Endodontic Microbial Communities in Apical Periodontitis

Buonavoglia, Alessio; Zamparini, Fausto; Lanave, Gianvito; Pellegrini, Francesco; Diakoudi, Georgia; Spinelli, Andrea; Lucente, Maria Stella; Camero, Michele; Vasinioti, Violetta Iris; Gandolfi, Maria Giovanna; Martella, Vito; Prati, Carlo

doi:10.1016/j.joen.2022.11.015

Cited by 17 publications

(7 citation statements)

References 56 publications

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“…Preoperative tooth condition and a different initial diagnosis may influence root canal treatment healing (as reported in the multilevel analysis in Table 5 ). A long healing time increases the risks of apical reinfection in teeth affected by pulp necrosis or periapical abscesses [ 74 , 75 , 76 ], due to the presence of highly pathogenic Gram-negative anaerobic bacteria (as Porphyromonas Gingivalis, Tannerella Forsithia, Prevotella Intermedia ) found in several clinical studies [ 76 , 77 ].…”

Section: Discussionmentioning

confidence: 99%

The Use of Premixed Calcium Silicate Bioceramic Sealer with Warm Carrier-Based Technique: A 2-Year Study for Patients Treated in a Master Program

Zamparini

Spinelli

Cardinali

et al. 2023

JFB

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Background: Recently several calcium silicate flowable sealers have been introduced as endodontic materials for the root canal. This clinical study tested the use of a new premixed calcium silicate bioceramic sealer in association with the Thermafil warm carrier-based technique (TF). Epoxy-resin-based sealer with the warm carrier-based technique was the control group. Methodology: Healthy consecutive patients (n = 85) requiring 94 root canal treatments were enrolled in this study and assigned to one filling group (Ceraseal-TF n = 47, AH Plus-TF n = 47) in accordance with operator training and best clinical practice. Periapical X-rays were taken preoperatively, after root canal filling and after 6, 12 and 24 months. Two evaluators blindly assessed the periapical index (PAI) and sealer extrusion in the groups (k = 0.90). Healing rate and survival rate were also evaluated. Chi-square tests was used to analyze significant differences between the groups. Multilevel analysis was performed to evaluate the factors associated with healing status. Results: A total of 89 root canal treatments in 82 patients were analyzed at the end-line (24 months). The total drop-out was 3.6% (3 patients; 5 teeth). A total of 91.1% of healed teeth (PAI 1-2) was observed in Ceraseal-TF, with 88.6% in AH Plus-TF. No significant difference was observed on healing outcome and survival among the two filling groups (p > 0.05). Apical extrusion of the sealers occurred in 17 cases (19.0%). Of these, 6 occurred in Ceraseal-TF (13.3%) and 11 in AH Plus-TF (25.0%). Three Ceraseal extrusions were radiographically undetectable after 24 months. All the AH Plus extrusions did not change during the evaluation time. Conclusions: The combined use of the carrier-based technique and premixed CaSi-based bioceramic sealer showed clinical results comparable with carrier-based technique and epoxy-resin-based sealer. The radiographical disappearance of apically extruded Ceraseal is a possible event in the first 24 months.

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Section: Discussionmentioning

confidence: 99%

The Use of Premixed Calcium Silicate Bioceramic Sealer with Warm Carrier-Based Technique: A 2-Year Study for Patients Treated in a Master Program

Zamparini

Spinelli

Cardinali

et al. 2023

JFB

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“…Several bacteria can participate these diseases, including those from the phyla Firmicutes, Actinomycetes, Fusobacteria, Spirochaetes, and Bacteroides ( Siqueira & Roca., 2022 ). Culture and identification techniques have shown that Firmicutes and Bacteroides are closely associated with the development of irreversible pulpitis and periapical periodontitis ( Rôças et al, 2016 ; Sánchez-Sanhueza et al, 2018 ; de Brito et al, 2020 ; Zahran et al, 2021 ; Buonavoglia et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Single-cell atlas of dental pulp stem cells exposed to the oral bacteria Porphyromonas gingivalis and Enterococcus faecalis

Zhang

et al. 2023

Front. Cell Dev. Biol.

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Introduction:Porphyromonas gingivalis and Enterococcus faecalis promote the development of pulpitis and periapical periodontitis. These bacteria are difficult to eliminate from the root canal systems, leading to persistent infection and poor treatment outcomes. We explored the response of human dental pulp stem cells (hDPSCs) to bacterial invasion and the mechanisms underlying the impact of residual bacteria on dental pulp regeneration.Methods: Single-cell sequencing was used to categorize the hDPSCs into clusters based on their response to P. gingivalis and E. faecalis. We depicted a single-cell transcriptome atlas of hDPSCs stimulated by P. gingivalis or E. faecalis.Results: The most differentially expressed genes in the Pg samples were THBS1, COL1A2, CRIM1, and STC1, which are related to matrix formation and mineralization, and HILPDA and PLIN2, which are related to the cellular response to hypoxia. A cell cluster characterized by high expression levels of THBS1 and PTGS2 was increased after P. gingivalis stimulation. Further signaling pathway analysis showed that hDPSCs prevented P. gingivalis infection by regulating the TGF-β/SMAD, NF-κB, and MAPK/ERK signaling pathways. Differentiation potency and pseudotime trajectory analyses showed that hDPSCs infected by P. gingivalis undergo multidirectional differentiation, particularly to the mineralization-related cell lineage. Furthermore, P. gingivalis can create a hypoxia environment to effect cell differentiation. The Ef samples were characterized by the expression of CCL2, which is related to leukocyte chemotaxis, and ACTA2, which is related to actin. There was an increased proportion of a cell cluster that was similar to myofibroblasts and exhibited significant ACTA2 expression. The presence of E. faecalis promoted the differentiation of hDPSCs into fibroblast-like cells, which highlights the role of fibroblast-like cells and myofibroblasts in tissue repair.Discussion: hDPSCs do not maintain their stem cell status in the presence of P. gingivalis and E. faecalis. They differentiate into mineralization-related cells in the presence of P. gingivalis and into fibroblast-like cells in the presence of E. faecalis. We identified the mechanism underlying the infection of hDPSCs by P. gingivalis and E. faecalis. Our results will improve understanding of the pathogenesis of pulpitis and periapical periodontitis. Furthermore, the presence of residual bacteria can have adverse effects on the outcomes of regenerative endodontic treatment.

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“…Pontoriero et al compared four different types of bioceramic sealer and reported that the presence of post-operative pain was not affected by the extrusion of the sealer [24]. Other conditions may affect the persistence of pain after endodontic therapy, and the presence of specific microbiota (and an elevated number of pathogens) may alter the healing steps [47].…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of a Novel Premixed Tricalcium Silicate Containing Bioceramic Sealer Used with Warm Carrier-Based Technique: A 12-Month Prospective Pilot Study

Spinelli,

Zamparini,

Lenzi

et al. 2023

Applied Sciences

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Background: This pilot prospective study analysed the clinical use of a new bioceramic premixed CaSi-containing sealer in association with a warm carrier-based technique. Methodology: Healthy patients (n = 38) requiring 40 root canal treatments were enrolled. Periapical X-rays were taken preoperatively, after root canal filling and after 1, 6, and 12 months. Two evaluators assessed the Periapical Index (PAI) and the sealer extrusion. The healing rate and survival rate were also evaluated. Barnard test was used to assess the relationship of each potential prognostic factor with periapical index (PAI) at 12-month follow-up. The significance level was set at 0.05. Results: Root canal treatments (n = 38) were analysed at the end-line (12 months). The total drop-out was 5% (two patients; two teeth). A total of 31 teeth (82%) (PAI 1-2) showed complete healing, while 7 (18%) are still healing. Cumulative survival was 100%. Apical extrusion of the sealers was observed in 18 cases (47%). Of these extrusions, nine (50%) resulted radiographically undetectable after 12 months. Conclusions: The study supports the use of premixed CaSi-based bioceramic sealers in association with carrier-based techniques. Periapical extrusion of the sealer and its radiographic modification or disappearance are possible events reported in the first 12 months.

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Endodontic Microbial Communities in Apical Periodontitis

Cited by 17 publications

References 56 publications

The Use of Premixed Calcium Silicate Bioceramic Sealer with Warm Carrier-Based Technique: A 2-Year Study for Patients Treated in a Master Program

The Use of Premixed Calcium Silicate Bioceramic Sealer with Warm Carrier-Based Technique: A 2-Year Study for Patients Treated in a Master Program

Single-cell atlas of dental pulp stem cells exposed to the oral bacteria Porphyromonas gingivalis and Enterococcus faecalis

Clinical Evaluation of a Novel Premixed Tricalcium Silicate Containing Bioceramic Sealer Used with Warm Carrier-Based Technique: A 12-Month Prospective Pilot Study

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