| dc.description.abstract | Background: A number of studies on root-treated teeth in various populations have
shown a prevalence rate of post-treatment disease of between 15 to 56.1%, with
microbial infection being the main cause.
Objective: The aim of this study was to identify microorganisms isolated from root-
treated teeth with post-treatment disease, as well as clinical and radiological features
associated with such teeth, in two institutions providing dental health care in Nairobi.
Study design: This was a descriptive cross-sectional study.
Subjects and Methodology: Forty five patients presenting with post-treatment
disease at the UNSDS and KNH participated in the study among whom thirty eight
had microbial sampling carried out. The dental institutions were selected through
convenient sampling. All the patients who presented to these institutions and
satisfied the inclusion criteria during the period of study were included in the sample.
An interviewer-administered semi-structured questionnaire was used to collect
demographic data, the presenting complaint and the date when the endodontic
treatment was carried out. Intra-oral clinical examination was done to identify the
affected tooth, assess signs and symptoms of post-treatment disease and the state
of the coronal restoration. Intra-oral periapical views were taken using the paralleling
technique. The radiographs were used to assess the integrity of the coronal
restoration, presence of periradicular radiolucency, missed canals and the quality
and extent of the root filling. Microbial sample collection was carried out using strict
asepsis. After removal of the root canal filling, intra-canal swabs were taken and
microorganisms were identified using PCR. The data obtained were analysed using
the Statistical Package for Social Sciences (SPSS) programme.
xii
Results: Thirty one patients (68.9%) presented with pain as the only complaint,
six(13.3%) had pain and swelling, one(2.6%) had pain, swelling and a sinus tract,
one(2.6%) had a sinus tract while six(13.3%) had no symptoms. Posterior teeth with
post-treatment disease were found to have been more thirty two(71.1%) than
anterior teeth. Forty(88.9%) of the filled canals had associated periradicular
radiolucency, twenty four(53.3%) had root filling short of the apex by more than
2mm, while fifteen(33.3%) had voids within the root filling. Microorganisms were
present in all the samples collected. The most frequently detected microbes were
Porphyromonas gingivalis, Prevotella nigrescens and Candida albicans. There was
no association between post-treatment disease and the quality of root filling or any of
the microorganisms.
Conclusion: Pain is the most common symptom in patients with post treatment
disease. Most of the teeth evaluated had periradicular radiolucency and inadequate
root-fillings. Although microorganisms were identified in all the teeth investigated,
only P. Intermedia was found to have a statistically significant association with pain
and swelling.
Recommendations: There is need to improve on the technical aspects of
endodontic treatment in the various dental institutions. More studies are needed to
determine whether there is indeed an association between post-treatment disease
and the quality of root filling as well as various intra-canal microorganisms. | en_US |
