Microbiological analysis of primary infected root canals with symptomatic and asymptomatic apical periodontitis of young permanent teeth

Jelena Marinković,Tatjana Marković,Ana Ćirić,Snežana Brkić,Milena Radunović,Dejan Marković,Ivan Soldatović

doi:10.2478/bjdm-2020-0027

Abstract

Background/Aim: Understanding the composition of bacteria in infected root canals is important for ameliorating the treatment strategies that lead to the elimination of pathogens and infection control, but also prevent reinfection. Aim of this study was to investigate microbial composition of primary infected root canals with apical periodontitis of young permanent teeth, originating form school children in Serbia, and its association with clinical symptoms. Material and Methods: To determine the bacterial composition of infected root canals in children, 35 endodontic samples were obtained. The identification of cultured bacteria was performed by MALDI-TOF MS analysis. The presence or absence of clinical symptoms were recorded. Results: Facultative anaerobes were 2,2 times more frequent than obligate anaerobes. The most common facultative anaerobes belonged to following genera, Streptococcus (58 isolates), Actinomyces (10) and Enterococcus (8), while predominant obligate anaerobes, belonged to genera Veillonella (15), Prevotella (9) and Fusobacterium (8). The most common clinical isolates recovered from infected root canals with symptomatic apical periodontitis were Veillonella parvula (10) and Fusobacterium nucleatum (7), while from the asymptomatic ones, they were Streptococcus mitis/Streptococcus oralis (5). Prevalence of Parvimonas micra, Prevotella buccae and Streptococcus constellatus within the root canals might be associated to clinical symptoms. Conclusions: Species of genera Streptococcus and Veillonella were the most common isolates from primary infected root canals with apical periodontitis in Serbian school children. Facultative anaerobes were predominant over obligate anaerobes. The prevalence of obligate anaerobes was much higher in symptomatic compared to asymptomatic root canal infections. No specific bacterial strain might be associated to a single examined clinical symptom (pain, tenderness to percussion or swelling), but majority of the strains are associated to all of the examined three symptoms.

Highlights

Primary infected root canals with apical periodontitis are untreated root canals, colonized for the first time by microorganisms[1], which exacerbate the functions of the root canal system and surrounding tissues
Certain isolates from the primary infected root canals of Serbian children (Table 1), including A. viscosus, Bifidobacterium spp., E. faecalis, F. nucleatum, Lactobacillus spp., P. micra, P. gingivalis, S. mutans and S. mitis, were identical to isolates recovered from the canals of adults originating from China, USA, Brazil, Netherlands, Sweden, Italy, UK, and Japan[12]
To the best of our knowledge, this study is a first one in which the effort was made to identify microbiota constituents within the primary infected root canals with apical periodontitis of pediatric patients in Serbia, with a particular focus to associate them with basic clinical symptoms

Summary

Introduction

Primary infected root canals with apical periodontitis are untreated root canals, colonized for the first time by microorganisms[1], which exacerbate the functions of the root canal system and surrounding tissues. Microbiota within such canals was investigated in many studies and diversity in its constituents was confirmed[1,2,3,4]. There was only one study on the microbial composition of permanent teeth in children in Turkey[16]. Based on difference in bacteria recovered from asymptomatic and symptomatic cases, some of the mentioned studies claimed composition of microbial community responsible for clinical symptomatology[9,16]. Analyzing correlation between clinical symptoms such as pain, swelling and tenderness and microbiota, Cogulu et al (2008)[16] revealed that the symptoms could be associated with the incidence of following bacteria within the infected root canals: Enterococcus faecalis, Fusobacterium nucleatum, Streptococcus spp., Prevotella intermedia and Parvimonas micra

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