Treponema diversity in root canals with endodontic failure.

Area of Science:

• Microbiology
• Endodontics
• Oral Health

Background:

• Persistent and secondary endodontic infections are a significant clinical challenge.
• The microbial etiology of endodontic treatment failure is complex and not fully understood.
• Oral Treponema species are implicated in periodontal disease and may play a role in endodontic infections.

Purpose of the Study:

• To determine the prevalence of eight specific oral Treponema species in teeth with endodontic treatment failure and periapical lesions.
• To identify which Treponema species are most frequently associated with these conditions.
• To explore potential associations between specific Treponema species and clinical factors.

Main Methods:

• Samples were collected from 40 root canals with documented endodontic failure and periapical lesions.
• DNA was extracted from the collected samples.
• A Nested-PCR technique with specific primers was employed to detect the presence of eight target Treponema species.

Main Results:

• Treponemas were detected in 56.5% (22/39) of the analyzed root canal samples.
• Up to six different Treponema species were identified in a single root canal.
• The most prevalent species were Treponema denticola and Treponema maltophilum (30.8% each), followed by Treponema medium and Treponema socranskii (20.5% each).
• Significant positive associations were observed between Treponema denticola and Treponema maltophilum, and between Treponema medium.
• Treponema lecithinolyticum showed a positive association with the presence of intraradicular posts.

Conclusions:

• A diverse range of oral Treponema species are present in teeth with endodontic treatment failure and periapical lesions.
• These findings suggest that Treponema species contribute significantly to the complexity of persistent and secondary endodontic infections.
• The complex oral microbiota in endodontic failure warrants further investigation for targeted therapeutic strategies.