Persistent extra‐radicular bacterial biofilm in endodontically treated human teeth: scanning electron microscopy analysis after apical surgery

• Published in: Microscopy research and technique Vol. 80; no. 6; pp. 662 - 667
• Main Authors: Sousa, Bruno Carvalho de, Gomes, Fábio de Almeida, Ferreira, Cláudio Maníglia, Rocha, Márcia Maria de Negreiros Pinto, Barros, Eduardo Bede, Albuquerque, Diana Santana de
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-06-2017
• Subjects: Bacteria; Biofilms; Biofilms - growth & development; Data processing; Dental Restoration Failure; Drug resistance; Electron microscopy; endodontic failure; Endodontics; Failure analysis; Humans; Infections; Microcracks; Micrography; microorganisms; Microscopy, Electron, Scanning - methods; Photomicrographs; Root Canal Preparation - methods; root canal therapy; Root Canal Therapy - methods; Root resorption; Scanning electron microscopy; Statistical analysis; Statistics; Surgery; Teeth; Tooth Root - microbiology; root canal therapy; microorganisms; endodontic failure
• ISSN: 1059-910X; 1097-0029
• DOI: 10.1002/jemt.22847

Biofilms are the main cause of endodontic failures. Even the best executed endodontic treatment can fail, when the infection is resistant to treatment or when it is located in inaccessible areas, such as the external surface of the root apex. The purpose of this study was to evaluate, by scanning electron microscopy, the presence of bacterial biofilm on endodontically treated teeth considered clinical failures and suitable for apical surgery. Root apices were collected from 20 teeth undergoing apical surgery and one negative control and analyzed under SEM. Digital photomicrographs of the root apices of 21 specimens at different magnifications were taken. Data were analyzed using descriptive statistics. Apical biofilms were observed in 100% of root canal treatments considered endodontic failure. Topographical analysis of the root apices revealed areas of resorption, microcracks, and apical foramina in 90%, 80%, and 50% of cases, respectively. Within the limits of this study, it can be concluded that endodontic failures present bacterial biofilm in areas inaccessible to conventional endodontic treatment, such as the external surfaces of the root apex.
In this study, the presence of bacterial biofilms colonizing areas inaccessible to conventional endodontic therapy was demonstrated in 100% of the cases.