrotic root canals of 10 teeth with endodontic-periodontal lesions. Evidencing of 40 different bacterial species were determined in each endodontic and periodontal sample using the checkerboard DNA-DNA hybridization method and Kinetic chromogenic LAL assay was used for quantification of endotoxins. Fisher’s exact test correlated the bacterial species with the endodontic or periodontal microbiota. The endotoxin levels (EU/mL) found in samples of the root canal and periodontal pocket were compared by the Wilcoxon test (p<0.05). Bacteria and LPS units were found in 100% of the endodontic and periodontal samples. The species E. faecium, P. acnes, G. morbillorum, C. sputigena and L. buccalis were strongly correlated with the endodontic microbiota and P. nigrescens with the periodontal microbiota. P. intermedia, P. endodontalis and V. parvula were more prevalent in both endodontic and periodontal microbiots. The endotoxin levels in the periodontal pocket (89600 EU/mL) were significantly higher than in the root canal (2310 EU/mL). It was concluded that the microbiota present in the periodontal and endodontic tissues is similar, with a higher prevalence of species of the orange complex and a higher level of endotoxin in the periodontal pockets.

Repair of teeth with cracks in crowns and roots: An observational clinical study

“…An important diagnostic clinical sign is the detection of a probing defect; absence of this defect (OR 0.027, 95% CI 0.003–0.27, p < .05) serves as a protective prognostic factor, which indicates longer survival (Walton & Tamse, 2015, Olivieri et al 2020). Longitudinal tooth fractures can produce a unique pattern of bone resorption around the fracture line, which is pathognomonic of the condition and enables definitive diagnosis (Rovai et al, 2019). These radiographic signs may not be evident at the onset of the phenomenon or if a bone lesion overlaps the root profile.…”

“…Both PRCT and DRCT may produce typical bone resorption surrounding the crack line, which is pathognomonic of the condition and often enables definitive diagnosis. Similar to the mechanism observed in endodontic pathosis, the aetiopathogenesis of inflammation in radicular cracked teeth is attributable to bacterial penetration of periodontal pockets through the crack line (Rovai et al, 2019). Localized bone resorption that occurs in a cracked tooth can be detected as a probing defect using a periodontal probe; however, the initially narrow pocket is often difficult to detect and becomes more noticeable only as it progresses.…”