Clinical ResearchBiofilms and Apical Periodontitis: Study of Prevalence and Association with Clinical and Histopathologic Findings
Section snippets
Clinical Specimens
The material for this study consisted of sequential biopsies of roots or root tips together with surrounding apical periodontitis lesions. Specimens were part of the histologic collection of one of the authors (DR). The material comprised 106 roots from 100 human teeth. Of these, 58 were teeth with untreated root canals (6 incisors, 3 canines, 18 premolars, and 31 molars) from 52 patients (25 females, 27 males) aged 18 to 75 years (mean, 42 years). In total, 64 roots from untreated teeth were
Biofilm Overall Prevalence
Bacteria were found in all specimens, except for one asymptomatic root canal–treated tooth in which disease emerged probably because of a foreign body reaction. This case was reported in a previous study (10). Overall, bacterial arrangements as intraradicular biofilms were observed in the apical segment of 82 of 106 (77%) root canals. Of these, 51 of 64 (80%) were from untreated canals and 31 of 42 (74%) from treated canals (Table 1). This difference was not statistically significant (χ2, p =
Discussion
Determination that a given human infectious disease is caused by biofilms is not an easy task. Difficulties may be related to several reasons, including the coexistence of biofilm and planktonic bacteria in many infections, the absence of a definitive marker for bacteria forming biofilms, and the loss of the biofilm phenotype when subject to sampling and culturing procedures (23). By taking such difficulties into account, Parsek and Singh (23) proposed the following criteria to define
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