Persistent extra-radicular bacterial biofilm in endodontically treated human teeth: scanning electron microscopy analysis after apical surgery.
Biofilms are the main cause of endodontic failures. Even the best executed endodontic treatment can fail, when the infection is resistant to treatment or when it is located in inaccessible areas, such as the external surface of the root apex. The purpose of this study was to evaluate, by scanning electron microscopy, the presence of bacterial biofilm on endodontically treated teeth considered clinical failures and suitable for apical surgery. Root apices were collected from 20 teeth undergoing apical surgery and one negative control and analyzed under SEM. Digital photomicrographs of the root apices of 21 specimens at different magnifications were taken. Data were analyzed using descriptive statistics. Apical biofilms were observed in 100% of root canal treatments considered endodontic failure. Topographical analysis of the root apices revealed areas of resorption, microcracks, and apical foramina in 90%, 80%, and 50% of cases, respectively. Within the limits of this study, it can be concluded that endodontic failures present bacterial biofilm in areas inaccessible to conventional endodontic treatment, such as the external surfaces of the root apex.
Department of Endodontics, Federal University of Ceará, Sobral, Brazil.
Bruno Carvalho de
http://orcid.org/0000-0002-0754-1374
BC
Sousa
Departmento of Endodontics, Fortaleza University, Fortaleza, Brazil.
Fábio de Almeida
FA
Gomes
Departmento of Endodontics, Fortaleza University, Fortaleza, Brazil.
Cláudio Maníglia
CM
Ferreira
Department of Microbiology, Fortaleza University, Fortaleza, Brazil.
Márcia Maria de Negreiros Pinto
MMNP
Rocha
Department of Physics, Federal University of Ceará, Fortaleza, Brazil.
Eduardo Bede
EB
Barros
Department of Endodontics, Pernambuco University, Recife, Brazil.
Diana Santana de
DS
Albuquerque
D018441:Biofilms / Q000254:growth & development*; D019232:Dental Restoration Failure; D006801:Humans; D008855:Microscopy, Electron, Scanning / Q000379:methods*; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods*; D014092:Tooth Root / Q000382:microbiology*
endodontic failure; microorganisms; root canal therapy