Identification of microorganisms in irreversible pulpitis and primary endodontic infections with respect to clinical and radiographic findings

Abstract

Objectives The aim of this study was to evaluate the composition of microbiota of irreversible pulpitis and primary endodontic infections with respect to clinical and radiographic findings by performing cultures and 16s rDNA sequencing in Iranian patients. Material and methods In this prospective cross-sectional study, samples were collected from 41 root canals for 4 main groups of patients. Bacterial identification was performed by the polymerase chain reaction (PCR) and 16s rDNA sequencing of aerobic and anaerobic cultivable colonies taken from patients' culture plates. Additionally, the presence of 13 bacterial species and 3 nonbacterial species was also explored using PCR and species-specific primers. Results Sixteen microbial species, 1 fungus (Candida albicans), and 1 virus (Herpes simplex virus) were discovered and isolated. Species with the highest prevalence were Dialister invisus (68.3%), Porphyromonas gingivalis (58.8%), Streptococcus salivarius (58.5%), and Treponema denticola (56.1%). Lysinibacillus fusiformis (19.1%) was detected in the root canals for the first time. Candida albicans was seen in 11 cases (26.8%). Herpes simplex virus (HSV) was seen in 4 patients (9.8%). Conclusions Our results suggest that Gram-negative anaerobic oral bacteria are the majority of the microbes in primary endodontic infections. Various combinations of bacterial species were related to different clinical and radiographic conditions. Lysinibacillus fusiformis was detected for the first time in primary endodontic infections. Clinical relevance The results of this investigation might help clinicians choose to identify suspected endodontic pathogens in the etiology of each form of pulpal and periradicular diseases to determine the best therapeutic measures.

The oralome and its dysbiosis: New insights into oral microbiome-host interactions

“…Recently, Zargar et al . [193] found 18 species in 41 root canals from patients with irreversible pulpitis. Among them, Dialister invisus , P. gingivalis , S. salivarius , T. denticola , C. albicans and HSV-1 were the ones with highest prevalence; Lysinibacillus fusiformis was detected for the first time in the root canals.…”

Fungal species in endodontic infections: A systematic review and meta-analysis

“…A total of seven workers [45,50,55,62,[80][81][82] used both paper points and hand files for sample collection. Only one of them [45] used cultural methods, thus the meta-analysis could not be performed, while six of them [50,55,62,[80][81][82] used PCR, and the resulting WMP was 15.6% (CI 95%: 5.8-25.4) (Fig 5).…”

“…A total of seven workers [45,50,55,62,[80][81][82] used both paper points and hand files for sample collection. Only one of them [45] used cultural methods, thus the meta-analysis could not be performed, while six of them [50,55,62,[80][81][82] used PCR, and the resulting WMP was 15.6% (CI 95%: 5.8-25.4) (Fig 5). Thirteen studies only included teeth presenting periapical lesion, with a WMP of 5.4% (CI 95%: 2.2-8.6) for cultural studies [45,47,48,51,52,57,58,65,66,72] (Fig 6) and 18.7% (CI 95%: 2.9-34.5) for molecular studies [55,64,72,78] (Fig 7).…”

“…On the contrary, some studies provided very precise descriptors of the protocols for sample selection (e.g. collection from the largest root canal associated with the periapical lesion) including the quality of disinfection of the sampling site, and single or multiple control specimens [45,46,48,[57][58][59]64,[67][68][69]71,72,75,76,81,82] all of which affect the microbiological outcomes. It must also be noted that all the included studies used rubber dam isolation procedures of the tooth before sampling procedures.…”

The Role of Vital Pulp Therapy in the Management of Periapical Lesions

“…Despite the long-standing concept of pulp tissue necrosis as the main contributing factor for periapical lesions, there has been a growing body of evidence that inflamed vital dental pulps are capable of causing apical periodontitis (AP) ( 3 , 4 ). Studies have shown that AP can be associated with irreversible pulpitis (IP); a condition defined as an immunological response of dental pulp tissue ( 5 , 6 ) to the inflammation caused mainly by microorganisms and/or their by-products ( 7 , 8 ), which could result in local changes in pulp/periapical connective tissues ( 9 , 10 ).…”