Fusobacterium nucleatum in endodontic flare-ups.
OBJECTIVE
The extent to which Fusobacterium nucleatum is recovered from root canals of teeth that present with an interappointment flare-up following endodontic instrumentation was investigated.


METHODS
Included in the study were 28 patients that sought emergency treatment after initiation of root canal therapy. Only non-painful teeth that had been treated because of a necrotic pulp and periapical inflammatory lesion were studied. Root canal samples for bacterial analysis were taken, transported to a bacteriological laboratory, and processed for a semiquantitative assessment of bacterial isolates. Bacterial findings were correlated with self-assessed pain intensity as recorded by means of a Visual Analogue Scale. Clinical presentation of swelling and presence of exudate in the treated root canals were also linked.


RESULTS
Bacteria were recovered from all teeth examined. Gram-negative anaerobic coccoid rods (Prevotella species and Porphyromonas species) were frequent isolates. All teeth in patients who were reported to be in severe pain (Visual Analogue Scale > or = 6) displayed F nucleatum. Nine out of 10 of these teeth also had swelling and exudate in the root canals. Samples from the remaining patients that had teeth with less pain score showed a variable bacterial recovery. None of these teeth displayed F nucleatum.


CONCLUSIONS
F nucleatum appears to be associated with the development of the most severe forms of interappointment endodontic flare-ups.
Chávez de Paz Villanueva
Luis Eduardo
LE
Department of Oral Microbiology, Faculty of Odontology, Göteborg University, Sweden. Luis.Chavez.de.Paz@odontologi.gu.se
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D003786:Dental Pulp Cavity / Q000382:microbiology*; D005122:Exudates and Transudates; D005260:Female; D005674:Fusobacterium Infections / Q000382:microbiology*; D016967:Fusobacterium nucleatum / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012390:Root Canal Therapy; D015163:Superinfection; D014098:Toothache / Q000382:microbiology*