Extraradicular endodontic infections

Abstract

Eight asymptomatic periapical inflammatory lesions which were refractory to conventional endodontic therapy were examined for the presence of bacteria. Access to the periapical lesions was gained using an aseptic surgical technique. Sterile currettes were used to take microbiological samples from the soft tissue lesions and scrapings from the surface of the root tips. Möller's VMGA III transport medium was utilized and the bacteriological samples were processed using a continuous anaerobic technique. Bacterial growth was evident in the samples from all 8 lesions. Two lesions exclusively yielded anaerobic bacteria and 5 lesions were heavily dominated by anaerobes. Black‐pigmented Bacteroides species as well as anaerobic gram–positive rods and cocci were isolated. Staphylococcus epidermidis was recovered from 3 lesions and 2 Actinomyces species were isolated from 1 lesion. Facultative Streptococcus species were rare periapical isolates. Our study clearly showed that anaerobic bacteria are able to survive and maintain an infectious disease process in periapical tissues.

Biopelícula extrarradicular: reporte de un caso clínico

“…Aunque se podría pensar en el uso de antibioticoterapia sistémica para controlarlas o erradicarlas, el principal problema de las biopelículas es su conocida resistencia antibiótica [1][2][3][4][5][6][7][8][9][10][11][12], debido en gran medida a la barrera de difusión que representa la matriz de polisacáridos extracelulares [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] y a la tasa de crecimiento disminuida que presentan los habitantes de dichas comunidades [17][18][19][20][21][22].…”

“…Otro punto de gran relevancia clínica en el tratamiento de las biopelículas extrarradiculares es que dichas infecciones pudieran remitir en sus síntomas agudos para luego producir episodios recurrentes [22,23]. Esto ocurre porque la terapia antibiótica solo es capaz de eliminar las células planctónicas, pero deja viables las formas sésiles, que se van a propagar en el interior de la biopelícula para continuar su diseminación y liberación de nuevas células planctónicas cuando la terapia antibiótica sea descontinuada [23].…”

“…Por otra parte, estas infecciones son difícil-mente resueltas por el sistema inmune del hospedero; incluso, dicha respuesta es capaz de ocasionar daños en los tejidos en vecindad a las biopelículas [20][21][22][23][24][25][26][27].…”

“…En estas situaciones clínicas, la cirugía apical representa una manera eficaz y efectiva de desorganizar o eliminar a los microorganismos contenidos en estas organizaciones microbianas [14][15][16][17][18][19][20][21][22][23][24][25][26][27].…”

Sealing the Gap of Vertical Root Fracture through the Root Canal

“…These findings were probably due to incomplete sealing due to limitations in fracture line preparation accuracy, exudate and bleeding into the fracture gap that inhibited bonding and technical errors during bonding. Biofilm may have also formed on the outer root surface around the fracture line, as it does in the cementum surface around the apical foramen in apical periodontitis [18][19][20][21][22][23][24]. In such cases there are limitations to treatment from within the root canal, making surgical treatment such as intentional replantation necessary.…”