What Is the Microbial Profile in Persistent Endodontic Infections? A Scoping Review

J Endod. 2023 Jul;49(7):786-798.e7. doi: 10.1016/j.joen.2023.05.010. Epub 2023 May 19.


Introduction: This scoping review aimed to map the evidence about the microbiota found in persistent endodontic infections.

Methods: The study protocol was prospectively registered and is available at https://osf.io/3g2cp. The electronic search was performed in MEDLINE via PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library, and Embase. The eligibility criteria were based on the PCC acronym, where P (Population) represents patients with teeth presenting persistent endodontic infection, C (Concept) represents microbial profile, and C (Context) represents undergoing endodontic retreatment. Clinical studies that evaluated the microbial profile of samples collected from root canals of teeth undergoing retreatment, using classical or molecular methods, were included. Studies that did not show a minimum period of 1 year between primary endodontic treatment and retreatment or did not radiographically evaluate the quality of primary root canal filling were excluded. Two reviewers independently selected the articles and collected data.

Results: From a total of 957 articles, 161 were read in full, and 32 studies were included. The most prevalent species were Enterococcus faecalis, Parvimonas micra, Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, Dialister invisus, Propionibacterium acnes, Tannerella forsythia, and Treponema denticola. Cases with symptomatology or inadequate root canal filling presented an increase in specific bacterial species compared to those with no symptomatology or adequate filling. A greater number of microorganisms was observed in teeth with inadequate coronal restoration compared to those with adequate restoration.

Conclusions: Persistent endodontic infections have a polymicrobial profile identified by the commonly used methods for bacterial detection/identification and are subject to the limitations present in each of those methods.

Keywords: Endodontics; microorganisms; persistent intraradicular infection; scoping review.

Publication types

  • Review

MeSH terms

  • Dental Pulp Cavity* / microbiology
  • Humans
  • Porphyromonas endodontalis
  • Porphyromonas gingivalis*
  • Prevotella intermedia