Microbiology and Treatment of Acute Apical Abscesses

Abstract

SUMMARY Acute apical abscess is the most common form of dental abscess and is caused by infection of the root canal of the tooth. It is usually localized intraorally, but in some cases the apical abscess may spread and result in severe complications or even mortality. The reasons why dental root canal infections can become symptomatic and evolve to severe spreading and sometimes life-threatening abscesses remain elusive. Studies using culture and advanced molecular microbiology methods for microbial identification in apical abscesses have demonstrated a multispecies community conspicuously dominated by anaerobic bacteria. Species/phylotypes commonly found in these infections belong to the genera Fusobacterium , Parvimonas , Prevotella , Porphyromonas , Dialister , Streptococcus , and Treponema . Advances in DNA sequencing technologies and computational biology have substantially enhanced the knowledge of the microbiota associated with acute apical abscesses and shed some light on the etiopathogeny of this disease. Species richness and abundance and the resulting network of interactions among community members may affect the collective pathogenicity and contribute to the development of acute infections. Disease modifiers, including transient or permanent host-related factors, may also influence the development and severity of acute abscesses. This review focuses on the current evidence about the etiology and treatment of acute apical abscesses and how the process is influenced by host-related factors and proposes future directions in research, diagnosis, and therapeutic approaches to deal with this disease.

Pathogenic Bacterial Species Associated with Endodontic Infection Evade Innate Immune Control by Disabling Neutrophils

“…This inhibition results from a cytotoxic effect on infiltrating neutrophils resulting in cell death through an apparently necrotic pathway and a strong suppression of antibacterial functions. The physical structure of the root canal and associated bone likely restricts access of innate and other immune cells to the site of the infection, contributing to the development of necrosis and the failure of innate immunity in these infections (27). Our results for the first time demonstrate that cytotoxic activity of bacterial species typically associated with these infections, especially P. intermedia, may also contribute to the persistence of these infections.…”

Effect of Simvastatin on induced apical periodontitis in rats: a tomographic and biochemical analysis

“…However, in general, endodontic diseases result from biofilm formation by microorganisms such as Candida albicans, Enterococcus faecalis 30 , and Porphiromona endodontalis 31 . The inclusion of simvastatin in this infectious-inflammatory process will provide additional information on the action of this drug in the periodontium, achieving a methodology for the use of this medication and proper dosage to provide periapical-induced disease modulation, as analyzed using an experimental rat model.…”

Loop-mediated isothermal amplification combined with PCR and immunohistochemistry for detecting <i>Porphyromonas gingivalis</i> in periapical periodontitis

“…Acute apical periodontitis can spread to other anatomical spaces, resulting in phlegmon and bacteriemia (2,3). Various bacteria species have been identified in periapical lesions, but the main pathogens involved in apical periodontitis development are unclear (4).…”