Microbiological findings and clinical treatment procedures in endodontic cases selected for microbiological investigation

Abstract

The relationship between bacteriological findings and clinical treatment procedures was investigated in root canal treatment cases that were selected for bacteriological investigation by general dental practitioners in Finland. The cultures were sent to the Oral Microbiological Service Laboratory at the Institute of Dentistry in Helsinki. Two groups of teeth were selected based on the type of infection present in the root canal system. The 'enteric bacteria' group consisted of 40 sequential cases where Enterococcus faecalis and/or other facultative enteric bacteria or Pseudomonas sp. were found in the samples in pure culture (35%) or together with other types of bacteria. The group 'non-enteric bacteria' consisted of 40 sequential cases where only non-enteric bacteria were found. The dentists who had sent the bacteriological samples received a questionnaire where they were asked about the treatment protocol and procedures. A total of 70 out of 80 questionnaires were returned. If the root canals had been unsealed at some point during the treatment, enteric bacteria were found more frequently than in canals with an adequate seal between the appointments. Of cases with enteric bacteria 55% had been open during the treatment, while in the group where only non-enteric bacteria were found 30% had been open. Enteric bacteria were also more frequently isolated in cases with a high number of appointments before sampling. In the enteric bacteria group 35% of the samples were taken at the 10th visit or later, while the corresponding percentage in the non-enteric group was 3%. In addition, the number of retreatment cases was significantly higher, 12 out of 34, in the enteric bacteria group than in non-enteric bacteria group, which was five out of 36. Other clinical parameters showed no differences between the two groups. The results emphasize the importance of controlled asepsis throughout the root canal treatment.

Microbial Leakage of Gutta-percha and Resilon™ Root Canal Filling Material: A Comparative Study Using a new Homogeneous Assay for Sequence Detection

“…Enterococcus faecalis is not particularly demanding from the nutritional standpoint. This resistant microorganism can survive extreme challenges and is frequently isolated in cases of endodontic failure [35,36], since it can penetrate the dentine tubules and escape chemomechanical treatment of the root canal system [37].…”

Antibacterial Effect of Selected Root-End Filling Materials

“…Although aerobic and facultative microorganisms are usually minor constituents of primary infections, they have been found with higher frequency in cases in which the treatment had been protracted, in flare-ups, and in failing cases (13,14). These microorganisms can enter the root canal system before, during or after treatment and may then cause secondary infections (15).…”

Enterococcus faecalis Adhesin, Ace, Mediates Attachment to Particulate Dentin

“…Although it has been isolated from plaque, saliva, mucosa, and human gingiva (10), E. faecalis is infrequently found in intact, necrotic pulp tissue (3)(4)(5). However, it is the bacterium most frequently recovered from endodontically treated teeth with persistent apical periodontitis (6,8). There have been few investigations into the specific E. faecalis virulence factors that allow persistence in root canals.…”