On the dynamics of root canal infections—what we understand and what we don't

Zehnder, Matthias; Belibasakis, Georgios N.

doi:10.4161/21505594.2014.984567

Cited by 56 publications

(53 citation statements)

References 86 publications

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“…Apical periodontitis is the inflammatory reaction to the presence of micro-organisms in the pulpless root canal space (Bergenholtz, 1974). These infections can take an acute course or remain clinically silent (Zehnder & Belibasakis, 2015). Studies have revealed the presence of a wide variety of bacterial species in infected root canals (Siqueira & Rocas, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Studies have revealed the presence of a wide variety of bacterial species in infected root canals (Siqueira & Rocas, 2009). Reports on the presence or absence of certain taxa under different clinical conditions are plentiful, but certain core aspects of root canal infections remain elusive (Zehnder & Belibasakis, 2015). There appear to be two reasons for this.…”

Section: Introductionmentioning

confidence: 99%

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FISHing for gutta‐percha‐adhered biofilms in purulent post‐treatment apical periodontitis

Zehnder

Rechenberg

Thurnheer

et al. 2016

Molecular Oral Microbiology

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This study investigated the possibility of depicting individual taxa in clinically relevant biofilms using fluorescent in situ hybridization (FISH). Gutta-percha samples were collected from the apical aspect of root canals associated with a chronic apical abscess (test samples, n = 8). Corresponding control samples were obtained from previously filled root canals with apparently normal periapical tissues (n = 3). The transport medium was investigated for detached biofilm fragments using FISH staining and conventional epifluorescence microscopy. Gutta-percha samples were stained by multiplex FISH, and inspected using confocal laser scanning microscopy. FISH of the transport medium confirmed the presence of the main species formerly identified by conventional methods in post-treatment purulent endodontic infections, most prominently Fusobacterium spp., Bacteroidetes and Prevotellaceae. Treponemes were identified in five of eight cases associated with purulent infections, but Enterococcus faecalis and Staphylococcus spp. were not identified. The biofilms on gutta-percha from root canals associated with apical periodontitis showed dense aggregates of variable composition. Control samples contained few, if any, bacteria in the transport medium, and featured no biofilms on the respective gutta-percha specimens. The current study revealed some direct, visual in situ information on the nature of biofilms associated with purulent periapical infections in man.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

FISHing for gutta‐percha‐adhered biofilms in purulent post‐treatment apical periodontitis

Zehnder

Rechenberg

Thurnheer

et al. 2016

Molecular Oral Microbiology

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“…However, chronic or acute infections may occur when microorganisms are present at the periapex. [4041] The usage of human saliva is advantageous because it highly simulates the clinical setting. However, it cannot simulate the alterations in the oral environment such as thermal changes or the effect of dietary regimen on the salivary flow.…”

Section: Introductionmentioning

confidence: 99%

In vitro and ex vivo microbial leakage assessment in endodontics: A literature review

Savadkouhi

Bakhtiar

Ardestani

2016

J Int Soc Prevent Communit Dent

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The aim of this study was to perform a literature review of published in-vitro and ex-vivo studies, which evaluated microbial leakage in endodontics in the past 10 years. A comprehensive electronic literature search was carried out in PubMed database for English articles published from 2005 to 2016 using the keywords “endodontics,” “in vitro,” “ex vivo,” “microbial leakage,” “microbial penetration,” “saliva,” “Enterococcus faecalis,” “E. faecalis,” “endodontic sealers,” “temporary filling material,” “apical plug,” “mineral trioxide aggregate,” and “MTA.” The keywords were combined using Boolean operators AND/OR. Based on our search strategy, 33 relevant articles were included in the study. There are three main methods for assessment of bacterial microleakage, namely, (A) the dual-chamber leakage model, (B) detection of bacteria using a scanning electron microscope (SEM), and (C) polymerase chain reaction. All bacterial leakage models have some limitations and may yield different results compared to other microleakage evaluation techniques (i.e., dye penetration, fluid filtration, or electrochemical tests). The results of SEM correlated with those of microbial leakage test in most studies. Microbial leakage test using saliva better simulates the clinical setting for assessment of the leakage of single or mixed bacterial species.

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“…After a patient receives RCT, it can be difficult to thoroughly gauge the level of debridement achieved in the post-treatment setting, unless an obvious clinical event such as infection or persistent discomfort brings the patient back to the treating clinician [21]. In the clinical scenarios described herein, we report on a unique presentation of odontogenic therapies in human subjects, where there was immediate evaluation of the efficacy of treatments through ex vivo analyses of the treated teeth.…”

Section: Citationmentioning

confidence: 99%

Ex Vivo Scanning Electron Microscopy Evaluation of Cleaning Efficacy Following In Vivo Endodontic Treatment: A Report of 2 Cases

DiVito¹,

Rassoulian²

2017

Dentistry

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In endodontic therapy, thorough cleaning of the root canal system which results in the complete or near elimination of diseased or necrotic pulp tissue and resident microorganisms is the most critical factor in ensuring a favorable outcome. Removal of both debris and the smear layer from the canals is important, since organic matter from these materials may promote bacterial growth and inhibit obturation materials from having proper contact with the canal wall. This report of two cases is the first known presentation of teeth receiving in vivo treatment and then analyzed post extraction via ex vivo scanning electron microscopy (SEM).The two cases describe patients with similar clinical presentation and diagnoses who required single-tooth extractions. The treating clinician provided in vivo chairside endodontic therapy using two different available treatment modalities: standard root canal treatment and the GentleWave® Procedure. The teeth were then extracted and underwent ex vivo SEM analyses as part of an ongoing clinical study. Similarities and differences in the level of debridement in the root canal systems were observed between the two cases, with greater reduction in accumulated debris and smear layer scores present in the tooth treated with the GentleWave Procedure. Further research is ongoing to provide additional evidence-based data regarding outcomes related to the cleaning efficacy of different endodontic therapies.

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On the dynamics of root canal infections—what we understand and what we don't

Cited by 56 publications

References 86 publications

FISHing for gutta‐percha‐adhered biofilms in purulent post‐treatment apical periodontitis

FISHing for gutta‐percha‐adhered biofilms in purulent post‐treatment apical periodontitis

In vitro and ex vivo microbial leakage assessment in endodontics: A literature review

Ex Vivo Scanning Electron Microscopy Evaluation of Cleaning Efficacy Following In Vivo Endodontic Treatment: A Report of 2 Cases

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