Impact of bacteriological testing using an anaerobic culture system on the success of nonsurgical endodontic treatment: a retrospective study.

Abstract

Objectives: Residual bacteria at the time of root canal obturation significantly influence endodontic treatment outcomes in teeth with apical periodontitis, and confirmation of bacterial elimination from the root canal prior to obturation may improve long-term prognosis. However, the contribution of root canal bacterial culture to treatment outcomes in teeth with infected root canals is debated. This study aimed to retrospectively evaluate treatment outcomes in cases in which root canal obturation was performed after confirming negative bacteriological test results.

Methods: The medical records of patients with apical periodontitis or pulp necrosis in whom root canal obturation was performed after confirming a negative bacteriological test result using an anaerobic culture system at the Department of Endodontics and Operative Dentistry at Hiroshima University Hospital between April 1, 2015, and September 30, 2023, were retrospectively reviewed. Treatment outcomes were assessed by comparing dental radiographs obtained before treatment with those obtained during the follow-up, ranging from 3 to 24 months after root canal obturation.

Results: This retrospective study included 284 teeth from 218 patients, and the success rate was 89.1%. Tooth type, number of root canals, type of treatment, preoperative radiolucency around the root apex, preoperative root canal obturation material, dentist experience, and postoperative extent of root canal obturation material did not significantly affect treatment outcomes.

Conclusions: The findings of this retrospective study suggest that infection control incorporating bacteriological examination of root canals using an anaerobic culture system may contribute to a high success rate of nonsurgical endodontic treatment, regardless of other prognostic factors.