Root Canal Microorganisms Profiles of Upper Anterior Teeth with Periapical Lesion

Abstract

ABsTRACT Microorganisms are the main causative agents on the development of apical periodontitis. Microorganisms infecting the root canal system are colonized in communities as biofilm. These bacterial communities show distinct pattern related to the different forms of apical periodontitis which are determined by species richness and abundance. Objective: This study is aimed to examine the root canal microorganisms on upper anterior teeth of asymptomatic apical periodontitis and chronic apical abscess. Methods: Samples were collected from patients referred to Endodontic Department of Hasanuddin University Dental Hospital from July 2013 to September 2013. Twenty two samples, aged 17-40 were collected from 16 patients with asymptomatic apical periodontitis, and 36 samples, aged 18-50 were collected from 36 patients with chronic apical abscess. Microorganisms were evaluated using cultural technique. Results: The results showed predominant bacteria in asymptomatic apical periodontitis is Porphyromonas spp while in chronic apical abscess both Streptococcus spp and Porphyromonasspp showed similar frequencies. This study showed Porphyromonas spp plays dominant role in apical periodontitis either in asymptomatic apical periodontitis or chronic apical abscess. Conclusion:This study showed different composition of bacteria within different apical periodontitis and Porphyromonas spp is the most prevalent bacteria found in both asymptomatic apical periodontitis and chronic apical abscess. ABsTRACT Profil mikroorganisme dalam saluran akar dengan kelainan periapikal. Berbagai mikroorganisme merupakan agen penyebab terjadinya periodontitis apikalis. Mikroorganisme yang menginfeksi sistem saluran akar berkoloni membentuk suatu komunitas biofilm. Jumlah komunitas bakteri ini menunjukkan pola khusus yang terkait dengan bentuk periodontitis apikalis yang terjadi. Tujuan: Melakukan pemeriksaan mikroorganisme di saluran akar gigi anterior atas dengan periodontitis apikalis dan abses apikalis kronis. Metode: Sampel didapat dari pasien yang dirawat di Departemen Endodontik Rumah Sakit Gigi Mulut Universitas Hassanuddin selama Juli-September 2013. Sampel periodontitis apikalis asimtomatis dikumpulkan dari 16 pasien berusia antara 17-40 tahun dan sampel abses apikal kronis didapat dari 36 pasien berusia 18-50 tahun. Identifikasi jenis mikroorganisme dilakukan dengan metode kultur. Hasil: Penelitian ini menunjukkan bahwa bakteri yang mendominasi periodontitis apikalis asimtomatis adalah Porphyromonas spp, sedangkan dalam abses apikalis kronis, Streptococcus spp dan Porphyromonas spp mempunyai frekuensi yang sama. Oleh karena itu, Porphyromonas spp mempunyai peran dominan dalam periodontitis apikalis dan abses apikalis kronis. simpulan: Penelitian ini menunjukkan perbedaan komposisi bakteri yang ada dalam periodontitis apikalis dan abses apikal kronis, namun Porphyromonas spp merupakan bakteri yang mendominasi keduanya. point #25 into the canal for 60secs. Following removal from the canal, the paper point was immediately put into a screw-cap container filled with 3mL transport medium of Cary Blair agar. The container was directly sent to the microbiology laboratory. Isolating and detection of species The paper point was taken out from the container and inserted into the other container filled with enhancement medium of Brain-Heart Infusion Broth (BHIB), incubated anaerobically for 24 h at 37 o C in gas vac. One mL of cultivated bacteria, added with 9mL NaCl 0.9% were diluted and repeated in 3 series until it reached 10 3 CFU bacteria. In the third container with 10 3 CFU of bacteria, 1mL was taken and swabbed on a sterile petri dish. Nutrient Agar (NA) was poured into the dish and then incubated, anaerobically, using gas vac for 24 h at 37 o C. The appeared colonies were counted conventionally and then were stained for morphology of bacterial cells. 9 REsULTs Out of 58 samples, 22 were diagnosed with asymptomatic apical periodontitis and 36 were diagnosed with chronic apical abscess. In the cultured plates, 54 plates had only one predominant species and 4 plates had two predominant species. With regard to asymptomatic apical periodontitis, 18 teeth had only one predominant species, while the remaining 4 teeth had two predominant species. In teeth with chronic apical abscess, each sample showed only one predominant species. Porphyromonas spp was the most prevalent species in teeth with asymptomatic apical periodontitis, followed by Propionibacterium spp and Streptococcus spp. Meanwhile, in teeth with chronic apical abscess, Streptococcus spp was the most prevalent species followed by Porphyromonas spp and Propionibacterium spp. The prevalent bacteria found from the root canals of asymptomatic apical periodontitis and chronic apical abscess are presented in Table 1 and 2, respectively. The distribution of species type in the teeth with asymptomatic apical periodontitis and chronic apical abscess are presented in Figure 1 and 2, respectively. DIsCUssION Primary root canal infections are the cause of primary apical periodontitis which can become into chronic or acute state of disease. Root canal systems of primary infections are occupied by mixed community of bacteria, but dominated by anaerobic bacteria,