Endodontics| Volume 93, ISSUE 2, P179-183, February 2002

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Fusobacterium nucleatum in endodontic flare-ups


      Objective. The extent to which Fusobacterium nucleatum is recovered from root canals of teeth that present with an interappointment flare-up following endodontic instrumentation was investigated. Study Design. Included in the study were 28 patients that sought emergency treatment after initiation of root canal therapy. Only nonpainful teeth that had been treated because of a necrotic pulp and periapical inflammatory lesion were studied. Root canal samples for bacterial analysis were taken, transported to a bacteriological laboratory, and processed for a semiquantitative assessment of bacterial isolates. Bacterial findings were correlated with self-assessed pain intensity as recorded by means of a Visual Analogue Scale. Clinical presentation of swelling and presence of exudate in the treated root canals were also linked. Results. Bacteria were recovered from all teeth examined. Gram-negative anaerobic coccoid rods (Prevotella species and Porphyromonas species) were frequent isolates. All teeth in patients who were reported to be in severe pain (Visual Analogue Scale ≥ 6) displayed F nucleatum. Nine out of 10 of these teeth also had swelling and exudate in the root canals. Samples from the remaining patients that had teeth with less pain score showed a variable bacterial recovery. None of these teeth displayed F nucleatum. Conclusion.F nucleatum appears to be associated with the development of the most severe forms of interappointment endodontic flare-ups. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:179-83)
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