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- Impact of bacteriological testing using an anaerobic culture system on the success of non-surgical endodontic treatment: a retrospective study
- Jun Nakanishi, Noriko Saito-Nakayama, Shizu Hirata-Tsuchiya, Daisuke Furutama, Ayaka Miyata-Arita, Tomoki Kawayanagi, Takuya Arita, Saki Nishihama, Tomoya Naruse, Wang Chutian, Song Bingxin, Naoki Sadaoka, Tomoki Kumagai, Kazuma Yoshida, Katsuhiro Takeda, Hideki Shiba
- J Korean Acad Conserv Dent ;Published online July 16, 2026
- DOI: https://doi.org/10.5395/rde.2026.51.e33 [Epub ahead of print]
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Abstract
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ePub - Objectives
Residual bacteria at the time of root canal obturation significantly influence endodontic treatment outcomes in teeth with apical periodontitis, and confirmation of bacterial elimination from the root canal prior to obturation may improve long-term prognosis. However, the contribution of root canal bacterial culture to treatment outcomes in teeth with infected root canals is debated. This study aimed to retrospectively evaluate treatment outcomes in cases in which root canal obturation was performed after confirming negative bacteriological test results.
Methods
The medical records of patients with apical periodontitis or pulp necrosis in whom root canal obturation was performed after confirming a negative bacteriological test result using an anaerobic culture system at the Department of Endodontics and Operative Dentistry at Hiroshima University Hospital between April 1, 2015, and September 30, 2023, were retrospectively reviewed. Treatment outcomes were assessed by comparing dental radiographs obtained before treatment with those obtained during the follow-up, ranging from 3 to 24 months after root canal obturation.
Results
This retrospective study included 284 teeth from 218 patients, and the success rate was 89.1%. Tooth type, number of root canals, type of treatment, preoperative radiolucency around the root apex, preoperative root canal obturation material, dentist experience, and postoperative extent of root canal obturation material did not significantly affect treatment outcomes.
Conclusions
The findings of this retrospective study suggest that infection control incorporating bacteriological examination of root canals using an anaerobic culture system may contribute to a high success rate of nonsurgical endodontic treatment, regardless of other prognostic factors.
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Clinical Research
- Prognostic factors influencing clinical outcome of nonsurgical endodontic treatment
- Seonah Kim
- J Korean Acad Conserv Dent 2010;35(6):436-444. Published online November 30, 2010
- DOI: https://doi.org/10.5395/JKACD.2010.35.6.436
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Abstract
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Objectives This study aimed to assess prospectively the clinical outcome of nonsurgical endodontic treatment and identify patient- and tooth-related factors, rather than treatment-related factors, that were the best predictors of this outcome.
Materials and Methods The inception cohort comprised 441 teeth (320 patients) and 175 teeth (123 patients) were followed up for 1-2 years. Age, gender, presence of medical disease, number of canals, previous endodontic treatment, presence of sensitivity and pain, pulp vitality, swelling or sinus tract of pulpal origin on the gingiva, periapical radiolucency and tendency of unilateral bite on the affected tooth were recorded at treatment start.
Results The outcome was classified on the basis of periapical radiolucency as healed or non healed. The overall healed rate in these cases, including nonsurgical retreatment, was 81.1%. Four tooth-related factors had a negative impact in the bivariate analysis: previous endodontic treatment, necrotic pulp, preoperative gingival swelling or sinus tract of pulpal origin, and preoperative periapical radiolucency. Stepwise logistic regression analysis including patient-, tooth-related factors and level of the root canal filling as a treatment-related factor showed that preoperative gingival lesion (odds ratio [OR]: 4.4;
p = 0.005), preoperative periapical radiolucency (OR: 3.6;p = 0.011), and ≤ 1-2 mm under root filling length (OR: 9.6;p = 0.012) were significant predictors of failure.Conclusions A preoperative gingival lesion of pulpal origin can influence the outcome of nonsurgical endodontic treatment in addition to preoperative periapical radiolucency.
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Citations
Citations to this article as recorded by
- Predicting outcomes of nonsurgical retreatment with artificial intelligence: A multicenter retrospective study using logistic regression, random forest, and extreme gradient boosting
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Journal of Conservative Dentistry and Endodontics.2026; 29(4): 373. CrossRef - NON-SURGICAL ENDODONTIC TREATMENT OF CHRONIC APICAL PERIODONTITIS WITH EXTENSIVE PERIAPICAL AND FURCATION BONE DESTRUCTION: A CASE REPORT WITH 18-MONTH FOLLOW-UP
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BULLETIN OF STOMATOLOGY AND MAXILLOFACIAL SURGERY.2026; : 34. CrossRef - A retrospective study on the prognostic factors and success, survival, and failure outcomes of treated endodontic‐periodontal lesions
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Contemporary Clinical Dentistry.2014; 5(2): 195. CrossRef
- Predicting outcomes of nonsurgical retreatment with artificial intelligence: A multicenter retrospective study using logistic regression, random forest, and extreme gradient boosting
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