Persistent, recurrent, and acquired infection of the root canal system post‐treatment

Abstract

Apical periodontitis is an inflammatory process in the periradicular tissues caused by microorganisms in the necrotic root canal. Accordingly, to achieve healing of apical periodontitis, the main goal of the treatment must be elimination of the infection and prevention of re‐infection. As shown by recent epidemiological studies in several countries around the world, post‐treatment endodontic disease is a far too common finding. To understand the reasons for survival of resistant bacteria in the filled root canal, it is important to know in detail the interaction between treatment procedures and the root canal flora in primary apical periodontitis. Therefore, in the first half of this review, the focus is placed on control of infection in primary apical periodontitis. This is followed by a detailed description of the resistant root canal microflora and a discussion about the present and future strategies to eliminate even the most resistant microbes in post‐treatment disease.

The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics

“…16 Both in vitro and in vivo observations show that bacterial penetration into dentinal tubules occurs as a random process, with bacterial colonies seen as sporadic, dense accumulations of cells (rather than as a continuous film), extending out from the main canal towards the periphery. 17 The reported frequency of dentinal tubule invasion in necrotic, infected teeth varies between 50 and 90 per cent. 17 When a root canal infection develops, the predentine is readily infected but the calcified dentine is less readily infected.…”

“…17 The reported frequency of dentinal tubule invasion in necrotic, infected teeth varies between 50 and 90 per cent. 17 When a root canal infection develops, the predentine is readily infected but the calcified dentine is less readily infected. Bacterial species that penetrate the dentine are dominated by Gram-positive rods (68 per cent) and cocci (27 per cent).…”

Microbiological analysis of absorbent paper points employed by undergraduate students from a dental school in south of Brazil

“…Then, all the endodontic procedures are addressed to create and maintain the aseptic conditions for root canal filling 1 . The persistence of microorganisms is closely linked to the failures of endodontic treatments, and it often occurs due to failures on the root canal preparation, use of instruments and/or materials contaminated and infiltration of bacteria through the saliva 2,3 .…”

Evaluation of Stability and Antibacterial Activity of Various Concentrations of Triple Antibiotic Paste against Enterococcus faecalis: An in vitro Study

“…4 Control of periapical infection is necessary to prevent the infection spreading into the underlying permanent tooth bud which lies in close proximity to the wide furcated roots of the deciduous teeth. 5 When failure of endodontic treatment occurs due to persistent bacterial infection in the root canal system, it is called as secondary infection. 6 The bacteria associated with periapical infection in primary teeth is polymicrobial in nature with a combination of Grampositive, Gram-negative aerobic and anaerobic organisms inhabiting the root canals, but studies have reported the maximum predominance of anaerobic microorganisms in the infected root canals.…”