scholarly journals Root Canal Microbiota of Teeth with Chronic Apical Periodontitis

2008 ◽  
Vol 46 (11) ◽  
pp. 3599-3606 ◽  
Author(s):  
I. N. Rocas ◽  
J. F. Siqueira
Keyword(s):  
Root Canal ◽  
Apical Periodontitis

Persistent Apical Periodontitis: Bacterial Taxonomic Analysis and Treatment Through Intentional Replantation

2020 ◽  
Author(s):  
Fernando Eduardo Coria-Valdiosera
Keyword(s):  
Antibiotic Therapy ◽  
Root Canal ◽  
Resistance Mechanisms ◽  
Apical Periodontitis ◽  
Infectious Process ◽  
Identification Of Bacteria ◽  
The Right ◽  
Apical Lesions ◽  
Endodontic Retreatment

Introduction: The microorganisms own different resistance mechanisms that allow them to resist the chemo-mechanical cleanliness of root canal and antibiotic therapies causing the persistence of apical lesions. Methods: This clinical case describes a male patient diagnosed with pulp necrosis in the right lower central incisor due to trauma, which developed apical periodontitis manifesting itself extra orally. Root canal treatment along with antibiotic therapy was performed, but because the infectious process persisted, endodontic retreatment and a new antibiotic therapy were carried out, however, the clinical evolution was not favorable. For this reason, the intentional replantation was chosen as the outright treatment, performing apicectomy and curettage of the periapical lesion, from which the isolation and taxonomic study of microorganisms were carried out, with the respective antibiogram. Results: In the 10-day clinical follow-up, the extraoral infectious process disappeared almost completely and 6 months later, a complete repair of the bone tissue was observed on the tomography. Conclusion: A better understanding of the persistence of apical periodontitis was achieved by taxonomic identification of bacteria and the intentional replantation allowed to remove the apical biofilm gaining an excellent wound healing.

scholarly journals An experimental intraradicular biofilm model in the pig for evaluating irrigation techniques

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Toshinori Tanaka ◽  
Yoshio Yahata ◽  
Keisuke Handa ◽  
Suresh V. Venkataiah ◽  
Mary M. Njuguna ◽  
...  
Keyword(s):  
16S Rrna ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Exposure Model ◽  
Rrna Gene ◽  
16S Rrna Sequence ◽  
Bacterial Phyla ◽  
Biofilm Model ◽  
Biofilm Removal

Abstract Background We established an in vivo intraradicular biofilm model of apical periodontitis in pigs in which we compared the efficacy of different irrigant activation techniques for biofilm removal. Methods Twenty roots from the deciduous mandibular second premolar of 5 male pigs were used. After pulpectomy, canals were left open for 2 weeks and then sealed for 4 weeks to enable the development of an intracanal biofilm. The intraradicular biofilms was evaluated using SEM and bacterial 16S rRNA gene-sequencing. To investigate the efficacy of biofilm removal, root canal irrigations were performed using conventional needle, passive ultrasonic, subsonic, or laser-activated irrigation. Real-time PCR was conducted to quantitate the remaining biofilm components. Statistical analysis was performed using ANOVA followed by a Tukey kramer post-hoc test with α = 0.05. Results The pulp exposure model was effective in inducing apical periodontitis and SEM analysis revealed a multi-layer biofilm formation inside the root canal. 16S rRNA sequence analysis identified Firmicutes, Bacteroidetes, and Fusobacteria as the predominant bacterial phyla components, which is similar to the microbiome profile seen in humans. None of the tested irrigation techniques completely eradicated the biofilm components from the root canal, but the subsonic and laser-activated irrigation methods produced the lowest bacterial counts (p < 0.05). Conclusions An experimental intraradicular biofilm model has been successfully established in pigs. Within the limitations of the study, subsonic or laser-activated irrigation demonstrated the best biofilm removal results in the pig system.

scholarly journals Effect of Antibacterial Root Canal Sealer on Persistent Apical Periodontitis

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 741
Author(s):  
Zheng Wang ◽  
Ge Yang ◽  
Biao Ren ◽  
Yuan Gao ◽  
Xian Peng ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Therapeutic Effect ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Control Group ◽  
Root Canal Sealer ◽  
Root Canal Filling ◽  
First Time ◽  
Cone Beam Computer Tomography ◽  
Better Than

The infection of Enterococcus faecalis and its interacting microorganisms in the root canal could cause persistent apical periodontitis (AP). Antibacterial root canal sealer has favorable prospects to inhibit biofilms. The purpose of this study was to investigated the antibacterial effect of root canal sealer containing dimethylaminododecyl methacrylate (DMADDM) on persistent AP in beagle dogs for the first time. Persistent AP was established by a two-step infection with Enterococcus faecalis and multi-bacteria (Enterococcus faecalis, Lactobacillus acidophilus, Actinomycesnaeslundii, Streptococcus gordonii). Root canal sealer containing DMADDM (0%, 1.25%, 2.5%) was used to complete root canal filling. The volume of lesions and inflammatory grade in the apical area were evaluated by cone beam computer tomography (CBCT) and hematoxylin-eosin staining. Both Enterococcus-faecalis- and multi-bacteria-induced persistent AP caused severe apical destruction, and there were no significant differences in pathogenicity between them. DMADDM-modified sealer significantly reduced the volume of periapical lesion and inflammatory grade compared with the control group, among them, the therapeutic effect of the 2.5% group was better than the 1.25% group. In addition, E.faecalis-induced reinfection was more sensitive to the 2.5% group than multi-bacteria reinfection. This study shows that root canal sealer containing DMADDM had a remarkable therapeutic effect on persistent AP, especially on E. faecalis-induced reinfection.

scholarly journals BiodentineTM Full Pulpotomy in Mature Permanent Teeth with Irreversible Pulpitis and Apical Periodontitis

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 720
Author(s):  
Xuan Vinh Tran ◽  
Lan Thi Quynh Ngo ◽  
Tchilalo Boukpessi
Keyword(s):  
Root Canal ◽  
Periodontal Ligament ◽  
Clinical Signs ◽  
Apical Periodontitis ◽  
Permanent Teeth ◽  
Definitive Treatment ◽  
Capping Agent ◽  
Root Canal Therapy ◽  
Pulp Capping ◽  
Irreversible Pulpitis

Vital pulp therapy, including direct pulp capping and partial and full pulpotomy, is primarily indicated for immature or mature permanent teeth with reversible pulpitis. Mature permanent teeth with irreversible pulpitis are frequently treated with root canal therapy. This report presents two cases of full pulpotomy using BiodentineTM in mature permanent teeth with irreversible pulpitis and acute apical periodontitis. The periapical radiograph illustrated a deep carious lesion extended to the pulp with apical radiolucency lesion or widened periodontal ligament space. Full pulpotomy with a tricalcium silicate-based cement was chosen as the definitive treatment. After decayed tissue excavation under a rubber dam, the exposed pulp tissue was amputated to the level of the canal orifice with a new sterile bur. BiodentineTM was applied as the pulp capping agent after hemostasis was obtained and for temporary restoration. The clinical signs disappeared quickly after the treatment. After one month, the coronal part of the temporary restoration was removed, and a composite resin was placed over the capping agent as a final restoration. At two-year follow-ups, the teeth were asymptomatic. Radiographs showed healing of the periapical lesion and periodontal ligament. BiodentineTM full pulpotomy of mature permanent teeth with irreversible pulpitis and apical periodontitis can be an alternative option to root canal therapy.

scholarly journals Prevalence evaluation of apical periodontitis and its relationship with endodontic and restorative treatment in a community in Southern Brazil

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Julia Machado Saporiti ◽  
Andressa Gomes ◽  
Melissa Feres Damian ◽  
Nadia De Souza Ferreira
Keyword(s):  
Root Canal ◽  
Apical Periodontitis ◽  
Endodontic Treatment ◽  
Endodontically Treated Teeth ◽  
Chi Square ◽  
Root Canal Filling ◽  
Restorative Treatment ◽  
Anterior Teeth ◽  
Chi Square Test

Objective: The aim of this study was evaluate radiographically prevalence of apical periodontitis (AP) in endodontically treated teeth (ETT) and relate with demographic factors, quality of endodontic treatment and coronal restoration. Material and methods: Data were collected from dental records wich contained full-mouth radiographic series. In ETT, arch, dental group and presence of AP were evaluated. Quality of root canal filling, presence and quality of coronal restoration and type of restorative material were also collected. Data were evaluated using descriptive statistics and Chi-square Test. Results: Of 70 patients included in the final sample, the majority were female (54.3%) and age ranged from 13 to 77 years (47.14 ± 13.18). Of 1,333 teeth evaluated, 73 (5.4%) had endodontic treatment, being the majority maxillary (74%) and anterior teeth (52.1%). Of teeth without endodontic treatment, 320 (25.4%) had AP. Failure rate was high (52.8%) and quality of root canal filling and coronal restoration were considered inadequate in majority cases (58.3% and 47.7%, respectively). Dental group had a statistically significant relationship with presence of AP in ETT, being more frequent in anterior teeth (p = 0.019). Conclusion: It was concluded that prevalence of AP in ETT was high and dental group was the factor that most influenced prevalence of AP in ETT.KeywordsApical periodontitis; Radiography; Root canal filling.

scholarly journals Healing of a tooth with an overinstrumented apex, extensive transportation and periapical lesion using a 5 mm calcium hydroxide apical plug: an 8-year follow-up report

2012 ◽  
Vol 23 (5) ◽  
pp. 608-611
Author(s):  
Ronaldo Araújo Souza ◽  
Yara T. Corrêa Silva-Sousa ◽  
Suely Colombo ◽  
Maurício Lago ◽  
Marco Antonio Hungaro Duarte ◽  
...  
Keyword(s):  
Calcium Hydroxide ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Filling Material ◽  
Root Canal Filling ◽  
Apical Constriction ◽  
Gutta Percha ◽  
Open Apices ◽  
Canal Transportation

Besides the risk of filling material extrusion throughout the apex, a satisfactory apical seal can be difficult to achieve in canals with open apices or iatrogenic enlargements of the apical constriction. These situations pose a challenge to root canal filling. This paper describes the root canal filling of a maxillary right canine with an overinstrumented apex, complete loss of the apical stop, extensive canal transportation and apical periodontitis. A 5 mm calcium hydroxide apical plug was placed before root canal filling. The plug was made by soaking paper points with saline, dipping the points in calcium hydroxide powder and then applying it to the apex several times, until a consistent apical plug was obtained. The canal was then irrigated with saline in order to remove any residual calcium hydroxide from the root canal walls, dried with paper points and obturated with an inverted #80 gutta-percha cone and zinc oxide-eugenol based sealer by the lateral condensation technique. An 8-year radiographic follow-up showed formation of mineralized tissue sealing the apical foramen, apical remodeling and no signs of apical periodontitis.

scholarly journals Effects of Contemporary Irrigant Activation Schemes and Subsequent Placement of an Interim Dressing on Bacterial Presence and Activity in Root Canals Associated with Asymptomatic Apical Periodontitis

2020 ◽  
Vol 9 (3) ◽  
pp. 854 ◽  
Author(s):  
Alexandre P. L. Carvalho ◽  
Laura C. L. Nardello ◽  
Fernanda S. Fernandes ◽  
Fernanda P. Bruno ◽  
Luiza R. Paz ◽  
...  
Keyword(s):  
Calcium Hydroxide ◽  
Root Canal ◽  
Quantitative Polymerase Chain Reaction ◽  
Apical Periodontitis ◽  
Universal Primers ◽  
Rrna Gene ◽  
Root Canal Preparation ◽  
Root Canals ◽  
Mechanical Preparation ◽  
Root Canal Disinfection

New tools for activating endodontic irrigants have evolved, yet their impact on root canal disinfection, in comparison to the passive placing of an inter-visit medication, have not yet been fully elucidated. The use of DNA- and rRNA-based methods may cast some new light on this issue, as they allow a comparison to be made between microbial presence and activity. Therefore, the aim of this single-arm intervention trial is to evaluate the antibacterial effect of endodontic procedures using both molecular methods. Root canal samples were obtained from 20 patients with asymptomatic apical periodontitis after each treatment step: access cavity, chemo-mechanical preparation, adjunctive procedures (XP-endo Finisher file and passive ultrasonic irrigation), calcium hydroxide medication, and 2nd-visit root canal preparation. DNA and cDNA from the samples were subjected to quantitative polymerase chain reaction with universal primers for the bacterial 16S rRNA gene. Chemo-mechanical preparation promoted a drastic reduction in bacterial levels and activity, whereas the adjunctive procedures did not make a significant contribution to further disinfection. At the 2nd visit, bacteria were active after the use of calcium hydroxide medication; however, they were significantly reduced after a 2nd-visit preparation. Consequently, the lowest bacterial levels were found at the end of the treatment. This clinical trial, which used an rRNA and rDNA combined approach, confirmed previous studies showing that root canal preparation represents the main strategy for root canal disinfection.

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