Unraveling the Endodontic Archaeome: A Systematic Review with Meta-Analysis

Jessica Alves Cena; Jessica Alexandra de Vasques Castro; Aline Belmok; Loise Pedrosa Sales; Laudimar Alves de Oliveira; Cristine Miron Stefani; Naile Dame-Teixeira

doi:10.1016/j.joen.2023.07.025

Unraveling the Endodontic Archaeome: A Systematic Review with Meta-Analysis

J Endod. 2023 Aug 6:S0099-2399(23)00469-7. doi: 10.1016/j.joen.2023.07.025. Online ahead of print.

Authors

Jessica Alves Cena¹, Jessica Alexandra de Vasques Castro¹, Aline Belmok², Loise Pedrosa Sales¹, Laudimar Alves de Oliveira¹, Cristine Miron Stefani¹, Naile Dame-Teixeira³

Affiliations

¹ Department of Dentistry, School of Health Sciences, University of Brasilia, Brasilia, Brazil.
² Department of Cell Biology, Institute of Biology, University of Brasilia, Brasilia, Brazil.
³ Department of Dentistry, School of Health Sciences, University of Brasilia, Brasilia, Brazil; Oral Biology Division, School of Dentistry, University of Leeds, Leeds, UK. Electronic address: nailedame@unb.br.

PMID: 37544428
DOI: 10.1016/j.joen.2023.07.025

Abstract

Introduction: The controversial issue of whether the Archaea domain plays a role in endodontic infections is the focus of this systematic review with meta-analysis. The aim is to emphasize the significance of minority microbial domains in oral dysbiosis by evaluating the prevalence of archaea in root canals and its association with clinical parameters such as symptomatology and type of endodontic infection.

Methods: The search strategy involved researching 6 databases and the gray literature. Publications were accepted in any year or language that identified archaea in samples from endodontic canals. A 2-step selection process narrowed the final choice to 16 articles. The methodological quality of the studies was evaluated using tools from the Joanna Briggs Institute, and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

Results: The results showed that archaea were present in 20% (95% [confidence interval] CI = 8%-32%) of individuals with endodontic samples analyzed. The samples were about twice as likely to be archaeal-positive if collected from individuals with primary vs. persistent/secondary infection (odds ratio = 2.33; 95% CI = 1.31-4.14; I² = 0%), or individuals with self-reported vs. symptom-free infections (odds ratio = 2.67; 95% CI = 1.47-4.85; I² = 0%). Methanogenic archaea were reported in 66% of the included studies. Representative members of phyla Thaumarchaeota and Crenarchaeota were also identified.

Conclusions: Archaea are present in about one-fifth of the infected root canals. Recognized biases in experimental approaches for researching archaea must be addressed to understand the prevalence and roles of archaea in endodontic infections, and to determine whether the decontamination process should include the elimination or neutralization of archaea from root canals (International Prospective Register of Systematic Reviews protocol = CRD42021264308).

Keywords: Archaea domain; endodontic diseases; endodontic infection; endodontic microbiota; low-abundance microorganisms; oral microbiology.

Publication types

Review