Abstract
Aim
To elucidate the presence of apical periodontitis in the root canal of teeth with
secondary/persistent infection, including composition of microbiota, levels of endotoxins
and lipoteichoic acid (LTA), and clinical implications of these findings.
Method
Samples were collected from root canals of 50 patients who needed endodontic retreatment
and had radiographic evidence of apical periodontitis. Microorganisms were identified
by using the culture technique and biochemical tests. Nested–polymerase chain reaction
(nested-PCR) was used to identify 17 species of specific bacteria. Lipopolysaccharides
(LPS) and LTAs were quantified by using, respectively, limulus amebocyte lysate and
enzyme-linked immunosorbent assay tests.
Results
Bacteria were detected in all samples by culture and molecular methods. A total of
154 gram-positive strains, of 188 strains isolated, were found in the root canals
by culture. Enterococcus faecalis and Gemella morbillorum were the most prevalent species identified by the biochemical tests, whereas molecular
analyses (nested-PCR) showed a high frequency of P. gingivalis, E. faecalis, and Fusobacterium nucleatum. LPS and LTA were detected in all samples, with mean values being 3.52 EU/mL and
597.83 pg/mL, respectively. Significant statistical correlations were found between
levels of LTA and clinical features.
Conclusion
Despite the prevalence of gram-positives, the microbiota present in secondary/persistent
infections showed a large variety of species. Within this diversity, associations
were found between specific bacteria and clinical features. In addition, higher levels
of LTA were statistically associated with larger periapical radiolucent areas, but
no correlation between this feature and LPS was found.
Key Words
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Article info
Publication history
Published online: April 18, 2021
Identification
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© 2021 American Association of Endodontists.
