Del Fabbro Massimo, Samaranayake Lakshman P, Lolato Alessandra, Weinstein Tommaso, Taschieri Silvio
Director of Center of Research for Oral Health, Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, IRCCS Galeazzi Orthopedic Institute, Universitá degli Studi di Milano, Milano, Italy.
J Investig Clin Dent. 2014 Nov;5(4):245-54. doi: 10.1111/jicd.12045. Epub 2013 Jun 14.
The present study aimed at reviewing the literature on extraradicular infections of endodontically treated teeth, summarizing the main hypotheses on etiopathogenesis and describing the most suitable techniques to identify the composition of pathogenic extraradicular microorganisms. Medline database was searched using the keywords "Apical biofilm," "extraradicular infection," "secondary endodontic lesion," "endodontic retreatment," "biofilm" either alone or combined with AND. A further hand search was performed on the main endodontic journals. The most frequent bacterial species identified in different studies and with different techniques may vary considerably. Although the presence of some species of microorganisms seems to be determinant, the true origin of extraradicular infection is still undetermined. The literature analysis showed marked differences in methodology, materials, aims, and techniques adopted, which led to highly heterogeneous outcomes. The picture emerging from this review is that extraradicular infection is likely a multifactorial disease that requires further systematic investigation using standardized techniques.
本研究旨在回顾有关根管治疗后牙齿根尖外感染的文献，总结病因发病机制的主要假说，并描述鉴定根尖外致病微生物成分的最合适技术。使用关键词“根尖生物膜”“根尖外感染”“继发性根管病变”“根管再治疗”“生物膜”单独或与“AND”组合检索Medline数据库。还对主要的根管治疗期刊进行了手工检索。不同研究采用不同技术鉴定出的最常见细菌种类可能有很大差异。尽管某些微生物种类的存在似乎是决定性的，但根尖外感染的真正起源仍未确定。文献分析表明，所采用的方法、材料、目的和技术存在显著差异，导致结果高度异质性。本次综述呈现的情况是，根尖外感染可能是一种多因素疾病，需要使用标准化技术进行进一步的系统研究。
