Association of endodontic signs and symptoms with root canal pathogens: A clinical comparative study

Abstract

Objective: The purpose of this study was to evaluate the association of the common root canal pathogens namely; Streptococcus mitis and Enterococcus faecalis with specific endodontic signs and symptoms. Materials and Methods: Sixty subjects scheduled for endodontic treatment were divided into two groups comprising of 30 subjects with primary endodontic infections and 30 subjects with failed endodontic treatment. The endodontic signs and symptoms of the subjects were assessed using clinical and radiographic methods. Root canal samples were collected using sterile paper point. Advanced microbiological culture techniques were used to isolate S. mitis and E. faecalis from the root canal samples. The presence of root canal pathogens was then correlated with the corresponding endodontic signs and symptoms. Statistical analysis was done using Student's t-test and Fisher's exact test. Results: S. mitis was significantly associated with pain and periapical lesions in primary and retreatment cases (P = 0.04). E. faecalis had a strong correlation with tenderness on percussion in retreatment cases (P = 0.016). Conclusion: Association of S. mitis with pain and periapical lesion, as well as E. faecalis with tenderness on percussion, suggests a correlation between endodontic signs and symptoms with specific root canal bacterial species. Knowledge regarding the association of root canal pathogens and specific endodontic signs and symptoms could help in better understanding and a predictable therapeutic management of root canal infections.