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Abstract 22
1 Influence of residual bacteria on periapical tissue healing
Influence of residual bacteria on periapical tissue healing
after chemomechanical treatment and root filling of experimentally infected
monkey teeth
Lars Fabricius1, Gunnar Dahlén1, Göran Sundqvist
2, Risto-Pekka Happonen
3, Åke J. R. Möller1
Fabricius L, Dahlén G, Sundqvist G, Happonen R-P, Möller ÅJR.
Influence of residual bacteria on periapical tissue healing after
chemomechanical treatment and root filling of experimentally infected
monkey teeth. Eur J Oral Sci 2006; 114: 278-285. © 2006
The Authors. Journal compilation © 2006 Eur J Oral Science
The purpose of this study was twofold: first, to determine the
influence on the healing of the periapical tissues when selected
bacterial strains and combinations thereof remain after root canal
treatment; and, second, the relationship to healing of the quality
of the root filling. In eight monkeys, 175 root canals, previously
infected with combinations of four or five bacterial strains and with
radiographically verified apical periodontitis, were endodontically
treated, bacteriologically controlled, and permanently obturated.
After 2 - 2.5 yr, the periapical regions were radiographically and
histologically examined. Of these teeth, 48 root canals were also
examined for bacteria remaining after removal of the root fillings.
When bacteria remained after the endodontic treatment, 79% of the root
canals showed non-healed periapical lesions, compared with 28% where
no bacteria were found. Combinations of residual bacterial species
were more frequently related to non-healed lesions than were single
strains. When no bacteria remained, healing occurred independently
of the quality of the root filling. In contrast, when bacteria remained,
there was a greater correlation with non-healing in poor-quality root
fillings than in technically well-performed fillings. In root canals
where bacteria were found after removal of the root filling, 97% had
not healed, compared with 18% for those root canals with no bacteria
detected. The present study demonstrates the importance of obtaining
a bacteria-free root canal system before permanent root filling in
order to achieve optimal healing conditions for the periapical tissues.
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