ABSTRACT
AIMS: The aim of this study was to determine the occurrence and role of yeasts, enteric gram-negative rods and Enterococcus species in root-filled teeth with chronic apical periodontitis, and the antimicrobial effect of iodine potassium iodide (IKI) irrigation. METHODOLOGY: Forty symptom-free root-filled teeth with chronic apical periodontitis were included in the study. The patients were divided into two groups. In group A the canals were filled with calcium hydroxide for 10-14 days after cleaning and shaping; in group B the canals were irrigated with IKI for 5 min after cleaning and shaping followed by a permanent root filling. Microbiological samples were taken from the canals before and after the chemomechanical preparation and after iodine irrigation (group B). RESULTS: Microbes were isolated from 33 of 40 teeth in the initial sampling. Yeasts were isolated from six teeth, three of them together with E. faecalis. Enteric rods (Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis) were present in three teeth and E. faecalis was isolated from 21 of the 33 culture positive teeth, 11 in pure culture. Growth was detected in 10 teeth of the second samples. Six of the 10 cases were E. faecalis, with five being a pure culture. All third samples (after IKI) except one were negative. The number of microbial cells per sample did not correlate with lesion size. Two flare-ups were recorded, both in teeth with a mixed infection. CONCLUSION: The high prevalence of enteric bacteria and yeasts in root-filled teeth with chronic apical periodontitis was established. IKI improved the antimicrobial effect of the treatment.
Subject(s)
Periapical Periodontitis/drug therapy , Periapical Periodontitis/microbiology , Root Canal Irrigants/pharmacology , Root Canal Irrigants/therapeutic use , Tooth, Nonvital/microbiology , Bacterial Infections/drug therapy , Bacterial Infections/etiology , Bacterial Infections/microbiology , Calcium Hydroxide/pharmacology , Calcium Hydroxide/therapeutic use , Candida albicans/drug effects , Candida albicans/isolation & purification , Chronic Disease , Colony Count, Microbial , Enterococcus faecalis/drug effects , Enterococcus faecalis/isolation & purification , Gram-Negative Facultatively Anaerobic Rods/drug effects , Gram-Negative Facultatively Anaerobic Rods/isolation & purification , Humans , Iodine/pharmacology , Iodine/therapeutic use , Iodine Compounds/pharmacology , Iodine Compounds/therapeutic use , Periapical Periodontitis/etiology , Potassium Iodide/pharmacology , Potassium Iodide/therapeutic use , Retreatment , Root Canal Therapy , Tooth, Nonvital/complicationsABSTRACT
OBJECTIVES: The presence of yeasts in periodontal pockets has been described in a few studies. The association between yeasts and putative periodontal pathogens is not well described. This study aims at assessing the prevalence of yeasts in periodontal pockets and possible associations with the clinical conditions of the sampled sites and other micro-organisms present. MATERIAL AND METHODS: 2 subject groups form the basis for this study. The 1st comprises results from microbiological samples from periodontal pockets of 128 subjects. The 2nd originates from 126 periodontal patients with untreated pockets. Microbiological identification was performed after cultivation on blood and Sabouraud agar plates, and "checkerboard" DNA-DNA hybridisation. RESULTS: The prevalence of subjects with yeasts in the pockets was 15.6% and 17.5% in the 2 groups respectively and was inconsistent according to gender. No correlation was found between age and the presence of yeasts. Eubacterium saburreum was weakly correlated with presence of yeasts (r=0.194 p=0.03). Yeasts were rarely found in both samples from the same individual. CONCLUSIONS: Our results indicate that yeasts can be expected to be present in periodontal pockets in one out of 6 periodontal patients independent of gender and age. Eubacterium saburreum seems to occur frequently together with yeasts.
