The present study analyzes the composition of the endodontic microbial flora in teeth affected by nontreated chronic apical periodontites, as well as in teeth subjected to unsuccessful conservative endodontic treatments.
Materials and method: The content of 20 radicular canals belonging to teeth with chronic apical periodontitis subjected to no previous endodontic treatment, and of 20 obturated canals of teeth subjected to unsuccessful 1-5 year-old conservative endodontic treatment (the teeth having to be surgically treated, as well) was microbiologically analyzed.
Results: The microbial flora collected from the analyzed samples included: Gram negative bacili (BGN); Gram positive bacili (BGP); Gram negative cocci (CGN); Gram positive cocci (CGP). In most samples (10 cases, 50%), only one microorganism was found. Two microbial species were identified in 3 cases (15%); in 5 radicular canals (25%) – bacterial associations were determined, and in 2 samples (10%) no cultured microorganisms could be observed. In the radicular canals previously endodontically-treated and obturated, the most frequently occurring was Enterococcus faecalis (11 samples, out of which, in 6 cases, as the only cultured microorganism). The value of the correlation coefficient, r=0.914832, indicates the close association between the presence of microorganisms in the radicular canals and the failure of the conservative therapy.
Conclusions: The endodontic treatment of chronic apical periodontites necessarily requires destruction of the microorganisms in the radicular canals. Identification of bacteria in the infected canals and adjacent areas, as well as checking on the sterilization of the endodontic space prior to obturation, might improve the long-term success of the conservative treatment of chronic apical periodontites.
- chronic apical periodontites
- microbiological analysis
- radicular canals