What are the Micro organisms found in a Failed Endodontic Treated tooth with Apical Pathology or Apical Periodontitis
An Endodontic Treated tooth with Post operative Apical Periodontitis often is a result of improper BMP during Root Canal Treatment.
Only a small number of species of micro organisms have been found in the root canals of properly endodonticaly treated teeth which in follow up revealed a persisting Asymptomatic periapical radiolucencies.
So in case of a failed Endodontic therapy it is easy to identify the micro organisms based on Culture methods as the number of species to suspect are very few.
The Micro organisms Genera found in Periapical regions of a Failed Endodontic treated tooth are:
- Actinomyces
- Enterococcus
- Propioni bacterium (previously called as Arachnia)
- Yeasts
- Candida Albicans – Most commonly isolated Fungus
Enterococcus Fecalis – Most common pathogen in most cases of failed Endodontic Treatment.
Among the enterococcus Species the most commonly found is Enterococcus Fecalis which is given particular interest because it is “Rarely found in Untreated and Infected Root Canals”. This means that Enterococcus Fecalis is found alone in the Root canal and can live without help from other Micro organisms.
Enterococcus Fecalis can grow as a mono infection in treated canals in the absence of Synnergistic support from other bacteria.
Therefore E. Fecalis is held to be a Recalcitrant (Stubborn) Microbe among the potential etiologic agents of post treatment apical periodontitis.
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I am Varun, a Dentist from Hyderabad, India trying my bit to help everyone understand Dental problems and treatments and to make Dental Education simplified for Dental Students and Dental fraternity. If you have any doubts feel free to contact me or comment in the post, thanks for visiting.
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How you know E. facalis is the major cause ? It can also be as a commensal bacteria .
Many studies have been conducted with samples from failed RCT treated tooth being collected and checked for the bacteria in the peri apical region. Will be sharing the links to these studies in the next comment.
About 3 years ago I a peace of a large filling in my molar had broken off ..The dentist insisted I needed a root canal ” because I need something to anker the filling to” ! Reluctantly I had the procedure done. After the procedure,I felt a very light pain, especially,if I was chewing on that molar, and a slight sensitivity and swelling of the gums around the tooth.I thought it would eventually get back to normal, but it did not. I never really felt well again after the procedure and the symptoms described persisted, to 3 years later- no better – no worse! But now I have developed serious healthproblems, and wonder if the dental problem is “at the root “? Of this, and I will have to have it all extracted ? How do I know what to do ?….
Hi Frederika,
May your health improve soon, as for the tooth infection the slight pain persisting and gum swelling might suggest to a Gum problem or the Root Canal not being done completely. If you want to find out if it was the Root Canal a periapical Xray would be the best option to see whether there is any infection in the bone. After an Xray is taken the Dentist will decide if the tooth needs to be extracted or left alone. From the Xray even the Gum problem can be diagnosed.
hello docter varun i want to share something about root canal treatment , a pt. came to me and told me that his tooth was treated by root canal but after the treatment the tooth is still very much sensitive , he even can’t touch it with his own tounge .
Did you take an Xray ?
There can be many reasons for this – Missed Canal, Over extension of the GP point beyond the apex, Periapical pathology still present or even something as simple as a High point from the Post Endo Restoration.
Check one by one to eliminate the cause and treat it accordingly.