Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis

By Sjogren U, Figdor D, Persson S, Sundqist G

Date: 06/1998
Journal: JOE

Summary: 

Purpose: To investigate the role of infection on the prognosis of endodontic therapy by following-up teeth that had their  RCT in a single appointment

N= 55 single rooted teeth           

      Inclusion: teeth with necrotic pulp and  periapical lesion

Materials/Methods:  

•Access, initial sample, instrumentation up to #40, irrigation 0.5% NaOCl, post instrumentation sample, obturation with GP by lateral compaction & chloroform dipping technique.

•The cases were followed up yearly for 5 years.

•3 of the failure cases were analyzed histologically or by immunohistochemistry

Most highlighted Results: 

•All initial samples yielded  +Ve cultures •After instrumentation (40%) were positive and (60%) were negative to culture

•Complete periapical healing occurred in 94% of negative culture at the time of obturation and in 68% of the positive culture group (P<0.05) •Investigation of 3 failures revealed the presence of Actinomyces  species in each case

•The size of PA lesion had no influence on tx. Outcome

Clinical significance:

The importance of thorough eliminating bacteria from the root canal system before obturation