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Residual bacteria in root apices removed by a diagonal root-end resection: a histopathological evaluation
1Department of Endodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv, Israel. sh_lin@rambam.health.gov.il
International Endodontic Journal
|March 28, 2008
Summary
Bacteria are frequently found in root ends of teeth with persistent periapical lesions, even with good root canal fillings. Diagonal root-end resection may expose these infected areas to surrounding tissues.
Area of Science:
- Endodontics
- Oral Surgery
- Microbiology
Background:
- Persistent periapical lesions often indicate residual infection.
- Root-end resection is a surgical procedure to treat persistent periapical lesions.
Purpose of the Study:
- To investigate the presence of bacteria in the apical root segments after 45-degree root-end resection.
- To assess the relationship between root filling quality and bacterial presence in these segments.
Main Methods:
- Histological examination of 27 apical root segments using Brown and Brenn staining.
- Radiographic evaluation of root canal filling quality by two blinded endodontists.
- Assessment of bacterial presence in the main canal, dentinal tubules, and irregular spaces.
Main Results:
- Bacteria were detected in 85.2% of the root segments.
- Bacterial presence was observed in the main canal, dentinal tubules, irregular spaces, or a combination.
- No correlation was found between radiographic root filling quality and bacterial presence.
Conclusions:
- Infected irregular areas are common in root tips of teeth with persistent periapical lesions.
- The radiographic quality of root canal fillings did not prevent bacterial contamination in these areas.
- 45-degree root-end resection might expose these contaminated irregularities to the periapical tissues.
