Abstract

This study aimed to detect the presence of enterococci in the root canals of untreated and treated teeth with periapical disease and to compare this to their presence in the saliva and in the immediate surgical environment during root canal treatment. Using an aseptic technique, 33 samples were obtained from 27 untreated and 6 previously treated teeth associated with apical periodontitis. Reduced Transport Fluid (RTF) was used as transport medium. Saliva samples and areas in the surgical environment were also sampled. These were performed prior to chemo-mechanical debrjdement and obturation for every case. The saliva was diluted to 10- J and was plated on Bile Aesculin Azide (BEA) agar whereas the rest of the samples were plated on Bile Aesculin (BE) agar. These plates were then incubated aerobically at 37°C for 48 hours. All the colony types that blackened the agar were sub-cultured to obtain pure isolates and tested on 6.5% sodium chloride (NaCI). Growth on this medium was Gram stained for further confirmation of cell morphology. Gram positive cocci isolated from previous positive test were identified as enterococci. Enterococci were recovered from untreated cases only; from 2 teeth (in 2 patients) prior to chemo-mechanical debridement, from 3 teeth (in 3 patients) prior to obturation and I from saliva sample. A 'total of 5 samples from 5 different patients were positive for enteroco·cci. Sampling in the immediate surgical environment revealed a low occurence in the range of3.0% (1/33) to 15_2% (5/33). In conclusion, the occurence of enterococci in patients and the immediate surgical environment was low number.

Highlights

  • Bacterial presence in root canal system has been shown to be the primary cause of pulpal necrosis and subsequently apical periodontitis [1,2]

  • Failure of root canal treatment is usually caused by intra-radicular bacteria, which might have been inaccessible to instrumentation [3]

  • The samples were not obtained from the same patient and no enterococci were detected in the root canals of these two patients

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Summary

Introduction

Bacterial presence in root canal system has been shown to be the primary cause of pulpal necrosis and subsequently apical periodontitis [1,2]. Apical periodontitis could be successfully treated by chemo-mechanical debridement of the root canal system. Failure of root canal treatment is usually caused by intra-radicular bacteria, which might have been inaccessible to instrumentation [3]. Root canal infection is usually polymicrobial in nature [3,9] with anaerobic microorganisms as the predominant group and approximately equal proportions of Gram-positive and Gram-negative bacteria [10]. Enterococcusfaecalis has been reported to survive as single species in untreated root canals [11]

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