Elsevier

Journal of Endodontics

Volume 37, Issue 9, September 2011, Pages 1206-1212
Journal of Endodontics

Clinical Research
Analysis of Symptomatic and Asymptomatic Primary Root Canal Infections in Adult Norwegian Patients

https://doi.org/10.1016/j.joen.2011.05.026Get rights and content

Abstract

Introduction

This molecular study analyzed the microbiota of primary root canal infections from adult Norwegian patients.

Methods

Samples were taken from the necrotic root canals of teeth with symptomatic (n = 13) or asymptomatic (n = 21) apical periodontitis and chronic apical abscesses (n = 9). DNA was extracted from samples, and bacterial identifications were performed by a closed-ended reverse-capture checkerboard approach targeting 50 candidate endodontic pathogens.

Results

Bacterial DNA was detected in all cases. In teeth with asymptomatic apical periodontitis, the most frequent taxa were Dialister invisus (71%), Fusobacterium nucleatum (62%), and Porphyromonas endodontalis (62%). In chronic apical abscesses, the most prevalent taxa were P. endodontalis (100%), D. invisus (89%), Parvimonas micra (78%), and Solobacterium moorei (78%). In teeth with symptomatic apical periodontitis, the most prevalent taxa were D. invisus, P. endodontalis, S. moorei, Propionibacterium acnes, and Streptococcus species (all in 69%). None of the targeted taxa were significantly associated with either sinus tract or pain (P > .05), except for Selenomonas sputigena, which was more frequently found in painful cases (P = .04). No taxa were found in significantly higher levels in any conditions (P > .05). Cluster analyses revealed bacterial groupings that differed between cases with and without pain.

Conclusions

Although basically the same species were highly prevalent in the different conditions examined and none of the most prevalent taxa were positively associated with symptoms, results revealed that species formed different partnerships and associations in samples from teeth with or without pain. Therefore, it is possible that more virulent multispecies communities can form as a result of overall bacterial combinations and give rise to acute inflammation.

Section snippets

Subjects, Sample Taking, and DNA Extraction

Root canal samples were taken from 43 Norwegian patients presenting to an endodontic private practice office in Bekkestua, Norway for treatment of teeth with apical periodontitis. Teeth included in this study were from adult patients, all of them with necrotic pulps and radiographic evidence of apical periodontitis. Each patient contributed one tooth. Twenty-one cases showed no pain or sinus tract at the time of treatment and were diagnosed as asymptomatic apical periodontitis. Nine cases

Results

All sample extracts were positive for PCR amplification by using the universal 16S rRNA gene primers, indicating that bacterial DNA was present in all examined samples and was available for analyses, and significant inhibitors of the PCR reaction were not present. Negative controls yielded no amplicons.

Overall, the results of the reverse-capture checkerboard analysis revealed that 48 of the 50 oligonucleotide probes tested were reactive with 1 or more clinical samples. In general, the number of

Discussion

The desire to find a single or at least a group of major species that is associated with acute symptoms is an ever recurrent theme in the study of endodontic infections. Nonetheless, evidence accumulated over the years from studies with diverse methodologies has suggested that there might be neither a single nor even a small group of bacterial culprits when it comes to endodontic symptomatology (10). Endodontic infections are usually characterized by multispecies biofilm communities (11), and

Acknowledgments

The authors are grateful to Mr Marlei Gomes da Silva for his valuable technical assistance.

The authors deny any conflicts of interest related to this study.

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