Capacity of anaerobic bacteria from necrotic dental pulps to induce purulent infections.

Combinations of bacteria isolated from the root canals of teeth with necrotic pulps and periapical bone destruction were tested for their capacity to induce abscess formation and transmissible infections when inoculated subcutaneously into guinea pigs. Transmissible infections could be induced with combinations obtained from teeth with purulent apical inflammation, but not with combinations from symptomless teeth with chronic apical inflammation. All combinations which gave transmissible infections contained strains of Bacteroides melaninogenicus or B. asaccharolyticus (formerly B. melaninogenicus subsp. asaccharolyticus). The results suggest that purulent inflammation in the apical region in certain cases may be induced by specific combinations of bacteria in the root canal and that the presence of B. melaninogenicus or B. asaccharolyticus in such combinations is essential. However, with one exception, the strains needed the support of additional microorganisms to achieve pathogenicity. The results indicate that Peptostreptococcus micros was also essential. Histological sections of the lesions in the guinea pigs showed that all bacterial combinations induced acute inflammation with an accumulation of polymorphonuclear leukocytes and the formation of an abscess. However, the presence of B. melaninogenicus or B. asaccharolyticus in the combinations resulted in a failure of abscess resolution, with a gradually increaseing accumulation of polymorphonuclear leukocytes.