Pinto K P, Barbosa A F A, Silva E J N L, Santos A P P, Sassone L M
Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil.
J Endod. 2023 Jul;49(7):786-798.e7. doi: 10.1016/j.joen.2023.05.010. Epub 2023 May 19.
This scoping review aimed to map the evidence about the microbiota found in persistent endodontic infections.
The study protocol was prospectively registered and is available at https://osf.io/3g2cp. The electronic search was performed in MEDLINE via PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library, and Embase. The eligibility criteria were based on the PCC acronym, where P (Population) represents patients with teeth presenting persistent endodontic infection, C (Concept) represents microbial profile, and C (Context) represents undergoing endodontic retreatment. Clinical studies that evaluated the microbial profile of samples collected from root canals of teeth undergoing retreatment, using classical or molecular methods, were included. Studies that did not show a minimum period of 1 year between primary endodontic treatment and retreatment or did not radiographically evaluate the quality of primary root canal filling were excluded. Two reviewers independently selected the articles and collected data.
From a total of 957 articles, 161 were read in full, and 32 studies were included. The most prevalent species were Enterococcus faecalis, Parvimonas micra, Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, Dialister invisus, Propionibacterium acnes, Tannerella forsythia, and Treponema denticola. Cases with symptomatology or inadequate root canal filling presented an increase in specific bacterial species compared to those with no symptomatology or adequate filling. A greater number of microorganisms was observed in teeth with inadequate coronal restoration compared to those with adequate restoration.
Persistent endodontic infections have a polymicrobial profile identified by the commonly used methods for bacterial detection/identification and are subject to the limitations present in each of those methods.
本综述旨在梳理有关持续性牙髓感染中微生物群的证据。
该研究方案已进行前瞻性注册，可在https://osf.io/3g2cp获取。通过PubMed、Lilacs、BBO、Scopus、Web of Science、Cochrane图书馆和Embase在MEDLINE中进行电子检索。纳入标准基于PCC首字母缩写，其中P（人群）代表患有持续性牙髓感染的牙齿患者，C（概念）代表微生物谱，C（背景）代表正在接受牙髓再治疗。纳入使用经典或分子方法评估从接受再治疗的牙齿根管中采集样本的微生物谱的临床研究。排除在初次牙髓治疗和再治疗之间未显示至少1年时间间隔或未通过影像学评估初次根管充填质量的研究。两名审阅者独立选择文章并收集数据。
在总共957篇文章中，161篇被全文阅读，32项研究被纳入。最常见的菌种为粪肠球菌、微小单胞菌、牙髓卟啉单胞菌、牙龈卟啉单胞菌、中间普雷沃菌、隐匿戴阿利斯特菌、痤疮丙酸杆菌、福赛坦纳菌和齿垢密螺旋体。有症状或根管充填不足的病例与无症状或充填良好的病例相比，特定细菌种类有所增加。与冠部修复良好的牙齿相比，冠部修复不足的牙齿中观察到的微生物数量更多。
持续性牙髓感染具有通过常用细菌检测/鉴定方法确定的多微生物谱，并且受到每种方法中存在的局限性的影响。
