Prevalence of Treponema spp. in endodontic retreatment-resistant periapical lesions.

This study investigated the presence of the Treponema species in longstanding endodontic retreatment-resistant lesions of teeth with apical periodontitis, the association of this species with clinical/radiographic features, and the association among the different target species. Microbial samples of apical lesions were collected from twenty-five adult patients referred to endodontic surgery after unsuccessful root canal retreatment. Nested-PCR and conventional PCR were used for Treponema detection. Twenty-three periradicular tissue samples showed detectable levels of bacterial DNA. Treponema species were detected in 28% (7/25) of the cases. The most frequently detected species were T. socranskii (6/25), followed by T. maltophilum (3/25), T. amylovorum (3/25), T. lecithinolyticum (3/25), T. denticola (3/25), T. pectinovorum (2/25) and T. medium (2/25). T. vicentii was not detected in any sample. Positive statistical association was found between T. socranskii and T. denticola, and between T. maltophilum and T. lecithinolyticum . No association was detected between the presence of any target microorganism and the clinical or radiographic features. Treponema spp. are present, in a low percentage, in longstanding apical lesions from teeth with endodontic retreatment failure.

Bejel in Malatya, Turkey.

Bejel is a form of endemic syphilis which is transmitted by non-venereal route. According to our knowledge, no cases of bejel have been reported from Turkey for more than 30 years. In this report, three children and their father who suffer from bejel are presented. The history, physical findings, laboratory investigations, treatment and results of the cases are reviewed, and the related literature is discussed.

The radiology of bone and joint infection.

Many of the classic radiological features of skeletal infection are now seldom seen due to modern imaging techniques enabling early diagnosis and prompt treatment. It is important to remind ourselves of the potential complications which may develop when the correct diagnosis is delayed or missed.

Endemic nonvenereal treponematosis (bejel) in Saudi Arabia.

A total of 2,515 individuals attending a large military hospital in Saudi Arabia who had appropriate radiologic evidence of treponematosis were studied clinically and serologically. The indications are that nonvenereal treponematosis (bejel) exists in considerable numbers among the nomadic communities living in rural areas. In contrast, venereal syphilis is less common in this population and is found almost exclusively in urban populations. Some of the high-risk regions for bejel have been identified. Many individuals from nomadic communities complained of persistent pain in the lower limbs, which was often associated with radiologic evidence of osteoperiostitis of the long bones. It also appears that within the last 30 years bejel has become clinically attenuated, with the majority of seropositive individuals having latent disease. A hypothesis is put forward that persistent lesions are sustained by superinfection and that improvements in hygiene have resulted in a decrease in the incidence of reexposure. Measures to control the infection are outlined.