Bacterial examination with anaerobic culture system for samples from root canals for the achievement of biological root canal treatment

DOI 3 Citations 32 References
  • Tomoyuki IWATA
    Department of Periodontics and Endodontics, Hiroshima University Hospital
  • Takamune HINO
    Department of Periodontal Medicine, Division of Frontier Medical Science, Hiroshima University Graduate School of Biomedical Sciences
  • Yasuko KITAMOTO
    Department of Periodontal Medicine, Division of Frontier Medical Science, Hiroshima University Graduate School of Biomedical Sciences
  • Hideki SHIBA
    Department of Periodontics and Endodontics, Hiroshima University Hospital
  • Ikuko OGAWA
    Center of Oral Clinical Examination, Hiroshima University Hospital
  • Mayumi MORIMOTO
    Department of Periodontics and Endodontics, Hiroshima University Hospital
  • Hiroyuki KAWAGUCHI
    Department of Periodontal Medicine, Division of Frontier Medical Science, Hiroshima University Graduate School of Biomedical Sciences
  • Hiroki NIKAWA
    Center of Oral Clinical Examination, Hiroshima University Hospital
  • Hidemi KURIHARA
    Department of Periodontics and Endodontics, Hiroshima University Hospital Department of Periodontal Medicine, Division of Frontier Medical Science, Hiroshima University Graduate School of Biomedical Sciences

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  • 生物学的根管治療を達成するための根管内細菌嫌気培養検査

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Abstract

<p>Abstract : Biological root canal treatment is a new concept based on the regulation of functions of host cells, such as pulp cells, periodontal ligament cells and cementblasts, to induce mineralized tissue formation to obturate the root canal or root apex foramen. The most important step to achieve biological root canal treatment is to remove bacteria infected in the root canal without damaging the host cells. Topical application of an anti-microbial agent after mechanical root canal enlargement and chemical root canal irrigation may be effective to remove the infected bacteria and prepare the environment to induce host cell functions because of the agent’s selective toxicity.</p><p> In this report, we introduce our anaerobic culture system for clinical bacterial examination and susceptibility test for endodontic treatment in Hiroshima University Hospital and analyze the data accumulated from clinical bacterial examinations. </p><p> The bacterial samples were taken from cases of pulpectomy and infected root canal treatment at different stages of endodontic treatment : at the first visit, when the clinical symptoms changed during treatment, and before root canal filling (when mechanical enlargement was completed and there was no clinical symptoms).</p><p> In the samples taken before root canal filling, that is, after mechanical enlargement and chemical irrigation have been done and the clinical symptoms have disappeared, 51.5% and 54.8% were positive in pulpectomy cases and infected root canal treatment cases, respectively. Only half of the endodontic treatment cases achieved negative culture by the mechanical enlargement and chemical irrigation. Thus, bacterial examination is useful to decide the timing for root canal filling and to estimate the prognosis of the treated tooth. Since the susceptibility of bacteria against the anti-microbial agents varied among the samples, the susceptibility test is essential for selecting anti-microbial agents for topical application in endodontic treatment.</p><p> Complete removal of infected bacteria is essential for biological endodontic treatment with regulation of host cell functions. The bacterial examination guarantees the progress of the steps of biological endodontic treatment. However, the bacterial examination reported in this paper is an old method that is inconvenient for daily endodontic treatment. The system must be improved by new technology.</p>

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