Detection of Treponema denticola in root canal systems in primary and secondary endodontic infections. A correlation with clinical symptoms.

AIM The aim of the study was to investigate the presence of Treponema denticola in primary and secondary root-infected canal systems with periapical pathology and correlations with clinical signs and symptoms. METHODOLOGY Endodontic samples were obtained from canals of 102 teeth: 79 had primary endodontic disease and 23 secondary endodontic disease. For each tooth, clinical data including symptoms and X-ray appearance were examined. The presence of T. denticola biological samples from the root canal space was detected by a PCR assay. RESULTS T. denticola was detected in 24 out of the 79 teeth with primary infection and in 8 out of the 23 teeth with secondary infection. Teeth with specific clinical symptoms were frequently associated with T. denticola presence inside the root canal system. CONCLUSIONS The presence of T. denticola in root canal system in association with specific clinical signs and symptoms of endodontic disease strongly suggests that this spirochete might play a critical role in the pathogenesis of the acute infection and rapid bone tissue alterations in both primary and secondary endodontic infections.