Apical Periodontitis
Conditions
Brief summary
Post-treatment apical periodontitis is a fairly prevalent condition frequently caused by a persistent endodontic infection due to failure of the endodontic treatment. Microbial species in treated or untreated root canals were found to be different, with the former being less diverse and mainly characterized by Gram positive, facultative anaerobes bacteria than the latter. Enterococcus faecalis is the most frequently detected species in root-filled teeth in many studies (Zhang et al., 2015). In fact, E. Faecalis retains many virulence factors allowing adhesion to host cells and extracellular matrix, tissue invasion and damage through toxins release, as well as the ability to survive even in harsh environmental conditions. Further studies are needed to clarify E. faecalis prevalence among the different forms of pulpal and periapical lesions as well as its correlation with clinical symptoms.
Interventions
PROCEDURERoot Canal Treatment
Chemo-mechanical preparation will be performed using reciprocating instruments . Irrigation will be carried out with 5.25% NaOCl during instrumentation and a final flush of 17% EDTA followed by 5.25% NaOCl. After drying with paper points, canal obturation will be achieved through continuous condensation wave technique. Obturation with gutta-percha will be performed using Reciproc blue R25 master cones and root canal sealer using the BeeFill 2 in 1 device (VDW, GmbH) with a small heat carrier (#40 tip size and .03 taper) following the manufacturer's instructions. After the down-packing phase, the back-filling will be performed with the same device and manual compaction using endodontic pluggers.
Sponsors
University of Siena
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Inclusion criteria
* between the ages of 18 and 70; * good systemic health. * patients in need of an endodontic treatment/retreatment
Exclusion criteria
* taking antibiotic therapy in the previous 3 months; * presence of communication between the canal system and the oral cavity; * teeth that are not perfectly isolated; * teeth with probing depth \>4 mm with positive BOP.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of E.Faecalis in the canal before the treatment for each group | Pre-treatment microbial sampling in the canal was carried out 1 day once arrived at working length with a 10 K-file | E.Faecalis prevalence in the canal before the treatment will be calculated for each group. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation between E.Faecalis presence in the canal before the treatment and the pulpal/periapical status | Pre-treatment microbial sampling in the canal was carried out 1 day once arrived at working length with a 10 K-file | Correlation between E. faecalis presence in the canal before the treatment and the pulpal/periapical status for each group will be calculated through measures of association |
Other
| Measure | Time frame | Description |
|---|---|---|
| Correlation between E. Faecalis presence in the canal before the treatment and its presence in saliva (pre-treatment) | Pre-treatment microbial sampling in saliva was carried out 1 day before rubber dam isolation. Pre-treatment microbial sampling in the canal was carried out once arrived at working length with a 10 K-file. | Correlation between E. Faecalis presence in the canal before the treatment and its presence in saliva (pre-treatment) will be calculated |
| Ability of the endodontic treatment to remove E. Faecalis from the canal | Pre-treatment microbial sampling in the canal was carried out 1 day once arrived at working length with a 10 K-file. Post treatment microbial sampling will be carried out at the end of the endodontic treatment after the final wash with EDTA and NaOCl | Pre-post endodontic treatment comparison as to E. Faecalis presence in the canal will be carried out |
| Correlation between the presence of E. Faecalis in the canal before the treatment and the presence of a radiographic lesion | Pre-treatment microbial sampling in the canal was carried out 1 day once arrived at working length with a 10 K-file | Correlation between the presence of E. Faecalis in the canal before the treatment and the presence of a radiographic lesion (measured with the PAI score) |
Countries
Italy
Outcome results
None listed