Microbiological status of root‐filled teeth with apical periodontitis

TLDR

The study examined the microbiological status of 100 root‑filled teeth with apical periodontitis and 20 teeth without periapical pathology. In the apical periodontitis group, 117 bacterial strains were isolated from 68 teeth, predominantly facultative anaerobes (69%) with 53% showing sparse growth and 42% heavy growth, and Enterococci were most frequent (78% heavy growth); in the technical group, 9 of 20 teeth yielded 13 strains, mostly very sparse, leading to the conclusion that the canal microflora differs from untreated necrotic pulp and that nonsurgical retreatment strategies should be reconsidered.

Abstract

The present study examined the microbiological status of 100 root‐filled teeth with radiographically verified apical periodontitis — the pathology (P) group — and of 20 teeth without signs of periapical pathosis — the technical (T) group. In the P group 117 strains of bacteria were recovered in 68 teeth. In most of the cases examined one or two strains were found. Facultative anaerobic species predominated among these isolates (69% of identified strains). Growth was classified as ‘sparse’ or ‘very sparse’ in 53%, and as ‘heavy’ or ‘very heavy’ in 42%. Enterococci were the most frequently isolated genera, showing ‘heavy’ or ‘very heavy’ growth in 25 out of 32 cases (78%). In 11 teeth of the T group no bacteria were recovered, whilst the remairling nine yielded 13 microbial strains. Eight of these grew ‘very sparsely’. It is concluded that the microflora of the obturated canal differs from that found normally in the untreated necrotic dental pulp, quantitatively as well as qualitatively. Nonsurgical retreatment strategies should be reconsidered.