CLINICAL-SIGNIFICANCE OF DENTAL ROOT-CANAL MICROFLORA

Objectives: Previous work by this group has shown that a significant a ssociation exists between pain and the presence of either Prevotella o r Peptostreptococcus spp. in dental root canals, The aim of this study was to examine a more extensive series of canals microbiologically, t o determine whether any other particular endodontic symptoms or clinic al signs showed specific associations with individual bacterial specie s. Methods: Seventy root canals were examined microbiologically and cl inical data collected to investigate in detail such associations. Resu lts: Of the canals studied, 37 were associated with pain, 49 with tend erness to percussion, 23 with swelling, six with purulent exudate and 57 presented with wet root canals. Anaerobes were isolated from 70.3% of painful canals and from 29.7% of pain-free canals, Significant asso ciations were found between (a) pain and either Prevotella spp. or pep tostreptococci, both with P < 0.01; (b) tenderness to percussion and P revotella spp. (P < 0.01) or anaerobes (P < 0.05); (c) swelling and Eu bacterium spp, (P < 0.01), or with Prevotella spp, or Pstr. micros, bo th with P < 0.05; (d) purulent exudate and any one of F. necrophorum ( P < 0.01), Prev. loescheii, Streptoccoccus constellatus or Bacteroides spp. (each P < 0.05); (e) wet canal and facultative anaerobes (P < 0. 01), and any one of the genera of Eubacterium, Peptostreptococcus, Pre votella or Propionibacterium (each P < 0.05). Conclusion: It was concl uded that several different endodontic clinical signs and symptoms are significantly associated with specific bacterial species.