Persistent Extraradicular Infection in Root-filled Asymptomatic Human Tooth: Scanning Electron Microscopic Analysis and Microbial Investigation after Apical Microsurgery

dc.creatorSignoretti, FGC
dc.creatorEndo, MS
dc.creatorGomes, BPFA
dc.creatorMontagner, F
dc.creatorTosello, FB
dc.creatorJacinto, RC
dc.date2011
dc.dateDEC
dc.date2014-07-30T14:31:18Z
dc.date2015-11-26T16:37:53Z
dc.date2014-07-30T14:31:18Z
dc.date2015-11-26T16:37:53Z
dc.date.accessioned2018-03-28T23:21:05Z
dc.date.available2018-03-28T23:21:05Z
dc.identifierJournal Of Endodontics. Elsevier Science Inc, v. 37, n. 12, n. 1696, n. 1700, 2011.
dc.identifier0099-2399
dc.identifierWOS:000298126400019
dc.identifier10.1016/j.joen.2011.09.018
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/59366
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/59366
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1272144
dc.descriptionIntroduction: Procedural accidents have a negative effect on healing and might contribute to the persistence of infections in inaccessible apical areas, requiring surgical intervention. This report describes a case of persistent apical periodontitis of a lower left first molar associated with the sinus tract and a periapical lesion that required nonsurgical endodontic retreatment and apical surgery for resolution. Methods: The tooth had received endodontic treatment 3 years ago and had to be retreated using the crown-down technique with chemical auxiliary substance (2% chlorhexidine gel), foramen patency, and enlargement and was filled in a single appointment. The occlusal access cavity was immediately restored with composite resin. After 1 month, it could be observed that the sinus tract persisted and, radiographically, the lesion remained unaltered. Therefore, endodontic microsurgery was indicated. Apical microsurgery was performed under magnification with the use of a dental operating microscope including apicectomy, root end with ultrasound, and sealing with mineral trioxide aggregate. A microbiological sample was collected from the apical lesion. The resected distal root apex was observed by scanning electron microscopy. Results: The following species were detected: Actinomyces naeslundii and Actinomyces meyeri, Propionibacterium propionicum, Clostridium botullinum, Parvimonas micra, and Bacteroides ureolyticus; scanning electron microscopic analysis revealed bacterial biofilm surrounding the apical foramen and external radicular surface. Gutta-percha overfilling at the apex because of a zip caused during initial endodontic treatment could be observed. A 6-month follow-up showed apparent radiographic periapical healing, which progressed after 24 months. Conclusion: Gram-positive anaerobic bacteria and extraradicular biofilm seem to participate in the maintenance of persistent periapical pathology, and endodontic retreatment followed by periapical microsurgery proved to be a successful alternative in the resolution of persistent extraradicular infections. (J Endod 2011;37:1696-1700)
dc.description37
dc.description12
dc.description1696
dc.description1700
dc.languageen
dc.publisherElsevier Science Inc
dc.publisherNew York
dc.publisherEUA
dc.relationJournal Of Endodontics
dc.relationJ. Endod.
dc.rightsfechado
dc.rightshttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.sourceWeb of Science
dc.subjectApical periodontitis
dc.subjectapical surgery
dc.subjectendodontic failure
dc.subjectendodontic outcome
dc.subjectnonsurgical retreatment
dc.subjectroot canal infection
dc.subjectEndodontic Treatment
dc.subjectPeriradicular Surgery
dc.subjectTreatment Failure
dc.subject1st Molars
dc.subjectFollow-up
dc.subjectRetreatment
dc.subjectTeeth
dc.subjectPeriodontitis
dc.subjectFrequency
dc.subjectTherapy
dc.titlePersistent Extraradicular Infection in Root-filled Asymptomatic Human Tooth: Scanning Electron Microscopic Analysis and Microbial Investigation after Apical Microsurgery
dc.typeArtículos de revistas


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