Microbiology of endodontics treatment.pptx

dentistry

1. Microbiology of Endodontic Treatment Dr Safiullah Malakzay Department: Operative Dentistry and Endodontics Instructor: Ustad . ALI Maisam Eshraqi Date: 10 th January 2022

2. Contents ‰ Portals of Entry for Microorganisms ‰ Classification of Microorganisms ‰ Microbial Virulence and Pathogenicity ‰ Factors Influencing the Growth and Colonization of Microorganisms ‰ ‰ Types of Endodontic Infections ‰ Identification of the Bacteria ‰ How to Combat Microbes in the Endodontic Therapy?

3. Introduction For many years, the interrelationship of microorganisms and root canal system has been proved.

4. History of microbiology in association to endodontics 1890 : WD Miller (Father of oral microbiology) authorized book “Microorganisms of human mouth” 1965 : Kakehashi : bacteria are responsable pulp & peri apical disease 1976: Sundqvist : Different culturing Root canal infection multibacterial

5. Portals of Entry for Microorganisms ‰ Microorganisms may gain entry into pulp through several routes.

6. Entry through Open Cavity

7. Through Open Dentinal Tubules Microorganisms can pass into the dentinal tubules and subsequently to the pulp. Bacteria are preceded in course of tubules by their breakdown products which may act as pulp irritants.

8. Through Faulty Restoration

9. Through the Periodontal Ligament or the Gingival Sulcus

10. Classification of Microorganisms Gram-positive organisms Streptococcus , Enterococcus, Treponema , Candida, Actinomyces , Lactobacillus . Gram Negative organisms Fusobacterium , Campylobacter, Bacteroides , Veillonella , Neisseria.

11. Factors Influencing the Growth and Colonization of Microorganisms Influence of Oxygen Nutritional Factors Bacteriocins Coaggregation

12. Microbial Virulence and Pathogenicity

13. Virulent factors • Lipopolysaccharides (LPS) • Extracellular vesicles :-bacterial adehesion • Enzymes: spread of infection,neutralization Im • Fatty acids • Polyamines • Capsule • Pilli

14. Types of Endodontic Infections Intraradicular Infections Primary Secondary Secondary Intraradicular Infections

15. Primary Intraradicular Infections (Virgin Infection) These are those microorganisms which initially invade the pulp tissue These are characterized by presence of mixed habitat, mainly dominated by Gram-negative obligate anaerobes Gram-positive anaerobes: Peptostreptococcus , Eubacterium , Actinomyces , and Streptococcus are also seen in primary intraradicular infections

16. Secondary Intraradicular Infections These infections are introduced during or after the treatment In these infections, those organisms are present which were not prevalent during primary endodontic infections

17. • Sources of microbes during treatment can be: – caries , plaque or calculus – Contamination of instruments and irrigation solutions

18. Sources of microbes between the appointments – Leakage of restorative materials – Tooth opened for drainage

19. Sources of microbes after root canal treatment – Leakage of restorative materials – No use of rubber dam – Secondary Caries Commonly found microorganisms in these infections can be Pseudomonas aeruginosa , Staphylococcus, E coli, Enterococcus faecals ,

20. Extraradicular Infections These are characterized by microbial invasion and proliferation in the inflamed periradicular tissues as a result of intraradicular infections: acute alveolar abscess Extraradicular infections can be caused by intraradicular bacteria or bacteria from outer side Commonly found microorganisms in extraradicular infections are Actinomyces sp., Treponema sp., P

21. Identification of the Bacteria Gram’s Stain ‰It was developed by Christian Gram in 1884 ‰ It helps in differentiating bacteria in Gram-positive and Gram-negative organisms Culture Culture taking method though done less these days still holds its importance because of wide range of bacteria found in the endodontic infections.

22. How to Combat Microbes in the Endodontic Therapy? Following measures should be taken to completely get rid of these irritants . Thorough Cleaning and Shaping of the Root Canal System Drain Antibiotics Intracanal Medicaments Use of Calcium Hydroxide in Canals

23. Thorough Cleaning and Shaping of the Root Canal System

24. Drain

25. Use of Calcium Hydroxide in Canals

26. Reference Textbook of Endodontic,Nisha Garg , Amit Gaarg ,;Latest Edition Enternet