Detection of bacteraemias during non-surgicalroot canal treatment.
Some dental procedures initiate a bacteraemia. In certain compromised patients, this bacteraemia may lead to distant site infections, most notably infective endocarditis.


OBJECTIVE
To investigate whether a detectable bacteraemia was produced during non-surgical root canal therapy.


METHODS
Thirty patients receiving non-surgical root canal therapy were studied. Three blood samples were taken per patient: pre-operatively, peri-operatively and post-operatively. In addition, a paper point sample was collected from the root canal. The blood samples were cultured by pour plate and blood bottle methods. The isolated organisms were identified by standard techniques. Blood samples were analysed for the presence of bacterial DNA by the polymerase chain reaction (PCR). In two cases where the same species of organism was identified in the root canal and the bloodstream, the isolates were typed by pulsed field gel electrophoresis (PFGE).


RESULTS
By conventional culturing, a detectable bacteraemia was present in 9 (30%) of the 30 patients who had no positive pre-operative control blood sample. In 7 (23.3%) patients, the same species of organism was identified in both the bloodstream and in the paper point sample from the root canal system. Overall, PCR gave lower detection rates compared with conventional culture, with 10 of 90 (11%) of the blood samples displaying bacterial DNA. PFGE typing was undertaken for two pairs of culture isolates from blood and paper points; these were found to be genetically identical.


CONCLUSIONS
Non-surgical root canal treatment may invoke a detectable bacteraemia.
Savarrio
L
L
Department of Adult Dental Care (Level 6), University of Glasgow Dental School, 378 Sauchiehall Street, Glasgow G2 3JZ, UK. lee.savarrio@northglasgow.scot.nhs.uk
Mackenzie
D
D
Riggio
M
M
Saunders
W P
WP
Bagg
J
J
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology; D001419:Bacteria / Q000145:classification; D001431:Bacteriological Techniques; D002710:Chlorhexidine / Q000627:therapeutic use; D003737:Dental Cavity Preparation / Q000295:instrumentation / Q000379:methods; D003786:Dental Pulp Cavity / Q000382:microbiology; D004587:Electrophoresis, Agar Gel; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006171:Gutta-Percha / Q000627:therapeutic use; D006801:Humans; D006861:Hydrogen Peroxide / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011193:Potassium Iodide / Q000627:therapeutic use; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D012388:Root Canal Irrigants / Q000627:therapeutic use; D012389:Root Canal Obturation; D012390:Root Canal Therapy / Q000379:methods; D016733:Rubber Dams; D012973:Sodium Hypochlorite / Q000627:therapeutic use
D000891:Anti-Infective Agents, Local; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D011193:Potassium Iodide; D006171:Gutta-Percha; D006861:Hydrogen Peroxide; D012973:Sodium Hypochlorite; D002710:Chlorhexidine