Microbiological status of root canal after unsuccessful endodontic treatment

Jelena Neskovic, Milica Jovanovic-Medojevic, Đurica Grga, B. Popović, S. Živković
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Abstract

Summary Introduction The main objective of endodontic treatment is to eliminate infection from root canal and prevent reinfection by three-dimensional hermetic obturation of the canal system. Endodontic failure can occur due to inability of complete control and elimination of infection from the root canal. The aim of this study is to investigate, by PCR technique, microbiological status of previously endodontically unsuccessfully treated teeth immediately after the removal of obturation material. Material and Methods The analysis included 30 teeth indicated for endodontic retreatment. After removing previous root canal filling material, the bacteriological sample was taken by sterile instrument (# 15) and paper points. Standard PCR technique was used to analyze the incidence of E.faecalis, P.micros, P.intermedia, P. endodontalis and A.actinomycetemcomitans. Results Positive bacteriological findings were registered in 80% of cases, while bacteria were not identified in 20% of all samples (all taken from the root canals without significant changes in periapical tissue). From 24 canals with identified bacteria, 17 had affected apical periodontium. The most dominant microbe in root canals with positive bacteriological finding was E.faecalis (83.3% of the canals) and P.intermedia (75%). In case of teeth with chronic periapical changes, the most common was E. faecalis (94%) and P.intermedia (82.3%). Conclusion The presence of periapical lesions significantly affects microbiological status of endodontically treated teeth. The presence of bacteria was confirmed in most teeth with periapical lesions, while the most frequently identified bacteria were E. faecalis, P.intermedia and P.micros.
根管治疗不成功后根管微生物状况
根管治疗的主要目的是通过根管系统三维封闭,消除根管感染,防止再感染。由于无法完全控制和消除根管感染,可能会发生根管衰竭。本研究的目的是通过聚合酶链反应(PCR)技术来研究牙髓治疗失败的牙齿在移除封闭材料后的微生物状况。材料与方法选择30颗牙进行根管再治疗。除去之前的根管填充材料后,用无菌仪器(15号)和纸点进行细菌学取样。采用标准PCR技术分析粪e.f ecalis、微P.micros、中间p.m entmedia、牙髓p.m endotalis和放线菌a.m etcomitans的发病率。结果80%的病例细菌学检查呈阳性,而20%的样本未检出细菌(所有样本均取自根管,根尖周组织无明显变化)。24根根管中,17根根管感染根尖牙周组织。根管中细菌检出阳性的主要微生物为粪芽孢杆菌(占根管的83.3%)和中间芽孢杆菌(占根管的75%)。对于慢性根尖周病变的牙齿,最常见的是粪芽孢杆菌(94%)和中间芽孢杆菌(82.3%)。结论根尖周病变的存在显著影响根管治疗后牙齿的微生物状态。大多数根尖周病变的牙齿都有细菌存在,而最常见的细菌是粪肠杆菌、中间芽胞杆菌和微芽胞杆菌。
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