Microbiology of Endodontic

 

• Learning Objective

  • Pathway of infection
  • Correlation of Microbes to infection
  • Microflora in intraradikular and ekstraradikular infection
  • Microflora involved in persistent infection
  • Bacterial biofilms

• Introduction

  Preservation of teeth by endodontic therapy has gained lot of popularity because of increased and predictable success rate of endodontic procedures

  a complete understanding of endodontic pathology and the abilities of the dentist is required

• Endondontic Infection

  • What is it

• Goals of endodontic treatment

  • eradicate the infection (hilangkan)
  • prevent microorganisms from infecting or re-infecting the root and/or periradicular tissues. (cegah)

• Pathway of infection

  • Dentinal tubules (0,2mm)
  • Open cavity
  • Periodontal membrane
  • Blood stream
  • Faulty restoration

  

• CORRELATION OF MICROBES TO INFECTION

  • Endodontic infections
  • Obligate anaerobic bacteria → dominan
  • There are various microorganisms related to intra-radicular and extraradicular infections and organisms involved in persistent infection.

Microflora in intraradikular and ekstraradikular infection

• Intraradicular infections

  • intraradicular microorganism usually constrain themselves in the root canal due to the defense barrier (membatasi di saluran akar krn gabisa lewat)
  • Gram negative
  • Gram positive

• Extraradicular infections

  → bisa tembus defense barrier

  • In specific circumstances, microorganisms can overcome this defense barrier and establish an extraradicular infection.
  • This may lead to development of acute apical abscess with purulent inflammation in periapical tissue.
  • The extraradicular infections are dependent on or independent of an intraradicular infection. ( misal pathway dari membran periodontal, tidak lewat intraradicular)
  • dominant microorganisms → anaerobic bacteria

Microflora involved in persistent infection

• Bacteria persisting intracanal disinfection procedures and after root canal treatment

  Some microorganisms are resistant to antimicrobial treatment and can survive in the root canal after biomechanical preparation.

  • Gram negative anaerobic rods
  • Gram positive bacteria

Bacterial biofilms

• Virulence factor

  identification and characteristic of specific virulence factor that might play a role in endodontic infection

  • LPS (Lipopolysacharide)
  • Eksotoxin
  • PG (Peptidoglycan)
  • LTA (Lipoteichoic acid)
  • Fimbriae
  • Capsules
  • Extracellular proteins
  • Short- chain fatty acids

• BACTERIAL BIOFILMS

  • What is it
  • Conclusion