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    Endodontic Microbiology: Dr. Ammar Abu Mostafa

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    pattason
    This document discusses endodontic microbiology and the treatment of endodontic infections. It covers the portals of entry for bacteria to enter the pulp, the role of bacteria in pulp necrosis and periapical disease, and some of the common bacterial species found in endodontic infections like Enterococcus faecalis. It also discusses abscesses, cellulitis, and the treatment of endodontic infections which involves debridement, irrigation with sodium hypochlorite and EDTA, intracanal medication with calcium hydroxide, and drainage.

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    Endodontic Microbiology: Dr. Ammar Abu Mostafa

    Uploaded by

    pattason
    146 views12 pages
    This document discusses endodontic microbiology and the treatment of endodontic infections. It covers the portals of entry for bacteria to enter the pulp, the role of bacteria in pulp necrosis and periapical disease, and some of the common bacterial species found in endodontic infections like Enterococcus faecalis. It also discusses abscesses, cellulitis, and the treatment of endodontic infections which involves debridement, irrigation with sodium hypochlorite and EDTA, intracanal medication with calcium hydroxide, and drainage.

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    Microbes associated with endodontic infections

    Original Title

    Endodontic microbiology

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    This document discusses endodontic microbiology and the treatment of endodontic infections. It covers the portals of entry for bacteria to enter the pulp, the role of bacteria in pulp necrosis and periapical disease, and some of the common bacterial species found in endodontic infections like Enterococcus faecalis. It also discusses abscesses, cellulitis, and the treatment of endodontic infections which involves debridement, irrigation with sodium hypochlorite and EDTA, intracanal medication with calcium hydroxide, and drainage.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    146 views12 pages

    Endodontic Microbiology: Dr. Ammar Abu Mostafa

    Uploaded by

    pattason
    This document discusses endodontic microbiology and the treatment of endodontic infections. It covers the portals of entry for bacteria to enter the pulp, the role of bacteria in pulp necrosis and periapical disease, and some of the common bacterial species found in endodontic infections like Enterococcus faecalis. It also discusses abscesses, cellulitis, and the treatment of endodontic infections which involves debridement, irrigation with sodium hypochlorite and EDTA, intracanal medication with calcium hydroxide, and drainage.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 12

    ENDODONTIC

    MICROBIOLOGY
    ENDO 412 Lecture No 5 part II

    Dr. Ammar Abu Mostafa


    Learning outcomes
     Portals of entry to the pulp
     Bacterial role in Pulp and Peri-apical pathosis
     Enterococcus faecalis
     Absecess and Cellulitis
     Management of the infected teeth
    Portals of Entry to the Pulp
     Caries
     Through anomalous tract like radicular lingual groove
     Through fracture line
     Via exposed dentin
     Around restorations
     From periodontal pockets to the pulp via apical
    foramen, accessory and lateral canals
    Pulp Necrosis & Bacterial Invasion
     Bacterial penetration into dentinal tubules of
    necrotic teeth is greater than teeth with vital pulp,
    due to the following reasons:
    1. The presence of fluids in dentinal tubules
    2. The presence of odontoblastic processes
    3. Formation of tertiary dentin

     Vital pulp is more resistant to bacterial invasion than


    necrotic pulp
    Bacterial Role in Pulp Infection
     In an experimental study; after intentional pulp
    exposure, pulp necrosis and periradicular lesion
    developed in rats with normal microbial flora but not
    in germ-free rats
     Microorganisms invade the necrotic pulp and infect
    the root canal system, including the dentinal tubules

    Coccal forms of bacteria seen in the


    cross-section of a fractured dentinal tubule
     Most of the bacteria in an endodontic infection are
    strict anaerobes
     With increasing time and depth of pulp infection, the
    microbial flora changes from a predominantly
    facultative, Gram-positive flora to an almost
    completely anaerobic and mainly Gram-negative flora.
     Endodontic infections are polymicrobial, no single
    microorganism or group of bacteria has been proven
    to be more pathogenic than another.
     The following strains are commonly found in
    endodontic infections: Fusobacterium , Prevotella,
    Prophyromonas, Peptostreptococcus, and Veillonella.
     The microbial flora in retreatment cases is different
    from bacteria in primary apical periodontitis. Typically
    retreatment cases show enterococcus faecalis ,
    streptococci, and anaerobic Gram-positive rods in high
    frequencies.
     Fungi have been identified in root canals and in teeth
    refractory to RCT.
     Viruses, including HIV, are also present in the pulp.
    Bacterial Role in Periradicular Disease
     Bacteria and bacterial by-products of the root canal
    play the major role of periradicular lesion
     The bacteria are polymicrobial and are similar to
    those isolated from infected root canals
    Resistance of Oral Microbes to
    Medicaments
     Enterococci has been shown to be relatively
    resistant to Ca(OH)2 and occur in high frequency in
    retreatment cases
    Abscess & Cellulitis
     Abscess is a cavity containing pus (purulent
    exudate) consisting of bacteria, bacterial by-products,
    inflammatory cells, numerous lysed cells, and the
    contents of those cells.
     Cellulitis is a diffuse, erythematous, mucosal, or
    cutaneous infection that may rapidly spread into
    deep facial spaces and become life threatening.
    Treatment of Endodontic Infections
    The key to successful treatment of endodontic
    infections is removal of the reservoir of infection
    (necrotic tissue, bacteria, and bacterial by-products) by
    the following procedures:
    1. Debridement of the root canal system by mechanical
    instrumentation
    2. Root canal irrigation: NaOCl & EDTA
    3. Intracanal medication: Ca(OH)2
    4. Drainage
    End of the Lecture

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