Oral treponemes in primary root canal infections as detected by nested PCR.

AIM: To investigate the prevalences of four Treponema species in primary root canal infections using a nested PCR assay.
METHODOLOGY: Samples were obtained from 32 infected root canals. Twenty-two cases showed chronic asymptomatic periradicular lesions and 10 symptomatic cases were diagnosed as acute apical periodontitis. DNA extracted from the samples was initially amplified using universal 16S rDNA primers. A second round of amplification used the first PCR products to detect a specific fragment of the 16S rDNA of each Treponema denticola, T. socranskii, T. vincentii and T. pectinovorum.
RESULTS: Bacteria were present in all cases sampled. T. denticola was detected in 77.3% of the asymptomatic cases, T. socranskii in 40.9%, T. vincentii in 18.2% and T. pectinovorum in 13.6%. In the cases diagnosed as acute apical periodontitis, T. denticola was detected in 80%, whilst T. socranskii and T. vincentii were detected in 40% and 10% of cases, respectively. No symptomatic case yielded T. pectinovorum. In general, nested PCR detected T. denticola in 78.1% of the cases, T. socranskii in 40.6%, T. vincentii in 15.6% and T. pectinovorum in 9.4%. At least one of the four Treponema species was found in 84.4% of the cases examined.
CONCLUSIONS: The species T. denticola was detected in a large number of the cases examined: the prevalence of T. socranskii was also relatively high. The species T. vincentii and T. pectinovorum were also found, but in a smaller number of cases. Based on these data, the recognized pathogenicity of these microorganisms and their involvement with other oral diseases, they should be included in the restricted set of putative endodontic pathogens.