Bacterial status in root-filled teeth exposed to the oral environment by loss of restoration and fracture or caries a histobacteriological study of treated cases.

By Ricucci D, Bergenholtz D

Date: 06/2001
Journal: JOE

Summary: 

Purpose: describe histological & microbiological findings in root filled teeth that exposed to caries & oral environment.

•N=  32 teeth

Materials/Methods:

-Teeth included: operated by one DR, root fillings had been exposed to either extensive caries\oral exposure for at least 3 months. Root filled 3 years or more prior to extraction.

-At the onset of endodontic treatment, 17 had been diagnosed with a vital pulp & 14 teeth had a necrotic pulp of which 10 teeth had presented radiographic evidence of apical periodontitis.

-Before extraction, a radiograph of each tooth was taken for an evaluation of the periapical status.

-A standardized protocol followed, No attempts to remove smear layer. Different sealers with laterally compacted GP.

-Haematoxylin and eosin for assessment of inflammatory status, while a modified brown/brenn technique for staining of bacteria.

Most highlighted Results: 

1.In (96%) bacteria were limited to the coronal 1/3 only and were not present in the apical portion of the canal.

2.In one root, bacteria were noted in the apical end while not being seen either in the mid-root portion or coronally.

3.Soft tissue attached to root tip displayed either a non-infiltrated  tissue or small tissue infiltrates of MNLs associated with dispersed sealer particles. Distinct inflammatory infiltrates in 7 \39 roots suggesting microbial exposure.

Clinical significance: 

 Well-prepared and filled root canals resist bacterial penetration even upon frank and long-standing oral exposure by caries, fracture or loss of restoration.