Yeasts in Apical Periodontitis

Abstract

Microbiological reports of apical periodontitis have revealed that yeasts can be isolated from approximately 5-20% of infected root canals. They occur either in pure cultures or together with bacteria. Almost all isolated yeasts belong to the genus Candida, and the predominant species is C. albicans. Pheno- and genotypic profiles of C. albicans isolates show heterogeneity comparable with those of isolates from other oral sites. C. albicans expresses several virulence factors that are capable of infecting the dentin-pulp complex, including dentinal tubules. This causes, consequentially, an inflammatory response around the root apex, which suggests a pathogenic role for this organism in apical periodontitis. Yeasts are particularly associated with persistent root canal infections that do not respond favorably to conservative root canal therapy. This may be due to the resistance of all oral Candida species against a commonly used topical medicament, calcium hydroxide. However, other antimicrobial agents may offer alternative therapeutic approaches and improve the treatment of these persistent cases of apical periodontitis.

Enrichment of Multilocus Sequence Typing Clade 1 with Oral Candida albicans Isolates in Patients with Untreated Periodontitis

“…In normal healthy gingivae, the free gingival margin and the tooth surface are in close proximity to each other, leaving very little space for microbial colonization (13). Periodontitis is an infection of the oral gingival tissue that is caused by a combination of microorganisms commonly found in dental plaque, such as streptococci, staphylococci, fusobacteria, Porphyromonas species, Campylobacter species, actinobacteria, and many others (30,37). As periodontitis manifests, the gingival margin becomes enlarged, causing the gingival tissue to detach from the tooth, resulting in the formation of periodontal pockets.…”

“…Candida species have been isolated from 40 to 60% of healthy mouths (29), although they are rarely found in subgingival sites in patients with good oral health (35). Candida species have frequently been isolated from periodontal pockets; however, their role, if any, in the etiology of periodontitis remains to be elucidated (5,8,27,30,35,37). Several previous studies investigated the prevalence and possible role of Candida species in periodontitis, all of which identified C. albicans as the Candida species most frequently isolated from periodontal pockets (3,9,19,20,31,35).…”

Novel anti-infective implant substrates: Controlled release of antibiofilm compounds from mesoporous silica-containing macroporous titanium

“…It has reported activity against the formation of biofilms of human pathogenic yeasts like Candida albicans [30,31] and bacterial pathogens like Pseudomonas aeruginosa, Escherichia coli, Staphylococcus epidermidis, Staphylococcus aureus [31] and Porphyromonas gingivalis (Jan Michiels, unpublished data), which was recently confirmed in vivo for C. albicans and S. aureus [31]. All these pathogenic species are known to form biofilms on medical devices and implants [32][33][34][35][36][37].…”

Root Canal Infection and Endodontic Apical Disease

“…Their article identifies multiple virulence factors of Candida that allow it to infect the dentin-pulp complex and penetrate the dentinal tubules causing an inflammatory reaction and suggesting a pathogenic role of this organism in apical periodontitis (30).…”