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PubMed2005

Rebuilding core foundations for existing crowns using a custom-made template.

This article describes a simple procedure for reproducing the internal contours of existing crowns to rebuild composite core foundations for endodontically treated abutment teeth. In the event of core fracture or recurrent caries under a crown, problems may be encountered when constructing a new dowel and core to retrofit an existing crown to the newly fabricated core. The procedure described in this article involves the use of a custom-made template and plastic foil to fabricate new composite core foundations for existing crowns.

Crowns↗
PubMed2005

Long-term survival of endodontically treated molars without crown coverage: a retrospective cohort study.

STATEMENT OF PROBLEM: Teeth are weakened after endodontic treatment and should, ideally, be crowned, especially posterior teeth. However, this is not always possible. Information about the longevity of endodontically treated teeth without crown coverage may assist in selecting appropriate treatment modalities. PURPOSE: The aims of this cohort study were to evaluate the survival rate for endodontically treated molars without crown coverage and to identify possible related factors. MATERIAL AND METHODS: A total of 220 endodontically treated permanent molar teeth in 203 subjects on a waiting list for fixed prosthodontic treatment at the Faculty of Dentistry-Mahidol University, Thailand, were included. Follow-up data were derived from a clinical examination and review of the dental record and radiographs. Subjects were not included in the study if teeth had provisional crowns, definitive restorations with cuspal coverage, or with dowel and core and/or crown restorations. The outcome evaluated was defined as a failure if there were negative findings in the condition of a tooth that required a restoration, tooth repair, or extraction. Tooth loss due to endodontic and periodontal reasons was excluded. The independent variables assessed were patient age, gender, location (maxilla or mandible), the existence of an opposing dentition and adjacent teeth, remaining tooth structure, and types of restorative material. Kaplan-Meier analysis with a 95% confidence level was used to calculate the survival probability, and a log-rank test was used to determine whether significant differences existed. RESULTS: Overall survival rates of endodontically treated molars without crowns at 1, 2, and 5 years were 96%, 88%, and 36%, respectively. With greater amounts of coronal tooth structure remaining, the survival probability increased. Molar teeth with maximum tooth structure remaining after endodontic treatment had a survival rate of 78% at 5 years. Restorations with direct composite had a better survival rate than conventional amalgam and reinforced zinc oxide and eugenol with polymethacrylate restorations. CONCLUSION: Within the limitations of this study, the amount of remaining tooth structure and types of restorative material have significant association with the longevity of endodontically treated molars without crown coverage.

Acrylic Resins↗
PubMed2005

In vitro fracture resistance of endodontically treated central incisors with varying ferrule heights and configurations.

STATEMENT OF PROBLEM: The in vitro effectiveness of a uniform circumferential ferrule has been established in the literature; however, the effect of a nonuniform circumferential ferrule height on fracture resistance is unknown. PURPOSE: This in vitro study investigated the resistance to static loading of endodontically treated teeth with uniform and nonuniform ferrule configurations. MATERIAL AND METHODS: Fifty extracted intact maxillary human central incisors were randomly assigned to 1 of 5 groups: CRN, no root canal treatment (RCT), restored with a crown; RCT/CRN, no dowel/core, restored with a crown; 2 FRL, 2-mm ferrule, cast dowel/core and crown; 0.5/2 FRL, nonuniform ferrule (2 mm buccal and lingual, 0.5 mm proximal), cast dowel/core and crown; and 0 FRL, no ferrule, cast dowel/core and crown. The teeth were prepared to standardized specifications and stored for 72 hours in 100% humidity prior to testing. Testing was conducted with a universal testing machine with the application of a static load, and the load (N) at failure was recorded. Statistical analysis was performed with a 1-way analysis of variance and the Tukey Honestly Significant Difference test (alpha=.05). The mode of fracture was noted by visual inspection for all specimens. RESULTS: There was strong evidence of group differences in mean fracture strength ( P <.0001). Following adjustment for all pairwise group comparisons, it was found that the lack of a ferrule resulted in a significantly lower mean fracture strength (0 FRL: 264.93 +/- 78.33 N) relative to all other groups. The presence of a nonuniform (0.5 to 2-mm vertical height) ferrule (0.5/2 FRL: 426.64 +/- 88.33 N) resulted in a significant decrease ( P =.0001) in mean fracture strength when compared with the uniform 2-mm vertical ferrule (2 FRL: 587.23 +/- 110.25 N), the group without RCT (CRN: 583.67 +/- 86.09 N), and the RCT-treated tooth with a crown alone (CRN/RCT: 571.04 +/- 154.86 N). The predominant mode of failure was an oblique fracture extending from the lingual margin to the facial surface just below the insertion of the tooth into the acrylic resin. CONCLUSION: The results demonstrated that central incisors restored with cast dowel/core and crowns with a 2-mm uniform ferrule were more fracture resistant compared to central incisors with nonuniform (0.5 to 2 mm) ferrule heights. Both the 2-mm ferrule and nonuniform ferrule groups were more fracture resistant than the group that lacked a ferrule.

Crowns↗
PubMed2005

An in vitro comparison of cast metal dowel retention using various luting agents and tensile loading.

STATEMENT OF PROBLEM: No clear consensus exists regarding the choice of luting agents for the retention of cast metal dowels used as a treatment alternative for endodontically treated teeth with excessive loss of coronal tooth structure. PURPOSE: The purpose of this in vitro study was to investigate the retention of the dowel/luting agent/tooth complex while applying different luting agents to cast metal dowels under vertical tensile loading. MATERIAL AND METHODS: Sixty extracted, noncarious mandibular premolars with roots of approximately 15-mm length were selected. For each tooth, a tapered root canal preparation was completed to a maximum diameter of 1.60 mm and a length of 11 mm, a common clinical configuration to accommodate cast metal dowels. Sixty cast metal dowels were fabricated for the tooth specimens and cemented with 1 of 3 luting agents (n = 20): zinc-phosphate cement (ZPC) as a control, phosphate-methacrylate resin luting agent (PMRL, Panavia F), and phosphate-methacrylate resin luting agent with metal dowel surfaces modified with a silane coating technique (PMRLS, Panavia F + Siloc). Tensile bond strength (TBS) of the specimens was measured with a universal testing machine at a crosshead speed of 0.5 mm/min. Data (kg) were statistically analyzed using a 1-way analysis of variance and a Scheffe multiple range test (alpha=.05). The homogeneity of variances was analyzed using the Levene test. RESULTS: The TBS values of ZPC (34.2 +/- 10.54 kg) were significantly higher than PMRL (22 +/- 9.57 kg) and PMRLS (21.7 +/- 7.64 kg). There was no significant difference between the PMRL and PMRLS groups. CONCLUSION: Within the limitations of this study, the use of zinc-phosphate cement provided greater TBS for cast metal dowels than the resin luting agent with and without the silane coating technique. The TBS values with and without the silane coating technique were not statistically different.

Dental Cements↗
PubMed2005

Finite element analysis of stresses in endodontically treated, dowel-restored teeth.

STATEMENT OF PROBLEM: Endodontically-treated, dowel-restored teeth may experience fracture, but investigations of variables related to fracture are often inconclusive and occasionally contradictory. PURPOSE: The finite element method was used to analyze the stresses in dowel-restored teeth. The variables studied were material, shape, bonding, modulus of elasticity, diameter, and length of the dowel. MATERIAL AND METHODS: The model of the dowel-restored tooth involved dentin, ligament, cortical and trabecular bone, gingiva, and gutta-percha. The dowels were made of glass fiber, titanium, or zirconia and modeled as an approximation of the brands ParaPost Fiber White, ParaPost XH, and Cerapost, respectively. The dowel was cemented with zinc-phosphate cement or with bonded or nonbonded resin luting agents, and an approximation of the material properties of these 2 materials were used in the modeling. The restoration included a composite resin core and a gold crown. Other variables included taper versus parallel-sided posts, modulus of elasticity, diameter, and length of post. The model was axisymmetrical in 3 dimensions. A load of 100 N was applied to the crown at an angle of 45 degrees, and tensile, shear, and von Mises stresses were calculated. RESULTS: The generated stresses decreased with respect to the dowel material in the following order: glass fiber, titanium, and zirconia. Stresses were in general higher with tapered than with parallel-sided dowels. Stresses were reduced by bonding and with an increasing modulus of elasticity, increasing diameter, and increasing length of the dowel. CONCLUSIONS: Within the limitations of this study, it was found that all investigated dowel-related factors influenced the stress field generated in dowel-restored teeth.

Alveolar Process↗
PubMed2005

Fracture resistance of endodontically treated maxillary premolars restored with CAD/CAM ceramic inlays.

STATEMENT OF PROBLEM: Endodontically treated posterior teeth are more likely to fracture compared to posterior teeth with vital pulps. Reinforcement with an extracoronal restoration that covers the cusps is the most commonly recommended method for reducing the risk of fracture. It is not known whether bonded intracoronal restorations without cuspal coverage will reduce the risk of fracture. PURPOSE: The aim of this in vitro study was to investigate whether reinforcement of endodontically treated premolars with MOD preparations could be achieved by insertion of bonded CAD/CAM ceramic inlays. MATERIAL AND METHODS: Forty-five extracted maxillary premolars were equally distributed among 3 groups (END, CER, CTR). In group END (n=15), root canals were enlarged with a rotary NiTi system and obturated with heat-softened gutta-percha around a plastic carrier (Thermafil). After filling of the endodontic access cavities with autopolymerizing composite resin (Luxacore), standardized MOD cavity preparations were made and CAD/CAM ceramic inlays (CEREC) were fabricated and then bonded to the teeth with composite resin (Tetric) and an adhesive system (Syntac Classic). In group CER (n=15), teeth without endodontic treatment were restored with bonded inlays (CEREC). Sound premolars served as controls (group CTR, n=15). Teeth were then thermal cycled (1445 cycles, dwell time: 30 seconds, 5 degrees /55 degrees C). An eccentric load was applied on the buccal incline of the palatal cusp in a universal testing machine until cusp fracture (N). Fracture load was evaluated with the Mann-Whitney test, and type of fracture, with a chi-square analysis (alpha=.05). The type of fracture was determined by visual inspection: type I - supragingival fracture within the palatal cusp; type II - fracture below cemento-enamel junction of palatal cusp; and type III - fracture of palatal cusp and central portion of the tooth exposing the root canal cavity. RESULTS: No significant difference was found among the 3 groups with respect to load required for fracture. Mean fracture load +/- SD was recorded as follows: 291.6 +/- 113.7 N for group END, 363.2 +/- 140.3 N for group CER, and 296.5 +/- 170.5 N for group CTR. Regarding fracture modes, significantly more teeth from group END exhibited fractures of type III and II compared with control specimens. CONCLUSION: Teeth restored with bonded CAD/CAM ceramic inlays (CEREC) fractured with a significantly higher number of severe fractures compared to the control group.

Bicuspid↗
PubMed2006

Effect of surface treatment on retention of glass-fiber endodontic posts.

STATEMENT OF PROBLEM: The effects of surface treatment on the retention of prefabricated fiber-reinforced epoxy resin posts are not well understood because most studies measure retention shortly after cementation, without artificial aging. PURPOSE: The purpose of this study was to evaluate the effect of surface treatment on the retention of glass-fiber endodontic posts luted with resin cement and subjected to artificial aging. MATERIAL AND METHODS: Thirty-two single-rooted teeth were selected, the coronal aspect of each tooth was removed, and the remaining root received endodontic therapy. Specimens were then divided into 4 groups (n = 8). Post spaces were prepared to a depth of 10 mm by using ISO 90 rotary instruments. The tapered posts received 1 of 4 surface treatments: cleaning with alcohol (Alc), cleaning with alcohol and conditioning with ED-Primer material (Alc-ED), airborne-particle abrasion (Air), or airborne-particle abrasion and conditioning with ED-Primer material (Air-ED). All posts were luted with a composite resin luting agent (Panavia F) after conditioning the canal dentin with autopolymerizing dentin primer (ED-Primer) and without acid etching of the canal dentin. After cementation, the specimens were stored in water at 37 degrees C for 30 days and subjected to simulated aging conditions consisting of 7500 thermal cycles (5 degrees C/55 degrees C) and 300,000 mechanical loading cycles with 30 N. Retention (N) of the posts was measured with a universal testing machine with a crosshead speed of 2 mm/min. The data were analyzed using 1-way ANOVA and the Tukey HSD test (alpha = .05). The dislodged posts were also examined microscopically at x8 and x20 magnification to evaluate the mode of failure. RESULTS: The mean retentive values (N) and SDs of the test groups were as follows: Alc, 375.9 +/- 85.0; Alc-ED, 421.2 +/- 46.8; Air, 534.8 +/- 65.8; and Air-ED, 555.8 +/- 86.9. Airborne-particle-abraded posts had significantly higher retention compared with nonabraded posts (P < .001). Treating the post's surface with ED-Primer material prior to cementation had no significant effect on retention. The failure mode was purely adhesive at the resin cement-post interface for all nonabraded posts. A mixed failure mode, adhesive at the resin cement-dentin interface, at the resin cement-post interface, and cohesive in the resin cement, was observed for airborne-particle-abraded posts. CONCLUSION: Treating the surface of the posts with ED-Primer material before cementation with Panavia F cement produced no significant improvement in the retention of the posts. Airborne-particle abrasion of the surface of the post significantly improved the retention.

Air Abrasion, Dental↗
PubMed2006

Clinical evaluation of pulpless teeth restored with conventionally cemented zirconia posts: a pilot study.

STATEMENT OF PROBLEM: Adhesive resin cements are commonly used to lute all-ceramic posts despite limited scientific data on the clinical effectiveness of using bonding agents within prepared root canals. PURPOSE: The purpose of this study was to retrospectively evaluate the clinical performance of conventionally cemented zirconia posts. Loss of retention, fracture of posts, and fracture of teeth were evaluated. MATERIAL AND METHODS: Thirty pulpless teeth in 22 patients were treated with zirconia posts. With the exception of 3 situations in which posts were inserted directly and the access openings were closed with composite resin, teeth were restored with indirectly fabricated post-and-core foundations made from zirconia posts (Cerapost or Cosmopost) combined with heat-pressed ceramic cores (IPS Empress Cosmo) and ceramic crowns (IPS Empress II). Restorations (posts and crowns) were cemented with glass-ionomer cement (KetacCem) or resin-modified glass-ionomer cement (ProTec Cem) and reevaluated, retrospectively, for failures such as loss of retention or fractures. Data were reported using descriptive statistics. RESULTS: The mean observation period was 29 months (range 8-44 months). No loss of retention or fracture of any restoration was observed. CONCLUSION: Although this study involved a relatively short observation period, there were no signs of failure of conventionally cemented zirconia posts with ceramic crowns.

Crowns↗
PubMed2006

Influence of remaining coronal tooth structure location on the fracture resistance of restored endodontically treated anterior teeth.

STATEMENT OF PROBLEM: A restored endodontically treated tooth is less likely to fracture when there is axial tooth structure between the core base and preparation finish line. However, an accurate prognosis requires knowing whether fracture resistance depends on a complete circumferential distribution of tooth structure or tooth structure in a specific location related to the applied force. PURPOSE: This in vitro study investigated the fracture resistance of restored endodontically treated teeth when residual axial tooth structure was limited to one half the circumference of the crown preparation. MATERIAL AND METHODS: Fifty extracted maxillary anterior teeth were sectioned 18 mm from their apices, endodontically treated, and divided into 5 groups of 10 teeth each. Four groups were prepared with full shoulder crown preparations having axial wall heights of 2 mm around the preparation circumferences. In 3 of the groups with axial tooth structure, one half of the axial tooth structure was removed, palatally, labially, or proximally, and groups were identified according to the site of retained coronal tooth structure. For the fifth group, all axial tooth structure was removed to the level of the preparation shoulder. Thus, in 1 group the axial walls were circumferential, 360 degrees around the preparations (Complete group), in 3 groups the axial walls were continuous for 180 degrees (Palatal, Labial, and Proximal groups), and the last group had no retained coronal tooth structure incisal to the finish line (Level group). All 50 prepared teeth were then restored with quartz fiber posts (Bisco), composite resin (Bisco) cores, and metal crowns. A universal testing machine compressively loaded the tooth specimens from the palatal at a crosshead speed of 0.5 cm/min at an angle of 135 degrees to the long axis of teeth until failure occurred. A survival analysis was conducted using a log-rank test followed by Holm-Sidak pairwise tests (alpha=.05) to detect significant differences in median failure load between groups. The mode of failure was determined by visual inspection of all specimens. RESULTS: The median failure load (P<.001) was 607 N, 782 N, 358 N, 375 N, and 172 N for the Complete, Palatal, Labial, Proximal, and Level groups, respectively. The predominant mode of failure was an oblique palatal to facial root fracture for the groups with remaining coronal tooth structure. In the Level group, post debonding was the predominant mode of failure. CONCLUSION: For restored endodontically treated teeth that do not have complete circumferential tooth structure between the core and preparation finish line, the location of the remaining coronal tooth structure may affect their fracture resistance.

Dental Restoration Failure↗
PubMed2006

Influence of dentin bonding agents and polymerization modes on the bond strength between translucent fiber posts and three dentin regions within a post space.

STATEMENT OF PROBLEM: Debonding is the most frequent failure encountered with translucent fiber posts and usually occurs along the post space dentin-adhesive interface. PURPOSE: The purpose of this study was to evaluate the effect of different dentin bonding agents and polymerization modes on the bond strength between translucent fiber posts and root dentin in different regions of the post space. MATERIAL AND METHODS: Forty maxillary canines with similar root lengths were selected, sectioned at the cemento-enamel junction, and the roots were endodontically treated. Following post space preparation, the roots were divided into 4 groups of 10 specimens each, and the post spaces were treated with 1 of 4 different dentin bonding agents: light-polymerized, single-bottle bonding agent Excite (Group EX); dual-polymerized, single-bottle bonding agent Excite DSC (Group EX-DSC); self-etching primer Clearfil Liner Bond 2V with a light-polymerized bonding agent, Bond A (Group CL-LC); or self-etching primer Clearfil Liner Bond 2V with a dual-polymerized bonding agent, Bond A+B (Group CL-DC). Translucent fiber posts (D.T. Light-Post), 2.2 mm in diameter, were luted (Panavia F) in each specimen after respective dentin bonding procedures. The roots were cut into 3-mm-thick sections, perpendicular to the long-axis in cervical, middle, and apical post space dentin. Push-out tests were performed with a universal testing machine at a crosshead speed of 0.5 mm/min, and bond strength values (MPa) were calculated by dividing the force at which bond failure occurred by the bonded area of the post. The data were analyzed with 1- and 2-way analysis of variance and Tukey multiple comparison tests (alpha=.05). Dentin adhesive bonding mechanisms in different regions of the post spaces were evaluated with a scanning electron microscope. RESULTS: The highest mean bond strength values were obtained for Group CL-LC (18.3 +/- 4.1 MPa). The dual-polymerized bonding agent resulted in significantly lower bond strength (P<.001) in combination with self-etching primer (Group CL-DC) (13.2 +/- 2.5 MPa). The light-polymerized and dual-polymerized single-bottle bonding agents provided similar bond strengths (12.7 +/- 5.0 for EX; 13.5 +/- 5.3 for EX-DSC). The regional bond strength values of single-bottle bonding agents were reduced significantly in apical post space dentin (P<.001). Self-etching primers did not demonstrate regional differences in post space dentin bonding and dense resin tags were apparent. CONCLUSION: Data suggests that the self-etching primer system used in this study was unaffected by the morphological variations in the post space dentin compared to the single-bottle bonding agents. Dual polymerization did not improve the bond strength values of the bonding agents tested.

Analysis of Variance↗
PubMed2006

Treatment concepts for restoration of endodontically treated teeth: A nationwide survey of dentists in Germany.

STATEMENT OF PROBLEM: Opinions concerning proper restoration of endodontically treated teeth (ETT) vary. A variety of techniques and materials for post-and-core restorations are available. The rationale for post placement performed by German dentists was unknown. PURPOSE: The purpose of this study was to determine current opinions, applied techniques, and materials for the restoration of ETT in Germany. MATERIAL AND METHODS: A nationwide questionnaire-based survey containing 18 multiple choice questions regarding treatment philosophies, favored post type, and materials for core foundations was mailed to 36,500 German general dentists. A total of 6029 questionnaires (16.5%) were returned. Data were evaluated in terms of the dentists' occupational experience and the frequency of post placement. Descriptive statistics were used to analyze the data. RESULTS: Irrespective of their occupational experience, 52% of the surveyed dentists consider post placement for almost every postendodontic restoration of ETT. The majority of dentists (54%) believe that a post reinforces ETT. Cast posts and cores are used by 55% of all dentists, whereas 34% use prefabricated posts exclusively. Screw posts are the most popular prefabricated post type (47%). Composite resin (51%) is preferred for core foundation, followed by glass ionomer cements (GICs) (26%). Amalgam is seldom used (0.5%). Posts are placed primarily with zinc phosphate cement (51%), followed by GIC (38%). CONCLUSION: The treatment philosophy of German dentists is not in complete agreement with recommendations found in the literature. The belief that a post would reinforce an ETT might explain the high frequency of post placements. Due to the partially inconsistent responses, it is difficult to derive a generalized treatment concept.

Cementation↗
PubMed2004

Surface debris of canal walls after post space preparation in endodontically treated teeth: a scanning electron microscopic study.

PURPOSE: To evaluate surface cleanliness of root canal walls along post space after endodontic treatment using 2 different irrigant regimens, obturation techniques, and post space preparation for adhesive bonding. STUDY DESIGN: Forty teeth, divided into 4 groups, were instrumented, using Ni-Ti rotary files, irrigated with NaOCl or NaOCl+EDTA and obturated with cold lateral condensation (CLC) or warm vertical condensation (WVC) of gutta-percha. After post space preparation, etching, and washing procedure, canal walls were observed using a scanning electron microscope (SEM). Amount of debris, smear layer, sealer/gutta-percha remnants, and visibility of open tubules were rated. RESULTS: Higher amounts of rough debris, large sealer/gutta-percha remnants, thick smear layer, and no visibility of tubule orifices were recorded in all the groups at apical level of post space. At middle and coronal levels areas of clean dentin, alternating with areas covered by thin smear layer, smaller debris, gutta-percha remnants, and orifices of tubules partially or totally occluded by plugs were frequently observed. CONCLUSIONS: After endodontic treatment, obturation, and post space preparation SEM analysis of canal walls along post space shows large areas (covered by smear layer, debris, and sealer/gutta-percha remnants) not available for adhesive bonding and resin cementation of fiber posts.

Acid Etching, Dental↗
PubMed2006

Radiographic features of vertically fractured endodontically treated mesial roots of mandibular molars.

OBJECTIVE: The purpose of this study was to evaluate the most frequent radiographic appearance of bony lesions around endodontically treated vertically fractured mesial roots of mandibular molars. STUDY DESIGN: For the study, 49 extracted mesial roots with vertical fractures (study group) were evaluated and compared to 52 extracted roots without fractures (control). RESULTS: The "halo" (36.7%) and "periodontal" (28.6%) type radiolucencies were the most typical appearances of periradicular areas around the mesial roots of mandibular molars with vertical root fractures. By itself, bifurcation radiolucency was statistically insignificant (6.1%), however in conjunction with other areas of radiolucency, it was significant (63.3%, P < .0378). No radiolucency (38.5%) and periapical radiolucency (32.7%) were predominant features in the control (nonfractured roots). Amalgam dowel in the coronal part (1-2 mm) of the root was found in 67.3% of the vertically fractured roots (P < .0006). Defined but not corticated (57.2%) or diffuse (32.6%) borders were typical for vertically fractured mesial roots. CONCLUSIONS: The use of significant variables, such as "periodontal" and "halo" bony radiolucencies, bifurcation involvement, and the presence of amalgam dowel, has prediction sensitivity of 77.6% (VRF group) and specificity of 82.7% (nonfractured roots).

Alveolar Bone Loss↗
PubMed2006

Intentional replantation for a periodontally involved hopeless incisor by using autologous platelet-rich plasma.

The aim of the present case is to describe the use of autologous platelet-rich plasma (PRP) in an intentional replantation procedure for a periodontally involved lower right central incisor with 18 months follow-up. Brief information is also given on the preoperative preparation of PRP in the dental office. PRP preparation is a new biotechnology, and the prepared material contains thrombocyte concentrates and high levels of growth factors. This material promotes healing time in a range of various sites. In this case, a tooth with severe periodontal breakdown was treated with PRP with intentional replantation procedure. This tooth was previously treated with root canal treatment and root planing. The tooth was extracted, and was replanted with autologous PRP. Clinical and radiographic follow-up for 18 months demonstrated new bone formation around the apical portion of the root and all clinical parameters indicated a trend of healing. The mobility of this previously grade III mobile incisor returned to normal limits. We speculate that intentional replantation with PRP application may induce wound healing and may induce bone formation.

Adult↗
PubMed2006

Enterococcus faecalis in dental root canals detected by culture and by polymerase chain reaction analysis.

OBJECTIVE: The objective of this study was to investigate the presence of Enterococcus faecalis in endodontic infections by culture and polymerase chain reaction analyses. STUDY DESIGN: Microbial samples were obtained from 50 teeth with untreated necrotic pulps (primary infection) and from 50 teeth with failing endodontic treatment (secondary infection). Culture techniques were used including serial dilution, plating, incubation, and biochemical identification. For PCR detection, samples were analyzed using a species-specific primer of the 16S rDNA and the downstream intergenic spacer region. RESULTS: Culture and PCR detected the test species in 23 of 100 and 79 of 100 of the teeth, respectively. E faecalis was cultured from 2 (4%) of 50 necrotic canals and from 21 (42%) of 50 root-treated canals. PCR detection identified the target species in 41 (82%) and 38 (76%) of 50 primary and secondary infections respectively. CONCLUSION: E faecalis was detected as frequently in teeth with necrotic pulp as in teeth with failing endodontic treatment when a PCR analysis was used.

Bacterial Typing Techniques↗