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Resolution of persistent periapical infection by endodontic surgery
F B A Ferreira1, A L Ferreira, B P F A Gomes
1Endodontic Unit, Piracicaba Dental School, State University of Campinas, SP, Brazil.
International Endodontic Journal
|February 12, 2004
Summary
Microorganisms, including Propionibacterium acnes, were found on a root tip during endodontic retreatment. Scanning electron microscopy revealed cocci and fungi, aiding in understanding persistent periapical lesions.
Area of Science:
- Microbiology
- Endodontics
- Scanning Electron Microscopy
Background:
- Persistent periapical lesions and fistulas can indicate endodontic treatment failure.
- Surgical endodontic retreatment may be necessary when conventional methods fail.
Observation:
- A maxillary premolar with a fistula and periapical reaction underwent endodontic retreatment for one year.
- Despite repeated intracanal medicament changes, the lesion and exudate persisted.
Findings:
- Microbiological analysis of the fistula detected Propionibacterium acnes, a bacterium linked to endodontic failures.
- Scanning electron microscopy (SEM) of the resected root apex revealed cocci and fungal forms near a root foramen.
Implications:
- This case highlights the potential role of specific microorganisms in persistent endodontic infections.
- Identifying microbial contaminants on root apex surfaces can inform treatment strategies for complex endodontic cases.