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- Microorganisms: the reason to perform endodonticsPublication . Teles, Ana Moura; Manso, M. Conceição; Loureiro, Sara; Pina, Cristina Maria San Román Gomes de; Cabeda, José ManuelThat we perform Endodontics because there are microorganisms is now beyond doubt. Nevertheless, not only the microorganisms, but also the host response have a profound effect on the progression of the disease. Many papers confirmed the polymicrobial nature of pulpal and periapical diseases of endodontic origin and the efficiency of the chemo-mechanical procedures based on physical and chemical elimination of their etiologic factors, whose principles were first presented as far as 1928 by Hall. Since not only bacterial load may be related to the clinical outcome, but also the bacterial composition of the microbiological canal ecosystem, we aimed at the enumeration of the microorganisms present in the different types of endodontic infections. Although the emerging picture is clearly a complex one, not allowing clear-cut association of bacteria and clinical situation, only the further pursuit of elucidation of the many factors involved (including geographical variability) will ultimately lead to rational treatment solutions.
- A review of microbiologic root canal sampling: updating an emerging picturePublication . Teles, Ana Moura; Manso, M. Conceição; Pina, Cristina Maria San Román Gomes de; Cabeda, José ManuelObjectives: The significance of microorganisms in root canals with regard to the aetiology of periapical infection and the need for crucial bacteria control during treatment are undeniable. In this study, we report and discuss a review of the literature on Microbiological Root Canal Sampling (MRS). The procedure is analyzed in detail, discussing its powers, limitations and the influence of sample collection procedures on the incidence of true and false positive results. Data sources: MEDLINE/PUBMED, B-On and library files of Oporto University were accessed. Selection: Papers were selected using the keywords: “root canal sampling”; “apical periodontitis”; “endodontic pathogens”; “root canal infection”; “Culture”; “molecular biology”. The references were selected under inclusion criteria such as English language, accessibility, relevance to the theme and scientific rigor. Conclusions: This review illustrated the absolute need to adhere to strict methodology procedures if valid samples are to be obtained. A combination of Culture and molecular identification approaches have confirmed the polymicrobial nature of endodontic infections with a predominance of anaerobic bacteria. Nucleic acid-based techniques provide significant additional information particularly regarding the not-yet-cultivable species of the microbial community, but greatly increase the budget of the procedure. Thus, assessment of the endodontic microflora, in the context of a polymicrobial biofilm ecosystem, and its relevance to endodontic treatments must rely in the complementariness of Culture and Metagenomics approaches as they are neither mutually exclusive nor competitive, but strongly complementary.