Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/588018107f8c9d0a098b4a55
Revista de Odontologia da UNESP
Review Article

Infecção endodôntica como fator de risco para manifestações sistêmicas: revisão da literatura

Endodontic infection as factor of risk for systemic manifestations: review of the literature

Silva, J.M.; Marceliano, M.F.V.; Souza, P.A.R.S.; Lamarão, S.M.S.

Rev. odontol. UNESP, vol.36, n4, p.357-364, 2007
PDF
Downloads: 26
Views: 2442

Resumo

A teoria da infecção focal perdurou por muito tempo, impedindo o progresso científico da Endodontia. Acreditava-se que microrganismos ou toxinas oriundos de infecções orais agiam como foco de infecções, podendo disseminar-se sistemicamente. Essa teoria caiu em descrédito devido à falta de evidências científicas que lhe dessem suporte. Com o desenvolvimento das técnicas de cultivo e isolamento, novas pesquisas foram realizadas. Atualmente, volta-se a questionar a relação entre infecções orais e manifestações sistêmicas, principalmente em relação à endocardite infecciosa. Inúmeros estudos confirmam a presença de bactérias provenientes de canais radiculares infectados, na circulação sanguínea, pela ocorrência da bacteriemia, podendo ser determinante para complicações sistêmicas. O objetivo deste trabalho é revisar criticamente a literatura relacionada às infecções endodônticas como fator de risco à condução de possível manifestação sistêmica. A literatura sugere que a bacteriemia pode estar associada à endotoxinas bacterianas de canais infectados, apresentando riscos para complicações sistêmicas, e que tais riscos podem ser minimizados quando medidas terapêuticas adequadas são aplicadas, como manipulação cuidadosa de canais infectados e antibioticoterapia profilática para pacientes de alto risco.

Palavras-chave

Endocardite infecciosa, infecção focal dentária, bacteriemia

Abstract

The theory of the focal infection has been lasted for a long time, hindering scientific progress of endodontics. They used to believe that microorganisms or toxins of oral infections had a special role as focus of infections, being able to spread systematically. This theory has lost credibility due to lack of support scientific evidences. With the development of culture and isolation techniques, new researches had been carried through. Currently, they started to search again about the relationship between oral infections and systemic manifestations, especially related infectious endocarditic. Innumerable studies confirm the presence of bacteria proceeded from infected root canals in bloody circulation due to the forthcoming of bacteremia, being able to determinate systemic complications. The aim of this study is to revise critically the literature content suggesting that endodontic infections can act as a risk factor and often being able to promote systemic manifestation. The literature suggests that bacteremia can be associated to infected canals bacterial endotoxins and cause potential risk to systemic complications, such risks can be minimized when therapeutical measures are applied (careful manipulation of infected canals and prophylactic antibiotic therapy to high risk patients).

Keywords

Endocarditis, focal infection dental, bacteremia

References

 


1. O’Reilly PG,, Claffey NM. A history of oral sepsis as a cause of disease. Periodontol 2000. 2000;23:13-8.

2. Miller WD. The human mouth as a focus of infection. Dent Cosmos.1891;33:689-95.

3. Hunter W. The coming of age of oral sepsis. BMJ. 1921;859.

4. Billings F. Chronic focal infections and their etiologic relations to arthritis and nephritis. Arch Intern Med. 1912;9:484-98.

5. Mayo CH. Mouth infection as a source of systemic disease. J Am Med Assoc. 1914;63:2025-6.

6. Rosenow EC. The relation of dental infection to systemic disease. Dent Cosmos. 1917;59:485-91.

7. Rhein ML, Krasnow F, Gies W. A prolonged study of the electrical treatment of dental focal infections a preliminary report. Dent Cosmos. 1926;68:971-81.

8. Cecil RL, Archer BH. Chronic infectious arthritis; an analysis of 200 cases. Am J Med Sci. 1927;173:258‑70.

9. Shandalow SL. Oral focal sepsis in relation to systemic disease. Dent Cosmos. 1928;70:609-18.

10. Cecil RL, Nicholls EE, Stainsby WJ. The bacteriology of the blood and joints in chronic infectious arthritis. Arch Intern Med.1929;43:571-605.

11. Bellizzi R, Cruse WP. A historic review of endodontics, 1689-1963. Part 3. J Endod. 1980;6:576-80.

12. Pallasch TJ. The focal infection theory: appraisal and reappraisal. Calif Dent Assoc J. 2000;28:194-200

13. Miller WD. An introduction to the study of the bacteriopathology of the dental pulp. Dent Cosmos. 1894;36:505‑28.

14. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965;20:340-9.

15. Sundqvist G. Bacteriological studies of necrotic dental pulps. 1976 [dissertação] apud Sundqvist G. Ecology of the root canal flora. J Endod. 1992;18:427-30

16. Moller AJ, Fabricius L, Dahlen G, Ohman AE, Heyden G. Influence on periapical tissues of indigenous oral bacteria and necrotic pulp tissue in monkeys. Scand J Dent Res. 1981;89:475-84.

17. Tronstad L. Recent development in endodontic research. Scand J Dent Res. 1992;100:52-9.

18. Sundqvist G. Taxonomy, ecology, and pathogenicity of the root canal flora. Oral Surg Oral Med Oral Pathol. 1994;78:522-30.

19. Alencar AH, Pimenta FC, Ito IY, Bruno KF, Leonardo MRL. Determinação dos microrganismos no canal radicular, antes do preparo biomecânico e após a utilização da medicação intracanal, em dentes com necrose pulpar e reação periapical crônica. Arq Odontol. 2005;41:105‑92.

20. Nair PN. Apical periodontitis: a dynamic encounter between root canal infection and host response. Periodontol 2000. 1997;13:121-48.

21. Sunde PT, Olsen I, Debelian GJ, Tronstad A. Microbiota of periapical lesions refractory to endodontic therapy. J Endod. 2002;28:304-10.

22. Siqueira Jr JF, Rôças IN, Moraes SR, Santos KRN. Direct amplification of rRNA gene sequences for identification of selected oral pathogens in root canal infections. Int Endod J. 2002;35:345-51.

23. Tronstad L, Sunde PT. The evolving new understanding of endodontic infections. Endod Topics. 2003;6(1):57‑77.

24. Tomazinho LF, Avila-Campos MJ. Detection of Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, and Prevotella nigrescens in chronic endodontic infection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:285-8.

25. Skaung N. Complicações sistêmicas de infecções endodônticas. In: Bergenholtz G, Horsted-Bindslev P, Reit C. Endodontia. Rio de Janeiro: Guanabara Koogan; 2006. p. 138-48.

26. Jones NW, Newsom SJ. Experimentally produced focal infection in relation to cardiac structure. Arch Pathol. 1931;13:392-414.

27. Murray M, Moosnick F. Incidence of bacteremia in patients with dental disease. J Lab Clin Med.1941;26:801-2.

28. Gier RE, Mitchell DF. Anachoretic effect of pulpitis. J Dent Res. 1968;47:564-70.

29. Farrington FH. The incidence of transient bacteremia following pulpotomies on primary teeth. J Dent Child. 1973;40:175-84.

30. Baumgartner CJ, Heggers P, Harrison JW. The incidence of bacteremias related to endodontic procedures. I. Nonsurgical endodontics. J Endod. 1976;2:135-40.

31. Baumgartner JC, Heggers JP, Harrison JW. Incidence of bacteremias related to endodontic procedures. II. Surgical endodontics. J Endod. 1977;3:399-402.

32. Everett ED, Hirschmann JV. Transient bacteremia and endocarditis prophylaxis. A review. Medicine. 1977;56(1):61-77.

33. Pallasch TJ. Pharmacology of anxiety, pain and infection. In: Ingle JI, Bakland LK: Endodotics. 4ª ed. Baltimore: Williams e Wilkins; 1994. p. 641-79.

34. Starkebaum M, Durack D, Beeson P. The “incubation period” of subacute bacterial endocarditis. Yale J Biol Med. 1977;50(1):49-58.

 

588018107f8c9d0a098b4a55 rou Articles
Links & Downloads
1807-2577 (Electronic)
Rev. odontol. UNESP ©2024 All rights reserved.

Rev. odontol. UNESP

Share this page
Page Sections