Basic Research
New Bacterial Composition in Primary and Persistent/Secondary Endodontic Infections with Respect to Clinical and Radiographic Findings

https://doi.org/10.1016/j.joen.2013.10.005Get rights and content

Abstract

Introduction

The aim of the present study was to analyze the microbiota of primary and secondary/persistent endodontic infections of patients undergoing endodontic treatment with respect to clinical and radiographic findings.

Methods

Samples from the root canals of 21 German patients were taken using 3 sequential sterile paper points. In the case of a root canal filling, gutta-percha was removed with sterile files, and samples were taken using sterile paper points. The samples were plated, and microorganisms were then isolated and identified morphologically by biochemical analysis and sequencing the 16S rRNA genes of isolated microorganisms.

Results

In 12 of 21 root canals, 33 different species could be isolated. Six (50%) of the cases with isolated microorganisms were primary, and 6 (50%) cases were endodontic infections associated with root-filled teeth. Twelve of the isolated species were facultative anaerobic and 21 obligate anaerobic. Monomicrobial infections were found for Enterococcus faecalis and Actinomyces viscosus. E. faecalis was most frequently isolated in secondary endodontic infections (33%). Moraxella osloensis was isolated from a secondary endodontic infection that had an insufficient root canal filling accompanied by a mild sensation of pain. A new bacterial composition compromising Atopobium rimae, Anaerococcus prevotii, Pseudoramibacter alactolyticus, Dialister invisus, and Fusobacterium nucleatum was recovered from teeth with chronic apical abscesses.

Conclusions

New bacterial combinations were found and correlated to clinical and radiographic findings, particularly to chronic apical abscesses. M. osloensis was detected in root canals for the second time and only in German patients.

Section snippets

Patient Selection

Twenty-one patients (25–75 years of age) who had been referred to the University of Freiburg–Medical Center, Freiburg, Germany, for endodontic treatment took part in this study. Patients were excluded from the study if they showed 1 of the following criteria: severe systemic diseases, pregnancy or lactation, use of any antibiotics within the past 30 days, participation in another clinical study during the previous 3 months, teeth that could not be isolated with a rubber dam, teeth without a

Results

In 12 of 21 root canals, 33 different bacterial species could be isolated (Table 2). Six (50%) of the cases with isolated microorganisms were associated with primary endodontic infections, and 6 (50%) with secondary/persistent endodontic infections. The CFUs ranged from 1 × 103 to 1.49 × 107 CFU/mL. The largest number of microorganisms was isolated from a tooth with a chronic apical abscess. In 2 of 6 cases with an intracanal dressing, either Ledermix or calcium hydroxide, microorganisms were

Discussion

Although there are many reports addressing the microbiota in endodontic infections up to now, only few studies described the bacterial prevalence in German patients 12, 13, 14, 15. Moreover, only few studies on the endodontic infections correlated with chronic apical abscesses have been published 15, 16, 17, 18. In the present clinical in vivo study, microorganisms were isolated from teeth with a primary or secondary/persistent endodontic infections, and the isolated microorganisms were

Acknowledgments

The authors thank Dr Annette Anderson for her assistance in reviewing the manuscript.

Supported by the German Research Foundation (DFG, AL 1179/1-1).

The authors deny any conflicts of interest related to this study.

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