Prevalence of Bacteria of Genus Actinomyces in Persistent Extraradicular Lesions—Systematic Review

Abstract

Actinomyces are anaerobic, rod-shaped, Gram-positive bacteria. They are associated with persistent extraradicular endodontic infections, with possible involvement of the soft tissues of the maxillofacial district. Many studies reported conflicting data on the presence of bacteria of the genus Actinomyces in endodontic infections. The aim of this systematic review of the literature was to determine the real prevalence of such bacteria in primary and/or secondary endodontic infections and in cases of persistence with extraradicular involvement. This systematic review was performed according to the PRISMA protocol. A search was carried out through the Scopus and PubMed databases of potentially eligible articles through the use of appropriate keywords. The literature research resulted in preliminary 2240 records which, after the elimination of overlaps and the application of inclusion and exclusion criteria, led to the inclusion of 46 articles focusing on three outcomes (primary outcome: number of teeth with the presence of a persistent extraradicular infection in which the presence of Actinomyces was ascertained; secondary outcome: number of teeth with endodontic infection in which the presence of Actinomyces was assessed; tertiary outcome: difference in the prevalence of bacteria of the genus Actinomyces between primary endodontic infections and secondary endodontic infections). Results of the meta-analysis show how bacteria of the genus Actinomyces are present in primary and secondary intraradicular infections and in those with persistence with a prevalence (ratio between teeth with actinomyces and teeth with infection) ranging from 0.091 up to 0.130 depending on the subgroups analyzed.

Pathological and Therapeutic Approach to Endotoxin-Secreting Bacteria Involved in Periodontal Disease

“…These optional anaerobic Gram-positive bacteria are very often associated with caries, primary and secondary endodontic infection, as well as with a progression of tooth decay [ 126 ]. Evidence places these microorganisms among the main responsible of persistent extraradicular infections, complicated endodontic treatments and periapical lesions in the presence or not of root canal restorations, as was concluded by Dioguardi et al (2020) [ 82 ], in a systematic review that provided data on the prevalence of the Actinomyces in persistent root lesions. It is also mentioned that infection can occur via mucosal lesions, endodontic pathways and periodontal disease.…”

“…The colonization of endodontic or periodontal tissues by microorganisms in carious, periodontal, and traumatic lesions leads to persistent infections such as dental pulpitis, dental necrosis, periodontitis and endo-perio lesions, among others [ 82 ]. Local infections of the oral cavity have been related to systemic conditions.…”

Microbial Association with Genus Actinomyces in Primary and Secondary Endodontic Lesions, Review

“…The following review was performed on the basis of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) [25] indications. The methodology has already been adopted in other systematic reviews on the topic (Actinomyces and Propionibacterium) by the same authors [26][27][28].…”

“…The risk of bias was assessed using the Newcastle-Ottawa case-control scale, modified by the authors to adapt it to microbiological studies, as already done in previous systematic reviews with meta-analyses [26,27]. The results are reported in detail in Table 7.…”

Clinical outcome of bonded partial indirect posterior restorations on vital and non-vital teeth: a systematic review and meta-analysis

“…The risk of bias was assessed through the Newcastle-Ottawa Case-Control Scale, modified by the authors, as demonstrated in previous systematic reviews with meta-analysis [41,42]. The results are reported in Table 3.…”