Microbiology

The bacteria isolated from an inflamed pulp and root canal are aerobic and facultative anaerobic organisms. Streptococcus salivarius generally constitutes less than 8% of the microorganisms of the infected root canal. Enterococcus faecalis has been reported in 10% to 30% of inflamed root canals (12). Other recovered microorganisms are yeasts and gram-negative bacteria, mostly neisseriae and gram-negative rods, such as Proteus vulgaris and E. coli. These bacteria may be difficult to eliminate from contaminated root canals.

Studies of the bacteriology of root canals have detected anaerobic bacteria. The quality of these studies varies considerably, however, and the anaerobic techniques generally are not always optimal. Most of these studies do not avoid contamination of the root canal specimen by oral flora. Avariety of anaerobes have been recovered, accounting for 25% to 30% of the root canal isolates. These include anaerobic streptococci, anaerobic gram-negative bacilli (AGNB), actinomyces, propionibacteria, veillonellae, and others (13).

Using polymerase chain reaction (PCR), Rolph et al. (12) detected clones related to the genera Capnocytophaga, Cytophaga, Dialister, Enterococcus, Eubacterium, Fusobacterium, Gemella, Lactobacillus, Mogibacterium, Peptostreptococcus, Prevotella, Propionibacterium, Selenomonas, Solo-bacterium, Streptococcus, and Veillonella.

Several PCR studies have revealed new endodontic pathogens (14). These organisms include Tannerella forsythensis (formerly Bacteroides forsythus), Prevotella tannerae, Porphyromonas endodontalis, P. gingivalis, F. nucleatum, Treponema spp. (Treponema denticola, Treponema socranskii, and Treponema vincentii), Dialister pneumosintes, Slackia exigua (formerly Eubacterium exiguum), Mogibacterium timidum (formerly Eubacterium timidum) and Eubacterium saphenum.

The bacterial complex composed of T. forsythensis, P. gingivalis, and T. denticola, termed the "red complex," has been implicated in severe forms of periodontal disease (15).

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