Sousa Bruno Carvalho de, Gomes Fábio de Almeida, Ferreira Cláudio Maníglia, Rocha Márcia Maria de Negreiros Pinto, Barros Eduardo Bede, Albuquerque Diana Santana de
Department of Endodontics, Federal University of Ceará, Sobral, Brazil.
Departmento of Endodontics, Fortaleza University, Fortaleza, Brazil.
Microsc Res Tech. 2017 Jun;80(6):662-667. doi: 10.1002/jemt.22847. Epub 2017 Feb 5.
Biofilms are the main cause of endodontic failures. Even the best executed endodontic treatment can fail, when the infection is resistant to treatment or when it is located in inaccessible areas, such as the external surface of the root apex. The purpose of this study was to evaluate, by scanning electron microscopy, the presence of bacterial biofilm on endodontically treated teeth considered clinical failures and suitable for apical surgery. Root apices were collected from 20 teeth undergoing apical surgery and one negative control and analyzed under SEM. Digital photomicrographs of the root apices of 21 specimens at different magnifications were taken. Data were analyzed using descriptive statistics. Apical biofilms were observed in 100% of root canal treatments considered endodontic failure. Topographical analysis of the root apices revealed areas of resorption, microcracks, and apical foramina in 90%, 80%, and 50% of cases, respectively. Within the limits of this study, it can be concluded that endodontic failures present bacterial biofilm in areas inaccessible to conventional endodontic treatment, such as the external surfaces of the root apex.
生物膜是牙髓治疗失败的主要原因。即使是执行得最好的牙髓治疗，当感染对治疗有抗性或者感染位于难以到达的区域（如根尖外表面）时，也可能会失败。本研究的目的是通过扫描电子显微镜评估被认为是临床失败且适合根尖手术的牙髓治疗牙齿上细菌生物膜的存在情况。从20颗接受根尖手术的牙齿和1个阴性对照中收集根尖，并在扫描电子显微镜下进行分析。拍摄了21个标本根尖在不同放大倍数下的数码显微照片。使用描述性统计分析数据。在100%被认为是牙髓治疗失败的根管治疗病例中观察到根尖生物膜。根尖的地形分析显示，分别有90%、80%和50%的病例存在吸收区域、微裂纹和根尖孔。在本研究的范围内，可以得出结论，牙髓治疗失败在传统牙髓治疗难以到达的区域（如根尖外表面）存在细菌生物膜。
