Prevalence of Bacteria of Genus Actinomyces in Persistent Extraradicular Lesions-Systematic Review.

Mario Dioguardi,Giuseppe Troiano,Luigi Laino,Vito Crincoli,Diego Sovereto,Lorenzo Lo Muzio,Mario Alovisi

doi:10.3390/jcm9020457

Abstract

Actinomyces are anaerobic, rod-shaped, Gram-positive bacteria. They are associated with persistent extraradicular endodontic infections, with possible involvement of the soft tissues of the maxillofacial district. Many studies reported conflicting data on the presence of bacteria of the genus Actinomyces in endodontic infections. The aim of this systematic review of the literature was to determine the real prevalence of such bacteria in primary and/or secondary endodontic infections and in cases of persistence with extraradicular involvement. This systematic review was performed according to the PRISMA protocol. A search was carried out through the Scopus and PubMed databases of potentially eligible articles through the use of appropriate keywords. The literature research resulted in preliminary 2240 records which, after the elimination of overlaps and the application of inclusion and exclusion criteria, led to the inclusion of 46 articles focusing on three outcomes (primary outcome: number of teeth with the presence of a persistent extraradicular infection in which the presence of Actinomyces was ascertained; secondary outcome: number of teeth with endodontic infection in which the presence of Actinomyces was assessed; tertiary outcome: difference in the prevalence of bacteria of the genus Actinomyces between primary endodontic infections and secondary endodontic infections). Results of the meta-analysis show how bacteria of the genus Actinomyces are present in primary and secondary intraradicular infections and in those with persistence with a prevalence (ratio between teeth with actinomyces and teeth with infection) ranging from 0.091 up to 0.130 depending on the subgroups analyzed.

Highlights

Endodontic lesions may represent a consequence of the invasion of the endodontic space by bacteria
The bacteria Enterococcus faecalis is considered the main cause for intraradicular apical persistence infections and endodontic failures; often an endodontic retreatment can determine the remission of the disease [4]
After an initial screening phase performed on abstracts identified on the evaluated databases, the potentially eligible articles are qualitatively evaluated in order to investigate the role of bacteria of genus Actinomyces in endodontic infections and persistent extraradicular infections on endodontically treated teeth

Summary

Introduction

Endodontic lesions may represent a consequence of the invasion of the endodontic space by bacteria. Intraradicular infections sustained by Enterococci may be sustained by an important component of extraradicular infection [5] This last one may be: dependent on an intraradicular infection (generally following endodontic retreatment), i.e., with the remission of the intraradicular infection, the extraradicular infection is eradicated; or independent, when the infection persists despite endodontic treatment, and the apical outer surface of the roots is covered with bacterial biofilms sometimes in filamentous aggregates. Bacteria such as Actinomyces and Propionibacterium are among those responsible for persistent extraradicular infections [6]

Methods

Results

Discussion

Conclusion