Apical actinomycosis as a continuum of intraradicular and extraradicular infection: case report and critical review on its involvement with treatment failure.
This article reports a case of extraradicular actinomycosis that clearly formed a continuum with the intraradicular infection. Histobacteriologic and histopathologic analyses of the root tip and attached apical periodontitis lesion obtained by surgery from a tooth with persistent disease were performed to look for the possible reasons for persistent disease. Although no stainable bacteria were observed in the apparently well-treated main canal, apical ramifications were clogged with dense bacterial biofilms that were contiguous to extraradicular actinomycotic aggregates. A critical review of the literature revealed that there is no clear evidence that apical actinomycosis is indeed an independent entity leading to persistent apical periodontitis lesions.
Ricucci
Domenico
D
Private practice, Rome, Italy. dricucci@libero.it
Siqueira
José F
JF
D000197:Actinomycosis, Cervicofacial / Q000150:complications* / Q000628:therapy; D000328:Adult; D003751:Dental Fistula / Q000209:etiology / Q000382:microbiology / Q000601:surgery; D003790:Dental Pulp Necrosis / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D010485:Periapical Periodontitis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D019233:Retreatment; D019227:Tooth Apex / Q000382:microbiology