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Endodontic Microbiology

Endodontic Microbiology. To treat effectively one must know the cause and effect of microbial invasion of the pulp and the surrounding periapical tissues. Introduction. Theory of Focal Infection. 1890 W.D Miller 1909 E.C Rosenow 1910 William Hunter 1940 Reimann.

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Endodontic Microbiology

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  1. Endodontic Microbiology

  2. To treat effectively one must know the cause and effect of microbial invasion of the pulp and the surrounding periapical tissues. Introduction

  3. Theory of Focal Infection • 1890 W.D Miller • 1909 E.C Rosenow • 1910 William Hunter • 1940 Reimann

  4. 1939 Fish – 4 Zones of Infection • Zone of Infection • Zone of Contamination • Zone of Irritation • Zone of Stimulation

  5. ENDODONTIC INFECTIONS An infectious disease is the result of invasion of the tissues by microbes and the reaction of the tissues to their presence which produces clinical signs and symptoms

  6. Association of microbes with Endodontic disease • WD Miller–Father of Oral Microbiology • Kakehashi et al – 1965 True Significance of bacteria in Endodontic disease..

  7. Caries Invasion of Pulp a/w Caries Invade & multiply within Dentinal tubules DT 1-4µm microbes <1µm

  8. Vital pulp - resistant Movement of bacteria is restricted by Viable • Odontoblastic process • Mineralized crystals • Various macromolecules

  9. Trauma Direct exposure of pulp • Inflammation • Necrosis • Bacterial penetration 2mm in 2 weeks

  10. Necrotic pulp is rapidly invaded and colonized • Peritubular and reparative dentin may impede the progress • Dead tracts – virtual highways

  11. Infected root canal system Egress of irritants Periodontium Debatable

  12. Periodontal Abscess Endodontic Abscess Spirochetes 30-58% 0-10%

  13. AnachoresisTRAUMATISED TEETH - INFECTED Microbes INFECT ION Lymph Blood Inflammation

  14. Anaerobic • Absence of oxygen • Function at low oxidaton – reduction potential • Lack enzymes superoxide dismutase and catalase • Faultative anaerobes – grow in presence or absence of oxygen and has the enzymes

  15. Microaerophilic • Can grow in oxygen. • But predominantly derive their energy from anaerobic source….

  16. Aerobic • Oxygen is a must • Possess both enzymes

  17. Most bacteria in Endodontic infection are strict anaerobes No of CFU’s in an infected root canal is between 102 &108 Size of periapical radiolucency directly proportional to no of bact. species and CFU’s in root canal.

  18. Root canal system: Selective habitat Tissue fluids breakdown products of necrotic pulp These nutrients , low oxygen tension and bacterial byproducts determine which bacteria will predominate nutrient rich with polypeptides and amino acids.

  19. Antagonistic relation Metabolites (ammonia) Bacteriocins - antibiotic like proteins

  20. Sundquist et al – culturedintact root canals 99% strict anaerobes Baumgartner et al – apical 5mm 67% strict anaerobes

  21. A polymicrobial ecosystem is produced that selects for anaerobic bacteria over a period of time. • Gomes et al and sundquist suggest a symbiotic relationship that leads to an inc in virulence

  22. Frequently found

  23. Microbiological Diagnostic Techniques

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