Highlights
- •This systematic review analyzed Treponema species in endodontic infection.
- •The type of infection and presence of symptoms implicates Treponema prevalence.
- •A specific approach focusing on Treponema species should be provided in therapy.
Abstract
Introduction
This systematic review and meta-regression analysis aimed to calculate a combined
prevalence estimate and evaluate the prevalence of different Treponema species in primary and secondary endodontic infections, including symptomatic and
asymptomatic cases.
Methods
The MEDLINE/PubMed, Embase, Scielo, Web of Knowledge, and Scopus databases were searched
without starting date restriction up to and including March 2014. Only reports in
English were included. The selected literature was reviewed by 2 authors and classified
as suitable or not to be included in this review. Lists were compared, and, in case
of disagreements, decisions were made after a discussion based on inclusion and exclusion
criteria. A pooled prevalence of Treponema species in endodontic infections was estimated. Additionally, a meta-regression analysis
was performed.
Results
Among the 265 articles identified in the initial search, only 51 were included in
the final analysis. The studies were classified into 2 different groups according
to the type of endodontic infection and whether it was an exclusively primary/secondary
study (n = 36) or a primary/secondary comparison (n = 15). The pooled prevalence of Treponema species was 41.5% (95% confidence interval, 35.9–47.0). In the multivariate model
of meta-regression analysis, primary endodontic infections (P < .001), acute apical abscess, symptomatic apical periodontitis (P < .001), and concomitant presence of 2 or more species (P = .028) explained the heterogeneity regarding the prevalence rates of Treponema species.
Conclusions
Our findings suggest that Treponema species are important pathogens involved in endodontic infections, particularly in
cases of primary and acute infections.
Key Words
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 accessOne-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 EndodonticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Periodontitis: a polymicrobial disruption of host homeostasis.Nat Rev Microbiol. 2010; 8: 481-490
- Microbiology and treatment of acute apical abscesses.Clin Microbiol Rev. 2013; 26: 255-273
- The breadth of bacterial diversity in the human periodontal pocket and other oral sites.Periodontol 2000. 2006; 42: 80-87
- Molecular signaling mechanisms of the periopathogen, Treponema denticola.J Dent Res. 2011; 90: 1155-1163
- Roles of oral bacteria in cardiovascular diseases–from molecular mechanisms to clinical cases: implication of periodontal diseases in development of systemic diseases.J Pharmacol Sci. 2010; 113: 103-109
- An introduction to the study of the bacterio-pathology of the dental pulp.Dent Cosmos. 1894; 36: 505-528
Dobell C. Antony Van Leeuwenhoek and His “Little Animals.” London: Staples Press Limited; 1932.
- Cultural studies on mouth spirochaetae (Treponema microdentium and macrodentium).J Exp Med. 1912; 15: 81-89
- Darkfield microscopy as a diagnostic aid in differentiating exudates from endodontic and periodontal abscesses.J Endod. 1988; 14: 35-38
- Bacteroides endodontalis and other black-pigmented Bacteroides species in odontogenic abscesses.Infect Immun. 1985; 49: 494-497
- Spirochetes at the forefront of periodontal infections.Periodontol 2000. 2005; 38: 13-32
- Clinical investigation of bacterial species and endotoxin in endodontic infection and evaluation of root canal content activity against macrophages by cytokine production.Clin Oral Investig. 2014; 18: 2095-2102
- Antigenic activity of bacterial endodontic contents from primary root canal infection with periapical lesions against macrophage in the release of interleukin-1beta and tumor necrosis factor alpha.J Endod. 2010; 36: 1467-1474
- Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia: the “red complex,” a prototype polybacterial pathogenic consortium in periodontitis.Periodontol 2000. 2005; 38: 72-122
- Treponema species associated with abscesses of endodontic origin.Oral Microbiol Immunol. 2004; 19: 336-339
- Identification of spirochetes (treponemes) in endodontic infections.J Endod. 2003; 29: 794-797
- Comparison of the genome of the oral pathogen Treponema denticola with other spirochete genomes.Proc Natl Acad Sci U S A. 2004; 101: 5646-5651
- Effect of glucose on Treponema denticola cell behavior.Oral Microbiol Immunol. 2008; 23: 234-238
- Frequency, microbial interactions, and antimicrobial susceptibility of Fusobacterium nucleatum and Fusobacterium necrophorum isolated from primary endodontic infections.J Endod. 2008; 34: 1451-1456
- PCR-based identification of Treponema maltophilum, T amylovorum, T medium, and T lecithinolyticum in primary root canal infections.Arch Oral Biol. 2003; 48: 495-502
- Treponema species detected in infected root canals and acute apical abscess exudates.J Endod. 2010; 36: 1796-1799
- PCR-based identification of bacteria associated with endodontic infections.J Clin Microbiol. 2002; 40: 3223-3231
- Identification of oral spirochetes at the species level and their association with other bacteria in endodontic infections.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92: 329-334
- Identification of selected putative oral pathogens in primary root canal infections associated with symptoms.Anaerobe. 2002; 8: 200-208
- Oral treponemes in primary root canal infections as detected by nested PCR.Int Endod J. 2003; 36: 20-26
- Systematic literature review and meta-analysis.Semin Reprod Endocrinol. 1996; 14: 161-169
- Molecular methods for pathogen and microbial community detection and characterization: current and potential application in diagnostic microbiology.Infect Genet Evol. 2012; 12: 505-521
- Characterization of new periodontal and endodontic isolates of spirochetes.Eur J Oral Sci. 1996; 104: 41-47
- Comparison of endotoxin levels found in primary and secondary endodontic infections.J Endod. 2012; 38: 1082-1086
- Microorganisms from canals of root-filled teeth with periapical lesions.Int Endod J. 2003; 36: 1-11
- Treponema denticola interactions with host proteins.J Oral Microbiol. 2012; 4
- Microbiological status of root-filled teeth with apical periodontitis.Int Endod J. 1998; 31: 1-7
- Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85: 86-93
- Starvation survival and recovery in serum of Candida albicans compared with Enterococcus faecalis.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110: 125-130
- Microbial transformation from normal oral microbiota to acute endodontic infections.BMC Genomics. 2012; 13: 345
- Assessment of periradicular microbiota by DNA-DNA hybridization.Endod Dent Traumatol. 2000; 16: 191-196
- Fluorescence in situ hybridization (FISH) for direct visualization of bacteria in periapical lesions of asymptomatic root-filled teeth.Microbiology. 2003; 149: 1095-1102
- Selected endodontic pathogens in the apical third of infected root canals: a molecular investigation.J Endod. 2004; 30: 638-643
- Bacteria in the apical root canal of teeth with primary apical periodontitis.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107: 721-726
- Phylogenetic analysis of bacterial and archaeal species in symptomatic and asymptomatic endodontic infections.J Med Microbiol. 2007; 56: 110-118
- Molecular epidemiology and association of putative pathogens in root canal infection.J Endod. 2000; 26: 599-604
- Comparison of profiles of key periodontal pathogens in periodontium and endodontium.Endod Dent Traumatol. 2000; 16: 269-275
- Detection of Treponema denticola in endodontic infections by 16S rRNA gene-directed polymerase chain reaction.Oral Microbiol Immunol. 2000; 15: 335-337
- Checkerboard DNA-DNA hybridization analysis of endodontic infections.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 89: 744-748
- Polymerase chain reaction detection of Treponema denticola in endodontic infections within root canals.Int Endod J. 2001; 34: 280-284
- Detection of putative oral pathogens in acute periradicular abscesses by 16S rDNA-directed polymerase chain reaction.J Endod. 2001; 27: 164-167
- “Red complex” (Bacteroides forsythus, Porphyromonas gingivalis, and Treponema denticola) in endodontic infections: a molecular approach.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 91: 468-471
- Comparison of 16S rDNA-based PCR and checkerboard DNA-DNA hybridisation for detection of selected endodontic pathogens.J Med Microbiol. 2002; 51: 1090-1096
- Treponema socranskii in primary endodontic infections as detected by nested PCR.J Endod. 2003; 29: 244-247
- Positive and negative bacterial associations involving Dialister pneumosintes in primary endodontic infections.J Endod. 2003; 29: 438-441
- Occurrence of two newly named oral treponemes—Treponema parvum and Treponema putidum—in primary endodontic infections.Oral Microbiol Immunol. 2005; 20: 372-375
- Differences in prevalence of selected bacterial species in primary endodontic infections from two distinct geographic locations.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 99: 641-647
- Microarrays complement culture methods for identification of bacteria in endodontic infections.Oral Microbiol Immunol. 2005; 20: 253-258
- Prevalence of selected bacterial named species and uncultivated phylotypes in endodontic abscesses from two geographic locations.J Endod. 2006; 32: 1135-1138
- Polymerase chain reaction of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia in primary endodontic infections.J Endod. 2007; 33: 1049-1052
- A comparison of sensitivities of the conventional and the real-time polymerase chain reaction methods for detection of Treponema denticola in periapical abscesses.Saudi Med J. 2007; 28: 1453-1455
- Evaluation of the microbiota of primary endodontic infections using checkerboard DNA-DNA hybridization.Oral Microbiol Immunol. 2007; 22: 390-397
- Quantification and characterization of Synergistes in endodontic infections.Oral Microbiol Immunol. 2007; 22: 260-265
- Occurrence of herpes simplex virus 1 and three periodontal bacteria in patients with chronic periodontitis and necrotic pulp.Can J Microbiol. 2008; 54: 326-330
- A microbiological profile of symptomatic teeth with primary endodontic infections.J Endod. 2008; 34: 541-545
- Comparative analysis of endodontic pathogens using checkerboard hybridization in relation to culture.Oral Microbiol Immunol. 2008; 23: 282-290
- Diversity of spirochetes in endodontic infections.J Clin Microbiol. 2009; 47: 1352-1357
- The microbiota of acute apical abscesses.J Dent Res. 2009; 88: 61-65
- Detection of treponema denticola in symptomatic apical periodontitis and in symptomatic apical abscesses by real-time PCR.Eur J Dent. 2009; 3: 107-113
- Real-time polymerase chain reaction of “red complex” (Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola) in periradicular abscesses.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110: 670-674
- Viral-bacterial associations in acute apical abscesses.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 112: 264-271
- A microbiological profile of unexposed and exposed pulp space of primary endodontic infections by checkerboard DNA-DNA hybridization.J Endod. 2012; 38: 889-893
- Bacteria of asymptomatic periradicular endodontic lesions identified by DNA-DNA hybridization.Endod Dent Traumatol. 2000; 16: 197-204
- Detection of bacteria in endodontic samples by polymerase chain reaction assays and association with defined clinical signs in Italian patients.Oral Microbiol Immunol. 2005; 20: 289-295
- Molecular analysis of Filifactor alocis, Tannerella forsythia, and treponema denticola associated with primary endodontic infections and failed endodontic treatment.J Endod. 2006; 32: 937-940
- Periopathogenic bacteria in persistent periapical lesions: an in vivo prospective study.J Periodontol. 2007; 78: 905-908
- Molecular identification and quantification of bacteria from endodontic infections using real-time polymerase chain reaction.Oral Microbiol Immunol. 2008; 23: 384-390
- Detection of Treponema denticola in root canal systems in primary and secondary endodontic infections. A correlation with clinical symptoms.New Microbiol. 2008; 31: 67-73
- Microbial analysis of canals of root-filled teeth with periapical lesions using polymerase chain reaction.J Endod. 2008; 34: 537-540
- Microorganisms in root canal-treated teeth from a German population.J Endod. 2008; 34: 926-931
- Bacterial diversity in persistent periapical lesions on root-filled teeth.J Oral Microbiol. 2009 May 21; 1 (http://dx.doi.org/10.3402/jom.v1i0.1946)
- Proteomic analysis of endodontic infections by liquid chromatography-tandem mass spectrometry.Oral Microbiol Immunol. 2009; 24: 347-352
- Quantification of cultivable bacteria and endotoxin in post-treatment apical periodontitis before and after chemo-mechanical preparation.Eur J Clin Microbiol Infect Dis. 2012; 31: 2575-2583
- Symptomatic and asymptomatic apical periodontitis associated with red complex bacteria: clinical and microbiological evaluation.Odontology. 2013; 101: 84-88
- Treponema diversity in root canals with endodontic failure.Eur J Dent. 2013; 7: 61-68
Article info
Publication history
Published online: March 17, 2015
Identification
Copyright
© 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
