Association of Enterococcus faecalis with different forms of periradicular diseases.

Data from culture studies have revealed that Enterococcus faecalis is occasionally isolated from primary endodontic infections but frequently recovered from treatment failures. This molecular study was undertaken to investigate the prevalence of E. faecalis in endodontic infections and to determine whether this species is associated with particular forms of periradicular diseases. Samples were taken from cases of untreated teeth with asymptomatic chronic periradicular lesions, acute apical periodontitis, or acute periradicular abscesses, and from root-filled teeth associated with asymptomatic chronic periradicular lesions. DNA was extracted from the samples, and a 16S rDNA-based nested polymerase chain reaction assay was used to identify E. faecalis. This species occurred in seven of 21 root canals associated with asymptomatic chronic periradicular lesions, in one of 10 root canals associated with acute apical periodontitis, and in one of 19 pus samples aspirated from acute periradicular abscesses. Statistical analysis showed that E. faecalis was significantly more associated with asymptomatic cases than with symptomatic ones. E. faecalis was detected in 20 of 30 cases of persistent endodontic infections associated with root-filled teeth. When comparing the frequencies of this species in 30 cases of persistent infections with 50 cases of primary infections, statistical analysis demonstrated that E. faecalis was strongly associated with persistent infections. The average odds of detecting E. faecalis in cases of persistent infections associated with treatment failure were 9.1. The results of this study indicated that E. faecalis is significantly more associated with asymptomatic cases of primary endodontic infections than with symptomatic ones. Furthermore, E. faecalis was much more likely to be found in cases of failed endodontic therapy than in primary infections.

[1]  P. Trieu-Cuot,et al.  Sequencing the Gene Encoding Manganese-Dependent Superoxide Dismutase for Rapid Species Identification of Enterococci , 2000, Journal of Clinical Microbiology.

[2]  P. H. Roy,et al.  Development of a PCR Assay for Rapid Detection of Enterococci , 1999, Journal of Clinical Microbiology.

[3]  G. Tyrrell,et al.  Identification of Enterococcus Species and Phenotypically Similar Lactococcus andVagococcus Species by Reverse Checkerboard Hybridization to Chaperonin 60 Gene Sequences , 2000, Journal of Clinical Microbiology.

[4]  I. N. Rôças,et al.  Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals. , 2002, Journal of endodontics.

[5]  C. Reit,et al.  Microbiological status of root-filled teeth with apical periodontitis. , 1998, International endodontic journal.

[6]  D. Figdor.  Microbial aetiology of endodontic treatment failure and pathogenic properties of selected species. , 2004, Australian endodontic journal : the journal of the Australian Society of Endodontology Inc.

[7]  J. Baumgartner,et al.  Bacteria in the apical 5 mm of infected root canals. , 1991, Journal of endodontics.

[8]  A. Blanch,et al.  Identification of Enterococcus spp. based on specific hybridisation with 16S rDNA probes. , 2002, Journal of microbiological methods.

[9]  P. Courvalin,et al.  Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR , 1995, Journal of clinical microbiology.

[10]  E. Johansson,et al.  Prevalence of black-pigmented bacteroides species in root canal infections. , 1989, Journal of endodontics.

[11]  P. Papapanou,et al.  A protocol for polymerase chain reaction detection of Enterococcus faecalis and Enterococcus faecium from the root canal. , 2002, International endodontic journal.

[12]  J. Slots,et al.  Enterococci in human periodontitis. , 1992, Oral microbiology and immunology.

[13]  U Sjögren,et al.  Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. , 1998, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[14]  A. Sigurdsson,et al.  Bacteria isolated after unsuccessful endodontic treatment in a North American population. , 2001, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[15]  M. Evans,et al.  Mechanisms involved in the resistance of Enterococcus faecalis to calcium hydroxide. , 2002, International endodontic journal.

[16]  G. Bergenholtz.  Micro-organisms from necrotic pulp of traumatized teeth. , 1974, Odontologisk revy.

[17]  G. Gherardi,et al.  Routine Molecular Identification of Enterococci by Gene-Specific PCR and 16S Ribosomal DNA Sequencing , 2001, Journal of Clinical Microbiology.

[18]  M. Gilmore,et al.  Virulence of enterococci , 1994, Clinical Microbiology Reviews.

[19]  I. N. Rôças,et al.  Actinomyces species, streptococci, and Enterococcus faecalis in primary root canal infections. , 2002, Journal of endodontics.

[20]  G. Tyrrell,et al.  Species identification of enterococci via intergenic ribosomal PCR , 1997, Journal of clinical microbiology.

[21]  R. Weiger,et al.  Microbial flora of sinus tracts and root canals of non-vital teeth. , 1995, Endodontics & dental traumatology.

[22]  del Mar Lleó M,et al.  Competitive polymerase chain reaction for quantification of nonculturable Enterococcus faecalis cells in lake water. , 1999, FEMS microbiology ecology.

[23]  I. Balčiūnienė,et al.  Isolation of yeasts and enteric bacteria in root-filled teeth with chronic apical periodontitis. , 2001, International endodontic journal.

[24]  K. Schleifer,et al.  Transfer of Streptococcus faecalis and Streptococcus faecium to the Genus Enterococcus nom. rev. as Enterococcus faecalis comb. nov. and Enterococcus faecium comb. nov. , 1984 .

[25]  E. Hoshino,et al.  Predominant Obligate Anaerobes in Necrotic Pulps of Human Deciduous Teeth , 1993 .

[26]  B. Gomes,et al.  Microorganisms from canals of root-filled teeth with periapical lesions. , 2003, International endodontic journal.

[27]  I. Balčiūnienė,et al.  Isolation of Enterococcus faecalis in previously root-filled canals in a Lithuanian population. , 2000, Journal of endodontics.

[28]  Qiang Zhu,et al.  PCR-Based Identification of Bacteria Associated with Endodontic Infections , 2002, Journal of Clinical Microbiology.

[29]  I. Brook,et al.  Aerobic and anaerobic microbiology of periapical abscess. , 1991, Oral microbiology and immunology.

[30]  J. Siqueira,et al.  A scanning electron microscopic evaluation of in vitro dentinal tubules penetration by selected anaerobic bacteria. , 1996, Journal of endodontics.

[31]  P. Hsueh,et al.  Determination of Enterococcus faecalis groESL Full-Length Sequence and Application for Species Identification , 2001, Journal of Clinical Microbiology.

[32]  J. Nicoli,et al.  Microorganisms isolated from root canals presenting necrotic pulp and their drug susceptibility in vitro. , 2001, Oral microbiology and immunology.