Low-Diversity Microbiota in Apical Periodontitis and High Blood Pressure Are Signatures of the Severity of Apical Lesions in Humans.

(1) Background: In developed countries, the prevalence of apical periodontitis (AP) varies from 20% to 50% for reasons that could be associated with the apical periodontitis microbiota ecology. (2) Methods: We performed a clinical study in the Odontology department of Toulouse hospital in France, to sequence the 16S rRNA gene of AP microbiota and collect clinical parameters from 94 patients. Forty-four patients were characterized with a PAI (periapical index of AP severity) score lower or equal to 3, while the others had superior scores (n = 50). (3) Results: The low diversity of granuloma microbiota is associated with the highest severity (PAI = 5) of periapical lesions (Odds Ratio 4.592, IC 95% [1.6329; 14.0728]; p = 0.001; notably, a lower relative abundance of Burkholderiaceae and a higher relative abundance of Pseudomonas and Prevotella). We also identified that high blood pressure (HBP) is associated with the increase in PAI scores. (4) Conclusions: Our data show that a low diversity of bacterial ecology of the AP is associated with severe PAI scores, suggesting a causal mechanism. Furthermore, a second risk factor was blood pressure associated with the severity of apical periodontitis.

Assessment of root canal transportation of 2Shape and ProTaper gold in mandibular molar mesial canals: A micro-computed tomographic study.

The aim of this study was to compare shaping abilities of Protaper Gold® (PTG) and 2Shape® (TS) by using a new automatic process and micro-computed tomography (Micro-CT). 32 first mandibular molars with two separate mesial canals were selected. Only mesial roots were prepared with PTG and TS. Pre- and post-operative scans were performed using Micro-CT to provide volumes with a voxel size of 20 µm. Volumes, non-instrumented area, amount of transportation and centering ability in coronal, middle and apical third shaping time and procedural errors were recorded. TS and PTG increased the endodontic volume of 2.98 mm3 (±1.56) and 3.21 mm3 (±1.78) respectively with no statistical difference (p = .168) and no procedural errors. No significant difference was found concerning canal transportation among groups but only within the same group PTG (p value < .001) and TS (p value < .001). The mean centering ratio was significantly different only between the section levels for PTG (p value < .001) and TS (p value = .01); it was significantly reduced in the cervical third. The percentage of untouched canal walls ranged between 29.78% (±15.145) and 36.60% (±11.968) respectively for PTG and TS with no statistical difference among groups (p value = .168). TS and PTG with post machining heat treatment were able to produce centered preparations with no significant difference or procedural errors. TS system provided a shorter preparation time than PTG files.

Oral health and microbiota status in professional rugby players: A case-control study.

OBJECTIVE: Elite athletes are prone to develop oral diseases, which could increase the risk for injuries. The aim of this study was to evaluate the oral health and the composition of oral microbiota of elite rugby players compared to the general population. METHODS: We set up a case-control study by screening 24 professional rugby players (PRG) and 22 control patients (CG) for dental and gingival examinations and performed a taxonomic analysis and a predicted functional analysis of oral microbiota. RESULTS: The Decay, Missing and Filled (DMF) teeth index (5.54 ± 6.18 versus 2.14 ± 3.01; p = 0.01) and the frequency of gingivitis (58,33% versus 13.63%) were significantly increased in PRG compared to CG. PRG were characterized by a dysbiotic oral microbiota (Shannon Index: 3.32 ± 0.62 in PRG versus 3.79 ± 0.68 in CG; p = 0.03) with an increase of Streptococcus (58.43 ± 16.84 versus 42.60 ± 17.45; p = 0.005), the main genus implicated in caries. Predicted metagenomics of oral microbiota in rugby players was suggestive of a cariogenic metagenome favourable to the development of caries. CONCLUSIONS: Our study shows that the oral health of PRG was poorer than the general population. PRG are characterized by a dysbiotic oral microbiota with an increase of the relative abundance of Streptococcus genus, positively correlated to the weight and negatively correlated to the diversity of oral microbiota. CLINICAL SIGNIFICANCE: Dental screening should be included in the medical follow-up of professional rugby players as a part of their health management. New strategies such as using probiotics like Lactobacillus could help to control the dysbiosis of oral microbiota.

Effect of asymmetry on the behavior of prototype rotary triple helix root canal instruments.

INTRODUCTION: Two factors affect the choice of instruments for root canal preparation: its ability to achieve the canal's shaping and its safety. These factors depend on the profile of the instrument and the design of its active part. In this study, we tried to assess the role of an asymmetric cross-section on the behavior of the instrument by measuring the stresses generated during the preparation of a simulated canal. METHODS: Three 25-mm-long, 0.06 taper, ISO size #30 helical nickel-titanium instruments were tested. The first HeroShaper (Micro-Mega, Besançon, France) used had a symmetric triple helix section (H0). The others, based on the HeroShaper design, had a constant asymmetry of 4/100 mm (H4) or 6/100 mm (H6). Six canals were prepared using each instrument, and the experimental conditions (ie, speed and movement) were the same for each sample. A dynamometer with a sensitivity of 0.1 N recorded the stresses transmitted by the instruments. RESULTS: Torque and apical force increased proportionally with instrument penetration. At the end of the preparations, the axial stress averaged 7.39 N for the symmetric instrument and 5.92 and 5.15 N for the asymmetric instruments, which indicated a significant statistical analysis of variance (P < .001). The average torque was low (1.05-1.13 N.cm), which indicated a nonsignificant statistical analysis of variance (P = .2385). CONCLUSIONS: In this study, axial stresses decreased, but torque did not change with an asymmetric triple helix cross-section.

Validation of cone beam computed tomography as a tool to explore root canal anatomy.

INTRODUCTION: Cone beam computed tomography (CBCT) can provide dentists with high-quality 3-dimensional images of dental structures because of its high spatial resolution. The reconstructions of root canal systems given by the Kodak 9000 3D were compared with histologic sections to evaluate the reliability of the reconstructions. METHODS: Nine intact freshly extracted teeth with closed apexes were scanned by using the Kodak 9000 3D (spatial resolution 76 microm and 14 bits contrast resolution). After reconstruction of the volumes, the outline of the root canals was defined by segmentation. Histologic sections were then made of each specimen at predetermined levels. After digitization (resolution, 0.5-1 microm), 2-dimensional cone beam reconstructions were compared with the outline of the canals obtained by histologic sections by using areas and Feret's diameters. The statistical analysis was performed by using the Pearson correlation coefficient. RESULTS: Strong to very strong correlation was found between the data acquired by using CBCT and histology: r (area) = 0.928; r (diameter) = 0.890. CONCLUSIONS: The Kodak 9000 3D appears to be a very interesting, reliable, noninvasive measuring tool that can be used in all spatial planes.