Rapid Chairside Microbial Detection Predicts Endodontic Treatment Outcome

Alan Knight, Ian Blewitt, Nassr Al-Nuaimi, Tim Watson, Dylan Herzog, Frederic Festy, Shanon Patel, Federico Foschi, Garrit Koller, Francesco Mannocci, Alan Knight, Ian Blewitt, Nassr Al-Nuaimi, Tim Watson, Dylan Herzog, Frederic Festy, Shanon Patel, Federico Foschi, Garrit Koller, Francesco Mannocci

Abstract

Background: The aim of this longitudinal, one-year cohort study was to explore the hypothesis that fluorescence sampling of the root canal space prior to obturation could predict the outcome of root canal treatment (RCT).

Methods: Sixty-five teeth underwent primary RCT and were followed up clinically and radiographically. The outcome was determined radiographically with periapical radiographs (PR) and cone beam computed tomography (CBCT) scans.

Results: Success at 12 months was predictable based on the fluorescence score. When the fluorescence score (defined as the percentage of signal over total signal including background) was lower than 67, there was a 4.5 times (Odds ratio (OR) = 0.028; 95% confidence interval (CI): 0.003, 0.291, p = 0.001) greater chance of success (90% overall). When the readings were above this threshold, the success rate was 20%.

Conclusion: A chairside sampling method is able to predict the outcome of RCT, through the use of paper point sampling and fluorescence staining. This has reduced the prevalence of persistent infections by guiding the optimum time for obturation. ClinicalTrials.gov trial NCT03660163.

Keywords: bacteria; biofilm(s); clinical outcomes; clinical studies/trials; computed tomography; endodontics.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the trial showing the process of patient recruitment, exclusion and follow-up.
Figure 2
Figure 2
Levels of fluorescence reading (AU) reflects patients’ (n = 65) response to endodontic treatment according to “loose” success criteria. The probability of 12-month success was 4.5 times (Odds ratio (OR) = 0.028; 95% confidence interval (CI): 0.003, 0.291, p = 0.001) higher when the fluorescence reading was lower than 67 (%) with success rates of 90% and 20%, respectively, for teeth with readings below and above this threshold.

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