Microorganisms are able to survive and cause persistent infection in the extraradicular area. The aims of this study were to investigate the primary bacterial flora and the localization of extraradicular biofilm in persistent apical periodontitis lesions.
Apical root samples from root-end surgery were collected from 23 root-filled teeth with apical periodontitis. Five samples were examined for the presence of biofilm by scanning electron microscopy. Another 5 samples were examined for the presence of biofilm by Brown and Brenn–modified Gram staining. The DNA from 13 samples was processed for amplification via polymerase chain reaction and separated with denaturing gradient gel electrophoresis. Selected bands were excised from the gel and sequenced for identification.
The extraradicular biofilm present on the external root surface of treated teeth consisted of abundant, amorphous extracellular material and multiple bacterial species. The following species were detected in the microbial community from the apical samples: Actinomyces sp. oral, Propionibacterium, Prevotella sp. oral, Streptococcus, Porphyromonas endodontalis, and Burkholderia. The prevalence of Actinomyces sp. oral and Propionibacterium were highest (84.6% and 61.5%, respectively).
Extraradicular biofilm was present on the external root surface of treated teeth with persistent periapical lesions. Actinomyces sp. oral and Propionibacterium are likely important contributors to extraradicular biofilm formation and persistent periapical infection.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Endodontics
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Pathogenesis of apical periodontitis and the causes of endodontic failures.Crit Rev Oral Biol Med. 2004; 15: 348-381
- Apical root canal microbiota as determined by reverse-capture checkerboard analysis of cryogenically ground root samples from teeth with apical periodontitis.J Endod. 2010; 36: 1617-1621
- Participation of bacterial biofilms in refractory and chronic periapical periodontitis.J Endod. 2002; 28: 679-683
- Bacterial biofilms: a common cause of persistent infections.Science. 1999; 284: 1318-1322
- On the causes of persistent apical periodontitis: a review.Int Endod J. 2006; 39: 249-281
- Update on endodontic microbiology: candidate pathogens and patterns of colonisation.ENDO (Lond Engl). 2008; 2: 7-20
- Characterization of bacterial flora in persistent apical periodontitis lesions.Oral Microbiol Immunol. 2009; 24: 502-505
- Localization of Porphyromonas gingivalis-carrying fimbriae in situ in human periodontal pockets.J Dent Res. 2004; 83: 941-945
- Bacterial strategies for overcoming host innate and adaptive immune responses.Nat Immunol. 2002; 3: 1033-1040
- New bacterial compositions in root-filled teeth with periradicular lesions.J Endod. 2009; 35: 169-174
- Refractory apical periodontitis associated with a calculus-like deposit at the root apex.J Dent Sci. 2010; 5: 109-113
- Surgical endodontic treatment of refractory periapical periodontitis with extraradicular biofilm.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110: e40-e44
- Identification and localization of extraradicular biofilm-forming bacteria associated with refractory endodontic pathogens.Appl Environ Microbiol. 2005; 71: 8738-8743
- Scanning electron microscopy of bacteria in the apical part of root canals in permanent teeth with periapical lesions.Endod Dent Traumatol. 1991; 7: 226-229
- Persistent extraradicular infection in root-filled asymptomatic human tooth: scanning electron microscopic analysis and microbial investigation after apical microsurgery.J Endod. 2011; 37: 1696-1700
- EM evaluation of bacterial biofilm and microorganisms on the apical external root surface of human teeth.J Endod. 2002; 28: 815-818
- Identification of dominant pathogens in periapical lesions associated with persistent apical periodontitis.Chin J Dent Res. 2010; 13: 115-121
- Molecular characterization of the microbial flora residing at the apical portion of infected root canals of human teeth.J Endod. 2011; 37: 1359-1364
- Immunocytochemical demonstration of Actinomyces species and Arachnia propionica in periapical infections.J Oral Pathol. 1985; 14: 405-413
- Periapical actinomycosis involving Actinomyces israelii.J Endod. 1988; 14: 147-149
- Survival of Arachnia propionica in periapical tissue.Int Endod J. 1988; 21: 277-282
- Microbiota of periapical lesions refractory to endodontic therapy.J Endod. 2002; 28: 304-310
- Cell surface structures of Actinomyces israelii.Aust Dent J. 1997; 42: 125-128
- Pathogenicity of Actinomyces israelii and Arachnia propionica: experimental infection in guinea pigs and phagocytosis and intracellular killing by human polymorphonuclear leukocytes in vitro.Oral Microbiol Immunol. 1992; 7: 129-136
- Pyrosequencing analysis of the apical root canal microbiota.J Endod. 2011; 37: 1499-1503
Published online: April 23, 2012
© 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.