Abstract
Objective:The aims of this study were to investigate the presence of Enterococcus faecalis in primary endodontic infections and failed endodontic treatments using real-time PCR and to determine the statistical importance of the presence of E. faecalis in a Turkish population with endodontic infections.Material and Methods: E. faecalis was investigated from 79 microbial samples collected from patients who were treated at the Endodontic Clinic of the Dental School of Atatürk University (Erzurum, Turkey). Microbial samples were taken from 43 patients (Group 1) with failed endodontic treatments and 36 patients (Group 2) with chronic apical periodontitis (primary endodontic infections). DNA was extracted from the samples by using a QIAamp® DNA mini-kit and analyzed with real-time PCR SYBR Green.Results: E. faecalis was detected in 41 out of 79 patients, suggesting that it exists in not less than 61% of all endodontic infections when the proportion test (z= -1.645, <x= 0.05) was applied. Real-time PCR SYBR Green allowed for the detection of E. faecalis in 32 out of 43 (74.4%) in Group 1, and in 9 out of 36 (25%) in Group 2.Conclusions:These results suggest that E. faecalis is a frequent isolate for endodontic infections in Turkish patients, and is more often associated with failed endodontic treatments than primary endodontic infections.
Highlights
Enterococci are facultative anaerobic, Gram-positive coccus, and part of the normal flora in the oral cavity and gastrointestinal tract
Some signs and symptoms were present in 43 canals with failed endodontic treatment, as follows: 8 cases with spontaneous pain; 30 with tenderness to percussion; 3 with pain to palpation; 1 with sinus tract; 2 with purulent exudates
Endodontic bacteria have been studied by culture techniques, which rely on the isolation, growth, and laboratory identification according to morphology and biochemical tests
Summary
Enterococci are facultative anaerobic, Gram-positive coccus, and part of the normal flora in the oral cavity and gastrointestinal tract. Enterococci possess a number of virulence factors such as aggregation substance, enterococcal surface proteins, gelatinase, extracellular superoxide production, capsular polysaccharides and antibiotic resistance determinant[14,20]. They are recognized as potential human pathogens causing 12% of nosocomial infections. Chronic apical periodontitis frequently develops and enlarges without any subjective signs and symptoms. This condition is usually associated with periradicular radiolucent changes. These changes range from thickening of the periodontal ligament and resorption of the lamina dura to destruction of apical bone resulting in a well demarcated radiolucency[28]
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